BACKGROUND: Various artifacts are found to be appeared in the nuclear magnetic resonance; the frequently appearing ones are the motion artifacts, plait artifacts, metallic artifacts, partial volume effect artifacts, chemical shift artifacts, phase artifacts, zipper artifacts and so on. However, there is still has no report on the controlling and revising method of the zipper artifacts which is produced in the spin-echo sequence imaging process. OBJECTIVE: Based on the discussion of the mechanism of the production of zipper artifact in the spin-echo sequence imaging process, a new impulse sequence is worked out to avoid the zipper artifact. METHODS: Standard SE sequence was complied to obtain the standard image, and compiling the artifact sequence to obtain the linear disturbance image and zipper artifact image, compiling the modified sequence to obtain the modified zipper artifact image. RESULTS AND CONCLUSION: Usually, the linear disturbance image could obtained in the instantaneous gradient of 5 degree with the echo sequence of 120 degree, and the zipper artifact will be obtained in the instantaneous gradient of 90 degree with the echo sequence of 120 degree. Modified sequence instantaneous gradient of 90 degree with the echo sequence of 120 degree can completely eliminate zipper artifact. The interesting result obtained in this paper is that the zipper artifact can be totally avoided with this new impulse sequence.

OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

Objective: To explore the safety and efficacy of intravenous thrombolysis therapy with tissue plasminogen activator ( tPA) in aged acute ischemic stroke patients. Methods:The patients treated with intravenous tPA were analyzed and divided into≥80-year group (n=16) and <80-year group (n=79), and 30 hospitalized patients with the age above 80 years without thrombolytic therapy were selected as the control group. The prognosis of the three groups was compared. Results:①The incidence of ICH in the two thrombolysis therapy groups was 13. 9% and 18. 7% in 24h, and that of SICH was 5. 1% and 6. 3% with no significant difference (P>0. 05). ② No significant difference was found in favorable prognosis between the two therapy groups 90 days after thrombolysis (P=0. 771), while very bad prognosis rate was higher in the≥80-year group than in the <80-year group (P<0. 05). ③The≥80 years group had an increased favorable outcome compared with the control group (P<0. 05), while the very bad prognosis rate in the two groups showed no significant difference (P>0. 05). Conclusion:It is safe and effective for old patients to receive IV-tPA throm-bolysis therapy.

Objective To evaluate the clinical significance of a modified T-staging system for hilar cholangiocarcinoma(HCC).Methods From 1999 through 2007,98 HCC patients were stratified by the Tstaging system.Statistical differences were evaluated for resectability,radical resectability,concomitant partial hepatectomy,partial portal vein resection,histological differentiation,lymph node characteristic and survival rate.Results There were 43 HCC patients graded at T1,37 at T2 and 18 at T3 respectively.The resectability rates were 65%,40% and 11%,and radical resection was achieved in 46%,21% and 0% respectively.Resectabilities decreased with increasing T stage(χ~2=15,P<0.01;χ~2=14,P<0.01,separately).In patients with T1 and T2 tumors who underwent resection,the concomitant partial hepatectomy accounted for 60% and 73%(χ~2=0.6,P>0.05),partial portal vein resection for 3% and 33%(χ~2=4,P<0.05),poor differentiated types for 71% and 40%(χ~2=4,P<0.05),and lymph node metastasis for 50% and 40%(χ~2=0.4,P>0.05),respectively.The 1-,3-and 5-year survival rates in patients with T1 lesions were 58%,30%and 18%,in 12 patients it was 43%,11%and 0.The 1-and 2-year survival rate in T3 patients was 12%and 0.Patients witll T1 or T2 stage tumors had a significantly longer survival than those with T3(P<0.05)(Log rank χ~2=14,Breslow χ~2=12,P<0.01;Log rank χ~2=6,Breslow χ~2=4,P<0.05,individually),and the difference in survival between T1 and T2 was not significant(Log rank χ~2=2,Breslow χ~2=1,P>0.05).Conclusions The T-staging system is appropriate for preoperative evaluation in HCC patients.However,its correlation with tumor histological differentiation and lymphatic characteristics needs to be elucidated.

Objective To explore the clinical characteristic of rapidly progressive glomerulonephritis(RPGN) induced by the antithyroid agents[propylthiouracil(PTU) and methimazole(MMI)].Methods The analysis was made according to the drug histories,clinical manifestation,serology investigations,renal biopsy in 2 children.Results Two cases presented with gross hematuria,proteinuria and renal dysfunction.One case with antineutrophil cytoplasmic antibody(ANCA)-positive and vasculitis lesion with cresent in the renal biopsy;another presented with mesengial proliferation and cresent.They both had been diagnosed RPGN induced by antithyroid agents for 5 years because of Graves disease.The treatment included that PTU and MMI were withdrawn and then combined prednisone with mycophenolate mofetil(MMF)were applied.One year after treatment,the urine analysis and renal function returned to normal.Conclusions The antithyroid agents may induce RPGN.A early diagnosis and immunosuppressive therapy can improve its prognosis of the disease.

This study was aimed to establish the PCR methods to detect nucleophosmin (NPM) gene and its mutation. 2 leukemia cell lines and 23 specimens from patients with acute myelogenous leukemia (AML) were investigated. The level of NPM mRNA was detected by RT-PCR. The exon-12 of NPM gene in leukemia cell lines was amplified by PCR and sequenced. Using the plasmid containing cDNA of NPM mutation A as a positive template, the PCR procedure to detect mutation A was established and evaluated. Then, the mutation of NPM was analyzed in 23 AML specimens. The results indicated that the expression level of NPM in leukemia cell lines was higher than that in normal cells. Different overexpression levels of NPM mRNA were found in all 23 AML specimens. PCR indicated that mutation had been not occurred at NPM exon-12 in THP1 and K562 cells, but a T base was deleted at 3' untranslated region of NPM gene in K562 cells. The PCR used for directly detecting NPM mutation A can specially amplify the NPM mutation gene. The method was reproducible, whose coefficient of variability was 1.6% and 3.1% in intra-and inter-assays respectively. The lowest detectable limit was 100 pg cDNA. Using the PCR methods, NPM mutation A could be detected in 2 out of 23 AML specimens, but NPM mutation A was not found in THP1 and K562 cells. It is concluded that the RT-PCT method detecting NPM mRNA level and the PCR method detecting directly NPM mutation are established. NPM mRNA is overexpressed in leukemia cells; NPM mutation A occurs in some AML patients.
Adult ; Base Sequence ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation ; Nuclear Proteins ; genetics ; Polymerase Chain Reaction ; methods ; RNA, Messenger ; genetics ; metabolism ; Young Adult

Objective To investigate the clinical effects' differences of screw and suture fixation by arthroscopy in treatment of patients with ACL tibial avulsion fracture. Methods 80 patients with ACL tibial avulsion fracture were chosen and randomly divided into both groups including A group (40 patients) with suture fixation by arthroscopy and B group (40 patients) with screw fixation by arthroscopy; and the operation time, the Lysholm knee score, the IKDC knee function subjective scale score, the difference of uninjured and injured side displacement, and the incidence of flexion contracture of both groups were compared. Results The operation time of B group were significantly shorter than A group (P < 0.05). There was no significant difference in the Lysholm knee score, the IKDC knee function subjective scale score and the difference of uninjured and injured side displacement between the two groups (P > 0.05). There was no significant difference in the incidence of flexion contracture between the two groups (P > 0.05). Conclusion Screw and suture fixation by arthroscopy in treatment of patients with ACL tibial avulsion fracture possess the same clinical effects to higher the stability of reduction and improve the joint motion function; but screw fixation by arthroscopy application can efficiently shorten the operation time and reduce the operation difficulty.

OBJECTIVETo investigate the mothod and therapeutic efficacy of total hip anthroplasties (THA) for osteoarthritis secondary to Crowe type IV developmental dysplasia of hip in adults.

METHODSFrom May 2006 to December 2013, THA was performed on 15 adult patients (17 hips) with Growe type IV acetabular dysplasia, including 13 females and 2 males, with a mean age of 30.9 years old (22 to 58 years old) and an average preoperative Harris score of (34.0 ± 6.5) points. Traction of the affected limb was not performed before surgery. After extensive release and lengthening of soft tissues, sub-trochanteric osteotomy of the femur was performed, hip joint center was rebuilt and the abduction function was restored.

RESULTSThe patients were followed up with a mean period of 33 months (ranged from 6 months to 5 years). The postoperative Harris score was 85.0 ± 7.3,higher than the preoperative score. The extended length of limb ranged from 1.6 to 5.4 cm, with a mean of (3.42 ± 0.65) cm. The shortening and malformation of the affected limb were corrected in the most patients,with the difference in length of the two legs less than 1.5 cm. After surgery, 1 patient experienced partial sciatic nerve injury, which was largely recovered after 3 months of conservative treatment. One patient experienced complete sciatic nerve injury, which was partially recovered after 6 months of conservative treatment; a foot-drop varus deformity was formed in the distal end of the affected limb, which was improved after tendon transposition and transplantation. Joint pain was relieved, and the joint function was restored significantly. Over the follow-up period, no severe complications such as dislocation, infection, prosthesis loosening, or subsiding occurred.

CONCLUSIONSatisfactory efficacy can be achieved for adult Growe type IV acetabular dysplasia associated with osteoarthritis by THA, with proper soft tissue release and lengthening, sub-trochanteric osteotomy of femur, joint functional restoration, appropriate choice of prosthesis, and careful protection of nerves and vessels.

Adult ; Arthroplasty, Replacement, Hip ; methods ; Female ; Hip Dislocation, Congenital ; complications ; Humans ; Leg Length Inequality ; therapy ; Male ; Middle Aged ; Osteoarthritis, Hip ; surgery

To compare the pharmacokinetics of syringin, eleutheroside E and isofraxidin after intravenous administration of each monomer and Ciwujia injection. Twenty-four Sprague-Dawley rats were randomly divided into four groups and intravenously administrated with syringin, eleutheroside E, isofraxidin, and Ciwujia injection, respectively. The concentrations of the three components in rat plasma were determined by LC-MS/MS. DAS 2.0 software was applied to calculate the pharmacokinetic parameters while the SPSS 17.0 software was used for statistical analysis. Significant difference (P < 0.05) was found between each monomer and the injection on the main pharmacokinetic parameters such as AUC, CL and t1,/2. Compared with the injection, the group treated with the syringin has obvious decrease in AUC, and increase in CL while the group treated with eleutheroside E has obvious increase in AUC, and decrease in CL The t1/2 of isofraxidin was prolonged in Ciwujia injection. Pharmacokinetic characters of the ingredients in the injection varied greatly from the monomer. Other constituents in the injection may have an impact on the pharmacokinetic profiles of these three components.
Administration, Intravenous ; Animals ; Coumarins ; administration & dosage ; blood ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Lignans ; administration & dosage ; blood ; pharmacokinetics ; Male ; Phenylpropionates ; administration & dosage ; blood ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) in the macroscopic classification of rectal carcinoma. Methods Seventy-one patients with rectal carcinoma were examined by ultrasound after intrarectal infusion and intravenous bolus injection of SonoVue preoperatively. And three types were divided according to the shape of the tumor:protruding type, ulcerative type and invasive type. After surgery, DCUS and perfusion contrast-enhanced ultrasonography (PCUS) were compared with final pathologic results respectively, and the relationship between general tumor type and TN staging were analyzed.Results The accuracy of DCUS [88.7%(63/71) ] in macroscopic classification of rectal carcinoma was significantly higher than that of PCUS [73.2%(52/71) ](χ2=5.534,P<0.05). For the invasion depth into the intestinal wall, the protruding type was mainly in T1, T2 and T3 stages while ulcerative and invasive type in T2, T3 and T4 stages (χ2=12.322, P<0.05 ). For the stage of lymph node, the protruding type was mainly in N0 and N1 while ulcerative and invasive type in N1 and N2(χ2=6.733,P < 0.05 ). Conclusions DCUS, with its high accuracy, is a new valuable method for macroscopic classification of rectal carcinoma.In the aspect of intestinal wall invasion and the lymph node, protruding type is less severe than ulcerative type and invasive type.