Objective To study the diagnostic value of 3 dimentional CT reconstruction in upper urinary tract obstructive diseases. Methods 37 patients with upper urinary tract obstructive diseases underwent thin slice helical CT scan and 3 dimentional reconstruction of the urinary tract as well as 3 dimentional CT angiography when needed. Results All the cases have been definitely diagnosed including ureteral carcinoma in 8, bladder carcinoma in 2, ureteral calculi in 9, benign ureteral stricture in 7, congenital malformation in 7 and pelvic tumor in 4.All the patients except those with pelvic tumors underwent surgical intervention and the diagnosis were confirmed.The operative findings were in concord with the helical CT results. Conclusions 3 dimentional CT reconstruction of the urinary tract can provide distinct urinary tract images and helps determining the site and the cause of the obstruction. Compared with other methods, the procedure has the advantages of high resolution, rapid imaging and low invasiveness. It might become the most valuable means of detecting upper urinary tract diseases.

Objective To investigate the effects of tibiofibula crossing healing on ankle joint movement. Methods A retrospective study was done for seven patients who experienced tibiofibula crossing healing for an average of 30 months (10 to 54 months) from September 1999 to November 2003. There were four left sides and three right sides. Two patients received plate fixation for their open tibiofibula fractures, while the other five intramedullary nailing for their closed fractures. The plantar flexion and dorsiflexion of the ankle were measured at the follow-ups. Results According to the Kofoed' s evaluation system for the ankle joint, six were assessed as excellent and one as good in this series. Tibiofibula crossing healing had an average influence of 6.3 degrees on the dorsiflexion of ankle, but little influence on the normal gait. Five patients reported different extents of discomfortableness at the ankle. Conclusion Tibiofibula crossing healing has a significant influence on ankle cataplasia.

Objective To investigate effects of celecoxib on the expression of cyclooxygenase-2 (COX-2), apoptotic protease activation factor-1 (Apaf-1) and function of mobility in rat model of severe craniocerebral trauma. Methods For?ty-eight adult male Wistar rats were randomly divided by random number table into four groups. Normal group was given no manipulation. Sham group was given scalp incision and sutured. The severe closed craniocerebral injury model was estab?lished via Foda method in rats of injury group. Treatment group was given intraperitoneal injection of celecoxib [ 250 mg/(kg·6 h)] on the basis of injury group. The intraperitoneal injection of same volume of normal saline was given in the other three groups. Samples were taken altogether after 72 hours. Changes of COX-2 and Apaf-1 were detected by immunohistochemis?try and Western blot assay. Ten days after the restoration, six rats were taken from each group for assessing neurological im?pairment scale (NSS). Results The expression levels of COX-2 and Apaf-1 were significantly higher in injury group than those of other groups. The expression levels of COX-2 and Apaf-1 were significantly lower in treatment group than those of injury group but the levels were significantly higher than those of sham group and normal group (P < 0.05). NSS scores showed that rats in treatment group improved mobility compared with that of injury group (P<0.05), but there was difference compared with Sham group and control group (P<0.05). Conclusion Celecoxib, with its specific inhibitoty effect on pro?tein COX-2, can effectively reduce inflammatory reactions lower the expression of Apaf-1 and reduce apoptosis of neurons, improving the prognosis of dysfunction of mobility after craniocerebral injury.

Purpose:To investigate the value of susceptibility-weighted imaging(SWI)in evaluating the histopathologic grade of cerebral astrocytomas.Materials and Methods: 18 patients with histologically proven cerebral astrocytomas,including 7 diffuse astrocytomas,3 ana-plastic astrocytomas and 8 glioblastomas before treatment were involved in this study.The features on SWI were analyzed in 18 cerebral astrocytomas.Results: The veins in the tumors were not detected in 7 diffuse astrocytomas.Slight edema round tumors appeared in all the diffuse astrocytomas.Plenty veins in the tumors and severe edema round the tumors appeared in 3 anaplastic astrocytomas and 8 glioblastomas.The hemorrhagic foci were detected in 1 anaplastic astrocytomas and 6 glioblastomas.The edema round the tumors were moderate or severe in all the anaplastic astrocytomas or glioblastomas.Conclusions: Susceptibility-weighted imaging can provide the informations about blood supply,hemorrhagic focus and edema round the tumors.SWI is very useful for preoperative evaluation of the histopathologic grade of cerebral astrocytomas,especially for evaluation of high or low grade astrocytomas.

Objective To study the effect of celecoxib on learning and memory function,cyclooxygenase(COX-2) and the apoptotic protease-activating factor-1(Apaf-1) protein expression after traumatic brain injury in rat.Methods A total of 72 adult male Wistar rats were equally and randomly divided into the normal control group,sham operation group,trauma group and Celecoxib treatment group.Postoperative 72 h-reperfusion was performed for taking brain specimens.The immunohistochemical method and Western blot were used to respectively detect COX-2 and Apaf-1 protein expression change;the Morris water maze test was adopted to detect the learning and memory function on preoperative 5 d and at postoperative 72 h.Results The COX-2 and Apaf-1 protein expression in the trauma group was significantly higher than that in other groups (P＜0.05),and the protein expression in the treatment group and trauma group was decreased,but still higher than that in the sham operation group and normal group(P＜ 0.05);in the Morris water maze test,the prolongation of escape latency time in the trauma group was maximal among 4 groups (P ＜0.05),but the treatment group had a shorter time compared with the trauma group (P＜0.05).Conclusion Craniocerebral trauma can cause different degrees of learning and memory dysfunction,and COX-2 inhibitor celecoxib can downregulate the expression of COX-2 and Apaf-1 protein,inhibit inflammation reaction and cellular apoptosis,and improve the learning and memory dysfunction after traumatic brain injury.

Objective To evaluate the effects of pacing in right ventricular septum (RVS) on hemodynamics among atrioventricular sequential dual chamber pacing Methods Twenty patients with high grade or complete atrioventricular block received permanent dual chamber pacemaker ( DDD ),were randomized into right ventricular septum pacing group (RVS)and right ventricular apex pacing group (RVA)according to the ventricular leads position.The QRS duration of the ECG,the left ventricular ejection (LVEF),the interventricular mechanical delay( IVMD )and the plasma levels of brain natriuretic peptide (BNP)were compared before and after operations.Results Compared with the preoperation,the mean QRS duration ( ( 187.00 ± 15.67 ) ms and (94.00 ±9.17 ) ms),the IV MD ( (43.20 ± 6.79 ) ms and ( 15.00 ± 4.08 ) ms ),the level of BNP ( ( 89.70 ± 8.30) ng/L and (40.00 ± 4.73 ) ng/L) increased( P ＜ 0.05 ) and LVEF decreased significantly ( (53.70 ± 1.34) % and (58.60 ±1.65 )% ,P ＜ 0.05 ) in RVA group,but didn't change in RVS group (P ＞ 0.05 ).After three months following up,the mean QRS duration and the IVMD in RVS group( (119.00 ±7.38 )ms,(19.00 ±4.59)ms) were shorter than that of RVA group( ( 187.00 ± 15.67) ms,(43.20 ± 6.79) ms) ( P ＜ 0.05 ),the LVEF was higher and the plasma level of BNP was lower than that of RVA group ( (57.00 ± 2.00) % and ( 53.70 ± 1.34) %,(44.20 ± 9.18 ) ng/Land ( 89.70 ±8.30) ng/L,P ＜0.05).Conclusions The RVS pacing could keep the normal ventricular activation sequence and biventricular contraction synchrony farthest without side effects on hemodynamics in comparison with the RVA pacing.The RVS pacing is more approaching physiological rhythm than the RVA pacing.

Objective To characterize the changes in the dimensions during systolic and diastolic periods in the aorta with ECG-gated multi-detector CTA scans.Methods The CT angiograms of 115 patients (78 males,mean age 55.2 ± 9.4 years;37 females,mean age 60.1 ± 8.5 years) both in systolic and diastolic periods were obtained on a 64-slice ECG-gated multi-detector CT scanner.The diameters were measured at four anatomic levels of the aorta.(Level A:1 mm proximal to the innominate artery;Level B:1 mm distal to the left common carotid artery;Level C:1 mm distal to the left subclavian artery;Level D:10cm distal to the left subclavian artery).On each level,the maximal and the minimal diameters were measured both in systolic and diastolic periods.Results The paired sample t test results showed a significant difference between the systolic and diastolic diameters in all individual subjects on every level (P ＜0.001).The mean maximum diameter changes were 1.95％ (range-2.0％ to 7.0％),2.12％ (range-3.0％ to 6.0％),1.88％(range-1.0％ to 8.0％)and2.47％(range-3.0％ to 10.0％)at level A,B,C and D,respectively.The mean minimum diameter changes were 1.43％ (range-3.0％ to 5.0％),2.67％ (range-2.0％ to 11.0％),1.75％ (range-14.0％ to 9.0％)and 2.99％ (range -2.0％ to 11.0％) at level A,B,C and D,respectively.Conclusions The differences of the aortic diameters between systolic and diastolic periods are significant.The pulsatility of aorta in Chinese population may be different from published Western literature.

Researches have shown that melatonin is neuroprotectant in ischemia/reperfusion-mediated injury. Although melatonin is known as an effective antioxidant, the mechanism of the protection cannot be explained merely by antioxidation. This study was devoted to explore other existing mechanisms by investigating whether melatonin protects ischemia/reperfusion-injured neurons through elevating autophagy, since autophagy has been frequently suggested to play a crucial role in neuron survival. To find it out, an ischemia/reperfusion model in N2a cells was established for examinations. The results showed that autophagy was significantly enhanced in N2a cells treated with melatonin at reperfusion onset following ischemia and greatly promoted cell survival, while autophagy blockage by 3-MA led to the shortened N2a cell survival as assessed by MTT, transmission electron microscopy, and laser confocal scanning microscopy. Besides, the protein levels of LC3II and Beclin1 were remarkably increased in ischemia/reperfusion-injured N2a in the presence of melatonin, whereas the expression of p-PKB, key kinase in PI3K/PKB signaling pathway, showed a decrease when compared with untreated subjects as accessed by immunoblotting. Taken together these data suggest that autophagy is possibly one of the mechanisms underlying neuroprotection of melatonin.

Aim To investigate the effects of celecoxib on cyclooxygenase-2(COX-2) and caspase-9 expression and motor function after traumatic brain injury in rats.Methods The rats were divided into control group, sham operation group, trauma group and treatment group.The model of closed craniocerebral trauma was established by Marmarou method, the gene expression of COX-2 and Caspase-9 was detected by real-time quantitative PCR(qPCR), the protein expressions of COX-2 and Caspase-9 were detected by immunohistochemical staining, and the motor function of the rats was evaluated by the neurological impairment score(NSS).Results The gene and protein expression of COX-2 and Caspase-9 in traumatic group was significantly higher than in other three groups (P<0.05), the expression of COX-2 and Caspase-9 in treatment group was significantly lower than in traumatic group(P<0.05), but still higher than the sham operation group and the normal group(P<0.05);compared with the trauma group, the motor function of the treatment group could be effectively improve (P<0.05), but compared with the control group and the sham operation group, the difference was statistically significant(P<0.05).Conclusion Celecoxib can reduce the inflammatory response after craniocerebral injury by specific inhibition of COX-2, and further reduce the expression of Caspase-9, thereby reducing the apoptosis of nerve cells, and improving motor function after traumatic brain injury in rats.

Objective To identify the candidate genes in the vicinity of a susceptibility locus (urinary albumin 1,UA-1) contributing to the development of albuminuria in type 2 diabetic KK/Ta mice. Methods Total RNA was extracted from the kidneys of KK/Ta (n=3) and BALB/c (n=2) mice at 20 weeks of age.The gene expression profile in kidney was investigated using the Affymetrix Murine Genome U74Av2 array.Competitive RT-PCR was used to confirm the differential expression of syndecan-4 which located in the vicinity of UA-1.Genome DNA was extracted from KK/Ta and BALB/c mice.DNA sequence analysis of the coding and promotor region of syndecan-4 gene was conducted. Results In the vicinity of the susceptibility locus (UA-1)contributing to the development of albuminuria in type 2 diabetic KK/Ta mice,10 candidate genes that showed differential expression were identified.Among them,the gene expression of syndecan-4in KK/Ta kidneys at 20 weeks of age was up-regulated by 26.1 times of age-matched BALB/c kidneys.Sequence analysis revealed two synonymous polymorphisms in the coding region (A93C and T216C) and three polymorphisms in the promoter region (-T263C,-T396C and -G669A) of the syndecan-4 gene.The TATA box was found at 321 bp upstream from the transcription start site,and the T263C polymorphism was located in the binding site of transcription factor Clox.Conclusions Syndecan-4 gene is mapped in the vicinity of the susceptibility locus contributing to the development of albuminuria in type 2 diabetes.The gene expression of syndecan-4 in KK/Ta kidneys is up-regulated than that in age-matched BALB/c kidneys at 20 weeks of age.Thus syndecan-4 may be one of the potential candidate genes responsible for diabetic nephropathy.Sequence differences in the promoter region influence the expression levels of syndecan-4 genes in KK/Ta kidneys.