Objective To explore the effects of selective intra arterial chemotherapy for preoperative gastric cancer. Methods 35 cases of gastric cancer treated by selective intra arterial perfusion of chemrotherapy before operation, together with clinical manifestations、findings in operation, pathological changes and clinical effects were retrospectively reviewed. Results The total effective rate proved by pathology was 81%, of them slight efficiency was in 14 patients(45%), moderate in 11 patients(36%). The clinical relieve rate was 77%, complete relieve in 5 patients(14%), partial relieve in 14 patients(45%). Conclusions Interventional intra arterial perfusion chemotherapy of gastric cancer before operation is an effective method for elevating resection rate of gastric cancer.

Objective To compare changes in indexes and analyze their values in prognosis of severe burn patients with sepsis.Methods A retrospective analysis was conducted. The patients with severe burn sepsis admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2016 were enrolled. The blood culture was positive in the clinical diagnosis of sepsis. According to the prognosis, the patients were divided into death group and survival group. Their general information, vital signs, blood routine examination, serum sodium (Na+), serum glucose (Glu), C-reactive protein (CRP) and arterial partial pressure of carbon dioxide (PaCO2) at the time of admission and diagnosis of sepsis as well as the level of serum procalcitonin (PCT) at admission, diagnosis of sepsis and 1-8 days of post diagnosis were also compared. Receiver operating characteristic curve (ROC) was used to analyze the prognostic value of each index, and multivariate Cox regression analysis was used to analyze the influence of each index on the survival time, and the survival curve of Kaplan-Meier was analyzed for dead patients.Results There were 25 cases of severe burn patients with sepsis, which were admitted to hospital within 12 hours after injury; the time of diagnosis of burn sepsis was (14±6) days; 8 cases of survival; 17 cases died, the mortality rate was 68.0%, the time from diagnosis of sepsis to death was (28±14) days. The age of the death group was significantly higher than that of the survival group (years: 41±12 vs. 29±9,t = 2.598,P = 0.016), but there was no significant difference in the gender, total burn area,Ⅲ degree area, and the time of diagnosis of sepsis between the two groups. The platelet count (PLT) at the diagnosis of sepsis in death group was significantly lower than that of the survival group (×109/L: 69±43 vs. 180±108,t = -2.773, P = 0.023), and the PCT at 1-8 days of post-diagnosis in the death group was significantly higher than that of survival group [μg/L: 4.4 (2.2, 9.0) vs. 1.6 (0.7, 2.3),Z = -2.521,P = 0.012], but there was no significant difference in body temperature, heart rate, white blood cell count (WBC), percentage of neutrophils (Neu), Na+, Glu, CRP, PCT, PaCO2 at the time of admission and diagnosis of sepsis and PLT at the time of admission between the two groups. ROC curve analysis showed that the area under ROC curve (AUC) of age, PLT at the time of diagnosis and PCT at 1-8 days of post-diagnosis of sepsis was 0.808, 0.779, 0.825, respectively, for predicting the prognosis of patients with severe burn sepsis (allP < 0.05). At the cut-off age of 32, the sensitivity was 73.3% and the specificity was 75.0%. As the cut-off of PLT was 138×109/L at the time of diagnosis, the sensitivity was 92.3% and the specificity was 75.0%. As the cut-off of PCT was 2.39μg/L at 1-8 days of post-diagnosis of sepsis, the sensitivity was 73.3% and the specificity was 87.5%. Multivariate Cox regression analysis showed that age and PLT at the time of diagnosis were the favorable factors for the survival time of patients with severe burn sepsis (β value were -1.834, -0.029, respectively, bothP < 0.05). Kaplan-Meier survival analysis for patients in the death group showed that the median survival time of patients ≥32 years old was longer than that of patients < 32 years old (days: 32 vs. 9); 18-day cumulative survival rate was significantly higher than that of patients < 32 years old [83.3% (10/12) vs. 25.0% (1/4),χ2 = 9.705,P = 0.003].Conclusion Age, PLT at diagnosis of sepsis and PCT at 1-8 days after diagnosis of sepsis could be used as prognostic indexes for severe burn patients with sepsis.

Objective By using 18F-deoxyglucose (18F-FDG) positron emission computed tomography (PET-CT) to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen (HBO) therapy,and to investigate the mechanisms of H BO treating patients with traumatic brain injury.Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group.The patients of both groups received routine clinical interventions (including neuroprotection,dehydration,reducing intracranial pressure,anti-infection and other symptomatic treatments).Patients of the HBO group received the basic treatment combined with HBO therapy one tine per day for 7 days per week.In early stage and 4 weeks after treatment,all patients were examined with PET-CT scanning and Glasgow coma scale (GCS),disability rating scale (DRS) at the same time.Results There was standard uptake value (SUV) of significant difference between affected and unaffected brain areas in two groups before treatment(P＜0.01),but no significant difference between two groups (P＞0.05).After 4-week of treatment,SUV of affected and unaffected brain areas of two groups improved,the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group (P＜0.0l).The GCS and DRS scores of HBO group were also significantly better than that of control group (P＜0.05).Conclusion The 18F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area,promote the brain functional recovery and awakening,and improve the prognosis in patients with severe traumatic brain injury.

At present,the urinalysis has many puzzles and problems,this paper is proposed consensus of the key problems including standardization method in the urine formed elements examination,the urinalysis screening test,the results of reference intervals between the different examination methods,quantitative of the visible components,using centrifugal or non-centrifugal urine to do urine formed elements examination and the development direction of automatic urine sediment analyzer.These key problems are discussed and the consensus are put forward,in order to cause concern.( Chin J Lab Med,2012,35:790-791 )

Objective To evaluate the heterozygous ambiguity resolution primers (HARPs) method in resolving ambiguous genotyping results of human leukocyte antigen (HLA) genes in Chinese Hart population, and choose some appropriate HARPs primers. Methods HLA-A, HLA-B and HLA-DRB1 genes of 416 southern Chinese Han individuals were genotyped by sequence-based-typing(SBT) method and then the ambiguous genotyping samples were sequenced again by HARPs primers provided by American Atria company. Results The percentage of ambiguous genotyping samples resolved by HARPs for HLA-A, HLA-B and HLA-DRBI locus was 86.3% (132/153), 73.9% (130/176) and 38.1% (85/223) respectively. Among them, 48.5% (64/132)HLA-A, 80.0% (104/130)HLA-B and all HLA-DRB1(85/85)samples only need one primer, 47.7 % (63/132)HLA-A and 20.0% (26/130)HLA-B samples need two primers. Three to six different HARPs primers can resolve more than 90% ambiguities. Conclusion HARPs is a convenient method and could be a routine method to resolve ambiguities for HLA-A, HLA-B and HLA-DRB1 genes genotyped by SBT in Chinese Han population.

Objective To study the molecular genetic polymorphism of exons 1,5, 6, 7 of HLA-C gene in Chinese population and evaluate the significance of additional sequencing based typing at exons 1,5, 6, 7 of HLA-Cw gene in clinical HLA matching, Methods A total of 324 individuals were typed at exons 2,3, 4 of HLA-C gene by sequence-based typing. If ambiguities appeared outside of exons 2 -4, we designed a total of 5 in-house sequencing primers and optimized the sequencing reaction, additional sequencing based typing at exons 1,5, 6, 7 was performed to solove the emerging ambiguities. Results In the three hundred and twenty-four samples typed by PCR-SBT at exons 2, 3 and 4 of HLA-Cw gene, 23.8 % (77/324) of the typed samples were assigned the conclusive genotype in four digital level 76. 2% (247/324) of the typed samples were given with the ambiguous allele combination results, in which 73 kinds of ambiguous allele combinations were detected. Increasing the additional sequencing analysis at exons 1, 5, 6, 7 of HIA-C gene, ten frequent ambiguities including Cw* 030201/030202, Cw* 070201/0750, Cw* 040101/0409N/0430, Cw* 0403/0409N/0430, Cw* 080101/0822 could be distinguished. ConclusionsIncreasing the sequencing anlysis at exons 1, 5, 6 and 7 of HLA-Cw gene will help to make clear the ambiguous SBT results and also improve the accuracy of HLA-Cw typing. It shows important significance in clinical histoeompatibility matching.

OBJECTIVETo study the genetic polymorphisms of human leukocyte antigen (HLA)- A, B, C, DRB1, DQA1, DQB1, DPA1and DPB1among ethnic Hans from southern China.

METHODS481 randomly selected individuals were genotyped using a polymerase chain reaction (PCR) sequence-based typing (SBT) method for the above genes. Their allele frequencies were determined by direct counting.

RESULTSIn total, 28 HLA-A, 57 HLA-B, 28 HLA-C, 40 HLA-DRB1, 18 HLA-DQA1, 17 HLA-DQB1, 6 HLA-DPA1and 21 HLA-DPB1alleles were identified. Among these, common alleles (with allelic frequencies > 0.05) included A*1101, A*2402, A*0207, A*3303, A*0201, B*40:01, B*46:01, B*58:01, B*13:01, B*15:02, C*01:02, C*07:02, C*03:04, C*03:02, C*08:01, C*03:03, C*04:01, DRB1*09:01, DRB1*15:01, DRB1*12:02, DRB1*08:03, DRB1*03:01, DRB1*04:05, DRB1*11:01, DQA1*01:02, DQA1*03:02, DQA1*03:03, DQA1*06:01, DQA1*01:03, DQA1*05:05, DQA1*01:04, DQA1*03:01, DQA1*05:01, DQB1*03:01, DQB1*03:03, DQB1*06:01, DQB1*05:02, DQB1*03:02, DQB1*02:01, DQB1*03:02, DQB1*06:02, DPA1*02:02, DPA1*01:03, DPA1*02:01, DPB1*05:01, DPB1*02:01, DPB1*13:01, DPB1*04:01and DPB1*02:02.For each of the locus, the overall frequencies of common alleles were 75.57%, 52.81%, 78.28%, 62.16%, 86.70%, 77.23%, 95.32% and 81.59%, respectively.

CONCLUSIONThe allelic frequencies of the 8 selected HLA loci among ethnic Hans from southern China may served as a reference for anthropology, legal medicine, transplantation and disease association studies.

Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Gene Frequency ; Genotype ; Genotyping Techniques ; methods ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-C Antigens ; genetics ; HLA-DP Antigens ; genetics ; HLA-DQ alpha-Chains ; genetics ; HLA-DQ beta-Chains ; genetics ; HLA-DRB1 Chains ; genetics ; Histocompatibility Antigens Class I ; genetics ; Histocompatibility Antigens Class II ; genetics ; Humans ; Linkage Disequilibrium ; Polymerase Chain Reaction ; Polymorphism, Genetic

OBJECTIVETo report the initial application of brain protection device in the dilatation and stenting of atherosclerotic stenosis of the carotid and vertebral artery.

METHODSEighteen patients with 21 atherosclerotic stenoses of the carotid or vertebral artery underwent dilatation and/or stenting with brain protection device (filterwire or angioguard). The clinical results were summarized and the indispensability and feasibility of the device was discussed.

RESULTSWith the aid of brain protection device, endovascular dilatation and (or) stenting were performed in all the patients with 21 stenoses of the carotid or vertebral artery. The interventional manipulation was successful and no complications occurred.

CONCLUSIONSBrain protection device is helpful to decrease the embolic complication caused by atherosclerotic plaque and thromboembolus and to increase the security of interventional therapy, during the dilatation and/or stenting of stenosis of the carotid or vertebral artery.

Adult ; Aged ; Angioplasty, Balloon ; adverse effects ; methods ; Carotid Stenosis ; therapy ; Female ; Follow-Up Studies ; Humans ; Intracranial Embolism ; etiology ; prevention & control ; Male ; Middle Aged ; Protective Devices ; Stents ; adverse effects ; Vertebrobasilar Insufficiency ; therapy

Objective To investigate the effect of different radiation doses on the accuracy of iodine quantification and CT value of virtual monochromatic image with a muti-spectral CT iodine phantom using second-generation dual-layer detector spectral CT(DLCT).Methods The second-generation DLCT scan abdominal phantom was used,which consisted of six different concentrations of iodine rods at 4,8 and 12 g/L.The scan parameters were set at 100,120 and 140 kVp tube voltages,and six radiation exposure sequences were scanned at each tube voltage:5,10,15,20,25 and 30 mGy.Measure the iodine concentration value and the CT value at the single level of 50,70 and 100 keV,and calculate the absolute error value of iodine concentration and CT value under different radiation exposure.SPSS 22.0 software single factor analysis of variance was used to compare the difference between the io-dine concentration and the absolute error of CT value under different Radiation exposure,and LSD method was used to compare the two groups.Results The absolute error of CT value of 4 g/L iodine rod with 10～30 mGy scanning at 100 keV energy level was significantly higher than that of 12 g/L and 8 g/L(P＜0.05),and the absolute error of iodine concentration measurement of other iodine rods with different concentrations at different Radiation exposure had no statistical difference.Conclusions The second-generation double-layer detector spectral CT has high meas-urement stability for iodine concentration quantification and CT value accuracy under conditions of radiation dose greater than 5 mGy.

Objective To evaluate the feasibility of peripheral artery CT angiography (CTA)under 70 kV with 50 ml contrast medium on the third-generation dual-source CT. Methods Totally 82 patients who were equally randomized into two groups:70 kV group:the scan was performed under 70 kV tube voltage+50 ml iopromide on the third-generation dual-source CT;and 100 kV group:the scan was performed under 100 kV tube voltage+90 ml iopromide on the second-generation dual-source CT. The CT number of abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were measured and contrast to noise ratio(CNR),signal to noise ratio(SNR)were calculated. The image quality was compared between these two groups. Results The dose-length product was (195.8±46.9)mGy·cm in 70 kV group,which was significantly lower than that in 100 kV group (461.6±57.9)mGy·cm,and was decreased by 57% (t=-22.848,P=0.000). Compared with the 100 kV group,the CT number of the proximal abdominal aorta in 70 kV group was significantly lower(t=-2.502,P=0.014),while the CT number of superficial femoral arteries (t=3.053,P=0.003)and popliteal arteries (t=4.013,P=0.000)was much higher in 70 kV group. SNR and CNR of proximal abdominal aorta,distal abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were significantly lower in 70 kV group than those in 100 kV group (all P<0.05). The artifacts in abdominal aorta (t=2.893,P=0.000)and feet arteries (t=3.776,P=0.000)were higher in 70 kV group than those in 100 kV group,the enhancement of abdominal aorta (t=-1.000,P=0.002)and feet arteries (t=2.893,P=0.010)were lower in 70 kV group,the enhancement of femoral-popliteal arteries (t=-1.000,P=0.000)and arteries of calf (t=4.261,P=0.000)were higher in 70 kV group. Compared with the 100 kV group,the image noise in aorta (t=2.048,P=0.044),femoral-popliteal arteries (t=8.370,P=0.000),arteries of the calf (t=8.315,P=0.000)and feet arteries (t=7.202,P=0.000)were higher in 70 kV group. Conclusion Compared to conventional scan protocol,using 70 kV tube voltage with 50 ml contrast medium to perform peripheral artery CTA can assure the image quality and meanwhile remarkably reduce the radiation dose and the use of contrast medium.
Aorta, Abdominal ; diagnostic imaging ; Arteries ; diagnostic imaging ; Artifacts ; Computed Tomography Angiography ; Contrast Media ; Humans ; Iohexol ; analogs & derivatives ; Leg ; blood supply ; Radiation Dosage ; Signal-To-Noise Ratio ; Tomography, X-Ray Computed