1.MRI and Ultrastructural Pathology on Acute Myocardial Infarction
Guangxun CHENG ; Renmin CHANG ; Hong ZENG ; Xuelin ZHANG ; Hong SHEN ; Yili LIU
Journal of Practical Radiology 2001;0(08):-
Objective To study the MRI features and its ultrastructural pathology basis in different myocardial injury areas after acute infarction.Methods 10 rabbits were given ligation of left anterior descending branch 24 hours to make pathologic models.All animals underwent conventional MRI,contrast media dynamic enhancement MRI,cine-MRI and dobutamine stress test.Myocardial blood flow was measured with radioactive micropheres to define risk regions.Ischemic and infarcted regions were defined as Even's blue and 2,3,5triphenyltetrazolium chloride(TTC)negative regions respectively,and made electron microscopy specimens to observe the changes of mitochondria and myofibril.The myocardial ultrastructural injury was scored and graded.Results There were no significant change on T 1WI,but the signal intensity on T 2WI increased significantly after AMI.The diseased myocardium became thinning were seen in 40% cases,and the abnormal flowing high signal were seen in 60% cases.The dynamic enhancement time-signal intensity curves were different in normal,ischemic and infarcted regions.Cine-MRI showed the cardiac wall movement impairing and the wall thick thinning,but the wall movement reinforcing and the wall thick thickening after dobutamine stress.The water content of ischemic and infracted myocardium were marked higher than normal myocardium.The myocardial blood flow in diseased regions were decreased significantly than that in normal regions.The volume density and numerical density of mitochondria in different injury regions showed significant differences.Conclusion MRI appearances of AMI were associated with the injury degree of myocardial ultrastructure and the residual myocardial blood flow.
2.Percutaneous kyphoplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures
Xisan WANG ; Min WANG ; He LIU ; Cheng LIU ; Guangxun HU ; Dongning LIU
Journal of Endocrine Surgery 2012;06(3):188-191
Objective To discuss the methods and the effects of percutaneous kyphoplasty(PKP)in the treatment of thoracolumbar osteoporotic vertebral compression fractures ( OVCFs).Methods Retrospective analysis was made on 110 vertebrae in 96 thoracolumbar OVCFs patients undergoing transpedicular unilateral PKP or PKP combined with percutaneous vertebroplasty(PVP) from Jan.2004 to Nov.2011.We analyzed the change of the anterior heights of the vertebra,the clinical outcomes using VAS and Oswcstry bcforc and after the treatment,and the rate of cement leakage.Results 85 vertebrae were treated with the PKP sucessfully,and 25 vertebraewere treated with both PKP and PVP sucessfu]ly.All patients were satisfied with the diffusion of the cement.Theoperation time of each vertebra was about 20-40 minutes for one side.The injection volume of of each vertebrawas about 5.4 ml.According to VAS and Oswestry,the pain was alleviated obviously after the operation ( P <0.01) and the anterior heights of the vertebrae changed ( P < 0.01).The leakage of the cement was the only complication in these patients and most of the leakage happened at the anterior of the vertebrae and the vein nearby.The overall rate of the leakage was 56.3%.For the 40 vertebrae of the 36 patients that were followed up,1patient had fracture in a neighbor vertebra and 1patient had subsidence in the upper anterior edge of the treated vertebra where there was no cement filled in,but the patient had no discomfort.Conclusion PKP or PKP combined with PVP are safe,convenient and effective methods in treating OVCFs.
3.Clinical analysis of 47 cases with mid-and long-term biliary complications after liver transplantation
Weiwei JIANG ; Jun LI ; Hong CHEN ; Zhongyang SHEN ; Mingliang CHENG ; Tieyan FAN ; Xu WANG ; Qing ZHANG ; Xinguo CHEN ; Guangxun XU
Organ Transplantation 2015;(2):93-97
Objective To investigate the incidence,treatment and outcome of mid-and long-term biliary complications after liver transplantation.Methods Clinical data of 651 patients who underwent liver transplantation at General Hospital of Armed Police Forces from April 2002 to February 2012 were retrospectively studied to analyze the incidence, treatment and outcome of mid-and long-term biliary complications after liver transplantation.Results Among 651 liver transplant cases,47 patients (7.2%) developed mid-and long-term biliary complications.The mean time of onset was 21 months.Forty seven patients underwent 48 cases of treatment in total.Nine cases received anti-inflammatory therapy alone.Fourteen cases were treated with choledochoscope lithotomy,choledochoscope biliary cast or placing the biliary support tube.And 13 cases underwent endoscopic retrograde cholangiopancreatography (ERCP)nephrolithotomy, expanding the bile duct or placing the biliary support tube,including 1 patient was switched to percutaneous transhepatic cholangial drainage (PTCD)due to ERCP failure.Seven cases received drainage by PTCD and 5 cases were treated with anti-inflammatory therapy combined with choledochoscope or PTCD. The total efficacious rate was 92% . Among 3 invalid patients, two patients were treated with secondary liver transplantation and one died.Conclusions The mid-and long-term biliary complications probably occur after liver transplantation.Individualized therapies should be chosen based upon the types and severity of biliary complications,which yields relatively high efficacious rate.Secondary liver transplantation should be performed as necessary.