Moyamoya disease is a cerebrovascular disease w hich is characterized by progressive cerebrovascular stenosis and occlusion. The direct and indirect revascularizations modalities are the preferred methods for the treatment of moyamoya disease now . This article review s the surgical modalities of moyamoya disease.

Objective To explore the value of water -based material decomposition images for detection of bone marrow edema (BME)in sacroiliitis with energy spectral CT.Methods The sacroiliac (SI)joints of nine spondyloarthropathy patients with sacroiliitis (the research group)and eight healthy volunteers (the control group) were underwent MRI and energy spectral CT.The mixed energy image of energy spectral CT was reconstructed to be mono energy image.Then,the mono image was divided into water -based image and calcium image by material divid-ed and analyzed software.The SI para -articular marrow region water -calcium relative concentration of research group was compared with that of control group.The BME diagnosis efficiency and optimal water -based concentration of energy spectral CT was analyzed by receiver operating characteristic (ROC)curve.Then,the sensitivity,specificity, positive likelihood ratio and negative likelihood ration were calculated.Results The water -based concentration of BME in research group (1 067.43 ±10.84)g/L was higher than that of control group (1 039.43 ±8.01)g/L(t =-3.14,P =0.003).Meanwhile,the calcium -based concentration of research group (68.98 ±20.53)g/L was not different from control group (78.03 ±26.39)g/L(t =1.88,P =0.066).ROC curve showed that the diagnosis efficiency was medium as the area of under curve was 0.75.When the optimal concentration of water -based was 1 052.00g/L,the diagnosis efficiency was the best.The sensitivity and specificity was 84.00%,62.50% respectively. Conclusion There are reference value and potential clinical value with energy spectral CT water -based concentra-tion detection for diagnosis BME in patients with sacroiliitis.

Objective To provide imaging anatomy basis for percutaneous nephrolithotomy ( PCNL) by measuring relative displacement and changes in anatomical position of kidney and colon under the prone and low-oblique supine positions.Methods Forty-six patients scheduled for PCNL underwent 64-slice spiral CT scan under the prone and low-arch oblique supine position before the PCNL.The horizontal distance of kidney and colon,the distance from colon and analog puncturing line,the distance between the kidney and colon were measured and compared between the 2 positions.Results The distance from colon and analog puncturing line under the low-oblique supine and prone positions were as follows,the left (26.56 ±15.36) mm versus (12.25 ±13.16) mm (t=3.527,P<0.05),the right (25.85 ±14.26) mm versus (13.57 ± 12.53) mm (t=3.234,P<0.05).The differences of the rest distances between the 2 positions were not significant ( P>0.05).Conclusions The distance between colon and analog puncturing line increases in the low-arch oblique supine position,because the colon shifts to the ventral.The PCNL in low-arch oblique supine position may reduce the incidence of colon injury,and improve surgical safety.

Objective To study the clinical characteristics,treatment and prognosis of neonatal VACTERL association.Method The clinical data of newborns diagnosed with VACTERL association from January 2010 to December 2015 were collected and retrospectively analyzed.Result A total of 33 patients diagnosed with VACTERL association were included,including 23 males and 10 females.Among them,17 cases were term infants,15 cases premature infants and 1 case of overdue birth,with an admission age of 1 to 24 days.The most common deformities were cardiac anomalies (C) in 27 cases (81.8％),followed by anal atresia/anorectal malformation (A) in 25 cases (75.8％),renal deformity (R) in 24 cases (72.7％),limb abnormalities (L) in 20 cases (60.6％),Tracheoesophageal fistula (TEF) in 8 cases (24.2％) and vertebral abnormalities (V) in 3 cases (9.1％).11 cases (33.3％) had other deformities.Among these 33 patients,24 cases had 3 types of malformations and 9 cases had 4 types of malformations.The most common combination was ACR (n =8).20 patients had no abnormalites on chromosome karyotype test including 2 patients had normal gene microarray results.16 patients received surgical treatment during neonatal period and 13 of them recovered and discharged.Among the other 17 cases received no surgery,only 1 patient improved and discharged.A telephone follow-up was proceeded in 14 discharged cases at 1 year old.Among them,13 cases had good prognosis,however,the remaining one was dead.Conclusion VACTERL association is a rare non-random combination of multiple malformations.The early discovery and appropriately treatment after diagnosis will improve the prognosis and prevent death.Doctors should reinforce the ability to detect various types of deformities and examine the chromosome and gene properly.

Objective To investigate the effect of di-(2-ethylhexyl) phthalate (DEHP) on the postnatal lung development in newborn rats.Methods A total of 60 newborn Sprague-Dawley rats (weighing 5.0-8.0 g) in five age groups were studied in the first experiment.The rats were divided based on the different postnatal ages:postnatal day (PND)I,PND4,PND7 and PND14.A total of 45 newborn Sprague-Dawley rats (weighing 5.0-8.0 g) were randomly divided into three groups according to the dosage of DEHP administered in the second experiment.The newborn rats were administered DEHP through intraperitoneal injection at 10 (low-dose subgroup),100 (medium-dose subgroup) or 750 (high-dose subgroup) mg/kg daily from PND1 to PND13.The rats were sacrificed on PND14.Pups were sacrificed with lethal dose injection of pentobarbital sodium.The lung was removed.The right middle lobes were used for analysis.The tissue was processed for histology and lung sections were stained with HE for light microscopic (LM) morphometric measurement.The analysis was performed by means of a digital image analysis system,including pulmonary interstitial area ratio (IAR) and total length density of all segments.One-way ANOVA,LSD and Dunnet T3 methods were used for statistical analysis.Results In the normal controls,IAR decreased significantly by (31.97±5.03) ％,(30.05±3.57)％,(25.33± 1.83)％ and(22.01 ±2.19)％,respectively,from PND1 to PND14 (P＜0.05 or P＜0.01).IAR in medium-and high-dose subgroups increased significantly by (24.11 ±2.78)％ and (26.53± 3.42)％,respectively on PND 14.The total length density of all segments in unit area lung volume increased significantly by 0.047 8±0.003 7,0.050 0±0.002 9,0.071 2±0.003 0 and 0.084 4±0.004 3,respectively from PND1 to PND14 (P＜0.01).In the DEHP treated animals,when compared with the control group,IAR was significantly higher on PND14 (P＜0.05 or P＜0.01),while the total length density of all segments in unit area lung volume was significantly decreased (P＜0.05 or P＜0.01).Length density in medium-and high-dose subgroups were higher than that of low-dose subgroup by 0.082 9±0.001 8,0.077 2±0.002 0 and 0.071 3±0.003 7,respectively on PND14 (P＜0.05 or P＜0.01).Conclusions Medium-and high-dose DEHP affect the postnatal lung development in rats in a dose-dependent mode.

To investigate the intervention effects of Morinda officinalis How. on 'Kidney-yang deficiency syndrome' induced by hydrocortisone in rats, the metabolic profiles of rat urine were characterized using proton nuclear magnetic resonance and principal component analysis (PCA) was applied to study the trajectory of urinary metabolic phenotype of rats with 'Kidney-yang deficiency syndrome' under administration of M. officinalis at different time points. Meanwhile, the intervention effects of M. officinalis on urinary metabolic potential biomarkers associated with 'Kidney-yang deficiency syndrome' were also discussed. The experimental results showed that in accordance to the increased time of administration, an obvious tendency was observed that clustering of the treatment group moved gradually closed to that of the control group. Eight potential biomarkers including citrate, succinate, alpha-ketoglutarate, lactate, betaine, sarcosine, alanine and taurine were definitely up- or down-regulated. In conclusion, the effectiveness of M. oficinalis on 'Kidney-yang deficiency syndrome' is proved using the established metabonomic method and the regulated metabolic pathways involve energy metabolism, transmethylation and transportation of amine. Meanwhile, the administration of M. officinalis can alleviate the kidney impairment induced by 'Kidney-yang deficiency syndrome'.

Ojective To compara the individual differences and clinical efficacy of cis-atracurium intermittent bolus injected according to fat-free mass and real body weight. Methods Forty patients (ASAI-II) who had no neuromuscular disease and underwent selective abdominal surgery under general anesthesia were randomly divided into group FFM (n=20) and group RBW(n=20) according to the different administration method. The responses of adductor pollicis to train-of-four (TOF) stimulation were monitored. Anesthesia was induced with propofol 2 mg/kg, fentanyl 3 ug/kg, cis-atracurium 129.6μg/kg (group FFM) or 100μg /kg (group RBW),and maintained with propofol and fentanyl given by target-controlled infusion. Intubation was attempted when T1 reached maximal inhibition. When the TOF stimulus T1 recovery to 5%, both group additional cis-atracurium 64.8 μg/kg (group FFM) or 50μg /kg (group RBW). The onset time, nonresponsive time, clinical duration, recovery index, pharmacological duration, cis-atracurium consumption, interval and frequency were recorded. Results No significant differences were found in general, interval, frequency,onset time, clinical duration, nonresponsive time,recovery index, pharmacological duration between the two groups (P > 0.05); There were significant differences in the cisatracurium consumption between two groups (P < 0.05); Compare with the group RBW, the differences of pharmacological duration and nonresponsive time between different individuals in group FFM were smaller (P < 0.05). Conclusion It can reduce the individual differences of muscle relaxant effect to apply cis-atracurium and cis-atracurium consumption according to fat-free mass.

Objective To supply a scientific basis for laying out a unified standard of reference value of Chinese newborn boys' hemoglobin. Methods After the reference values of 5169 Chinese healthy newborn boys' hemoglobin tested in 78 areas were collected, a research was made on the relationship between the reference value of Chinese newborn boys' hemoglobin and altitude by using curvilinear regression analysis. Results As the altitude gradually increased, the reference value of Chinese newborn boys' hemoglobin gradually increased by index law, with significant correlation (R=0.601, F=43.05, P= 0.0000). One curvilinear regression model was given out: =176.9e 0.00008662x?25.3. Conclusion If altitude of a particular area is known, the reference value of Chinese newborn boys' hemoglobin in this area can be established by using regression model. According to the correlation between Chinese newborn boys' hemoglobin and altitude, China can be divided into three regions: Qinghai-Tibet Region, Central Region, Eastern Region.

Objective To discuss the safety and efficacy of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture.Methods There was an retrospective analysis on operation videos and clinical data for 16 participants of inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture with the period from March in 2012 to September in 2015. And these were statistically analyzed including the operation time, intraoperative bleeding volume, postoperative drainage volume, removal time of drainage tube, admission time after operation and the incidence of postoperative complications of vesicoureteric reflux and stenosis.Results The operations of 16 participants were completed successfully without converting to open surgery. The operation time was 60 ~ 125 min (Mean time: 85 min); intraoperative bleeding volume was 20 ~ 50 ml (Mean volume: 32 ml); postoperative drainage volume was 60 ~ 400 ml (Mean volume: 106 ml); removal time of drainage tube was 3 ~ 6 d (Mean time: 4.2 d) and admission time after operation was 7 ~ 10 d (Mean time: 8.5 d). There was the follow-up with 6 ~ 18 months (Mean time: 12 months) for participants. No anastomotic stenosis was present. In addition, one participant was suffered from mild vesicoureteric relfux. And there was no aggravation during 18 months.Conclusions The inserting ureterovesical reimplantation by means of laparoscopy associated with six-stitch suture was safe and effective. It was found that the operation time was significantly shortened and the incidence of postoperative complications of vesicoureteric relfux and anastomotic stenosis was not increased. By contrast, the six-stitch suture could reduce the incidence of anastomotic stenosis.

OBJECTIVETo investigate the metabolic profile of hydrocortisone-induced 'Kidney-yang deficiency syndrome'in rats and the intervention effects of Morinda officinalis.

METHODProton nuclear magnetic resonance (1H-NMR) technique was used to analyze the rat metabonome in serum. Orthogonal partial least squares discriminant analysis (OPLS-DA) were processed to analyze the metabonome difference between the control and hydrocortisone treated samples. Twelve potential biomarkers were selected, via the parameter of variable importance in the projection (VIP). Principal components analysis (PCA) was employed to process the data from the M. officinalis. treatment group and the intervention effects of M. officinalis, was investigated through the selected potential biomarkers.

RESULTAfter hydrocortisone treatment, the energy metabolism, amino acids metabolism and gut microflora environment were seriously disturbed and transmethylation was surpressed. M. officinalis could effectively alleviate the disturbance of energy and amino acids metabolism and enhance transmethylation, but could not modulate the gut microflora environment.

CONCLUSIONThe results obtained suggested that metabonomic studies could better reflect the whole status of metabolism in bio-systems, and could be treated as a potential powerful approach in pharmacological studies and investigation of the essence of 'syndrome' in traditional Chinese medicine.

Animals ; Biomarkers ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Kidney ; drug effects ; metabolism ; Male ; Metabolomics ; Morinda ; chemistry ; Rats ; Rats, Sprague-Dawley ; Yang Deficiency ; drug therapy ; metabolism