Humans ; Eosinophilia/diagnosis* ; Thrombosis/etiology* ; Heart Diseases/complications*

OBJECTIVETo analyze the relation of plasma D-dimer levels and incidence of deep venous thrombosis after spinal surgery.

METHODSThe clinical data of 63 patients underwent spinal surgery from October 2009 to October 2010 were retrospective analyzed. There were 40 males and 23 females with an average age of 48 years old(21 to 76) in operation. Operation levels of 15 cases were in cervical vertebrae, 4 cases were in thoracic vertebrae,and 44 cases were in lumbar vertebrae. Thirty patients with spinal fracture were caused by trauma and 33 patients without trauma, 11 patients combined with nerve injury. The patients were divided into two groups according to plasma D-dimer levels, more than or equal to 500 microg/L was D-dimer positive group and less than 500 microg/L was D-dimer negative group. Venous blood of all patients early morning with empty stomach were testd on admission, and at 2 h, 1 d, 2 d, 3 d, 4 d, 6 d, 8 d, 10 d, 15 d after operation,respectively.

RESULTSThere was no statistically significant differences in sex, operative segments, implants, operative posture, age, bleed volume, body weight, peroperative D-dimer levels between two groups. After operation, plasma D-dimer of 19 patients were more than or equal to 500 microg/L, with persistent or progressive increasing. Two cases occurred deep venous thrombosis in D-dimer positive group, they respectively were found at 3 days and 8 days after operation. Both of them underwent posterior decompression and internal fixation. However,no deep venous thrombosis was found in D-dimer negative group.

CONCLUSIONPostoperative D-dimer assay can effective predict deep venous thrombosis occurrence. D-dimer level more than or equal to 500 microg/L will be considered as a risk factor for deep venous thrombosis after spinal surgery.

Adult ; Aged ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spine ; surgery ; Ultrasonography ; Venous Thrombosis ; blood ; diagnostic imaging ; surgery ; Young Adult

Objective To study the diagnosis value of high frequency sonography in nontraumatic upper limb nerve torsion.Methods High frequency sonography images of thirteen patients with diagnosed nontraumatic upper limb nerve torsion were retrospective analyzed.The sonography features were compared with the clinical surgery.Results The position and internal structure of nerve can be found by high frequency ultrasound,and which nerve fascicle,location and scope of nerve torsion can be displayed clearly.The features of high frequency sonography was single or multi-segmental hourglass-like change,the two sides of nerve with hourglass like change was thickened,the echo was low,and perineurium structures in upper limb nerve was blurry.Conclusions High frequency sonography is the preferred imaging method for diagnosis of nontraumatic upper limb nerve torsion.

Objective To study the clinical value of color Doppler ultrasonography in the persistent sciatic artery.Methods The ultrasonographic images of eleven patients with persistent sciatic artery diagnosed by CT angiography or digital subtraction angiography were retrospective analyzed,the ultrasonographic features were summarized.Results The sciatic artery showed the enlarged internal iliac artery,which continued into the thigh in a posterior location,the sciatic artery described a tortuous course toward the knee,slowly filling normal-appearing popliteal artery in 8 cases,there were no connection with popliteal artery in 1 cases.The common femoral artery and superficial femoral artery was dysplasia in 7 patients,which was thinner than the popliteal artery.Conclusions The ultrasonography is the effective imaging method for diagnosis of the persistent sciatic artery.

Objective To study the value of high frequency sonography in diagnosis of peripheral nerve lipofibroma hamartoma.Methods The high frequency sonography images of seventeen patients with diagnosed peripheral nerve lipofibroma hamartoma were retrospective analyzed.The sonography features were compared with clinical surgery.Results The position and internal structure of nerve can be found by high frequency ultrasound,and which nerve fascicle,location and scope of lipofibroma hamartoma can be displayed clearly.The involved peripheral nerve was showed expansive growth.Because the hyperechoic fat tissue and hypoechoic nerve fibers alternated with one and another,the feature of high frequency sonography was lotus-like,there was no blood flow signal in nerve.Conclusions High frequency sonography is the preferred imaging method for diagnosis of lipofibroma hamartoma.

Objective To study the clinical value of high frequency ultrasonography in acute closed mallet finger.Methods The high frequency ultrasonographic images of thirty-six patients with diagnosed acute closed mallet finger were retrospective analyzed.The ultrasonographic features were analyzed.Results The position and internal structure of extensor tendon could be showed by high frequency ultrasound,the position and injury level of acute closed mallet finger were identified.In 36 patients of acute closed mallet finger,6 cases were complete tear combined avulsion fracture,the ultrasonography showed the disruption in the extensor tendon at the level of the distal interphalangeal joint,the hyperechoic fracture fragment were found in the distal end of extensor tendon.22 cases were complete tear and no avulsion fracture,the longitudinal imaging showed the disruption in the extensor tendon at the level of the distal interphalangeal joint and the retraction of the tendon end.8 cases were partial tear,the ultrasonography showed that extensor tendons were thickened and hypoechoic,the section of extensor tendons were still continuous.Conclusions High frequency ultrasonography is the preferred imaging method for diagnosis of acute closed mallet finger,it will be important value for clinical treatment method.

Objective To study the effect of once-weekly injection of recombinant human parathyroid hormone rhPTH(1-34) on the healing of bone fracture in rats.Methods Fifty male 3-month old SD rats were used in this study to produce unilateral tibial fracture and received internal fixation with a Kirschner needle.Based on the dose and frequency of rhPTH (1-34) injection, the rats were randomly divided into five groups (n=10 each) as follows: subcutaneous injec-tions of saline, and rhPTH in a dose of 10, 20, 10, and 20 μg/kg/d.After 4 weeks of treatment, the rats were euthana-tized and the fractured tibia were assessed by X-ray, dual energy X-ray absorptiometry ( DXA) ,micro-computed tomography ( microCT) and three-point bending test.Results The fracture healing in the 20μg/kg/w group was better than the saline group.The fracture healing in the 20μg/kg/w group was as well as the 10 μg/kg/dgroup.The BMD of 20μg/kg/w group was 26.2%higher than the saline group.The mineralized callus volume in the 20μg/kg/w group was 51.4%higher than the saline group.The total callus volume in the 20μg/kg/w group was 21.6%higher than the saline group.The ultimate load of the 20 μg/kg/w group was 29.3% higher than the saline group.There was no significant difference between the 20 μg/kg/w group and 10 μg/kg/d group in BMD, bone micro-architecture, and biomechanical strength ( P >0.05 ) . Conclusions Once weekly injection of rhPTH (1-34)can promote the bone fracture healing.

Objective To investigate the risk factors of bronchopulmonary dysplasia(BPD)in very low birth weight infant.Methods The clinical data of 49 very low birth weight infants in our NICU from Sep 2006 to Sep 2009 were reviewed,and divided into BPD group(n =15)and without BPD group(n =34).The risk factors of BPD were analysed.Results Compared with the infants without BPD,there were significant differences in gestational age[(29.30 ± 1.48)week vs(30.54 ± 1.60)week],hospital-acquired infection(9 cases vs 10 cases),intrauterine infection(9 cases vs 8 cases),the time for continuous positive airway pressure(CPAP)[(12.47 ± 5.83)d vs(4.24 ± 4.19)d],the time for hyperoxia[(1.47 ± 1.41)d vs (0.18 ±0.63)d],patent ductus arteriosus(5 cases vs 1 cases)(P＜0.05).Logistic regression revealed that intrauterine infection and the time for CPAP were independent risk factors of BPD(P ＜0.05).Conclusion Prophylaxis of intrauterine infection may decrease the mortality and severity of BPD.The prolonged time for CPAP may predict the risk of BPD.

Objective To investigate the effect of subclinical hypothyroidism during pregnancy on hippocampus insulin-like growth factor Ⅰ (IGF-Ⅰ) signaling pathway in rat offspring.Methods A total of 60 female Wistar rats were evenly divided into control(CON),subclinical hypothyroidism(SCH),and clinical hypothyroidism (CH) groups.The hippocampus of progenies were collected on the postnatal day 3,postnatal day 7 to measure protein kinase B (Akt) and phosphorylated-Akt (p-Akt) by Western blot,IGF-Ⅰ and insulin-like growth factor Ⅰ receptor (IGF-Ⅰ R) by Elisa.Morris water maze and field excitatory postsynaptic potential long-term potentiation were measured at the postnatal 40 day.Results Western blot and Elisa revealed that levels of IGF-Ⅰ,IGF-Ⅰ R,and p-Akt of pups from SCH group were lower than that of CON group and were higher than CH group on day 3 (P ＜ 0.05).On day 7,the levels of IGF-Ⅰ,IGF Ⅰ R,and p-Akt of pups from SCH group were lower than CON group (P＜ 0.05),but no difference was observed in p-Akt and IGF-Ⅰ R level between SCH group and CH group (P ＞ 0.05).Latencies of all groups had shortened in Morris water maze test with increasing of training trials.The slope of field excitatory postsynaptic potenial was increased in all groups after Theta burst stimulation.The amplification percentage of slope of field excitatory postsynaptic potenial in SCH group's was lower than control group's but was higher than CH group's(all P values＜0.05).Conclusions Maternal subclinical hypothyroidism impairs long-term potentiation induction in hippocampus of rat might be associated with the levels of IGF-Ⅰ,IGF-Ⅰ R,and p-Akt.

Objective:To investigate the value of ultrasound in the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.Methods:From July 2010 to July 2020, 12 patients with hourglass-like fascicular constrictions of the anterior interosseous nerve diagnosed in Shandong Medical Imaging Research Institute Affiliated to Shandong University were retrospectively analyzed. The characteristics of the high-frequency ultrasonographic images were summarized and compared with clinical surgery.Results:The hourglass-like fascicular constrictions of the anterior interosseous nerve were all located in the median nerve of the distal upper arm in 12 patients, including 9 cases of single hourglass change and 3 cases of multiple hourglass like changes. High-frequency ultrasound can accurately locate the location of the hourglass-like fascicular constrictions of the anterior interosseous nerve and the extent of neuropathy. The sonogram of hourglass-like fascicular constrictions of the anterior interosseous nerve showed single or multiple hourglass-like changes in the median nerve of the distal upper arm. The nerve fasciculars on both sides of hourglass-like changes were thickened. There was significant difference between the diameter of the affected fascicular and the corresponding position of the contralateral fascicular[(0.20±0.04)cm vs (0.11±0.03)cm, P<0.01]. There was significant difference between the cross-sectional area of the median nerve at the widest part of the lesion side and the corresponding position of the contralateral side[(0.14±0.03)cm 2 vs (0.09±0.03)cm 2, P<0.01]. Conclusions:High-frequency ultrasound is the preferred image method for the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.