Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Objective To determine the significance of change of insulin-like growth factor-1(IGF-1) and study the effect of IGF-1 on expression of Bcl-2 and Bax.Methods Male Balb/c mice were randomly divided into control group,coxsackie B3(CVB3) infection group(infection group),CVB3 infection with IGF-1 treated group.Animals were killed at d7,d14.The immunohistochemical studies and medical imagine analysis system were performed to evaluate the expression of Bcl-2 and Bax in myocardial tissue.Serum IGF-1 concentrations were assayed by radioimmunoassay(RIA).Results In infection group,the concentrations of IGF-1 were more decreased than that of control group and the expression of Bcl-2 reduced and Bax increased(P

Objective To analyze the differential expression of proteome between metastatic lymph nodes and normal lymph nodes in esophageal squamous cell carcinoma.Methods Two dimensional polyacrylamide gel electrophoresis(2-DE)technique and computer-assisted image analysis were used to separate the protein spots and analyze the differential expression of proteome in the metastatic lymph nodes and normal lymph nodes.Results There were 23 protein spots significantly differentially expressed,of which 4 protein spots were newly found,1 protein spot disappeared,14 protein spots increased markedly,and 4 protein spots decreased significantly.Conclusion The proteomic expression in metastatic lymph nodes of esophageal squamous cell carcinoma is significantly different from that of the normal lymph nodes,which may be associated with the mechanism of metastasis of esophageal squamous cell carcinoma.

Objective To investigate the effect of the modified wrist-hand orthosis on the spasm and function of wrist-hand in hemiplegic patients. Methods 56 patients with hemiplegia after stroke were divided into observation group (n=28) and control group (n=28). All the patients received routine rehabilitation, including physical therapy, occupational therapy, and Hufschmidt therapy. The observation group wore modified wrist-hand orthosis 4-8 hours a day after the treatment, with interval of 15 min per 30-60 min. All the patients were assessed with modified Ashworth Scale (MAS), simple Fugl-Meyer Assessment (FMA) and active range of motion (AROM) of flexion, extension, radial deviation and ulnar deviation of wrist before and 4 weeks, 8 weeks and 12 weeks after treatment. Results There was no significant improvement in both groups 4 weeks after treatment, nor difference between groups. The scores of MAS and FMA improved 8 weeks after treatment in both groups (P<0.05), and improved more in the observation group than in the control group (P<0.01). While the AROMs improved in the observation groups (P<0.05), and the AROM of extension was more than that of the control group (P<0.01). 12 weeks after treatment, the scores of MAS and FMA improved further in the observation group (P<0.01), and improved more than those of the control group (P<0.01). The AROMs of flexion, extension and radial deviation improved more in the observation group than in the control group (P<0.05). Conclusion The modified wrist-hand orthosis can obviously relieve the spasm of wrist-hand flexor in patients with hemiplegia after stroke, and promote the motor function.

Objective To investigate the safety, efficacy and feasibility of CT-guided percutaneous conformal cryoablation for lung cancer. Methods The inclusion criteria were: (1) Poor respiratory function and aged patients who can not bear the thoracic surgical operation. (2) Peripheral lung cancer involving the pleura and chest wall which can not be resected. (3) Residual tumor after other comprehensive treatment. (4) Focal lung cancer but the patient refused surgical resection. The exclusion criteria were: (1) Multifocal lesions. (2) Lesion close to mediastinum with possible risk of vessel injury. (3) Severe impairment of pulmonary functions, the maximum voluntary ventilation is less than 39%. (4) Repeated cough or dyspnea, can not cooperate with the procedure. (5) Poor systemic conditions, cachexia or bleeding. Totally, 76 lung carcinoma lesions on 66 patients were treated by CT-guided percutaneous conformal cryoablation using 17 G cryoprobes. The maximum diameters of the tumors ranged from 1.5 cm to 1.6 cm. For the tumors with the maximum diameter less than 3.0 cm, they were treated by double-needle clamping cryoablation. For those with the maximum diameter between 3.0 and 5.0 cm, they were treated by multiple-needle conformal cryoablation. For those with the maximum diameter larger than 5.0 era, they were treated with multipleneedle conformal cryoablation, with the needle distance less than 1.5 cm. All the patients were followed-up 6 to 24 months after the procedure using contrast-enhanced CT to evaluate the tumor size and enhancement. Results For 18 cases with the maximum diameters less than 3.0 cm, CT scan during the procedure showed that the frozen areas extended beyond the edge of the lesions more than 1.0 cm, the lesion attenuated, narrow-band-like encircled translucency around the lesions and "target sign" with ground-glass density of the peripheral lung tissue. There was no enhancement during the first 1 st、3 rd month follow-up, only fibrosis scar in 6 th month follow-up. Seven patients were followed up 2 years later, 5 of them have no recurrence or metastasis, one had mediastinal lymphopathy and one had bone metastasis 1 year later. For the 22 cases with maximum diameters between 3.0 cm and 5.0 cm, CT scan during procedure showed the frozen areas covered the lesions, lobulation and spiculation disappeared and the tumor size slightly enlarged. The lesions volume reduced during 1 st and 3 rd month follow-up. Nine cases were followed up for 2 years, 4 had no recurrence, 3 were stable and 2 had remote metastasis. For 26 cases with the maximum diameters larger than 5.0 cm, CT scan during the procedure showed the frozen areas covered 70%-90% of the tumor, there was no frozen damage to the surrounding lung tissue. Twenty-six patients had postoperative radiotherapy and chemotherapy. Follow-up in the 6 th month showed that 9 lesions decreased, 11 were stable and 6 progressed with remote metastasis. Complications included hemoptysis (3), bloody sputum (26), pneumothorax (19). Five pneumothorax were treated by close drainage and recovered 5 days. Conclusion CT-guided percutaneous conformal cryoablation is an effective and minimal invasive procedure for the lung carcinoma treatment.

Objective To compare CT and MR imaging in guiding and monitoring cryoablation of hepatic tumors. Methods A total of 131 lesions in 121 patients with malignant tumors of liver were treated with imaging-guided percutaneous cryotherapy. There were 73 males and 48 females, mean age 60 years. Of the 121 patients, 61 patients had cryoablation under CT guidance and 60 patients under the guidance of MRI. CT-guidance was performed with the Philips big-bore CT in spiral mode, with 5 mm slice thickness.The MR guidance was performed with GE 0.35 T scanner assisted with infrared navigator (Xinaomdt), and both fast gradient echo sequence and fast spin-echo sequence were used. The cryoablation system is a magnetic resonance compatible system (Galil, Israel), equipped with 17 G cryoprobes that are 1.47 mm in outside diameter. A combination of multiple eryo-probes and conformal cryoablation were adopted in accordance with the location, the shape and the adjacent structure of each lesion. Each cryoablation included two freezing-thawing cycles. Scanning was performed intermittently during the operation to monitor the degree of ablation. The mean scanning time, the lesion depiction and ablation process monitoring, the efficacies of lesion ablation, complications,and survival time were analyzed with x2 test Results The mean scanning time was (5.6±1.8)min for CT and (22.0±2.6)min for MR. CT provideda good depiction of the lesion and the ribs which were poorly displayed on MR images. The metal probe could create artifacts on the CT images and it was difficult for CT to show the formation of ice ball of the lesion formed after embolization with lipiodol. MR was superior to CT in displaying, guiding and monitoring of ablation of lesions near such special ragions as the diaphragm dome, the hepatic hilum, and the gallbladder. MR was not affected by high-density embolization material and the metal probes, and thus was superior to CT in depicting the lesion,and monitoring the formation of ice ball and the process of lesion ablation, etc.However, MR scan was time consuming, and image quality of low-field open MR was less desirable than that of CT. The 12-month overall survival rates were 90.2%(55/61) and 90.0%(54/60), respectively. The overall efficacies of lesion ablation were 75.4%(46/61) and 83.4%(50/60), respectively. Conclusion CT has advantages of fast scanning and good display of such structures as ribs in the path of puncture as compared with MR. MR can display a lesion with multi-planar imaging, and is superior to CT in monitoring the procedure of ablation,especially in displaying, guiding and monitoring ablation of lesions near such special regions as the diaphragm dome, the hepatic hilum, and the gallbladder.

OBJECTIVETo determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.

METHODSWe performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.

RESULTSUreterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.

CONCLUSIONAnatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.

Adult ; Cystoscopes ; Ejaculation ; physiology ; Ejaculatory Ducts ; anatomy & histology ; physiology ; Endoscopy ; instrumentation ; methods ; Hematuria ; Hemospermia ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostate ; anatomy & histology ; physiology ; Rectal Neoplasms ; surgery ; Semen ; secretion ; Spermatozoa

Objective To compare volumetric‐modulated arc therapy(VMAT) with intensity‐modulated radiation therapy (IMRT) for brain metastases with regard to the dosimetric character .Methods Sixty patients who were diagnosed with brain me‐tastases were included in this study .The target area received two dose levels using late addition amount technique ,WBRT (30 Gy/10 F) with following addition (20 Gy/10 F) to 59 Gy .For a fair comparison ,VMAT and IMRT treatment plans were respectively designed for every patient with the same dosimetric constraints .Dosimetric comparisons between VMAT and IMRT plans were ana‐lyzed to evaluate :target coverage and homogeneity ,conformity of PTV ;sparing of OARs ;monitor units (MUs) .Results Two treatment plans all reached the treatment need .When compared with IMRT ,there was no significant difference in Dmean of eyeball , len ,optic never ,visual chiasma ,parotid ,brain stem ,and external auditory canal of VMAT (P>0 .05) .The Dmax of eyeball ,len ,pa‐rotid ,and external auditory canal of VMAT were lower than that in IMRT group (P<0 .05) .The VMAT group has the less MUs (P=0 .017) and less treatment time .Conclusion VMAT can reach the big‐dose radiotherapy need on brain metastases clinically . There are no significant diffference between VMAT and IMRT on Dmax ,Dmean ,CI ,and HI .The Dmax of eyeball ,len ,parotid ,and external auditory canal of VMAT were lower than that in IMRT group .The VMAT can reduce the radiotherapy time .

BACKGROUNDHIV is a neurotropic virus which can cause brain white matter demyelination, gliosis, and other pathological changes that appear as HIV encephalitis or AIDS dementia. The purpose of this study was to investigate the change of the diffused condition of water molecules in brain white matter in early acquired immune deficiency syndrome (AIDS) patients using MR diffusion tensor imaging (DTI).

METHODSDTI examinations were performed on a Siemens 3.0T MR scanner in 23 AIDS patients with normal brain appearance by conventional MRI and 20 healthy volunteers as the control group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in nine regions; corpus callosum (CC) knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter, parietal lobe white matter, occipital lobe white matter, and the anterior and posterior limbs of the internal capsule. The mean FA and ADC values from each region were compared in three groups: the symptomatic, asymptomatic and the control.

RESULTSThe mean FA values were significantly lower and the mean ADC values were significantly higher in all nine regions in patients in the symptomatic group than in the asymptomatic and control group patients. In the asymptomatic group, the mean FA values were significantly lower and the mean ADC values were significantly higher at the CC knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter and parietal lobe white matter, than in the control group. There were no significant differences at other regions between the two groups.

CONCLUSIONSThe diffused changes of water molecules in brain white matter in AIDS patients are related to brain white matter regions. DTI examination can detect the brain white matter lesions early in AIDS patients.

Acquired Immunodeficiency Syndrome ; pathology ; Adolescent ; Adult ; Aged ; Brain ; pathology ; Diffusion Tensor Imaging ; methods ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the time course change in myocardial high mobility group box-1 (HMGB1) after myocardial infarction in rats.

METHODSMyocardial infarction (MI) was induced in SD rats by ligation of the anterior descending coronary artery. At 1, 2, 4, and 8 weeks after MI, the cardiac function of the rats was examined, and the expressions of HMGB1 at mRNA and protein levels in the myocardium were detected using real-time RT-PCR and Western blotting, respectively.

RESULTSCardiac function test confirmed that the MI model was successfully induced. The expression of HMGB1 mRNA was increased in early stage (1 week) after MI, while significantly down-regulated in later stage (4-8 weeks after MI). HMGB1 protein showed a similar biphasic pattern of changes, and was up-regulated early (1-2 weeks) after MI (P<0.05) and decreased markedly (P<0.01) at 8 weeks.

CONCLUSIONSAs an inflammatory regulator, HMGB1 can modulate inflammatory response early time after MI and functions later as a transcriptional modulator, thus contributing to the myocardial repair after MI. Interventions targeting HMGB1 in different stages after MI may prove helpful in reducing the complications, improving the prognosis and promoting long-term survival.

Animals ; Blotting, Western ; HMGB1 Protein ; genetics ; metabolism ; Male ; Myocardial Infarction ; physiopathology ; Myocardium ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors