Radiation dose and clinical value of whole-brain CT perfusion imaging in the assessment of collateral circulation / 中华放射医学与防护杂志

Objective:To assess the radiation dose and clinical value of "one-stop" whole-brain CT perfusion (CTP) imaging in the evaluation of collateral circulation for patients with acute ischemic stroke (AIS), regarding the digital subtraction angiography (DSA) as the reference.Methods:This retrospective study included 32 AIS patients, for whom both CTP and DSA were obtained <24 h since onset. All CTP scans were acquired in whole-brain volume perfusion mode using a 320-row CT with the phase-specific settings of tube currents to optimize the image quality of CTA images, where multiple-phase (mp) CTA images were extracted from the CTP data in post-processing. The volume CT dose index (CTDI vol), dose length product (DLP), and effective dose were compared to those reported in previous studies. The perfusion parameters of the infarct lesions and their contralateral regions were compared using the paired t-tests. One radiologist scored the collateral circulation with only the CTP and with the CTP plus mp-CTA using a 5-point scale. Another radiologist performed the same evaluation on the DSA. The diagnostic accuracy was calculated referring to the result based on DSA. The scores were analyzed using the Pearson correlation coefficient. The agreement of scores was quantified with the Kappa test. Results:The mean CTDI vol was 184.18 mGy, which was comparable to the result of a previous study (184.19 mGy), and the mean effective dose was reduced 39% compared to that reported in the literature for combined CTP and CTA scanning (6.1 vs 10 mSv). There were statistically significant differences in cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), transit time to peak (TTP), and time-to-maximum (Tmax) between the infarct lesions and their contralateral regions ( P<0.01). The scores between CTP and DSA were significantly correlated ( r=0.95, P<0.01), as well as the scores between CTP plus mp-CTA and DSA ( r=0.98, P<0.01). The Kappa value was 0.64 ( t=7.53, P<0.01) between CTP and DSA, while it increased to 0.88 ( t=9.99, P<0.01) for CTP plus mp-CTA. With the result of DSA as a reference, the diagnostic accuracy was 71.9% and 90.6% for CTP and CTP plus mp-CTA, respectively. Conclusions:The "one-stop" whole-brain CTP imaging with phase-specific settings of tube currents can provide reliable CTP and multiple-phase CTA images simultaneously, which could reasonably reduce the radiation dose. Combined use of multi-phase CTA and CT perfusion improves the diagnostic accuracy of collateral circulation in AIS patients.

A retrospective study of the correlation between the iliac cortical density line and pelvic tilt angle / 国际生物医学工程杂志

Objective:To investigate the correlation between the iliac cortical density line and pelvic tilt (PT) in X-ray films of patients with kyphosis.Methods:The imaging data of 67 patients with kyphosis treated in Tianjin Beichen Hopsital from August 2016 to December 2019 were analyzed retrospectively. PT and iliac tilt (IT) were measured on lateral X-ray of the spine. IT was defined as the angle between the density line of the iliac cortex and vertical direction. The correlation between PT and IT was analyzed, and a linear regression model was established.Results:PT and IT can be determined by X-ray lateral films of spine in 67 patients. Pearson correlation analysis results showed that PT was significantly correlated with IT( r=0.852, P<0.05). Subgroups analysis was conducted by gender. The linear regression formulas for females and males were PT=IT-12.9° and PT=IT-16.7°, respectively. Conclusions:When it is difficult to identify the femoral head on X-ray film, IT can be measured conveniently and directly through the density line of the iliac cortex, and then PT can be reliably evaluated through IT.

Application of regional arterial infusion chemotherapy in short-term neoadjuvant chemotherapy for advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of short-term neoadjuvant chemotherapy (NACT) in patients with advanced gastric cancer (AGC), and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.</p><p><b>METHODS</b>Clinical data of 310 AGC patients treated with one course of NACT using EOF regimen(epirubicin, oxaliplatin and fluorouracil plus calcium folinate) in our hospital from January 2008 to December 2011 were retrospectively analyzes. Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.</p><p><b>RESULTS</b>All the 310 AGC patients completed one course of NACT and none was interrupted by adverse events. Postoperative pathological remission rate was 33.9% (105/310) and 5 patients (1.6%) had complete pathological remission. The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group(42.4% vs. 23.6%, P = 0.001). Multivariate analysis revealed that chemotherapy method(HR=1.827, 95% CI:1.006-3.316, P = 0.048) was associated with significantly higher pathologic response.</p><p><b>CONCLUSIONS</b>Pathological response rate is quite low following short-term NACT. Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.</p>

Study on promotion of growth hormone for colorectal cancer cell proliferation / 肿瘤研究与临床

Objective To detect the expression of GHR in colorectal cancer cell lines and determine whether recombinant human growth hormone can promote the proliferation of colorectal cancer cells in vitro.Methods GHR distribution was assessed by flow cytometry and immunofluorescence method in 9 colorectal cancer cell lines.The effect of recombinant human growth factor on colorectal cancer cell line proliferation was assessed by MTT method.Results Different GHR expression was determinated in 9 colorectal caner cell lines.GHR was highly expressed in HCT-8 while GHR expression could hardly be detected in LoVo.r-hGH could promote GHR(+) HCT-8 cell proliferation at 50 ng/ml and 100 ng/ml (P ＜0.05).But this effect was not dose dependent.When the neutralizing antibody was used to block GHR activity,this r-hGH dependent proliferation effect was eliminated.r-hGH could not promote GHR (-) LoVo cell proliferation (P ＞0.05).Conclusion The results demonstrates that r-hGH could promote GHR (+) tumor cell proliferation and this effect is mediated by GHR.The use of r-hGH on the colorectal cancer patients should be cautious.

Tertiary peritonitis: clinical features ,diagnosis and treatment / 医学研究生学报

Tertiary peritonitis is manifested by immunodeficiency and serious diseases which is different with secondary and primary peritonitis. It is a complex nosocomial infection in surgical patients. The pathogenesis, clinical features, diagnosis and treatment of tertiary peritonitis is reviewed.

The relationship between angiogenesis,proliferation and lymph node metastasis in rectal cancer / 医学研究生学报

Objectives:To study the relationship between angiogenesis,proliferation and lymph node metastasis in rectal cancer. Methods: Forty six rectal cancer specimens were examined immunohistochemically. The intratumor microvessel density(MVD), vascular endothelial growth factor (VEGF)expression positive rate and Ki 67 label index(Ki 67 LI) were detected and their relationship with tumor invasion and lymph node metastasis were analyzed. Results: The MVD, VEGF expression positive rate and Ki 67 LI increased significantly( P

MONITORING ACUTE REJECTION OF PANCREAS ALLOGRAFT TRANSPLANT / 解放军医学杂志

To investigate the monitoring of acute rejection of porcine pancreaticoduodenal allografts, 12 pigs were subjected to pancreaticodudenal allografts, among them 6 pigs received triple therapy for 7 days. Serial biopsies were performed in pancreas allografts for diagnosis of pancreatic acute rejection. Amylase secretion was determined periodically.The levels of TNF ? and NO in serum were serially monitored.The results showed that amylase secretion decreased,TNF ? and NO concentration in serum increased significantly as acute rejection was detected histo pathologically in pancreatic grafts. It suggested that monitoring of amylase secretion, serum TNF ? and NO concentration could be used to decide the proper time of performing biopsy for early diagnosis of acute rejection of the pancreas allograft.

Changes of angiogenesis in rectal cancer patients after preoperative radiotherapy / 中国普通外科杂志

Objective To explore the effect of preoperative radiotherapy on angiogenesis of rectal cancer. Methods Twenty patients with advanced lower rectal carcinoma received preoperative radiation with a dosage of 30～40 Gy each time for a total of 15～20 sessions during a period of 3～4 weeks. The definitive surgery was performed 7～10 days after radiotherapy. Another 20 patients undergoing tumor resection without preoperative radiotherapy served as control. Tumor sample was sent for pathology. The expression of vascular endothelial growth factor (VEGF) and CD34 in the rectal cancer were detected immunohistochemically. The intratumoral microvessel density (MVD) was measured. Results Fifteen patients were found with grade Ⅱ and five patients with grade Ⅲ tissue response in radiotherapy group. The diameter of intratumoral microvessel was smaller in radiotherapy group than in control group( P

Effect of growth hormone on liver protein synthesis in patients with portal hypertension / 肠外与肠内营养

Objectives: To investigate the effect of growth hormone on liver protein synthesis in patients with portal hypertension following TIPS. Methods: Ten patients with liver cirrhosis and portal hypertension were injected with rhGH (8 U/day) for 7days after TIPS. The serum levels of Alb, PA and FN were detected before and days 3 and 7 after TIPS and use of rhGH. Plasma insulin like growth factor 1 (IGF 1) was also measured by immunoradiological method. Results: As compared with the day before TIPS and rhGH, the levels of IGF 1, Alb , PA and FN were significantly increased on the 7th day after TIPS and rhGH treatment( P

Nutritional support and metabolic intervention after combined liver and intestinal transplantation / 肠外与肠内营养

Objective: To observe the effect of nutritional support and metabolic intervention in a patient receiving combined liver and intestinal transplantation. Methods: Glycyl glutamine(Gly Gln)and arginine supplemented total parenteral nutrition(TPN) was administered since postoperative day(POD)1. Glutamine(Gln) and arginine supplemented enteral nutrition(EN) was applied since POD 4. Growth hormone(GH) was delivered intermittently since POD 4.With adaptation and tolerance, enteral feeding was progressively increased while parenteral nutrition reciprocally decreased. Results: Transplanted organs functioned well. Conclusions: Rehabilitation of the allograft function can profit from the application of nutritional support and metabolic intervention.

Bowel nutritional rehabilitation therapy for gut dysfunction after acute mesenteric artery ischemia / 肠外与肠内营养

Objective: To evaluate the effectiveness of bowel nutritional rehabilitation therapy in patients with gut dysfunction caused by acute mesenteric artery occlusion. Methods: Two patients with acute mesenteric artery occlusion received management of revascularization by operative and nonoperative approach. Viability dusky bowel was leaved in one patient. Second look laparotomy was performed to access the viability of the bowel in another patient. The patients remained gut dysfunction and received bowel nutritional rehabilitation therapy early after operation. Results: The gut function of the patients recovered and had normal diet after bowel nutritional rehabilitation therapy. Conclusions: The gut dysfunction caused by acute mesenteric artery occlusion should be treated with bowel nutritional rehabilitation early.