Objective To explore the technique and feasibility of using 1.5 T MR guided radiofrequency ablation (RFA) of hepatic malignant tumor. Methods Twenty three patients with 44 malignant lesions in liver confirmed by pathology were treated with 1.5 T MR guided RFA using MR compatible multipolar RF electrode. Only patients refusing open surgery or suffering from unresectable lesions were included. Of these, 11 patients had primary hepatic carcinoma and 12 patients had hepatic metastases. The mean maximal diameter of lesions was (3.3 ± 1.8)cm. Postoperative MR was performed; the ablation zone covered and exceeded 0.5 to 1.0 cm to the margin of initial tumor was considered successful. Results All ablations were successful and lesions created by radio frequency were large enough to cover the initial tumor volume in all cases. No severe complications such as biliary fistula, perforation of diaphragmatic muscle,postoperative jaundice and pneumothorax were encountered. The mean operative time was (93 ± 33 ) min.The RF electrodes appeared in MRI as low signal structure. The ablation lesions were well-defined hyperintensity in T1 WI and hypo-intensity with a thin rim of high signal intensity on T2WI and DWI. Conclusion 1.5 T MR guided RFA of hepatic malignant tumor is an effective and safe technique.

Objective:To investigate the effects of epidural spinal cord stimulation (ESCS) and treadmill training on the locomotion function and ultrastructure of spinal cord anterior horn after moderate spinal cord injury in rats. (IT, n=3). All rats received a moderate spinal cord injury surgery. Four weeks after surgery, rats in SE group received an electrode implantation procedure, with the electrode field covering spinal cord segments L2-S1. Four weeks after electrode implantation, rats received subthreshold ESCS for 30 min/d. Rats in TY group received 4cm/s treadmill training for 30min/d. Rats in SI group received no intervention, as a control group. All procedures in these three groups lasted four weeks.The open field Basso,Beattie and Bresnahan (BBB) scale was used before and after intervention to evaluate rats' hindlimb motor function. Result:After four weeks intervention, rats in TT group improved their open field locomotion scores to 20. In contrast, no significant improvement was observed in groups SI and SE. The morphology of synapses and neurons were similar regardless of whether rats had undergone ESCS, treadmill training or not. Conclusion:ESCS alone was not sufficient to improve the walking ability of spinal cord injured rats. ESCS or treadmill training alone might not contribute to the changes of ultrastructure in anterior horn of spinal cord that underlie the recovery of walking ability. Further research is needed to understand the contributions of combination of ESCS and treadmill training to the rehabilitation of spinal cord injured rats.

Objective To explore the potential of creating a cat model of spinal cord infarction initiated by a photochemical reaction in terms of the neuroethology, motor evoked potential, and morphological outcomes. Meth-ods Fifteen cats were divided into three groups at random. T_13 in the spinal cord was photochemically irradiated for 40 min, 60 min or 80 min in different groups. A photochemically-induced infarction was produced by intravenous in-jection of rose Bengal (35 mg/kg) combined with immediate cold light irradiation (3000 klx) of the spinal cord.Neuroethology changes were observed every day after the surgery far 21 days, and morphological changes were exam-ined at day 21, before which the motor evoked potential was examined and compared with measurements taken before injury. Results The spinal cord infarctions induced by intravenous injection of rose Bengal plus cold light irradia-tion for 40 min were stable by day 8, while the other two groups were stable by day 12. The size of the infarction area in the spinal cord was stable, while the neuroethology, electrophysiological and histopathological changes in the cats were significant. Conclusions All of the cats demonstrated decreased functional mobility after photochemically in-duced thrombosis of the spinal cord, with corresponding pathomorphological and electrophysiologic changes. The model of infarction was stable and reliable.

Objective To investigate the effects of epidural spinal cord electrical stimulation (ESCES) on spinal cord reflexes in normal adult rats, and to find out where and how the spinal cord reflexes are generated. Methods Ten adult female Sprague Dawley rats were anaesthetized and an electrode was placed at the S, spinal cord segment. Single electric pulses with 200 μs pulse width and voltages of 400 mV, 600 mV and 1200 mV were used in the ESCES. 1200 mV voltages with 50 Hz, 60 Hz, 80 Hz, 100 Hz frequency were also tested. EMG signals were re-corded with concentric needle electrodes in the rats' semitendinosus muscles to observe the characteristics of spinal cord reflexes. Results The voltage threshold for generating semitendinosus muscle response was 300 mV. The three ESCES voltages induced 2 kinds of spinal cord reflexes. The 400 mV and 600 mV stimulation induced spinal cord reflexes with short latency (5.27±0.36 ms and 5.19±0.67 ms respectively). The 1200 mV stimulation volt-age induced spinal cord reflexes with long latency (2.57±0.23 ms). Spinal cord reflexes could be generated by 50 Hz, 60 Hz, 80 Hz, and 100 Hz ESCES. At the higher frequencies, spinal cord reflexes declined late in the ex-periments and then appeared irregular. In some of the rats, spinal cord reflexes vanished entirely late in the stimula-tion experiments. The latency and duration of the spinal cord reflexes induced by 50 Hz ESCES were (4.46 ± 1.07) ms and (7.33±1.00)ms respectively. These were significantly different from the latency and duration initia-ted by 60 Hz, 80 Hz or 100 Hz ESCES. Conclusions Different ESCES voltages induce different spinal cord refle-xes generated differently. The long latency reflexes might be monosynaptic responses mediated by dorsal root excite-ment, while the short latency reflexes might be sarcous exciting electric activity mediated by direct excitement of mo-tor neurons or motor fibers. The irregular spinal cord reflexes induced by higher frequency ESCES might be one kind of monosynaptic response. Irregularly appearing spinal cord reflexes induced by higher frequency stimulation might due to the inhibitory effect of higher frequency stimulation.

Objective To study the relationships between tissue damage and the ability of the pancreatic cells to regenerate ,and analyze the alteration of the pancreatic cells regeneration .Methods Sixty rats were divided into two groups :impact group(the pan‐creas was injured by a BIM‐Ⅲ biotical impact machine ,40 rats) and control group(sham operated ,20 rats) .All rats were sacrificed at 6 h ,24 h ,72 h ,7 d after operation .The level of AMS ,LPS in the serum were detected by spectrophotometry ,pancreatic cells re‐generation were examined and analyzed by TUNEL staining and flow cytomertry ,and the Bcl‐2 and Bax expression were measured by Western blot .Results In the impact groups ,LPS was activated later than AMS ,and lasted persistently .The results from TUNEL stain ,flow cytometry and Western blot indicated that pancreatic trauma induces cell death and the compensatory prolifera‐tion of pancreatic cells .The characteristics of pancreatic cells regeneration in the animal model of isolated pancreatic trauma indicate that the proper remedial time is in the first 24h after the pancreatic trauma .Conclusion Detecting AMS and LPS at the same time can help us to determine the exocrine function of pancrease .

Objective To investigate the choice of methods and time on the treatment of Gustilo type Ⅲ B and type ⅢC open tibia fractures by bone fixation and tissue flap repairing.Methods The clinic data of 136 cases of Gustilo Ⅲ B and Ⅲ C open tibia fractures were retrospectively studied.There were 102 males and 34 females,with average age of 34 years(range 14 to 68 years).Ninety-eight cases were classified as Gustilo type Ⅲ B and 38 cases were type Ⅲ C in degree.In all cases,one hundred and thirteen were treated with onestage external fixation,ninteen cases were treated with secondary bone fixation.Sixty-seven cases of all wounds were repaired by one-stage vascular pedicle skin flap.Seven wounds were repaired by one-stage free flaps with vascular anastomosis.Sixty-two cases were secondary repaired by different flaps after defect tissue under VSD (vacuum-sealing-drainage) treatment by 1 to several weeks,which contains 9 free skin graft,eleven muscle flaps based on posterior tibial artery perforator,thirteen flaps based on fibial artery perforator,fourteen gastrocnemius falps and 15 cross-leg flaps.Results Wound of all cases were healed wholly.Primary union occurred in 121 cases,twelve,cases healed after bone grafting for segmental bone defect.Three cases with delayed union healed after reoperation for infection that caused osteomyelitis and sinus tract.The period of bone healing was form 5 to 12 months.Conclusion The treatment of Gustilo Ⅲ B and Ⅲ C open tibia fractures by onestage or secondary bone fixation and tissue flap repairing get their advantages and disadvantages,but one-stage bone fixation and tissue flap repairing was better where appropriate.

Objective To investigate the value of percutaneous balloon dilation and percutaneous transhepatic cholangial drainage (PTCD) catheter maintenance in the treatment of benign biliary strictures.Methods The clinical data of 21 patients with benign biliary strictures at Peking Union Medical College Hospital from June 2005 to June 2011 were retrospectively studied,in which 12 patients in severe stricture (stenosis ＞ 70％ ) were treated with percutaneous balloon dilation and PTCD catheter placed across the stricture,while another 9 patients in median stricture( stenosis ＜ 70％ ) were only treated with PTCD catheter maintenance.Results Of the 12 patients underwent balloon dilation and 6-12 months ( median:9 months)of PTCD catheter placement,11 patients had the catheter successfully removed.In the follow-up of 6-24months ( median:10 months),patency of bile duct was preserved in 9 of 11 patients,and recurrent stenosis was seen in 2 patients.A severe complication with biliary artery branch rupture and massive hemobilia was seen in 1 patient during balloon dilation.Of the 9 patients only treated with 1-12 months (median:6months) of PTCD catheter placement,7 patients had the catheter successfully removed.In the follow-up of 5-18 months (median:8 months),patency of bile duct was preserved in 5 of 7 patients,and recurrent stenosis was seen in 2 patients.No severe complication occurred.Conclusions When endoscopy therapy is failed or the patient can't undergo endoscopy therapy,the percutaneous balloon dilation and PTCD catheter maintenance method is an effective alternative therapeutic approach in the treatment of benign biliary strictures.The moderate benign biliary stricture may be effectively treated only by the PTCD catheter maintenance method.

Objective To investigate the relationship between multi-slice spiral CT perfusion imaging and tumor angiogenesis and cell cycle protein D1 (cyclinD1) expression in patients with peripheral lung cancer. Methods Seventy-three patients with peripheral lung cancer underwent 16-slice spiral CTperfusion imaging. The CT perfusion imaging were analyzed for time density curve (TDC), perfusion parametric maps and the respective perfusion parameters (BF, BV, PS, PH, and PHpm/PHa). Correlation between the respective perfusion parameters and immunohistochemical findings of MVD measurement and cyclinD1 expression were evaluated. Statistical method used one factor analysis of variance (One-wayANOVA) and Pearson correlation analysis. Results The shape of TDC of three groups of peripheral lung cancers (adenocarcinoma, squamous cell carcinoma, and other type of cancer) was similar. They showed a steeper slope, was obvious increase of nodular HU value [ peak height of TDC is respectively (44. 87±6. 83), (34. 91 ± 8.05), (40. 66±5. 87) HU ], changed little after reaching peak height, became flat at peak, had a platform. Forty-four patients were cyclinD1 positive expression, the peripheral lung cancers with cyclinD1 positive expression showed significantly higher MVD value than that of the peripheral lung cancers with cyclinD1 negative expression [ respectively (33.88± 14. 81), (23. 17±11.66) band/high magnification, P < 0. 01]. The cancers with cyclinD1 positive expression showed significantly higher PH,PHpm/PHa, BF,BV, PS value than those of the cancers with cyelinD1 negative expression[respectively P <0. 05]. MVD was positively correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups ofcancers with cyclinD1 positive expression. Among, the correlation coefficient (r value) of BV, PS, BF was0. 409, 0. 517,0. 503 respectively(all P < 0. 01). MVD was significantly correlated with them. The r valueof PH, PHpm/PHa is 0. 319,0. 324 respectively(all P < 0. 05). MVD was less correlated with them. MVDwas not correlated with PH, PHpm/PHa, BF, BV, and PS of the three groups of cancers with cyclinD1 negative expression. Conclusions Multi-slice spiral CT perfusion imaging moderately correlated with tumorangiogenesis and reflected MVD measurement and cyclinD1 expression. It provided not only a noninvasive method of quantitative assessment for blood flow patterns of peripheral lung cancer but also an applicable diagnostic method for peripheral lung cancer.

Objective To compare internal fixation with hallow compression screws combined vascularized bone graft(observation group) with only three hallow compression screws(control group) in young patients' Garden III and IV femoral neck fractures. Methods The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and mid-dle-aged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery;280 patients were treated by closed reduction with 3 hallow com-pression screws. Results Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no sta-tistical difference(P>0.05). It was 0.7％of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6％, and incidence of femoral neck shortening was 8.8％. In the control group, inci-dence of avascular necrosis of femoral head was 14.6％, nonunion incidence rate was 4.6％, and incidence of femoral neck shortening was 22.5％. The differences between two groups was statistically significance( P<0.05). Conclusion The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures.

PURPOSE: The data on the differences between sputum autoantibodies (Sp-Abs) and serum autoantibodies (Se-Abs) in reflection of autoimmune responses to lungs is still lacking. METHODS: Ten types of Abs were investigated in matched Se and Sp samples collected from recruited subjects. Correlations between Ab levels and airway inflammatory parameters and measures of pulmonary function were assessed. The network-based and inter-correlated analysis was performed to explore the patterns of Sp- and Se-Ab profiles. RESULTS: Fifty stable asthmatic patients and 24 healthy volunteers were recruited for our study, 15 with mild asthma, 18 with moderate asthma and 17 with severe asthma. The concentrations of Sp-Ab against U1 small nuclear ribonucleoprotein (Sp-anti-U1-SnRNP), Sp-Ab against Smith antigen and Se-Ab against thyroid peroxidase (anti-TPO) in severe asthmatics and Sp-anti-U1-SnRNP in moderate asthmatics were significantly higher compared to healthy controls and mild asthmatic subjects (P < 0.05). Sp-anti-U1-SnRNP levels were positively correlated with the dose of inhaled corticosteroids, Sp eosinophil counts and fractional exhaled nitric oxide (r = 0.326, P = 0.022; r = 0.356, P = 0.012; r = 0.241, P = 0.025, respectively) and negatively correlated with Sp neutrophil counts (r = −0.308, P = 0.031) with adjustment for age. Spearman's correlation matrix showed multiple inter-correlations among Sp-Abs and Se-Abs (P < 0.05) while only the levels of Ab against DNA topoisomerase and anti-TPO in Se were correlated with those Sp-Ab counterparts (P < 0.05). The network-based analysis defined 2 clusters: clusters 1 and 2 contained 10 Sp-Abs and 10 Se-Abs, respectively. CONCLUSIONS: This study observes that Sp-Abs are more associated with clinical parameters and the severity of disease in asthma compared to Se-Abs. Targeting on Sp-Abs which are the hallmark of the localized autoimmune event might help us better understand the role of autoimmunity in the pathological mechanism of asthma.
Adrenal Cortex Hormones ; Asthma ; Autoantibodies ; Autoimmunity ; DNA Topoisomerases, Type I ; Eosinophils ; Healthy Volunteers ; Humans ; Iodide Peroxidase ; Lung ; Neutrophils ; Nitric Oxide ; Ribonucleoproteins, Small Nuclear ; Sputum