Analysis of 50 cases of bloodstream infection with Listeria monocytogenes / 中国热带医学

@#Abstract: Objective　To analyze the characteristics of bloodstream infection of Listeria monocytogenes and provide basis for the diagnosis and treatment of the disease. Methods　We retrospectively analyzed the cases of Listeria monomyrhosi bloodstream infection in Peking Union Medical College Hospital (PUMCH) from April 2012 to April 2022. The age, sex, onset time, underlying disease, symptoms, diagnosis, treatment and prognosis of the patients were analyzed, as well as the changes of white blood cells (WBC), neutrophils, lymphocytes, and C-reactive protein (CRP) before and after anti-infection treatment. Results　Fifty cases of Listeria monocytogenes bloodstream infection confirmed by blood culture were involved. The age of patients ranged from 0 to 82 (43.7±20.0) years old, among whom 20.0% were over 60 years old. The onset time of patients was the highest in spring (44.0%), followed by winter (24.0%), and relatively fewer in summer and autumn (14.0%-18.0%). The median diagnosis time was 3 days (1-60 days). After the etiological diagnosis, 45 patients (90.0%) had underlying diseases or pregnancy status, and 45 patients were adjusted to the target antibacterial treatment mainly with carbapenems (48.9%) and penicillins (44.4%). The level of WBC, neutrophils, lymphocytes, monocytes, and CRP after treatment were significantly lower than those pre-treatments (P<0.05). Among all patients, 36 cases (72.0%) were treated according to the Antimicrobial Treatment Guidelines for Fever Sanford, of which 26 cases (72.2%) were discharged from the hospital, two cases died, one case was transferred to other hospitals, and 7 cases had a poor prognosis. Conclusions　Autoimmune diseases, tumor diseases, pregnant patients are susceptible to Listeria monocytogenes infection. Penicillins are the first choice for effective empiric therapy. For the patients allergic to penicillins, trimethoprim/sulfamethoxazole or meropenem could be used.

Research on applying genetic and environmental risk score in risk-adapted colorectal cancer screening / 中华流行病学杂志

Objective: To evaluate the effectiveness of a risk-adapted colorectal cancer screening strategy constructed utilizing genetic and environmental risk score (ERS). Methods: A polygenic risk score (PRS) was constructed based on 20 previously published single nucleotide polymorphisms for colorectal cancer in East Asian populations, using 2 160 samples with MassARRAY test results from a multicenter randomized controlled trial of colorectal cancer screening in China. The ERS was calculated using the Asia-Pacific Colorectal Screening Score system. Logistic regression was used to analyze the association between PRS alone and PRS combined with ERS and colorectal neoplasms risk, respectively. We also designed a risk-adapted screening strategy based on PRS and ERS (high-risk participants undergo a single colonoscopy, low-risk participants undergo an annual fecal immunochemical test, and those with positive results undergo further diagnostic colonoscopy) and compared its effectiveness with the all-acceptance colonoscopy strategy. Results: The high PRS group had a 26% increased risk of colorectal neoplasms compared with the low PRS group (OR=1.26, 95%CI: 1.03-1.54, P=0.026). Participants with the highest PRS and ERS were 3.03 times more likely to develop advanced colorectal neoplasms than those with the lowest score (95%CI: 1.87-4.90, P<0.001). As the risk-adapted screening simulation reached the third round, the detection rate of the PRS combined with ERS strategy was not statistically different from the all-acceptance colonoscopy strategy (8.79% vs. 10.46%, P=0.075) and had a higher positive predictive value (14.11% vs. 10.46%, P<0.001) and lower number of colonoscopies per advanced neoplasms detected (7.1 vs. 9.6, P<0.001). Conclusion: The risk-adapted screening strategy combining PRS and ERS helps achieve population risk stratification and better effectiveness than the traditional colonoscopy-based screening strategy.

Research progress of microparticles in traditional Chinese medicine decoction / 药学学报

Decoction is a classical dosage form of traditional Chinese medicines. In the process of decocting, various complex components produce physical interactions and chemical reactions, among which physical interactions include van der Waals force, hydrogen bond, electrostatic interaction, π-π stacking, etc., and chemical reactions include Maillard reaction, oxidation reaction, hydrolysis reaction, degradation reaction, polymerization reaction, etc. New substances and original ingredients from chemical reactions can be further activated. These effects form the basis of particle formation in the broth. The sizes of the particles in decoctions range from nanoscale to micron scale, mostly composed of polysaccharide, protein matrix, wrapped in water insoluble molecules, can increase the dispersion of insoluble components and the stability of unstable components, as well as reduce the volatile components and toxic components of volatile components, and ultimately achieve the purpose of efficient absorption and toxicity reduction. From the angle of physical change and chemical reaction in the process of decoction, this paper expounds the formation mechanism of particles in decoction, expounds the research method of particles, analyzes the components in particles and the interaction between components, and then explains the pharmacodynamic characteristics of traditional Chinese medicine decoction, which provides the foundation for the modernization of Chinese decoction.

Study on Impedance of Implantable Cardiac Pacemaker in Unipolar/Bipolar Pacing Mode by in Vitro Experiment / 中国医疗器械杂志

The unipolar/bipolar pacing mode of pacemaker is related to its circuit impedance, which affects the battery life. In this study, the in vitro experiment scheme of pacemaker circuit impedance test was constructed. The human blood environment was simulated by NaCl solution, and the experimental environment temperature was controlled by water bath. The results of in vitro experiments showed that under the experimental conditions similar to clinical human parameters, the difference between the circuit impedance of bipolar mode and unipolar mode is 120~200 Ω. The results of the in vitro experiment confirmed that the circuit impedance of bipolar circuit was larger than that of unipolar mode, which was found in clinical practice. The results of this study have reference value to the optimization of pacing mode and the reduction of pacemaker power consumption.

Effects of Kinesio Taping on Lower Limb Function for Stroke Patients at Different Recovery Stages / 中国康复理论与实践

Objective:To observe the effect of Kinesio taping on lower limb motor function in patients with hemiplegia at different stages of stroke. Methods:From August, 2015 to August, 2017, 60 patients at stages of Brunnstrom III (n = 30) and Brunnstrom IV (n = 30) were randomly divided into control group (n = 15) and treatment group (n = 15). All the patients received comprehensive rehabilitation training, while the treatment group taped Kinesio taping in the lower extremities, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Time 'Up & Go' Test (TUGT) and gait analysis before and after treatment. Results:The results of all the measurements improved after treatment in all the groups (P < 0.001). For the patients at Brunnstrom IV, FMA-LE score and walking speed improved more in the treatment group than in the control group after treatment (P < 0.01); for those at Brunnstrom III, FMA-LE score, walking speed, TUGT time, hip extension angle and gait symmetry improved more in the treatment group than in the control group after treatment (P < 0.05). Conclusion:Kinesio taping is effective on the lower limb motor function for patients with hemiplegia after stroke, especially for patients at Brunnstrom III.

Impact of somatic mutations on clinical and pathologic outcomes in borderline resectable and locally advanced pancreatic cancer treated with neoadjuvant chemotherapy and stereotactic body radiotherapy followed by surgical resection

Purpose@#The purpose of this study was to determine if somatic mutations are associated with clinical and pathologic outcomes in patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) who were treated with neoadjuvant chemotherapy and stereotactic body radiotherapy (SBRT). @*Materials and Methods@#Patients treated with neoadjuvant chemotherapy and SBRT followed by surgical resection from August 2016 to January 2019 and who underwent next generation sequencing of their primary tumor were included in the study. Next-generation sequencing was performed either in-house with a Solid Tumor Panel or with FoundationOne CDx. Univariate (UVA) and multivariable analyses (MVA) were performed to determine associations between somatic mutations and pathologic and clinical outcomes. @*Results@#Thirty-five patients were included in the study. Chemotherapy consisted of modified FOLFIRINOX, gemcitabine and nab-paclitaxel, or gemcitabine and capecitabine. Patients were treated with SBRT in 33 Gy in 5 fractions. On UVA and MVA, tumors with KRAS G12V mutation demonstrated better pathologic tumor regression grade (TRG) to neoadjuvant therapy when compared to tumors with other KRAS mutations (odds ratio = 0.087; 95% confidence interval [CI], 0.009–0.860; p = 0.036). On UVA and MVA, mutations in NOTCH1/2 were associated with worse overall survival (hazard ratio [HR] = 4.15; 95% CI, 1.57–10.95; p = 0.004) and progression-free survival (HR = 3.61; 95% CI, 1.41–9.28; p = 0.008). On UVA, only mutations in NOTCH1/2 were associated with inferior distant metastasis-free survival (HR = 3.38; 95% CI, 1.25–9.16; p = 0.017). @*Conclusion@# In BRPC and LAPC, the KRAS G12V mutation was associated with better TRG following chemotherapy and SBRT. Additionally, NOTCH1/2 mutations were associated with worse overall survival, distant metastasis-free survival, and progression-free survival.

Co-transfection of hepatocyte growth factor and truncated TGF-ß type II receptor inhibit scar formation

Wound scarring remains a major challenge for plastic surgeons. Transforming growth factor (TGF)-β plays a key role in the process of scar formation. Previous studies have demonstrated that truncated TGF-β type II receptor (t-TGF-βRII) is unable to continue signal transduction but is still capable of binding to TGF-β, thereby blocking the TGF-β signaling pathway. Hepatocyte growth factor (HGF) is a multifunctional growth factor that promotes tissue regeneration and wound healing. Theoretically, the combination of HGF and t-TGF-βRII would be expected to exert a synergistic effect on promoting wound healing and reducing collagen formation. In the present study, lentivirus-mediated transfection of the two genes (t-TGF-βRII/HGF) into fibroblasts in vitro and in a rat model in vivo was used. The results demonstrated that the expression of t-TGF-βRII and HGF in NIH-3T3 cells was successfully induced. The expression of both molecules significantly reduced collagen I and III expression, and also inhibited fibroblast proliferation. Furthermore, histological examination and scar quantification revealed less scarring in the experimental wound in a rat model. Moreover, on macroscopic inspection, the experimental wound exhibited less visible scarring compared with the control. Therefore, the present study demonstrated that the combination gene therapy of t-TGF-βRII and HGF promoted wound healing, with less scarring and more epithelial tissue formation, not only by suppressing the overgrowth of collagen due to its antifibrotic effect, but also by promoting tissue regeneration.

Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years / 神经科学通报·英文版

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years / 神经科学通报·英文版

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

On the current situation of the knowledge-attitude-practice of clinical scientific research ability of pediatric residents in standardized residency training / 中华医学教育探索杂志

Objective:To understand the clinical research knowledge, attitude and practice of pediatrics residents in standardized residency training, and to provide scientific basis for improving their capability of clinical medical scientific research.Methods:A self-complied questionnaire survey including demographic information, knowledge and attitudes toward capability of medical scientific research as well as personal interview was conducted in 22 pediatric residents during the standardized residency training from April to July, 2017. Data were analyzed by (mean±standard deviation) and percentage for description, and qualitative data were analyzed by classification and induction. SPSS 18.0 was used to analyze the data.Results:Firstly, the total score of basic knowledge in clinical scientific research was (54.14±23.06), with the scores between 31 and 60 being the most. Secondly, all these residents believed that capability of clinical medical scientific research was very important for them and clinical research training was necessary for them during the standardized residency training. Thirdly, the residents had the scientific research practices but no article published during the standardized residency training. Fourthly, the residents hoped to improve their capability of clinical scientific research by various means during the training.Conclusion:It is indicated that basic knowledge on capability of clinical medical research is still insufficient in standardized residency training of pediatrics residents, so relevant measures should be taken to cultivate their capability of clinical scientific research.

Determination of 16 PAHs in workplace air by high performance liquid chromatography with ultraviolet/fluorescence detection / 中国职业医学

OBJECTIVE: To establish a method for simultaneous detection of 16 kinds of gas and particle-phase polycyclic aromatic hydrocarbons(PAHs) in workplace air by high performance liquid chromatography with ultraviolet and fluorescence detector(HPLC-UV-FLD).METHODS: PAHs in workplace air were collected by polytetrafluoroethlene filter with XAD-2 tube. The samples were added with 5 mL of acetonitrile. The samples were extracted by ultrasound and eluted with acetonitrile-water gradient. Ultraviolet with tandem fluorescence detector was used for determination.RESULTS: Eleven kinds of PAHs showed a good linear range of 1.0-400.0 μg/L. Five kinds of PAHs showed a good linear range of 10.0-2 000.0 μg/L and the linear correlation coefficient was greater than 0.999 0. The minimum detection concentration was 0.000 01-0.000 67 mg/m~3 (75 L air sample). The average elution efficiency of filter on granular PAHs except for naphthalene and acenaphthene ranged from 71.0% to 99.0%. The average desorption efficiencies of adsorbent tube was 43.0%-90.0%. The within-run relative standard deviations(RSD) was 0.3%-8.3%, and the between-run RSD was 0.0%-9.2%.CONCLUSION: This method is simple, sensitive, has good linear range and precise. It is suitable for simultaneous detection of PAHs in workplace air.

Detection of 2-methylpropanal,2-methyl butanal and 3-methyl butanal in workplace air by portable gas chromatography-mass spectrometry / 中国职业医学

OBJECTIVE: To establish a method for detection of 2-methylpropanal,2-methyl butanal and 3-methyl butanal in workplace air by portable gas chromatography-mass spectrometry( GC-MS). METHODS: The workplace air was collected by portable GC-MS sampling probe. After enrichment by Tri-bed tube,the thermal desorption sample was analyzed by retention time and characteristic ion characterization. The characteristic ion peak area was quantified. RESULTS: The linear ranges of 2-methylpropanal,2-methyl butanal and 3-methyl butanal were 0. 079-15. 880,0. 080-16. 080 and 0. 161-32. 120 mg/m~3,respectively. All the correlation coefficients were greater than 0. 999. The detection limits were 0. 012,0. 007 and0. 013 mg/m~3,and the quantitation limits were 0. 041,0. 023 and 0. 044 mg/m~3,respectively. The recovery rates of2-methylpropanal,2-methyl butanal and 3-methyl butanal were 92. 2%-104. 4%. The within-run relative standard deviation( RSD) was 5. 8%-9. 1%. The between-run RSD of different batches samples was 9. 3%-19. 6%. CONCLUSION: This method has high accuracy and is precise,which is suitable for rapid qualitative and quantitative detection of2-methylpropanal,2-methyl butanal and 3-methyl butanal in workplace air.

Factors influencing demand for emergency education for college students in Liaoning Province / 中国学校卫生

Objective@#To understand demand for emergency education among college students and to analyze the influencing factors, to provide the evidence for college to make prevention and controlling measures.@*Methods@#A survey was conducted among college students who were selected by stratified random sampling from 4 colleges in Liaoning Province, and data were analyzed using general descriptive analysis, chi-square test and multivariate Logistic regression analysis.@*Results@#There were 90.7% of college students who had urgent needs for emergency education. Students who were female(93.9%), seniors(94.4%), learning in medical colleges(97.6%), having mothers with higher education levels(92.6%), and living in urban areas(94.4%) had higher educational needs. Multivariate analysis showed that gender (OR=5.00), school category (OR=3.87), emergency attitude (OR=8.02), active learning behavior (OR=3.91), emergency knowledge self-assessment (OR=6.64) were influencing factors(P<0.05).@*Conclusion@#The emergency knowledge and preparation of college students were insufficient and emergency education was needed. The government and schools should strengthen their attention and input, develop more effective ways to disseminate emergency knowledge among students so as to improve their response ability.

Research progress in mechanisms underlying autism spectrum disorders / 中国实用儿科杂志

The autism spectrum disorders(ASDs)are a complex group of neuropsychiatric conditions defined by impairment in three core behavioral domains:social interaction,verbal and non-verbal communication,and restricted interests/repetitive behaviors. Extensive genetic studies have led to the identification of many autism susceptibility genes,and increased understanding on the contribution of de novo and inherited copy number variation. Here,we seek to place recent genetic findings within a developmental and brain circuit context,and approach the basic understanding of autism neuropathology from multiple genetic,molecular,cellular and neural circuit domains. The authors reviewed literatures that interrogates brain mechanisms of ASDs utilizing animal models,primarily in mice. Understanding genetic data within a brain development context will shed light on how individual risk genes operate to determine patient symptomatology,which will inform circuit specific behavioral interventions leading to better intervention and disease outcomes.

Protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice / 中国药科大学学报

@#This study aimed to investigate the protective effects of Baibu Tang on bleomycin-induced pulmonary fibrosis in mice. After intratracheally giving bleomycin(3. 5 mg/kg), mice were orally administered Baibu Tang once a day for 14 consecutive days, takingnintedanib as a positive control. The anti-fibrotic effects were assessed by the hydroxyproline level and the histopathological changes in H&E or Masson stained lung tissues. The results revealed that the lung coefficient, hydroxyproline content, inflammation and collagen deposition were increased significantly in the lung tissue of the model mice. Both ethanol and water extracts of Baibu Tang significantly improved all the pathological indexes in mice, but the effect of the ethanol extract was better than that of the water extract. Baibu Tang with Baibu(root of Stemona tuberosa)containing different components(neotuberostemonine, tuberostemonine and stemoninine, respectively)could significantly reduce hydroxyproline level and collagen deposition in the lung tissue of bleomycin-induced mice, and there was no significant difference in their activity. This result showed that the changes in the chemical composition of Stemona tuberosa(Baibu, monarch drug for Baibu Tang)have little effect on the anti-fibrosis activity of Baibu Tang, and its mechanism and material basis need further investigation.

Relationship between Iron Metabolism and Platelet Parameters in Patients with Iron Deficiency Anemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the relationship between iron metabolism and thrombocytosis.@*METHODS@#iron metabolism indexes , erythrocyte and platelet parameters of iron deficiency anemia patients with thrombocytosis were collected, the correlation of platelet parameters with iron metabolism indexes and erythrocyte parameters was analysed; the difference in erythrocyte，platelet and iron parameters between severe anemia group (hemoglobin<60 g / L) and mild and moderate anemia group (hemoglobin≥60 g / L) were compared; the changes of platelet count before and after treatment were observed.@*RESULTS@#There was a significant negative correlation between serum iron and platelet count (r=-0.404,P<0.01).Serum iron negatively correlated with platelet crit(r=-0.288,P<0.05). Transferrin saturation negatively correlated with platelet count and platelet crit(r=-0.353,P<0.01;r=-0.271, P<0.05).Serum ferritin and total iron binding capacity revealed no significant relation with any platelet parameters.Hemoglobin level , hematocrit and mean corpuscular hemoglobin concentration negatively correlated with platelet count(r=-0.239,P<0.05;r=-0.250,P<0.05;r=-0.339,P<0.01).There were differences in iron metabolism indexes and platelet parameters between mild to moderate anemia group and severe anemia group. After treatment, the platelet count decreased or was normal.@*CONCLUSION@#The important iron metabolism indexes affecting platelet count are serum iron and transferrin saturation,that is,the severer iron deficiency, the higher platelet count.Patients with more severe and hypochronic anemia has higher platelet count.

Hp infection and expression of TGF-βR II,IL-6 and TNF-α in patients with chronic atrophic gastritis / 中国免疫学杂志

Objective:To investigate the effect of Helicobacter pylori(Hp) infection in patients with chronic atrophic gastritis (CAG) and the expression of transforming growth factor-β receptorⅡ,interleukin 6 and tumor necrosis factor-α in gastric mucosa.Methods:76 cases of gastroscope biopsy specimens were collected in the CAG patients,the infection of Hp was detected by PCR fluorescence,and immunohistochemical staining was used to determine the expression of TGF-βRⅡ,IL-6 and TNF-α in gastric foveolar epithelium and stromal inflammatory cells.Results:There were significant differences in chronic inflammation between Hp-positive and Hp-negative group (P<0.05).Expression of IL-6 in stromal inflammatory cells was significantly different between Hp-positive and Hp-negative group (P<0.05).Expression of TGF-βRⅡ and TNF-α was not significantly different in two groups(P>0.05).IL-6 expressed instromal inflammatory cells were correlated with chronic inflammation (r=0.249,P=0.03).The degree of intestinal metaplasia and dysplasia were correlated with the atrophic severity respectively(r=0.697,0.366).Conclusion:IL-6 is related to the chronic inflammation in patients with CAG who has Hp infection.The chronic atroplic severity promotes the development of intestinal metaplasia and dysplasia.

Choke vessel growth in perforator flaps and the conception of angiosome / 中国组织工程研究

BACKGROUND: Perforator flaps are used to repair skin and soft tissue defects. As a bridge between adjacent perforator vessels, choke vessels play an important role in the survival of extended perforator flap. OBJECTIVE: To review the research status and progress of the growth of choke vessels in perforator flaps. METHODS: A computer-based search of PubMed, CNKI and SinoMed databases was performed for the relevant literature concerning the research status and progress of the growth of choke vessels in perforator flaps published from 1984 to 2017. The keywords were "perforator flap, perforator vessels, choke vessels, choke zone" in English and Chinese, respectively.RESULTS AND CONCLUSION: Totally 51 articles were included for summary. Perforator flaps are extensively used to repair skin and soft tissue defects caused by various factors. Adjacent perforter vessels are connected by choke vessels, and the extended perforter flap survival is closely related to the dilatation and growth of choke vessels. Similarity may exist between the growth of choke vessel and angiogenesis. Hypoxia and ischemic preconditioning and inflammatory environment may promote the growth of choke vessels.

Assessment of liver function using T1 mapping on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI / 中华放射学杂志

Objective To investigate the effectiveness of T1 mapping on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA-enhanced) MRI for the assessment of liver function.Methods One hundred and twenty six patients with clinically suspected focal liver lesions and chronic viral hepatitis B underwent MRI were prospectively enrolled.Patients were divided into four subgroups as follows: chronic viral hepatitis B (n=22), liver cirrhosis with Child-Pugh A (n=52), Child-Pugh B(n=41),Child-Pugh C(n=11).Twenty three healthy volunteers with normal liver function were enrolled as control group.Non-enhanced and Gd-EOB-DTPA enhanced MRI of liver were performed in all subjects.Look-Locker sequences with exactly the same scan parameters and geometry position(the level of porta hepatis) were performed pre and post-contrast separately at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA administration.T1 relaxation times and reduction rates of T1 relaxation times[ΔT1(%)]of the liver parenchyma were measured and calculated.One-way ANOVA was used to compare T1 relaxation times and ΔT1(%) for control group, chronic viral hepatitis B group, liver cirrhosis with Child-Pugh A group, Child-Pugh B group,and Child-Pugh C group.ROC curve analysis was performed to compare the diagnostic performance of T1 relaxation times and ΔT1(%) values in discriminating control group + chronic viral hepatitis B group + liver cirrhosis with Child-Pugh A group from Child-Pugh B + C group. Results T1 relaxation times and ΔT1(%)showed significant difference(P<0.05)among control group and different liver function groups. T1 relaxation times and ΔT1(%) of both liver cirrhosis with Child-Pugh B group and Child-Pugh C group were significantly different(P<0.05)in comparison with those of control group,chronic viral hepatitis B group and liver cirrhosis with Child-Pugh A group at all time points.T1 relaxation times of the control group,chronic viral hepatitis B group,liver cirrhosis with Child-Pugh A group and Child-Pugh B group reduced with the scanning time increase,ΔT1(%)raised with the scanning time increase.T1 relaxation times progressively increased from control group to Child-Pugh C group at every time point.ΔT1(%)showed a constant decrease from control group to Child-Pugh C group at all time points.The areas under ROC curve of T1 relaxation time pre and post-contrast at 5,10,15 and 20 minutes for assessment of liver function were 0.817,0.952,0.950,0.946,and 0.949 respectively.The areas under ROC curve of ΔT1(%)post-contrast at 5, 10, 15 and 20 minutes for evaluation of liver function were 0.873, 0.876, 0.885, and 0.898, respectively. Conclusion Gd-EOB-DTPA-enhanced T1 mapping MRI is useful for the evaluation of liver function, and helpful for distinguishing patients with moderate and severe liver damage from normal and mild liver damage.

Effect of acupuncture at complementary acupionts on mast cells and histamine/bradykinin released by mast cells in the regions of acupionts / 针灸推拿医学（英文版）

Objective: To observe the changes in numbers and degranulation status of local mast cells (MCs) of the complementary acupionts, as well as the concentrations of serum histamine and bradykinin after acupuncture at rat's complementary acupionts of Yanglingquan (GB 34) and Yinlingquan (SP 10), for exploring the mechanisms of the synergistic effect of complementary acupionts. Methods: Using random number table method, 40 Wistar rats were randomly divided into a blank control group (group K), an acupuncture at Yanglingquan (GB 34) group (group A), an acupuncture at Yinlingquan (SP 9) group (group B), an acupuncture at Yanglingquan (GB 34) and Yinlingquan (SP 9) group (group AB), and an acupuncture at points near Yanglingquan (GB 34) and Yinlingquan (SP 9) group (group CD), 8 rats in each group. Group A received acupuncture at Yanglingquan (GB 34); group B received acupuncture at Yinlingquan (SP 9); group AB received acupuncture at Yanglingquan (GB 34) and Yinlingquan (SP 9); group CD received acupuncture at the control points [points 3 mm away from Yanglingquan (GB 34) and Yinlingquan (SP 9) respectively]. Acupuncture was performed at bilateral points in each group. Rats in group K were fixed using the same method as rats in the other 4 groups without acupuncture stimulation. Needles of 0.35 mm in diameter and 40 mm in length were used for acupuncture. Needle handle was connected to the G6805-Ⅱ mode electroacupuncture (EA) device after needling qi was obtained, with sparse-dense wave, frequency of 2 Hz/100 Hz and current of 1 mA to keep the needle handles slightly tremulous while the rats kept quiet. Rats were continuously stimulated by EA for 20 min each time. Experimental interventions were conducted on the 1st, 3rd, 5th and 7th days when the experiment started, for 4 times in total. Specimens from rats in each group were collected 2 h after the 7th day. The levels of histamine and bradykinin in serum were detected by enzyme-linked immunosorbent assay (ELISA). Local tissues of the points were used to prepare cryosections. The changes of MCs were observed after toluidine blue staining. Results: Compared with group K, the numbers and degranulation rates of MCs in group A, group B, group AB and group CD were significantly increased (all P<0.05). The number and degranulation rate of MCs in group AB were significantly higher than those in group A, group B and group CD (all P<0.05). The order of histamine levels from high to low was: group AB >group B > group A > group CD > group K, and the differences were statistically significant (all P<0.05); the levels of bradykinin in group AB, group A and group B were significantly higher than those in group K and group CD (all P<0.05). There was no significant difference in the bradykinin level between group A and group B, nor between group CD and group K (all P>0.05). Conclusion: The number and degranulation rate of MCs of the complementary acupionts are significantly increased after acupuncture at complementary acupionts of Yanglingquan (GB 34) and Yinlingquan (SP 9) of rats, and the serum levels of histamine and bradykinin are increased, which may be one of the mechanisms of the synergism produced by the combination of complementary acupionts.