Research Progress of Spectral CT in Lung Cancer / 中国医学影像学杂志

Conventional CT is an important imaging modality for the evaluation of lung cancer,but it has a single imaging modality.At present,multiparametric imaging techniques of spectral CT(such as virtual monoenergetic imaging,spectral attenuation curves,material decomposition images and material effective atomic number)are valuable in improving the detection rate of lesions,differentiating benign and malignant of lung nodes,assessing lymph node metastasis,pathological staging,efficacy and prognosis of lung cancer.Here,this article summarizes and reviews spectral CT imaging methods and the results of studies related to the above four techniques in lung cancer.

Application of dual-energy computed tomography in preoperative evaluation of Ki-67 expression levels in solid non-small cell lung cancer.

To investigate whether there were significant differences in dual-energy CT (DECT) in reflecting different quantitative parameters among different levels of Ki-67 expression in patients with solid non-small cell lung cancer (NSCLC). The diagnosis performance of DECT in patients with solid lung adenocarcinoma (LAC) among NSCLC was further discusses. Two hundred fifteen patients confirmed with solid NSCLC were enrolled and analyzed retrospectively in this study. 148 patients were confirmed with LAC among all patients. Three expression levels of Ki-67 were determined by the percentage of Ki-67 positive cancer cells with immunohistochemistry: high-level group (>30%), middle-level group (10%-30%), and low-level group (≤10%). And the latter two levels also known as non-high-level group. The quantitative parameters of enhanced chest DECT (venous phase, VP), including iodine concentration (IC), water concentration (WC), CT value at 40 keV (CT40keV), the slope of energy spectral attenuation curve (λHU) and normalized iodine concentration (NIC) were measured and calculated by gemstone spectral imaging Viewer software. One-way ANOVA was used for the comparison of normal distribution DECT parameters between three levels for patients with NSCLC and patients with LAC. Non-normal distribution data were tested by non-parametric test. In addition, the receiver operating characteristic curve of statistically significant DECT parameters was drawn to distinguish the non-high-level and the high-level of Ki-67. Area under the curve (AUC), sensitivity, specificity was calculated to measure the diagnostic performance of parameter. Both in solid NSCLC and LAC, the IC, NIC, WC, λHU and CT40keV at VP in the high-level group were significantly lower than those in the middle- and low-level group respectively, and the WC at VP in the high-level group was significantly higher than that in the middle- and low-level group respectively (all P < .05). Receiver operating characteristic analysis showed that IC and λHU at VP performed better in distinguishing the high-level and the non-high-level of Ki-67 (NSCLC: AUC = 0.713 and 0.714 respectively; LAC: AUC = 0.705 and 0.706 respectively). Quantitative parameters of DECT provide a new non-invasive method for evaluating the proliferation of cancer cells in solid NSCLC and LAC.

Effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy / 中国医师杂志

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.

Voxel-based morphometry on brain structures in Parkinson’s disease patients with mild cognitive impairment / 实用放射学杂志

Objective To investigate the abnormal region of gray matter and distribution in patients with Parkinson’s disease (PD),and explore the brain structural changes closely related to mild cognitive impairment(MCI).Methods 20 cases of PD-MCI, 1 7 cases of PD-nMCI and 20 normal controls (NC)were examined by 3D-T1 WI brain volume sequence.The data of three groups were analyzed using voxel-based morphometry(VBM)based on SPM8 to generate gray matter map.Results Compared to NC,decreased gray matter volume in PD-nMCI was observed in the right temporal lobe,including the middle temporal gyrus,inferior temporal gyrus,and right fusiform gyrus,uncus and left superior temporal gyrus.Compared to PD-nMCI,decreased gray matter volume in PD-MCI was observed in the bilateral midfrontal gyrus,inferior frontal gyrus,left precentral gyrus,right midtemporal gyrus,superior temporal gyrus,bilateral insular,and right cuneus,lingual gyrus,posterior cingutate.Conclusion Decreased gray volume in PD-nMCI is mainly located in the right temporal lobe and right uncus.With occurrence of MCI,abnormal brain regions are gradually extended.Gray matter atrophy in the bilateral midfrontal gyrus,inferior frontal gyrus,and left precentral gyrus are related to the MCI.

MR imaging quantitative study of intracranial hypotension syndrome / 中华神经医学杂志

Objective To investigate the MRI findings and the variability of quantitative indicators in intracranial hypotension syndrome (IHS) to yield a deeper understanding of the disease.Methods The clinical data and MR imaging findings of 26 patients with IHS confirmed by lumbar puncture during August 2006 to December 2013 in our hospital were retrospectively analyzed.Other 26 healthy volunteers matched with gender and age were recruited as control group.The MRI findings (dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and sagging brain) and quantitative assessments (mamillopontine distance and pontomesencephalic angle) were evaluated retrospectively by two doctors,the consistency between the two doctors was assessed by Kappa consistency test.The difference of mamillopontine distance and pontomesencephalic angle between patient group and control group was assessed by t test.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy and assure the optimal diagnostic threshold.Results There were excellent interobserver agreements for dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and the measurement of mamillopontine distance and pontomesencephalic angle (Kappa=l.000,0.846,1.000,0.906,0.919 and 0.808,P＜0.05).Sagging brain showed moderate agreement between readers (Kappa=0.606,P＜0.05).The mamillopontine distance (5.4±1.6 mm) and pontomesencephalic angle (47.8±8.7 °) in patient group were significantly lower than those of control group (6.9±1.1 mm and 61.0±6.1 °,P＜0.05).The area under ROC curve of mamillopontine distance and pontomesencephalic angle was 0.774 and 0.908,respectively,and the diagnostic value ofpontomesencephalic angle was higher than that of the mamillopontine distance.The sensitivity and specificity were 73.1％ and 73.1％,respectively,when mamillopontine distance was 6.4 mm.The sensitivity and specificity were 76.9％ and 96.2％,respectively,when pontomesencephalic angle was 51.7°.Conclusions The MR imaging findings present characteristic features of IHS.The quantitative indicators including mamillopontine distance and pontomesencephalic angle are helpful in clinical diagnosis of IHS.

Effects of different doses of ketamine on systemic inflammatory cytokines at early stage of rabbits with severe burn / 中国中西医结合急救杂志

Objective To investigate the effect of different doses of ketamine on inflammatory cytokines in rabbits with severe burn at early stage and preliminarily approach its regulatory action on early stage of inflammatory reaction due to stress of trauma.Methods Forty healthy male New Zealand rabbits were randomly divided into four groups in accord with the random number table method: normal control group, scald model group, ketamine analgesia group and ketamine anesthesia group. Before scald, pentobarbital sodium was used for anesthesia, afterwards catheters were inserted into internal jugular vein and internal carotid artery respectively ready for use, and 24 hours later, Ⅲ degree scald at the animal back and buttocks occupying 30% total body surface area (TBSA) was performed as the scald model for all the rabbits except those in normal control group. In ketamine analgesia group, after scald for 0.5 hour, 0.5 mg/kg ketamine intravenous injection was given to the rabbits as the loading dosage and then persistent intravenous pump infusion of 9μg·kg-1·min-1 ketamine was applied for all together 24 hours. In ketamine anesthesia group, after scald for 0.5 hour, 1.5 mg/kg ketamine intravenous injection was given to the rabbits, and then persistent intravenous pump infusion of 45μg·kg-1·min-1 ketamine was applied for 4 hours to maintain systemic anesthesia. In normal control and scald model groups, only intravenous infusion of equal amount of normal saline was given to the rabbits. The amount of intravenous transfusion in each group and the total dosages of ketamine used in ketamine analgesia group and ketamine anesthesia group were recorded. Before scald and 0.5, 6, 12, 24 hours after scald, arterial blood gas analyses were made, and the levels of serum interleukins (IL-1, IL-6) and tumor necrosis factor-α (TNF-α) were determined.Results Although the indexes of blood gas analysis were changed in the four groups, they were all in the normal range, showing that the respiratory function was in the normal range and indirectly reflecting that the circulatory function was also in the normal range, thus the effects on cytokines by factors of respiratory and circulatory functions were ruled out. The levels of IL-1, IL-6 and TNF-α before scald showed no statistically significant differencesamong the four groups (allP > 0.05). From 0.5 hour after scald, the levels of IL-1, IL-6 and TNF-α were markedly higher in model group than those of normal control group [IL-1 (ng/L): 30.27±0.93 vs. 13.79±1.11, IL-6 (ng/L): 47.22±1.49 vs. 46.31±4.12, TNF-α (ng/L): 243.39±20.85 vs. 190.95±14.97, allP < 0.05], and the situation continued until 24 hours after scald; the levels of IL-1, IL-6 and TNF-α from 6 hours after scald were significantly decreased in ketamine analgesia and ketamine anesthesia groups compared with those in the model group, and from 12 hours after scald, the degrees of descent in levels of the above indexes in ketamine analgesia group were more obvious than those in ketamine anesthesia group [IL-1 (ng/L): 19.28±2.51 vs. 40.12±10.31, IL-6 (ng/L): 52.10±4.23 vs. 72.20±10.11, TNF-α (ng/L): 246.03±20.74 vs. 313.71±27.34, allP < 0.05].Conclusion The low-dose ketamine analgesia and ketamine anesthesia have certain degree of inhibitory effect on the expression and release of inflammatory cytokines at the early stage in rabbits with severe burn, the effect of long-term low-dose ketamine analgesia being more significant.

Protective effect of propofol on liver in severely scalded rabbits / 中华麻醉学杂志

Objective To evaluate the protective effect of propofol on liver in severely scalded rabbits.Methods Twenty healthy male New Zealand rabbits, aged 3-4 months, weighing 2.3-2.5 kg, were randomly divided into either scald group (group S, n =10) or propofol group (group P, n =10).Thirty percent of the total body surface was shaved chemically with 10％ sodium sulphate and then exposed to 98 ℃ water for 20 s to produce third degree thermal injury at the back and buttocks of anesthetized rats.In group P, propofol was injected at a dose of 1.5 mg/kg at 1 h after scald, followed by an infusion of 4 mg· kg-1 · h 1 for4 h.The equal volume of normal saline was given in groupS.Before scald (T1), at 1 h after scald (T2) , and at 6, 12 and 24 h after administration of propofol or normal saline (T3-5) , blood samples were taken from the internal jugular vein for determination of serum alanine aminotransferase (ALT) activity (by lactate dehydrogenase method), aspartate aminotransferase (AST) activity (by MDH), and tumor necrosis factor-alpha (TNF-α) concentrations (by enzyme linked immunosorbent assay).The rabbits were sacrificed at T5, and their livers were removed and cut into sections which were stained with haematoxylin and eosin and examined under microscope.Results The serum ALT and AST activities and TNF-α concentrations were significantly higher at T2-5 than at T1.Compared with the values at T2, the serum ALT and AST activities and TNF-α concentrations in group S and serum TNF-α concentrations in group P were significantly increased at T3-5, and no significant change was found in the serum ALT and AST activities at T3-5 in group P.Compared with group S, the serum ALT and AST activities and TNF-α concentrations were significantly decreased at T3 5, and the pathological changes were mitigated in group P.Conclusion Propofol provides protective effect on liver in severely scalded rabbits.

Influence of sulfentanyl on hemodynamics and stress reaction on patients with operations on cranium and brain during anesthesia induction period / 中国现代医生

Objective To discuss influence of sulfentanyl on hemodynamics and stress reaction on patients with opera-tions on cranium and brain during anesthesia induction period. Methods A total of 100 cases of clinical information of patients with severe brain injury were divided into two groups in accordance with different anesthetic methods, with 50 cases in anesthesia group A (fentanyl as anesthetic method) and 50 cases in anesthesia group B (sulfentanyl as anesthetic method). The changes of MAP, HR, cortisol (Cor) in plasma and glucose (Glu) in blood before the anesthesia induction (T0), 2 minutes after anesthesia induction and before the trachea cannula (T1), 1 minute after the trachea cannula (T2), upon the incision of scalp (T3), upon the drilling of skull (T4), and upon the withdrawal of trachea cannu-la (T5) were observed. Results The MAP and HR of patients in anesthesia group B at T1, T2, T3, T4 and T5 were all lower than those in anesthesia group A (P<0.05). The Cor in plasma and Glu in blood of patients with severe brain injury in anesthesia group B at T2, T3, T4 and T5 were all lower than those in anesthesia group A(P<0.05). Conclusion Compared with fentanyl, the application of sulfentanyl on patients with severe brain injury has more favorable curative effect on hemodynamics and stress reaction during anesthesia induction period, which can maintain the circulatory sys-tem more stable, is more suitable for the anesthesia induction.

1H-MR Spectroscopy of Traumatic Brain Injury in Rabbits / 中国医学影像学杂志

Purpose To evaluate 1H proton magnetic resonance spectroscopy (1H-MRS) in detecting traumatic brain injury (TBI) and its metabolic changes during the initial two weeks after trauma using rabbit modes. Materials and Methods Fifteen Chinese rabbits were randomly divided into sham control group (n=5) and TBI group (n=10), 1H-MRS was performed 1 hour, 6 hours, 24 hours and 2 days, 7 days, 14 days after trauma, the concentration of N-acetylaspartate (NAA), creatine (Cr), choline-compound (Cho), NAA/Cr and Cho/Cr in each group was evaluated. At 6 hours, 24 hours and 168 hours after injury, 1 rabbit was slaughtered after abdominal anesthesia at each time point, the sample was ifxed with left heart catheterization perfusion after death, brain tissue was obtained, blocked, dehydrated into frozen section, HE staining was used for observation. Results Compared with the control group, NAA/Cr ratio in the trauma region decreased by 29%1 hour after trauma, with maximal reduction of 40% (at 24 hours) before increasing slightly, the NAA/Cr ratio returned to control level gradually until 168 hours later. The Cho/Cr ratio decreased by 16% 1 hour after trauma, with maximal reduction of 30%(at 6 hours) and increased gradually until finally su rpassed control level (168 hours) for 20% and then became stable. NAA/Cr ratio and Cho/Cr ratio showed statistically significant changes between each observing time point (P<0.05). Conclusion 1H-MRS can be used for dynamic detection of cerebral metabolism without injury, and is superior to MRI in detecting early abnormality of the brain, with NAA/Cr as the most sensitive parameter. Detecting the changes of NAA/Cr, Cho/Cr ratios in the trauma region can be used as a guide for assessment of the clinical treatment effectiveness of TBI.

Morphological changes of brain gray matter structure in patients with Parkinson's disease / 中华神经医学杂志

Objective To investigate the abnormal region of gray matter and its' structural changes closely related to mild cognitive impairment in patients with Parkinson's disease (PD) using voxel-based morphometry(VBM) method.Methods Thirty-seven clinically defined PD patients and 20 normal controls (NC),collected in our hospital from March 2011 to February 2013,were examined using T1WI three-dimensional brain volume sequence (3D-fast spoiled gradient echo,3D-FSPGR).We classified PD patients into 2 subgroups according to the extent of cognitive impairment:20 patients with mild cognitive impairment (MCI) and 17 patients with none mild cognitive impairment (nMCI).The data of three groups were analyzed using VBM based on SPM5 to generate gray matter map.Results As compared with NC group,PD patients showed extensively decreased gray matter volume,involving bilateral frontal,temporal,occipital and parietal lobes,insular,parahippocampal gyrus,amygdale and right uncus.As compared with PD-nMCI patients,decreased gray matter volume in PD-MCI patients was observed in bilateral midfrontal gyrus,inferior frontal gyrus,bilateral insular,left precentral gyrus,left superior temporal gyrus and right midtemporal gyrus.Conclusions Areas of decreased gray volume in PD patients locate in widespread brain regions involving limbic system and neocortex.Gray matter atrophy in bilateral midfrontal gyrus,inferior frontal gyrus,insular and left precentral gyrus is related to the mild cognitive impairment.

Effects of levator ani muscle exposure in abdominal perineal resection for rectal cancer / 中华消化外科杂志

Objective To investigate the effects of levator ani muscle exposure in abdominal periueal resection for rectal cancer.Methods The clinical data of 109 patients with rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2001 to January 2008 were retrospectively analyzed.There were 55 patients received traditional procedure (conventional method group) and 54 patients received modified procedure with levator ani muscle exposure (levator ani muscle exposure group).The mesorectum was sharply dissected according to the total mesorectal excision principle.It is essential to remove the rectum along with the mesorectum up to the level of the levators.Preoperative bowel preparation,anesthesia,body position,abdominal incision,perineal incision and suture of the 2 groups were the same as Miles procedure.In the conventional method group,the superficial dissection was carried out with electrocautery or ultracision harmonic scalpel.The presacral space was entered by dividing the rectococcygeus muscle,commencing at the level of the tip of the coccygeus.The levators were then divided near the pelvic wall attachments and next procedures were performed without levator ani muscle exposure.In levator ani muscle exposure group,once the ischiorectal fat was cleared by electrocautery,the planes of levator ani muscle were identified and exposed after dividing the rectococcygeus muscle and next procedures were performed.The patients in stage Ⅰ only needed to follow-up; the patients in stage Ⅱ had to receive chemotherapy with following situation:poor differentiation,T4 stage,blood vessel or lymphatic invasion,number of lymph nodcs detected ＜ 12.Patients in stage Ⅲ or Ⅳ needed adjuvant chemotherapy.The follow-up evaluation included blood routine examination,hepatic and renal function examination,chest radiography,hepatobiliary ultrasonographic evaluation and determination of CEA levels (once every 3 months in the first year after operation,and once every 6 months after one year).Abdominal CT scan and colonoscopy should be employed every year.All the patients were followed up till December of 2012.All data were analyzed using the chi-square test or t test.The survival curve was drawn using the Kaplan-Meier method,and the prognosis was analyzed using the Log-rank test.Results The operation time were (60 ± 15)minutes and (30 ± 10) minutes in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =3.936,P ＜ 0.05).The intraoperative blood loss were (300 ± 60) mL and (30±20) mL in the conventional method group and the levator ani muscle exposure group,with significant difference between the 2 groups (t =5.687,P ＜ 0.05).Three patients were with rectal injury,1 with urethral injury,1 with vaginal injury,and 10 with incision infection in the conventional method group.There were 9 patients with incision infection in the levator ani muscle exposure group.The course of chemotherapy was under 12 in 30 patients,and above 6 in 41 patients.The median time of follow-up of the patients was 56 months (range,15-95 months).Of the 109 patients,10 missed the follow-up,15 patients had local recurrence,30 had distal metastasis,and 35 patients died.The 1-,3-,5-year cumulative survival rates were 93.4％,76.0％ and 65.6％.The 5-year survival rates were 65.2％ and 66.3％ for patients in the conventional method group and the levator ani muscle exposure group,with no significant difference between the 2 groups (x2=4.210,P ＞0.05).Conclusion Levator ani muscle exposure method provides clearer vision of operational field,shorter operation time,less blood loss and less injury to the rectum or urinary tract (vagina).

Preliminary study of brain gray matter in mild cognitive impairment in Parkinson's disease / 中华老年医学杂志

Objective To analyze the abnormal region of gray matter and its distribution characteristics in Parkinson's disease (PD) patients with mild cognitive impairment (PD-MCI),and to investigate the structural brain changes which closely related to mild cognitive impairment.Methods 27 PD patients were examined by T1WI three-dimensional brain volume (3D-fast spoiled gradient echo,3D-FSPGR) sequence,and were divided into 2 groups:PD patients with mild cognitive impairment group (PD-MCI group,n＝15) and PD patients without mild cognitive impairment (PD-nMCI group,n=12).Gray matter map in the two groups were analyzed by using voxel based morphometry (VBM) based on SPM5.Results There were significant differences in MMSE and MoCA scores between the two groups (P＜0.01 or 0.05).Compared with PD-nMCI group,gray matter volumes in PD-MCI group were decreased in bilateral mid frontal gyrus,left precentral gyrus,right mid-temporal gyrus,left superior temporal gyrus,transverse temporal gyrus,bilateral lingual gyrus,right cuneus,bilateral insular and right posterior cingutate gyrus.Conclusions Gray matter atrophy in bilateral mid-frontal gyrus,insular and left precentral gyrus is closely related to the mild cognitive impairment in PD patients.

Cholesterol nucleation-promoting potency of retinol binding protein / 中华消化外科杂志

Objective To detect the nucleation-promoting potency of retinol binding protein (RBP) in the simulated bile system,and observe the process of cholesterol nucleation and crystallization.Methods Small and synthetic bile systems were synthesized.RBP (RBP group),α1-acid glycoprotein (AAG,AAG group) and albumin ( Alb,Alb group) were added into the Small bile respectively.The derived indices of nucleation time,crystal growth rate and final concentration of crystal were studied by Busch method.Alb ( control group) and RBP (experimental group) were added into the Small and synthetic bile systems respectively.The nucleation time was detected by polarizing microscopy according to the Holan method and the nucleation-promoting potency was calculated according to the Holzbach method. The morphological dynamics of cholesterol nucleation and crystallization were observed under a light microscope.All data were analyzed by using the analysis of variance or the t test.Results The derived indices of nucleation time,crystal growth rate and final concentration of crystal were 0.66,1.29 and 1.01 in the AAG group,and 0.73,1.02,0.95 in the RBP group,respectively.In the Small bile system,the average nucleation time of cholesterol monohydrate crrystals were ( 12.2 ± 1.2 )days in the control group and (8.2 ± 1.5)days in the experimental group,respectively,with a significant difference between the 2 groups (t =2.97,P ＜ 0.05 ).The nucleation activity of RBP was 0.67 in the Small bile system.In the synthetic bile system,the average nucleation time of cholesterol monohydrate crystals were (9.5 ± 1.1 ) days in the control group and (7.5 ± 1.1 )days in the experimental group,respectively,with a significant difference between the 2 groups ( t =2.35,P ＜ 0.05 ).The nucleation activity of RBP was 0.79 in the synthetic bile system.The process of cholesterol nucleation and crystallization was divided into 4 stages,and the split phenomenon appeared in the bile system at day 21.Conclusion RBP is a pro-nucleation factor in simulated bile system.

CT Features and Differential Diagnosis of Inflammatory Pseudotumor of the Liver / 中国医学影像学杂志

Purpose:To analyze the CT appearances and diagnostic value of inflammatory pseudotumor of the liver(IPL)_O Materials and Methods: The CT findings of 19 patients with inflammatory pseudotumor of the liver proved by pathology were analyzed respectively.Results: 17 cases were solitary lesion and 2 cases had multiple lesions.19 lesions showed hypodense,2 lesions isodense on pre-contrast.On the contrast CT scan,showed no enhancement during arterial phase,but during portal venous phrase and delayed phase,strong enhancement at the edge and septa in the center or mural node,of the lesions were visible.Conclusion: CT diagnosis is possible in most cases of IPL by three phase dynamic scanning.

The Value of Color Doppler Ultrasonography in Monitoring Hemodynamic Changes in Patients with Hyperdynamic Circulatory State before and after Orthotopic Liver Transplantation / 中国医学影像学杂志

Purpose:The value of color doppler ultrasonography( CDUS) in monitoring hemodynamic changes was investigated in patients with hyperdynamic circulatory state before and during 730 days after orthotopic liver transplantation.Materials and Methods:83 cases of orthotopic liver transplantation (OLT) were examined by CDUS to assess the hemodynamic changes of portal vein,hepatic artery,splenic artery and longitudinal diameter of the spleen ( LDS).Results:(1) Portal flow velocity ( PFV) was significantly lower in pre-OLT but higher than controls (P < 0.05 ) during 730 days after OLT.Resistance index of the hepatic artery ( HARI) in pre-OLT and within 7 days- after OLT was significantly higher (P<0.05).(2) Resistance index of splenic artery ( SARI) was also significantly higher in pre-OLT (P < 0.05 ).LDS was significantly higher after OLT than in both pre-OLT phase and controls(P<0.05).Conclusions: In early stage after OLT,HARI changed from high to low value and so did PFV,which kept the stability of hepatic blood flow.In late stage,high PFV and large spleen improved,but could not back to normal.

Anticancer effects of tea polyphenols on colorectal cancer with microsatellite instability in nude mice / 中西医结合学报

To study the anticancer effects of tea polyphenols on colorectal cancer with microsatellite instability (MSI) in nude mice and to explore its mechanism.

Relation Between CD44v6 and Lymph Node Metastasis and Prognosis of Gastric Carcinoma / 中国普外基础与临床杂志

Objective To investigate the relation between CD44v6 and lymph node metastasis and prognosis of gastric carcinoma. Methods The expression of CD44v6 in 100 cases of advanced human gastric carcinoma was detected by immunohistochemical two-step method. Its relation with clinical pathology and prognosis was analyzed. Results CD44v6 expression occurred in 64%(64/100) of all gastric carcinomas; with the increase of depth of cancer invasion and local lymph node metastasis, the expression of CD44v6 elevated. Conclusion CD44v6 plays an important role in lymph node metastasis of human gastric carcinoma. It may be used as a new indicator to predict metastatic potential and prognosis of gastric carcinoma.

The impact of Syk expression on cell apoptosis in gastric carcinoma / 中国癌症杂志

Background and purpose:Spleen Tyrosine Kinase(Syk) may play a significant role in tumor signal transduction.Some studies showed that Syk was an anti-oncogene against oncogene Her-2.We investigated the impact of Syk expression on metastasis and apoptosis of gastric cancer cells in order to explore the new target therapy for the treatment of gastric carcinoma.Methods:Expression of Syk was evaluated by RT-PCR in 44 human gastric cancer tissues and adjacent normal gastric tissue samples,and apoptosis index in gastric carcinoma was detected by flow cytometry.The relationship between apoptosis index in gastric carcinoma and Syk expression was analyzed.Results:All normal gastric tissues demonstrated expression of the Syk gene,while 34 out of 44 gastric cancer tissues did not show any detectable Syk mRNA expression,there was a significant difference between the two groups(?2=9.14,P

The analysis on relation of gastric lymph node status to prognosis of patients with gastric carcinoma / 临床外科杂志

Objective To study the correlation of the number and ratio of involved lymph nodes and the prognosis of gastric carcinoma .Methods 174 patients with positive gastric lymph nodes were included,they were treated by radical gastrectomy and lymph nodes dissection (D2 or D3)in our department. The number and ratio of metastastic gastric lymph nodes were calculated. Their influence and their interrelation with pathogenic parameters were analyzed. Results The overall 5 year survival rate was 29.59%, and the five year survival rates of patients with 1 20 per cent and more than 20% positive lymph nodes were 70.58%,11.86% respectively, one to five positive lymph nodes and five more were 46.47%,17.35% respectively, the five year survival rate was decreased as the ratio and number of involved lymph nodes increased. Studies also indicated that with the increase of depth of cancer invasion ,the number and ratio of involved lymph node elevated.Conclusions The results shows that the number and ratio of involved lymph nodes correlated to tumour progression and the five survival rate.Perigastric lymph node status can be considered as a simple and effective prognosis factor.

Experience in diagnosis and treatment of digestive tract bleeding with gastrointestinal vascular malformation / 临床外科杂志

Objective To summarize the experience of diagnosis and management of bleeding with GIVM.Method The clinical data of 26 patients admitted from 1989 to 1999 were analyzed retrospectively.Results GIVM with bleeding were revealed by endoscopies (42%),by ECT (55%),by selective arteriography (83%),by barium radiography (0%),and by exploratory laparotomy(100%).1 case was cured by conservative treatment.Bleeding intestinal segment was resected in 14 cases.4 cases were cured by interventional therapy.The others were cured by sclerosing agent injection,or by suture ligation of the dilated vessel or arterial gastroduodenalis.Conclusions Endoscopy is the first choice in the bleeding from GIVM.ECT may beused later if endoscopy is useless.Selective arteriography is the most valuable method in GIVM diagnosis.If necessary, exploratory laparotomy and intraoperative endoscopies may be used.Resecting bleeding segment is the most effective treatment.Other methods such as interventional therapy and suture ligation of dilated vessel are also effective.