OBJECTIVETo simulate the surgical approaches for intracranial aneurysms using three-dimensional CT angiography (3D-CTA) and assess the value of 3D-CTA in early microneurosurgery for ruptured intracranial aneurysms.

METHODSForty-eight patients with spontaneous subarachnoid hemorrhage due to ruptured intracranial aneurysm were confirmed by early operation. All the patients were classified according to Hunt-Hess, including 11 of grade I, 29 of grade II, and 8 of grade III. CTA was performed before the operation and surgical simulation was conducted. The preoperative findings on CTA and the intraoperative findings were compared and the clinical value of cerebral 3D-CTA was analyzed.

RESULTSPre-operative 3D-CTA clearly displayed the location, size and shape of the aneurysms, the axis direction of the aneurysm apex and the width of aneurysm neck. The spatial relation between the parent aneutysm artery, the aneurysm, the peripheral vessels and the bony structures were also demonstrated. These findings were basically consistent with the intraoperative findings. The Glasgow outcome score was 5 in 41 patients, 4 in 4 patients, 3 in 2 patients, and 2 in 1 patient upon discharge from the hospital.

CONCLUSIONSPreoperative 3D-CTA examination can simulate the surgery for ruptured aneurysms to help improve the surgical success rate.

Adult ; Aged ; Aneurysm, Ruptured ; diagnostic imaging ; surgery ; Cerebral Angiography ; methods ; Computer Simulation ; Female ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography, Interventional ; Subarachnoid Hemorrhage ; diagnostic imaging ; etiology ; surgery ; Tomography, Spiral Computed

OBJECTIVE: To evaluate the use of endoscopic surgery for hypertensive cerebral hemorrhage. METHODS: Sixteen patients with hyertensive intracerebral hematoma were evacuated with neuroendoscope. The surgical invasive markers, volume of remaining hematoma, and prognosis were compared with those of 19 comparable patients undergoing conventional craniotomy. RESULTS: Complete evacuation of hematoma was achieved in 9 patients, and partial evacuation in 7. All patients were followed up for 6 months. According to GOS, the result was excellent in 6 patients, good in 6, fare in 2, poor and dead in one respectively. The volume of remaining hematoa and invasive markers significantly decreased (P < 0.05); No difference was found in prognosis between the two groups (P > 0.05). CONCLUSION Neuroendoscopic surgery for hypertensive intracerebral hematoma is characterized by mini-invasion, time-saving, and direct-vision, and is a new approach in this field.
Adult ; Aged ; Female ; Follow-Up Studies ; Hematoma ; surgery ; Humans ; Intracranial Hemorrhage, Hypertensive ; surgery ; Male ; Middle Aged ; Neuroendoscopy ; Neurosurgical Procedures

OBJECTIVETo explore the clinical characteristics,diagnosis and treatment of abdominal cocoon.

METHODSClinical data of 203 cases with abdominal cocoon including 7 cases in our hospital and 196 cases reported in Chinese literature from January 1995 to June 2005 were analyzed retrospectively.

RESULTSThe male to female ratio was approximately 1.2:1. The mean age at diagnosis was 33 years. The main clinical manifestations included recurrent acute or chronic intestinal obstruction in 147 cases (72.4%), abdominal mass in 53 cases (26.1%). Of the 203 cases, abdominal plain X-ray were performed in 163, B-ultrasound in 85, CT in 68 and barium meal in 32 cases, however, only 6 cases (3.0%) were diagnosed as abdominal cocoon preoperatively. All the cases received operations included partial or total excision of the membrane and enterolysis in 172 cases (84.7%), together with bowel resection in 34 cases (16.7%) and appendectomy in 51 cases (25.1%). Postoperative complications included recurrent obstruction in 55, and death in 11 cases (5.4%).

CONCLUSIONSThe preoperative diagnosis of abdominal cocoon is difficult. Operations should be performed on the cases with intestine obstruction. Recurrent adhesive intestinal obstruction is the main postoperative complication.

Abdominal Cavity ; pathology ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Intestinal Obstruction ; diagnosis ; pathology ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the efficacy of semiconductor low level laser irradiation for the treatment of postoperative exposure of hydroxyapatite orbital implants.

METHODS22 cases with postoperative exposure of hydroxyapatite orbital implants were divided into three groups according to the size of implants exposure. The exposure wound in the 3 groups was irradated with semiconductor low level laser 5 min per day for 5-15 days. The follow-up period ranged from 2 to 24 months.

RESULTSIn the group with less then 3 mm of exposure, the wound healed in 1 week after 5-10 days irradiation; in the group with implant exposure of 4-7 mm, the would healed in 1-2 weeks after 10-15 days irradiation; in the group with implant exposure of 8-10 mm, the would healed in 2-3 weeks after 10-15 days irradiation. Compared with the treatments of drugs and/or surgical repair, which was used for another 20 cases of exposure of hydroxyapatite orbital implants, semiconductor low level laser increased healing rate obviously in the groups with implant exposure of 4-7 mm and 8-10 mm (P = 0.019, 0.018).

CONCLUSIONSemiconductor low level laser has better effects than drugs and/or surgical repair for exposure of hydroxyapatite orbital implants.

Adolescent ; Adult ; Aged ; Child ; Durapatite ; therapeutic use ; Eye ; pathology ; radiation effects ; Female ; Follow-Up Studies ; Humans ; Low-Level Light Therapy ; methods ; Male ; Middle Aged ; Orbital Implants ; adverse effects ; Postoperative Complications ; etiology ; radiotherapy ; Semiconductors ; Treatment Outcome

Objective: To study the changes of TGFβ/Smad signaling expression in oral squamous cell carcinoma (OSCC) after hyperthermia. Methods: The expression of TGFβ, Smad2, 3, 4 and 7 in OSCC of tumor bearing nude mice were examined by quantitative real-time RT-PCR and Western blot respectively. Results: The mRNA expression of TGFβ, Smad2 and 3 was decreased significantly, and the mRNA levels of Smad7 was elevated in hyperthermia (HT) group (n = 10) (P ＜ 0. 05), but the mRNA expression of Smad4 did not change significantly compared with that of control group (n = 10) . The changes of protein expression of TGFβ, Smad7 and 4 were consistent with that of mRNA, the expression of Smad2 and 3 was not significantly different between the groups, but the expression of p Smad2 and p Smad3 decreased dramatically in HT group (P ＜ 0. 05) . Conclusion: TGFβ/Smad signaling exhibits important role in the antitumor effects of hyperthermia, and the inhibition of Smad7 on R-Smad phosphorylation may play a key role.

OBJECTIVEThis study aimed at exploring the feasibility of using dried blood spots (DBS) to detect HIV drug resistance genotyping in China by comparing the results of drug resistance from DBS, plasma and whole blood samples.

METHODSBlood samples were collected from 39 AIDS patients from Anhui (10), Yunnan (13), Hunan (6) and Xinjiang (10) provinces and autonomous regions. The HIV strains that infected these patients covered all the major HIV-1 subtypes prevailing in China (B, CRF01_AE, CRF07_BC). HIV drug resistance genotyping assay was performed on DBS as well as on the whole blood and plasma samples from the same patients simultaneously by using an in-house nest RT-PCR method. Drug resistance levels were determined based on Stanford University HIV drug resistance database, and the results from these three types of samples were compared.

RESULTSThe percentages of successful amplification of protease and reverse transcriptase regions in the pol gene were 95% (37/39) from DBS, 92% (36/39) from whole blood and 100% (39/39) from plasma samples. The sequences from the three types of samples showed more than 99% identity.86% (31/36) of the DBS samples had the same set of drug resistance mutations as those which were detected from plasma samples. The differences probably resulted from mixed bases.

CONCLUSIONSThere was no major difference in detecting HIV drug resistance genotyping among DBS, plasma and whole blood samples. Therefore, DBS is useful for detection of HIV drug resistance genotyping and is particularly valuable in developing countries like China, especially in remote rural regions.

Dried Blood Spot Testing ; Drug Resistance, Viral ; genetics ; Feasibility Studies ; Genotype ; HIV Infections ; blood ; genetics ; virology ; HIV Seropositivity ; blood ; genetics ; virology ; HIV-1 ; drug effects ; genetics ; Humans ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load

OBJECTIVETo investigate the expression of nuclear factor kappa B (NF-kB), transforming growth factor beta1 (TGFbeta1), fibronectin (FN) in liver from diabetic rats.

METHODSTwenty male Sprague-Dawley rats were divided randomly into two groups: normal control group (n = 10) and type 2 diabetic group (n = 10). After 4 weeks of high-fat feeding, diabetic group rats were injected with low dosage streptozotocin (30 mg/kg) intraperitoneally to induce type 2 diabetic rat models. The diabetic rats received high-fat feeding for another 12 weeks. At the end of the experiment, the fibrosis lesion was observed under light microscopy after Masson staining. The mRNA levels of NF-kB, TGFbeta1, FN from rats liver were assayed by semi-quantity RT-PCR, the protein levels of NF-kB, TGFbeta1, FN was detected by IHC.

RESULTSFibrosis was found in diabetic rats. The levels of TGFbeta1, FN mRNA in liver tissues increased in diabetic rats compared with normal control rats (0.91+/-0.19 vs 0.47+/-0.20, t = 5.233, P less than 0.05; 1.85+/-0.70 vs 1.22+/-0.39, t = 2.463, P less than 0.05). And the protein levels of NF-kB P65, TGFbeta1, FN in liver tissues from diabetic rats were significantly higher than those in normal control rats (10978.77+/-8782.59 vs 4206.86+/-1430.56, Z = 1.979, P less than 0.05; 8551.00+/-4768.68 vs 4036.85+/-1051.12, Z = 2.303, P less than 0.05; 16980.30+/-11529.29 vs 5701.95+/-9461.75, t = -2.391, P less than 0.05).

CONCLUSIONUpregulation of NF-kB, TGFbeta1, FN in liver tissues may play a role in the hepatic fibrogenesis in diabetic rats.

Animals ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Diabetes Mellitus, Type 2 ; metabolism ; pathology ; Fibronectins ; metabolism ; Liver ; pathology ; Liver Cirrhosis ; etiology ; metabolism ; pathology ; Male ; NF-kappa B ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects (test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein (H-FABP), C-reactive protein (CRP), β-endorphin (β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone (CORT) and troponin I (TnI) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ mRNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of TnI and CORT, while increased the level of SOD and the expression levels of PPARγ mRNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.
Animals ; Heart Injuries ; physiopathology ; Male ; Mice ; PPAR gamma ; genetics ; physiology ; RNA, Messenger ; genetics ; Real-Time Polymerase Chain Reaction ; Stress, Physiological

OBJECTIVE: To explore the correlation between Fragile X mental retardation gene-1 (FMR1) gene CGG repeats with diminished ovarian reserve (DOR). METHODS: For 214 females diagnosed with DOR, DNA was extracted from peripheral blood samples. FMR1 gene CGG repeats were determined by PCR and capillary electrophoresis. RESULTS: Three DOR patients were found to carry FMR1 premutations, and one patient was found to carry gray zone FMR1 repeats. After genetic counseling, one patient and the sister of another patient, both carrying FMR1 permutations, conceived naturally. Prenatal diagnosis showed that both fetuses have carried FMR1 permutations. CONCLUSION FMR1 gene permutation may be associated with DOR. Determination of FMR1 gene CGG repeats in DOR patients can provide a basis for genetic counseling and guidance for reproduction.
Female ; Fragile X Mental Retardation Protein/metabolism* ; Fragile X Syndrome/genetics* ; Humans ; Ovarian Diseases ; Ovarian Reserve/genetics* ; Primary Ovarian Insufficiency/genetics* ; Trinucleotide Repeats/genetics*