Objective To investigate an early diagnostic method and a rapid efficient treatment method to teat osteofascial compartment syndrome(OCS). Methods From January 2007 through December 2008,16 male patients with OCS were treated in our department.They were aged from 15 to 55 years (average,32 years).Twelve patients had OCS at the leg and 4 at the foot.All patients had no vascular or nerval injury.The modified Whiteside method was used to measure the pressue of the osteofascial compartment.All patients were treated with open decompression and vacuum sealing drainage (VSD).After swelling subsided,the wounds were directly sutured,decompresively sutured or treated with skin grafting. Merchant scoring was used to evaluate the postoperative efficacy in terms of limb-affected function,pain,gait,joint function,joint stability and range of motion. Results All patients were followed up for 12 to 14 months (average,13 months).All incisions closed up.Fourteen patients obtained excellent recovery of the function and sensation of the distal limb-affected;one patient had hypoesthesia and numbness at the the distal limb-affected; one patient had contracture,numbness and functional disturbance.By the Merchant scoring system,9 cases were excellent,5 good and 2 fair,giving a good to excellent rate of 87.5％. Conclusions The modified Whiteside method used to meausre the interstitial pressure is a reliable early diagnostic method for OCS.Decompression plus VSD may lead to rapid and efficient treatment of OCS and a reduced disability rate of the limb-affected.

Objective To study the relatinonship between the regional cerebral blood flow (rCBF) and NF-kB expression in perihematoma region after intracerebral hemorrhage (ICH).Methods 27 healthy dogs were divided into control group (3 cases) and ICH group (24 cases) at random. The models of ICH were made by injecting self-blood into the frontal lobes. At different points (3 h, 6 h, 12 h, 24 h, 48 h, 72 h, 7 d and 15 d), the changes of rCBF in the region of perihematoma were observed by perfusion weighted imaging (PWI). Immunohistochemistry SP method was used to detect expressions of NF-kB. Immune positive cells were stained brown-yellow colour in the cytoplasm and/or nucleus, and NF-kB positive particles that transformed from cytoplasm to nucleus showed activation of NF-kB. Results In the region of perihematoma, PWI showed hypo-perfusion within 12h, reperfusion or hyper-perfusion from 12 to 24 h, and slightly hypo-perfution after 48h. NF-kB positive cells presented at 6 h, reached the peak from 12 to 48 h, decreased from 72 h to 7 d, nearly disappeared at 15 d. NF-kB positive cells mainly existed in the region of perihematoma. From 12 to 48 h, NF-kB expression was markedly in quantities of neurons and gliacytes. The activated NF-kB was clearly shown at the same time.Conclusions Cerebral ischemia and reperfusion in the region of perihematoma could induce expression of NF-kB, which was involved in the inflammatory and immune reaction and resulted in the ingury caused by cerebral ischemia and reperfusion.

Objective To evaluate the utility of diffusion-weighted MRI(DWI)and the correlation between the abnormalities in DWI and the clinical factors in patients with transient ischemic attack of the brain(TIA).Method Clinical,conventional MRI,and DWI data were collected on 59 consecutive patients with TIA between March and July 2006 within 7 days of the onset of TIA symptoms.The relationship between DWI-detected findings and patients' clinical manifestations was then analyzed.Results DWI-detected abnormalities were displayed in 22 of 59 cases(37%,positive group).Prolonged TIA duration(TIA duration≥30 minutes),repeated episodes,motor deficits,aphasia,history of either stroke or TIA,diabetes mellitus,and atrial fibrillation were observed more frequently in the positive group than in the negative group.In 9 of 22 cases,the identified lesions were not detected by conventional MRI(T2-weighted imaging or fluid-attenuated inversion recovery).In other 13 cases,abnormalities were present on both DWI and conventional MRI.Conclusions In TIA patients,prolonged TIA duration(TIA duration≥30 minutes),repeated episodes,motor deficits,aphasia,history of either stroke or TIA,diabetes mellitus,and atrial fibrillation were significantly correlated with detectable abnormalities on DWI.

Objective To evaluate the therapeutic effect of proximal femoral nail(PFN)and dynamic hip screw(DHS)for intertrochanteric femoral fracture(IFF).Methods From September,2004 to May,2007,39 IFF patients treated by PFN and 36 by DHS were enrolled into the analysis.The operative complications,postoperative complications and the recovery of hip function of IFF patients were observed to evaluate the therapeutic effect of the two methods.Results The blood loss amount was higher,the incidence of postoperative complications was higher and the excellent rate of Harris score of hip function was lower in IFF patients treated by DHS than that in IFF patients by PFN(P

Objective To explore the dynamic changes of diffusion tensor imaging(DTI) in spinal cord of goats with persistent compression injury. Methods Eighteen goats weighted 20--25 kg were divided into three groups with completely random design: A, B and C. A balloon catheter was inserted into the epidural space at C3-4 level via intervertabral foramen for each goat. The balloon was inflated by injection of variable volumes of saline in group A and B 10 days following operation. The volume of saline was 0. 3 ml in group A and 0. 2 ml in group B,respectively. The compression sustained for 40 days. Group C served as uncompressed control without injection of saline. The locomotor rating score was applied to each group. Conventional MRI and DTI were performed. The apparent diffusion coefficient (ADC)and fractional anisotropy (FA) values were measured. Histopathological assessments of the compressed spinal cord were performed 50 days following operation with light microscope and transmission electron microscopy. Results Before operation, the locomotor rating score was 5, the ADC value was ( 1.23 ± 0. 05 ) × 10-3 mm2/s and the FA value was (0. 72 ± 0. 05 ) each group. Of six goats in Group A, the locomotor rating score severely decreased and reached( 1.5±0. 4)on the 40 th day after compression. The ADC value at compression site decreased soon and reached the minimum (0. 75±0. 04) × 10-3mm2/s on the 5 th day after compression. Then the ADC value increased gradually, restored normal on the 10 th day or so, then became markedly higher than normal and reached( 1.61±0. 05) × 10-3mm2/s on the 40 th day. The FA value at compression site decreased soon, reached(0. 54±0. 04)on the 1st day, then decreased gradually and reached(0. 43 ± 0.05) on the 40 th day. It appeared high signal intensity on T2WI on the 10 th day. In Group B, the locomotor rating score was moderately decreased and reached(3.4±0. 5 )on the 40 th day. The ADC value at compression site decreased slightly firstly, reached( 1.08±0. 04) × 10-3mm2/s on the 1st day, restored normal on the 20 th day or so, then increased gradually, became higher than normal and reached ( 1.27 ± 0. 05) × 10-3mm2/s on the 40 th day. The FA value increased slightly firstly, reached (0. 78±0. 05 )on the 1st day, then decreased gradually, restored normal on the 15 th day or so, became lower than normal and reached(0. 67±0. 05) on the 40 th day. There was no abnormality on conventional MRI. In Group C, the locomotor rating score, ADC value and FA value remained unchanged. There was no abnormality on conventional MRI. There were dynamic changes over time of the ADC value and FA value in Group A and B, which was more marked in Group A than that in Group B ( repeated measurements analysis of variance, F=426. 7 for the ADC value and F =7895.2 for the FA value, P < 0. 01 ). Histopathologically, swelling and degeneration of axons and neurons as well as the disarrangement of myelin sheathes could be seen. The pathological changes were more marked in Group A than in Group B. In Group C, no abnormality could be seen. Conclusion There are dynamic changes of DTI in cervical spinal cord with compressive injury that correlated with the degree and duration of compression. The ADC value decreased firstly, restored normal and then increased. The FA value increased firstly, restored normal and then decreased in mild compression while solely decreased in serious compression.

Objective To investigate the clinical features and incidence of depression in patients with different lo-cations and pathological types of brain tumors. Methods Hamilton Depression Scale (HRSD) was used to assess the de-pression in 140 patients with brain tumor before and after operation. Results The preoperative mean depression rating score was 15.36 ± 6.52 and the prevalence rate of depression was 50 cases (35.7%) in 140 patients with brain tumor. The postoperative mean score of depression was 9.71 ± 5.55 and the prevalence rate of depression was 9 cases (6.4%) in 140 patients with brain tumor. The postoperative depression score and the prevalence rate was significantly decreased after op-eration (P<0.05)(χ2=36.10,P<0.05). The postoperative depression score in either benign or malignant brain tumors was significantly lower after than before operation(all P<0.05)The postoperative depression score in either the left or right or bilateral brain lesions were significantly decreased after than before operation(all P<0.05).Conclusion Pa-tients with brain tumors have different degrees of depression in perioperative. Depression may be associated with brain tu-mour pathological types and lesion sites in patients with brain tumors.

BACKGROUND: Vascular endothelium growth factor (VEGF) is an endothelium mitogen and angiogenic factor with strong potential during recovery from cerebral infarction (CI). Can such therapeutic effect be detected with magnetic resonance diffusion imaging?OBJECTIVE: To study the therapeutic efficacy of VEGF plasmid in treating focal cerebral infarction in a dog experimental model with the aid of diffusion- and hemodynamic-weighted magnetic resonance imaging (MRI),with the morphological results compared with those of immunohistochemical examination.DESIGN: Completely randomized controlled, double blind evaluation,analysis of variance, Pearson correlation analysis, follow-up for 2 weeks.SETTING: Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University.MATERIALS: This study was carried out at the Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University,between April 2001 and March 2002. Totally 18 healthy adult dogs weighing 10-15 kg were randomly divided into control group and experiment group with half in each.METHODS: All dogs were subjected to femoral intubation and then made into CI model by the occlusion of middle cerebral artery with an embolus injected through the internal carotid artery. Dogs in control group were put to death at postoperative 24 hours, 1 week and 2 weeks with three at each time point, while four dogs in experiment group were put to death at postoperative 1 week and five at 2 weeks. Dogs in experiment group received microinjection of 0.5 mL fluid containing pcD2/hVEGF121 (500-600 μg)instantly after operation, which was replaced with physical saline of the same volume at the same time point in control group. Then they were subjected to MRI scanning once an hour for 4 times, with the sequence of T1WI, T2WI, 3D-TOFMRA, DWI and CET1WI, which was repeated at postoperative 24 hours, 3 days, 1 week and 2 weeks. Based on the MR images, pathological focuses were selected for morphological observation of cells with the aid of HE staining, and CD34 IHC staining was used for counting micrangium, as well as VEGF staining for VEGF positive cells.Then the apparent distribution coefficient (ADC) was calculated, and the differences between different time points and groups were analyzed by analysis of variance. The number of capillaries and VEGF positive cells of each high-power field was counted, with the results compared with those of MR scanning so as to explore the correlation between MR signal changes and IHC results.MAIN OUTCOME MEASURES: ① The number of capillaries and VEGF positive cells in each high-power field was counted at postoperative 24 hours, 1 week and 2 weeks; ② MR images of each group.RESULTS: Data of the 18 dogs entered the final analysis. ① Diffusionweighted imaging (DWI) showed higher signals at infarctional region at postoperative 1 hour, which became strengthened as time went by. ②ADC decreased to (5.61 ±1.39) mm2/s at postoperative 3-4 hours, about 43% lower than that of the opposite hemisphere [(9.85±2.04) mm2/s]. It resumed to (9.83±1.11) mm2/s, but was still lower than the normal level.③ The subsequent MR scanning proved that ADC ratio presented an increasing tendency in contrast with the decreasing tendency at super-acute stage. The increment was even more marked in control group and the difference was significant at postoperative 2 weeks (P=0.032, 0.006). ④ The number of capillary positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 2 weeks [(28.80±3.29)/field, (20.70±4.47)/field, (P ＜ 0.01)]. ⑤ The number of VEGF positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 1 and 2weeks [(64.20±9.40)/field, (51.90±5.74)/filed; (72.70±6.98)/filed,(58.40±6.35)/field, (P ＜ 0.01)].⑥ The results of MR scanning and IHC were subjected to correlation analysis and revealed that ADC ratio was closely correlated with the number of capillary positive cells, with Pearson correlation coefficient being 0.679 (P ＜ 0.01). Moreover, the number of capillaries and the number of VEGF positive cells were significantly correlated (r=0.668, P ＜ 0.01).CONCLUSION:Morphological observation and IHC revealed that both the local capillaries and VEGF protein content increased markedly in timedependant manner due to VEGF plasmid gene therapy.Meanwhile,the change of ADC ratio was found to be closely correlated with the number of VEGF positive cells and the number of capillaries.

To observe the morphology and anatomic variations of the circle of Willis and its clinical significance. To measure and establish the normal reference parameters of average diameters of its component vessels in the healthy Chinese by using 3D-TOF MR angiograms and to determine whether age-or sex-related differences exists in the circle' anatomy. MRA was performed in 153 healthy subjects. According to its integrity, Willis'circle was divided into four types: (1) Type I, showing an intact circle. (2) Type II, having a complete anterior circulation but an incomplete posterior circulation. (3) Type III, having an incomplete anterior circulation but a complete posterior circulation. (4) Type IV, having an incomplete anterior and posterior circulation. Based on the development of the components of the circle, each type was subdivided into four subtypes: typical, variable, hypoplastic and mixed. The statistically significant differences were not found in each type or subtypes between the different age and sex groups. Result of 153 cases, Type I, II, III and IV was found in 53 (34.64%), 73 (47.71%), 8 (5.23%), and 19 (12.42%) respectively. The display rate of the anterior and the posterior communicating arteries was 87.58%o (134/153) and 65.34% (100/153) respectively. Display rate of fetaltype posterior cerebral artery(PCA) was 20.92%. 3D-TOF MR angiography has important clinical significance for evaluating morphology and anatomic variations of circle of Willis. The normal values of diameter of cerebral arteries on MR angiograms may play a reference role in diagnosing cerebral vascular diseases.
Adolescent ; Adult ; Aged ; Anthropometry ; Child ; Child, Preschool ; Circle of Willis ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiography

Objective:To identify the risk factors for functional delayed gastric emptying(FDGE)after retroperitoneal tumor resection.Meth-ods:Sixty-seven patients with postoperative FDGE after retroperitoneal tumor resection from September 2017 to December 2022 admited in Peking University International Hospital were included in the observation group,and 836 normal patients who underwent ret-roperitoneal tumor resection during the same period were included in the control group.Medical histories and clinical treatment data were obtained for each group and compared to identify the risk factors for FDGE after retroperitoneal tumor resection.Results:The overall incid-ence of postoperative FDGE was 7.42%.Factors that were significantly elevated(P<0.05)in the observation group relative to the control group included adverse mental factors(37.31%),preoperative digestive tract obstruction(41.79%),postoperative abdominal cavity complic-ations(79.10%),diabetes(29.86%),average age of(61.85±6.11)years,and blood loss(1 011.94±507.30)mL.Pre-and post-surgery albumin levels[(38.22±3.75)g/L and(30.22±3.36)g/L,respectively]were significantly reduced(P<0.05)in the observation group compared to the control group.Risk factor analyses revealed that advanced age,diabetes,preoperative digestive tract obstruction,intraoperative blood loss,perioperative albumin level,postoperative abdominal cavity complications,and adverse mental factors were correlated with postoperative FDGE.Conclusions:Diverse factors could impact the risk of FDGE after retroperitoneal tumor resection.Patients should be accurately evalu-ated;reasonable and detailed prevention and treatment plans should be developed.

This study was aimed to investigate the effect of traditional Chinese medicine (TCM) compound "Ji-Sui-Kang (JSK)" on the differentiation of neural stem cells (NSCs).Drug serum of JSK was prepared.The primary NSCs were isolated and cultured.NSCs were identified.Fetal bovine serum (FBS) was used to induce differentiation of NSCs.Different doses of drug serum of JSK was added to intervene the differentiation.There were the high-,medium-,and low-dose group.The blank control group was also set.The β Ⅲ-tubulin and GFAP were used to detect the differentiation of NSCs.And then,it was compared with the control group without drug serum.Positive cells ofβ m-tubulin and GFAP in different visual fields were counted.And the percentage of positive cells in the total number of cells was calculated.Fluorescence microscope was used to conduct quantitative fluorescence experiments.The results showed that the cultured neurospheres were expressed of Nestin protein.The percentage ofβⅢ-tubulin positive cells in the high-,medium-and low-dose group of drug serum of JSK was significantly higher than that in the control group (P＜0.05).The percentage of GFAP positive cells in the high-,medium-and low-dose groups of drug serum of JSK was significantly lower than that in the control group (P＜0.05).And the high-dose group of drug serum of JSK was statistically significant compared with the middle-and low-dose group of drug serum of JSK (P＜0.01).It was concluded that TCM compound JSK promoted thedifferentiation of NSCs intoβⅢ-tubulin positive cells.It provided a basis for treatment of SCI with TCM.