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Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.
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Objective To establish a culture method for primary human nail matrix cells in serumfree media.Methods Nail matrix tissues were collected from 9 patients,who received nail or toe amputation and nail bed repair in Peking University Shenzhen Hospital between January 2016 and December 2016,and cultured in the serum-free DEME/F-12 media at a 37℃ incubator with an atmosphere of 5% CO2 in air for 2-3 days.Then,primary human nail matrix cells were cultured in keratinocyte serumfree media (CnT-07),and the morphology of human nail matrix cells was observed by microscopy during the culture process.Immunofluorescence cytochemistry with anti-keratin 5 (K5) and K10 was performed to identify the acquired cells,and flow cytometry to analyze the cell purity.Results After 2 or 3 days of the culture,some cells began to crawl out from the tissue.On day 10,large cell masses were formed,some cells were morphologically similar to epithelioid cells arranged in a paving stone-like pattern,and some were flat giving a spindle-shaped or star-shaped appearance.Immunofluorescence cytochemistry showed that some cells could express both K5 and K10,which proved the existence of nail matrix cells,and 37.6% of the cells expressed K10.Conclusion Human primary nail matrix cells could be successfully cultured by using the tissue culture method with serum-free culture media,and the nail matrix cells cultured in vitro can express both K5 and K10.
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OBJECTIVE: To identify the time dependent profiles of gene expression and featured co-expression network modules in peripheral blood of rats after middle cerebral artery occlusion (MCAO). METHODS: Microarray GSE119121 from GEO database was analyzed by R language to identify the significantly changed genes in peripheral blood at different time points (0, 1, 2, 3, 6 and 24 h) after MCAO. Gene expression patterns at different time courses were screened by STEM tools. Then, function annotation and pathway enrichment of differentially expressed genes (DEGs) were performed using the Gene Ontology (GO) database and the Kyoto Gene and Genomic Encyclopedia (KEGG) database. Depending on CEMiTool package, gene expression profile matrix was inputted into R to construct the co-expression networks and to analyze modules, and enrichment analysis was conducted to evaluate the correlation between the modules and different time points. RESULTS Comparing with gene at 0 h, the numbers of DEGs in peripheral blood at different time points after MCAO were 163 (1 h), 502 (2 h), 527 (3 h), 550 (6 h), and 75 (24 h), respectively. Moreover, a total of 38 gene expression patterns were enriched, and pattern 65 and pattern 34 were specifically up-regulated or down-regulated at 2-6 h. Hp, Nos2, P2ry10, and Klf12 were representative genes of these two models. The co-expression network module analysis showed that the gene status in the early acute phase (1-6 h) was positively correlated with the Module 2. Module 3 and Module 4 was positively correlated with phase phase 1-3 h and 2-6 h, respectively. Noteworthy, Module 6 gradually changed from positive correlation (0-2 h) to negative correlation (3-24 h) with the MCAO time course, and Module 6 was mainly related to viral response and innate immune response. The hub genes of Module 6 included Mx1, Mx2, and Rtp4. CONCLUSIONS Our study has identified the featured genes and dynamic co-expression network modules in peripheral blood after acute ischemic stroke, which provides a potential basis for judging the onset time of ischemic stroke.
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Objective:To study the analgesic effect of dezocine combined with sufentanil in hip arthroplasty. Methods:Totally 60 patients with hip arthroplasty were randomly divided into the observation group and the control group. The 30 patients in the observation group were treated with dezocine combined with sufentanil, and those in the control group were treated with sufentanil. The analgesic efficacy and adverse reactions in the two groups were investigated and analyzed. Results:The visual analog scale ( VAS) in the obser-vation group in 3h, 6h, 12h, 24h and 48h after the surgery was significantly lower than that in the control group (P<0. 05). MMSE score in the observation group in 1h, 3h and 5h after the surgery was higher than that in the control group (P<0. 05). The total effec-tive rate of the observation group was 100. 00%, which was much higher than that of the control group (70. 00%, P<0. 05). There was significant difference in the adverse reactions between the two groups(P<0. 05). Conclusion:The efficacy of dezocine combined with sufentanil used in hip arthroplasty is significant with lower incidence of adverse reactions, which is worthy of popularized applica-tion in clinical practice.
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Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.
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<p><b>OBJECTIVE</b>This meta-analysis was performed to analyze the effect of preserving the native aortic valve on short- and long-term prognosis post aortic root reconstruction surgery for patients with Marfan syndrome.</p><p><b>METHODS</b>Database including Pubmed,Embase, Cochrane library, CNKI, Wanfang,VIP and CBM were searched to collect studies comparing clinical results of valve sparing surgery with composite valve graft surgery for patients with Marfan syndrome. Study quality was assessed by Newcastle-Ottawa Scale and publication bias was assessed by visual inspection of the funnel plot together with Egger test. Clinical outcomes data was extracted from the manuscripts and analyzed with Revman 5.0 supplied by Cochrane collaboration.</p><p><b>RESULTS</b>Seven clinical trials with 690 patients were included. Meta- analysis demonstrated that valve sparing surgery was associated with a lower incidence of re-exploration (RR = 0.51, 95%CI:0.29- 0.90, P < 0.05), thromboembolism (RR = 0.17, 95%CI:0.05-0.57, P < 0.01), endocarditis (RR = 0.31, 95%CI:0.11-0.94, P < 0.05) and significantly lower long-term death rate (RR = 0.37, 95%CI:0.18-0.74, P < 0.01). Reoperation rate was similar between the two groups (RR = 1.07, 95%CI:0.35-3.27, P > 0.05).</p><p><b>CONCLUSION</b>Valve sparing aortic root reconstruction surgery is a superior procedure to composite valve graft surgery in term of improving the short- and long-term prognosis for patients with Marfan syndrome.</p>
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Humans , Aorta , General Surgery , Aortic Valve , General Surgery , Marfan Syndrome , General Surgery , Organ Sparing Treatments , Methods , Prognosis , Treatment OutcomeABSTRACT
Objective To measure the expression of peroxisome proliferator-activated receptor β/δ (PPARβ/δ) in epidermal keratinocytes from patients with psoriasis,and to investigate its regulatory factors.Methods Tissue specimens were obtained from both lesional and non-lesional skin of 20 patients with psoriasis as well as from normal skin of 15 human controls.An immunohistochemical method was used to examine the expression of PPARβ/δ in these tissue specimens.Epidermal keratinocytes were isolated from these tissue specimens and subjected to a primary culture.After several passages of subculture,non-lesional psoriatic keratinocytes were stimulated with different concentrations of GW501516 (an agonist of PPARβ/δ,0-100 ng/ml) and Ca2+ (0-3.0 mmol/L).Reverse transcription-PCR and Western blot were performed to measure the mRNA and protein expressions of PPARβ/δ in the primary keratinocytes and stimulated keratinocytes respectively.Results Immunohistochemistry showed that the expression intensity of PPARβ/δ was significantly higher in lesional psoriatic skin than in normal control skin (t =19.28,P < 0.01) and non-lesional psoriatic skin (t =23.26,P < 0.01).Increased mRNA and protein levels of PPARβ/δ were observed in lesional psoriatic keratinocytes as compared to normal control keratinocytes (both P <0.01) and non-lesional psoriatic keratinocytes (both P < 0.01).Among these stimulated non-lesional psoriatic keratinocytes,those treated with GW501516 at 10 ng/ml and those with Ca2+ of 1.0 mmol/L showed the strongest expression of PPARβ/δ (both P < 0.01).Conclusions The expression of PPARβ/δ,which is higher in lesional psoriatic skin,can be enhanced by GW501516 and Ca2+ in keratinocytes.
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Background and purpose:The transcription factor PAX6 is primarily expressed in embryos. PAX6 is also expressed in several tumors and plays oncogenic or tumor suppressor role. This study aimed to investigate the expression of PAX 6 in non-small cell lung cancer (NSCLC) tumor samples and cell lines; and evaluate the effects of PAX6 on the proliferation and invasion of tumor cells and the expression level of cyclin E and p38.Methods:Western blot was carried out to detect the PAX6 protein level in 86 NSCLC tumor tissues, paired adjacent normal tissues and 2 cell lines. PAX6 siRNA was transfected into human lung cancer A549 cell line. Anchorage-independent growth and invasiveness of tumor cells were measured by MTT and transwell cell invasion assay, respectively. Cyclin E and p38 protein level before and after transfection were detected by western blot.Results:Comparison with tumor adjacent tissues and normal human bronchial epithelial cells 16HBE, PAX6 in NSCLC tissues and A549 cell lines was signiifcantly higher expression. After transfection with efifcient sequence of PAX6 siRNA for A549 cell lines, the down expression of PAX6 inhibits tumor cell proliferation, the proportion of cells in G1 phase increased, the cell invasion and migration decreased remarkably. Cyclin E and p38 activity was inhibited inPAX6 knockdown cells.Conclusion:PAX6 accelerate cell cycle progression by activating cyclin E and p38. PAX6 is a potential target for diagnosis and therapy.
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Objective To summarize the mid-term result and clinical experience of individual treatment for Stanford type B aortic dissection.Method 213 patients (172 male,41 female) with Stanford type B aortic dissection were admitted between Apr 2008 and Jan 2013.Age ranged from 23 to 83 averaging 54 ± 9.63 patients were treated conservatively and 47 patients underwent open surgery,103 patients by endovascular repair.Result Patients in conservative group were older than those in open surgery group.Preoperative waiting time was the longest in open surgery group.Concomitant procedures adopted in open surgery group included replacement of ascending aorta and aortic arch in 3 patients and fenestration of stented elephant trunk in 19 patients; 31 patients received bypass graft of cervical vessels during endovascular repair.Mortality was 11.1%,4.3%,3.9% in conservative group,open surgery group and endovascular group,respectively.Compared with open surgery,endovascular repair had a lower incidence of perioperative complications (P < 0.05).186 patients were followed-up with a mean follow-up duration of (26± 17) months.There were no difference in mortality and complications between the three groups.Conclusions In Stanford B aortic dissection,individualized therapy based on patient's condition achieves a favorable mid-term result with low mortality and complication rate.
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Objective To observe the therapeutic effect of traditional Chinese medicine(TCM)granules made by the formula of Shegan Mahuang decoction for treatment of patients with asthma. Methods A prospective study was conducted,51 cases of light to moderate asthma(cold type)patients were randomly divided into treatment group (25 cases)and control group(26 cases). Conventional symptomatic treatments were of the same in two groups. The patients in control group were given salbutamol aerosol inhalation,100μg each time,4 times per day;based on the treatment of the control group,additionally the above mentioned TCM granules dissolved in water was administered orally 1 dose/day taken twice once in the morning and another once in the evening in treatment group. The therapeutic course was 12 weeks in both groups. Before and after treatment,the asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1)and peak expiratory flow(PEF)were observed. The therapeutic effect,adverse reaction and compliance were evaluated. Results The number of patients with asthma completely controlled in the treatment group was significantly higher than that in the control group(16 cases vs. 9 cases,χ2=4.82,P=0.028). In the patients of two groups,FEV1,PEF and ACT scores were significantly improved after treatment,and in the treatment group,they were obviously higher than those in control group〔FEV1(L):2.67±0.46 vs. 2.32±0.47,PEF(L/min):327.6±49.4 vs. 273.1±42.8,ACT score:22.8±2.0 vs. 21.1±2.6,all P<0.05〕. After treatment,FEV1%predicted value was increased in the treatment group but decreased in control group,there was significantly statistical difference〔(0.68±0.07)% vs.(0.80±0.11)%,P<0.05〕,no significant adverse reaction was found,compliance was good. Conclusion TCM granules made by formula of Shegan Mahuang decoction can improve the clinical symptoms, pulmonary function and control level in patients with asthma,so it is an effective medicine for the control of asthma.
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Objective To investigate the serum prostate specific antigen tPSA),ratio of serum free PSA to total PSA (f/t),prostate volume (PV) and prostate specific antigen density (PSAD),their correlation with prostatic intraepithelial neoplasia (PIN) and their clinical diagnostic significance. Methods Retrospectively evaluate 165 cases of patients with PIN ( including 31 cases of LGPIN,134 cases of HGPIN),which confirmed by pathology,and 252 cases of benign prostatic hyperplasia (BPH),49 patients with prostate cancer (PCa),both diagnosed by pathology,as control.The average age of BPH,LGPIN,HGPIN,PCa groups were 70.13 ± 0.43,70.97 ± 1.28,70.74 ± 0.64,70.37 ± 1.40,the International Prostate Symptom Score (IPSS) were 20.20 ± 0.88,14.71 ± 3.42,20.19 ± 1.239,19.27 ± 2.73,and the PV were 58.07 ± 3.58,56.01 ± 7.52,60.74 ± 4.81,47.56 ± 6.54,respectively.The data of PSA,f/t,PV and PSAD were analyzed and compared within the four groups. Results Age,IPSS score and PV had no significant difference among the four groups (P > 0.05).The PSA level of BPH,LGPIN,HGPIN,PCa groups were 5.65 ±0.38,5.86 ±0.81,8.91 ±0.71,13.80 ±1.83,the f/t ratio were 0.26 ±0.01,0.24 ±0.02,0.22 ±0.01,0.167 ± 0.01,and the PSAD level were 0.11 ± 0.01,0.10 ± 0.02,0.19 ±0.03,0.48 ±0.12,respectively.PSA,f/t and PSAD were not significantly different between HGPIN and LGPIN ( P > 0.05 ),and likewise between LGPIN and BPH patients ( P > 0.05 ).PSA,f/t and PSAD were significantly different between LGPIN and PCa patients ( P < 0.05),and likewise between HGPIN and BPH patients (P < 0.05 ).PSA and PSAD were significantly different between HGPIN and PCa (P < 0.05 ).The areas under the ROC curve of PSA and PSAD of HGPIN were 0.6281 (P <0.01 ) and 0.5919 (P <0.05).Conclusions PSA and PSAD are correlated with HGP1N and can predict the existence of HGPIN early;PSAD can identify HGPIN and PCa,when PSA and f/t are normal.The clinical features of LGPIN are similar to BPH,and HGPIN is easy to develop to PCa.
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<p><b>OBJECTIVE</b>To investigate the shear bond strength between veneering ceramic and zirconia core in different all-ceramic systems.</p><p><b>METHODS</b>Twenty disk-shaped specimens with 8 mm in diameter and 3 mm in height for each zirconia system (Lava, Cercon, IPS e.max ZirCAD, Procera) were fabricated respectively and divided into four groups: Lava group, Cercon group, IPS e.max ZirCAD group, Procera group. For each group, 10 specimens were sintered with 1 mm corresponding veneering ceramic, while the other were sintered with 2 mm corresponding veneering ceramic respectively. The shear bond strength and fracture mode of specimens were observed and determined.</p><p><b>RESULTS</b>The values of shear bond strength for Lava, Cercon, IPS e.max ZirCAD and Procera were (13.82 +/- 3.71), (13.24 +/- 2.09), (6.37 +/- 4.15), (5.19 +/- 5.31) MPa in the group of 1 mm thicked veneering ceramics, respectively, while the values in the group of 2mm thicked veneering ceramics were (38.77 +/- 1.69), (21.67 +/- 3.34), (12.70 +/- 4.24), (9.94 +/- 6.67) MPa. The values of Lava and Cercon groups were significantly higher than that of IPS e.max ZirCAD and Procera groups (P < 0.05). And the values of 2 mm thicked veneering ceramic group were significantly higher than that in 1 mm thicked groups (P < 0.05). Adhesive fracture between core and veneering ceramics were observed in the fracture modes of most specimens.</p><p><b>CONCLUSION</b>The shear bond strength of veneering ceramic to the zirconia framework are different from the zirconia system we chose, and the thickness of veneering ceramic has a great impact on its shear bond strength.</p>
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Humans , Ceramics , Dental Bonding , Dental Porcelain , Dental Stress Analysis , Dental Veneers , In Vitro Techniques , Materials Testing , Metal Ceramic Alloys , Shear Strength , Surface Properties , Titanium , ZirconiumABSTRACT
Objective The purpose of this study was to evaluate the disinfection effectiveness and properties of acrylic resin via microwave irradiation. Methods Forty acrylic resin base dentures fabricated in a standardized procedure were chosen and divided into Group A,B,C and D randomly. Group A,B and C were immersed in 200ml distilled water and submitted to microwave irradiation at 700W for 3,4,5 minutes individually. Group D was used as positive control. Bacteria specimens from each group were got for culture and numbers were calculated. Then the four groups were tested for the flexural strength and impact strength by universal test machine before and after microwave irradiation sterilization. Results The germicidal ratio of Group B was more than 90% ,while the ratio of group C was 100%. There was no significant difference in flexural strength and impact strength between group C and group D. Conclusions Microwave irradiation for 5 minutes at 700W produced sterilization of dentures contaminated with all bacteria whereas the denture strength is not affected. Microwave irradiation at 700W solution for 5 minutes was effective to sterilize acrylic resin base dentures.
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Objective To summarize the experience of aortic root surgery in Stanford A aortic dissection operations.Methods From January 2005 to September 2010, the clinical data of 59 patients with Stanford A aortic dissection was analyzed. There were 43 men and 16 women , ranging in age from 21 to 74 years old, duration of disease varied from 16 hours to 27 days. Among the group, 31 complicated by aortic valve incompetence, 12 Marfan syndrome, 9 single lower limb blood supply dysfunction, 6 right coronary artery involvement. All cases received aortic root surgery under deep hypothermic circulatory arrest. Bentall procedure was performed in 31 patients, Wheat procedure in 15 patients and David procedure in 13 patients.Results The time of cardiopulmonary bypass in the group was 149 to 204 min with an average of ( 171 ± 19) min,and the cross clamp time was 81 to 122 min with an average of (104 ±13) min, and the arrest time was 30 to 47 min with an average of (39 ±7) min. There was 1 case of operative death, which was treated on an emergency basis. Postoperative complications occurred in 20 cases. 17 cases experienced temporary mental dysfunction, 2 cases were infected with MRS A, 1 of which died from MODS, 1 case of single lower limb blood supply dysfunction remained after the first operation and recovered by reoperation (bilateral femoral bypass operation) . All cases were reexamined before discharge, postoperative mean LVEF was (56. 3 ±3.4)% (ranged 51% -62%), aortic annular diameter varied from 22 mm to 27 mm, aortic sinus diameter range from 23 mm to 31mm. 51 patients were followed up, with a mean follow-up time of (24.9 ± 17.2) months (ranged 2-54 months). 54 patients of Stanford A aortic dissection survived well with normal lives and activities. Four non cardiac deaths, one was chronic renal failure, the others were brain hemorrhage. Conclusion Prognosis and operative security of Stanford A aortic dissection patients can be significantly improved by individualized aortic root surgery.
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Objective Acute type B aortic dissection (ATBAD) is a life-threatening condition.Open surgical (OS) repair with a prosthetic graft has been a conventional treatment for ATBAD.Thoracic endovascular aortic repair (TEVAR),as a less invasive and potentially safer technique,has been used increasingly in recent decade.Evidence to support the use of TEVARin these patients is needed.This meta-analysis was to assess the efficacy of TEVAR versus conventional OS in patients with ATBAD.Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched 2010,Issue 4),MEDLINE,EMBASE,CINAHL,Web of Science 、OpenSIGLE 、National Technical Information Service(NTIS) 、CNKI 、Chinese Biomedicine Database 、VIP、WanFang Data for clinical trials and additional sources for published and unpublished trials until 1/18/2011.Controlled trials in which patients with ATBAD were assigned to TEVAR or OS repair were included.The authors extracted independently the following information using a specifically designed data collection form for individual trial included:first author and the year of publication,study population,interventions used (TEVAR or OS repair) and outcomes (short-term mortality,short-term complications,long-term complications and long-term mortality rates).Data were extracted on the relevant methodological domains to minimize the bias in the analysis with use of the Cochrane methods for bias assessment and Grading of Recommendations Assessments Development and Evaluation (GRADE)methods.For each outcome,GRADE criteria and Cochrane Bias evaluation were used to evaluate the quality of the evidence with regard to inconsistency (heterogeneity),indirectness,imprecision,and other potential sources of bias,such as publication and reporting bias.Revman5.0 and GRAED profiler 3.2.2 software were used to analyze the data.Results Five trials (318 participants) were included in the analysis.The five studies were limited by lack of allocation concealment and blindness,and the studies were small.The evidence quality determined with the GRADE approach for 30-day mortality was poor and for other variables was very poor.As compared with ATBAD,TEVAR associated with a significantly reduced short-term mortality,M-H fixed odds ratio 0.19,95% CI [0.09,0.39],P<0.001.However,TEVAR could not improve the postoperative outcomes such as complications or long-term mortality,M-H random odds ratio 1.40,95% CI[0.24,8.18].Conclusion TEVAR can be weakly recommended as an alternative for the treatment of ATBAD in selected cases and may not be used as a general option in place of surgery based on the current evidences.
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Objective To study the applicability of unilateral and bilateral antegrade cerebral perfusion during deep hy-potbermia circulatory arrest (DHCT) surgery and to determine a better method of brain protection. Methods 60 patients un-derwent aortic arch surgery were random divided into either unilateral cerebral perfusion group with a cannula in the innominate artery (n = 30 ) , or bilateral cerebral peffusion gToup with an additional cannula in the left carotid artery ( n = 30 ). S-100β,neuron specific enolase (NSE) were assayed at the following time points: the beginning of cardiopulmonary bypass (T_1), the beginning of circulatory arrcst( T_2 ), antegradc cerebral perfusion (ACP) 25 min( T_3 ), the end of ACP( T_4 ), the end of car-diopulmonary bypass ( T_5 ) , 1h( T_6 ) , 6h ( T_7 ) and 24h( T_8 ) after operation. Neurological deficit incidence and mortality were also obtained. Results There is no statistical significance for S-100β and NSE plasma concentration among time points of T_1、T_2 and T_3. But every time point among T_4、T_5、T_6、T_7 ,Ts do have statistical significances. The incidence of central nervous system dysfunction in group unilateral ACP was higher than that in group bilateral ACP ( 33.33% vs. 10.00%, P = 0.028 ).But there is no significant difference between the two groups in mortality( 3.33% vs. 6.66% ,P = 1. 000 ). Conclusion There is no significant difference between unilateral ACP and bilateral ACP in 25 min during DHCA. But as the DHCA time extends, the effect of bilateral ACP will be better.
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Objective To summarise the clinical experience on the treatment of aortic dissection with stent-graft. Methods From June 2005 to November 2008, 117 patients with aortic dissection underwent surgery with stented elephant trunk (CRONUS stent-graft)which was implanted through the aortic arch under deep hypothermic circulatory arrest, including Stanford A in 50 patients who underwent Bentall operation and total arch grafting with stented elephant trunk operation in 28, Wheat operation and total arch grafting with stented elephant trunk operation in 8, ascending aorta and total arch replacement with stented elephant trunk operation in 14 and Stanford B in 67 patients who all underwent stented elephant trunk operation. Results The location of the entry was in the ascending aorta in 35 patients, the aortic arch in 4, the proximal descending aorta in 78. Cardiopulmonary bypass time was ( 159 ±31 ) min, average cross clamp time was (95 ±23) min, and average selected cerebral perfusion and lowerbody arrest time was (27 ±8) min. The in-hospital mortality was 2.6% (3/117). One patient died of the hemorrhage shock, one died of multi-organ failure postoperatively and the third died of infective endocarditis. The complications included transient neurologic deficit in 11(9.4%), cerebrovascular accident in 6 (5. 1%, cerebral embolism in 2 and cerebral hemorrhage in 4, of which 5 cases were discharged from hospital. One case died of multiorgan failure 18 days after discharge owing to his family' s giving up treatment), hemorrhage of anastomose which was treated by reoperation in 5,hoarseness in 2, renal failure in 1. One case died of the cerebral hemorrhage after 4 months due to inappropriate anticoagulation during following up. Conclusion The treatment of the aortic dissection with stent-graft which was implanted into the descending aorta through aorta arch is safe, effective and feasible, which will be helpful to vascular reconstruction by accurately close subintimal rip and can streamline surgery with minimally invasive and less complications.
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Objective It is controversial to the surgical treatment of the DeBakey I aortic dissection.The purpose of the study was to summarize the clinical experience on total arch replacement combined with implantation of stented elephant trunk into the descending aorta for DeBakey I aortic dissection.Methods From June 2005 to March 2008,41 consecutive patients with acute(in 31)or chronic(in 10)DeBakey I aortic dissection underwent total arch replacement combined with implantation of stented elephant trunk into the descending aorta.The mean age was 57(27~76)years.Thirty-two patients were male.The procedure was performed under deep hypothermic circulatory arrest and selected cerebral perfusion.The stented elephant trunk was implanted through the aortic arch under deep hypothermic circulatory arrest.The stented elephant trunk was an 8~10 cm long self-expandable graft.Concomitant procedures included Bentall operation and total arch replacement in 24,Wheat operation and total arch replacement in 6,ascending aorta and total arch replacement in 11.Computed tomography was performed in every patient before discharge to evaluate the postoperative outcomes of the procedure.Results Cardiopulmonary bypass time was(168±32)min.The cross clamp time was(109±24)min and selective cerebral perfusion and the lowerbody circulatory arrest time wsa(31±11)min.The in-hospital mortality was 4.9%(2/41).One patient died of hemorrhagic shock and another died of multi-organ failure postoperatively.Fourteen cases suffered complications and 12 cases were cured.One case died of the cerebral hemorrhage after 4 months due to inappropriate anticoagulation during follow up.Conclusion Ascending aorta and total aortic arch replacement combined with implantation of stented trunk into descending aorta is a safe,effective and feasible way in closing the residual false lumen of the descending aorta with a low morbidity and mortality.This procedure might contribute to a better long-term outcomes of DeBakey I aortic dissection.
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Objective To study the related factors of male pattern alopecia(MPA) and efficacy of finasteride as well as to survey the related factors influencing the life quality of patients with MPA.Methods Questionnaire with dermatology life quality index(DLQI) and center for epidemiologic studies depression scale(CES-D) were adopted to assess the life quality and psychological changes of 320 outpatients with MPA.The 320 patients with MPA of Hamilton grades Ⅱ-Ⅶ took finasteride tablet of 1mg/day for over 4 months in this clinical tria1.We analyzed the related factors of MPA,tested the related indexes,and observed for changes of hair growth and adverse reactions.Results DLQI and CES-D scores of the 320 MPA patients obviously increased.Many factors including inheritance and psychological influence were correlated with MPA.The total efficacy rate after treatment for over 4 months was 80.8%.Conclusion Hair loss significantly affected the life quality of patients with MPA and brought negative effects on the patients' psychology,which can worsen hair loss.Therefore,appropriate psychotherapy and other treatments should be given to them.MPA is a kind of disease caused by multiple factors and oral administration of finasteride(1mg) is effective and safe for treating MPA.
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<p><b>OBJECTIVES</b>To identify the cortical areas engaged during Chinese word processing using functional magnetic resonance imaging (fMRI) and to examine the reliability and reproducibility of fMRI for localization of functional areas in the human brain.</p><p><b>METHODS</b>FMRI data were collected on 8 young, right-handed, native Chinese speakers during performance of Chinese synonym and homophone judgment tasks on two different clinical MRI systems (1.5 T GE Signa Horizon and 1.5 T Siemens Vision). A cross correlation analysis was used to statistically generate the activation map.</p><p><b>RESULTS</b>Broca's area, Wernicke's area, bilateral extrastriate, and ventral temporal cortex were significantly activated during both the synonym and homophone activities. There was essentially no difference between results acquired on two different MRI systems.</p><p><b>CONCLUSIONS</b>FMRI can be used for localizing cortical areas critical to Chinese language processing in the human brain. The results are reliable and well reproducible across different clinical MRI systems.</p>