Objective To evaluate the efficacy and safety of a novel mutated recombinant tissue-type plas-minogen activator (rt-Pam) in a rat model of acute cerebral thrombosis. Method Eighty-seven adult Wister rats were randomly divided into control group, recombinant tissue-type plasminogen activator (rt-PA) group, low dose of rt-Pam group and routine dose of rt-Pam group. The rats of different groups were treated for 3 hours after thrombosis of middle cerebral artery. The size of infarction, neurological scores and severity of hemorrhage were observed 24 hours after treatment. The protective role of rt-Pam in the brain tissue was evaluated as per the infiltration of neutrophils and the concentration of plasminogen activator receptor-1 (PAR-1). Results Compared with control group, the sizes of infarction in the low dose of rt-Pam group and routine dose of rt-Pam group were significantly smaller [(108.5 ±27.3) mm3 and (68.3 ±17.2) mm3 vs. (323.4 ±42.3) mm3]. The neurological scores were evidently correlated with the size of infarction (r = 0.613, P<0.001), while the liability of cerebral hemorrhage in low dose of rt-Pam group was not significantly increased. The rt-Pam also reduced the production of myeloperox-idase, as well as the production of PAR-1 in comparison with rt-PA group [(13.8 ± 3.1) vs. (28.3±4.5), P <0.00l]. Conclusions The novel rt-Pam could be a better thrombolytic agent than rt-PA in treating acute stroke.

Adult ; Female ; HSP27 Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; biosynthesis ; blood ; HSP90 Heat-Shock Proteins ; biosynthesis ; blood ; Heat-Shock Proteins ; biosynthesis ; blood ; Hepatitis B Core Antigens ; blood ; Hepatitis B, Chronic ; metabolism ; pathology ; Humans ; Liver ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Proteins ; biosynthesis ; blood

Objective To evaluate the application and the good qualities of high-resolution ultrasound and CDFI-guided mammotome minimally invasive biopsy device in the diagnosis and treatment of breast lesions.Methods The common clinical operations and the lesions which were guided mammotome minimally invasive biopsy device by high-resolution ultrasound and CDFI were contrasted.The effects of treatment were evaluated.Results 307 le- sions of 102 patients were removed by this method,and the operational process was successful.Patients' skin lacera- tions were tiny.Only one lesion was clinically diagnosed as mild blood clot under skin,but without other complica- tions.Conclusion Contrasted with the common clinily operations.the high-resolution ultrasound and CDFI-guided mammotome minimally invasive biopsy device in the diagnosis and treatment of breast lesion is effective,and the scar is tiny.It releases patients' pain.

Adolescent ; Adult ; Aged ; Female ; Hepatitis B, Chronic ; pathology ; physiopathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; pathology ; Male ; Middle Aged ; Receptor, Cannabinoid, CB1 ; analysis ; Young Adult

Objective To investigate the relationship between myocardial ischemia and slow coronary flow phenomenon with 99Tcm-methoxyisobutylisonitrile (MIBI) adenosine myocardial perfusion SPECT imaging. Methods Forty-four patients were divided to three groups according to the result of coronary angiography(CAG). There were GAG-positive(P-GAG) (n=12),slow coronary flow (CSF) (n =22),and normal coronary flow (NCF) (n = 10). Results of adenosine myocardial perfusion imaging were compared among these three groups. Semi-quantitative visual scoring method was used to evaluate the myocardial perfusion:0 = normal,1 = mild decrease,2 = moderate decrease,3 = severe decrease,4 = defect. Statistical analysis was performed using variance analysis,t-test and x2-test. Results No significance was observed at age ( t =0.27,0. 54 and 0. 59),sex (x2 = 0. 92),hypertension,hyperlipemia and diabetes (x2 = 1.23,all P ＞ 0.05 ) among the three groups. A significantly higher frames of the coronary thrombolysis in myocardial infarction (TIMI) flow was noted in CSF than in NCF groups (33.7 ±5.5 vs 17.6 ±3.9,t = 9. 58,P ＜0. 001 ). The positive adenosine myocardial perfusion imaging rate were significant among these three groups with 100% (12/12) in P-CAG group,77.3% (17/22) in CSF group,and 20% (2/10) in NCF group. When using semi-quantitative visual scoring method,significantly higher average ischemia segments were noted in CSF group than in NCF group ( 1.06 ± 0.77 and 0. 91 ± 0.80,t = - 2. 02,P ＜ 0. 05 ),but was less than that in P-CAG group (2.41 ±0.79,t =4. 54,P ＜0.001 ). The degree of ischemia of CSF group was higher than that in NCF group ( 8.01 ± 6.06,and 2.73 ± 2.60,t = - 2.07,P ＜ 0.05 ) and was less than that in P-CAG group (14. 07 ±12. 77 ,t=1.44,P＞0. 05). Conclusion Slow coronary flow phenomenon can be detected by adenosine myocardial perfusion image to offer the evidence of diagnosis and treatment for the chest pain patients with negative coronary angiography results.

OBJECTIVETo explore the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid occupied lesions with injection of sulphur hexafluoride microbubbles.

METHODSFifty nine cases of conventional ultrasonic diagnosis of thyroid lesions in patients with 73 lesions re-sulfur hexafluoride microbubble ultrasound contrast real-time inspection, the use of CEUS and contrast pulse sequencing (CPS).

RESULTSSeventy-three lesions were satisfied with the dynamic contrast perfusion imaging. Ultrasound contrast prompted the 15 lesions (13 cases) of malignant lesions by postoperative pathology confirmed papillary thyroid carcinoma, ultrasound images showed a low or mixed echo, boundary ambiguity, accompanied by Microcalcification foci, blood flow distribution I rank or grade III. Ultrasound prompted 58 lesions (46 cases) of benign lesions, blood flow distribution of grade II or III, the performance of a variety of two-dimensional ultrasound image, showing cystic, solid or liquid-solid mass, border clearance. Contrast with the surrounding thyroid tissue, lesionsor=20 mm papillary thyroid carcinoma, manifested prior to the beginning of the adjacent thyroid substance to enhance and dissection, showing the form of high-enhanced perfusion; thyroid follicular adenoma as early as the beginning of the adjacent thyroid substance to enhance and dissection, mass retained within the contrast agent longer time, showing the form of high-enhanced perfusion; nodular goiter enhanced for thyroid nodules and adjacent synchronization started to pick up in real terms, after the 6 lesions showed nodular contrast slightly earlier than the adjacent thyroid substance started to pick up, 28 lesions with synchronous real beginning of the adjacent thyroid dissection, 11 lesions of nodular dissipated early on (started receding time < or = 25 s) adjacent to thyroid substance.

CONCLUSIONThe real-time CEUS with injecting sulphur hexafluoride microbubbles is valuable in the diagnosis and differential diagnosis of the thyroid occupied lesions.

Adult ; Aged ; Contrast Media ; Female ; Humans ; Male ; Microbubbles ; Middle Aged ; Sulfur Hexafluoride ; Thyroid Neoplasms ; diagnostic imaging ; Ultrasonography ; Young Adult

OBJECTIVETo establish the methods of Polychlorinated Dibenzo-p-Dioxins and Dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) compounds determination by isotope dilution HRGC/HRMS simultaneously in human placenta tissue from mothers, and assess the human exposure risk to dioxins and PBDEs in study.

METHODSConcentrations of 17 PCDD/Fs and 12 dioxin-like PCBs as well as 7 PBDEs were measured in human placenta tissue samples by isotope dilution HRGC/HRMS. SigmaTEQ (PCDD + PCDFs + PCBs) concentration using WHO-TEF factor and PBDEs concentration was calculated respectively. Risk assessment of mother exposure to dioxins and PBDEs was evaluated.

RESULTSMedian of SigmaTEQ (PCDD + PCDFs + PCBs) concentration for six samples was 18.15 WHO-TEQ pg/g lipid, ranging from 5.14 - 67.01 WHO-TEQ pg/g lipid. Although the median of SigmaTEQ (PCDD + PCDFs + PCBs) was lower than that of human blood of EU and Japan, and close to that of Korea and Taiwan non-exposure as reported in the literatures, the highest SigmaTEQ (PCDD + PCDFs + PCBs) concentration of placenta sample exceeded the value of high dioxins exposure area subjects in Taiwan. The dominant contributor congener for WHO-TEQ were 2, 3, 4, 7, 8-PeCDF, 1, 2, 3, 7, 8-PeCDD, PCB126, totally accounted for 65 percent of SigmaWHO-TEQ. Median and average of PBDE concentration for six samples were 2.73 ng/g lipid and 7.17 ng/g lipid, respectively, ranging from 0.95 - 25.99 ng/g lipid. BDE47 was the dominant contributor congener for the total concentration, accounted for 35 percent.

CONCLUSIONThe methods of PCDD/Fs, PCBs and PBDEs compounds determined by isotope dilution HRGC/HRMS simultaneously in human placenta tissue from mothers were established successfully, and the human exposure risk to PCDD/Fs, PCBs and PBDEs should be surveyed for the donor with the highest SigmaTEQ (PCDD + PCDFs + PCBs) and PBDEs concentration of placenta sample in the future.

Benzofurans ; analysis ; Female ; Halogenated Diphenyl Ethers ; analysis ; Humans ; Maternal Exposure ; Placenta ; chemistry ; Polychlorinated Biphenyls ; analysis ; Polychlorinated Dibenzodioxins ; analogs & derivatives ; analysis ; Pregnancy

Objective To evaluate the treatment effect of combination of dexmedetomidine and droperidol on emergence agitation during general anesthesia recovery period in the elderly undergoing thoracotomy. Methods Sixty patients with severe emergence agitation during general anesthesia recovery period undergoing thoracotomy for esophageal cancer or pulmonary lobectomy, aged 66-75 years, falling into ASA physical status Ⅱ or Ⅲ, were divided into three groups, 20 patients in each according to table of random number: group droperidol (group F) and group dexmedetomidine (group D) and group dexmedetomidine combining droperidol (group DF). In group F, 0.06 mg/kg droperidol was administrated via central vein. In group D, 1 μg/kg dexmedetomidine was pumped via central vein in 10 min, followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. While in group DF, 0.03 mg/kg droperidol was administrated via central vein and 0.5 μg/kg dexmedetomidine was pumped via central vein in 10 min, then followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. The agitation scores and the Ramsay scores were collected after the beginning of anti-agitation. Arterial blood partial pressure of carbon dioxide was tested. Postoperative complications including nausea and vomiting were recorded. Results Compared with group D, the agitation scores at 5, 10, 15 and 20 min in group DF were lower (P ＜ 0.05). Comparing with group F, the agitation scores at 60, 90 and 120 min in group DF were lower (P ＜ 0.05). The incidence of over-sedation in group DF and in group D was less than that in group F (P ＜ 0.05). PaCO2 was unaltered in all the groups after treatment. The incidence of nausea, vomiting, bradycardia, hypertension, hypotension and respiration depression and long QT interval between the groups were comparable. Conclusion Combination of dexmedetomidine and droperidol is effective and safe in the treatment of agitation during sevoflurane general anesthesia recovery period in the elderly undergoing thoracotomy.

Objective To explore features and clinic values of LNR anatomy with multiple planar reconstruction techniques with 16-slice spiral CT at the same slice.Methods The lumbar vertebrae with normal adults of 55 cases and 23 cases with abnormal ENR caused by 8 cases with protrusion of lumbar disc, 5 cases with spinal stenosis,4 cases with malignant tumor,5 cases with trauma and 1 case with lumbar TB confirmed by operation were scanned with 16-slice spiral CT made in American GE company in routine posture of the lumbar vertebrae,reconstructed LNR with UNIX system in workstation (ADW 4.1),and analyzed their normal and abnormal anatomic manifestations at the same slice.Results All of LNR can symmetrically showed on oblique and coronal planes according to different segments:one segment from L1 to L5(55,100% ),two segments: from L1 to L2,L2 to L3 and L3 to L4(55,100% ),three segments: from L1 to L3 (49,88%),from L2to L4(46,84% )and from L3 to L5(20,36% ),four segments: from L1 to L4 (15,27% )and five segments:(8,15% ),respectively.Each LNR,including their whole shapes of passage from starting to end,direction,size,shape,tension and peripheral relationship and so on can showed clearly on oblique and coronal planes and on other planes. However,the later planes can increase LNR but decreasing numbers of LNR and especially increase very long one LNR reconstruction.Primary manifestation of all diseases can be showed on oppressing along its walking line,meanwhile,20 cases with adhesion, 14 cases with displacement,13 cases atrophy and 9 cases with increasing diameter.Conclusions Image anatomy features of full LNR with 16-slice spiral CT with the multiple plane reconstruction techniques is very ideal ways at the same slice.It is a very valuable way to make diagnosis and treatment of LNR diseases.The concept of"road sing"and showing"at the same slice"of LNR are tried to rise from in order to make foundation for studying their image.

Objective To observe the effect of ultrasound-guided anterior quadratus lumborum block at lateral supra-arcuate ligament(QLB-LSAL)and transversus abdominis plane block(TAPB)on analgesia and recovery quality after laparoscopic partial hepatectomy(LPH).Methods Fifty-eight patients underwent elective LPH were selected and divided into the quadratus lumborum group or the transversus abdominis group randomly,with 29 patients in each group.The quadratus lumborum group received bilateral QLB-LSAL,and the transversus abdominis group received bilateral subcostal TAPB block before surgery.Both groups received 20 mL of 0.33%ropivacaine on each side.All patients used patient-controlled intravenous analgesia(PCIA)postoperatively.The numeric rating scale(NRS)scores for rest and movement were recorded at 2,4,6,12,24 and 48 hours postoperatively,as well as the Quality of Recovery-15(QoR-15)scores at 1 day preoperatively,1 and 3 days postoperatively.The perioperative anesthetic agent consumption,PCIA pressing frequency,remedial analgesia use in 48 h,postoperative nausea and vomiting(PONV)incidence and time of first out-of-bed mobilization were also recorded.Results Compared with the transversus abdominis group,the quadratus lumborum group had lower movement NRS scores at 2,4,6,12,24 and 48 hours postoperatively,and lower rest NRS scores at 2,4,6,12 and 24 hours postoperatively(P＜0.05).The quadratus lumborum group had higher QoR-15 scores at 1 and 3 days postoperatively(P＜0.05).Patients in the quadratus lumborum group had reduced perioperative remifentanil and sufentanil consumption,postoperative 48-hour rescue analgesia use,PCIA pressing frequency,PONV incidence and time of first out-of-bed mobilization(P＜0.05).Conclusion QLB-LSAL block provides superior analgesic effects and recovery quality compared to TAPB block after LPH.