BACKGROUND:Percutaneous vertebraplasty is a new means for the treatment of vertebral compression fractures and bone metastases. The multiplaner reconstruction with digital substraction angiography (DSA)-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, which can effectively prevent the leakage of bone cement. OBJECTIVE:To explore the value of DSA-Innova 3D in the guidance of puncture of percutaneous vertebroplasty. METHODS:From March 2014 to September 2014, a total of 72 patients with 94 vertebras were selected for percutaneous vertebraplasty, of whom 36 (48 vertebras) with Innova 3D (experimentalgroup) and 36 (46 vertebras) without Innova 3D (control group). Spiral CT scan was performed in al patients to assess the distribution of bone cement. The imaging quality in the two groups was compared by Mann-Whitney U test. RESULTS AND CONCLUSION:CT showed bone cement leakage occurred in 7 of the 36 patients in the control group. Leakages were into the lumber disc in two cases, paravertebral space in two cases, vertebral pedicle in onecase or veins in two cases. However, only one case of bone cement leakage was observed in the experimental group. With the guidance of DSA-Innova 3D, the experimental group had signficantly lower leakage and fluoroscopic time than the control group (P < 0.05). The multiplaner reconstruction with DSA-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, thereby effectively reducing the leakage of bone cement.

Objective The relationship between fever and the recent curative effect of transcatheter arte -rial chemoembolization ( TACE) and the related factors of fever after transcatheter arterial chemoembolization in large hepatocellular carcinoma is discussed in this paper .Methods One hundred and twenty patients with large liver cancer were divided into two groups according to the fever after TACE .The fever in group A ,and there was no fever in group B after TACE .The changes of the lesions in the two groups were compared after the first inter-ventional treatment .The factors affecting the fever after TACE were analyzed .Results The CT was performed at about one and half month after the first intervention .The curative effects of A and B were evaluated by RECIST criteria.Two groups of CR,PR,SD,PD were 0,11.11%,71.11%,17.78%and 0,0,33.33%,66.67%,respec-tively.The difference of the efficiency of OR was statistically significant (P=0.049).The probability of fever of four types of iodine oil deposits are as follows:100%,93.33%,81.93%,0.Blood supply type,middle and severe hepatic arteriovenous fistula,the use of gelatin sponge,tumor necrosis,and the use of iodine oil were more than 25ml may be factors affecting postoperative fever .Conclusion The clinical symptoms of fever after TACE sug-gest that the lesion is well embolization and iodine oil deposit is good ,and the lesion is not easy to progress ,and short-term curative effect is better .The analysis of the factors that affect the postoperative fever may help to eval-uate the curative effect of patients with large hepatocellular carcinoma .

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

The report expounds the importancr of 'jiangxi treatment' by discussing the meaning,the researches in the past dynasties and the collation of variety methods of 'jiangxi treatment'. It thinks that the 'jiangxi treatment'in TCM includes the right way to decoct drugs,the rational way to take drugs and the variety ways to 'jiangxi 'after taking drugs. Thus,it should be used selectively in clinical. And the report suggests that the 'jiangxi treatment' is a effective way to increase the clinical eff icacy of drugs.

Objective:To investigate the biological mechanism of the degeneration of cervical spine in cervical spondylosis(CS) by analyzing the alteration of bone matrix components.Methods:Twenty five degenerative cervical vertebra and 8 blood samples from CS cases were collected.The contents of hyaluronic acid(HA),laminin(LN),pro collagen Ⅲ,collagen Ⅳ were detected by radioimmunoassay.Calcium,phosphate and total protein levels were detected by automatic biochemical analyzer.Results:Ruling out the inference of blood, the contents of HA, LN, pro collagen Ⅲ and collagen Ⅳ were significantly lower in degenerated CS vertebra than in the control, so as the levels of calcium and phosphate. Conclusion:Bone matrix components are obviously decreased during the degeneration of cervical vertebra, resulting in the alleviation of bone tenacity and hardness. This may be one of the biological mechanisms of cervical vertebra degeneration and deterioration of cervical spine biomechanics.

Objective To investigate protective effects of dexmedetomidine on oxygen-glucose deprivation/reperfusion(OGD/R)-induced neuronal apoptosis.Methods SH-SY5Y cells were differentiated to neurons with ATRA and followed by TPA.According to the results of preliminary experiment, OGD/R modle was constructed by oxygen-glucose deprivation(OGD) for 12 h and reperfusion(R) for another 12 h.During the start of the OGD, neurons were immediately divided into six groups: group D0(0 μmol/L dexmedetomidine), group D1(0.1 μmol/L dexmedetomidine), group D2 (1 μmol/L dexmedetomidine), group D3 (10 μmol/L dexmedetomidine), group D4(100 μmol/L dexmedetomidine), group D5 (1 000 μmol/L dexmedetomidine).After reperfusion 12 h, the cell viability was evaluated by the method of MTT.The cellular apoptosis was observed by flow cytometry method.The protective effects of different concentration dexmedetomidine on OGD/R-induced neuronal apoptosis were investigated.Then in chosen the exact group having protective effects, endoplasmic reticulum stress specific protein mesencephalic astrocyte-derived neurotrophic factor (MANF) and pro-apoptotic protein Caspase-3 and CHOP were detected by Westernblot method.Results Compared with group D0, there was no difference on the cell viability and cellular apoptosis induced by OGD/R in groups D1 and D2, but a significant decrease and increase in groups D4 and D5 (P<0.01 or P<0.05).And only group D3 had a neuroprotective effect, significantly increased the cell viability and inhibited the apoptosis (P<0.01).Further studys found that group D3 significantly up-regulated ER stress specific protein MANF (P<0.01) and inhibited up-regulation of Caspase-3 and CHOP (P<0.01).Conclusion These data suggest that 10 μmol/L dexmedetomidine had neuroprotective effect on OGD/R-induced neuronal apoptosis and significantly increased cell viability.Our results also indicate that up-regulation of ER stress specific protein MANF and inhibition of CHOP and Caspase-3 by MANF are involved in the neuroprotective effects of Dexmedetomidine.

PurposeTo optimize the imaging parameters of clinical MRI scanner in rat pancreas imaging to improve the image quality and to provide better MRI image quality and more economical research method for imaging study of rat pancreas. Materials and Methods Twenty-four healthy male Wistar rats were randomly divided into the conventional sequence (CS) group, the adjustment sequence (AS) group and the optimization sequence (OS) group, with 8 rats in each group. The rats in the CS group were scanned with conventional parameters using a clinical MRI scanner. The principle of parameter adjustment was: parameters associated with T1WI or T2WI imaging quality (TR, TE, slice thickness, NEX, FOV and matrix) was set with four changes, and only one of the six parameters was changed in each scan, image quality was evaluated by two senior radiologists, the parameter corresponded the best image quality evaluated consistently by two radiologists were selected as the optimal imaging parameter, all the optimized parameters were set up step by step in this way which formed the imaging parameters in OS group. The pancreatic signal intensity and signal to noise ratio was compared between CS group and OS group after imaging.Results The optimized sequence parameters in clinical MRI scanner were listed below: T1WI sequence (M3D/FSPGR/15): TR 6 ms, TE 2.5 ms, slice thickness 2.0 mm, NEX 8, FOV 7 cm×7 cm, Matrix 120×120; T2WI sequence (FSE-XL/90): TR 4000 ms, TE 71 ms, slice thickness 2.0 mm, NEX 1, FOV 8 cm×8 cm, Matrix 192×160. The pancreatic SI in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.16 and 3.80,P<0.01), while the pancreatic SNR in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.65 and 3.26,P<0.01).Conclusion The optimized parameters can improve the imaging quality of rat pancreas MRI significantly, thus provide a reference for the related experimental study.

Objective To investigate the effects of Houpupaiqi mixture on the recovery of gastrointestinal function after open gastrointestinal surgery,and evaluate the efficacy and safety of Houpupaiqi mixture.Methods A total of 144 selected patients who underwent open gastrointestinal surgery were enrolled into the multi-center prospective randomized double-blind controlled clinical trial from October 2010 to September 2011.Of the 144 patients,66 were from People's Hospital of Peking University,72 were from Beijing Friendship Hospital of Capital University of Medical Sciences,and 6 were from People's Hospital of Guangdong Province.All the patients were randomly divided into 2 groups (test group:96 patients,control group:48 patients) at the ratio of 2∶1 according to the random number table.Five patients who did not meet the criteria were excluded from the study,and then there were 92 patients in the test group and 47 patients in the control group.The study was assessed by the ethics committees,and all the patients signed the informed consent form.Houpupaiqi mixture (50 ml) or placebo (50 ml) were administered in the test group and control group at postoperative 16 and 20 hours,respectively.Parenteral and enteral nutritional support were given after pulling out of gastric tube.A standard intravenous analgesia was applied in the 2 groups,and agents which stimulate or suppress gastrointestinal motility were prohibited.The time for the recovery of regular bowel sounds,the first exhaust and first defecation time,and the time of first solid food intake of the 2 groups were recorded.Vital signs were recored before operation and after drug administration.Blood and urinary routine test,hepatic and renal function test,electrocardiogram examination,record of adverse drug event were carried out at postoperative day 6.The time for the indexes above and relevant frequencies were calculated,and the survival curve were drawn by Kaplan-Meier method.All the time points were analyzed using the Log-rank test.The measurement data were analyzed using the t test or rank-sum test,and the enumeration data were analyzed using the chi-square test or Fisher exact probability.Results The median time for the recovery of regular bowel sounds,median time for first exhaust and defecation were 21.4 (20.0,23.7)hours,45.0 (40.0,54.0) hours and 65.5 (54.7,74.0) hours in the test group,and 47.5 (44.0,56.5) hours,91.0 (87.0,93.8)hours,98.0 (94.0,113.5)hours in the control group,there were significant differences between the 2 groups (Log-rank values =21.67,53.15,11.81,P＜0.05).The median time of first solid food intake were 72.5 (66.2,110.5) hours of the test group and 116.3 (114.8,117.3) hours of the control group,with no significant difference between the 2 groups (Log-rank value =13.70,P ＞ 0.05).There were no significant differences in the body temperature,respiration,heart rate,systolic blood pressure and diastolic blood pressure before and after medication between the 2 groups (Z =0.03,0.68,0.97,0.22,0.72,P ＞ 0.05).There were no significant differences in the number of patients with abnormal results of blood test,hepatic function,renal function and electrocardiogram between the 2 groups (P ＞ 0.05).No severe adverse event was observed in the clinical trial.Conclusion Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of the patients who underwent open gastrointestinal surgery with relatively low adverse events.

Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.

OBJECTIVETo identify the correlation of the volume of residual urine (VRU) with the severity of bladder outlet obstruction (BOO) and detrusor contractility in patients with benign prostatic hyperplasia (BPH).

METHODSA total of 152 patients with clinically diagnosed BPH underwent ultrasonography for measurement of the prostate volume and RVU, free uroflowmetry, and urodynamic examination for the severity of BOO and detrusor contractility. Using the software SPSS20. 0, we analyzed the correlation between the ultrasonographic results and urodynamic parameters and compared the two sample means by the t-test.

RESULTSThe prostate volume was correlated positively with BOO severity (r = 0.432, P < 0.01) and detrusor contractility (r = 0.343 , P < 0.01) while Qmax negatively with BOO severity (r = 0.327, P < 0.01) but not significantly with detrusor contractility (r = 0.123, P > 0.05). VRU showed a significantly negative correlation with detrusor contractility when > 150 ml (r = -0.490, P < 0.01), even more significantly when > 300 ml (r = -0.717, P < 0.01), but exhibited no significant correlation with it when ≤ 150 ml (r = 0.041, P > 0.05).

CONCLUSIONVRU can somehow predict the detrusor function. For patients with VRU > 150 ml, especially for those with VRU > 300 ml, the detrusor function should be evaluated and urodynamic examination is recommended for exact assessment of BOO severity and detrusor contractility.

Aged ; Humans ; Male ; Muscle Contraction ; Muscle Hypertonia ; diagnostic imaging ; physiopathology ; Organ Size ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; physiopathology ; Severity of Illness Index ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; physiopathology ; Urine ; Urodynamics