Objective To explore the effect of E-Flow imaging on the radiotherapy of cervical lymph nodes metastasized from nasopharyngeal carcinoma.Methods A total of 52 nasopharyngeal carcinoma patients with 94 invasion neck lymph nodes were treated with conventional radiotherapy. Lymph node size, hemodynamic parameters, and blood supply were detected by E-Flow imaging and two-dimensional ultrasound before and after the radiotherapy. The relationship between those examinations and radiotherapy effect was analyzed.Results Of the 94 metastatic cervical lymph nodes from nasopharyngeal carcinoma before the radiotherapy, 40 disappeared, 52 reduced, and 2 maintained the original size after the radiotherapy. Blood flow in all residual lymph nodes decreased or disappearaed. Artery flow spectrum in the lymph node was changed from the high-speed high impedance to low-speed low resistance. The size of cervical lymph node and blood flow before the radiotherapy were associated with clinical efficacy (P<0.05). Conclusion E-Flow imaging plays an important role in assessing the efficacy of radiation therapy by changing the blood supply of cervical lymph node and its size before and after the radiotherapy.

ObjectiveTo summarize the experience of the operations of pancreaticoduodenal combined trauma.MethodsClinical data of pancreaticoduodenal combined trauma in 12 cases were analyzed retrospectively.Head of pancreas with duodenal combined trauma occurred in 9 cases,body-tail of pancreas with duodenal conbined trauma in 3 cases.Diferrent operative fashion were used.ResultsPostoperative pancreatic fistula in 2 cases( 16.7％ ),were cured by continuing lower pressure suction of all cases,11 cases were cured (91.7％ ) and 1 cases died (8.3％).ConclusionOperation in time and correct operative fashion were the key of successful treatment.Three-cavity twoBlakemore Tube had a certain value.

Esophageal and Gastric Varices ; diagnosis ; etiology ; pathology ; Hemorrhage ; Humans ; Liver Cirrhosis ; complications ; pathology

Objective To study the effects of atorvastatin on expression of lysyl oxidase(LOX) in myocardial tissue of rats with diabetic cardiomyopathy (DCM) and its mechanism.Methods Thirty DCM SD rats were randomly divided into 3 groups:DCM group,treatment group (atorvastain 2 mg · kg-1 · d-1 by gastric gavage) and β-aminopropionitrile group(β-aminopropionitrile 80 mg · kg-1 · d-1 by gastric gavage),10 cases in each group.Other 10 SD rats were selected as the control group.At the end of week 8,the rats were killed for extracting the myocardial tissue RNA and protein.Expression levels of LOX,MMP-2 and NF-κB mRNAs and proteins in myocardial tissue of DCM rats were measured by RT-PCR and Western blot.Results The expression levels of LOX,MMP-2 and NF-κB mRNAs and proteins in the DCM group were significantly higher than those in the control group (P＜0.01),and compared with the DCM group,the expression of BAPN LOX,MMP-2 and NF-κB mRNA and proteins in the treatment group were significantly deceased (P＜0.01).Conclusion Atorvastatin can reverse the expression of LOX in myocardial tissue of DCM rat,and then may regulate the expression of MMP-2 and NF-κB.

Objective To summarize the experience in endovascular repair of De Bakey type Ⅲ aortic dissection in recent years and summarize the prevention and management of the related perioperative complications.Methods From January 2009 to January 2011,49 cases of endovascular repair for De Bakey type Ⅲ aortic dissection were performed under general anesthesia in our department.There were 45 male and 4 female.The follow-up was performed in the outpatient department or by telephone.Results There was no inhospital death and no paraplegia events.Severe complication included:coma,2 cases ( 4.1％ ) ; endoleak,2 cases (4.1％ ) ; upper limb ischemia,2 cases (4.1％ ).Recurrent proximal aortic dissection,1 case.Fever was occurred in most of those cases.Conclusion Endovascular repair of aortic dissection improves the outcome of aortic dissection patients.But more attention should be pay to prevent the severe complications,It will help to improve the prognosis and life quality by reducing the risk of retrograde dissection,acute brain ischemia and endoleak.

Objective To discuss MRI characteristics and differential diagnosis of fourth ventricular masses. Methods We retrospectively analyzed 90 cases' MRI findings of fourth ventricular masses that were proved by the surgery (n=83) or were diagnosed by more than three professors and assistant professors in the neuroradiology field (n=7). Results These masses in our study included the medulloblastomas (n=27),the ependmomas (n=18),the choroid plexus papillomas (n=11),the metastases (n=7),astrocytoma (n=6),astrocytomas and glioma (undifferentiated and mixed patten are 5cases),epidermoid cysts (n=5),cerebral cysticercosis (n=4),cavernous hemangiomas (n=4),venous malformation (n=3). Their shapes were spheroridal or irregular,and some masses could become cystic changes in the masses. Most masses could be enhanced or a few couldn't be enhanced with DPTA on MRI. Conclusion The demonstration of fourth ventricular depends on MR findings. It is important to differentiate these masses between within and without fourth ventricular for the differential diagnosis.

BACKGROUND: Clinical observation demonstrates that accelerated fracture healing or lower limb heterotopic ossifications always occur in patients with paraplegia. It indicates that peripheral nervous system may play an important role in fracture healing process.OBJECTIVE: To observe bone histomorphometery parameter, callus formation and biochemical change during the process of fracture healing of unilateral lower limb denervated tibia.DESIGN: Self-control animal experiment.SETTING: Tianjin Hospital.MATERIALS: Totally 36 six-month-old healthy male Wistar rats, with mean body mass of 210 g, were used in this experiment.METHODS: This experiment was carried out at Animal Experimental Center of Tianjin Hospital from March 2001 to March 2004. Denervated tibia fracture model and innervated tibia fracture model were made in the same rat. Animals were executed under anaesthetic status at week 2 and week 4 after fracture. Bilateral tibias were chosen to take radiografts.Biomachamical strength was measured and non-decalcification sections were prepared to perform bone histomorphometery observation.MAIN OUTCOME MEASURES: ① Comparison of wet weight of bilateral tibias and callus of rats between two groups after fracture. ②X-ray plain film scoring. ③ Biomechanical testing of tibial samples. ④ Histomorphological observation of fracture healing RESULTS: ① Wet weight of bilateral tibia and callus of rats in denervated group was much higher than that in innervated group at weeks 2 and 4 after fracture [(0.94±0.15) vs (0.76±0.14) g, (1.06±0.26)vs (0.81±0.10) g,P ＜ 0.05]. ②In X-ray plain film scoring, callus formation was significantly increased in denervated group (P ＜ 0.01). ③In biomechanical testing of three-point bending of tibial sample, callus intensity was significantly lower at weeks 2 and 4 after fracture in denervated group than in innervated group[ (9.88±8.49)vs ( 16.62±13.38 ) N, ( 12.77±7.55 )vs (20.19±10.60) N,P ＜ 0.05]. ④Bone histomorphometery showed that compared with innervated group, mineralized bone trabecula width of denervated group was significantly reduced (P ＜ 0.05), osteoid width was increased , osteoclast index and bone absorption area were significantly increased (P ＜ 0.05), and there were no significant difference of fibroblast index and bone formation area between two groups; Compared with innervated group, mineralized deposition rate in the denervated group was significantly reduced (P ＜ 0.05), the mature time of osteoid was elongated (P ＜ 0.05).CONCLUSION: Peripheral nervous system may play an important role during early and middle period of fracture healing. Intact innervation is essential for normal fracture healing.

Objective To employ intraoperative discography to determine the injured intervertebral disc segments that can not be identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53％,68％ and 76％ respectively.Mean operation time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.

Objective To investigate the protective effect of phycocyanin on focal cerebral ischemia reperfusion in rats.Methods The model of the middle cerebral artery occlusion and reperfusion(MCAO/R) was established using the intraluminal filament occlusion with 60 healthy adult male Wistar rats,and treated by phycocyanin.The expressions of NF-?B,IL-6 and neuronal apoptosis were detected to evaluate the effects of phycocyanin on above indexes.Results The expression level of NF-?B increased successfully from reperfusion 6h,peaked at reperfusion 1d,and then decreased in cortex and striatum in ischemic group.The expression site and change principle of IL-6 were similar to those of NF-?B except of expression peak at reperfusion 2d.The neuronal apoptosis increased successfully from reperfusion 6h,reached peak at reperfusion 1d and 2d in cortex and striatum respectively,and the changed character was coincident with NF-?B and IL-6 expressions.The expressions of NF-?B and IL-6 reduced and the number of neuronal apoptosis decreased significantly after applying phycocyanin compared to the control group in the same time.Conclusion Phycocyanin could inhibit neuronal apoptosis and down-regulate the expressions of NF-?B and IL-6 after cerebral ischemia-reperfusion.

Objective To investigate the application value of pancreatic duct guide wire and transpancreatic septotomy with precutting technique in difficult endoscopic retrograde cholangiopancreatography.Method258 patients who underwent difficult endoscopic retrograde cholangiopancreatography from April 2014 to April 2016 were selected as study subject, 128 patients among them received the technique of pancreatic duct guide wire, the other 130 patients received transpancreatic septotomy with precutting techniques. The success rate, intubation time and incidence of complications were compared between these two methods for cannulation.Result There was no signiifcant difference in preoperative clinical data between the two groups, the success rate did not differ signiifcantly between the two groups (93.75 % vs 93.85 %). Compared with transpancreatic septotomy with precutting techniques group, pancreatic duct guide wire group is less intubation time consuming (5.92 ± 0.69 vs 12.81 ± 3.67) min, the difference was statistically significant (t = -2.27,P < 0.05). 25 patients experienced complications, with 6 cases of acute pancreatitis, 2 cases of biliray tract infection in pancreatic duct guide wire group, and 8 cases of acute pancreatitis, 3 cases of hemorrhage,6 cases of biliray tract infection in transpancreatic septotomy with precutting techniques group. The pancreatic duct guide wire group had a signiifcantly lower incidence of complications (6.25 % vs 13.08 %). the difference was statistically signiifcant (χ2 = 3.27,P < 0.05). The incidence of acute pancreatitis did not differ signiifcantly between the two groups (4.69 % vs 6.15 %).ConclusionsPancreatic duct guide wire and transpancreatic septotomy with precutting techniques both can further improve the success rate of bile duct cannulation with ERCP. The incidence of acute pancreatitis did not differ significantly between two groups. But pancreatic duct guide wire group is less intubation time consuming, and had a significantly lower incidence of complications. Because of the convenience and safety of the pancreatic duct guide wire technique, and the insertion of the pancreatic duct does not increase the risk of postoperative acute pancreatitis. We think that this method is more worthy of Clinical promotion.