载超顺磁性氧化铁高分子液态氟碳纳米粒的制备及体外显像

目的制备一种能同时用于超声造影及MR成像的多模态造影剂,观察其体外成像效果。方法采用双乳化法合成载超顺磁性氧化铁（SPIO）纳米颗粒及全氟己烷（PFH）的高分子微球（s-PFH／PLGA）,检测其一般特性及光声信号。对不同浓度的s—PFH／PLGA水囊模型进行超声显影,以JC200聚焦超声肿瘤治疗系统辐照后观察回声强度变化;对不同铁含量的s—PFH／PLGA进行MR成像。结果透射电镜下s—PFH／PLGA呈球形,SPIO颗粒均匀分布在外壳上,平均粒径（738．9±158．4）nm,平均电位（-15．9士6．9）mV,并检测到明显光声信号。体外超声显像中s—PFH／PLGA呈点状高回声,HIFU辐照后回声强度增强。s-PFH／PLGA在T2wI中呈负增强显像;随着铁含量增高,MRI信号呈降低趋势。结论成功制备的载SPIO及PFH多模态造影剂具有体外超声、MR显影功能。     

Magnuson法与Bankart法治疗习惯性肩关节前脱位的疗效比较

目的：比较Magnuson法与Bankart法手术治疗习惯性肩关节前脱位的临床效果。方法回顾性分析2011年1月至2012年10月广州军区广州总医院采用Magnuson法和Bankart法手术治疗的43例习惯性肩关节前脱位患者的临床资料,其中Magnuson组21例、Bankart组22例。观察两组切口长度、术中出血量和手术时间的差异,采用肩关节功能Neer评分评价术前,术后6、12个月的肩关节功能。结果两组切口长度、术中出血量和手术时间比较,差异无统计学意义（P＞0.05）。43例患者均获随访,随访时间11～18个月（平均15.3个月）。末次随访时两组患者均未再次出现肩关节脱位。与术前比较,两组术后6、12个月肩关节功能Neer评分均较术前有明显改善（P＜0.05）。Bankart组术后6个月肩关节功能Neer评分优于Magnuson组（P＜0.05）,但术后12个月两组Neer评分比较,差异无统计学意义（P ＞0.05）。结论对于习惯性肩关节前脱位患者,Bankart法较Magnuson法术后肩关节功能恢复快,但两种术式对肩关节功能的远期改善程度似无明显差别。     

Increased pulse wave velocity and carotid intima–media thickness in patients with carpal tunnel syndrome

Introduction: Carpal tunnel syndrome (CTS) is associated with cardiovascular risk factors. The aim of our study was to determine whether carotid intima–media thickness (CIMT) and carotid–femoral pulse wave velocity (cf-PWV), as surrogates of cardiovascular disease and arterial stiffness, are increased in patients with carpal tunnel syndrome. Methods: Forty patients with CTS and 40 gender- and age-matched controls underwent cf-PWV assessment, CIMT measurement, and nerve conduction study. Results: CIMT and cf-PWV were increased significantly in patients with CTS. They correlated positively with median sensory and motor nerve distal latency. Whereas both CIMT and PWV related to CTS, only CIMT independently predicted CTS. Conclusions: There is both increased pulse wave velocity and CIMT and a positive correlation between these parameters and median nerve sensory distal latency in patients with CTS. CTS appears to be associated with arterial stiffness and atherosclerotic burden, but the underlying mechanisms require further study. Muscle Nerve 47: 872–877, 2013     

Validation of micro-CT against the section method regarding the assessment of marginal leakage of sealants

Background: The aim of this study was to validate the micro‐CT and related software against the section method using the stereomicroscope for marginal leakage assessment along the sealant‐enamel interface. Methods: Pits and fissures of the occlusal surface of 10 teeth were sealed with a resin‐fissure sealant material without acid etching, thermocycled for 5000 cycles, immersed in 50% silver nitrate for three hours and scanned using micro‐CT. Teeth were embedded in epoxy resin and cut in three sections. The middle section was subjected to micro‐CT and stereomicroscopy. Images were taken from the left and right sides of the sealant‐enamel interface at both the left and the right site of the section. Two experienced evaluators assessed marginal leakage. Results: Both assessment instruments observed no leakage in 37 out of the 40 images evaluated. Leakage at the sealant‐enamel interface was observed in three stereomicroscopy images only. A fracture line in the sealant was seen on eight stereomicroscopy images and observed in only two micro‐CT images. Conclusions: The quality of the micro‐CT and related software used in the present study does not qualify it to replace the section method as the gold standard for marginal leakage assessment at the sealant‐enamel interface of permanent teeth.     

Sensory outcomes of the anterior tongue after lingual nerve repair in oropharyngeal cancer

Primary treatment of oropharyngeal cancer often involves surgical resection and reconstruction of the affected area. However, during base of tongue reconstruction the lingual nerve is often severed on one or both sides, affecting sensation in the preserved tissue of the anterior tongue. The loss of specific tongue sensations could negatively affect a person's oral function and quality of life. The aim of this study was to explore the effects of different types of lingual nerve intervention on sensory function for patients with base of tongue cancer as compared to healthy, age-matched adults. Subjects included 30 patients who had undergone primary oropharyngeal reconstruction with a radial forearm free-flap and 30 matched controls. Sensations tested were temperature, two-point discrimination, light touch, taste, oral stereognosis and texture on the anterior two-thirds of the tongue. Results indicated that type of surgical nerve repair may not have a significant impact on overall sensory outcomes, providing mixed results for either nerve repair technique. Sensations for the nonoperated tongue side and operated side with lingual nerve intact were comparable to matched controls, with mixed outcomes for nerve repair. The poorest sensory outcomes were observed in patients with the lingual nerve severed, while all patients with lingual nerve intervention exhibited deteriorated taste sensation on the affected tongue side. Overall, patients in this study who had undergone oropharyngeal reconstruction with lingual nerve intervention exhibited decreased levels of sensation on the operated tongue side, with minimal differences between types of lingual nerve repair.     

Effect of bolus administration of non-ionic radiopaque contrast media on blood pressure variation

IntroductionHaemodynamic changes may occur with the rapid intravenous injection of contrast media due to the osmolality of such pharmaceuticals. This study sought to evaluate the effect of bolus administration of intravenous contrast media on blood pressure variation during the Contrast-Enhanced Computed Tomography (CECT) of the abdomen.MethodsThe study included 74 patients who underwent abdominal CECT and they were placed in the first group receiving a maximum of 80 ml of iodinated contrast via pressure injector (4 ml/s). A further 74 patients, who underwent non-contrast enhanced abdominal CT, were placed in the second group in which 80 ml of normal saline was administered via the same manner. Patients with hypertension and who were on anti-hypertensive drugs were excluded from the study. Non-invasive blood pressure was monitored before the injection of contrast media/saline and immediately after the portal venous phase for the CECT scan and after 45 s following the administration of normal saline in the non-contrast CT group. Mean systolic and diastolic blood pressures from both groups were compared to find out the effect of contrast bolus administration on blood pressure variation.ResultsBoth systolic and diastolic blood pressure increased with the injection of contrast media among CECT scan group. No significant changes in systolic and diastolic blood pressure were found before and after the scan in the non-contrast group.ConclusionBolus administration of 80 ml saline has no effect on blood pressure. The increased blood pressure in contrast enhanced studies was induced by the iodinated contrast media and not by the bolus effect.