Comparative study of femoral head replacement and internal fixation in the treatment of unstable intertrochanteric fractures in the elderly / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of femoral head replacement and internal fixation in the treatment of unstable intertrochanteric fractures in the elderly.@*METHODS@#Retrospective analysis of 70 cases of unstable intertrochanteric fractures treated from January 2016 to January 2019 and meeting the inclusion and exclusion criteria, 39 cases were fixed with closed reduction and new proximal femoral intramedullary nail(InterTAN), and 31 cases were treated with open trochanter reconstruction and artificial femoral head replacement. The operation time, intraoperative bleeding, hospital stay, weight bearing time, postoperative complication rate and hip function recovery (Harris score) were compared between two groups.@*RESULTS@#All cases were followed up for 12 to 24 months. There were no significant differences in intraoperative bleeding and hospital stay between the two groups (@*CONCLUSION@#InterTAN and femoral head replacement can treat unstable intertrochanteric fractures in the elderly, but femoral head replacement can move down early, improve the quality of life at the end of life, reduce postoperative complications and facilitate the treatment of coexisting diseases in internal medicine.

Quality of Life in Old Patients with Dysphagia and Its Related Factors / 中国康复理论与实践

objective To investigate the quality of life in old patients with dysphagia and the related factors. Methods:From January to December, 2019, 523 old inpatients were selected and investigated with Swallowing-Quality of Life Questionnaire (SWAL-QOL), Eating Assessment Tool-10 (EAT-10), videofluoroscopic swallowing study (VFSS), Nutritional Risk Screening 2002 (NRS-2002) and FRIED scale. Results:There were 160 inpatients diagnosed dysphagia (30.59%). The total score of SWAL-QOL in the inpatients with dysphagia was (45.15±13.31), and the dimension scores from low to high were appetite, social function, swallowing symptoms, mental health, sleep, eating fear, eating time, fatigue, swallowing burden and communication. For the total score of SWAL-QOL, EAT-10 score ≥ 19 was the risk factor, while good health condition and accepting swallowing treatment were the protective factors. Conclusion:The quality of life is poor for the old inpatients with dysphagia, and early screening and intervention for dysphagia are needed.

Comparative study on chronic multiple organ injury in normal rats caused by high dose of Tripterygium Glycosides Tablets from 6 different manufacturers / 中国中药杂志

The aim of this paper was to compare different effects of Tripterygium Glycosides Tablets from 6 different manufacturers on multiple organ injuries in rats and to explore mechanism of hepatotoxicity preliminarily from the perspective of apoptosis and oxidative stress. Rats were randomly divided into the groups normal, Zhejiang, Hunan, Hubei, Shanghai, Jiangsu and Fujian(7 groups with 16 rats in each group, sex in half). Rats were given Tripterygium Glycosides Tablets at 144 mg·kg~(-1)·d~(-1)(16 times the clinical equivalent dose) once a day according to its corresponding group like rats in Zhejiang group was given Tripterygium Glycosides Tablets from Zhejiang manufactures continuously for 20 days with the life and death situation of mice to be observed, then rats were executed to detect various indicators. RESULTS:: showed that 8 female rats in Zhejiang group died after 15 days of administration, the serum NEUT of rats in Hubei, Fujian and Shanghai groups was significantly lower than that of normal rats. The serum AST, ALT and/or TBiL levels were increased in all rats, and serum BUN and/or CRE levels of rats were also increased in Hunan, Hubei, Fujian and Shanghai groups. In dosage groups, testicular and ovarian coefficients of rats were reduced, the number of sperm were significant decreased while the rate of sperm malformation increased and sperm dynamics parameters of normal, especially in Jiangsu and Zhejiang groups. Liver histopathology and apoptosis of liver cells were observed in dosage groups, especially in Jiangsu and Hubei groups. In liver, Nrf2, HO-1 and Bcl-2 were inhibited and the protein expression level of Bax were increased simultaneously in dosage groups. These results showed that all Tripterygium Glycosides Tablets from 6 manufacturers could lead to chronic multiple organ injuries with disparate specialties in rats, and Jiangsu and Zhejiang groups were more toxic. It could be the mechanism promoting mitochondrial mediated Bax/Bcl-2 cell apoptosis signaling pathway and negatively regulating Nrf2/HO-1 oxidative stress signaling pathway that Tripterygium Glycosides Tablets from 6 different manufacturers resulted in chronic liver injury, the results above were for reference only in subsequent study.

Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#Mental disorders of the elderly population in China deserve attention. Social health is significantly associated with depression. This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.@*METHODS@#We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province, China. Face-to-face interviews were used to complete a structured questionnaire for all participants. We used the Social Health Scale for the Elderly (SHSE) to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms. Multivariate logistic regression was used to evaluate the association between social health status and depressive symptoms.@*RESULTS@#Of the total of 3757 participants included, 1887 (50.23%) were female, and the mean±standard deviation (SD) age was (70.0±8.3) years. The rate of depressive symptoms was 25.92%. The social health score was higher in non-depressed participants than in depressed participants (raw score 50.7 vs. 48.3, P<0.001). Participants with "moderate" or "good" social health had a significantly lower risk of depressive symptoms than those with "poor" social health (odds ratio (OR)=0.55, 95% confidence interval (CI): 0.46-0.66 for moderate social health; OR=0.45, 95% CI: 0.35-0.60 for good social health). The association between social health and depressive symptoms was consistent across several subgroups.@*CONCLUSIONS@#Social health is significantly inversely associated with depressive symptoms. The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits, but systematic assessment to guide intervention merits further investigation.

Characterization and fungal community of antler dermophytosis in Jilin and Liaoning provinces / 中国人兽共患病学报

Dermophytosis is a common fungal disease that affects fast-growing antlers of sika deer (Cervus nippon)and red deer (Cervus elaphus),causing the so-called 'white-skin antlers'and 'crusted antlers'.Here we described the features of dermophytosis in deer antler observed from 20 affected deer from 8 farms in Jilin and Liaoning province by clinical findings,he-matology,pathological examination and fungal species distribution.The fungal infection in the antlers as indicated by HE stai-ning,affected only epidermis and the dermis layers,with the main lesion of necrosis of the dermis tissue and inflammatory in-filtrate.Hematologic profile suggested the insignificant cell count change of lymphocyte,neutrophil,white blood cell between dermophytosis and healthy deer(n=10).A total of 68 fungi isolates were then recovered from the antlers with dermophytosis, of which 64.7% (44/68)were identified as members within Deuteromycotina,the rest 35.3% (24/68)belonged to the Saccha-romycotina.Notably,the well-known opportunistic pathogen,including species within Trichophyton,Epidermophyton as well as Candida albican,might account for the dermophytosis of deer antler.In conclusion,'white-skin antlers'and 'crusted antlers'are high likely caused by opportunistic fungi.

An analysis on curative effect of Biafine combined with routine drugs in retention enema treatment for radiation proctitis of cervical cancer / 中国医学装备

Objective: To observe and analyze the clinical efficacy of Biafine combined with routine drugs in retention enema treatment for radiation proctitis of cervical cancer. Methods: 80 patients with cervical cancer who have complications of acute radiation proctitis after radiotherapy were divided into observation group(Biafine combined with routine drugs in retention enema treatment, 40 cases)and control group(routine drugs in retention enema treatment, 40 cases). The curative effects of two methods for radiation proctitis of cervical cancer were compared and researched. Results: The effective rate of observation group for curing radiation proctitis was 95% , and it was 75% in control group. The difference of effective rate between the two groups was significant(x2=7.333, P<0.05). Conclusion: It is significant that Biafine is applied to combine with routine drugs in retention enema treatment for radiation proctitis.

Preliminary study of intervention in effect of Bushen Huoxue recipe on calcification of lumbar vertebra cartilage endplate of the aging gerbils / 中国骨伤

<p><b>OBJECTIVE</b>To study the effect of Bushen Huoxue decoction on calcification of cartilage endplate in lumbar vertebrae.</p><p><b>METHODS</b>Six healthy male gerbils with 2-month-old were selected as normal control group, and 24 7-month-old healthy male gerbils were fed to 12-month-old to establish the aged gerbil model. Thirty gerbils were randomly divided into five groups as follow: the normal control group (=6), model group (=6, normal saline 4 ml/kg, intragastric 30 d), Bushen Huoxue low dose group(=6, 1.9× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), Bushen Huoxue middle dose group(=6, 3.8× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), Bushen Huoxue high dose group(=6, 7.6× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), the intervention group administered for 1.36 g from 7-month-old age, 30 d. The animals were sacrificed at the age of 2 months in the normal control group and 12 months of age in the other groups. The morphology of the lumbar vertebral cartilage endplate, the area of vascular bud, the ratio of non-calcified/calcified layer were analysis by HE chromosome visual method. The expression of type X collagen and BMPs in cartilage endplates were detected by rabbit monoclonal immunohistochemical staining.</p><p><b>RESULTS</b>The relative area of the vascular buds cartilage endplate measurements showed that compared with the model group, middle dose group and normal control group increased (<0.05), high and low dose groups all had different degrees of increase, but no statistical significance(>0.05). The ratio of cartilage endplate thickness of non-calcified/calcified showed that compared with the model group, Bushen Huoxue middle dose, normal control group increased, with statistical significance(<0.05), and high and low dose groups all had different degrees of increase, but there were no statistical significance(>0.05). Compared with the model group, the expression of type X collagen in the cartilage endplate of the normal group, the Bushen Huoxue low, middle and high dose groups decreased, and had statistical significance(<0.01); compared with the model group, the expression of BMPs in the normal group, Bushen Huoxue middle dose group increased, with statistically significant(<0.01), while the high and low dose groups increased in different degrees, but there was no statistical significance(>0.05).</p><p><b>CONCLUSIONS</b>Bushen Huoxue prescription can delay the calcification of cartilage endplate in the process of aging, suggesting that it can be used as a preventive medicine for early disc degeneration.</p>

Detection of Multi-drug Resistant Acinetobacter Lwoffii Isolated from Soil of Mink Farm / 生物医学与环境科学（英文）

There were 4 Acinetobacter lwoffii obtained from soil samples. The antimicrobial susceptibility of the strains to 16 antimicrobial agents was investigated using K-B method. Three isolates showed the multi-drug resistance. The presence of resistance genes and integrons was determined using PCR. The aadA1, aac(3')-IIc, aph(3')-VII, aac(6')-Ib, sul2, cat2, floR, and tet(K) genes were detected, respectively. Three class 1 integrons were obtained. The arr-3-aacA4 and blaPSE-1 gene cassette, which cause resistance to aminoglycoside and beta-lactamase antibiotics. Our results reported the detection of multi-drug resistant and carried resistant genes Acinetobacter lwoffii from soil. The findings suggested that we should pay close attention to the prevalence of multi-drug resistant bacterial species of environment.

Bushen Huoxue Recipe Inhibited Vascular Calcification in Chronic Renal Failure Rats by Regulating BMP-2/Runx2/Osterix Signal Pathway / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Bushen Huoxue Recipe (BHR) on inhibiting vascular calcification (VC) in chronic renal failure (CRF) rats by regulating BMP-2/Runx2/Osterix signal pathway, and to explore its possible mechanism.</p><p><b>METHODS</b>Thirty SD rats were randomly divided into the normal group, the model group, and the BHR group, 10 in each group. Rats in the model group and the BHR group were administered with 250 mg/kg adenine suspension by gastroagavage and fed with 1.8% high phosphorus forage, once per day in the first 4 weeks, and then gastric administration of adenine suspension was changed to once per two days in the following 5-8 weeks. Rats in the BHR group were administered with BHR at the daily dose of 55 g/kg by gastrogavage in the first 8 weeks, once per day. Equal volume of normal saline was given to rats in the normal group by gastrogavage for 8 weeks. Histological changes in renal tissue and aorta VC were observed by HE staining and alizarin red staining respectively. Levels of calcium (Ca), phosphorus (P), serum creatinine (Cr), blood urea nitrogen (BUN), and intact parathyroid hormone (iPTH) in serum were detected. Protein expression levels of bone morphogenetic protein (BMP-2), Runt related transcription factor (Runx2) , and Osterix were detected by Western blot.</p><p><b>RESULTS</b>HE staining showed that compared with the normal group, disordered glomerular structure, tubular ectasia and dropsy, intracavitary inflammatory cell infiltration, dark brown crystal deposition in kidney tubules, renal interstitial fibrosis, and decreased number of renal blood vessels in the model group. Compared with the model group, normal glomerular numbers increased more, reduced degree of tubular ectasia, decreased number of inflammatory cells, and reduced adenine crystal deposition in the BHR group. Alizarin red staining showed that compared with the normal group, calcified nodes could be found in the model group, with extensive deposition of red particle in aorta. Compared with the model group, calcified nodes were reduced in the BHR group. Compared with normal group, serum levels of P, SCr, BUN, and iPTH significantly increased, serum Ca level significantly decreased, protein expressions of BMP-2, Runx2, Osterix also increased in the model group (P < 0.05, P < 0.01). Compared with the model group, serum levels of P, SCr, BUN, and iPTH levels significantly decreased, serum Ca level significantly increased, protein expressions of BMP-2, Runx2, Osterix also decreased in the BHD group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>BHD could improve renal function, Ca-P metabolism, and renal histological changes in CHF rats, down-regulate the expression level of BMP-2/Runx2/Osterix signal pathway in vascular calcification of CRF, which might be one of the mechanisms for inhibiting VC in CHF.</p>

Changes of nucleus pulposus after in vitro culture of rabbit whole intervertebral disc and spinal motion segment / 中国骨伤

<p><b>OBJECTIVE</b>To compare the changes of nucleus pulposus after in vitro culture of rabbit whole intervertebral disc and spinal motion segment.</p><p><b>METHODS</b>Twenty-one New Zealand white rabbits which were randomly divided into organ group with 8 rabbits and segment group with 13 rabbits. Fifty intervertebral discs and 50 spinal motion segments were harvested respectively under aseptic conditions from two groups. These specimens were maintained in organ culture with hyperosmotic media (410 mOsm/kg), then 10 discs of the two groups were observed respectively by HE staining, immunohistochemistry of collagen type III, proteoglycan content and cells viability of nucleus pulposus before culture and at 3, 7, 14, 21 days after culture.</p><p><b>RESULTS</b>HE staining showed the intervertebral disc tissue structure remained intact after culture of 21 days organ group and 14 days segment group,but there was severely degenerated of 21 days segment group. The intensity value of type II collagen immunohistochemical staining in the nucleus pulposus were not changed significantly between 21 days organ group and 14 days segment group (P > 0.05), but the staining of segment group at 21 days became shallower, there was significant difference compared with before each time points and organ group at 21 days (P < 0.05). PAS/AB staining of proteoglycan of nucleus pulposus showed that there were not decrease of tinting strength of two groups within 7 days, but the strength weakened slightly of two groups at 14 days, and the tinting strength became weaker at 21 days segment group, the change is more obvious than the organ group. The intensity value of fluorescence staining of nucleus pulposus cells was not changed significantly within 7 days of two groups (P > 0.05), the intensity value decreased slightly at 21 days organ group and 14 days segment group, but there were no significant difference compared with before time points (P > 0.05) however at 21 days segment group the intensity decreased as cells viability of nucleus pulposus decreased,and there was a significant difference compared with before each time points and organ group at 21 days (P < 0.05).</p><p><b>CONCLUSION</b>It is not obviously degenerated of the discs of organ group cultured within 21 days and segment group cultured within 14 days, but there was significant degeneration of the intervertebral disc of segment group after cultured 21 days, so the rabbit spinal motion segment can be used on research about the biomechanics of intervertebral disc as a vitro experimental model within 14 days.</p>

Effect of traditional Chinese medicines with different properties on thermoregulation and temperature-sensitive transient receptor potentialion channel protein of rats with yeast-induced fever / 中国中药杂志

<p><b>OBJECTIVE</b>To compare the intervention effects of four traditional Chinese medicines (TCMs) with typical cold or hot property on body temperature and temperature-sensitive transient receptor potential ion channel proteins (TRPs) of rats with yeast-induced fever.</p><p><b>METHOD</b>The pyrexia model was induced by injecting yeast suspension subcutaneously. Totally 108 male SD rats were randomly divided into the normal group, the model group, the Rhei Radix et Rhizoma treated group, the Coptidis Rhizoma treated group, the Euodiae Fructus treated group, and the Alpiniae Officinarum Rhizoma treated group, with 18 rats in each group. At the 4 h, 8 h and 12 h after injection of yeast, the rats were sacrificed to collect their hypothalamus and dorsal root ganglion. The expressions of TRPV1 and TRPM8 were detected by immunohistochemistry and Western blot method.</p><p><b>RESULT</b>Compared with the normal group, after injection of yeast, the temperature of rats in the model group notably increased, and reached the peak at 8 h (P < 0.01). The TRPV1 level in hypothalamus and dorsal root ganglia (DRG) of the model group significantly increased, whereas the TRPM8 level significantly reduced. Compared with the model group, the Rhei Radix et Rhizoma group and the Coptidis Rhizoma group showed significant decrease in the high body temperature of rats caused by yeast, down-regulation in the expression of TRPV1, and up-regulation in the expression of TRPM8 (P < 0.05 or P < 0.01). Euodiae Fructus and Alpiniae Officinarum Rhizoma had no significant effect on either temperature or TRPs of fever rats.</p><p><b>CONCLUSION</b>Rhei Radix et Rhizoma and Coptidis Rhizoma, both are TCMs with cold property, can reduce the temperature of fever rats induced by yeast, which may be related to their effective regulation of TRPV1 and TRPM8 in hypothalamus and DRG, while Euodiae Fructus and Alpiniae Officinarum Rhizoma had no relevant effect.</p>

Eenie, Meenie, Miney, Moe, who is responsible for the antibody-dependent enhancement of Aleutian mink disease parvovirus infection? / 病毒学报

Aleutian mink disease parvovirus (AMDV) causes a persistent infection associated with immune complex disease, hypergammaglobulinemia, and high levels of antiviral antibodies. Despite the presence of an antibody, the virus is not cleared in vivo. Pre-existing antibodies may enhance viral infections, by Fc-receptor-mediated antibody-dependent enhancement (ADE), but the mechanism that underlies ADE has not been fully defined. Three models have been proposed, including: (1) interactions between antibody and FcR, complement C3 fragment and CR, or between C1q and C1qR, which promotes viral attachment to cells; (2) suppression of IFN-gamma-mediated host-cell antiviral gene expression by the upregulation of negative regulators of pathogen pattern recognition; and (3) the promotion of early IL-10 secretion. In addition, the role of cytokine IL-6 in ADE mediated disease development is discussed, to facilitate a better understanding of the pathogenesis of AMDV infection, as well as give insights into rational vaccine design approaches.

Analysis of monitoring results of Keshan disease from 2007 to 2011 in Baoji City of Shaanxi Province / 中国地方病学杂志

Objective To learn the existing state of Keshan disease and its trend in Baoji City,and to provide a scientific basis for control of the disease.Methods Feng,Qianyang,Linyou and Long Counties,the Keshan disease affected areas were selected to carry out the case study,and Keshan cases were searched from all registered cases of myocardial patients of the past three years at county-level medical institutions and hospitals of townships(towns).Thirteen villages affected by Keshan disease in Qianyang,Fengxiang,Feng,Linyou and Long Counties were selected as monitoring points to carry out a intensified monitoring.All subjects were surveyed by comprehensive clinical physical examination and 12-lead ECG tracings,and they were diagnosed according to the Keshan disease diagnostic criteria.Ten households were selected randomly in each monitoring point(village),and self-produced wheat samples and adult subject's occipital hair samples were collected for detecting selenium levels.Results Seven hundred and forty-six cardiac cases which containing 17 cases of chronic Keshan disease were discovered in 32 medical institutions,and there were no acute and subacute type of Keshan disease patients.Five thousand seven hundred and twenty-three subjects were examined in the 13 monitoring sites,and 65 cases of Keshan disease were diagnosed which including 17 cases of slow and 48 cases of potential Keshan disease,and no acute or subacute case was found.The total detection rate was 1.14％,and the detection rate ranged from 0 to 2.86％.Hair selenium mean was 0.420 mg/kg; wheat selenium mean was 0.079 mg/kg.Conclusions The Keshan disease detection rate of Baoji City is at a low level.The selenium level of local residents has reached the level of non-endemic area.Constant detection of patient with Keshan disease means various control measures should be reinforced.The comprehensive monitoring program,such as monitoring people's in vivo and in vitro selenium level and others,should be established as soon as possible.

An analysis of monitoring results on iodine deficiency disorders in Baoji City of Shaanxi Province from 2009 to 2011 / 中国地方病学杂志

Objective To learn the control status of iodine deficiency disorders in Baoji City of Shaanxi Province.Methods From 2009 to 2011,according to the National Iodized Salt Monitoring Program,the iodized salt was monitored,and thyroid was examined in 12 counties(areas) of Baoji City.According to rural and urban area stratification,60 children aged 8 to 10 were selected in each county(district),and their urine samples were collected for determination of iodine content.In 2011,per capita daily salt intake was surveyed by the three weighing method at children's home whose urine was collected.Chencang Area,Fufeng County and Taibai County,representatives of Baoji City different geomorphic features were selected for investigation of water iodine,and urinary iodine of pregnant and lactating women,and 15 people were selected in each county (district).Results From 2009-2011,in the 12 counties(areas) in Baoji City,the coverage rate of iodized salt was all 100.00％(3468/3468); the qualified rate of iodized salt and the consumption rate of qualified iodized salt were all ＞ 99.00％.Children's goiter rate was 3.41％(87/2548),3.06％(77/2520) and 3.33％(84/2520),and they were all less than that of the national standard (＜ 5％).Medians of urinary iodine of 8-10 years old children were 368.20,293.80 and 332.50 μg/L,respectively,and the ratios of urine iodine ≥300 μg/L were accounted for 66.42％ (797/1200),48.05％(692/1440) and 56.67％(816/1440),respectively.Median urinary iodine of pregnant women was 301.81 μg/L and lactating women was 329.79 μg/L.A total of 1116 households were investigated,the median of per capita daily salt intake was 8.9 g.Eighteen water samples were collected,range of water iodine value were 0.60-10.25 μg/L.Conclusions Iodine nutrition in general population of Baoji City is exceeded the optimum level,and the current iodized salt concentration has some down space,but fully consideration should be taken on iodine needs in different iodine deficiency areas and among different groups of people.

Functional reconstruction of ischemic contracture in the lower limb / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis.</p><p><b>METHODS</b>A total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient.</p><p><b>RESULTS</b>Postoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral sural-tibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients.</p><p><b>CONCLUSIONS</b>Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb.</p>

Glossopharyngeal neuralgia:MR findings / 中华放射学杂志

Objective To investigate the possibility of MRI on visualizing the relationship between glossopharyngeal nerve and surrounding vessels,and to evaluate the significance of MRI in the diagnosis and treatment of glossopharyngeal neuralgia.Methods MRI findings were analyzed retrospectively in 12 patients with glossopharyngeal neuralgia,and were compared with surgical findings and effect of pain relief.Results The artery compression or contact of the glossopharyngeal entry zone,as revealed during operation in l0 patients with glossopharyngeal neuralgia,was visualized on MRI in 9 and not seen in 1.The venous compression of the glossopharyngeal entry zone was not identified on MRI in 1.The conglutinative arachnoids of the glossopharyngeal entry zone was not visualized on MRI in 1.MRI demonstrated the affected glossopharyngeal nerve root entry zone was compressed or contacted by the posterior inferior cerebellar artery (PICA)in 8 patients and by the vertebral artery in 1 patient.One patient's offending vessel was confirmed to be the anterior inferior cerebellar artery(AICA)by the operation,and the surgical findings were corresponded with MRI in others.Vascular compression or contact of the affected glossopharyngeal nerve was not visualized on MRI in 3 patients,and operation confirmed that the glossopharyngeal nerve root entry zone was compressed by unknown artery in 1,by small vein in 1,and by eonglutinative araehnoids in 1, respectively.Eight patients presented with symptoms of the ipsilateral trigeminal neuralgia concurrently.The compression of the affected trigeminal nerve root by superior cerebellar artery(SCA)was visualized on MRI in 6 patients,and operation did not reveal the source of artery compression in 1 and corresponded with MRI findings in other 5 cases.Vascular compression of affected trigeminal nerve was not visualized on MRI in 2 patients,and intraoperative inspection revealed that trigeminal nerve root was compressed by draining vein of brainstem in 1 and not compressed by any vessels in 1.All patient's neuralgia resolved after microvascular decompression of glossopharyngeal nerve and trigeminal nerve.Conclusion It is possible to visualize the glossopharyngeal and surrounding arteries on MRI,and it is of great significance in the diagnosis and treatment of this kind of glossopharyngeal neuralgia.