Objective To compare two methods 3D flash and diffusion-weighted images(DWI)in reconstructing the brain surface anatomy,and to evaluate their displaying ability,advantages,limitations and clinical application.Methods Thrity normal cases were prospectively examined with 3 D flash sequence and echo-planar DWI.Three-dimensional images were acquired with volume-rendering on workstation.Brain surface structures were evaluated and scored by a group of doctors.Results Main structures of brain surface were clearly displayed on three-dimensional images based on 3D flash sequence.Average scores were all above 2.50.For images based on DWI,precentral gyrus,postcentral gyrus,superior parietal lobule, superior frontal gyrus,precentral sulcus,central sulcus,postcentral sulcus,intraparietal sulcus and superior frontal sulcus were best shown with average scores between 2.60-2.75,However,supramarginal gyrus, angular gyurs,middle frontal gyrus,inferior frontal gyrus,superior temporal gyrus,lateral sulcus,inferior frontal sulcus could not be well shown,with average scores between 1.67-2.48.Middle temporal gyrus, inferior temporal gyrus,superior temporal sulcus and inferior temporal sulcus can only get scores from 0.88 to 1.27.Scores of images based on 3D flash were much higher than that based on DWI with distinct differentiations,P values were all below 0.01.Conclusion Three-dimensional images based on 3D flash can really display brain surface structures.It is very useful for anatomic researches.Three-dimensional reconstruction of brain surface based on DWI is a worthy technique to display brain surface anatomy, especially for frontal and parietal structures.

Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication.Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass (MIDCAB).Age range from 70 to 82 years with a mean of(72.1?6.0)years.Patients suffered from multi vessel disease.Many minimally invasive techniques of“Y”blood vessel graft anastomosis,anastomosis of blood vessel graft to descending aorta,minimally invasive direct,thoracoscope assist were used.Results All patients were survived.The mean duration of intubation was (6.9?0.9) hours.The average ICU stay was (2.5?0.5)days.No patients received blood transfusion.During the short-term follow-up(3 to 14 months) patients had no complaint of angina,Conclusions The technique of“Y”blood vessel graft anastomosis,descending aorta blood vessel graft,minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

In order to study the accumulation of Fritillaria thunbergii cultivar, peimine content in Xiaye, Kuanye, Duozi and Xiaosanzi bulbs of different sizes and parts was determined by HPLC-ELSE. The results indicated that the peimine content varied significantly with the cultivar type, the size and part of bulb. The distribution laws of peimine were as follow: Xiaosanzi > Duozi > Xiaye > Kuanye, small-size bulb > big-size bulb, core bud > scale. The peimine yield per plant in Duozi was the highest.
Cevanes ; analysis ; Chromatography, High Pressure Liquid ; Fritillaria ; chemistry ; growth & development

Objective To assess the various features of Budd-Chiari syndrome(BCS)on three- dimensional contrast-enhanced magnetic resonance angiography(3D CE MRA)and to evaluate the potential value of this new technique.Methods Thirty-three patients with BCS underwent 3D CE MRA examination. In 23 cases,BCS was secondary to hepatocellular carcinoma(21 patients)or right adrenal carcinoma (1 patient)or thrombophlebitis(1 patient).Ten patients had primary BCS.The patency of the hepatic veins,inferior vena cava(IVC)and portal veins were assessed.The presence of intra-and extrahepatic collaterals,liver parenchymal abnormalities and porto-systemic varices were evaluated.The diagnosis on 3D CE MRA was correlated with that on inferior vena cavography and right hepatic venography,which were available in 10 and 2 cases respectively.Results Various features of BCS were displayed on 3D CE MRA. Hepatic venous findings included tumor thrombosis(19 patients),tumor compression(2 patients), nonvisualization(4 patients)and focal stenosis(4 patients)of the hepatic veins.IVC findings were severe stenosis or occlusion(10 cases),tumor direct invasion(2 cases),tumor thrombosis(3 cases), thrombophlebitis(1 case)and web formation(3 cases).Intrahepatic collaterals were demonstrated in 9 patients including 2 with "spider web" sign.Detected extrahepatic collaterals included dilated azygos and hemiazygos veins(13 cases)and left renal-inferior phrenic-pericardiophrenic collaterals(2 cases).The occlusion of the left portal vein and the presence of porto-systemic varices were depicted in 2 and 10 patients respectively.Liver parenchymal abnormalities identified by 3D CE MRA consisted of caudate lobe enlargement(7 cases),heterogenous enhancement(18 cases)and associated tumors(18 cases). Compared with inferior vena cavography and hepatic venography,the accuracy of 3D CE MRA in the diagnosis of IVC obstruction or hepatic venous stenosis was 100%.Conclusion 3D CE MRA can display various features of BCS and has the potential to provide an accurate diagnosis.

OBJECTIVETo evaluate the safety and effectiveness of a modified method of holmium laser enucleation of the prostate (HoLEP)--6-o'clock tunnel HoLEP for the treatment of benign prostate hyperplasia (BPH).

METHODSWe included 112 cases of BPH in this study, 57 treated by 6-o'clock tunnel HoLEP (experimental group) and the other 55 by conventional HoLEP (control group). We compared the operation time, volume of the resected prostatic tissue, intraoperative blood transfusion, volume of bladder irrigation solution, postoperative hemoglobin change, and incidence of urinary incontinence between the two groups.

RESULTSStatistically significant differences were observed between the experimental and control groups in the operation time ([56.01 ± 8.62] min vs [68.65 ± 9.08] min), cases of intraoperative blood transfusion (0 vs 2), volume of bladder irrigation solution ([27.51 ± 3.67] L vs [36.89 ± 6.47] L), postoperative hemoglobin decrease ([10.70 ± 2.50] g/L vs [12.60 ± 3.30] g/L), and cases of postoperative stress-induced urinary incontinence (2 vs 7) (all P <0.05). One-month follow-up revealed smooth urination in both groups of patients but no true urinary incontinence or secondary bleeding in either.

CONCLUSIONModified 6-o'clock tunnel HoLEP can significantly reduce the operation time, bladder irrigation, and intraoperative bleeding, and therefore can be used as a safe and effective option for the treatment of BPH.

Case-Control Studies ; Hemorrhage ; prevention & control ; Holmium ; Humans ; Laser Therapy ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Operative Time ; Postoperative Period ; Prostatic Hyperplasia ; surgery ; Therapeutic Irrigation ; statistics & numerical data ; Urinary Bladder ; Urinary Incontinence ; epidemiology ; etiology ; Urinary Incontinence, Stress ; etiology

Education, Dental ; Oral Medicine ; education

Nine hundred and forty nine general physicians in Beijing urban area received surgical skill assessment in 2008.The assessment results of five surgical skills (taking out stitches,changing dressings,skin suture,knot with gloves and wearing isolation gown) were analyzed with the relations of different gender,age,educational background,professional title,specialty,hospital grade,length of service and times of test taking.The average score of the total assessment was 71.The score was lower in the practitioners who were male,older than 50 years,higher educational background,lower professional tide,more than 2 times of test taking,and who were specialized in traditional Chinese medicine,ophthalmology and otorhinolaryngology and emergency medicine.Results suggest that the levels of surgical skills in general practitioners are generally low and periodical training is needed.

BACKGROUND:Clinical physicians should pay attention on how to reduce ankle fracture healing wounds, reduce bleeding, improve operating technique, and improve repair effect, especialy for comminuted fracture. It is necessary to understand how to develop a detailed plan before repair, observe specific circumstances of the fracture from multiple angles, and establish three-dimensional images using two-dimensional X-ray films or CT scan. These raise a chalenge for each physician. OBJECTIVE:To explore the application effect of three-dimensional print, minimaly invasive percutaneous screw and locking plate fixation in the repair of ankle fractures. METHODS: A total of 26 cases of fracture of ankle joint were treated from January 2012 to June 2014. There were 9 cases of double ankle fracture, 12 cases of three ankle fractures, and 5 cases of three ankle fractures involved PILON fracture on the lower tibia. They received spiral CT scanning on the ankle joint, and stored in the format of di.com. After processing with minics software, data were converted into STL format, and then input into the three-dimensional printer. Thus, models of ankle joint were made at the ratio of 1:1. The repair scheme was made. After discharge, X-ray films were checked every month to observe the healing condition of fractures. According to Mazur ankle score standard, ankle joint function was assessed. RESULTS AND CONCLUSION: Al 26 cases were folowed up for 6-12 months. The fractures were healed. The healing time was 4-6 months, averagely 5.5 months. The healing was good, without vascular and nerve damage, or plate breakage. In accordance with the Mazur ankle score standard, there were excelent in 11 cases, good in 13 cases with an excelent and good rate of 92%. The operation time was (64±15) minutes, and intraoperative blood loss was (100±15) mL. The incision was healed in stage one. These findings confirm that the simulation training and operation in fracture models of three-dimensional print have smal injuries to patients with ankle fracture. The bleeding was less, the operation was simple, the healing time was short, and the functional recovery was rapid, especialy for comminuted fracture.

ObjectiveTo observe the inhibition effect of docetaxel-loaded lipid microbubbles (DLLM) combined with ultrasound targeted microbubbles destruction (UTMD) on microvessel in rabbit VX2 liver tumor models.MethodsSixty rabbits were randomly divided into 6 groups (n= 10),i.e.Doc group (used docetaxel only),DLLM group (used docetaxel-loaded lipid microbubbles),Doc+US group (used docetaxel combined with ultrasound positioning irradiation),PLM+US group (used microbubbles combined with ultrasound positioning irradiation),DLLM+US group (used docetaxel-loaded lipid microbubbles combined with ultrasound positioning irradiation) and control group.The expression of CD34 and VEGF and microvessel density (MVD) were compared among different groups.ResultsAfter treatment,the expression of CD34 in DLLM+US group was lower,the MVD of DLLM+US group was markedly lower than that of the other groups (P＜0.01),while the expression of VEGF in this group was the lowest among all 6 groups (P＜ 0.01).ConclusionDLLM combined with UTMD can inhibit the generation of microvessels in rabbit VX2 liver tumor,thus inhibit the growth of the tumor.

Objective:Study on proliferation of gastric cancer cells (GCCs) and expressions of VEGF under the CO2 pneumoperitoneum environment,and effect of Bcl-2 specific inhibitor on the expression of VEGF in GCCs/TAMs co-culture system.Methods:TAMs induced by PMA and IL-4 in vitro.TAMs and MKN-45 cells were co-cultured in Transwell chamber,in pseudo CO2 pneumoperitoneum environment.Proliferation activity of GCCs was detected by MTT assay,and ELISA method was used to detect VEGF concentration in the cell culture supernatant.Results:Co-culture system was divided into CO2 pneumoperitoneum group and control group.Proliferation activity of MKN-45 cell and expression of VEGF of 5mmHg,10mmHg and 15mmHg groups are no difference with the control group;25 mmHg group is opposite to the former.The cells in co-culture group and CO2 pneumoperitoneum group (15 mmHg) were added to ABT-737,VEGF expression of co-culture + ABT-737 group was significantly lower than that of in the control group(P=0.001).Co-cultured cells VEGF expression in pneumoperitoneum group was significantly lower than the control group without inhibitor (P=0.000).Conclusion:Normal laparoscopic pneumoperitoneum is no stimulation of tumor cell proliferation defects,And higher pneumoperitoneum pressure might increase the hypoxia status of tumor microenvironment,promote tumor malignant progression.The interaction between tumor cells and TAMs may be achieved by paracrine Bcl-2-VEGF loop.