Objective To investigate the imaging features in neonates with hypoglycemic brain injury by early and serial MRI.Methods Neonates who were admitted to neonatal department from May 2005 to Jul 2013 received MRI and diffusion-weighted imaging(DWI) scan within 7 days after hypoglycemia.Fortynine neonates were diagnosed with hypoglycemic brain injury.Thirty-four neonates received second MRI scan between 2 ～3 weeks after hypoglycemia.Seven neonates received third MRI scan.Results All the 49 neonates showed hyperintensity on DWI in the regions of occipital and parietal lobe for the first MRI scan(mainly involved 33 cases).Six cases combined frontal lobe and temporal lobe.Ten cases presented widespread cortex and white matter involvement.All the cases presented hypointensity on DWI for the affected area,T1 and T2 weighted image signal changes were not obvious.Some cases presented deep white matter and gray matter injury.Thirty-four cases received second MRI scan between 2 ～3 weeks after hypoglycemia,20 presented hypointensity on DWI,hypointensity on T1 weighted image and hyperintensity on T2 weighted image.Eleven cases with normal signals,and the other 3 were absorbing.Seven cases received third MRI scan,appeared encephalomalacia,myelin retardation,white matter volume decreased,hypoplasia of corpus callosum.The more severe the clinical symptoms was,the more severe the degree of brain injury showed.Conclusion Cerebral occipital and parietal regions are the most vulnerable in neonatal hypoglycemic brain injury.Early DWI for the imaging diagnosis of hypoglycemic brain injury should be taken within one week after hypoglycemia.Mild injury is recoverable,but severe would chang into necrosis and encephalomalacia.Some combined deep white and gray matter injury might related to hypoxia and ischemia.

Objective To compare the effect of tension-free vaginal tape (TVT) and vaginal reconstructive surgery (VR) on women with severe genital prolapse and stress urinary incontinence.Methods 43 patients with stage I or II vaginal anterior defect and stress urinary incontinence were assigned to TVT group(21 patients) and VR group (22 patients) . Results Maximum quantity of urine, pressure of detrusor at maximum quantity of urine, and abdominal leakage point pressure occured significantly in TVT group after operation(P<0.05). Postoperative satisfaction rate were higher in TVT group(P<0.05). Conclusion TVT is more effective to improve the quality of life in women with stress incontinence.

Objective There are many methods to treat adult humeral shaft fracture. Plates fixation and intramedullary locking nail are two important methods. Though plate fixation are "gold criterion", there were many defects limited its development. With humeral intramedullary nail widely used, this study is to analysis and investigates the complications of locked nailing in humeral shaft fractures. Methods Between January 2000 and January 2004, 90 humeral shaft fractures (74 acute fractures and 16 delayed unions or nonunions) in 89 patients were treated with humeral intramedullary locking nails and followed up for an average of 25.4 months(12-34 months). There were 56 males and 33 females, with an average age of 39.3 years. Acute fractures included 62 closed, 7 Gustilo type Ⅰ, 3 type Ⅱ and 2 type Ⅲa open fractures. 12 nonunions had previous operations. 8 patients had radial nerve palsy. In general, acute fractures were treated with closed nailing and nonunions were treated with open nailing with bone grafting. 53 proximal humeral fracture were treated by antegrade nail, the others with distal humeral fracture were treated by retrograde nail. Results In total, 17 patients had 18 significant complications. 5 of them were persistent nonunions. There was no statistics difference between antegrade nail and retrograde nail. The others were protruded screws, fracture gap, shoulder impairment, elbow impairment, angular malunion, deep infection and postnailing radial nerve palsy. Conclusion The risk of operative comminution was significantly higher in retrograde nailing, and operative comminution resulted in a significantly higher risk of nonunion. Many complications of humeral locked nailing can be prevented by improving the implant design or surgical techniques.

Objective To explore the feasibility of endoscopic thyroidectomy through the approach of areola of breasts.Methods Endoscopic thyroidectomy via areola of breasts approach was carried out in 26 cases from March 2003 to September 2005.Thyroid nodules were right-sided in 13 cases,left-sided in 10 cases,bilateral in 1 case,and not palpable in 2 cases of hyperthyroidism(grade 1).There were 9 cases of solitary nodule and 15 cases of multiple nodules.The nodules were cystic in 5 cases,solid in 13 cases,and mixed in 6 cases,with 1~4 cm in diameter.Preoperative diagnoses included 9 cases of thyroid adenoma,15 cases of nodular goiter,and 2 cases of primary hyperthyroidism.Results The thyroidectomy was performed successfully under endoscope in 25 cases,with an operation time of 50~210 min(mean,112 min),including 4 cases of tumor enucleation,10 cases of unilateral partial thyroidectomy,8 cases of bilateral partial thyroidectomy,and 3 cases of bilateral subtotal thyroidectomy with isthmus resection.A conversion to open surgery was required in 1 case owing to thyroid carcinoma with trachea involvement.Pathological findings showed 4 cases of thyroid adenoma,18 cases of nodular goiter,2 cases of primary hyperthyroidism,and 2 cases of thyroid carcinoma.The drainage tubes were removed at 24~48 hours after operation.No nerve or parathyroid injuries occurred.The length of postoperative hospital stay was 3~6 d(mean,4.2 d).Follow-up observations in 25 cases for 3~33 months(mean,13 months) revealed no local recurrence.The patients were satisfied with cosmetic effects.The 2 cases of thyroid carcinoma were followed for 9 and 11 months,respectively,presenting no recurrence or metastasis.Conclusions Endoscopic thyroidectomy via areola of breasts approach is feasible and effective,offering satisfactory cosmetic outcomes.

Objective To study the method and effect of superomedial pedicled mammaplasty based on Würinger's horizontal septum.Methods During August 2014 to August 2015,25 cases of cromastia were treated with septum-based mammaplasties with a superomedial pedicled and vertical incision.Based on the preoperation design,the superomedial pedicle was deepithelialized with preservation of the dermis and the subdermal plexus.The pedicle was dissected as described,the excess tissue was removed with the prepectoral fascia preserved.After remodeling the shape of mammary gland,the incision was sutured.Results There was no hematoma,no fat liquefaction and no partial or complete NAC necrosis.The pre and postoperative NAC sensibilities were comparable in all the patients.The patients were followed up for 6 to 12 months,and all the patients were satisfied with the therapeutic effect and expressed acceptance to the scar.Conclusions The breast reduction based on wellvascularized septum and superomedial pedicle is safe with minor scar,even in large breasts.This technique demonstrates ease of pedicle shaping and breast remodeling.The satisfied effect could be obtained for patients with severe ptosis of breasts just after operations and in future.

bone fracture, mild col apse of the articular surface;femoral head deformation, bone fracture, articular surface col apse, hip degeneration. MRI of four categories of avascular necroses appeared as phase Ⅰ:line-like low signal of weight-bearing area of femoral head on T1WI, high signal on T2WI as the main change. Phase Ⅱ:clear boundary crescent-shaped uneven signal on T1WI, T2WI displayed moderately higher, uneven slightly lower signal around, showing a typical two-line sign. Phase Ⅲ:femoral head deformation, subchondral fracture, col apse, crescent formation, zonal low signal on T1WI, medium or high signal on T2WI. Phase Ⅳ, Ⅴ:complete destruction of articular cartilage, joint space narrowing, significant col apse and deformation of the femoral head, non-specific secondary osteoarthritis of the acetabulum, such as sclerosis, cystic degeneration and marginal osteophyte. The X-ray, CT, MRI performances of four types of avascular necroses at the same period were basical y the same.

Objective To examine the distribution of flurbiprofen axetil in cerebral-spinal fluid (CSF) by determining the CSF concentration of flurbiprofen after iv administration. Methods Seventy-two ASA Ⅰ or Ⅱ patients of both sexes aged 18-75 yr weighing 54-82 kg undergoing spinal or combined spinal-epidural anesthesia for lower extremity or lower abdominal surgery were studied. Flurbiprofen axetil 1 mg/kg was injected intravenously.CSF 2 ml and venous blood 3 ml were obtained simultaneously every 5 min after iv injection for 45 min (T1-9 ) for determination of flurbiprofen concentration using high performance liquid chromatography, and the CSF/blood flurbiprofen concentration ratio was caculated. Results Flurbiprofen was not detected in CSF at T1,2 after iv injection in 3 and 4 patients. The CSF flurbiprofen concentration was significantly higher at T4-9, and CSF/blood flubiprofen concentration ratio higher at T5-9 than at T3 ( P ＜ 0.05). There was no significant difference in CSF flurbiprofen concentrations among T4-9 ( P ＞ 0.05 ) Conclusion Flurbiprofen is detected in CSF after iv injection, the CSF flurbiprofen concentration peaks at 20 min after iv injection and it lasts until 45 min after iv injection.

Cancer metastasis is composed of a complex cascade that involves a variety of critical steps beginning with detachment from the primary tumor and ending with growth of tumor at a distant site, such as bone. The "seed-and-soil hypothesis" predicts that the bone microenvironment expresses factors through which attract a variety of cancer cells and promote the tumor development. The ending point of tumor development in bone is achieved through the bidirectional and dynamic interaction between tumor cells and the cells in their growth microenvironment. A variety of factors produced by the bone microenvironment, contribute to the pathogenesis of cancer skeletal metastasis. In this review, using prostate cancer (CaP) as an example, some of general mechanisms of cancer metastasis will be summarized. In addition, the current understanding of the interaction between tumor cells and the bone microenvironment will be addressed. Finally, the research directions in the near future will be suggested.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; blood ; diagnosis ; Phosphopyruvate Hydratase ; blood ; Prognosis

Cochlear Implantation ; Cochlear Implants ; Humans ; Tinnitus