Obbjective To evaluate the diagnostic value of 64-slice spiral CT angiography (CTA) in multiple intracranial aneurysms (MIA). Methods Twenty-five patients (9 males and 16 females, aged from 17 to 68 years) with suspected MIA underwent 64-slice spiral CTA with slice thi ckness of 0.625mm. The data of all patients were reconstructed with multiplanar reconstruction (MPR), 3-dimensional shade surface display (3-SSD), volume rendering (VR) and maximum intensity projection (MIP). The clinical diagnostic value was evaluated with the results of surgery or interventional embolization therapy. Results A total of 61 aneurysms were detected by 64-slice spiral CTA in 25 patients, among them 17 patients were with 2 aneurysms, 6 patients with 3 aneurysms, 1 patient with 4 aneurysms and 1 patient with 5 aneurysms. The 64-slice spiral CTA could not only clearly demonstrate MIA, but also the size, neck, axis point and parent artery of each aneurysm, and the spatial relationship between aneurysm and the adjacent vessels and bone structures. Twenty-one patients underwent microsurgery and four underwent embolization, the location, size and shape of aneurysm and its spatial relationship with adjacent structures were in accordance with the findings of 64-slice spiral CTA. Conclusion The 64-slice spiral CTA could be used as the first choice in the diagnosis of MIA for its high accuracy, and may be an important adjunct to digital subtraction angiography (DSA) in MIA treatment.

Objective: To investigate the relationship between the dysplasia of horizontal segment (A1 segment) of anterior cerebral artery and the formation of anterior and posterior communicating artery aneurysms. Methods: The data of 64-slice computed tomography angiography (CTA) of 216 patients were analyzed retrospectively. Of the 216 patients, CTA found 126 patients with aneurysm. They were divided into anterior communicating artery aneurysm (ACoAA) group (n = 69) and posterior communicating artery aneurysm (PCoAA) group (n = 57 ). The other patients without aneurysm revealed by CTA but with headache and dizziness (n = 90) were used as a control group. The presence or absence of aneurysm, the location, shape, size and neck width of aneurysm, the apex pointing of aneurysm as well as the relationship between the aneurysmal bodies and surrounding structures were analyzed. The prejudged results and the surgical results were compared. Whether the anterior cerebral artery A1 segment had dysplasia or not and whether it had fetal-type posterior cerebral artery or not were observed at the same time. Results: Circled digit oneA total of 126 patients with communicating artery aneurysm were revealed by 64-slice CTA, among them 69 were ACoAA and 57 were PCoAA. Taking DSA and surgery as determining standards, the sensibility and specificity detected by 64-slice CTA were 100%. Circled digit twoUnilateral hypoplasia or absence of A1 segment of anterior cerebral artery reached 81.7% in the ACoAA group, which was significantly higher than that in the PCoAA group or the control group (P < 0.05); fetal-type posterior cerebral artery in the PCoAA group reached 56.1% , which was significantly higher than that in the ACoAA group or the control group (P < 0.05). Conclusion: 64-slice CTA has higher sensibility and specificity for detecting cerebral aneurysms. Unilateral hypoplasia or absence of A1 segment of anterior cerebral artery and fetal-type posterior cerebral artery are closely associated with the occurrence of intracranial communicating artery aneurysms.

Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

Objective To observe the clinical effectiveness and prognostic factors of autologous hemopoietie stem cell transplantation on diabetic peripheral angiopathy patients under different degrees of vascular lesions. Methods Thirty-six patients with diabetic were divided into mild vascular stenosis group (group A: 20 lower extremities, vascular stenosis less than 50% ), moderate vascular stenosis group(group B :26 lower extremities, vascular stenosis of 50%-70% ) and severe vascular stenosis group (group C: 25 lower extremities, vascular stenosis greater than 70% ) according to the degree of vascular lesions. All patients were given the stem cell mobilization for 5 days, then peripheral hemopoietic stem cells were gathered on the last day and transplanted to ischemic limb by using monoeyte stem cell suspend liquid with 3 cm × 3 cm intervals.Each index of three groups was regularly observed ( 1th,12th and 18th month respectively after the operation)and comprehensive evaluated. Meanwhile,the transplantation prognostic factors (age, disease duration, post-prandial 2 hours blood glucose, glycated hemoglobin, blood pressure, triglycerides) were analyzed by multiple regression. Results Twelve months after transplantation, the ankle brachial index (ABI) and percutaneous oxygen pressure (TcPO2) of all three groups increased compared with that before the transplantation (P<0.05). In the 18th month after transplantation, the ABI still increased in group A and B (P< 0.05), and no significant changes were found in group C compared with that in the 12th month. Eighteenth month after transplantation, lower extremities of 8 patients (40%) in group A, 8 patients (31%) in group B and 6 patients (24%) in group C were examined to have neovascularizatian. Age, disease duration, blood pressure, post-prandial 2 hours blood glucose, glycated hemoglobin and triglycerides were all the important factors that affected diabetic peripheral angiopathy recurrence after transplantation. Conclusions The long-term effica-cy of stem cell transplantation on diabetic peripheral angiopathy patients at a mild to moderate degree is superior to that with severe vascular lesions. Close monitoring of blood glucose, blood pressure and triglycerides in the operation perinatal stage is required.They are the important prognostic indicators.

Studies have shown that women's menopause caused by permanent cessation of ovarian function is closely related to lipid metabolism disorders. Er-xian Decoction has been used in the clinical treatment for gynecological diseases and has a good effect on diseases related to reduced sex hormone function. In this study, metabolomics was performed on bilateral ovariectomized model rats within 12 weeks after modeling to mimic the physiological state of menopausal women in different menopausal stages and Er-xian Decoction dosed model rats. The results of liver oil red O staining sections showed lipid metabolic disorder of bilateral ovariectomized model rats and the regulating effects of Er-xian Decoction. 46 potential biomarkers (6 steroid hormones, 3 sphingolipids, 11 phospholipids and 26 glycerides) in plasma and 32 potential biomarkers (1 steroid hormones, 20 phospholipids and 11 glycerides) in liver were obtained based on lipidomics analysis. Then, we analyzed the differential metabolic pathways and construct the lipid metabolism network significantly regulated by Er-xian Decoction. The results provided valuable information for in-depth understanding of the gradual changes on lipid metabolism disorders under menopausal conditions and the characteristics and mechanisms of compound Er-xian Decoction's regulatory effects. The study complied with the procedures established by the Animal Experiment Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and passed the animal experiment ethics examine (No. 00000918).

Pneumoconiosis

Objective To evaluate the preoperative diagnosis and treatment of primary non-specific ureteritis,and to better understand this disease.Methods Three cases of primary non-specific ureteritis (1 man and 2 women)were reported.Their age was 28,38,68 years,respectively.One ease was found to have hydronephrosis on B-ultrasound at physical examination with no symptoms,and 2 had abdominal pain. The lesions were detected in lower part of the ureter in 2 cases,and in middle in I.The patients were diag- nosed preoperatively with combined use of MRU and ureteroscopy.Partial resection of the diseased part of the ureter was performed in all the cases.Results Pathological findings confirmed the diagnosis of non-spe- cific ureteritis.Microscopy showed necrotic tissue and inflammatory cell infiltration of ureteral mucosa,dilated and congested blood vessels,hypertrophic muscular layer,and proliferation of fibrous tissue.During the fol- low-up of 2 years,the patients had no symptoms and were free from hydronephrosis.Conclusions The eti- ology of primary non-specific ureteritis is unclear,and no typical symptoms can be found clinically.Combined use of MRU and ureteroscopy is helpful for definite diagnosis of the disease.Partial resection of the diseased part of the ureter has good results.

0.05).The combined use of sinomenine and CsA could prolong graft survival significantly(groups 4 vs groups 1,2,3,5)(P

Objective To investigate the inhibitory effect of paclitaxel on rat graft arteriosclero- sis and the mechanism.Methods The rat abdominal aortic allograft model was used.All rats were divided into three groups:isograft control group (Wistar to Wistar),allograft group (Wistar to SD) and allograft paclitaxel-treated group (Wistar to SD).Rats in allograft paclitaxel-treated group re- ceived paclitaxel (2 mg?kg~(-1)?d~(-1)) from the operation day to post-operative day 14 and others received same dosage of vehicle (0.9% normal saline).Animals were sacrificed and the grafts were harvested at 30th day after operation.Intimal proliferation was studied by light microscopy.The apoptosis of vascular smooth muscle cells (VSMCs) was detected by transmission electronic microscopy and termi- nal deoxynucleotidyl transferase biotin nick end-labeling (TUNEL) method.Results Morphological analysis showed that grafts had no change after operation in isograft control group,but in allograft group intimal proliferation,inflammatory cells infiltration in neointima and adventitia and stenosis of allografts were obvious.After treatment with paclitaxel,there was a significant decrease in intimal proliferation,inflammatory cells infiltration and stenosis.Apoptosis index of VSMCs was higher in the allograft paclitaxel-treated group than other groups.Conclusion Paclitaxel can inhibit intimal pro- liferation in aortic allografts and prevent the graft from arteriosclerosis possibly by inducing the apoptosis of VSMCs.

Objective To study the clinical result of the surgical treatment of upper cervical vertebra disease from high anterior cervical retropharyngeal approach.Methods Among 14 patients,there were 7 C_(2.3)disc hernia- rions combined with C_(2.3)dislocations,3 Hangman fractures,2 odontoid process fractures and 2 C_3 tumors.All patients underwent the high anterior cervical retropharyngeal approach.10 cases were given discectomy of C_(2.3)or focus clear- ance of C_3,iliac bone autograft or titanium cage filled and internal fixation with titanium plate.2 cases of odontoid process fractures were given anterior screw fixation.Results 14 cases got successful exposure.The decompression, reduction,lesion clearance and fusion with internal fixation were done in all patients.There were no important vascu- lar or nerve injuries.The surgical treatment could improve the spinal cord nerve function to a certain degree for the cases with compression of spinal cord.Conclusion Good exposure of upper cervical spine and effective surgical oper- ation could be achieved from high anterior cervical retropharyngeal approach,with minimal trauma and complication, and it was a favorable approach.