Objective To study the features of hippocampal atrophy (HA) by MRI in mild Alzheimer's disease(AD) patients. Methods Fifteen mild AD patients and 30 healthy controls were included in this study and all subjects were examined by both MRI and MMSE. The differences in the hippocampal volume between the mild AD and the control were analysed, and relationships between the hippocampal volume and age, MMSE scores were evaluated. Results The hippocampal volume of the mild AD was decreased significantly than that of the controls 〔(2 08?0 46)cm 3 vs (3 11?0 19)cm 3, t =2 71, P 0 05). Conclusions MRI-based HA could be used to differentiate the mild AD patients effectively from the healthy subjects and could also be regarded as a status marker for the early clinical diagnosis of AD.

Objective To investigate the levels of platelet-derived growth factor-BB (PDGF-BB) and its role in the pathogenesis of the patients with hepatic diseases.Methods The levels of serum PDGF-BB in 30 chronic patients (hepatitis B,26; hepatitis C,4),24 patients with post-hepatitis cirrhosis,30 patients with primary hepatocellular carcinoma,and 20 normal controls were measured by ELISA.The levels of PDGF-B mRNA in peripheral blood mononuclear cells were measured by reverse transcription polymerase chain reaction (RT-PCR).Results The serum levels of PDGF-BB and the levels of PDGF-B mRNA in peripheral blood mononuclear cells were significantly higher in the patients with hepatic diseases (F=1774.40,1037.42,P

Objective To evaluate the therapeutic effect of transarterial chemoembolization (TACE) combined with CT-guided 125I seed implantation in treating hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus(PVTT), and to discuss the technical points. Methods A total of 48 HCC patients with PVTT were enrolled in this study. TACE combined with CT-guided 125I seed implantation was carried out in all 48 patients. Based on the sites of PVTT, the lesions were classified into type A (PVTT within main portal vein), type B(PVTT within level-1 portal branch) and type C(PVTT within level-2 or more distal portal branch). According to whether the 125I seeds were directly implanted into the PVTT or not, the patients were divided into direct in-tumor thrombus implantation group (group A) and around tumor thrombus implantation group (group B; the 125I seeds were implanted in the liver parenchyma or in tumor tissue around the tumor thrombus within 1.7 cm region). The tumor thrombus control rate(TTCR), the disease control rate(DCR), the time to progress(TTP) and the overall survival rate of patients(OS) were determined, and the results were compared among different types and groups. Results TACE combined with CT-guided 125I seed implantation was successfully accomplished in all 48 patients. The median OS of type A, B and C was 8, 11.5 and 15 months respectively(P=0.003);the TTCR of type A, B and C was 61.5%, 70.8%and 72.7%respectively(P=0.548); the DCR of type A, B and C was 69.2%, 75%and 81.8% respectively (P=0.483); the median TTP of type A, B and C was 4.5, 8 and 11 months respectively(P=0.030);the median TTP of intra-hepatic tumor of type A, B and C was 5, 9 and 9.5 months respectively(P=0.012). The median OS in group A and group B was 10 and 11.5 months respectively (P=0.239); the TTCR in group A and group B was 69.2% and 68.2%respectively(P=0.591); the DCR of intra-hepatic tumor in group A and group B was 73.1% and 77.3%respectively(P=0.502); the median TTP of tumor thrombus in group A and group B was 7 and 10 months respectively(P=0.276); and the median TTP of intra-hepatic tumor in group A and group B was 8 and 9.5 months respectively(P=0.089). Conclusion For the treatment of hepatocellular carcinoma complicated by portal vein tumor thrombus, TACE combined with CT-guided 125I seed implantation can effectively control the progress of both the tumor thrombus and the intra- hepatic tumor and prolong patient’s survival time. Implantation of 125I seeds into the portal vein tumor thrombus and implantation of 125I seeds into the liver parenchyma around the tumor thrombus have the same therapeutic results. (J Intervent Radiol, 2015, 24:488-493)

Objective To explore the clinical efficacy of secondary unreamed intramedullary nailing following primary external fixation for open tibial shaft fractures.Methods From March 2011 to June 2014,we treated 28 open tibial shaft fractures.They were 17 men and 11 women,aged from 21 to 62 years (average,38.2 years).After thorough debridement,the tibia was stabilized temporarily with external fixation.The wounds were handled with primary closure or secondary repair with skin grafts or tissue flaps.After the wounds healed,the external fixation was replaced by unreamed intramedullary nailing.Fracture union and complications were documented.The clinical efficacy was evaluated at the final follow-ups according to the Johner-Wruhs scoring system.Results All the 28 patients were followed up for 12 to 18 months (average,13.5 months).Bony union was achieved in all after 4 to 15 months (average,4.9 months).Delayed union was observed in 4 cases which were healed after dynamic fixation.There was no deep infection,nail breakage,malunion or limb shortening in any one.Mild knee pain was reported by 5 cases after surgery.According to the Johner-Wruhs criteria,18 cases were excellent,7 good,and 3 moderate,giving an excellent to good rate of 89.3％.Conclusion Primary external fixation and secondary unreamed intramedullary nailing can result in good fracture union with satisfactory biomechanical stability and favorable early rehabilitation in the treatmeut of open tibial shaft fractures.

Objective To describe the technique, efficacy, and safety of percutaneous interventional therapy for anastomotic biliary strictures after orthotopic liver transplantation (OLT).Methods From May 2004 to December 2009, 25 patients with anastomotic biliary strictures afte OLT were enrolled in our study. The modalities of biliary drainage included external drainage in 22patients, and external-internal drainage in 3 patients who underwent re-transplantation. All patients accepted percutaneous interventional therapy in our hospital, including single PTBD in 4 patients,PTBD combined with balloon dilation in 14 patients, balloon dilation and plastic stent implantation in 5 patients, balloon dilation and metallic stent implantation in 2 patients. The drainage catheters were exchanged every 1 to 3 months. Results The success rate of PTBD was 100%. Of the all 25patients, 15 (60 %) patients were cured, and 10 (40 %) patients were improved. The effective rate was 100 %. The drainage catheters failed to pass through the narrow bile duct when initial PTBD in 7 patients, and success was achieved in 3 patients by operation again after biliary drainage for one week.In the other 4 patients, anastomotic bile ducts were occluded, which was confirmed by cholangiography after biliary drainage for 4 to 8 weeks. The rate of biliary tract infection was 24 % (6/25). No serious procedure-related complications occurred in the all 25 patients. Conclusion PTBD combined with balloon dilation and biliary stenting is a effective and safe therapeutic modality for anastomotic biliary strictures after OLT, which can improve the patients' clinical symptoms and elevate patients' quality of life. To avoid bile duct occlusion, the drainage catheters should be passed through the narrow segments of bile duct when initial PTBD.

Objective To evaluate the diagnostic value of dual-source CT angiography (DSCTA) for intracranial aneurysms.Methods The data of DSCTA and digital subtraction angiography (DSA) were collected from 95 patients with subarachnoid hemorrhage (SAH).The efficacies of detection and description of morphologic features of intracranial aneurysms were analyzed retrospectively.Results A total of 117 aneurysms in 88 patients were detected with DSCTA.Two patients were suspected of having aneurysms,and no aneurysrms were detected in 5 patients.These patients were reexamined with DSA,4 were diagnosed as having aneurysm,and the aneurysms were not detected in 3 patients.DSA results were considered as gold standard,the specificity,sensitivity and accuracy of DSCTA for the detection of intracranial aneurysms were 100％,96.7％and 96.8％,respectively.The larger volume of intracranial aneurysm was,the higher the sensitivity of DSCTA diagnosis would be.Even for small aneurysms,the sensitivity of DSCTA diagnose was more than 90％.In addition,tmeasurement results of the maximum diameter and neck width of aneurysms measured by DSCTA were almost consistent with DSA.Condclusions SCTA is a non-invasive,quick,reliable,and effective method,and can provide accurate imaging information for surgery.The specificity and sensitivity of the diagnosis of aneurysms with DSCTA are almost the same with DSA.It has more advantages than DSA in the emergency operation of intracranial aneurysms.

Objective:To investigate the safety and effect of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and sorafenib on large hepatocellular carcinoma (HCC) patients treatment.Methods:From Jan 2012 to Dec 2017, 36 patients (Male: 33, Female: 3, average age: 51.8) with large HCC lesions(5-7 cm) received TACE plus with RFA and sorafenib in the Third Affiliated Hospital of Sun Yat-sen University. Efficacy was evaluated after TACE. Each patient was received follow-up after RFA procedure. The occurrence rate of complications and overall survival (OS) were recorded. Log-rank univariate analysis was used to analyze the OS data.Results:The median TACE time was 4, and the RFA time was (1.7±0.7) . Mean duration time of sorafenib administration was (37.7±28.8) months. Adverse events of sorafenib: 26(72.2%) hand-foot skin reaction, 6(16.7%) hypertension, 22(61.1%) diarrhea, 17(47.2%) alopecia, 3(8.3%) oral ulcer and 1(2.8%) gastrointestinal hemorrhage. Median OS was 63.0 months, and 1-year, 3-year and 5-year survival rate was 100%, 72.7% and 52.6%. The cumulative survival rate of patients taking whole course of sorafenib ( n=21) was better than that of patients taking remedial ( n=15); the cumulative survival rate of patients with alpha fetal protein (AFP) <200 μg/L ( n=26) before treatment was better than ≥200 μg/L ( n=10); the cumulative survival rate of patients with good TACE response ( n=19) was better than that of patients with no response ( n=17), and the differences were statistically significant (all P<0.05). Conclusions:TACE plus with RFA and sorafenib are safe and effective for large HCC patients with 5-7 cm lesions and this treatment might improve OS. The whole-course sorafenib, lower base AFP value (<200 μg/L) and good TACE response were considered as the good factors for the combination therapy in large HCC patients.

Objective To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation (OLT) treated with the interventional techniques.Methods The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables (including biliary complication, hepatic artery restenosis,early or late artery complication, and so on) were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of percutaneous interventional treatment for hepatic artery complications after OLT. Results Twenty-one patients were followed for mean 436 days, median 464 days (3-1037 days). The poor-prognosis group included 11 patients (5 cases received retransplantation, and 6 died). The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days (3-616 days). The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days (245-1037 days).Univariate analysis showed there were significant difference in biliary complication, total bilirubin and indirect bilirubin between the two groups. The binary logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management (P = 0.027, OR =22.818). Conclusion Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombisis receiving interventional treatment.

BACKGROUND: 3,4-Methylenedioxymethamphetamine (MDMA) is one kind of amphetamine-type stimulants (ATS) with stimulating and hallucinogenic properties, and its damage to human is extremely serious and complicated. It has become a research hot in the field of addiction behavior abroad. OBJECTIVE: To observe the effect of long-term neurotoxicity of MDMA on cognitive function. DESIGN: A randomized control animal experiment. SETTING: Laboratory of Psychopharmacology, Mental Health Center, West China Hospital of Sichuan University. MATERIALS: The experiment was carried out in the Laboratory of Psychopharmacology of the Mental Health Center, West China Hospital of Sichuan University from July 2003 to February 2004. Sixteen male adult Wistar rats, provided by the animal center of Sichuan university, were randomly assigned to study group (n=10) and control group (n= 6). INTERVENTIONS: Rats in study group were administrated with MDMA (10 mg/kg), once per hour for four times, and the total amount was 40 mg/kg, and those in the control group were treated with saline of the same volume. The Morris water-maze test was performed at 2, 8, 26 and 32 weeks after the last administration respectively to observe the spatial learning and memory function. MAIN OUTCOME MEASURES: The escape latencies and the times of crossing the exact position of the former platform were observed at 2, 8, 26 and 32 weeks after the last administration respectively. RESULTS: Four rats in the study group died within 12 hours during the experiment, 1 in the study group and 1 in the control group died at 6 and 17 weeks respectively, finally 5 rats in the study group and control group left till 32 weeks respectively. At 2, 8, 26 and 32 weeks after the last administration, there were no .significant differences in the escape latencies between the two group (P ＞ 0.05), and the times of crossing the exact position of the former platform also had no significant differences [(7.67±2.16), (7.50±2.95) times; (6.60±1.14), (7.0±1.67) times;(7.40±1.52), (6.60±2.61) times; (6.80±4.55), (5.80±1.79) times; P ＞ 0.05]. CONCLUSION: The long-term neurotoxicity of MDMA has no obvious effect on the spatial learning and memory function.

BACKGROUND: Methamphetamine (MA) has neurotoxic effects to central nervous system. However, as the 5-hydroxytryplamine reuptake enhancer, it is uncertain that if there are protective effects of tianeptine to the damages of 5-hydroxytryp-taminergic neurons caused by MA.OBJECTIVE: To investigate the neurotoxicity of MA and the neuroprotective effects of tianeptine as well as the acting mechanism.DESIGN: Randomized case control study based on animals.SETTING: Animal research room and pathology research room of a university.MATERIALS: The experiment was completed in the Experimental Animal Centre of Sichuan University and Molecular Pathology Laboratory of West China Hospital during June to August 2003. Totally 25 male Wistar rats were injected MA through abdominal cavity to build model. Methamphetamine was provided by National Institute for the Control of Pharmaceutical and Biological Products(NICPBP) while tianeptine was given by French Servier Company (Batch No. OE3086). The TUNEL testing kit was purchased from Boehringer Mannheim Company.INTERVENTIONS: There were one control group and four experimental groups(A, B, C, D). A group was used intraperitoneal injection of MA while B, C, D, groups were administered tianeptine 7 days, 4 days before and the same day of MA administration. Normal saline with same volume was injected into rats of control group. HE stain and silver stain were conducted after experiment to observe the morphologic changes of neurons. And TUNEL method was used to detect apoptotic cells.MAIN OUTCOME MEASURES: The HE stain and silver stain of brain tissue sections and counts of TUNEL positive neurons.RESULTS: MA could damage the axon and dendrite of neurons and the absorbance of silver positive cell was(50.74 ± 1.86) . It could also induce cell apoptosis while the apoptotic cell count every high power field was 29.26 ±4. 14. There were less apoptotic cells in the group with 7 days usage of tianeptine with the cell count of( 18.90 ± 1.60) per high power field.CONCLUSION: MA can cause neurotoxicity by inducing cell apoptosis.And giving tianeptine in advance can protect neurons.