Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

OBJECTIVETo assess the early efficacy of metallic modular radial head prostheses in patients with Mason III and IV unreconstructable radial head fractures.

METHODSThe medical records of 16 patients (9 males, 7 females) with a mean age of 43 years old (31 to 57) with Mason III/IV unreconstructable radial head fractures requiring metallic modular radial head replacement between January 2009 and March 2012, were reviewed retrospectively. The functional results were assessed by range-of-movement, Mayo elbow performance score (MEPS). All patients underwent radiographic evaluation for radial head height and radiolucent lines.

RESULTSFourteen patients were evaluated with follow-up for 12 to 33 months with an average of 23 months. Range of movement parameters was significantly lower in the affected elbow than in the unaffected side (P < 0.01). MEPS results were excellent in 9 cases, good in 2 cases, fair in 2 cases, and poor in 1 case. According to Grewal grading, there were 4 cases of periprosthetic lucencies of the radius and 1 case had significant clinical signs of loosening.

CONCLUSIONRadial head replacement with the metallic modular prostheses yields satisfactory results regarding range of motion and function of the elbow joint in short term. The evolution of this prostheses needs to be evaluated with further studies to assess mid-term and long-term follow-up results.

Adult ; Arthroplasty, Replacement, Elbow ; methods ; Female ; Fracture Fixation ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies

OBJECTIVETo explore possible alterations in velopharyngeal function after maxillary advancement.

METHODSTen patients (3 secondary deformity of cleft palate, 7 maxillary retrusion) had maxillary advancement surgery. Pre- and post-operative examinations consisted of lateral cephalometric radiography, nasopharyngoscopy and speech recording.

RESULTSThere was no significant changes on speech or velopharyngeal competence after maxillary advancement. Cleft palate patients appeared slight hypernasality and nasal emission.

CONCLUSIONSGood velopharyngeal function pre-operation is not affected after the surgery of maxillary advancement.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Osteotomy, Le Fort ; Palate ; physiopathology ; surgery ; Pharynx ; physiopathology ; surgery ; Voice Quality ; Young Adult

Objective:To assess the early efficacy of metallic modular radial head prostheses in patients with MasonⅢandⅣunreconstructable radial head fractures. Methods:The medical records of 16 patients (9 males,7 females) with a mean age of 43 years old (31 to 57) with MasonⅢ/Ⅳunreconstructable radial head fractures requiring metallic modular radial head replacement between January 2009 and March 2012 ,were reviewed retrospectively. The functional results were assessed by range of movement,Mayo elbow performance score (MEPS). All patients underwent radiographic evaluation for radial head height and radiolucent lines. Results:Fourteen patients were evaluated with follow up for 12 to 33 months with an average of 23 months. Range of movement parameters was significantly lower in the affected elbow than in the unaffected side (P<0.01). MEPS results were excellent in 9 cases,good in 2 cases,fair in 2 cases,and poor in 1 case. According to Grewal grading,there were 4 cases of periprosthetic lucencies of the radius and 1 case had significant clinical signs of loosening. Conclusion:Radial head replacement with the metallic modular prostheses yields satisfactory results regarding range of motion and function of the elbow joint in short term. The evolution of this prostheses needs to be evaluated with further studies to assess mid term and long term follow up results.

Objective To investigate the influence of competitive flow at different lelves on wall shear stress (WSS) of left internal mammary artery graft after coronary artery bypass grafting. Methods The left internal mammary artery (LIMA) left anterior descending (LAD) anastomotic model was extracted and reconstructed from CT images based on thresholding method by using SimVascular software. The competitive flow was divided into three groups according to different stenosis of LAD, including no competitive flow group (100% stenosis of LAD), mild competitive flow group (50% and 75% stenosis of LAD) and severe competitive flow group (0% and 30% stenosis of LAD). The hemodynamic performace of the anastomotic model under different conditions of competitive flow was observed by computational fluid dynamics (CFD) method. Results With the increment of competitive flow, the value of WSS was decreased gradually while the oscillation of WSS was increased remarkably in LIMA graft. The time average WSS (TAWSS) of LIMA graft in severe competitive flow group (0% stenosis: 2.73 Pa, 30% stenosis: 2.85 Pa) was lower than that in the mild competitive flow group (50% stenosis: 4.77 Pa, 75% stenosis: 6.01 Pa) and no competitive flow group (100% stenosis: 8.64 Pa), while its oscillatory shear index (OSI) (0% stenosis: 0.206; 30% stenosis: 0.085) was much higher than that in other two groups (50% stenosis: 0.014; 75% stenosis: 0.013; 100% stenosis: 0.006). Conclusions When the stonosis of LAD was smaller than 50%, the WSS in LIMA graft was obviously lower and oscillatory due to severe competitive flow. Such unfavorable feature of WSS may influence the long term-patency of LIMA graft and long term-survival of operations.

Objective: To probe into the etiology of the sever e post-renal transplantation infection and its diagnosis and t reatment. Methods: A retrospective analysis was made on the seve re infected cases among 1 504 renal transplantation cases. Results: (1)The infected rate in the whole group was 23.74%,and 14.01% of the infecti on cases was severely involved. (2) About 86% of the severe infection occurred within 6 months after operation and as high as 82% of the patients were successf ully rescued by various etiological treatment. (3) The main etiological causes according to their frequency and type were: Bacteria(Mycobacterium tub erculosis, Pseudomonas, Aureus staphylococcus, Bacillus cloacae, etc.); Fungus (Candida albians, Candida tropicals, Penicillum patulum). Cytomegalo virus also often appeared. Conclusion: (1) Infection is one of t h e common complications after renal transplantation and severe infection is an im portant cause of death. (2) Correct diagnosis and combined therapy in time may improve its success rate. (3) Characterized germ spectrum exists in severe post -renal transplantation infection and its role is of great importance to clinica l management.

This study was purposed to investigate the correlation between the dose infused megakaryocytic precursors (CD34+, CD34+CD61+) and recovery time of platelet count following an allogeneic PBSCT and/or BMT through quantitative detection of CD34+ and its subpopulation in peripheral blood and BM mobilized by G-CSF. 24 patients with various hematologic malignancies received PBSCT/BMT from their HLA matched or unrelated donors and haploidentical siblings in April-December 2007. 20 evaluated patients were divided into 2 groups according to different transplant schemes. HLA matched group received PBSCT regime and haploidentical group received PBSCT combined with BMT. CD34+CD61+ subpopulations in sample from patients receiving PBSCT/BMT were measured by flow cytometry immediately or storage over night. The results showed that the median number of infused CD34+, CD34+CD61+ and CD34-CD61+ cells in haploidentical group were 6.24x10(6)/kg (1.53-20.48), 66.19x10(4)/kg (8.16-493.83), and 34.38x10(6)/kg (14.71-109.16) respectively, in HLA matched group those were 4.88x10(6)/kg (1.00-8.24), 14.16x10(4)/kg (11.63-96.87), and 13.50x10(6)/kg (1.74-35.61), respectively. Median days of ANCs>0.5x10(9)/L and platelets>20x10(9)/L were 18.5 (11.0-29.0) days and 16.5 (9.0-35.0) days in haploidentical group respectively; in HLA matched group those were 14.5 (9.0-24.0) and 10.5 (6.0-37.0) respectively. A significance difference of median days for ANC engraftment presented between two groups (p=0.048). There was no significant difference of time for platelet engraftment between 2 groups. For patients with CD34+ cell dose>2x10(6)/kg there was significant difference of time of platelet engraftment between HLA matched and haploidentical groups (p=0.006). The number of CD34+CD61+ cells infused in 12 haploidentical patients or in 8 HLA matched patients were much better correlated with the time of platelet recovery up to 20x10(9)/L than that of number of CD34+ cells infused in total 20 patients (r=-0.768 and p=0.004 for haploidentical CD34+CD61+ cells, r=-0.747 and p=0.033 for HLA matched CD34+ CD61+ cells, r=-0.449 and p=0.047 for CD34+ cells). There was an inverse correlation between the number of infused CD34+ CD61+ cells and time of platelet engraftment. Therefore, as the number of CD34+ CD61+ cells increased, duration of platelet engraftment (time to reach platelet count of 20x10(9)/L) shortened significantly. It is concluded that the determining the number of megakaryocytic precursor by flow cytometry may predict the platelet reconstitutive capacity of the allogeneic hematopoietic stem cell transplantation, which is in haploidentical PBSCT and in BMT.
Antigens, CD34 ; immunology ; Bone Marrow Transplantation ; Female ; Flow Cytometry ; Graft Survival ; Haploidy ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Megakaryocytes ; cytology ; immunology ; Platelet Count ; Thrombopoiesis ; Transplantation, Homologous

OBJECTIVETo evaluate the surgical technique and indication on descending aortic aneurysms.

METHODSFrom January 1996 to June 2006, 41 patients with descending aortic aneurysm underwent operation, including DeBakey type III dissection in 26, false aneurysm in 6, true aneurysm in 4, and residual or newly complicated type III dissection after the surgery of Marfan syndrome in 5. Operations were performed by left heart bypass in 9, femoral-femoral bypass in 7, pulmonary-femoral bypass in 2, and deep hypothermic circulatory arrest in 23. The whole thoracic descending aorta was replaced in 15, and intercostal arteries were reimplanted in 12.

RESULTSOne patient died of acute renal failure with the hospital mortality 2.4%. Main complications: respiratory dysfunction in 6, renal dysfunction in 6, recurrent nerve injuries in 4, chylothorax in 2, and no paraplegia.

CONCLUSIONSSurgical intervention of descending aortic aneurysm still has its unique advantages and indications; surgical safety is markedly improved by the use of deep hypothermic circulatory arrest.

Adolescent ; Adult ; Aged ; Aortic Aneurysm, Thoracic ; surgery ; Extracorporeal Circulation ; methods ; Female ; Follow-Up Studies ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Retrospective Studies

UNLABELLEDTo explore the occurrence patterns of pulmonary complications at different stages in haploidentical bone marrow transplantation, a series of clinical data as the onset time, etiology, management choices and prognosis in 18 patients with pulmonary disorders were summarized. The results showed that in 18 out of 70 patients after bone marrow transplantation occurred pulmonary complications which included pneumonia affected by bacteria (7 cases), fungus (5 cases) and cytomegalovirus (CMV, 4 cases), bronchiolitis obliterans organizing pneumonia (BOOP, 1 case), and idiopathic pneumonia syndrome (1 case), out of which 8 cases died. Fungal and CMV pneumonia occurred predominantly 2 to 3 months after transplantation, whereas bacterial pneumonia was observed in the duration of 3 to 12 months and 4 cases of them suffered from secondary fungal infections during treatment. BOOP and idiopathic pneumonia syndrome were diagnosed 12 months and 50 days after transplantation respectively.

IN CONCLUSIONpulmonary complications were commonly seen in haploidentcal bone marrow transplantation, and fungal pneumonia might be the main cause that needs intensive management.

Adult ; Bone Marrow Transplantation ; adverse effects ; Cryptogenic Organizing Pneumonia ; etiology ; Cytomegalovirus Infections ; etiology ; Female ; Haplotypes ; Humans ; Lung Diseases ; etiology ; Male

OBJECTIVETo explore the effects of pre-acupuncture and immediate acupuncture on kidney function and oxygen free radical metabolism in rats with simulated weightlessness.

METHODSTwenty male clean-grade Wister rats were randomly divided into a normal control group, a model group, a pre-acupuncture group and an immediate acupuncture group, 5 rats in each one. The rats in the normal control group did not receive any treatment but free activities for 4 weeks. The rats in the rest groups received 4-week tail suspension to establish the model of simulated weightlessness. One week before the tail suspension, the rats in the pre-acupuncture group were treated with electroacupuncture at "Shenshu" (BL 23), "Pishu" (BL 20) and "Sanyinjiao" (SP 6) for 30 min per treatment, once a day for 7 days. The rats in the immediate acupuncture group received tail suspension and acupuncture at the same time; during the tail suspension, the electroacupuncture was applied at "Shenshu" (BL 23), "Pishu" (BL 20) and "Sanyinjiao" (SP 6) for 30 min per treatment, once every other day for 14 days. The colorimetric method was used to measure the content of blood urea nitrogen (BUN) in serum as well as activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) and content of malonaldehyde (MDA) in renal tissue in each group.

RESULTSCompared with the normal control group, the content of BUN in the model group was increased significantly (P<0.01), the activity of SOD and GSH-PX in nephridial tissue was significantly reduced (both P<0.01), and the content of MDA was increased significantly (P<0.05). Compared with the model group, the content of BUN in the pre-acupuncture group and immediate acupuncture group was significantly reduced (P<0.01, P<0.05), the activity of GSH-PX in the pre-acupuncture group was obviously increased (P<0.05) and the content of MDA in the immediate acupuncture group was increased significantly (P<0.01). Compared with the immediate acupuncture group, the content of MDA in the pre-acupuncture group was lower (P<0.01).

CONCLUSIONThe pre-acupuncture and immediate acupuncture both have the capacity to improve the kidney function and anti-oxygen free radical injury in rats with simulated weightlessness, however, the capacity to increase the protection ability of the kidney and eliminate free radical in the pre-acupuncture group is superior to that in the immediate acupuncture group, which is likely to be related with improving antioxidant ability of kidney.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Antioxidants ; metabolism ; Humans ; Kidney ; metabolism ; Kidney Diseases ; metabolism ; physiopathology ; therapy ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Wistar ; Reactive Oxygen Species ; metabolism ; Space Flight ; Superoxide Dismutase ; metabolism ; Weightlessness ; adverse effects