Objective To compare dexmedetomidine versus midazolam sedation for myocardial protection in the patients undergoing percutaneous coronary intervention (PCI).Methods Sixty patients with acute myocardial infarction who required for emergency PCI,were selected and randomly divided into 2 groups (n =30 each) using a random number table:dexmedetomidine group (group D) and midazolam group (group M).In group D,a loading dose of dexmedetomidine 1 μg/kg was infused intravenously for 10 min before surgery.In group M,midazolam 0.05 mg/kg was injected intravenously before surgery.Dexmedetomidine 0.2-1.4 μg· kg-1 · h-1 and midazolam 0.02-0.10 mg·kg-1 ·h-1 were given via a pump during surgery until the end of surgery in the two groups.The RASS score was maintained at-2-2 in two groups.Before administration and on 3rd day after surgery,cardiovascular color doppler ultrasound was performed to record left ventricular ejection fraction (LVEF),venous blood samples were collected for determination of the levels of serum myocardial enzyme and cardiac troponin I (cTnI),and the development of surgical complications,duration of ICU stay and length of hospital stay were recorded.Results Compared with group M,the activities of serum creatine kinase,creatine kinase isoenzyme-MB,aspartate amino transferase and lactic dehydrogenase and cTnI concentrations were significantly decreased,LVEF was increased,and duration of ICU stay and length of hospital stay were shortened in group D.There was no significant difference in the development of postoperative complications between the two groups.Conclusion Dexmedetomidine sedation provides better efficacy for myocardial protection and prognosis and is more suitable for sedation than midazolam in the patients undergoing PCI.

Objective To study the time-dependent changes and mechanisms of auditory cortex in prelingual sensorineural hearing loss. Methods Two groups (9-12, 19-22-year-old) of hearing-loss patients and matched normal hearing subjects received MR diffusion and MRS examination. The ROI for ADC measurement were placed on the Heschl gyrus (HG), and for NAA/Cr, Cho/Cr on the superior temporal gyrus(STG). Results There was no statistical difference among groups both in the NAA/Cr and Cho/Cr (P>0.05), Left side NAA/Cr 2.46±0.51, 2.49±0.52, 2.26±0.33;Right side NAA/Cr 2.26±0. 46, 2. 44±0. 45, 2. 27±0. 46. Left side Cho/Cr 0. 88±0. 21,0. 92±0. 18, 0. 87±0. 13 ; Right side Cho/Cr 0. 88 ± 0. 18, 0. 87 ± 0. 22, 0. 81 ± 0. 16. There was statistical difference of ADC value among normal hearing subjects and 9-12, 19-22-year-old hearing-loss patients(F = 4. 42, P < 0. 05, F = 11.37,P<0. 05). There was significant difference of ADC value between normal hearing and 19-22 year-oldhearing-loss (q = - 44. 89, P = 0. 008, q = - 54. 28, P = 0. 027) on both left and right HG, and there wassignificant difference between normal hearing and 9-12 year-old hearing-loss only on right HG (q =- 32. 54, P = 0. 000), Left side (860 ± 103), (885 ± 48), (905±77) mm<'2>/s, Right side (848 ± 73),(880 ± 61), (902 ± 52) mm2/s. Conclusion Compared with the normal hearing, the ADC value increased in 20-year-length of deafness. The NAA/Cr and Cho/Cr of STG showed no changes among the three groups.

Acquaintance of the lymph node is very important to evaluate whether the tumor is malignant or benign and therefore to the treatment of the tumors. Lymphography is now considered the gold standard for this purpose. Many computer aided diagnose (CAD) technologies have been developed to help radiologists to diagnose the tumor by the lymphography cases. In this paper, a computer aided diagnose model is constructed by Semi-naive Bayes Classification. The experiments carried out in our laboratory validated the Semi-Naive Bayes Classification on lymphography case. The result of experiments showed that Semi-Naive Bayes Classification could classify lymphography case effectively.
Algorithms ; Bayes Theorem ; Diagnosis, Computer-Assisted ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Lymphography ; Neoplasms ; diagnosis

BACKGROUND:The phenomenon of temporary ischemia of the tissues and organs caused by injury is common in the clinic. However, there are few studies on the treatment of ischemia/reperfusion injury. It is significant to investigate the effect of TanshinoneⅡA on improving uterine ischemia/reperfusion injury in a rat model. OBJECTIVE:To observe the effect of TanshinoneⅡA intervention on improving uterine ischemia/reperfusion injury in rats. METHODS:The rat models of uterine ischemia/reperfusion injury were established by suture method. The rats that were intraperitonealy injected with Sodium Tanshinone IIA Silate injection (20 mg/kg) at 5, 3, 1 days and 30 minutes before the operation were included in the experimental group. Model and sham operation groups were established for comparison. RESULTS AND CONCLUSION:Spectrophotometry and immunohistochemical staining results showed that at 1 and 3 hours of ischemia/reperfusion, the malondialdehyde concentration and Bax protein expression in the injuried rat uterine tissue were significantly decreased (P < 0.05), superoxide dismutase (SOD) activity and Bcl-2 protein expression were significantly increased (P < 0.05) in the experimental group than in the model group. The results confirm that TanshinoneⅡA has a protective effect on uterine ischemia/reperfusion injury in rats.

Objective To observe MSCT and clinical features in patients of laryngocarcinoma combined with other primary carcinomas. Methods Five patients of laryngeal cancer combined with multiple primary cancer were enrolled in the study. Three paitents had long-term smoking history more than 20 years. Three paitents had various degree of radiotherapy, chemotherapy and immunotherapy. The second primary cancer located in right upper lung lobe in 2 patients of synchronous cancer and 1 patient of metachronous cancer. The others located in soft palate, uvula and the left side of zone Ⅱ and zone Ⅳ in the neck, respectively. MSCT and clinical characteristics were analyzed. Results Five patients of multiple primary cancers included 2 patients of synchronous cancer and three patients of metachronous cancer. MSCT found the appearances of malignant tumors in various parts in all 5 patients and cervical lymph nodes metastasis in 2 patients. Conclusion The possibility of prime laryngocarcinoma combined with other primary cancers should be considered when other organ malignant tumor was detected in patients with laryngeal carcinoma, especially in patients with history of long-term smoking, radiotherapy and chemotherapy and immunotherapy. Long-term following-up of cervix and other organs should be taken for the postoperative patients of laryngocarcinoma.

Objective To study the MRI features of sporadic Creutzfeldt-Jakob disease(sCJD). Methods Three patients with clinically diagnosed sCJD underwent MR study,including SE T_1WI,FSE T_2 WI,and DWI sequences.The MR imaging features were analyzed.Results The lesions were not definite either in SE T_1 WI or in FSE T_2 WI,but were prominent in DWI.Abnormal hyperintensive signal appeared in the cerebral cortex,with the frontal,parietal,and occipital lobes being the mostly involved region.The subcortical white matter was normal.The bilateral caudate nuclei and thalami could also be involved.The abnormal signal could be either symmetrical or asymmetrical.There was diffuse atrophy of the brain parenchyma in the late phase of disease,especially in the cortex.Conclusion With the application of MR study,especially the DWI,combined with its characteristic clinical manifestation,the diagnosis of sCJD can be made definitely.

Objective To study the imaging of central pentine myelinolysis (CPM) and extrapontine myelinolysis(EPM) after liver transplantation and value of DWI. Methods Eight patients after liver transplantation with CPM and EPM were included in our study, 4 cases of female and 4 cases of male.MR examinations were performed on Philips 1.5 T MRI system. The sequences included SE T1 WI, FSE T2Wl,axial SE-EPI DWI,TR/TE 6225/118.7 ms, ETL 128, FLIP 90°, thickness 5 nun, matrix 128 ×128,b=1000 mm2/s. Results Four of B type hepatitis and cirrhosis and 1 case combined with hepatic carcinoma, 1 of C type hepatitis with cirrhosis from schistosome,2 of C type hepatitis and cirrhosis, 1 of cholangiogenic cirrhosis. MR demonstrated prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem sparing of the corticospinal tract and peripontine tissue. The lesion manifested high signal intensity both on DWI and ADC map indicating T2 effect and vasogenic edema. Follow up MR in 2 cases 2 months later showed more prolongation of T1 and T2 than the first time and the lesion manifested iso-intensity signal on DWI and high signal intensity on ADC map suggesting increased diffusivity. Abnormal signal intensities were detected on the bilateral caudate head, globus pallidus, putamen and cerebral cortex in 3 cases. Conclusion CPM should be considered when prolongation of T1 and T2 with a shape of butterfly, round or quadrangle on the brain stem, sparing of the corticospinal tract and peripontine tissue was detected for patients of pest-transplantation. When combined with other area abnormality, EPM and CPM should be considered. DWI can early and sensitively show the lesion.

Objective To evaluate the value of MSCT in differentiate cystic lesions in different cervical region. Methods Forty cases with cyst lesions in the neck which was confirmed by pathology were collected in our study. The following diseases were excluded: cystic lesions from thyroid gland and thymus or bronchus, cystic changes of solid lesions ( necrotic lymph node) and cystic or solid lesions in the parotid gland. All patients underwent MSCT scan on GE Lightspeed 16. The parameters were following: 120 kV,260 mA, thickness 5 mm, pitch 1. 375. The delay time for contrast enhanced CT was 25 seconds for arterial phase and 60 seconds for vein phase. Results Lesions were analyzed in 4 different cervical regions including parotid gland, midline, lateral cervix and posterior cervix. Among the lesions in parotid area,2 were first brachial cyst and the other 2 were epidermoid cyst. First brachial cyst occurred intraparotid gland and epidermoid cyst occurred intraparotid or extraparotid gland. Among the lesions in midline area, 17 cases were thyroglossal cysts,81.0% were in the level hyoid bone, 12 cases of thyroglossal cysts protruded at the preepiglottic space or oral base. Another kind of lesions in midline included 3 cases of epiglottic cysts and 1 epidermoid cyst in the lower level of the neck which involved infrasternal level. The 12 cases of second brachial cysts occurred in the lateral neck. Ten cases were in the left side. Type Ⅱ was the most common type and account for 5 cases among all of second brachial cysts. Type Ⅰ and type Ⅱ were running up,accounting 3 cases respectively. Type Ⅳ account for 1 case. Two cases with lymphangioma and 1 case with third brachial cyst located at the posterior neck. Conclusion According to the location and typical imaging appearance, MSCT can do the differentiation of different cystic lesions in the different area of neck.

Objective To measure the vitamin B1 levels in plasma,erythrocytes and urine of the patients with type 2 diabetes,and to analyze the correlation of vitamin B1 level with the progression of diabetic nephropathy,and to clarify the metabolism of nutrtion mechanism of type 2 diabetic nephropathy.Methods Total 90 patients with type 2 diabetes and 30 healthy volunteers were recruited.According to the levels of microalbuminuria,the patients with type 2 diabetes were divided into non diabetic nephropathy (NDN)group,early diabetic nephropathy (EDN)group and clinical diabetic nephropathy (CDN)group (n=30);the healthy people was used as normal control (NC) group.The vitamin B1 levels in the plasma,erythrocytes and urine were examined with high performance liquid chromatography (HPLC). The correlation of microalbuminuria with the plasma viamin B1 level was analyzed. Results The level of vitamin B1 in plasma of the patients in NC group was (7.1±3.3)μg·L-1,while it was (4.0±2.3)μg·L-1 in NDN group,(3.1±1.0)μg·L-1 in EDN group and (2.3±0.6)μg·L-1 in CDN group. Compared with NC group,the vitamin B1 levels in the plasma in NDN,EDN and CDN groups dropped 43.7%, 56.3%,and 67.6%,respectively (P<0.05). The excretion of vitamin B1 in urine were (2.9 ± 0.8),(9.0 ± 4.7),(11.7±3.9),and (15.6±5.0)μg·L-1 in NC group,NDN group,EDN group and CDN group, respectively.Compared with NC group,the vitamin B1 levels in the urine in NDN,EDN and CDN groups were increased by 2,3 and 4 times,respectively (P<0.05).A negative correlation was found between the level of microalbuminuria and the level of vitamin B1 in plasma (r=-0.62,P=0.013).Conclusion Vitamin B1 deficiency can be observed in the early stage of diabetic nephropathy,and the level of vitamin B1 is closely correlated with the progression of diabetic nephropathy.

BACKGROUND:Pedicle screw fixation is the mainstream type of spine operation currently. The key point of the fixation is to make the screw pass through the center of pedicle. The angle of pedicle screw implantation is a key factor for repair quality. In previous literatures, angle of pedicle screw is determined according to the patient body, and is easily disturbed by factors such as position of the body. OBJECTIVE:To determine the inserting angle of pedicle screw of lower lumbar spine taking local anatomic landmark as a reference using digital technology. METHODS:3D-CT data of 100 patients were selected. The fourth and fifth lumbar vertebrae received three-dimensional reconstruction, and the operation was simulated using digital technology to achieve optimal placement. After simulation, the angle of pedicle screw was measured. The angle of the planes of the midline of the screw and the midline of the spine served as coronal angle. The angle of the planes of the midline of the screw and the upper surface of the vertebral body served as sagittal angle. RESULTS AND CONCLUSION:Measure results suggest that each angle was bigger than the angle in previous studies, which might be induced by different reference markers. Standard deviation of each angle was also big. These findings verify that the anatomical differences of pedicles were apparent. Thus, we should insert the pedicle screws individual y. Method of locating reference using anatomic landmarks of a single vertebral body can maximize to avoid interference posture. The combination with preoperative three-dimensional reconstruction is more in line with the requirements of pedicle screw, and can effectively improve the accuracy of pedicle screws.