Effect of early thoracic paracentesis drainage on acute lung injury in severe acute pancreatitis / 临床肝胆病杂志

Objective To investigate the effect of early thoracic paracentesis drainage for pleural effusion with a small or moderate volume on acute lung injury in patients with severe acute pancreatitis (SAP). Methods A retrospective analysis was performed for the clinical data of 107 patients with SAP who were admitted to The General Hospital of Western Theater Command from January 2015 to December 2021, and according to whether thoracic paracentesis drainage was performed within the first three days after admission, the patients were divided into thoracic paracentesis drainage group (TPD group with 51 patients) and non-thoracic paracentesis drainage group (N-TPD group with 56 patients).The two groups were compared in terms of laboratory markers and clinical outcome on days 5 and 10 after admission.The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Compared with the N-TPD group, the TPD group had a significantly shorter length of stay in the intensive care unit, a significantly shorter length of hospital stay, and significantly lower hospital costs (all P < 0.05), while there were no significant differences between the TPD group and the N-TPD group in mortality rate (9.8% vs 14.3%, χ 2 =0.502, P =0.478) and the incidence rate of sepsis (29.4% vs 44.6%, χ 2 =2.645, P =0.104).The TPD group had a significant reduction in the incidence rate of acute respiratory distress syndrome (ARDS)( χ 2 =6.038, P =0.043), as well as a significantly lower incidence rate of moderate ARDS than the N-TPD group (7.8% vs 21.4%, χ 2 =3.874, P =0.049).Compared with the N-TPD group, the TPD group had a significantly lower rate of use of mechanical ventilation (35.3% vs 57.2%, χ 2 =6.735, P =0.034) and a significantly lower proportion of patients receiving invasive mechanical ventilation (9.8% vs 26.8%, χ 2 =5.065, P =0.024).Compared with the N-TPD group, the TPD group had a significantly lower incidence rate of pulmonary infection (23.5% vs 42.9%, χ 2 =4.466, P =0.035) and a significantly shorter duration of systemic inflammatory response syndrome (11.2±5.0 days vs 16.8±4.7 days, t =5.949, P < 0.001).Compared with the N-TPD group, the TPD group had significantly better laboratory markers (high-sensitivity C-reactive protein, interleukin-1, interleukin-6, interleukin-8, tumor necrosis factor-α, arterial partial pressure of oxygen, oxygen saturation, and oxygenation index) and incidence rate of respiratory failure on days 5 and 10 after admission (all P < 0.05).On day 10 after admission, the TPD group had significantly better APACHE Ⅱ score and modified Mashall score than the N-TPD group (both P < 0.05). Conclusion For SAP patients with a small or moderate volume of pleural effusion, early thoracic paracentesis drainage can effectively improve acute lung injury, alleviate systemic inflammatory response, shorten the length of hospital stay, and reduce hospital costs.

Current research status of left-sided portal hypertension after superior mesenteric-portal vein confluence pancreaticoduodenectomy / 临床肝胆病杂志

Surgical operation is the main treatment method for pancreatic cancer, and in clinical practice, radical surgery for pancreatic cancer is often combined with superior mesenteric-portal vein confluence pancreaticoduodenectomy to achieve R0 resection. However, severe left-sided portal hypertension (LSPH) may occur after splenic vein dissection, resulting in a series of pathological changes such as congestive splenomegaly, thrombocytopenia, backflow obstruction of splenic vein, and gastrointestinal varices, and in some cases, it can lead to fatal gastrointestinal hemorrhage and hemorrhagic shock. Therefore, in order to better manage LSPH in clinical practice, this article systematically analyzes and reviews the pathogenesis, treatment regimens, and control strategies of LSPH after combined superior mesenteric-portal vein confluence pancreaticoduodenectomy and put forward corresponding suggestions based on current studies.

Research advances in acute pancreatitis-associated ascites fluid / 临床肝胆病杂志

Acute pancreatitis-associated ascites fluid (PAAF) is a common complication in patients with acute pancreatitis (AP) and is closely associated with the severity of AP, the development of local and systemic complications, and prognosis. PAAF may originate from the leakage of abdominal blood vessels, lymphatic vessels, and pancreatic duct. Recent studies have found that early removal of PAAF by abdominal paracentesis drainage can help to reduce systemic inflammation and alleviate pancreatitis-associated organ injury, thereby improving the conditions of patients with severe AP and reducing mortality. However, it is still not completely clear how PAAF aggravates systemic inflammatory response, participates in pancreatic injury and damage of distal organs, and leads to the aggravation of disease conditions in patients with AP. Therefore, this article gives an overview of PAAF and summarizes related studies in recent years, so as to provide directions for exploring the pathophysiological process and treatment of AP.

Research progress of radioprobes targeting fibroblast activating protein / 中国药科大学学报

@#Fibroblast activating protein (FAP) is an important biomarker of cancer associated fibroblasts and activated fibroblasts, which is highly expressed in activated fibroblasts of many tumor and fibrotic tissues, but not in normal tissues and non malignant lesions. Therefore, FAP has become an excellent target for diagnosis and treatment of tumors and other diseases. PET imaging and internal radiotherapy based on FAP inhibitor (FAPI) have been used in the diagnosis and treatment of many diseases, such as cancer and fibrosis. We first introduce the mechanism of disease occurrence and progression mediated by FAP and its clinical significance as a therapeutic target.Then,we systematically summarize the FAP probes labeled with 125I, 68Ga, 64Cu and other radionuclides, including their structural evolution, imaging, biodistribution and pharmacokinetic properties.After that, the reported strategies to improve the pharmacokinetic properties and target affinity of probes are summarized, including the use of squaramide linkers,modification with albumin binding agent,the development of dual-targeting probes.Finally, some suggestions for the future development of novel radioactive probes targeting FAP and the clinical application of classical probes are proposed.

Infection control status of novel coronavirus pneumonia and radiation safety at CT workplace / 中华放射医学与防护杂志

CT is an important imaging tool for the diagnosis of novel coronavirus pneumonia (COVID-19), therefore, it′s necessary to strictly control the disinfection of CT workplace and equipment and biosafety to avoid the place from becoming a potential infection source and to reduce the risk of infection of patients and radiological staff. It is also necessary to reduce the CT scan dose to minimize the radiation hazards on patients under the premise of ensuring the CT image quality and diagnostic efficiency. Based on the survey that novel coronavirus residues after disinfection at some CT workplace in domestic and overseas and the application of low-dose CT scan in diagnosis of COVID-19, as well as the current situation of radiological protection management in emergency hospital, this paper summarizes and proposes suggestions on infection control and radiological protection for CT workplace to strengthen the defense line of COVID-19 prevention and control.

Investigation and analysis on the infection control and radiation safety of radiodiagnostic workplace for COVID-19 / 中华放射医学与防护杂志

Objective:To survey and supervise the risk of infection control and radiation safety in the radiological diagnostic workplace for COVID-19, and provide data support for the safety protection of radiographers and related staff.Methods:4 emergency hospitals for COVID-19 including 2 makeshift hospitals, module hospital and brick pattern hospital in Hubei province were performed for testing and evaluation of imaging performance and radiological protection for the 8 new installed CT scanners and places according to the national standards of WS 519-2019 and GBZ 130-2013. The infection control safety factors such as the layout of the equipment room were monitored and investigated. Two COVID-19 designated hospitals including general hospital and infectious disease specialized hospital were selected to carry out field investigation and sampling of environmental biological samples for 4 CT rooms. Then the samples were detected for the nucleic acid of novel coronavirus. The results of radiodiagnostic workplace overall arrangement, infection prevention and the nucleic acid testing were analyzed, and the biological safety reliability and risk point were evaluated.Results:The indicators of imaging performance and radiation protection for 8 CT scanners in emergency hospitals could meet the requirements of national standards.Each of 2 makeshift hospitals had 3 CT rooms with the area of 38.8 m 2 and 4 mm Pb equivalent thickness of protective shielding. The CT rooms in module hospital and brick pattern hospital were 20.0 m 2, and 35.8 m 2 in areas, with 4 mm Pb equivalent and 3 mm Pb equivalent thickness of protection shielding, respectively. The 8 radiological diagnostic workplaces of the emergency hospitals were designed and constructed based on " three zones with two passage ways" . The result of the nucleic acid test indicated that the positive samples were found at the multiple sites such as scanning bed, internal of gantry and ground touched by patients in CT scanning room. The areas such as console panel and ground were risked of pollution by the virus infected hands and feet of radiographers. In addition, the similar positive samples were found in the areas in scanning room with no touch of patients, such as observation window and air outlet. Conclusions:8 CT scanners and rooms in 4 emergency hospitals basically meet the requirements of imaging performance and radiation protection. The disinfection of COVID-19 radiodiagnostic workplace should be standardized.

Characteristics of primary mediastinal large B-cell lymphoma in 18F-FDG PET/CT imaging / 中华核医学与分子影像杂志

Objective@#To investigate the characteristics of primary mediastinal large B-cell lymphoma (PMBL) in 18F-fluorodeoxyglucose (FDG) PET/CT imaging.@*Methods@#From July 2010 to April 2019, 18F-FDG PET/CT images of 27 patients (10 males, 17 females, median age 31 (19-57) years) with pathologically confirmed PMBL from the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The location, shape, density, presence of necrosis and calcification, and invasion around or beyond the lesions were observed. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured by automatic segmentation algorithm method. Spearman correlation analysis was used to evaluate the correlation between SUVmax or MTV or TLG and the maximum diameter or Ann Arbor staging.@*Results@#The lesions appeared as anterior mediastinal huge masses in 27 patients, and grew in the anterior mediastinal cross-regionally in 25 patients, lobulated at the edge in 24 patients. Low-density necrosis lesions were found in 18 patients. The lesions were surrounded by large blood vessels in 15 patients and tracheae were compressed in 12 patients. Lung tissues were invaded in 3 patients, abdominal lymph nodes and bone marrow were invaded in 1 patient, and no splenomegaly was found in 27 patients. The maximum diameter, SUVmax, MTV and TLG were (11.6±3.7) cm, 21.07 (15.78, 25.09), 190.43 (130.14, 350.75) cm3 and 2 165.54 (1 465.86, 4 185.21) g, respectively. There was no correlation between SUVmax and the maximum diameter of lesions (rs=-0.305, P=0.122), while MTV and TLG were positively correlated with the maximum diameter (rs values: 0.741, 0.532, both P<0.05). The maximum diameter, MTV and TLG were positively correlated with Ann Arbor staging (rs values: 0.394, 0.413, 0.422, all P<0.05), while SUVmax was not (rs=0.031, P>0.05).@*Conclusions@#PMBL mostly presents as large anterior mediastinal mass with the high 18F-FDG uptake in 18F-FDG PET/CT imaging, and the focal necrosis is common, while abdominal lymph nodes, spleen and bone marrow invasion are rare. MTV and TLG of lesions positively correlate with Ann Arbor staging.

Characteristics of primary mediastinal large B-cell lymphoma in 18F-FDG PET/CT imaging / 中华核医学与分子影像杂志

Objective To investigate the characteristics of primary mediastinal large B-cell lymphoma (PMBL) in 18F-fluorodeoxyglucose (FDG) PET/CT imaging.Methods From July 2010 to April 2019,18F-FDG PET/CT images of 27 patients (10 males,17 females,median age 31 (19-57) years)with pathologically confirmed PMBL from the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.The location,shape,density,presence of necrosis and calcification,and invasion around or beyond the lesions were observed.The maximum standardized uptake value (SUVmax),metabolictumor volume (MTV) and total lesion glycolysis (TLG) were measured by automatic segmentation algorithm method.Spearman correlation analysis was used to evaluate the correlation between SUVmax or MTV or TLG and the maximum diameter or Ann Arbor staging.Results The lesions appeared as anterior mediastinal huge masses in 27 patients,and grew in the anterior mediastinal cross-regionally in 25 patients,lobulated at the edge in 24 patients.Low-density necrosis lesions were found in 18 patients.The lesions were surrounded by large blood vessels in 15 patients and tracheae were compressed in 12 patients.Lung tissues were invaded in 3 patients,abdominal lymph nodes and bone marrow were invaded in 1 patient,and no splenomegaly was found in 27 patients.The maximum diameter,SUVmax,MTV and TLG were (11.6±3.7) cm,21.07(15.78,25.09),190.43 (130.14,350.75) cm3 and 2165.54 (1465.86,4185.21) g,respectively.There was no correlation between SUVmax and the maximum diameter of lesions (rs =-0.305,P =0.122),while MTV and TLG were positively correlated with the maximum diameter (rs values:0.741,0.532,both P＜0.05).The maximum diameter,MTV and TLG were positively correlated with Ann Arbor staging (rs values:0.394,0.413,0.422,all P＜0.05),while SUVmax was not (rs=0.031,P＞0.05).Conclusions PMBL mostly presents as large anterior mediastinal mass with the high 18F-FDG uptake in 18F-FDG PET/CT imaging,and the focal necrosis is common,while abdominal lymph nodes,spleen and bone marrow invasion are rare.MTV and TLG of lesions positively correlate with Ann Arbor staging.

Protective effect of Rhubarb on newborn rats with bronchopulmonary dysplasia / 中华实用儿科临床杂志

Objective To investigate the effect of Rhubarb on bronchopulmonary dysplasia(BPD) and its potential mechanism.Methods Neonatal Sprague-Dawley rats (postnatal day 4) were exposed to 600 mL/L 02 to induce BPD.The experimental rats were randomly divided into 4 groups with 16 in each group:air + saline group,air +Rhubarb (600 mg/kg)group,and hyperoxia + saline group,and hyperoxia + Rhubarb group.The rats were sacrificed and lung tissues were obtained on day 14 and 21 after birth.Hematoxylin-easin staining was used to detect the pathomorphology of the lungs.Apoptosis of the lung tissue was detected by means of TdT-mediated dUTP nick-end labeling (TUNEL).The expression of Fas was detected by adopting Western blot.The activity of Caspase-8 and Caspase-3was detected by using spectrophotometer.Results The lung structure of rats was markedly abnormal (decreased,enlarged and simplified alveoli) after being exposed to hyperoxia at any time point.The apoptosis indexes (39.91 ± 1.91vs.10.11 ± 1.64,48.80 ± 4.51 vs.12.90 ± 3.18),the expression levels of Fas (0.47 ± 0.02 vs.0.21 ± 0.01,0.55 ±0.02 vs.0.22 ±0.01) and the activities of Caspase-8 (52.59 ± 1.23 vs.40.74 ± 1.08,60.20 ± 3.48 vs.40.39 ±2.47) and Caspsase 3 (57.17 ± 1.88 vs.42.00 ± 1.19,64.57 ± 2.79 vs.41.54 ± 1.27) were all increased in the hyperoxia + saline group compared with those in the air + saline group on day 14 and 21,and the differences were statistically significant(all P ＜ 0.001).However,compared with the hyperoxia + saline group,Rhubarb administration dramatically decreased pulmonary apoptosis index (26.49 ± 2.65 vs.22.97 ± 3.66),Fas protein level (0.27 ± 0.03 vs.0.31 ± 0.01) and the activity of Caspase-8 (32.70 ± 2.69 vs.30.66 ± 4.48) and Caspase-3 (44.94 ± 1.60 vs.44.59 ± 1.66),and the differences were statistically significant (all P ＜ 0.001).Meanwhile,lung damage after hyperoxia was significantly attenuated in the hyperoxia + Rhubarb group.Conclusion Rhubarb can reduce the hyperoxic lung injury of BPD by reducing the apoptosis of newborn rat lung tissue cells,and the mechanism may involve the apoptosis pathway of Fas.

Impact of timing of abdominal paracentesis drainage on treatment outcomes in patients with severe acute pancreatitis / 中华肝胆外科杂志

Objective To study the impact of early abdominal paracentesis drainage (APD) on the clinical course in patients with severe acute pancreatitis and massive peritoneal effusion.Methods From January 2012 to January 2017,107 patients with severe acute pancreatitis treated at the Chengdu Military General Hospital were retrospective studied.According to whether the patients underwent abdominal paracentesis drainage within a week of hospital admission,they were divided into the APD group (n=66) and the Non-APD group (n=41).The APD group was further subgrouped into the 0-2 d (within 48 h),3-5 d and 6 -7 d subgroups.The mortality rates,progression rates,length of stay,cost of stay,organ failure rates and inflammatory state of each subgroup of the APD were statistically analyzed and compared.Results 22 patients in the Non-APD group progressed in four weeks to require percutaneous catheter drainage (PCD).The rate of progression was 53.7％,and the mortality rate was 22％.In the APD group,21 patients underwent PCD treatment within 4 weeks.The rate of progression was 31.8％ and the mortality rate was 9.1％.In the APD group,the progression rate for the patients in the 0-2 d subgroup was 6.9％,and the in-hospital mortality rate was O.When compared with the other subgroups,the 0 to 2 d subgroup of patients had significantly lower progression and in-hospital mortality rates,lower hospitalization duration and hospitalization costs.These patients at 1 week after hospitalization also had significantly better inflammatory indexes,less incidence of organ failure and better disease severity scores (P＜0.05).Conclusions The results confirmed the effectiveness of APD in treating patients with severe acute pancreatitis with significant peritoneal effusion.Puncture treatment within 48 hours significantly improved prognosis of patients.The best time window of APD treatment for patients with severe acute pancreatitis with massive abdominal fluid is within 48 hours of hospitalization.

Effect and regulatory mechanism of peritoneal macrophage polarization in the progress of acute pancreatitis / 中华消化外科杂志

Acute pancreatitis (AP) is a local and systemic inflammation process which is characterized by extensive infiltration of inflammatory cells and outbreak of inflammatory factors.Recent researches have shown that macrophage play a critical role in the process of AP,in particular,peritoneal macro phage as a main innate immune cell in the peritoneal cavity which has been reported not only serve as the first line in host defense,but also help maintaining the immune homeostasis and coordinate the repair and regenerate response by regulating the polarization of their phenotype.Recently,peritoneal macrophages could interact with ascetic fluid of AP patient,and further affect the development and resolution of inflammation.In this review,authors focused on the role and regulatory mechanism of peritoneal macrophage in the progress of AP.

Regulation of rhubarb on heat shock protein 70 expression and lung protection in rats with hyperoxia-induced new bronchopulmonary dysplasia / 中国小儿急救医学

Objective To investigate the effect of rhubarb on hyperoxia-induced new bronchopulmo-nary dysplasia ( BPD) in rats. Methods Full-term Sprague-Dawley rats were exposed or not ( control group) in 600 ml/ L oxygen 4 days after birth and injected with normal saline (BPD group),rhubarb (BPD+ rhubarb group) or a combination of rhubarb with quercetin (BPD + rhubarb + quercetin group). Immuno-histochemical staining was used to detect the pathological changes of the rat lungs. HSP70 expression level was quantified by western blot. Results Compared with control group,BPD group showed decreased radial alveolar 14 and 21 days after the drug treatment,which was rescued by the coexistence of rhubarb. Quercetin, as an inhibitor of HSP70,counteracted the effect of rhubarb. The lung of the BPD + rhubarb + quercetin group showed a similar phenotypic change with that of the BPD group. In addition,the expressions of HSP70 in lung tissues of rhubarb group at 14 days and 21 days after the treatment were higher than those of other groups, there were significant differences between rhubarb group and other groups(F = 62. 46,P < 0. 01;F = 95. 90, P < 0. 01). Conclusion Rhubarb may attenuate the hyperoxia-induced new bronchopulmonary dysplasia in rats by activating HSP70 expression.

Diagnosis and treatment of peripancreatic infection in severe acute pancreatitis / 中华胃肠外科杂志

The peripancreatic infection is a severe complication during severe acute pancreatitis. Early diagnosis, effective prevention and timely treatment are directly associated to prognosis. In recent years, with the promotion and application of the concept of damage control and the rapid development of imaging intervention techniques, the treatment for peripancreatic infection has become "multi-step, step-up" minimally invasive surgical strategy from early laparotomy. The transformation of this concept and method has significantly improved the efficacy of peripancreatic infection in clinical practice. However, there are still many problems to be solved, such as prophylactic antibiotics, the choice of minimally invasive surgical techniques, and the management of early ascites. In addition, due to the variability and complexity of the course of severe acute pancreatitis, there is no uniform standard for clinical treatment and management of peripancreatic infection. Only through multidisciplinary collaboration, including surgery, imaging, nutrition and intensive care, can we truly achieve appropriate risk assessment, accurate clinical diagnosis and effective individualized treatment for these patients.

Progress of Research on Relationship Between Neuronal Nitric Oxide Synthase and Gastrointestinal Motility Disorders / 胃肠病学

Nitric oxide synthase (NOS) is a key enzyme for production of nitric oxide (NO) in vivo.With the deepening of study on biochemical and molecular characteristics of NOS,the intervention of NOS-NO pathway playing an important role in gastrointestinal motility disorder is appreciated.This article reviewed the progress of research on relationship between neuronal nitric oxide synthase (nNOS) and gastrointestinal motility disorders.

Protective effect of human umbilical cord-derived mesenchymal stem cells against severe acute pancreatitis in rats / 解放军医学杂志

Objective To study the protective effects of human umbilical cord-derived mesenchymal stem cells (ucMSCs)against severe acute pancreatitis (SAP) in rats.Methods A total of 135 Sprague-Dawley male rats were randomly divided into Sham group,SAP group and SAP+ucMSCs group (45 each).SAP+ucMSCs group:Severe acute pancreatitis was induced by injecting 5％ sodium taurocholate (0.1ml/100g) into the common bilio-pancreatic duct and then CM-DiI-labeled ucMSCs at 1 × 107cells/kg were injected via the tail vein.All the rats were sacrificed 12,24 and 72 hours after SAP.The 72h death rate was counted.Pathological changes in the pancrease were detected by HE staining and pathological score was graded,ucMSCs colonization was observed by fluorescence microscopy.The serum levels of amylase,lipase,TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA.Results ucMSCs colonize the injured area of pancreatic tissue,the 72h death rate was reduced,and the serum amylase and lipase were also reduced significantly.Moreover,ucMSCs significantly reduced the pathological score of the pancrea and the level of proinflammatory cytokines (TNF-α and IL-1β),but the levels of anti-inflammatory cytokines were increased (IL-4 and IL-10).Conclusion Transplantation of ucMSCs can reduce the severity of pancreatic injury and inflammation in SAP rats.

Development and application of a multifunctional impactor based on animal experiments / 中国组织工程研究

BACKGROUND: A few devices have been reported to be used for studies on trauma, but these devices are unavailable for establishing the animal models of trauma because of their limited application range. OBJECTIVE: To develop a multifunctional impact system and evaluate its application effect, thus paying ways for establishing the animal models of trauma and basic experiments.METHODS: The multifunctional impact system was designed based on the theory of energy storage device, simple multifunctional impact device and impact parameter measuring equipment, and its effectiveness and stability were detected. The rat chest and different visceral organs were subjected to the closed impact experiment using a 5 cm2 impact at the predetermined parameter of 200, 300, 400, 500 kPa, respectively. Afterwards, the rats were sacrificed for morphological observation.RESULTS AND CONCLUSION: The multifunctional impactor was successfully developed, of which the maximum impact stress could be adjusted from 0 to 200 kg and compressive and extrusion stress also could be continuously adjusted from 0 to 100 kg. The experimental results showed that the impactor made certain damage to the rat lung, liver and spleen suggesting its favorable effectiveness (P 0.05). These findings suggest that the impactor is easy to operate in various ways and holds good effectiveness and stability, and its impact parameters can be detected in real time. Therefore, the impactor is suitable for both establishing the animal model of trauma and basic experiments.

Comparison of the effect of different contrast to the heart rate during coronary dual-source CT angiography / 实用放射学杂志

Objective To investigate the influence of iodixanol-320 and iopromide-370 on the heart rate of patients in coronary dual-source CT angiography (CTA).Methods The data of 389 patients underwent coronary CTA examinations were retrospectively collected and received contrast media (CM) with either iodixanol-320 (group A) or iopromide-370 (group B), randomly.The heart rate before CM injection (predose HR), during injection (postdose HR) were both recorded.As for the preclinical protocol, patients with heart rate less than 75 beats per minute were pretreated with nitrates (n=278),0.25 mg.Mean heart rate changes from pre to postdose HR were assessed.Results The patients whose mean heart rate changes from pre to postdose were larger than 10 beats per minute was 8(4.4%) for group A and 10(4.8%) for group B.No statistically differences were observed between them(P>0.05).With only intravenous injections of two contrast agents, the patients' heart rates decreased in both groups (4.2 vs 2.7 beats per minute,P>0.05), while the effect could be reduced by nitrates.Conclusion There is no difference in the heart rate between the 2 agents after intravenous injection of either iodixanol-320 or iopromide-370 in coronary CTA with approximately 4% patients whose mean heart rate changes from preto postdose were larger than 10 beats per minute in each group.

Effect of the intra-abdominal infection on peritoneal lymphatic stomata and regulatory mechanism of PD123319 on peritoneal lymphatic stomata / 中华消化外科杂志

Objective To investigate the effect of the peritoneal lymphatic stomata on intra-abdominal infection and the regulatory mechanism of angiotensin Ⅱ receptor specific inhibitor PD123319 on peritoneal lymphatic stomata.Methods The experimental study was adopted.Forty rats were divided into the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group by the random number table,every group had 10 rats.The classic appendix perforation (CLP) intraabdominal infection model was established in the abdominal infection group.After establishing the model of abdominal infection,PD123319 solution was injected intraperitoneally immediately (0.2 g/kg) in the abdominal infection drug intervention group.Abdominal cavity of the rats in the sham operation group was opened,and then was shut after flipping the intestine.The rats in the control group,sham operation group and intra-abdominal infection group were treated with intraperitoneal injection of 1ml stroke-physiological saline solution.After 2 hours,the rats were sacrificed,and peritoneal tissue was taken for the following tests.(1) The aperture size and distribution density of peritoneal lymphatic stomata were observed by scanning electron microscope (SEM).(2) The nitric oxide (NO) concentration in the peritoneal tissues was detected using nitric oxide nitric acid reduction method.(3) The expressions of endothelial nitric oxide synthase (eNOS) and Phospho-eNOS (P-eNOS) were detected by the Western blot.(4) The intracellular Ca2+ concentration were detect by flow cytometry.Measurement data with normal distribution were presented as-x ± s.The comparison among groups was analyzed using the ANOVA and pairwise comparison was analyzed by the LSD test.Results (1) The aperture size and distribution density of the peritoneal lymphatic stomata in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (2.3 ± 0.4) μm,(2.5 ± 0.5)μm,(4.7 ±0.5)pm,(3.8 ±0.5)pm and (2.0 ±0.8) × 108/m2,(2.1 ±0.7) × 108/m2,(6.2 ± 1.3) × 108/m2,(4.6 ± 1.4) × 108/m2,with statistically significant differences among the 4 groups (F =98.130,56.780,P ＜ 0.05).There were statistically significant differences in the aperture size and distribution density of the peritoneal lymphatic stomata between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =11.586,8.573,3.854,3.098,P ＜ 0.05) and no statistically significant differences between the control group and sham operation group (t =1.281,0.514,P ＞0.05).(2) The concentrations of NO in the peritoneal tissues in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.380 ± 0.024) μmol/gprot,(0.450 ±0.020) μmol/gprot,(1.253 ±0.033) μmol/gprot and (0.579 ±0.035) μmol/gprot,with a statistically significant difference among the 4 groups (F =52.725,P ＜ 0.05).There were statistically significant differences in the concentration of NO between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =10.536,67.798,P ＜ 0.05) and no statistically significant difference in the concentration of NO between the control group and sham operation group (t =2.007,P ＞ 0.05).(3) The results of Western blot showed that the expressions of eNOS and P-eNOS in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.591 ± 0.028)U/mg,(0.603 ± 0.007) U/mg,(0.615 ± 0.027) U/mg,(0.626 ±0.026) U/mg and (0.578 ±0.003)U/mg,(0.603 ± 0.071) U/mg,(0.773 ± 0.033) U/mg,(0.710 ± 0.012) U/mg,with no statistically significant difference in the expression of eNOS among the 4 groups (F =0.902,P ＞ 0.05) and with a statistically significant difference in the expression of P-eNOS among the 4 groups (F =205.062,P ＜ 0.05).There were statistically significant differences in the expression of P-eNOS between the control group and sham operation group or intra-abdominal infection group (t =7.678,13.322,P ＜ 0.05) and between the intra-abdominal infection group and intraabdominal infection drug intervention group (t =4.035,P ＜0.05).(4) The results of flow cytometry showed that Ca2+ concentration in the control group,sham operation group,intra-abdominal infection group and intraabdominal infection drug intervention group were respectively 82.200％ ± 0.060％,81.730％ ± 0.052％,21.980％ ± 0.010％,29.500％ ± 0.004％,showing a statistically significant difference between the 4 groups (F =21 271.030,P ＜ 0.05).There were statistically significant differences in the Ca2+ concentration between the intra-abdominal infection group and control group (t =164.750,P ＜ 0.05) and between the intra-abdominal infection group and intra-abdominal infection drug intervention group (t =21.338,P ＜ 0.05),and no statistically significant difference between the control group and sham operation group (t =1.861,P ＞ 0.05).Conclusion The intra-abdominal infection could increase aperture size and distribution density of peritoneal lymphatic stomata,and PD123319 may be through inhibiting the activation of NO synthase to decrease the concentration of NO,enhance the concentration of Ca2+ in peritoneal mesothelial cells and reduce the opening of peritoneal lymphatic stomata.

Evaluation of the severity of chronic obstructive pulmonary disease with the percentage of the total cross-sectional area of small pulmonary vessels for the lung area in multi-slice CT / 中华放射学杂志

Objective To investigate the role of the percentage of the total cross-sectional area of small pulmonary vessels for the lung area (%CSA) from multi-slice CT (MSCT) in evaluating the severity of chronic obstructive pulmonary disease (COPD). Methods One hundred and sixty-six COPD patients and 166 normal subjects underwent chest MSCT scans and all data were analyzed retrospectively. COPD patients underwent pulmonary function tests (PFT), including forced expiratory volume in one second (FEV1%) and FEV1/forced vital capacity (FEV1/FVC), and were classified into mild (n=32), moderate (n=65), severe (n=69) groups according to pulmonary function results, respectively. The%CSA less than 5 mm2 and 5—10 mm2 for the lung area (%CSA0.05). FEV1%and FEV1/FVC in COPD patients were (60.38±15.52)%and 57.95±22.27.%CSA<5 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.609 and 0.721, P<0.01, respectively).%CSA5-10 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.271 and 0.288, P<0.01, respectively). Conclusion The measurement of%CSA<5 and%CSA5-10 in MSCT images correlated with PFTs and%CSA<5, which may play an important role in evaluating the severity of COPD.

Research progress of systemic inflammatory response syndrome in acute pancreatitis-associated lung injury / 中华消化外科杂志

As a result of the early amplification of the inflammatory response in the acute pancreatitis, systemic inflammatory response syndrome (SIRS) is a main cause of acute pancreatitis-associated lung injury (APALI) , while early combined acute lung injury or acute respiratory distress syndrome causes a high mortality of acute pancreatitis.A series of inflammatory mediators and cytokines play important roles in the process of SIRS and APALI, therefore, inflammatory reaction restoring a balance becomes a key point of the treatment of pancreatitis lung injury.