Moyamoya disease is a chronic progressive cerebrovascular disease. It got its nickname, the moyamoya disease, because the image of abnormal blood vascular net at the skull base in the encephaloangiography of such patients is very similar to smog. The moyamoya disease can be divided into two types: ischemic and hemorrhagic according to its clinical manifestations and imaging characteristics. In the ischemic type of moyamoya disease, when the blood vascular lumens are not narrow enough to completely block the blood flow, the chief manifestation is the cerebral blood circulation insufficiency; when the salvage is not in time, the disease will further progress to develop vascular obstruction or thrombosis, resulting in cerebral infarction, finally hemiplegia, aphasia, etc. irreversible symptoms and signs occur. In the primary hospital, the first choice for treatment of acute cerebral infarction (ACI) is drug thrombolysis. However, the main treatment for moyamoya disease with ACI is chiefly revascularization. This article reported a patient with moyamoya disease and ACI successfully treated by intravenous reteplase for thrombolysis in People's Hospital of Pucheng County.

Objective By analysis oflateralepicondylitis patients MRI features to explore the lateralepicondylitis namedrationality and authorized its opinions for the ninth edition surgery textbook. Methods Cochrane's systematic review methods were used to retrieve the literature about lateralepi-condylitis patients MRI features fromCochrane Library, Medline, OVID, EMBASE, Chinese biomedical literature database (CBM), VIP, CNKI, Wan fang digital journals, and totally 31 articles were reviewed. 13 articles met the inclusion criteria for the lateral epicondyle of humerus elbow in patients with MRI findings. In accordance with the case-control data RevMan 5.0 software was used for Meta analysis withodds ratio (OR) as count data statistics. Interval estimation wasmade of 95% confidence interval (CI). When the datacannot be performed Meta analysis, only qualitative analysis was made. Results 13 studies met the inclusion criteria, including 315 ipsilateralelbows (5 patients with bilateral disease, 305 patients with unilateral disease) and 169 asymptomatic side of the elbow (98 cases of patients with the contralateral elbow, 71 cases of healthy volunteers). The results of Meta analysis suggested that pa-tients and healthy volunteers of elbow MRI showed statistically significance [OR=88.55, 95%CI=(29.20, 268.57)]. Between ipsilateral elbow and contra lateral of elbow MRI showed statistically significance [OR=80.17, 95%CI=(21.53, 298.59)]. MRI analysis showed that in addition to signs of extensor tendon injury, the elbow was also widely associated with other changes, such as radial collateral ligament in-jury, bone marrow edema, joint effusion, tendon tear, and elbows muscle edema. Conclusion Through MRI findings,the maln pathological changes of the so-called lateralepicondyliti-saremalnly for total ex-tensor tendon and adjacent tissue of chronic injury, Naming the current external humeral epicondylitis is unreasonable. Therefore, periarthritis of lateral epicondyle of humerus seems to be the best appropri-ate term to be usedwhenthe ninth edition surgery textbooksisauthorized.

Objective To apply electrical impedance tnmography that is a new evaluation ap-proach to monitor the development of retroperitoneal injury. We used retroperitoneal inject blood model in pigs to study the feasibility on monitoring retroperitoneal bleeding and to provide premise in theory and practice for clinical application. Methods Five pigs were used on the experiment. We insert a vessel into the retroperitoneal and inject blood to simulate retroperitoneal bleeding. Sixteen electrodes were atta-ched on the abdominal region circumference of pigs and used for electrical current injection and surface voltage measurement. Then the monitoring images were performed by electrical impedance tomography. Results The images of electrical impedance tomography retroperitoneal inject blood model of five pigs were clear, the minimal impedance scale was decreasing significantly as the bleeding volume increasing and the images were changed significantly too. The computerized tomography and the dissecting results confirmed the blood was limited in retroperitoneal. Conclusions The establishments of pigs retroper-itoneal inject blood model was successful. The images of electrical impedance tomography retroperitoneal inject blood model were clear with significant contrast. It's feasible to use electrical impedance tomography system to monitor the retroperitoneal bleeding. This technique may become a useful tool for monitoring ret-roperitoneal injury in intensive care patients.

Objective To investigate the risk factors and patterns of radiation induced gastroduodenal complications in patients with pancreatic cancer following tomotherapy (TOMO) using endoscopy.Methods Patients with pancreatic cancer who were treated TOMO in Air Force General Hospital from February 2010 to May 2015 were collected.All patients underwent endoscopic examination before and after radiotherapy.The radiation injuries were observed,and factors influencing radiation-induced gastroduodenal complications were analyzed.Results The median time of gastroscopy after radiotherapy was 1 month,radiation gastritis and duodenitis were 41 cases (58.6％),radiation gastric and duodenal ulcers were 30 cases (42.9％),and hemorrhage 7 cases (10.0％),scar formation 3 cases (4.3％),6 cases (8.6％) had newly developed gastric retention,and 4 cases (5.7％) had newly developed gastric varix.Univariate analysis showed that relieving jaundice and radiation protection (amifostine) were associated with the development of radiation gastric ulcers (x2 =4.186,P =0.041;x2 =5.679,P =0.017).Conmon terminology criteria for adverse events (CTCAE) ≥2 was associated with the development of radiation duodenal ulcers (x2 =3.960,P =0.047).Mean dose (Dmean) ＞ 13.39 Gy and Dmean ≤13.39 Gy gastric ulcers rates were 25.0％ and 9.1％,respectively (AUC =0.740,P =0.048).Conclusion The TOMO induced gastroduodenal injury in patients with pancreatic cancer is frequent.Relieving jaundice is the protection of radiation gastric ulcer.Dmean ＞ 13.39 Gy is independent predictive factors for radiation gastric ulcers.Patients after TOMO should be examined by endoscopy early.

Objective To explore the correlation between acute gastrointestinal side effects caused by radiotherapy in pancreatic cancer and degree of gastroduodenal radioactive injury under gastoendoscopy.Methods From February 2010 to May 2015,112 patients with pancreatic cancer and received radiotherapy were enrolled.The correlation between gastroscopic findings and degree of gastrointestinal side effects (grade zero to five) was analyzed.The effects of different radiotherapy on the formation of radiation ulcers were also investigated.Chi-square test and Spearman correlation analysis were performed for statistically analysis.Results The incidence of radioactive gastroduodenitis was 57.1 ％ (64/112).The incidence of radiation-induced ulcer was 42.0 ％ (47/112).Among the 112 patients with pancreatic cancer and received radiotherapy,patients with over grade two nausea,vomiting,dyspepsia and constipation received symptomatic treatment.Thirty-one patients (27.7 ％) of them received appetitestimulating treatment,53 patients (47.3％) were given anti-nausea treatment,39 patients (34.8％)received therapy of promoting digestion,and 24 patients (21.4 ％) received therapy of relieving constipation.The incidence of radiation-induced ulcer in patients with grade one acute gastrointestinal side effects was 25.8 ％ (8/31),lower than that of patients with over grade two acute gastrointestinal side effects (48.1％,39/81),and the difference was statistically significant (x2 =4.595,P=0.032).The grade of acute gastrointestinal side effects was positively correlated with that of radiation-induced injury under gastroendoscopy (r=0.295,P =0.002).The incidences of radiation-induced ulcer of gamma knife radiotherapy and helical tomotherapy were 50.0 ％ (15/30) and 39.2 ％ (31/79),respectively,and the difference was not statistically significant (x2 =1.032,P =0.301).Conclusions The occurrence of radiation ulcers should be alerted if over grade two acute gastrointestinal side effects presented in patients with pancreatic cancer and received radiotherapy.The radiotherapy caused gastrointestinal side effects can not be evaluated just according to clinical symptoms.Endoscopic findings and pathological diagnosis are the gold standard.

Piglets having each a body weight of 20-30 kg and an abdominal perimeter like human's were used in the experiment. Being guided by ultrasound, we stabbed the piglet's abdomen, placed a catheter on the liver's lower margin, then injected the anticoagulated blood through the catheter by electrical infusion pump with constant speed respectively, and monitored the whole process by EIT. We observed the image change, using Ultrasound and CT to examine the area of blood injection after the end of monitoring,and we dissected to check the result of observations. The results reveal: (1) Ultrasound, CT and dissection are all able to find out a large amount of blood in piglet's abdominal cavity; (2) The pixel value of EIT target area decreases with the increase of blood, and the change in impedance image can be obviously observed. Therefore, this animal model is suitable for simulating intraperitoneal bleeding, and the speed of bleeding therein can be controlled. We can get a limpid image when EIT is used for monitoring the intraperitoneal bleeding simulated by this animal model.
Animals ; Electric Impedance ; Female ; Hemorrhage ; diagnosis ; etiology ; physiopathology ; Image Interpretation, Computer-Assisted ; methods ; Male ; Monitoring, Physiologic ; methods ; Peritoneal Diseases ; diagnosis ; etiology ; physiopathology ; Plethysmography, Impedance ; methods ; Swine ; Tomography ; methods

Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T.Methods One hundred and eighteen patients with esophageal carcinoma,proven by the gastroscopic biopsy,were prospectively studied using 3.0 T MR.The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images,the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured.The MR images were reviewed in the transverse plane.According to the seventh American joint committee on cancer,the MR stage was made and the tumor's thickness was measured.The MR images and the histopathological slices were matched.The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference,Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis.Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement.Results Ninety seven cases(82.2％,97/118) of MR stage were accurately made,including 7 T1a,15 T1b,18 T2,25 T3 and 32 T4a cases,furthermore,14 cases were over staged and 7 cased were underestimated.The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3％(7/12) to 100.0％(32/32),the specificity was 95.3％ (82/86) to 98.1％ (104/106),and the accuracy was 91.5％ (108/118) to 96.6％ (114/118),respectively.Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0,2.6 and 2.1 mm,which demonstrated a good consistency.Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging.

Objective To introduce the therapeutic procedures of helical tomotherapy based total marrow irradiation(HT-TMI), and validate the feasibility of TMI. Methods At 1 week before bone marrow transplantation,12 patients received TMI conditioning regimen at a prescriptive dose of 12 Gy in 3 times,once daily. Patient immobilization, CT simulation, target delineation, plan design and dosimetric verification were implemented in sequence according to the TMI procedures. The dosimetric paramaters of the target and normal tissues were analysed. The correlation between the dose verification and image-guided results was observed. Results Compared with total body irradiation(TBI), TMI could significantly reduce the irradiation dose to normal tissues. The median dose D50of all normal tissues except the oral cavity were lower than 6 Gy,where The D50of lens,brain,lung and liver are (1.8±0.1) Gy, (5.7±0.2) Gy, (5.2±0.2) Gy, and (4.6±0.2) Gy, respectively. Pass rate of γ Index was larger than 95% with 3mm/3% criterian for each section. The positioning error of head and neck was relatively lower than that of pelvis at x-axis,and was higher at z-axis.Conclusions Helical tomotherapy based TMI is a feasible and reasonable approach,which has evident dosimetric advantage.

Objective·To explore the effects of the cancer-testis antigen(CTA)family member CT63 on proliferation,differentiation,and tumorigenicity of chronic myeloid leukemia(CML)cells,and uncover the underlying molecular mechanisms.Methods·The link between CT63 expression and the prognosis of myeloid leukemia patients was analyzed using bioinformatics methods(TCGA database).A K562 cell line with CT63 knockdown was established.The knockdown efficiency of CT63 was confirmed by qRT-PCR and Western blotting.Live-cell imaging and CCK-8 methods were adopted to evaluate the inhibitory effect of CT63 knockdown in CML cells.A subcutaneous tumorigenesis assay in nude mice was conducted to examine the effects of CT63 on tumorigenesis,tumor growth,and differentiation of K562 cells in vivo.Phorbol 12-myristate 13-acetate(PMA)-induced monocyte/macrophage differentiation experiment was carried out to investigate the role of CT63 in the differentiation of K562 cells in vitro.Mitochondrial function was assessed to determine the impact of CT63 on CML cells both in vivo and in vitro.Results·The Kaplan-Meier survival curve indicated that low expression levels of CT63 were correlated with longer survival in patients with myeloid leukemia.Down-regulation of CT63 in K562 cells inhibited proliferation and promoted differentiation.Live-cell imaging and CCK-8 assays displayed that knockdown of CT63 inhibited cell proliferation and extended cell doubling time in K562 cells.In the subcutaneous xenotransplantation model,down-regulation of CT63 inhibited tumor growth in nude mice.K562 cells expressing lower levels of CT63 were more prone to differentiate into monocyte/macrophage both in vivo and in vitro under PMA exposure condition.Knockdown of CT63 suppressed the activity of mitochondrial respiratory chain complex Ⅳ.This led to decreased expression of mitochondrial markers,including cytochrome C oxidase Ⅳ(COX Ⅳ),pyruvate dehydrogenase,succinate dehydrogenase A(SDHA),and voltage-dependent anion channel(VDAC),thus affecting the mitochondrial metabolic activity of K562 cells.Conclusion·CT63 is related to the prognosis of myeloid leukemia patients.CT63 plays an important role in promoting proliferation and inhibiting differentiation of K562 cells in vivo and in vitro.CT63 serves as a switch to regulate the balance between proliferation and differentiation of CML cells via the modulation of mitochondrial activity.

Magnetotactic bacteria (MTB), a group of phylogenetically diverse organisms that use their unique intracellular magnetosome organelles to swim along the Earth's magnetic field, play important roles in the biogeochemical cycles of iron and sulfur. Previous studies have revealed that the bacterial actin protein MamK plays essential roles in the linear arrangement of magnetosomes in MTB cells belonging to the Proteobacteria phylum. However, the molecular mechanisms of multiple-magnetosome-chain arrangements in MTB remain largely unknown. Here, we report that the MamK filaments from the uncultivated 'Candidatus Magnetobacterium casensis' (Mcas) within the phylum Nitrospirae polymerized in the presence of ATP alone and were stable without obvious ATP hydrolysis-mediated disassembly. MamK in Mcas can convert NTP to NDP and NDP to NMP, showing the highest preference to ATP. Unlike its Magnetospirillum counterparts, which form a single magnetosome chain, or other bacterial actins such as MreB and ParM, the polymerized MamK from Mcas is independent of metal ions and nucleotides except for ATP, and is assembled into well-ordered filamentous bundles consisted of multiple filaments. Our results suggest a dynamically stable assembly of MamK from the uncultivated Nitrospirae MTB that synthesizes multiple magnetosome chains per cell. These findings further improve the current knowledge of biomineralization and organelle biogenesis in prokaryotic systems.
Actins ; chemistry ; metabolism ; Adenosine Triphosphate ; metabolism ; Bacteria ; classification ; metabolism ; Bacterial Proteins ; chemistry ; metabolism ; Magnetospirillum ; classification ; metabolism ; Nucleotides ; metabolism ; Phylogeny ; Substrate Specificity