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Intervertebral disc degeneration is the most common cause of chronic low back pain and the leading cause of disability in adults. The fact that lacking of effective treatment methods often causes a serious economic and social burden. Intervertebral disc degeneration is the result of multifactorial factors. The prevalence of intervertebral disc degeneration increases drastically with age, what is more, mechanical trauma, genetic predisposition,lifestyle factors and certain metabolic disorders. At present, the main treatment methods both pharmacological and surgical interventions just aim at relieving symptoms and improving function, and can not fundamentally reverse the process of intervertebral disc degeneration, which not only bring inevitable side effects and high cost, but also the long-term curative effect is limited. In theory, biological therapy can not only reverse or delay the process of it, but also can maximize preservation and restore the normal physiological function of the disc, which has been the focus and hot spot areas of research in recent years. The methods of inhibiting inflammation, promote the proliferation and division of residual cells, stem cell transplantation, cell scaffolds and new biomaterials all provide new ideas and direction for the treatment of intervertebral disc degeneration. This paper makes a review of the research progress in related fields, in order to provide a valuable reference for the selection of intervertebral disc degeneration treatment options.
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Objective:To study the effect of enhanced recovery after surgery (ERAS) on intestinal function and gut microbiota changes in patients who underwent laparoscopic gastrectomy.Methods:From Aug. 2018 to Dec. 2019, 80 patients who underwent laparoscopic radical D2 gastrectomy for gastric cancer in the first Department of Gastrointestinal Surgery of Yantai Yuhuangding Hospital were selected. According to whether it adopts ERAS treatment or not, patients were divided into 2 groups (n=40) : ERAS group and traditional perioperative treatment group. The time of postoperative bowel sounds, the time of first exhaust and defecation, the proportion of antibiotic-related diarrhea and surgical site infection (SSI) were recorded. Stools were collected before operation, first time after operation, 1, 2 weeks and 1 month after operation. 16S rRNA sequencing method was used to identify the diversity and species of gut microbiota. The diversity index of intestinal flora in the perioperative period and changes in the proportion of probiotics (bifidobacterium and lactobacillus) were compared.Results:The appearance time of bowel sounds, the first exhaust and defecation time [ (16.25±6.41) h, (23.95±6.02) h, (34.95±9.34) h] in ERAS group were significantly earlier than those in the traditional treatment group [ (22.3±6.49) h, (28.45±7.12) h, (48.1±15.64) h], and the difference was statistically significant ( P<0.05) . The incidence of antibiotic-related diarrhea was higher in the traditional treatment group (3/40) than in ERAS group (1/40) , but the difference was not statistically significant ( P>0.05) . The ratio of postoperative SSI was slightly higher in ERAS group, but the difference was not statistically significant ( P>0.05) . In the perioperative period, the intestinal flora diversity index (Chao1 and Shannon index) and the proportion of probiotics (lactobacillus acidophilus and bifidobacterium) were not significantly different between the two groups before surgery ( P>0.05) ; while at the first time, one week, 2 weeks after the operation, and 1 month after the operation, ERAS group was higher than the traditional group ( P<0.05) ; and at each postoperative time point, the traditional group decreased significantly than the ERAS group. The first time decrease was the largest, ( P<0.05) ; With the passage of time after operation, the diversity of intestinal flora and the proportion of probiotics gradually recovered. By 1 month after operation, the two groups did not return to the preoperative gut microbiota diversity state or proportion. Conclusion:The concept of enhanced recovery after surgery (ERAS) promotes the recovery of intestinal function in patients with gastric cancer, does not reduce the proportion of antibiotic-associated diarrhea (AAD) or surgical site infections (SSI) , and maintains the diversity of gut microbiota balance and stability.
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Objective To investigate CT and MRI features of hepatic sclerosed hemangioma (HSH).Methods CT and MRI findings were retrospectively reviewed in 20 cases of HSH,all of which were confirmed pathologically after hepatic surgery.Twenty patients underwent CT scan,4 patients underwent MRI.Meanwhile,the enhancement pattern and signal intensity were analyzed either.Results Twenty patients showed main part of tumor was hypo-attenuating on CT plain scanning,and 16 patients showed the central area of tumor was markedly more hypo-attenuating on CT plain scanning.After administration of intravenous contrast media,multifocal linear or small nodular enhancement in the peripheral area was seen during the arterial phase on 16 patients of HSH.Venous phases showed centripetal enhancement or spread around the nodules enhancement which continued to delayed phases with low density of no enhancement in the lesion area.Four patients showed no obvious enhancement on arterial phases and slight separation sample enhancement at the edge or inside of the lesions with a wide range of non enhancement areas on venous phase and delayed phase.Four patients were performed MRI examination,the lesions demonstrated hypointensity with a lower signal area on T1WI,hyperintensity with a higher signal intensity area on T2WI.The DWI sequence of b value were 0,150,800 s/mm2,all of which were obviously hypointensity.The edge of lesions showed small nodular enhancement on arterial phase,irregular concentric enhancement on venous phase and delayed phase,and there was no enhancement area with lower signal in the center of the lesion.Conclusions The enhancement pattern of HSH different from cavernous hemangioma,with a larger non enhancement area in the center of the lesions and similar to other hepatic masses with central scar,differential diagnosis dependence on CT and MRI dynamic enhanced scan.
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ObjectiveTo investigate the clinical features of patients with decompensated liver disease complicated by acute stroke. MethodsA retrospective analysis was performed for the clinical data of 15 patients who were hospitalized in Beijing You'an Hospital, Capital Medical University and diagnosed with decompensated liver disease complicated by acute stroke from January 2011 to December 2015, including medical history, neurological manifestations, treatment, and prognostic features. ResultsAmong the 15 patients, 11 had acute hemorrhagic stroke (AHS), and 4 had acute ischemic stroke (AIS); among the 11 patients with AHS, 4 (36.36%) had hemorrhage caused by brain metastatic tumor of liver cancer (tumor-associated stroke), and 3 (27.27%) were complicated by liver failure. Among the 15 patients, 12 (80%) had disturbance of consciousness as the early neurological manifestation, and the confirmed diagnosis was made based on head CT findings; the treatment mainly included symptomatic support and rehabilitation training. The patients with AHS had poor prognosis. Four (26.67%) of the 15 AHS patients died, among these patients, 2 had liver failure complicated by AHS, 1 had liver cirrhosis complicated by AHS, and 1 had brain metastases complicated by AHS. ConclusionPatients with decompensated liver disease complicated by acute stroke tend to develop the manifestations of AHS, which may be related to a poor clotting mechanism and brain metastasis of liver cancer, and have poor prognosis. Head CT scan should be performed for patients with decompensated liver disease accompanied by neuropsychiatric abnormalities as early as possible to help with early diagnosis and timely treatment.
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Objective To investigate the effect of microbubble-enhanced non-focused ultrasound on posttraumatic liver hemorrhage.Methods Twenty healthy New Zealand white rabbits with posttraumatic liver hemorrhage were divided into control group,microbubble group,ultrasound with microbubble group,and heparin with ultrasound and microbubble group according to the random number table,with five rabbits per group.Thrombin time (TT),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),and coagulation reaction time (R value) and mechanical strength (A value) of the thrombelastogram were detected.Pre-and post-treatment bleeding were measured to evaluate the hemostatic effect.Liver specimens were harvested to perform histopathological study with HE staining.Results TT [(25.8 ± 11.3) s] and APTF [(58.7 ± 18.7) s] in heparin with ultrasound and microbubble group showed significant prolongation compared with other three groups (P ＜ 0.05).Control group showed higher FIB than other three groups,but the differences were insignificant (P＞0.05).PT did not differ significantly among groups (P＞0.05).R value [(78.3±5.1) min] and A value [(0.13 ± 0.05)mm] in heparin with ultrasound and microbubble group differed significantly from these in other three groups (P0.05 ).After treatment,bleeding area in heparin with ultrasound and microbubble group [(2.2 ±1.3)cm2] wasincreased when compared to ultrasound with microbubble group[(0.8+0.7) cm2](p< 0.05 ), butboth were lower than that in control group [( 5.7+0.6)cm2 ]and microbubble group [( 5.3 ±0.6)cm2]( P<0.05). HE staining showed significant hepatic cell edema in ultrasound with microbubble groupand heparin with ultrasound and microbubble group that compressed hepatic sinus,blood vessels in theportal area and central vein,and significant blood stasis in blood vessels.Conclusion Microbubblesenhanced non-focused ultrasound has good hemostatic effect for posttraumatic liver hemorrhage.
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Objective To explore the efficacy of autologous pleural patch in surgical operation on the patient with chronic tuberculous empyema.Methods Autologous pleura patches were used to repair the pulmonary wound in the surgical operations for 7 patients with chronic tuberculous empyema,who received surgical management in Hebei Provincial Chest Hospital from August 2012 to November 2014.The leak time of the patient and the time of the chest tube were recorded,the pulmonary re-examination was observed by chest X-ray,and the follow-up results were recorded.Results The time of persistent pulmonary air leak of 6 patients was not more than 10 hours after operation,1 patient was not more than 24 hours.Review of X-ray chest showed that good for lung,4-7 d after operation removal of thoracic dosed drainage tube,there was no death and no chest infection in 7 patients and review of CT chest showed no significant residual cavity.After follow-up for 6-24 months 7 patients had satisfactory efficacy,there was no pneumothorax and thoracic infection,no residual cavily.Conclusion Autologous pleura can be used to patch the pulmonary wound in the surgical operation on the patient with chronic tuberculous empyema.
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Objective To investigate the effect of microbubble-enhanced non-focused ultrasound on liver uhrastructure during the treatment of hepatic trauma.Methods The model of hepatic trauma was established in 18 healthy New Zealand rabbits.The subjects were divided into trauma group,ultrasound group and ultrasound-microbubble group according to the random number table,with 6 rabbits each.Thicker region of the left hepatic lobe was treated by custom-made non-focused ultrasound for 5 min.Peak intensity (PI) was used to evaluate the blood reperfusion of the target region after treatment.Liver specimens were performed transmission electron microscope examination immediately and 24 h after treatment to analyze ultrastructure changes.Results PI ratio in ultrasound-microbubble group (15.1 ± 2.6) was significantly lower than that in trauma group (23.1 ± 1.1) and ultrasound group (23.4 ± 1.3) (P ＜ 0.05).But the difference between trauma and ultrasound groups was insignificant (P ＞ 0.05).Compared with trauma and ultrasound groups immediately after treatment,hepatic cells in ultrasoundmicrobubble group had obvious edema,sinusoids thinned,organelles arranged in disorder,mitochondrial edema was present,endothelia cells of interlobular hepatic artery,interlobular vein and bile canaliculi in the portal area damaged,and microvilli of bile canaliculi disappeared.Hepatic cells showed morphology of apoptosis 24 h after treatment.Conclusion Microbubble-enhanced non-focused ultrasound can be used to make rapid hemostasis by decreasing the blood perfusion,but it causes certain damage to the ultrastructure of hepatic cells and may induce apoptosis in the radiation zone and neighboring cells.
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Objective To investigate the correlation between dynamic contrast-enhanced CT and MRI image findings of intrahepatic mass-forming cholangiocarcinoma(IMCC) and pathologic differentiation.Methods The CT and (or) MRI features of ninety-five patients with IMCC proved by pathologic examination were retrospectively reviewed.Sixty-five patients underwent multiphasic dynamic contrast-enhanced CT scan, twenty-nine underwent multiphasic dynamic contrast-enhanced MRI scan and ten patients underwent multiphasic dynamic contrast-enhanced CT and MRI examination simultaneously.According to the case history and laboratory examination, patients were divided into groups: with chronic hepatitis and without chronic hepatitis and according to the maximum diameter of the tumor, they were divided into＜3 cm, 3 to 6 cm and＞6 cm groups.The imaging features of tumor enhancement were reviewed among groups.The pathologic results and imaging features were compared and patients were divided into well differentiated, moderately differentiated, and poorly differentiated groups.Analyzed by Chi-square test, the difference of tumor enhancement between groups were analyzed.Results The patterns of multiphasic dynamic contrast-enhanced CT and MRI in IMCC patients had five types: type 1:60 cases, peripheral rim and (or) separating enhancement during artery phase, followed by centripetal enhancement progressively and(or) separating enhancement in the equilibrium phase;type 2:11 cases, peripheral rim enhancement in the artery phase and hypointensity (hypoattenuating) during equilibrium phase with central nodular enhancement;type 3:15 cases, no enhancement in the arterial phase and internal heterogeneous enhancement during equilibrium phase;type 4: 6 cases, heterogeneous enhancement in the early phase and wash-out during equilibrium phase;type 5 : 3 cases, no enhancement throughout dynamic enhancement.The results showed that in hepatitis group type1 to 5 had 31, 7, 12, 5 and 1 cases and without hepatitis group had 29, 4, 3, 1 and 2 cases.There was no statistical significance between groups(x2=3.567,P=0.059).The maximum diameter＜3 cm group(28 cases) had 9, 8, 6, 3 and 2 case which showed enhancement type1 to 5;3 to 6 cm group(40 cases) had 27, 2, 7, 3 and 1 cases and＞6 cm group(27 cases) had 24, 1, 2, 0 and 0 cases.There was significant difference in groups(x2=19.582,P＜0.01).Pathological well differentiated and moderately differentiated groups(40 cases) had 24, 7,6, 2 and 1 cases presented enhancement type 1 to 5 and poorly differentiated group(55 cases) had 36, 4, 9, 3 and 3 cases.There was no statistical difference in three differentiated groups(x2=0.296,P=0.586).Conclusions CT and MRI enhancement patterns of IMCC are presented with diversity.The imaging features are associated with focus size and had no relationship with pathological differentiated degree.
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Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.
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Objective To illustrate the chest radiography and MSCT findings of measles pneumonia in adults. Methods One hundred and sixty three measles patients underwent chest radiography, MSCT was performed in 3 of them. Measles pneumonia was confirmed in 10 patients (6.13%). Results Eight of 10 patients had abnormal appearances in initial chest radiography. The characteristic chest radiographic findings were ground-glass opacities (n=6) and bronchial wall thickening (n=2). MSCT showed bilateral multiple ground-glass opacities in 1 patient,unilateral patchy ground-glass opacities with lobular distribution in the right upper lung in 2 patients. Conclusions Familiarizing with radiographic and MSCT appearances of measles pneumonia in adults is very important for the differential diagnosis and appropriate management of measles pneumonia. Normal initial chest radiography cannot exclude the involvement of the lungs.
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Objective To investigate CT findings of hepatic necrosis and regeneration after liver failure.Methods Five patients with liver failure underwent CT scan before orthotopic liver transplantation.These findings were retrospectively reviewed and correlated with gross specimen and pathologic findings obtained after transplantation.Results Among 5 cases,the CT appearances of liver failure can be divided into 3 types.(1)Massive confluent aggregate foci in 2 patients demonstrated low attenuation and high attenuation as geographical patlerns on CT scans before contrast enhancement.respectively.The histopathological liver changes showed massive necrosis and regencratinn. Regions of necrosis enhanced to attenuation greater than that of normal liver parenchyma in portal-venous phase,the regions of regeneration enhanced to attenuation greater than that of normal liver parenchyma in arterial phase on postcontrast CT images.(2)In 2 patients,diffuse nodules of liver demonstrated high attenuation on plain CT scans,which was nodular necrosis and nodular regeneration pathologically.All enhanced to attenuation greater than that of normal liver parenchyma in arterial phase.The former showed hypointensity in portal-venous phase and equilibrium phase.The latter enhanced to attenuation equal to that of normal liver parenchyma in portalvenous phase and equilibrium phase on postcontrast CT images.(3)Multiple small foci in 1 case demonstrated low attenuatiun on precontrast CT images and enhanced to hyperintensity in portal-venous phase and isointensity in arterial phase and equilibrium phase on postcontrast CT images.The histopathological liver changes showed multiple necrosis.Conclusion Liver failure may reveal characteristic imaging patterns at CT.
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Objective To evaluate the pulmonary imaging features in patients with severe or critical severe A H1N1 influenza. Methods Clinical and imaging findings of 18 cases with H1N1 pneumonia were retrospectively analyzed. These patients were divided into 2 groups including severe group (n=11) and critical group (n=7). Results Among the severe group, bilateral ill-defined nodules and patch shadows were found in 8 cases, local ill-defined patchy was shown in 3 cases, and consolidation of right inferior lung was demonstrated by CT scan in 1 case. Among the critical group, diffuse ground-glass attenuation with partial consolidation were found in bilateral lungs of 4 cases, subcutaneous emphysema was observed in 1 case. CT showed diffuse ground-glass attenuation and nodular like consolidation in bilateral inferior lungs in 1 case, and other 3 cases showed diffuse consolidation of bilateral lungs. Conclusions The radiologic findings of severe and critical severe pulmonary infections with H1N1 include ill-defined nodules and patch shadows of bilateral lung in sever patients, diffuse peribronchial ground-glass opacity and multifocal consolidation in critical severe patients. The radiologists should learn the features of H1N1 pneumonia on thoracic plain film and CT to make diagnosis in time.
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Objective To evaluate the imaging findings of congenital anomalies of inferior vena eava (IVC) with 64-slice spiral CT. Methods Between January 2008 and May 2009, 6986 patients who had routine abdominal 64-row multi-detector computed tornography were retrospectively analyzed for congenital anomalies of IVC. Results Among 6986 cases, 25 cases with congenital anomalies of IVC were identified. Six case were left IVC, showing IVC left to the aorta inferior to the renal hilum. Ten cases were double IVC, showing two IVC besides the aorta inferior to the renal hilum. Five cases were abnormal renal vein, showing retroaortic and circumaortic left renal vein. Two cases were IVC interruption with collateral circultion by azygous or hemiazygous vein, contrast-enhanced CT scan showing deficiency of the IVC between hepatic and renal hilums, the enlarged azygos vein communicating with IVC at renal level and the hepatice vein draining into the right atrium. Venography showed that IVC draining into the superior vena cava through azygous or hemiazygous veins. One case was interruption of the IVC with portal vein continuation, contrastenhanced CT scan showing the communication between the IVC and portal vein. One case was hemiazygos continuation of a left IVC, contrast-enhanced CT scan demonstrating dilatation hemiazygos continuation of a left IVC and jointed the azygos vein. Conclusion The 64-slice spiral CT can be a diagnostic standard for congenital anomalies of inferior vena cava.
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Objective To investigate the expression and clinical significance of ABCG2 protein in hepato-cellular carcinoma (HCC). Methods Specimens of HCC were collected at The First Aifiliated Hospital of Sun Yat-sen University from January 2005 to December 2006. The expression of ABCG2 protein in 165 samples of HCC tissue, 25 samples of normal liver tissue and 40 samples of cirrhotic liver tissue was detected using immunohisto-chemistry. The correlation between the expression of ABCG2 protein and clinicopathological characters was then analyzed. Enumeration data, survival rate and the difference between groups were analyzed with a chi-square test, the Kaplan-Meier method and Log-rank test, respectively. Results ABCG2 protein expression was weakly posi-tive in all normal and cirrhotic liver tissues. In HCC tissues, the expression of ABCG2 protein was strongly positive in 66 cases and weakly positive in 99 cases. The expression of ABCG2 protein was related to tumor diameter, tumor number, adjacent organ invasion and TNM stages (χ2 =8. 130, 14. 279, 4. 820, 21. 179, P <0. 05). Kaplan-Meier survival analysis revealed that patients with strongly positive ABCG2 protein had a significantly lower 3-year overall survival (24. 1%) compared with those with weakly positive ABCG2 protein (39. 4%) (χ2 = 15.716, P<0.05). Conclusions The expression level of ABCG2 protein is related to tumor invasiveness, TNM stage and prognosis. ABCG2 has the potential to become a new target for HCC treatment.
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Objective To test amyloid beta protein(Aβ)40 and Aβ42 levels in CSF and apolipoprotein E (ApoE) genotype in patients with Alzheimer's disease(AD) and study whether or not the Aβ is related to the severity of dementia and the genotypes of ApoE.Methods 48 AD patients including 27 cases of mild type and 21 cases of serious type and 35 normal controls were selected.Aβ40 and Aβ42 in CSF and ApoE genotype were analyzed.Results Aβ40 levels were ( 12.3 ±4.6) μg/L,( 11.7 ±4.1 ) μg/L,( 12.6 ±4.9) μg/L and ( 11.0 ±3.7) μg/L(t = 1.377,0.705 and 1.385 ,all the p values were greater than 0.05) and Aβ42 levels were ( 105.3 ±25.4) ng/L,(110.7 ±21.7) ng/L,(96.9 ±23.9) ng/L and (123.5 ±29.6) ng/L(t=3.006,2.832,and 3.488,all the p values less than 0.01 ),in AD group,mild AD group,moderate to serious AD group and normal controls,respectively.Aβ40 levels were (11.9 ± 5.2) μg/L vs.(10.5 ± 3.8) μg/L in AD and controls with ApoEε4(t=0.696,P＞0.05) and (12.6 ±4.5) μg/L vs.(11.4 ±3.4) μg/L without ApoEε4(t = 1.008,P＞0.05).Aβ42 levels were (99.7 ± 23.8) ng/L vs.( 129.6 ± 31.0) ng/L in AD and controls with ApoEε4( t =1.632,P ＞ 0.05 ) and ( 110.4 ± 28.4) ng/L vs.( 129.6 ± 31.0) ng/L in those without ApoEε4 ( t = 2.110,P ＜0.05 ).Conclusions The CSF level of Aβ is abnormal in AD,and it is related to the severity of the disease and the ApoE genotypes.
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Objective To demonstrate the spectrum of multi-detector spiral CT (MSCT) findings of drug-induced liver injury (DILI). Methods From May 2008 to January 2010, DILI was identified in 10 cases based on their clinical and pathological results. The spectrum of CT findings was analyzed retrospectively. Results According to the CT features, DILI were divided into three types. ( 1 ) Two cases presented diffuse hepatic injury, which appeared as homogeneous hypo-attenuation in precontrast CT scan and mild enhancement after contrast injection. The histopathological findings of the involved 1ivers include hepatocellular steatosis, neutrophil and eosinophil infiltration, punctiform necrosis and canalicular cholestasis. (2) Six cases presented focal hepatic injury, including massive wedge-shaped necrosis in 4,multiple small necroses in 1 and multiple regenerated nodules in 1. In precontrast CT scan, hepatic necroses were seen as inhomogeneous hypo-attenuation areas, which turned to hyper-attenuation after contrast injection and presented "flip-flop" sign between precontrast CT scan and portal venous phase scan. In the case with regenerated nodules, slight hyper-attenuation lesions were detected with diffuse distribution in liver in precontrast CT scan, which showed enhancement in hepatic arterial phase and turned to iso-attenuation in portal venous phase and equilibrium phase. The histopathological changes included massive necrosis or bridging necrosis with abundant neutrophil and eosinophil infiltration in 5 cases, nodular regeneration with cholestasis and feathery degeneratin in 1 case. (3) Two cases presented liver cirrhosis. CT displayed obvious nodularity of liver, which complicated with splenomegaly, ascites and collateral veins. The histopathological changes of these two cases included punctiform necrosis, canalicular cholestasis and pseudolobular formation. Conclusion CT signs of DILl have certain characteristics, which may help in detecting and determining the severity of liver damage.
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Objective To investigate the effects of magnesium isoglycyrrhizinate on liver regeneration and hepatic function following partial hepatectomy in thioacetamide induced cirrhotic rats.MethodsForty-five cirrhotic Wistar rats undergoing 2/3 hepatectomy were randomly assigned to control group ( Group A), Group B and Group C starting the day of hepatectomy, rats in Group B were injected 60mg per kg body-weight magnesium isoglycyrrhizina daily intraperitoneally until the day of sacrifice. Rats in Group A recevied same dose of sodium chloride. In Group C, magnesium isoglycyrrhizina was administered daily 3 days before hepatectomy until the rats were sacrificed. Liver function, serum HGF, serum PLA2,BrdU labelling index and percentage of intial liver weight on days 1, 2 and 7 post hepatectomy were assessed. ResultsRats in Group A had significantly lower BrdU labelling index and serum HGF level than Group C ( t = 2. 831, P ＜ 0.05; t = 3.427, P ＜ 0.05 ) and a markedly higher level of serum PLA2 than the other groups on day 1 posthepatectomy ( Group B t = 2. 794, P ＜ 0.05; Group C t = 2. 902, P ＜ 0.05 ).Rats in Group A had a lower BrdU labelling index and a more increased level of serum PLA2 than Group B and Group C on day 2 posthepatectomy ( BrdU labelling index: Group B t = 2. 736, P ＜ 0.05; Group C t =3.083, P＜0.05; PLA2: Group B t =2.794, P＜0.05; Group C t =2.902, P＜0.05), but had no significant difference in HGF level with the other two groups. The three groups were similar in ALT, AST,TP and intial liver weight on days 1,2 after operation. On the 7th day posthepatectomy, rats in Group A had a higher level of AST ( Group B t = 4. 508, P ＜ 0.05; Group C t = 2. 967, P ＜ 0.05 ) and a lower level of TP ( Group B t = 2. 838, P ＜ 0.05; Group C t = 2. 743, P ＜ 0.05 ), lower liver weight than the other two groups ( Group B t = 3.316, P ＜ 0.05; Group C t = 4. 093, P ＜ 0.05) but there was no difference between the three groups in BrdU labelling index, HGF and PLA2 level. Rats in Group C had significantly higher BrdU labelling index and serum HGF level than the rats in Group B on day 1 after hepatectomy( t = 2. 831, P ＜0.05; t = 2. 836, P ＜ 0.05 ).ConclusionsMagnesium isoglycyrrhizinate inhibits aminopherase release and enhancing liver regeneration in cirrhotic rats after partial hepatectomy.
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Objective To investigate the relationship of lacunar infarction (LI) and white matter lesion with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) Methods Fifty-three patients were diagnosed as SIVD according to the criteria of Erkinjuntti. The symptoms and signs were recorded by an interview and examination, and neuropsychological assessment and magnetic resonance imaging (MRI) were performed. A semi-automated MRI quantitative method was used to measure the volume of white matter hyperintensity (WMH) and the number of LI was counted. Correlation and the partial correlation analysis were performed to examine the relationship of general cognitive function with the volume of WMH and the number of LI. Results The pseudobulbar paralysis symptom and the upper motoneuron injury sign were the most common in these patients (18.9% and 37.7%). Correlation analysis showed that there was positive correlation between the volume of WMH and age (r = 0. 518, P < 0. 05), and there was negative correlcction between mini-metal state examination (MMSE) scures and the volume of WMH (r=-0.514, P<0. 05), After controlling confounding factors, only age was positively correlated with the volume of WMH (r=0. 400, P=0. 004). There were negative correlation between the number of LI, the volume of WMH and MMSE scores(r=-0. 456,-0. 514,-0. 385,-0. 382;all P<0. 05), and the years of education was positively correlated with MMSE scores (r= 0. 518, P< 0. 001). Conclusions Age may not be the main risk factor for cognitive impairment in patients with SIVD. The volume of WMH and the number of LI are independent risk factors for cognitive impairment in patients with SIVD. Patients with severer SIVD or more LI show poorer performance on cognitive function.
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ObjectiveTo explore the clinical characteristics and radiological manifestations of immune reconstitution inflammatory syndrome(IRIS)in acquired immunodeficiency syndrome(AIDS)patients with tuberculosis(TB)during highly active antiretroviral therapy(HAART).MethodsThe clinical and radiological data in 4 AIDS patients with TB who presented IRIS were analyzed retrospectively.ResultsThe clinical presentations of IRIS in 4 patients included fever(4 cases),weakness and weight loss(3 cases),abdominal pain(2 cases),cough with sputum(1 case),dyspnea(1 case).Cervical and(or)supra-clavicular lymph node enlargement were seen in 3 patients,inguinal lymph node enlargement in 1 patient,abdominal lymph node enlargement in 1 patient,hilar or mediastinal lymph node enlargement in 2 patients,pulmonary parenchyma and liver were involved in 2 patients,the involvement of kidney,adrenal gland,mesentery,peritoneum,psoas,brain and cutis was respectively found in 1 patient.The clinical and radiological presentations of IRIS were temporary and self-limited,improvement can be seen with antituberculosis therapy and HAART. ConclusionsIt is possible to have IRIS during HAART in AIDS patients with TB.Imaging examinations play an important role in the early diagnosis,monitoting and evaluating the response to therapy of IRIS.