This study was designed to observe the clinical value of low-density lipoprotein immune complexes (LDL-ICs) in patients with type 2 diabetes mellitus (T2DM). Fifty-four patients with type 2 diabetes + macroangiopathy (DM-MA group), 48 patients with type 2 diabetes (DM group), 45 patients with macroangiopathy ( MA group), and 30 normal controls ( NC group) were enrolled. LDL-ICs levels in the DM-MA group were significantly higher than those in the other three groups. The levels of LDL-ICs in the MA group were higher than those in the NC and DM groups. There was a significant difference in LDL-ICs between the DM and NC groups. LDL-ICs levels were positively related with body mass index (BMI), glycesylated hemoglobin Alc(HbAlc), blood pressure, total cholesterol, and triglyceride. There was no significant relationship between low-density lipsprotcin cholesterol and LDL-ICs. A significantly negative correlation was recorded between high-density lipoprotein cholesterol and LDL-ICs. Our study suggests that LDL-ICs, blood pressure, and HbAlc may be risk factors of macroangiopathy in type 2 diabetic patients.

Objective To investigate the methods, feasibility, outcome and indications of atlantoaxial pedicle screw system in the treatment of upper cervical injury. Methods Thirteen patients with upper cervical injury were treated by atlantoaxial pedicle screw system. There were four patients with old odontoid fractures, two with new odontoid fractures (Aderson ⅡC), three with rapture of the transverse ligament of C1 and four with C1 fracture. Results A total of 26 pedicle screws and 26 pedicle screws were implanted. The mean operation time and perioperative blood loss were 2.6 hours and 470 ml, respectively. No injury to the vertebral artery and spinal cord was observed. All patients were followed up for 4-25 months (mean 13 months). The clinical symptoms were improved to some extent according to Japanese Orthopedic Association scoring system, with improvement rate of 72%-91% (mean 81%). The screws were verified to be fixed in a proper position, and no hardware broken or loosening was observed except for one C1 screw penetrating the medial superior cortex of lateral mass for 3 mm without affecting occipito-aflantal motions. All patients had a solid bony fusion 3-6 months later. Conclusion The atlantoaxial pedicle screw system is feasible in the treatment of upper cervical injury with the advantages of better outcomes and wider indications.

OBJECTIVETo explore the clinical effect of plantar medial perforator artery based reverse island medial dorsal pedal neurocutaneous vascular flaps.

METHODS12 cases with soft tissue defects of forefeet were treated by plantar medial perforator artery based reverse island medial dorsal pedal neurocutaneous vascular flaps. The flap size ranged from 3.0 cm x 3.5 cm to 5.5 cm x 8.5 cm.

RESULTAll flaps survived completely. The patients were followed up for 6 - 24 months. The texture and flexibility of the flaps were normal with no ulcer. The sensation improved with the two-point discrimination of 7 - 10 mm. The cosmetic and functional results were satisfactory. The wounds at donor site healed primarily.

CONCLUSIONSThe flaps have expanded size for large defects with good flexibility, thickness and texture. It is easily performed with less morbidity to main artery.

Adult ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Tibial Arteries ; surgery ; Young Adult

OBJECTIVETo study the value of ultrasound elastography in evaluation of ethanol-induced lesions of liver.

METHODSAlcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis. Then freehand elastography of the lesion from the identical scan plane was obtained with SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later. The original high quality radiofrequency data were acquired through an ultrasound research interface which was provided by the ultrasound system. Then, corresponding elastograms were produced offline using cross-correlation technique and compared with gross pathology findings.

RESULTSGray-scale sonogram showed a hyperechoic area with acoustic shadow below appeared immediately after alcohol injection. The hyperechoic area tended to be diffuse and its boundary to be illegible with time. On the contrary, the ethanol-induced lesion in elastogram appeared as a low strain hard region surrounded by high strain soft hepatic tissues, with clear but irregular boundaries. Sequential elastograms with the sketched lesion boundaries showed that the lesion area increased in the first 3 minutes after ethanol injection, and then reached a plateau which corresponding to gross specimen.

CONCLUSIONUltrasound elastography is capable of detecting and evaluating the diffusion of ethanol-induced hepatic lesion, and more sensitive and accurate than routine sonography.

Animals ; Elasticity ; Elasticity Imaging Techniques ; instrumentation ; methods ; Ethanol ; pharmacology ; Liver ; diagnostic imaging ; drug effects ; pathology ; Swine ; Ultrasonics

OBJECTIVETo study the value of ultrasound elastography in the evaluation of ethanol-induced lesions of liver.

METHODSAlcohol with a dose of 2 ml was injected into a fresh porcine liver under ultrasound guidance to create stiff necrosis. Then freehand elastography of the lesion from the identical scan plane was obtained with Siemens SONOLINE Antares system using VF10-5 probe at about every 30 seconds till 6 minutes later. The original high-quality radio-frequency data were acquired through an ultrasound research interface provided by the ultrasound system. Corresponding elastograms were then produced offline using cross-corre-lation technique and compared with gross specimen.

RESULTSA hyperechoic area with acoustic shadow below appeared immediately after alcohol injection. The hyperechoic area diffused and its boundary was illegible following injection. On the contrary, the ethanol-induced lesion in elastography appeared as a low strain hard region surrounded by high-strain soft hepatic tissues with clear but irregular boundaries. Sequential elastograms with the lesion boundaries sketched showed that the lesion area grew in the first 3 minutes after ethanol injection and then reached a plateau, which corresponded to the gross specimen.

CONCLUSIONUltrasound elastography can be used to detect and evaluate the diffusion of ethanol-induced hepatic lesion.

Animals ; Disease Models, Animal ; Elasticity Imaging Techniques ; methods ; Ethanol ; adverse effects ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases ; diagnosis ; diagnostic imaging ; pathology ; Swine

Biomarkers ; blood ; Diagnostic Techniques, Digestive System ; Elasticity ; Hepatitis C, Chronic ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; etiology

OBJECTIVETo investigate the feasibility and clinical value of intraoperative ultrasonography (IOUS) in thoracic spinal decompression surgery.

METHODSTen patients with confirmed thoracic spinal stenosis underwent thoracic spinal decompression in our center from August 2009 to December 2010. The appearance of the compressed section of spinal cord was observed with IOUS. Before and after the decompression operation, the diameters of dural sac and the spinal cord were recorded respectively. The location and nature of the compression-causing mass were confirmed.

RESULTSIOUS clearly showed the shape of the normal and the compressed sections of dural sac and spinal cord. In the 14 thoracic spinal cord sections of these 10 patients, the anteroposterior diameter, horizontal diameter, and their ratio were bigger than those before decompression. The values of anteroposterior diameter and anteroposterior/horizontal diameter ratio showed significant differences(the P value of dural sac anteroposterior diameter comparison was 0.008, which of spinal cord was 0.007; the P values of these two structures ratio comparison were both 0.002 before and after decompression), while the horizontal diameter presented no significant differences (the P values of both structures were 0.270 and 0.195 respectively before and after decompression).

CONCLUSIONSIOUS can clearly show the morphological changes of the dural sac and spinal cord before and after the decompression. In addition, it helps surgeons to locate and specify the nature of the compression-causing mass on the ventral side of dural sac. Furthermore, IOUS can suggest whether the decompression is sufficient in a real-time manner.

Adult ; Decompression, Surgical ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Spinal Cord ; diagnostic imaging ; Spinal Stenosis ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; Treatment Outcome ; Ultrasonography

AIMTo evaluate the in vitro/in vivo correlation for three kinds of self-designed sustained-release nitrendipine formulations using deconvolution method.

METHODSThe characteristics of in vivo release were calculated by deconvolution method using the data of plasma concentration of three kinds of self-designed sustained-release nitrendipine formulations in healthy dogs, in which the in vivo results of nitrendipine solution after oral administrated to dogs were used as weight function. It was the compared with characteristics of in vitro release to assess the in vitro/in vivo correlations.

RESULTSThe good correlations of in vitro/in vivo were shown in three kinds of self-designed sustained-release nitrendipine formulations using deconvolution method.

CONCLUSIONThe deconvolution method exhibited advantage in evaluation of in vitro/in vivo correlation for self-designed sustained-release nitrendipine formulations.

Administration, Oral ; Animals ; Delayed-Action Preparations ; Dogs ; Methylcellulose ; analogs & derivatives ; Microspheres ; Nitrendipine ; administration & dosage ; blood ; pharmacokinetics ; Powders ; Silicone Gels ; Technology, Pharmaceutical ; methods

OBJECTIVETo evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the diagnosis of biliary diseases.

METHODSCEUS was performed in 57 patients with biliary diseases. The contrast enhancement characteristics and the morphologic features were observed. The ultrasonographic results were compared with those obtained through conventional 2-D ultrasound (2D-US), color Doppler flow ultrasound (CDFI), and clinical, surgical, and laboratory findings. In some cases, the ultrasonographic results were also compared with those obtained from contrast-enhanced computed tomography (CECT).

RESULTSThe diagnostic accuracy of 2D-US combined with CEUS was significantly higher than that of 2D-US combined with CDFI 87.7% vs 71.9%; chi(2) = 4.41, P < 0.05). CEUS clearly showed the presence/absence of blood supply in biliary lesions and offered real-time imaging of the microcirculation perfusion in the lesions. It also offered useful information to differentiate biliary tumors from stones, bile mud, and/or blood clots. It distinctly displayed the size and contour of the lesions as well as the infiltrated range, depth, and the involved area. However, CEUS is most useful in reflecting blood perfusion patterns; it had limited value in differentiating the malignancies of polypoid lesions. The diagnostic accuracy (87.0% vs 91.3%;chi(2) = 0. 45, P > 0.05) and the size and range of the lesions displayed (0.4-6.2 cm vs 0.4-6.0 cm, P = 0.721) were not significantly different between CEUS and CECT.

CONCLUSIONCEUS is a useful tool in the routine ultrasonography of biliary diseases.

Adult ; Aged ; Aged, 80 and over ; Biliary Tract Diseases ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography ; Young Adult

OBJECTIVETo assess the treatment outcome of ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug(LIFT-plug) for transsphincteric perianal fistulas.

METHODSClinical data of 36 patients with transsphincteric perianal fiftula who were managed by the LIFT-plug technique between November 2010 and February 2012 were analyzed retrospectively.

RESULTSClinical healing of the fistula, defined as the absence of drainage with no evidence of residual fistula tract, occurred in 34(94.4%) patients. The operative time ranged from 12 to 35 minutes(mean, 17 minutes). The median postoperative length of stay was 5 days. The median healing time was 18 days. No complications requiring intervention occurred. The postoperative follow up was at least 3 months and two patients had recurrence(5.6%).

CONCLUSIONSLIFT-plug procedure for the management of transsphincteric perianal fistulas is simple with high healing rate, minimal invasiveness, quick healing, and without disturbance to anal function. LIFT-plug is an ideal procedure for intrasphinteric fistula.

Aged ; Fecal Incontinence ; Humans ; Ligation ; Operative Time ; Rectal Fistula ; surgery ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Wound Healing