CD56 Antigen ; metabolism ; Carcinoid Tumor ; diagnostic imaging ; metabolism ; pathology ; surgery ; ultrastructure ; Chromogranin A ; metabolism ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; ultrastructure ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism ; Tomography, X-Ray Computed ; Vimentin ; metabolism

AIM: To investigate the feasibility of reendothelialization of the injured arterial wall by autologous endothelial cell transplantation and their influences on neointima proliferation. METHODS: New Zealand white rabbits (n=30) were subjected to bilateral iliofemoral artery balloon injury. Cultured, autologous venous endothelial cells were immediately transplanted into one vessel(transplantation group), whereas the contralateral artery received medium only(control group). Reendothelialization of the injured arterial wall was analysed 4 hours or 4 days after cell transplantation by fluorescent tracing、scanning electron microscope(SEM) and Evans blue staining. Pathology analysis was employed 28 days after cell transplantation to evaluate neointima proliferation. RESULTS: The transplanted endothelial cells had adhered into the aterial wall 4 hours after transplantation and began to attach and spread 4 days later. A number of fluorescent labeling endothelial cells were observed in the endothelial injured arterial wall. The vessels in control group were stained nearly completely by Evans blue, whereas about 60% area was not stained in transplantation group. Pathological examination demostrated that neointimal area and maximal intima thickness in transplantation group significant decreased than those in control. CONCLUSION: Autologus endothelial cells were effectively transplanted into the injured arterial wall by balloon catheter, and it can relieve neointima proliferation in the long time.

OBJECTIVE: To determine the effects of cervical kyphosis on the recovery of swallowing function in subacute stroke patients. METHODS: Baseline and 1-month follow-up videofluoroscopic swallowing studies (VFSSs) of 51 stroke patients were retrospectively analyzed. The patients were divided into the cervical kyphosis (Cobb's angle <20°, n=27) and control (n=24) groups. The penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcomes Measurement System swallowing scale (ASHA NOMS), and videofluoroscopic dysphagia scale (VDS) were used to determine the severity of dysphagia. Finally, the prevalence of abnormal VFSS findings was compared between the two groups. RESULTS: There were no significant differences in baseline PAS, ASHA NOMS, and VDS scores between the two groups. However, the follow-up VDS scores in the cervical kyphosis group were significantly higher than those in the control group (p=0.04), and a follow-up study showed a tendency towards worse ASHA NOMS scores (p=0.07) in the cervical kyphosis group. In addition, the cervical kyphosis group had a higher occurrence of pharyngeal wall coating in both baseline and follow-up studies, as well as increased aspiration in follow-up studies (p<0.05). CONCLUSION: This study showed that stroke patients who had cervical kyphosis at the time of stroke might have impaired recovery from dysphagia after stroke.
American Speech-Language-Hearing Association ; Deglutition ; Deglutition Disorders* ; Fluoroscopy ; Follow-Up Studies ; Humans ; Kyphosis* ; Prevalence ; Respiratory Aspiration ; Retrospective Studies ; Stroke*

BACKGROUNDFractional flow reserve (FFR) is currently considered as the gold standard for evaluating the functional significance of coronary stenosis. However, its potential benefits in real-world practice remain unknown in China. This study aimed to test the hypothesis that the use of FFR is associated with improved outcome and reduced cost in Chinese real-world clinical practice.

METHODSA retrospective cohort study was carried out using the database of Second Affiliated Hospital of Zhejiang University, a tertiary and high-volume center in China. Clinical events were compared using the Cox proportional hazards model during a median follow-up of 13 months.

RESULTSThe study cohort consisted of 366 consecutive patients referred for coronary revascularization with adjunct FFR and 366 matched controls, from 2010 to 2014. Major adverse cardiac events (MACEs) (death, myocardial infarction, repeated revascularization, or hospitalization for angina) at 4 years were found in 12.0% of angiography-guided patients and 4.9% in the FFR-guided group (P < 0.001). The mean number of implanted stents was significantly lower in FFR treated subjects (0.52 ± 0.82 stents) compared with the angiography-guided group (0.93 ± 0.96 stents) (P < 0.001). No difference in overall costs at initial hospitalization was observed between angiography-guided percutaneous coronary intervention (PCI) compared with FFR-guided PCI (RMB 33,000 Yuan, range: RMB 7393-44,700 Yuan) versus RMB 21,200 Yuan (RMB 19,100-47,100 Yuan) (P = 0.54). However, costs for MACEs during follow-up were significantly reduced in the FFR-guided arm (P < 0.001).

CONCLUSIONSIn the contemporary clinical practice, FFR-guided PCI is associated with decreased use of stents, improved clinical outcome, and reduced costs, compared with angiography-guided PCI.

Aged ; China ; Costs and Cost Analysis ; Female ; Fractional Flow Reserve, Myocardial ; physiology ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; economics ; methods ; Retrospective Studies

PURPOSE: To evaluate the effect of changes of parameters of diffusion tensor imaging (DTI), including slice thickness/slice number, b-value and the direction number of a diffusion gradient on fractional anisotropy (FA). MATERIALS AND METHODS: Three groups of normal volunteers underwent brain diffusion tensor imaging with the use of three different imaging parameters as follows: a different slice thickness/slice number (6 mm/20 slices and 2.33 mm/54 slices), a different b-value (800 s/mm2/1000 s/mm2) and a different number of directions of the diffusion gradient (6 and 15 directions). The signal to noise ratio (SNR) and FA were measured by a ROI measurement at the anterior corona radiata, superior corona radiata, putamen and corpus callosum. We compared the mean SNR and FA in each group by the use of the paired T-test. RESULTS: The SNR decreased and the FA increased significantly according to the increase of the slice number (6 mm/20 slices vs. 2.33 mm/54 slices). The SNR of DTI with 15 diffusion gradient directions was significantly higher than DTI with six directions, without a difference of FA. There were no significant changes of the SNR and FA of DTI according to the b-value. CONCLUSION: It is essential and useful in the clinical application of DTI to understand the effect of imaging parameters on FA.
Anisotropy* ; Brain ; Corpus Callosum ; Diffusion Tensor Imaging* ; Diffusion* ; Healthy Volunteers ; Putamen ; Signal-To-Noise Ratio

OBJECTIVETo investigate the long-term clinical efficacy and adverse effects of botulinum toxin-A (BTX-A) injection in the treatment of gastrocnemius spasticity in children aged 9-36 months with cerebral palsy.

METHODSEighty children aged 9-36 months with cerebral palsy and gastrocnemius spasticity were selected and randomly divided into a BTX-A injection group and a conventional treatment group (n=40 each). The children in the BTX-A injection group received injections of BTX-A guided by color Doppler ultrasound and 4 courses of rehabilitation training after injection. Those in the conventional treatment group received 4 courses of the same rehabilitation training alone. Before treatment and at 1, 2, 3, and 6 months after treatment, the modified Tardieu scale (MTS) was applied to assess the degree of gastrocnemius spasticity, the values in the passive state measured by surface electromyography (sEMG) were applied to evaluate muscle tension, and the Gross Motor Function Measure (GMFM) was used to evaluate gross motor function.

RESULTSCompared with the conventional treatment group, the BTX-A injection group had significantly greater reductions in MTS score and the values in the passive state measured by sEMG (P<0.05), as well as significantly greater increases in joint angles R1 and R2 in MTS and gross motor score in GMFM (P<0.05). No serious adverse reactions related to BTX-A injection were found.

CONCLUSIONSBTX-A injection is effective and safe in the treatment of gastrocnemius spasticity in children aged 9-36 months with cerebral palsy.

Botulinum Toxins, Type A ; administration & dosage ; Cerebral Palsy ; drug therapy ; physiopathology ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Muscle Spasticity ; drug therapy ; physiopathology ; Muscle, Skeletal ; drug effects ; physiopathology ; Prospective Studies ; Treatment Outcome

Organic acids are widely distributed in plants and related products, and participate in a wide range of metabolic pathways (e.g. tricarboxylic acid cycle), showing diverse pharmacological activities. As a widely used Chinese patent medicine, its adverse reactions are often reported. Therefore, we should further clarify the chemical components of Shenfu injection, and prepare strict quality standards to ensure the safety and effectiveness of its clinical use. Shenfu injection is prepared from red ginseng (steamed roots of Panax ginseng) and black prepared lateral roots of Aconitum carmichaelii (Heishunpian) by using modern extraction process, and organic acids are regarded as one of its main components. In current study, a hydrophilic interaction chromatography (HILIC) coupled with mass spectrometric method (HILIC-LC-MS) was developed and validated for the simultaneous determination of 14 organic acids, including cinnamic acid, ferulic acid, 4-hydroxylbenzoic acid, L-(+)-lactic acid, adipic acid, fumaric acid, caffeic acid, succinic acid, maleic acid, malonic acid, D-malic acid, (-)-shikimic acid, D-tartaric acid, and quinic acid in Shenfu injection. Satisfactory retention and separation were achieved for all organic acids on HILIC chromatographic column. Except cinnamic acid (231 μg•L⁻¹), lactic acid (113 μg•L⁻¹) and malonic acid (32.5 μg•L⁻¹), the limit of quantitation for the remaining 11 compounds were less than 10 μg•L⁻¹. D-Malic acid, malonic acid, quinic acid, L-(+)-lactic acid, and cinnamic acid were observed to have higher contents in Shenfu injection (>1.89 mg•L⁻¹), whereas caffeic acid and adipic acid were undetectable in all batches. Above all, the developed method is suitable for the simultaneous determination of organic acids in Shenfu and some other traditional Chinese medicine injections.

OBJECTIVETo accurately define the injury position of medial patellar retinaculum with acute injury under the guiding of high frequency ultrasonography, and to study therapeutic effects of suture operation on medial patellar retinaculum in the injuried position.

METHODSFrom June 2009 to March 2014, there were 17 patients with acute patellar dislocation, 6 males and 11 females with average age of (16.2±6.2) years old. The duration time of patellar dislocation was 2 weeks. Before operation, the medial patellar retinaculum of all patients were examined with the high frequency ultrasonography, and the skin with the non-continuous fiber was iudicated as the surface mark under the high frequency ultrasonography. The injury position of medial retinaculum was in the middle of 5 patients who were treated with suture operation of arthroscopic medial retinaculum. The injury position was in the patellar edge in 12 patients who were treated with fixing bone anchor on patella and arthroscopic suture operation of medial retinaculum. The CT examination and Kujala scores, patellar tilt angle on CT film, measured maximal angles of passive or active knee flexion and apprehension test were observed before treatment and postoperative 18 months.

RESULTSEighteen months after treatment, Kujala scores were 92.2±11.1 and patellar tilt angle were(11.5±4.2) °, and there was no statistical difference between post-operation and pre-operation. The difference between maximal angles of passive knee flexion(133.5±4.2) ° and normal had no statistically significance. Maximal angles of active knee flexion were(153.5±4.6) °. Ultrasonography showed the continuous fiber of medial retinaculum. A patient showed positive apprehension test and no patient had the recurrence patella instability after operation.

CONCLUSIONSThe injury position of medial patellar retinaculum was accurately shown by high frequency ultrasonography and treated with arthroscopic suture operation. Knee immobilization time after operation was shorten. Eighteen months after operation, knee joint function was good, and no patient had the recurrence patella instability.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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