Objective To study the MRI findings and pathologic characteristics of cesarean scar pregnancy during the first-trimes-ter.Methods Clinical data,MRI findings and pathologic manifestations of 23 CSP patients confirmed by surgery and pathology were analyzed retrospectively.Results On pathologic specimens by the microscope,villi and decidua tissue were found in the myometrium of all 23 cases (100%),and smooth muscle tissue in the uterus scar was incomplete in 12 cases (52.2%).The incision scars were found in the uterine lower antetheca in 21 cases,which showed low signal on T1 WI and T2 WI.A majority of the gestational sac pro-truded into intrauterine in 12 cases.The gestational sac located in the scar of lower uterine antetheca in 10 cases and in the myometri-um around the scar in 1 case.The gestational sac of 22 cases were quasi-round with the size between 1.8 cm×1.2 cm and 6.4 cm× 2.7 cm.The gestational sacs showed homogeneous low signal on T1 WI and high signal on T2 WI in 8 cases,heterogeneous high signal on T2 WI and STIR sequence in 1 5 cases,a little short T1 signal of bleeding in 9 cases,and heterogeneous high signal on DWI sequence in 3 cases.The gestational sac borders were well-defined in 18 cases and blurred in 5 cases.Among 5 cases performed by enhanced MRI,there were 3 cases which gestational sac walls were ring-shaped enhanced.Conclusion MRI findings of CSP had certain char-acteristics and could reflect the pathological characteristics of CSP.MRI had important reference value in early diagnosis of CSP and the choice of treatment.

BACKGROUND: Schwann calls are seed cells for constructing tissue engineered peripheral nerves. But their in vitro isolation, culture and purification are difficult. Acellular nerve allografts (ANA) have a great effect on repairing peripheral nerve defects, and it can induce marrow stromal cells (MSCs) into Schwann-like calls. Accordingly, MSCs can be used as seed calls theoretically in constructing tissue engineered peripheral nerves, instead of Schwann cells OBJECTIVE: To observe the repairing effect of tissue engineered peripheral nerves constructed with MSCs on sciatic nerve defects and to assess the feasibility of repairing peripheral nerve defects with MSCs as seed calls. DESIGN, TIME AND SE'I-rlNG: A randomized control animal experiment was conducted in the laboratory of Basic Medicine Collage of Dali Collage from July to December in 2008.MATERIALS: A total of 30 SD rats were divided randomly into 3 groups, with 10 in each group. In MSCs+ ANA group, end-to-end anastomosis were performed with 10/0 non traumatic suture to broken ends of rat sciatic nerves and tissue engineered nerves cultured using MSCs combined with ANA; In ANA group, ANA were bridged to broken ends of sciatic nerves; In METHODS: The 10ram sciatic nerve defects in rats were repaired using MSCs-constructed tissue engineered peripheral nerves, whose repairing effects were evaluated at week 12 post transplant through sciatic function index (SFI), gastrocnemius wet weight recovery rate, S-100 immunohistochemical staining and electron microscope observation, etc. MAIN OUTCOME MEASURES: Morphological changes of calls were observed during the culture of compounds; SFI and gastrocnemius wet weight recovery rates were detected after transplantation; New myelinization, axon growth and nerve fiber distdbuUon were observed with toluidine blue staining; Schwann calls growth and nerve fiber regeneration were observed with transmission electron microscope combined with S-100 protein immunohistochemical staining method.RESULTS: The detection results showed that SFI and gastrocnemius wet weight recovery rate were higher in the MSCs+ ANA group than in the ANA group (P < 0.05). Compared the ANA group, the MSCs+ ANA group had more S-100 proteins expressed in its compounds obviously, and the number, the diameter of its myelinated nerve fibers as well as its myelin sheath thickness were all greater than those of the ANA group (P < 0.05). The repairing effect of the MSCs+ ANA group was close to that of the autotransplantation group.CONCLUSION: MSCs-constructed tissue engineered nerves have a better effect on repairing peripheral nerve defects than ANA, and MSCs as seed cells have a high value in peripheral nerve tissue engineering.

Objective To explore whether adiponectin activates AMP-activated protein kinase(AMPK) via LKB1 pathway or not in skeletal muscle and liver tissues.Methods Male Sprague-Dawley rats ( n =28 ) were divided into normal control diet( NC,n =15 ) and high-fat diet( HF,n =13 ) groups.After 16 weeks feeding,fasting blood free fatty acids( FFA ),triglyceride( TG ),total cholesterol( TC ),fasting plasma glucose( FPG ),fasting insulin(FINS),and adiponectin were determined.The protein levels of AMPKα,phosphorylated AMPKα ( p-AMPK ),and LKB1 in the skeletal muscle and liver tissues were analyzed with Western blot.Cultured primary skeletal muscle cells and hepatic cells were incubated with aditonectin and radicicol.The expression of AMPKα,p-AMPKα,and LKB1 inthese cells were analyzed with immunofluorescence method.Results Compared with NC group,body weight,FFA,TG,FPG,and FINS in rats of HF group were significantly higher( all P＜0.05 ) while serum adiponeetin level was lower( P＜0.05 ).The levels of AMPKα phosphorylation and LKB1 expression in the skeletal muscle and liver tissues of HF group were lower than those in NC group. In primary skeletal muscle cells and hepatic cells,adiponectin significantly increased the levels of AMPKα phosphorylation and LKB1 expression ( all P＜ 0.05 ),which were decreased by radicicol ( P＜0.05 ).Conclusion Adiponectin may activate AMPK via LKB1 pathway in skeletal muscle and liver tissues of rats.

PurposeTo evaluate multislice spiral CT (MSCT) in diagnosing abdominal anaphylactoid purpura (AAP), and to explore its role in treatment follow-up.Materials and Methods Clinical and MSCT data of 13 patients with confirmed AAP were retrospectively analyzed. All patients underwent abdominal CT scan and thin layer reconstruction. Upper endoscopy was performed in 8 patients prior to treatment. MSCT was performed in 10 patients and endoscopy in 4 patients posttreatment, then clinical and CT features were compared to pretreatment findings.Results In pretreatment CT scan, single segment bowel involvement was found in 2 cases, multisegmental bowel involvement in 10 cases, and no positive finding in 1 patient. The duodenum and jejunum were involved in 8 patients and stomach in 5 patients. The diseased bowel wall showed swelling and thickening with decreased attenuation and homogeneous luminal narrowing with equivocal lining and double loop sign. Infiltration was found in 10 patients, small ascites in 3 patients. Patients were misdiagnosed as acute pancreatitis in 2 cases, acute cholecystitis, small bowel obstruction and peritonitis in 1 case respectively. Of 13 patients, five patients were cured, and the other 8 patients were improved. The clinical symptoms including rash, abdominal pain, occult blood, leukocytosis, vomiting, melena, urine occult blood were improved (χ2=5.59-18.33,P<0.05 orP<0.01). Post treatment CT showed significant improvement of bowel edema and infiltration (P<0.01). There was no statistically significant difference in change of ascites (P>0.05).Conclusion MSCT findings of AAP are nonspecific. CT diagnosis is difficult before skin rash. Combining CT characteristics of multisegmental bowel edema and clinical manifestations is helpful. CT examination can effectively follow up treatment response.

Objective To observe the clinical effects of insulin glargine combined with novonorm in treatment of patients with newly diagnosed type 2 diabetes. Methods 112 cases of newly diagnosed type 2 diabetes patients were randomly separated into observation group(56 cases)and control group(56 cases). Observation group was treated with insulin glargine combined with novonorm. Control group was treated with novolin30R. The levels of FPG,2hPG and HbA1c before and after treatment,the control time of blood sugar,amounts of insulin and incidence of low blood sugar were observed in both groups. Results Compared with pre-treatment, FPG,2hPG and HbA1 c were significantly decreased (all P ＜0.05) after treatment, but there were no significant differences in both two groups (P ＞0. 05). The control time of blood sugar, amounts of insulin and incidence of low blood sugar in observation group were significantly lower than those in control group (all P ＜ 0.05). Conclusion Insulin glargine combined with novonorm in treatment of patients with newly diagnosed type 2 diabetes could effectively control blood sugar,shorten the control time of blood sugar,decrease amounts of insulin,and low incidence of low blood sugar.

Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

AIM: To construct human Egr-1 promoter luciferase reporter system and study its activity induced by i-onizing radiation. METHODS: Egr-1 promoter was obtained by human genomic PCR and cloned into pGL3-basic vector. After transfection of recombinant plasmid into human tumor cells, the Egr-1 promoter activity induced by ionizing radiation was detected by luciferase reporter assay. RESULTS: The luciferasy reporter system of Egr-1 promoter was successfully constructed. The activity of Egr-1 promoter was substantially increased after different doses of IR and reached to the peak at the time point of 48h after IR. CONCLUSION: The Egr-1 promoter was constructed in this study showed IR inducible activity in tumor cells, laying foundation for the research of radiation, mediated gene therapy.

Objective To evaluate the diagnostic value of multi-slice computed tomography (MSCT)for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound (US)examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias (P =0.000).On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans (P = 1.000 ).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis (P =0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias (P =0.01 9).Furthermore,MSCT can exactly reveal the complications of incisional hernias (7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.

Objective To investigate the hemostatic effect of Bletillastriata hemostatic sponge .Methods Tail hemor‐rhage model in rats was preparation .Another model was established in liver and spleen hemorrhagic model of rabbits ,Beagle dog's abdominal aorta and liver were made .Hemostasis was performed with medical gauze ,gelatin sponge and Bletillastriata hemostatic sponge .The hemostatic effects were evaluated by total blood loss ,hemostatic time and histological observation . Observation of Bletillastriata hemostatic sponge change was completed to determine their degradation in the bodies .Results Rats tail hemorrhage was clamped ,after 1 min , Bletillastriata hemostatic sponge could effectively stop the bleeding .The Bletillastriata hemostatic sponge has good hemostatic effect of rats tail hemorrhage model compared to blank group(P<0 .01) . Compare with the gelatin sponge group ,the Bletillastriata hemostatic sponge could significantly shorten the liver and spleen bleeding time(P<0 .05) ,decrease the volume of the spleen bleeding(P<0 .05) and the liver bleeding(P<0 .01) ,in hemor‐rhagic model of rabbits .Compared with the gelatin sponge group ,Bletillastriata hemostatic sponge could more effectively stop the bleeding in the abdominal aorta and liver model of Beagle dogs (P<0 .05) .The Bletillastriata hemostatic sponge could be degraded in vivo .Histologic study revealed the Bletillastriata hemostatic sponge was no significant pathological change around the liver and spleen .Conclusion The Bletillastriata hemostatic sponge has good hemostatic effect .The hemostatic effect of Bletillastriata hemostatic sponge is better than gelatin sponge ,which could be a good topical hemostatic material .

OBJECTIVE: To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. METHODS: Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. RESULTS: Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann: excellent facial nerve function (House-Brackmann I–II level) cases accounted for 75.2% (79/105), facial nerve function III–IV level cases accounted for 22.9% (24/105), and V–VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I–II level) was 74.4% (58/78). CONCLUSION: Acoustic neuroma patients after surgery, the long-term (≥1 year) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient’s age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.
Acoustics* ; Colon, Sigmoid ; Facial Nerve* ; Humans ; Hydrocephalus ; Microsurgery ; Mortality ; Neuroanatomy ; Neuroma, Acoustic* ; Outpatients ; Recurrence ; Retrospective Studies ; Telephone