Objective To study the value of CT in confirming the diagnosis of schwannoma of the cervical sympathetic nerve ( SSN) or vagus nerve (SVN) before operation.Methods From October 1988 to March 2001,45 SSNs and 14 SVNs confirmed by surgery and pathology were analyzed to discover the rules of displacement of common carotid artery (A),internal carotid artery (I) and internal jugular vein (V). Results 43 SSNs located at the level of common carotid bifurcation or/and upper neck with A or/and I abutting against and displacing to the lateral periphery of the tumor.In 35 SSNs with enhanced CT,the V was also abutted against and displaced to the lateral periphery of the tumor.The rest two SSNs located at the root of the neck with A and V anterolateral to but not abutting against the tumor.The growth of 12 SVNs all resulted in separation between the A or I and the V.The A or I was displaced to the medial periphery of SVN and the V to the lateral periphery.Their distance was 90? to 180?. Conclusion During the growth of SSN or SVN,the CT axial scan can still accurately reflect the anatomical positional relationships among A,I,and V with the cervical sympathetic nerve or vagus nerve.So CT is a very valuable tool in confirming the diagnosis of SSN or SVN preoperatively.

Purpose: To report 2 cases of papillary thyroid carcinoma occurring in a thyroglossal duct remnant, and to discuss the diagnostic and therapeutic methods by reviewing the literature. Methods: An asymptomatic midline mass occurring in the upper neck was the sole presenting complaint in 2 cases. The preoperative evaluation included a complete head and neck examination, B-ultra sound examination and FNAB. The Sistrunk procedure was done. A lobectomy( case 1) and a lumpectomy ( case 2) were performed respectively, because of the abnormality found in their thyroid gland. A modified neck dissection was performed in case 2 because of regional lymphadenopathy. The following histologic studies were carried out on tissues with HE stain. Results: Diagnoses of thyroglossal duct carcinoma were made by several pathologists. Tissues from thyroid were first diagnosed as nodular goiter in case 1 and thyroid adenoma in case 2. In case 2, one positive lymph node and invasion to the hyoid bone was found. Conclusions: Malignant lesions are rare in the thyroglossal duct remnant. The diagnostic criteria is acknowledged. Resection of the thyroglossal duct carcinoma by the Sistrunk procedure is an adequate surgical approach. But the controversy about further treatment will continue because of the lack of large series of patients and the 10 to 20 year follow-up.

Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P

The microenvironment after peripheral nerve injury becomes complicated for axon regeneration, which can be promotion, inhibition, or both. This paper summarized the researches about the effect of microenvironment on axon regeneration after peripheal nerve injury.

Purpose:To analyze the patterns of cervical lymph node metastasized from different primary sites of head and neck cancers based on computed tomography (CT) imaging study.Methods:We studied the CT showing the positional relationship between 160 patients with different primary sites of head and neck squamous cell carcinoma and their cervical lymph node metastases using our new modified classification retrospectively.Results:The metastatic rates of level Ⅱa, Ⅱc and Ⅴ were significantly different between nasopharyngeal and non nasopharyngeal carcinoma ( P

Objective To observe the effects of Jiaji electroacupuncture and neurodynamic mobilization technique on axon regeneration and content of brain-derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF) in rabbits with sciatic nerve injury. Methods 30 male adult rabbits were assigned to sham (A, n=6), model (B, n=6), neurodynamic mobilization (C, n=6), Jiaji electroacupuncture (D, n=6), and Jiaji electroacupuncture combine with neurodynamic mobilization (E, n=6) groups. The group C was treated with neurodynamic mobilization, the group D with Jiaji electroacupuncture, and the group D with both 3 days after modeling of clamping at sciatic nerve, while the groups A and B with no treatment. The axon regeneration was observed with HE staining, and the content of BDNF and CNTF in serum was measured with ELISA 4 weeks after treatment. Results The axons regeneration was observed better in the groups C, D and E than in the group B. The content of BDNF and CNTF was more in the groups C, D and E than in the group B (P<0.05). Conclusion Both Jiaji electroacupuncture and neurodynamic mobilization can improve axon regeneration with synergistic action, which may associate with the increase of BDNF and CNTF in serum.

Objective To describe the CT appearance of recurrent laryngeal nerve paralysis,discuss the anatomic and pathologic basis of this paralysis,and evaluate CT diagnosis.Methods 32 cases of recurrent laryngeal nerve paralysis clinical confirmed were analyzed retrospectively.All of these patients had the CT scans from the level of hyoid bone to the upper thorax,the slice and interval are 5 mm.Results CT findings of recurrent laryngeal nerve paralysis included: oblique of aryepiglottic fold,dislocation of arytenoids cartilage and cricoarytenoid joint,dilation and relaxation of piriform sinus for 27 cases (84.4%);wide and asymmetrical ventricle of larynx for 16 cases(50.0%);asymmetrical and fix of vocal fold for 11 cases(34.4%) et al.Conclusion The recurrent laryngeal nerve innervate all the intrinsic muscles of the larynx except cricothyroid muscle,paralysis of the nerve leads to atrophy of related muscles.CT scan demonstrate the larynx morphologic changes of recurrent nerve paralysis and is helpful to identify the etiology.

Objective To assess the association between admission plasma glucose (APG) and noreflow during primary percutaneous coronary intervention (PCI) in patients with ST-elevation acute myocardial infarction (STEMI). Methods A total of 1413 patients with STEMI successfully treated with PCI were divided into no-reflow group and normal reflow group. Results The no-reflow was found in 297 patients (21.0%) of 1413 patients; their APG level was significantly higher than that of the normal reflow group [( 13.80 ±7.47) vs (9.67 ±5.79) mmol/L, P＜0.0001]. Multivariate logistic regression analysis revealed that current smoking ( OR 1.146, 95% CI 1.026-1. 839,P = 0.031), hyperlipidemia ( OR 1. 082,95% CI 1. 007-1. 162, P = 0. 032), long reperfusion ( ＞ 6 h, OR 1. 271, 95% CI 1. 158-1. 403, P =0. 001 ) , admission creatinine clearance ( ＜ 90 ml/min, OR 1.046, 95% CI 1. 007-1.086, P = 0.020 ) ,IABP use before PCI (OR 9.346, 95%CI 1.314-67. 199, P=0.026), and APG ( ＞ 13.0 mmol/L, OR1.269, 95% CI 1.156-1.402, P = 0.027) were the independent no-reflow predictors. The no-reflow incidence was increased as APG increased ( 14. 6% in patients with APG ＜ 7. 8 mmol/L and 36. 7% in patients with APG ＞ 13.0 mmol/L, P = 0.009 ). Conclusion APG ＞ 13.0 mmol/L is an independent noreflow predictor in patients with STEMI and PPCI.

Objective To identify independent predictors of no-reflow after primary percutaneous coronary intervention (PPCI)in aged patients with ST-elevation acute myocardial infarction (STEMI), and thus construct a no-reflow predicting model.MethodsTotal of 668 aged patients with STEMI and successfully treated with PPCI were divided into the no-reflow group and the normal flow group. All clinical, angiographic and procedural data were collected. Multiple logistic regression analysis was used to identify independent no-reflow predictors.ResultsThe no-reflow was found in 181 of 668 (27.1％) patients.Multiple stepwise logistic regression analysis identified that admission systolic blood pressure (SBP)＜100 mm Hg, collateral circulation 0-1 grade, pre-PCI thrombus score ≥ 4, and intra-aortic balloon pump (IABP) use before PCI were independent noreflow predictors.The no-reflow incidence significantly enhanced as the numbers of independent predictors increased [10.0％ (2/20), 13.7％ (32/233), 30.8％ (85/276), 38.1％ (37/97), and 59.5％ (25/42) in patients with 0, 1, 2, 3, and 4 independent predictors, respectively,x2 =25.796,P＜0.01) ]. ConclusionsThe no-reflow predictors are admission SBP ＜ 100 mm Hg, collateral circulation 0-1grade, pre-PCI thrombus score≥4, and IABP use before PCI in patients with STEMI and treated with PPCI. The prediction model may provide basis for therapeutic decision.

Objective To assess independent no-reflow predictors in patients with STEMI after primary drug-eluted stenting.Method A prospective study was carried out in 1413 patients with STEMI treated with primary drug-eluted stenting within 12 hours after onset of AMI from January 2007 through March 2010.The patients were divided into the no-reflow group and the normal reflow group.Univariate and multivariate logistic regression were applied to identification of no-reflow predictors.Results The no-reflow was found in 297(21.0％)of 1413 patients.Univariate and multivariate logistic regression identified that age ＞65 years,long time from onset to reperfusion ＞6 hours,admission plasma glucose(APG)＞ 13.0mmol/L,collateral circulation ≤ 1,pre-percutaneous coronary intervention(PCI)thrombus score ≥ 4,and intra-aortic balloon pump(IABP)used before PCI(P ＜0.05)were independent no-reflow predictors.The no-reflow rate significantly increased as the number of predictors increased(P ＜ 0.01).Conclusions There are 6 factors associated with coronary no-reflow used for prediction in patients with STEMI after primary drug-eluted stenting.