Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.

Objective To evaluate the changes of the upper airway of the patients with obstructive sleep apnea syndrome (OSAS) before and after operations and to know the effects of operations by MSCT. Methods The upper airway dimensions of 26 patients with OSAS were measured on multiplanar reformatted (MPR), curved-planar reformatted (CPR), volume rendering(VR) images of 16-slice spiral CT. The measurements include the anteroposterior calibres and the areas on the reformatted axial images on the pharyngeal cavity levels, the calibres and the minimum areas in retropalatal and retroglossal regions, the areas of the soft palate and uvula on the reformatted sagittal view with maximum thickness, the maximum wall thickness of the right and left the upper airway on the coronary images, the volume of the upper airway before and after the operations. The measurements were correlated with the polysomnography (PSG) records. The data were analyzed paired-samples t-test and Pearson correlations. Results By comparison, the anteroposterior calibres and the cross-sectional areas on the reformatted axial view of the lower retropalatal region (slice 4) of the upper airway increased significantly after operations. The anteroposterior diameter increased from 5. 9 mm before operations to 12.8 mm after operations, where t = - 5.506, P < 0.05. The areas increased from 51.0 mm~2 before operations to 275.0 mm~2 after operations, where t = -5.011, P <0.05. In the higher retropalatal region (shce 2) of the upper airway, the anteroposterior diameter decresased from 14.8 mm before operations to 9.2 mm after operations, where t = 2.867, P < 0.05. The areas decreased from 241.0 mm~2 before operations to 128.0 mm~2 after operations, where t = 3.087, P < 0.05. The anteroposterior calibres of retroglossal region (slice 7) decreased from 12.7 mm before operations to 10.3 mm after operations,where t = 3.718, P <0.05. The L-R calibres and the minimum areas of of retropalatal increased significantly from 6.4 mm, 33.0 mm~2 before operation to 10.9 mm, 76. 0 mm~2 after operation, where t = -3.413, -2. 216, respectively and P < 0.05. Of the 9 cases whose apnea and hypopnea index (AHI) ≤5 events/hour after operations, the minimum areas of retropalatal region, the anterio-posterior diameter, L-R calibres increased significantly. The areas increased from 41.0 mm2 before operations to 76.0 mm~2 after operations, were t = -4. 932, P <0.05. The anteroposterior calibres increased from 4.6 mm before operations to 6.6 mm after operations, where t = - 7. 308, P < 0.05. The L-R calibres increased from 8.3 mm before operations to 13.6 mm after operations, where t = - 4.320, P < 0.05. Conclusions MPR、CPR、VR of MSCT can evaluate the not only the morphology but the function changes of the upper airways on the OSAS patients. The increasing of the minimum cross-sectional area may be one of the important indications for evaluating operations. The narrowing of the higher retropalatal region of the upper airway after operations should be an alert to the clinicians.

Objective To explore the behavioral and emotional status of the migrated children one year after they were victimized from earthquake in Wenchuan. Methods 513 victimized children migrated out of disaster area were investigated, with Achenback Child Behavior Checklist ( CBCL), the Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depression Self-rating Scale for Children (DSRSC). The controls were local children ( n = 475 ) coming from the same schools. Results 487 answered files were validated. There were significant differences between the victimized and migrated children and the local children in many scores of CBCL, such as total sores( (26.73 ±6.28)Vs (20.26 ±5.76), t= 16.64, P＜0. 01 ) and withdrawal( (3.23 ±1. 68 ) Vs ( 2.02 ± 1.43 ), t = 12.91, P ＜ 0.01 ), somatization complaining( ( 2.79 ± 1. 34 ) Vs ( 1.67 ± 1.22 ), t =13.55, P ＜ 0. 01 ) and anxiety-depression scores ( ( 3.38 ± 1.79 ) Vs ( 1.95 ± 1. 21 ), t = 14.48, P ＜ 0.01 ), as well as its factors such as social problem, attentional problem, attack behavior, internalizing behavior, social communication and school scores. On the SCARED and DSRSC, the two groups were significantly different in total scores of anxiety and depression as well as in such factors as somatization, generalized anxiety, separated anxiety. Conclusion Though migrated out of the earthquake area, the victimised children still suffer obviously from behavioral problems, and anxious and depressive emotion one year after the earthquake.

BACKGROUND: Human periodontal ligament fibroblasts (HPLF) is the crucial cells in maintaining the configuration and function of periodontium. Adverse stress may cause HPLF to synthesize more inflammatory agents, which may cause the damage of periodontium.OBJECTIVE: To investigate the role of p38 MAPK of HPLF in the expres sion of inflammatory cytokine of interleukin-6 (IL-6) subjected to mechanical pressure, and explore the mechanism of the occlusal trauma to periodontium.DESIGN: A randomized and controlled trial.SETTING: Pathological Laboratory of the Fourth Military Medical Univer sity of Chinese PLA.MATERIALS: The HPLF were obtained from the middle part of 1/3 pe riodontium of 12 to 16-year-old youth whose 20 healthy permanent premo lar teeth should be extracted for orthodontic need. Main reagents and ap paratus: IL-6 enzyme-linked immunoabsorbent assay (ELISA) kit (Staff Room of Immunology of the Fourth Military Medical University of Chinese PLA); ELISA apparatus (Huadong Electronic Tube Factory); p38 MAPK specific inhibitor of SB203580 (produced by Biochemical Company, ob tained as a present from Professor Jiang, Staff Room of Pathophysiology, Southern Medical University).METHODS: The cells were primarily cultured till the 4-5 passages, and randomly divided into four groups: ①pressure-loading control group: the cell s were not subjected to pressure-loading and without pretreatment; ② pressure-loading group: the cells were subjected to continuous pressure-load ing (200 kPa) but without pretreatment; ③ pretreatment control group: the supernatant were added with 10 g/L dimathyl sulfoxide (DMSO, SB203580 solvent) at 1 hour before pressure-loading, the method and time of pressure loading were the same as those in the pressure-loading group; ④ pretreated group: the cells were pretreated with 1 μmol/L SB203580 (a specific in hibitor of the p38 MAPK) at 1 hour before pressure-loading, the method and time of pressure-loading were the same as those in the pressure-loading group. The cytosol and the supernatant in each group were sampled at 16 and 24 hours after pressure-loading respectively. The IL-6 expressions at different time points were detected with ELISA.MAIN OUTCOME MEASURES: The amount of IL-6 expression in HPLF induced by pressure with or without pretreatment by SB203580, a specific inhibiter of p38 MAPK.RESULTS: The expressions of IL-6 after continuous pressure-loading for 16 and 24 hours in the pressure-loading group were (143.1±0.42) and (49.46±1.01) ng/L, which were obviously higher than those in the pres sure-loading control group [(18.36±0.43), (18.78±0.50) ng/L, P ＜ 0.05]. The expressions of IL-6 after continuous pressure-loading for 16 and 24 hours in the pretreatment group were (56.39±0.72) and (21.52±1.39) ng/L, which were obviously higher than those in the pressure-loading control group [(137.96±0.54), (48.47±0.79) ng/L, P ＜ 0.05].CONCLUSION: p38 MAPK of HPLF acts as important cooperative mechanism to regulate IL-6 synthesis induced by mechanical pressure.

The paper reported an investigation of the pharmacokinetics of SN-38 (7-ethyl-10-hydroxy-camptothecin) in rats and the tissue distribution in mice after injection of irinotecan hydrochloride nanoparticles (CPT-11) via tail veins. An LC-MS/MS method was established to determine the concentrations of SN-38 in whole blood of rats and in different tissues of mice. The pharmacokinetics and tissue distribution of SN-38 were compared after the intravenous injection of CPT-11 NPs and CPT-11 solution. Compared with irinotecan solution, the elimination half-life of SN-38 was prolonged from 2.17 h to 2.67 h after the intravenous injection of CPT-11 NPs, but its AUC had little change. After the injection of CPT-11 NPs in mice, over time, the concentrations of CPT-11-metabolized SN-38 in CPT-11 NPs were significantly higher in the whole blood, colon and lungs than those in CPT-11 solution, followed by in the spleen and liver, but those in the heart and brain had no change. However, the amount of SN-38 in the kidneys was reduced with time. CPT-11 NPs could prolong SN-38's (one of its metabolites) blood circulation time in rats and significantly increased the concentration of CPT-11-metabolized SN-38 in the whole blood, colon and lungs of mice. CPT-11 NPs made SN-38 efficiently target-bind to the colon and lungs of mice.
Animals ; Antineoplastic Agents, Phytogenic ; pharmacokinetics ; Camptothecin ; analogs & derivatives ; pharmacokinetics ; Chromatography, Liquid ; Colon ; metabolism ; Half-Life ; Injections, Intravenous ; Lung ; metabolism ; Mice ; Nanoparticles ; administration & dosage ; Rats ; Tandem Mass Spectrometry ; Tissue Distribution

Objective To analyze the changes and characteristics of respiratory tract bacteria in Hebei 3A Hospital, and to provide new rationale for clinical diagnosis and treatment.Methods A single-center retrospective analysis was conducted. 7497 patients with respiratory tract infection admitted to Hebei Chest Hospital from January 2013 to December 2016 were enrolled. Deep sputum was collected, and the bacterial cultures and susceptibility analysis was conducted in sputum and upper respiratory secretions were collected by fiberoptic bronchoscopy.Results A total of 7497 patients with respiratory tract infection were enrolled in the study, and 11909 strains of 13 kinds of dominant pathogens were isolated. The dominant pathogens for respiratory tract infection wereMonilia albican (23.7%),Klebsiella pneumoniae (12.9%),Pseudomonas aeruginosa (11.6%),Escherichia coli (9.5%),Candida glabrata (9.1%),Acinetobacter baumanii (7.9%),Aspergillus (6.7%),Stenotrophomonas maltophilia (4.5%), coagulase negativeStaphylococcus(3.7%) and some species ofPseudomonas (3.7%),Staphylococcus aureus (3.0%),Aerobacter cloacae (1.9%), andCandida tropicalis (1.8%). A total of 6198 strains of 7 kinds of Gram negative (G-) bacilli infection dominant pathogens accounts for 52.0% of all infections,Klebsiella pneumonia (24.8%),Pseudomonas aeruginosa (22.3%),Escherichia coli (18.2%) andAcinetobacter baumanii (15.3%) were the main pathogens, and increased year by year. Susceptibility analysis showed that the preferred antibiotics for G- bacteria were carbapenems, followed by risperidone, sulbactam, cefepime, amikacin, and the third generation of cephalosporins. A total of 798 strains of 2 kinds of Gram positive (G+) bacilli infection dominant pathogens accounted for 6.7% of all infections, were coagulase negativeStaphylococcus(54.8%) and Staphylococcus aureus (45.2%), each had changed little by year. Susceptibility analysis showed that G+ bacteria were sensitive to glycopeptides, followed by cefoxitin, cotrimoxazole, the tetracyclines, quinolones, azithromycin, erythromycin and so on. The advantages of 4 species of fungi were 4913 strains, accounted for all of the 41.3% strains, with 57.5% of Candida albicans, and the trend was increasing year by year. Susceptibility analysis results showed that the antifungal susceptibility of dominant fungi were higher.Conclusions G- bacilli is still the main source of infection, and showed an upward trend year by year. Fungal infection rate cannot be ignored, and we must pay attention to fungal infection incentives. We should strengthen the rational use of antibiotics.

OBJECTIVE:To evaluate the biological compatibility and clinical therapeutic effect of the medical sterilized bone wax.METHODS:Embedding test and pathological test as well as hemolytic test were performed by using rabbits as test animal.12531case-times were investigated in respect to the therapeutic effect,prognosis and satisfactory rate.RESULTS:The embedded bone wax was coated by connective tissue and has not been absorbed without surrounding inflammation,edema or necrosis.The bone wax could not be absorbed after stanching bleeding of the bone broken surface.No hemolytic phenomena were observed.The wound healing obtained a satisfactory rate of99.1%.CONCLUSION:The sterilized medical bone wax has good biological compatibility and is safe and effective to stanch bleeding.It is convenient to use due to its singer dose sterilized packaging.

OBJECTIVE:To prepare the sterilized medical bone wax and to establish the standard of quality control.METHODS:The bone wax was identified with chemical approach and the quality of bone wax was evaluated by saponification value.RESULTS:The bone wax was appropriate in formula,feasible in preparing technique and satisfactory in therapeutic efficacy with a satisfication rate of 98%.CONCLUSION:There are no obvious differences between the bone wax developed by our hospital and imported bone wax in quality,therefore the prepared bone wax can take the place of imported products.

OBJECTIVEThe study aimed to evaluate and compare the efficacy and safety of dihydroartemisinin-piperaquine phosphate (Artekin) and artemisinin-piperaquine (Artequick) in the treatment of uncomplicated falciparum malaria.

METHODSA total of 103 uncomplicated falciparum malaria patients were enrolled and randomly assigned to two groups: 52 cases in the Artequick group, and 51 cases in the Artekin group. The patients in the Artequick group were administered with Artequick, twice in 24 h, whereas the patients in the Artekin group were given Artekin 4 times in 2 days. The mean parasite clearance time, mean fever clearance time, 28-day cure rate and parasite recrudescence rates of the two groups were then compared.

RESULTSThe mean parasite clearance time and the mean fever clearance time were 43.2+/-13.9 h and 24.7+/-9.9 h, in the Artequick group, and 36.5+/-17.1 h and 22.7+/-11.2 h, in the Artekin group. In both groups the 28-day cure rate was 100%, and the parasite recrudescence rate was 0.

CONCLUSIONBoth medicines had high cure rates, low recrudescence rates, and no serious adverse reactions. The administration of Artequick, however, was more convenient and lower incidence of gastrointestinal side effects than that of Artekin, so as to increase the efficacy in the malaria population.

Adolescent ; Adult ; Anti-Infective Agents ; administration & dosage ; adverse effects ; Antimalarials ; administration & dosage ; Artemisinins ; administration & dosage ; adverse effects ; Drug Combinations ; Female ; Humans ; Integrative Medicine ; Malaria, Falciparum ; drug therapy ; Male ; Quinolines ; administration & dosage ; adverse effects ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the clinical value of 18F-fluorodeoxyglucose positron emission tomography (FDG PET)/CT for the diagnosis and management of lung nodules.

METHODSTwenty patients were evaluated: 15 with suspected cancer and 5 confirmed cancer. PET/CT scans were performed by discovery LS-PET/CT system.

RESULTS(1) The diagnostic accuracy of PET/CT was 100% in these 20 patients. Of 15 patients with suspected cancer, 7 were diagnosed as having benign disease and 8 malignant. All the 5 patients with confirmed cancer were all FDG positive. Of 11 single lesions on CT, 3 were positive by PET/CT images, 6 of 8 with positive CT images were diagnosed as having metastasis to the tissue outside the lung and the other 2 were metastatic. (2) After PET/CT scanning, the therapy scheme of 16 out of 20 patients were changed, and continual observation was practiced in 2, 3 were treated by anti-inflammation regimen, 2 by operation, 4 by local radiotherapy, 3 by chemotherapy only, 4 by radiotherapy plus chemotherapy or operation. (3) The radiotherapists made use of PET/CT fusion imaging for positioning in 8 patients who were indicated for radiotherapy. One of them who had received MM50 one course of intensity medulated conformal radiotherapy was re-examined by PET/CT after one and half months, the former parenchymal nodule disappeared and the glucose metabolism returned to normal. Two of them were finally operated after the surgeons have decided an operative approach on estimation of extent of lesion by the PET/CT fusion images. Pathological results showed no cancer cell involvement in the specimen margin or the local lymph nodes.

CONCLUSION(1) PET/CT is better in discriminating malignant from benign lung nodules than CT only. (2) PET/CT scanning facilitates an accurate assessment of response in clinical staging and neoadjuvant therapy scheme of lung cancer. (3) PET/CT fusion imaging provides an accurate biological target for radiotherapy and confirms the operation plan and extent of surgery.

Adult ; Aged ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lung Neoplasms ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; Solitary Pulmonary Nodule ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed