Objective To evaluate the role of lumbosacral somatosensory evoked potential (LSSEP) examination in the diagnosis of lumbosacral disc herniation (LDH). Methods Somatosensory evoked potential (SEP) from posterior tibial nerve, L_4, L_5 and S_1 dermatomes SEP, and lumbosacral SEP was recorded in 54 patients with radiculopathy caused by LDH. Results The SEP from posterior tibial nerve was abnormal in 22 cases (40.74%). The SEP from L_5 and/or S_1 dermatome was abnormal in 47 cases (87.04%, P

Objective To explore the change and its significance of blood concentrations of high sensitive C-reactive protein(hs-CRP) and D-Dimer in patients with acute cerebral infarction caused by internal carotid artery.Methods The blood levels of D-Dimer and hs-CRP in 69 patients with acute cerebral infarction were measured,and compared with the normal controls.The relationships between the levels of hs-CRP and D-Dimer and NIHSS or the areas of infarction were analyzed.Results Compared with those in normal control group,the blood levels of D-Dimer and hs-CRP in patients with acute cerebral infarction increased significantly(all P

AIM:To investigate the protective effect of ginger oil on liver.METHODS:Mouse model of acute hepatic injury induced by carbon tetrachloride and acetaminophen were used to observe the protective effect of ginger oil on liver.RESULTS:Ginger oil could obviously decrease ALT and AST levels of mouse model of acute hepatic injury induced by carbon tetrachloride and acetaminophen,significantly decrease MDA level of rat liver tissue and mouse serum(P

Objective To explore the incidence and significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases.Methods Imaging studies including MR,CT and plain radiograph were retrospectively reviewed in 245 cases of benign osseous tumors and tumor like diseases proved by pathology(borderline tumor,cases associated with pathological fractures,cases with lesions of skull were excluded from the study).The incidence of bone marrow and soft tissue edema were defined on T2WI with fat suppression on MRI in all the cases.x2 test was performed for the incidence rate of edema in the benign tumors and tumor like diseases.The pre-operative diagnoses were reviewed,and the influence of edema to the differential diagnosis between the benign and malignant was analyzed.Results The total incidence of bone marrow and soft tissue edema associated with benign tumors and tumor like diseases was 37.1％ (91/245),which included Langerhans cell histiocytosis 85.2％ (23/27),osteoblastoma85.0％ (17/20),osteoid osteoma93.6％ (29/31),ehondroblastoma 87.0％ (20/23).There was no statistically significant difference of edema incidence among the above-mentioned four diseases.(x2=6.35,P＞ 0.05).Both cases of endosteal capillary hemangioma had edema around.No edema was found around the lesions of other kinds of diseases.41 of 91 cases (45.1％) with edema were misdiagnosed as malignant tumor by MRI pre-operatively.Conclusion The marrow and soft tissue edema is a common sign in the benign bone tumor and tumor-like diseases,and it is frequently seen in Langerhans cell histiocytosis,osteoblastoma,osteoid osteoma,chondroblastoma.

Objective To research the clinical characteristics of cerebral infarction involving the anterior and posterior circulation in the same time. Methods Collected the clinical data of 11 patients with cerebral infarction involving the anterior and posterior circulation in the same time, who was confirmed by clinical and radiographic examination. Results In the majority of 11 patients, they had multiple risk factors in the same time. By Chinese Ischemic Stroke Subclassification (CISS) criteria, there were 3 patients with large-artery atherosclerotic brain infarction (aortic arch atherosclerosis and intracranial and extracranial large arteries atherosclerosis coexist), 3 patients with cardiogenic stroke, 3 patients with undetermined etiology (intracranial and extracranial large arteries atherosclerosis and cardiogenic stroke maybe coexist), 2 patients with other etiologies(1 patient with Moyamoya disease, 1 patient with polycythemia vera). There were multiple vascular stenosis in the 3 patients with large artery atherosclerosis, and the posterior communicating artery was open. Conclusions Cerebral infarction involving the anterior and posterior circulation in the same time is rare, cardiogenic stroke is more often, the relevant examinations should be perfect to definite the rare cause.

Objective To explore the relationship of D-Dimer and high sensitive C-reactive protein in serum in acute cerebral infarction. Methods 64 patients with acute cerebral infarction were measured with the D-Dimer and Hs-CRP and compared with that of 50 healthy subjects as the controls. Their scores of National Institutes of Health Stroke Scale (NIHSS) were recorded and the correlation with the D-Dimer and Hs-CRP level was analyzed. Results Compared with those in controls, the levels of D-Dimer and Hs-CRP in patients with acute cerebral infarction were significantly higher (P<0.05), and those in patients with large infarction area were significantly higher than those in patients with small infarction area (P<0.01). The levels of D-Dimer and Hs-CRP uncorrelated with the scores of NIHSS.Conclusion The D-Dimer and Hs-CRP level is helpful to assess the acute cerebral infarction.

Objective To evaluate the efficacy of stereotactic body radiation therapy (SBRT) on the survival of patients with early stage pancreatic cancer.Methods The clinical data of 103 T1-2N0M0 pancreatic cancer patients treated by CyberKnife SBRT at the Department of Radiation Oncology of Changhai Hospital from January 2012 to December 2016 was retrospectively analyzed.Kaplan-Meier method was used for survival analysis and Cox proportional hazards model was utilized to identify survival related factors.Results The median overall survival(OS) of T1-2N0M0 pancreatic cancer patients who had unresectable pancreatic cancer or refused surgery was 17.7 (16.1-19.3) months.1-year and 2-year OS rate were 86.3％ and 24.6％,respectively.The median progression free survival(PFS) was 13.0(10.7-15.3) months.1-year and 2-year PFS rate were 54.5％ and 6.3％,respectively.Patients with chemoradiation,BED10 ≥60 Gy and CA19-9 decrease ＞ 50％ after treatment had longer OS and PFS.Conclusions SBRT is a safe and effective treatment for patients with T1-2N0M0 pancreatic cancer.

Objective To identify the 2- year recurrence- related factors in patients with myasthenia gravis (MG) after treatment of low-dose tacrolimus. Methods The clinical data of 100 MG patients treated with low- dose tacrolimus from February 2011 to February 2016 were retrospectively analyzed. All patients were followed up at least 2 years, and the risk factors affecting the recurrence of MG patients were analyzed. Results At the end of follow-up, there were 49 cases who had recurrence, and the recurrence rate was 44.5％ (49 / 110). Logistic regression analysis result showed that reducing dosage or withdrawal, MG crisis and diabetes mellitus were the independent risk factors for recurrence of MG patients (OR = 134.113, 8.850 and 6.652; P < 0.01 or <0.05). Conclusions The rate of recurrence with low- dose tacrolimus treatment in patients with MG during 2 years is higher. Reducing dosage or withdrawal should be avoided, especially in patients with a history of MG crisis. Patients with diabetics mellitus need to control blood glucose stability to avoid recurrence.

Objective To identify the effect of stereotactic body radiation therapy (SBRT) on the survival of patients with recurrent pancreatic cancer after surgery.Methods The data of 104 patients with recurrent pancreatic cancer after surgery who underwent SBRT in the Department of Radiation Oncology of Changhai Hospital,Navy Medical University from February 2012 to December 2016 were retrospectively analyzed.The prescription doses ranged from 35-40 Gy/4-8 f.Survival analysis was performed using the Kaplan-Meier method,and relevant factors affecting patients' survival were screened by the Cox proportional hazards model.Results The median overall survival (OS) and progression free survival (PFS) was 12.5 (11.0-14.0) months and 7.3 (6.0-8.7) months,respectively,while the 1-year rate of OS and PFS was 55.8％ and 22.1％,respectively.Multivariate analysis indicated that tumor stage,biological effect dose (α/β =10,BED10),the decrease of CA19-9 level after treatment,and follow-up chemotherapy were all related factors affecting overall survival;tumor stage,BED10,the degree of pain relief and the decrease of CA19-9 level after treatment were related factors affecting PFS.Conclusions Patients suffering recurrent pancreatic cancer with early tumor stage,normal CA19-9 level and mild pain before treatment could be better treated by SBRT,BED10 ≥60 Gy and follow-up chemotherapy after radiotherapy can prolong the survival of patients.

Objective To propose the method of dose distribution calculated by one-step optimization with 7 shells (Cao method) and compare with that by three-step optimization with 4 shells (Blanck method) and CyberKnife treatment plans for pancreatic cancer. Methods 20 cases of pancreatic cancer who underwent CyberKnife treatment were retrospectively analyzed,and CT was performed to localize and delineate the target area and endangering organs. Dosage was optimized and evaluated with Blanck method and Cao method. The planning target volume (PTV) conformity index (CI), new conformity index (nCI), homogeneity index (HI),gradient index (GI), coverage, dose-volume and doses to organs at risk were compared. Results Compared with Blanck method, CI (1.11 ± 0.05 vs 1.15 ± 0.05), nCI (1.20 ± 0.06 vs 1.23 ± 0.06), coverage [(92.48 ± 1.85)% vs (93.53 ± 2.15)%], volumes encompassed by 100% and 30% prescription dose line (36.46 ± 16.64 vs 38.19 ± 17.68; 286.19 ± 126.52 vs 320.93 ± 154.82) and monitor unit (56 369 ± 20 019 vs 57 814 ± 20 531) were significantly decreased,while GI was increased (3.22 ± 0.19 vs 3.11 ± 0.19), and all the differences were statistically significant (P<0.05). Additionally, Dmax of the intestine (21.17 ± 2.90 vs 20.63 ± 3.13), D10cc of the stomach (12.78 ± 2.57 vs 13.11 ± 2.43), D5ccof the duodenum (11.01 ± 3.45 vs 11.50 ± 3.25), D10ccof the duodenum (9.30 ± 3.31 vs 9.78 ± 3.07) and D0.35ccof the spinal cord (6.09 ± 0.98 vs 6.59 ± 0.92) were all significantly decreased (P<0.05). No significant differences were found on other parameters. Conclusions Better dose distributions are accessible by one-step optimization with 7 shells in CyberKnife treatment plans for pancreatic cancer.