OBJECTIVETo investigate the advantages and disadvantages of dual energy with dual-source computed tomography (CT) in cerebral angiography by comparing those of neuro-digital subtraction angiography (Neuro-DSA) .

METHODSTotally 300 patients with normal CT angiography (CTA) images underwent dual energy CT angiography (DE-CTA groups, n=200) and Neuro-DSA scan (Neuro-DSA groups, n=100) using dual source CT. The comparison of two scan approaches was based on image quality, radiation does, post-processing methods, and duration of scanning and subtraction.

RESULTSThe image quality of intracranial blood vessels in DE-CTA group showed no significant difference with that in Neuro-DSA group (P>0.05) , while the number of Grade I images was significantly higher than those of other three grades (P<0.01) . However, the effect of the skull base bone removal with Neuro-DSA is superior to DE-CTA (P<0.01) . The duration of scanning was significantly longer in DE-CTA group than in Neuro-DSA group (P<0.01) . However, the radiation dose, time of entire examination, and time of subtraction were significantly lower/shorter in DE-CTA group than in Neuro-DSA group (P<0.01) . The radiation dose of DE-CTA group is 26.3% lower than Neuro-DSA group.

CONCLUSIONSThe image quality of intracranial blood vessels with head DE-CTA is same as Neuro-DSA, while head DE-CTA has lower radiation doses and higher inspection efficiency than Neuro-DSA. However, the effect of the skull base bone removal needs to be improved.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; methods ; Cerebral Angiography ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVETo evaluate the value of echocardiography in the diagnosis of noncompaction of the ventricular myocardium (NCVM) and to elucidate the echocardiographic characteristics of NCVM.

METHODSThis study included 53 patients (28 boys and 25 girls), with an age for initial diagnosis of 15 days to 18 years, who were diagnosed with NCVM by echocardiography between May 2006 and May 2015. Transthoracic two-dimensional echocardiography and color Doppler were performed for qualitative diagnosis, and the end-diastolic non-compacted layer/compacted layer (N/C) ratio measured in the parasternal ventricular short-axis sectional view was selected as the criterion for quantitative diagnosis.

RESULTSThe excessively prominent ventricular trabeculae and deep inter-trabecular recesses were all seen in 53 cases, and the blood flow in the cardiac chambers was connected to the inter-trabecular recesses. The areas involved in NCVM were mainly the apex (100%) and the middle segment of the left ventricular lateral wall (98%), followed by the middle segment of the left ventricular posterior wall (49%) and the middle segment of the left ventricular inferior wall (42%). In 53 children with NCVM, the N/C ratio was 4.3±1.9 (2.1-10.0). Cardiac insufficiency was found in 83% (44/53) of the children with NCVM, and the left ventricular ejection fraction for these children was (43±9)%.

CONCLUSIONSEchocardiography can be used in the qualitative and quantitative diagnosis of NCVM and in the evaluation of cardiac function. The apex and the middle segment of the left ventricular lateral wall are often involved in NCVM, accompanied by decrease in the left ventricular ejection fraction.

Adolescent ; Child ; Child, Preschool ; Echocardiography ; Female ; Heart Ventricles ; abnormalities ; diagnostic imaging ; Humans ; Infant ; Infant, Newborn ; Male ; Stroke Volume ; Ventricular Function, Left

OBJECTIVETo observe the effects of interleukin-8 monoclonal antibody on smooth muscle cell proliferation and balloon inflation-induced abdominal aorta stenosis in rabbits.

METHODSThirty-six New Zealand white rabbits were randomly assigned to balloon inflation group (group A, n = 12), interleukin-8 monoclonal antibody pre-treated rabbits (2 mg/kg for 3 days before balloon inflation, group B, n = 12) and sham-operated control group (group C, n = 12). Peripheral blood was collected before experiment and at 4 h, 1, 3, 7, 14, and 28 days post balloon inflation or sham operation and the levels of IL-8 were measured by enzyme linked immunosorbent assay (ELISA). The ratio of positive and negative masculine cells in the high power microscopic field was determined in proliferating cell nuclear antigen (PCNA) stained slide. Histopathologic examination was performed in abdominal aorta and luminal area, intima and tunica media area were measured.

RESULTSPlasma interleukin-8 began to rise at 4 h and peaked at 1 day and remained increased up to 28 days after balloon inflation in rabbits of group A, plasma interleukin-8 level in group A was significantly higher than in group B and C at 4 h and thereafter post operation. The ratio of positive and negative masculine cells was significantly increased in group A compared to group C and was significantly lower in group B than in group A. Abdominal aorta stenosis, luminal area, intima and tunica media area were significantly reduced in group B than in group A. Correlation analysis indicated that there were positive relations between plasma IL-8 level and intima thickness, area of intima and tunica media, respectively (r = 0.894, 0.783, 0.801, 0.912, all P < 0.01).

CONCLUSIONSPlasma IL-8 level is increased in this abdominal aorta stenosis model and is positively correlated to the severity of abdominal aorta stenosis. IL-8 monoclonal antibody could significantly reduce abdominal aorta stenosis in this abdominal aorta stenosis model.

Animals ; Antibodies, Monoclonal ; pharmacology ; therapeutic use ; Aorta, Abdominal ; pathology ; Aortic Coarctation ; drug therapy ; pathology ; Cell Proliferation ; drug effects ; Interleukin-8 ; immunology ; Muscle, Smooth, Vascular ; cytology ; drug effects ; Myocytes, Smooth Muscle ; drug effects ; Rabbits

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; HIV Infections ; physiopathology ; Humans ; Liver Diseases ; physiopathology ; virology ; Male ; Middle Aged ; Risk Factors ; Young Adult

OBJECTIVETo analyze the risk factors for hospital mortality after operations for type A aortic dissection.

METHODSTotally 766 consecutive patients (586 male and 180 female patient, aged (45±12) years, ranging from 16 to 78 years), who underwent surgery for type A aortic dissection from January 2001 to December 2010, were studied retrospectively. Preoperative and operation related clinic factors were analyzed by univariate analysis, followed by Logistic regression model, to identify the risk factors of hospital mortality.

RESULTSOverall, 37 patients (4.8%) died during hospitalization. On univariate analysis, significant risk factors for hospital mortality were male, acute status, renal dysfunction, cardiac dysfunction, cardiopulmonary bypass time, duration of operation, volume of blood transfusion, re-operation for bleeding (χ2=4.008-27.093, P<0.05). On Logistic regression model, independent risk factors were acute status (OR=2.784, 95%CI: 1.166-6.649, P=0.021), renal dysfunction (OR=6.285, 95%CI: 1.738 - 22.723, P=0.005), cardiac dysfunction (OR=3.052, 95%CI: 1.083-8.606, P=0.035), re-operation for bleeding (OR=3.690, 95%CI: 1.262-10.791, P=0.017), volume of blood transfusion (OR=1.033, 95%CI: 1.008-1.058, P=0.010). Additionally, male (OR=0.387, 95%CI: 0.177-0.848, P=0.018) was protective factor, and alternatively, female was indeed one of the independent risk factors for hospital mortality.

CONCLUSIONFemale, acute status, renal dysfunction, cardiac dysfunction, re-operation for bleeding, volume of blood transfusion were independent risk factors for hospital mortality after operations for type A aortic dissection.

Adolescent ; Adult ; Aged ; Aneurysm, Dissecting ; mortality ; surgery ; Aortic Aneurysm, Thoracic ; mortality ; surgery ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Young Adult

OBJECTIVETo research the expectorant components in volatile oil from the root and rhizome of Aster tataricus.

METHODGC-MS was applied to isolate and identify the compounds. In addition, TLC was used to isolate compound, and its structure was elucidated on the basis of spectral data analysis. At the same time, its expectorant effect was observed by method of the excretion quantity of phenol red in trachea of mice.

RESULTSeven compounds were isolated and identified by GC-MS, they were (R)(-)-p-menth-1-en-4-ol (1), 2-undecanone (2), n-decanoic acid (3), (-)-spathulenol (4), hexahydrofamrnesyl acetone (5), hexadecanoic acid (6), and cis-9, cis-12-octaecadienoic acid (7). A known compound 1-acetoxy-2-ene(E)-4,6- decandiyne was isolated from the root and rhizome of A. tataricus, and it was shown to have expectorant effect.

CONCLUSION1-Acetoxy-2-ene(E) -4,6- decandiyne, a main compound in volatile oil, had been found to have expectorant effect.

Animals ; Aster Plant ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Expectorants ; chemistry ; isolation & purification ; pharmacology ; Gas Chromatography-Mass Spectrometry ; Magnetic Resonance Spectroscopy ; Male ; Mice ; Oils, Volatile ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry

OBJECTIVETo explore the effect of Astragalus membranaceus (AM) on T-helper cell type 1 (Thl) specific transcription factor T-box expressed in T cells (T-bet) expression and Thl/Th2 equilibrium.

METHODSThe levels of T-bet mRNA in peripheral blood mononuclear cells (PBMCs) from 15 patients with asthma and 15 healthy subjects were determined by reverse transcription-polymerase chain reaction (RT-PCR). PBMCs in asthma patients were incubated with AM and then the concentration of interferon gamma (IFN-gamma) and interleukin-4 (IL-4) in the supernate before and after AM intervention were determined by ELISA. The numbers of CD4 + CCR3 + and CD4 + CCR5 + cells were counted by flow cytometry.

RESULTSThe expression of T-bet mRNA and the level of IFN-gamma were lower, but level of serum IL-4 was higher in asthma patients when compared with those in healthy subjects respectively. After AM (60 microg/ml) intervention, the former two parameters raised and showed a positive correlation between them, while the level of IL-4 was decreased. The mean percentage of CD4 + CCR3 + cells in asthma patients was significantly higher but that of CD4 + CCR5 + cells was lower when compared with those in healthy subjects respectively. After AM intervention, the abnormal change in the two indexes was improved to certain extent, showing a reversing status of Th2 polarization.

CONCLUSIONAM could increase the expression of T-bet mRNA and Thl cytokines such as IFN-Y, and might reverse the Th2 predominant status in asthma patients.

Adult ; Asthma ; drug therapy ; immunology ; Astragalus membranaceus ; Cell Polarity ; Cross-Sectional Studies ; Female ; Humans ; Interferon-gamma ; biosynthesis ; blood ; Interleukin-4 ; blood ; Male ; Middle Aged ; Phytotherapy ; RNA, Messenger ; analysis ; Receptors, CCR3 ; Receptors, CCR5 ; blood ; Receptors, Chemokine ; blood ; T-Box Domain Proteins ; genetics ; Th1 Cells ; drug effects ; immunology ; Up-Regulation

OBJECTIVE: To compare clinical effects of the improved interface screw fixation of femoral end of anterior cruciate ligament with classic femoral lateral loop plate fixation. METHODS: A retrospective analysis of 65 patients who underwent arthroscopic anterior cruciate ligament reconstruction from January 2019 to September 2021 were performed. According to the different fixation methods of the femoral side, 35 patients were divided into loop plate fixation(loop plate group), including 27 males and 8 females, aged from 18 to 50 years old with an average of (35.00±7.60) years old;30 patients in interface screw fixation(interface screw group), including 20 males and 10 females, aged from 18 to 50 years old with an average of (32.00±8.50) years old. Hospital stay, hospital expenses, operation time, complications, C-reactive protein at 1, 3, 6 days after operation, and postoperative Lysholm score and International Knee Documentation Committee(IKDC) score at 18 months were compared between two groups. RESULTS: All patients were successfully operated, and obtained follow-up from 18 to 36 months with an average of (25.16±4.50) months. Anterior drawer test and Lachman test of all patients turned to negative. There were no statistical differences in hospital stay, hospital expenses and complications between two groups(P>0.05);operation time in loop plate group was (74.00±6.84) min, and (91.67±6.34) min in interface screw group, and had difference between two groups(P<0.05). C-reactive protein on the 1st and 3rd day after operation was (40.00±10.10), (20.00±8.23) mg·L^-1 in loop plate group, and (60.00±8.93), (30.00±8.66) mg·L^-1 in interface nail group, had statistical difference between two groups (P<0.05);while there was no difference in C-reactive protein on the 6th day after operation(P>0.05). At 18 months after operation, Lysholm and IKDC scores showed no significant difference between two groups (P>0.05). In loop plate group, medullary enlargement on coronal and sagittal views were (2.75±0.19) mm, (1.55±0.25) mm, and (2.81±0.22) mm, (1.61±0.20) mm in interface screw group, and had statistical difference between two groups(P<0.05). CONCLUSION In the reconstruction of anterior cruciate ligament, the common interface screw on the femoral side is changed to the sheath interface screw, and intramedullary screw is changed to the compression and fixation of tendon from outside to inside of joint. Although the operation procedure is relatively complicated and operation time is slightly longer, it has advantages of no residual metal foreign body after operation, and clinical effect is no different from classical loop plate suspension fixation, which is still a good choice.
Female ; Male ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; C-Reactive Protein ; Retrospective Studies ; Femur ; Anterior Cruciate Ligament Reconstruction ; Bone Screws

Objective:To investigate the survival rates of patients with liver cancer in Shanghai from 2002 to 2013. Methods:Data on new cases and deaths of liver cancer patients withfollow-up information from 2002 to 2013 were obtained from the Population-Based Cancer Registry and Vital Statistics System of the Shanghai Municipal Center for Disease Control and Prevention.Incidence and survival rates were stratified by year of diagnosis,gender,district,age-group and stage at diagnosis for analysis.Statistical indicators,such as case numbers,proportions,median age and mean age were calculated.The 1-to 5-year observed survival rates were calculated based on the life table method.The probabilities of surviving from 0 to 99 years old were estimated with the Elandt-Johnson model,and then cumulative expected survival rates were calculated using the Ederer Ⅱ method.Finally,the 1-to 5-year relative survival rates were calculated. Results:A total of 49 455 new cases of liver cancer were diagnosed from 2002 to 2013 in Shanghai,including 35 115 males and 14 340 females.The ratio of males to females was 2.45:1.The proportions of stage Ⅰ,stage Ⅳ and stage unknown were 3.32％,13.93％and 69.13％,respectively.The median survival time of patients with liver cancer diagnosed from 2002 to 2013 was 0.77 years,the 5-year observed survival rate was 13.23％,and the 5-year relative survival rate was 14.47％.According to the 5-year observed survival rate and 5-year relative survival rate of the cases,both survival indicators were higher in urban areas than in suburban areas,higher in males than in females,higher in cases under 45 years of age than in those over 75 years of age,higher in cases diagnosed from 2011 to 2013 than those diagnosed from 2002 to 2004.Additionally,the survival rate of cases decreased with increasing stage at diagnosis. Conclusion:With the continuous improvement of the diagnosis and treatment of liver cancer in Shanghai,the survival rate of patients with liver cancer has shown a significant upward trend over time.However,compared with various malignant tumors such as gastric cancer and breast cancer,the improvement effect of liver cancer survival rate is still not significant.Additionally,a high proportion of cases with unknown clinical stage at the time of diagnosis and a low survival rate of stage Ⅳ cases were observed.This study provides a basis for the prevention and research of liver cancer.

BACKGROUNDAnomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare but potentially life-threatening congenital heart defect. A retrospective analysis was carried out to elucidate the surgical outcomes of ALCAPA in infants and children using follow-up echocardiography.

METHODSFrom September 2008 to March 2017, 26 children diagnosed with ALCAPA underwent left coronary re-implantation. All surviving patients received echocardiography during follow-up.

RESULTSThe mortality rate after the operation was 11.5%. Before repair, twenty patients (76.9%) presented with left ventricular (LV) dysfunction. The mean Z-score of the preoperative LV end-diastolic diameter was 4.42 ± 2.09. Mitral regurgitation (MR) was present in all patients. Two patients (7.7%), both with mitral valve prolapse, underwent mitral valve repair at the time of ALCAPA repair. Two children required postoperative extracorporeal membrane oxygenation. LV function normalized at a median time of 5.3 months (range: 0.5-36.0 months). The Z-score of the LV end-diastolic diameter decreased simultaneously. The degree of MR gradually decreased in all surviving patients. All patients had patency of the proximal left coronary artery confirmed by echocardiography at the most recent follow-up. Six patients (26.1%) showed supravalvar pulmonary stenosis and seven patients (30.4%) showed right pulmonary stenosis during follow-up.

CONCLUSIONSCoronary re-implantation was effective for rebuilding a dual coronary system in patients with ALCAPA and resulted in progressive improved LV function and reduced functional MR. Echocardiography was valuable for evaluating the outcomes. LV function, the degree of MR, and possible complications could be detected with follow-up echocardiography.