Objective To explore role of 64-slices spiral CT in differetiation of acute chest pains.Methods Thirty six patients with acute chest pains were performed 64-slices spiral CT chest angiography.Two-dimensional and three-dimensional reconstruction was performed in all patients by means of multiplanar reconstruction(MPR)(coronal,sgittal oblique),curved planar reformation(CPR), maximum intensity projection(MIP),and volume rendering(VR).All images were blindly reading by two experienced radiologist.DSA were performed at the same time in 16 cases.Results The coronary artery branches,pulmonary artery and aortic artery in all patients were showed clearly,The acute myocardial infarction were showed in 10 cases,The pulmonary artery embolism in 14 cases,The aortic dissection in 6 cases respectively,The Coronary embolism in One case ,pneumothorax In One case The constrictive pericarditis in 1 case respectively.Normal findings in 4 cases.Conclusion 64-slices spiral CT is a useful and noninvasive examination in acute chest pain.

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Objective To investigate the ostengenie potential of adipose-derived stem cells(AD- SCs)when exposed to adenovirns containing hBMP-2 cDNA(Adv-hBMP-2)and offer a choice of cell source for gene therapy and tissue engineering.Methods Human adipose tissues were obtained from patients who received orthopaedic surgery or liposuction.ADSCs were obtained by digesting the adipose tissues.Firstly,flowcytometric analysis was performed for the confirmation of mesenchymal stem cell ori- gin and the surface markers including CD34,CD44,CD68,CD71,CD90,and CD105.The ADSCs were transfected by Adv-hBMP-2 and the effects were tested in vitro,lmmunoprecipitation and Western blotting and ELISA were performed for confirming BMP gone transduction and its stable expression.The transform of ADSCs was assessed by extracellular ALP staining,intracellular ALP spectrophotometry,von Kossa staining and RT-PCR.In the in vivo experiment ADSC-Adv-hBMP-2 cells were injected into the hind limb of nude mice and analyzed radiographically and histologically.Results ADSCs were successfully isolated from human adipose tissues.The isolated ADSCs expressed CD44,CD71,CD90 and CD105 and CD34 and CD68 were absent.The result confirmed the mesenchymal stem cell origin of the cells.West- ern blotting and ELISA confirmed successful and persistent hBMP-2 production by ADSC-Adv-hBMP-2 cells.Extracellular ALP staining,intracellular ALP spectrophotometry,yon Kossa staining and RT-PCR revealed that ADSCs treated with Adv-hBMP-2 had a tendency of transfering into osteoblast.X-ray and H&E sections from hind limb of nude mice injected with ADSC-Adv-hBMP-2 cells confirmed bone forma- tion at 2 weeks.Conclusions Liposuction aspirates contain abundant ADSCs that can be transduced with hBMP-2 gene,and the tranduced ADSCs differentiate into the osteoblast.ADSCs may be an ideal source of mesenchyme-lineage stem cells for gone therapy and tissue engineering.

OBJECTIVETo evaluate the effect of combined preoperative xeloda and pelvic radiotherapy on locally advanced lower rectal cancer.

METHODSSixty lower rectal cancer patients were divided randomly into two groups. 30 patients (Group A) were treated with operation alone and 30 patients (Group B) were treated with xeloda and radiotherapy before operation.

RESULTSThe operative resection, anal preservation and local recurrence rates were 86.66%, 33.33%, 15.38% in group A and 100%, 83.33%, 0% in group B (P < 0.05 and P < 0.01).

CONCLUSIONCombined preoperative xeloda and radiotherapy for lower rectal cancer is able to significantly improve the operative resection, anal preservation and decrease the local recurrence rates.

Adult ; Aged ; Antimetabolites, Antineoplastic ; therapeutic use ; Capecitabine ; Combined Modality Therapy ; Deoxycytidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Female ; Fluorouracil ; analogs & derivatives ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Radiotherapy ; adverse effects ; Rectal Neoplasms ; therapy

OBJECTIVETo preliminarily research the formular about the Traditional Chinese Medicine (TCM) syndrome of adolescent neck pain.

METHODSAn observation table of adolescent neck pain syndromes was formulated,and 1 397 patients with adolescent neck pain were investigated to establish a database of adolescent neck pain. The Descriptive Statistical Analysis and Hierarchical Cluster Analysis were performed by statistical software.

RESULTSTotally 60 TCM symptoms was clustered into 4 TCM syndromes by Hierarchical Cluster Analysis. The expert panel of TCM syndromes preliminarily formulate 4 TCM syndromes of adolescent neck pain by analyzing the result of Cluster Analysis and discussing their clinical experience.

CONCLUSIONAdolescent neck pain is a category of Tendon Trauma's Bi-syndrome of TCM. Ying, Wei, Qi and blood block caused by exopathy, strains, and internal injury is considered as the main pathogenesis of adolescent neck pain. Base on statistical result and expert's opinions, 4 TCM syndromes about adolescent neck pain were formulated: cold-dampness syndrome, dampness-heat blockage syndrome, liver-stagnation and spleen-deficiency syndrome, Qi and Yin deficiency of both heart and kidney syndrome.

Adolescent ; Adult ; China ; epidemiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Neck Pain ; diagnosis ; epidemiology ; Young Adult

OBJECTIVETo compare the effects of two contrast agents, Gd-DTPA and HSA-Gd-DTPA, in magnetic resonance (MR) lymphography.

METHODSTwelve New-Zealand rabbits were randomized into Gd-DTPA and HSA-Gd-DTPA groups with subcutaneous (interdigital skin fold) injection of the two contrast agents (0.2 ml of 0.5 mmol/L Gd(3+)) for MR lymphography of the popliteal lymph nodes examined in the axial and sagital orientation. T(1)-weighted, T1-weighted fat suppressed, and T(2)-weighted spin-echo (SE) images of the lymph nodes were obtained in plain scans. The post-contrast scanning started at 30 min, 1 h and 3 h after Gd-DTPA administration and at 10 min, 30 min and 60 min after HSA-Gd-DTPA injection to obtain T(1)-weighted images with identical imaging parameters. The signal intensity of popliteal lymph node was measured and the enhancement rate calculated.

RESULTSAfter subcutaneous injection, Gd-DTPA quickly entered blood circulation to result in obvious enhancement of the anterior-tibial vein and the urine and also in heterogeneous enhancement of the popliteal lymph nodes. HSA-Gd-DTPA did not enter the blood, causing obvious homogeneous enhancement of the lymphatic vessels and lymph nodes. HSA-Gd-DTPA resulted in higher enhancement rate than Gd-DTPA, and the enhancement rate in Gd-DTPA group decreased with time as opposed to that of the HSA-Gd-DTPA group.

CONCLUSIONHSA-Gd-DTPA has better performance than Gd-DTPA in MR lymphography after subcutaneous administration.

Animals ; Contrast Media ; administration & dosage ; pharmacokinetics ; Gadolinium DTPA ; administration & dosage ; pharmacokinetics ; Humans ; Lymph Nodes ; diagnostic imaging ; Lymphography ; instrumentation ; methods ; Rabbits ; Random Allocation ; Serum Albumin ; administration & dosage ; pharmacokinetics

BACKGROUNDCardiac involvement is the most common complication of Kawasaki disease (KD); however, the underlying mechanisms are not understood. The present study was designed to investigate changes in plasma hydrogen sulfide (H(2)S) and nitric oxide (NO) levels in the acute and recovery stages of KD children and to examine their clinical significance.

METHODSThirty-five KD patients and 32 healthy children were enrolled in the study. KD patients were divided into two subgroups: a non-cardiac involvement group and a cardiac involvement group. Plasma H(2)S levels were measured using the sulfur-sensitive electrode method and plasma NO levels and NO synthase activity were determined using the nitrate reductase method both before and after intravenous immune globulin (IVIG) therapy.

RESULTSPlasma H(2)S levels significantly decreased in KD patients during the acute phase of the disease and NO levels were significantly increased, compared with the control group (P < 0.01). After treatment with IVIG, both plasma H(2)S and NO levels significantly increased (P < 0.01). The plasma levels of H(2)S were significantly lower in the cardiac involvement group compared with the non-cardiac involvement group (P < 0.05).

CONCLUSIONH(2)S and NO may play a role in the pathophysiological process of inflammation during the acute phase of KD. Endogenous H(2)S may exert protective effects with respect to cardiac complications in KD.

Child ; Child, Preschool ; Female ; Humans ; Hydrogen Sulfide ; blood ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; blood ; Nitric Oxide ; blood

Moving the mandibular posterior teeth into a severely atrophic edentulous space is a challenge. A carefully designed force-and-moment system that results in bodily protraction of the posterior teeth with balanced bone resorption and apposition is needed in such cases. This report describes the treatment of a 19-year-old woman with missing mandibular first molars due to juvenile periodontitis. Miniscrews were used as absolute anchorage during protraction of the mandibular second and third molars. Bodily mesial movement of the mandibular second and third molars was achieved over a distance of 11 to 17 mm after 39 months of orthodontic treatment.

BACKGROUNDDoppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease (KD). However, the diagnostic accuracy for the whole coronary artery lesions is limited. The purpose of this study was to compare the diagnostic value of dual-source computed tomography (DSCT) and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.

METHODSSixteen patients, 12 with typical KD and 4 with atypical KD, underwent DSCT and Doppler color echocardiography. The position and internal diameter of each coronary artery lesion was measured. Correlation analysis was used to compare the diagnostic value of the two imaging modalities.

RESULTSIn the typical KD group, seven patients did not have any coronary artery lesion as confirmed by both DSCT scans and Doppler color echocardiography; in four patients proximal coronary artery injuries were identified by both modalities; in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography. In the atypical KD group, three cases showed the same results with both modalities, while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography. There was a good correlation between the two imaging modalities (Kappa value, 0.768 (>or= 0.75)).

CONCLUSIONDSCT coronary artery angiography is an accurate, non-invasive, and valuable technique for detecting and following up coronary artery lesions in patients with KD.

Adolescent ; Child ; Child, Preschool ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Echocardiography, Doppler, Color ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

To compare the diagnostic value between the thyroid imaging reporting and data system ( TIRADS) and ultrasound ( US ) patterns of 2015 American Thyroid Association ( ATA ) guidelines in the differentiation of benign and malignant thyroid nodules. 639 patients in Jiangsu province who were scheduled for ultrasound-guided fine-needle aspiration biopsy or thyroidectomy were recruited for the retrospective study. All of them were categorized based on TIRADS and ultrasound patterns of ATA ( 2015 ) guidelines. The receiver operating characteristic curve was established to assess and compare the diagnostic value of the two models. Results:( 1 ) 639 patients with 847 thyroid nodules were included in this study, 510 females and 129 males. The mean age was (46. 77 ±12.98)yearsold. (2)818nodulescouldbeclassifiedaccordingtoTIRADS. ThemalignancyratesofTIRADS2,3, 4A, 4B, 5 were 0, 15. 9%, 49. 1%, 78. 8% ,and 100%, respectively. (3) Ultrasound patterns of ATA could be assigned to 793 nodules. The malignancy rates of nodules with very low, low, intermediate, high suspicion for malignancy were 6. 2%, 10. 3%, 24. 9% and 70. 1%, respectively. (4) Ultrasound patterns of ATA had higher specificity (77. 9%) compared to TIRADS. The sensitivity and area under curve of ultrasound patterns of ATA were lower than those of TIRADS, though, not significant. Ultrasound patterns of ATA(2015) guidelines may yield higher specificity in the differential diagnosis of benign and malignant thyroid nodules, while TIRADS classification may offer a relatively higher sensitivity and area under curve.