BACKGROUND:There have been many studies on the diagnosis of osteoporotic vertebral compression fractures. However, there are few studies on the diagnostic methods of fracture in different periods. OBJECTIVE:To comparatively analyze the application value of high-intensity magnetic resonance imaging (MRI) and single photon emission computed tomography combined with CT scan image fusion (SPECT-CT) in the diagnosis of osteoporotic vertebral compression fractures. METHODS:Clinical data of 35 patients with osteoporotic vertebral compression fractures were retrospectively analyzed, including 56 vertebrae. There were 14 males and 21 females, with an average age of 72.6 years. The course of disease was within 3 weeks in 22 patients, belonging to acute fractures. The course of the disease was between 4 and 12 weeks in 10 patients, belonging to the subacute fractures. The course of disease was 6 months in 3 patients, belonging to the fracture healing period. Al patients were tested with high-intensity MRI and SPECT-CT examination, and were treated with vertebroplasty or percutaneous kyphoplasty. The Fisher exact method was used to compare the two diagnostic methods in the diagnosis of vertebral fracture. RESULTS AND CONCLUSION:(1) In the 56 responsible vertebral bodies, 32 vertebral bodies belonged to the acute-stage fractures, and 24 vertebral bodies belonged to the non-acute-stage fractures. In al the fractures, MRI diagnosed 49 segments;SPECT-CT diagnosed 52 segments. The sensitivity of SPECT-CT testing was higher than MRI, and its specificity was less than MRI. There was a high consistency of diagnosis between fractures. (2) In the 32 acute vertebral fractures, the two tests diagnosed 29 segments. The sensitivity of SPECT-CT was higher than that of MRI, but its specificity was lower than that of the MRI. There was a high consistency between the diagnoses of fractures. (3) In the 24 non-acute vertebral fractures, MRI diagnosed 20 segments;SPECT-CT diagnosed 23 segments. SPECT-CT was more sensitive than MRI;the specificity of SPECT-CT was lower than MRI. There was a high consistency between the two diagnoses of fractures. (4) There was a high consistency in the MRI and SPECT-CT examination to determine the fracture of different periods of responsibility of the vertebral body, but the sensitivity of SPECT-CT is higher than MRI examination;SPECT-CT is an effective inspection method in the diagnosis of vertebral fractures.

Adult ; Aspergillosis ; etiology ; therapy ; Aspergillus fumigatus ; Heart Transplantation ; Humans ; Male

Objective To evaluate the efficacy of Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management in patients undergoing upper mediastinal tumor resection. Methods Twenty-two ASA Ⅱ or Ⅲ patients, aged 24-66 yr, weighing 48-78 kg, scheduled for elective resection of upper mediastinal tumor, were randomly divided into 2 groups (n=11 each):double-lumen tube group(groupⅠ) and Coopdech bronchial blocker combined with a strengthened single-lumen tube group(group Ⅱ).One-lung ventilation was achieved with a double-lumen tube in groupⅠ. The Coopdech bronchial blocker combined with a strengthened single-lumen tube was used for airway management and the Coopdech bronchial blocker was used for lung isolation when one-lung ventilation was required in group Ⅱ. The fiberoptic bronchoscope was used to assist endotracheal tube positioning in both groups. The intubation time, positioning time, the number of patients required for tube displacement, the number of fiberoptic bronchoscopy, increase in airway peak pressure, degree of lung collapse, postoperative sore throat and hoarseness, and the number of patients needing ventilator-assisted ventilation were recorded. Results The intubation time was significantly shorter, the number of patients required for tube displacement was significantly smaller,and the rate of increase in airway peak pressure and incidences ofpostoperative sore throat and hoarseness were significantly lower in group Ⅱ than in group Ⅰ (P＜0.05 or0.01). Conclusion The efficacy of the Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management is better in patients undergoing upper mediastinal tumor resection than the double-lumen tube.

AIM:To establish a microthrombus model by carrageenan (Ca)/ lipopolysaccharides (LPS) intraperitoneal injection in rats with hyperhomocysteinemia (HHcy) and endothelial dysfunction induced by L-methionine intake. METHODS: ① Male Sprague Dawley rats were randomly divided into 2 groups: control and endothelial dysfunction (HHcy) groups. L-methionine was administered by gavage in HHcy group for total 4 weeks. Purified water was administered by gavage in control rats. Plasma Hcy, NO and vWF were examined and the thoracic aorta were excised after 4 weeks of L-methionine treatment to evaluate endothelial function. ② Male Sprague Dawley rats were randomly divided into 3 groups to establish a microthrombus formation model with Ca/ LPS: control, microthrombus formation (Ca/LPS) and endothelial dysfunction plus mitoarothrombus formation (HHcy+Ca/LPS) groups. Control rats were injected with normal saline (NS). Ca/LPS rats were intraperitoneally injected with carrageenan (Ca) and followed by lipopolysaccharides (LPS) 16 h later. HHcy+Ca/LPS rats were intragastric gavaged by L-methionine for total 4 weeks, and then were injected with Ca/LPS in the same way as Ca/LPS group. Cruor parameters and platelet count were detected at 20 h after LPS or NS injection and the mesentery microcirculation was monitored. Plasma NO and vWF were also detected at 24 h after LPS or NS injection. RESULTS: ① Plasma Hcy concentrations and vWF level were significantly increased in HHcy group, while plasma NO content was significantly decreased compared with that in control group. Endothelial dependent relaxation (EDR) of aortic rings was significantly decreased in HHcy group, suggesting endothelial damage/dysfunction was induced by HHcy. ② Mesentery capillary was obviously blocked by microthrombus in Ca/LPS rats and was blocked more seriously in HHcy+Ca/LPS rats. Cruor parameter results suggested that Ca/LPS rats were in hypercoagulable phase and HHcy+Ca/LPS rats were in hypocoagulable phase at 20 h after LPS injection. Platelet count and plasma NO content in HHcy+Ca/LPS group were significantly decreased, while plasma vWF level was significantly increased compared with Ca/LPS group. CONCLUSION: L-methionine intake induces severe HHcy and causes endothelial dysfunction in rats. Microcirculation dysfunction and microthrombosis can be caused by Ca/LPS intraperitoneal injection and may be aggravated by endothelial dysfunction.

Citri Fructus identification by fingerprint and chemometrics was investigated in this paper. Twenty-three Citri Fructus samples were collected which referred to two varieties as Cirtus wilsonii and C. medica recorded in Chinese Pharmacopoeia. HPLC chromatograms were obtained. The components were partly identified by reference substances, and then common pattern was established for chemometrics analysis. Similarity analysis, principal component analysis (PCA) , partial least squares-discriminant analysis (PLS-DA) and hierarchical cluster analysis heatmap were applied. The results indicated that C. wilsonii and C. medica could be ideally classified with common pattern contained twenty-five characteristic peaks. Besides, preliminary pattern recognition had verified the chemometrics analytical results. Absolute peak area (APA) was used for relevant quantitative analysis, results showed the differences between two varieties and it was valuable for further quality control as selection of characteristic components.
Chromatography, High Pressure Liquid ; Citrus ; chemistry ; classification ; Discriminant Analysis ; Drugs, Chinese Herbal ; chemistry ; Fruit ; chemistry ; classification ; Mass Spectrometry ; Principal Component Analysis

Objective To investigate Helicobacter pylori combined with N-methyl-N-nitrosourea (MNU) gavage for preparing balb/c mouse gastric cancer model.Methods Eighty balb/c mice were randomly divided into four groups after 1-week adaptive feed,normal group,model group Ⅰ,Ⅱ and Ⅲ,20 cases in each group.The model group Ⅰ,Ⅱ and Ⅲ were given Helicobacter pylori bacteria liquid (CFU=109/mL) gavage,once every other day for 5 times;then,the freshly configured MNU solution 0.15,0.3,0.6 mL gavages were in turn given,MNU and pure water allocation ratio was 5mg:3mL.Once gavage per week for continuous 10 weeks.Results The model group II had 66.67% adenocarcinoma,the model group I were gastritis with mild atypical hyperplasia,and all mice in the model group III died.Conclusion This method can prepare the gastric cancer model.

Objective Small-for-size syndrome (SFSS) is a common and serious problem after living donor liver transplantation (LDLT) of small grafts.To prevent SFSS by selecting large enough graft,enlarging outflow tract,and controlling the portal vein pressure and flow during LDLT.Methods 113 adult LDLT recipients were reviewed from Dec.1,2007 to Nov.30,2009.Enlarging the portal outflow tract by the incision of the anterior rim of the orifice of the right hepatic vein (RHV),modificating graft inflow,and selecting large enough graft were done to prevent SFSS.The relationship between the patients' GRWR,portal vein flow,portal vein pressure and the occurrence of SFSS was analyzed.Results All patients received the outflow orifice modification.The portal vein pressure and the portal vein flow were decreased after spleen artery ligation.No SFSS ocurred.Conclusion Selecting large enough liver graft,and enlarging portal vein inflow and outflow were safe for the LDLT recipients,and can effectively prevent SFSS.

Objective To investigate the effect of lung protective ventilation regimen on regional cerebral oxygen saturation(rSO2)during one-lung ventilation(OLV)in elderly patients undergoing radical esophagus cancer resection.Methods Forty ASA Ⅰ-Ⅲ patients,aged 65-76 yr,weighing 45-75 kg,undergoing radical esophagus cancer reseclion,were randomly divided into 2 groups(n =20 each):conventional ventilation group(group CV)and prolective ventilation regimen group(group PV).Anesthesia was induced with midaaolam 0.05 mg/kg,sufentanil 0.4 μg/kg,rocuronium 1 mg/kg and propofol 1.5 mg/kg and maintained with 2％ sevoflurane and intermittenl iv boluses of rocuronium 0.5 mg/kg.Double lumen tube was inserted.Correct positioning was verified by fiberoptic broncboscopy.The patients were mechanically ventilated.In group CV,PEEP was set at 0,Vt was set at 10 ml/kg,and I:E was set at 1:2 during two-lung ventilation(TLV)and OLV.In group PV,PEEP was set at 5 cm H2O,Vt was set at 6 ml/kg,and I:E was set at 1:2 during TLV and OLV.PETCO2 was maintained at 35-40 mn Hg in both groups.Arterial blood samples were taken before induction of anesthesia,at 10 min of TLV and at 30 min of OLV for blood gas analysis.Qs/Qt was calculated and rSO2 was recorded at the same time.Low rSO2 (rSO2 score ＞ 3000％)was recorded during OLV.Results Compared with group CV,PaO2 and rSO2 were significantly increased,and Qs/Qt was significantly decreased at 30 min of OLV,and the incidence of low rSO2 was significanfly decreased in group PV(P ＜ 0.05).Conclusion Lung protective ventilation regimen can improve oxygenation,decrease intrapulmonary shunt,and reduce the occurrence of low rSO2 during OLV in elderly patients undergoing radical esophagus cancer resection.

Objective To compare the effects of different medications of fentanyl during anesthesia induction on fentanyl-induced cough.Methods Four hundred and twenty ASA Ⅰ or Ⅱ patients aged 18-60 yr undergoing selective operations under general anesthesia,were randomly divided into 4 groups ( n =105 each):group Ⅰ (control group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg,propofol 2 mg/kg,and rocuronium 1 mg/kg,group Ⅱ (pre-injection group) received successive intravenous injection of midazolam0.05 mg/kg,fentanyl 0.5 μg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 1.5 μg/kg,group Ⅲ (dilution group) received successive intravenous injection of midazolam 0.05 mg/kg,fentanyl 2 μg/kg (20 μg/ml),propofol 2 mg/kg,and rocuronium 1 mg/kg,and group Ⅳ (last injection group) received successive intravenous injection of midazolam 0.05 mg/kg,propofol 2 mg/kg,rocuronium 1 mg/kg,and fentanyl 2 μg/kg.Fentanyl concentration was 50 μg/ml in each group except group Ⅲ.Endotracheal intubation was performed 2 min after anesthesia induction.The incidence and severity of fentanyl-induced cough before intubation were recorded and the incidence of propofol-induced pain was recorded.Invasive arterial blood pressure (ABP) and heart rate (HR) were observed before induction (T1 ),immediately after induction (T2 ),at time of coughing (T3 ),and at time of endotracheal intubation (T4).Results ABP and HR had no significant differences at T1,T2,T3,and T4between the four groups (P ＞ 0.05).The incidence of propofol-induced pain had no significant differences between the four groups (P ＞ 0.05).The incidences of cough was 7.6％ in group Ⅱ,9.5％ in group Ⅲ,and 1.9％ in group Ⅳ,which were significantly lower than 35.2％ in group Ⅰ ( P ＜ 0.01).The incidence of cough in group Ⅳ was significantly lower than that in groups [ and Ⅲ (P ＜ 0.05).In the four groups,ABP and HR were significantly higher at T3 than that at T1 and T2 ( P ＜ 0.01 ).Conclusion Different medications of fentanyl including last injection,pre-injection,and dilution of fentanyl can significantly reduce the incidence of fentanyl-induced cough during anesthesia induction,and injection has the best effect.

Objective The study was designed to compare the ultrasound-guided technique for the cannulation of subclavian vein with the traditional technique using anatomic landmarks.Methods One hundred and twenty ASA Ⅱ or Ⅲ patients undergoing cannulation of subclavian vein before gastrp-intestinal tumor resection were randomly divided into 2 groups (n=60 each) according to the technique used for cannulation:ultrasound-guided group (group US) and anatomic landmark group (group AL).The puncture time,successful puncture and complications were recorded.Resulls The success rate was 100% in group US;while the cannulation failed in one patient in group AL.The rate of successful puncture at 1st attempt was 100% in group US but ouly 90% in group AL.The cannulation time was significantly shorter in group US than in group AL.The incidence of accidental puncture of subclavian artery,hematoma and pneumothorax was significantly higher in group AL than in group US.Conclusion The ultrasound-guided catheterization of the subclavian vein is superior to the landmark technique.