Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.

Bone Neoplasms ; diagnosis ; pathology ; surgery ; Child ; Diagnosis, Differential ; Femur ; pathology ; Fibroma ; diagnosis ; pathology ; surgery ; Humans ; Male

Rice straw degradation with white rot fungi and cellulose multienzyme was studied. The results indicated that the LiP, MnP activity produced by P. chrysosoporium 172 could reach 28.3U/g and 12.6U/g respectively under suitable culture condition. And the lignin was degraded efficiently in contrast with the cellulose and hemicellulose in rice straw solid fermentation. Following treatment with white rot fungi, using multienzyme produced by A. niger NL-1 could greatly accelerate the decomposition of rice straw. The decomposition rate of cellulose, hemicellulose, lignin and the loss rate of dry material were 53.8%,57.8%,44.5% and 46.3% respectivity when hydrolysis rice straw 48h with cellulase multienzyme (including 3 IU /g rice straw) after culture P. chrysosoporium 172 for 10 days. Scanning electron microscope analysis showed the cell wall of rice straw was destroyed severely, and the whole tissue got loosely. These results demonstrated the rice straw had been decomposed efficiently and completely.

Aim To monitor the whole blood trough concentration of cyclosporine A (CsA) in renaltransplant recipients reciving triple therapy with mycophenolate mofetil, cyclosporine andprednisone and to establish an optimal therapeutic window of CsA. Methods Sampleswere measured by specific fluorescence polarization immunoassay. According to the timeafter operation and different therapy plan, the whole blood trough concentration of CsA ineach group was compared with that in control group.Results The optimal therapeuticwindow of CsA with MMF plan was 150~300 ?g? L-1 (less than one month after op-eration), 120~260?g?L-1 (1~

Objective To evaluate the safety and clinical efficacy of system thrombolysis combined with percutaneous catheter thrombus fragmentation and thrombectomy for acute massive pulmonary embolism. Methods Ninteen patients with acute massive pulmonary embolism were treated with IVC filter placement, percutaneous catheter thrombus fragmentation and system thrombolysis combined with anticoangulation using low-molecular-weight heparin.Four of 19 patients underwent adjuvant Stranb Rotarex catheter thrombectomy.Results Twenty-one procedures were performed in 19 patients.Improvement of pulmonary artery patency and initial relief of symptoms immediately occurred in 18 of 19 patients after interventional therapy.The oxygen saturation increased from 86% to 97%.Pulmonary artery pressure decreased from 33? 5mm Hg(1mm Hg=0.133kPa)to 25?5mmHg after interventional therapy(t=13.2,P

Objective - （ ） To analyze the occurrence pattern of work related musculoskeletal disorders WMSDs among workers Methods in a shipyard based on latent category model. A total of 446 workers from a shipyard in Guangdong Province were selected as the research subjects using convenience sampling method. The prevalence of WMSDs in the past year was ， investigated using China Musculoskeletal Questionnaire and the occurrence patterns of WMSDs were analyzed by latent class. Results （ ） The prevalence of WMSDs in the past year was 71.1% 317/446 . The prevalence of WMSDs in single site was 24.4% （ ）， （ ） - 109/446 and was 46.6% 208/446 in multiple sites. The prevalence of WMSDs in multiple sites was 3.9 17.3 times higher than that in single site. The fitting results of latent class model showed that the model with three latent classes was the best - （ ）， model. The three potential categories of WMSDs occurrence patterns in the study subjects were the all site group 28 patients （ ）， （ ）， ， the neck and lower back/waistgroup 153 patients and the few or no site group 265 patients accounting for 6.3% 34.3% ， Conclusion and 59.4% respectively. WMSDs of shipyard workers have obvious category characteristics. Latent class analysis can be used to explore the occurrence pattern of WMSDs in shipyard workers.

OBJECTIVETo determine whether preoperative contrast delay-enhanced cardiovascular magnetic resonance imaging (DE-CMR) could help predict long-term survival of patients with severe chronic aortic regurgitation and extremely dilated left ventricular chamber after aortic valve replacement.

METHODSTotally 37 patients enrolled between February 2008 and November 2010 with severe chronic aortic regurgitation and extremely dilated left ventricular chamber, who met the echo criteria, that was left ventricular end diastolic dimension > 70 mm or left ventricular end systolic dimension > 55 mm, and were scheduled to the surgery. The 2-dimensional echocardiographic examinations and CMR with late gadolinium-enhancement (LGE) were performed routinely preoperatively. According to the results of CMR, the patients were divided into 2 groups: the LGE positive(+) group and LGE negative(-) group. The association of LGE with event free survival, postoperative cardiac function and postoperative hospital stay time was investigated. Fifteen patients had significant LGE signals in CMR films, while the other twenty-two were silent. All of them received the operative procedures, including aortic valve replacement in 28 cases, Bentall procedure in 3 cases, aortic valve replacement and ascending aorta replacement in 6 cases, and concomitant mitral valve repair in 11 cases.

RESULTSOver a follow-up of 33.6 months, 1-year, 2-year and 3-year event free survival rates in LGE(-) group were 94.7%, 88.4%, and 72.6%, respectively, compared to 80.0%, 48.9%, and 32.6%, respectively in LGE(+) group (χ(2) = 7.244, P = 0.007). The postoperative hospital stay time of LGE(-) group was (9 ± 2) days, which of LGE(+) group was (10 ± 3) days (t = 1.175, P = 0.248).

CONCLUSIONSLGE positive signal in CMR films is a potential predictor of persistent cardiac failure after aortic valve replacement for patients with severe chronic aortic regurgitation and extremely dilated left ventricular chamber. It has intimate relationship with malignant arrhythmia and sudden death, which makes it a valuable technique in preoperative evaluation and risk stratification.

Aortic Valve Insufficiency ; complications ; diagnosis ; surgery ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular ; complications ; diagnosis ; surgery ; Magnetic Resonance Imaging ; methods ; Postoperative Period ; Prognosis

OBJECTIVETo observe initial radiographic manifestations and evaluate its value for the diagnosis and differential diagnosis in patients with severe acute respiratory syndrome (SARS).

METHODSInitial chest radiographs of 79 patients, 15 to 69 years old (mean age 34.1 years, 40 men and 39 women), were retrospectively reviewed in the study. For all patients, average temperature was 38.8 degrees C and mean time from onset of the fever to the time of initial radiographs taken was 5.8 days. Location, abnormal distribution, appearance of lung abnormalities, effusion of pericadiaum and pleura, and lymphadenopathy were observed. Abnormal distribution and associated findings were compared. Differences of mean age, temperature, and the time were statistically analyzed between patients with and without abnormal findings.

RESULTSInitial chest radiographs were normal in 36 of 79 patients (45.5%). Abnormal radiographs in 43 patients (81.3%) showed exudative changes. No significant difference of mean age and day (form onset of the fever to the time of initial radiographs taken) was found between the patients with and without abnormal initial chest radiographs (P > 0.05). No lymphadenopathy, effusion of pericadiaum and pleura were found on the initial chest radiographs.

CONCLUSIONSThe main abnormal radiographic appearance of lung in patients with SARS is exudative changes. SARS patients with normal initial chest radiographs are not uncommon and abnormal radiographic findings may appear to be late after onset of fever. Therefore, more attention should be paid in the clinical diagnosis of SARS.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; diagnostic imaging

OBJECTIVETo investigate the clinical effects of spinal canal decompression and pedicle screw reduction and fixation, and intervertebral bone grafting fusion for the treatment of lumbar spondylolisthesis associated with nerve compression symptoms.

METHODSPostlaminectomy vertebral lamina reconstruction and pedicle screw reduction and fixation were performed in 32 patients with lumbar spondylolisthesis between August 2007 and August 2008. Of them, 26 patients were followed up for more than 1 year, including 16 males and 10 females who ranged in age from 55 to 76 years (mean 62.5 years). The course of disease was 2-10 years. All patients had low back pain, numbness and pain in one or both lower extremities and intermittent claudication symptoms. Radiograms showed L3, L4 or L5 anter-olisthesis of I to III degree. There were 18 cases of regressive olisthesis and 8 cases of spondylolysis. The clinical improvement, the vertebral reduction, the lamina fusion rate and canal stenosis state were observed and assessed.

RESULTSThe wounds healed well in all 26 cases without occurrence of significant complications. Clinical improvement was assessed according to the JOA lower back pain score scale. The mean preoperative score was 5.2 +/- 1.5, and 23.1 +/- 1.9 at 3 months after operation. The result was excellent in 20 cases, good in 5 cases, and fair in 1 case. The mean score on the last followed-up was 22.9 +/- 2.4, and the result was excellent in 19 cases, good in 5 cases, and fair in 2 cases. JOA score at 3 months after operation and that at the last followed-up were significantly different from that before operation (P = 0.00), and there was no significant difference between JOA score at 3 months after operation and that at the last followed-up (P > 0.05). Complete reduction was achieved in 17 degree I case and 5 degree II cases. Two degree II cases were improved to degree I, and 2 degree III cases were improved to degree I. Vertebral fusion was achieved 3 months after operation in 20 cases, and in all cases at the last followed-up. CT examination at the last follow-up showed no stenosis of the vertebral canal, dural sac and nerve root compression. The rebuilt vertebral lamina fused well. No graft bone absorption or failing fixation occurred.

CONCLUSIONPostlaminectomy reconstruction of the vertebral lamina and pedicle screw reduction and fixation can achieve satisfactory reduction and spine biomechanical stability in the treatment of lumbar spondylolisthesis, and can prevent latrogenic stenosis of the vertebral canal due to nerve oppression by the postoperative scar and nerve adhesion, with good early and medium-term curative effects. In addition, it provides a new way of thinking in the treatment of lumbar spondylolis-thesis.

Aged ; Biomechanical Phenomena ; Bone Screws ; Female ; Humans ; Laminectomy ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Spinal Fusion ; Spondylolisthesis ; surgery

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis