Objective To explore the CT appearances of solitary pulmonary metastases(SPM)in order to improve the level of CT diagnosis of SPM.Methods The CT findings of 21 cases with SPM proved by pathology were analyzed retrospectively . Results 1.The distribution of lesions:in 21 cases with SPM were:10 ( 47.6% ) niduses in left lung , 11 ( 52.4% ) lung in right ;3 (14.3% ) in bilateral superior lobuses ( excluding segmentum lingulare ),5 ( 23.8% ) in lobus medius and segmentum lingulare,13 ( 61.9% ) in inferior lobuses;14(66.7%)in external 1/3 of lung field,5(23.8%)in middle 1/3 and 2(9.5%)in interior1/3; 2.The diameter of lesions were:d3 cm(4,19.0%). 3.The shape and the margin of lesions were:circular or ellipse niduses with smooth surface and clear tumor-lung interface in 15 ( 71.4% ) ,irregular-shaped niduses in 6 ( 28.6% ) , with lobulation sign in 3 , spiculae in 2 , pleural indentation,bronchovascular bundles and halo in 1 respectively ; 4.The density of lesions were:Uniform soft tissular density in 16 cases(76.2%),calcification in 2,cavity in 1 and necrotic area in 2; 5.In all 21 cases,it was not found that SPM invaded bronchi nearby .Conclusion SPM has some certain characterizes on CT,but only by combining CT appearances with clinic and pathology,its correct diagnosis can be done.

OBJECTIVE: To observe the protective effects of Corydalis ambailis migo total alkaloids (COAMTA) on cerebral ischemia/reperfusion injury in rats and to investigate its mechanism. METHODS: The effects of COAMTA on decapitated gasping mouse model and rat model of middle cerebral artery ischemia (2 h)/reperfusion (22 h) were observed. The neurological scale, cerebral infarcted volume and cerebral water content subjected to cerebral middle artery ischemia/reperfusion in rats were recorded. The activities of nitric oxide synthase (NOS) and superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in the ratso brain were measured. Cell apoptosis in ischemic penumbral area was observed with light microscope in the method of terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL). RESULTS: The average gasping time of the mice (6.0 mg/kg or 9.0 mg/kg COAMTA) was significantly prolonged, the cerebral infarcted volume and cerebral water content of the rats (5.0 mg/kg or 7.5 mg/kg COAMTA) were significantly decreased, as compared with the control groups. The average activity of SOD in cerebral tissue of the rats (5.0 mg/kg or 7.5 mg/kg COAMTA) was significantly higher than that of the control groups, meanwhile, the average activity of NOS and the content of MDA declined significantly. The cell apoptosis in ischemic penumbral area of the rats (5.0 mg/kg COAMTA) was significantly inhibited as compared with the control groups. CONCLUSION: COAMTA can facilitate the protection against cerebral ischemia/reperfusion damage. The mechanism is related to inhibiting the activity of NOS and lipoperoxidation, increasing the activity of SOD and decreasing the neuronal apoptosis.

Objective To study the relationship between the expression of inducible nitric oxide synthase(iNOS)and neural cell apoptosis after chronic cauda equina compression. Methods Totally 30 male adult SD rats were randomly divided into 2 groups as the control group and the experi?mental group. The control group received sham operation with single laminectomy of L5 lumina. In the experimental group,the silicon sheet was in?serted into the spinal canal of L4 to cause single level compression of cauda equina. The L4 level of spinal cords were harvested at 2 weeks,4 weeks,8 weeks,and 12 weeks after operation in the experimental group,and at 4 weeks in the control group respectively,and then immunohistochemistry and image analysis were performed to observe the expression of iNOS in spinal cord and the TUNEL method was applied to observe cell apoptosis. The morphology of cells was observed by transmission electron microscope. Results There was few amount of iNOS expressed in the control group. The expression of iNOS was slight at 4 weeks in the experimental group and was higher at 8 weeks and 12 weeks compared with the control group. Small amount of neural cell apoptosis was evidenced in the control group,while neuron apoptosis appeared remarkably in the experimental group since 4 weeks and increased with the extension of time. Transmission electron microscopy found apoptosis changes in neurons in the experimental group. Conclusion The expression of iNOS increases in corresponding spinal cords after chronic compression of cuada equine and neural cell apoptosis oc?curs,indicating that iNOS is positively correlated with neural cell apoptosis.

Objective To perspectively evaluate the long-term efficacy of low dose leflunomide in treatment of rheumatoid arthritis.Methods Twenty-eight patients with rheumatoid arthritis were randomly divided into treatment group( n =15 ) and control group ( n =13 ).The patients in treatment group were treated with low dose leflunomide( omitting the loading dose) and with maintenance dose of 10 mg/day.And the patients in control group were treated with sulphasalazine in the dose of 1.5 ～ 2.0 g/d.The observation lasted for 18 months and the observed indicator were as follows:( 1 ) The primary efficacy indicators:counts of swollen and tender joints,overall assessment of disease status made by patients and physicians; ( 2 ) Secondary efficacy indicators:pain visual analogue scale,duration of morning stiffness,health assessment questionnaire (HAQ),Creaction protein,the American College of Rheumatology Outcome Assessment (ACR20,50).Results Eighteen months after treatment,the primary efficacy indicators in the treatment group were superior to the control group ( swollen joint counts:( - 8.5 ± 6.3 ) vs ( - 7.9 ± 6.4) ; overall assessment by patients:( - 1.4 ± 0.8 ) points vs ( - 1.2 ± 0.6) points; overall assessment by physicians:( - 1.4 ± 1.2 ) points vs ( - 1.3 ± 0.9 ) points; P ＜0.01 ).In the secondary efficacy indicators,pain visual analogue scale,duration of morning stiffness and health assessment questionnaire(HAQ) in the treatment group were significantly improved compared with the control group(VAS score:( - 32.4 ± 23.7) points vs ( - 31.6 ± 24.8) points; duration of morning stiffness:( [ - 97.8 ± 6.2 ] min vs [ - 92.4 ± 5.2 ] min; HAQ:[ - 0.62 ± 0.08 ] points vs [ - 0.57 ± 0.02 ] points,P ＜0.01 ),there was no significant difference on the percentage of patients achieving ACR20 standard between the treatment group and the control group (76.9％ vs 75.0％,P ＞ 0.05 ),but there was significant difference on the percentage of patients achieving ACRS0 standard between the treatment group and the control group( 61.5％ vs 47.0％,P ＜ 0.05 ).The gastrointestinaladverse reactions for patients in the treatment group were mild and there were 2 cases of elevated blood pressure,2 cases of elevated liver enzymes and 2 cases out of the trail,in the control group,there was 1 case out of the trial.Conclusion The long-term treatment of active rheumatoid arthritis with low dose leflunomide can achieve exact efficacy and good tolerability compared with the treatment with sulfasalasine.

Aim To study the protective effects of Rhynchophyll a of total alkaloids ( RTA ) on cerebral ischemia/reperfusion injury and the possi ble mechanism of action. Methods The effects of RTA on decapit ated gasping model and model of middle cerebral artery ischemia 2 h/reperfusion 22 h were observed. The neurological scores, cerebral infarct volume and cerebr al water content after ischemia/reperfusion were observed in rats respectively. The activities of NOS and SOD and the content of MDA in rat's brain tissue were measured. Neuron apoptosis in ischemia penumbral area were detected by terminal depoxynucleotidyl transferase mediated dUTP-biotin nick end labeling ( TUNEL ) . Results The average gasping times in mice treated with RTA 50 , 75 mg?kg -1 was significantly prolonged. The cerebral infarct volume and cerebral water content in rats treated with RTA 40, 60 mg?kg -1 were sign ificantly decreased in ischemic rats. RTA 40, 60 mg?kg -1 increased the ac tivity of SOD ,and decreased the activity of NOS and the content of MDA in the i schemic brains of rats. The number of apoptotic neurons in ischemia penumbral ar ea of cerebral tissue of rats treated with RTA 40, 60 mg?kg -1 was signif icantly lower than that in control rats. Conclusions RTA has pr otective effect on cerebral ischemia/reperfusion injury; this may be related to inhibit the activity of NOS and lipoperoxidation, and increasing the activity of SOD and decreasing neuron apoptosis.

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.

Smart dressings, which show obvious advantage and potential in wound treatment and real-time monitoring, attract widespread attention in recent years. Real-time and dynamic acquiring wound information is vital to the treatment and prognosis of wound. Further research on smart dressings is helpful for wound management, personalized treatment, and realization of medical application translation of health monitoring technology. In the article, we categorize smart dressings and conclude their functions according to the type of micro-environment information of wound gathered by smart dressings.

Objective:To evaluate the efficacy of botulinum toxin A injection therapy with ultrasound-guided for benign masseter hypertrophy.Methods:Twenty cases (40 sides) of masseter hypertrophy were injected with botulinum toxin A, among which 10 cases were taken as experimental group and the other 10 cases as control group. The experimental group had preoperative ultrasound examination to measure the thickness of masseter, and use ultrasound-guided precise injection during the operation, and then ultrasound recheck to measure the postoperative masseter thickness; The other 10 cases of control group adopt traditional 3-point injection method.Results:The masseter thickness of the two groups at different period of times after treatment was decreased ( P<0.001), the most obviously decrease happened 4-12 weeks after injection. The mean reduction was 26.8% at 4 weeks and 28.4% at 12 weeks after injection. Masseter muscle thickness recovered by 22% at 24 weeks and by 20% at 36 weeks. The average follow-up was 6.0±2.4 months with no serious complications occurred. In the control group, there was a partial masseter bulge in one case. The satisfactory rate of the patients in the experimental group was higher than that of the control group. Conclusions:Botulinum toxin A injection therapy with ultrasound-guided for benign masseter hypertrophy is an effective treatment, which is more accurate and effective than the traditional injection method.