Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)complicating anterior cervical surgery.Methods1052patients were performed anterior cervical surgery between October1997and October2002.Of 1052cases,926cases were of cervical spondylotic myelopathy(CSM),and126of ossification of posterior longitudinal ligament (OPLL).11patients suffered from cerebrospinal fluid leakage during operation.There were8males and3females aging from46to72years(average,58years).In the group of CSM,there were2cases of CSFL(0.22%)occurred in resection of osteophyte of the posterior vertebral edge,who were serious CSM of C 4,5 and C 5,6 with severe anterior compression by osseous mass to spinal cord showed on MRI.In the group of OPLL,there were9cases of CSFL(7.14%)occurred in resection of the ossified posterior longitudinal ligament accompanied with severe spinal canal stenosis and anterior compression to spinal cord on radiological imagings,4of them were con-tinuous OPLL from C 2 to C 6 combined with herniation of cervical disc,3segmental,and2mixed.Results The defect area of spinal dura were(0.6～2.0)cm?(1.0～1.5)cm.The cerebrospinal fluid was blocked with fascia and absorbable gelatin sponge during the operation.If CSFL was persistent more than3days after oper-ation,expectant treatment was performed.After the operation,no CSFL occurred in8of 11patients,and the other3cases with postoperative CSFL were cured5,14and17days by dressing change,blocking the wound with gelatin sponge,and suturing of the wound respectively.All patients were followed up for 10to62months(mean,26months).No cerebrospinal fluid cyst and infection occurred.There were no significant negative effects of CSFL on the recovery of neuromuscular function.Conclusion CSFL following cervical anterior surgery can be cured by blocking up leakage of spinal dura during operation,however,conventional conservative treatment including of dressing change,antibiotics administration,horizontal position with low pillow are necessary after operation.

Adult ; Hand Injuries ; surgery ; Humans ; Male ; Occupational Diseases ; surgery ; Paint

ObjectiveTo assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement ofhepatocellularcancer( HCC )aftertransarterialchemoembolization( TACE )treatment.Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced,arterial,portal,and delayed phases scanning after TACE treatment.Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images.DSAs were performed in all these patients.Two blinded and independent readers evaluated the data in 2 reading sessions:standard nonenhanced,arterial phase,portal phase,and delayed phase images were read in session A,and virtual nonenhanced,arterial phase,portal phase,and delayed phase images in session B.Sensitivity and specificity were calculated,with the DSA data set as the reference standard.The sensitivity and specificity were compared with Chi-square test.Results DSA revealed 63 lesions in 27 patients,and 39 of them had blood supply.Overall sensitivity and specificity were 74.4％ (29/39) and 83.3％ (20/24) for session A,and 94.9％ (37/39),95.8％ (23/24) for session B,respectively.The sensitivity of the two reading sessions was significantly different (x2 =6.303,P ＜ 0.05 ),while the specificity was insignificantly different ( x2 =2.009,P ＞ 0.05 ).Conclusion Compared with standard dynamic protocols,an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.

Objective To observe the role of rosiglitazone in unclipped kidneys of two-kidney- one-clip hypertensive rats and examine its relationship to angiotensinⅡreceptors.Methods Two- kidney-one-clip hypertensive rats were divided randomly into 4 groups as follows:positive control group (CONT),traditional antihypertensive drugs group (TAHD,reserpine 50?g?kg~(-1)?d~(-1), dihydralazine 6.25 mg?kg~(-1)?d~(-1) and hydrochlorothiazide 6.25 mg?kg~(-1)?d~(-1),regular-dose rosiglitazone group (RRGL,rosiglitazone 5 mg?kg~(-1)?d~(-1)),and high-dose rosiglitazone group (HRGL, rosiglitazone 20 mg?kg~(-1)?d~(-1)).Sham operation rats were as negative controls.Each group had 8 rats. Animals were monitored and sacrificed at 10th week.Results Blood systolic pressure in TAHD group and HRGL group was significantly lower than that in CONT group [TAHD(137?27 ) mm Hg and HRGL (143?16) mm Hg vs CONT (191?25 ) mm Hg,P＜0.05],but no significant difference between the former two groups was found.Nor did the blood systolic pressure between RRGL group [(176?18) mm Hg] and CONT group.At 10th week,rats in SHAM group and treated groups had lower urinary urinary protein excretion rate,glomerular injury score and wall-to-lumen ratio of arteriole than those in CONT group [vs CONT urinary protein excretion rate (44.60?17.40) mg/24 h,P＜0.05; vs CONT glomerular injury score 60.85?33.05,P＜0.05;vs CONT wall-to-lumen ratio of arteriole 2.33?1.01,P＜0.01,except TAHD group].Though with the similar level of blood pressure,blood glucose and lipid,HRGL,compared with TAHD group showed lower urinary protein excretion rate [HRGL (16.78?3.50) mg/24 h vs TAHD (27.94?12.79) mg/24 h,P＜0.05],decreased glomerular injury score (HRGL 18.04?7.76 vs TAHD 27.92?6.39,P＜0.05) and wall-to-lumen ratio of arteriole (HRGL 1.75?0.38 vs TAHD 2.16?0.90,P＜0.05) in the cortexes of unclipped right kidneys.The expression of type 1 angiotensinⅡreceptor (AT1R) mRNA was no difference in HRGL group and TAHD group,but the expression of type 2 angiotensinⅡreceptor (AT2R) mRNA was more intensive in HRGL group.Conclusion Rosiglitazone can protect the kidneys from hypertensive injury,especially in high dose.The beneficial effects seem incompletely dependent on the metabolism modulating and reduction of blood pressure,but in relationship to the upregulation of AT2R mRNA.

Objective To discuss the level and its relativity analysis of IL-16 and IgE in asthmatic children .Methods Compare and analyze the level of IL-16,IL-10 and IgE between 18 asthmatic children and 14 healthy children.Results The serum level of IL-16 and IgE in asthmatic children was much higher than the contrast, P

Child ; Endoscopy ; Humans ; Male ; Paraganglioma ; surgery ; Urinary Bladder Neoplasms ; surgery

BACKGROUND:Previous studies have shown that different doses of ionizing radiation may have some impact on maturation and immune function of dendritic cells. OBJECTIVE:To evaluate the effect of 18 F-FDG with different concentrations on maturation and immune function of dendritic cells from human peripheral blood mononuclear cells in vitro. METHODS:Human peripheral blood mononuclear cells-derived mature dendritic cells were divided into five groups:PBS, 92.5×10 4, 185×104, 370×104, 740×104 Bq/mL 18 F-FDG were separately added into each group. Dendritic cells were col ected 24 hours later. Apoptosis rate, phenotypic expression (CD1α, CD80, CD83, CD86, HLA-DR), ability of mixed lymphocyte reaction and expression of macrophage inflammatory protein 1αand monocyte chemotactic factor-1 in cellculture supernatant were detected. RESULTS AND CONCLUSION:Apoptosis rate, phenotypic expression of CD86, ability of mixed lymphocyte reaction and expression of monocyte chemotactic factor-1 were down-regulated after culture in 740×10 4 Bq/mL 18F-FDG. However, 18F-FDG at other concentrations had no influence on maturation and immune function of dendritic cells. This study demonstrates that low-concentration 18F-FDG has little influence on apoptosis, maturation, antigen presentation, and migratory capacity of dendritic cells, and it may be selected at an appropriate concentration as a label for dendritic cells in vitro.

BACKGROUNDTo study characteristics of peripheral T cell subsets in 94 children with chronic hepatitis B and to elucidate its relationships with clinical status and hepatic pathology.

METHODSPeripheral T cell subsets were detected using flow cytometric analysis with specific monoclonal antibodies staining in 94 patients with HBV infection. The authors simultaneously detected their serum ALT, markers of HBV infection and examined liver biopsy material for pathological changes.

RESULTSIn patients with serious liver lesion, the ratio of CD4+/CD8+ cells was significantly higher than those with mild lesion (1.41+/-0.54 vs 1.08+/-0.35, P less than 0.05), which seemed to be associated with the various liver lesions among the patients. In female cases, the levels of CD4+ T cells and the ratio of CD4+/CD8+ T cells were higher than their counterpart in male cases (33.1+/-5.39 vs 28.8+/-6.28, 1.28+/-0.32 vs 1.02+/-0.36, P less than 0.05), but the level of CD8+ T cells was lower than those in males (26.79+/-4.66 vs 30.51+/-7.17, P less than 0.05). There was no obvious correlation between T cell subsets and circulating HBV viral load, the size of spleen among the HBV-infected children.

CONCLUSIONThe characteristics of peripheral T cell subsets probably suggests the immune disorder occurred in these children with hepatitis B compared with healthy controls and its mechanism needs further investigation.

Child ; Child, Preschool ; Female ; Hepatitis B, Chronic ; immunology ; pathology ; Humans ; Infant ; Liver ; pathology ; Male ; T-Lymphocyte Subsets ; immunology

OBJECTIVESTo elucidate the possible involvement of monoamine neurotransmitters in the development of neurobehavioral damage produced by acrylonitrile in drinking water in male rat brains.

METHODSTotally 30 male SD rats were randomly divided into three groups, the control group (n = 10), low dosage group (n = 10), and high dosage group (n = 10), which were respectively administered 0 mg/L, 50 mg/L, 200 mg/L acrylonitrile (AN) in drinking water. The treatment was lasted for 12 weeks. Seven animals were randomly selected from each group for determination of monoamine neurotransmitters in striatum and cerebellum by high performance liquid chromatography with electrochemical detector and activities of monoamine oxidase in cortex.

RESULTSThe contents of dopamine in the striatum of low and high dosage groups were decreased to (2.2 +/- 0.7) and (3.2 +/- 2.0) microg/g wet tissue, respectively, and compared with that of control group (9.0 +/- 4.2) microg/g wet tissue, the differences were statistically significant. There were no statistical differences among the contents of dopamine in the cerebellum of all rats, and the levels of 3,4-dihydroxyphenylacetic acid (DOPAC), the major metabolite of dopamine in the cerebellum were (186 +/- 41), (245 +/- 90) and (115 +/- 65) ng/g wet tissue in the control, low and high dosage groups, respectively and in low-dosage group they were significantly higher than those in other groups. There was dosage-dependently decreasing of the contents of serotonin of striatum in the control (249 +/- 34) ng/g wet tissue, low dosage (155 +/- 95) ng/g wet tissue and high dosage groups (128 +/- 101) ng/g wet tissue.

CONCLUSIONThis study underlines the importance of alterations in the monoamine neurotransmitters system as a possible causative mechanism behind the behavioural and functional changes produced by acrylonitrile.

Acrylonitrile ; administration & dosage ; toxicity ; Animals ; Biogenic Monoamines ; metabolism ; Brain ; drug effects ; metabolism ; Carcinogens ; administration & dosage ; toxicity ; Cerebellum ; drug effects ; metabolism ; Chromatography, High Pressure Liquid ; methods ; Corpus Striatum ; drug effects ; metabolism ; Dopamine ; metabolism ; Dose-Response Relationship, Drug ; Drinking ; Male ; Neostriatum ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism

OBJECTIVETo investigate the clinical manifestation and surgical outcome of spinal osteoblastoma.

METHODSFrom June 2006 to July 2010, 11 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 7 males and 4 females with an average age of 23.5 years (range, 16 - 34 years). The tumors were located at C(5) in 3, C(6) in 4, C(7) in 2, C(6) ~ T(1) in 1 and T(11) in 1. Based on WBB classification, 9 were 1 - 3 or 10 - 12 and 2 were 4 - 9 and 1 - 3. All the operations had been performed with en-bloc resection. The posterior approach was used for 9 patients, and combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 8 patients. To evaluate the change of pain before and after the operation by visual analogue scales (VAS), and to assess functional status of the spine by McCormick scale. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones.

RESULTSAll cases were followed up for 12 - 64 months (average, 28.4 months). The average surgical time was 130.5 minutes (range, 90 - 210 minutes), with the average intraoperative blood loss of 560 ml (range, 300 - 1000 ml). During the follow-up period, the VAS grade reduced from 6.3 ± 1.1 to 2.5 ± 1.0 (t = 8.48, P < 0.05). There were 8 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up.

CONCLUSIONSSpinal osteoblastoma has its own specific radiographic feature. There are some recurrence in simple curettage of tumor lesion. The thoroughly en-bloc resection of tumor or spondylectomy, bone fusion and strong in ter fixation are the key points for successful surgical treatment.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Osteoblastoma ; diagnostic imaging ; surgery ; Pain Measurement ; Radiography ; Retrospective Studies ; Spinal Neoplasms ; pathology ; surgery ; Treatment Outcome ; Young Adult