Objective To assessed the image quality and diagnostic value of the coronary artery diseases with 64-slice spiral computed tomography (64-SCT) angiography. Methods A retrospective image analysis of 39 patients who were diagnosed with coronary heart disease by both the 64-SCT and the invasive coronary angiography (CAG). Results In 507 coronary artery segments (13 coronary segments for each patient),1-,2-,3-class image quality by 64-SCT were in 185 (36.5%),236 (46.5%),86 (16.9%) segments respectively,and the heart rate range was respectively 62?5,66?4 and 75?10 per minute. Totally 421/507 (83.1%) segments that were of 1-,2-class image quality,met the requirements of clinical diagnosis,whereas 86/507 (16.9%) segments could not be sufficiently evaluated because of severe calcifications (51/86,59.3%) and/or motion artifacts (35/86,40.7%). Taking CAG as the gold standard diagnostic technique for coronary heart disease,of the lesions≥50% stenosis by 64-SCT (without any exclusion criteria),the overall sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 89.8%,94.9%,93.3%,88.5%,95.5%,respectively. Conclusion Our results indicate high diagnostic accuracy of coronary artery disease by 64-SCT compared to CAG. 64-SCT is a simple,convenient,safe and reliable,non-invasive effective method for diagnosis of coronary heart disease.

Objective To observe the anatomy status of the anterior clinoid process (ACP)and the anterior clinoid segment of in-ternal carotid artery (ICA)respectively by multisliced computed tomography (MSCT),and to provide useful imaging information for ACP removal surgery.Methods A total of 100 patients (200 sides)had volume rendering reconstruction of skull.Cranium was removed along cranio-orbital bone in simulation.Then the anatomical structures of the ACP and its surrounding were observed in cephalad direction.The total length,medium length,basic width,medium width of the ACP and the sagittal view curve length of anterior clinoid segment of the ICA from both sides were measured.Results Total length of left ACP was (9.82±2.48)mm,basal width was (9.47±1.88)mm,medium length was (5.03±1.55)mm,medium width was (6.1 9 ±1.75)mm;for right side total length was (10.41±2.1 6)mm,basal width was (9.66 ±2.21)mm,medium length was (5.86 ±2.48)mm,medium width was (6.66±1.5 1)mm.Left anterior clinoid segment of ICA curve length was (6.74±2.25)mm;right was (8.54±3.00)mm.Paired sample t test showed no significant difference in total length,basal width and medium width of ACP in both sides (P >0.05);while the difference in medium length and curve length of the anterior clinoid segment of ICA were statistically significant respectively (P <0.05).Conclusion MSCT can clearly display the vivisection and variation status of the ACP and the anterior clinoid segment of the ICA and can provide useful imaging information for removal of ACP in operation.

Purpose To study the exposure extent of internal carotid artery siphon (ICAS) before and after removing anterior clinoid process (ACP) using multislice spiral CT (MSCT) simulation, and to improve the tumor resection rate and ensure the operation effect. Materials and Methods MSCT three-dimensional images reconstruction simulating supraorbital keyhole approach of 100 patients (200 sides) were observed, the distance between the crotch of anterior cerebral artery and middle cerebral artery and ICAS before and after removing ACP (exposure extent) was measured. Results In 100 patients (200 sides ACP), the exposure extent before and after removing ACP were (14.3±3.9) mm and (30.5±4.2) mm, respectively on the left side with statistical difference (t=45.278, P<0.001), and were (15.9±3.8) mm and (31.8±3.9) mm, respectively on the right side with statistical difference (t=40.513, P<0.001). The exposure extent increased (16.3±3.6) mm and (15.8±3.9) mm, respectively on the left and right side with no statistical difference (t=0.251, P>0.05). Conclusion MSCT simulating supraorbital keyhole approach in removing ACP can effectively increase the exposure length of ICA, and enlarge the exposure extent of sella region, thus provide reliable imaging information for removing tumor and selecting surgical project in this region.

OBJECTIVETo investigate the nephrotoxic effects of methyl cantharidimide tablets on urinary protein and enzymes in Beagle dogs.

METHODBeagle dogs were randomly divided into negative control group(blank tablet), methyl cantharidimide tablets group (6.11,12.21, 24.42 mg x kg(-1)), continuously 30 days of oral adminiStration, once a day. The drug and control group were collected and determined fresh urine in 1, 2, 3 and 4 weeks of the administration; Serum urea nitrogen (BUN), creatinine (Crea), total protein (TP) and albumin (ALB) as well as sodium, potassium, chloride electrolyte were determined on 15 and 30 days of the administration; Urine albumin (mAlb), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin( NGAL), N-acetyl-beta-D-glucosaminidase (NAG), clusterin, beta2-microglobulin (beta2-MG), alpha1-microglobulin (alpha1-MG), alanine aminopeptidase( AAP) and im- munoglobulins IgG were tested on 15 and 30 days of the administration.

RESULTCompared with the control group, urine protein and white blood cells was significantly increased in each dose group. On 15 days of the administration, mAlb were higher in each dose group, KIM-1, NGAL, clusterin, NAG and AAP were significantly higher in high-dose group, while the middle and low dose group had no significant difference, as well as blood SCr and BUN no obvious abnormalities. On 30 days, mAlb, KIM-1, clusterin, NAG, AAP were increased in each dose group, appearing dose-effect relationship, beta2-MG and NGAL levels were significantly increased in high-dose group. Contents above indicators were increased with significant dose and time relationship, and serum BUN, Scr were correlated, suggesting that urine mAlb, KIM-1, clusterin, NAG and AAP indicators that can sensitively respond the changes of proteins and enzymes in urine.

CONCLUSIONMethyl cantharidimide tablets has a renal toxicity, urine mAlb, KIM-1, clusterin, NAG and AAP can be used as the early nephrotoxic biomarkers of methyl cantharidimide tablets.

Animals ; Biomarkers ; urine ; Dogs ; Female ; Kidney ; drug effects ; Kidney Diseases ; chemically induced ; Male ; Proteins ; metabolism ; Tablets ; adverse effects ; Urine ; chemistry

Objective To explore whether the expression level of heparanase (HPA) and its coagulation proteins on leukemic blast membrane could determine the hemostatic balance on the surface of leukemia cells.Methods Forty patients of leukemia were studied,and 20 patients with iron dificient anemia as the control group.Expression of tissue factor (TF),heparanase (HPA),tissue factor pathway inhibitor (TFPI),and urokinase plasminogen activator receptor (UPAR) on leukemic blast surfaces were analyzed by flowcytometry.Results The expression of TF,UPAR,and HPA in AML,ALL,CML,CLL and CRAL groups were significantly higher compared with the control group (t =.3.289,3.507,2.701,P ＜0.05; t =2.498,0.802,3.090,P ＜0.05; t =2.642,3.308,2.696,P ＜0.05; t =3.417,3.434,2.382,P ＜0.05; t =2.193,2.272,2.263,P ＜0.05).There were no significantly differences between the leukemic cell expression of TFPI and the control group (P ＞0.05).Expression of TF,UPAR,HPA in AML patients were significantly higher than ALL,CML and CLL groups (t =2.463,2.179,2.276,P ＜0.05; t =2.637,2.402,2.095,P ＜0.05; t =2.548,2.425,2.412,P ＜0.05).The levels of TF,UPAR and HPA in M3,M4 and M5 patients were higher than that of M1,M2 groups (P ＜0.05).There were no significantly differences among M3,M4 and M5 (P ＞0.05).Conclusions These results suggest that TF,UPAR and HPA are predominately expressed on leukemic blast surface,particularly in M3and M4,5 subtypes.The expression of coagulation proteins on blast membrane might determine the hemostatic balance on the surface of leukemia cells.

White-rot fungus manganese peroxidase (MnP) oxidizes a wide range of substrates, rendering it an interesting enzyme for potential applications. The stability of MnP can be improved by immobilization. With sodium alginate, gelatin, or chitosan as a carrier, and glutaraldehyde as the crosslinking agent, MnP was co-immobilized using the embed-crosslinked method and the adsorb-crosslinked method. The immobilization conditions and the partial properties of the three immobilized enzymes were investigated. When compared with the free enzyme, the optimum pH values and the temperatures of the three immobilized MnPs carried by alginate, gelatin, and chitosan were respectively shifted from 7.0 to 5.0, 5.0, 3.0 and from 35 degrees C to 75 degrees C , 55 degrees , 75 degrees C . The thermostabilities of the three immobilized MnPs were considerably better than that of the native enzyme. The chitosan-decreased by less than 5% even after repeated use for 6 - 9 times. The ability of decolorizing azo dyes in static and shaky situation by gelatin-immobilized MnP approached to the free enzyme, and there was no loss of enzyme activity during 2 repeated batch reactions.
Adsorption ; Alginates ; chemistry ; metabolism ; Biocatalysis ; drug effects ; Chitosan ; chemistry ; metabolism ; Dose-Response Relationship, Drug ; Enzymes, Immobilized ; chemistry ; metabolism ; Fungal Proteins ; chemistry ; metabolism ; Gelatin ; chemistry ; metabolism ; Glucuronic Acid ; chemistry ; metabolism ; Glutaral ; pharmacology ; Hexuronic Acids ; chemistry ; metabolism ; Hydrogen-Ion Concentration ; Kinetics ; Peroxidases ; chemistry ; metabolism ; Schizophyllum ; enzymology ; Substrate Specificity ; Temperature

OBJECTIVETo evaluate the clinical value of MDCT and MRI in the diagnosis and treatment of complex fractures of tibial plateau.

METHODSFrom March 2004 to January 2009,71 patients with complex fractures of tibial plateau estimated Schatzker III, V and VI were included in the study. Their X-ray films, MDCT, MRI were analyzed and compared. Twenty-four patients (14 males and 10 females with a mean age of 33.6 years) were treated with double incision and single plate. Average follow-up period was 31.4 months. Twenty-one patients (12 males and 9 females with a mean age of 33.2 years) were treated with double incision and bilateral plates. Average follow-up period was 28.4 months. Twenty-six patients (17 males and 9 females with a mean age of 35.3 years) were treated with bilateral plates via genicular anterior midline incision. Average follow-up period was 28.4 months. The index such as diagnosis correction for fracture location, fracture comminuted degree,fracture displacement degree,bone defect degree,and positive ration for number of collapsed joint surface,injuries of cruciate ligament, collateral ligament and menisci of knee joint.

RESULTSThe satisfaction score of X-ray flims, MDCT and MRI were (1.04 +/- 0.20), (1.82 +/- 0.38) and (1.12 +/- 0.33) separately for fracture positions; (0.81 +/- 0.51), (1.92 +/- 0.26) and (0.83 +/- 0.60) separately for fractures comminuted degree; (1.23 +/- 0.48), (1.92 +/- 0.26) and (0.46 +/- 0.58) separately for fracture displacement degree; (0.36 +/- 0.51), (1.55 +/- 0.79) and (0.26 +/- 0.53) separately for bone defect; the number of patients having collapse of tibial articular surface were 6,61 and 12 separately; the number of patients having cruciate ligaments were 3,10 and 17 separately; the number of patients having menisci injuries were 0,0 and 6 separately;the number of patients having collateral ligament injuries were 1, 1 and 8 separately. MDCT was the most sensitive method in the diagnosis of tibial articular surface collapse,avulsion tibial fracture at the point of cruciate ligament,fracture comminuted degree and fracture displacement degree (P < 0.01). MRI was the most sensitive method in the diagnosis of injuries of cruciate ligament, collateral ligament, menisci, the cartilage peeling of articular surface (P < 0.01).

CONCLUSIONMDCT and MRI further detail the Schatzker classification based on X-ray films, which also conduce to make precise diagnosis and reasonable treatments. MDCT and MRI are more sensitive for the diagnosis of insidious damages around knee.

Adult ; Case-Control Studies ; Diagnostic Techniques and Procedures ; Female ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Tibia ; diagnostic imaging ; injuries ; Tibial Fractures ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVETo explore optimal choice of surgical treatment and operative approach for closed complex tibial plateau fractures and its influencing factors.

METHODSFrom January 2003 to January 2011, 95 patients with closed complex tibial plateau fractures were estimated Schatzker V and Vl, and treated with three different surgical methods. The methods included single plate through anterolateral incision (Group A, 22 cases), double plates through inside and outside incisions (Group B, 36 cases), and double plates through antero-midline incisions (Group C, 37 cases). There were 56 males and 39 females, ranged the age from 19 to 57 years (averaged, 36.3 years), 50 cases in left, 45 cases in right. According to Schatzker classification, 51 cases were type V, 44 cases were VI. The data of operation time, intraoperative blood loss, complications (infectious of wound, necrosis, bad incision, collapse fracture, loosen of internal fixation, fracture failure)and recovery of function of lower limb joint were collected.

RESULTSThere were no significant difference among three groups in operation time (P > 0.05); blood loss in group A was obvious better than other groups (P < 0.05); collapse of joint surface and failure rate of internal fixation in group A was higher than other groups (P > 0.05); Merchant score after 1 year were higher in group B, C than group A. For lower limb function, 10 cases got excellent results, 5 good, 4 fair and 3 poor in group A; 21 cases got excellent results, 11 good, 3 fair and 1 poor in group B; 23 cases got excellent results, 11 good,2 fair and 1 poor in group C.

CONCLUSIONThe blood loss in group A was least, but fracture exposure and joint surface was not satisfactory, and stable fixation could not be achieved, the long-term result was not good. For fractures with double condyles and dislocated involved, double plates through inside and outside incisions or double plates through antero-midline incisions was suggested,which benefit good reduction of joint surface, stable fixation, and erlier exercise.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation ; adverse effects ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

The objective of this study was to investigate the effect of cyclooxygenase-2 (COX-2) in the angiogenesis of bone marrow in leukemia patients. 51 patients with newly diagnosed acute leukemia were taken as study objects, 18 healthy volunteers were enrolled in the control group. Bone marrow microvessel density (MVD) in bone marrow biopsy tissue section was determined with immunohistochemistry method, the vascular endothelial growth factor level in serum was detected with ELISA method and the expression of cyclooxygenase-2 in bone marrow cells was assayed by flow cytometry. The results showed that the MVD, VEGF level, positive rate of COX-2 expression in leukemia group all obviously increased as compared with the control group (p < 0.05). The correlative coefficients of MVD, VEGF level and COX-2 expression rate were 0.614, 0.423 and 0.577 respectively (p < 0.05). In conclusion, as well as solid tumors, leukemia may be also a angiogenesis-dependent malignant tumor. Coordination of COX-2 with VEGF may promote angiogenesis in bone marrow.
Adolescent ; Adult ; Aged ; Bone Marrow Cells ; metabolism ; pathology ; Case-Control Studies ; Child ; Child, Preschool ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Infant ; Leukemia ; metabolism ; pathology ; Male ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult