Objective To evaluate the value of DSA image mosaic in arteriography in lower extremities. Methods 22 suspected cases were examined by bolus chase, and then the images were mosaiced to a full picture after processing by Paste to judge the image effects of vessels. Results This method could display the whole image by one injection of contrast media. Vary lesions were found in the 22 cases. Conclusion This method can display the lower extremities lesions directly, which is better than traditional DSA.

Objective To compare the safety and efficiency of non -ionic monomer diagnostic opaque, iodixanol (Visipaque) and that of non -ionic disomer diagnostic opaque, iohexol (Omnipaque). Methods By comparing retrospectively the DSA opacification of 60 patients from 2006 to 2007, patients′ indispositions, adverse reactions and pictorial efficiency were recorded respectively. Results In the control group, iodixanol showed less indisposition caused by injection than iohexol and there′ s no obvious difference of indisposition. Both images met diagnostic requirements. Conclusion Both iodixanol and iohexol are safe, efficient and well -tolerant diagnostic opaque. Iodixanol is better than iohexol in indisposition caused by injection.

Objective To explore the effects of Methylprednisolone (MP) on level of monocyte chemoattractant protein 1 (MCP-1) expression and macrophages infiltration in early spinal cord injured (SCI) rats.Methods Animal SCI model was established by modified Nystrm method. 72 rats were randomly divided into three groups: SCI group, normal saline control group and MP treatment group. Each group,divided into three subgroups, were sacrificed at 1 d, 3 d, 7 d postinjury. Spinal cord tissues were collected and sections were made to do following examinations: (1)morphological observation by hematoxylin and eosin stain;(2)the expression and distribution of local MCP-1 positive cells, and the infiltration of macrophages by immunohistochemical method. The cell population of different time points were counted and compared.Results MP reduced the proportion of both MCP-1 positive cells and marcrophages in local spinal cord, meanwhile MP elevated the mean density of Olsiwski corpuscle at all time points as compared with those in control group (all P

Objective To compare the function and influence of magnetic resonance cholangiopancreatography (MRCP) and T tube cholangiography before pulling out T tube after biliary tract surgery. Methods Clinical data from 248 patients with T tube drainage after biliary tract surgery bewteen January 2009 and June 2011 were retrospectively analyzed.Among them, the T tube cholangiography group was 195 cases, and MRCP group was 53 cases.Analyzed the function, the toxic side reaction and effect of prolonged hospitalization time of T tube cholangiography group and MRCP group,and discussed the diagnostic effect of MRCP before pulling out T tube after biliary tract surgery.Results Two groups of patients got distinct and integrated image of the bile ducts all.Compared with T tube cholangiography group, all 53 cases patients of MRCP group got accurate of diagnosis results, no fake positive results and adverse reaction occurred, and no prolonged hospitalization. Conclusion MRCP can replace T tube cholangiography as a means of diagnosis before removal of T tube.

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective To evaluate the osteogenic characteristics of an injectable silk fibroin (SF) enhanced calcium phosphate cement (CPC) composite loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2) on lumbar interbody fusion in sheep. Methods Twenty-four mature sheep were randomly divided into two groups. Each sheep underwent L1.2, L3.4 and L5.6 lumber interbody fusion, and the three disc spaces were randomly implanted with three of the following materials: SF/CPC, CPC/rhBMP-2, SF/CPC/rhBMP2 and autogenous iliac crest bone. One group was killed at 6 months and the other at 12 months. The fusion segments were observed and analyzed by manual palpation, CT scan, undestructive biomechanical testing, undecalcified histology, and histomorphology. Results The fusion rates of SF/CPC, CPC/rhBMP-2, SF/CPC/rhBMP-2 and autogenous bone assessed by manual palpation were 0, 33.33%, 55.56% and 77.78% respectively at 6 months. At 12 months, the fusion rates improved to 11.11%, 44.44%, 77.78% and 77.78%, respectively.The biomechanical results showed that fusion stiffness was significantly greater in autograft compared with SF/CPC/rhBMP-2, CPC/rhBMP-2, and SF/CPC in 4 degrees of freedom (flexion, extension, right bending, and left bending) at 6 months. The SF/CPC/rhBMP-2 composite showed similar stiffness as autograft, which was significantly greater than CPC/rhBMP-2 and SF/CPC at 12 nonths. Both CPC/rhBMP-2 and SF/CPC/rhBMP-2 showed significantly greater stiffness at 12 months compared with that of at 6 months. The results showed that bone volume was significantly greater in autograft compared with SF/CPC/rhBMP-2, CPC/rhBMP-2, and SF/CPC at 6 months. There was significant difference among ceramic residue among SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2, with SF/CPC the greatest and SF/CPC/thBMP-2 the least. At 12 months, the bone volume of SF/CPC/rhBMP-2 composite was comparable with autograft, and greater than that of CPC/rhBMP-2 and SF/CPC. The bone volume of SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2 was significantly greater at 12 months than that of at 6 months. The ceramic residue of SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2 were significantly decreased. Conclusion The SF/CPC/rhBMP-2 composite had excellent osteoconduction and osteoinduction, and balanced degradation and osteogenesis, which may be a kind of ideal bone grafts in spinal fusion.

Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .

Objective:To investigate the methylation status of the RASSF1A gene promoter in upper tract urothelial carcinoma (UTUC)tissues and its correlation with clinicopathologic characteristics and postoperative recurrence of primary UTUC.Methods:In a retrospective design,a total of 687 patients who underwent surgeries for primary UTUC in the urology department of Peking University First Hospital were enrolled.The methylation status of the RASSF1A gene promoter was analyzed using methylation-sen-sitive polymerase chain reaction on tumor specimens.Results:Aberrant methylation for the RASSF1A gene promoter was detected in 183 (26.6%) DNA samples in total.Aberrant methylation of the RASSF1A gene was strongly associated with tobacco consumption (P =0.044),ipsilateral hydronephrosis (P <0.001 ),tumor location (P <0.001 ),tumor stage (P =0.001 ),tumor grade (P =0.007), lymph node metastasis (P =0.001 )and growth pattern (P =0.013).The methylated RASSF1A gene promoter was an independent risk factor for bladder recurrence (P <0.001,HR =0.471)and contrala-teral recurrence (P =0.030,HR =0.269)of UTUC after surgery.Hypermethylated RASSF1A was pre-dictive for improved bladder recurrence-free survival (BRFS)(P <0.001)and contralateral recurrence-free survival (CRFS)(P =0.021)in the UTUC patients.Compared with the patients with unmethylated RASSF1A,the patients containing tumors with hypermethylated RASSF1A had tendency toward longer re-currence-free survival time [(114.4 ±3.9)months vs.(84.0 ±3.2)months for BRFS,(138.1 ±1.8) months vs.(132.9 ±1.9)months for CRFS]and higher estimated cumulative recurrence-free survive rates (five-year survival rate for example,79.8% ±3.4% vs.57.4% ±2.6% for BRFS,98.9% ± 0.8% vs.93.0% ±1.4% for CRFS).Additionally,tumor multifocality (P =0.002,HR =1.538), and ureteroscopy before surgery (P =0.001,HR =1.725)were independent risk factors for bladder re-currence in postoperative UTUC patients.Conclusion:The methylation status of the RASSF1A gene pro-moter appears to be a promising epigenomic biomarker for assessing the aggressiveness of UTUC and a predictor predicting the urinary tract recurrence after surgery.

Objective To investigate the role of the percentage of the total cross-sectional area of small pulmonary vessels for the lung area (%CSA) from multi-slice CT (MSCT) in evaluating the severity of chronic obstructive pulmonary disease (COPD). Methods One hundred and sixty-six COPD patients and 166 normal subjects underwent chest MSCT scans and all data were analyzed retrospectively. COPD patients underwent pulmonary function tests (PFT), including forced expiratory volume in one second (FEV1%) and FEV1/forced vital capacity (FEV1/FVC), and were classified into mild (n=32), moderate (n=65), severe (n=69) groups according to pulmonary function results, respectively. The%CSA less than 5 mm2 and 5—10 mm2 for the lung area (%CSA<5 and %CSA5-10) of small pulmonary vessels were measured with Image J image-processing program. Comparison of%CSA<5 and%CSA5-10 between the COPD and control groups was perfomred using t test, and the comparison between the 3 COPD subgroups and control group were carried out using ANOVA test. The correlation between %CSA and PFT was evaluated by the Spearman rank correlation test. The sensitivity and specificity of %CSA to diagnose COPD and the best cutoff were calculated from areas under the ROC curves. Results %CSA<5 of COPD patients and control group were (0.56 ± 0.19)%and (0.82 ± 0.15)%(t=12.80, P<0.001), respectively.%CSA5-10 of the two groups were (0.19 ± 0.09)%and (0.33 ± 0.16)%(t=8.93,P<0.001), respectively. The AUC values of%CSA<5 and%CSA5-10 were 0.866 and 0.790, respectively. When the cut-off values of%CSA<5 and%CSA5-10 were 0.65%and 0.24%, the sensitivities and specificities were 88%and 71%, 76%and 81%, respectively. The mean values of%CSA<5 in mild, moderate and severe groups were (0.67±0.20)%, (0.61±0.16)%and (0.44±0.14)%, respectively (P<0.05). The mean values of %CSA5-10 in the three groups were (0.19 ± 0.06)%, (0.19 ± 0.10)% and (0.20 ± 0.08)%, respectively.%CSA5-10 in the three groups were of no significant difference (P>0.05). FEV1%and FEV1/FVC in COPD patients were (60.38±15.52)%and 57.95±22.27.%CSA<5 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.609 and 0.721, P<0.01, respectively).%CSA5-10 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.271 and 0.288, P<0.01, respectively). Conclusion The measurement of%CSA<5 and%CSA5-10 in MSCT images correlated with PFTs and%CSA<5, which may play an important role in evaluating the severity of COPD.

Objective To investigate the effect of indoor coal PM2.5 on the airway inflammation and the pathological morphology alterations of lung tissue in asthmatic rats induced by ovalbumin(OVA). Methods Forty six?week?old male SD rats were randomly divided into four groups(Control,OVA,PM2.5,PM2.5+OVA). Normal saline,OVA(15μg/mL)and(or)PM2.5(2.5 mg/mL)were given to rats in the four groups through intratracheal instillation for four times (two weeks one time),respectively. Twenty?four hours after the last intratracheal instillation ,bronchoalveolar irrigation lavage fluid (BALF) was collected for determinations of serum interleukin 4(IL?4),interferon gamma (IFN?γ). The lung tissue was collected for HE staining and electron microscopy detection. Results HE staining showed less inflammatory cell infiltration was observed in the control group;In PM2.5 group and OVA group,there was medium quantity of inflammatory cell infiltration,In PM2.5+OVA group, severe inflammatory cell infiltration was observed. Electron microscopy showed no abnormal lung tissue in the control group,but organelles were gradually destroyed,endothelial cell edama,alveolar interval with a large number of fibersin were observed in PM2.5 group. The exfoliated cells,local typeⅡ cells with visible damage were found in OVA group. A large number of fibers were existed among the lung tissues and organelles were destroyed,thickness of basement membrane was non?uniform,and blood air barrier structure was not clear in PM2.5 + OVA group. Compared with PM2.5+OVA group,concentration of IL?4 in PM2.5,OVA and the control group was siganificantly different(P < 0.05). A negative correlation between IL?4 and IFN?γ was observed (r =-0.358,P < 0.05). Conclusion Indoor coal PM2.5 exacerbates the airway inflammatory cell infiltration and airway remodeling in OVA?induced asthmatic rats.