Objective To evaluate the clinical application of postprocessing technique of spiral CT images in chest diseases.Methods Chest spiral CT was performed in 105 cases and 10 normal controls.The postprocessing images were done using software and compared to conventional CT, fiberoptic bronchoscopy, operation and pathological results. Results The postprocessing images had better MPR and 3D view of organs, nice contrast between of lesion and sorroundings structures.This postprocessing techniques provided more informations in observing and analysing the chest disease.Conclusion Postprocessing technique of spiral CT images is an important complimentation for 2D CT analysis, and has many advantages especially on thoracic disease diagnosis,but they should be applied in combination with two-dimensional CT to achieve accurate diagnosis.

AIM:The direct renin inhibitor aliskiren displays antihypertensive and antialbuminuric effects in humans and in animal models . Emerging evidence has shown that aliskiren localizes and persists in medullary collecting ducts even after treatment was discontinued . The purpose of the present study was to investigate whether aliskiren regulates renal aquaporin expression and improves urinary concen -trating defect induced by lithium .METHODS:The mice were either fed with normal chow or LiCl diet (40 mmol/kg dry food per day for first 4 days and 20 mmol/kg dry food per day for last 3 days ) for seven days .Some mice were intraperitoneally injected aliskiren ( 50 mg/kg BW per day in saline ) .RESULTS:Mice injected aliskiren developed decreased urine output and increased urine osmolal -ity when compared with controls .Aliskiren significantly increased protein abundance of AQP 2 and phosphorylated-S256 AQP2 in the kidney inner medulla .Immunohistochemistry and immunofluoresence showed increased apical and intracellular labeling of AQP 2 and pS256-AQP2 in collecting duct principal cells of kidneys in mice treated with aliskiren .Aliskiren treatment prevented urinary concen-trating defect in lithium-treated mice , and improved the downregulation of AQP 2 and pS256-AQP2 protein abundance in inner medulla of the kidney .In primary cultured rat inner medulla collecting duct cells , aliskiren dramatically increased AQP 2 protein abundance which was significantly inhibited either by PKA inhibitor H 89 or by adenylyl cyclase inhibitor MDL 12330, indicating an involvement of the cAMP signalling pathway in mediating aliskiren-induced increased AQP 2 expression .CONCLUSION: The direct renin inhibitor aliskiren upregulates AQP 2 protein expression in inner medullary collecting duct principal cells and prevents lithium -induced nephro-genic diabetes insipidus ( NDI) likely via PKA-cAMP pathways .

OBJECTIVE To investigate the pathogenic change and bacterial antibiotic resistance in lower respiratory tract infection in inpatients of chronic pulmonary heavt disease(CPHD) for recently 3 years and to provide reference for clinical treatment.METHODS Retrospective analysis was conducted on sputum cultivation from CPHD patients who were hospitalized from Jan 2004 to Dec 2006.RESULTS A total of 772 pathogenic strains were isolated,60.1 % of which were Gram-negative bacilli.Pseudomonas aeruginosa,Klebsiella Pneumoniae,Escherichia coli and Acinetobacter baumannii were the main Gram-negative pathogens.Gram-positive bacilli accounted for 13.7%,most of which were Streptococcus pneumoniae,Staphylococcus aureus and so on.Fungi accounted for 26.2%.Imipenem/cilastatin sodium was the most sensitive drug for P.aeruginosa,Acinebacter and Enterobacteriaceae.And vancomycin hydrochloride was the most for S.aureus.Their multiple drug-resistance to anti-microbial agents was serious.CONCLUSIONS Gram-negative bacteria are the majority of the pathogens from CPHD of lower respiratory tract infection in hospital.The pathogens show multiple drug-resistance in drug sensitive test.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.

Objective To investigate the vasopressin (VP) response to increasing osmotic pressure in the late-phase of septic shock patients.Methods Thirty-seven septic shock patients hospitalized in intensive care unit (ICU) of the First Hospital of Hebei Medical Unive~ity from January 2012 to September 2013 were enrolled.All patients received 3％ hypertonic saline solution infusion.Serum concentrations of VP and sodium were measured before and after hypertonic saline solution infusion.Patients with ratio of difference in VP and sodium before and after infusion of 3％ hypertonic saline (△VP/△Na) ≤0.5 pg/mmol were defined as nonresponders,and who ＞0.5 pg/mmol defined as responders.The age,acute physiological and chronic health evaluation Ⅱ (APACHE Ⅱ) score,blood pressure,albumin level,vasoactive drug between the two groups were also analyzed.Results VP level in the nonresponsive group (n=20,54.05％) was markedly lowered before (ng/L:10.41 ± 1.70 vs.18.25 ± 5.90,t=5.29,P＜0.01) and after (ng/L:11.36 ± 1.90 vs.24.33 ± 5.46,t=9.33,P＜0.01) 3％ hypertonic saline solution infusion,compared with that in the responsive group (n =17,45.95％).All patients in the two groups were given dopamine (DA) or norepinephrine (NE) for maintaining blood pressure,and the dose in the nonresponsive group were higher than those in the responsive group [DA (μg· kg-1· min-1):14.91 ± 3.78 vs.8.64 ± 1.69,t =-5.02,P＜ 0.01 ; NE (μg· kg-1· min-1):1.03 ± 0.48 vs.0.38 ± 0.12,t=-3.12,P＜0.01].Three patients were given DA plus NE in the nonresponsive group while patients in the responsive group received only single drug therapy.The age,APACHE Ⅱ score,blood pressure,albumin level,sodium level before and after hypertonic saline solution infusion between the two groups were not statistically different.Conclusion VP secretion to osmotic challenge was impaired and decreased in the late-phase of septic shock,prompting dysfunction in VP synthesis.

Objective To characterize the clinical factors which influence water suppression and auto-shimming line width for liver 3.0 T 1H-MRS.Methods Fifty-seven cases with liver 1H-MR spectroscopy(1H-MRS) were retrospectively studied, including chronic type B hepatitis (n=5), fatty liver (n=14), chronic type B hepatitis combining fatty liver (n=3) and normal situation (n=35).Independent t test was used to characterize the difference of general condition (height, weight, body mass index etc.) between different water suppression effect groups and between different shimming effect groups.Using Chi-square test to analyze whether water suppression rate and auto-shimming line width between fatty liver groups and non-fatty liver exist significance difference .Results By comparing WS ≥90% (n=47)group with WS < 90% (n=10) group, the former showed smaller average height[(164.7±8.0) and (170.5±3.7) cm respectively], weight[(61.8±10.4) and (73.4±5.4) kg respectively], BMI [(22.7±3.2) and (25.2±1.3)kg/m2 respectively]and LW[(17.7±3.7)and(24.6±6.3) Hz respectively]than the latter (t=-3.488,-3.415,-4.002 and-3.327, P < 0.05).By comparing LW 20 Hz (n=41) group with LW 20 Hz (n=16) group, the former showed better water suppression rate [(93.0±2.7)% and (86.1±8.5)% respectively]than the latter(t=3.213,P <0.05), whereas larger weight[(62.2±11.6) and (68.1±6.1)kg respectively]and BMI[(22.8±3.4) and (24.2±1.9)kg/m2 respectively](t=-2.516,-2.024,P <0.05).LW≤20 Hz in the fatty liver and non-fatty liver group was 7/17 and 34/40, respectively (X2=11.347, P < 0.05).WS < 90% in the fatty liver and non-fatty liver group was 10/17 and 0/44, respectively (X2=28.536, P < 0.05) .Conclusion Hepatic steatosis exerts an adverse effect in water suppression and shimming.

The purpose of this paper is to clarify the structure-activity relationship of anti-tumor activity of diosgenin derivatives in vitro. Study has found that diosgenin can inhibit the reproduction of tumor cells by inducing apoptosis and the main target spot of this effect is Bcl-2. Based on the characteristics of pharmacophoric points' of the three-dimensional pharmacophore for Bcl-2 inhibitors, we have docked lots of diosgenin derivatives with Bcl-2, then synthesized 31 compounds of them, finally assessed the anti-tumor activity of the diosgenin derivatives in vitro against A375, A549, HepG-2 and K562. Preliminary studies of SAR have indicated that the aliphatic esters, and aromatic esters of diosgenin without F ring have no anti-tumor activity in vitro. The triazole bromides of diosgenin all achieve fairly good anti-tumor activity in vitro, and those with larger hydrophobic group have the better activity. The stronger is the hydrogen bonding interaction and dipole-dipole interaction of the heterocyclic of diosgenin and diosgenin without F ring and the acid ester of diosgenin without F ring, the better is the activity of derivatives.

Objective To evaluate the cardioprotection induced by ischemic preconditioning ( IPC) and hypoxic preconditioning ( HPC) which were carried out by using the double cardiopulmonary bypass ( CPB) circuits in in vivo hearts of dogs. Methods Eighteen healthy male dogs, weighing 17?5-24?5 kg, aged 13-24 months, were divided into 3 groups ( n=6 each) using a random number table: my?ocardial ischemia?reperfusion group (group I∕R), IPC group and HPC group. The double CPB circuits were established as follows: systemic and coronary circulation, and independent systemic and coronary cir?culation was carried out. In group IPC, the aorta was clamped, and the coronary circulation pump was sus?pended for 5 min followed by 5 min opening, repeating for 3 cycles. In group HPC, the aorta was clamped, the coronary circulation was started, and pure nitrogen was insufflated for 5 min followed by 5 min of oxygen insufflation, repeating for 3 cycles. CPB was performed for 1 h starting from the time point immediately after IPC or HPC. Before splitting of sternum ( T1 ) , after establishment of double CPB circuits ( T2 ) , at the end of preconditioning ( T3 ) , and at 60 and 120 min after restoration of spontaneous heart
beat ( T4,5 ) , heat rate, mean arterial pressure, central venous pressure, left ventricular end?systolic pres?sure, left ventricular end?diastolic pressure and the maximum rate of increase∕decrease of left ventricular pressure were recorded. Blood samples were collected from the right internal jugular vein at T1 and T4,5 for determination of serum cardiac troponin I concentrations. The animals were sacrificed after determination of the parameter or after blood sampling at T5 , myocardial specimens were obtained for examination of the ul?trastructure and for detection of apoptosis in cardiomyocytes, and apoptosis index was calculated. Before aortic clamping, immediately after aortic unclamping and at 30 min after aortic unclamping, myocardial specimens were obtained for determination of ATP contents in cardiomyocytes. Results Compared with I∕R group, left ventricular end?systolic pressure was significantly increased, and the serum cardiac troponin I concentrations were significantly decreased at T4,5 , the myocardial ATP contents were significantly in?creased immediately after aortic unclamping and at 30 min after aortic unclamping, apoptosis index was sig?nificantly decreased ( P<0?05 or 0?01) , and the pathological changes were significantly attenuated in IPC and HPC groups. Compared with group IPC, the myocardial ATP contents were significantly increased (P<0?05), and the pathological changes were attenuated in group HPC. Conclusion Both HPC and IPC can exert cardioprotection when carried out by using the double CPB circuits, and HPC provides better cardioprotection than IPC in in vivo hearts of dogs.

Objective To discuss the influence of motor imagery therapy on the recovery of the stroke patients with aphasia.Methods Sixty cases of stroke patients with aphasia were divided into the treatment group and the control group according to the odd and even of last number.The single number was set into the control group.The double number was given to the treatment group.There were thirty patients in each group.Both groups received the conventional drug treatment and routine care of the Department of Neurology.On this basis,from the second day in hospital,the treatment group received the speech rehabili tation training with motor imagery therapy.Aphasia assessment was done for the two groups on the first day in hospital with CRRCAE.On the first day and after receiving ten-day treatment with motor imagery therapy,the grade of the severity for aphasia of Boston Diagnostic Aphasia Examination (BDAE) was done to assess the severity of aphasia in two groups.The scores of the two groups were compared.Results Before the treatment,there was no significant difference between the two groups.After receiving ten times treatment,both the two groups were improved.Compared with the control group,the treatment group became better.There was statistically significant difference between the two groups.Conclusions For the stroke patients with aphasia,motor imagery therapy has significant effect on their recovery.

AIM: To study the effect of cholecystokinin octapeptide(CCK-8) on lipopolysaccharide (LPS)-stimulated pulmonary interstitial macrophage(IM) in vitro. METHODS: Pulmonary IM were isolated and cultured in the presence of LPS, CCK-8, proglumide(the antagonist of CCK receptors) and vehicle alone or together. The expression of mCD14 protein was assayed by flow cytometry, and sCD14 in the supernatant was analyzed semi-quantitatively by Western blot, and TNF-? in the supernatant was detected with ELISA. RESULTS: CCK-8, at concentrations from 10 -7 mol/L to 10 -6 mol/L inhibited significantly the expression of mCD14, the release of sCD14 and TNF-? to the supernatant up-regulated by LPS(1 mg/L). The effect of CCK-8 was inhibited by proglumide. CONCLUSION: CCK-8 modulated negatively several functions of LPS-stimulated pulmonary IM through CCK receptors, which may be one of the mechanisms for CCK-8 to alleviate the inflammation in lung tissues during endotoxemia.

Objective To explore the cost-effectiveness and clinical effect of three platinum based chemotherapy regiments for advanced non small cell lung cancer (NSCLC).Methods 100 patients who were diagnosed as NSCLC,were randomly divided into four groups.The group Ⅰ received NP which was given NVB and DDP.The group Ⅱreceived GP which was given GEM and DDP.The group Ⅲ received TP which was given taxotere and DDP.The clinical effect,adverse reaction and cost effectiveness of the three groups were assessed.Results The clinical effective rates of the three groups were 31.43%,36.36%,37.50% from Ⅰ to Ⅲ group.The adverse events of the group Ⅰ and group Ⅱ were more than those of the group Ⅲ.In the adverse effects of treatment,the major cytotoxicity was digestive reaction and leukopenia in the two groups,but they were tolerable.The ratios of cost effectiveness in the four groups were 550.22yuan,556.48yuan,583.23yuan from Ⅰ to Ⅲ group.Conclusion The NP group is the best one in total cost.