BACKGROUND Cerebral syphilitic gumma is a relatively rare clinical disease.Its clinical manifest-ations are non-specific,and the imaging manifestations are similar to other in-tracranial occupying lesions,often misdia...BACKGROUND Cerebral syphilitic gumma is a relatively rare clinical disease.Its clinical manifest-ations are non-specific,and the imaging manifestations are similar to other in-tracranial occupying lesions,often misdiagnosed as tumors or abscesses.There are few reports on this disease in the relevant literature.To our knowledge,we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.CASE SUMMARY We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics.The cli-nical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported.Clinical manifestations,classifications,and diagnostic points were retro-spectively analyzed.The patient was admitted to the hospital with fever and limb weakness.Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test.The patient was misdiagnosed as having a brain abscess and underwent a craniotomy.A postoperative pathological diagnosis of syphilis gumma was made.The patient improved and was discharged after penicillin anti-syphilis treatment.Follow-up recovery was satisfactory.CONCLUSION Cerebral syphilitic gumma is rare in clinical practice,and it is often misdiagnosed and missed.Clinical diagnosis should be considered in combination with multiple examinations.展开更多
A total of 66 samples (from 27 cases with neuromyelitis optica, 26 cases with multiple sclerosis, and 13 cases with optic neuritis) were tested for aquaporin-4 antibody by a cell-based immunofluores-cence assay and an...A total of 66 samples (from 27 cases with neuromyelitis optica, 26 cases with multiple sclerosis, and 13 cases with optic neuritis) were tested for aquaporin-4 antibody by a cell-based immunofluores-cence assay and an enzyme-linked immunosorbent assay. The sensitivities and specificities of the two assays were similar. We further analyzed an additional 68 patients and 93 healthy controls using the enzyme-linked immunosorbent assay. A Kappa test showed good consistency between the two methods in terms of detection of anti-aquaporin-4 antibody in the sera of neuromyelitis optica patients. No significant correlations were identified with onset age or disease duration, suggesting that aquaporin-4 antibody is a good marker for neuromyelitis optica. The enzyme-linked immu-nosorbent assay can be used for quantifying aquaporin-4 antibody concentrations and may be useful to dynamically monitor changes in the levels of aquaporin-4 antibody during disease duration.展开更多
Uric acid is reduced in demyelinating diseases,including multiple sclerosis and neuromyelitis optica(NMO).Longitudinally extensive transverse myelitis(LETM)is often an early manifestation of NMO.Whether uric acid leve...Uric acid is reduced in demyelinating diseases,including multiple sclerosis and neuromyelitis optica(NMO).Longitudinally extensive transverse myelitis(LETM)is often an early manifestation of NMO.Whether uric acid levels are reduced at presentation of LETM remains unknown.The present study investigated serum uric acid levels by evaluating 35 patients with LETM,64 with NMO,62 with multiple sclerosis,63 with other neurological diseases and 65 healthy controls.In addition,we tested the correlation between serum uric acid and the clinical characteristics of LETM.All patients were in the acute phase,defined as less than 1 month from onset or relapse.The results revealed that serum uric acid levels in LETM were significantly lower than in multiple sclerosis,other neurological diseases and healthy controls,but no difference was found between LETM and NMO.A negative correlation between uric acid levels and Expanded Disability Status Scale scores was found in LETM patients(r=-0.545,P<0.05).The results suggest that uric acid levels are reduced in patients with LETM,raising the possibility that lower uric acid levels are an indicator of disease disability.Moreover,reduced uric acid levels may be a risk factor in NMO.展开更多
A fundamental problem in the direct manufacturing of flexible devices is the low melting temperature of flexible substrates,which hinders the development of flexible electronics.Proposed here is an electron-cyclotron-...A fundamental problem in the direct manufacturing of flexible devices is the low melting temperature of flexible substrates,which hinders the development of flexible electronics.Proposed here is an electron-cyclotron-resonance sputtering system that can batch-fabricate devices directly on flexible substrates under a low temperature by virtue of the polariton energy transfer between the plasma and the material.Flexible graphene nanosheet-embedded carbon(F-GNEC)films are manufactured directly on polyimide,polyethylene terephthalate,and polydimethylsiloxane,and how the substrate bias(electron energy),microwave power(plasma flux and energy),and magnetic field(electron flux)affect the nanostructure of the F-GNEC films is investigated,indicating that electron energy and flux contribute to the formation of standing graphene nanosheets in the film.The films have good uniformity of distribution in a large size(17 mm×17 mm),and tensile and angle sensors with a high gauge factor(0.92)and fast response(50 ms)for a machine hand are obtained by virtue of the unique nanostructure of the F-GNEC film.This work sheds light on the quantum manufacturing of carbon sensors and its applications for intelligent machine hands and virtual-reality technology.展开更多
To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. T...To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. The incidence rate of HH among patients in the intensive care unit(ICU) was found to be 0.9%-11.9% [1]. Occurrence of HH appears to have a significant impact on the clinical outcome.展开更多
Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs.In this study,we performed single-cell RNA sequencing analysis to compare the cellular comp...Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs.In this study,we performed single-cell RNA sequencing analysis to compare the cellular composition and subpopulationspecific gene expression between cartilage with macroscopically confirmed osteoarthritis(n=5)and cartilage without osteoarthritis(n=5)from the interphalangeal joints of five donors.Of 105142 cells,we identified 13 subpopulations,including a novel subpopulation with inflammation-modulating potential annotated as inflammatory chondrocytes.Fibrocartilage chondrocytes exhibited extensive alteration of gene expression patterns in osteoarthritic cartilage compared with nonosteoarthritic cartilage.Both inflammatory chondrocytes and fibrocartilage chondrocytes showed a trend toward increased numbers in osteoarthritic cartilage.In these two subpopulations from osteoarthritic cartilage,the ferroptosis pathway was enriched,and expression of iron overload-related genes,e.g.,FTH1,was elevated.To verify these findings,we conducted a Mendelian randomization study using UK Biobank and a population-based cross-sectional study using data collected from Xiangya Osteoarthritis Study.Genetic predisposition toward higher expression of FTH1 mRNA significantly increased the risk of hand osteoarthritis(odds ratio=1.07,95%confidence interval:1.02–1.11)among participants(n=332668)in UK Biobank.High levels of serum ferritin(encoded by FTH1),a biomarker of body iron overload,were significantly associated with a high prevalence of hand osteoarthritis among participants(n=1241)of Xiangya Osteoarthritis Study(P-for-trend=0.037).In conclusion,our findings indicate that inflammatory and fibrocartilage chondrocytes are key subpopulations and that ferroptosis may be a key pathway in hand osteoarthritis,providing new insights into the pathophysiology and potential therapeutic targets of hand osteoarthritis.展开更多
Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is...Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is the main treatment for radiation osteonecrosis.The repair after the operation is very important.Inappropriate repair or lack of repair can easily cause local infection that can even spread to the brain,aggravating osteonecrosis.This study aimed to verify the feasibility and safety of the ante-rolateral thigh free fascia flap in repairing large skull base defects.Methods:From June 2021 to July 2022,a total of 12 patients with a history of radiotherapy for naso-pharyngeal carcinoma received surgical treatment at the Department of Otolaryngology Head&Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.All patients were diagnosed with radiation osteonecrosis of the skull base with large skull base defects.During the endoscopic operation,a free anterolateral thigh fascia flap was used to repair the skull base and complete vascular anastomosis reconstruction.The preoperative and postoperative pain scores were retrospectively analyzed,and the dynamic changes in endoscopic surgery sites were observed.Results:The 12 patients had a median age of 58 y,with 8(66.7%)males and 4(33.3%)females.The median headache score for the patients was 5(4-7)before surgery.The patient's headache was significantly relieved postoperatively,with 11 patients having a score of 0 and one patient having a score of 1.The stench was completely resolved after the operation.There were no serious complications during the perioperative period or 12 months after the operation.Conclusion:The application of anterolateral thigh free fascia flap in skull base reconstruction is a safe and reliable reconstruction technique suitable for endoscopic surgical repair of large-scale skull base necrosis.展开更多
目的采用Wolff骨重建理论分析全髋关节置换(total hip arthroplasty,THA)对股骨近端骨重建进程的影响。方法根据骨重建控制方程,利用Python语言编写骨重建程序。在ABAQUS软件中分别建立术前股骨模型与术后股骨及假体有限元模型。对比TH...目的采用Wolff骨重建理论分析全髋关节置换(total hip arthroplasty,THA)对股骨近端骨重建进程的影响。方法根据骨重建控制方程,利用Python语言编写骨重建程序。在ABAQUS软件中分别建立术前股骨模型与术后股骨及假体有限元模型。对比THA手术前后骨重建进程,分析假体植入对THA术后中远期股骨力学性能的影响。结果假体植入后,股骨近端应力持续降低,受力点由股骨头转移到假体,出现明显的应力遮挡现象。应力遮挡区域内骨丢失现象严重。股骨干皮质骨变薄,应力遮挡有所缓解。假体底端内侧受挤压,应力显著高于外侧,此处骨质分布不均。结论THA术后股骨近端内侧出现明显的应力遮挡,导致骨丢失,造成假体松动;假体底端两侧应力水平存在差异,引起骨质分布不均,导致假体与股骨配合不紧密,造成术后患者大腿中段的疼痛。展开更多
BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As t...BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As this entity is very rare,little is known on its imaging features,especially magnetic resonance imaging (MRI) findings.In women,at MRI,the cystic component shows T1 hypointensity and T2 hyperintensity,while the solid component shows T1 hyperintensity and T2 hypointensity.CASE SUMMARY We report the computed tomography (CT) and MRI findings of MESTK in a 19- year-old male adolescent.To our knowledge,this case report is the first report of MRI findings of MESTK in male adolescents.The patient was admitted to Subei People's Hospital (Jiangsu Province,China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination.Blood tests were all normal.Non-enhanced CT showed a round,well-circumscribed complex mass,approximately 45 mm × 40 mm in size.MRI revealed a clear wellcircumscribed mass with a mixed arrangement of solid and cystic components.On T2 weighted images,some hypointensities were found in the solid areas.After contrast enhancement,moderate or mild enhancement was found in the solid component,which increased with time.A radical left nephrectomy was performed.The pathology analysis revealed a mixed epithelial and stromal tumor.The patient had no imaging findings of recurrence or metastasis at 12 months following surgery.CONCLUSION The possibility of MESTK should be considered in male adolescents.MRI can provide useful information for the preoperative diagnosis.展开更多
To prevent and treat Parkinson's disease in its early stages,it is essential to be able to detect the degree of early dopaminergic neuron degeneration.Dopamine transporters(DAT) in the striatum regulate synaptic d...To prevent and treat Parkinson's disease in its early stages,it is essential to be able to detect the degree of early dopaminergic neuron degeneration.Dopamine transporters(DAT) in the striatum regulate synaptic dopamine levels,and striatal ^(99m)Tc-TRODAT-1 single-photon emission computed tomography(-SPECT) imaging is a marker for presynaptic neuronal degeneration.However,the association between the degree of dopaminergic degeneration and in vivo ^(99m)Tc-TRODAT-1 SPECT imaging is unknown.Therefore,this study investigated the association between the degree of 6-hydroxydopamine(6-OHDA)-induced dopaminergic degeneration and DAT imaging using ^(99m)Tc-TRODAT-1 SPECT in rats.Different degrees of nigrostriatal dopamine depletion were generated by injecting different doses of 6-OHDA(2,4,and 8 μg) into the right medial forebrain bundle.The degree of nigrostriatal dopaminergic neuron degeneration was assessed by rotational behavior and immunohistochemical staining.The results showed that striatal ^(99m)Tc-TRODAT-1 binding was significantly diminished both in the ipsilateral and the contralateral sides in the 4 and 8 μg 6-OHDA groups,and that DAT ^(99m)Tc-TRODAT-1 binding in the ipsilateral striatum showed a high correlation to apomorphine-induced rotations at 8 weeks post-lesion(r = –0.887,P < 0.01).There were significant correlations between DAT ^(99m)Tc-TRODAT-1 binding in the ipsilateral striatum and the amount of tyrosine hydroxylase immunoreactive neurons in the ipsilateral substantia nigra in the 2,4,and 8 μg 6-OHDA groups at 8 weeks post-lesion(r = 0.899,P < 0.01).These findings indicate that striatal DAT imaging using ^(99m)Tc-TRODAT-1 is a useful technique for evaluating the severity of dopaminergic degeneration.展开更多
BACKGROUND A primary central nervous system lymphoma(PCNSL)presenting with massive hemorrhage is a rare occurrence that is difficult to distinguish from a high-grade glioblastoma.Comprehensive descriptions of the imag...BACKGROUND A primary central nervous system lymphoma(PCNSL)presenting with massive hemorrhage is a rare occurrence that is difficult to distinguish from a high-grade glioblastoma.Comprehensive descriptions of the imaging characteristics of such tumors have not yet been reported.Herein,we reported a case of a PCNSL with massive hemorrhage by presenting the imaging features of computed tomography(CT)imaging and structural and perfusion magnetic resonance imaging(MRI).CASE SUMMARY A 48-year-old man presented with headache lasting for 10 d.CT of the brain showed a round,heterogeneous,high-density lesion with surrounding edema in the right temporal lobe.For further diagnosis,a series of MRI examinations of the brain were subsequently performed,and a hemorrhagic lesion with ring-like enhancement was determined.The whole lesion was relatively hypoperfused on arterial spin labeling images.Surgical resection of the lesion and histopathological examination confirmed that the lesion was a diffuse large B-cell lymphoma with massive hemorrhage.CONCLUSION PCNSLs with hemorrhage occur very rarely,and structural and perfusion MRI examinations are requested exceedingly rarely.This case provided insight into some characteristics of a hemorrhagic lymphoma on CT and MRI examinations.Perfusion MRI examination may be useful for the differential diagnosis of PCNSLs and other brain tumors.展开更多
文摘BACKGROUND Cerebral syphilitic gumma is a relatively rare clinical disease.Its clinical manifest-ations are non-specific,and the imaging manifestations are similar to other in-tracranial occupying lesions,often misdiagnosed as tumors or abscesses.There are few reports on this disease in the relevant literature.To our knowledge,we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases.CASE SUMMARY We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics.The cli-nical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported.Clinical manifestations,classifications,and diagnostic points were retro-spectively analyzed.The patient was admitted to the hospital with fever and limb weakness.Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test.The patient was misdiagnosed as having a brain abscess and underwent a craniotomy.A postoperative pathological diagnosis of syphilis gumma was made.The patient improved and was discharged after penicillin anti-syphilis treatment.Follow-up recovery was satisfactory.CONCLUSION Cerebral syphilitic gumma is rare in clinical practice,and it is often misdiagnosed and missed.Clinical diagnosis should be considered in combination with multiple examinations.
基金the grants from the Ministry of Sciences and Technology of China, No. 2006AA02A408, 2008ZX09312-014
文摘A total of 66 samples (from 27 cases with neuromyelitis optica, 26 cases with multiple sclerosis, and 13 cases with optic neuritis) were tested for aquaporin-4 antibody by a cell-based immunofluores-cence assay and an enzyme-linked immunosorbent assay. The sensitivities and specificities of the two assays were similar. We further analyzed an additional 68 patients and 93 healthy controls using the enzyme-linked immunosorbent assay. A Kappa test showed good consistency between the two methods in terms of detection of anti-aquaporin-4 antibody in the sera of neuromyelitis optica patients. No significant correlations were identified with onset age or disease duration, suggesting that aquaporin-4 antibody is a good marker for neuromyelitis optica. The enzyme-linked immu-nosorbent assay can be used for quantifying aquaporin-4 antibody concentrations and may be useful to dynamically monitor changes in the levels of aquaporin-4 antibody during disease duration.
基金the National Natural Science Foundation of China,No. 30971037
文摘Uric acid is reduced in demyelinating diseases,including multiple sclerosis and neuromyelitis optica(NMO).Longitudinally extensive transverse myelitis(LETM)is often an early manifestation of NMO.Whether uric acid levels are reduced at presentation of LETM remains unknown.The present study investigated serum uric acid levels by evaluating 35 patients with LETM,64 with NMO,62 with multiple sclerosis,63 with other neurological diseases and 65 healthy controls.In addition,we tested the correlation between serum uric acid and the clinical characteristics of LETM.All patients were in the acute phase,defined as less than 1 month from onset or relapse.The results revealed that serum uric acid levels in LETM were significantly lower than in multiple sclerosis,other neurological diseases and healthy controls,but no difference was found between LETM and NMO.A negative correlation between uric acid levels and Expanded Disability Status Scale scores was found in LETM patients(r=-0.545,P<0.05).The results suggest that uric acid levels are reduced in patients with LETM,raising the possibility that lower uric acid levels are an indicator of disease disability.Moreover,reduced uric acid levels may be a risk factor in NMO.
基金support of the National Natural Science Foundation of China(Grant Nos.52275565,NSFC-JSPS:52011540005,and 62104155)the Natural Science Foundation of Guangdong Province(Grant No.2022A1515011667)the Guangdong Kangyi Special Fund(Grant No.2020KZDZX1173).
文摘A fundamental problem in the direct manufacturing of flexible devices is the low melting temperature of flexible substrates,which hinders the development of flexible electronics.Proposed here is an electron-cyclotron-resonance sputtering system that can batch-fabricate devices directly on flexible substrates under a low temperature by virtue of the polariton energy transfer between the plasma and the material.Flexible graphene nanosheet-embedded carbon(F-GNEC)films are manufactured directly on polyimide,polyethylene terephthalate,and polydimethylsiloxane,and how the substrate bias(electron energy),microwave power(plasma flux and energy),and magnetic field(electron flux)affect the nanostructure of the F-GNEC films is investigated,indicating that electron energy and flux contribute to the formation of standing graphene nanosheets in the film.The films have good uniformity of distribution in a large size(17 mm×17 mm),and tensile and angle sensors with a high gauge factor(0.92)and fast response(50 ms)for a machine hand are obtained by virtue of the unique nanostructure of the F-GNEC film.This work sheds light on the quantum manufacturing of carbon sensors and its applications for intelligent machine hands and virtual-reality technology.
基金supported by grants from the National Natural Science Foundation of China (81571475, 81471480, 81671956 and 81630037)the Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talentsthe Key Program of the Independent Design Project of National Clinical Research Center for Child Health (G20B0009)。
文摘To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. The incidence rate of HH among patients in the intensive care unit(ICU) was found to be 0.9%-11.9% [1]. Occurrence of HH appears to have a significant impact on the clinical outcome.
基金supported by the National Natural Science Foundation of China(81930071,82072502)the National Natural Science Foundation Regional Innovation and Development Joint Fund(U21A20352)+5 种基金the National Key Research and Development Project(2022YFC3601900,2022YFC2505500)the Project Program of National Clinical Research Center for Geriatric Disorders(Xiangya Hospital,2021LNJJ06,2022LNJJ07)the Natural Science Foundation of Hunan Province(2022JJ20100)the Key Research and Development Program of Hunan Province(2021SK2017)the Science and Technology Innovation Program of Hunan Province(2022RC3075)the Central South University Innovation-Driven Research Program(2023CXQD031)。
文摘Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs.In this study,we performed single-cell RNA sequencing analysis to compare the cellular composition and subpopulationspecific gene expression between cartilage with macroscopically confirmed osteoarthritis(n=5)and cartilage without osteoarthritis(n=5)from the interphalangeal joints of five donors.Of 105142 cells,we identified 13 subpopulations,including a novel subpopulation with inflammation-modulating potential annotated as inflammatory chondrocytes.Fibrocartilage chondrocytes exhibited extensive alteration of gene expression patterns in osteoarthritic cartilage compared with nonosteoarthritic cartilage.Both inflammatory chondrocytes and fibrocartilage chondrocytes showed a trend toward increased numbers in osteoarthritic cartilage.In these two subpopulations from osteoarthritic cartilage,the ferroptosis pathway was enriched,and expression of iron overload-related genes,e.g.,FTH1,was elevated.To verify these findings,we conducted a Mendelian randomization study using UK Biobank and a population-based cross-sectional study using data collected from Xiangya Osteoarthritis Study.Genetic predisposition toward higher expression of FTH1 mRNA significantly increased the risk of hand osteoarthritis(odds ratio=1.07,95%confidence interval:1.02–1.11)among participants(n=332668)in UK Biobank.High levels of serum ferritin(encoded by FTH1),a biomarker of body iron overload,were significantly associated with a high prevalence of hand osteoarthritis among participants(n=1241)of Xiangya Osteoarthritis Study(P-for-trend=0.037).In conclusion,our findings indicate that inflammatory and fibrocartilage chondrocytes are key subpopulations and that ferroptosis may be a key pathway in hand osteoarthritis,providing new insights into the pathophysiology and potential therapeutic targets of hand osteoarthritis.
基金This study was approved by Ethics Committee of Sir Run Run Shaw Hospital,Zhejiang University School of Medicine(20200210[18]).
文摘Objective:Radiation osteonecrosis of the skull base after radiotherapy for nasopharyngeal carcinoma is one of the most serious complications,affecting patient survival and quality of life.To date,surgical resection is the main treatment for radiation osteonecrosis.The repair after the operation is very important.Inappropriate repair or lack of repair can easily cause local infection that can even spread to the brain,aggravating osteonecrosis.This study aimed to verify the feasibility and safety of the ante-rolateral thigh free fascia flap in repairing large skull base defects.Methods:From June 2021 to July 2022,a total of 12 patients with a history of radiotherapy for naso-pharyngeal carcinoma received surgical treatment at the Department of Otolaryngology Head&Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.All patients were diagnosed with radiation osteonecrosis of the skull base with large skull base defects.During the endoscopic operation,a free anterolateral thigh fascia flap was used to repair the skull base and complete vascular anastomosis reconstruction.The preoperative and postoperative pain scores were retrospectively analyzed,and the dynamic changes in endoscopic surgery sites were observed.Results:The 12 patients had a median age of 58 y,with 8(66.7%)males and 4(33.3%)females.The median headache score for the patients was 5(4-7)before surgery.The patient's headache was significantly relieved postoperatively,with 11 patients having a score of 0 and one patient having a score of 1.The stench was completely resolved after the operation.There were no serious complications during the perioperative period or 12 months after the operation.Conclusion:The application of anterolateral thigh free fascia flap in skull base reconstruction is a safe and reliable reconstruction technique suitable for endoscopic surgical repair of large-scale skull base necrosis.
文摘目的采用Wolff骨重建理论分析全髋关节置换(total hip arthroplasty,THA)对股骨近端骨重建进程的影响。方法根据骨重建控制方程,利用Python语言编写骨重建程序。在ABAQUS软件中分别建立术前股骨模型与术后股骨及假体有限元模型。对比THA手术前后骨重建进程,分析假体植入对THA术后中远期股骨力学性能的影响。结果假体植入后,股骨近端应力持续降低,受力点由股骨头转移到假体,出现明显的应力遮挡现象。应力遮挡区域内骨丢失现象严重。股骨干皮质骨变薄,应力遮挡有所缓解。假体底端内侧受挤压,应力显著高于外侧,此处骨质分布不均。结论THA术后股骨近端内侧出现明显的应力遮挡,导致骨丢失,造成假体松动;假体底端两侧应力水平存在差异,引起骨质分布不均,导致假体与股骨配合不紧密,造成术后患者大腿中段的疼痛。
基金Supported by National Natural Science Foundation of China,No.81401384Social Develop Foundation of Yangzhou,No.2017066+1 种基金Yangzhou City Science and Education Strengthening Leading Talents Project,No.LJRC201810Yangzhou City Science and Education Strengthening Key Talents Project,No.ZDRC201873
文摘BACKGROUND Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported).They occur almost exclusively in postmenopausal women,with only seven cases reported in men.As this entity is very rare,little is known on its imaging features,especially magnetic resonance imaging (MRI) findings.In women,at MRI,the cystic component shows T1 hypointensity and T2 hyperintensity,while the solid component shows T1 hyperintensity and T2 hypointensity.CASE SUMMARY We report the computed tomography (CT) and MRI findings of MESTK in a 19- year-old male adolescent.To our knowledge,this case report is the first report of MRI findings of MESTK in male adolescents.The patient was admitted to Subei People's Hospital (Jiangsu Province,China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination.Blood tests were all normal.Non-enhanced CT showed a round,well-circumscribed complex mass,approximately 45 mm × 40 mm in size.MRI revealed a clear wellcircumscribed mass with a mixed arrangement of solid and cystic components.On T2 weighted images,some hypointensities were found in the solid areas.After contrast enhancement,moderate or mild enhancement was found in the solid component,which increased with time.A radical left nephrectomy was performed.The pathology analysis revealed a mixed epithelial and stromal tumor.The patient had no imaging findings of recurrence or metastasis at 12 months following surgery.CONCLUSION The possibility of MESTK should be considered in male adolescents.MRI can provide useful information for the preoperative diagnosis.
基金supported by the National Natural Science Foundation of China,No.81571250
文摘To prevent and treat Parkinson's disease in its early stages,it is essential to be able to detect the degree of early dopaminergic neuron degeneration.Dopamine transporters(DAT) in the striatum regulate synaptic dopamine levels,and striatal ^(99m)Tc-TRODAT-1 single-photon emission computed tomography(-SPECT) imaging is a marker for presynaptic neuronal degeneration.However,the association between the degree of dopaminergic degeneration and in vivo ^(99m)Tc-TRODAT-1 SPECT imaging is unknown.Therefore,this study investigated the association between the degree of 6-hydroxydopamine(6-OHDA)-induced dopaminergic degeneration and DAT imaging using ^(99m)Tc-TRODAT-1 SPECT in rats.Different degrees of nigrostriatal dopamine depletion were generated by injecting different doses of 6-OHDA(2,4,and 8 μg) into the right medial forebrain bundle.The degree of nigrostriatal dopaminergic neuron degeneration was assessed by rotational behavior and immunohistochemical staining.The results showed that striatal ^(99m)Tc-TRODAT-1 binding was significantly diminished both in the ipsilateral and the contralateral sides in the 4 and 8 μg 6-OHDA groups,and that DAT ^(99m)Tc-TRODAT-1 binding in the ipsilateral striatum showed a high correlation to apomorphine-induced rotations at 8 weeks post-lesion(r = –0.887,P < 0.01).There were significant correlations between DAT ^(99m)Tc-TRODAT-1 binding in the ipsilateral striatum and the amount of tyrosine hydroxylase immunoreactive neurons in the ipsilateral substantia nigra in the 2,4,and 8 μg 6-OHDA groups at 8 weeks post-lesion(r = 0.899,P < 0.01).These findings indicate that striatal DAT imaging using ^(99m)Tc-TRODAT-1 is a useful technique for evaluating the severity of dopaminergic degeneration.
文摘BACKGROUND A primary central nervous system lymphoma(PCNSL)presenting with massive hemorrhage is a rare occurrence that is difficult to distinguish from a high-grade glioblastoma.Comprehensive descriptions of the imaging characteristics of such tumors have not yet been reported.Herein,we reported a case of a PCNSL with massive hemorrhage by presenting the imaging features of computed tomography(CT)imaging and structural and perfusion magnetic resonance imaging(MRI).CASE SUMMARY A 48-year-old man presented with headache lasting for 10 d.CT of the brain showed a round,heterogeneous,high-density lesion with surrounding edema in the right temporal lobe.For further diagnosis,a series of MRI examinations of the brain were subsequently performed,and a hemorrhagic lesion with ring-like enhancement was determined.The whole lesion was relatively hypoperfused on arterial spin labeling images.Surgical resection of the lesion and histopathological examination confirmed that the lesion was a diffuse large B-cell lymphoma with massive hemorrhage.CONCLUSION PCNSLs with hemorrhage occur very rarely,and structural and perfusion MRI examinations are requested exceedingly rarely.This case provided insight into some characteristics of a hemorrhagic lymphoma on CT and MRI examinations.Perfusion MRI examination may be useful for the differential diagnosis of PCNSLs and other brain tumors.
