Objective　To study the MRI signs in spinal cord injury. Methods　A tatal of 90 cases of spinal cord injury examined with magnetic resonance(MR)，40 underwent a GE 0.5T superconducting system and 50 with a SIEMENS Open 0.2T. With spine surface coil, all of them were examined with axial and sagittal spin echo sequences, while 10 given extra coronal sequence. MRI findings and its correlation with prognosis of patients were analyzed. Results　Among the 90 cases of spinal cord injury, incomplete and complete transection of spinal cord was found in 14 cases (13.2%), spinal cord edema in 11 (10.4%), intraspinal cord hemorrhage in 27 (25.5%), compression and dislocation in 27(25.5%), malacia in 16(15.1%), and atrophy in 11(10.4%). Conclusion　From the morphologic and pathological changes of spinal cord MRI can not only direct the option of treatment protocols, but may also evaluate the prognosis of spinal cord injuries. Demonstrated by MRI, it suggests that.

Objective To investigate the pH changes of arterial blood in patients with acute left heart failure.Methods Thirty-eight patients with acute left heart failure were selected as our subjects,who all underwent diuresis,the strong heart diuresis,dilation of blood vessels,reducing the load on the heart,and making water and electrolyte balance of conventional medication,and then parallel oxygen mask,respirator mode synchronized intermittent mandatory ventilation(SIMV).If hypoxia was not significantly improved,and positive pressure ventilation with end expiratory(PEEP) treatment was conducted.Results After treatment,the level of pH,heart rate(HR),breathing rate(RR),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2) and mean arterial pressure(MAP) were (7.4 ± 0.3,86.3 ± 6.2) times/min,(22.5 ±4.8) times/min,(84.8 ±7.3) mmHg,(43.3 ±5.5) mmHg,(81.1 ±3.2) mmHg,different from those before treatment(7.1 ±0.1),(118.3 ±8.2) times/min,(36.2 ±7.1) times/min,(47.2 ±6.6) mmHg,(48.3 ±5.2) mmHg,(96.2 ±4.5) mmHg),and the differences were significant (t =5.848,19.188,9.854,23.552,4.072,16.857 respectively; P ＜ 0.01).With the progress of treatment,pH value and pHi value in patients showed a rising trend.Regression analysis showed a positive correlation and the regression equation was Y =-0.559 4 + 1.103 7X.Conclusion Patients with acute left heart failure show abnormal blood pH level and the corresponding change inside red blood cells.Then it causes changes in arterial blood oxygen carrying capacity of red blood cells,reduces the cell through the capillary capacity.Therefore,it can result in decrease of gas exchange levels in patients and hypoxia.Treatment should be considered imbalance the body of the improved state of acid-base.

Objective To study metabolism of polyunsantured fatty acid (PUFA) and to investigate the relationship between different PUFA compositions and △6 desaturase (D6D) activity in colorectal carcinoma (CRC).Methods Fresh frozen malignant CRC tissues were obtained from 61 patients and blood samples were detected in 38 patients.The PUFA composition in these samples was determined by gas-liquid chromatography on a capillary column.The fatty acid product-to-precursor ratios in blood and tissue as estimates of desaturase activity (D6D activity index),and its relationship with the ratios between different PUFA compositions were investigated.Results Metabolism of ω-6 PUFA dominated in PUFA metabolism path.The ratio of ω-6/ω-3 PUFA was 4.89 in blood samples and 10.15 in tissues.The ratio of LA/ALA was 101.92 in blood samples and 86.16 in tissues.The ratio of ω-6/ω-3 LC-PUFA was 2.86 in blood samples and 4.51 in tissues.The D6D activity index in ω-6 PUFA metabolic processes both in tissues (t =1 1.609,P =0.00) and blood samples (t =-9.151,P =0.00) were higher than that in ω-3 PUFA.Conclusion In colorectal carcinoma,the ω-6 PUFA metabolic not only plays an important role in the metabolism of PUFA,but also is more active than the ω-3 PUFA metabolic,and in some way links to the development of tumorigenesis in CRC.

Objective To evaluate the curative efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on bile leaks after orthotopic liver transplantation (OLT). Methods Data of 12 cases, hospitalized in our hospital from March 2013 to February 2016, with bile leaks after OLT confirmed by magnetic resonance imaging of the pancreas (MRCP) or ERCP were retrospectively analyzed . The curative efficacy of ERCP was evaluated including clinical symptoms of bile leaks and complications, occurrence time and location, diagnosis and treatment process and efficacy. Results In this study, 12 cases were male patients, with the average age of 49.75 ± 8.55 (age from 35 to 62 years old). Among them 11 cases were successfully treated by endoscopic nasobiliary drainage (ENBD), and the success rate of endoscopical therapy was 91.7%, the curative rate of bile leaks was 91.7%(11/12). No ERCP related serious complications and death were found in patients. Nine cases combined with biliary strictures and/or biliary duct stone/bile plug were performed endoscopic sphinctrotomy (EST) during the first time of ERCP, and accepted further ERCP treatment after 2 weeks when the bile leaks were healed. All patients with ENBD were carried out well except one case. Conclusion ERCP is a safe and effective minimally invasive treatment method for different types of bile leaks after OLT.

Objective To evaluate the effects of sevoflurane anesthesia on the sleep architecture of rats.Methods Sixteen pathogen-free healthy male Sprague-Dawley rats,aged 10-12 weeks,weighing 300-350 g,were divided into 2 groups (n=8 each) using a random number table:control group (group C) and sevoflurane group (group S).Each rat was implanted with a transmitter for recording electromyogram and electroencephalogram via telemetry.The rats were exposed to 2.4％ sevoflurane and pure oxygen 1.5 L/min for 5.5 h followed by 0.5 h washout with pure oxygen in group S,and the rats were exposed to pure oxygen 1.5 L/min for 6 h in group C.Then the rats were taken into the sleep monitoring box,and the 24 h after anesthesia was divided into 4 time periods according to the circadian rhythm:L1 (14:00-20:00),D1 (20:00-02:00),D2 (02:00-08:00) and L2 (08:00-14:00).The total time spent on wakefulness,on non-rapid eye movement (NREM) sleep and on REM sleep,the number of wakefulness,NREM sleep and REM sleep,and the time spent on wakefulness,on NREM sleep and on REM sleep during each time period were recorded using Version 3.0 Neurosore software.Results Compared with group C,the total time spent on wakefulness was significantly shortened,the total time spent on REM sleep was prolonged,the number of NREM sleep was increased,the time spent on REM sleep in L1 and D1 time periods was prolonged,the time spent on wakefulness in D2 time period was shortened,the time spent on NREM sleep was prolonged (P＜0.05),and no significant change was found in the total time spent on NREM sleep or the number of REM sleep and wakefulness in group S (P＞0.05).Conclusion Sevoflurane anesthesia can change the stability of sleep architecture,increase REM sleep and reduce wakefulness in rats.

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

The objective of the study was to prepare and evaluate the quality of curcumin-piperinedual drug loaded self-microemulsifying drug delivery system(Cur-PIP-SMEDDS). Simplex lattice design was constructed using optimal oil phase, surfactant and co-surfactant concentration as independent variables, and the curcumin and piperine were used as model drugs to optimize Cur-PIP-SMEDDS formulation. In the present study, the drug loadings of curcumin and piperine, mean particle size of Cur-PIP-SMEDDS were made as indicators, and the experiment design, model building and response surface analysis were established using Design Expert 8. 06 software to optimize and verify the composition of SMEDDS formulation. The quality of Cur-PIP-SMEDDS was evaluated by observing the appearance status, transmission electron microscope micrographs and determining particle diameter, electric potential, drug entrapment efficiency and drug loading of it. As a result, the optimal formulation of SMEDDS was CapryoL 90-Cremophor RH40-TranscutoL HP (10:60:30). The appearance of Cur-PIP-SMEDDS remained clarified and transparent, and the microemulsion droplets appeared spherical without aggregation with uniform particle size distribution. The mean size of microemulsion droplet formed from Cur-PIP-SMEDDS was 15.33 nm, the drug loading of SMEDDS for Cur and PIP were 40.90 mg · g(-1) and 0.97 mg · g(-1), respectively, the drug entrapment efficiency were 94.98% and 90.96%, respectively. The results show that Cur-PIP-SMEDDS can increase the solubility and stability of curcumin significantly, in the expectation of enhancing the bioavailability of it. Taken together, these findings can provide the reference to a preferable choice of the Cur formulation and contribute to therapeutic application in clinical research.
Alkaloids ; chemistry ; Benzodioxoles ; chemistry ; Chemistry, Pharmaceutical ; methods ; Curcumin ; chemistry ; Drug Carriers ; chemistry ; Drug Combinations ; Drug Delivery Systems ; Drugs, Chinese Herbal ; chemistry ; Emulsions ; chemistry ; Methylmethacrylates ; chemistry ; Particle Size ; Piperidines ; chemistry ; Polystyrenes ; chemistry ; Polyunsaturated Alkamides ; chemistry

BACKGROUNDChoroidal melanoma is the most common intraocular malignant tumor in adults. It threatens not only the visual function but also the patient's life. Therefore, it is important to find a non-traumatic, quantitative and repetitive diagnostic method. This study investigated the value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of choroidal melanoma.

METHODSCEUS were performed in 51 cases of choroidal melanoma, which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma. The characteristics of the time-intensity curve of the contrast agent were analyzed. For the quantitative analysis, the following parameters of the contrast agent in the lesion were included: rising time (RT), time to peak (TTP), maximum intensity (MI) and the mean transit time (MTT).

RESULTSChoroidal melanoma had the following characteristics on CEUS: Choroidal lesions were completely filled with contrast agent. The typical filling pattern was centripetal, with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion. In some cases, areas with contrast agent filling defect were observed in the lesions. The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion. Quantitative analysis showed that in choroidal melanoma, MI of contrast agent (191.31% ± 146.90%) was significantly more than that of the normal tissue (100.00% ± 0.00%) (P < 0.05) and MTT ((63.56 ± 26.04) seconds) was significantly less than that of the normal tissue ((149.87 ± 182.68) seconds) (P < 0.05). TTP (22.80 ± 9.85) was less than that of the normal tissue ((29.57 ± 24.76) seconds) and RT ((18.52 ± 7.09) seconds) was less than that of the normal tissue ((26.45 ± 21.83) seconds). Both the differences of TTP and RT were not statistically significant though. Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT, the sensitivity was 90.5% and the specific degrees was 85.7%.

CONCLUSIONSCEUS is a new method to diagnose tumors in the eye. Choroidal melanoma may be diagnosed objectively and accurately by combining the graphic characteristics on CEUS and the time-intensity curve quantitative analysis.

Adolescent ; Adult ; Aged ; Choroid Neoplasms ; diagnosis ; diagnostic imaging ; Contrast Media ; Female ; Humans ; Male ; Melanoma ; diagnosis ; diagnostic imaging ; Middle Aged ; Ultrasonography ; Young Adult

AIM:To compare the two techniques of pre-chop and non-pre-chop, and discuss the technical advantages of the capsulorhexis forceps assisted pre-chop.METHODS:Totally 149 cases of age-related cataract were randomly divided into using pre-chop (Group A) and non-pre-chop (Group B) techniques groups, for Group A patients received phacoemulsification after pre-chop by using capsulorhexis forceps.The ultrasonic energy, average phacoemulsification time, intraoperative complications, 1d, 1wk uncorrected visual acuity (UCVA) and 1d, 3d,1wk postoperative corneal edema were recorded and compared.RESULTS:The subgroups of the same group of nuclei were compared in the two groups.The ultrasonic time in Group A was lower than that of Group B, and the difference was significant(P<0.01).Also the corneal edema in the former was lighter than that of the latter(P<0.05).There was difference in uncorrected visual acuity(UCVA) between groups(P<0.05).CONCLUSION:Compared with non-pre-chop, the time of ultrasound in pre-chop group was shorter, the degree of corneal edema was lighter and early postoperative UCVA was better.

ObjectiveTo observe the effect of rehabilitation on fractures around knee treated with external fixation.Methods48 cases with the fractures around knee who accepted early rehabilitation after external fixation had been observed for 0.5～4 years.ResultsAll the cases came up to clinical healing standards within 7 months. According to Kolmert's standard, the rate of fine and good was 89.6%.ConclusionThere was satisfactory outcome treating fractures around knee with external fixation. Early rehabilitation is important to avoid the knee joint rigor.