Objective To report a case of neuromyelitis optia with hiccups as the first symptom. Methods 1 case received laboratory examination according to the clinical symptoms, signs, especially aquaporin-4. Results Aquaporin-4 antibody was positive. Conclusion Aquaporin-4 may play an important role in the pathogenesis of neuromyelitis optia.

ObjectiveTo explore the application of finasteride during ipratropium bromide treatment in the elderly with chronic obstructive pulmonary disease. Methods The 263 patients who were hospitalized for chronic obstructive pulmonary disease (COPD) and treated with ipratropium bromide (aged 63-89 years) in Cadre Wards of Ji Shui Tan Hospital from Jan.2006 to Jan.2011 were reviewed.They were divided by gender and combination of benign prostatic hyperplasia (BPH) and treatment of finasteride.The duration of ipratropium bromide treatment,time to dysuria and the severe degree of dysuria were evaluated.Results None of the female patients suffered from difficult urination or discontinued impratropium bromide for abnormal urination,while there were 23.3％ cases with difficult urination,5.8％ catheterization and 3.4％ discontinued bromide in male patients.More patients suffered from catheterization and bromide discontinuance in prostatic hyperplasia group (8.0 ％ and 4.7 ％ ) as compared with non-prostatic hyperplasia group (P＜ 0.05).The occurrence of urethral catheterization for dysuria or ipratropium bromide discontinuance obviously decreased 40％ and 30％,respectively,after finasteride treatment (P＜0.01). Conclusions The COPD patients complicated with BPH should be treated with finasteride to prevent the occurrence of abnormal urination and urinary retention during the treatment of ipratropium bromide.

Objective To discuss application of initiative infrared ray computer assisted 3D navigation system in spinal complex operation to improve surgical safety. Methods From December 2002 to July 2004, we performed 90 cases of spinal operation assisted by computer 3D navigation system. There were 38 cases of spinal fractures, and 236 cases of pedicle fixation. In lumbar spine surgery, fluoroscopy was commonly used, because the pedicle of lumbar spine was thick enough. 3D computer navigation was used in the other cases. Results 4 screws (1.7%) were not in good position, and the position error rate was 0.23 to 0.56 mm (automatically calculated by the computer). But we had once performed 272 cases of fixation with cervical pedicle screws just assisted by G arm or C arm fluoroscopy, 29 (10.7%) of which were not in good position. Conclusion In comparison, computer navigation assisted operation can make pedicle screw positioning more correct.

Technological advances in spinal surgery have brought about changes to the theories and methods of treatment of spinal fractures. New techniques, such as pedicle screw fixation, upper cervical fixation, minimal invasive method, computed navigation method, have made it possible that much more spinal fractures can be treated operatively rather than conservatively. These changes have also made the recovery of patients more satisfactory. But if the new techniques are not used properly, they can do harms to the patients. Therefore, how to apply the new techniques properly and avoid unnecessary harms to the patients at the same time is a serious problem that we must face and solve.

Objective To investigate the effect of visfatin on the NG2 cell number in the brain of normal rats and rats with cerebral ischemia/reperfusion (I/R) injury. Methods Transient focal cerebral I/R model was established by middle cerebral artery occlusion (MCAO) and a monofilament suture via intraluminal approach in rats. Thirty adult male Wistar-Kyoto rats were randomly divided in to four groups, namely, a sham operation group (Sham), a cerebral I/R model group(MCAO), Sham+FK866(a specific inhibitor of visfatin) group, and cerebral I/R+FK866 group. Animats nn the latter two groups were intragastsically given FK866 (1 mg/[kg • d]) for a consecutive of 14 days; Sham operation or MCAO was pefformed at the 7th day of FK866 treatment. The NG2 cells were observed by immunofluorescence staining in animal brains at the 7th day after surgery. Results There was no signficant difference in NG2 cell numbeis between the Sham group and Sham + FK866 group. Cerebral I/R model group had significantly less NG2 cells in the core region of infarction(P<0. 01) and significantly more in the penumbra area (P<0. 01) compared with the Sham group, with no significant change in the contralateral side. The NG2 cell numbers were not significantly different between the cerebral I/ R model group and cerebral I/R + FK866 group in the above mentioned areas. Conclusion Inhibition of visfatin shows no noticeable effect on NG2 cell number in the brains of normal and cerebral I/R rats, indicating that the neuroprotective effect of visfatin is not assoiiated with NG2 cells.

Craniocerebral Trauma ; surgery ; Humans ; Maxillofacial Injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To investigate the expressions of RTN4 and TG2 in papillary thyroid cancer tissues and their clinical pathological significance.Methods A total of 40 samples of papillary thyroid cancer tissues and 20 samples of para‐carcinoma tissues were collected from the Department of Pathology ,Renmin Hospital of Wuhan University ,China.The expression levels of RTN4 and TG2 were detected by means of immunohistochemical staining and their relationship with clinicopathological charac‐teristics of papillary thyroid carcinoma was analyzed.SPSS 13.0 soft package was used for one‐way analysis of variance and SNK test of the average absorbance and the average positive area rate (α=0.05).Bivariate correlation analysis of the positive area rate of the expressions of RTN4 and TG2 was conducted (α=0.05).Results ①The expression levels of RTN4 and TG2 were much higher in the papillary thyroid carcinoma tissues than those in the para‐carcinoma tissues (P<0.05). ② The expres‐sion levels of RTN4 and TG2 were significantly higher in lymph node metastasis group than those in the group without lymph node metastasis (P<0.05).The positive expression rates of RTN4 and TG2 were much higher in clinical stage Ⅰand Ⅱ groups than those in clinical stage Ⅲ and Ⅳ groups (P<0.05).They were significantly increased in low differentiation group than in high or moderate differentiation group (P< 0.05).The expressions of RTN4 and TG2 were not statistically associated with tumor size ,age and sex (P>0.05). ③The positive correlation was found between the expressions of RTN4 and TG2 in papilla‐ry thyroid carcinoma tissues (r=0.587 ,P<0.05).Conclusion ① The expressions of RTN4 and TG2 were up‐regulated in pa‐pillary thyroid carcinoma tissues ,which is related with over‐proliferation and increase of apoptosis resistance of cancer cells. ②RTN4 and TG2 play an important role in the proliferation and metastasis of papillary thyroid carcinoma. ③ RTN4 and TG2 may play a synergistic role in the development of papillary thyroid carcinoma.

Purpose Placenta implantation (PI) is a rare but severe pregnancy complication, and imaging diagnosis is always difficult. This paper aims to explore the ideal fast-imaging MRI sequences for PI and to provide high quality images for diagnosis. Materials and Methods The MRI images of 21 cases with pathology confirmed PI were retrospectively analyzed. Prenatal MRI of 2D fast-imaging employing steady-state acquisition (2D FIESTA) and single-shot fast spin echo (SSFSE) sequences were performed, and the imaging quality rating and the accuracy in detecting PI were compared. Results Satisfactory images were acquired in 71.4% (15/21) of the patients using 2D FIESTA, and 38.1% (8/21) using SSFSE with statistically significant difference (χ2=4.790, P<0.05). The MRI features of PI included placenta heterogeneity, low-signal-intensity bands, abnormal placental vascularity, uterine junction zone interruption, placental tissue invading the myometrium, placenta tissue into uterine serosa, and the detection rates of 2D FIESTA and SSFSE sequences on the above features were 57.1%, 57.1%, 28.6%, 61.9%, 66.7% and 14.2%, respectively; 90.4%, 71.4%, 38.1%, 42.9%, 28.6% and 6.5%, respectively. The detection rates of placenta heterogeneity and placental tissue invading the myometrium using these two sequences are statistically different (χ2=4.560 and 6.109, P<0.05). Conclusion The images quality of 2D FIESTA sequence is higher than those of the SSFSE sequence. 2D FIESTA sequence shows better delineation of the border of the placenta and uterine, and SSFSE sequence shows better contrasts of the placenta;therefore, combining these two can improve MRI diagnostic value for PI.

Objective To discuss postoperative analgesia effect of patient automatic controlled epidural analgesia (PCEA) and cocktail therapy (CT) after total hip replacement. Methods Eighty-eighty patients of selective total hip replacement were selected, and the patients were divided into PCEA group and CT group by random digits table method with 44 cases each. The postoperative resting state and active state visual analogue score (VAS), dosage of opioid, discharge time, postoperative complications, postoperative sleep quality score and hip joint mobility were compared between 2 groups. Results The resting state and active state VAS in PCEA group 12, 24 and 48 h after operation were significantly lower than those in CT group, resting state: (3.68 ± 1.45) scores vs. (4.23 ± 1.14) scores, (2.61 ± 1.04) scores vs. (3.92 ± 1.23) scores and (2.31 ± 0.97) scores vs. (3.56 ± 1.21) scores, active state:(4.54 ± 1.63) scores vs. (5.87 ± 2.11) scores, (3.51 ± 0.94) scores vs. (4.34 ± 1.07) scores and (3.01 ± 0.95) scores vs. (4.05 ± 1.17) scores, and there were statistical differences (P<0.05). But there were no statistical differences in VAS 72 h after operation and at discharge between 2 groups (P>0.05). The dosage of opioid in PCEA group was significantly lower than that in CT group:(9.58 ± 5.35) mg vs. (11.27 ± 4.48) mg, and there was statistical difference (P<0.05). The incidences of nausea vomiting and headache dizziness in CT group were significantly lower than those in PCEA group: 20.45% (9/44) vs. 45.45% (20/44) and 4.55% (2/44) vs. 13.64% (6/44), and there were statistical differences (P<0.05). There were no statistical differences in length of hospital stay, postoperative sleep quality score and postoperative hip joint mobility between 2 groups (P>0.05). Conclusions Choice of analgesic regimen of choice should not be made only according to the length of hospital stay. Individualized treatment is recommended. According to specific circumstances and needs of patients, patients with less anesthetics and a tendency to nausea should use PCEA, and for chronic pain patients CT may be more effective.

Deep vein thrombosis (DVT) is a serious complication of fractures. The incidence of ankle fracture which occurs most frequently intra-articular is 200/100 000, about 3.9%of all fractures. Domestic and foreign reports of ankle fractures and DVT were allocated and analyzed to review their correlation. Furthermore, different methods of rou-tined thromboprophylaxis was discussed. DVT incident after ankle fractures and the necessity of routined thromboprophy-laxis were reviewed. DVT incidence after ankle fractures was low and routine thromboprophylaxis was not necessary to all ankle fracture patients except the ones who had risk factors of thrombosis which could induce DVT.