Quantitative Evaluation of Sciatic Nerve Crush Injury with Conventional Ultrasound Combined with Shear-wave Elastography in Rabbit Models / 中国医学科学院学报

To explore the value of conventional ultrasound combined with shear-wave elastography in the quantitative evaluation of sciatic nerve crush injury in rabbit models. Forty healthy male New Zealand white rabbits were randomly divided into four groups (=10 in each group):three crush injury (CI) groups (2,4,and 8 weeks after crush) and control group (without injury). The thickness and stiffness of the crushed sciatic nerves and denervated triceps surae muscles were measured at different time points and compared with histopathologic parameters. Inter-reader variability was assessed with intraclass correlation coefficients. Compared with the control group,the inner diameters of the sciatic nerves significantly increased in the 2-week CI group [(1.65±0.34) mm (0.97±0.15) mm,=0.00] but recovered to the nearly normal level in the 8-week CI group [(1.12±0.18) mm (0.97±0.15) mm,=0.06];however,compared with control group [(8.75±1.02)kPa],the elastic modulus of the nerves increased significantly in all the CI groups [2-week:(14.77±2.53) kPa;4-week:(19.12±3.46) kPa;and 8-week:(28.39±5.26) kPa;all =0.00];pathologically,massive hyperplasia of collagen fibers were found in the nerve tissues. The thickness of denervated triceps surae muscle decreased gradually,and the elastic modulus decreased 2 weeks after injury but increased gradually in the following 6 weeks;pathologically,massive hyperplasia of collagen fibers and adipocytes infiltration were visible,along with decreased muscle wet-weight ratio and muscle fiber cross-sectional area. The inter-reader agreements were good. Conventional ultrasound combined with shear-wave elastography is feasible for the quantitative evaluation of the morphological and mechanical properties of crushed nerves and denervated muscles.

Anhydrous Ethanol Improves Efficiency of Radiofrequency Ablation for the Treatment of Benign Thyroid Nodules:A Prospective Randomized Controlled Trial / 中国医学科学院学报

To investigate the value of injecting a small amount of absolute ethanol into the benign solid nodules of the thyroid before radiofrequency ablation(RFA)to improve the efficiency of radiofrequency ablation. A total of 98 eligible patients(98 nodules)with pathologically confirmed benign solid nodules who were treated in our center from December 2016 to February 2018 were included and randomized into ethanol ablation(EA)combined with radiofrequency ablation(RFA)group(EA+RFA group)and RFA group,with 49 patients in each group.Routine ultrasound,contrast-enhanced ultrasound(CEUS),and thyroid function test were performed before treatment and 1,3,6,and 12 months after treatment.The general information,treatment time,ablation energy,ablation power,postoperative nodule volume reduction ratio(VRR),symptom score(SS)and cosmetic score(CS),thyroid function level,and incidence of complications were compared between these two groups. The mean treatment time [(441.30±243.31)s (790.70±349.82)s;= 4.403, =0.000],mean ablation energy [(3.92±2.01)kJ (5.15±2.12)kJ;=2.709, =0.009],and mean ablation power [(6.07±1.44)W (7.30±1.29)W;=3.612, =0.006] were significantly lower in the EA+RFA group than in the RFA group.At 3,6 and 12 months after surgery,the VRR in the EA+RFA group was(57.73±11.07)%(=-3.16, <0.001),(64.40±10.56)%(=-5.45, <0.001),and(77.29±8.48)%(=-10.46, <0.001),respectively;the VRR in the RFA group was(55.44±13.01)%(=-1.76, <0.001),(65.28±11.33)%(=-5.09, <0.001),and(75.17±9.84)%(=-8.93, <0.001),which were significantly smaller than those before surgery.There was no significant difference in VRR between the EA+RFA group and the RFA group at 1(=3.41, =0.33),3(=2.05, =0.21),6(=2.77, =0.49),and 12 months(=5.05, =0.10)after treatment.During the follow-up,no recurrence of nodules was observed on CEUS.In the EA+RFA group,the SS [(1.77±0.86).(5.54±2.15);=9.63, <0.001] and the CS[(1.39±0.77).(3.32±0.61);=10.09, =0.004]at 12 months after surgery were significantly lower than those before surgery.In the RFA group,SS [(1.63±1.04).(5.90±1.79);=12.72, <0.001] and CS [(1.64±0.83).(3.15±0.72);=8.13, =0.012] at 12 months after surgery were also significantly lower than those before surgery.The CSS in the EA+RFA group was significantly lower than that in the RFA group [(0.93±0.55).(2.44±0.53);=-11.70, =0.007].Both groups had no significant change in thyroid function during the follow-up period,and no serious complications were observed. Anhydrous alcohol injection can effectively improve the efficiency of radiofrequency ablation in treating benign solid thyroid nodules and is effective in reducing nodule volume,alleviating compressive symptoms,and decreasing cosmetic discomfort.

An Arithmetic for Quantifying the 3D Motion Space of Ankle / 中国康复理论与实践

Objective To obtain the three-dimensional (3D) motion space of ankle by an integral for the 3D rotation angle with mutual relationships of rotation angles in different directions, which is used to evaluate the flexibility and recovery of ankle more accurately and ful-ly. Methods Twenty-five graduate students were recruited to participate in this study, one group consisted of 20 healthy individuals without ankle injury, and the other was composed of 5 patients with ankle injury. A motion capturing system was used to simultaneously capture the 3D coordinates of the marked points on the foot. Next, these 3D coordinates were converted into rotation angles through trigonometric func-tions processed. The maximum rotation angles of adduction, abduction, varus, and eversion change with the rotation angles of plantar flex-ion and dorsal flexure were measured by using polynomial fitting. At last, the size of the ankle's 3D motion space was obtained by integrat-ing the fitting functions. Results The ankle's 3D motion space of the healthy people was 41.256, and the variation among them was less than 10%. The ankle's 3D motion space of the patient side was 33.163, and the variation among them was less than 15%because of the different degrees of rehabilitation. There was significant difference between two groups (t=8.804, P<0.01). With the same rotation angles of plantar flexion or dorsal flexure, the maximum rotation angle of varus was larger than that of eversion, and the maximum rotation angle of adduc-tion was larger than that of abduction. Conclusion The algorithm can be used to quantify the 3D motion space of ankle more accurately, and to achieve a more comprehensive evaluation of ankle's flexibility and rehabilitation.

An Arithmetic for Quantifying the 3D Motion Space of Ankle / 中国康复理论与实践

Objective To obtain the three-dimensional (3D) motion space of ankle by an integral for the 3D rotation angle with mutual relationships of rotation angles in different directions, which is used to evaluate the flexibility and recovery of ankle more accurately and ful-ly. Methods Twenty-five graduate students were recruited to participate in this study, one group consisted of 20 healthy individuals without ankle injury, and the other was composed of 5 patients with ankle injury. A motion capturing system was used to simultaneously capture the 3D coordinates of the marked points on the foot. Next, these 3D coordinates were converted into rotation angles through trigonometric func-tions processed. The maximum rotation angles of adduction, abduction, varus, and eversion change with the rotation angles of plantar flex-ion and dorsal flexure were measured by using polynomial fitting. At last, the size of the ankle's 3D motion space was obtained by integrat-ing the fitting functions. Results The ankle's 3D motion space of the healthy people was 41.256, and the variation among them was less than 10%. The ankle's 3D motion space of the patient side was 33.163, and the variation among them was less than 15%because of the different degrees of rehabilitation. There was significant difference between two groups (t=8.804, P<0.01). With the same rotation angles of plantar flexion or dorsal flexure, the maximum rotation angle of varus was larger than that of eversion, and the maximum rotation angle of adduc-tion was larger than that of abduction. Conclusion The algorithm can be used to quantify the 3D motion space of ankle more accurately, and to achieve a more comprehensive evaluation of ankle's flexibility and rehabilitation.

Ultrasound-guided PTCD combined with ERCP for the treatment of malignant obstructive jaundice:initial experience in 10 cases / 介入放射学杂志

Objective To evaluate the clinical effect of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) combined with endoscopic retrograde cholangio-pancreatography (ERCP) in treating malignant obstructive jaundice, and to discuss its technical points. Methods A total of ten cases with malignant biliary obstruction were enrolled in this study. After the failure of ERCP treatment, the patients had to be treated with ultrasound-guided PTCD immediately. The guide-wire was inserted into the duodenum through intrahepatic bile duct and common bile duct to connect with ERCP, which was followed by the biliary stent implantation or the removal of physical factors causing obstruction. The clinical results were analyzed. Results Technical success was obtained in all 10 cases. In the patients who underwent a successful guide-wire docking with ERCP the postoperative serum bilirubin was significantly decreased. The main complications were fever, elevation of amylase and transient bloody bile. Conclusion With the help of docking technique the combination use of ultrasound-guided PTCD and ERCP is a new tentative treatment for malignant obstructive jaundice after the failure of initial ERCP treatment. This technique carries promising value in clinical practice as it can significantly increase the success rate of ERCP.

Cytomegalovirus infects its host cells and induces their renin gene expression / 中华微生物学和免疫学杂志

Objective To explore renin expression in cytomegalovirus(CMV) infected juxtaglomerular cells(JG) and its biological significance. Methods JG model cell line As4.1 cells derived from kidney tissue were respectively incubated with murine CMV at multiplicities of infection(MOI) of 10, 0.1 and 0 for 5 d, and the control was mock infection with the same amount of ultraviolet inactive CMV as MOI 10, then the cells were harvested. CMV immediate early gene(IE1) mRNA in the cells was tested by RT-PCR. The renin positive cells and the renin fluorescence granules in the cells were examined by immunofluorescence stain. Whether or not re-nin antigen and CMV antigen were showed in the same cells by FITC and TRITC immunofluorescence. The renin gene expression in the cells was individually detected by real-time RT-PCR and Western blot. Results The cells infected by CMV showed typical cytopathic effect(CPE) and viral plaques in the cell monolayer. CMV IE1 mRNA was found in the viral infected cells by RT-PCR. The mass or ring granules of renin positive fluorescence appeared in the cytoplasm of the CPE cells. The renin positive cells congregated around the viral plaques. Renin positive granules and CMV positive granules showed in the same cells. Renin expression in the CMV infected cells exhibited in a dependent manner of ratio of infectious virus particles to cells. Conclusion CMV infection of the cells derived from kidney tissue induces renin expression related to a new pathogenesis of cardiovascular diseases.