Purpose To explore the CT features of extra-adrenal ganglioneuroma (GN), and to improve the diagnostic accuracy of the disease. Materials and Methods CT features of 13 patients with extra-adrenal GN confirmed by surgical pathology were retrospectively analyzed, and compared with pathological findings. Results Two of 13 lesions were located in neck, four in posterior mediastinum, four in retroperitoneal space, two in front of sacrum, one in the region of renal hilus. All these masses were well defined, two appeared as round, three as oval, 8 as irregular shape. Of eight cases with irregular shape, six lesions presented a tendency of wedging into the space encasing and lapsing the vessel, with no evidence of invasion of the surrounding organs or vessels. Two tumors grew along the vertebrae and invaded intervertebral foramen. On plain CT imagings, the attenuations of the tumors were less than that of muscle, the masses with homogeneous and nonhomogeneous density were found in four and nine cases, respectively. Two patients associated with scattered and patchy cafilication. After contrast administration, eight lesions showed inhomogeneous enhancement:slight enhancement were seen in the arterial phase and gradually more strong enhancement during the portal venous and delayed phase. Enhancing lines or patchy were observed inside these tumors. Pathologically, the tumors appeared on a large amount mucus background, a few of scattering or nesting ganglion cells were distributed in many mature spindle cells, which lined in weave or fasciculation. Conclusion CT manifestations of extra-adrenal GN have certain characteristics, which are correlated closely with pathological features, therefore is helpful for the diagnosis and differential diagnosis.

Objective To investigate the clinical efficacy of flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating for partial staghorn calculi.Methods 84 patients diagnosed as partial staghorn calculi in our hospital were randomly divided into group A and B with each group 42 patients.Patients in group A received the conventional minimally invasive percutaneous nephrolithotomy in the prone position,and patients in group B received the percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy in the modified Valdivia position.The post-operative stone free rate and complications were recorded.Results The surgery time in group B was longer than that in group A [(106.44±18.46)min vs(83.69±10.29)min],with statistically significant difference(P<0.05).However,the first stone free rate in group B was higher than that in group A(85.71% vs 59.52%,P<0.05),and the blood loss in group B was lower than that in group A [(70.02±9.15)ml vs(87.41±9.89)ml,P<0.05].The common complication of patients in two groups was fever(temperature >38.5℃),but there was no notably difference between the two group(P>0.05).Conclusion Compared with the regular percutaneous nephrolithotomy,flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating partial staghorn calculi has the shorter operation time,the less blood volume and the higher first stone free rate.Furthermore,the combination method did not significantly increasing the incidence of patient's complication.

Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.

Objective To investigate the value of creatine kinase and computed tomography(CT)angiography to evaluate short-term prognosis of patients with superior mesenteric artery embolism(SMAE).Methods The retrospective cross-sectional study was adopted.The clinical data of 26 patients with SMAE who were admitted to the first Affiliated Hospital of Wenzhou Medical University between January 2008 and October 2015 were collected.The patients received serologic examination and CT angiography firstly,and then medicinal conservative method and surgical method were respectively conducted according to the results of above examinations.Observation indices:(1)clinical features,(2)serum indicators results,(3)CT angiography results:①location(main stem and non-main stem)of SMAE and development of distal branches of superior mesenteric artery(SMA),②indirect signs,such as bowel wall thickening,bowel dilatation combined with effusion and air accumulation and pneumatosis intestinalis,(4)therapy and prognosis.Measurement data with normal distribution were presented as-x±s,comparisons among groups were analyzed by one-way ANOVA.Measurement data with skewed distribution were presented as M(range)and analyzed by the Kruskal-Wallis rank sum test,and pairwise comparison was done using the Nemenyi test.Results(1)Clinical features:of 26 patients with SMAE,6 patients had intestinal ischemia,8 patients had partial intestinal necrosis and 12 patients had long segmental intestinal necrosis(postoperative short bowel syndrome in 5 patients and total small intestinal necrosis and partial colonic necrosis in 7 patients).Duration of symptoms before diagnosis was(1.7±0.8)days in 6 patients with intestinal ischemia and(2.1±1.1)days in 8 patients with partial intestinal necrosis and(1.5±0.7)days in 12 patients with long segmental intestinal necrosis,with no statistically significant difference(F=1.27,P＞0.05).(2)Serum indicators results:levels of serum creatine kinase in patients with intestinal ischemia,partial intestinal necrosis and long segmental intestinal necrosis were 68 U/L(range,50-86 U/L),98 U/L(range,54-244 U/L)and 300 U/L(range,40-873 U/L),respectively,with a statistically significant difference among patients(H=7.32,P＜0.05)and between patients with intestinal ischemia and with long segmental intestinal necrosis(H=7.21,P＜0.05),and with no statistically significant difference between patients with partial intestinal necrosis and with intestinal ischemia or long segmental intestinal necrosis(H=1.53,2.07,P＞0.05).(3)CT angiography results:①developments of SMAE(main stem and non-main stem)and distal branches of SMA:main stem embolism of SMA in 13 patients demonstrated hypodense shadow,with non-contrast of distal branches of artery,including 1 with intestinal ischemia,1 with partial intestinal necrosis and 11 with long segmental intestinal necrosis.Main stem embolism of SMA in 8 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 3 with intestinal ischemia,4 with partial intestinal necrosis and 1 with long segmental intestinal necrosis.Main stem embolism of SMA in 2 patients demonstrated hypodense shadow,with non-contrast of distal branches of SMA,showing partial intestinal necrosis.Non-main stem embolism of SMA in 3 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 2 with intestinal ischemia and 1 with partial intestinal necrosis.②Indirect signs:5 patients had bowel wall thickening,including 3 with intestinal ischemia and 2 with long segmental intestinal necrosis.Seventeen patients had bowel dilatation combined with effusion and air accumulation,with gas fluid level in local intestinal canal,including 2 with intestinal ischemia,5 with partial intestinal necrosis and 10 with long segmental intestinal necrosis.Two patients had pneumatosis intestinalis,with bubble shadow of bowel wall,showing long segmental intestinal necrosis.(4)Therapy and prognosis:of 6 patients with intestinal ischemia,1 underwent embolectomy of SMA and 5 underwent low-molecular-weight heparin anticoagulation and vasodilator alprostadil therapy.Eight patients with partial intestinal necrosis received resection of necrotic intestine.Of 12 patients with long segmental intestinal necrosis,5 with postoperative short bowel syndrome received resection of necrotic intestine combined with postoperative parenteral hyperalimentation.The above-mentioned patients were improved and discharged from hospital after symptomatic treatment and surgery.Twelve patients with long segmental intestinal necrosis,7 with total small bowel necrosis and partial colonic necrosis underwent only exploratory laparotomy and then were dead in a short time.Conclusion Elevated creatine kinase and main stem embolism of SMA combined with non-contrast of distal branches using CT angiography maybe predict poor short-term prognosis of patients with SMAE.

Objective:To isolate and prepare the reference substances of phloroglucinol derivatives from Dryopteris fragrans by semi-preparation HPLC. Methods:After reflux extraction of Dryopteris fragrans with petroleum ether,the extracting solution was con-centrated and separated by silica gel column chromatography,and then isolated by semi-preparation HPLC. The isocratic elution was carried out using acetonitrile as the mobile phase at 3. 0 ml·min-1 and the injection volume was 0. 5 ml. Two phloroglucinol deriva-tives were isolated. Results:The chemical structure of the two phloroglucinol derivatives respectively was aspidin BB with the purity of 98. 81% and aspidin PB with the purity of 98. 57% by ultra high performance liquid chromatography. Conclusion:The isolation of as-pidin BB and aspidin PB by semi-preparation HPLC is simple and fast with the purity over 98%,which can be used to prepare the ref-erence substances.

OBJECTIVETo investigate the mechanisms of Wuling mycelia powder on memory retrieval impairment in rats with chronic epilepsy.

METHODSD rats were randomly divided into four groups: the pentylenetetrazole-kindling group (the model control group), the low dose of Wuling mycelia powder (0.3 g x kg(-1), ig) group, the high dose of Wuling mycelia powder (0.6 g x kg(-1), ig) group and the blank control group. After being successfully trained in the 8-arm (4-arm baited) radial maze, the rats were intraperitoneally injected with a subconvulsive dose (35 mg x kg(-1)) of pentylenetetrazole (saline in control group) every 48 h for 12 times. Wuling mycelia powder were orally administered 30 min before every pentylenetetrazole injection. Memory retrieval was tested at the same maze. Phosphorylated CREB were analyzed by Western blot. Brain pathological sections were stained using HE, hippocampal nerve cells were observed under optical microscopes.

RESULTBoth of reference and working memory abilities of these chronic epilepsy rats were impaired as expressed in the 8-arm radial maze but reversed by Wuling mycelia powder to some extent. Chronic epilepsy caused a decreasing p-CREB in hippocampal nerve cells and injury in hippocampal CA1 region and CA3 region among rats. Wuling mycelia powder inhibited hippocampal p-CREB from decreasing and protected hippocampal nerve cells.

CONCLUSIONWuling mycelia powder could ameliorate memory impairment induced by epilepsia. Its mechanism may be related to the increase in p-CREB expression in brain and the protective effect on hippocampal nerve cells.

Animals ; Chronic Disease ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epilepsy ; complications ; Hippocampus ; drug effects ; pathology ; Male ; Memory Disorders ; drug therapy ; Phosphorylation ; Rats ; Rats, Sprague-Dawley

Background Light-induced retinal damage results in the damage of retinl pigment epithelial (RPE) cells and therefore affects the pathogenesis and development of age-related macular degeneration (AMD).Studies showed that tissue factor (TF) is overexpressed in oxidative damaged RPE cells and the choroidal neovascularization (CNV) of AMD,speculating that the suppression of TF can prevent the damage of RPE cells and inhibit CNV.Objective This study was conducted to observe the protective effects of TF targeting peptide (TFTP),a new drug of autologous synthesis,on human RPE-cells induced by blue light.Methods Human RPE cells were isolated from donor eye and cultured.Cultured cells were divided into blank control group,model group and TFTP treated group.Light-induced RPE cell damage model was established by exposuring the cells in the blue light of (4.0±-0.5) mW/cm2 for 12 hours in the model group,and different concentrations (10,100,150,200,300 μmol/L) of TF-TP were added into the medium to pretreat the cells for 24 hours and then exposed the cells to the blue light for 12 hours in the TF-TP groups.The cell viability was determined by CCK-8 assay.The morphology and ultrastructure in the cells were observed under the inverted microscope and transmission electron microscope.The apoptosis of the cells was assayed by Hoechst staining.The expressions of TF and apoptosis-related protein bax,bcl-2 in the cells were determined by Western blot.Results CCK-8 assay showed that there was no significant difference in the cell viability among blank control group and different concentrations TF-TP groups (F=2.15,P =0.11).The cell survival rate of blank control group,model group and 150 μmol/L TF-TP group was (100.0±0.00) ％,(43.79±6.55) ％ and (63.45±3.57) ％,and the survial rate was increased in the 150 μmol/L TF-TP group compared with the model group (P =0.00),and 150 μmol/L was detemined as a optimal concentration of TF-TP.A lot of shrinkage,deformation,suspension cells were exhibited under the optical microscope,and decrease of microvilli structure,rupture of mitochondrial cristae and vacuolar degeneration of the cells were found in the model group,and the damage of the cells were evidently lightened in the 150 μ mol/L TF-TP group.The apoptosis rate of the cells were (0.98 ±0.19)％,(9.98 ±0.82) ％ and (5.73 ±0.88) ％ in the blank group,model group and 150 μmol/L TF-TP group,respectively,with a significant difference among the groups (F =206.18,P =0.00),and the apoptosis rate of the cells in the 150 μmol/L TF-TP group was significantly lower than that in the model group (P＜0.05).Compared with the blank control group,the relative expression of bax and TF was obviously increased and that of bcl-2 was decreased in the model group;while the expression of bax and TF was lower,and that of bcl-2 was higher in the 150 μmol/L TF-TP group compared with the model group (all at P ＜ 0.05).Conclusions Pretreation of TF-TP can lessen cell apoptosis and increase cell survival rate and therefore plays a protective role to blue light-induced human RPE cells possibly by inhibiting bax/bcl-2 apoptotic pathways mediated by TF.

Objective To explore the best therapeutic methods for acute mesenteric venous thromboses(AMVT)with different degrees of intestinal ischemic lesions. Methods 6 cases of acute abdomen were preoperatively diagnosed as AMVT with imaging. After laparotomy, patients were classified as congestive lesion(n=3)and necrotic lesion(n=3)according to the degree of intestinal sichemia and were treated with mesenteric thrombectomy and bowel resection, respeetively. All cases received heparin and urokinase perioperatively. Results Of the 3 patients receiving mesenteric thrombectomy, 2 were cured and the other one with ischemic ascending colon was cured after right hemicolectomy due to the complication of colic dynamic ileus and perforation 10 days after thrombectomy. The other 3 patients recovered after bowel resection. Follow-up from 8 months to 6 years showed no recurrence. Conclusion Combined with anti-coagulation therapy, thrombectomy and bowel resection are rational and effective protocol for congestive lesion and necrotic lesion, respectively in AMVT patients.

Objectives To investigate the imaging ability of magnetic sensitive weighted imaging (SWI) scans with 2.0 mm and 1.0 mm slice thickness on intracerebral veins and branches.Methods 47 healthy volunteers were recruited,including 20 males and 27 females,aged 21-45 (30.1 ± 12.93).Two SWI sequences with thickness of 2.0 mm and 1.0 mm were performed in all healthy volunteers.After reconstructed by minimal intensity projection (MIP),the display rate and diameter of intracerebral veins and branches were counted by two doctors.McNemar test and paired t-test were used for statistical analysis.Results (1) The display rates of bilateral internal cerebral veins,papular veins and left ventricular veins were 100％ in both scanning schemes,while the display rates of left and right septal veins,anterior caudate nucleus veins and right ventricular veins on SWI sequence images with 2.0 mm thickness were 90.0％ (left),91.0％ (right) and 87.2％ (right),91.5％,respectively.The display rates on SWI sequence images with 1.0 mm thickness were 97.9％ (left),94.0％ (right),97.9％ (left),95.7％ (right) and 95.7％ respectively.(2) There were significant differences in the diameter of bilateral septum pellucidum veins and bilateral anterior caudate nucleus veins between the two scanning schemes (P ＜ 0.05).While there was no significant difference in the diameter of bilateral internal cerebral veins,bilateral papular veins and bilateral intraventricular veins (P ＞0.05).(3) The displaying rate of veins with diameter ＞0.9 mm was 100％ for both scanning schemes,while the displaying rate of veins with diameter ranging from 0.6-0.9 mm (including 0.6 mm and 0.9 mm) in the two scanning schemes had significant difference (P ＜ 0.05).Conclusions SWI sequence can clearly show the anatomical shape of intracerebral veins and branches.In contrast to SWI of the scan slices thickness of 2.0 mm,the SWI of scan slices thickness of 1.0 mm showed more efficiency in display thinner brain venous.Therefore,using SWI sequence scanning scheme with 1.0 mm slice thickness will be more conducive to observe and study intracerebral veins and branches.

To investigate the effects of neuronal histamine on spatial memory acquisition impairment in rats with pentylenetetrazole-kindling epilepsy, and to explore its mechanisms.A subconvulsive dose of pentylenetetrazole (35 mg/kg) was intraperitoneally injected in rats every 48 h to induce chemical kindling until fully kindled. Morris water maze was used to measure the spatial memory acquisition of the rats one week after fully pentylenetetrazole-kindled, and the histamine contents in different brain areas were measured spectrofluorometrically. Different dosages of hitidine (the precursor of histamine), pyrilamine (H1 receptor antagonist), and zolantidine (H2 receptor antagonist) were intraperitoneally injected, and their effects on spatial memory acquisition of the rats were observed.Compared with control group, escape latencies were significantly prolonged on Morris water maze training day 2 and day 3 in pentylenetetrazole-kindling epilepsy rats (all<0.05); and the histamine contents in hippocampus, thalamus and hypothalamus were decreased significantly (all<0.05). Escape latencies were markedly shortened on day 3 by intraperitoneally injected with histidine 500 mg/kg, and on day 2 and day 3 by intraperitoneally injected with histidine 1000 mg/kg in pentylenetetrazole-kindling epilepsy rats (all<0.05). The protection of histidine was reversed by zolantidine (10 and 20 mg/kg), but not by pyrilamine.Neuronal histamine can improve the spatial memory acquisition impairment in rats with pentylenetetrazole-kindling epilepsy, and the activation of H2 receptors is possibly involved in the protective effects of histamine.
Animals ; Benzothiazoles ; pharmacology ; Brain Chemistry ; drug effects ; Epilepsy ; chemically induced ; complications ; Hippocampus ; chemistry ; Histamine H1 Antagonists ; pharmacology ; Histamine H2 Antagonists ; pharmacology ; Histidine ; pharmacology ; Hypothalamus ; chemistry ; Kindling, Neurologic ; physiology ; Memory Disorders ; drug therapy ; etiology ; Pentylenetetrazole ; Phenoxypropanolamines ; pharmacology ; Piperidines ; pharmacology ; Pyrilamine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Histamine H2 ; drug effects ; physiology ; Spatial Memory ; drug effects ; Spectrometry, Fluorescence ; Thalamus ; chemistry