Adult ; Biopsy, Needle ; Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Diseases ; pathology ; therapy ; Male ; Nephritis, Interstitial ; pathology ; Renal Dialysis ; Sarcoidosis ; pathology ; therapy ; Tuberculosis, Renal ; pathology

Objective To evaluate the clinical effect of edaravone injection on patients with early cerebral ischemia (ECI) after clipping of intracranial aneurysm.Methods Seventy-eight patients with intracranial aneurysms were randomly divided into control group and treatment group,with 39 cases in each group.Patients in two groups were given the treatments of high blood volume,high perfusion pressure,blood dilution and others.On the basis of control group,treatment group was intravenously dripped edaravone 30 g mixed in 0.9％ NaCl 100 mL,finished within 30 min.Control group was intravenously dripped 0.9％ NaCl 100 mL.The treatment was lasted for 14 d.The neurological function recovery and prognosis of two groups were compared.Results After treatment,the neurologic function defect (NFD) scores in treatment and control groups were (7.36 ± 5.42),(10.71 ± 4.39) points (P ＜ 0.05).Barthel scores in treatment and control groups were (49.20 ± 13.32),(37.58 ± 11.46) points (P ＜0.05).The blood flow velocity in brain and incidence of cerebral vasospasm (CVS) in treatment group were (95.38 ± 19.60)cm · s-1,12.82％ (5/39 cases).In control group,blood flow velocity in brain and incidence of CVS were (118.25 ± 17.94)cm · s-1,33.33％ (13/39 cases).There was significant difference between the two groups (P ＜ 0.05).The Glasgow outcome score (GOS) of 5 points in treatment group was 79.49％ (31/39 cases),had significant difference with that in control group,which was 58.97％ (23/39 cases,P ＜ 0.05).Serum super oxide dismutase (SOD),nitric oxide (NO) and malonaldehyde (MDA) in treatment group were (93.26 ± 13.71) U · mL-1,(5.29 ±0.53) nmol · mL-1 and (63.29 ± 10.58) mol · L-1 after treatment.Cerebrospinal fluid SOD,NO and MDA in treatment group were (61.34 ±4.26) U · mL-1,(4.40 ± 0.25) nmol · mL-1 and (1.83 ± 0.37) mol · L-1 after treatment.Serum SOD,NO and MDA in control group were (80.20 ± 11.59) U · mL-1,(6.74 ±0.32) nmol · mL-1 and (50.91 ±9.37) mol · L-1 after treatment.Cerebrospinal fluid SOD,NO and MDA in control group were (54.29 ± 6.64) U · mL-1,(5.12 ± 0.83) nmol · mL-1 and (1.50 ± 0.24) mol · L-1 after treatment.There was significant difference between the two groups (P ＜ 0.05).There were no obvious adverse drug reactions in two groups.Conclusion The scavenging effect of edaravone on oxygen free radical in serum and cerebrospinal fluid could significantly reduce cerebral artery blood flow and CVS incidence in patients with ECI after clipping of intracranial aneurysm.

Leukoaraiosis (LA) manifests as cerebral white matter hyperintensities on T2-weighted magnetic resonance imaging scans and corresponds to white matter lesions or abnormalities in brain tissue. Clinically, it is generally detected in the early 40s and is highly prevalent globally in individuals aged >60 years. From the imaging perspective, LA can present as several heterogeneous forms, including punctate and patchy lesions in deep or subcortical white matter; lesions with periventricular caps, a pencil-thin lining, and smooth halo; as well as irregular lesions, which are not always benign. Given its potential of having deleterious effects on normal brain function and the resulting increase in public health burden, considerable effort has been focused on investigating the associations between various risk factors and LA risk, and developing its associated clinical interventions. However, study results have been inconsistent, most likely due to potential differences in study designs, neuroimaging methods, and sample sizes as well as the inherent neuroimaging heterogeneity and multi-factorial nature of LA. In this article, we provided an overview of LA and summarized the current knowledge regarding its epidemiology, neuroimaging classification, pathological characteristics, risk factors, and potential intervention strategies.

OBJECTIVETo evaluate and compare the diagnostic value in atlantoaxial subluxation by CT three-dimensional (3D) reconstruction.

METHODS3D reconstruction findings of 41 patients with atlantoaxial subluxation were retrospectively analyzed, and comparisons were made among images of transverse section, multiplanar reformorting (MPR), surface shade display (SSD), maximum intensity project (MIP), and volume rendering (VR).

RESULTSOf 41 patients with atlantoaxial subluxation, 31 belonged to rotary dislocation, 5 antedislocation, and 5 hind dislocation. All the cases showed the dislocated joint panel of atlantoaxial articulation. Fifteen cases showed deviation of the odontoid process and 8 cases widened distance between the dens and anterior arch of the atlas. The dislocated joint panel of atlantoaxial articulation was more clearly seen with SSD-3D imaging than any other methods.

CONCLUSIONSAtlantoaxial subluxation can well be diagnosed by CT 3D reconstruction, in which SSD-3D imaging is optimal.

Adolescent ; Adult ; Aged ; Atlanto-Axial Joint ; injuries ; Child ; Female ; Humans ; Imaging, Three-Dimensional ; Joint Dislocations ; diagnostic imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

BACKGROUNDThe vertebral artery (VA) and atlantoaxial joint (AAJ), with complicated structures, are located in the depths of the head-neck boundary area, the regional anatomy of which cannot be shown globally and directly. This study aims to evaluate three-dimensional CT angiography (3DCTA) in displaying the AAJ, atlantoaxial segment of the vertebral artery (ASVA) and the identification of their interrelations.

METHODSSixty-eight subjects without pathology of the ASVA and AAJ were selected from head-neck CTA examination. All the 3D images were formed with volume rendering (VR) together with techniques of separating, fusing, opacifying and false-coloring (SFOF). On the 3D images, the ASVA and AAJ were observed, and their interrelations were measured.

RESULTSAll the 3DCTA images were of high quality and up to our requirements. They could clearly and directly show the ASVA, ascending along the AAJ. There were 5 curves in the course of the ASVA, of which 2 curves were away from the atlantoaxial joint, one in the 2nd curve of 0.0 mm - 5.4 mm, the other in the 4th of 2.6 mm - 9.2 mm. There was no significant difference in the measurements between left and right (P > 0.05). The curved parts of the ASVA slightly expanded, with the biggest diameter of 5.6 mm in the 4th curve. Statistical comparison shows that the left ASVA is larger than the right (P < 0.05). Variations of the ASVA were found in 8 cases and of the AAJ in 12.

CONCLUSIONS3DCTA can globally and directly demonstrate the structures of the AAJ, ASVA and their interrelations. The 3D imaging data make up and enrich the research contents of regional anatomy and lay the foundation for related study and applications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Atlanto-Axial Joint ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods ; Vertebral Artery ; diagnostic imaging ; Young Adult

BACKGROUNDIt is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD). Coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and revascularization. In this study, short-term result of CE combined with coronary artery bypass graft (CABG) was discussed in the treatment for the diffused CAD.

METHODSFrom January 2012 to April 2014, 221 cases of CABG were performed by the same surgeon in our unit. Among these cases, 38 cases of CE + CABG were performed, which was about 17.2% (38/221) of the cohort. All these patients were divided into two groups: CE + CABG group (Group A) and CABG alone group (Group B). All clinical data were compared between the two groups, and postoperative complications and in-hospital mortality were analyzed. The categorical and continuous variables were analyzed by Chi-square test and Student's t-test respectively.

RESULTSDiabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease were more common in group A. In this cohort, a total of 50 vessels were endarterectomized. Among them, CE was performed on left anterior descending artery in 11 cases, on right coronary artery in 29 cases, on diagonal artery in 3 cases, on intermediate artery in 2 cases, on obtuse marginal artery in 5 cases. There was no hospital mortality in both groups. The intro-aortic balloon pump was required in 3 cases in Group A (3/38), which was more often than that in Group B (3/183). At the time of follow-up, coronary computed tomography angiogram showed all the grafts with CE were patent (50/50). There is no cardio-related mortality in both groups. All these patients were free from coronary re-intervention.

CONCLUSIONSCoronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.

Aged ; Coronary Artery Bypass ; adverse effects ; methods ; Coronary Artery Disease ; surgery ; Endarterectomy ; methods ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; surgery ; Postoperative Complications ; Treatment Outcome

Objective To construct RhoA siRNA plasmid expression vector.Methods According to the computer aided design,RhoA-specific siRNA gene was synthesized and cloned into the RNAi-Ready Pgenesil-1 Vector.The constructed RhoA-RNAi plasmid were transfected into human HEPG2 cell.Western blot was used to detect the effect of RhoA-RNAi plasmid.Results The recombinant was cloned and the se- quence was obtained.RhoA-RNAi plasmid can down-regulate the expression of RhoA in human hepatocel- lular carcinoma cell line HEPG2.Conclusion Successfully cloning the recombinant makes it possible for searching new mechanism of RhoA in hepatocellular carcinoma.

Objective To explore regional variations of basic public health services implementation in Zhejiang Province at prefectural,county and township level,respectively.To find key problems which obstacle the equalization of basic public health services in Zhejiang Province.Methods Descriptive analysis was made on surveillance data of basic public health services in Zhejiang Province,2014.Gini coefficient of key indicators was calculated at prefectural,county and township level,respectively.To the key indicator with higher Gini coefficient,Lorenz curve was plotted and Gini coefficient of each prefectural-level city was calculated.Results An increasing tendency from prefectural to township level was showed in Gini coefficient of all twenty-five analyzed indicators.The Gini coefficient at township level was 0.497 for the average financial fund per migrant person,and the highest prefectural -level cities were Taizhou (0.709 ),Lishui (0.838 ), Quzhou(0.918).The Gini coefficient at township level of other indicators were 0.314 and 0.235 for the children and elderly health management of traditional Chinese medicine,and lower than 0.05 for maternal &children health care, immunization,and coverage rate of electronic health record,and between 0.066 to 0.179 for health management of chronic disease and severe mental illness patients.Conclusion Average financial fund per migrant person and health management of traditional Chinese medicine are current major problems which obstacle the equalization of basic public health services in Zhejiang Province.

OBJECTIVETo study the characteristics histologic and cytologic features and clinical usefulness of plasma cell myeloma (PCM) subtyping according to WHO PCM classification.

METHODSBone marrow biopsy plastic-embedded sections were stained with H-G-E and Gomori's stains, and bone marrow aspirate smears were stained with Wright's stain. The clinicopathologic findings were then analyzed.

RESULTSOf the 131 cases with PCM, three types of growth patterns were noted: interstitial (21 cases, 16.0%), nodular (46 cases, 35.1%) and packed (64 cases, 48.9%). Besides, there were three cytologic subtypes: mature plasma cell type (43 cases, 32.8%), immature (81 cases, 61.8%) and pleomorphic (7 cases, 5.3%) types. The age of patients with mature plasma cell type was significantly higher than that of immature type (P = 0.005); and the number of tumour cells in bone marrow smears was significantly higher than that of immature type (P = 0.003). The numbers of WBC and platelets in peripheral blood were also significantly higher than that of pleomorphic type (P = 0.024, P = 0.002, respectively). On the other hand, the number of platelets in peripheral blood of immature type was significantly higher than that of pleomorphic type (P = 0.019). Marrow fibrosis was more frequently observed in immature type than in mature plasma cell type (P = 0.000). The incidence of marrow fibrosis and osteolytic lesions was higher in high risk group than in low risk group (P = 0.000, P = 0.023 respectively). Twenty-one cases (56.8%) of the 37 cases treated with MP or MP and M2 chemotherapeutic regimens showed good response. However, there was no significant difference in treatment response and survival between different subtypes.

CONCLUSIONSEach subtype of PCM carries different clinicopathologic features in some aspects. The classification carries important value in pathologic diagnosis and probably in predicting prognosis.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Bone Marrow Examination ; Female ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Multiple Myeloma ; classification ; immunology ; pathology ; Prognosis

OBJECTIVETo investigate the frequencies of chemokine (C-C motif) receptor 5 gene (CCR5)Δ32 deletional mutation of in Han and Dai populations from Yunnan province. Immortalized cell lines were derived from a family carrying the CCR5Δ32 mutation.

METHODSBlood samples of 346 Han and 355 Dai individuals were collected for genotyping. The coding regions of CCR5 gene were amplified with PCR followed by agarose gel electrophoresis. Suspected mutations were verified with DNA sequencing. Immortalized cell lines were constructed by using Epstain Barr virus and cyclosporine A. The difference between the cell lines and original blood samples was verified with PCR.

RESULTSOne ethnic Han individual was confirmed to be heterozygous for a deletional mutation by sequencing, which has led to discovery of a family with CCR5Δ32. Nine immortalized cell lines were established from this family, and no difference between the cell lines and original blood samples was detected by PCR.

CONCLUSIONTogether with previous reports, this study has indicated a significant difference in CCR5Δ32 among different ethnic groups in China. Established immortalized cell lines can also provide material for future research.

Base Sequence ; China ; Ethnic Groups ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Receptors, CCR5 ; genetics ; Sequence Deletion