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

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.

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

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

Objective To analyze the epidemiology,infection status,risk factors and microbiological characteristics of Trichosporon asahii in urinary tract infection for guidance of selecting the prompt and effective antifungal drugs in clinical therapy.Methods A total of 18 strains of Trichosporon asahii isolated from the patients with urinary tract infection were selected from 2013 to 2016.The isolation and identification of pathogenic bacteria,results of antimicrobial susceptibility test and clinical data were investigated by retrospective epidemiological survey.Results The 5 antifungal drugs,i.e.,5-fluorocytosine,amphotericin B,fluconazole,itraconazole and voriconazole,exhibited favorable antibacterial activity for the 18 strains of Trichosporon asahii with resistance rate of 0,5.6％,0,0 and 0 except itraconazole which showed only 50％ of sensitive rate.The risk factors of Trichosporon asahii infection in urinary system mainly included such as male,basic diseases (100％),long-term use of broad-spectrum antimicrobial agents (100％),indwelling catheter (83.3 ％),application of corticosteroids (50.0％) and immunosuppressive agents (38.9％) as well as a small proportion of granulocytopenia (5.6％).The 16 cases treated with fluconazole were improved,while the other 2 cases died following the treatment with itraconazole or voriconazole for reasons irrelevant to antifungal treatment.Conclusion Trichosporon asahii could cause urinary tract infections with high risk factors including basic diseases,long-term use of broad-spectrum antimicrobial agents,indwelling catheter,etc.The drug of top choice should be fluconazole.The key elements for successful treatment of Trichosporon asahii infection include early diagnosis of pathogens and correct selection of antifungal agents based on sensitivity and resistance tests of drugs.

To investigate the prevalence of drug-resistance mutations, resistance to antiretroviral drugs, and the subsequent virological response to therapy in treatment-naive and antiretroviral-treated patients infected with HIV/AIDS in Henan, China, a total of 431 plasma samples were collected in Queshan county between 2003 and 2004, from patients undergoing the antiretroviral regimen Zidovudine + Didanosine + Nevirapine (Azt+Ddi+Nvp). Personal information was collected by face to face interview. Viral load and genotypic drug resistance were tested. Drug resistance mutation data were obtained by analyzing patient-derived sequences through the HIVdb Program (http://hivdb.stanford.edu). Overall, 38.5% of treatment-naive patients had undetectable plasma viral load (VL), the rate significantly increased to 61.9% in 0 to 6 months treatment patients (mean 3 months) (P＜0.005) but again significantly decrease to 38.6% in 6 to 12 months treatment patients (mean 9 months) (P＜0.001) and 40.0% in patients receiving more than 12 months treatment (mean 16 months) (P＜0.005). The prevalence of drug resistance in patients who had a detectable VL and available sequences were 7.0%, 48.6%, 70.8%, 72.3% in treatment-na(1)ve, 0 to 6 months treatment, 6 to 12 months treatment, and treatment for greater than 12 months patients, respectively. No mutation associated with resistance to Protease inhibitor (PI) was detected in this study. Nucleoside RT inhibitor (NRTI) mutations always emerged after non-nucleoside RT inhibitor (NNRTI) mutations, and were only found in patients treated for more than 6 months, with a frequency less than 5%, with the exception of mutation T215Y (12.8%, 6/47) which occurred in patients treated for more than 12 months. NNRTI mutations emerged quickly after therapy begun, and increased significantly in patients treated for more than 6 months (P＜0.005), and the most frequent mutations were K103N, V106A, Y181C, G190A. There had been optimal viral suppression in patients undergoing treatment for less than 6 months in Queshan,Henan. The drug resistance strains were highly prevalent in antiretroviral-treated patients, and increased with the continuation of therapy, with many patients encountering virological failure after 6 months therapy.

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