Objective To analyze the clinical features, recurrent characters in patients with recurrent Tolosa-Hunt syndrome (THS). Methods The clinical data of 24 hospitalized patients with recurrent THS from January 2006 to May 2016 were collected The general features, clinical manifestations, disease courses, recurrent features, lab and imaging studies, treatment measures and outcoming of recurrent THS patients was investigated , and compared with 69 patients with first attack THS in corresponding period. Results Recurrent THS patients were 25.8%(24/93) of total THS. The male rate in recurrent group was significantly higher than that in first attack group: 66.7%(16/24) vs. 42.0%(29/69), P<0.05. The involved rate of trigeminal nerves in recurrent group was significantly lower than that in first attack group:16.7%(4/24) vs. 33.0%(23/69), P<0.05. The disease courses were from 3 months to 20 years. The total recurrent frequencies were from 2 to 10 times. The recurrence occurred in the same side in 18 patients, and in contralateral in other 6 patients. The intervals were from 3 months to 6 years, and average intervals were 1.9 years. Two patients recurred in hormone reduction, and 22 patients recurred in hormone withdrawal. All cases received MRI examination. Nineteen patients (79.2%) of them had lesions in cavernous sinus. 16 patients had one side lesions and 3 patients had bilateral lesions. The recurrent patients still had good responds to corticosteroids treatment. Conclusions Recurrences in THS are common, taking place in about 26%total patients, and usually at an interval of months or years from the initial attack. These recurrences may be ipsilateral, contralateral, or rarely, bilateral. Corticosteroids are still effective to recurrent cases.

Objective To quantitatively assess left ventricular systolic function in rabbits with dilated cardiomyopathy(DCM) by quantitative tissue velocity imaging (QTVI). Methods Thirty rabbits were divided into two groups: group A(adriamycin group) and group B(sodium chloride group). Group A( n = 20) were given adriamycin 2 mg/kg intravenously once a week for eight weeks (total dose, 16 mg/kg) to induce DCM model, group B were given with the same dose of sodium chloride injection solution. Two dimensional echocardiography and QTVI examination were performed in all rabbits before and three weeks after the administration,respectively. Peak systolic velocity(Vs), peak displacement(D) and other common parameters were analyzed. Results Common parameters assessed after administration in group B did not show significant changes. The QTVI curves of left ventricle myocardium were regular and the value of Vs and D decreased gradually from the basal segments to the apical segments after the administration. The diameters of atrium and ventricle of group A increased,while the ejection fraction and fractional shortening of left ventricle decreased significantly ( P <0. 05 or P < 0.01). The pattern of the curves still had the regularity. But Vs and D value decreased significantly ( P <0. 05 or P <0. 01). Pathology of myocardium samples of group A showed the cardiomyocyte changes like dilated cardiomyopathy, while samples of group B had no significant change. Conclusions QTVI can accurately evaluate regional systolic function of left ventricle in rabbits with dilated cardiomyopathy, therefore provides experimental foundation for clinical observation and treatment.

BACKGROUND: Nanotechnology has widely used in tissue engineered reconstruction in recent years. Most reports are concerning carbon nanomaterials in bone reparation, but the study of peripheral nerve regeneration is poorly understood.OBJECTIVE: To improve the physical, chemical and biological properties of chitosan/collagen composite nerve conduit with functionalized carbon nanotubes, in addition, to investigate the therapeutic effect of this novel material.DESIGN, TIME AND SETTING: The same body controlled experiment of animals was performed at the Tissue Engineering Laboratory and The Key Laboratory of Thin Film and Microfabrication Technology, Shanghai Jiao Tong University from February 2005 to November 2006.MATERIALS: The carbon nanotubes were mixed with 2% chitosan solution, coated on the die to prepare chitosan/collagen composite nerve conduit with functionalized carbon nanotubes. The chitosan/collagen tubes were served as controls.METHODS: A total of 80 male adult-rats were prepared a 4 mm accessory nerve defects models, and repaired by nerve conduit in the experimental material and control material groups. In the auto nerve grafts group, the removed nerve was connected to the broken end. In the blank control group, there was no other treatment except removing 2 mm nerves. The left sides were served as experimental sides and the right sides as within-subject controls.MAIN OUTCOME MEASURES: The repairing outcomes were measured by electrophysiological, myophysiological, and histological measurements.RESULTS: The accessory nerve defects were repaired in a rat model using carbon nanotubes in chitosan/collagen-based composite nerve conduit. As time passed after the surgery, good results of the electrophysiological, myophysiological and histological measurements were achieved, which were similar or superior to those of the nerve autografts.CONCLUSION: The carbon nanotubes in chitosan/collagen-based composite can be an ideal candidate for peripheral nerve regeneration.

Objective To select sonogram features for the differential diagnosis of benign and malignant thyroid small nodules by Logistics regression analysis,and to contribute the binary Logistic regression model of sonogram features as independent variable and evaluate the value of conventional ultrasonography and ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid small nodules.Methods 166 thyroid nodules (≤ 10 mm) in 140 patients were reviewed and analyzed by 2D ultrasound,color Doppler flow imaging and UE.A Logistic model was obtained based on pathology as golden diagnosis criteria.The odds ratio of variables in the equation were compared to assess various variables,especially the efficacy of elastography in the diagnosis.Results Four statistically significant features were finally entering the Logistic stepwise regression model,including shape,calcification,the internal component of nodules and elasticity score.And the odds ratio of the elasticity score was higher than other features.Conclusions The analysis of binary Logistic regression can select the valuable variables for the diagnosis of pathological nature of thyroid small nodules.UE has much more dominances than other features.The combinated application of UE and 2D ultrasonic features plays a great clinical role in the final diagnosis of thyroid small nodules.

Objective To retrospectively review the history and development of radiotherapy quality assurance ( QA) in the Affiliated Cancer Hospital of Fudan University, and to report the primary experience and evolvement of an entire QA workflow management. Methods The multidisciplinary QA team has implemented an entire QA workflow management process in the Radiotherapy Center using the failure modes and effects analysis ( FMEA) and plan?do?check?act ( PDCA) tool since April 2015. Treatment data of approximately 6000 patients before and after implementation were compared. Results The error rate was reduced from 17% to 09% after using the entire QA workflow management. Conclusions Entire QA workflow management effectively improves the accuracy and safety of radiotherapy.

Objective To summarize the cases of surgical treatment of patients with patent ductus arteriosus (PDA),atrial septal defect(ASD),or ventricular septal defect(VSD) after failure of congenital cardiac catheterization(CCC).Methods From January 2000 to December 2013 in our hospital 26 patients were retrospectively studied,follow-up results recorded for each patient by telephone and outpatient follow-up review.Results There were no deaths.The average age of the patients was (18.8 ± 17.9) (3.0-67.0) years old.The median time of the intervals between interventions and surgeries were 14 days(2 hours to 5 years),the median length of hospital stay were 10 days(7-21 days),median cardiopulmonary bypass time was 67minutes (0-206 minutes),the median blocking time 40 minutes (0-90 minutes),the median time of mechanical ventilation 8.5 hours (2.0-88.0 hours),median ICU stay one day (1-6 days).The average follow-up were (93.0 ± 49.3) months (7.0-182.4 months).Surgical results were satisfactory.Conclusion Interventional treatment of congenital heart disease (CHD) is safe after all,but should strictly the indications controlled,the operations completed by skilled doctors.If there are complex complications,surgical intervention should be concerned,and the results are satisfactory.Patients after CCC should be followed up regularly.

Objective To investigate the clinical therapeutic effect of Shenqi Fuzheng injection for treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A prospective clinical study was conducted. Fifty-eight consecutive patients with AECOPD were admitted in Departments of Respiratory Disease and Critical Care Medicine in Zhuozhou City Hospital of Hebei Province from January 2012 to December 2013. They were randomly divided into western medicine (WM) control group (28 cases, the routine treatment of WM) and integrated traditional Chinese medicine (TCM) with WM group (30 cases, on the basis of conventional therapy, Shenqi Fuzheng injection 250 mL intravenous drip was given once a day for a therapeutic course of 10 days). The duration of mechanical ventilation, the successful rate of weaning from ventilator, the rate of using ventilator again after weaning, the length of stay in intensive care unit (ICU), and mortality were recorded respectively in the two groups. Before and after treatment, the arterial blood gas analysis, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), pulmonary function and dyspnea score were evaluated. Results Compared with the WM control group, the duration of mechanical ventilation (hours: 104±16 vs. 125±24) and the length of stay in ICU (days: 6.3±2.1 vs. 7.2±3.6) were significantly shorter, the rate of successful weaning from ventilator was obviously higher [73.3% (22/30) vs. 60.7% (17/28)], and the rate of using ventilator again after weaning was remarkably lower [13.3% (4/30) vs. 28.6% (8/28)] in the combined TCM and WM group, the differences between the two groups being statistically significant (allP < 0.05); the mortality was lower in the combined group [10.0% (3/30) vs. 10.7% (3/28)], but there was no statistically significant difference (P > 0.05). Compared with those before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC) and the ratio of FEV1/FVC were all significantly higher in the two groups after treatment, while the partial pressure of arterial carbon dioxide (PaCO2), APACHE Ⅱ score, CPIS score, residual volume/total lung capacity (RV/TLC), and the dyspnea score were all lower in the two groups after treatment, the more obvious changes in levels being after 10 days of treatment in combined TCM and WM group [pH: 7.44±0.04 vs. 7.40±0.08, PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 59.1±11.9 vs. 68.1±12.4, PaO2 (mmHg): 70.5±6.9 vs. 65.1±7.4, APACHE Ⅱ score: 14.5±4.2 vs. 17.4±2.2, CPIS score: 5.3±2.4 vs. 7.6±1.4, FEV1 (L): 1.60±0.47 vs. 1.54±0.34, FEV1/FVC: (65.33±2.65)% vs. (62.00±3.25)%, FVC (L): 1.72±0.21 vs. 1.66±0.21, RV/TLC: (42.13±1.67)% vs. (43.12±0.95)%, dyspnea scores: 1.71±0.54 vs. 2.32±0.65, allP < 0.05].Conclusion Shenqi Fuzheng injection possesses certain clinical value in treatment of patients with AECOPD, as it can obviously improve the pulmonary function and the data of arterial blood gas analyses, and effectively relieve the clinical symptoms.

Objective To evaluate left ventricular myocardial function of rabbit after ischemiareperfusion using speckle tracking imaging (STI),and to explore the myocardial protect effects of ischemia postconditioning (I-PostC) on reperfusion injury.Methods 24 Japanese rabbits were divided into ischemiareperfusion group (group Ⅰ) and I-PostC group (group Ⅱ) randomly.The characteristic changes of left ventricular global and regional myocardial strain and twist function of two groups were evaluated quantitatively by STI and compared with pathological results.Results ① Global longitudinal systolic strain rate(GLSrsys),global longitudinal systolic strain (GLSsys) and global longitudinal peak strain(GLSp) decreased in both groups,longitudinal systolic strain rate(SrLsys),longitudinal systolic strain(SLsys) and longitudinal peak strain(SLp) in the lateral wall of left ventricle decreased significantly and negative peak of SrLivr and PSI increased after the left ventricular branch of coronary artery was occluded;The values of Ptw and untwR of left ventricle were smaller.② After the artery was released,GLSp recovered in group Ⅱ,which was not seen in group Ⅰ.The values of SrLsys,SLsys and SLp increased significantly and negative peak of SrLivr and PSI decreased in group Ⅱ.However,only Slsys and SLp rebounded in group Ⅰ.Between the 2 groups,SrLsys andSLp in group Ⅱ were higher than that of group Ⅰ (P＜0.05 or 0.01),and SrLivr was lower compared with group Ⅰ (P ＜0.05).In group Ⅱ,Ptw and untwR changed back to a normal range (P ＜0.05 or 0.01),and no index has changed in group Ⅰ ;Between the 2 groups,Ptw and untwR in group Ⅱ were higher than that of group Ⅰ (P ＜0.05).③ The sensitivity and specificity of GLSrsys,GLSsys,SrLsys,SLsys and Ptw to detect rabbit myocardial infarction were 81.3 ％ and 75.0 ％,62.5 ％ and 81.2％,87.5％ and 87.5％,93.8％ and 75.0％,81.3％ and 68.7％ respectively.Conclusions STI may provide a promising approach to evaluate the global and regional myocardial function.It also can observe the protect effects of I-PostC on myocardial reperfusion injury accurately.

Objective To introduce a new computer-aided technique applicable for myocardial contrast echocardiography(MCE)to quantitate automatically calibrated myocardial contrast intensity(CI)and to test the value of color-coded images of calibrated CI in assessing myocardial perfusion.Methods There were two experimental groups of anesthetized rabbits,which underwent 30 min(group I)and 120 min(groupⅡ)coronary occlusion followed by 60 min reperfusion.MCE was performed on all rabbits during occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique.Myocardial calibrated CI of each segment was measured and a color-coded map was produced automatically by software.The risk areas and infarct sizes obtained by myocardial perfusional defect(MPD)and color-coded map were compared with those by fluorescent microsphere and triphenyl-tetrazolium chloride(TTC)staining.Results Compared with non-risk segments,myocardial CI values were significantly decreased in risk segments in group Ⅰ and Ⅱ before calibration (P＜0.01),however,myocardial calibrated CI values were significantly decreased in risk segments in group Ⅱ(P＜0.01)and not different in group Ⅰ after calibration.Calibrated CI in-70 pix was an optimal cutoff point to identify infarcted segments and to yield the sensitivity of 95% and specificity 87%.The correlation between the risk area by MPD and fluorescent staining was 0.84(P=0.003)whereas color-coded map and staining was 0.91 (P＜0.001).The correlation between the infarct size by MPD and TTC was 0.75(P＜0.001),and between color-coded image and TTC was 0.89(P＜0.001).Conclusions MCE with a new computer-aided technique canassess quantitatively myocardial perfusion and identify automatically risk area and infarct region.

Objective To assess the value of wave intensity (WI) on the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy(NOHCM).Methods 36 patients with hypertension with concentric hypertrophy,30 patients with NOHCM and 36 healthy volunteers were randomly selected to perform routine ultrasound examination and carotid arterial WI test.The conventional parameters,inlcuding interventricular septal thickness in diastole (IVSTd),left ventricular posterior wall thickness in diastole(LVPWd),left ventricular diameter in diastole(LVIDd) and WI parameters,including the first peak (W1),the second peak (W2),negative area (NA),the interval between the R wave of the ECG and the peak of W1 (R-1st),the interval between the peaks of W1 and W2 (1st-2nd) were archived and compared among the different groups.Results ① There were statistical significances in IVSTd among the three groups(P ＜0.01).LVPWd of hypertension group was obviously higher than that of normal and NOHCM groups (P ＜0.01),but there were no statistical significances in NOHCM and normal groups(P ＞0.05).There were no statistical significances in LVIDd among different groups(P ＞ 0.05).②Compared with the normal group,W1 in NOHCM group increased significantly,whereas W2 and R-1st was much lower (P ＜0.01);W1 and NA in hypertension group was obviously higher(P ＜0.01).W2 and R-1st in NOHCM group were much smaller than those of hypertension group (P＜0.01).③W2 in 850 mmHg · m · s-3 was an optimal cutoff value to identify NOHCM and hypertension and to yield the sensitivity of 78.9％ and specificity of 72.4％.R-1st in 98.5 ms was a cutoff point to discriminate NOHCM and hypertension and to bring the sensitivity 65.8％ and specificity 72.4％.Conclusions WI analysis can effectively distinguish the difference of NOHCM and hypertension and provide a new viewpoint for the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy.