OBJECTIVESTo introduce a classification system of upper sacral segment and its significance based on the continuous pelvic axial computed tomography scan.

METHODSThe whole pelvis 2.0 mm thick axial scan images of 127 cases were observed, the sacroiliac screw channel of S1 were measured, according to the size of the transverse screw channel the upper sacral segment were classified. Such as transverse screw channel existed and in at least 4 layer scan images its width was > 7.3 mm, it was defined as sacral segment of the normal type. Such as transverse screw channel existed and its maximum width was 7.3 mm or less on scanning level, it was defined as a transitional. Such as transverse channel did not exist, or its width on all scanning level was 0 mm or less, it was defined as dysplastic. Various cases,percentage, and the average of the transverse screw channel were calculated.

RESULTSThere were 58 normal (45.7%),42 transitional (33.1%), and 27 dysplastic (21.2%) upper sacral segments with an averaged width of the tansverse screw channel of 13.9 mm, 5.2 mm, and 0.9 mm, respectively. Each specimen could be defined as one of the three types of upper sacral segment without exceptions.

CONCLUSIONIt is possible to insert a transverse iliosacral screw into a normal upper sacral segment when indicated because of the capacious transverse screw channel. The transverse iliosacral screw placement into the transitional and dysplastic upper sacral segments was contraindicated because of the limited or none transverse screw channel. The transitional upper sacral segment was superior to the dysplastic segment due to its starting point location restriction on the true lateral sacral view.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Density ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; surgery ; Sacrum ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo analyze the influence of included angle between the anterior aspects of S2 and S vertebral bodies on pelvic inlet imaging in the pelvic midline sagittal plane.

METHODSTotally 58 axial pelvic CT scans were chosen as study objects including 43 males and 15 females,with an average age of 40.7 years old (ranged,18 to 68 years old). The angles between the anterior aspects of S2 and S1, vertebral bodies and the horizontal plane on midline sagittal CT reconstruction were measured to simulate the optimal S2 and S1 inlet angles. The included angle between the anterior aspects of S2 and S1 vertebral bodies was calculated by subtrocting the S1,inlet angle from the S2 inlet angle defined as a base number. Then, the impact of the calculated included angles on the pelvic inlet imaging was analyzed. Results:The S2 inlet angles averaged (30.5±6.5) degrees; the S inlet angles averaged (25.7±5.9) degrees. The difference between them was significant (t=3.35, P=0.001). Ten patients had zero angle between the anterior aspects of S2 and S1 vertebral bodies; 14 patients had negative angle, averaged-(8.9±8.1) degrees; 34 patients had positive angle,averaged (11.8+6.4) degrees.

CONCLUSIONThe difference of included angle between the anterior aspects of S2 and S1 vertebral bodies leads to the difference between S1 inlet view and S2 inlet view in most cases, complicating the pelvic inlet imaging,and affecting the reliability of the application of pelvic inlet view. Utilizing the angles measured on the preoperative midlihe sagittal CT reconstruction to obatin the patient-customized S1 and S2 inlet views could accurately guide the S1 and S2 iliosacral screw insertion.

Adolescent ; Adult ; Aged ; Animals ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Pelvis ; anatomy & histology ; injuries ; Spine ; anatomy & histology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo introduce the location and course of S1, S2 sacral nerve root tunnel and to clarify the significance of the anterior aspect of sacral nerve root tunnel on placement of iliosacral screw on the standard lateral sacral view.

METHODSFirstly the data of 2.0 mm slice pelvic axial CT images were imported into Mimics 10.0, and the sacrum, innominate bones, and sacral nerve root tunnels were reconstructed into 3D views respectively, which were rotated to the standard lateral sacral views, pelvic outlet and inlet views. Then the location and course of the S1, S2 sacral nerve root tunnel on each view were observed.

RESULTSThe sacral nerve root tunnel started from the cranial end and anterior aspect of the vertebral canal of the same segment and ended up to the anterior sacral foramen with a direction from cranial-posterior-medial to caudal-anterior-lateral. The tunnel had a lower density than the iliac cortex and greater sciatic notch on the pelvic X-rays,especially on the standard sacral lateral view, on which it showed up as a disrupted are line and required more careful recognition.

CONCLUSIONIt can prevent the iliosacral screw from penetrating the sacral nerve root tunnel and vertebral canal when recognizing the anterior aspect of sacral nerve root tunnel and choosing it as the caudal-posterior boundary of the "safe zone" on the standard lateral sacral view.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; innervation ; surgery ; Radiography ; Sacrococcygeal Region ; diagnostic imaging ; innervation ; surgery ; Sacrum ; diagnostic imaging ; injuries ; innervation ; surgery ; Spinal Nerve Roots ; diagnostic imaging ; surgery ; Young Adult

OBJECTIVETo investigate the effects of butyl alcohol extract of Baitouweng decoction ( BAEB) on yeast-to-hyphae transition of Candida albicans isolates from vulvovaginal candidiasis (VVC) in alkaline pH.

METHODSerial 2-fold dilution assay was used to determine the minimal inhibitory concentrations (MICs) of Baitouweng decoction extracts against C. albicans isolates from VVC, XTT assay was applied to determine the metabolic activity of C. albicans hypha treated by BAEB for 6 h. The morphological change of C. albicans treated by BAEB was inspected at different pH by inverted microscope, fluorescence microscope, scanning electron microscopy (SEM). Solid agar plate and semi-solid agar were utilized to evaluate colony morphology and invasive growth of C. albicans, respectively. Quantitative Real-time PCR (qRT-PCR) was adopted to observe the expressions of hyphae-specific genes including HWP1, ALS3, CSH1, SUN41 and CaPDE2.

RESULTThe MIC of BAEB against C. albicans is less than that of other extracts; hyphae grow best at pH 8. 0; 512 mg · L(-1) and 1,024 mg · L(-1) BAEB could inhibit formation of hyphae and influence colony morphology. When treated by 512 mg · L(-1) and 1,024 mg · L(-1) BAEB, the colonies became smooth; while by 0 and 256 mg · L(-1) BAEB, the colonies became wrinkled. In semi-solid agar, the length of hyphae decreased steadily as the concentration of BAEB lowered. The expression of HWP1, ALS3, CSHl, SUN41 were downregulated by 5.12, 4.26, 3.2 and 2.74 folds, and CaPDE2 was upregulated by 2.38 fold.

CONCLUSIONBAEB could inhibit yeast-to-hyphae transition of C. albicans isolates from VVC in alkaline pH.

Antifungal Agents ; isolation & purification ; pharmacology ; Candida albicans ; drug effects ; genetics ; growth & development ; Candidiasis, Vulvovaginal ; drug therapy ; microbiology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyphae ; drug effects ; growth & development

OBJECTIVESTo research radiographic anatomy of the main structure of the pelvic Teepee view, including its azimuth direction and view anatomy structure.

METHODSFrom June 2013 to June 2014 adult pelvic CT examination results were filtered, excluding skeletal deformities and pelvic osseous destruction caused by tumors, trauma, etc. The data of 2.0 mm contiguous CT scan of 9 adults' intact pelves was,selected and input into Mimics 10.01 involving 7 males and 2 females with an average age of (41.2±10.3) years old. Utilizing the software, the 3D CT reconstructions of the pelves were completed. Setting the transparency being high,the pelvic 3D reconstructions were manipulated from the pelvic anteroposterior view to the combined obturator oblique outlet view and fine-tuned till the regular Teepee-or teardrop-shaped appearance emerges. Cutting tools of the software were at the moment applied to separate the "Teepee" from the main pelvis for each reconstruction. Then the "Teepee" and the rest (main) part of the pelvis were displayed in different color to facilitate the analysis on the Teepee, iliac-oblique, and anteroposterior views.

RESULTSThe "Teepee" started from the posterolateral aspect of the anterior inferior iliac spine and finished at the cortex between the posterior superior iliac spine and the posterior inferior iliac spine in a direction of being from caudal-anterior-lateral to cranial-posterior-medial. The radiographic anatomical composition of the "Teepee" contained one tip, one base,and two aspects. With the inner and outer iliac tables being the inner and outer aspects of the "Teepee", the tip is consequently formed by their intersection. The base is imaged from the cortex of the greater sciatic notch. The medial-inferior-posterior portion of the "Teepee" contains a small part of sacroiliac joint and its corresponding side of bone of the sacrum.

CONCLUSIONSThe "Teepee" is a zone of ample osseous structures of the pelvis, aside from a small medial-inferior-posterior portion, the main zone of which can be accepted as a safe osseous zone for the anchor of implants stabilizing certain pelvic and acetabular fracture patterns. The Teepee view can be utilized as guidance for the safe percutaneous insertion of such implants.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; anatomy & histology ; diagnostic imaging ; injuries ; surgery ; Sacroiliac Joint ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective To observe the changes of autophagy and apoptosis in the cerebral cortex in rats with brain explosive injury and received hyperbaric oxygen (HBO) treatment, and investigate the effect and significance of HBO on them. Methods Fifty-four SD rats were randomly divided into control group (n=6), explosive injury group (n=24) and explosive injury treated with HBO group (n=24).The control group was not injured and 600 mg TNT electric detonators were exploded over the brain of rats at a 12 cm distance in the explosive injury group and explosive injury treated with HBO group. HBO management was given to the explosive injury treated with HBO group 3 and 22 h after explosive injury and at the same time of the other 6 d. RT-PCR and Western blotting were used to detect the changes of Beclin-1 and caspase-3 in the cerebral cortex on the 6th and 24th h, 3rd and 7th d of injury. Results The expression levels of Beclin-1 and caspase-3 in the explosive injury group and explosive injury treated with HBO group were obviously higher than those in the control group (P＜0.05). The levels of Beclin-1and caspase-3 in the explosive injury treated with HBO group were significantly lower than those in the explosive injury group at the same time points (P＜0.05). Conclusion The decreased expressions of autophagy and apoptosis in brain cells by HBO treatment might be one of the possible mechanisms of treating craniocerebral injury.

Objective To compare the treatment outcomes,complications and histopathologic features between conventional parotidectomy and functional regional parotidectomy in the treatment for pleomorphic adenoma of parotid gland and to provide clinical,and pathological evidence for determining the safe surgical margin.Methods Of 109 patients,60 patients received conventional parotidectomy and 49 patients received functional regional parotidectomy.The rates of tumor recurrence and complications were compared between the groups of patients.Results There was no significant difference in the incidence of tumor recurrence,the facial paralysis and sialosyrinx between two groups.The rates of Frey's syndrome,numbness of auricular region,and facial asymmetry were 30.0％,61.7％,and 38.3％ in the patients with conventional parotidectomy respectively,while the rates were 6.1％,30.6％,and 8.2％ in the patients with functional regional parotidectomy,with significant statastically difference,respectively (P ＜ 0.05 ).Of 109 patients,33 with incomplete capsule,29 with capsule penetration,25 with pseudopodia,and 13 with satellite nodules.There was no significant difference in the depth of tumor infiltration between two groups of patients.For the tumor smaller than 2 cm,the depth of infiltration in conventional group was from 0.061 to 1.122 mm,functional group was from 0.442 to 3.127 mm (Z =- 1.093,P =0.057) ; for the tumors between 2 - 4 cm,the depth in conventional group was from 0.081 to 7.908 mm,functional group was from 0.082 to 6.632 mm ( Z =-0.214,P =0.831 ) ;for the tumor larger than 4 cm,the depth of infiltration was from 0.340 to 8.476 mm.Conclusions Compared with conventional parotidectomy,functional regional parotidectomy has good outcomes and less complications.The surgical margins of pleomorphic adenomas of the parotid gland should be determined by the size of tumor.The 1 cm-surgical margins are safe for the tumors less than 4 cm,and the tumors more than 4 cm should be treated with superficial parotidectomy.

OBJECTIVETo study the protective effect of intensive insulin treatment on the myocardium of severely scalded rats, and to primarily explore its mechanism.

METHODSEighteen SD rats were divided into three groups, with 6 rats in each group. The rats in burn and intensive insulin group were inflicted with 30% TBSA full-thickness injury on the back. Isotonic saline containing 0.12 U/ml insulin solution, and 100 g/L glucose solution were infused into the rats in the intensive insulin group to keep plasma glucose at the level of 4.0 - 6.6 mmol/L (the total fluid amount was 2 ml x kg(-1) x 8h(-1)). In sham burn group,fluid was given according to physiological demand. The same amount of isotonic saline was infused into the rats in burn group. The venous blood was obtained for the detection of plasma glucose contents, and the left ventricular systolic pressure (LVSP) and left ventricular end-diastolic pressure (LVEDP) were recorded via aortic ventricle cannula before scald and at 1, 2, 3, 4, 5, 6 post-scald hours (PSH). The tissue of the left ventricle was harvested at 6 PSH for the detection of troponin T expression in myocardiocytes.

RESULTSPlasma glucose level was increased to (7.6 +/- 1.7) mmol/L - (8.4 +/- 4.7) mmol/L in burn group during 1-6 PSH, which was significantly higher than that in intensive insulin group (4.5 +/- 0.9) mmol/L - (5.2 +/- 1.3) mmol/L, P < 0.01). Compared with the intensive insulin group, LVSP was markedly decreased in the burn group (60 +/- 11 mm Hg vs 72 +/- 8 mm Hg, P < 0.05) at 1 PSH,whereas LVEDP was increased significantly (21.3 +/- 11.3 mmHg vs 11.7 +/- 5.2 mmHg, P < 0.05). Intensive insulin treatment could significantly inhibit the loss of troponin T protein in myofilaments of myocardium.

CONCLUSIONIntensive insulin treatment possesses a protective effect on myocardia function after severe burns, and it may be related to its preventive effect on the loss of contractile protein in cardiocytes.

Animals ; Blood Glucose ; metabolism ; Burns ; drug therapy ; metabolism ; Insulin ; administration & dosage ; therapeutic use ; Male ; Myocardial Contraction ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Troponin T ; metabolism

OBJECTIVETo investigate the protective effect of insulin on oxygen-radical induced hepatic injury in severely scalded rats in early stage of severe scald.

METHODSEighty-four male Sprague-Dawley rats were randomly divided into three groups: i. e, normal group, saline group, and insulin group, with 28 rat in each group. The rats in the latter two groups were subjected to 30% TBSA full-thickness scald on the back, and received intra-peritoneal injection of 40ml/kg isotonic saline, and subcutaneous injection of 3 IU/kg insulin, respectively. The total anti-oxygen capability (T-AOC), the expression of superoxide dismutase (SOD), reactive oxygen species (ROS) and intercellular adhesion molecule (ICAM-1) in hepatic tissue, and serum alanine transaminase (ALT) were determined in each group at 6, 12, 24, 48 post-scald hours (PSH) with corresponding methods.

RESULTSThe hepatic T-AOC and SOD content were obviously decreased, while the ROS content were markedly increased at 6 PSH in saline group compared with that in normal group (P < 0.05 or P < 0.01). The expression of ICAM-1 and serum content of ALT were significantly higher than that in normal group at 12 PSH and 48 PSH (P < 0.01). At 24 PSH, the hepatic T-AOC (386 +/- 75) U/g and SOD content (210 +/- 39 ) U/g were obviously higher in insulin group than those in saline group [(124 +/- 18), (111 +/- 9) U/g, respectively, P < 0.01), but the ROS content (154 +/- 29 ) U/g was much lower than that in saline group [(351 +/- 41) U/g, respectively, P < 0.01]. At 48 PSH, the serum content of ALT and hepatic expression of ICAM-1 in insulin group exhibited obvious difference when compared with those in saline group (P < 0.01). Meanwhile, Pathological examination showed that hepatic injury was alleviated by insulin administration after scald.

CONCLUSIONInsulin administration early after severe scald exhibits protective effect on liver function by improving anti-oxygen radical ability of rat liver.

Alanine Transaminase ; blood ; Animals ; Burns ; metabolism ; pathology ; Insulin ; pharmacology ; Liver ; drug effects ; metabolism ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the protective effect of insulin on vascular endothelial cells of rats at early post-burn stage,and its mechanism.

METHODSAdult male Sprague-Dawley rats were randomly divided into 3 groups: i. e, sham scald group (n = 7), scald group (n = 7) and treatment group (n = 7). The rats in the latter 2 groups were subjected to 30% TBSA full-thickness burns with 94 degrees C water, and the sham scald rats were treated with 37 degrees C water. Intra-peritoneal injection of 40 ml/kg isotonic saline solution and subcutaneous injection of 3 units/kg insulin were given to the rats in treatment group after being subjected to 30% TBSA full-thickness burns. Subcutaneous injection of equal amount of isotonic saline was given to the sham and burn groups. The changes in vascular endothelial cell structure were observed with electron microscopy at 24 post-scald hours(PSH). Meanwhile, the blood glucose contents, the serum levels of nitric oxide (NO) and nitric oxide synthetase (NOS) were determined with oxidase method and colorimetric method, respectively.

RESULTSThe injury of arterial endothelial cells in the treatment group was obviously alleviated compared with that in burn group. The blood glucose content in the treatment group (7.1 +/- 0.7 mmol/L) was significantly lower than that in scald group (8.2 +/- 1.0 mmol/L, P < 0.05), though it was much higher in both groups than that in sham scald group (4.9 +/- 0.8 mmol/L, P < 0.01) at 24 PBH. The serum content of NO, total NOS and cNOS in treatment group were obviously higher than those in scald group (P < 0.01), but there was no obvious difference in iNOS content between the two groups(P > 0.05).

CONCLUSIONInsulin exhibits protective effect on vascular endothelial cells in severely scalded rats at the early post-burn stage, and it is attributed to its promotion of cNOS level leading to NO production.

Animals ; Blood Glucose ; analysis ; Burns ; blood ; drug therapy ; pathology ; Disease Models, Animal ; Endothelial Cells ; drug effects ; pathology ; Insulin ; therapeutic use ; Male ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley