Adult ; Dimethylformamide ; adverse effects ; Glutathione ; blood ; Humans ; Male ; Methanol ; adverse effects ; Nitric Oxide ; blood ; Occupational Exposure ; Oxygen ; metabolism ; Superoxide Dismutase ; blood ; Surveys and Questionnaires ; Toluene ; adverse effects

Objective To compare the clinical results of open reduction and plate internal fixation and percutaneous kirschner-wire fixation in the management of distal radius fractures. Methods A retrospective comparison was done on clinical data of 110 patients with distal radius fractures who were treated by plate internal fixation and that of 107 by pereutaneous kirschner-wire fixation from January 2002 to June 2007. Results All patients were followed up for 5-12 months. According to Gartland and Werley scoring system, the excellent rate was 86.4% in plate internal fixation group, which was significantly higher than 74.8% in percutaneous kirschner-wire fixation group (P <0.05). As for type C3 fractures, the excellent rate of the two groups were 76.9% and 70.0%, with no statistical difference (P >0.05). Conclusions Compared with percutaneous kirschner-wire fixation, plate internal fixation is better in treatment of distal radius fractures, but has poor results in management of type C3 fractures.

Objective To study the clinical characteristics, diagnosis, and treatment of patients with persistent low levels of β-hCG. Methods To analyze the clinical data of 6 patients with persistent low level of β-hCG retrospectively and review the relevant literature. Results The periods of low levels of β-hCG in the 6 patients were 10-53 months. The range of β-hCG was 3～637 U/L. The last pregnancy were hydatidiform mole in 5 cases and abortion in 1 case. After hydatidiform mole 5 cases were received multi-chemotherapy. Normal level of β-hCG maintained 1-12 months after chemotherapy, then β-hCG titer has gone up again, One patient developed lung metastases after 30 months and then cured by surgery and chemotherapy. There were no clinical evidence of malignancy in the other 4 cases, and 1 case received no therapy after abortion during course of therapy and following up. Conclusion Persistent low level of hCG was a special kind of disease with poor response to chemotherapy, but the majority were with stable status. Therapy should be restrained if there was no evidence of malignancy.

A female patient with hair cell leukaemia was treated with human leukocyte interferon at a daily dose of 1.5 ? 104 for 27 days. The bone marrow cells were studied with electron microsepy. The follow up investigation of the bone marrow hair cells revealed that there were widening of the perinuclear space, disintegration of nuclear membrane, vaeuolization as well as expansion of the rough endoplasmic retieulum

Objective To identify the imaging characteristics of calcifying pseudoneoplasms of the neuraxis (CAPNON) and do literature review.Methods Five patients of pathologically-proved CAPNON underwent preoperative MR examination,among which 4 underwent CT scan,2 underwent DSA examination and 1 underwent SPECT. All imaging data were retrospectively analyzed with the emphasis on imaging characteristics.Results Five patients of CAPNON with the diameter of 1.5 to 5.0 cm were found in five patients ( Male 4 ; Female 1 ; age 25 to 60 years old ).Three lesions were located in the skull base,one was located in the cervical spine and one in the foramen magnum and upper cervical segment. All patients underwent MRI examination and 4 of them also took CT scanning.On plain CT,all lesions showed obvious calcification.On T1WI all masses showed hypointensity,and on T2WI 4 of the lesions showed iso- or hypointensity and 1 heterogeneous signal intensity. On contrast-enhanced MR images, peripheral enhancement was demonstrated in 3 lesions,homogeneous enhancement was found in case and one lesion showed no enhancement. The pathologic analysis indicated that inside the lesions were abundant calcification,fibroepithelial tissue and mucoid matrix and no edema was detected around the lesions.Conclusions CAPNON displayed the predilection to male adults and the neuraxis was the predilection site.Calcification on CT images,hypointensity on MR images and peripheral enhancement will be helpful for the diagnosis of CAPNON,but the final confirmation still needs the pathologic results.

0.05).Conclusion DTI can noninvasive detect the potential disorder of corpus eallosum in vivo,thus providing useful information to differentiate the cerebral ischemia disease from multiple sclerosis.

Objective To study the changes of motor cortex in patients with amyotrophic lateral sclerosis(ALS)while executing sequential finger tapping movement by using blood oxygenation level dependent(BOLD)functional MRI.Methods Fifteen patients with definite or probable ALS and 15 age and gender matched normal controls were enrolled in the BOLD study,and all the subjects were right-handed with no other diseases or any recent medication history.A 3.0 T MR scanner was employed and gradient echo EPI(GRE-EPI)sequence was used to acquire the functional images.Subjects executed sequential finger tapping movement at a frequency of 1-2 Hz during a block design task.fMRI data were analyzed by using statistical parametric mapping(SPM)2.Volume of activated brain areas was compared with the use of a Student's t-test.Results Bilateral primary sensorimotor cortex(PSM),bilateral posterior aspect of premotor area(PA),bilateral supplementary motor area(SMA),contralateral inferior lateral premotor area (ILPA),bilateral parietal region(PAR),and ipsilateral cerebellum showed activation in both ALS patients and normal controls when executing the same motor task.The activation areas in bilateral PSM and bilateral posterior aspect of PA(right hand ipsilateral activation:ALS(924.5±141.1)mm3,control(829.9±98.4)mm3,P=0.05;right hand contralateral activation:ALS(9143.8±702.8)mm3,control(8638.8±506.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(1162.5±357.4)mm3,control(902.5±184.2)mm3,P＜0.05;left hand contralateral activation:ALS(8255.2±870.2)mm3,control (5934.6±616.4)mm3,P＜0.05),bilateral SMA(right hand bilateral activation:ALS(6564.3±720.6)mm3,control(4710.7±416.3)mm3,P＜0.05;left hand bilateral activation:ALS(6970.5±961.8)mm3,control(3688.9±672.3)mm3,P＜0.05),and ipsilateral cerebellum(right hand ipsilateral activation:ALS(2720.0±1154.2)mm3,control(254.3±84.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(4794.4±1237.0)mm3,control(1689.0±719.6)mm3,P＜0.05)were significantly larger in ALS patients than in normal controls.Extra activation areas including ipsilateral ILPA,contralateral cerebellum and bilateral posterior limb of internal capsule were only detected in ALS patients.Conclusions Similar activation areas were seen in both groups while executing the same motor task,but the activated areas were more prominent in ALS group.The increased activation areas in ALS patients may represent neural reorganization.while the extra activation areas in ALS patients may indicate functional compensation.

Objective To evaluate gray matter volume,white matter volume and FA value changes in amyatrophic lateral sclerosis(ALS)patients by voxel-based morphometry(VBM)and voxel-based diffusion tensor analysis(VBDTA).Methods Thirty-nine definite or probable ALS patients diagnosed by El Escorial standard and 39 healthy controls were recruited and underwent conventional MR scans and the neuropsychological evaluation.The 3D FSPGR T_1WI and DTI data were collected on GE Medical 3.0 T MRI system.The 3D T_1 structural images were normalized,segmented and smoothed,and then VBM analysis was performed.DTI data were acquired from 76 healthy controls,and FA map template was made.FA maps generated from the DTI data of ALS patients and healthy controls were normalized to the FA map template for voxel-based analysis.ANCOVA was applied,controlling with age and total intracranial volume for VBM and age for VBDTA.A statistical threshold of P＜0.01(uncorrected)and cluster level of more than continuous 20 voxels determined significance.Results Statistical results showed no significant difference in the global volumes of gray matter and white matter,total intracranial volumes and gray matter fraction between ALS patients and healthy controls,but the white matter fraction of ALS patients(0.29±0.02)was significantly less than that of healthy controls(0.30±0.02)statistically(P=0.003).There was significant reduction of gray matter volumes in bilateral superior frontal gyri and precentral gyri,right middle frontal gyrus,right middle and inferior temporal gyrus,left superior occipital gyms and cuneus and left insula in ALS patients when compared with healthy controls;and the regional reduction of white matter volumes in ALS patients mainly located in genu of corpus callosum,bilateral medial frontal gyri,paracentral lobule and insula,right superior and middle frontal gyrus and left postcentral gyrus.VBDTA showed decrease in FA values in bilateral parahipocampal gyri and cingulate gyri in ALS patients compared with healthy controls.Conclusions VBM and VBDTA analysis results suggest that ALS is not simply a motor neuron disease but a multisystem disorder;and VBDTA has a potential value for the detection of FA value changes of cingulate and parahippocampal gyral white matter in suspected cognitive impairment of ALS patients.

Objective To investigate the probable risk factors for type 2 diabetic patients complicated nonalcoholic fatty liver disease (NFLD)in elderly, through comparing the body composition, serum lipid profile, incidences of abdominal obesity and metabolic syndrome (MS) between elderly type 2 diabetic patients with and without NFLD. Methods The enrolled elderly type 2 diabetic patients were divided into NFLD group (n=83) and non-NFLD group (n=85). Their clinical data including body composition, serum lipid profile, incidences of abdominal obesity and MS were analyzed retrospectively and compared. Results Compared with non-NFLD group, the BMI [(26.9±2.5) kg/m~2 vs. (24.1±2.5) kg/m~2, P=0.000], waist-hip ratios (WHR) ((0.92±0.07) vs. (0.87±0.06), P=0.000], total body fat percentage [(29.6%±6.6%) vs. (25.3%±5.5%),P=0.000], abdominal fat [(11.0±2.5) kg vs. (8.7±2.3) kg, P=0.000], visceral fat [(3.0±0.7) kg vs. (2.3±0.6)kg, P=0.000], visceral fat area [(97.6±22.2) cm~2 vs. (75.5±21.1) cm~2,P=0. 000], serum triglyceride [(1.98±0.94) mmol/L vs. (1.22±0.61) mmol/L, P=0.000]were all increased, while serum HDL [(1.23±0.32) mmol/L vs. (1.40±0.37) mmol/L, P=0.002]was decreased in NFLD group. The incidences of over-body fat (68.7% vs. 36.5%, P=0. 000),dyslipidemia (47.0% vs. 21.2%, P=0. 000), abdominal obesity (69.9% vs. 43.5%, P=0.001) and MS (49.4% vs. 9.6%, P=0.000) were obviously increased. But there were no statistical differences in serum TC [(4.93±0.94) mmol/L vs. (4. 73±1.07) mmol/L, P=0.219]and LDL [(3.23±0.80) mmol/L vs. (3. 07±0.89) mmol/L, P=0. 229]between the two groups. Logistic regression showed that high BMI (β=1.268, P=0.000, OR=3.56), over-total body fat percentage (β=0.902, P=0.023, OR=2.47)and the existence of MS (β=1. 664, P=0. 000, OR=5.28) were related to elderly type 2 diabetic patients complicated NFLD. Conclusions The high BMI, over-total body fat percentage are related to elderly type 2 diabetic patients complicated NFLD, and NFLD is probably one of components of metabolic syndrome.

Objective To evaluate anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol in patients undergoing short surgery. Methods Fifty ASA Ⅰ or Ⅱ patients who scheduled for elective surgery under general anesthesia were enrolled in study. The anesthesia was induced with intravenous injection of midazolam 0.03 mg/kg and sevoflurane inhalation. Induction of anesthesia was started with 6% sevoflurane and fresh gas flow rate of 6 L/min. The inspired concentration of sevoflurane was reduced to 2% as soon as eyelash reflexes of these patients were abolished. At the same time, remifentanil 2 μg/kg was injected slowly over 1 min,and 30 s later,patients were mechanically ventilated after tracheal intubation. 2% sevoflurane was kept inhaling, and remifentanil and propofol were kept pumping for anesthesia maintenance. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO_2) and bispectral index (BIS)were recorded before administration,at the time of the disappearance of eyelash reflex, immediately before tracheal intubation,and immediately after tracheal intubation. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was also recorded. And conscious recovery, spontaneous breathing recovery,the endotracheal extubafion time and OAAS score were recorded. Results All patients were successfully intubated at the first attempt. The satisfactory intubation conditions were found in 82% (41/50) of cases. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was (73 ± 12) s. MAP,heart rate and SpO_2 remained stable and BIS was maintained at 45-55 before and after tracheal intubation, and all patients were quick recovery. Conclusion The anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol without muscle relaxant in patients undergoing short surgery is smooth, safe and reliable.