Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.

Objective To study the prevention and treatment of complications occurring in anterior cervical spinal surgery.Methods3163cases with cervical spondylotic meylopathy,spinal injury,spinal tu-mor and spinal tuberculosis treated by anterior cervical surgery,were included in this study.Trephination,corpectomy,disectomy and debridement were used for decompression,iliac bone autograft,BAK cage,cubic shaped cages and titanium mesh cages were used for bone grafting,while anterior cervical spine locking plates were performed in some of the cases.1848cases were followed-up from6months to8years with an aver-age of 2years and3months.646cases suffered from operative complications,372cases were immediate due to anterior cervical surgery,and the incidence of morbidity was11.76%.Results26cases of transient laryn-geal nerve or superior laryngeal nerve injury recovered in4to12weeks without special treatment.Most of 16cases with cervical hemotoma were caused by bleeding of smaller blood vessels and obstruction of drainage.13cases of spinal cord or nerve root irritation or injury were treated with medicine for dehydration,12of them had good result.11cases of CSF leakage were cured with cervical spinal immobilization and moderate local compression.8cases of local infection were cured with antibiotics or combined with debride-ment and suturing.2cases of esophagus perforation were repaired and healed.8cases of grafted bone dis-placement were re-operated on the day or second day of occurring.17cases of pseudoarthritis had revision surgery.6of 35cases of adjacent segments degeneration with new symptoms of spinal cord compression were treated with anterior cervical decompression again,and had good results.Most of 342cases of iliac donor side com plications were local pain or lateral femoral cutaneous nerve injury,infection occurred in some cases.Compli cations related to instruments included10cases of BAK subsidence,1case of plate breakage,1case of screws and plate back-out and7cases of titanium mesh cage subsidence.216cases of cervical axial pain were cured3to6months later with medicine.There was1case of sudden death in this group.Conclusion Many kinds of operative complications could occur in anterior cervical surgery.A standardized procedure in diagnosis and surgery methods are the key points to decrease and prevent operative related complications.

Objective To assess the value of CT perfusion imaging in differentiation of mild from moderate liver fibrosis .Methods 18 patients with mild liver fibrosis (F1 phase) and 21 ones with moderate fibrosis (F2 and F3 phase) confirmed by liver biopsy were analyzed ,and all patients underwent the liver 256‐slice CT perfusion imaging .The differences in the CT parameters including hepatic arterial perfusion (HAP) ,portal venous perfusion (PVP) ,total liver perfusion (TLP) and time to peak (TTP) between dif‐ferent fibrosis were analyzed .ROC curve was used to evaluate the ability of perfusion indexes to distinguish mild from moderate liver fibrosis ,then the maximum Youden index was selected as a cutoff point to calculate the sensitivity and specificity .Results Compared with the mild fibrosis ,the TTP [(43 .86 ± 13 .41)s vs (37 .84 ± 9 .97)s ,P=0 .034)] in liver with moderate fibrosis was significantly increased .However ,no differences in the HAP ,PVP and TLP were found .The ROC curve analysis showed that a TTP threshold of 41 .7 s allowed discrimination of mild from moderate fibrosis with a sensitivity of 72 .7% and a specificity of 75% .Conclusion 256‐slice CT perfusion imaging can reflect the hemodynamic changes of liver fibrosis ,and the TTP may help to discriminate mild from moderate fibrosis .

OBJECTIVETo study the effects of Bushen Zhuangjin Decoction (BZD) containing serum on the apoptosis of chondrocytes induced by mechanics stimulus.

METHODSThe BZD containing serum was extracted. The chondrocyte nutritive media was divided into 3 groups, i.e., the common nutritive medium group, the blank rabbit serum medium group, and the BZD nutritive medium group. The apoptosis of chondrocytes was induced by continuing mechanics stimulus in 24 h. Then the chondrocytes were collected. The apoptosis rate of chondrocytes was determined by flow cytometry. The contents of interleukin 1beta (IL-1beta) and nitric oxide (NO) in the corresponding media were determined.

RESULTSThe apoptosis of chondrocytes in the BZD nutritive medium group (19.55 +/- 7.98)% was lower than that of the common nutritive medium group (39.32 +/- 13.45)% and the blank rabbit serum medium group (37.87 +/- 9.67)%, showing statistical difference (P < 0.05). The contents of IL-1beta and NO were also lower in the BZD nutritive medium group with statistical difference when compared with those of the other two groups (P < 0.05).

CONCLUSIONBZD containing serum could protect mechanics stimulus induced apoptosis of chondrocytes.

Animals ; Apoptosis ; drug effects ; Cartilage, Articular ; drug effects ; Cells, Cultured ; Chondrocytes ; cytology ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Flow Cytometry ; Interleukin-1beta ; analysis ; Nitric Oxide ; analysis ; Rabbits ; Serum

OBJECTIVETo observe the short-term clinical results of the adjacent segment degeneration after the implantation of Coflex system at the interspinous space of adjacent segment to lumbar fusion.

METHODSFifty patients with grade III disc (Thompson MRI classification) of adjacent segment to lumbar fusion were included and divided alternately into two groups according to the order of hospitalization from January to November 2009. Coflex system was implanted at the interspinous space of adjacent segment to lumbar fusion in 25 patients as Coflex group, the other 25 patients did not have any surgical treatment were as control group. The followed up time was 2 years. Visual analogue scale (VAS) score of low back pain, changes of disc height and motion range of adjacent segment to lumbar fusion on X-ray imaging were evaluated by independent sample t-test or paired samples t-test.

RESULTSThere were 22 patients in Coflex group and 21 patients in control group were followed up 2 years post-operation. The difference of VAS score between two groups was no significance (P > 0.05). In Coflex group, the change of postoperative disc height was no significance (P > 0.05), but the motion range was significantly reduced to 47% of the preoperative value (t = 7.99, P < 0.05). In control group, the postoperative disc height decreased slightly, without significant difference to the preoperative value (P > 0.05). Between the two groups, no differences of the disc height and motion range were found before operation, but the differences of the disc height changes (t = 6.7, P < 0.05) and motion rang (t = -14.5, P < 0.05) were significant in 2 years post-operation. No complications such as Coflex system loosen, immigration and spinal process fracture were occurred.

CONCLUSIONSCoflex system can obviously limit the motion range and maintain the disc space height of adjacent segment to lumbar fusion, and prevent its degeneration in some degree.

Adult ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Prospective Studies ; Spinal Fusion ; adverse effects ; instrumentation ; methods ; Treatment Outcome

OBJECTIVETo offer normal reference of diameter of the cervical spinal cord and available diameter of cervical spinal canal and to screen scientific radiographic criteria to define and quantify cervical spinal cord disease.

METHODSThe magnetic resonance images of 120 normal people had been measured. The data of diameters of cervical spinal cord, CSF, M, the ratio of diameters of cord and CSF, and the ratio of diameters of cord and M had been collected and statistical analysis was made. And the relationships between the data above and each of gender, the length of C-spine and age were evaluated. In addition, the ratio of diameters of cord and CSF, and the ratio of diameters of cord and M was evaluated.

RESULTSThe study showed that in healthy people, the diameters of cervical spinal cord, CSF and M was larger in the males than in the females, decreased with age, and increased with the length of C-spine but the diameter of CSF. And the ratio of diameters of cord and CSF increased with age and not affected by the length of C-spine. However, the ratio of diameters of cord and M was not affected by age and the length of C-spine.

CONCLUSIONThe ratio of diameters of cord and M is not affected by individual variation and can be used to evaluate cervical spinal cord atrophy, compression and impaired in patients with cervical myelopathy and can be important information in looking for clinically critical points.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; anatomy & histology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Canal ; anatomy & histology ; Spinal Cord ; anatomy & histology

OBJECTIVETo construct a miR-155-based lentivirus vector to induce cyclooxygenase-2 gene silencing in nasopharyngeal carcinoma (NPC) cells by expressing anti-COX-2 shRNAmir.

METHODSmiR-155-based anti-COX-2 shRNAmir template was synthesized and inserted into pLVTHM plasmid. The recombinant pLVTHM/shRNAmir was transfected into 293FT cells for packaging the lentivirus vector. After infection with the lentivirus vector, the GFP-positive cells were screened by flow cytometry, and COX-2 mRNA level was detected by RT-PCR.

RESULTSRestriction digestion and DNA sequencing confirmed successful construction of the anti-COX-2 vector pLVTHM/shRNAmir. A subline of C666-1 cells was established after infection with the lentivirus vector, and the COX-2 expression in the cells was stably silenced.

CONCLUSIONThe shRNAmir lentivirus vector constructed may serve as an effective COX-2 inhibitor, which may facilitate future studies of gene therapy of NPC.

Cell Line, Tumor ; Cyclooxygenase 2 ; genetics ; Genetic Vectors ; genetics ; Humans ; Lentivirus ; genetics ; metabolism ; MicroRNAs ; genetics ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; pathology ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To explore the approach and early effects of endovascular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Methods Six cases with portal vein stenosis of cancerous thrombus,which caused by primary hepatic carcinoma(5 cases)and eholangiocarcinoma(1 case)and the severity of stenosis showed on contrast enhanced CT were more than 75% or occluded,were performed percutaneous transhepatie or transsplenic portography.FLUENCY~(TM) endovascular stent-graft(10 mm diameter)was placed at the position of stenosis after gastroesophageal varices embolization.Portal pressure was measured pre-and post-deployment.Results Stents were successfully placed in all patients.The average portal pressure decreased from 50.7 cm H_2O(1 cm H_2O = 0.098 kPa)to 41.3 cm H_2O after endovascular stent-graft deployment.The restenosis were found in 2 cases after one month.Haematemesis and refractory aseites appeared in one case respectively,the other 4 cases showed no significant symptoms above caused by portal hypertension.Conclusion It is safe and feasible for endovaseular stent-graft deployment in the treatment of portal stenosis of cancerous thrombus.Selecting the suitable indications,the symptoms of portal hypertension can be controlled effectively.

OBJECTIVETo investigate the effects of atrial natriuretic peptide (ANP) on ischemia and reperfusion cochlea in guinea pigs.

METHODSThe guinea pigs were randomly allocated into four groups: experiment groups (A1 and B1) and control groups (A2 and B2). Cochlear ischemia and reperfusion was induced by thrombus and thrombolysis method. In experiment group A1, ANP was administered 10 min before the ischemic insult. In experiment group B1, ANP was administered at the beginning of reperfusion. In control groups, instead of ANP, normal sodium was injected. The blood flow of cochlea (CoBF) was monitored continuously with laser Doppler flow meter and the threshold of auditory brainstem response (ABR) was measured.

RESULTSBefore the induction of ischemia, the CoBF of experiment group A1 was higher than that of the control group A2. From the reperfusion moment to the end of the experiment, there was no difference between the CoBF of the two groups. In B1 and B2 groups, no difference could be seen between the two groups before the induction of ischemia. After reperfusion, the blood flow of control group B2 recovered to 70% of the base level, while the CoBF of experiment group B1 restored to almost the same level of the beginning. Before ischemia, the ABR threshold of the four groups had no difference. At 30 min of ischemia, the threshold of experiment group Al was lower than that of control group A2. And there was no difference in experiment group B1 and control group B2. At 30 min and 60 min of reperfusion, the threshold of experiment group B1 was significantly lower than that of control group B2. No difference could be seen between experiment group A1 and control group A2.

CONCLUSIONSAdministration of ANP at the beginning of reperfusion protects the cochlea from ischemia and reperfusion injury. The administration can not only increase the CoBF, but lower the ABR threshold.

Animals ; Atrial Natriuretic Factor ; pharmacology ; Cochlea ; blood supply ; drug effects ; physiopathology ; Disease Models, Animal ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs ; Reperfusion Injury ; drug therapy ; physiopathology

OBJECTIVESTo study the diagnosis and treatment for the injury of cervical disc and longitudinal ligament.

METHODSFrom 2001 to 2005, the clinical data of sixty-three patients with cervical disc and longitudinal ligament injury were studied. Early treatment was done based on spinal cord injuries and spinal stabilities by X rays and MRI. Early operation was done in fifty-four cases and early non-operation in nine cases.

RESULTSThe follow-up time was six to forty-one months in all patients. The neurological recovery was found in two of eight complete SCI post-operation, thirty-one in thirty-nine incomplete SCI. Cervical collar or plaster orthotic were used in nine cases with four to six weeks. Evidence of instability was noted in four patients, who were operated with anterior decompression fusion. Neck chronic pain was found in two patients, anterior decompression and fusion was done in one with cervical spinal cord compression.

CONCLUSIONSMRI examination is the most value measure for the diagnosis of cervical disc and longitudinal ligament injury. Early anterior decompression and fusion was an important approach for cervical disc and longitudinal ligament injury.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Decompression, Surgical ; Female ; Humans ; Intervertebral Disc ; injuries ; surgery ; Longitudinal Ligaments ; injuries ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Injuries ; diagnosis ; therapy