Objective:To investigate morphologic variations of circle of Willis in healthy adults using 3D-TOF MR angiography in medical examination and its clinical significance. Methods:To analyze the characteristics of the vascular morphology in 442 healthy adults of head 3D-TOF MRA in the post processing workstation retrospectively. Results: All the 442 cases, the variations of circle of Willis were found in 152,the variations of A1, A2, ACoA, PCoA, P1 were found in 76(50.00%), 23(15.13%), 7(4.61%), 101(66.45%), 68(44.74%). The variation of A1 was positively correlated with PCoA, the variation of PCoA in female was more than in male. Conclusion:Medical examination-3D-TOF MRA has important value to display morphologic variations of circle of Willis in healthy adults, which can provide important guide value in the clinical.

The gene and the amino acid sequence of the structural and regulatory region of the Pseudomonas aeruginosa with different resistance patterns were analyzed. Six strains with different resistance patterns were selected and the AmpC beta-lactamase was identified. The objective gene fragment was amplified by colonies PCR. The sequences of the PCR-products were analyzed. The DNA sequence of the structural gene ampC and the regulatory genes ampR, ampD and ampE was detected. The 6 strains and the wild-type Pseudomonas aeruginosa are highly homogeneous in structural and regulatory region. Some new mutant points were found.
Bacterial Proteins/*genetics ; DNA, Bacterial/genetics ; Point Mutation/*genetics ; Pseudomonas aeruginosa/enzymology ; Pseudomonas aeruginosa/*genetics ; Sequence Analysis, DNA ; beta-Lactam Resistance/*genetics ; beta-Lactamases/*genetics

Objective The aim of this article is to study the clinical features, image, electroencephalogram and gene mutation of mitochondrial encephalomyopathy with MELAS and to improve understanding of the disease. Methods Clinical data was collected from 12 MELAS cases. Their clinical symptoms, head imageological result,electroencephalo-gram and gene mutation were analyzed. Results The average onset age was 28 years old. The main manifestations of 12 patients were epilepsy(66.7%), stroke-like episodes(50.0%), mental behavious disorder and decrease of perceive (41.7%),diabetes or abnormal glucose tolerance(41.7%), hearing impairment(41.7%). The imaging results showed long T1, long T2 and high signals on DWI. The nidus involved occipital lobe, temporal lobe, parietal lobe most. Five of six cases undergoing MRS imaging had large lactate peak at 1.33 ppm. There were 9 cases carrying mtDNA A3243G muta-tion. Conclusion The clinical presentation of MELAS is highly variable without any obvious specificity on MRI and EEG. Large lactate peak on MRS may indicate the disease. Most patients carry A3243G mutation.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Combined Modality Therapy ; Female ; Humans ; Hypesthesia ; therapy ; Male ; Middle Aged ; Moxibustion

Objective: To describe 3D-TOF MRA features of anomalous vertebral artery(VA) and evaluate its clinical significance in healthy adults who were accepted physical examination. Methods: A total of 442 cases in which 3D-TOF MRA was performed were retrospectively reviewed to discuss the incidence and relationship between VA origin and course variation. Results: Among this 442 cases, the incidence of origin variation was 4.75%(21/442) in which all cases were unilateral(19 cases in the left and 2 cases in the right). In these cases, the anomalous VA originated from the aortic arch or the right common carotid artery. All of the 21 cases with origin variation had the aberrant entrance position into the transverse foramen (4th or 5th). The incidence of abnormal entrance position into the transverse foramen was 9.50%(42/442),of which most cases(95.24%, 40/42)were unilateral. Of 40 cases, the incidence of both sides was the same(50.00%(20/40)). Conclusion: The VA origin variation always happened in the left side, and often combined with the course variation. 3D-TOF MRA plays an important part in the detection of the anomalous vertebral artery in healthy adults. It can provide useful information for the surgery and the therapy of related diseases.

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Radiation Pneumonitis ; etiology ; Radiosurgery ; adverse effects ; methods ; Radiotherapy, Image-Guided

Cochlea ; metabolism ; Deafness ; genetics ; Humans ; Mutation

BACKGROUND:Total hip arthroplasty is an optimal choice for patients with late hip dysplasia. Crowe type IV developmental dysplasia of the hip increases the difficulty of the operation, and the surgery is controversial.
OBJECTIVE:To evaluate the clinical effects of total hip arthroplasty on Crowe type IV developmental dysplasia of the hip and the method of reconstruction of acetabulum and the treatment of proximal femur.
METHODS:A total of 12 patients (14 hips) with Crowe type IV developmental dysplasia of the hip underwent total hip arthroplasty. Preoperative Harris hip score was averagely (35.0±6.8) points. Al hips were treated with smal acetabular components combined with medial protrusion technique in acetabular reconstruction, as wel as subtrochanteric shortening osteotomy in femur. Joint function of hips was evaluated according to the Harris hip score.
RESULTS AND CONCLUSION:Al patients were fol owed up with an average of 4.6 years (ranged 1 to 7 years). Two cases (two hips) suffered from infraction of greater trochanter of femur during replacement, and it was fixed with wire. There was complete sciatic nerve injury in one case, which partial y restored after conservative treatment for 1 month. No infection, prosthesis loosening, or deep venous thrombosis with obvious clinical manifestations was visible. Bone union was observed at the site undergoing osteotomy at the side of femur. After replacement, final fol ow-up showed that Harris hip score was averagely (84.0±7.0) points. The mean amount of postoperative leg lengthening was 5 cm (range 4-6 cm). Shortened limbs were corrected satisfactorily. These results suggested that total hip arthroplasty using smal acetabular component, medial protrusion, and femoral subtrochanteric shortening osteotomy technique for the Crowe type IV developmental dysplasia of the hip can effectively restore hip function and leg length. The long-term curative effects require further investigations.

Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP) in treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty(PKP),and group B were treated with percutaneous vertebroplasty(PVP).The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity(P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance (P ＜ 0.05).The postoperative recurrence rate was 18.03 ％ (11/61) in the observation group and 9.84 ％ (6/61) in the control group,and the difference had statistical significance (P ＜ 0.05).Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.

Objective To explore the early diagnosis and treatment of congenital mesenteric hiatual hernia.Methods A retrospective study was carried out in 4 patients with congenital mesenteric hiatual hernia in Tongji hospital from Nov.2005 to Mar.2007,and combining lite-rature,the diagnosis and treatment of mesenteric hiatal hernia was summed up.Results Four patients were diagnosed in operation.One case was thought as adhesive intestinal obstruction before operation;two patients were on emergency operation and 2 patients were on time-elective operation;one patient preoperative CT scan may suggest mesenteric hiatal hernia;one case had partial resection of small intestinal,the others were replaced the intestine and fixed the defect.One patient occurred early septic shock;all of them had get well.Conclusions It′s hard to diagnose the congenital mesenteric hiatual hernia before operation.Abdomen CT examination and multislice spiral CT angiography (MSCTA) help to diagnose.Early diagnosis and timely operation are the therapeutic key of congenital mesenteric hiatual heria.For the patients with recurrent abdominal pain,who was not confirmed with a variety of inspection,laparoscopic exploration can provide diagnosis,and can take the initiative to control the development of disease.