ObJective To summarize the microsurgieal techniques through direct Sylvian fissure approach. Methods A retrospective analysis was conducted in 62 patients undergoing microsurgeries through direct Sylvian fissure approach, including 4 with cavernous angioma in the Sylvian fissure, 5 with insular lobe tumors, 33 with middle cerebral artery aneurysms, 15 with glioma spanning or invading the Sylvian fissure, 1 with metastatic tumor, 2 with arteriovenous malformations, and 2 with temporal lobe epilepsy. Results All the vascular lesions were exposed satisfactorily and managed appropriately. Of the 19 cases ofgliomas and metastatic tumors, total resection was achieved in 13 cases, and subtotal resection in 6 cases. Transient aphasia or hemiparesis occurred postoperatively in a few patients but all recovered within 1 or two months. Conclusions The Sylvian fissure provides a good surgical route as a subarachnoid space between the frontal, parietal, temporal and insular lobes. The Sylvian fissure should be carefully separated under the operating microscope with high-power magnification, and tension-free retaction is critical in important language areas. In the management of tumors involving the Sylvian fissure, we recommend that extended resection be performed after exposure and appropriate preservation of important blood vessels in the fissure.

OBJECTIVETo explore the mechanism of electroacupuncture at "Neiguan" (PC 6) improving acute myocardial ischemia.

METHODSThe rats were randomly divided into a sham operation group, a myocardial ischemia model group and a myocardial ischemia model plus electroacupuncture group. The acute myocardial ischemia model was developed byligation of the descending anterior branch of the coronary artery, and electroacupuncture was given at bilateral "Neiguan" (PC 6). Serum myocardial enzymes was determined by biochemical method and the expression of c-fos mRNA in myocardium was detected by using reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe activities of serum myocardial enzymes and the expression of c-fos mRNA in ischemic myocardium were significantly increased as compared with those in the sham operation group (P < 0.05), and after electroacupuncture they were significantly decreased (P < 0.05).

CONCLUSIONThe mechanism of electroacupuncture at "Neiguan" (PC 6) improving acute myochadial ischemia is possibly related with down-regulation of expression of c-fos mRNA in myocardium.

Acupuncture Points ; Animals ; Electroacupuncture ; Genes, fos ; Humans ; Myocardial Ischemia ; genetics ; Myocardium ; metabolism ; Rats

OBJECTIVETo observe the clinical significance of postoperative personalized antithrombotic therapy for patients with hemophilic arthritis (HA) patients after arthroplasty.

METHODSFrom September 2005 to October 2013, 11 cases of arthroplasty for hemophilic arthritis in hip and knee total operation 14 times,including 1 case of double knees (calculated as one operation), operation in left knees 6 times, operation in right knees 5 times, 2 in hip. All the patients were male and the age ranged from 23 to 57 years old,with an average of (36.1 ± 11.0) years old; the average weight was (64.1 ± 8.9) kg. All the patients were preoperatively diagnosed and classified as hemophilic arthritis with the radiological images and laboratory tests. According to the function of joints, the risk of postoperative venous thromboembolism (VTE), and dynamic observation of Factor VIII:C (FVIII:C) activity, patients were treated with personalized antithrombus by adjusting the dosage of recombinant human coagulation factor VIII (Kogenate FS). All the patients were orderly divided into postoperatively distal joints moving group and none-moving group to observe the coagulation function.

RESULTSThe enrolled patients had no postoperative complication of VTE and pulmonary embolism (PE). The APTT and D-2 were different between two groups in the postoperative early stage. Length of hospital day was shorter in the moving group than none-moving group.

CONCLUSIONBecause of the self-coagulation disorder, patients with HA tended to bleed. However it doesn't mean that there is no risk of postoperative thrombosis. Therefore,it's important to determine how to control the balance between postoperative antithrombus, hemostasis,and coagulation factor replacement therapy after arthroplasty for HA. Postoperative moving has proved helpful for HA, especially in reducing the risk of hemostasis and shortening the time in hospital.

Adult ; Arthritis ; surgery ; Arthroplasty ; adverse effects ; Factor XIII ; metabolism ; Hemophilia A ; complications ; Hemostasis ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Thrombosis ; prevention & control ; Young Adult

BACKGROUNDThe diagnosis of Parkinson's disease is presently based on non-specific symptoms. However, radionuclide dopamine transporters imaging can provide specific diagnostic tool for Parkinson's disease. This study was designed to investigate the effects of imaging of dopamine transporters with 99mTc-TRODAT-1 in early diagnosis or differential diagnosis of Parkinson's disease.

METHODSNine normal monkeys were used to establish N-methyl-4-phenyl-1, 2, 3, 6-tetra-hydropyridine (MPTP) hemi-Parkinsonian animal models, and they were subjected to imaging. Twenty-nine patients with Parkinson's disease, 12 age-matched healthy volunteers, and 18 age-matched patients with Parkinson's syndrome were investigated. Single photon emission computer tomography (SPECT) was performed 3 hours after intravenous injection of 740 MBq 99mTc-TRODAT-1. Striatum specific uptake of 99mTc-TRODAT-1 was calculated according to the ratio of striatum (ST) to cerebellum (CB) in dopamine transporters uptake.

RESULTSIn normal monkeys, bilateral ratio of ST/CB was 2.34 +/- 0.41. After the injection of MPTP, uptake rate of 99mTc-TRODAT-1 at damaged region was much lower than that at the contralateral region, resulting in a significant difference in the ratio of ST/CB (right: ST/CB = 1.73 +/- 0.35; left: ST/CB = 1.90 +/- 0.30), especially in hemi-Parkinsonian model monkeys (right: ST/CB = 1.29 +/- 0.17; left: ST/CB = 1.80 +/- 0.33). The ratios of ST/CB were 1.57 +/- 0.17 and 1.61 +/- 0.14 for the right and left respectively in the healthy volunteers, 1.04 +/- 0.29 and 1.06 +/- 0.30 in the age-matched patients with Parkinson's disease, and 1.56 +/- 0.17 and 1.59 +/- 0.18 in the age-matched patients with Parkinson's disease syndrome. A significant difference was noted between group of Parkinson's disease, normal controls and Parkinson's disease syndrome.

CONCLUSIONThe results suggest that 99mTc-TRODAT-1 dopamine transporters SPECT has clinical application value in early diagnosis or differential diagnosis of Parkinson's disease.

Adult ; Aged ; Animals ; Dopamine Plasma Membrane Transport Proteins ; Female ; Haplorhini ; Humans ; Male ; Membrane Glycoproteins ; analysis ; Membrane Transport Proteins ; analysis ; Middle Aged ; Nerve Tissue Proteins ; analysis ; Organotechnetium Compounds ; Parkinson Disease ; diagnosis ; Radiopharmaceuticals ; Tomography, Emission-Computed, Single-Photon ; Tropanes

OBJECTIVETo explore the relationship between polymorphisms of DNA repair gene XRCC1 and susceptibility to radiation injury.

METHODSIn 1:1 case-control study, 113 abnormal chromosome workers exposed to ionizing radiation were selected as cases and 113 normal chromosome as controls who matched with case for sex, age (+/- 5 years), nation, type of work, the same or more but in 2 years work length and the same similar levels of the cumulative exposure radiation dose. Genotypes were analysed using PCR based restriction fragment length polymorphism techniques.

RESULTSThe frequency of XRCC1 26304TT allele in case group (18.58%) was significantly higher than that in control group (7.08%), with OR for radiation damage being 3.47 (95% CI 1.43 - 8.44, P < 0.05). No association was observed between XRCC1 G27466A and G28152A and susceptibility to radiation injury.

CONCLUSIONThe mutation of XRCC1 C26304T is related with the susceptibility to radiation injury. The polymorphisms of XRCC1 G27466A and G28152A are not found to have association with abnormal chromosomes.

Adult ; Case-Control Studies ; Chromosome Aberrations ; DNA Repair ; DNA-Binding Proteins ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Radiation Injuries ; genetics ; X-ray Repair Cross Complementing Protein 1

Objective To determine the changes of cerebrospinal fluid(CSF) ?-endorphin(?-EP) and C-reactive protein(CRP) in children with central nervous system(CNS) infection.Methods Sixty-five children suffered from CNS infection were determined the plasma and CSF ?-EP and CRP concentration during the acute and recovering stage with radioimmunoassay, which included 48 viral encephalitis, 12 purulent meningitis and 5 tuberculou meningitis,and 24 non-CNS disease children were as control group.Results The concentrations of plasma and CSF ?-EP of every experimental group were obviously higher than those of control group during the early stage of CNS infection and these were obviously lower during the recovering stage. The serum concentration of CRP during acute stage was significantly higher than that during recovering stage. No change of serum and CSF CRP concentration was determined during either the acute or recovering stage in the other two experimental groups.Conclusions Determining the plasma and CSF ?-EP is mea-(ningful) in early diagnosis of CNS infection,and determining the serum CRP at the same time may be helpful in differentiating septic and inseptic infection.

Objective To evaluate the capability and accuracy of multi-shce spiral computed tomography(MSCT)in detecting atherosclerotic plaques in nonstenotic coronary arteries with reference to the findings of intravascular ultrasound(IVUS)in a segment analysis.Methods Both IVUS exams and 16-row MSCT scans were performed on 35 consecutive patients among whom 30 patients had successful MSCT scans.A total of 94 coronary segments without significant coronary stenoses were paired-analyzed both on IVUS and MSCT segment by segment.The plaques were classified as calcified,fibrotic and soft types according to the echogeneity on IVUS.Plaque attenuation on MSCT was measured and expressed by Hounsfield units(HU).Results When referred to IVUS,MSCT had a sensitivity of 82.1%(46/56)and specificity of 89.5% (34/38),respectively in detectiong any plaques.For the detection of calcified plaques,the sensitivity and specificity were 92.1%(35/38)and 96.4%(54/56),respectively.For the detection of mixed and noncalcified plaques,MSCT had sensitivity of 73.2%(30/41)and specificity of 88.7%(47/53).But for the detection of the noncalcified plaque,the sensitivity was 66.7%(12/18). According to the findings On IVUS,the plaques were classified as calcified(n=19),fibrotic(n=19)and soft(n=16).The CT attenuation of calcified plaques was(489?169)HU(196 to 817 HU),fibrotic plaques(69?21)HU(25 to 117 HU)and soft plaques(23?18)HU(-12 to 47 HU).Nonparametric Kruskal-Wallis test revealed a significant difference of plaque attenuation among the three groups(P

Objective To discuss the surgical skills in microsurgical resection of large acoustic neurornas via the retrosigmoid approach for reducing the neural damage and complications of such surgeries. Methods Twenty-one cases of large acoustic neuroma treated with microsurgery via the retrosigmoid approach were retrospectively analyzed in view of the surgical approach, microsurgical techniques, intraoperative accidents, and management of the postoperative complications. Results The tumors were totally removed in 18 cases and subtotally in 3 cases. The facial nerve function was well preserved in 17 cases (80.9%), and the acoustic nerve was preserved in 5 cases (23.8%). Intraoperative cardiac arrest occurred in 1 case, and 4 patients developed short-term postoperative complications, but no death occurred in these cases. Conclusion Microsurgical resection through the retrosigmoid approach is safe for removal of large acoustic neuroma, and proficient microsurgical skills and thorough understanding of the microanatomy are crucial for total tumor resection and reduction of the nerve injuries and surgical complications.

OBJECTIVETo study the frequency distribution in polymorphism of the apoprotein B 3' variable number tandem repeat (ApoB3'VNTR) and influence factors on hyperlipemia in civil aircrew.

METHODSApoB genotypes were determined by PCR technology and agarose gel electrophoresis. The blood lipids were measured by routine kits. Personal information of flight personnel was collected by questionnaire.

RESULTSPrevalence of the total dyslipidemia (49.5%) and overweight (55.6%) of flight personnel were much higher than that of domestic general population (29.2% and 49.1%) respectively (P < 0.05). There were 16 alleles and 54 kinds of genotypes of ApoB3'VNTR in the 682 flight personnel. The frequency distribution of alleles and genotypes of aircrew in the two air companies had same trend, which was different from the general population. The frequency of the homozygote was 76.54%, which was much higher than that of the other peoples home and abroad (21.50%). The frequency of the big allele (VNTR > or =39) in hyperlipemia groups were higher than that of normal groups. By analysis of co-variance, the body mass index (BMI), low density lipoprotein (LDL) and the total cholesterol(TC) increased with the cumulate flight hours (P < 0.05). In multivariate logistic regression analysis, the BMI was the only factor influencing blood lipids, and the cumulate flight hours was only factors affecting the BMI. Taking the cumulate flight hours logarithm as the independent variable(X), and the BMI as dependent variable(Y), the linearity equations was: Y = 2.730X + 13.584 (R2 = 0.159, P < 0.01).

CONCLUSIONThere are perhaps special genetic characteristics in the polymorphism of the ApoB3'VNTR in the aircrew. The big allele is correlated with the hyperlipemia. The flight burden not only directly affects the BMI and blood lipids levels, but also it can indirectly affect the lipids levels by BMI.

Adult ; Apolipoproteins B ; genetics ; Aviation ; Body Mass Index ; Cholesterol ; blood ; Genotype ; Humans ; Hyperlipidemias ; epidemiology ; genetics ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Minisatellite Repeats ; Polymorphism, Single Nucleotide

BACKGROUNDThe conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty (TKA). This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography (CT) images of the knee.

METHODSFrom October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People's Hospital were divided into a guide plate group (GPG, 21 cases) and a traditional surgery group (TSG, 21 cases) using a random number table method. In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation. TSG cases were treated with the conventional method. Outcomes were obtained from the postoperative image examination and short-term follow-up.

RESULTSOperative time was 49.0 ± 10.5 min for GPG, and 62.0 ± 9.7 min in TSG. The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ± 1.7°, 89.0 ± 1.1°, 6.6 ± 1.4°, and 0.9 ± 0.3° in GPG, and 86.7 ± 2.9°, 87.6 ± 2.1°, 8.9 ± 2.8°, and 1.7 ± 0.8° in TSG, respectively. The Hospital for Special Surgery scores 3 months after surgery were 83.7 ± 18.4 in GPG and 71.5 ± 15.2 in TSG. Statistically significant differences were found between GPG and TSG in all measurements.

CONCLUSIONSA customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images. This allows for shorter operative times and better postoperative alignment than the traditional surgery. Application of the digital guide plate may also result in better short-term outcomes.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Knee ; diagnostic imaging ; Male ; Middle Aged ; Osteotomy ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; methods