Acute Disease ; Adult ; Angioplasty, Balloon, Coronary ; adverse effects ; Humans ; Hypopituitarism ; etiology ; therapy ; Male

Objective To explore imaging manifestations of hepatic epithelioid hemangioendothelioma (HEH). Methods CT and MR images in 14 patients with HEH proven by histopathology were retrospectively analyzed. Plain and two-phase contrast-enhanced CT scan were performed in 5 cases, non-contrast and multiphase contrast-enhanced MR scan were performed in 7 cases, CT and MRI were both performed in 2 cases. Characteristics of CT and MR T2WI images were classified and analyzed. All lesions were classified into three types:multiple, diffuse and solitary form. Results (1) Multiple form of HEH:228 lesions were found in 11 patients, including 178 lesions on MRI and 50 lesions on CT. On T2WI, three or two layered-target-signs with hyperintensity core were found in 79.2% (141/178) of the lesions. Three layer-target-sign included hyperintensity core, hypointensity rim and slightly high signal halo from the inside out. Two layer-target-sign included hyperintensity core and slightly high signal halo from the inside out. Characteristics of dynamic contrast-enhanced scan included peripheral two or three layered-rim-like enhancement in 66.3%( 118/178) of the lesions;peripheral, gradual rim-like enhancement with enhanced core in 27.0%( 48/178) of the lesions;heterogeneously mild enhancement in 2.2%( 4/178) of the lesions;centripetal enhancement in 4.5%( 8/178) of the lesions. Fifty lesions were found in CT, which showed low density nodules or masses with clear margins. Two-layered-black-target sign were found in 42 lesions in contrast-enhanced images, white-target sign were found in 3 cases, and centripetal enhancement was found in 5 cases. (2) Diffuse form of HEH:in one of the two cases of this type, the lesions could not be separated from normal liver parenchyma, gradual enhancements were found along with the vessels in the center of the lesions. (3) Solitary form of HEH: one case, the lesion showed heterogeneous density in non-contrast CT images and gradual enhancement in contrast-enhanced images. Conclusions We found some imaging characteristics of HEH. Two or three layered-target-sign on T2WI and black-target sign, white-target sign on contrast-enhanced images were unique imaging features of HEH.

BACKGROUND:Genetic studies have shown that there may be association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women, but there are some differences in the conclusions.
OBJECTIVE:To study the association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women through Meta-analysis.
METHODS:The PubMed database, Embase database, CNKI database and Wanfang database were searched for the observational studies about the association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women. The standardized mean difference was considered as the effect indicator and calculated with random or fixed effect models according to the significance of heterogeneity.
RESULTS AND CONCLUSION:A total of 9 articles were included with a total of 8 799 and 9 365 participants for which vertebral and spine bone mineral density had been measured, respectively. The analysis results showed that the bone mineral density of the postmenopausal women with the G al ele of G1181C was significantly lower than that of the postmenopausal women with the C al ele. Similar results were obtained in Caucasian population subgroup analysis. The Caucasian population subgroup analysis showed that the bone mineral density of the postmenopausal women with GG genotype of G1181C was lower than that of the postmenopausal women with GC and CC genotype. The results indicate that there is association between osteoprotegerin gene G1181C polymorphism and bone mineral density in postmenopausal women, and G al ele is a risk factor for lower bone mineral density.

Objective The author seeked the suitable tidal volume in order to decrease mechanical ventilation-induced lung injury during closed circuit anesthesia in infants.Methodes 50 infants who practiced selective orthopedics operation randomly divided into traditional mode(12~15ml/kg,groupT,n=25)and low tidal volumes(7~8ml/kg,groupL,n=25).The bronchoalveolar lavage fluid of intants were collected immediately after tracheal intubation(T1)and before tracheal extubation,respectively.Interleukin-6 and interleukin-8 in the bronchoalveolar lavage fluid were determined by enhancement solid-phase enzyme immunoassay action(EASIA),TNF-? in the bronchoalveolar lavage fluid were determined by euzymelinked immunosorbent assay(EIA).The numbers of polymorphonuclear neutrophils in the bronchoalveolar lavage fluid of intants were examined.The infants' SpO2,arterial blood pressure and PetCO2 were monitored continuously.Arterial blood gas was analysised.The time of analepsia and complications of lung were observed after operation.Results PaCO2、PetCO2 in groupL were higher than that in groupT,pH in groupL lower than that in groupT at 30 min,60 min,120 min after mechanical ventilation and before extubation,respectively.The contents of PMN,TNF-?,IL-6 and IL-8 in BALF collected at T2 more than that at T1 in groupT.The contents of PMN,TNF-?,IL-6 and IL-8 in BALF in groupL less than that in groupT at T2(P

Objective To investigate the effect of ambroxol administered before surgery on contents of PMN,TNF-?,IL-6 and IL-8 in bronchoalveolar lavage fluid after closed circuit anesthesia in infants.Methods 40 infants who practiced selective orthopedics or abdominal operations were randomly divided into ambroxol group (group A) and control group (group B). Two days before operation,infants in group A and group B were administed ambroxol 0.3 mg/kg or 0.9 normal saline 10 ml through intravenous injection three times per day,respectively .The last single dose was administered before anesthesia induction.The bronchoalveolar lavage fluid of intants were collected immediately after tracheal intubation(T1) and before tracheal extubation(T2),respectively.Interleukin-6 and interleukin-8 in the bronchoalveolar lavage fluid were determined by enhancement solid-phase enzyme immunoassay action(EASIA),and TNF-? in the bronchoalveolar lavage fluid by euzymelinked immunosorbent assay (EIA).The numbers of polymorphonuclear neutrophils in the bronchoalveolar lavage fluid were examined. The contents of PMN,TNF-?,IL-6 and IL-8 in two groups were compared .The time of analepsia and complications of respiratory tract were observed after operation.Results Compared with group A, the contents of PMN,TNF-?,IL-6 and IL-8 in BALF collected at T2 were significant higher in group B (P

Objective To investigate the change of serum Nogo-A protein in patients with acute closed brain injury, and explore its relationship with the severity of neuronal damage and prognosis. Methods Thirty-one patients with acute closed brain injury were enrolled. Venous blood samples (2 mL) were obtained 1, 3 and 5 d after injury. Serum concentrations of Nogo-A protein were determined by ELISA. Patients were divided into mild (n =7), moderate (n = 10) and severe (n = 14) injury groups according to Glasgow coma score (GCS), and were divided into favorable prognosis (n = 23) and poor prognosis (n = 8) groups according to Glasgow outcome score (GOS). Another 20 healthy adults were served as controls. Results The mass concentrations of serum Nogo-A protein in mild, moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in control group (P < 0.01), and the mass concentrations of serum Nogo-A protein in moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in mild injury group (P <0.05, P <0.01). The mass concentrations of serum Nogo-A protein 1, 3, 5 d after injury were significantly higher in poor prognosis group than those in favourable prognosis group (P < 0.01). Conclusion Serum Nogo-A protein level significantly increases after brain injury, and is related to the degree of injury and prognosis.

OBJECTIVETo explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation.

METHODSFrom January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared.

RESULTSAll patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis.

CONCLUSIONChosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.

Acromioclavicular Joint ; injuries ; physiopathology ; surgery ; Adult ; Bone Plates ; adverse effects ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Range of Motion, Articular ; Shoulder Dislocation ; complications ; physiopathology ; surgery ; Shoulder Pain ; etiology ; Treatment Outcome ; Young Adult

Objective To optimize the formulation of the sunscreen used in military training.Methods The different formulations of sunscreen were prepared according to the orthogonal design,and then applied on 3M adhesive tape posted on the color dish with a certain amount;the absorbance in 280 nm-320 nm and 320 nm-400 nm of them were measured and the arithmetic mean (A) was concluded.By comparing A,the protective effect and the main factors affecting preventive bask were determined.The preventive bask test of the optimum formula was carried out in human trials using the method of multi point increasing ultraviolet irradiation.Results OMC,TinosorbTM M,rutin,pearl powder and baicalin all had significant effects in preventing UVA.OMC had a significant effect in preventing UVB.The formula 1 (containing the five materials mentioned above) had the best effects in preventing both UVA (SPF 18) and UVB (PA+).Conclusions The formula 1 has the best effects in preventing both UVA and UVB.

Objective To explore a better method for treatment atrophic rhinitis.Methods 56 patients with atrophic rhinitis(96 lateral)were treated by nasal submucou pediculated bone-suberiosteal muscle flap extracted from anterior wall of sinus maxillaries.Results All patients were followed 2 to 10 years,total effective rate was 100 %, with 49 cases(87.5 %)showing prominent effect.Conclusion The grafted flap cannot be assimilated,felled off and necrosis,because the flap has rich blood supply.This methods has obvious short-term effective and stable long-term effective.No complications were found.

Objective To assess the contribution of transrectal realtime tissue elastography (TRTE) on the differential diagnosis of prostatic diseases. Methods A total of 88 prostatic disease patients with 95 lesions proved by pathology from May 2012 to January 2013 in the Afifliated Drum Tower Hospital of Medical College of Nanjing University were included. The elasticity grade and strain ratio were calculated by using TRTE. According to the gold standard of pathological results, the sensitivity, speciifcity, accuracy rate were calculated to evaluate the effectiveness of elasticity grade and strain ratio in distinguishing benign and malignant prostatic diseases;and the receiver operating characteristic (ROC) curves were made respectively. The accuracy of elasticity grade and strain ratio in diagnosing prostatic diseases was also compared using chi-square test. Results Forty-seven benign lesions were found in the 95 prostatic lesions and the other 48 lesions were malignant. The elasticity grades of the 95 prostatic lesions were as follows:GradeⅠ26, GradeⅡ19, GradeⅢ16, GradeⅣ21, and GradeⅤ13. Elasticity grade ≤Ⅱwas considered to be benign, while grade ≥Ⅲwas malignant. The sensitivity, speciifcity, accuracy rate of elasticity grade in diagnosis of prostatic malignant lesions was 79.17%(38/48), 74.47%(35/47) and 76.84%(73/95), respectively. According the ROC curve analysis, the cutoff point of strain ratio was 4.67, and Youden′s index was 0.622. The sensitivity, speciifcity, accuracy rate of strain ratio was 83.33%, 78.72%and 81.05%, respectively. The area under ROC curves of strain ratio was superior to that of elasticity grade. But the diagnosis accuracy of the two approaches was almost the same in statistics (χ2=0.51, P>0.05). Conclusions TRTE is valuable in the differential diagnosis of the prostatic benign and malignant lesions. Both strain ratio and elasticity grade are useful approaches, and have similar diagnostic accuracy.