Adult ; Aged ; Angiography, Digital Subtraction ; Carcinoma, Hepatocellular ; diagnostic imaging ; therapy ; Chemoembolization, Therapeutic ; Female ; Hemangioma ; diagnostic imaging ; therapy ; Humans ; Liver Neoplasms ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Radiography, Interventional ; methods ; Tomography, X-Ray Computed ; methods

PurposeTo explore the multislice CT (MSCT) and clinical manifestations of diaphragmatic hiatus hernia with hernial sac effusion, in order to improve its diagnostic rate.Materials and MethodsMSCT data were retrospectively analyzed for morphologies and clinical manifestations in 32 patients with diaphragmatic hiatus hernia and hernial sac effusion.Results32 patients included 21 males and 11 females (χ2=0.64,P>0.05). 25 patients were older than 60 years and 7 cases younger than 60 years (χ2=13.58,P<0.01). There were 27 cases with non-viscera hiatus hernia including 23 cases of combined fat-water hernia and 4 cases of simple effusion. 5 cases were of viscera type hiatus hernia (χ2=5.47,P<0.05). 28 cases showed ascites including 23 cases with non-viscera hiatus hernia and 1 case with viscera type hiatus hernia (χ2=9.56,P<0.01). The axial images from different levels of non-viscera hiatus hernia with liquid hernial sac demonstrated quasi-circular, meniscus, ringlike and teardrop shapes.Viscera type hiatus hernia and liquid hernial sac were found to be irregular shape . All patient sufferered from dysphagia, chest distress and epigastric discomfort.ConclusionThe increased pressure gradient between thorax and abdomen driving ascites into supradiaphragmatic hernial sac and clamping by hiatus may be the main mechanism. Quasi-circular, meniscus, ringlike andteardrop were the characteristic signs of diaphragmatic hiatus hernia with hernial sac effusion.

Objective To investigate the differences of clinical symptoms,risk factors,plasma D?dimer level and severity of acute pulmonary embolism( APE) between females and males. Methods Clinical data of 153 cases APE patients were analyzed retrospectively. Symptoms,risk factors,electrocardiogram( ECG) findings, plasma D?dimer level and risk classification were analyzed between females and males. Results The proportion of palpitation in females was significantly higher than that in males ( 29. 3%( 24/82 ) vs. 8. 5%( 6/71 ) ,χ2=10. 46,P<0. 01) . The proportion of chest pain in females was significantly lower than that in males ( 4. 9%( 4/82) vs. 25. 4%( 18/71) ,χ2=12. 96,P<0. 01) . The proportion of patients who had three or more symptoms was significantly higher in females than that in males ( 32. 9%( 27/82 ) vs. 7. 0%( 5/71 ) ,χ2 = 15. 41, P<0. 01). D?dimer mean level in females was significantly higher than that in males(334. 00(620. 00) μg/L vs. 528. 00( 812. 75) μg/L,Z=-2. 447,P<0. 05) . The proportion of low risk patients in females was lower than that in males ( 31. 7%( 26/82 ) vs. 53. 3%( 38/71 ) ,χ2 = 7. 44, P<0. 01 ) , while the proportion of the intermediate?high?risk patients was higher ( 34. 1% ( 28/82 ) vs. 14. 1 ( 10/71 )%,χ2 = 8. 20, P<0. 01) . Conclusion The symptoms was more variable in females with the main symptom of palptation. The level of plasma D?dimer is higher in females than that in males. The prognosis of females may be severe than that of males.

Objective To determine the feasibility and the optimal dose reduction of AIDR 3D on piglet chest CT which can provide image quality (IQ) comparable to filtered back projection (FBP).Methods Twenty-nine normal pigs with the weight of 3-12kg underwent 640-slice MDCT chest CT (Aquilion one,Toshiba) for 5 times with 80 kvp and various mAs.SureExposure3D technique were used and the index of noise were set to SD 10.0,12.5,15.0,17.5,20.0(Group A,B,C,D,E) to reduce dose successively.Group A were reconstructed with FBP,Group B,C,D,E were reconstructed using AIDR 3D (strong level).Quantitative image noise and signal to noise ratio(SNR) were measured in each group.Two radiologists graded subject image quality on both lung images (artifacts,central airway,lung tissue) and mediastinal images (mediastinal structure) and overall image quality using a 5-point scale in a blinded manner.Analysis of variance (ANOVA) and LSD test were used for comparisons of objective evaluation indices (CT value,noise,SNR)and radiation dose(CTDIvo1,DLP,ED) among the five groups.The Friedman test and Wilcoxon test were used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A receiver-operating characteristic (ROC) analysis was performed to establish a radiation reduction threshold up to which comparable IQ(score≥4) was maintained.Results Compared with Group A[noise(15.25 ± 3.14)HU,SNR 3.23 ± 1.07],Group B,C had significant lower noise and higher SNR [noise (12.11 ± 2.75),(13.18 ± 3.16)HU; SNR 4.13 ± 1.38,3.80 ± 1.20;F =7.38,3.11,P ＜0.05].Group D,E showed no significantly different noise and SNR with Group A[noise (15.14±4.51),(15.79 ±4.17)HU;SNR 3.40± 1.56,3.45 ± 1.70;P＞0.05].Group B,C had significant better subject image quality compared with Group A (P ＜0.01).Group D had no significantly different subject image quality compared with Group A (P ＞ 0.05).Group E had 5 pigs with overall image scores of ＜ 3.The ROC curve of IQ established SD 17.5 (Group D) as optimal cut-off point (AUC 0.75,95％ CI 0.58-0.92).Group D provided equivalent subjective image score and objective IQ measurements compared with FBP images in Group A.The ED of group D was 59％ lower than that of group A[CTDIvol (1.14±0.27) mGy vs (0.47 ±0.16)mGy,F=183.83,P＜0.01].Conclusion Using AIDR 3D technique,80 kvp with SureExposure3D (SD 17.5) can provide comparable IQ compared with routine dose with FBP reconstruction,and reduce 59％ dose in piglet model.

Objective To evaluate the role of P2X3 receptors in the development and mnaintenance of neuropathic pain (NP) and the relationship with nuclear factor kappa B (NF-κB) in dorsal root ganglia of rats.Methods Thirty-six SPF healthy male Sprague-Dawley rats,weighing 180-200 g,aged 4-6 weeks,in which intrathecal catheters were successfully implanted,were divided into 3 groups (n =12 each) using a random number table:sham operation group (group S),NP group and P2X3 receptor antagonist A-317491 group (group A).At 3 days after intrathecal catheters were successfully implanted,NP was induced by chronic constriction injury to the sciatic nerve.The sciatic nerve was only exposed but not occluded in group S.Intrathecal injection was performed twice a day for 14 consecutive days starting from 1 day after operation.Normal saline 20 μ l was intrathecally injected in group S and group NP,and A-317491 100 nmol/10 μ1 and normal saline 10 μ l were intrathecally injected in group A.Thermal paw withdrawal threshold (TWT) and mechanical paw withdrawal threshold (MWT) were measured on day 1 before operation and at 30 min after intrathecal injection on days 1,3,7,10 and 14 after operation.On days 7 and 14 after operation,the rats were sacrificed and the dorsal root ganglia of the lumbar segment were removed for determination of the expression of P2X3 receptors and NF-κB p65 by Western blot.Results Compared with group S,TWT and MWT were significantly decreased at each time point after operation,and thc expression of P2X3 receptors andi NF-κB p65 in dorsal root ganglia was up-regulated on days 7 and [4 after operation in group NP (P＜0.05 or 0.01).Compared with group NP,TWT was significantly increased at each time point after operation,MWT was increased on days 3,7,10 and 14 after operation,anl the expression of P2X3 receptors and NF-κB p65 in dorsal root ganglia was down-regulated on days 7 and 14 after operation in group A (P＜0.05).Conclusion The mechanism underlying the development and maintenance of NP is related to the up-regulation of P2X3 receptor expression and promotion of the expression of NF-κB in dorsal root ganglia of rats.

Objective To evaluate the role of transient receptor potential channel 8 (TRPM8) in the development and maintenance of neuropathic pain and the relationship with nuclear factor kappa B (NF-κB) in the dorsal root ganglion of rats.Methods Thirty-six pathogen-free healthy adult male SpragueDawley rats,weighing 180-200 g,aged 6-8 weeks,were divided into 3 groups (n=12 each) using a random number table:sham opeation group (group S),neuropathic pain group (group NP) and TRPM8 bocker BCTC group (group BCTC).Neuropathic pain was induced by ligation of the right sciatic nerve in anesthetized rats.BCTC 20 nmol was intrathecally injected once a day on preoperative day 1 and postoperative days 1,3,7 and 10 in group BCTC.The thermal,mechanical and cold pain thresholds were measured on preoperative day 1 and postoperative days 1,3,7,10 and 14.The dorsal root ganglions of the lumbar segment (L4-6) were removed on postoperative days 7 and 14 for determination of the expression of TRPM8 and NF-κB p65 by Western blot.Results Compared with group S,the thermal and mechanical thresholds were significantly decreased on postoperative days 1-14,and the cold pain threshold was decreased on postoperative days 3-14 in NP and BCTC groups,the expression of TRPM8 and NF-κB p65 in dorsal root ganglions was up-regulated on postoperative days 7 and 14 in group NP (P＜0.05),and no significant change was found in the expression of TRPM8 and NF-κB p65 in dorsal root ganglions in group BCTC (P＞0.05).Compared with group NP,the thermal pain threshold was significantly decreased and the cold pain threshold was increased on postoperative days 3-14,the expression of TRPM8 and NF-κB p65 in dorsal root ganglions was up-regulated on postoperative days 7 and 14,and no significant change was found in the mechanical pain threshold in group BCTC (P＞0.05).Conclusion NF-κB activation after opening of TR-PM8 in dorsal root ganglion neurons is involved in the development and maintenance of neuropathie pain in rats.

Objective To evaluate the diagnostic efficiency of Q?SPECT, CTPA, Q?SPECT/CT, and Q?SPECT/CTPA for pulmonary embolism (PE) in rabbit models. Methods (1) The PE models were constructed by injecting Gelfoam into the femoral vein of New Zealand rabbits ( n=30) . Q?SPECT, CTPA, Q?SPECT/CT and Q?SPECT/CTPA fusion images were obtained by integrated SPECT/CT. (2) All images were interpreted by two experienced nuclear radiologists who were blind to pathologic findings. The locations and numbers of lung lobes with PE were recorded respectively. ( 3) Serial sectioning of the lungs was per?formed and pathologically determined. (4) Se, Sp and Ac of different methods were compared using McNemar test;PPV and NPV were compared usingχ2 test. Kappa test was used to analyze the consistency between two nuclear radiologists. Kappa values<0.40 were interpreted as poor consistency, 0.40 to 0.75 as moderate con?sistency, >0.75 as good consistency. Results (1) Histologically confirmed emboli were present in a total of 26 pulmonary lobes and absent in 79 lobes. (2)The Se, Sp, Ac, PPV, and NPV of 4 imaging methods were:53.8%(14/26), 93.7%(74/79), 83.8%(88/105), 14/19, 86.0%(74/86) for Q?SPECT;73.1%(19/26), 96.2%(76/79), 90.5%(95/105), 86.4%(19/22), 91.6%(76/83) for CTPA;76.9%(20/26), 93.7%(74/79), 89.5%(94/105), 80.0%(20/25), 92.5%(74/80)for Q?SPECT/CT;88.5%(23/26), 91.1%(72/79), 90.5%(95/105), 76.7%(23/30), 96.0%(72/75) for Q?SPECT/CTPA. (3) McNemar test showed Q?SPECT/CT and Q?SPECT/CTPA had higher diagnostic Se for the detection of PE than Q?SPECT (χ2=4.167, 7.111, both P<0.05) , but without any significant difference with CTPA in diagnostic efficiency (χ2=0-2.250, all P>0.05) . Q?SPECT/CT had higher diagnostic Ac than Q?SPECT (χ2=4.167, P<0.05) . There was no significant difference between Q?SPECT/CT and Q?SPECT/CTPA in diagnostic effi?ciency (χ2=0.001-1.333, all P>0.05). (4)Kappa values of 4 imaging methods for radiologist 1 and 2 were 0.902, 0.915, 0.973, and 0.884. Conclusions Q?SPECT/CT imaging provides good Se and Sp. The diag?nostic efficiency of Q?SPECT/CT is better than that of Q?SPECT and is corresponded roughly to the efficien?cy of CTPA, Q?SPECT/CTPA. The diagnosis of two radiologists on Q?SPECT/CT images has the best con?sistency.

Objective To clone and express the outer surface protein C ( OspC) from a Chinese Borrelia afzelli FP1 strain and to evaluate the immune protectivity of the recombinant OspC protein ( rOspC) . Methods The gene encoding OspC protein of Borrelia afzelli FP1 strain was amplified by polymerase chain reaction (PCR) and then inserted into pET-30a plasmid to construct the recombinant expression plasmid pET-30a-OspC. The transformed E. coli BL21 strains carrying pET-30a-OspC plasmid were induced by IPTG to express OspC protein. The expressed proteins were purified by Ni-IDA resin chromatography and analyzed by SDS-PAGE and Western blot assay. Indirect immunofluorescence assay ( IFA) was performed to detect anti-rOspC protein antibodies in serum samples from rabbits immunized with rOspC protein. In vitro neutral-ization test was performed for evaluation the immune protectivity of rOspC protein. Results The recombi-nant expression plasmid pET-30a-OspC was successfully constructed and highly expressed in E. coli BL21. A strong antigen-antibody reaction between the rOspC protein and polyclonal antibody against Borrelia afzelli FP1 strain was detected by Western blot assay. The titers of IgG in serum samples from rabbits immunized with rOspC protein were significantly elevated. The in vitro neutralization test indicated that 106/ml of Borre-lia afzelli FP1 strains were neutralized by every anti-OspC protein serum sample from the experiment group. Conclusion The rOspC protein showed a strong immune protectivity against Borrelia afzelli, which could be used in the development of polyvalent subunit vaccine against lyme disease.

OBJECTIVEThe aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible.

METHODSA retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regenera- tion and surgical complications were observed. The long-term effects of the treatment were followed up.

RESULTSThe inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The post- operative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed.

CONCLUSIONEnucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.

Adult ; Bone Regeneration ; Female ; Humans ; Male ; Mandible ; Mastication ; Neoplasm Recurrence, Local ; Odontogenic Tumors ; Retrospective Studies

Objective:To compare the outcomes of guide bone regeneration by calcined bovine bone and Bio-Oss graft material in alveolar ridge preservation after tooth extraction.Methods:280 patients were divided into two groups randomly.Each patient had single tooth extracted.The sockets were filled with calcined bovine bone in 140 patients and Bio-Oss graft in another 140 patients. After shaping,all the sockets were covered with Bio-Gide membrane.Buccal mucoperiosteal flap was released and sutured to close the alveolar sockets.The patients were regularly examined at the 1st,12th and 24th week after surgery.Physical examination and X-ray evaluation were applied to compare the outcomes of the two materials in alveolar ridge preservation.Results:No infection and re-jection occurred.The radiographic results showed the width and height of the alveolar bone were preserved well at the 12th and 24th weeks.No statistically difference was found in the two groups at the 1st and 24th weeks(P>0.05).Conclusion:The two graft ma-terials can effectively preserve alveolar bone after tooth extraction.