Objective: To investigate the CT perfusion (CTP) imaging for evaluation of hemodynamic changes in patients with internal carotid stenosis before and after the medication and stenting. Methods: Forty patients with severe unilateral internal carotid stenosis (ipsilateral stenosis > 70%, contralateral stenosis < 30%) were detected by CT angiography (CTA) and conformed by digital subtraction angiography (DSA), CTP imaging was performed at the same time. Twenty-two patients with good vascular compensation at the ischemic sites and with no significant delay in blood flow were treated with medication (aspirin 100 mg, clopidogrel 75 mg and atorvastatin 20 mg daily). CTA and CTP were performed again after one year. Stenting was performed in the other 18 patients without vascular compensation or inadequate compensation and significantly delayed in blood flow, and then they took anti-platelet aggregation and plaque stable drugs (the same as the medication group). The relative perfusion parameters including regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional mean transit time (rMTT), and regional time to peak (rTTP) in both groups (including the examination on admission and reexamination after one year) were compared. All the absolute perfusion parameters of the ipsilateral and contralateral sides in the operation group (including before the procedure, 7 days and one year after the procedure) were also compared. Results: Circled digit one All the relative perfusion parameters before medication and before operation were compared. In addition to rCBF (0.86 ± 0.18; 0.42 ± 0.26) and rCBV (1.02 ± 0.03; 1.15 ± 0.06), there were no significant difference in other parameters (P > 0.05). Circled digit two All the relative perfusion parameters after taking medicine for one year in the medication group and one year after the procedure in the operation group were compared. In addition to rCBF, there were significant differences in other parameters (P < 0.05). Circled digit three TTP and MTT were delayed on the ipsilateral sides before the procedure, and CBF were decreased to various degrees in 18 patients in the operation group, compared to the contralateral sides, there were significant difference. Seven days after the procedure, CTP imaging showed that CBF was improved significantly, and TTP and MTT were still delayed. In comparison with the ipsilateral and contralateral sides one year after the procedure in CTP imaging, there were no significant differences among TTP, MTT, CBF, and CBV. The comparative analysis of the absolute parameters at 3 time points were performed, and there were significant differences in the changes of TTP, MTT, and CBF on the ipsilateral sides (P < 0.05). Circled digit four After the medication group were followed up for 1 year, there were two new patients with TIA, and one of the two patients improved before the treatment. Eighteen patients in the operation group were followed up for one year after the procedure, and there were no new patients suffered TIA. Among the 16 patients with TIA before the procedure, 9 improved, and there were significant differences before and after the procedure (P < 0.05). Conclusion: CTP imaging can accurately reflect the medication and hemodynamic conditions of patients with internal carotid stenosis before and after stenting, According to the related parameters in combination with the clinical and DSA results, it has the guiding role for reasonable choice of surgical indications and objectively evaluate the efficacy and prognosis.

Purpose To observe the changes of choroidal circulation and the retinal lesions caused by ocular contusion with indocyanine green angiography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twenty six cases (86.2%) showed defected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the longest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels. Damage of retinal pigment epithelium was found in the areas of choroidal abnormal perfusion. Conclusion ICGA combined with simultaneously FFA, is valuable in evaluating blunt injury of the ocular fundus and beneficial to its diagnosis and treatment.

Adult ; Angiolymphoid Hyperplasia with Eosinophilia ; Female ; Humans ; Male ; Middle Aged

AIM:To observe the clinical effect of femtosecond laser assisted penetrating keratoplasty.
METHODS: Twenty-four cases ( 24 eyes ) with corneal lesions were performed with femtosecond laser assisted penetrating keratoplasty. Preoperative and postoperative endothelial cell density and visual quality were compared.RESULTS: One week after operation, corneal grafts were clear in 21 eyes (87. 5%), mild cloudy in 3 eyes (12.5%);visual acuity ≥0. 5 in 18 eyes (75. 0%), 0. 2 ~0.4 in 6 eyes ( 25. 0%). After 3mo the mean corneal astigmatism was 2. 16±0. 21D ( range 2. 25 ~ 3. 09D). Compared to conventional penetrating keratoplasty which mean corneal astigmatism was average 3. 67±0. 38D after operation, there was significant difference between two groups ( P< 0. 05 ). There were significant differences between preoperative and postoperative visual acuity and astigmatism (both P<0. 05).
CONCLUSION: Femtosecond laser assisted penetrating corneal transplantation operation can improve patient's visual quality. And compared to traditional penetrating keratoplasty astigmatism decreased significantly, incision can be made in individual shape more precisely and neatly.

Chronic Disease ; Female ; Humans ; Lead Poisoning ; complications ; Middle Aged ; Occupational Diseases ; Renal Insufficiency ; chemically induced

OBJECTIVETo systematically assess the efficacy and safety of Rhodiola in treating chronic stable angina pectoris.

METHODSOur group searched the Cochrane library, PubMed, Embase, Chinese biomedical literature database (CBM), VIP database (VIP), Chinese Journal Full-text Database (CNKI) for the literature published in English and Chinese till April 2013. Randomized controlled trials (RCTs) were included on the therapeutic effect of Rhodiola or Rhodiola plus conventional Western medicine in comparison with the conventional Western medicine treatment on stable angina. Data were extracted according the data extraction form. The literature methodological quality was assessed by using the Cochrane handbook, and data analyzed by Rev-Man 5.2 Software for Meta-analysis. The effect indicators of outcomes was expressed by odds ratio (OR) and 95% CI.

RESULTSA total of 7 randomized controlled trials, 662 cases of stable angina pectoris patients met the inclusion criteria and all published in Chinese, without one scientific design and high quality literature. Compared with the conventional Western medicine treatment, combined with oral administration of Rhodiola could improve the efficiency of anti-angina (OR = 2.49, 95% CI: 1.02 - 6.09). Combined with intravenous infusion of Rhodiola could also improve the efficacy of angina pectoris (OR = 4.86, 95% CI: 2.4 - 9.82). Oral administration of Rhodiola couldn't improve ECG efficacy (OR = 1.25, 95% CI: 0.67 - 2.34). Intravenous infusion of Rhodiola could improve the clinical efficacy (OR = 2.94, 95% CI: 1.61 - 5.35). Combined with the conventional treatment, intravenous infusion of Rhodiola could improve the whole blood viscosity (low and high shear rates) and inverse variance (IV) (-1.36 and -0.99, 95% CI: -1.65 - 1.07 and -1.26 - 0.71), but could not reduce serum fibrinogen and D-dimer level. The incidence rate of adverse reactions was higher than that of the conventional treatment combined with Rhodiola (OR = 0.1, 95% CI: 0.02 - 0.51).

CONCLUSIONSOn the basis of routine treatment, Rhodiola could further improve patients' symptoms. Combined with intravenous medication, Rhodiola could increase the ECG improvement rate, and reduce adverse reactions. But the methodological quality of included studies was poor, the number of samples was small, and influence factors such as the intervention period was short. This conclusion needs scientific and rational design in a larger sample, multicenter clinical trial to verify.

Objective:To investigate frequencies of microsatellite instability(MSI)and loss of heterozygosity(LOH)in renal ceil carcinoma(RCC),and to discuss the relationship of clinicopathological characteristics of RCC with MSI and LOH. Methods:Twelve microsatellite markers located at chromosomes 3p,9p and 14q were selected to investigate microsatellite alterations(MSI and LOH)in 31 RCC specimens and their paired metastasis specimens by polymerase chain reaction- polyacrylamide gel elect rophoresis-ethylene dibromide(PCR-PAGE-EB)staining and sequencing.Results:The frequency of MSI could reached 61.3% and that of LOH could reach 54.8%.The highest frequency of MSI was at locus of D9S168(32.3%);the highest frequency of LOH was at locus of D3S1289(21.4%).No correlation was found between MSI or LOH and the patients' age,sex,pathology type and metastastis,except that MSI was correlated with TNM stage of RCC(P

Objective To compare the efficacy of 18F-FDG PET/CT, 99Tcm-MDP bone scintigraphy (BS), and combination of the two techniques (PET/CT + BS) for detecting bone metastasis by ROC curve analysis. Methods All 296 patients with various cancers, who underwent both 99Tcm-MDP BS and 18F-FDG PET/CT within two months, were retrospectively analyzed. These images were interpreted according to 5-point scale (0: definitely negative, 1: probably negative, 2: equivocal, 3: probably positive, 4:definitely positive for bone metastasis), and the scale of PET/CT + BS was the sum of PET/CT and BS. In light of the confirmed diagnosis derived from pathology or follow-up, ROC curve analysis was performed.The area under the ROC curve (AUC) was compared by z-test. Results Of 296 cases, 61 (20.6%) were confirmed as bone metastases and 235 (79.4%) were negative. The AUC were 0. 919 (95% confidence interval (95% CI) :0. 867 - 0. 971) for BS, 0. 949 (95% CI: 0. 906 - 0. 991) for PET/CT, and 0. 994 (95% CI: 0.988-0.999) for PET/CT + BS, rctrospectively. The AUC of PET/CT + BS was statistically significantly larger than that of BS (z=2. 866, P=0.004) or PET/CT (z =2.027, P=0.043), while the AUC of PET/CT was larger than that of BS, but no statistically significance (z = 0. 881, P = 0. 378) was showed. The optimal sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value(NPV) were 90. 2% (55/61), 85. 1% (200/235), 86. 1% (255/296), 61. 1% (55/90), 97. 1%(200/206) for BS, 88.5% (54/61), 97.0% (228/235), 95.3% (282/296), 88.5% (54/61), 97.0% for PET/CT, and 98.4% (60/61), 95.7% (225/235), 96.3% (285/296), 85.7% (60/70) for PET/CT + BS,respectively. The specificity (χ2 = 19.862, P<0. 001), accuracy (χ2 = 23. 361, P<0.001) and PPV (χ2 =11. 791, P =0.001) of PET/CT + BS were significantly higher than those of BS, the sensitivity of PET/CT +BS was significantly higher than that of PET/CT (χ2 =4.167, P=0.031). Compared with BS, PET/CT had a higher specificity (χ2 = 19.600, P<0. 001), accuracy (χ2 = 13. 755, P <0. 001), PPV (χ2 = 13. 608, P <0. 001), but their sensitivity showed no statistically significant difference (χ2 = 0, P = 1. 000). Conclusions The efficacy of 18F-FDG PET/CT for detecting malignant bone metastasis was superior to that of 99Tcm-MDP BS alone. The detection ability can be obviously improved by combination of the two techniques.

Objective To determine the effect of histotype and histodifferentiation on the maximum standardized uptake value (SUV_(max)) of non-small cell lung cancer (NSCLC) ~(18)F-fluorodeoxyglucose (FDG) PET/CT imaging.Methods Two hundred and sixty patients with NSCLc underwent ~(18)F-FDG PET/CT imaging.They were classified according to (1) histotype:as adenocarcinoma (AC),squamous cell carcinoma(SQC),adenosquamous carcinoma (ASC) and other type carcinoma (OTC),and (2) histodifferentiation:as grade Ⅰ (well-differentiated),grade Ⅱ (moderate-differentiated) and grade Ⅲ (poor-differentiated).The SUV_(max) and size(long diameter)of the primary lesions were measured.Multivariate regression analysis was used to analyze the relationship between the SUV_(max) and variable factors including histotype,histodifferentiation,lesion size,age,sex,body height,body weight,body mass index (BMI),blood glucose level,dose,and rate of dose.Results Two hundred and sixty patients had 260 primary NSCLC tumors.There were 161 AC(15 grade Ⅰ,88 grade Ⅱ,58 grade Ⅲ),74 SQC(6 grade Ⅰ,39 grade Ⅱ,29 grade Ⅲ),15 ASC(7 grade Ⅱ,8 gradeⅢ)and OTC(8 large cell,2 carcinosarcoma).Only lesion size (F=87.046.P＜0.001),histodifferentiation (F=87.604,P＜0.001) and histotype (F=66.663,P＜0.001) were included for multivariate regression analysis with SUV_(max).After adjustment for lesion size,the SUV_(max)(mean and 95%confidence interval) in ascending order was AC Ⅰ:3.3(2.1-4.5),ACⅡ:6.0(5.5-6.6),SQCⅠ:6.1(4.2-8,0),ASC Ⅱ:6.6(4.8-8.4),SQCⅡ.7.8(7.0-8.6),OTC:8.1(6.6-9.6),AC Ⅲ:8.3(7.6-8.9),ASC Ⅲ:8.7(7.0-10.4),and SQC Ⅲ:8.9(8.0-9.8).11he SUV_(max) of AC Ⅰ was significantly lower than that of SQC Ⅰ(q=-2.786,P=0.017),same for AC Ⅱ and SQC Ⅱ(q=-1.776,P＜0.001),but no statistically significant differences were found among AC Ⅲ,ASC Ⅲ and SQC Ⅲ(q=-0.593,-0.422,0.171,P=0.288,0.642,0.860,respectively).For the same histotype lesions,the difference of SUV_(max) among AC Ⅰ,Ⅱ and Ⅲ was statistically significant(q=-2.720,-4.943,-2.223,all P＜0.001),as also for SQC Ⅰ and Ⅲ(q=-2.751,P=0.012).Conclusion Histotype and histodifferentiation are significant correlative factors for ~(18)F-FDG uptake of NSCLC,with histodifferentiation being the factor with greater impact.

Adolescent ; Exercise Tolerance ; physiology ; Female ; Humans ; Male ; Oxygen Consumption ; physiology ; Swimming ; physiology ; Young Adult