Objective To discuss the clinical features,diagnosis and operative treatment in Crohn disease(CD)characterized by acute abdomen.Method The clinical data of 26 CD cases testified by pathology after emergency operations from April 1997 to February 2009 were retrospectively analyzed.Results In 26 cases of acute abdomen,17 cases characterized by mechanical obstruction,6 cases characterized by peritonitis,3 cases characterized by hemorrhage of digestive tract.Eight cases(30.8%)were diagnosed before operation,and 13 cases(50.0%)were diagnosed during operation,totally 80.8%(21/26).All patients received surgical operations as following:resection and anastomosis in 21 eases,resection and fistulation in 4 cases,ileotransverso-stomy in 1 case.Two cases died after operation,and others discharged including 1 case received second operation within 5 days.Conclusion It is difficult to be diagnosed before operation when CD characterized by acute abdomen,and appropriate emergency operations are needed according to the particular cases.

Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.

Objective To investigate the correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma.Methods From 2004 to 2010,a total of 1076 patients diagnosed as BPH underwent transurethral plasma kinetic enucleation of prostate (TUPKEP) in our hospital,and their clinical data were respectively analyzed.Among them,42 cases were found to have incidental prostatic carcinoma.The correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma were observed.Results Among 1076 BPH patients undergoing TUPKEP operation,42 cases (3.9％) aged 56-88 years were found to have incidental prostatic carcinoma,which all displayed as prostatic adenocarcinoma including 18 cases at T1 a stage and 24 cases at T1b stage.10 cases received endocrinal therapy,14 cases received bilateral orchiectomy,14 cases underwent radical prostectomy and 4 cases were treated with watchful waiting.Patients were followed up for 24 to 96 months.The survival rates were 100.0％ and the rates of progression were 0.0％,20.0％,0.0％ in T1 a patients received watchful waiting,androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 100.0％ and total rate of progression was 11.1％ in T1a patients.The survival rates were 71.4％,100.0％ and the rates of progression were 42.9％,0.0％ in T1 b patients received androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 83.3 ％ and total rate of progression was 25.0 ％ in T1 b patients.Compared with T1 b patients,the total survival rate was higher (x2=18.19,P＜0.01) and the rate of progression was lower in T1 a patients (x2 =6.52,P＜0.05).Conclusions The survival rate in T1 a patients accepted androgen-deprivation therapy is similar to that in T1 a patients with watchful waiting.Compared with T1a patients,the survival rate is lower but the rate of progression is higher in T1 b patients received active androgen-deprivation therapy.The survival rate is higher in T1 b patients treated with radical prostectomy than in those received other treatments.Watchful waiting is acceptable for T1 a patients.T1 b patients should be treated with radical prostectomy for a better effect.

Mesial temporal lobe epilepsy (mTLE) is the most common type of refractory focal epilepsy. Diffusion tensor imaging (DTI) can provide qualitative and quantitative information on the microstructural arrangement of epileptic brain tissue. DTI is significant for insights to the pathophysiological mechanism of mTLE, and has potential for investigation of changes in structural connectivity of mTLE. The development and application of DTI in research of mTLE were reviewed in this article.

Objective To compare the usefulness of contrast-enhanced T1 high resolution isotropic volume excitation (THRIVE) sequence and fat-saturated TSE sequence in detection of spinal metastases.Methods Thirty-one consecutive patients with spinal metastases were recruited.All patients received post-contrast TSE T1WI followed by a fat-suppressed THRIVE sequence.The number of lesions,SNR and CNR for both sequences,and the scoring of image quality concerning motion-artifact and tumor conspicuity were compared.Results Acquisition time of the post-contrast TSE T1W sequence and the THRIVE sequence was 2 min 55 s and 33 s,respectively.No significant difference was found in the number of lesions detected between the two sequences (Z=-0.816,P=0.414).The SNR (432.54±271.60) and CNR (233.27± 197.65) of the THRIVE sequence were significantly lower than the SNR (674.32±375.79) and CNR (312.38±207.49) of the TSE T1W sequence respectively (t=-4.366,-2.660,P＜0.001,0.012).Tumor conspicuity of the post-contrast TSE sequence was better than that of THRIVE sequence (Z=-4.082,P＜0.001),while the motion-artifact in TSE sequence was more severe (Z=2.291,P=0.022).Conclusion The post-contrast THRIVE sequence is capable of decreasing acquisition time and motion-artifact.Besides,its detected efficacy is equal to that of TSE sequence.There is practical possibility to replace the conventional post-contrast TSE T1WI sequence with the THRIVE sequence in the imaging of spinal metastases.

Objective To investigate the expression and distribution of basic fibroblast growth factor (bFGF)and platelet-derived growth factor (PDGF)in the different phases of femoral neck fracture.Methods Immunohistochemical assays were used to determine the expression and distribution of bFGF and PDGF protein in 36 human specimen of femoral neck fracture.A was measured and analyzed by CMIAS color imaging analysis system for signals of bFGF protein were found high in the mesenchymal cells,monocyte and vascular endothelial cells at 1st week after fracture in 9 subjects,with A of (0.4076 ±0.0902).The weakly positive signals of PDGF protein were found in the mesenchymal cells,while strongly positive in the vascular endothelial cells with A of (0.2261 ±0.0636).At 2rd week,in 9 cases the expression of bFGF and PDGF was strongly expressed in fibroblasts,endothelial cells,cartilage cell and cartilage matrix,osteoblast,with A of[(0.6404±0.0920)and (0.7457±0.0756)]and significandy higher than that at 1st week (P＜0.05,P＜0.01).There was no significant difference between the 3rd and 3nd week with A of[(0.7168±0.1346)and (0.8033±0.0491),P＞0.05 ].The expression of bFGF and PDGF protein was reduced obviously at 4th week but was positive in young and cartilage tissue,with A of [(0.5374correlation between bFGF and PDGF protein in different phases (r1week=0.792,r2week=0.834,r3week=0.880,entiation of cartilage cell and osteoblast,and induce proliferation of vascular endothelial cells and new blood vessel.③ Both bFGF and PDGF are bone growth factors, cooperating in regulating proliferation and differentiation of cartilage cell and osteoblast for fracture healing.

Objective To screen out the PI3K/Akt pathway related genes in vascular smooth muscle cells (VSMCs) subjected to cyclic strain. Method VSMCs of rat aorta were subjected to cyclic strain (10 %, 1 Hz) by using a FX-4000T system. Phosphorylation of Akt was examined by Western blotting. Suppression subtractive hybridization (SSH) method was employed to analyze the differently expressed cDNA sequence between the strained VSMCs pretreated with and without wortmannin, a specific inhibitor of PI3K. These fragments were ligated with T vectors, screened through the blue-white screening system to establish cDNA library, and was sequenced and analyzed in GenBank with BLASTN search.Result Level of Akt phosphorylation of VSMCs was significantly enhanced by the mechanical strain compared with the control. Ten different expressed sequence tags (EST) were gained after sequencing 30 clones randomly selected from 54 white clones. There may be six genes related with the mechanical strain and cell signal PI3K/Akt, such as High mobility group box 1 (HMGB1), Neural precursor cells expressed (Nedd4a), Cyclin-dependent kinase 5 (CDK5), Histone deacetylase 3 (HDAC3), Ubiquitin-like 1 (Uble1a) and Heterogeneous nuclear ribonucleoprotein H1 (hnRNP). Conclusion SSH is an effective and reliable approach to screen out the genes related with the mechanical strain and PI3K/Akt pathway in VSMCs.

Aim To study the protective effect of the compound flavones on chronic alcohol induced testicu-lar damage in mice. Methods One hundred SPF C57 BL/6 mice were randomly divided into 5 groups:normal control group, chronic alcohol group, alcohol+low-dose drug group, alcohol+high dose drug group, and drug control group. Chronic alcohol testicular inju-ry model in mice was established by intragastric admin-istration of increasing dose of alcohol every four weeks for 6 months, meanwhile compound flavone interven-tion was in process. The activity of super oxide dis-mutase( SOD) , the levels of malondialdehyde( MDA) and testosterone in testicular tissue were measured. HE staining was used to observe testicular histomorpholo-gy, and ultrastructure changes were detected by elec-tron microscope. Results In chronic alcohol group, MDA content was obviously increased, while SOD and testosterone levels were decreased compared with nor-mal control group ( P <0. 05 ) . In addition, germinal epithelium, support cells and sperm production at all levels showed degraded degeneration in chronic alcohol group. However, compound flavonoids could success-fully reverse alcohol-induced testicular damage in a dose-dependent way. Conclusion The compound of flavones may have therapeutic potential for alcohol-in-duced testicular injury through inhibiting lipid peroxi-dation and increasing the level of testosterone.

Objective To compare eradication rates,safety and compliance of minocycline quadruple and tailored therapies in patients retreated for Helicobacter pylori (H.pylori) infection.Methods Between January 2014 and June 2014,135 patients with dyspepsia (18-70 years) and H.pylori infection after at least one previous eradication treatment at a tertiary hospital were randomly assigned to a 10-day treatment with minocycline quadruple therapy versus tailored triple regimen of PPI,amoxicillin and a third antibiotic.In the group of tailored therapy,medications were adjusted based on clarithromycin sensitivity and cytochrome P450 isoenzyme 2C19 genotype.Eradication status was assessed 4-12 weeks after treatment.Results Although H.pylori eradication rates were higher in the minocycline therapy group than that in the tailored therapy group in intention-to-treat [84.1％ (95％ CI 75.0％-93.2％) vs 75.8％ (95％ CI 65.1％-86.5％),P =0.245] and per-protocol [88.3％ (95％ CI 80.3％-96.3％) vs 79.7％ (95％CI 69.7％-89.7％),P =0.197] analyses,the differences between the two groups were not statistically significant.The incidence of adverse effects and compliance between the two groups were also comparable.Conclusions The tailored therapy in this study had a poor eradication efficacy in the retreated patients with H.pylori infection.Minocycline quadruple therapy achieved a relatively satisfactory eradication efficacy and may be an alternative choice for the retreatment of H.pylori infection.Clinical trial registration Chinese Clinical Trial Registry,ChiCTR-TRC-13003975.

Objective:To study the safety and effect of enteral nutrition in preoperative bowel preparation and postoperative early enteral nutritional support for patients with colorectal cancer.Methods:42 patients with colorectal cancer were randomized into 2 groups.21 patients in the experimental group(enteral nutrition group) were applied with Nutrison Fibre as a kind of liquid diet in preoperative bowel preparation and postoperative early(in 12~24 hours) enteral nutritional support.21 patients in the control group(traditional therapy group) made the bowel preparation by the traditional method of semiliquid-liquid-fasting with infusion and managed with ordinary process after operation.The times of intestinal lavage the evening before operation,the satisfaction of colon cleaning,recovery time of passing flatus,occurrence of ill reaction and complication were observed.Parameters including body weight,hemoglobin(Hb),lymphocyte count(LY),plasma total protein(TP),serum albumin(ALB),prealbumin(PA) were measured and compared before bowel preparation(3th day before operation),before operation and on the 8th day after operation.Results:There were no statistical difference in the two groups about the satisfaction of colon cleaning.In the experimental group,the time of intestinal lavage was fewer(P(0.05).) But in the control group,Hb,LY,TP,ALB and PA were all significantly lower(P