Prediction of Pulmonary Disease Progression in Patients with COVID-19 Based on CT Radiomics / 中山大学学报(医学科学版)

ObjectivesBased on the changes of lung lesions in patients with COVID-19 at different stages， a nomogram model describing CT image features was established by radiomics method to explore its efficacy in predicting the progression of the disease. MethodsThis retrospective study enrolled 136 patients with COVID-19 pneumonia who received at least two CTs including three cohorts （training cohort and validation cohort 1 and 2）. Patients in the training cohort were divided into three groups according to time between onset of fever symptoms and the first CT. The clinical manifestations and CT features of each group were analyzed and compared. A nomogram to predict disease progression was constructed according to the CT features of the patients， and its performance was evaluated. ResultsThe training cohort consisted of 41 patients.A nomogram was generated to predict disease progression based on three CT features： irregular strip shadow， air bronchial sign， and the proportion of lesions with irregular shape ≥50%. AUC（95%CI）=0.906（0.817，0.995）.The C index of the training cohort was 0.906， and the C index of the internal verification was 0.892. AUC（95%CI）of the validation cohort 1 （34 cases） =0.889（0.793，0.984）；AUC（95%CI）of the validation cohort 2 （61 cases）=0.876（0.706，1.000）.The calibration curves show that the predicted values of the nomogram are in good agreement with the observed values. ConclusionThe nomogram model based on CT radiomics can predict the outcome of lung lesions in patients with high sensitivity and specificity.According to the changes of CT image characteristics of patients with COVID-19， lung lesions will be improved when the proportion of irregular cable shadow， air bronchogram and irregular lesions is greater than 50%.

Treatment of floating knee injury in children with elastic intramedullary nail / 中国骨伤

OBJECTIVE@#To observe the clinical effect of elastic intramedullary nail in minimally invasive treatment of floating knee injury in children.@*METHODS@#From January 2009 to September 2017, 11 children with floating knee injury were treated with one-off open reduction and elastic intramedullary nail or external fixator fixation, including 7 males and 4 females, aged 5.0 to 11.0 years, with an average age of 8.3 years. The treatment results were evaluated according to karlstrom's standard.@*RESULTS@#Eleven patients were followed up for 8 to 48 months, with an average of 28 months. All the fractures healed at one time, and there were no complications such as nonunion, malunion and serious dysfunction of knee joint. The length of the affected limb in 2 cases was 1.2 to 1.5 cm longer than that in the opposite side without shortening. According to Karlstrom scoring standard, 8 cases were excellent, 1 case was good and 2 cases were middle.@*CONCLUSION@#Elastic intramedullary nail minimally invasive treatment of floating knee injury in children is a safe and effective treatment, which can effectively reduce the fracture and promote bone healing, which is conducive to early functional recovery.

Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures / 中国骨伤

OBJECTIVE@#To explore clinical effects of ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures.@*METHODS@#From January 2015 to March 2017, 20 patients with acute closed Achilles tendon rupture were treated by minimal traverse-cross technique repair with ultrasound guided. Among them, including 13 males and 7 females, aged from 28 to 49 years old with an average of(31.3 ±4.5) years old. All patients were single side injury. Fifteen patients on the left side and 5 patients were on the right side. The time from injury to operation ranged from 1 to 5 days with an average of (2.5±0.7) days. Operative time, postoperative complications were observed, and AOFAS score before and after operation at 12 months were compared.@*RESULTS@#All patients were followed up for 12 to 27 months with an average of(15.2±4.9) months. Operative time ranged from 33 to 65 min with an average of(43.7±5.6) min. Incision of one patient were continued oozing and improved after changing dressings, other patients were healed at stage I. No sural nerve irritation symptoms and palindromic rapture of heel tendon occurred. AOFAS score was improved from 65.2±7.4 before operation to 97.7±4.7 after operation at 12 months (t=22.5, <0.01); 18 patients got excellent results and 2 good.@*CONCLUSIONS@#Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures, which promise minimal incision, protect sural nerve, ensure quality of tendon anastomosis and fixation, and is a ideal method for repairing acute closed Achilles tendon ruptures.

Endoscopic Approach to Remove Intra-extracranial Tumors in Various Skull Base Regions: 10-year Experience of a Single Center / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base. Herein, we described a pure endoscopic transnasal or transoral approach (ETA) for the removal of intra-extracranial tumors in various skull base regions.</p><p><b>METHODS</b>Retrospectively, clinical data, major surgical complications, pre- and postoperative images, and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.</p><p><b>RESULTS</b>Gross total tumor removal was achieved in 80/85 cases (94.1%) in this study. All 37 cases with tumors in anterior skull base and all 14 cases with tumors in jugular foramen received total tumor removal. Thirteen and three cases with tumors in clivus received total and subtotal tumor removal, respectively. Total and subtotal tumor removal was performed for 16 cases and 2 cases in lateral skull base, respectively. The complications in this study included: cerebrospinal fluid leakage (n = 3), meningitis (n = 3), and new cranial nerve deficits (n = 3; recovered in 3 months after surgery). In the follow-up period of 40-151 months (median: 77 months), seven patients (8.8%) out of the 80 cases of total tumor removal experienced recurrence.</p><p><b>CONCLUSIONS</b>Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases. Surgical procedure for radical removal of tumors is feasible and safe.</p>

Affected Factors of Separating Erythrocytes by Discontinuous of Density Gradient Centrifugation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the affected factors of the separation of red blood cells by discontinuous density gradient method, and to establish the optimal operating conditions of percoll for the separation of erythrocytes.</p><p><b>METHODS</b>The osmolality of different ratio of Percoll and 1.5 mol/L NaCl were 9:1, 10:1, 11:1, 12:1, 13:1 ratio, was detected respectively. The isotonic osmolality ratio was selected as optimum stock isotonic Percoll solution(SIP). Evaluation criteria: All the different density cells were separated sufficiently by centrifugation, there is little red cell retention and entrainment phenomena. The separation efficacy of different red cell suspension concentration, different centrifugal force, different centrifugal speed, different temperature and different time were compared.</p><p><b>RESULTS</b>The separation efficacy of red cell suspension concentration which not exceed 50% was better than above 50%, efficacy of 4 000×g was superior to 3 000×g and 2 000×g, 2-8 centrifugal acceleration and deceleration centrifugal could obtain the satisfactory efficacy, the 4 °C layered effect was more stable than room temperature, the separation effect of 20 min was better than 15 min and 10 min.</p><p><b>CONCLUSION</b>Percoll and 1.5 mol/L NaCl 12:1 to 11:1 can be used as stock isotonic percoll solution, preferentially selected 4 °C as centrifugal conditions. When conditions of separation was satisfied, the centrifugal acceleration and deceleration is 2-8, the optimal centrifugal effect can be obtained with the decrease of erythrocyte suspension concentration, with centrifugation time prolonging and centrifugal force increasing.</p>

Effect of pterygium excision combined with limbal stem cell on visual acuity and refractive status / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract? AlM: To study the effect of pterygium excision combined with limbal stem cell on visual acuity and refractive status.?METHODS:A total of 120 cases ( 178 eyes ) pterygium cases were enrolled in our hospital from March 2012 to May 2014 and divided into observation group ( 60 cases, 90 eyes) and control group (60 cases, 88 eyes) according to different treatment methods. Patients in observation group received pterygium excision combined with limbal stem cell transplantation, those in control group received pterygium excision. Vision levels, astigmatism degrees were compared. The effects of age, working environment and medial rectus muscle insertion distance from corneal limbus on postoperative visual acuity were analyzed.? RESULTS: Before operation, acuity levels and astigmatism degrees of two groups had no difference ( P>0. 05 ); 1, 2 , 3, 4wk after operation, visual acuity in observation group were higher than that in control group (0.49±0.09 vs 0.34±0.07, 0.76±0.11 vs 0.42±0.04, 0.95± 0. 14 vs 0. 59±0. 08, 1. 09±0. 18 vs 0. 74±0. 10), astigmatism degrees were lower than that in control group (0. 96±0. 12 vs 1. 85±0. 28, 0. 68±0. 08 vs 1. 51±0. 23, 0. 54±0. 08 vs 1. 23± 0.19,0.42±0.07 vs 0.91±0.14); visual acuity of patients older than 45 years old, indoor work, medial rectus muscle insertion distance from corneal limbus 3-5 mm were higher, astigmatism degrees were lower.?CONCLUSlON:Pterygium excision combined with limbal stem cell transplantation is helpful to improve visual acuity and astigmatism degree; recovery of visual acuity is affected by age, working environment and medial rectus muscle insertion distance from corneal limbus.

Research achievements on biological activities of calycosin / 中国中药杂志

Calycosin, which is a kind of typical phytoestrogen, can bind with estrogen receptor and produce estrogen-like effects. Calycosin were reported to have antioxidant, anti-osteoporosis, anti-tumor and immunomodulating activities. This review covers biological activities and its mechanism of calycosin. It will provide a useful reference for clinical research and rational utilization of monomericompound.

Mini-open repair for the treatment of acute closed achilles tendon ruptures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures.</p><p><b>METHODS</b>From April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out.</p><p><b>RESULTS</b>The wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100).</p><p><b>CONCLUSION</b>The surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.</p>

The lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contraction of popliteal fossa / 中国骨伤

<p><b>OBJECTIVE</b>To discuss clinical results of the lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contracture of popliteal fossa.</p><p><b>METHODS</b>Form January 1999 to December 2011, 11 patients with scar contraction of popliteal fossa were treated with the lateral superior genicular artery perforator iliotibial band flap. Among the patients, 7 patients were male and 4 patients were female,ranging in age from 24 to 58 years old,with an average of 33 years old. The operation time ranged from 3 months to 1 year after trauma. Eight patients had injuries in the right side and 3 patients had the injuries in the left. Five patients had the injuries caused by traffic,3 patients had the injuries caused by hot compression and other 3 patients suffered from burns. The flap area ranged from 7.0 cm x 4.0 cm to 20.0 cm x 8.0 cm.</p><p><b>RESULTS</b>All the flaps survived. Three patients had epidermis necrosis. After 5 months to 2 years follow-up period,the knee function recovered,the flap shape was favorable and the skin firmness was moderated.</p><p><b>CONCLUSION</b>The lateral superior genicular artery perforator iliotibial band flap is a practical, simple and an ideal donor in the reconstruction of popliteal fossa scar contracture.</p>

Clinical applications of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation.</p><p><b>METHODS</b>From June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method.</p><p><b>RESULTS</b>According to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared.</p><p><b>CONCLUSION</b>The sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.</p>

An analysis of surgical outcome and influencing factors in patients of congenital basilar invagination with atlantal-axial dislocation: report of 120 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical outcome and its influencing factors in patients of congenital basilar invagination (BI) with atlanto-axial dislocation (AAD).</p><p><b>METHODS</b>From May 2004 to August 2010, 120 patients who had BI with AAD were surgically treated with direct posterior intraoperative distraction-reduction and fixation technique, 93 patients were successfully followed up by means of questionnaire survey, telephone and clinical evaluation. Pre- and postoperative dynamic cervical X-rays, computed tomographic scans, 3-dimentional reconstruction views and magnetic resonance imaging were performed. Pre- and postoperative Japanese Orthopaedic Association (JOA) score, distance between odontoid tip and Chamberlain's line and atlantodental interval were measured to evaluate the surgical result. Statistical analysis was performed by means of paired t test and Pearson Correlation analysis.</p><p><b>RESULTS</b>There were 93 cases were followed up for 24-99 months with an average of 46.5 months. Until the final follow-up, clinical symptoms were improved in 79 patients (84.9%), and were stable in 7 patients (7.5%) and deteriorated in 4 patients (4.3%). Three patients died postoperatively (3.2%). Patients without intramedullary signal intensity change (ISIC) had better surgical outcome. Patients with compression from anterior odontoid tip and posterior bone margin of occipital foramen had the worst surgical outcome (F = 3.987, P < 0.01). Overall, good decompression and bone fusion were shown on postoperative image in 87 patients (93.5%). There were 3 deaths in this series because of basilar artery thrombosis, posterior fossa hematoma and unknown reasons each.</p><p><b>CONCLUSIONS</b>The direct posterior intraoperative distraction-reduction and fixation technique is an effective simple and safe method for the treatment of BI with AAD. Anterior compression from odontoid tip and posterior compression from bone margin of occipital foramen-atlantal posterior arch play important roles in its developing mechanism. ISIC on MRI is a predictive factor for the worse surgical outcome.</p>

Early experience of resection of meningiomas in anterior skull base with intra-extracranial extension via a pure endoscopic endonasal approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The early experience of treating anterior skull base meningiomas with intra-extracranial extension via pure endoscopic endonasal approach (EEA) was presented, the safety, feasibility and preliminary treatment outcomes were investigated.</p><p><b>METHODS</b>Eight patients with intra-extradural meningiomas who were admitted from October 2006 to October 2010 were operated on via EEA in one stage in Xuanwu hospital. In this study, the operative technique was described, the degree of resection, complications and the early clinical outcomes were discussed.</p><p><b>RESULTS</b>The complete resection of meningiomas with intra-extracranial extension was achieved in all patients using EEA in one stage. Preoperative visual symptoms were improved or resolved in all cases who presented with preoperative visual complaints. No patient in our series experienced a new neurological deficit after surgery or recurrence and death related meningiomas in the follow-up period (33-75 months). One patient experienced postoperative cerebrospinal fluid leak, delayed meningitis and secondary hydrocephalus which responded to therapy. After treatment, the patient was cure.</p><p><b>CONCLUSION</b>Our limited experience indicates that EEA is feasible and safe for the complete resection of anterior skull base meningiomas with intra- and extracranial extension in one stage in selected cases.</p>

Surgery for jugular foramen schwannomas via a pure endoscopic transoral approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To report a new approach, endoscopic transoral approach for the resection of jugular foramen schwannoma.</p><p><b>METHODS</b>Nine patients with jugular foramen schwannoma (three males and six females, ranging in age from 15 to 61 years old) were treated by direct surgery via a pure endoscopic transoral approach to the jugular foramen. Eight patients complained of hypoglossal nerve palsy with hemiatrophy of the tongue; six cases complained of vagus nerve palsy. Three cases complained of glossopharyngeal nerve palsy, one case complained of facial nerve palsy and hearing loss.</p><p><b>RESULTS</b>The nerves in this area were preserved and radical intracapsular removal of the tumor was performed via endoscopic transoral approach in the nine cases. Tumor removal, as assessed by intraoperative endoscopic inspection, postoperative magnetic resonance imaging and clinical evaluation, revealed all tumors were completely removed. One patient suffered from temporary swallowing difficulties and temporary right vagus palsy 1 day after surgery. There were no others intraoperative and postoperative complications. All patients were followed up for 4 - 29 months, no recurrences were occurred in all these patients and the muscle bulk, motor and the pre-postoperative swallowing function, the vagus palsy, the facial nerve palsy and hearing loss had improved in these patients.</p><p><b>CONCLUSION</b>The endoscopic transoral approach and intracapsular removal of the tumor provided for successful minimally invasive surgery in the jugular foramen schwannomas.</p>

The analysis of urinary N-methylacetamide by GC-NPD with a direct injection / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method to detect N-methylacetamide (NMAC) concentration in urine of workers occupationally exposed to NMAC with directly injecting the sample into capillary gas chromatography.</p><p><b>METHODS</b>After frozen urine samples were isolated from precipitation by centrifugation, the aliquot of supernatant was pretreated by protein precipitation with dilution of methanol. The methanol supernatant was separated by Polyethylene Glycol (PEG) capillary columns and detected by nitrogen phosphorous detector (NPD).</p><p><b>RESULTS</b>Good linearity was obtained in the concentration range of 1.0 ∼ 250 mg/L. The correlation coefficient was 1.0000. The minimum detection limit of NMAC in urine was 0.2 mg/L. The method recovery rates were 96.0% ∼ 99.4% at three different concentrations. The mean recovery rate was 97.8%. The relative standard deviations (RSD) of intra- and inter-day were between 1.5% ∼ 3.4%.</p><p><b>CONCLUSION</b>The method was simple, rapid, selective and sensitive and was applicable to detect the urinary NMAC concentration for monitoring occupational exposure levels.</p>

Biological limit value for occupational exposure to N, N-dimethylacetamide / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish Biological Limit Value (BLV) for N, N-dimethylacetamide (DMAC).</p><p><b>METHOD</b>201 workers in 3 spandex factories exposed to DMAC were recruited. Air samples were collected using personal air samplers, and urine samples from each works were collected at the end of shift at end of workweek. The urinary metabolite NMAC and air samples of DMAC were determined by gas chromatography (GC). Percentile and relative internal exposure (RIE) were analyzed and proposed a BLV for DMAC.</p><p><b>RESULTS</b>The number of workers who exposure to DMAC below OELs were 133 (66.2%) among 201 workers monitored. Geometric mean (range) concentration of DMAC in air was 19.4 (0.40 ∼ 300.12) mg/m(3), and that of NMAC in urine was 23.7 (1.30 ∼ 189.42) mg/g Cr. A linear correlation was found between the personal air DMAC and creatinine-adjusted NMAC levels in urine collected at the end of shift at end of workweek (F = 188.872, R(2) = 0.487,P < 0.001). The relationship can be described by the equation Log (NMAC mg/g Cr) = 0.685 + 0.455 log (DMAC mg/m(3)). According to the equation the current China OELs value of 20 mg/m(3) would lead to a mean NMAC concentration of 18.92 mg/g Cr. The 90th percentile biomonitoring result below 20 mg/m(3) 8-hour TWA is 23.9 mg MMAC mg/g Cr, and that of NMAC in urine calculated by relative internal exposure (RIE) was 19.0 mg/g Cr.</p><p><b>CONCLUSION</b>A BLV of 20 mg/g Cr NMAC in urine at the end of shift at end of workweek for DMAC was recommend by reference to official values from other countries.</p>

Treatment of atlantoaxial instability with C1-C2 posterior transarticular screw fixation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the technique of C1-C2 transarticular screw fixation for atlantoaxial instability or dislocation.</p><p><b>METHODS</b>Among 14 patients with atlantoaxial instability, 10 were male and 4 patients were female, with an average age of 38.6 years ranging from 17 to 62 years. All patients were treated by internal fixation with transarticular screws.</p><p><b>RESULTS</b>There were 28 screws applied in 14 patients. All patients were followed up. The average follow-up period was 16 months (range, 9 to 35 months). The postoperative JOA score was ranging from 13.8 to 15.8 with the average score of (14.50 +/- 0.66) and the improved rate of (76.12 +/- 4.94)%. No spinal injury and vertical artery injury was found and osseous fusion was completed in all patients.</p><p><b>CONCLUSION</b>The technique of C1-C2 transarticular screw fixation is one of the best treatments for atlantoaxial instability. Without the help of structural bone graft and aided internal fixation, morselized cancellous bone graft can acquire effective osseous fusion.</p>

Slide platelet aggregation test used as a monitor for patient treated with anti-pletelet drugs / 中国实验血液学杂志

The aim was to verify the effectiveness of slide platelet aggregation test (SPAT) to monitor the inhibition effect of anti-platelet drugs. A group of eight healthy volunteers was examined for SPAT value and T(50) (time necessary for reaching 50% of total aggregation) induced by ADP, arachidonic acid (AA) and cationic propyl gallate (c-PG) respectively before and after administration of ASA in dose of 100 mg/day for 3 days. The group of 41 inpatients at the Department of Cardiovascular Disease treated with anti-platelet drugs and the group of 327 healthy blood donors were also examined for SPAT. The SPAT value of healthy volunteer samples stored at room temperature were measured hourly for four hours. The results showed that: (1) no significant difference was detected between the T(50) before and after ASA administration in health volunteer group when ADP was used as inducer, but a significant difference was detected in this group when AA or c-PG was used as inducer. There was significant linear correlation between SPAT value and T(50) induced by c-PG in health volunteer group before and after administration of ASA (r = 0.998, P = 0.000); (2) there was no significant difference between the SPAT value of health volunteer group before administration of ASA and the SPAT value of health blood donors group (P = 0.853), but there was a significant difference between the SPAT values before and after administration of ASA in health volunteer group (P = 0.000). There was significant difference when the SPAT value of the inpatients treated with anti-platelet drugs was compared with that of healthy blood donor group and with that of health volunteer group before and after administration of ASA (P = 0.000). The cut-off value of SPAT in health blood donor group was 44.6 +/- 11.7 seconds, reference value was from 21.1 seconds to 68.0 seconds; (3) there was no significant difference between SPAT values when platelets samples stored at room temperature for 1, 2, 3, 4 hours (P = 0.815). In conclusion, SPAT can rapidly monitor the inhibition effect of anti-platelet drugs and SPAT may have the similar clinic value with T(50) induced by c-PG.

Relationship between the increase of hepatic D-bifunctional protein activity and bile acid biosynthesis in rats / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine the physiological role of D-bifunctional protein (DBP) in bile acid biosynthesis through investigating the effect of increasing activity of DBP on bile acid biosynthesis.</p><p><b>METHODS</b>Twenty male Wistar rats were divided into two groups: diethylhexyl phthalate (DEHP) group (n = 10) and control group (n = 10). Serum triglyceride, total cholesterol, hepatic DBP activity, and fecal bile acids were assayed. The mRNA levels of hepatic peroxisome proliferator-activated receptor alpha (PPARalpha), DBP, and cholesterol 7alpha-hydroxylase (CYP7A1) were detected by RT-PCR.</p><p><b>RESULTS</b>Compared with control group, serum triglyceride level was decreased significantly and PPARalphamRNA level was increased significantly in DEHP group (P < 0.01). Together with a sharp induction of DBP mRNA expression and DBP activity in DEHP group (P < 0.01), the levels of CYP7A1 mRNA and fecal bile acids were significantly increased by 1.9 times and 1.6 times respectively compared to control group (P < 0.01). There was a significantly positive correlation between DBP mRNA level or DBP activity and CYP7A1 mRNA level (r = 0.89, P < 0.01; r = 0.95, P < 0.01).</p><p><b>CONCLUSION</b>The up-regulation of DBP mRNA and activity in liver can result in the increase in CYP7A1 mRNA expression and bile acid biosynthesis, suggesting that DBP may be involved in bile acid biosynthesis together with CYP7A1.</p>

Evaluation of the value of ultrasonography in diagnosis of liver fibrosis in patients with chronic viral hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>It is important to use noninvasive methods to differentiate liver fibrosis and liver cirrhosis. A prospective study was conducted to evaluate the validity of ultrasonography (US) in evaluating the severity of liver fibrosis in patients with chronic viral hepatitis in reference to the pathologic diagnosis of their liver biopsy specimens.</p><p><b>METHODS</b>The liver fibrosis status of 324 chronic viral hepatitis patients was evaluated by both needle biopsy and US. Histologically their liver fibrosis was graded as S0-S4, and the inflammatory reaction in the liver was graded as G1-G4. The US examination included qualitative description of the liver surface and liver parenchyma, and the quantitative parameters were vascular diameters, blood flow volume and spleen size.</p><p><b>RESULTS</b>US qualitative description of the liver surface and liver parenchyma was correlated to the severity of fibrosis and the degree of the inflammation seen in the liver biopsies. An analysis of US quantitative parameters showed that a cut-off value of 12.1 cm for the length of spleen had a sensitivity of 60.0%, and specificity of 75.3% in detecting early liver fibrosis. For other quantitative parameters, the cut-off values were 8mm for the diameter of the splenic vein, 30.5 cm/sec for maximal blood flow velocity in the portal vein and 12 mm in diameter of the main portal vein. The diagnostic sensitivities for these parameters were 60.0%, 78.6% and 76.7%; the diagnostic specificities were 78.1%, 66.9% and 44.6% respectively.</p><p><b>CONCLUSION</b>Early cirrhosis can be detected by US, and the sonographic results were well paralleled with their pathologic diagnoses made by liver biopsies. Individual US parameter has limited sensitivity and specificity in diagnosing early cirrhosis. In clinical practice a combination of 2-3 parameters could be used to detect or exclude severe liver fibrosis.</p>

Qualitative analysis of batch preparing cryopreserved fresh platelet rich plasma / 中国实验血液学杂志

To evaluate the efficiency and effectiveness of batch preparing cryopreserved fresh platelet-rich plasma (cryo-FPRP) derived from the volunteer donors, platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid concentration, and lactic dehydrogenase (LDH) concentration, germiculture, CD62p positive rate, PAC-1 positive rate, and the fluorescence intensity of platelet GPIb-IX-V were detected in ACD whole blood, fresh platelet-rich plasma (FPRP), FPRP with 5% dimethyl sulphoxide DMSO (DMSO-FPRP), and thawed cryopreserved FPRP (cryo-FPRP); the procoagulant activity of FPRP and cryo-FPR was determinated. The results showed that (1) 70 percentage of platelet were separated from the whole blood into FPRP, and the counts of residual erythrocyte and leucocyte were below 1 x 10(9), and below 1 x 10(7) per unit respectively. (2) The plasma pH, lactic acid concentration and PAC-1 positive rate retained a stable level during the preparing, storing and thawing process. (3) Plasma LDH concentration, platelet CD62p positive rate and GPIb-IX-V concentration in platelet surface were enhanced significantly after being frozen and thawing. (4) The plasma clotting time induced by cryo-FPRP were significantly shorter than that induced by FPRP. It is concluded that: (1) The batch platelet preparing process can efficiently obtain platelet from whole blood donated by volunteer, and the process didn't activate the platelet. (2) Cryopreservation can prevent lactic acid accumulation, pH reduce and activation of GPIIb/IIIa. (3) The membrane of partial platelets are affected by freezing and thawing. (4) The density of GPIb-IX-V complexes in platelet surface and its procoagulant activity are enhanced significantly after the FPRP freezing and thawing process.