High dose methotrexate is a cornerstone of therapy for acute lymphoblastic leukemia and osteosarcoma.However MTX levers exhibit significant inter-individual variability in clinical,and acute toxicity after high-does MTX is often unexpected,thus it needs individual administration.

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

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

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

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

To investigate epidemiologic feature and genetic variance of Sapovirus among children in China, fecal specimens were collected from children under 5 years old with acute diarrhea from Feb 2006 to Jan 2007 in nine provinces including Anhui, Fujian et al. A total of 1,110 fecal samples were detected for Sapovirus by reverse transcriptase-PCR (RT-PCR). Ten samples (0.9%) were positive for Sapovirus. The PCR products were then sequenced and analysed by phylogenetic tree. The results indicated that the detected Sapovirus strains were classified into two genogroups and three genotypes, including G I/1, G I/3, G II/3.
Astroviridae Infections ; epidemiology ; etiology ; genetics ; Base Sequence ; Caliciviridae Infections ; epidemiology ; China ; epidemiology ; Diarrhea ; classification ; virology ; Feces ; virology ; Gastroenteritis ; epidemiology ; etiology ; virology ; Genetic Variation ; Humans ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; Sapovirus ; classification ; genetics

Objective To investigate the changes of indications, degree of difficulty in procedure, complication and its severity in endoscopic retrograde cholangiopancreatography (ERCP) in Changhai hospital from 2001 to 2007. Methods The clinical data, including demographic data, indications, degree of difficulty in procedure, success rate, complication rate and severity of complication, of 2374 patients who underwent ERCP in 2001 and 2007 (966 in 2001 and 1408 in 2007), were retrospectively reviewed. Results Indications of ERCP changed at an interval of 5 years. Operations due to bile duct stone decreased (59.0% vs. 49.3%, P=0.000), while operations due to pancreas disease, especially chronic pancreatitis (6.6% vs. 18.5%, P=0.000) and recurrent pancreatitis (0.2% vs.1.6%, P=0.001), increased. Patients with biliary duct problems after liver transplantation appeared in 2007. The procedures of ERCP performed in 2007 were more difficult (P=0.000), with an increased percentage of Degree 5 procedure (7.3% vs. 33.3%, P=0.000). The number of diagnostic ERCP significantly decreased (Degree 1 + Degree 3, 30.5% +2.8% vs. 5.9% +3.1%, P=0.000). There was no significant difference in the success rate between the two years (P=0.084). The complication rate of ERCP in 2007 was significantly higher than that in 2001 (3.73% vs. 7.88%, P=0.000), but the severity of complication showed no significant difference (P=0.820). Conclusion Cases of diagnostic ERCP decreased in 2007. Indications of ERCP have changed, with a decrease in bile duct diseases and an increase in pancreatic diseases. The procedures are more complicated, but it does not lead to lower success rate. The increase in complication rate is possibly due to increase of therapeutic ERCP.

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 investigate the chemical components of Boswellia carterii.

METHODSChromatographic technologies were used for separation and purification, while spectral analysis was used for structure elucidation.

RESULTSSix compounds were isolated and their structures were identified as acetyl-alpha-boswellic acid (1), acetyl-beta-boswellic acid (2), lup-20(29)-ene-3 alpha-acetoxy-24-oic acid (3), alpha-boswellic acid (4), beta-boswellic acid (5) and acetyl-11-keto-beta-boswellic acid (6).

CONCLUSIONCompound 3 is a new constituent.

Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Boswellia ; chemistry ; Cell Division ; drug effects ; HL-60 Cells ; Humans ; Molecular Structure ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification ; pharmacology

OBJECTIVETo observe effect of serum of the rat after acupuncture on Ca2+ content of cultured nervous cells in vitro for exploring the role of humoral factors in acupuncture.

METHODSNeurons of the cerebral cortex from the new born rats were taken and were cultured in a medium, 7 - 10 days later, fluorescein-molecular probe Fluo-3AM was used for staining of intracellular Ca2+. The intracellular Ca2+ levels in the nervous cells cultured with the serum of the normal rats or the rats given acupuncture at "Baihui" (GV 20), "Zusanli" (ST 36), "Quchi" (LI 11) and "Sanyinjiao" (SP 6) for 2 weeks were determined by using a laser confocal microscope.

RESULTSAfter addition of the serum of.normal rats, the intracellular Ca2+ level increased and then gradually got stable, and when the acupuncture serum was added to the cultured medium, its level decreased to a certain extent.

CONCLUSIONAcupuncture serum can significantly decrease Ca2+ level in cultured cells of the cerebral cortex, which provides a direct evidence for involvement of humoral factors in the role of acupuncture.

Acupuncture Therapy ; Animals ; Cells, Cultured ; Cerebral Cortex ; Neurons ; Rats, Sprague-Dawley