Background and purpose:Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions.Methods:There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate:ΔT/N. ROC was used to ifnd out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging.Results:The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, speciifcity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, speciifcity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold ofΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, speciifcity and accuracy were 88.5%, 71.4% and 86.2%, respectively.Conclusion:Dual-phase18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and speciifcity. However it still has false positivity, and should be analyzed with CT and clinical history.

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Objective To evaluate the effect of type Ⅱ odontoid fracture,type Ⅰ Hangman fracture,C2-C3 disc injury on stability of C1-C2 and C2-C3 segments and investigate the clinical significance.Methods Ten fresh-frozen cadaveric cervical specimens (5 men and 5 women; 25-45 years of age,mean 35.7 years) were selected to test the stability of C1-C2 and C2-C3 segments in the settings of intact condition (control group),type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury.Range of motion (ROM) and neutral zone (NZ) of those segments were measured.Results Compared with the intact condition,type Ⅰ Hangman fracture produced no significant variations in C1-C2 ROM in all loading modes and C2-C3 ROM during left and right lateral bending; type Ⅱ odontoid fracture produced no significant variations in C2-C3 ROM in all loading modes and C1-C2 ROM during left and right rotation; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture revealed no significant variations in C1-C2 ROM during left and right rotation and C2-C3 ROM during extention; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury produced no significant variations in C1-C2 ROM during left and right lateral bending and extension-flextion and C2-C3 ROM in all loading modes (P ＜ 0.05).Conclusions Type Ⅰ Hangman fracture can reserve C1-C2 segmental left and right rotation and extension-flextion; type Ⅱ odontoid fracture can reserve C1-C2 segmental left and right lateral bending and extension-flextion; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury can reverse atlantoaxial rotationary stability and C1-C3 segmental stability in all directions.This study provides the biomechanical basis for clinical treatments and the related researches of internal fixation.

Objective To study the role of water exact from salvia miltiorrhiza (SM) in promoting hair regrowth in testosterone (T)-induced alopecia in mice.Methods Pathological alopecia mice were induced by T and the mice were randomly divided into control group,model group,Zhanggvanp 101 group,SM low-dose group,SM middle-dose group,SM high-dose group (20,40,80 mg/ml,respectively).The effects of SM on hair regrowth were evaluated by measuring hair length,weight and the number of hair follicle.The concentration of serum T and estrodiol (E2),the content of skin VEGF,MDA,SOD,and GSH-Px were measured after external inunctum for 21 days.Results (1) SM significantly promoted regrowth hair length,weight and the number of hair follicle (P＜0.05) (2) SM significantly balanced the hormones by reducing levels of T and increasing E2 (P＜0.05) (3) SM significantly reduced the content of MDA by increasing the activity of SOD and GSH-Px (P＜0.05) (4) SM significantly increased the level of VEGF (P＜0.05) Conclusion In the pathological alopecia mice induced by T,SM can effectively promote the hair regrowth,with the possible mechanism of balancing hormones,being anti-oxidant and improving VEGF expression.

OBJECTIVE: To analyze the general and forensic pathological characteristics of death due to fat embolism syndrome (FES) and to provide reference data for forensic identification. METHODS: Twenty autopsy cases due to FES were selected from the forensic center of a medical college from 1999 to 2012. The general and forensic pathological characteristics such as the ways and types of injuries, clinical manifestation and the pathological changes were summarized. RESULTS: Fat embolism mainly occurred after long bone fracture or a large area of soft tissue injury with the majority of cases being fat embolism of lung and occasional cases being combined embolisms of lung and brain as well. The onset of symptoms appeared shortly after the injury or surgery. Lipid droplets could be observed within small pulmonary vessels and verified by special staining. CONCLUSION There are particular characteristics in death due to FES in concern with types of injuries, onset of symptoms and pathological findings. In order to find out the direct evidence of FES, special staining (oil red O staining) can be used in the forensic identification.
Autopsy ; Cause of Death ; Death ; Embolism, Fat/mortality* ; Forensic Pathology ; Fractures, Bone/complications* ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/etiology* ; Soft Tissue Injuries/complications*

Objective To observe the efficacy and safety of different initial doses of nebulized budesonide inhalation (BI) in infants and young children with moderate to severe asthma exacerbations.Methods A multi-center,parallel controlled clinical trial was performed during Sep 2008 to Apr 2010 in three hospitals,which were Department of Pediatrics,Shanghai Jiaotong University Affiliated Shanghai First People's Hospital,Department of Pediatrics,Shanghai Jiaotong University School of Medicine Affiliated Xinhua Hospital,and Department of Respiratory,Fudan University Affiliated Children's Hospital.One hundred and fifty children aged 6 to 36 month with moderate to severe asthma exacerbations were randomly divided into two groups.The high-starting-dose group was treated with a dose of 1 mg nebulized BI every 8 h for 2 days,while the conventional-starting-dose group was treated with a dose of 0.5 mg cvcry 8 h for 4 days.The terbutaline sulfate aerosol liquid was administered with a dose of 2.5 mg each time as needed.The primary outcome measures were severity scores,which were assessed at admission (0 h),and 8 h,16 h,24 h,48 h,72 h after treatment separately.The secondary outcome measures included the use of β2 receptor agonist,the systemic use of corticosteroids,average length of hospital stay and total cost.The data was analyzed with SPSS 13.0.Results (1) The clinical severity scores were significantly decreased at all time points after treatment in both groups (P ＜ 0.05).Compared with conventional starting-dose of BI,high starting-dose of 3.25 ± 1.82,P ＜ 0.01).(2) The terbutaline doses and the systemic corticosteroids do-ses were significantly reduced in high-starting-dose group compared with conventional-starting-dose group [(16.27 ± 12.99) mg vs (22.90 ± 18.27) mg,P ＜ 0.05 ; (4.54 ± 18.18) mg vs (11.16 ± 21.34) mg,P ＜ 0.05).The average length of hospital stay and the total cost of the two groups showed no significant differences (P ＞ 0.05).(3) There were no side effects associated with BI.Conclusion Compared with conventional treatment,high-starting-dose of BI can control symptoms fast and reduce the use of systemic corticosteroid without any side effects.BI improved symptoms more quickly at 8 h (2.87 ± 1.60 vs 4.48 ± 2.24,P ＜ 0.01) and 16 h (2.48 ± 1.56 vs

Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling.Near infrared spectroscopy probe was placed on the forehead.Anesthesia was induced with propofol TCI (Cp =5 μg/ml),fentanyl 3 μg/kg and rocuronium 0.6 mg/kg.The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml/kg,RR 10-12 bpm,I∶ E 1∶2,FiO2 =1.0).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with sevoflurane (end-tidal concentration 1.0％-1.7 ％) or propofol TCI (Cp =3-4 μg/ml) in combination with remifentanil TCI (Cp =3.5 ng/ml) and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS was maintained at 40-60 during operation.rSO2 was recorded before induction of anesthesia (T0),10 min before and 10 min after blood vessel was clamped (T1,T2) and 10 min after anastomosis was completed (T3).Results rSO2 was significantly increased on the operated side at T3 in PR group while in SR group bilateral rSO2 was significantly increased at T1-3 as compared with the baseline values at T0 (P ＜ 0.05 or 0.01).rSO2 on the operated side was significantly higher at T1 in group SR than in PR group (P ＜ 0.05).Conclusion The efficacy of sevoflurane-remifentanil anesthesia is similar to that of propofol-remifentanil anesthesia for revascularization for moyamoya disease in terms of maintence of the balance between cerebral oxygen supply and demand.

[Abst ract] Objective To explore the relationship between expression of S100B in hippocampus of depression model rats induced by chronic stress and its depression like behavior,and the antidepressant effect of fluoxetine.Methods 40 rats were put into control group,fluoxetine group,CUS group and CUS plus fluoxetine group,using random number table.Rats in each groups received corresponding treatment.Chronic unpredictable stresses (CUS) were performed on rats for 42 days.Fluoxetine (5 mg/(kg · d)) were delivered to rats by intragastric administration from day 22 to day 42.Then,S100B protein were marked and observed by immunohistochemical method.Open-field test,sucrose consumption and body weight were used to evaluate behavioral changes.Results Scores in behavioral test were reduced significantly by 42 days of stress (main effects of stress,P＜0.05).Effects of stress on behavioral scores were reversed by 21 days fluoxetine treatment (interactions,P＜0.05).CUS resulted in elevated expression of S100B in CA1,CA3 and DG sub-regions in experimental rats (OD values,CUS,0.331 ±0.01,0.353 ± 0.01,0.381 ± 0.007 ; control,0.238 ± 0.007,0.237 ± 0.010,0.228 ± 0.006.Simple effects of stress,P=0.000; P=0.000; P=0.000).Fluoxetine treatment reversed the elevated expression of S100B in CA1,CA3 and DG sub-regions in model rats (OD values:CUS plus fluoxetine,0.233 ± 0.015,0.240 ± 0.005,0.254± 0.015; fluoxetine,0.241±0.007,0.233±0.013,0.227±0.017; Interactions between fluoxetine and CUS,P=0.000; P=0.000; P=0.000).Conclusion Sub-regional over expression of S 100B in hippocampus is associated with depression like behavior of rats.Reversed S100B expression in these sub-regions is an indicator of effective antidepressant treatment but not a mechanism for it.

Objective To discuss the clinical outcome of the modified super large dorsal metacarpal artery flap in reconstruction of circumferential fingertip avulsion. Methods Twenty-four patients with circumferential fingertip avulsion were treated by the modified super large dorsal metacarpal artery flap from January 2004 to August 2008. There were six index fingers, 11 middle fingers, five ring fingers and two little fingers with surface defects beyond the distal interphalangeal joint and the distal degloving length ranged from 0.8 cm to 3.1 cm. Emergency operation was performed on 22 fingers and stage Ⅱ surgery was done for distal skin necrosis of two fingers. Results Twenty-one patients with 21 fingers were followed up for 6-28 months, which showed that all flaps survived, with satisfactory appearance and function, and that the point discrimination of flap was for 6-9 mm ( average 7.6 mm). Conclusion Modified super large dorsal metacarpal artery flap is an ideal method for reconstruction of the circumferential fingertip avulsion with advantages of easiness, convenience and short treatment period.

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged ; Pulmonary Artery ; Pulmonary Embolism ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism