Objective To evaluate the diagnostic value of MRI in brachial plexus injury.Methods Total 98 patients with brachial plexus injury were examined by MRI before operation.Fifty-four of 98 patients MR imaging were obtained by 0.5 Tesla scanner and other 44 patients were obtained by 1.5 Tesla scanner.The scanning sequences include: SE T_1WI,T_2WI,FFE T_2WI and T_2WI SPIR. Exploration of the supraclavicular plexus was carried out and the MR imaging were compared with the operative finding in 63 patients.Thirty-five patients who had not surgery were followed-up.Results MR imaging found pre-ganglionic injuries in 45 patients and post-ganglionic injuries in 56 patients.Pre-and post-ganglionic injuries simultaneously in 16 patients among them.MR imaging can not find injury sings in 13 patients.The positive rate was 86.73%.MR imaging finding of pre-ganglionic injuries include:(1) Spinal cord edema and hemorrhage,2 patients (4.44% ).(2)Displacement of spinal cord,17 patients (37.78%).(3)Traumatic meningoceles,37 patients (82.22%).(4)Absence of roots in spinal canal, 25 patients(55.56% ).(5)Scarring in the spinal cnanl,24 patients (53.33%).(6)Denervation of erector spine,13 patients (28.89%).MR imaging finding of post-ganglionic injuries include:(1)Trunk thickening with hypointensities in T_2WI,23 patients (41.07%).(2)Nerve trunk complete loss of continuity with disappeared of nerve structure,16 patients (28.57%).(3)Continuity of nerve trunk was well with disappearance of nerve structure,14 patients(25.00%).(4)Traumatic neurofibroma,3 patients (5.36%).Conclusion MR imaging can reveal Pre-and post-ganglionic injuries of brachial plexus simultaneously.MR imaging is able to determine the location (pre-or post-ganglionic)and extent of brachial plexus injury,provided important information for treatment method selection.

Objective To improve recognition and imaging diagnosis of aneurysmal bone cyst secondary to a giant cell tumor.Methods To collect the dates of 12 patients with aneurysmal bone cyst secondary to a giant cell tumor were proved by operation and pathology from January 2003 to October 2006. Analyzed and summarized their imaging manifestations and correlation with pathohistology.Results Six lesions were located in epiphysis and metaphysic regions of long bone.Six lesions were located in pelvis.All cases showed a cystic lesion with expanded and osteolytic,eccentric 10 cases and centric 2 cases.Four cases display trabeculate,the margin is well define with a rim of bone sclerosis in 2 cases.Magnetic resonance imaging(MRI)scans were available in 10 patients.All case showed cystic,dilated lesions with solid areas. Eight cases manifested single or multitude solid nodules in big cystic wall.Two cases appeared solid masses with multitude cysts.The sign of multitude fluid-fluid level,best seen on T_2-weighted images,was present in all patients.Seven cases emerged soft-tissue masses.MR found indicative of large amounts of hemosiderin in one cases.Eight cases were examined by spiral CT with plain scanning and enhancement scanning. Reconstructed image were CTA and 3D-MPR(three dimensions multiplanar reconstruction)imaging.All cases showed cystic,dilated lesions with solid areas.The sign of multitude fluid-fluid level was present in 6 patients.The solid areas and cystic-wall of lesions showed contrast enhancement in 8 patients.3D-MPR imaging showed supply blood vessel of tumors in 3 cases.Arteriovenous malformation did not found in all patients.The surgeons'operative findings and the gross specimens were studied in all patients.All lesions were composed of solid areas and cystic areas.The diagnosis of pathology were ABC with GCT(grade Ⅱ)in 10 cases and ABC with GCT(grade Ⅲ).Conclusion Aneurysmai bone cyst secondary to a giant cell tumor is not rare.Adequately recognizing the pathologic basis of ABC,and selecting imaging techniques correctly (X-ray and MRI,or X-ray and CT)is especially important to diagnose a giant-cell tumor with secondary aneurysmai bone cyst.When an eccentric,expanded,lytic tumor with a cystic-solid lesion in epiphysis of long bone or pelvis shows multiple fluid levels,a giant-cell tumor with secondary aneurysmai bone cyst components should be sufficiently considered.

OBJECTIVETo evaluate the feasibility and efficacy of a new MRI imaging method--diffusion weighted imaging (DWI) with short TI version recovery-echo planar imaging (STIR-EPI) sequence in differentiating benign cervical lymph nodes from malignant ones. METHODS Twenty nasopharyngeal carcinoma patients and fourteen volunteers received both conventional MRI and DWI with STIR-EPI. Ability of detecting lymph nodes between conventional MRI and STIR-EPI-DWI was compared, and the difference of apparent diffusion coefficient (ADC) value between metastatic lymph node and normal lymph node was analyzed.

RESULTSDWI was more sensitive in detecting lymph node than conventional MRI. ADC value of metastatic lymph node (0. 766 +/- 0. 119) x 10 (-3) mm(2)/s was significantly lower than that of normal lymph node (0. 975 +/- 0. 179) x 10 - mm2/s (P < 0. 01).

CONCLUSIONAs a new MRI imaging technique in detecting cervical lymph nodes, diffusion weighted imaging ( DWI) with short TI version recovery-echo planar imaging ( STIR-EPI) sequence is more reliable and sensitive than conventional MRI imaging, providing an alternative way to differentiate benign lymph nodes from malignant ones.

Adult ; Aged ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Echo-Planar Imaging ; methods ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; Neck ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVETo investigate whether the fetal immune tolerance induction could replace the HLA typing for hematopoietic stem cell transplantation.

METHODSImmune tolerance of SD rats was induced by injecting host Wistar rats peripheral blood mononuclear cells into yolk sac of the embryo, afterward the mature male offsprings were used as donor. The host female recipients received lethal dose irradiation and bone marrow transplantation(BMT). The Wistar rats transplanted with bone marrow from donor and unrelated SD rats as well as the rats which received radiation alone were used as control. The survival, histopathologically GVHD, the mental status, food and water intake, coat characteristics, activities were observed. Forty days after BMT, autologous and allogenous skin transplantation between donor and recipient rats was performed to observe the engraftment of solid organ.

RESULTSThe survival of the rats received bone marrow grafts from the immune tolerant donor was significantly longer than that of control groups (30 day survival rates were 86.7%, 6.7%, 0%, and 0% respectively), and there was no histopathologically GVHD observed, while in the sham group, the manifestations of GVHD was clearly visible. The skin engraftment rate between the host and the immune tolerant donor was significantly higher than that among non-related rats (84.6% and 0% respectively).

CONCLUSIONThe induction of immune tolerance in embryo can overcome the HLA barrier and provide a good donor for hematopoietic stem cell and solid organ transplantation.

Animals ; Embryo, Mammalian ; immunology ; Female ; Graft vs Host Disease ; immunology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Immunosuppression ; Male ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Transplantation Chimera

AIM:To understand the clinic effect of intravitreal anti-vascular endothelial growth factor(VEGF) drugs injection in the treatment of fundus disease in the real-world study (RWS).METHODS:The clinical cases treated with anti-VEGF drugs in our department from September 2012 to June 2015 were enrolled in this study.Retrospective investigation was reviewed to the kinds of diseases, frequency, usage, efficacy, adverse reaction, and the effects on visual acuity, fundus and macular thickness which were treated with intravitreal anti-VEGF drugs injection.RESULTS:In 305 patients (340 eyes) treated with anti-VEGF drugs, 53 patients (60 eyes, 17.6%) were wet age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) 16 cases (18 eyes, 5.3%), diabetic macular edema (DME) 120 cases (134 eyes, 39.4%), branch retinal vein occlusion (BRVO) secondary macular edema 61 cases (68 eyes, 20.0%), central retinal vein occlusion (CRVO) secondary macular edema 29 cases (32 eyes, 9.4%), idiopathic choroidal neovascularization (ICNV) 16 cases (18 eyes, 5.3%), high myopia with choroid neovascularization 4 cases (4 eyes, 1.2%), neovascular glaucoma 4 cases (4 eyes, 1.2%), retinal angiomatous proliferation (RAP) 1 cases (1 eyes, 0.2%) and optic papillary neovascularization 1 cases (1 eyes, 0.2%).The minimum age was 16 years old, and the maximum age 90 years old.There were 247 cases (275 eyes, 80.9%) were treated with intravitreal ranibizumab injection, 58 cases (65 eyes, 19.1%) intravitreal conbercept injection.The time number of all patients accepted anti-VEGF drugs treatment was 465, with an average of 1.7 times per eye.Which, the 3 + PRN treatment method in 98 patients (109 eyes, 32.1%), 1 + PRN treatment in 207 patients (231 eyes, 67.9%).69 cases (77 eyes, 22.6%) were used alone to receive anti-VEGF drugs therapy, 10 cases (11 eyes, 3.2%) combined with intravitreal triamcinolone injection(TA), 35 cases (39 eyes, 11.5%) combined with vitrectomy, 26 cases (29 eyes, 8.5%) combined with photodynamic treatment (PDT), 165 cases (184 eyes, 54.1%) combined with simple laser treatment.After anti-VEGF drug treatment, majority of patients' the best corrected visual acuity (BCVA), fundus and central macular thickness(CMT) were significantly improved, compared with the pre-treatment, the difference is significant (P<0.05).So that anti-VEGF drugs can effectively improve visual function and ocular fundus for fundus diseses.There were no serious adverse reactions except 3 patients appearling skin redness, itching, rash, 1 patient low low-grade fever and 1 patient acute cerebral infarction during the treatment.CONCLUSION:Intravitreal anti-VEGF drugs injection can significantly improve the visual function and ocular fundus for patients with fundus diseases, but there are still some adverse events, which should be attached great importance to medical workers.

Objective To observe the efficacy and safety of PEG-interferon α-2a(PEG-IFNα-2a)treatment on lamivudine(LAM)-resistant chronic hepatitis B (CHB)patients.Methods Eighty-one patients with lamivudine-resistant HBeAg (+) chronic hepatitis B patients were enrolled and divided into PEG-IFNα-2a treatment group(40 cases) and adefovir dipivoxil (ADV) control group (41 cases).Two groups were combined with LAM in the first 12 weeks(W).The ALT normalization rate,the HBV DNA and HBeAg negative rate,and the HBeAg seroconversion rate were observed in 12 W,24 W,48 W.Results The ALT normalization rate in 12 W,24 W of PEG-IFNα-2a group was 62.5%and 80.0%.AND it was higher than that of ADV group.The HBeAg negative rate and HBeAg seroconversion rate in 48 W of PEG-IFNα-2a group were 60% and 57.5%,which were higher than that of ADV group.The difference was statistically significant(P<0.05).Conclusion PEG-IFNα-2a treatment of lamivudine-resistant HBeAg (+) chronic hepatitis B is superior to ADV,and its security is well.

Objective To explore the correlation of traditional Chinese medicine(TCM)syndrome types with endoscopic features and pathological types of gastric polyps.Methods A total of 1 746 patients with gastric polyps admitted to the Department of Spleen and Stomach Diseases,Dongguan Hospital of Guangzhou University of Chinese Medicine were enrolled.The clinical data of the patients were collected,including gender,age,information obtained by four diagnostic methods of TCM,and pathological types and predilection sites of gastric polyps as well as their number and size.The distribution of TCM syndromes in the patients with gastric polyps and their correlation with endoscopic features and pathological types of the polyps were analyzed.Results(1)Of the 1 746 patients,1 107(63.40%)were female and 639(36.60%)were male,with the male to female ratio being 1∶1.73.The incidence of gastric polyps was positively correlated with the age(P＜0.01):the older the age,the higher the incidence rate.The middle-aged and elderly people were the predilection population for gastric polyps,and the patients aged over 40 years old accounted for 87.40%.(2)The TCM syndrome types of patients with gastric polyps were predominated by spleen-stomach qi deficiency syndrome(418 cases,23.94%),and then came cold-damp obstruction syndrome(394 cases,22.57%),damp-heat in the spleen and stomach syndrome(353 cases,20.22%),qi stagnation and phlegm obstruction syndrome(311 cases,17.81%)and phlegm blended with blood stasis syndrome(70 cases,15.46%).(3)There was a statistically significant difference in the distribution of TCM syndromes between the genders(P＜0.01):spleen-stomach qi deficiency syndrome,cold-damp obstruction syndrome,qi stagnation and phlegm obstruction syndrome and phlegm blended with blood stasis syndrome were more common in the female,while damp-heat in the spleen and stomach syndrome was more common in the male.The distribution of TCM syndromes varied in different age groups(P＜0.01):patients aged over 30 years old were more likely to suffer spleen-stomach qi deficiency syndrome,patients aged 30-39 and 40-49 years old were more likely to suffer damp-heat in the spleen and stomach syndrome,patients aged 50-59 years old were more likely to suffer qi stagnation and phlegm obstruction syndrome,and patients aged 60 years old or above were more likely to suffer cold-damp obstruction syndrome.(4)The pathological types of gastric polyps were predominated by fundus gland polyps(1 327 cases,76.00%),followed by hyperplastic polyps(266 cases,15.23%),inflammatory polyps(146 cases,8.36%),and adenomatous polyps(7 cases,0.40%).There was a statistically significant difference in the distribution of TCM syndromes among various pathological types(P＜0.01):fundus gland polyps were common in the patients with spleen-stomach qi deficiency syndrome,hyperplastic polyps were common in the patients with qi stagnation and phlegm obstruction syndrome,inflammatory polyps were common in the patients with cold-damp obstruction syndrome,and adenomatous polyps were common in the patients with phlegm blended with blood stasis syndrome.(5)Gastric polyps were characterized by multiple polyps(1 120 cases,64.15%),single polyp was rare(626 cases,35.85%).The distribution of TCM syndromes varied in the patients with different number of polyps(P＜0.05):patients with multiple polyps were predominated by spleen-stomach qi deficiency syndrome(25.45%),patients with single polyp were predominated by damp-heat in the spleen and stomach syndrome(24.28%).(6)Gastric polyps frequently appeared in the gastric body and gastric fundus,with the diameter being or less than 0.5 cm.And the differences of the distribution of TCM syndromes in the patients with various favored sites and polyp size were not statistically significant(P＞0.05).Conclusion TCM syndrome types of patients with gastric polyps are correlated with gender and age of the patients and with the pathological types and number of gastric polyps.The incidence is positively correlated with the age,and middle-aged and elderly people are the predilection population of gastric polyps.The female incidence is significantly higher than that of the male,and damp-heat in the spleen and stomach syndrome is more common in the male while the rest of syndrome types are more common in the female.The patients with gastric fundus gland polyps usually suffer spleen-stomach qi deficiency syndrome,patients with hyperplastic polyps usually suffer qi stagnation and phlegm obstruction syndrome,patients with inflammatory polyps usually suffer cold-damp obstruction syndrome,and patients with adenomatous polyps usually suffer phlegm blended with blood stasis syndrome.

Objective To explore the application effect of nursing intervention under non-anesthesia textile fiber laryngoscope inspection. Methods Selects 1000 textile fiber laryngoscope inspection patients,divides into the experimental group and control group each 500 individuals randomly, the control group carries out the convention operation sequence, and the experimental group does not carry on the nasopharyngeal throat anesthesia before inspection. The psychological suggestion, music nursing, touching applies in textile fiber laryngoscope inspection were implemented under non-anesthesia in textile fiber laryngoscope inspection and observe its function effect. Results Experimental group in textile fiber laryngoscope inspection process,diastolic pressure and heart rate change obvious lightly in control group, the difference has statistics significance (t =-2.164,-2.282,P ＜0.05), tense sense of fear and disgusting vomitive degree also remarkable lightly in control group, the difference has statistics s.ignificance (x2 =9.06,24.9 ,P ＜0.01),the inspection defeat case number obviously is also short in the control group. Conclusions The nursing intervention can help the textile fiber laryngoscope to inspect the patient to sharpen the adaptive comprehensively, complete the inspection smoothly under the non-anesthesia, after having avoided the anesthesia, the body produces each kind of ill response, is providing the user-friendly service, establishes protects the trouble relations harmoniously,enhances the patient degree of satisfaction aspect to have the important meaning.

OBJECTIVETo investigate the diversify of the nuclear pathway of c-Jun NH2-terminal kinases (JNK) during transient brain ischemia/reperfusion injury in hippocampal neuron apoptosis in spontaneously hypertensive rats (SHR) and to test whether the neuroprotection of curcumine on transient brain ischemia/reperfusion injury in SHR is related to the nuclear pathway of JNK.

METHODSMale Wistar-Kyoto (WKY) rats and SHR were randomly divided into five groups (n = 6): WKY sham group (W-Sham), WKY ischemia/reperfusion group (W-I/ R), SHR sham group (S-Sham), SHR ischemia/reperfusion group (S-I/R) and SHR curcumine (a chinese traditional medicine)100 mg/kg treatment group (S-Cur), which were sacrificed at 2 h, 6 h, 24 h, 3 d and 7 d after reperfusion. Global brain ischemic model was established by 4-VO method. The TdT-mediated dUTP nick end labeling (TUNEL) method was used to detect the neuron apoptosis in hippocampal CA1 region. The immunohistochemical method was applied to investigate the expressions of c-jun and c-fos in hippocampal CA1 region.

RESULTSThe expressions of apoptosis and c-jun and c-fos in CA1 region in S-Sham group, W-I/R group and S-I/R group were more than those in W-Sham group (P < 0.05), were significantly increased in S-I/R group than those in W-I/R group (P < 0.05), and were significantly decreased in S-Cur group than those in S-I/R group (P < 0.05).

CONCLUSIONNeuronal apoptosis and the expressions of c-jun and c-fos are more in SHR hippocampal. Global brain ischemia/reperfusion injury induces more expressions of apoptosis in hippocampal neuron in SHR, and the more expressions of c-jun and c-fos may participate in that process. The neuroprotection of curcumine in SHR is related to c-jun and c-fos.

Animals ; Apoptosis ; drug effects ; Brain Ischemia ; metabolism ; pathology ; CA1 Region, Hippocampal ; drug effects ; metabolism ; Curcumin ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Male ; Neurons ; drug effects ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Reperfusion Injury ; metabolism ; pathology

Aim To observe whether matrix metallo-proteinase-14 ( MMP-14) and tissue matrix metallopro-teinase inhibitor-4 ( TIMP-4) were involved in the car-diac-protection of mitochondrial aldehyde dehydrogen-ase 2 ( ALDH2) against high glucose induced rat pri-mary cardiomyocyte injury. Methods Rat primary cardiomyocytes were cultured. The cardiomyocyte via-bility was detected by MTT assay at different concentra-tion of glucose at different time point. After established high glucose-induced cardiomyocytes injury model, cardiomyocytes were randomly divided into 4 groups:normal control group ( NG, glucose at 5.5 mmol· L-1) , NG + Alda-1 group ( Alda-1 at 20 μmol·L-1) , high glucose group ( HG, glucose at 30 mmol·L-1) and HG+Alda-1 group. The cell viability at 48 h and oxidative stress level were detected by MTT and DHE staining methods. The protein expressions of ALDH2, MMP-14 and TIMP-4 were determined by Western blot. Results The cardiomyocytes injury model was established according to the cell activity result. Com-pared with NG group, the cell viability, the protein ex-pressions of ALDH2, MMP-14, the ratio of MMP-14/TIMP-4 were decreased, TIMP-4 protein expression and the level of oxidative stress were increased in HG group. Compared with HG group, in HG + Alda-1 group, the cell viability, the protein expressions of AL-DH2, MMP-14, the ratio of MMP-14/TIMP-4 were in-creased, the levels of oxidative stress and TIMP-4 pro-tein expression were decreased. Conclusion Activa-tion of mitochondrial ALDH2 may relieve high glucose induced cardiomyocytes injury. The protective effect was likely related to the inhibition of oxidative damage, down-regulation of MMP-14 and up-regulation of TIMP-4 proteins.