Objective To investigate the applicative value in stages of pre-infarction period using dynamic perfusion CT. Methods Dynamic perfusion CT was performed in 32 cases of cerebral hypoperfusion. The ratios of side-to-side were measured at hypoperfusion areas in the regional cerebral ischemia. The stages of pre-infarction period were made as the following: (Ⅰ 1) TTP was delayed, MTT, rCBF and rCBV were normal; (Ⅰ 2) TTP and MTT were delayed, rCBF was normal, and rCBV was normal or slightly increased; (Ⅱ 1) TTP and MTT were delayed, rCBF was decreased, and rCBV was normal or slightly decreased; (Ⅱ 2) TTP and MTT were delayed, rCBF and rCBV were decreased. Results There were 4 cases in stage Ⅰ 1. Regional hypoperfusion was revealed only by TTP map. The mean ratios of rCBF, rCBV, MTT, and TTP were 1.00, 1.00, 1.00, and 1.30, respectively. In stage Ⅰ 2, the areas of delayed TTP and MTT were found in all 13 cases. The rCBF and rCBV maps appeared normal in 8 cases. Another 5 cases showed normal rCBF and slightly increased rCBV areas. The mean ratios of rCBF, rCBV, MTT, and TTP were 1.00, 1.03, 1.38, and 1.30, respectively. In stage Ⅱ 1, the areas of delayed TTP and MTT were revealed in all 8 cases. The depiction of decreased rCBF was also found in 8 cases. The areas of decreased rCBV were showed in 5 cases, and normal rCBV maps were revealed in 3. The mean ratios of rCBF, rCBV, MTT, and TTP were 0.56, 0.94, 1.49, and 1.47, respectively. In stage Ⅱ 2, the areas of delayed TTP and MTT were revealed in all 4 cases, in whom depiction of decreased rCBF and rCBV was also found. The mean ratios of rCBF, rCBV, MTT, and TTP were 0.42, 0.59, 1.57, and 1.55, respectively. Conclusion CT perfusion imaging and its parameters' analysis may play an increasing role to delineate the depiction of cerebral hypoperfusion in pre-infarction period. Analyzing the relationship of rCBF, rCBV, MTT, and TTP is very helpful to know the status of the capillary vessels in regional cerebral hypoperfusion area and to provide functional information with our stages of pre-infarction period.

Objective To intruduce a method of making cerebral perfusion mapping and measurement using dynamic CT with a personal computer. Methods We generated the cerebral perfusion mapping and measurement from a series dynamic CT images with a personal computer. The theoretic basis of our technique is central volume principle. The application software was made using visual C++ language with Windows 98 platform. Results This method was applied to a case of transient ischemic attack (TIA). The cerebral perfusion mapping contributed to display the abnormal area of ischemia, which showed as normal imaging appearances in routine CT and MR images. Conclusion Personal computer aided mapping and measurement of cerebral perfusion with dynamic CT is a simple and accessible technique for delineating the hemodynamic response, including abnormal regional cerebral blood flow, blood volume, mean transit time, and time to peak in cases of hyperacute ischemic stroke which was viewed as normal imaging findings in routine CT and MR examination. This method is more suitable to examine emergency cases than MR perfusion imaging and may be used in any facility where CT scanner and personal computer are available.

Objective To investigate the changs of serum and urine vascular endothelial growth factor(VEGF) in children with steroid-sensitive nephrotic syndrome(SSNS) at their active and remission stage.Methods Serum and morning urine levels of VEGF were assayed by Liquichip in 30 patients with SSNS at the active and remission stage and 30 normal age-and sex-matched controls.Results Serum levels of VEGF in patients at the active stage [(186.62?106.21) ng/L] were significantly higher those that at the remission stage [(118.75?73.08) ng/L] and than those in control group [(108.64?54.75) ng/L](P0.05).Morning urine levels of VEGF in patients at the active stage [(201.66?100.46) ng/L] were significantly higher than those at the remission stage [(116.35?55.99) ng/L] and than those in control group [(99.94?42.07) ng/L](P0.05).Conclusions Serum and morning urine levels of VEGF are significantly elevated in patients with SSNS,however they are significantly lower after the treatment of steroid.There is no obvious difference between the patients at the remission stage and healthy controls.VEGF involves pathogenetically and physiologically in SSNS during its onset and growth.

Objective To study the feasibility, indications and clinical value of primary suture after the common bile duet exploration(CBDE).Methods One hundred and fimr cases of choledocholithiasis were chosen for primary suture by 5-Oviger after CBDE. Post-operative complications and the length of hospital stay were compared with those with T-tube drainage. Results Compared with T-tube drainage group, the complication rate was reduced and the length of hospital stay in primary suture group was shortened. And also the mortality and operation time were decreased significantly. Conclusion The primary suture after CBDE in selected oases is safe and reliable.

Objective To investigate variation in the carotid bifurcation geometry of adults of different age by MR angiography images combining image post-processing technique. Methods Images of the carotid bifurcations of 27 young adults (≤40 years old) and 30 older subjects ( >40 years old) were acquired via contrast-enhanced MR angiography. Three dimensional (3D) geometries of the bifurcations were reconstructed and geometric parameters were measured by post-processing technique. Results The geometric parameters of the young versus older groups were as follows: bifurcation angle (70.268°± 16.050° versus 58.857°±13.294°), ICA angle (36.893°±11.837° versus 30.275°± 9.533°), ICA planarity (6.453°±5.009° versus 6.263°±4.250°),CCA tortuosity (0.023°0.011 versus 0.014± 0.005), ICA tortuosity (0.070±0.042 versus 0.046±0.022), ICA/CCA diameter ratio (0.693± 0.132 versus 0.728±0.106), ECA/CCA diameter ratio (0.750±0.123 versus 0.809±0.122), ECA/ ICA diameter ratio (1.103±0.201 versus 1.127±0.195), bifurcation area ratio (1.057±0.281 versus 1.291±0.252). There was significant statistical difference between young group and older group in bifurcation angle, ICA angle, CCA tortuosity, ICA tortuosity, ECA/CCA and bifurcation area ratio (F= 17.16,11.74,23.02,13.38,6.54,22.80,respectively, P<0.05). Conclusions MR angiography images combined with image post-processing technique can reconstruct 3D carotid bifurcation geometry and measure the geometric parameters of carotid bifurcation in vivo individually. It provides a new and convenient method to investigate the relationship of vascular geometry and flow condition with atherosclerotic pathological changes.

Objective To apply a non-invasive and feasible method for the quantification of local wall shear stress (WSS) in vivo using magnetic resonance imaging. Methods The fight common carotid artery of a young healthy male volunteer was examined using cine phase-contrast MR sequence. The cross- sectional area, average flow velocity, maximum velocity and flow rate were obtained. Three dimensional paraboloid model was applied to measure WSS value at common carotid artery. Results The mean/peak WSS was (0.75±0.41)N/m2 for the common carotid artery; The mean (range) velocity was (23.4± 12.0) cm/s; The mean (range) luminal vessel area was (32.2±2.9) mm2; The blood flow rate was (7.8±4. 6) ml/s; Conclusion WSS's magnitude, distribution and changes can be determined by MR imaging combining with the three-dimensional paraboloid method.

Child ; Evidence-Based Medicine ; Humans ; Nephrotic Syndrome ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Recurrence

Objective 　To evaluate the clinical measurement of cerebral perfusion by dynamic CT. Methods　 Thirteen normal adults were examined by dynamic CT for the measurement of cerebral blood flow (CBF). Another dynamic CT scans with the measurement of CBF were performed separately to rule out cerebral ischemia in 5 cases and secondary Parkinson disease in 2. Results　 Normal cerebral cortical perfusion was measured at 59.3～96.8 ml*min-1*100g-1 with the　mean value 76.2 ml*min-1*100g-1. Normal white matter perfusion was measured at 27.1～43.1 ml*min-1*100g-1 with the mean value 33.9 ml*min-1*100g-1. In 5 cases of suspending cerebral ischemia, one showed increase of CBF and 4 presented decrease of CBF. In 2 cases of suspending secondary Parkinson disease, one appeared decrease of CBF and other one was normal. Conclusion　 Dynamic CT scan with the measurement of CBF can demonstrate the hemodynamic status of normal brain and pathological lesion. Combined with routine CT scan, measurement of cerebral perfusion by dynamic CT is an ideal method to show the morphological and functional changes of brain tissue simultaneously.

Objective:To investigate the effect of free fatty acid on leptin receptor in rats.Methods:High plasma free fatty acid rat model was created by intravenous injection of free fatty acid. Western blot was used to assess the protein level of leptin-receptor in rat liver, muscle and pancreas tissues. The RNA expression level of leptin-receptor was examined by RT-PCR .The tyrosine phosphorylation of leptin-receptor was examined by immuno-precipitation. Results:The protein and RNA levels of leptin-receptor in liver,muscle and pancreas tissues of high plasma free fatty acid rats were similar to those of normal group(P>0.05).But the tyrosine phosphorylation of leptin-receptor significantly downregulated in liver and muscle tissues as compared with control group(P<0.05). Conclusions:High plasma free fatty acid may affect the tyrosine phosphorylation of leptin-receptor in rat liver and muscle.

Objective To explore the protective mechanism of tea polyphenols (TPs) ion oxidative stress damage of the rat articular cartilage tissue caused by brick-tea fluorosis. Methods One hundred and twenty wistar male rats were randomly divided into 6 groups according to body mass: fluoride group with drinking water containing 100.00 mg/L F-, fluoride plus TPs group treated with 100.00 mg/L F- and 10.0 g/L TPs, fluoride plus aluminum group fed with 100.00 mg/L F- and 200.00 mg/L Al3+, fluoride plus aluminium and TPs group treated with 100.00 mg/L F-,200.O0 mg/L Al3+ and 10.0 g/L TPs;brick-tea group treated with drinking water containing 100.00 mg/L F-,215.00 mg/L Al3+ and 9.2 g/L TPs, which was steeped by the brick-tea;control group treated with tap water. The animals were bred for three months and then sacrificed. The level of SOD,T-AOC and MDA in blood serum were detected,also the level of NO and cytokine IL-1β and IL-6, the expression of iNOS mRNA and protein in articular cartilage were respectively analyzed by RT-PCR and immunohistochemistry. Results Blood serum SOD level in the fluoride plus aluminum and TPs group[(664.009 ± 29.589)kU/L] was higher compared with that in the fluoride group[(625.328 ± 27.199)kU/L], fluoride plus aluminum group[(652.282±13.926)kU/L], although no statistically significant differences was found(P > 0.05) ;blood serum T-AOC level of the fluoride plus TPs, fluoride plus aluminum and TPs group, brick tea group[(10.874 ± 0.721), (11.871 ± 0.941), (10.380 ± 2.747)kU/L] was higher compared with fluoride group, fluoride plus aluminum group [(8.849 ± 1.887), (8.210 ± 1.740)kU/L], the differences all being statistically significant(P < 0.05) ;blood serum MDA level in the fluoride plus aluminum and TPs group[(3.235 ± 0.446)μmol/L] had significances compared with fluoride group, fluoride plus aluminum group [(3.889 ± 0.387), (4.580 ± 0.474)μmol/L, all P < 0.05)];blood serum NO level in fluoride plus Tps group, fluoride plus aluminum and TPs group, brick-tea group[(23.278 ± 2.386), (20.643 ± 2.623), (24.367 ± 6.072) μmol/L] had tatistical differences compared with fluoride group, fluoride plus aluminum group[(32.962 ± 8.268), (34.909 ± 6.288)μmol/L, all P < 0.05];blood serum IL-1β level of fluoride group, fluoride plus aluminum, fluoride plus Tps, fluoride plus aluminum and TPs group and brick-tea group [(4.728 ± 0.297), (4.412 ± 0.229), (4.432 ± 0.285), (4.516 ± 0.351), (4.614 ±0.2270)n/L] did not have inter-group differences (F = 2.314,P > 0.05);the blood serum IL-6 level of fluoride plus aluminum and TPs group, brick-tea group[(7.231 ± 0.596), (7.325 ± 0.290)ng/L] had statistical differences compared with fluoride plus aluminum[(8.256 ± 0.635)ng/L, P < 0.05]. The iNOS mRNA correspondent expression content of fluoride plus Tps group, fluoride plus aluminum and TPs group, brick-tea group(0.482 ± 0.021,0.447±0.021,0.491 ± 0.022) had statistical differences compared with fluoride group, fluoride plus aluminum group (0.562 ± 0.025,0.591 ± 0.020, all P < 0.05). Cells with positive iNOS protein expression of control group were mainly distributed at the surface layer of joint, while the cells of experiment groups were distributed both at the surface layer and the intermediate layer. Conclusions Tea polyphenols could alleviate oxidative stress damage on the articular cartilage, exerting protection against brick-tea fluorosis on rats through cleaning up free radicals, elevating total anti-oxidation capability, diminishing the generation of lipid peroxide.