Objective By using multi detector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. Methods CT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrast enhanced dual phase scanning of upper abdomen. Results In hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67?0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized non dependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54?1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had high attenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); micro abscess and gas in the gallbladder wall was observed in 1 case respectively. Conclusion MDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.

Objective To explore the features of activation mapping induced by olfactory stimulation with functional magnetic imaging (fMRI), which will help to reveal the neural mechanism of olfactory dysfunction and contribute to the earlier diagnosis and treatment of neural degenerative disorders.Methods In this prospective study, 21 healthy volunteers were recruited in the Affiliated Hospital of North Sichuan Medical College from March to October 2015.Olfactory function was evaluated by using Visual Analogue Scale (VAS).During the fMRI scanning, all subjects received olfactory stimulation of rose and lavender odor.The brain activation was obtained by using softwares matlab2008a and SPM8.Results All subjects had normal olfactory function evaluated by VAS score (4.86±0.07).The activated brain areas included: bilateral inferior parietal lobule, bilateral inferior frontal gyrus-orbitofrontal gyrus, left insula, bilateral inferior temporal gyrus, left putamen, bilateral hippocampus, bilateral cingulate cortex, bilateral piriform cortex, bilateral amygdale, left lingual gyrus, bilateral cerebellum (t=2.62, P<0.01).Conclusions Olfactory is associated with multiple brain regions.The combination of olfactory event-related design and fMRI, as an objective measurement of olfactory, can be applied to investigate the olfactory cortical brain mapping.

Objective To study the changes of cognitive function and brain microstructure of patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) from neuropsychological test and voxel-based morphometry.Methods Sixteen patients with BECTS and 16 healthy volunteers,who were matched in gender,age and education,were enrolled in this study from May 2014 to May 2015 in the Affiliated Hospital of North Sichuan Medical College.The cognitive function and morphometry of the subjects were evaluated by neuropsychological test (full scale intelligence quotient (FSIQ),verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ)) and high-resolution T1-weighted imaging scanning.Thereafter,these data were analyzed with Student's t test,Chi-squared test and correlation analysis.Results (1) FSIQ(79.3±13.3),VIQ(82.3±12.1) andPIQ(81.3±10.3)ofBECTS group were significantly lower than the control group (107.0 ± 6.4,101.6 ± 6.5,114.8 ± 6.2;t =9.511,7.521,16.360,all P ＜0.01).(2) Patients with BECTS showed significantly increased gray matter volume in the bilateral putamen,paracentral lobule and right supplementary motor area (P ＜ 0.05,FDR-corrected).(3) A significant negative correlation was found between the gray matter volume of the left putamen and age of epilepsy onset (r=-0.586,P=0.017).Conclusions (1) There is a certain degree of cognitive impairment in patients with BECTS.(2) Patients with BECTS have some changes in brain microstructure.Genetic factors could indirectly influence the children's brain developmental trajectory,and the age of onset may be associated with the changes on the brain microstructure.

Based on the analysis of definition and the causes of excessive medical treatment, this paper discus-ses the harm of excessive medical treatment concretely, including increased health care costs, the waste of medical resources, worsening doctor-patient conflicts that influence the development of holistic medicine. And in the per-spective of ethics, professional spirit and the humanistic quality, it puts forward the prevention and countermeasures to solve the problem of excessive medical treatment.

Objective To study the value of carotid plaque magnetic resonance imaging (MRI) in pre-operation assessment in the elderly patients with carotid atherosclerosis and explore the possibility of minimizing the contrast weightings to gain sweeptime. Methods Totally 70 elderly patients with cerebral ischemia (average age of 68.8 years) underwent carotid MRI and digital subtraction angiography (DSA) due to the appearance of carotid plaque detected by ultrasound. Carotid plaque MRI was acquired with 3.0T MR scanner and 8 channel surface coil. The standard carotid plague MRI program included pre-and post-contrast T1 weighted imaging (T1WI), T2 weighted imaging, proton density weighted imaging and 3D time of flight MR angiography (3D TOF MRA). All these program were divided into two combinations: the 5-sequence MRI (all the sequences) and 2-sequence MRI (T1WI and TOF MRA). Digital subtraction angiography (DSA) in coronal and lateral views of carotid artery was performed with GE Advantx LCN+. The software SPSS 13.0 was used to statistically analyze the difference between MRI and DSA, and that of two sequence combinations was used in the detection of luminal stenosis and fibrous cap (FC) rupture. Results Totally 135 arteries were analyzed while 3 arteries in one patient were excluded due to the poor quality image and stent placement. The degree of luminal stenosis were (38.3±31.0)% and (38.5±30.9)%, respectively, detected by the two MRI sequence-combination with no significant difference (t=2.447, P＞0.05) and was (35.1±31.8)% by DSA. There was a good concordance between MRI and DSA in luminal stenosis detection (Kappa value: 0.773). No statistical difference was found between two MR sequence combinations in detecting FC rupture (both in 36 vessels). DSA detected FC rupture of 16 vessels, showing remarkably difference contrast to MRI(χ2=12.0, P＜0.01). Conclusions MRI can accurately detect the luminal stenosis and FC rupture. The short time scanning resulting from sequence optimization could make MRI much more suitable than DSA to do the pre-operation assessment for senile carotid atherosclerotic patients.

Objective Aδ and C fiber nociceptors can be excited when people received contact heat stimulation(CHS) and this excitation may be reflected by functional magnetic resonance imaging(fMRI).The aim of this study was to observe the different fMRI characteristics in CHS with distinct temperatures in healthy people and to explore the pain related functional network.Depending on the fMRI results,we can evaluate the values of CHS-fMRI during the research of brain functional connectivity.Methods Twenty-two healthy volunteers were recruited to this study.During the acquisition of fMRI,the right dorsal forearm received two different CHS in 41 and 51 degree respectively(41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group),and two series of fMRI data were obtained for each subject.The brain activation was obtained by using one sample t test for the 41 ℃CHS-fMRI group and 51 ℃CHS-fMRI group separately.The difference between 41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group was analyzed by paired-sample t-test.Result These activated brain areas in 41 ℃ CHS-fMRI group included bilateral superior temporal gyrus (STG),contralateral transverse temporal gyrus,contralateral amygdala,bilateral insula,bilateral inferior frontal gyrus (IFG),contralateral hippocampus,bilateral putamen,contralateral supramarginal,ipsilateral postcentral,ipsilateral inferior parietal lobule,ipsilateral middle temporal gyrus (MTG),bilateral cerebelum,bilateral middle cingulate cortex and bilateral posterior cingulate cortex.These activated brain areas in 51 ℃ CHS-fMRI group included bilateral STG,bilateral amygdala,contralateral hippocampus,bilateral thalamus,contralateral putamen,bilateral insula,bilateral IFG,bilateral cerebellum,contralateral postcentral,contralateral superior parietal lobule,bilateral MTG,bilateral precuneus,and contralateral cuneus.Compared with 41 ℃ CHS-fMRI group,the 51 ℃ CHS-fMRI group showed higher brain activation in bilateral cerebellum (right:4.455,left:3.891),ipsilateral precuneus (4.150),contralateral insula (3.530),contralateral IFG (3.530),and contralateral postcentral (3.530; t =2.83,P ＜ 0.01).Conclusions There are common brain activated areas and specific areas for each group,which suggested that existence of two central pathways activated by Aδ and C fiber which have different effects in perception of pain and have their brain network responsively.It may become one of the ideal pain stimulation methods with CHS-fMRI,which warrant worth further research.

OBJECTIVETo investigate the technique and therapeutic effect of laparoscopy-insisted vaginoplasty with peritoneum in patients with androgen insensitivity syndrome.

METHODSFrom May. in the Fifth People' s Hospital of Shenzhen. The therapeutic effect was retrospectively analyzed.

RESULTSLaparoscopy-insisted vaginoplasty was successfully completely with peritoneum in patients with androgen in 4 cases. Ileumtivity segyndroment was used instead of peritoneum in one case. Open operation was not adopted in any cases. The ectopic testicles were removed during operation in 4 cases. The average operation time and bleeding volume was 60 min and 20 ml, respectively. Rectum, bladder and urethra were not injured in any case. The average vaginal length was 9 cm (range 8-10 cm) 21-28 days after operation. 6 months after operation, the surface of reconstructed vagina was smooth, ruddy and flexible, with satisfactory anatomical and functional results. Normal sexual activity was achieved in 2 cases.

CONCLUSIONSLaparoscopy-insisted vaginoplasty with peritoneum could be used for female patients with androgen insensitivity syndrome. The ectopic testicles should be removed. Estrogen supplement and psychological guide after operation are also important.

Adult ; Androgen-Insensitivity Syndrome ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Peritoneum ; surgery ; Reconstructive Surgical Procedures ; methods ; Vagina ; surgery ; Young Adult

OBJECTIVETo explore the effect of combination therapy of tetramethylpyrazine (TMP) with methotrexate (MTX) on collagen induced arthritis (CIA) rats.

METHODSTotally 55 male SD rats were stratified by body weight. Nine of them were randomly recruited as the normal control group. The rest 46 were immunized with type II bovine collagen (C II) for establishing rheumatoid arthritis (RA) model. Forty successfully modeled rats were randomly divided into 4 groups according to swollen toe degree, i.e., the CIA group, the TMP group, the MTX group, and the TMP plus MTX group, 10 in each group. Rats in the MTX group were administered with MTX (1. 2 mg/kg) , once per week for 4 continuous weeks. Those in the TMP group were administered with 40 mg/kg TMP, once per day for 10 continuous days, and then discontinued for 7 successive days, and continued for another 10 successive days. Rats in the TMP plus MTX group were administered with a mixture of equal dose MTX and TMP, and when MTX was discontinue, TMP was administered according to the way in the TMP group. Equal volume of saline solution was given to rats in the normal control group and the CIA group. Clinical parameters including ankle width (mediolateral diameter) and hindpaw swelling were measured at day 0, 4, 11, 18, and 26 after treatment. Rats were sacrificed 28 days after treatment, their knee joints and ankle joints were collected for pathological analyses. Serum levels of IL-1β, IL-6, and IL-17A were detected by ELISA. Changes of fibrinogen (FIB) and platelet aggregation rate (PAg) were detected.

RESULTSCompared with the normal control group, the ankle width and hindpaw swelling increased significantly (P < 0.01), contents of FIB and PAg increased obviously (P < 0.05, P < 0.01), serum levels of IL-1β, IL-6, and IL-17 increased remarkably (P <0. 01) in the CIA group. Obvious cell proliferation, inflammatory cell infiltration, hyperemia and edema of synovial tissues could be seen. Pannus formed and immerged in cartilages, resulting in necrosis. Compared with the model group, changes of ankle width and hindpaw swelling were all alleviated in each medicated group (P <0. 05, P <0. 01). Of them, the effect was superior in the MTX group to that of the TMP group and the MTX plus TMP group (P < 0.05, P < 0.01). Contents of FIB, serum levels of IL-1β and IL-6 decreased significantly in the MTX group (P < 0.05). Contents of FIB, serum levels of IL-1β and IL-6 decreased significantly in the TMP group and the MTX plus TMP group (P < 0.05). Besides, serum levels of FIB and IL-6 were obviously lower in the MTX plus TMP group than in the TMP group and the MTX group (P < 0.01). Levels of PAg and IL-17A were more significantly lowered in the TMP group than in the MTX plus TMP group and the MTX group. Pathological changes could be alleviated in each medicated group, with the optimal effect obtained in the MTX plus TMP group.

CONCLUSIONCombination of TMP with MTX could significantly ameliorate inflammatory reactions and FIB contents of CIA rats.

Animals ; Arthritis, Experimental ; Arthritis, Rheumatoid ; Cattle ; Collagen Type II ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Hemorheology ; Interleukin-17 ; Interleukin-1beta ; Interleukin-6 ; Male ; Methotrexate ; therapeutic use ; Pyrazines ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Synovial Membrane

Objective To evaluate the bacteriostatic effect of recombinant human lactoferrin(rhLF) on Helicobacter(H .) py‐lori and its influence on CagA ,Ure and gastric mucosal IL‐8 .Methods The minimum inhibitory concentration(MIC)and the influ‐ence of different drug concentrations on the proliferation of H .pylori were detected .The effects of rhLF on the mRNA and protein expressions of CagA and Ure in H .pylori were detected by RT‐PCR and Western blot ,respectively .The animal study :Balb/c mice were adopted and assigned randomly into four groups ,including the standard triple+rhLF(group A) ,rhLF(group B) ,standard tri‐ple(group C) and normal saline(group D) .The histopathological HE staining was used to observe the gastric inflammation and ELISA was used to detect the IL‐8 level of gastric tissue in each group .Results MIC was 0 .5 mg/mL ,moreover rhLF inhibited the bacterial growth and proliferation with a concentration‐dependent manner .rhLF could reduce the expression of H .pylori major viru‐lence factor CagA ,mRNA and protein of Ure .Comparing the group A with the group B ,C and D ,the gastric mucosal inflammation score and the IL‐8 levels of gastric tissue homogenates had statistically significant differences(P<0 .05) .Conclusion rhLF inhibits the growth and proliferation of H .pylori ,moreover inhibit the expression of major virulence factor CagA in H .pylori ,mRNA and protein of Ure in different degrees ,weakens its pathogenicity ,meanwhile reduces the IL‐8 level in mice gastric mucosa ,and allevi‐ates H .pylori related gastric mucosal inflammatory response .

A case of a patient with subgingivally fractured incisor was presented. Two weeks after root canal therapy, the subgingival fragment was restored with fiber post, resin core and temporary crown. Gingivoplasty was performed around. after the subgingival fragment had been elevated in the axial direction by means of edgewise fixed appliance. Stabilized and held for 6 months, the incisor was restored with all ceramic crown. Optimal esthetic was achieved when restoration was performed after rapid orthodontic extrusion which had lifted up the fracture line above the level of the gingival line within 14 days. At 6-month follow-up, the periodontal tissues were normal and neither luxation nor relapse was noted.
Crowns ; Dental Porcelain ; Esthetics ; Gingiva ; Humans ; Incisor ; Orthodontic Extrusion ; Post and Core Technique ; Root Canal Therapy ; Tooth Fractures