Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.

Objective To evaluate the value of lymphoscintigraphy in diagnosis of chylous ascites in children.Methods Lymphoscintigraphy was done in 6 cases,computed tomography(CT) was done in 4 cases,X-ray exam was done 42 times.And their video repore were compared.Results Lymphoscintigraphy was done in 6 cases,5 cases′ results were positive which diagnosed chylous ascites,and their leaking positions were also found.Conclusion Lymphoscintigraphy has the qualitative and orientational effect on diagnosis of children with chylous ascites.

OBJECTIVETo investigate the clinical outcomes of semicircular decompression in treating old thoracolumbar fractures and intractable neuropathic pain.

METHODSFrom September 2009 to September 2013, 21 patients with old thoracolumbar fracture and intractable neuropathic pain were treated with semicircular decompression. Among initial surgery, posterior pedicle screw fixation was used in these patients, with or without laminectomy. All patients were male, range in age from 20 to 28 years old with an average of (25.00±2.38) years. Vertebral body residual bone block resulted in intra-spinal placeholder more than 50%. All patients were complete spinal cord injury (ASIA grade) or cauda equina injury. VAS scores was from 6 to 10 points with the mean of 7.14±0.91. In these patients, MRI, CT, X-rays were performed; denomination and dosage of analgesics were recorded; nerve function and pain status were respectively evaluated by ASIA grade and VAS score before and after operation.

RESULTSAll patients were followed up from 8 to 32 months with an average of (17.29±6.02) months. All bone fragments of spinal canal were removed and spinal cord decompressions were achieved. At final follow-up, VAS scores were from 0 to 8 points with an average of (2.43±2.46) points, and were obviously reduced than peroperative data (P<0.05). Eleven cases of them stopped analgesic intake and 7 cases reduced using. Three patients' symptoms and VAS scores were not improved.

CONCLUSIONOld thoracolumbar fractures and intractable neuropathic pain need receive imaging examination as soon as possible and consider semicircular decompression therapy if bone fragments were in vertebral canal and spinal canal stenosis existed. This therapy can effectively relieve pain and profit nerve functional recovery.

Adult ; Decompression, Surgical ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Neuralgia ; etiology ; surgery ; Pain, Intractable ; etiology ; surgery ; Spinal Fractures ; physiopathology ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Visual Analog Scale ; Young Adult

OBJECTIVETo evaluate the results of calcium hydroxide-based sealer Sealapex in the treatment of chronic apical periodontitis.

METHODSA total of 100 cases with chronic apical periodontitis were included and divided into two groups, calcium hydroxide sealer (Sealapex) group and ZOE sealer group, and Sealapex and ZOE sealer were respectively used. All cases were followed up for two years after treatment and the clinical results compared between the two groups. The evaluation was based on clinical examination and radiographic assessment using periapical index (PAI) and digital subtraction radiography (DSR) technique.

RESULTSThere was no significant difference between the ZOE group and Sealapex group in overall healing rates and mean quantitative analysis at 3 months and 2 years after treatment (P = 0.206, 0.776). A correlation was found between PAI and DSR (P < 0.01, gamma = 0.58).

CONCLUSIONSSealapex sealer could obtain satisfactory effects for the treatment of chronic apical periodontitis. The combination of DSR and PAI methods was able to monitor the radiographic bone changes of periapical disease.

Calcium Hydroxide ; therapeutic use ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Male ; Periapical Periodontitis ; therapy ; Periodontal Index ; Radiography, Dental, Digital ; Root Canal Filling Materials ; therapeutic use ; Treatment Outcome

0.05).However,the shorter the history of the disease,the better the efficacy of the treatment.The younger the patient was,the better the efficacy of the treatment.Conclusions Vulva dystrophy can be treated with focused ultrasound effectively and safely.This approach appears to be a new promising treatment method.

Objective To investigate the correlation between residual strength of neck and shoulder muscles and respiratory function in patients with cervical spinal cord injury.Methods From January,2015 to June,2016,the muscle strength of sternocleidomastoid,trapezius and deltoid was tested in 30 patients with cervical spinal cord injury five and 24 weeks after injury.Meanwhile,their neurological and pul-monary function was evaluated.Results There was correlation between the vital capacity and muscle strength of deltoid both five and 24 weeks after injury(r>0.806,P<0.05)in the patients intermittent without ventilation,and it was found in sense score five weeks after injury (r=0.914,P<0.01),motor score(r=0.979,P<0.001)and the muscle strength of trapezius(r=0.894,P<0.01)24 weeks after injury.Conclu-sion The residual strength of neck and shoulder muscles,especially of deltoid,plays an important role in the respiratory function in patients with cervical spinal cord injury.

OBJECTIVETo define the clinical features of postoperative chylothorax for lung cancer (PCLC), and to compare them with those for esophageal cancer (PCEC).

METHODWe retrospectively analysed clinical characteristics of 12 patients with chylothorax among 4 084 patients receiving resection of lung cancer, as well as 52 in 4 479 patients having resection of esophageal cancer since 1985 at our hospital.

RESULTSThe incidence of PCLC was 0.29% and that of PCEC was 1.16%. The percentage of diagnosis confirmed within 4 postoperative days was 33.3% for PCLC, and 76.9% for PCEC. The rate of typical chylous pleural effusion was 83.3% for PCLC, and 5.8% for PCEC. Symptoms and signs of PCLC were much milder than those of PCEC. The re-operation rate was 16.7% for PCLC, and 96.2% for PCEC. All patients were discharged uneventfully.

CONCLUSIONThe incidence, causes, clinical manifestations, diagnosis, and treatment of PCLC is different from those of PCEC.

Adult ; Aged ; Chylothorax ; etiology ; therapy ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVE: To investigate the changes of anti-apoptotic protein Bcl-2 expression in neurons and activation of brain astroglial cells, and the relationship between astrocytes and neurons in mice after a single intracerebroventricular (ICV) stereotaxic injection of lipopolysaccharide (LPS). METHODS: C57BL/6J mice of different ages were divided into a control group and an experiment group. Immunohistochemistry to Bcl-2 and that to GFAP were conducted to observe the expression of Bcl-2 protein in neurons and GFAP in astrocytes in the brain at different time-points after the LPS injection. The glial cell type expressing Bcl-2 was characterized with immunofluorescence double labeling. RESULTS: GFAP-immunoreactive cells in the control mice were observed mainly within hippocampal formation, piriform, entorhinal cortex, septum, striatum, amygdaloid nucleus, subcortical white matter, as well as in the main fiber tracts. At 24 h after the LPS treatment there was no obvious difference in GFAP immunoreactivity compared with the controls. Astrocytes were markedly activated in periventricular brain regions such as hippocampus, the hypothalamic parenchyma surrounding the third ventricle, with larger cell body and hypertrophic processes 2 days after the endotoxin treatment. After the LPS injection, Bcl-2 positive cells were distributed widely in the brain, such as in the cortex (primary and secondary motor cortex, somatosensory cortex), hypothalamic parenchyma surrounding the third ventricle, diagonal band, hippocampus, septum and the red nucleus of the midbrain. At these sites, Bcl-2 induction increased significantly 2 days after the ICV LPS injection, with some subregional differences, peaking on 4th day. No immunofluorescent double labeling cells for GFAP and Bcl-2 were observed in the brain of the mice after the LPS administration, but merging GFAP positive astrocytes and Bcl-2 positive neurons were seen. Double staining for Bcl-2 and GFAP also showed that the projections of activated astrocytes were found in the sheath of Bcl-2 positive neurons 4 days after the ICV LPS administration. CONCLUSION LPS can activate astroglial cells and upregulate of Bcl-2 expression in the neurons in the mouse brain, which may participate in the administration of central nervous system to central-immunity stimulated regulation and the protective response to the inflammatory stimulus. The projections of activated astrocytes are found in the sheath of Bcl-2 positive neurons, indicating that there is close relationship between astrocytes and neurons.
Animals ; Astrocytes ; cytology ; drug effects ; metabolism ; Brain ; cytology ; drug effects ; metabolism ; Fluorescent Antibody Technique ; Glial Fibrillary Acidic Protein ; biosynthesis ; Immunohistochemistry ; Injections, Intraventricular ; Lipopolysaccharides ; administration & dosage ; pharmacology ; Mice ; Mice, Inbred C57BL ; Neurons ; cytology ; drug effects ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; Random Allocation

BACKGROUNDIt is a surgical dilemma when patients present with both severe heart disease and neoplasms. The best surgical treatment remains controversial. This study aimed to analyze the early and long-term results of simultaneous surgical treatment of severe heart disease and neoplasms.

METHODSWe reviewed the clinical records of 15 patients who underwent simultaneous neoplastic resection and cardiac surgery between September 2006 and January 2011. There were 5 male and 10 female patients. The mean age was (59.2 ± 12.5) years and the mean left ventricular ejection fraction was (57.4 ± 11.0)%. All patients were followed up completely for a period of 12 to 51 months (mean, (33.1 ± 11.2) months).

RESULTSFifteen patients underwent simultaneous cardiac surgery and neoplastic resection. Cardiac procedures consisted of off pump coronary artery bypass grafting (n = 7), aortic valve replacement (n = 3), mitral valve replacement (n = 3), mitral valve replacement with coronary artery bypass grafting (n = 1) and left atrial myxoma resection (n = 1). Neoplastic resection consisted of lung cancer resection (n = 5), colonic cancer resection (n = 3), gallbladder resection (n = 1), colonic cancer resection with gallbladder resection (n = 1), hysterectomy (n = 2), hysterectomy with bilateral salpingo-oophorectomy (n = 2) and left ovariectomy (n = 1). Pathological examination confirmed malignant disease in 10 patients and benign disease in 5 patients. There were no perioperative myocardial infarctions, stroke, pericardial tamponade, renal failure or hospital deaths. The most frequent complications were atrial fibrillation (33.3%), pneumonia (26.7%), low cardiac output syndrome (6.7%) and delayed healing of surgical wounds (6.7%). There was 1 late death 42 months after surgery for recurrent malignant disease. At 1 and 3 years, survival rates were 100% (Kaplan-Meier method).

CONCLUSIONSSimultaneous cardiac surgery and neoplastic resection was not associated with increased early or late morbidity or mortality. Cardiopulmonary bypass does not appear to adversely affect survival in patients with malignant disease. The long-term survival was determined by tumor stage.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Female ; Heart Diseases ; surgery ; Humans ; Hysterectomy ; adverse effects ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Ovariectomy ; adverse effects ; Thoracic Surgery ; statistics & numerical data ; Treatment Outcome

OBJECTIVETo evaluate the optimal timing of hepatectomy for intrahepatic lithiasis complicated with acute cholangitis.

METHODSOne hundred and twenty-six patients with hepatolithiasis who had a history of acute cholangitis and underwent hepatectomy were reviewed retrospectively. According to the period between the surgery and last attack of acute cholangitis, 126 patients were divided into 3 groups: > 3 months (group A, n = 73), 1 approximately 3 months (group B, n = 28), < 1 month (group C, n = 25). The operation time, blood loss, hospital stay, postoperative complications and stone residual rate were compared among the groups.

RESULTSThe intraoperative blood loss of C group was (644.0 +/- 625.7) ml, which was significantly higher than those of A and B group [(409.2 +/- 250.7) ml and (423.2 +/- 237.1) ml, respectively]. The numbers of patients who needed transfusion and the amount of blood transfusion in group C were also higher than those of group A and B. The incidence rate of complications, residual stone in group C were all markedly higher than those of group A and B. The period of hospital stay in group C was much longer than that in group A and B.

CONCLUSIONSThe optimal timing of hepatectomy for hepatolithiasis complicated with acute cholangitis is at least one month after subsidence of cholangitis.

Adult ; Aged ; Bile Ducts, Intrahepatic ; Cholangitis ; complications ; Cholelithiasis ; complications ; surgery ; Female ; Hepatectomy ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Time Factors