BACKGROUND: Biliary complications are the common complication of liver transplantation. However, it is difficult to find the complications, since no obvious characteristic signs on the patients. Magnetic resonance imaging (MRI), especially,magnetic resonance cholangiopancreatography (MRCP) may provide a comprehensive evaluation of the functions and complications of the transplanted liver as a safe, noninvasive and exact technique.OBJECTIVE: To evaluate the manifestation of biliary system after liver transplantation by MRCP and its value of diagnosis of biliary complications.DESIGN: Comparative observation.SETTING: Medical Imaging Center, Nanfang Hospital, Southern Medical University.PARTICIPANTS: A total of 13 male liver transplantation patients aged from 40-58 years, who received imaging examination at Medical Imaging Center, Nanfang Hospital, Southern Medical University from January 2003 to January 2005, were enrolled. Original causes of liver failure included cirrhosis (n =11) and primal hepatic carcinoma (n =2). Ten received orthotopic liver transplantation, while 3 received piggyback orthotopic liver transplantation. Anastomotic mode of bile duct was common bile duct end-to-end anastomosis. The interval between transplantation and MRI examination ranged from 15 days to 1 year. All patients knew the items of examination and agreed to participate in the experiment.METHODS: Thirteen patients with orthotopic liver transplantation underwent turbo spin-echo (TSE) and fast low angle shot (FLASH), MRCP, Gd-DTPA enhanced MRI to analyze the characteristics of each imaging after liver transplantation.MAIN OUTCOME MEASURES: The imaging findings of the reestablished bile duct and complications of bile duct at MRCP.RESULTS: The diameters of bile duct and caliber were normal, no stricture on anastomotic stoma in 3 patients.Thick-section planes of MRCP did not develop biliary duct of one case. Biliary dilation occurred in 8 patients. There were 5 cases of biliary strictures and 2 cases of choledochus stone. Mucocele of bile duct remnant was identified in 2 cases.Bile leakage occurred in 1 case after T-tube was removed. Rejection reaction occurred in 2 cases.CONCLUSION: MRCP not only can display the image of reestablished biliary tract after liver transplantation, but also can exactly diagnose complications rapidly.

BACKGROUND: Sonography is believed by many scholars to be sensitive for the detection of hepatic arterial thrombosis and stenosis, but it is difficult to show the anastomotic vascular stenosis. MR angiography is better than sonography in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.OBJECTIVE: To evaluate the role of MR angiography (MRA) in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.DESIGN: Contrast trial observation.SETTING: Medical Imaging Center of Nanfang Hospital, Southern Medical University.PARTICIPANTS: Eleven adult male patients had undergone liver transplantations at Nanfang Hospital of Southern Medical University between January 2004 and December 2006. They ranged in age from 40 to 58 years, average 49 yeas. Original causes of liver failure in the study group included cirrhosis (n =9) and primal hepatic carcinoma (n =2) diagnosed by pathohistological methods. And 9 cases had undergone orthotopic liver transplantations while 2 cases with piggy-back liver transplantation.METHODS: Eleven consecutive adult patients underwent MR imaging examinations after orthotopic liver transplantation using a breath-hold 2D True Fast Imaging with Stead-state Precession and Fast Low Angle Shot. MR triphasic contrast-enhanced 3D imaging was also performed. Enhancement scan: A final gadolinium-enhanced axial and coronal T1WI spin-echo sequence with spectral fat saturation was performed after completion of the MRA. The vascular diameter stenosis was calculated according to S (S=[(D-d)/D]×100%) by ECST method, d as the inner diameter of the most obvious stenosis while D as normal diameter. Degree of stenosis: normal as S 0-30%, mild stenosis as S 31%-50%, moderate stenosis as S 51%-85%, and severe stenosis as S 86%-100%. Then the imaging findings after liver transplantation were analyzed. Meanwhile the sonography was performed.MAIN OUTCOME MEASURES: ① MR Image analysis of vascular anatomy and vascular complications after liver transplantation.②Normal findings after liver transplantation by using sonography.RESULTS: All 11 patients were involved in the result analysis.①MRA: The anastomosis of hepatic artery, portal vein and inferior vena cava were smooth in 3 cases. The high signal intensity was seen around portal vein at T2WI in 1 case with a shorter interval after transplantation and persisted 3 weeks. In 1 case, the caliber of the donor portion was smaller than the recipient portion. Among other 8 cases, hepatic artery complication included hepatic artery winding in 2 cases and aneurysm formation of donor's hepatic artery in 2 cases, but the twig of the hepatic artery was normal. Mild Portal vein stenosis at the anastomosis was found in 2 cases, caused by the different calibers of the donor portion from the recipient portion, but the inter-hepatic branches of the portal vein were normal. Clubbed dilatation of hepatic veins end-brush was depicted in 2 cases whose inferior vena cava at the anastomosis was not stenosis. Inferior vena cava thrombosis was found in 1 case. The thrombus displayed the low signal intensity in the high signal intensity of inferior vena cava. By follow-up examination, the degree of clubbed dilatation of hepatic veins end-brush reduced after half a year and inferior vena cava thrombosis disappeared by treatment. ②Sonography: By ultrasound examination, 1 case who had hepatic artery winding combining to aneurysm formation of donor's hepatic artery was discovered just hepatic artery winding. In 2cases that had mild portal vein stenosis at the anastomosis, 1 case was diagnosed normal while the other was not affirmed. The clubbed dilatation of hepatic veins end-brush was not depicted. The others were same as MRI diagnosis.CONCLUSION: Dynamic enhanced 3D MRA imaging can provide a comprehensive assessment of vascular anatomy in most recipients of liver transplants, and is an accurate and quick method to diagnose the vascular complication after liver transplantation.

Objective To explore the value of CT in diagnosing abdominal leiomyosarcoma.Methods CT findings of abdominal leiomyosarcomas conformed pathologically in 9 patients were analyzed.Results The tumors localized in peritoneum in 3 cases,in stomach in 3 cases,in rectum,colon and uterus in 1 case respectively.On plain CT scan,the tumors appeared as unhomogeneous dense masses with mecrosis at the centre,the periphery of tumors was flocculation or ringlike,and having fluid-fluid level in 1 case.The delayed peripheral enhancement on contrast CT could be seen.Conclusion CT imaging can help to diagnosis the abdominal leiomyosarcoma.

At present,the medical profession generally acknowledged the best way to treat osteosarcoma is gene therapy,which includes tumor suppressor gene therapy,antisense gene therapy,suicide gene therapy,immune gene therapy,combined gene therapy,etc.But no matter what kind of gene therapy is that the gene must have a safe carrier.Gene therapy has made a breakthrough in osteosarcoma recently.On the basis of widespread use,we should emphasize the importance of gene vectors.

Traditional moxibustion treatment mainly relies on doctors using specific techniques to stimulate the patient's acupoints with ignited moxa sticks. In view of the poor reproducibility, and different methods of different doctors, difficult to carry out quantitative and qualitative research work in clinical research, a moxibustion mechanical arm was designed. The hardware modules of the mechanical arm are composed of power, micro controller STM32, position servos, moxibustion strip thruster, human-computer interaction panel and sensors; the software parts are composed of main control program and interrupt service program. The use of this moxibustion mechanical arm will enhance the system's multi-task adaptability and could perform a variety of moxibustion methods including circling moxibustion and sparrow-pecking moxibustion. The data collected in real time will be transmitted to PC through bluetooth, displayed on OLED, and the system operation modes could be switched by button. Clinical trials showed that moxibustion mechanical arm had the same treatment effects with traditional moxibustion. Meanwhile, its convenience of ope-ration, repeatability of treatment, doctors and patients's treatment experience are all better than those of traditional moxibustion.

OBJECTIVETo observe clinical efficacy in treating cutaneous deficiency of traumatic shank amputation stump with full-thickness skin graft combined with vacuum sealing drainage.

METHODSFrom September 2009 to December 2012, 15 patients with cutaneous deficiency of traumatic shank amputation stump were treated with full-thickness skin graft combined with vacuum sealing drainage. Among patients, there were 11 males and 4 females with an average age of 41.5 (ranged from 25 to 62) years old. Ten cases were caused by traffic accident and 5 cases were caused by heavy object, 9 cases on left and 6 cases on right. Six patients with smashed wound were treated with debridement and amputation, combined with vacuum aspiration in-emergency; 9 patients caused by infection and necrosis were treated with debridement and amputation, combined with vacuum aspiration, and full-thickness skin graft were performed at stage II. The skin defect area of residual limbs ranged from 40 cm x 20 cm to 25 cm x 15 cm.

RESULTSAll patients were followed up from 3 months to 1 year. Full-thickness skin graft of residual limbs were survived,and obtained satisfactory walking function with prosthetic. Residual skin increased thicken, wearproof without rupture and pain.

CONCLUSIONFull-thickness skin graft combined with vacuum sealing drainage in treating cutaneous deficiency of traumatic shank amputation stump could reserve the length of residual limbs, increase survival rate of skin graft with less scar of survival skin, get good wearability and it is conducive to prosthetic wear. It is a simple and easy treatment method.

Adult ; Amputation Stumps ; surgery ; Female ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Skin ; injuries ; Skin Transplantation

OBJECTIVETo investigate the diagnostic value of MRI in radial head fracture with forearm interosseous membrane injuries.

METHODSFrom December 2011 to December 2012,26 patients with fractures of capitulum radial in our hospital were collected. There were 15 males and 11 females, ranging in age from 21 to 53 years old,with an average of 37.6 years old. All the patients visited hospital within 72 hours after injuries. X-ray radiography of full ulnar radial length in injured side, CT in injured side (three-dimensional reconstruction if necessary) and MRI (including the elbow and wrist joints) were performed within a week after the injury. The MRI manifestations of the forearm interosseous membrane (with or without damage, the injured location and the injury degree ) and the fractures degree of radial head were observed and compared for the relativity.

RESULTSRadial head fracture from Mason type I to III was associated with the forearm interosseous membrane injury. Radial head fracture degree was positive correlated with forearm interosseous membrane injury degree (P < 0.05).

CONCLUSIONRadial head fracture with suspicious forearm interosseous membrane injury is necessary to take MRI for checking for any interosseous membrane injury and injury degree, then choose the right treatment for radial capitulum fracture, only in this way can be helpful for the functional recovery of elbow and forearm.

Adult ; Female ; Forearm ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; injuries ; Middle Aged ; Radius Fractures ; diagnosis ; pathology ; Young Adult

OBJECTIVETo compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius.

METHODSFrom January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up.

RESULTSTwo cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,P<0.05); after 12 months' following up, advanced Gartland-Werley score was respectively 2.66 +/- 1.01 and 3.08 +/- 1.00, but with no statistical meaning (t=-1.55, P>0.05).

CONCLUSIONLCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

Adult ; Aged ; Bone Plates ; External Fixators ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; surgery ; Treatment Outcome ; Young Adult

Crocetin, a naturally occurring carotenoid, possesses antioxidant and antiatherosclerotic properties, of which the underlying mechanism remains unclear. In the present study, we examined the effects of crocetin (0.1, 1, 10 μmol·L(-1)) on angiotensin II (Ang II, 0.1 μmol·L(-1)) induced expression of vascular cell adhesion molecule-1 (VCAM-1) in human umbilical vein endothelial cells (HUVECs) and monocyte-endothelial cell adhesion. The effects of crocetin on the activation of nuclear factor kappa B (NF-κB) and intracellular reactive oxygen species (ROS) were also observed. The results demonstrated that crocetin notably suppressed Ang II induced NF-κB activation (P<0.01) and VCAM-1 expression (P<0.05, P<0.01) in HUVECs, accompanied by a markedly reduced monocyte-endothelial cell adhesion (P<0.05, P<0.01). In addition, preincubation with crocetin resulted in a significant enhancement of cellular antioxidant capacity (P<0.05, P<0.01), while Ang II induced intracellular ROS decreased markedly (P<0.05, P<0.01). These results indicated that crocetin was capable of suppressing Ang II induced VCAM-1 expression and monocyte-endothelial cell adhesion by suppression of NF-κB activation, which might be derived from the enhancement of antioxidant capacity and subsequent reduction of intracellular ROS.
Angiotensin II ; metabolism ; Antioxidants ; pharmacology ; Carotenoids ; pharmacology ; Cell Adhesion ; drug effects ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; metabolism ; Humans ; Monocytes ; cytology ; NF-kappa B ; metabolism ; Reactive Oxygen Species ; metabolism ; Vascular Cell Adhesion Molecule-1 ; metabolism

OBJECTIVE： To evaluate the clinical therapeutic effect of L-glutamine granules on intestinal damage of severe burn patients and the safty of the drug.METHODS： Thirty-nine severe burn patients were randomly divided into two groups： control group（C group， nineteen patients） and L-glutamine treatment group（GLN group， twenty patients） .GLN group patients were given L-glutamine in a dose of 30g per day for 7 days， and C group patients were given the same dosage of placebo for 7 days.The plasma L-glutamine concentration， the degree of intestinal mucosa damage， blood biochemistry and complication were observed and wound healing rate of burn area was determined， then the length of hospital stay was recorded.RESULTS： After 7 days of taking L-glutamine orally， plasma L-glutamine concentration in GLN group was significant higher than that in C group（P<）. The degree of intestine damage and intestinal mucosal permeability in GLN group were lower than those in C group. In addition, the wound healing rate was faster and the length of hospital stay was shorter in GLN group than those in C group. CONCLUSION: Administration of L-glutamine could abate the degree of intestine damage obviously, lessen intestinal mucosal permeability, ameliorate wound healing rate and reduce the length of hospital stay.