Objective To analyze the MR findings of vagal paraganglioma.Methods Six cases of vagal paraganglioma(4 benign and 2 malignant)were retrospectively analyzed with the emphasis on the location,MR signal intensity,dislocation of the carotid vessels,and the metastasis of the tumor.Results The tumors located in the superior(4 cases),middle(1 case)and inferior(1 case)neck,respectively,with right-sided in 4 cases and left-sided in 2 cases.The signal intensities of the six tumors were heterogeneous,combined with 'salt and pepper' appearance in 4 cases in which the 'pepper' appearance was more marked.On MR angiography performed in 4 cases,carotid arteries were found dislocated anteriomedially.Two cases were diagnosed as malignancies by the manifestations of destruction of surrounding bone,metastasis of bilateral lungs and/or the lymph nodes.Conclusion Vagal paragangliomas could be correctly diagnosed before surgery according to their locations and signal intensities.

From March 2004 to March 2005, 43 patients (49 hips) admitted to Department of Orthopedic Surgery, Fushun Central Hospital for minimally invasive total hip arthroplasty (THA) were selected, including 22 male and 21 female aged 22-79 years. All patients underwent THA with cementless prosthesis. The preoperative Harris scores were (46.2?5.3). For comparison, 35 patients (43 hips) were selected undergoing standard THA at the same period, including 22 male and 13 female, aged 31-78 years; 16 patients underwent THA with mixed prosthesis (cementless prosthesis for acetabulum; cemented prosthesis for the femur), and the others with cementless prosthesis. Their preoperative Harris scores were (43.4?4.6). The perioperative bleeding, operation time, incision length, postoperative functional recovery, and prosthetic position were compared. The THA was succeeded in all patients, and all subjects were followed up for 13.1 months averagely. The perioperative bleeding, drainage, blood transfusion and incision length in minimally invasive THA group were significantly less than standard group (P

China ; epidemiology ; Hearing Loss, Sudden ; diagnosis ; epidemiology ; Humans

Objective To explore the initial effects of the treatment of proximal femoral nail-helical blade (PFNA) in elderly patients with intertrochanteric fracture of the incomplete lateral wall type. Methods A total of 25 patients were enrolled in this study including 8 cases of type A2, 17 cases of type A3 according to AO classification. All patients under-went three-dimensional CT scan. In all patients with type A2 fracture, there were 6 cases with coronal plane fracture on the greater trochanter, and PFNA was used instead of DHS when an iatrogenic fracture occurred in 2 patients. All other patients were treated with closed reduction and fixed with PFNA. Results All patients healed and the average healing time was 11 weeks, one patient fell down once again and the fracture occurred on the shaft, when a long PFNA was used, both of the frac-tures healed 14 weeks after surgery. In all of the 25 patients,1 patient died due to cerebral hemorrhage 13 months after sur-gery;2 patients needed walking aids due to the presence of osteoarthritis of the knee and calf muscular venous thrombosis was diagnosed in 3 cases. No complications were found in the other patients, such as infection, nonunion and fixation failure. According to the Harris hip score system, there were 14 cases of“excellent”,8 cases of“good”,2 cases of“fair”and1 pa-tient of“poor”.Conclusion The PFNA treatment can provide a good fixation for intertrochanteric fractures of incomplete lateral wall type, which allow patients to do exercise early and achieve an excellent initial outcome.

Objective:To investigate the relationship between herpesviridae and malignant or benign laryngeal diseases.Method:128 paraffin-embedded laryngeal squamous cell carcinoma and laryngeal epithelium hyperplastic lesions were detected by polymerase chain reaction (PCR) and PCR-ISH for herpesviridae. Result:HSV-1 was detected in 10 cases by PCR,among them 3 were laryngeal squamous cell carcinoma (LSCC),1 was carcinoma in situ(CIS),4 were laryngeal polyps and 2 were laryngeal keratosis. Except 1 LSCC and 1 CIS, 8 of 10 cases were positive while detected by PCR-ISH. In benign diseases, signals were shown from basal layer to superficial cell; in malignant lesions, the signals were scattered in the diseases.Conclusion:Most of laryngeal diseases were not related to herpesviridae, but HSV-1 may acts as initiator in the development of a few cases.

Objective To study the maternal blood glucose management of gestational diabetes mellitus during the labor and relationship of maternal blood glucose in labor and neonatal blood sugar. Methods A prospective study on maternal blood glucose monitoring and control during labor was carried in 40 pregnant women with abnormal glucose metabolism. We adjusted maternal blood glucose by low-dosage constant insulin drop during labor. Results Maternal blood glucose in labor arranged between 3.8 ～ 11.2 mmol/L,and low-dosage constant insulin drop was used in 17 cases (42.5%). The neonatal blood glucose was (4.0?1.5)mmol/L following delivery and (3.9?1.0)mmol/L at 24-hour postpartum. There were 2 cases with neonatal hypoglycemia. The neonatal blood glucose of the rest 23 cases was (4.2?1.5)mmol/L,and (3.9?1.0)mmol/L at 24-hour postpartum,and 1 case with neonatal hypoglycemia. There was no the difference of the blood glucose level of newborns between mothers with abnormal glucose metabolism and the normal pregnant women. Conclusion It is necessary to monitor and control the blood glucose level by low dose constant insulin during labor in pregnant women with abnormal glucose metabolism.

Objective By detecting the variation of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) DNA methylation in preeclampsia-like mouse models generated by different ways, to explore the roles of multifactor and multiple pathways in preeclampsia pathogenesis on molecular basis. Methods Established preeclampsia-like mouse models in different ways and divided into groups as follows: (1) Nw-nitro-L-arginine-methyl ester (L-NAME) group: wild-type pregnant mouse received subcutaneous injection of L-NAME;(2) lipopolysaccharide (LPS) group:wild-type pregnant mouse received intraperitoneal injection of LPS; (3) apolipoprotein C-Ⅲ (ApoC3) group: ApoC3 transgenic pregnant mouse with dysregulated lipid metabolism received subcutaneous injection of L-NAME;(4)β2 glycoprotein I (β-2GPI) group:wild-type pregnant mouse received subcutaneous injection ofβ-2GPI. According to the first injection time (on day 3, 11, 16 respectively), the L-NAME, LPS and ApoC3 groups were further subdivided into:pre-implantation (PI) experimental stage, early gestation (EG) experimental stage, and late gestation (LG) experimental stage.β-2GPI group was only injected before implantation. LCHAD gene methylation levels in placental were detected in different experimental stage. Normal saline control groups were set within wild-type and ApoC3 transgenic pregnant mice simultaneously. Results (1) CG sites in LCHAD DNA:45 CG sites were detected in the range of 728 bp before LCHAD gene transcription start site, the 5, 12, 13, 14, 15, 16, 19, 24, 25, 27, 28, 29, 30, 31, 32, 34, 35, 43 CG sites were complex sites which contained two or more CG sequences, others were single site which contained one CG sequence. The 3, 5, 6, 11, 13, 14, 18, 28 sites in L-NAME, LPS, ApoC3 and β-2GPI groups showed different high levels of methylation; the 16, 25, 31, 42, 44 sites showed different low levels of methylation; other 32 sites were unmethylated. (2) Comparison of LCHAD gene methylation between different groups:the methylation levels of LCAHD gene at 3, 11, 13, 14, 18 sites in L-NAME, LPS, ApoC3 andβ-2GPI groups were significantly higher than those in the normal saline control group (P<0.05); and the methylation levels of 42, 44 sites in these groups were significantly lower than those in the normal saline control group (P<0.05). (3) Methylation of LCHAD gene at the same site between different experimental stages: ① The 3, 11, 18 sites of EG experimental stage was significantly lower than PI and LG experimental stage in L-NAME group (P<0.05);the 3, 11, 18 sites of PI experimental stage was significantly lower than EG and LG experimental stage in LPS group (P<0.05);these sites of PI experimental stage was significantly higher than EG and LG experimental stages in ApoC3 group (P<0.05).②The methylation of site 5 in L-NAME and LPS groups were significantly higher than that of the normal saline control group (P<0.05), and the LG experimental stages were significantly higher than other stages, but in ApoC3 group , only PI and EG stages were significantly higher than the normal saline control group (P<0.05).③At site 6 in L-NAME group which showed high methylation level was significantly higher than the same site in other groups which showed low methylation level (P<0.05).④At 13, 14 sites, earlier preeclampsia onset caused a lower methylation level in L-NAME group, but PI experimental stage was significantly higher than EG and LG experimental stages in LPS group (P<0.05), EG experimental stage was significantly higher than PI and LG experimental stages in ApoC3 group (P<0.05). ⑤ At site 28, earlier preeclampsia onset caused a higher methylation level in L-NAME group, but PI experimental stage was significantly lower than EG and LG experimental stages in LPS group (P<0.05), EG experimental stage was significantly higher than PI and LG experimental stages in ApoC3 group (P<0.05).⑥The 16, 25, 31 sites in ApoC3 group were significantly higher than other groups (P<0.05). ⑦ At site 42 in β-2GPI group was unmethylated, but it in other groups showed low methylation level, the methylation level of site 42 inβ-2GPI group was significantly lower than that in other groups (P<0.05). Conclusions The methylation of 6 and 42 CG sites may be related to LCHAD gene expression in placenta of L-NAME and β-2GPI induced preeclampsia-like models respectively;LCHAD gene expression and DNA methylation may not have obviouscorrelation in LPS and ApoC3 induced preeclampsia-like models. Differences exist in LCHAD DNA methylation in preeclampsia-like models generated by different ways, revealed a molecular basis to expand our understanding of the multi-factorial pathogenesis of preeclampsia.

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.

A retrospective study was conducted based on the clinical data of 15 choledocholith patients after Billroth-Ⅱgastroenterestomy who were treated with endoscopic retrograde cholangio-pancreatography (ERCP) through colonoscopy or duodenoscopy.It showed that choledocholith removed by colonoscopy for patients with Billroth-Ⅱ gastroenterestomy can achieve comparable therapeutic effect,but this method can reduce the operation difficulty,shorten the operation time and significantly increase the success rate.

Objective To explore the clinical value of tissue synchronization imaging(TSI) in assessment of the characteristics of myocardium asynchrony in patients with ischemic cardiomyopathy(ICM). Methods Thirty-eight patients with ICM were divided into two groups: 26 patients without left bundle branch block(LBBB) in group A, and 12 patients with LBBB in group B. The control group consisted of 26 normal healthy subjects. According to 2D color,the characteristics of myocardium motion in each group were compared by TSI. The time for reaching systolic velocity peak(Ts) and early diastole velicity peak(Te) were measured separately in 12 segments. Standard deviations of Ts(Ts-SD) and Te(Te-SD) as well as difference of Ts(Ts max-min) and Te(Te max-min) of all 12 segments were calculated. The myocardium synchronization were assessed in each group. Results ①91.8% segments in the control group showed normal, with only 8.2% segments were slightly prolonged. TSI of all the ICM patients showed an obvious uneven chroma distribution from green to yellow and then to red. There were far more yellow or red segments than in the control group. ②Ts-SD.Ts max-min of LV 12 segments were significantly prolonged in all ICM groups compared with that in the control group ( P <0. 05). Systolic asynchrony was more obvious in group B than in group A. ③Te-SD,Te max-min of LV 12 segments were significantly prolonged in ICM groups than in the control group ( P < 0. 05). Diastolic asynchrony was more obvious in group B than in group A( P < 0. 05). ④Compared with that in the control group, postsystolic shortening(PSS) was common in patients with ICM. 32. 4% segments of group A were detected PSS.and 56. 0% segments of group B were detected PSS. Conclusions Left ventricular systolic and diastolic mechanical asynchrony is obvious in patients with ICM and PSS is common among them. Systolic and diastolic mechanical asynchrony is more severe in ICM patients with LBBB. TSI is the optimal means to evaluate the characteristics of asynchronous myocardial contraction.