Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Objective To compare the safety and the clinical outcomes between proximal femoral nail antirotation (PFNA) and InterTan nail in treatment of femoral intertrochanteric fracture using a Meta analysis.Methods A computer-based online search was performed of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese Biomedical Literature Database,PubMed,Ovid database for clinical trials regarding PFNA and InterTan nail in the treatment of femoral intertrochanteric fractures.A Meta analysis was done to compare operation time,intraoperative bleeding,time for fracture healing,postoperative Harris hip score,and postoperative complications between the 2 groups using statistical software RevMan 4.2.Results A total of 7 studies were included (one of 7 points and 6 of 2 points by Jadad quality grading),involving 491 patients (all one-sided).PFNA was used in 266 patients and InterTan nail in 225.The operation time in the PFNA group was significantly shorter than in the InterTan nail group [WMD=-15.58,95％ CI (-21.60,-9.56),P ＜0.001].The Harris hip score at the last follow-up was significantly lower in the PFNA group than in the InterTan nail group[WMD =-2.33,95％ CI (-4.14,-0.53),P =0.01].There were no statistically significant differences between the 2 groups in bleeding volume [WMD =-33.89,95％ CI (-71.88,4.11),P =0.08],bone healing time [WMD =1.60,95％ CI (-2.32,5.52),P =0.42],or postoperative complications [OR =1.90,95％ CI (0.98,3.69),P =0.06].Conclusions Although InterTan nail may lead to longer operation time than PFNA,the risk of surgery may not be much increased and the former has an advantage of better hip functional recovery than the latter.

Objective To evaluate the effect of tourniquet on incisional infection based on animal model,and evaluate the effect of ischemia preconditioning on incisional infection,so as to provide experimental basis for the ra-tional use of tourniquet in clinic.Methods 100 BALB/c mice were randomly divided into 4 groups,with 25 mice in each group.Group A:tourniquet+methicillin-resistant Staphylococcus aureus (MRSA)incisional infection;group B:ischemic preconditioning+ MRSA incisional infection ;group C :MRSA incisional infection;group D:blank control.The survival rates,temperature,routine blood testing,and change in soft tissue beside femoral incision were compared among 4 groups.Results During observation period ,the survival rate in group A was 68%,in group B,C,and D were all 100%,group A was lower than group B,C,and D (P <0.05).The temperature at each time point was significantly different among group A,B,and C (P <0.01 );temperature curves of 4 groups were significantly different (P <0.01 );except basal body temperature,temperature at the other time points among 4 groups were significantly different(all P <0.01);routine blood testing results (white blood cell count,total granu-locyte count,and total lymphocyte count)among 4 groups on the third,and seventh day were significantly different (all P <0.05);on the seventh day,routine blood testing results of 4 groups all returned to normal level,but group A was slightly higher than group B,C,and D.Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.Conclusion Mice incisional infection will be aggrava-ted by using lower limb tourniquet,incision healing and body function recovery time will be delayed,even lead to death.Ischemic preconditioning before making an incision model can reduce the severity of incisional infection,and shorten wound healing time.

Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95％ CI:(0.14,0.47),P ＜ 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95％ CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95％CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.

AIM:To investigate the role of PI3K/Akt and JAK2/STAT3 pathways in the protection of sulfur dioxide (SO2) against limb ischemia/reperfusion (I/R)-induced acute lung injury (ALI) in rats.METHODS:ALI was induced by limb I/R in the SD rats.Na2 SO3 (0.54 mmol/kg, ip)/NaHSO3 (0.18 mmol/kg, ip) as SO2 donor was injec-ted at 20 min before reperfusion.The inhibitors of JAK2/STAT3 and PI3K/Akt pathways, Stattic (3 mg/kg, iv) and LY294002 (40 mg/kg, iv), respectively, were injected at 1 h before reperfusion.Peripheral blood and lung tissues were collected for determining the contents of the cytokines, the protein levels of the molecules related to the signaling pathways, apoptosis and histopathologic changes by ELISA, TUNEL and Western blot.RESULTS:Compared with control group, the content of MDA, the activity of MPO, lung coefficient, apoptotic index, cytokine expression, and the protein levels of p-Akt and p-STAT3 in I/R group all increased significantly, and administration of Na2 SO3/NaHSO3 attenuated the damage in the lung.Besides, the results of Western blot showed that the rat lung tissues expressed p-STAT3 protein and p-Akt pro-tein.After I/R, the protein levels of p-STAT3 and p-Akt were increased.After using Na2 SO3/NaHSO3 , p-Akt was in-creased, but p-STAT3 was decreased (P<0.05).CONCLUSION:Both JAK2/STAT3 and PI3K/Akt pathways are like-ly involved in the protective effect of SO2 against limb I/R-induced ALI in rats.The activation of JAK2/STAT3 signaling pathway increases I/R injury.Reversely, the activation of PI3K/Akt signaling pathway reduces I/R injury.Besides, JAK2/STAT3 and PI3K/Akt signaling pathways may have crosstalk during I/R-induced ALI and JAK2/STAT3 pathway may have an impact on the P13K/Akt pathway.

BACKGROUND:Some studies have shown that blocking the venous return can promote fracture healing but there is no study about the effect of repeated transient ischemia on promoting fracture healing. OBJECTIVE:To observe the promoting effect of repeated transient ischemia on early fracture healing based on micro-CT technique. METHODS: Forty-eight Wistar rats were used to make animal models of right tibial midpiece closed fractures folowed by K-wire fixation. Rats were randomly divided into four groups: 24-hour group, 48-hour group, 72-hour group and control group. Tourniquet was used on the root of the affected thigh, inflated for 10 minutes, and then released for 10 minutes. Three above-mentioned cycles were taken as an ischemic treatment. At 24 hours after fracture fixation, the ischemic treatment was first carried out, and after that, it was done every 24 hours in the 24-hour group, every 48 hours in the 48-hour group and every 72 hours in the 72-hour group. In the control group, the tourniquet with no inflation was used once on the right lower limb every 24 hours after fixation. Al the rats were kiled at 2 weeks after modeling to take out the right tibia with removal of K-wires for micro-CT observation. RESULTS AND CONCLUSION:The trabecular bone volume and total volume in the regions of interest were significantly higher in the 24-hour group than the other three groups (P < 0.05), but the tissue mineral density and calus tissue mineral density were significantly lower in the 24-hour group than the other three groups (P < 0.05).There was no significant statistical difference in the bone volume fraction among the four groups (P > 0.05). These findings indicate that within 2 weeks after fractures, the repeated transient ischemia can promote fracture healing, which may be related to the improvement in the secretion of growth factor, revascularization and osteoblast proliferation induced by repeated transient ischemia.

Objective To investigate the effect of low dose lipopolysaccharide ( LPS ) preconditioning on prevention of incision infection by drug-resistant bacteria.Methods Methicillin-resistant Staphylococcus aureus ( MRSA) suspension with concentration of 1.8 ×109 CFU/mL was prepared.Sixty BALB/c mice were randomly divided into five groups (12 in each group, half male and half female).A medical longitudinal incision of the right thigh was made in mice in group 1-4, and 1, 0.5, 0.25 and 0 mL bacteria suspension was dropped on the surface of the incision and the incision was observed 4d after the model established.Group 5 was the blank control.Then 112 BALB/c mice were randomly divided into 7 groups ( each group had sixteen mice, half male and half female ): group A ( preconditioned with LPS 0.25 mg· kg-1· time-1), group B ( preconditioned with LPS 0.5 mg · kg-1 · time-1 ), group C (preconditioned with LPS 1 mg· kg-1 · time-1 ), group D (preconditioned with LPS 1.5 mg· kg-1 · time-1 ) , group E ( preconditioned with sterile normal saline) , group F ( incision infected) , and group G ( blank control) .LPS was given by intraperitoneal injection 48 h and 24 h before the establishing of the infection model.Body temperature was monitored every day after the model established, blood routine examination was performed on d3 and d7, and serum cytokines was detected on d7.All the mice were sacrificed on d7, and soft tissues around the incision were taken for hematoxylin-eosin staining.Repeated measures ANOVA and univariate ANOVA were performed for data analysis. Results Redness and suppuration were observed in 6 mice infected with 0.5 mL bacteria suspension, respectively, then 0.5 mL bacteria suspension was used for LPS preconditioning experiments.With LPS preconditioning, the body temperatures of mice in group B were with relatively minor changes, and the rises of white blood cells and lymphocytes on d3 and d7 were relatively modest.Granulocytes in group B returned to the normal level on d7.Besides, the rises of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-αin group B were also less, while IL-10 was increased greatly.Suppuration was observed in 4 mice in group B ( 4/16, 25.00%), and the rate was lower than group D, E and F (χ2 =7.988, 19.940 and 19.940,P<0.01). Conclusion LPS (0.5 mg· kg-1 · time-1 ) preconditioning can reduce the severity of incision infection caused by MRSA in mice.

Objective To analyze the MRI features of rare intracranial germ cell tumors of the pineal region compared with pathologic findings.Methods The MRI and pathologic data of 32 patients with rare intracranial germ cell tumors of the pineal region were reviewed retrospectively.All cases were proved by surgery and pathological examinations.Results Fourteen teratomas with malignant transformations were cyst-solidary which were mixed signals on plain MRI and the solid components showed obvious enhancement.The adiposity signals could be seen in teratomas.The level of serum or CSF AFP was high.Microscopically,many tissue components could be seen.The signal of 6 yolk sac tumors were homogeneous,and they had great enhancement after enhanced scanning.Increasing of preoperative serum AFP level could be seen in all patients.The 5 embryonal carcinomas were well-defined margin masses and heterogeneous with cystoid variation and necrosis and moderate to severe edema.The solid components showed obvious enhance.The signals of 7 mixed germ cell tumors were atypical,which depended on the components of germ cell tumors.Conclusion The MRI findings of the rare intracranial germ cell tumors of the pineal region(teratomas with malignant transformations,yolk sac tumors endodermal sinus tumor,embryonal carcinomas and mixed germ cell tumors)show some feature which are correlated with pathology.Suggestive diagnosis could be made combined with clinical data and MRI features.

Autophagy plays an important role in the regulation of activation and inflammation of microglia after ischemic stroke. The interaction between autophagy of microglia and the inflammation mediated by microglia after ischemic stroke was complex and a large num-ber of molecules were involved. The receptors of microglia activation and related substances may be possible mechanism in the regulation of microglia autophagy. Autophagy inhibitors and microglia receptor targeting therapy may provide new strategies for the clinical treatment of ischemic stroke. This paper summarized the progress of microglia autophagy after ischemic stroke.

BACKGROUND:Previous studies have found that endogenous gaseous signaling molecules such as NO, CO, H2S and SO2 play an important role in acute lung injury;there also have other gases participation, such as carbonyl sulfide.
OBJECTIVE:To investigate the effect of carbonyl sulfide for limb ischemia-reperfusion induced acute lung injury and its mechanism in rats.
METHODS:A total of 64 Sprague-Dawley rats were randomly divided into eight groups. Control group:without treatment;model group:limb ischemia for 4 hours and then reperfusion for 2 hours. Low-, moderate-and high-dose carbonyl sulfide groups were intraperitoneal y injected with 0.2, 0.5, 1.0 mL carbonyl sulfide respectively at 20 minutes before ischemia for 4 hours and reperfusion for 2 hours. Low-, moderate-and high-dose air groups were intraperitoneal y injected with 0.4, 1.0, 2.0 mL air respectively at 20 minutes before ischemia for 4 hours and reperfusion for 2 hours. 2 hours after reperfusion, the morphological changes of lung tissues and the change of lung coefficient were observed. The expressions of tumor necrosis factor-a, interleukin-1βand interleukin-6 both in lung tissue and serum were detected by enzyme linked immunosorbent assay. Cel apoptosis was measured by TUNEL assay.
RESULTS AND CONCLUSION:(1) Compared with the control group, significant damage of lung tissue was seen, and the lung coefficient increased significantly in the model group (P<0.05). The expressions of tumor necrosis factor-a, interleukin-l and interleukin-6 both in lung tissue and plasma increased (P<0.05), and apoptotic rate increased. (2) Compared with the model group, low-, moderate-and high-doses of carbonyl sulfide could mitigate the degree of lung injury, and reduce pulmonary coefficient and apoptotic rate. The low dose showed the most obvious effect. Low-and moderate-dose carbonyl sulfide could significantly decrease expressions of tumor necrosis factor-a, interleukin-1βand interleukin-6 both in lung tissue and plasma (P<0.05). (3) No significant difference in each index was visible in the low-, moderate-and high-dose air groups compared with the model group. (4) Results suggested that low dose of exogenous carbonyl sulfide through anti-inflammatory, anti-oxidant effects plays the protective role on limb ischemia/reperfusion-induced acute lung injury in rats.