Objective To measure the normal cerebrospinal fluid of the midbrain aqueduct peak velocity of different age groups by using magnetic resonance imaging (MRI) time‐spatial labeling inversion pulse (time‐SLIP) ,and to discuss the flow law of CSF . Methods Forty‐one cases of healthy volunteers ,including 23 cases of male ,18 cases of female ,aged 7 -73 .Patients were divided into 4 groups:7- <15 age group (n=11) ,15- <35 age group (n=10) ,35- <45 age group (n=9) ,≥45 age group (n=11) .We used the application of Toshiba 1 .5 T MRI head coil ,MRI sequence of time‐SLIP marked CSF to calculated the peak velocity of CSF in the midbrain aqueduct and measure the diameter and length of the midbrain aqueduct .Results The peak flow velocity be‐tween the 7- <15 age group and 15 - <35 age group ,35 - <45 age group ,≥45 age group were statistically significant (P<0 .05);inner diameter and length were no statistically significant difference (P>0 .05) between age .Conclusion In the midbrain aqueduct ,CSF is two‐way flow and supports the CSF of the pulsatile flow theory ;MRI sequence of time‐SLIP could measure CSF velocity and display the turbulence fluiding .

Objective To investigate the clinical value of dual‐source CT (DSCT ) in assessing adult congenital heart disease (ACHD) .Methods The data in 29 ACHD patients with DSCT were retrospectively analyzed .Results Among 29 cases ,the major‐ity suffered from two or more cardiovascular malformations ,in which 20 cases had intracardiac malformations ,including 4 cases (13 .79% ) tetralogy of Fallot ,6 cases (20 .69% ) were atrial septal defect ,4 cases(13 .79% ) were bicuspid aortic valve (13 .79% ) and 8 cases (27 .58% )were ventricular septal defect ;19 cases had extracardiac malformations ,in which 3 cases(10 .34% ) were co‐arctation of the aorta ,4 cases (13 .79% ) were patent ductus arteriosus ,3 cases (10 .34% ) were transposition of the great arteries and 5 cases (17 .24% ) were anomalous pulmonary venous connection .Conclusion DSCT could not only clearly demonstrate the cardiovascular malformations in ACHD patients ,but also conduct the observation on the lung ,trachea and bronchia ,which can pro‐vide detailed anatomic information for surgery .

Objective To investigate the value of 64-slice spiral computed tomography(CT)angiography in preoperative evaluation of spinal vascular intervention.Methods Seventeen patients with segmental injury of the spinal cord underwent the enhanced 64-slice CT scan of the spine.Thin-slice reconstruction was done,with the slice thickness of 0.625 mm and interval of 0.625 mm.The data were transferred to the work station ADW4.2 in DICM format.Image postprocessing technologies such as volume rendering(VR),maximum intensity projection(MIP)and multi-planar reformat(MPR)were used to conduct three-dimensional reconstruction and analyze the anatomical characteristics of radiculomedullary artery.Results Radiculomedullary artery could be found in the thoracolumbar segment of 16 patients(16/17,94%).Among them,one artery(1/17,6%)went into the vertebral canal through the left intervertebral foramen of T4/5,two(2/17,12%)through the left intervertebral foramen of T10/11,one (1/17,6%)through the left intervertebral foramen of T11/12,four(4/17,24%)through the left intervertebral foramen of L1/2,two(2/17,12%)through the left intervertebral foramen of L2/3,two (2/17,12%)through the right intervertebral foramen of T11/12,two(2/17,12%)through the right intervertebral foramen of T12/L1,two(2/17,12%)through the right foramen of L2/3 andl0(10/17,59%)through the left intervertebral foramen.Either CT scan or DSA examination found no radiculomedullary artery in one patient.All the above findings were in accordance with the results of DSA examination.Conclusions Spiral 64-slice CT scan can provide significant preoperative evaluation information for spinal vascular intervention,for it can accurately and visually show the anatomical features of the radiculomedullary artery such as open position,flow tendency,caliber size and spatial relationship with the surrounding vessels.

Objective To assess the value of pulmonary artery CT obstruction index for the evaluation of the severity of pulmonary embolism (PE),and to investigate the relation between pulmonary artery CT obstruction index and D-dimer levels.Methods 125 patients were diagnosed as PE by computed tomographic pulmonary angiography (CTPA)and D-dimer.Patients were separated into high-risk group and non-high risk group.CT obstruction index,D-dimer levels,diameter of the pulmonary artery were compared between two groups. Spearman’s rank correlation coefficients were used to assess the correlation between the CT obstruction index and the D-dimer levels,diameter of the pulmonary artery.Results CT congestion index of high-risk PE group was obviously higher than that of the non-high risk group (P=0.000).The diameter of pulmonary artery in high-risk PE group was obviously greater than that of the non-high risk group,the difference was statistically significant (P=0.000).No statistically significant difference was found in D-dimer levels between the two groups (P=0.103).There was no correction with CT congestion index and D-dimer levels(P=0.71).Conclusion The D-dimer levels of serum was a predictor of pulmonary embolism,cannot evaluate the severity of PE.CT obstruction index can reflect the severity of PE in some extent as an indicator of PE,there was no correlation with CT obstruction index and D-dimer levels.

Objective　To investigate the relationship betwee n tricuspid insufficiency (TI) and the function of the right ventricle, degree o f pulmonary vascular pathological change in patients with rheumatic heart diseas e so as to provide the indication of operation for treating TI. Methods 　41 cases of rheumatic heart disease with TI accompanying with bicuspid pathological changes were reviewed. Correlation analysis was done between the s everity of TI and the right ventricular size(RVS), pulmonary artery pressure(PAP ), pulmonary artery resistance(PAR) etc. Results　It was found t hat the size of the right ventricle, PAP, PAR were positively correlated to th e degree of TI. Tricuspid annuloplasty should be carried out in patients with RV D>40 mm, PAR >48 kPa*s/L, PAP>8 kPa. Conclusion　TI resulted ma inly from insufficient function of the right ventricle and marked patholog ical changes of the pulmonary blood vessels. Doppler echocardiography evaluation for the function of right ventricle and pathological condition of pulmonary blo od vessels might be of significant in deciding whether tricuspid annuloplasty sh ould be performed simutaneously in patients of bicuspid valve replacement.

OBJECTIVEThrough determination of the dynamic change of the active component in different parts of Prunella vulgaris at different growth stages, to find the optimal harvest time.

METHODTotal flavonoids content was determined by using the spectrophotometric method, and the content of ursolic acid and oleanolic acid was determined by HPLC. The contents of ash and extract were determined according to the methods in Chinese Pharmacopeia (2005 edition).

RESULTThere existed the active components in all parts of P. vulgaris, but the active component contents in different parts of P. vulgaris of at different growth stages, changed very obviously.

CONCLUSIONIn Yangtze-Huaihai region, the optimal harvest time of Prunella spike best harvest is at the end of June, and Prunellastem at the end of May. All parts of P. vulgaris have medicinal value.

BACKGROUNDTo evaluate the response, adverse effects and survival of MVP regimen and TVP regimen.

METHODSSixty six patients with advanced non-small cell lung cancer were randomized into two groups:MVP arm (32 patients, mitomycin C 6-8 mg/m² d1, vindesine 2-3 mg/m² d1 and d8, cisplatin 70-80 mg/m² d1) and TVP arm (34 patients, pirarubicin 40-50 mg/m² d1, vindesine and cisplatin were the same as arm MVP). Characteristics of the patients were similar in two arms. All patients received two to four cycles of chemotherapy.

RESULTSThe overall responses were 34% (11/32) in the MVP arm and 56% (19/34) in the TVP arm. There were 1 complete response, 10 partial responses in the MVP arm and 1 complete response, 18 partial responses in the TVP arm. TVP regimen appeared to have a higher objective response, but no statistically significant difference in the response was observed between two regimens (Chi-square=2.269, P=0.132). Main side effects were hematological toxicities. Grade III+IV hematological toxicities were significantly higher in the patients of arm TVP than arm MVP, especially neutropenia (79% vs 44%, Chi-square=7.458, P=0.006). Median survival time was 12 months vs 8 months, and 1-, 2-, 3-year survival rates were 53% vs 24% (Chi-square=4.943, P=0.026), 17% vs 6%, 6% vs 0, for arm TVP and arm MVP, respectively..

CONCLUSIONSMVP regimen has a lower response rate and longer survival time but less hematological toxicities than TVP regimen. The results suggest MVP regimen is a safe and active regimen for advanced non-small cell lung cancer.

BACKGROUNDTo investigate the immunohistochemical detected method and the clinical incidence of the bone marrow micrometastases (BMM) in patients with non-small cell lung cancer (NSCLC) and to analyze the sensitivity and specificity and clinical application value.

METHODSBone marrow samples were collected from the anterior superior iliac spines or posterior superior iliac spines of 53 patients with NSCLC in clinical stage I to III and 15 patients in stage IV, and the BMM was detected by immunohistochemical techniques (IHC) using monoclonal antibodies AE1/AE3 against cytokeratin. Chi-square test was used statistically.

RESULTSThe IHC sensitivity could be 10⁻⁵. The BMM positive rate was 22.6% (12/53) in stage I to III and 53.3% (8/15) in stage IV, and there was a significant difference in the BMM positive rate between stage I to III and stage IV (P < 0.05). No correlation was observed between BMM and sex, age, KPS, pathology classification and cancer cell differentiation.

CONCLUSIONSThe detection of BMM by IHC is convenient, sensitive, and specific. It might be helpful to diagnose bone marrow micrometastasis in patients with NSCLC.

Benign metastasizing leiomyoma (BML) often occurs in women with a history of uterine leiomyoma at the childbearing age. At the same time, BML cases with multiple sites of metastatic lesions are extremely rare. A BML patient with multiple metastases of uterine leiomyoma in two lung and lumbar spine after surgery was admitted to Department of Spinal Surgery, Second Xiangya Hospital, Central South University in September 2017. Positron emission tomography/computed tomography (PET/CT) can perform a whole body examination for BML patients, which can find metastases in many parts of the body such as lung, abdominal cavity, pelvic cavity and spine. The PET/CT results are helpful to a comprehensive diagnosis. The imaging and clinical features of BML are now explored in combination with the characteristics of the case and relevant literature reports.
Female ; Humans ; Leiomyoma ; Lumbar Vertebrae ; Lung Neoplasms ; Positron Emission Tomography Computed Tomography ; Uterine Neoplasms