Objective To investigate the advantage of separate bolus injection technique in CT urography (CTU) improving the display of the whole urinary tract.Methods Sixty cases of CTU examination,were divided into observation group and control group by random digits table with 30 cases each,observation group used separate bolus injection technique and control group used single bolus injection technique.The scanning included routine scanning,cortical phase,medullary phase and lag phase.Reconstruction of lag phase displayed the whole urinary tract.Then the image quality was compared between two groups.Results The whole urinary tract showed excellent in 12 cases (40.0％,12/30),good in 17 cases (56.7％,17/30),normal in 1 case (3.3％,1/30) in control group,which showed excellent in 23 cases (76.7％,23/30),good in 7 cases (23.3％,7/30) in observation group,there was significant difference in excellent rate between two groups (P ＜ 0.01).The CT value of starting of ureter was (238.6 ± 82.5) HU,middle-lower ureter was (245.9 ± 112.3) HU in control group and (239.0 ± 93.8),(235.3 ± 74.6) HU in observation group,there was no significant difference between two groups (P ＞0.05).There was no difference in developing of urolithiasis between two bolus injection techniques.Conclusion The application of separate bolus injection technique in CTU examination can reduce the dose of the first contrast material and contrast material reaction,and receive high-quality image of the whole urinary tract.

Objective To explore the relationship between the expression of basic fibroblast growth factor (bFGF) and microvessel density(MVD)in non-small cell lung cancer.Methods The expression of bFGF and MVD were observed in 54 eases of NSCLC were detected with in situ hybrldization and immunohistochemical detection.Resuits The expression of bFGF and MVD was greater in adenecarcinomas than in squamous cell carcinomas of NSCLC (P＜0.05).The expression of bFGF was significantly different among the three groups of both squamous cell carcinomas and adenocarecnomas with varying differentiation (P＜0.05).There was hisher bFGF expression and greater MVD in NSCLC patients with regional lymplmode involvement and those with laterdistant metastasis(P＜0.05).Condusion bFGF may play an important role in tumor angiogenesis and lymphatic metastasis of human NSCLC,and detection of bFGF may be a good metastasis and prognostic predictors for human NSCLC.

Objective In this study,we aim to evaluate the risk and incidence of traumatic cervical spinal cord injury (CSCI) in patients with traumatic cervical spinal canal stenosis (CSCS) without major fracture or dislocation,and evaluate the feasibility of preventive decompression surgery. Methods This study included eighty?seven patients with traumatic CSCI without major fracture or dislocation treated in our department between 2005 and 2012. Mann?Whitney U test was used for statistical analyses. Analysis of variance (ANOVA) was used to calculate the relative and absolute risks for the incidence of traumatic CSCI without major fracture or dislocation related with CSCS. Results The relative risk for the incidence of traumatic CSCI with CSCS was 145.7 times higher than that for the incidence without CSCS. However ,only 0.000026% of patients with CSCS may be able to avoid developing traumatic CSCI if they underwent decompression surgery before trauma. Conclusions Prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

Animals ; Cytokines ; blood ; Endotoxemia ; blood ; therapy ; Endotoxins ; blood ; toxicity ; Enzyme-Linked Immunosorbent Assay ; Hemofiltration ; Interleukin-1 ; blood ; Interleukin-10 ; blood ; Models, Animal ; Swine ; Time Factors ; Tumor Necrosis Factor-alpha ; analysis

Objective To evaluate the clinical outcome of one-level posterior lumbar interbody fusion (PLIF) performed with microendoscopic approach.Methods A consecutive series of 56 patients who under went one-level PLIF procedure(24 cases performed with microendoseopic approach and 32 cases with tradition- al open approach)were studied from January 2005 to May 2006.The following data were compared between 2 groups with 12 to 27 months follow-up:estimated blood loss,postoperative drainage,transfusion needs,surgi- cal time,length of hospital stay,postoperative back pain by visual analogue scale,complications,and the clinical and radiographic results.Results The microendoscopic approach was found to have a significantly less blood loss,less postoperative drainage,less needs of transfusion,less postoperative back pain,shorter re- covery time and shorter length of hospital stay.However,the microendoscopic approach needed significantly longer surgical time.There was no significant difference between 2 groups in the aspects of the complications and the clinical and radiographic results.Conclusion The one-level PLIF performed with microendoscopic approach minimize estimated blood loss,length of hospital stay,postoperative back pain.It also shows the ex- cellent surgical efficacy of the microendoscopic approach for suitable patients.

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.

Objective The prognosis of traumatic brain injury is closely associated with the apoptosis of neural cells .This study investigated the anti-apoptosis effect of alpha lipoic acid (α-LA) and its possible mechanism in the mouse model of traumatic brain injury. Methods Seventy-two healthy male ICR mice were randomly divided into four groups of 18 each:sham operation +vehicle, sham operation +α-LA, trauma +vehicle, and trauma +α-LA.The model of traumatic brain injury was made by weight-dropping.The animals in the α-LA groups were treated with intragastric α-LA at 30 minutes after surgery, while those in the vehicle groups with oral dimethyl sulfoxide in corn oil .At 48 hours after treatment , brain samples were collected from the mice for determining brain edema , measuring the expressions of cytochrome c , Bcl-2-associated X protein ( Bax ) , and caspase-3 in the mitochondria and cytosol of the brain tissue by Western blot and immunohistochemistry respectively , and detecting the survival of the neurons and apoptosis of neural cells in the cortical area by Nissl staining and TUNEL , re-spectively. Results The brain water volume , caspase-3 expres-sion, and neural cell apoptosis were markedly higher while the neuron survival remarkably lower in the trauma +vehicle group than in the sham operation +vehicle and sham operation +α-LA groups ( P<0.01).Compared with the mice in the trauma +vehicle group, those in the trauma +α-LA group showed significantly reduced proportion of water in the brain tissue ([79.89 ±0.55] vs [81.71 ± 0.66]%, P<0.05), expression of caspase-3 ([58.40 ±7.31] vs [47.42 ±7.74]%, P<0.05), and apoptosis of neural cells ([59.63 ±8.61] vs [44.86 ±7.32]%, P <0.05), but increased survival rate of neurons ([44.45 ±10.56] vs [57.46 ± 11.01]%, P<0.05).The expression of cytochrome c in the mitochondria was remarkably decreased and that of Bax markedly in -creased in the trauma +vehicle than in the sham operation +vehicle and sham operation +α-LA groups (P<0.01). Conclusion Alpha lipoic acid has a protective effect against traumatic brain injury in mice , probably by inhibiting the apoptosis of neural cells through the mitochondrial pathway .

Polymyxin E shows effective treatment of the infection induced by resistant gramnegative bacteria, but its nephrotoxicity severely limits the clinical application of this drug. In this work, methoxypolyethylene glycols 2000 (mPEG2K)-polymyxin E (PME) was synthesized via chemical grafting reaction and had been characterized. The antimicrobial activity and cytotoxicity of mPEG2K-PME in vitro were investigated on Escherichia coli and HK-2 cells, separately. Intra-abdominal infection model was further established in order to study the therapeutic effect and the toxic effect on kidney of mice. The results showed that mPEG2K-PME exhibited significant inhibitory effect on Escherichia coli and had a lower toxicity on HK-2 cells in vitro. At the same time, mPEG2K-PME had a good efficacy in the treatment of Escherichia coli infected mice in vivo. Moreover, nephrotoxicity caused by mPEG2K-PME was significantly reduced compared to free PME. mPEG2K-PME is promising in development of new preparations with high efficiency and low toxicity.

Objective To compare the value of two‐dimensional shear wave elastography (2D‐SWE) and real‐time tissue elastography (RTE) in the assessment of liver fibrosis in patients with chronic liver disease. Methods One hundred and ten patients with chronic liver disease scheduled for liver biopsy were studied. Both 2D‐SWE and RTE were performed on these patients in a same day. The correlation coefficient of liver fibrosis level, receiver operating characteristic (ROC) curve of S≥2, and S=4 of 2D‐SWE and RTE were compared according to pathologic results. Results The correlation coefficient of liver fibrosis level for 2D‐SWE ( r =0 7.76, 95% CI 0 6.83 -0 8.45, P =0.000) was higher than that of RTE ( r =0 5.61, 95% CI 0 4.07-0 6.84, P =0.000)( Z =2 9.3, P =0.003). The area under ROC curve for S≥2 and S=4 of 2D‐SWE were 0 8.66 and 0 9.57 respectively, RTE were 0 7.50 and 0 8.43 respectively, which indicated that 2D‐SWE was better than RTE. Conclusions The diagnostic performance of 2D‐SWE was better than RTE for the assessment of liver fibrosis and cirrhosis.