Objective To analyze the CT and MRI features of primary central nervous system lymphoma ( PCNSL) and improve the accuracy of MRI diagnosis.Methods MRI features of 13 cases with PCNSL confirmed by pathology were retrospectively analyzed.All the cases were accepted MRI plain scanning and enhanced scanning. Tumor location, tumor size, signal intensity, enhancement characteristics, age distribution, cystic changes and the presence of calcification and intratumoral hemorrhage were assessed.Results Single lesion was found in 5 cases,and multiple lesions were found in 8 cases.Supra-tentorial lesions were found in 11 cases,the lesions involved both supra and infra tentorial were found in two cases.18 lesions located in deep-brain tissues,such as the thalamus,basal gan-glia,corpus callosum,midbrain and pons.7 lesions located at the surface of the brain,such as the temporal lobe,fron-tal lobe,occipital lobe and parietal lobe.The PCNSLs were found varied shapes in MRI,17 PCNSLs manifested irregu-lar shape,5 PCNSLs manifested round or ovoid shape,3 manifested butterfly shape.The average size of these lesions was 4.8cm.The PCNSLs manifested uniform or low T1 WI signal,uniform or slight high T2 WI signal,slight high or high signal on FLAIR,and slight high signal on DWI.11 cases manifested uniform signal and 2 cases manifested non-uniform signal.Different degrees of edema and mass effect were found combined with the lesions.The CT scan showed 6 cases were slighted high density,4 cases were equal density,3 cases were showed low density.Cystic chan-ges and calcifications were not found.In all cases,significant homogeneous enhancement was shown in 3 cases,moder-ate heterogeneous enhancement was shown in 1 case and mild enhancement was shown in 1 case.In multifocal dis-ease,significant homogeneous enhancement was shown in 14 cases,moderate heterogeneous enhancement was shown in 6 cases and mild enhancement was not shown.Conclusion The CT and MRI features of PCNSL of immunocompe-tent patients are always uniformity, whether T1 WIor T2 WI, while of immunodeficiency patients are complicated, all these features are helpful to make correct diagnosis.

Objective To investigate the effect of cluster interventions for prevention of ventilator-associated pneumonia (VAP)on mechanical ventilation.Methods A total of 110 patients with mechanical ventilation more than 48 hours at the intensive care unit(ICU)between April 2011 and June 2012 were randomly divided into three groups:control group(n=36),subglottic secre-tion drainage(SSD)group(n=37),cluster(CL)group(n=37).At the end of study,VAP incidence rate,VAP related death rate, duration of mechanical ventilation,ICU length of stay(LOS)were investigated and compared among the three groups.Results The morbidities of VAP between control group and SSD group were significantly different in the third day,the 7th day of mechanical ventilation.The morbidity of VAP of CL group was lower than that of control group,The morbidity of VAP of CL group was lower than that SSD group in the over 9 day.and its duration of mechanical ventilation and ICU LOS were significantly lower than those of SSD group and control group.However,there was no significant difference of VAP related death rate among the three groups. Conclusion Strictly implement semi-supine position and oropharynx intervention strategies of each link in mechanical ventilation that has important significance to preventing ventilator-associated pneumonia.

ObjectiveTo study the application of magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in brain metastases, and the relationship between DWI results and the primary tumor pathology. Methods76 cases with brain metastases were grouped according to the primary cancer pathology. The apparent diffusion coefficient (ADC) of tumor parenchyma, capsule area, edema around tumors and normal parenchyma were determined; the ratio of high signal on the DWI were calculated (namely diffusion limited) in different tumor. ResultsThe ADC was (1.1364±0.310)×10-3 mm2/s in tumor parenchyma, (2.167±0.472)×10-3 mm2/s in capsule, (1.597±0.238)×10-3 mm2/s in edema and (0.812±0.158)×10-3 mm2/s in normal parenchyma (P<0.05). 15 cases appeared diffusion limited (19.7%), in which the primary tumors were lung cancer in 10 patients (66.6%) (including 5 cases with small cell lung cancer, 5 cases with none small cell lung cancer), breast cancer in 3 cases, and the other 2 cases were colon cancer and teratocarcinoma of testis (P>0.05). The minimum ADC were (0.72±0.16)×10-3 mm2/s in tumor parenchyma with diffuse limited metastases and (0.78±0.21)×10-3 mm2/s without diffuse limited (P=0.325). ConclusionDWI can respond to brain metastases to the microstructure change, but diffusion limited may not be related with the primary histopathology.

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game.
METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games.
RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P<0. 05).
CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Objective To investigate the curative effects of dexamethasone in the prevention of delayed encephalopathy after acute carbon monoxide poisoning in the rats.Methods Eighty healthy male Wistar rats were randomly(random number)divided into hyperbaric group(H),dexamethasone group (D),combined treatment group(C)and model control group(M)after carbon monoxide poisoning,twenty rats in each group.Twelve air-modeling rats were selected as normal control group(N).Using eight-arm maze training and testing,the rat's function of cognitive and memory was detected.The serum MBP levels were detected by enzyme-linked immunosorbent assays(ELISA).Magnetic resonance imaging was used for observing the demyelination of the head and the morbidity of delayed encephalopathy.Measured data was analyzed with single factor analysis of variance(one-way ANOVA).Results The result of eight-arm maze showed that there were 6,7,1,1 rats with delayed encephalopathy in groups M,H,C,D,respectively.At 3 days after poisoning,except N group,the serum MBP levels of every groups increased significantly.At 10 days after poisoning,serum MBP levels in groups C and D were significantly decreased,then returned to normal levels at day 18.The serum MBP in groups M and H was higher than normal levels at all the time.Head MRI showed except D group,the rest groups were abnormal signals,which appeared 7 in M group,6in H group and 1 in C group.Conclusions Dexamethasone administrated as soon as possibly after acute carbon monoxide poisoning may reduce the serum MBP levels,prevent demyelination occurs,decrease the pathological damage,eventually play a preventive role in DE.

Objective To construct an anti-keratin autoantibody (AK auto Ab) transgenic mouse model. Methods Linearized transgene plasmid was microinjected into the zygotes of CBA?C57BL/6 mice, which were transplanted into the oviducts of pseudo-pregnant mice. PCR was used to identify the genotype of the offsprings, and ELISA was applied to measure the serum levels of AK auto Ab. Results Twelve transgene positive founder mice were obtained, and 9 of them produced offsprings as the third generation. The serum level of AK auto Ab was increased in 3 of the transgenic mice. Conclusions AK auto Ab transgenic mice were successfully established; these mice could serve as an animal model with increased serum levels of AK auto Ab.

OBJECTIVETo explore the direct contribution of dexamethasone (Dex) for insulin resistance inducing in thecal cells and effects of berberine (Ber) and puerarin (Pue).

METHODSOvarian thecal cells from porcine follicles were isolated and cultured in vitro. Insulin resistance of thecal cells was induced by Dex treatment for 48 h. Then the glucose utilization ratio of thecal cells was detected. Meanwhile, the effects of Ber and Pue on insulin signal transmission and steroid hormones synthesis were determined by RT-PCR and Western blotting.

RESULTS(1) After being treated by Dex for 48 h, the [3-3H] -glucose uptake in cells was lowered by about half, and the glucose content in supernate increased for about 1/3. (2) The RT-PCR and Western blotting showed that levels of insulin receptor substrate-1 (IRS-1), mRNA and protein expression of glucose transporter 4 (GLUT4) lowered, peroxisome proliferator-activated receptor -gamma(PPARgamma) and cytochrome P450 17 hydroxylase (CYP17) mRNA or protein expression increased in the model cells. However, the changes of above insulin signal molecules and CYP17 expression were inversed significantly after treated with Ber and Pue for 48 h. (3) As compared with the control, in the model cells, levels of testosterone (T, microg/mL) was higher (0.82 +/- 0.20 vs 0.38 +/- 0.01, P < 0.05), while after Ber and Pue treatment it was 0.44 +/- 0.24 and 0.45 +/- 0.21 respectively, all lower than that in the model cells (P < 0.05). No significant change of serum progesterone was found in all groups (P > 0.05).

CONCLUSIONSAfter insulin resistance has been induced, the androgen synthetic capacity of thecal cells enhanced significantly. Ber and Pue could lower the degree of insulin resistance and the androgen synthesis in the model cells, displaying the favorable prospect of the two insulin sensitizing agents for the treatment of polycystic syndrome.

Animals ; Berberine ; pharmacology ; Cells, Cultured ; Female ; Insulin Resistance ; Isoflavones ; pharmacology ; Ovary ; cytology ; drug effects ; Swine ; Theca Cells ; drug effects

OBJECTIVETo compare the clinical efficacies of Chinese composite Yanting Decoction medicated via two different paths (via oral and via retention enema) in treating chronic pelvic inflammation.

METHODSAdopting the randomized multicentered parallel contrast principle, 93 patients were assigned to the retention enema (RE) group (47 cases) and the oral medicated (OM) group (46 cases) at random, Yanting Decoction was administered via respective paths for 10 days as one course. The changes of syndromes (qi-stagnance and blood stasis) and local signs were observed before and after treatment.

RESULTSIn the 47 patients of the RE group, 3 were cured, the treatment was markedly effective in 20, effective in 22 and ineffective in 2, the total effective rate being 95.7%; while in the 46 patients of the OM group, the corresponding number were 1, 8, 30, 7 and 84.8%, respectively, the difference of the total effective rate between groups was statistically significant (P <0.05). The total effective rate for TCM syndromes in the RE and the OM group was 95.7% (45/47) and 82.6% (38/46) respectively, and that for local signs, 97.9% (46/47) and 84.8% (39/46) respectively, the improvements in the RE group were better than those in the OM group (P <0.05).

CONCLUSIONChinese preparation Yanting Decoction shows good clinical efficacy in treating chronic pelvic inflammation of qi-stagnant blood-stasis type, the effect could be enhanced by medicating via retention enema than that via oral.

Adult ; Drug Administration Routes ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Pelvic Inflammatory Disease ; drug therapy ; Qi ; Treatment Outcome ; Young Adult

OBJECTIVETo study the reliability of establishing a neonatal piglet model of multiple organ dysfunction syndrome (MODS) by cecal ligation and puncture (CLP).

METHODSFourteen neonatal piglets were randomly assigned into Experiment group (n=9) and Control group (n=5). MODS model was established in the piglets from the Experiment group by CLP. The Control group underwent a sham-operation. Serum biochemical parameters (ALT, AST, ALB, BUN, Cr, CK-MB and lactic acid), blood platelet counting and blood gas analysis(PaO2 and PaCO2) were tested at 0, 24, 48, 72, 96, and 120 hrs after operation. The histomorphological changes of important vital organs were examined by hematoxylin-eosin staining under a light microscope.

RESULTSThe levels of serum ALT, AST, BUN, Cr, CK-MB and lactic acid in the Experiment group began to increase 24 hrs after operation. Significant differences were observed between the Experiment and the Control group at 48 hrs in ALT (83.0 +/- 9.3 U/L vs 57.8 +/- 15.8 U/L), AST (348.8 +/- 132.9 U/L vs 106.4 +/- 12.5 U/L), BUN (10.5 +/- 2.5 micromol/L vs 4.3 +/- 1.0 micromol/L), Cr (79.2 +/- 9.0 micromol/L vs 53.6 +/- 6.8 micromol/L), CK-MB (5152.0 +/- 1 857.8 U/L vs 1243.0 +/- 354.5 U/L), and lactic acid (12.3 +/- 4.0 mmol/L vs 4.6 +/- 1.5 mmol/L) (P < 0.01). The high levels of the above parameters persisted until 96 hrs after operation in the Experiment group and then decreased but were still higher than those at 0 h after operation. After operation, the blood platelet counting decreased significantly at 96 hrs, and PaO2 decrease and PaCO2 increase were observed at 48 hrs in the Experiment group compared with the Control group. All animals, except one, in the Experiment group died within 120 hrs after operation (with the MODS incidence of 56%), while none died in the Control group. The tissue injuries with different degrees were observed in the lungs, liver, heart, kidneys and gastrointestinal tracts of the Experiment group.

CONCLUSIONSNeonatal piglet MODS model can be established successfully by CLP.

Animals ; Animals, Newborn ; Disease Models, Animal ; Female ; Male ; Multiple Organ Failure ; blood ; etiology ; pathology ; Swine

OBJECTIVETo analysis the early complications of tibial fracture and its related factors, and propose a solution.

METHODSFrom December 2003 to December 2013,38 patients with early complications of tibial plateau fracture after operation were retrospectively analyzed. There were 35 males and 3 females, aged from 37 to 69 years old (averaged 42.3 years). According to Schatzker classification, 3 cases were classified as type II, 2 cases as type III, 2 cases as type IV, 19 cases as type V, 12 cases as type VI. The intervals between injury and operation ranged from 9 hours to 9 days, 26 cases within 3 days. Fifteen cases were treated with internal fixation of plates and 23 were treated by plate fixation and bone transplantation. Early complications included skin necrosis in 15 cases, infection in 6 cases, osteofascial compartment syndrome in 3 cases, common peroneal nerve injury in 2 cases, the superficial peroneal nerve injury in 3 cases, popliteal artery injury in 2 cases, loss of reduction in 7 cases.

RESULTSThe wound of 14 cases healed at the first stage and 24 cases healed delay. Hospitalization days ranged from 7 to 67 days (averaged 25.6 days). All patients were followed up for 12 to 36 months with an average of 16.4 months. The fracture healing time ranged from 3 to 9 months (averaged 6.9 months). According to Merchant knee function evaluation criteria, the results were excellent in 19 cases, good in 12, fair in 5 and poor in 2.

CONCLUSIONEarly complications of tibial fracture after operation is closely associated with the severe fracture complexity and related with preoperative preparation, surgical timing, operation incision selection and surgical technique. Early detection and timely processing reduce damage.

Adult ; Aged ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Tibial Fractures ; surgery