Objective To explore the difference of the tremor of Parkinson's disease(PD) in early stage and physiological tremor by tremor analysis.Methods 14 patients with PD(group PD) and 9 cases of physiological tremor(group physiological tremor) were studied.The surface electrode of the accelerometry(Acc) was pasted at the end of certer-metacarpal of back of hand.At the same time,surface electrodes of electromyography(EMG) were pasted on the forearm flexors and extensors.The tremor graphices and myoelectric activities were recorded in 30 s with and without 1000 g bearing respectively.Tremor frequency and related myoelectric activities were analysed.Results Acc record: The main manifestations were static tremor and tremor frequency was no significant difference when with and without loading in group PD.In group physiological tremor,the main manifestations were posture or active tremor.With loading,the tremor frequency was significant reduced(P

Objective To discuss the applied research of CT perfusion imaging on the diagnosis of splenic diseases. Methods 20 patients with splenic diseases which accepted treatment in our hospital from January 2012 to December 2014 were assigned into group A,including 7 cases of splenic lymphoma patients(group A1),8 cases of leukemia patients with spleen infiltration(group A2)and 5 cases of splenic metastasis(group A3). At the same time,20 healthy persons were selected as the control(group B). Results The result of CT scan was normal in group B,but that showed a variety of lesions in the spleen in group A. The spleen perfusion volume in the group A was significantly higher than that in the control group(P<0.05). The detection rate of CT perfusion imaging was significantly higher than that of CT scan(P<0.05). TIP and MTT in group A were significantly higher than those in group B,while BF,PEI and BV were significantly lower(P<0.05). Conclusion CT perfusion imaging has advantage of simple,short imaging time,less trauma,and a high diagnostic value for the spleen disease,which is an ideal detection means and can be used in clinic.

Objective To evaluate the diagnostic value of endoscopic ultrasonic elastography in lymph node staging of gastrointestinal tumors.Methods Thirty-nine abdominal lymph nodes and 26 mediastinal lymph nodes of 35 patients with gastric cancer or esophageal carcer were examined by endoscopic ultrasonic elastography of five-point elastic score.Lymph node at 1-3 points was regarded as negative(benign),while 4-5 points as positive(malignant).The diagnostic value of EUS elastography was determined by comparing the results with pathological findings.Results Of all the 65 lymph nodes,49 were diagnosed as positive and 16 negative.The sensitivity and specificity of EUSE in the diagnosis of malignant lymph nodes were 91.1%and 60.0%.respectively.Conclusion EUSE is helpful for diagnosis of malignant metastasic lymph nodes.

Objective To investigate the effect of midazolam on cardiopulmonary function during colonoscopy.Methods From June 2014 to June 2015,214 patients underwent colonoscopy were randomly divided into two groups:109 patients in the midazolam group and 105 patients in the non-sedated group(control group).systolic blood pressure(SBP),diastolic blood pressure (DBP),heart rate (HR) and peripheral blood oxygen partial pressure (SpO2) in the two groups before and after colonoscopy were compared.Results In the midazolam group,SBP and DBP decreased more during colonoscopy than in the control group.However,the frequency with a significant change in SBP was similar in both groups.During colonoscopy,HR andSpO2 decreased more in the midazolam group compared to those in the control group.SpO2 levels returned to normal after the procedure in two groups.Conclusion Midazolam has a tolerable effect on cardiopulmonary function and may be safely used during colonoscopy.

OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

OBJECTIVEThis study aims to evaluate the effect of customized titanium mesh, which was designed by mirror imaging and rapid prototyping technique, with Medpor applied for orbital fracture with enophthalmos.

METHODSOrbital axial, coronal, and sagittal CT scan, and three-dimension CT examination were performed routinely in. 18 cases of orbital fracture with enophthalmos preoperatively. Based on the CT data, prosthesis model was designed by reverse engineering and rapid prototyping technique. The customized titanium mesh and Medpor were applied for orbital reconstruction and enophthalmos correction. Orbital reduction and globe projection were evaluated by postoperative CT scan and clinical follow-up visits.

RESULTSCT scans revealed that the customized titanium mesh with Medpor had great accuracy to reconstruct the orbital fracture and correct the enophthalmos in all patients without serious complications. The eye and facial appearance and function recovered significantly. No serious complication occurred in the operation and after operation.

CONCLUSIONThe customized titanium mesh, based on mirror imaging and rapid prototyping technique, can accurately reconstruct the orbital fractures with enophthalmos. The application of Medpor can effectively correct enophthalmos and eyeball mobility malformation.

Enophthalmos ; therapy ; Facial Bones ; Humans ; Orbit ; Orbital Fractures ; surgery ; Polyethylenes ; Postoperative Period ; Prostheses and Implants ; Reconstructive Surgical Procedures ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

Objective To investigates the feasibility of diffusion tensor imaging (DTI) and diffusion tensor tracking (DTT) for evaluation of the effect of childbearing history on female pelvic floor muscles. Methods Forty-six healthy females were divided into two groups: nulliparous and primiparous. MR conventional sequences and DTI were acquired. The optimized FA threshold value was obtained by regulating the FA to fiber tracking. The two groups were compared in terms of ADC, FA, VRA and T2-WT. Results (1)The DTT of FA 0.18 got the highest score in fiber tracking . ( 2 ) The ADC of nulliparous subjects and the subjects who had given birth were (1.24 ± 0.11) ×10-3 mm2/s, (1.33 ± 0.11) ×10-3 mm2/s (P = 0.017). There were no statistical differences in FA, VRA and T2-WT between the two groups (P > 0.05). Conclusions The optimized FA threshold of fiber tracking in pelvic floor muscles is 0.18. DTI and DTT may be used to evaluate the effect of childbearing history on female pelvic floor muscles.

Objective To investigate the safety and efficacy on early treatment of large pancreatic pseudocyst by endoscopic ultrasound (EUS)-guided transgastric drainage. Methods The clinical data of 23 cases of large pancreatic pseudocyst treated with EUS-guided transgastric drainage from 2003 to 2008 was retrospectively analyzed. Results All were of single pseudocyst. Pseudocyst was present in the head of the pancreas in 3 cases, in the body of the pancreas in 11 cases, in the tail of the pancreas in 9 cases. Mean diameter of pancreatic pseudocysts was 11 cm( range 8 - 18 cm ). The interval between the finding of pseudocysts and EUS-guided transgastric drainage ranged 17 -65 d, averaging 31 d. Two had postoperative infection of the pseudocyst, one received percutaneons external drainage and the other one received surgical internal drainage. Three had postoperative gastrointestinal bleeding and were treated with antacid and hemostatic drugs. Patients were examined by CT two to three months later. Pancreatic pseudocysts disappeared completely in 6 cases and significantly shrank in the rest. The clinical symptoms of all patients,such as abdominal pain, abdominal bloating were significantly relieved. All patients were followed-up for 1 year, there was no pseudocyst recurrence, ulcer,bleeding or infection. Conclusions Early treatment of large pancreatic pseudocyst by EUS-guided transgastric drainage is safe and effective.

Objective To investigate the factors associated with delay in decision to seek treatment in patients with acute myocardial infarction(AMI) in Beijing. Methods This prospective,cross-sectional,multicenter survey was conducted from November 1,2005 and December 31 ,2006. The participants consisted of 799 patients with STEMI admitted within 24 h of symptom onset to 19 hospitals in Beijing. Data were collected by semi-structured interviews and medical records review. The patients were categorized into an early decision group and the a late decision group based on the 30 min cut-off. Results The median(25%,75%) decision delay in STEMI patients was 60(20, 180)min. Factors associated with late decision in an univariate analysis were age ≥65 years, retirement or unemployment, history of myocardial infarction,symptom onset at home and intermittent symptoms, whereas presence of bystanders such as friends,coworkers or even strangers,unbearable symptoms,dyspnea,sweating,syncope and attribution of symptoms to cardiac origin were related to early decision. Multivariate logistic analysis showed that history of myocardial infarction,absence of syncope, intermittent symptoms,bearable symptoms and attribution of symptoms to noncardiac origin were independent predictors of decision delay＞30 min. Patients in the early decision group had more chances to receive acute reperfusion therapies(P=0.001) and shorter time intervals from symptom onset to reperfusion therapies(P＜0.001). Conclusions To a great extent patients with AMI in Beijing delayed in decision to seek treatment. History of myocardial infarction, symptom characteristics and symptom attribution were associated with decision delay.

Objective To establish a mouse model of aorta dissection (AD) by β-aminopropionitrile (BAPN) in drinking water + subcutaneously pumped angiotensin II (Ang II) infusion.Methods Forty 3-week-old C57B1/6J male mice were randomly divided into two groups.All animals received 0.1 g/kg/d BAPN in drinking water for 4 weeks.Then the BAPN drinking + saline infusion group and BAPN drinking + Ang II infusion group received continuous saline or Ang II (1,000 ng/kg/min) infusion, respectively, via subcutaneous osmotic minipump for 72 hour.The mice were restricted in a noninvasive computerized tail-cuff system and their arterial systolic blood pressure and heart rate were monitored.Autopsy was performed if a mouse died during the experiment.At the end of the experiment, mice were sacrificed by injection with an overdose of sodium pentobarbital and the aortas were harvested.The formation of aortic false lumen was observed by pathology using hematoxylin-eosin staining.Results The overall incidence of AD in the BAPN drinking administration +Ang II infusion group was 95%, whereas the incidence of AD in the BAPN drinking administration +saline infusion group was only 5%.The mortality from dissecting aneurysm rupture was 24% in the BAPN drinking administration +Ang II infusion group during the experiment.Pathological examination of the aortic cross-sections clearly showed the formation of blood-filled false lumens induced by Ang II.Conclusions A mouse model with high incidence of aortic dissection is successfully established.