Child ; Clinical Laboratory Techniques ; Humans ; Microbiological Techniques ; Viral Load ; Virus Cultivation ; Virus Diseases ; diagnosis

Objective To evaluate the clinical significance of 18F-FDG PET/CT in localization and etiologic diagnosis of suspected pacemaker-related infection(SPRI).Methods Fifteen SPRI patients (10males,5 females,age range:45-86 years) were included in this retrospectively study.18F-FDG uptake in device-related region and abnormal 18F-FDG uptake out of the device region were visually interpreted.Final diagnosis was decided according to modified Duke's criteria and imaging interpretation.Diagnostic efficiency of 18 F-FDG PET/CT on SPRI was evaluated.Results Of 7 patients with suspected pocket infection,5 patients had hot spot of 18F-FDG in the pocket site,either in superficial skin and/or deep soft tissue.Of 9 patients with suspected infective endocarditis,a diffuse FDG uptake was demonstrated in 3 patients in the area of left atrium,right atrium,and right ventricle;another 3 patients had abnormal FDG uptake in other sites rather than in the implantation regions,and the rest 3 showed negative PET/CT results.In patients with SPRI,18F-FDG PET/CT diagnosed 7 cases of pocket infection,8 cases of infective endocarditis,14 cases of pacemaker-related infection.Conclusions 18F-FDG PET/CT imaging is useful in localization and etiologic diagnosis in SPRI patients.It might guide the clinical SPRI management.

Objective To investigate the value of 99Tcm-MDP imaging for the differential diagnosis between infection and aseptic loosening after total hip arthroplasty.Methods During February 2008 to August 2011,74 patients (32 males,42 females,average age (64.3±11.2) years) with hip pain after arthroplasty underwent 3-phase (blood flow,blood pool and bone phases) 99Tcm-MDP imaging.All patients had measurements of serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).Joint infection was defined as either increased peri-prosthetic soft tissue activity during perfusion and blood pool phases or increased peri-prosthetic bone activity during uptake phase,or positive in all 3 phases.Aseptic loosening was defined as having negative 99Tcm-MDP in all 3 phases.Clinical diagnosis was chosen as the gold standard.The blood flow-pool imaging was compared with the serum examinations.x2 test was used for statistical analysis.Results There were 74 symptomatic joints in 74 patients,including 24 joint infections and 50 aseptic loosening.For the detection of peri-prosthetic infection,combined perfusion-blood-pool phase was more accurate than bone uptake phase (90.5％ (67/74) vs 55.4％ (41/74) ;x2=23.159,P＜0.001),with the sensitivity of 91.7％ (22/24)vs 70.8％ (17/24) and specificity of 90.0％ (45/50) vs 48.0％ (24/50),respectively.The blood flow-pool imaging was also more accurate than CRP (73.0％ (54/74) ;x2 =7.656,P＜0.05) and ESR (71.6％ (53/74) ; x2 =8.633,P＜0.05),respectively.Conclusion 99Tcm-MDP perfusion/blood flow-pool imaging is an accurate modality for differentiating peri-prosthetic infection from aseptic loosening in patients with hip pain after arthroplasty.

Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Myositis Ossificans ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Prognosis ; Tomography, X-Ray Computed

Objective To reveal the changes of catecholamine and lactate levels in myocardial interstitial fluid during cardiopulmonary resuscitation in order to prove the protective effects of sildenafil pretreatment on post-resuscitation myocardial function in swine model of ventricular fibrillation (VF).Methods Twenty-four swine were randomly (random number) divided into three groups:saline group,sildenafil group and shame operation group.Sildenafil in dose of 0.5 mg/kg dissolved in 40 mL of saline was given to swine once intraperitoneally 40 min prior to VF in sildenafil group.The equivalent volume of saline (0.9％ NaC1) alone was administered instead in saline groups.There was no treatment in shame operation group.After ventricular fibrillation untreated for 8 min,open-chest cardiopulmonary resuscitation was initiated.The hemodynamic variables were recorded at baseline,4 min,1 h and 6 h after restoration of spontaneous circulation (ROSC).The interstitial fluid from the left ventricle wall was collected by using the microdialysis tubes at given intervals,in which the levels of dopamine,norepinephrine,epinephrine,and lactate were measured.The samples for pathological examination were taken at 24 hours after ROSC.Results The levels of catecholamine and lactate in the sildenafil group were lower than those in saline group at all different intervals (P ＜ 0.05 or P ＜ 0.01).The cumulative defibrillation energy was lower in the sildenafil group than that in the saline group (P ＜ 0.05).The hemodynamic changes and myocardial histological damage in sildenafil group were milder than those in saline group (P ＜ 0.05).The pathologic changes of myocardium and mitochondria in saline group were more severe than those in sildenafil group.Conclusions Sildenafil pretreatment prior to VF can effectively reduce endogenous catecholamine secretion and lactate levels in myocardial tissue,protecting the myocardium and improving post-resuscitation myocardial function.

Objective To explore the determination of urinary angiotensinogen (uAGT) in the urine of children with obstructive hydronephrosis and its relationship with impaired renal function, to provide a new and rapid reference index for the preoperative evaluation and postoperative follow-up of the children with hydronephrosis.Methods The data were collected from 48 children who were diagnosed as unilateral congenital renal pelvis and ureter obstruction in the outpatient or inpatient Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University,which were divided into operation group and non-operation group.There were 28 children in operation group(who were all severe hydronephrosis) ,who were all operated with dismembered pyeloplasty.There were 20 children in the non-operation group (who were all mild and moderate hydronephrosis).They temporarily had no surgery signs and hydronephrosis did not become increasingly serious for assuring the regular outpatient follow-up after being diagnosed as hydronephrosis;there were 20 children in the control group, 10 of which were male, and 10 female.The males were hospitalized children with hydrocele and the females were with inguinal hernia.Gender composition among the 3 groups, and the average age difference was not statistically significant.The clean urina of children in 3 groups was collected,3 times for operation group, once before operation and once in 6 weeks and once in 12 weeks after operation;3 times for non-operation group and control group with interval of 6 weeks in outpatient clinic.The children in operation group and non-operation group were all scanned for glomerular filtration rate (GFR) of diseased renal with radionuclide;enzyme-linked immunosorbent assay (ELISA) was adopted to determine the content of uAGT in the urine of the 3 groups of children, and automatic biochemical analyzer was used to measure the amount of urine creatinine (uCr).Results Before operation, in 6 weeks and 12 weeks after operation, uAGT / uCr average water of non-operation group and control group was significantly lower than the operation group, all the differences were statistically significant (F =34.360,14.683,5.035, all P ＜ 0.05).Preoperative and postoperative uAGT / uCr and GFR of diseased renal were of negative correlation(r =-0.647,-0.786, all P ＜ 0.05).In operation group, the preoperative and postoperative GFR average of diseased renal was 37.18 ± 7.31 and 45.27 ± 8.18.The difference of GFR changes was statistically significant before and after treatment (t =-3.971, P =0.000).Conclusions uAGT/uCr increased evidently in congenital renal pelvis and ureter obstruction patients who needed operation, so increase of uAGT might be the indicator of impaired renal function caused by obstructive hydronephrosis of children.

Type 2 diabetes mellitus is a kind of chronic metabolic disease,accompanied by multiple organ damages and involving the skeletal system as well.Osteoporosis is the most likely bone lesions suffered by patients with type 2 diabetes.The study found that,type 2 diabetic patients,compared with the normal people,will suffer from fracture at high risk,due to the decreased of bone quality and the increased risk of falling.The decrease of bone quality are the result of the deterioration of bone architecture and the loss of bone mass.The abnormal gait as well as the impairment of cognitive and the muscle weakness of type 2 diabetes,especially for elderly patients,will reduce their balance ability and increase their risk of falling,lead to an increased prevalence of fractures.

BACKGROUND:Core decompression may provide insufficient support for the subchondral bone in the treatment of early avascular necrosis of the femoral head and increase the risk of fracture and colapse. Quadratus femoris implantation cannot only provide good biological support, but also promote the revascularization at necrotic regions, thus repairing the necrosis of femoral head. OBJECTIVE: To compare the clinical effects of core decompression with bone paste implantation and core decompression with quadratus femoris implantation on early and middle-stage avascular necrosis of the femoral head. METHODS:Eighty-three patients with early avascular necrosis of the femoral head (92 hips) admitted at the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, China, from January 2009 to January 2012 were enroled and divided into groups of core decompression with bone paste implantation (46 cases, 49 hips) and core decompression with quadratus femoris implantation (37 cases, 43 hips) that were respectively injected with bone meal and autogenous bone and osteoinductive materials. RESULTS AND CONCLUSION: Al involved patients were folowed up. After 1 year of treatment, Harris scores in the two groups were both increased (P < 0.05). But the Harris score of core decompression with bone paste implantation group was lower than that of core decompression with quadratus femoris implantation group (P < 0.05). After 3 years of treatment, X-ray scores in the core decompression with quadratus femoris implantation group were significantly higher than those in the core decompression with bone paste implantation group (P < 0.05). These findings indicate that compared with core decompression with bone paste implantation, core decompression with quadratus femoris implantation is better to prevent femoral head colapse, improve hip function and delay the process of osteonecrosis of the femoral head.

Exosomes are nanosized lipid vesicles released from cells .They are believed to contain proteins, lipids and nucleic acid cargos , and are capable of deliver their cargos to recipient cells , which in turn alter the expression of genes in neighboring cells .An increasing body of evidence indicates that they play a pivotal role in cell-to-cell communication , which is hijacked during various physiological and pathological conditions , such as myocardial damage , angiogenesis , cardiac remodeling and atherogenesis plaque formation .Further research of intercellular communication mediated by exosomes may potentially aid in the possible application of exosomes for biomarker discovery , curative effects , as well as prognosis of cardiovascular diseases , even the use of exosomes as a therapeutic drug delivery system on the basis of the exosome′s ability to target specific cells , and transfer genetic materials.

Objective Study the anti-tumor effects in vivo of AMH-D on S-180 cell lines, the synergistic effects of AMH-D and cyclophosphamide,and investigate the way and its strength of the effect. Provide the basis for the development of anti-cancer drug. Methods Kunming mice were transplanted with S-180 tumor cells subcutaneously in the right armpit. Intraperitoneal injection was done after randomization on the next day. Mice were killed on the eleventh day, and tumors were stripped and weighed. The tumor weight was used as indicator for analysis and evaluation. Results The results showed that AMH-D could effectively inhibit the growth of S180 cells transplanted tumor. The tumor inhibition rate was 50.45%at the dose of 150 mg/kg, with a dose-effect relationship. There were no obvious impacts on the growth of the weight of mice. The results showed that AMH-D had a synergistic effect combined with cyclophosphamide within a certain dose. Conclusion Fungus extract AMH-D has a great effect on anti-tumor in vivo of S180 cells transplanted tumor, and has a synergistic effect combined with cyclophosphamide within a certain dose.