Adult ; Gamma Rays ; Humans ; Male ; Radiation Protection ; instrumentation ; Space Suits

Objective To Analyze the imaging characteristics of intraparenchymal schwannoma and the related pathology,in order to improve the accuracy of diagnosis and be in favor of the clinics and the prognosis.Methods Four cases were confirmed to be intraparenchymal schwannoma by pathological and immunohistochemistry examination.One case was examined with precontrast and enhanced CT scanning,one with unenhanced MRI scanning,two with unenhanced and enhanced CT and MRI scanning.Their images were retrospectively analyzed.Results Of the four cases,three patients were less than 30 years old,with tumors located supratentorially.Cysts were found in all cases,with nodules on the wall in 3 cases.The nodules were enhanced markedly in two cases and moderately in one ease.In addition,calcification was detected in one case and prominent peritumoral edema existed in 1 case.The picture of the pathology demonstrated Antoni type A and Antoni type B.Immunostaining showed intense immunoreactivity for S-100 protein and Vim and negative immunoreactivity for GFAP and EMA.Conclusions Intraparenchymal schwannoma mostly occurred in juvenile,which located supratentorially in most cases.The presence of a cyst and peritumoral edema together with the tumor appears to be characteristic of intraparenchymal schwannoma.Calcification or the enhanced nodule is the helpful sign for the diagnosis.Combining the imaging findings with the pathology and immunohistochemistry results can gain the accurate diagnosis.

Objectiye To introduce the surgical technique of arthroscopy assisted anatomical posterolateral corner (PLC) reconstruction,including popliteal ligament,popliteofibular ligament and lateral collateral ligament,and evaluate the results of this technique.Methods From August 2008 to April 2010,34arthroscopic posterior cruciate ligament (PCL) and PLC reconstruction surgeries were performed.The average age of the patients was 34.1 (15-52) years.There were 32 males and 2 females.The average time period from injury to surgery was 10.7 months.All patients were chronic injuries and combined ligament injuries,including PCL and PLC injuries.Some cases had other ligament injury,including 6 patients of anterior cruciate ligament (ACL) injury (17.6%),2 of ACL combined medial cruciate ligament (MCL) injuries (5.9%),and 5 of MCL injuries (14.7%).According to Fanellis classification,for type A posterolateral rotation instability,we performed arthroscopic popliteal ligament reconstruction or popliteal ligament combined popliteofibular ligament reconstruction.For type C posterolateral instability,we performed arthroscopic PLC anatomical reconstruction.Results During the follow-up period,14 patients had undergone a second look arthroscopic examination and removal of hardware.The average follow-up time was 18.5 months (13-25 months).At the final follow-up,physical examination,stability evaluation with KT-1000 and Telos stress view,and dial test were performed.The posterior displacement of the knee had decreased from 15.56 mm preoperatively to 5.16mm postoperatively.The external rotation instability had decreased from 14.92° preoperatively to -0.22°postoperatively.The average limitation of knee flexion was 4.23° and no knee extension was limited.Conclusion With the surgical technique of arthroscopy assisted anatomical PLC reconstruction,we can restore the external rotation stability of knee.This technique can be performed combine with PCL reconstruction.

BACKGROUND:Routine posterior cruciate ligament(PCL)reconstruction can improve posterior stability of the knee joint.But the wear between graft and outlet of tibial tunnel always reduces graft mechanical strength or enlarges tunnel,resulting residual laxity.OBJECTIVE:To explore the clinical application of fluoroscopy-based navigation technique for assisting tibiai tunnel placement in arthroscopic PCL reconstruction and to investigate the efficacy and feasibility of the technique.DESIGN,TIME AND SETTING:Case analysis was performed at Beijing Jishuitan Hospital between August 2006 and March 2007.PARTICIPANTS:of 15 eases with compound ligament injury,14 underwent allograft,and 1 underwent autograft bone-1/3 of patellar tendon-bone.METHODS:The navigation system consisted of tibia tracker fixed into the proximal tibia and tool tracker attachcd with PCL tibial drill guide.With registration and calibration,the navigation system identi fied and captured the infrared signals actively from the two trackers.The computer calculated the 3D-position of the knee joint relative to the PCL tibial drill guide and then the virtue tibial tunnel was imposed into the interactive images formed by the intraoperative C-aim images.The virtue tunnel was precisely adjusted according to the intraoperative planning protocol until the ideal position achieved.In the standard anteroposterior view,the centre of the outlet of tunnel should be in the midpoint between the medial and lateral eminence and 1.5 cm from the articular surface.In sagittal plane,with the intact posterior wall,the tibial tunnel should be as close as to the posterior proximal tibial cortex to get a maximum angulation.MAIN OUTCOME MEASURES:Fluoroscopy time and times,postoperative standard anterior and lateral X-ray,outlet of tibial tunnel,angle between graft and tunnel,attachment of tunnel to posterior cortex,and integrity of posterior wall.RESULTS:Among 15 patients,14 succeeded without navigation related complications and 1 failed.The frequency of intraoperative fluoroscopy reduced from 2-10 times to 2-4 times and the exposure time for fluoroscopy shortened 10-30minutes.The tibial outlet in all success cases was located within the tibialinsertion area of posterior cruciate ligament.The average angulation between the tibial tunnel and the graft was 123.3°;all cases showed close spatial relationship between tunnel and posterior proximal tibial cortex within 2 mm,with intact posterior wall in 10 cases and slightly broken in 4 cases.CONCLUSION:With high accuracy and time-saving features,fluoroscopy-based navigation system is a feasible technique in assisting tibial tunnel placement in arthroscopic PCL reconstruction surgery.

BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been popular in the treatment of patients with cardiac arrest (CA). However, the effect of ACD-CPR versus conventional standard CPR (S-CRP) is contriversial. This study was to analyze the efficacy and safety of ACD-CPR versus S-CRP in treating CA patients. METHODS: Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase "active compression-decompression cardiopulmonary resuscitation and cardiac arrest" in PubMed, EmBASE, and China Biomedical Document Databases. The Cochrane Library was searched for papers of meta-analysis. Restoration of spontaneous circulation (ROSC) rate, survival rate to hospital admission, survival rate at 24 hours, and survival rate to hospital discharge were considered primary outcomes, and complications after CPR were viewed as secondary outcomes. Included studies were critically appraised and estimates of effects were calculated according to the model of fixed or random effects. Inconsistency across the studies was evaluated using the I2 statistic method. Sensitivity analysis was made to determine statistical heterogeneity. RESULTS: Thirteen studies met the criteria for this meta-analysis. The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP. Totally 234 CA patients were found out hospitals, while the other 333 CA patients were in hospitals. Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality. ROSC rate, survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP, with relative risk (RR) values of 1.39 (95% CI 0.99–1.97), 1.94 (95%CI 1.45–2.59) and 2.80 (95% CI 1.60–5.24). No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06 (95% CI 0.76–1.60) and 1.00 (95% CI 0.73–1.38). CONCLUSION: Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours. Compared with S-CRP, ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge.

Objective To investigate the therapeutic effect and safety of microneurosurgery associated with Gamma Knife radiosurgery on the large meningiomas in sellar region, and to clarify its clinical curative effect. Methods The clinical data of 34 patients with large meningiomas in sellar region underwent microsurgery were retrospectively analyzed.All of them underwent microsurgery,and then treated with Gamma Knife radiosurgery in one month after operation if there were residual tumors.The tumor removal of situation,complication,rate of symptom remission,and recurrence rate were analyzed.Results Among the 34 patients,total resection (7 cases of Simpson grade Ⅰ and 12 cases of Simpson grade Ⅱ)was achieved in 19 cases (55.9%),subtotal resection (Simpson grade Ⅲ )in 14 cases (41.2%), and partial resection (Simpson grade Ⅳ )was achieved in 1 case (2.9%).The major complications were cranial nerve injuries (such as oculomotor nerve, trochlear nerve and abducens nerve,n=6),the contralateral limb paresis (n = 2),postoperative bleeding (n = 1),CSF leak with infection (n=3),and secondary epilepsy (n = 3 ); no death occurred postoperatively. All these patients were followed up for about 3 to 48 months.Postoperative headache disappeared in 24 cases (80%),and 6 cases were alleviated (20%);postoperative vision improved in 12 cases (80%),remained unchanged in 2 cases (13.3%)and deteriorated in 1 case (6.7%); postoperative olfactory function improved in 5 cases (62.5%) and 3 cases unchanged (37.5%); 5 cases recoverd from the ocular motility disorder (71.4%), and 2 cases unchanged (28.6%);7 cases recoverd from thehemiplegia (100%).One of the total resection cases (5.2%)and two of the non-total resection (13.3%)suffered from tumor recurrence.All of the non-total resection cases were treated with Gamma Knife radiosurgery.Conclusion The clinical effect of microneurosurgery associated with Gamma Knife radiosurgery in treatment of large meningiomas in sellar region is satisfactory.

OBJECTIVETo study the relativity between La protein and the stability of HBV mRNA and the expression of HBV protein.

METHODSFour specific siRNAs were obtained by transcription in vitro. After transfection with the siRNAs into HepG2.2.15 cells for 3 days, the inhibitive effects of La protein were analyzed by Western blot; the content changes of HBsAg, HBeAg and HBV-DNA were detected by ECL and RT-PCR.

RESULTSIn comparison to normal cells, La protein was less in the cells. There was less La protein in the cells trans-infected with siRNAs. HBsAg, the HBeAg and HBV-DNA secreted by the cells transfected with siRNA were also less than that in the normal cells.

CONCLUSIONThere is a correlation between La protein and HBV mRNA and the expression of HBV protein.

Autoantigens ; metabolism ; Cell Line, Tumor ; DNA, Viral ; Hepatitis B Surface Antigens ; Hepatitis B virus ; genetics ; metabolism ; Humans ; RNA, Messenger ; genetics ; metabolism ; RNA, Small Interfering ; RNA, Viral ; Ribonucleoproteins ; metabolism

OBJECTIVETo observe the effects of Naoyikang (NYK) on expression of choline acetyltransferase (ChAT) in brain of rats with Alzheimer' s disease (AD).

METHODBilateral infusions of Ibotenic acid (IBO) into nucleus basalis of Meynert (NBM) using hamilton syringe and stereotaxic apparatus were adopted to establish the rat model of AD. After intragastrically administrated with different solution for 28 days, immunohistochemistry and Western-blot were adopted to study the expression of ChAT in frontal cortex of AD rats.

RESULTNYK could improve the morphology and increase the number of ChAT immunoreactive neurons, and significantly promote ChAT protein expression.

CONCLUSIONNYK may be able to increase the synthesis of acetylcholine (ACh) through elevating the expression of ChAT protein, thus improving the level of brain ACh so as to protect central cholinergic neurons.

Alzheimer Disease ; enzymology ; Animals ; Blotting, Western ; Brain ; drug effects ; enzymology ; Choline O-Acetyltransferase ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation ; drug effects ; Immunohistochemistry ; Male ; Rats ; Rats, Sprague-Dawley

AIMTo study the effect of different intervals between occlusions of vertebral arteries and bilateral common carotid arteries on the Pulsinelli 4-vessel occlusion global cerebral ischemic model, and the features of ischemia of the brainstem and hippocampus induced by occulusion of bilateral common carotid arteries under the condition of occlusion of unilateral vertebral artery.

METHODSEighty four adult male Wistar rats were divided into 4 groups randomly: control group, bilateral vertebral artery occluding group, global brain ischemic insult group, and unilateral vertebral artery occluding plus bilateral common carotid arteries occluding group. In the global brain ischemic insult group, rats were further divided into 24 h, 48 h, and 72 h interval subgroups according to the interval between the occlusion of the vertebral arteries and bilateral common carotid arteries. The responses including enlarging of pupils and the light reflex during the brain ischemia were observed. The duration of right reflex disappearing, the general state, and the delayed neuronal death (DND) of pyramidal neurons in the CA1 hippocampus of the rats after the brain ischemia were also observed.

RESULTSAmong the global brain ischemic insult group, both the responses and DND were more severe in 72 h interval subgroup than those in 24 h and 48 h interval subgroups. There was no significant difference between 24 h and 48 h interval subgroups. When the bilateral common carotid arteries were occluded under the condition of occlusion of unilateral vertebral artery, severe DND was observed in the CA1 hippocampus ipsilateral to the occluding vertebral artery, but no significant DND was observed in the contralateral CA1 hippocampus.

CONCLUSIONThe results suggested that the prior occlusion of the bilateral vertebral arteries during producing Pulsinelli 4-vessel occlusion global cerebral ischemic model might be a cerebral ischemic preconditioning that could protect to some extent pyramidal neurons of the hippocampus against severe ischemic insult induced by occlusion of bilateral common carotid arteries within 48 h. Moreover, There is ipsilateral predominance of blood perfusion from one side of vertebral artery to the brainstem and hippocampus, although there was Willis artery circle in rats.

Animals ; Brain Ischemia ; prevention & control ; Hippocampus ; blood supply ; Ischemic Preconditioning ; methods ; Male ; Rats ; Rats, Wistar ; Vertebral Artery ; pathology

OBJECTIVETo investigate association of vitamin D receptor (VDR) gene polymorphisms with the susceptibility to chronic periodontitis (CP) of Han Nationality.

METHODSBuccal swabs from 166 patients with severe, moderate and mild CP respectively and 80 matched control individuals were collected. DNA was extracted from these buccal swabs using Chelex-100 method. VDR BsmI, ApaI, TaqI were tested with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The distribution of the genotypes and allele frequencies in the patient and control groups were analyzed.

RESULTSThe frequency of VDR ApaI allele A was significantly higher among patients with CP than controls. Frequencies of VDR ApaI allele A were significantly higher in severe CP patients than in moderate CP and mild CP respectively. There was no significant difference in the genotype distribution or the allele frequencies of VDR BsmI and TaqI between the controls and CP patients.

CONCLUSIONSThese data indicate that VDR ApaI allele A may be related to the susceptibility to CP in Han Nationality.

Adult ; Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Chronic Periodontitis ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptors, Calcitriol ; genetics