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OBJECTIVE: To assess the longitudinal evolution of cerebral perfusion after revascularization surgery in patients with moyamoya disease (MMD) by CT perfusion (CTP). MATERIALS AND METHODS: Thirty-one clinically confirmed MMD patients (12 males and 19 females, average age: 33.26 y, Suzuki stages 3 and 4: 19 and 11, respectively) who underwent revascularization surgery (bilateral (n=13) or unilateral (n=18)) were studied retrospectively. All patients underwent CTP examinations before and in the week after surgery and long-term (>3 months). CTP metrics (CBF, CBV, MTT, TTP, and delay TTP) were derived. The corresponding CTP metric values of the ROIs, which were manually drawn in the white matter (WM) and gray matter (GM), were recorded. RESULTS: Six patients developed a new or progressive cerebral infarction/hemorrhage. In all patients, compared with the preoperative level, the TTP of GM and WM decreased in the short term after the surgery (P ≤ 0.005). Concurrently, the WM CBF increased significantly a week after surgery (P =0.02). However, in the long-term follow-up, the CBV and CBF in the GM and WM decreased to equal to or lower than the preoperative level, especially for CBV in the WM (P =0.012). Furthermore, cerebral perfusion began to decrease in the sixth month, and a continuous decline was observed over the next two months. It returned to the presurgical level after one year. In addition, the improvement in postsurgical perfusion was greater in Suzuki stage 3 patients than stage 4 patients. CONCLUSION: Cerebral perfusion in patients with MMD improved shortly after surgery. However, in the long-term, brain perfusion decreased, most seriously in 6-8 months postoperatively, which might indicate that patients with MMD need timely follow-up and long-term intervention.
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Revascularización Cerebral , Enfermedad de Moyamoya , Masculino , Femenino , Humanos , Adulto , Enfermedad de Moyamoya/diagnóstico por imagen , Enfermedad de Moyamoya/cirugía , Estudios Retrospectivos , Perfusión , Hemorragia Cerebral , Tomografía Computarizada por Rayos X , Circulación Cerebrovascular , Revascularización Cerebral/efectos adversosRESUMEN
OBJECTIVE: To investigate the effect of the decoction of Fuzheng Jiedu Xiaoji formula (, FJXF) plus chemoembolization (TACE) on primary liver cancer (PLC) in patients, and study the underlying mechanism. METHODS: Patients with PLC who met the inclusion criteria were randomized into case group and control group. The case group was treated with FJXF combined with TACE. The control group was treated with TACE alone. The short-term clinical effect was evaluated; liver biochemistry, liver function index and multidrug resistance-associated indicators were detected. RESULTS: FJXF combined with TACE in the case group significantly increased the disease control rate than TACE alone in the control group (83.3% 61.1%). There was a reduction in the serum alpha-fetoprotein at 8 weeks after treatment in each group, while no difference between the two groups. The same trend can be observed for transaminase and direct bilirubin in both groups. In the case group, it showed a significant increase for albumin at 8 weeks after treatment, while no change in the control group. Multidrug resistance-associated indicators for multidrug resistance protein 1 and p-glycoprotein were upregulated in the case group but remained stable in the control group. CONCLUSIONS: FJXF combined TACE had a better short-term effect than TACE alone in patients with PLC. The potential mechanism was probably associated with alleviated multidrug resistance induced by FJXF. Additionally, FJXF didn't increase the risk of liver damage in the combined therapy.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Medicamentos Herbarios Chinos , Neoplasias Hepáticas , Carcinoma Hepatocelular/tratamiento farmacológico , Quimioembolización Terapéutica/efectos adversos , Terapia Combinada , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Anticoagulation therapy stands as a key treatment for thrombotic diseases. The consequential bleeding risk tied to existing anticoagulation methods significantly impacts patient prognosis. In the intensive care unit (ICU), patients often necessitate organ support, leading to the inevitable placement of artificial devices in blood vessels, thereby requiring anticoagulation treatment to avert clot formation that might impede organ support. Nevertheless, these patients commonly encounter a heightened risk of bleeding. Hemophilia B, identified in 1953, manifests as a deficiency in coagulation factor Ⅺ (FⅪ), which focused people's perspective on the endogenous coagulation pathway, that is, the contact pathway. Upon interaction between the surface of artificial devices and FⅫ, FⅫ activates, subsequently triggering FⅪ and initiating the "coagulation cascade" within the contact pathway. Inhibitors targeting the contact pathway encompass two primary categories: FⅫ inhibitors and FⅪ inhibitors, capable of impeding this process. This article reviews the role of FⅫ and FⅪ in activating the contact pathway, seeking to illuminate their contributions to thrombus formation. By listing the relatively mature drugs and their indications, clinicians are familiar with this new anticoagulant.
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OBJECTIVE@#To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children.@*METHODS@#Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria.@*RESULTS@#All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%.@*CONCLUSION@#The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.
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Masculino , Femenino , Humanos , Niño , Preescolar , Sulfato de Calcio , Húmero , Fracturas del Húmero/cirugía , Procedimientos de Cirugía Plástica , Fijación Interna de Fracturas/métodos , Hilos Ortopédicos , Curación de Fractura , Resultado del Tratamiento , Rango del Movimiento ArticularRESUMEN
Background/Aims@#Studies have shown that nucleos(t)ide analogue (NA) treatment can reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it is unclear which NA is most effective. We performed a meta-analysis and systematic review comparing the efficacies of NAs in CHB patients. @*Methods@#We searched literature databases for randomized controlled trials (RCTs) and observational studies that analyzed the hepatic biochemical response, virological response, seroconversion rate, drug resistance rate, and HCC incidence rate in CHB patients treated with NAs. Meta-analyses were performed with RevMan and Stata/SE software. @*Results@#Twelve cohort studies and one RCT were selected, in which entecavir (ETV), lamivudine (LAM), telbivudine (LdT), and/or tenofovir disoproxil fumarate (TDF) were evaluated in CHB patients. The meta-analysis showed that ETV was superior to LAM with regard to the HCC incidence (p<0.001), biochemical response (p=0.001), virological response (p=0.02), and drug resistance (p<0.001), and ETV was superior to LdT with regard to the virological response (p<0.001) and drug resistance (p<0.001). We found no significant difference between ETV and TDF with regard to the HCC incidence (p=0.08), biochemical response (p=0.39), virological response (p=0.31), serological conversion (p=0.38), or drug resistance (p=0.95). NA-treated patients with pre-existing cirrhosis had a 5.49 times greater incidence of HCC than those without cirrhosis (p<0.001). @*Conclusions@#ETV or TDF should be used for long-term first-line monotherapy in CHB patients according to the current guidelines. Standardized protocols are needed for future studies of ETV and TDF to facilitate conclusive comparisons. Patients with cirrhosis are at significantly elevated risk for HCC, despite the benefits of NA treatment.
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Magnetic resonance imaging is commonly used in clinical work for its high resolution for soft tissue, and without radiation or interaction of bone interference. For ENT physicians, to read MRI accurately and retrieve more information from it would help the clinical work a lot. This review introduces the principles of MRI, the anatomy, the inflammatory disease, benign tumors and malignancies of the nasonasal tract.
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Objective To investigate the clinical value of three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) sequence in preoperative evaluation of acoustic neuroma.Methods Totally 57 patients with acoustic neuroma confirmed by surgery and pathology were enrolled.All patients underwent preoperative routine head MR and 3D-SPACE sequence.The position,size and shape of the tumors were observed,and the display rate of surrounding cranial nerves was evaluated with 3D-SPACE sequence.The results were compared with those of conventional MRI and operation.Results All 57 patients were found with single tumor.The tumor in 1 patient (1/57,1.75%) limited in the internal auditory canal,and those in another 56 patients (56/57,98.25%) exceed the internal auditory canal crossing growth.The inner auditory canal fundus in 26 patients (26/57,45.61 %) were completely filled by the tumors,while those in another 31 patients (31/57) were uncompletely filled.3D-SPACE sequence showed 21 patients (21/57,36.84%) with solid type lesions,35 patients (61.40%,35/57) with solid with cystic type lesions and 1 patient (1/57,1.76%) with cystic type lesion.The coincidence rate of lesion types showed with 3D-SPACE sequence and intraoperative findings was 85.96 % (49/57).The display rate of trigeminal nerve internal cisternal segment,lower cranial nerves cisternal segment,abducens nerve cisternal segment,facial nerve internal acoustic meatus segment,facial nerve cisternal segment and acoustic nerve cisternal segment was 100% (57/57),100%(57/57),75.44% (43/57),50.88% (29/57),17.53% (10/57) and 19.30% (11/57),respectively,all significantly increased compared with those of conventional MRI (all P<0.05).Conclusion 3D-SPACE sequence can accurately display the relationship between tumor and adjacent cranial nerves,therefore has important clinical value in preoperative evaluation of acoustic neuroma.
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Objective To explore the value of small surface coil combined with three-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence in displaying mandibular nerves and their branches. Methods The maxillofacial regions of 52 volunteers were scanned unilaterally by a small surface coil combined with 3D-DESS-WE sequence. According to the Gray's anatomy atlas,MPR and CPR was done according to the anatomic position of mandibular nerve and the branches,the signal characteristics of the nerves and neighboring structures were analyzed. The displaying rate of the mandibular nerves and their branches were evaluated.The image quality and display of the nerve were subjectively scored. The signal intensity(SI) of the nerve and adjacent lateral pterygoid muscle were measured. The signal intensity ratio(SIR) of mandibular nerve/lateral pterygoid muscle (SIRN/M) was calculated. Results Compared with the muscles, the nerve showed iso-signal intensity. The subjective scores for all small coil 3D-DESS-WE images were 3.02 ± 0.82. The displaying rates of V3 trunk,anterior trunk,buccal nerve, posterior trunk,inferior alveolar nerve and lingual nerve were all 100%. V3 posterior trunk,inferior alveolar nerve and lingual nerve showed the best quality scores,which were all about 3 points,and the SIRN/M were about 1. The auricular temporal nerve and masseter muscle nerve were also basically satisfied. The displaying rate of mylohyoid muscle nerve,medial pterygoid nerve and lateral pterygoid nerve was low. Conclusion Small surface coil combine with 3D-DESS-WE sequence performed high-quality in mandibular nerves and their branches MR imaging using MPR,CPR post-processing technology,which are suitable for clinical application.
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Objective:To explore therapeutic effect of Fasudil combined Salmeterol Xinafoate and fluticasone propio‐nate powder for inhalation (Seretide) on patients with chronic obstructive pulmonary disease (COPD) combined pul‐monary arterial hypertension (PAH ) .Methods :A total of 120 patients ,who hospitalized in our department from Jan 2013 to Oct 2014 and conformed to diagnostic standards of COPD and PAH ,were selected .According to ran‐dom number table ,they were equally divided into routine treatment group (received routine therapeutic measures ) , Fasudil group (received Fasudil based on routine treatment group ) and combined treatment group (received Fasudil combined Seretide based on routine treatment ) . Pulmonary function indexes , mean pulmonary arterial pressure (mPAP) ,pulmonary arterial systolic pressure (PASP) ,6min walking distance (6MWD) and blood gas indexes were observed and compared among three groups before and after treatment .Results:Compared with routine treatment group after treatment ,there were significant reductions in mPAP [(54.1 ± 10.3) mmHg vs .(51.3 ± 9.5) mmHg vs . (48.5 ± 10.5) mmHg] and PASP [ (72.4 ± 9.7) mmHg vs .(63.4 ± 9.3) mmHg vs .(61.6 ± 9.1) mmHg] ,and sig‐nificant rise in 6MWD [ (259.4 ± 37.0) m vs .(274.2 ± 36.5) m vs .(288.3 ± 47.5) m] ,forced expiratory volume in one second [FEV1 ,(1.44 ± 0.32) L vs .(1.59 ± 0.38) L vs .(1.87 ± 0.34) L] and FEV1/forced vital capacity (FVC) [ (47.2 ± 11.9)% vs .(50.3 ± 12.1)% vs .(54.6 ± 11.7)% ];significant rise in partial pressure of oxygen in artery [PO2 ,(64.3 ± 9.8) mmHg vs .(68.9 ± 8.2) mmHg vs .(76.9 ± 9.5) mmHg] and saturation of arterial blood oxygen [SaO2 ,(65.0 ± 8.2)% vs .(71.0 ± 9.8)% vs .(76.8 ± 9.4)% ] ,and significant reduction in partial pressure of carbon dioxide in artery [PCO2 ,(63.6 ± 9.5) mmHg vs .(58.5 ± 9.6) mmHg vs .(51.3 ± 7.9) mmHg] in Fasud‐il group and combined treatment group ,and those of combined treatment group were significantly improved com‐pared to those of Fasudil group , P<0.05 or <0.01. Actual base excess of combined treatment group was signifi‐cantly higher than the other two groups , P<0. 01 both . Conclusion:Fasudil combined Seretide can significantly im‐prove pulmonary function reduction ,improve PAH ,quality of life and prognosis in COPD + PAH patients .
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Objective: To explore mechanism of fasudil combined salmeterol and fluticasone propionate powder for inhalation (Seretide) in treating chronic obstructive pulmonary disease (COPD) complicated pulmonary artery hypertension (PAH).Methods: A total of 120 patients accorded with diagnostic standards of COPD and PAH, who hospitalized in our department from Jan 2013 to Oct 2014, were selected.According to random number table method, patients were randomly and equally divided into routine treatment group, fasudil group (received intravenous drip of fasudil based on routine treatment group) and combined treatment group (received additional Seretide therapy based on fasudil group).Levels of nitric oxide (NO), endothelin-1 (ET-1), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured and compared among three groups before and after treatment.Results: Compared with before treatment, after two-week treatment, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in three groups, P<0.05 or<0.01;compared with routine treatment group after treatment, there were significant reductions in levels of CRP[(14.8±3.3) mg/L vs.(12.9±3.6) mg/L vs.(11.4±3.4) mg/L], ESR[(37.3±8.9) mm/h vs.(32.9±8.8) mm/h vs.(29.3±5.6) mm/h]and ET-1[(63.1±11.2) ng/L vs.(57.5±8.1) ng/L vs.(53.1±8.9) ng/L], and significant rise in NO level[(70.2±10.7) μmol/L vs.(76.0±8.0) μmol/L vs.(80.5±11.3) μmol/L]in fasudil group and combined treatment group, P<0.05 or<0.01;compared with fasudil group, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in combined treatment, P<0.05 all.Conclusion: Fasudil hydrochloride combined Seretide can significantly reduce levels of ESR, CRP and ET-1, and increase NO level in COPD + PAH patients.It may improve prognosis in these patients, which is worth extending.
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Objective To evaluate functional activity of the subcortical nuclei in Wilson's disease (WD) using resting state functional MRI (rs-fMRI),and to evaluate damage to the functional conjunction in the extracorticospinal tract in WD patients.Methods Twenty-two patients with WD (between January 2015 and January 2016),including 18 with cerebral type and 4 with hepatic type,and 20 age-matched healthy controls were enrolled.Neurological symptoms were scored using the modified Young Scale.Patients with cerebral type WD were divided into 4 subgroups.All study subjects underwent rs-fMRI of the brain.The values of amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (REHO) in the thalamus,caudate nucleus,putamen and globus pallidus were determined.The relationships between rsfMRI metrics and clinical status were evaluated.Results ALFF values were lower in the caudate nucleus,putamen and right thalamus of WD patients than in controls (t =-3.07,-3.00,-3.12,-2.46,-2.20;P =0.005,0.006,0.004,0.020,0.036),while REHO values were lower in the left caudate nucleus and left thalamus of WD patients (t =-2.38,-2.16;P =0.025,0.040).In the caudate nucleus (P =0.032,0.029,0.023),thalamus (P =0.022,0.041,0.035) ALFF values were lower in group 4 than in other groups.REHO values of the putamen (P =0.040,0.017,0.040) and thalamus (P =0.024,0.029 7,0.041) were higher in group 4 than in other groups.ALFF values in the caudate nucleus (t =-0.29,P=0.037),and thalamus (t =-1.77,P =0.042) were lower,and REHO values in the caudate nncleus (t =-1.46,P =0.040) were lower,in patients of cerebral type than in hepatic type patients.Conclusions The damage to the functional activity of the subcortical nuclei may occur in the WD patients.The functional activity of nuclei may be different between hepatic and cerebral type patients.Damage to the activity of neurons in the putamen and thalamus may correlate with psychiatric symptoms in WD patients.
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Objective To compare the different dehydrations of microwave-vacuurn drying and high temperature drying on contents of the major effective in fructus momordicae.Methods Using two different drying methods for processing of fructus momordicae, the mogroside Ⅴ, vitamin C in dried products which was determined by high performance liquid chromatography (HPLC) was used to a main indicator for comparing different drying methods.Results The contents of mogroside Ⅴ in fructus momordicae which processed by microwave-vacuum drying, microwave-vacuum drying after ripening treatment and high temperature drying were 1.14%, 1.19% and 0.60%;the contents of vitamin C were 0.21%, 0.30% and 0.000 06%.Conclusion The processing method of microwave-vacuum drying to keep active components is obviously better than which of high temperature drying.
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<p><b>OBJECTIVE</b>This study addresses the characters of magnetic resonance imaging (MRI) and clinical features, and curative effects in the screening of SSNHL due to inner-ear hemorrhage.</p><p><b>METHODS</b>MRI and relevant audiometric test were given to 160 patients with SSNHL, who were hospitalized in the First Affiliated Hospital of Sun Yat-sen University from January 2011 to April 2013. The clinical features and curative effects of patients with high signals in the labyrinth on MRI were analyzed.</p><p><b>RESULTS</b>MRI abnormities were found in 22 (13.8%) of the patients. Specifically, eight cases were considered for inner-ear hemorrhage. For the eight inner-ear hemorrhage cases, clinical features included the sudden onset of complete hearing loss, which worsened within several hours. Pure tone audiometry indicated profound sensorineural deafness. The prevalence of inner-ear hemorrhage was 5% in SSNHL cases and 18.6% in cases of profound sensorineural. MRI showed high signal intensity in the cochlear, semicircular canals or vestibule on unenhanced T1-weighted and fluid-attenuated inversion recovery images. The high signal intensity in the inner ear gradually degraded in six months. There was no improvement in hearing for the patients with inner-ear hemorrhage following symptomatic therapy.</p><p><b>CONCLUSION</b>SSNHL due to inner-ear hemorrhage is characterized by profound sensorineural deafness in all frequencies, and high signal intensity for the hemorrhagic inner ear on T1-weighted MRI, with poor prognosis.</p>
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Humanos , Audiometría de Tonos Puros , Cóclea , Sordera , Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita , Hemorragia , Imagenología Tridimensional , Imagen por Resonancia Magnética , Canales Semicirculares , Vestíbulo del LaberintoRESUMEN
Objective To explore the value of small surface coil combine with three-dimensional fast imaging with steady state precession and fat-suppression (3D-FISP-FS) sequence in displaying intra-parotid facial nerves segment and parotid ducts.Methods The parotid regions of 18 healthy volunteers who were excluded any parotid diseases were scanned by head&neck coil (36 sides) and 4 cm small surface coil (32 sides) combined with 3D-FISP-FS sequence prospectively. The obtained original images were treated through MIP, MPR and CPR, The MRI signal characteristics of parotid region structure, the subjective score of image quality, the signal intensity ratio (SIR) of facial nerve/parotid tissue (SIR N) and parotid duct/parotid tissue (SIRD) was calculated, and the displaying rates of the facial nerves and parotid ducts were observed. Wilcoxon matched-samples signed rank sum test was used to compare the scores of head&neck coil and small coil 3D-FISP-FS sequence images, paired t test was used to compare SIRN, SIRD of the two groups, Chi-square test was used to compare of the displaying rate of the facial nerves and parotid ducts in two groups. Results Eighteen volunteers were successfully performed MRI scan of parotid gland. On 3D-FISP-FS sequence images, the parotid gland was showed slightly low signal intensity, muscle tissue was showed medium signal intensity, the vessels were showed slightly high or high signal, parotid segment of facial nerve was showed tortuous line-like high signal intensity, and parotid duct was showed curve high signal intensity, lymph nodes were showed kidney shaped, oval or spindle shaped high signal intensity structures. The subjective scores for head and neck coil and coil images were (2.0 ± 0.9) and (1.5 ± 0.7) respectively, and the difference was statistically significant (Z=-2.714, P=0.007), image quality of small coil group was better than that of head and neck coil group. The SIRN of the two groups was 1.7±0.8 and 2.1± 1.2 respectively, and the SIRD was 1.8±0.7 and 2.5±1.7 respectively, which showed a statistically significant difference between the two groups (t value was 2.978, 2.427 respectively, P value was 0.006, 0.031 respectively).All facial nerve trunks could be displayed by head and neck coil and small coil. On head and neck coil images, 25 sides of temporofacial truck, 15 sides of cervicofacial truck, 17 sides of temporofacial branches, 11 sides of cervicofacial branches, 16 sides of the parotid duct could be displayed. On small coil images, 30 sides of temporofacial truck, 28 sides of cervicofacial truck, 26 sides of temporofacial branches, 23 sides of cervicofacial branches, 27 sides of the parotid duct could be displayed, which showed a statistically significant difference (P<0.05). Conclusion Small surface coil performed better in parotid MR imaging with 3D-FISP-FS sequence than that of head and neck coil, which can simultaneous clearly display the trunk and branches of the intra-parotid facial nerves and parotid ducts.
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Objective To explore the imaging characteristics of different sizes of MR small surface coil.Methods A water phantom with NiSO4· 6H2O for Siemens was scanned with 4 cm,7 cm and 11 cm small surface coils in Siemens 3.0 T MR system.T1WI,T2WI,three dimensional reversed fast imaging with steady state precession with diffusion-weighted(3D-PSIF-DWI) and three dimensional fast imaging with steady state precession and fat suppression(3D-FISP-FS) images were obtained.The imaging area,signal intensity (SI),standard deviation (SD) and signal-to-noise ratio (SNR) variations of different depths (from the near to the distant) were measured and compared.Curves according to the SI and SNR data were draw.SI and SNR characteristics of images obtained by L11 separately and used together with spine matrix coil were compared by using signed rank sum test.Results The signal intensity of images scanned by 4 cm,7 cm small surface coil decreased gradually in the depth of 0.2 to 2.2 cm,maintain good signal uniformity in the depth of 2.2 to 4.2 cm,and the signal intensity obtained by 11 cm coil maintain good signal uniformity in the depth of 5.2 cm.The optimum imaging widths of 4 cm,7 cm and 11 cm coil were about 7.0,8.5 and 11.0 cm.As the diameter of the coil increased,the imaging width and depth increased,but the received noise also increased.The SNR gradually reduced from the center to the edge of the coils.The imaging area increased but the local SNR decreased when using L11 coil combine with spine matrix coil,which showed a statistically significant difference (Z=-2.354,P=0.019).Conclusions A suitable size of small surface coil should be chosen according to the location and size of the organ or lesion before clinical MR examination.Other coils should be turned off to improve the SNR.
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<p><b>OBJECTIVE</b>To investigate the chemical constituents of Corydalis yanhusuo.</p><p><b>METHOD</b>The compounds were isolated and purified by column chromatography over macroporous absorption resin, silica gel, and Sephadex LH-20. Their structures were elucidated on the basis of physicochemical properties and spectral data.</p><p><b>RESULT</b>22 compounds were isolated and identified as corydaline (1), tetrahydropalmatine (2), protopine (3), tetrahydrocorysamine (4), tetrahydrocoptisine (5) , tetrahydroberberine (6), tetrahydrocolumbamine (7), noroxyhydrastine (8), dehydrocorydaline (9), glaucine (10), columbamine (11), 8-oxocoptisine (12), 13-methyl-columbamine (13), coptisine (14), palmatine (15), herberine (16), oxoglaucine (17), 13-methyl-palmatrubine (18), dehydrocorybulbine (19), stepharanine (20), adenosine (21), and N5 -acetylornithine (22).</p><p><b>CONCLUSION</b>Compounds 13, 20, 21, and 22 were isolated from this plant for the first time.</p>
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Adenosina , Alcaloides , Apomorfina , Aporfinas , Berberina , Alcaloides de Berberina , Cromatografía Liquida , Métodos , Corydalis , Química , Extractos Vegetales , Espectrometría de Masa por Ionización de Electrospray , MétodosRESUMEN
ObjectiveTo investigate the capacity and diagnostic value of various MRI seguences in patients with trigeminal neuralgia.Methods MR images of 60 patients with trigeminal neuralgia were analyzed retrospectively.The sensitivity,specificity and diagnostic value of various MRI sequences were evaluated comparing with clinical data and operation results.All patients were scanned with conventional sequences including SE-T1WI,T2WI,FLAIR of head.Among them,9 cases were injected with contrast agent,49 cases were scanned with 3D-TOF and 3D-TSE sequences on cerebellopontine angle additinally.The sensitivity,specificity and accuracy of the 3D-TOF and 3D-TSE sequences were analyzed by using the x2 test.Results Six cases with tumor,3 cases with radiculitis and meningitis,1 case with multiple sclerosis and 1 case with pons infarction were diagnosed by conventional MR sequences.MRI of 49 cases with 3D-TOF and 3D-TSE showed neurovascular compress proved by operation.The sensitivity,specificity and accuracy of 3D-TOF and 3D-TSE were 95.3% (41/43)vs.95.6% (43/45),66.7% (4/6)vs.50.0%(2/4) and 91.8% (45/49)vs.91.8% (45/49),and no significantly difference was found between the two sequences (x2 =0.13,0.19 and 0.17,P >0.5).ConclusionsMRI plays an important role in displaying the causes and diagnosis of trigeminal neuralgia.The conventional head MR sequences should be recommended for diagnosis of secondary TN caused by tumor and inflammation et al,and further 3D-TOF and 3D-TSE with high sensitivity and accuracy should be applied in patients with primary TN to display the neurovascular relationship.
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BACKGROUND: When the liver affected severe damage or excalation, liver stem cells rapidly proliferated and differentiated into mature liver cells to repair liver tissue. However, liver regeneration is a complicated multiple signal molecular regulatory process and related genes and proteins that participated in regulation remain unclear. OBJECTIVE: To investigate the expressions of CD34 and Delta-like-1 protein in rat liver regenerated tissues after partial hepatectomy. METHODS: Rat hepatic regeneration models were established after hepatectomy. Expressions of ATPase, proliferating cell nuclear antigen (PCNA), CD34 and Delta-like-1 protein were detected by hematoxylin-eosin staining, enzyme-histochemistry and immunohistochemistry method at various time points. RESULTS AND CONCLUSION: At the early stage of liver regeneration, the expression of ATPase was down-regulated, and the expressions of CD34 and Delta-like-1 protein were up-regulated. At the middle stage, the expression of ATPase was increased to the normal level, and the expressions of CD34 and Delta-like-1 protein were down-regulated. The expression of PCNA protein was continuously up-regulated. These suggest that the expressions of ATPase, CD34 and Delta-like-1 protein were different at different stages of hepatic regeneration, which means that different signal molecules were cooperated during the hepatic regeneration, and Notch-Delta signal pathway takes part in the pathogenesy.
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Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group.
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BACKGROUND: The middle ear is a little aerated cavity with a complex anatomy and a deep location. Computed tomagraphy virtual endoscopy (CTVE) can be used to reconstruct the stereoscopic images of internal surface of hollow organs using spiral CT volumetric data, providing findings similar to fiberendoscope.OBJECTIVE: To vedfy the ability to show the normal middle ear and the clinical application of virtual endoscopy based on 64-detector CT data.DESIGN, TIME AND SETTING: A confirmatory controlled observation was performed at Department of Radiology, First Affiliated Hospital of Sun Yat-sen University between October 2005 and March 2006.PARTICIPANTS: A total of 33 patients (66 ears) with suspected middle ear disease who underwent spiral CT examination were included in this study. Among included ears, 35 were normal, and 31 were impaired, including 24 ears presenting with chronic suppurative otitis media (10 simple otitis media, 5 granulomatous otitis media, and 9 middle ear cholesteatoma), 2 ears with post-operative recurred suppurative otitis media, 2 ears with carcinoma of middle ear, and 2 ears with temporal bone fracture, and lear with foreign body granuloma.METHODS: CT images of the temporal bone were obtained using 0.5 mm thick axis slices with a soft reconstruction kemel at 0.3 mm intervals. Virtual endoscopic images of middle ear on CT were generated from volumetric data using the Navigator software. CTVE images were observed from multiple directions using the Fly Through software, and compared with the axial and coronal images and surgery findings.MAIN OUTCOME MEASURES: The following structures were observed: auditory ossicle and joints, superior, middle, and inferior tympanum, sinus tympani, external acoustic meatus, tympanum, facial recess, tegmental wall, anterior and superior ligaments of malleus, posterior ligament of incus, and retrotympanum.RESULTS: A series of images were acquired as the virtual endoscope moved from the extemal auditory canal to the middle ear cavity. CTVE displayed the structures of normal middle ear with high details in 100%, except the anterior and posterior limbs of stapes in 68.6% (24/35) and 74.3 %(26/35), respectively. In the ears with supperative otitis media, the destruction of bone of handle, head of malleus, long and short limbs of incus, and limbs of stapes was found on CTVE in 91.7%(22/24), 95.8%(23/24), 95.8%(23124), 100%(24/24), and 87.5%(21/24), respectively. CTVE clearly showed the destruction of promontory, tegmental wall and facial nerve tube in one ear with carcinoma. CTVE showed the dislocation of incudomallear joint in one ear with temporal bone fracture. It took about 10-15 minutes to perform CTVE.CONCLUSION: CTVE can be used as a noninvasive and reliable method in displaying normal and pathologic middle ears. In cases of suspected bony destruction and confirmed trauma, it is helpful for diagnosis and surgical planning. CTVE of the middle ear can currently be considered as a complementary technique to conventional CT, and it is time-saving and reserves clinical generalization.