Objective To assess the contribution of CT perfusion in the quantitative diagnosis of meningiomas Methods The CT perfusion imaging was performed in 13 patients (including 2 recurrent meningiomas) by using Somatom Plus 4 helical CT The color map of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and mean transit time (MTT) was obtained by perfusion software, and rCBF, rCBV, and MTT were calculated in different areas Then the perfusion parameters and its mean ratios between tumor and contralateral normal brain tissue (CNBT) in each group of different pathologic types of meningiomas were compared using an unpaired or a paired Student t test Results The rCBV, rCBF, and MTT of meningiomas were significantly higher than those of CNBT [rCBV:(16 125?12 135) ml/100 g vs (2 158?1 345) ml/100 g, P 0 05) The characteristic time density curve (TDC) with high peaks was seen in 5 cases The rCBV and rCBF of 4 cases with peritumor brain edema were significantly lower than those of CNBT Conclusion CT perfusion imaging can not only provide quantitative information of meningiomas blood flow and show characteristic dynamic TDC, but also is useful in assessing pathology of tumor and demonstrating lower perfusion in peritumor brain edema and diagnosis of recurrent meningiomas

Objective To investigate the clinical characteristics of severe patients with influenza A H1N1. Methods Fifteen prenant pneumonia patients with influenza A H1N1 were selected from November 26 to December 20,2009. Results The average age of all patients was 24 years old,with an average gestational age of 32 weeks. Leukopenia was observed in 13. 3% of IS patients,and lymphopenia in 86. 7%. Data on the ratio of CD4 cells to CD8 cells were available for 12 patients,54. 5% of whom had an abnormal CD4:CD8 ratio(< 1. 4). Ten of the 14 patients(71. 4%)had increased serum lactate dehydrogenase levels,which were above 245 U per liter. Four patients (26. 6%) had elevated creatine kinase levels at admission. 4 cases of 15 patients (26. 7%) had decreased serum potassium levels,which were below 3.5 mmol per liter. Four patients (33. 3%)had C4 levels higer than 36 g per liter,and 4 cases had C3 less than 0.75 g per liter. All 15 patients had radiologically confirmed pneumonia with bilateral patchy alveolar opacities, affecting three or four lung quadrants. Findings on chest radiographs were consistent with the acute respiratory distress syndrome in all patients requiring mechanical ventilation. 4 cases were found a small amount of pleural effusion, of which 1 case was combined a small amount of pericardial effusion. Respiratory distress requiring intubation and mechanical ventilation developed in 9 patients within the first 24 hours after admission, who were all pregnant women. Two of them in the third trimester died, and 7 cases who were timely terminated pregnancy were in stable condition. Conclusions Pandemic influenza A(HIM) may pose an increased risk of severe illness in pregnant women, and it is easy to develop rapidly into adult respiratory distress syndrome. The pregnancy immunological tolerance may be involved in the severe lung injury process of H1N1 influenza pneumonia.

Objective To evaluate the changes in the expression of spinal endothelin-1 (ET-1) and its receptors in a mouse model of bone cancer pain (BCP).Methods Ninety-six healthy male SPF C3H/HeN mice,aged 4-6 weeks,weighing 20-25 g,were divided into 2 groups (n=48 each) using a random number table:sham operation group (group S) and BCP group.BCP was produced by injecting α-MEM 20 μl containing 1×104 cells/μ1 NCTC 2472 osteosarcoma cells into the distal medullary cavity of the right femur bone.In group S,t-MEM 20 μl was injected into the distal medullary cavity of the right femur bone.Mechanical paw withdrawal threshold (MWT) and the number of spontaneous flinches (NSF) were measured on 1 day before inoculation (T0) and 4,7,10,14 and 21 days after inoculation (T1-5).Twelve mice of each group were randomly sacrificed at T0,2,4,5,and the lumbar enlargement segments of the spinal cord were harvested to detect the expression of ET-1,endothelin type A receptor and endothelin type B receptor protein and mRNA (using Western blot or real-time polymerase chain reaction).Results The MWT was significantly lower and the NSF was higher at T1 in group S and at T1-5 in group BCP than at T0 (P＜0.05).Compared with group S,the MWT was significantly decreased and the NSF was increased at T2-s,and the expression of ET-1,endothelin type A receptor and endothelin type B receptor protein and mRNA was down-regulated at T2,4,5 in group BCP (P＜0.05).Conclusion The pathophysiological process of BCP is associated with down-regulating the expression of spinal ET-1 and its receptors in mice.

Objective:To investigate the efficacy of negative pressure wound therapy (NPWT) combined with a retrograde sural neurovascular flap for the repair of foot and ankle wounds.Methods:Eighty-eight patients with foot and ankle wounds who received treatment in Shandong Wendeng Osteopathic Hospital from July 2019 to January 2020 were included in this study. They were randomly assigned to undergo either NPWT combined with retrograde sural neurovascular flap repair (observation group, n = 44) or retrograde sural neurovascular flap repair alone (control group, n = 44). Clinical efficacy, flap survival, wound healing, and postoperative ankle function scores were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [97.73% (43/44) vs. 81.82% (36/44), &chi;2 = 6.07, P = 0.014]. Flap survival rate was significantly higher in the observation group than in the control group [100.00% (44/44) vs. 86.36% (38/44), &chi;2 = 4.47, P = 0.034]. Wound healing rate was significantly higher in the observation group than in the control group [97.73% (43/44) vs. 79.55% (35/44), &chi;2 = 7.22, P = 0.007]. Half a year after surgery, pain score, gait score, foot and ankle swelling score, range of motion of the tibiotalar joint, range of motion of the ankle joint were (1.81 ± 0.45) points, (1.40 ± 0.41) points, (1.98 ± 0.38) points, (0.41 ± 0.35) points, and (0.84 ± 0.51) points, respectively in the observation group, which were significantly lower than those in the control group ( t = 2.63, 2.62, 2.15, 2.09, 2.02, all P < 0.05). Conclusion:NPWT combined with a retrograde sural neurovascular flap greatly increases flap survival rate and wound healing rate and improves the ankle function of patients with foot and ankle wounds.