Objective To investigate the pathology and MRI features of the degeneration of lumbar intervertebral discs (IVD). Methods Thirteen human lumbar spine segments with 31 IVDs were harvested from fresh cadavers. High quality radiographs were taken for all specimens. Five segments with 20 IVD underwent MRI. Then, the radiographic and MRI findings were correlated with corresponding 87 pathologic sections. Results Variant degeneration was observed in pathologic sections in all 31 IVDs. With MRI T 2WI images, 20 IVDs showed linear and spotty high signal in the annular fibers, or most of the IVD showed high signal. On pathologic cuts, 22 of 31 IVDs showed infolding of annular fibers, 18 of 31 showed outfolding of annular fibers. On MRI T 1WI and T 2WI images, infolding and outfinding of annular fibers were seen as low signal. 20 of 31 IVDs had necrotic debris of cells in the nucleus pulposus. 14 of 20 demonstrated spotty low signal areas on MRI T 2WI images.7 Schmorl nodules were found. On pathologic sections Schmorl nodules were seen as IVD tissue protruding into vertebral endplates, they were seen as high signal on T 2WI images. Two large fissures found on sections were seen as low signal on T 2WI. Degenerative fibrosis seen on 6 IVD, which showed intermediate signal on T 2WI images. However, radiographs only demonstrated osteophytes on 3 vertebrae, 7 Schmorl's nodules. Sclerotic, concave and irregular endplates were seen in 11 IVDs, the latter is the indication of cartilaginous endplate disruption. Conclusion MRI is very useful in demonstrating the degeneration of IVD, radiograph is able to indirectly show the disapperance of cartilaginous endplate.

Radiologic examination was carried out on 114 subjects with chondromalacia ofpatella with follow up study for 1～17 years.All patients had a history of injury and/or overstrainedknee. The main early X-ray findings were :subchondral bone absorption and cystic degeneration ofpatella,sclerosis and haziness of the articular surface of patella, formation of small spur,subchon-dral bone absorption of articular surface of the femur,synovial thickening,patellar ligament widenedwith indistinct margin, hazy reticular appearance of subpatella fat, and thickened quadriceps femoraltendon etc. The X-ray manifestations of patella and adjacent tissue of patella became progressivelymore obvious but sparing the soft tissue with elapse of time.

Objectives: To evaluate the influences of enteral nutritfion(EN), parenteral nutrition(PN) and major gastrointestinal operation on HLA DR, CRP and IL 10 level. Methods: A prospective, successive and controlled trial was taken. 39 non infection patients with intestinal fistula and severe acute pancreatitis were divided into EN group ( n =18) and PN group ( n =21). 8 patients with major gastrointestinal operation(OP) were taken as OP group.10 patients admitted with the diagnoses of cholecystopolyp and inguinal hernia were taken as control group. The blood levels of HLA DR, CRP and IL 10 were measured and compared between groups. Results: Compared to control group〔(96.35? 4.282)%〕, OP group〔(60.23? 10.419)%〕 and PN group〔(78.72? 13.21)%〕 had significant decreases ( P

Objective To evaluate spiral CT in diagnosing vascular complications of pancreatitis. Methods The clinical and surgical results and the CT findings of 316 patients with acute or chronic pancreatitis were comparatively analyzed. Special attention was paid to the CT findings of the patients with peritoneal hemorrhage and vascular abnormality. CT Hu of celiac blood effusion was measured. Pseudoaneurysms, phlebothrombosis and venous thrombosis of peripancreatic vessels in CT enhancement were carefully analyzed. Results Acute pancreatitis was found in 275 out of the 316 patients, and chronic pancreatitis in 41 cases. Among those with acute pancreatitis, 20 had peritoneal cavity vascular complications. In the 13 cases of peritoneal cavity hemorrhage(including 5 patients complicated with digestive tract hemorrhage), CT identified 11 with as regional or diffuse slight high density fluid collections, and failed in 2 cases. CT scans detected gastric varices in 4 out of 7 patients with digestive tract hemorrhage. Of those with chronic pancreatitis, CT found celiac artery pseudoaneurysm in one, spleen artery pseudoaneurysm in one and splenic vein thrombosis with gastric varices in one. Conclusions (1)Regional or diffuse slight high or high density fluid collections were common CT findings of peritoneal cavity hemorrhage. (2)Enhanced spiral CT scanning could demonstrate peripanreatic vascular pseudoaneurysms. (3)Varices in gastric fundus and necrosis in pancreatic body and tail often indicate the formation of spleen venous thrombosis.

Objective To evaluate the value of MRI in diagnosing pigmented villonodular synovitis (PVNS). Methods MRI appearance of 23 pathologically proven cases of PVNS was analyzed. Results In 23 patients with PVNS, 9 cases occurred in knee joint, 9 cases in hip, 3 cases in ankle, 1 in elbow, and 1 in wrist. X ray of the 23 patients could only show the joint effusion, and bony erosion was found in 19 cases. CT scan showed joint effusion and bony erosion more clearly than X ray in 4 cases. The typical MRI appearance included intra articular joint effusion and extensive synovial proliferation which led to progressive destruction of cartilage and bone. The pigmented villonodules showed nodular low signal on both T 1WI and T 2WI, especially in FFE/T 2WI. Conclusion MRI is the most effective modality in the diagnosis of PVNS.

Objective To investigate curative effects of hypothermia on the secondary axotomy of nondisruptive axonal injury (NDAI) after diffuse brain injury (DBI).Methods A total of 16 male Sprague-Dawley rats were randomly and equally divided into hypothermia group (at 32℃ for 6 hours) and control group (at 37.5℃ ).The axonal swelling and axonal balls were detected by means of NF68kD immunochemistry after DBI caused by fluid percussion.The changes of maximal density of axonal swelling and axonal balls in callosum,diencephalon-mesencephalon,pons-oblongata and cerebellum were compared 24 and 72 hours after injury between both groups.Results NF68kD immunochemistry well showed axonal swellings and axonal balls in whole brain.The axonal swelling and axonal balls were significantly decreased 24 hours after DBI in both groups (P<0.05),especially in diencephalon-mesencephalon ,pons-oblongata and cerebellum (P<0.01).While there showed significant decrease of axonal swellings and axonal balls in pons-oblongata and cerebellum in hypothermia group 72 hours after DBI (P<0.05,P<0.01) but insignificant changes in the callosum and the diencephalon-mesencephalon compared with control group (P>0.05 ).Conclusions Hypothermia can retard the progress of mild or severe NDAI at early stage,which would taper with the longer time after injury except for partial mild NDAI.Hypothermia may prevent mild NDAI from secondary axotomy.

Objective To compare the efficacy and safety of singular double antithrombotie therapy (DT) using warfarin plus clopidogrel and the combined antithrombotie therapy of 3-month triple antithrombotie therapy (TT) using warfarin, aspirinand clopidogrel and 9-month double antithrombotie therapy (DT) for the patients with atrial fibrillation undergoing PCI. Methods Ninety patients with atrial fibrillation undergoing PCI were randomly divided into two groups evenly: one group was treated with dual antithrombotic therapy group (DT) and the other group with the combined therapy, e. g. 3-month triple antithrombotie therapy (TT) and 9-month double antithrombotie therapy (DT + TT for short). All patients were followed-up by 12 months. The two groups were compared in terms of incidences of death , myocardial infarction , stroke , target-vessel revascularisation , stent thrombosis and bleeding adverse events. Results The incidences of myocardial infarction, stroke, target-vessel revascularisation , stent thrombosis and bleeding adverse events in the TT + DT group were all significantly lower than the DT group (P < 0.05). The follow-up on the safety indicated that the rate of bleeding in the TT +DT group was insignificantly higher than the DT group (P > 0.05). Conclusion There is no significant difference in safety between the two groups. However, the therapy of TT + DT is more effective.

Aim To observe the effect of eplerenone(EPL) and Chinese decoction on cell apoptosis in obstructive nephropathy rats.Methods Sixty male Wistar rats were randomly divided into sham group, UUO group, EPL group and ZY group(n=15).Except sham group, the rats in the other groups were ligated with unilateral ureteral obstruction(UUO) for renal interstitial fibrosis model.The rats were treated with eplerenone at 100 mg·kg-1·d-1 added to diet in EPL group, and orally 13.7 g·kg-1·d-1 decoction of Chinese medicine in ZY group.The kidneys were harvested on 14th day, the number of renal cell apoptosis were detected by TUNEL, and serum aldosterone and 8-OhdG were detected with radioimmunoassay and ELISA.Caspase-12, caspase-9, Bax and Bcl-2 were examined by immunohistochemistry and Western blot.Results The levels of serum aldosterone, serum and urine 8-OhdG and the number of positive apoptotic cells increased significantly in UUO rats compared with Sham group.The overexpression of caspase-9, caspase-12 and Bax and down-regulated Bcl-2 were obvious in UUO group(P<0.01).The level of 8-OhdG, expression of caspase-9, caspase-12 and Bax were down-regulated, and Bcl-2 expression was up-regulated in eplerenone and Chinese decoction treated rats(P<0.01).Conclusion Eplerenone and Chinese decoction could inhibit cell apoptosis induced by oxidative damage after UUO via caspases and(or) Bax pathway.

Objective To compare the short term clinical efficacy of percutaneous resection and laparoscopic deroofing of renal cysts.Methods From October 2013 to June 2016,the data from 39 cases with renal cysts were followed for approximately 22 months (ranging 5-36 months).Patients were randomized into two groups.In the resectoscopic group(17 pts),the mean age of those patients was 57 years (ranging 34-81 years).The mean size of these cysts was 6.4cm (ranging 5.4-8.2 cm).The mean preoperative creatinine was 66.5μmol/L (ranging 38.1-108.8μ mol/L).The mean preoperative sodium was 141.4μ mol/L(ranging 135.6-145.1μmol/L).The mean preoperative potassium was 4.0μmol/L (ranging 3.4-4.7 μmol/L).In the latter laparoscope (22pts),the mean age of these patients was 60 years (ranging 46-73 years).The mean size of these cysts was 6.8cm (ranging 4.3-8.9cm).The mean preoperative creatinine was 74.8μmol/L (ranging 48.6-141.9μmol/L).The mean preoperative sodium was 141.5μmol/L(ranging 135.0-146.1 μmol/L).The mean preoperative potassium was 4.0μmol/L (ranging 3.1-4.8μmol/L).The operative time,blood loss,days of drainage,hospital stay and complications were compared with the two groups.Results All of the 39 cases were accepted the procedure successfully without open conversion.Compared the resectoscopic group with Laparoscopic,the mean operative time was 29.7 min (ranging 15-50 min) and 63.0min (ranging 20-1 00 min),mean blood loss was 36.6ml(ranging 10-80 ml) and 60.4ml(ranging 10-200 ml),days of drainage was 2.3 days and 3.1 days,hospital stay was 3.7 days and 5.1 days,the mean postoperative creatinine was 67.4 μmol/L(ranging 43.8-95.5 μmol/L) and 68.9μmol/L(ranging 46.5-157.6 μmol/L),the mean postoperative sodium was 141.2μmol/L(ranging 136.0-147.2 μmol/L) and 141.6 μmol/L(ranging 136.0-147.2 μmol/L),the mean postoperative potassium was 3.8 μmol/L (ranging 3.2-4.3 μmol/L) and 3.8μmol/L (ranging 3.3-4.3 μmol/L).The overall postoperative pathology was renal cysts.All cases were followed for approximately 19 months (ranging 6-35 months) and 22 months (ranging 5-36 months) in reseetoscopic and laparoscopic group respectively.No cysts recurrence was found by ultrasound.Conclusions Compared with laparoscopic deroofing,use of resectoscopic technology significantly enhances the possibility of achieving better intraoperative results in all patients with renal cysts.Percutaneous resection of simple renal cysts is safe and feasible.

Aim To observe the effect of mineralocor-ticoid receptor blockade eplerenone on cell proliferation in obstructed kidney of rats. Methods Renal intersti-tial fibrotic animals were made with unilateral ureteral obstruction (UUO) and treated with eplerenone100 mg · kg - 1 · d - 1 . The kidneys were harvested on the 10th day and proliferating cell nuclear antigen ( PC-NA ), serum and glucocorticoid induced kinase-1 (SGK-1 ) and transforming growth factor-β1 ( TGF-β1 ) were detected with immunohistochemistry and Western blot. Results Renal histopathology showed large quantities extracellular matrix (ECM) accumula-tion in kidney with UUO, large numbers of inflammato-ry cells infiltrated in renal interstitium, renal tubular expansion and exfoliation of epithelial cells . The cell proliferation and ECM accumulation were inhibited in eplerenone treated rats significantly. Immunohisto-chemistry and Western blot showed that expressions of PCNA,SGK-1 and TGF-β1 were significantly up-regu-lated with UUO and down-regulated by eplerenone. Conclusion Eplerenone plays the role in inhibiting the cell proliferation and reducing ECM accumulation by down-regulating expression of SGK-1 pathway in rats with unilateral ureteral obstruction.