Objective To define the significance of the anatomical division and features of popliteal artery in popliteal angioplasty.Methods This study involved 118 lower limbs in 113 cases of femoropoliteal occlusive disease undergoing angioplasty in our center between August 2011 and July 2013.A bent-knee angiogram was taken before recanalization of the lesion.The flexion pattern and the location of flexion points of popliteal artery were collected to study their relationship with the division of popliteal artery.A post-procedural bent-knee angiogram was taken in case of popliteal stenting to assess any change in flexion angulation and distal flow.Results There are diverse flexion patterns in popliteal artery,75.4％ of the flexion points locate in P2 segment,18.6％ in P1,and 6.0％ in P3.On post-procedural bent-knee angiogram in 73 cases of popliteal stenting,10 had a more acute distal flexion angulation,distal artery kinking was observed in another 6 cases of which 5 had compromised distal flow.Artery kinking only occurred in cross-flexion-point stenting.Conclusions A better understanding of the division and anatomical features of popliteal artery can be obtained via bent-knee angiogram.This is of value to angioplasty for lesions in different popliteal divisions.

Objective:To study the changes of upper airway dimension and morphology in Class Ⅱ mandibular retrusion children af-ter functional treatment by Twin-block appliance.Methods:The Cone-Beam CT(CBCT)data of upper airway of the subjects were measured with Dolphin 11.5 software before and after fuctional treatment by Twin-block appliance.The comparison of upper airway di-mension and morphology between pre-treatment and post-treatment was performed by paired t-text.Results:After functional treatment the volume of total upper airway,velopharyngeal airway,glossopharyngeal airway,laryngopharyngeal airway,oropharyngeal airway,the sectional area of the inferior of the soft palate(SP),tip of the epiglotti(TE),the sagittal diameter of SP,the lateral diameter of SP and TE increased(P <0.05)in the children;the airway's shape of SP was attended to be rounder and TE to be more flat.Conclusion:Functional treatment is effective in the treatment of skeletal Class Ⅱ mandibular retrusion of children by increase of the upper airway and improvement of respiration.

Objective To investigate the value of whole-liver MR perfusion imaging(MRPI)for early detection of coagulative necrosis after percutaneous ethanol injection(PEI)in rabbit liver VX_2 tumors. Methods VX_2 tumor cell suspension was inoculated into rabbit liver and liver VX_2 tumors[diameter of (2.6?0.6)cm]were induced in 10 male rabbits.MR T_1 WI and T_2 WI were performed to monitor the development of the liver tumor on the 2~(nd)and 3~(rd)week after inoculation.Whole-liver MRPI was performed in the 10 rabbits with liver VX_2 tumors before and 6 days after PEI therapy(1.0 ml ethanol was injected into the most enhanced tumor region under CT guiding).Signal intensity(SI)values of untreated tumor parts and treated areas 6 days after PEI were recorded respectively.The steepest slope(SS)and bolus arrival time (TO)of SI-time curves were measured.The t-Student test was used in statistical analysis of the data.Results There was significant difference in MRPI data between untreated tumor parts[TO:(16.0?1.2)s and SS: 38.9?2.2]and treated areas[TO:(50.8?5.9)s and SS:6.0?1.2]6 days after PEI(t was 15.8 and -39.6 respectively,P

Objective:To determine the immunological effects of a new type adjuvant CTA 1-DD/IgG.Methods:Intranasal im-munization of BALB/c mice with OVA in combination with adjuvant CTA 1-DD or CTA1-DD/IgG.Blood samples were subjected to OVA-specific IgG Abs detection and IgG subclass profiles assessment using ELISA.Splenic plasma cells secreting anti-OVA Abs were detected by ELISPOT.Results:CTA1-DD/IgG showed stronger activity in inducing OVA-specific IgG Abs and splenic Abs-secreting cells compared with CTA1-DD.The enhancement of IgG1,IgG2a and IgG2b Abs were observed,and the ratio IgG2a/IgG1 were >1 in both groups.Conclusion: CTA1-DD/IgG can exert enhanced adjuvant effects compared with CTA 1-DD.Mixed IgG subclasses are induced,indicating a more balanced Th1/Th2 response.

OBJECTIVETo assess the clinical value of endoscopic submucosal dissection(ESD) for duodenal lesion.

METHODSA total of 78 patients with duodenal lesion were treated with ESD from November 2006 to August 2010. The clinical data were retrospectively analyzed.

RESULTSThere were 46 male and 14 female patients. The mean age was(54±9) years. The lesion location included the duodenal bulb(n=39, 50%), the junction of bulb and descending part(n=19, 24.4%), and the descending part(n=20, 25.8%). The mean diameter of the lesions was(2.1±1.7) cm. Fifty-one(65.4%) lesions originated from the mucosa, including inflammatory/ hyperplastic polyps(n=22, 28.2%), villous/tubular adenoma(n=26, 33.3%), and hamartomas polyps(n=3, 3.8%). Twenty-five(32.1%) lesions originated from the submucosa, including Brunner's glands adenoma(n=15, 19.2%), ectopic pancreas(n=3, 3.8%), carcinoid tumor(n=3, 3.8%), lipoma(n=2, 2.6%), myxoinoma(n=1, 1.3%), and angio-lymphangioma(n=1, 1.3%). There were two lesions originated from the muscularis propria(n=2, 2.5%), and both were ectopic pancreas. All cases received ESD successfully. The mean operative time was(37±41) min and the mean blood loss was(23±15) ml. The perioperative complication rate was 35.9%(28/78), including intraoperative perforation(n=6), delayed perforation(n=3), intraoperative hemorrhage(n=10), delayed bleeding(n=7), and transient elevation of serum amylase(n=2). Postoperative pathological examination showed vascular invasion with tumor cells in one patient, who received extended resection later. The remaining 77 patients showed no recurrence during the followed up(rang, 3-23 months) using endoscopy.

CONCLUSIONESD is an effective, safe, minimally invasive method for the management of duodenal lesions.

Adult ; Aged ; Duodenal Diseases ; surgery ; Female ; Follow-Up Studies ; Gastroscopy ; methods ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Retrospective Studies

Primary spinal glioblastoma multiforme is very rare, especially in childhood. 13-year-old boy was admitted to our neurosurgical department because of paraparesis, sensory loss below T10 and sphincter disturbance. Thoracic myelogram showed complete obstruction at T10 level and total laminectomy with partial removal of the intramedullary cord tumor mass was performed under the impression of spinal cord tumor. Postoperatively, his symptoms and signs unchanged. Pathological diagnosis was intramedullary glioblastoma multiforme involving thoracic cord.
Adolescent ; Child* ; Diagnosis ; Glioblastoma* ; Humans ; Laminectomy ; Male ; Paraparesis ; Spinal Cord Neoplasms

OBJECTIVETo observe the curative efficacy of rhubarb, montmorillonite powder combined with blood purification on treatment for patients with severe acute organophosphorus pesticide poisoning (AOPP).

METHODS39 patients with AOPP were divided into treatment group (received the combined treatment of rhubarb, montmorillonite powder and blood purification on the basis of routine therapy, n = 21) and control group (only received the routine treatment because of financial difficulties or the will of family members, n = 18). The differences of clinical manifestations, curative effects and prognosis between two groups were compared.

RESULTSThe time of consciousness recovery, the duration of mechanical ventilation and the length of stay in hospital in treatment group were (6.5 ± 1.3), (7.9 ± 2.0) and (13.1 ± 3.2) days, which were significantly shorter than those [(8.4 ± 2.4), (10.7 ± 2.9) and (16.5 ± 3.7) days] of control group (P < 0.05). In 5, 6 and 7 day after treatment,the cholinesterase (ChE) activities of treatment group were significantly higher than those of control group (P < 0.05). The total amount and using time of atropine and pyraloxime methylchloride in treatment group were significantly smaller and shorter than those in control group (P < 0.05). The death rate of treatment group was [19.0% (4/21)], which were significantly lower than that of control group [19.0% (4/21)] (P < 0.05).

CONCLUSIONThe combined treatment of rhubarb, montmorillonite powder and blood purification of the AOPP patients has a better curative effect.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemofiltration ; methods ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organophosphate Poisoning ; therapy ; Pesticides ; poisoning ; Phytotherapy ; Prognosis ; Rheum ; Young Adult

OBJECTIVETo evaluate the efficacy of endoscopic self-expanded metal stent for the treatment of gastric outlet obstruction.

METHODSFifty-six cases of gastric outlet obstruction, collected from March 1999 to January 2008, were treated by endoscopic self-expanded metal stents. The success rate, complication rate and survival were evaluated.

RESULTSAmong the 56 cases, the male to female ratio was 33 to 23, and the average age was [65+/-14 (24-86)] years. Seventeen cases were gastric cancer, 4 duodenal carcinoma, 7 peri-ampulla carcinoma, 13 metastasis cancer and 15 presented recurrence after operations. The success rate of stent implantation was 98.2% (55/56). Forty-nine cases (87.5%) could eat liquid food 1-3 days after operations and eat semifluid food 4-9 days later. Forty-two cases (76.4%)could eat normal food after 10-16 days. The main complications included 14.5% of cases with pain, 1.8% with stent shift, 25.5% with bleeding and no one with perforation. Until January 20, 2008, 53 cases (96.4%) had been followed up. The mean survival time was [139+/-15 (14-332)] days, and the median survival time was 135 days. The re-stenosis rate was 5.7%, including 3 cases, happened in 143, 158 and 190 days after the operations respectively, and was successfully treated by second stent implantation.

CONCLUSIONEndoscopic implantation of self-expanded metal stent is a micro-invasive, safe, effective method for the treatment of gastric outlet obstruction.

Adult ; Aged ; Aged, 80 and over ; Endoscopy ; Female ; Gastric Outlet Obstruction ; surgery ; Humans ; Male ; Metals ; Middle Aged ; Stents ; Stomach Neoplasms ; surgery ; Treatment Outcome ; Young Adult

Objective To study the effects of erythrecyte on brain edema after traumatic intrace- rebral hemorrhage(TICH)and explore the mechanisms of erythrocyte in brain edema development follow- ing TICH.Methods Firstly,the brain injury model of SD rat was established by applying a free-fall- ing device,then whole blood(WB),lysed RBC(LRBC)or parked RBC(PRBC)were infused with ste- reotactic guidance into injured cortex to produce the model of TICH.All rats were killed at 1,3,and 5 days after injury.The brain water content was measured,immunohistochomistry(SABC)was applied to test HO-1 and TNF-?expressions.Results 1.In WB group,PRBC group and TBI group,the brain water content was the highest on the third day.The brain water content of LRBC group was markedly higher on the first day than on the third and fifth days.Comparison among the four groups showed the wa- ter content was the highest on the 1st day in LRBC group,and on the 3rd day in WB and PRBC groups; there was no significant difference among the four groups on 5th day.2.The positive expression of HO-1 and TNF-?coincided with the change of the water content in groups of WB,PRBC and LRBC.Conclu- sions In rat model of TICH,RBC plays an important role in delayed brain edema formation(3 days after injury),but has no influence at early stage(1 day after injury).The mechanisms of delayed brain edema involves RBC breakdown and inflammation reaction.

OBJECTIVETo investigate the feasibility and safety of endoscopic full-thickness resection(EFTR) in the treatment of colorectal submucosal tumor(SMT).

METHODSFrom September 2009 to March 2012, 4 cases with colorectal SMT received EFTR at the Endoscopic Center in the Zhongshan Hospital of Fudan University. The operative time, complications, and follow-up data were analyzed.

RESULTSThere were 3 females and 1 male. The age ranged from 33 to 78 years. The tumor location included the upper rectum(n=2), the ascending colon(n=1), and the descending colon(n=1). The mean operative time was 48.0(24-80) min. The mean diameter was 1.45(0.8-2.0) cm. Postoperative pathological examination revealed schwannoma, pneumatosis cystoides intestinalis, endometriosis, and mild hyperplasia of smooth muscle in the muscularis mucosa. There was no bleeding or perforation intraoperatively and postoperatively. Two patients developed abdominal pain and fever, one of whom had regional peritonitis and was managed by fasting and intravenous antibiotics. No surgical intervention was required. Postoperative follow up ranged from 1 to 30 months and no residual cancer or recurrence was found.

CONCLUSIONEFTR is a safe and effective method for colorectal SMT.

Adult ; Aged ; Colorectal Neoplasms ; surgery ; Endoscopy, Gastrointestinal ; methods ; Female ; Follow-Up Studies ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Retrospective Studies