Objective To investigate the effect of contrast material flow rate and delayed time on intracranial vascular spiral computed tomographic angiography(SCTA) imaging.Methods 30 patients were selected randomly who planed to do brain contrast enhanced CT examination.In all 30 patients a plane dynamic test scanning at suprasellar cistern level was preformed with 20ml contrast material at a flow rate of 2ml/s,3ml/s and 4ml/s respectively.A time-densty cure was originated from data collected with the software of Time-Lapse.Results The summit time of most intense enhancement of arteriovena was significantly shortened when the flow rate was increased from 2ml/s to 3ml/s or 4ml/s,and the summit time was shortened without satistically difference when the flow rate was increased from 3ml/s to 4ml/s.Conclusions The circulation time test with a little volume contrast material can become a routine procedure of SCTA examination to determine the best delayed time.The suitable flow rate of intracranial vascular SCTA is 3ml/s.

Objective To assess the value of intra-aortic balloon pump (IABP) support in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 41 patients with AMI complicated by CS receiving emergency PCI with IABP support were retrospectively reviewed, and 47 patients receiving emergency PCI without IABP support at the same time were included as the control group. Left ventricular function was evaluated in the 2 groups at 2 weeks and at 3 months after the operation respectively. The incidence of MACE was compared between the 2 groups at 30 days and also at 3 months after the operation. Results Patients receiving IABP support had greater improvement in left ventricular function at 2-week and 3-month after operation (43.8?8.2% vs 39.4?5.9%, 45.5?6.6 vs 40.6?4.6%, both P

Adult ; Blood Pressure ; Environmental Exposure ; Female ; Heart Rate ; Humans ; Hyperbaric Oxygenation ; adverse effects ; Male ; Middle Aged ; Occupational Exposure ; Personnel, Hospital ; Young Adult

Objective To find out the physical state of the human papillomavirus ( HPV) genome in hepatoma cell line HepG2 cells and the regulation of HPV late capsid protein 1 ( L1) expression and to explore the nature of the cytoryctes in HepG2 cells.Methods E2 and E6 in HPV18 were detected by PCR to evaluate the physical state of HPV18 genome .HepG2 L1 expression was detected by ELISA , light microscropy and electron microscrope immu-nohistochemistry assays , Western blot assay using HPV L 1 mice monoclonal antibody .L1 mRNA in HepG2 cells was detected by reverse transcriptional PCR ( RT-PCR) .Results PCR assay displayed that HPV DNA was inte-grated with HepG2 genome.ELISA assay showed that HPV L1 was present in lysate of HepG2 cells.Light micros-cropy demonstrated strong positive reaction in HepG2 cells.In microscopy, in the cytoplasm of partial HepG2 cells, there were lumpish cytorrhyctes materials which consists of very small and uniform particles and these parti -cles were marked by HPV L1 antibody labeled by colloidal gold .Western blot analysis showed a band at 56 ku dis-trict and it was L1 specific strap which demonstrated HPV 18 L1 was present in HepG2 cells.RT-PCR assay demon-strated the presence of L1 mRNA in HepG2 cells.Conclusions HepG2 cells are HPV18-positive HPV DNA ge-nome is integrated with HepG2 cells.HepG2 cells can express L1.The cytorrhyctes in HepG2 cells are composed of HPV18 L1 indicating that L1 can be expressed in HepG2.

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in tumor tissue on analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain. Methods One hundred and fifty advanced cancer patients with pain aged 51-64 yr weighing 54-65 kg were included in this study. The expression of P-gp was negative in the tumor tissue in 50 patients (group M1 and B1, n = 25 each) and positive in 100 patients (group M2 ,M3 ,and B2 ,B3, n =25 each). The PCA regimen for the 6 groups were listed in the table .Pain was assessed with VAS scores (0 = no pain, 10 = worst pain) and venous blood samples were taken for determination of blood morphine/buprenorphine concentrations at 4, 12, 24 and 48 h of PCIA. Results The six groups were comparable with respect to age, body weight, M/F sex ratio, types of cancer, baseline pain level and education. The analgesic efficacy of morphine and buprenorphine was better ( VAS scores were significantly lower)in P-gp expression negative patients (group M1 and B1 ) than in P-gp expression positive patients (group M2 and B2 ). Higher doses of morphine and buprenorphine provided better analgesic efficacy in P-gp expression positive patients in group M3 and B3 than in group M2 and B2. Plasma morphine and buprenorphine concentrations were comparable between group M1 , B1 and M2, B2 and were significantly higher in group M3 and B3 at each time point. Conclusion Positive P-gp expression in the tumor tissue can decrease the analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain.

Objective To evaluate the efficacy and safety of InVance bulbourethral sling for stress urinary incontinence after radical prostatectomy.Methods Six male patients with stress urinary incontinence after radical prostatectomy were treated with perineal sling (InVance) from March 2005 to March 2011,and the clinical data were analyzed.Results The operation time was 80-120 min and intra-operative blood loss was 20-50 ml.The catheter was removed at the second day after surgery.In a follow-up of 12 to 29 months,4 patients were dry,1 patient was improved,and 1 patient suffered treatment failure.There were 2 patients transient acute urinary retention and 1 patient short-term perineal pain in the main post-operative complication.In six months after the operation,urodynamic examination showed (15.9 ± 7.7) ml/s at Qmax and 0-20 ml/s at postvoid residual.Conclusion InVance bulbourethral sling for the treatment of stress urinary incontinence after radical prostatectomy appears to be safe,simple in the procedure and good effect to mild and middle incontinence.

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Objective To investigate the safety and obtain parameters of microeoagulation of dorsal root entry zone (DREZ) of cervical cord with bipolar foreps on animal model,and provide histological base for clinical application of treatment of brachial plexus avulsiol pain using microcoagulation of dorsal root entry zone.Methods On the base of swine's weight and spinal cord size in similar to human being,it was chosen to be experimental animal.The right DREZs of cervical cord were microcoagulated with bipolar forceps.The swines were fed in normal way.Their activities were observed.The mass change of the cervical cord segment were observed after 3 weeks and the cervical cord segment was fixed with 10% fromalin,paraffin sliced,HE dying.Coagulating space,depth and width were measured under microsope.The coagulating parameter were adjusted according to measuring outcome in order to achieving a most avaliable parameter.Results All post-op swine survived.When the microcogulation were made with bipolar forceps adopted following parame- ters:The distance of between the polar was 2.0 mm;The diameter of polar was 0.3 mm.The inserting depth 2 mm,the coagulated power 18 watt,the coagulated time was 2 second,then the width of lesions of DREZ in cross section was 1.15 mm and the depth of lesions was 3.10 mm,which was consistent with the area of hu- man DREZ of cervical cord.Conclusion The experiment on swine suggested,microcoagulation of DREZ by bipolar forceps is safe and no mortal complications when the testified parameters are adoped,and can achieve the area of DREZ of cervical cord in human.

Objective Bone marrow mesenchymal stem cells (BMSCs) were induced to differentiate to the special histological types of neurons in vitro.The morphological change of cells and positive expression of specific antigen on membrane were studied,and the function of connection between the induced BMSCs was also detected.The feasibility of BMSCs differentiate to the special histological types of neurons was investigated.Methods BMSCs were divided into group Ⅰ (induced with bFGF+GDNF),group Ⅱ (induced with bFGF+GDNF+WHI-P131 +Shh),and control group (no revulsive).The morphologic change of cells was observed,and the positive rate of neuron specific surface antigen and the content of dopamine were detected.Formation of mature synaptic structure was detected by immunohistochemical assay of postsynaptic density protein 95 (PSD-95) expression,and synaptic loop was shown by FM1-43 stain synaptic vesicles.Results By immunohistochemical staining,the positive rates of dopamine transporter (DAT) and tyrosine hydroxylase (TH) in group Ⅱ were significantly higher than those in group Ⅰ,and dopamine can been detected in cell culture supematant of group Ⅱ.After BMSCs was induced into dopamine neuron-like cells,number and length of cell protrusions,positive rate of PSD-95 and fluorescence intensity of FM1-43 in group Ⅱ were significantly higher than those of group Ⅰ.Conclusions There were no significant change in positive rate of neuron-specific surface markers,rate of cell survival and differentiation rate after BMSCs differentiated to dopaminergic neuron-like cells.The number and length of cell protrusions,content of dopamine in cell culture supematant,positive rate of dopaminergic neuron-specific surface antigen (DAT and TH),synaptic function index (positive rate of PSD-95 and fluorescence intensity of synaptic loop) of group Ⅱ were all significantly higher than that of group Ⅰ.

Objective To evaluate the efficacy of the suprapubic arch sling(SPARC)in female stress urinary incontinence by video-urodynamic tests.Method From January 2007 to October 2008,video-urodynamic tests,the pad test and ICI-Q-SF had been performed in all patients who received the SPARC before operation and 3,6 months after operation.Results Thirty-two cases of an effective follow-up for 6 to 20 months,31 patients were satisfied with urinary control,1 patient had mild urinary incontinence.Urodynamics:3,6 months after operation the maximum bladder capacity(MCC),residual urine(RU),detrusor pressure at maximum flow rates(Pdet,Qmax)were no statistical differences compared with those before operation(P＞ 0.05),3 months after operation,abdominal leak point pressure(ALPP)difference was statistically significant compared with that before operation(P =0.000),6 months after operation,the maximum urinary flow rate(Qmax),ALPP differences were statistically significant compared with those before operation(P values were 0.003,0.000).Static urethral pressure profile parameters before operation and 3,6 months after operation,the maximum urethral closure pressure(MUCP)was(35.2 ± 20.4),(53.1 ±22.5),(62.3 ± 19.8)cm H2O(1 cm H20 =0.098 kPa),respectively,functional urethral length(FUL)was (3.5 ± 1.3),(3.9 ± 0.9),(4.2 ± 1.1)cm,respectively,6 months after operation,MUCP,FU L differences were statistically significant compared with before operation(P values were 0.000 and 0.002).Conclusion Urodynamic evaluation by image,SPARC is one of the effective methods to treat the female stress urinary incontinence,the image within 6 months of urodynamic evaluation prompt surgery can increase urethral pressure,strengthen the control of urinary function,while no significant effect on bladder function.