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Objective: To investigate the analgesic mechanism of Tuina (Chinese therapeutic massage) by observing the effect of the N-methyl-D-aspartate receptor subunit 2B (NR2B)/postsynaptic density-95 (PSD-95) pathway on the dendritic structure of spinal cord dorsal horn in rats with lumbar disc herniation. Methods: Fifty Sprague-Dawley rats were randomly divided into a blank group, a model group, a Tuina group, a blocker agent group, and a blocker agent + Tuina group. The sciatic nerve chronic constriction injury (CCI) model was prepared by the sciatic nerve ligation method. From the 4th day after modeling, rats in the Tuina group and the blocker agent + Tuina group were subject to daily Tuina intervention, and those in the blocker agent group and the blocker agent + Tuina group were daily intrathecally injected with NR2B blocker agent (MK-801). The spontaneous pain score was used to observe the pain behavior of all rats. The expression levels of NR2B and downstream PSD-95 were measured by immunohistochemistry, and the dendritic structure changes were observed by Golgi staining for rat spinal cord dorsal horn after 14 d of continuous intervention. Results: Compared with the blank group, the degree of rat spontaneous pain after CCI was elevated in both the model and the Tuina groups (P<0.01) and was reduced in the Tuina group after the Tuina intervention compared with the model group (P<0.05). Compared with the model group, the rat spontaneous pain level after blocking NR2B was reduced in both the blocker agent group and the blocker agent + Tuina group (P<0.05). The NR2B and PSD-95 protein levels were significantly higher in the model group compared with the blank group (P<0.01); the total number of dendritic branches was increased (P<0.01), and the total dendritic length became longer (P<0.01) in the spinal cord dorsal horn. The rat NR2B and PSD-95 protein levels were significantly decreased in the Tuina group compared with the model group (P<0.01); the total dendritic branch number was reduced (P<0.01) and the total length was shortened (P<0.01) in the spinal cord dorsal horn. After blocking NR2B, the expression levels of NR2B and downstream PSD-95 protein were significantly lower in both the blocker agent group and the blocker agent + Tuina group compared to the model group (P<0.01). The total branch number was significantly reduced (P<0.01), and the total length was significantly shortened (P<0.01) of the dendrites in the spinal cord dorsal horn. Conclusion: Tuina may exert an analgesic effect by remodeling the dendritic structure in the spinal cord dorsal horn in rats with lumbar disc herniation, and its mechanism may be related to the inhibition of NR2B/PSD-95 signaling pathway.
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OBJECTIVE@#To analyze the characteristics of vestibular migraine (VM), in order to understand the auditory and vestibular function.@*METHOD@#One hundred cases of confirmed or suspected VM patients were observed. Routine examination including pure tone test, vestibular dual temperature test and vestibular evoked myogenic potential(VEMP) and video head impulse test(v-HIT) Were conducted.@*RESULT@#The incidence of male and female was about 1.00 : 2. 57. The average age of onset was 47 years, of which the youngest was 19 years old, and the oldest was 74 years old. Ninty-three cases of patients presented with vestibular sensitive performance, including photophobia, phonophobia,or motion sensitive. Fourty-two patients had migraine at the onset of the disease. Thirty-four patients had cochiear symptoms, including tinnitus, ear fullness, or epicophosis. In seventeen cases of fatigue, tension or poor sleep can cause vertigo. Nine patients had low blood pressure, 7 patients presented with hypertension. Two cases of vertigo were closely related to the change of position, and 1 case had visual aura. In the experiment, 94 patients had undergone VEMP test,with 44 cases of abnormal VEMP value. Seventy-nine patients had been examined v-HIT,of whom 2 patients were abnormal (both of which were reduced). Pure tone audiometry was abnormal in 35 cases. Five cases of patients showed abnormal vestibular-double temperature test.@*CONCLUSION@#Vestibular migraine is more prone to female, with young middle age, and can be accompanied by cochlear symptoms. Vestibular function tests (low frequency and high frequency) are normal.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Audiometry, Pure-Tone , Evoked Potentials , Head Impulse Test , Migraine Disorders , Diagnosis , Vestibular Function Tests , Vestibule, LabyrinthABSTRACT
Objective To elucidate clinical significance of the varied concentration of cytokines in patients , the concentration of endothelin-1(ET-1) in cerebrospinal fluid(CSF) and serum were investigated in 36 patients with acute craniocerebral injury .Methods In this study ,36 patients with acute craniocerebral injury were divided into two groups by their GCS scores ( GCS≤12 as moderate-severe injury group ,GCS>12 as mild injury group ) .Concentration of ET-1 in CSF and serum in 36 patients with acute craniocerebral injury were detected by ELISA .Results The con-centration of ET-1 was(38.89 ±9.50)μg/L in cerebrospinal fluid ( CSF) in moderate to severe patients ,which were significantly higher than that in mild injury groups [(22.25 ±8.55)μg/L](t=5.453,P=0.000) and control groups [(15.67 ±7.72)μg/L](t=8.347,P=0.000).And the levels of ET-1 in CSF in the mild injury groups were also obviously higher than that of the control groups (t=2.390,P=0.023).On the other hand,the concentration of ET-1 was(107.02 ±17.25)μg/L in sera in moderate to severe patients ,which were also significantly higher than that in mild injury groups[(46.21 ±11.19)μg/L](t=12.176,P=0.000)and control groups[(32.34 ±10.64)μg/L] (t=16.163,P=0.000).And the levels of ET-1 in sera in the mild injury groups were obviously higher than that of the control groups(t=3.751,P=0.001).The concentration of ET-1 in sera was significantly higher than that of CSF (t=9.974,P=0.000).Conclusion The concentration of ET-1 in CSF and sera in patients with acute craniocere-bral injury were associated with severe of brain injury .
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Objective To observe the relationship between CT signs, prognosis and the expression of CD44v3 and CD44v6 in peripheral non-small-cell lung cancer (NSCLC). Methods The expression of CD44v3 and CD44v6 was detected with immunohistochemistry (SP method) in 46 patients with peripheral NSCLC confirmed by surgery and pathology. The expression, CT signs and prognosis of NSCLC were analyzed respectively. Results The expression of CD44v3 and CD44v6 correlated with deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum (P<0.05), but not with the tumor size, vacuole sign, vessel convergence sign and pleural indentation in CT images of peripheral NSCLC (P＞0.05). The expression of CD44v3 and CD44v6 correlated with the three-year survival rate in peripheral NSCLC patients (P<0.05). Conclusion Deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum may indicate strong potential invasion and metastasis in peripheral NSCLC. The positive expression of CD44v3 and CD44v6 may suggest shorter survival time and poorer prognosis in peripheral NSCLC patients.
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<p><b>OBJECTIVE</b>To study the chest X-ray image features of patients with severe SARS.</p><p><b>METHODS</b>Chest X-ray image features in 36 patients with severe SARS were retrospectively analyzed. The image characteristics were compared with those of 224 patients with common SARS.</p><p><b>RESULTS</b>The important chest X-ray imaging features of 36 patients with severe SARS included small patch of infiltration (n = 27, 75.0%), large patch of infiltration (n = 22, 61.1%), large area of lung consolidation (n = 10, 27.3%), interstitial lung lesion (n = 26, 72.2%), ground-glass shadow (n = 28, 77.8%), irregular linear opacity (n = 15, 41.7%), diffuse lung lesion (n = 12, 33.3%), with single lung involved (n = 9, 25.0%), and both lungs involved (n = 32, 88.9%). The rates of large patch of infiltration, large area of lung consolidation, ground-glass shadow, diffuse lung lesion and involvement of both lungs in patients with severe SARS were significantly higher than those in patients with common type of SARS (all P < 0.01). Out of the 11 severe SARS patients who died, nine had large area of ground-glass shadow with air bronchogram in both lungs before death.</p><p><b>CONCLUSIONS</b>Large patch of infiltration, large area of consolidation, ground-glass shadow, diffuse lung lesion and involvement of both lungs were the main X-ray image characteristics of patients with severe SARS. Large area of ground-glass shadow with air bronchogram in both lungs indicated a bad prognosis.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Severe Acute Respiratory Syndrome , Diagnostic ImagingABSTRACT
Objective To explore the feasibility and value of MRI examination in colorectal carcinoma. Methods Thirty-eight patients with clinically suspected colorectal carcinoma were included in this study and all of them underwent MRI examination. About 300- 1 000 ml water was administered transrectally before scanning. Axial plain scan, three-planar enhanced scan and hydrography were performed, respectively. Results In 38 patients, 31 cases were pathologically proved as colorectal carcinoma. The main MRI findings were: intraluminal soft tissue mass (n=5), irregular thickening of colorectal wall and partial or circumferential stenosis of colorectal lumen (n=26). The tumors were all demonstrated as medium signal intensity on T 1-weighted images. Thirty of 31 cases showed slightly hyperintensity and one was conspicuous high signal intensity on T 2-weighted images. Marked enhancement was demonstrated in all foci. Focal low signal structures were presented in the pericolorectal fat on precontrast T 1-weighted SE sequence in 5 cases. Smooth margins were revealed in 12 cases and irregular and/or nodular margins of peripheral wall in 19 cases. Colorectal hydrography showed that there were intraluminal irregular filling defects (n=14), and that "cuff sign" or "sawn-off sign" was demonstrated in the distal end of tumor and its proximal part couldn't be seen (n=10). Thirty of 31 patients with pathologically proved colorectal carcinoma and 4 of 7 patients with non-colorectal carcinoma were correctly identified by MRI. The sensitivity, specificity, and accuracy were 96.8%, 57.1%, and 89.5%, respectively. The accuracy of MRI in T staging was 83.9% (26/31). The accuracy in T1-2, T3, and T4 staging was 75.0% (9/12), 88.2% (15/17), and 100% (2/2), respectively. Conclusion MRI could clearly show the longitudinal and horizontal invasion of colorectal carcinoma as a whole. It could accurately determine the invasive depth of local lesions. Barium enema examination may be partially replaced by colorectal hydrography with MIP reconstruction. It is of directorial value in clinical treatment.
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Objective To explore the role of MR imaging (MRI) in the differential diagnosis of pleural tumor. Methods Forty five cases of pleural tumor (8 benign and 37 malignant) were examined with both CT and MRI. The morphologic features of pleural lesions and MR signal intensity on T 1 weighted, T 2 weighted, and contrast enhanced T 1 weighted images were evaluated. Results On CT images, it was found that 30 cases were with diffuse pleural thickening (29 malignant and 1 benign), 28 with mediastinal pleural involvement (27 malignant and 1 benign), 23 with circumferential or irregular pleural thickening (22 malignant and 1 benign), and 9 with infiltration of the chest wall or diaphragm (only in malignant patients). On MR images, it was found that 32 cases were with diffuse pleural thickening (31 malignant and 1 benign), 29 with mediastinal pleural involvement (27 malignant and 2 benign), 24 with circumferential or irregular pleural thickening (23 malignant and 1 benign), and 11 with infiltration of the chest wall or diaphragm (only in malignant patients). According to the above mentioned morphologic features, CT had a sensitivity of 83.8% and a specificity of 62.5% in the detection of pleural malignancy, as compared to 86.5% and 62.5% by MRI, respectively. In combination with signal intensity and morphologic features, MRI had a sensitivity of 97.3% and aspecificity of 100% in the detection of pleural malignancy. Conclusion According to the morphological features only, MRI allowed a similar value in the detection and diagnosis of pleural tumor compare with CT. In combination with signal intensity and morphologic features, MRI is more useful and, therefore, superior to CT in differentiation of malignant from benign pleural tumor.
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Objective To assess the contribution of the portable chest computed radiography (CR) in evaluation of monitoring devices of the patients in the intensive care unit (ICU). Methods One hundred and sixty-two cases with 387 chest radiographs in the ICU were analysed retrospectively. The location of the catheters of monitoring devices and complications were observed.Results The malposition of the catheters was detected in 47 cases(16.9%),including the endotracheal (ET) tubes too deep at the position, the central venous catheters placed into the internal jugular veins,and the position of the thoracic drain tubes to be deep not enough causing the drain to fall.The complications after operation of monitoring devices were not common,including pneumothorax caused by ventilatory assistance,atelectasis and pneumonia caused by malposition of the ET tubes,totally in 11 cases.10 cases with cardiopulmonary abnormalities were discovered accidentally in all 162 cases(6.2%) when evaluation of monitoring devices.Conclusion Bedside chest CR not only can show the catheter position and the complications of the monitoring devices ,but also the cardiopulmonary abnormalities of patients in the ICU.
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Objective To evaluate the applied value of bedside chest radiography in the intensive care unit ( ICU ) . Methods One hundred and ninety-three cases with 507 chest radiographs (CXRs) in the ICU were analysed retrospectively. The appearances of cardiopulmonary abnormalities were analysed.Results 97.4% of the CXRs were satisfied for diagnosis. 83.9% of the CXRs showed cardiopulmonary abnormalities, including atelectasis, pneumonia, pulmonary edema, ARDS, pneumothorax, mediastinal and subcataneous emphysema,pleural effusion,pericardial effusion and pulmonary thromboembolism, and 6.2% out of these positive cases was discovered accidentally. The chest radiograph has moderate accuracy (77.9%) in visualizing cardiopulmonary abnormalities at the initial CXR including atelectasis,pneumonia,pulmonary edema and pleural effusion. Misdiagnosis occurred mainly on the patients with a small quantity of pneumothorax and pulmonary thromboembolism. About one-third cases of cardiogenic edema and ARDS were indistinguishable.Conclusion Bedside chest radiographs are of significant value for the patients in the ICU.
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Objective To report the CT app earances in SARS (severe acute respiratory syndrome). Methods Nine chest CT scanning examinations were performed in 6 cases of SARS that were verified by the clinic. CT films were acquired with standard pulmonary window, mediastinal window, and wide window, respectively.CT imaging appearances were summarized. Results In 5 of the 6 cases, multi-lobar or multi-segmental consolidations of bilateral lungs were detected. There was no distribution tendency for any specific pulmonary lobes or segments. The big consolidation and small multiple consolidations existed simultaneously. The big range of consolidation manifested as the bilateral or unilateral pulmonary segment consolidation that distributing along the bronchi tree. There was the air bronchogram in the consolidation. Each consolidation expanded along the pulmonary segment and mixed together to form a pulmonary segment consolidation, or even a whole pulmonary lobe consolidation. The foci that crossed the interlobar fissure were not observed. The small foci manifested as the bilateral multiple oval foci, which distributed along the lung markings. The big consolidation could appear as homogeneous densification, ground-glass appearance, or honeycomb consolidation. The ground-glass appearance could appear in cases of first visiting and in cases of recovery period. The pleural thickened was common and hydrothorax was rare. The mediastinal lymph node enlargement was not observed. Conclusion The limited SARS cases show a tendency that the pathological changes disseminate along broncho-alveolar system when SARS is developing.
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Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.
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0.05).(2)In 67 cases with pre-and post-image selection and reconstruction in single-slice or twin-slice helical CT,the slice concordance rate in measurement was 20.98% and 97.01%,respectively(?2=80.22,P=0.00).The slice concordance was all accomplished with the same method in multi-slice helical CT in 5 cases.(3)Peak heights and SPN-to-aorta ratios of malignant [(38.48?14.32)HU,(19.64?9.52)% ] and inflammatory SPN [(42.48?11.55)HU,(21.14?7.77)%] were significantly higher than that of benign SPN [(9.52?3.78)HU,(3.41?1.86)%,P0.05).Slice optimization of dynamic contrast-enhanced CT scan improved the diagnostic accuracy of SPN from 78% to 80%.Conclusion No significant efficacy was found in the attenuation between primitive images and reconstructive images with the same slice thickness of homogenous material.Slice concordance of dynamic contrast enhanced spiral CT could reflect objectively the morphological appearance and CT value changes of solitary pulmonary nodules,and may improve the veracity of diagnosis.
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Objective To investigate the imaging methods of multi-slice CT(MSCT) in costicartilage and the diagnostic value in the costicartilage injuries. Methods There were 100 cases in normal group and 36 cases in group of chest injuries. All cases were performed in volume scan according to conventional chest scan by SIEMENS Sensation 4 MSCT, then performed in thin slice low and high contrast image reconstructions. After that, all the source images were input into CT 3D workstations,costicartilage were imaged by postprocessing software such as multiplanar reconstructions(MPR), maximum intensity projection(MIP), surface shade display(SSD) and volume rendering technique(VRT). All the pictures were observed and analyzed by two radiologists. Results All postprocessed images that obtained from the MSCT could show the costicartilage clearly. Normal costicartilage displayed uniform density,regular shape and smooth surface;there were 6 injuries in 10 cases with costicartilage injuries,which displayed no uniformity density or cranny in costicartilage and showed cranny in 2 cases. No significant difference of image quality was found among the three imaging modes of MIP、SSD、VRT(?2=1.356, P=0.716). [JP2]Significant differences were found between MPR and other three imaging modes(U_ MIP:MPR=[JP]12.981,U_ SSD:MPR=12.652, U_ VRT:MPR=12.937, P=0.000). Conclusion So far, the MSCT is the best noninvasive imaging method to show the shape of costicartilage, it may be considered as a clinical “gold standard” in the diagnosis of costicartilage injury.