Objective To evaluate retrospectively the role of 18 F-fluorodeoxyglucose (FDG) PET/CT associated with MRI in the localization of epileptogenic foci. Methods Sixty-seven patients with medically resistant epilepsy were included from 2003 to 2008. All underwent 18F-FDG PET/CT and MRI for presurgical evaluation as well as post-surgical evaluation 12 to 65 months after operation. Based on postoperative seizure occurrence, patients were divided into two groups. One group was free of seizures ( Engel classification Ⅰ, Group 1) and the other was with postoperative seizure occurrence of any type ( Engel classification Ⅱ-Ⅳ, Group 2). X2-test or Fisher's exact test was used for the statistical analysis. Results About 71.6% (48/67) patients were defined as group 1, and 19 patients were group 2 ( 11 were Engel Ⅱ , 5 were Engel Ⅲ, and 3 were Engel Ⅳ ). In Group 1, no statistically significant difference was found between concordant (45/63) and discordant findings (3/4) with regard to 18F-FDG PET/CT and MRI images (Fisher's exact test, P ＞0.05). For 41 patients that showed focal abnormality both on MRI and 18F-FDG PET/CT, 80.5% (33/41) were found in group 1. For 20 patients that showed focal lesions on MRI while with multi-focal or generalized abnormal metabolism on 18F-FDG PET/CT, 11 (55.0%) were in group 1 and9 (45.0%) were group 2. There was no significant difference (33/41 vs 11/20, X2 =4.34, P ＜0.05 ). Conclusion 18F-FDG PET/CT associated with MRI may offer more helpful information for pre-surgical evaluation and prediction of prognosis of epileptic patients.

Animals ; Chronic Pain ; Freund's Adjuvant/adverse effects* ; Humans ; Inflammation ; Male ; Pelvic Pain/etiology* ; Prostatitis ; Rats

ObjectiveTo study the application of Metadata in search and find data with different structue in medical data resources share.MethodsStudy the definition and character of metadata, establish the metadata standard and directory service system to execute the data search service.ResultsThe Directory Service System based on the method of metadata has been developed, in which the data search service can be realized. ConclusionThe Directory Service System based on the method of metadata has been developed, in which the data search service can be realized. Conclusions It's a effective way to search and find data with different structue using method of metadata, and it is a important way to realize medical data resource share.

Objective To explore the three criteria of Ranson,CT severity index (CTSI) and the bedside index of severity in acute pancreatitis (BISAP) in assessment of severity and prognosis of acute pancreatitis.Methods A total of 503 diagnosed acute pancreatitis patients from January 2008 to April 2011 were studied retrospectively,including 356 mild acute pancreatitis (MAP) cases and 147 severe acute pancreatitis (SAP) cases.The differences of the three criteria of Rason,CTSI and BISAP in assessment of severity and prognosis of acute pancreatitis were compared with receiver operating characteristic (ROC) curve.The SAP group was divided into no organ failure group and organ failure group,and the predictive value of the three criteria in acute pancreatitis with organ failure was compared.Results There was significant differences between MAP group and SAP group with Rason,CTSI and BISAP score (x2 =236.88、126.24 and 101.27,P＜0.01).The sensitivity (97.3％) and AUC value (0.93) of Ranson criterion was highest.In no organ failure group and organ failure group of 147 SAP patients,there was significant difference between Ranson criterion and BISAP criterion (x2 =17.67 and 26.12,P＜0.01),both sensitivity were 100％,the specificity were 96％ and 85％ respectively,and the area under ROC curve (AUC) value of BISAP criterion (0.8) was the highest.In illness improved group and deteriorated group,the difference of score between Ranson criterion and BISAP criterion was significant (x2 ＝ 9.53 and 10.19,P＜0.05),and the AUC value of BISAP criterion (0.74) was the highest.Conclusions All three criteria can be used to determine the severity of acute pancreatitis.In predicting the risk of SAP with organ failure and prognosis,BISAP criterion is better than Ranson criterion.BISAP criterion is simple and easy to practice,which provides an important rule for evaluating the clinical condition of acute pancreatitis.

Objective To summarize the clinical features,diagnosis,treatment and prognosis of hepatolithiasis complicating cholangiocarcinoma. Methods From June 1958 to March 2011,709 cases of hepatolithiasis were admitted to Department of General Surgery,Peking University Third Hospital.The cases concomitant with cholangiocarcinoma were reviewed. Results 20 of 709 (2.8％ ) hepatolithiasis cases developed cholangiocarcinoma.17 cases (85％,17/20) were followed-up for 2 years (0 - 15 years).The hepatolithiasis course before the malignant diagnosis was 15 ± 1 1 years (3 -38 years).14 cases had frequent episodes of cholangitis,15 cases had liver cirrhosis.Preoperative diagnosis was established by CT,MRCP,B-ultrasound and tumor markers in 55％ (11/20) cases.4 cases underwent radical resection,7 received palliative resection,9 cases received conservative treatment.In radical resection,one lost to follow-up,one survived one year,two for 5 years.In palliative resection,2 lost to follow-up,two survived one year,one survived 3 years, one for 5 years. None in conservative group survived more than one year.Conclusions Cholangiocarcinoma developed from hepatolithiasis with a long history,frequent cholangitis,liver cirrhosis,especially in cases with imige showing thickness of bile duct or mass and rising tumor markers (CA19-9,CA125,CEA).The cases undergoing radical resection may have a favorable prognosis.

Female ; Humans ; Infant, Newborn ; Maple Syrup Urine Disease ; diagnosis ; therapy

Objective To compare the efficacy and safety of percutaneous nephrolithotomy ( PCNL) in modified supine Valdivia and traditional prone positions for the treatment of renal stones.Methods Clinical data of 80 consecutive patients with renal calculi who accepted PCNL from December 2012 to September 2014 were retrospectively reviewed.They were divided into modified supine Valdivia group ( n=44) and prone position group (n=36) according to the position during surgery.There was no significant difference between the 2 groups in age, sex, ASA class, stone location and size (P>0.05).Total operative time, ratio of multi-access, blood loss, perioperative complications and stone-free rate were compared between the 2 groups.Results All punctures were performed successfully.No case was converted to open surgery.No severe complications such as colon injury, pleura or peritoneum perforation, or death occurred intra-and post-operatively.In prone position, 1 patient was found to develop high intra-trachea pressure because of large stone burden and prolonged operative time (130 min).This procedure was stopped and the patient received the second session of PCNL 1 week later.The mean total operative time was significantly shorter in the modified supine than in the prone position ( 67.7 ±24.5 min versus 91.5 ±29.8 min, P<0.05).There were no significant differences in ratio of multi-access (14% versus 22%), mean blood loss (1.3 ±0.2 g/L versus 1.4 ±0.7 g/L), incidence of complications (18% versus 19%), and stone clearance rate ( 80% versus 86%) between the 2 groups ( P >0.05 ) .Conclusion PCNL in modified supine Valdivia is as safe and effective as that of prone position for the treatment of renal stones, but the former is more time-saving than the latter.

AIM: To explore whether strontium ranelate ( Sr ) promotes osteogenic differentiation of rat bone mesenchymal stem cells (BMSCs) through the Hedgehog/Gli1 signaling pathway.METHODS:BMSCs were isolated from 4-week-old rats by adherent culture and induced to differentiate into osteoblasts .According to the experimental purposes , the cells were exposed to different concentrations of Sr , cyclopamine ( Cy, an inhibitor of Hedgehog receptor ) or Gli1-siR-NA.The expression of Gli1 and Runx2 in the cells was detected by Western blotting .The activity of alkaline phosphatase ( ALP) was measured by the method of colorimetry , and the mineralized nodules were observed under microscope with aliz-arin red staining .RESULTS:Exposure to Sr at concentrations of 0.1 to 5 mmol/L for 7 d markedly increased the expres-sion of Gli1 in the BMSCs , and the increase in Gli1 expression was the most obvious following Sr exposure at concentration of 3 mmol/L.Cy at concentration of 10 μmol/L inhibited Sr-induced up-regulation of Gli1 expression.Transfection of the BMSCs with Gli1-siRNA not only obviously inhibited Sr-induced up-regulation of Gli1 and Runx2 ( a downstream protein of Gli1) expression, but also antagonized Sr-induced enhancement of ALP activity and the formation of mineralized nodules . CONCLUSION:The Hedgehog/Gli1 pathway is involved in Sr-induced osteogenic differentiation of rat BMSCs .

0.05). CONCLUSION: Genotype of VDR is related to BMD, but there is no enough evidence to support genotype of VDR as a genetic marker in predicting the risk of developing osteoporosis in Guangzhou postmenopausal women.

Objective To study the results of functional hemispherectomy for pediatric intractable epilepsy with hemisphere lesions , and to explore the indications of functional hemispherectomy , as well as the prognosis. Methods Twenty-four children with intractable epilepsy caused by hemisphere lesions were included , who underwent functional hemispherectomy. All patients were followed up for 3 ~ 48 months. Results All 24 cases obtained improvement of abnormal behavior , and no significant exacerbation of neurological deficits was observed. During the follow-up, 18 cases were in EngelⅠ(75%), 5 in Engel Ⅱ(21%), and 1 in Engel Ⅰ(4%) respectively. No long-term complication was observed. Conclusion Comprehensive presurgical evaluation is a prerequisite for the surgical treatment of pediatric intractable epilepsy caused by hemisphere lesions. Functional hemispherectomy can effectively control seizures and obviously improve the prognosis.