Objective To compare the diagnosic performance of conventional 2D and 3D Cube MR imaging to identify complete and partial tears of anterior cruciate ligament(ACL).Methods Farty patients suspected of having tears of anterior cruciate ligament were prospectively studied by 3.0 T conventional 2D and 3D Cube MR imaging and arthroscopy.MR images were interpreted in consensus by two experienced radiologists,and the ACL was diagnosed as being normal,partially torn,or completely torn.Diagnostic accuracy of 2D and 3D Cube MR for the detection of both complete and partial tears of ACL was calculated using arthroscopy as the standard of reference.Area under curve (AUC) of both methods were calculated using ROC curves and were compared using Hanley& McNeil curve comparisions.Results Sixteen patients had intact ACL,12 had complete tear,and 12 had partial tear of the ACL at arthroscopy.For complete ACL tear,AUC of 2D MR and 3D Cube was 0.839 and 0.923 respectively,and there was no significant difference on ROC curves (Z =1.245,P =0.213).For partial ACL tears,AUC of 2D and 3D Cube MR were 0.643 and 0.881 respectively,and there was significant difference on ROC curves (Z =2.384,P =0.017).Conclusions Both 2D MR and 3D Cube MR have high sensitivity and specificity for identifying the complete ruptures of ACL.3D Cube MRI appears to be superior inidentifying partial rupture of ACL.

BACKGROUND: Ultrasound-medium frequency electrotherapy has better pain-relieving effect,whether it involves enkephalin and the like neurotransmitter is still not very clear, it is necessary to carry out qualitative and quantitative analysis of the pain response in rats received ultrasound-medium frequency electrotherapy.OBJECTIVE: To investigate the pain-relieving effect of ultrasound-medium frequency electrotherapy and its influence on the enkephalin content in rats, aiming to probe its underlying mechanism and relationship with neurotransmitter enkephalin.DESIGN: Randomly controlled study taking experimental animals as subjects.SETTING: Department of Physiotherapy, First Hospital Affiliated to China Medical University, Institute of Basic Medicine, Peking Union Medical CollegeMATERIALS: This experiment was carried out at the Institute of Basic Medicine, Peking Union Medical College between June 2002 and March 2003. Forty healthy male Wistar rats were adopted and randomized into four groups,namely methionine enkephalin detection experimental group and control group,as well as leucine enkephalin detection experimental group and control group with 10 rats in each group ,amongst which methionine enkephalin experimental group and leucine enkephalin experimental group were generally designed as experimental group ,with the other two group as control group.METHODS: ①Rats ín the experímental group were subjected to ultrasound-medium frequency electrotherapy with frequency of 0.8 MHz in manner of geminal pulse,the modulatìng frequency was 100 Hz and ultrasound intensity of 0.9 W/cm2;the carrier frequency of medium frequency electricity was 4 kHz with modulating frequency of 100 Hz in manner of continuous wave,the electric current of medium frequency was 2 mA and acting time of 10 min. rats in control group received the same dealing,but the higher voltage of ultrasound-medium frequency electrotheprauetic instrument was not used, thereby no energy output was available. tail flick test(TFr) was used to test rat algesthesia,and stopwatch was used to record the time for tail flick(s) that was taken as the value of pain threshold. ②The threshold of pain was tested at 10 minutes instantly after ultrasoundmedium frequency electric stimulation,and then pituitary (removing the posterior pituitary lobe) and hypothalamus were obtained to detect the content of methionine enkephalin and leucine enkephalin by using radioimmuno assay.MAIN OUTCOME MEASURES: The changes of the pain threshold after treatment,the content of methionine enkephalin and leucine enkephalin.RESULTS: Totally 40 rats were enrolled in the experiment and entered in the results analysis. ① The changing rate of pain threshold in two experimental group were 265.79% and 272.90% respectively,the difference was of no statistical significance (P ＞ 0.05). ②After ultrasoundmedium frequency electrotherapy,the content of methionine enkephalin and leucine enkephalin in pituitary and hypothalamus were obviously higher than before treatment [ The changing rate of methionine enkephalin and leucine enkephalin in adenohypophysis was 300.48 ±36.21)% and(204.61±68.65)% , respectively, compared to (239.80±59.98)%and(205.53±51.62)% in hypothalamus, P ＜ 0.05]. ③Linear regression analysis revealed that the variance of the pain threshold was positively correlated with the content of methionine enkephalin in adenohypophysis(r=0.91 ,P ＜ 0.01), suggesting the increment of methionine enkephalin in adenohypophysis was closely connected with the increment of pain threshold,and the level of methionine enkephalin in adenohypophysis would be higher than that in control group by 117.02% when the value of pain threshold increased by100%.CONCLUSION: One of the important mechanisms for the pain-relieving effect of ultrasound-medium frequency electrotherapy might be the increase of methionine enkephalin in adenohypophysis.

Objective To investigate the therapeutic efficacy of lactulose combined with Bacillus subtilis duplex living bacterium in patients with constipation-predominant irritable bowel syndrome.Methods A total of 98 patients with constipation-predominant irritable bowel syndrome were divided into 3 groups according to the therapeutic drugs:lactulose group (33 cases),Bacillus subtilis duplex living bacterium group (30 cases) and combined treatment group (35 cases),and patients in all groups received mosapride.The course of treatment was 2 weeks in all groups.The symptoms of patients with abdominal pain,abdominal distention,defecate condition and quality of life before and after treatment was observed.Results The total efficacy of abdominal pain,abdominal distention in combined treatment group was higher than that in lactulose group and Bacillus subtilis duplex living bacterium group,in lactulose group was higher than that in Bacillus subtilis duplex living bacterium group,and there was significant difference (P ＜ 0.05).There was no significant difference in defecate Bristol grade before treatment among three groups (P ＞ 0.05).There was significant difference in defecate Bristol grade after treatment among three groups(P ＜ 0.05).There was significant difference in defecate Bristol grade before and after treatment in three groups(P ＜ 0.05).There was no significant difference in the quality of life before treatment among three groups (P ＞ 0.05),the quality of life after treatment in three groups was higher than that before treatment,and there was significantdifference (P ＜ 0.05).After treatment,the quality of life in combined treatment group was higher than that in lactulose group,in lactulose group was higher than that in Bacillus subtilis duplex living bacterium group,and there was significant difference (P ＜ 0.05).Conclusions The combined regimen of lactulose and Bacillus subtilis duplex living bacterium is more effective than lactulose or Bacillus subtilis duplex living bacterium alone.Thus the combined regimen of lactulose and Bacillus subtilis duplex living bacterium is an effective therapeutic method for constipation-predominant irritable bowel syndrome.

BACKGROUND:The CD133 expression in non-smal cel lung cancer shows some changes, which is definitely related to the occurrence and development of diseases. OBJECTIVE:To investigate the expression of CD133 in non-smal cel lung cancer, and to analyze its relationship with clinical pathological factors and prognosis. METHODS:Non-smal cel lung cancer tissue specimens from 135 cases were col ected, and normal lung tissue specimens from 60 cases were set as normal control group. Immunohistochemical staining was used to detect CD133 expression in two groups, and the relationship between the expression of CD133 protein and the clinical pathological factors was analyzed. RESULTS AND CONCLUSION:(1) The positive expression of CD133 protein in the non-smal cel lung cancer group was significantly higher than that in the normal control group (P<0.05). (2) CD133 protein expression had no association with age, gender, tumor size, tumor location, histological type (P>0.05), and CD133 protein expression was significantly increased with the differentiation of non-smal cel lung cancer (P<0.05). The positive expression rate of CD133 protein was significantly different between different clinical stages and lymph node metastasis (P<0.05). (3) CD133 and TNM staging were independent prognostic factors for non-smal cel lung cancer (P<0.05), and the median survival time was significantly shorter in the positive group than in the negative group (P<0.05). The results indicate that CD133 is involved in the occurrence, development, infiltration and metastasis of non-smal cel lung cancer, and it has important clinical significance for the disease progression and prognosis.

Small bowel adenocarcinoma (SBA) is a relatively uncommon neoplasm with poor prognosis. However, the incidence rate of this condition increases. SBA is usually diagnosed at the late stages, and the majority of patients present with the advanced stage. Data are limited when making decisions for treatment because of the lack of randomized trials for SBA. Radical surgery is considered necessary when possible. Adjuvant chemotherapy is predicted to be beneficial, but this procedure has not yet been investigated through randomized trials. Platinum-based chemotherapy is apparently the most effective treatment regimen used in retrospective tri-als for advanced SBA. Targeted therapies, such as those against the angiogenetic pathway or the epidermal growth factor receptor pathway, have not yet been established for this type of cancer. This article reviews the progress in the diagnosis and treatment of SBA.

ObjectiveTo improve the visualization of anteromedial and posterolateral bundles of anterior cruciate ligament (ACL) and investigate the optimal MRI plane for the bundles at a 3.0 T MR scanner.MethodsMR images of 149 knee joints were reviewed retrospectively.Display rates of AMB,PLB and their different parts (the top portion,the middle portion and the low portion) on MR different planes including axial,sagittal and coronal planes were analyzed and their differences were compared with the x2 section method.ResultsThere was no statistical difference in the display rates of two bundles of ACL between axial plane ( 115/149,77.2％ ) and coronal plane (103/149,69.1％ ) (x2 =2.4606,P ＞0.0125 ).Statistical differences were found between axial and sagittal plane,coronal plane and sagittal plane (21/149,14.1％ ) ( x2 =119.5138,92.8695 respectively,P ＜0.0125 ).There was a statistical difference for the top portion of ACL between axial plane ( 104/149,69.8％ ) and coronal plane,sagittal (0/149,0)and coronal planes ( 7/149,4.7％ ) ( x2 =135.081,159.7526 respectively,P ＜ 0.0125 ),between sagittal and coronal planes (x2 =7.1684,P ＜ 0.0125 ).For the middle portion of ACL,there was no statistical difference between axial plane ( 108/149,72.5％ ) and coronal plane (94/149,63.1％ ) (x2 =3.0120,P ＞ 0.0125 ),while statistical differences were found between axial and sagittal plane,coronal planes and sagittal plane ( 10/149,6.7％ ) ( x2 =134.7454,104.2173 respectively,P ＜ 0.0125 ).For the low portion of ACL,there was no statistical difference between axial plane ( 103/149,69.1％ ) and coronal plane (101/149,73.8％ ) (x2 =0.8065,P ＞0.0125),while statistical differences were detected between axial and sagittal plane,coronal planes and sagittal plane ( 18/149,12.1％ ) ( x2 =100.5300,115.9132,P ＜ 0.0125 ). The different parts of ACL displayed low intensity on different MR planes and normal morphology.ConclusionsACL can be displayed on conventional MR planes at a 3.0 T MR scanner to some extent.Axial and coronal planes might be the optimal MRI planes for ACL and its two bundles.

Objective To study the microsurgical and anatomic structures of brachial plexus roots and vertebral canal to find the best approaches for reimplantation of avulsed brachial plexus ventral roots into the spinal cord.Methods On nineteen cervicothoracic spine specimens,the brachial plexus nerves were exposed along to intervertebral foramen,and the spinal cord and brachial plexus roots were exposed by excising the vertebral arch and sectioning the spinal dura mater.The anatomy of brachial plexus roots and vertebrae,and the relative positions of spinal cord segments to vertebral discs were measured and observed.Results The relative positions of spinal cord segments to vertebral discs are:C5-7 spinal cord segments face C3,4,C4,5 and C5,6 vertebral discs;and C8 and T1 spinal cord segments face C6 and C7 vertebrae.Based on the anatomic finding,four approaches were found out: the lateroventral approach,the lateral approach by enlarging intervertebral foramen,the laterodorsal approach and the lateral and dorsal combined approach.Conclusions The brachial plexus ventral roots can be best reimplanted into the spinal cord by the lateroventral approach and the lateral approach.Although the laterodorsal approach and the lateral and dorsal combined approach are not the best,they are less difficuh and dangerous.

Objective To analyze the spectrum of underlying diseases in children with transient loss of consciousness (TLOC) through a multi-center and large sample clinical research.Methods Nine hundred and thirty-seven children with TLOC who came from Beijing,Hunan province,Hubei province and Shanghai of China from Aug 1999 to Apr 2011 were recruited in the present study,and then the spectrum of underlying diseases in children with TLOC was analyzed.Results In 937 children with TLOC,903 cases (96.4％ )were children with syncope,34 cases (3.6％) were non-syncope.And in 903 children with syncope,213 cases (23.6％) had vasovagal syncope (VVS) with vasoinhibitory response,46 cases (5.1％ ) had VVS with cardioinhibitory response,112 cases ( 12.4％ ) had VVS with mixed response,268 cases (29.7％ ) had postural tachycardia syndrome,22 cases (2.4％) had orthostatic hypotension,19 cases (2.1％ ) had situational syncope,21 cases (2.3％ ) had cardiogenic syncope,and 202 cases (22.4％ ) had unexplained syncope.Conclusion In children with TLOC,syncope was the most common underlying disease.And in children with syncope,the most common was VVS,followed by postural tachycardia syndrome.In three different hemodynamic patterns of VVS,the most common pattern was VVS vasoinhibitory pattern.

Objective To assessed the distribution of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in Xinjiang Uygur and Han nationality populations,and to investigate correlation and the incidence of all cases of macrovascular disease (coronary artery disease,carotid atherosclerosis and peripheral arterial disease)and analysis of risk factors.To further study the correlation between the incidence of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in type 2 diabetes melli-tus(T2DM)of Han and Uygur ethnic and the incidence of all cases vascular disease,then to analysis the risk factors. Methods 497 adults with T2DM who were treated in the Endocrinology department in hospital from May 2012 to April 2014 were involved in this study,including 298 Uygur patients and 199 Han patients.215 non -T2DMpatients who were treated in the Cardiology department in hospital were also involved in the study,including 93 Uighur patients and 122 Han patients.Then the total 712 patients were detectedby using PCR -SNP Stream technology to analyse rs2383206.rs10757278 loci SNP genotyping.The relevant results were compared with t test,two different genotype distribution and allele frequency were compared with χ2 test,multiple factors analysis were calculated by Logisitic regression.Results The distribution of genotype with two SNP loci had no significant difference between the patients in Uygur group and Han group (rs2383206χ2 =5.570,P =0.062;rs10757278 χ2 =2.721,P =0.257 ),and there's no significant difference between the patients with macrovascular disease and non -macrovascular disease in all patients(rs2383206χ2 =0.120,P =0.950;rs10757278 χ2 =1.027,P =0.598).Logisitic regression analysis showed that the incidence of macrovascular was significantly associated with increasing age(χ2 =28.820,P =0.000)and fatty liver(χ2 =5.210,P =0.020)in Uighur group with type 2 DM.In Han group with type 2 DM,the macrovascular was significantly associated with the increase of age (χ2 =19.980,P =0.000),elevated fasting blood glucose (FPG)(χ2 =4.070,P =0.044)and poor controlled with glycosylated hemoglobin (χ2 =4.280,P =0.040). Conclusion This study found that there's no correlation between two single nucleotide polymorphisms (SNPS)loci (rs2383206.rs10757278)on chromosome 9 p21 large with macrovascular in Uygur group and Han group.Increasing age,higher FPG and poor controlled with glycosylated hemoglobin combined with fatty liver were the risk factors for macrovascular.

OBJECTIVETo observe the effect of nitric oxide (NO) on the survival of a random pattern skin flap.

METHODSCaudal based random skin flaps (9 cm x 3 cm) were raised on the back of Wistar rats. Six methods were used in the experiment to observe the effect of NO synthase inhibitor L-NAME and NO synthase substrate L-arginine on flaps: image analysis technology; light and electron microscopic studies; enzyme histochemistry of NOS in flaps; concentration of NO2-/NO3- in plasma and wet/dry ratio of the flap tissue.

RESULTSSurvival area of flap in the L-arginine-treated group significantly increased (67.06 +/- 5.65)% (p < 0.01) whereas the area in the L-NAME-treated group significantly decreased (35.17 +/- 1.87)% (p < 0.01) compared with the control group (53.25 +/- 3.24)% at seven days after the operation. General and microscopic observations showed that pathological changes in the L-arginine-treated group were fewer. Abundant capillaries and fewer inflammatory cells were noticed in the L-arginine-treated group. Transmission Electron Microscopy (TEM) studies find endothelial swelling, thrombosis-formation and endothelial loss of contact with the basement membrane in the L-NAME treated group. Before operation, the serum NO concentrations were not significantly different in three groups (p > 0.05). After operation, NO concentration of the control group began to increase and reached to the top at the third day. L-Arg kept serum NO concentration in a higher level than the control. Enzyme histochemistry of NOS in flaps: microvessel intima in dermis, hair follicles, sweat glands and inflammatory cells showed oxford blue, more positive in flaps of the L-Arg treated group than the control group at the third day after operation. The flaps of L-NAME-treated group demonstrated negative or weak positive. Wet/dry ratio: twenty-four hours after flap elevation wet/dry weight ratios increased significantly in all regions of the flap of the L-arginine-treated rats compared with saline-treated rats. The ratios of the flaps of L-NAME-treated rats were reduced compared with saline-treated rats.

CONCLUSIONNO could improve microcirculation of the flap and increase its survival rates. The mechanism might be that NO could accelerate flap vascularization and protect flaps from ischemia-reperfusion injury.

Animals ; Arginine ; pharmacology ; Dermatologic Surgical Procedures ; Enzyme Inhibitors ; pharmacology ; Female ; Graft Survival ; drug effects ; Immunohistochemistry ; Male ; Microscopy, Electron ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitrates ; blood ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; antagonists & inhibitors ; metabolism ; Nitrites ; blood ; Rats ; Rats, Wistar ; Skin ; enzymology ; ultrastructure ; Skin Transplantation ; Surgical Flaps ; physiology