Risk factors for post-pancreaticoduodenectomy hemorrhage / 中华普通外科杂志

Objective:To investigate the independent risk factors of post-pancreaticoduodenectomy hemorrhage (PPH).Methods:The clinical data of 350 patients who underwent pancreaticoduodenectomy at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Chongqing Medical University from Jul 2014 to Oct 2018 were retrospectively analyzed, the chi-square test and Logistic regression were used for univariate and multivariate analysis.Results:Of the 350 cases, PPH occurred in 35, including intra-abdominal hemorrhage in 20 cases, gastrointestinal hemorrhage in 15 cases, the incidence of PPH was 10.0%. Seven of the 35 PPH cases died. Univariate analysis showed that preoperative bilirubin (χ 2=4.162, P=0.041), pancreatic fistula (χ 2=37.451, P=0.000), biliary fistula (χ 2=7.945, P=0.005), and intro-abdominal infection (χ 2=34.577, P=0.000) infection were significantly associated with PPH; multivariate analysis results indicated that pancreatic fistula ( P=0.000, OR=10.426, 95% CI=3.512-30.955), biliary fistula ( P=0.000, OR=15.754, 95% CI=3.500-70.902), and intro-abdominal infection ( P=0.003, OR=4.530, 95% CI=1.644-12.483) were independent risk factors of PPH. Conclusions:Pancreatic fistula, biliary fistula, and intro-abdominal infection are independent risk factors for PPH.

Value of CT texture analysis in the preoperative prediction of Fuhrman grade of clear cell renal cell carcinoma / 中华放射学杂志

Objective@#To detect the values of CT texture features in the preoperative prediction of Fuhrman grade of clear cell renal cell carcinoma (ccRCC).@*Methods@#The CT data of 206 patients with ccRCC admitted to the Third Affiliated Hospital of Soochow University from January 2011 to December 2016 were retrospectively analyzed, and the ccRCC cases were graded using Fuhrman grading system, including 38 cases of Grade Ⅰ, 107 cases of Grade Ⅱ, 50 cases of Grade Ⅲ and 11 cases of Grade Ⅳ. All subjects undergone plain and enhancement CT scans. There were two methods used for the extraction of texture features, including histogram (2 features: Kurtosis and Skewness) and gray-level co-occurrence matrix (6 features: Contrast, Correlation, Energy, Entropy, Homogeneity and Variance). Each texture feature during Grade Ⅰ to Ⅳ was compared using a one-way analysis of variance following the log-ratio transformation, and a Newman-Keuls test was performed for all pairwise comparisons. An independent sample t test was used to find the differences of each texture feature between low (Grade Ⅰ+Ⅱ) and high grade (Grade Ⅲ+Ⅳ) ccRCC. A Spearman Rank test was performed to quantify the correlation of each texture feature with Fuhrman grade in ccRCC. Receiver operating characteristic curve (ROC) was employed to compare the diagnostic performance of the texture features to differentiate the low grade from high grade ccRCC.@*Results@#Six texture features, including Contrast, Correlation, Entropy, Homogeneity, Variance and Kurtosis, were different during Grade Ⅰ to Ⅳ (all P<0.05) with the exception of the two features of Energy and Skewness (all P>0.05). Furthermore, five textures, such as Correlation, Entropy, Homogeneity, Variance and Kurtosis, were not significantly different between Grade Ⅲ and Ⅳ ccRCC. There was no clinical application value for the features of Correlation, Energy, Entropy, Variance and Skewness with the absolute coefficients of<0.3, in contrast, the correlation coefficients were -0.54, 0.39 and 0.32 for the features of Contrast, Homogeneity and Kurtosis, respectively (all P<0.05). Compared with that in the low grade ccRCC, the values of Contrast and Variance reduced in the high grade ccRCC (all P<0.05), while the values of Kurtosis, Correlation and Homogeneity increased significantly in the high grade ccRCC (all P<0.05), and no difference was found for the features of Skewness, Energy and Entropy between the low and high grade ccRCC (all P>0.05). When those features were used to differentiate the high from low grade ccRCC, the Contrast exhibited the biggest area under ROC of 0.806 (P<0.05), followed by the Correlation of 0.641, Homogeneity of 0.687, Kurtosis of 0.668 and Variance of 0.659.@*Conclusion@#CT texture features can preoperatively predict the Fuhrman grade of ccRCC, and the Contrast will likely be the potential imaging biomarker for the clinical application.

Determination of epichlorohydrin in workplace air by gas chromatograph-electron capture detector / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To develop a method for determining epichlorohydrin in the workplace air by gas chromatograph-electron capture detector (GC-ECD).</p><p><b>METHODS</b>Epichlorohydrin in the workplace air was collected by activated charcoal tubes, desorbed using acetone, and analyzed by GC-ECD.</p><p><b>RESULTS</b>A good linearity was obtained in the range of 1.0-50 µg/mL (r=0.999 7). The detection limit was 0.012 µg/ml, while the recovery rate was 88.1% and relative standard deviation ranged from 1.11% to 3.57%. The samples could be stored for seven days at room temperature.</p><p><b>CONCLUSION</b>This method effectively eliminates the interferences of alkanes on determination of epichlorohydrin and improves the sensitivity by 1 to 2 orders of magnitude, which can solve the problem of detection limit above standard in GBZ/T 160.58-2004.</p>

Determination of 24 metal elements and their compounds in air of workplace by ICP-AES / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a method for determination of the levels of 24 metal elements and their compounds in the air of workplace by inductively coupled plasma-atomic emission spectroscopy (ICP- AES).</p><p><b>METHODS</b>Sampling filters were digested by microwave, and diluted to 25 ml. Twenty-four elements (Mg, Ni, K, Mo, Zn, Ca, Ba, Pb, Mn, Cd, Cr, Co, Cu, Sr, Bi, Tl, Sn, Li, Sb, Zr, In, V, Y, and Be) were simultaneously measured by ICP-AES.</p><p><b>RESULTS</b>The detection limits for 24 elements were 0.001∼0.029 mg/L; liner correlation coefficient r values were all equal to or above 0.9994; the relative standard derivations were less than 5%; the recovery rates were 91.2%∼103.9%; the degradation rates in 7 days were less than 9.7%.</p><p><b>CONCLUSION</b>ICP-AES technique is a simple, rapid, accurate, and reliable method, which can be used to measure 24 metal elements and their compounds in the air of workplace.</p>

Mifepristone Improves Hyperglycemia in Diabetic Rats by Regulating Glucocorticoid Receptor Expression / 医药导报

Objective To observe the effect of mifepristone (MIF) on the level of corticotropin releasing hormone (CRH),adrenocorticotropic hormone (ACTH),corticosterone (CORT),insulin (INS) and aldosterone (ALD) in plasma and expression of glucocorticoid receptor (GR) mRNA in hippocampus in type 2 diabetic rats and to discuss the effect and mechanism by which mifepristone improves hyperglycemia. Methods Type 2 diabetes mellitus model was induced by high-fat diet plus intragastric administration of low dose streptozotocin (30 mg·kg-1 ). Rats were randomly divided into normal control group,model control group,positive control (MET) (metformin hydrochloride 200 mg·kg-1 ·d-1 ) group,mifepristone low dose (MIF-L) (10 mg·kg-1 ·d-1 ),medium dose (MIF-M) (25 mg·kg-1 ·d-1 ) and high dose (MIF-H) (50 mg·kg-1 ·d-1 ) groups. The normal control group and model control group were given distilled water. Fasting blood glucose (FBG) was measured once a week. The rats were decapitated after five weeks. Organ index, corticotropin release hormone ( CRH), adrenocorticotropic hormone (ACTH),corticosterone(CORT),insulin(INS) and aldosterone(ALD) levels were measured. The expression of GR mRNA in hippocampus was measured by using real-time PCR. Results Compared with the normal control group, body weight was decreased significantly (P0. 05). Relative expression of GR mRNA was significantly increased in MIF-L,MIF-M and MIF-H groups (all P <0. 01). Conclusion Hyperglycemia in type 2 diabetic rats can be improved by MIF. The possible mechanism may be related to regulating the HPA axis through inhibiting GR.

The feasibility of susceptibility weighted imaging for assessing renal difference of healthy volunteers after water loading / 中华放射学杂志

Objective To probe the feasibility of susceptibility weighted imaging (SWI) for evaluation of renal blood oxygenation level of healthy volunteers after water loading.Methods SWI of 11 healthy volunteers,acquired before (group 1) and after water loading (group 2),were assessed retrospectively by two radiologists with more than 10 years abdominal work experience independently.In those images of the same section plane derived from two groups,the phase values in cortex ((φ)cor) and medulla ((φ)med),difference between the same vein and surrounding tissue on phase map (△(φ)) were measured using SPIN software package,and the oxygen extraction fraction changes (△OEF) was calculated.The (φ)cor,(φ)med and △(φ) between two groups were compared by paired t test.And the intraclass correlation coefficient (ICC)was used to evaluate the consistency between two radiologists.Results For the radiologist 1,the (φ)cor,(φ)med and △(φ) were (0.046 ±0.019),(-0.014 ±0.003) and (1.3 ±0.4) rad in group 1,and were (0.047 ±0.014),(-0.012 ±0.005) and (1.1 ±0.4) rad in group 2 respectively,and no significant change was found in (φ)cor and (φ)med after water loading (t =-0.589 and-0.206,P ＞ 0.05 in all),except of in △(φ) (t =2.400,P ＜ 0.01).For the radiologist 2,the (φ)cor,(φ)med and △△(φ) were (0.049 ± 0.011),(-0.012 ± 0.004)and (1.5 ±0.4) rad in Group 1,and were (0.046 ±0.017),(-0.011 ±0.003) and (1.3 ±0.2) rad in group 2 respectively,there was no significant change in (φ)cor and (φ)med after water loading (t =0.590 and -0.974,P ＞ 0.05 in all),except of in △(φ) (t =2.760,P ＜ 0.05).Between two radiologists,the ICC of (φ)cor,(φ)med and △(φ) were 0.623,0.472 and 0.328 in group 1 and 0.599,0.442 and 0.445 in group 2 respectively.△OEF decreased about (-4.2 ± 2.3) c％ and (-4.3 ± 2.8) c％ measured by two radiologists respectively,and the consistency is good between two radiologists (ICC =0.784).Conclusion SWI provides a novel method to assess indirectly the oxygenation level of kidney,△OEF is an indicator with suitable reliability.

Establishment of the system of prenatal screening and prenatal diagnosis of thalassemia in Dongguan city / 中国基层医药

Objective To reduce birthrate of severe thalassemia children of this area and improve population diathesis.Methods The red blood cell indices analysis was carried out on all of the samples of 2 218 couples.GapPCR and RDB method were used for α-thalassemia genotyping and β-thalassemia genotyping.Results 277 cases of thalassemia (12.49％) were identified among the total cases.220 cases were with α-thalassemia(9.92％),which including 198 cases of--SEA/αα,11 cases of-α37/,7 cases of-α4.2/αα,57 cases were with β-thalassemia(2.57％),the types of mutation were CD41/42 (-TTCT),IVS2nt-654 (C→T),CD17 (A→T),-28 (A→G),TATAbox29 (A→G),CD71/72(+ A).42 carrier couples were detected for thalassemia and the fetuses were subjected prenatal diagnosis:3cases of Bart's edema,7 cases of β-thalassemia homozygote.Conclusions Neonates with major thalassemia can be clarified and even avoided by screening the incidence and types of genicmutations.Thus setting up the system of prenatal screening-prenatal diagnosis-selective abortion is effective to avoid the birth of neonates.And it is vital to improve the quality of human being.

CT and MRCP findings of autoimmune pancreatitis and small pancreatic carcinoma / 中华胰腺病杂志

Objective To increase the awareness of autoimmune pancreatitis (AIP) and correct diagnosis rate of AIP by investigating radiologic characteristic of AIP and small pancreatic cancers.Methods The clinical data and radiologic imaging of 24 AIP patients who met the Asia diagnostic criteria of AIP in 2008 and 25 cases of pathologically condirmed small pancreatic cancer were retrospectively reviewed.All imaging findings were reviewed,especially on the shape,enhancement patterns of mass,pancreatic ducts,peripancreatic and extra-pancreatic manifestations. Chi-square test and Fisher test were used for statistical analysis.ResultsThe imaging signs,including location of masses,distal pancreatic atrophy,enhancing mass during portal phase,truncated duct sign of pancreatic duct,capsule-like rim and renal involvement,was significantly different between AIP and small pancreatic cancer ( x2 =9.010,10.506,15.488,8.688,6.292 and 4.966 respectively,P ＜0.05 ).But only two signs,distal pancreatic atrophy and enhancing mass during arterial and portal phase,were statistically different between local AIP and small pancreatic cancer (P ＜0.05).ConclusionsThe typical imaging features of diffuse AIP is distinct and helpful for the differential diagnosis of AIP from small pancreatic carcinoma,but there is limited value in the differential diagnosis between local AIP and small pancreatic cancer.

Preoperative portal vein embolization for Gaint Hepatic alveolar echinococcosis

Hepatic echinococcosis, characterized by tumor-like infiltrative growth, is fatal if appropriate treatment is not undertaken on time. Surgical resection is still the most effective treatment for early stage patients. However, due to asymptomatic progression, many patients miss the opportunity to have the lesion removed. In this paper, we report a new method to treat a patient with giant hepatic echinococcosis. Based on preoperative portal vein embolization of the right portal venous branches, a radical right trisectionectomy of hepatic segment with complete removal of the giant lesion was performed successfully without any postoperative complications. To our knowledge, currently there is no report on the use of preoperative portal vein embolization to treat Hepatic echinococcosis

Concomitant Hepatolithiasis with Primary Hepatocellular Carcinoma: An innovative problem

Concomitant primary hepatocellular carcinoma with hepatolithiasis is a rare form. We present a case of left hepatolithiasis accompany with primary hepatocellular carcinoma of right lobe in a 62-year-old man, who underwent left lateral hepatectomy, cholecystectomy, common bile duct exploration and T-tube drainage 20 years ago for hepatolithiasis and gallstones. The tumor was detected during the follow-up for his residual hepatolithiasis. A right hemihepatectomy and common bile duct exploration and T-tube drainage was performed and left hepatolithiasis was remained for next operation to prevent hepatic failure. A histological examination of the specimen revealed typical features of hepatocellular carcinoma. This report describes staged management for patient with both benign and malignant hepatao-biliary disease

Applied value of muitislice CT in selecting living donor kidneys and excision methods / 中华器官移植杂志

Objective To evaluate the applied value of multislice CT (MSCT) in the selection of living donor kidneys and excision methods.Methods Ninety living renal donors underwent MSCT assessment.The nonenhanced,arterial,venous and excretory phase examinations were performed.Using maximum intensity projection and volume rendering techniques for vascular imaging,two blinded radiologists independently analyzed and evaluated all MSCT images.According to the CT reconstructive images,radiologists and physicians selected the left renal or the right renal donors,and chose laparoscopic or open live donor nephrectomy.Results On the 90 cases of donors,78 donors underwent nephrectomy in the left kidney.Seventy-one left kidney donors having no significant variation received the routine laparoscopic live donor nephrectomy.Seven left kidney donors on both sides had relatively obvious anatomical variations such as accessory renal artery,multi-branch renal vein and renal vein in the back of the abdominal aorta,and they were subjected to the left kidney open donor nephre.ctomy.Other 12 donors having significant variation in the left kidney were given nephrectomy in the right kidney,and all of them received hand-assisted laparoscopic live donor nephrectomy.All intraoperative records of urine collection system and renal vascular anatomy were consistent with the preoperative evaluation of MSCT,and the accuracy was 100 ％.Two imaging experts in the evaluation of renal artery,renal vein and urine collection system showed good consistency.Nephrectomy was successfully performed on 90 cases of donors,and.postoperative recipients had no renal vein thrombosis and other vascular complications.Conclusion MSCT can provide accurate and valuable information for the selection of living donor kidneys and excision methods as a “one-stop” technique for the preoperative evaluation of living renal donors.

The function changes of HPA axis in diabetic rat model induced by high lipid food plus STZ and relation with glucose and lipid metabolism / 中国药理学通报

Aim To investigate HPA axis change relation with glucose and lipid metabolism.Methods Wistar rats were injected intraperitoneally with STZ (30 mg·kg~(-1)) after fed with high lipid food for two months, then rats with blood glucose of over 15 mmol·L~(-1) were used in the experiment. Animals were divided into four groups: normal group, diabetic model group, treatment group (ROS 200 mg·kg~(-1) ·d~(-1) ig), and metformin group (200 mg·kg~(-1)·d~(-1) ig).Rats were decapitated after they had been administered ig for four weeks and were 24 hour urine collected.Plasma CRH, ACTH, corticosterone, hypothalamic CRH, ACTH of pituitary gland, 24 hour urinary corticosterone and plasma insulin were determined by ELISA and radio immunity kit respectively.Results In diabetic rat model induced by high lipid food and STZ, plasma and urinary glucose level and plasma TC, TG levels were increased, plasma HDL-C and hepatic glycogen content were reduced, which was synchronized with changes of higher pituitary ACTH, plasma and total 24 hour urine corticosterone excretion.Conclusion The disorder of glucose and lipid metabolism of model induced by high lipid food and low dose STZ may be linked to the change of HPA axis.The improvement of ROS on glucose and lipid metabolism in diabetic rats may be linked to the decrease of HPA axis activity.

Clinical value of 16-row multislice CT in the preoperative assessment of live kidney donor / 中华泌尿外科杂志

Objective To analyze the clinical value of 16-row multislice CT in the live kidney donor preoperative assessment. Methods Thirty-six kidney donors underwent 16-slice CT preopera-tive assessment. The non-enhanced, arterial phase, venous phase and excretory phase examinations were performed. Two radiologists independently studied renal vessels and urinary system of each case by maximum intensity projections and volume rendering techniques. The specificity and accuracy of 16-row muhislice CT in the evaluation o{ renal vessels and urinary system were calculated after comparing with surgical findings as reference. Results 16-row muhislice CT found 7 variant renal arteries. One variant artery confirmed in surgery was missed in the CT study. 16-row muhislice CT made cor-rect diagnosis of all variant anatomy of renal veins and ureters which were confirmed in surgery. For i-dentification of variant anatomy of renal arteries, veins and ureters, the specificity of 16-slice CT was 100% (29/29), 100% (32/32), and 100% (35/35), the overall accuracy was 97%(36/37), 100% (36/ 36), and 100%(36/36), respectively. Conclusions 16-row muhislice CT shows excellent value in the evaluation of renal vessels and urinary system in live kidney donors. 16-row multislice CT is suit-able for the noninvasive examination in live kidney donor preoperative assessment and provides all sup-portive and relevant information required by the surgeons.

Multislice spiral CT virtual endoscopy: the clinical application in the diagnosis of vascular diseases / 中华放射学杂志

Objective To evaluate the display ability and the clinical application of multislice spiral CT virtual endoscopy (CTVE) in the diagnosis of vascular diseases. Methods Fifty-six patients were examined by CT virtual endoscopy.32 patients also had DSA for comparison.18 patients were confirmed by operation (3 patients also had DSA).9 patients with pulmonary embolism were confirmed by other examinations and treatments.Results 56 patients showed successful CT virtual endoscopy images.CT virtual endoscopy images could clearly show the inner wall and inner structures of the vessels,mural thrombus,calcification form,stenosis of the vessels,the true and false lumina of aortic dissections,the lesion of false aneurysm,and the anatomic relationship between the lesion and surrounding structures of the normal vessels.Out of the 32 patients with vessel abnormalities on DSA,24 patients (75%) showed the lesions on CTVE.17 out of 18 patients with operation showed the lesions on CTVE.All 9 patients with pulmonary embolism showed the abnormalities on CTVE.Chi-square test:? 2=5.2809,P=0.071 patients showed the vascular diseases on CTVE in 56 patients (84%).Conclusion MSCT virtual endoscopy could provide more information of the vessel by displaying the inner wall and allowing users to map the vessels in a display.It is helpful in correct diagnosis and guiding surgery.

Clinical Value of HRCT in Staging Lung Interstitial Disease in Connective Tissue Diseases / 实用放射学杂志

Objective To study the clinical value of HRCT in staging of lung interstitial disease(LID) in connective tissue disease(CTD).Methods 222 patients with CTD confirmed clinically underwent HRCT scan.The staging of LID according to the HRCT features of LID were done and the therapeutic effect was compared between each stage.Results In 222 cases ,64 cases were negative on HRCT as stage 0,158 cases had disseminated LID in different degree,including stage Ⅰ in 107,stage Ⅱ in 36 and stage Ⅲ in 15.There were significant statistically between the therapeutic effect and staging of LID.Conclusion The staging of CTD with LID by HRCT is helpful for judging the extent of LID and clinical treatment.

Clinical Application in Diagnosis of Pulmonary Embolism by Multiple Spiral CT Angiography / 实用放射学杂志

Objective To evaluate the effectiveness of multiple spiral CT angiography in diagnosis of pulmonary embolism.Methods 16 patients clinically suspected of pulmonary embolism underwent multiple spiral CT angiography.Emboli were found in the 8 patients of all on multiple spiral CT angiography.5 of the patients were reexamined with this method 20 to 30 days after thrombolysis. Results In 8 patients with pulmonary embolism,43 vessels were involved with pulmonary embolism.The presence of pulmonary embolism on CT was seen as a total occlusion,partial filling defect,mural filling defect et al;dilated of pulmonary artery trunk;all signs with deceleration of pulmonary blood or “mosaic sign”. 5 patients were reexamined with this method.The emboli dissoved partly or entirely.Conclusion Multiple spiral CT angiography is a noninvasive and effective method for examining pulmonary embolism.

CT Diagnosis of Lung Cancer with the Appearance of Solitary Pulmonary Nodule(SPN) / 实用放射学杂志

Objective To evaluate the CT diagnosis of small peripheral lung cancer with the appearance of SPN