Objective To explore the feasibility of quantitative hemodynamics measurement of inferior vena cava (IVC) in healthy volunteers with phase-contrast sequence on 3.0 T MR system (3.0 T PC-MRI),and to evaluate the relationship between IVC lumen area,blood flow,and velocity.Methods Fifty healthy adult volunteers prospective underwent IVC PC-MRI at 3.0 T MR system.All volunteers were from our hospital for the routine chest or abdomen examinations,no heart disease and lung disease always,heart rate,blood pressure,electrocardiogram was in normal range,no abnormalities were found in clinical and abdominal imaging examinations,and IVC disease was excluded by ultrasonic examination.The area (A),mean velocity (MV),mean flux (MF),regurgitant fraction (RF) and time-flow curve of upper and middle segments of IVC during one cardiac cycle were observed.Independent samples t test was used to compare IVC lumen area and blood flow,velocity between different genders,different age groups (18 to 30 years old group,more than 30 years old group) and different phase velocity encoding value of IVC middle segment,one-way ANOVA was used to compare different phase velocity encoding value of IVC upper segment [(60,80,100)cm/s].Pearson correlation coefficient and regression equation were used to evaluate the relationships between area,blood flow,and velocity.Results Among 50 patients with successful completion of the examination,significant difference was found in A,MV,MF and RF between the different IVC segments.MF of the IVC middle segment were (37.94 ± 7.32) and (33.68 ± 6.65) ml/s in male (n =24) and female (n =26),respectively ; significant difference was found in different genders (t =2.49,P =0.017).MF of upper segment and middle segments of IVC were (54.89 ± 10.98)and (38.29 ± 7.54)ml/s in 18 to 30 years old group(n =27),while MF of upper segment and the middle of IVC were (44.96 ± 8.49) and (32.65 ± 5.59) ml/s in older than 30 years old group (n =23) with significant difference(t =3.34,2.15,P ＜ 0.01).Peak positive velocity were (55.36 ± 6.30),(61.30 ± 12.42),(62.55 ± 13.09) cnm/s in different phase velocities (60,80 and 100 cm/s),while peak negative velocity (PNV) were (42.37 ± 19.18),(32.79 ± 24.67),(24.61 ± 21.20) cm/s with significant differences (F =4.258,7.794,P ＜ 0.05).The overall image quality was good for quantitative measurement between different phase velocity encoding values of upper segment and the middle IVC (image evaluation are greater than or equal to 3,11 patients were three points,24 patients were four points,15 patients five points).The relation between the PC flow image of IVC and the cardiac cycle was sine wave,the area and the velocity of upper and middle segments of IVC was negative (r =-0.466 and-0.765,P ＜ 0.01),and no linear correlation between the area and the flow of upper and middle segments of IVC (r =0.259,0.046,P ＞ 0.05).There were slight reverse flow during systolic and diastolic cycle.Conclusion The area,flow and velocity of IVC can be rapidly,accurately and noninvasive measured with PC-MRI,and different ages,different genders and different anatomical parts of IVC had obvious hemodynamic differences.

ObjectiveTo investigate the early clinical risk factors of severe acute inhaled organic fluorine poisoning.Methods The clinical data of patients with acute poisoning of organic fluorine inhalation admitted since 2004 in Northern Jiangsu People's Hospital were retrospectively analyzed. According toDiagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning(GBZ66-2002), all the patients were divided into three groups: mild, moderate and severe poisoning groups, the severe cases were included in the intensive group, and the others were grouped in the non-intensive group. The contents in the survey were as follows: gender, age, vital signs on admission (body temperature, pulse rate, respiratory rate, systolic blood pressure), arterial blood gas analysis record〔arterial oxygen saturation(SaO2), oxygenation index(PaO2/FiO2), lactic acid(Lac) and arterial partial pressure of carbon dioxide(PaCO2), pH value(pH)〕. Before treatment, the white blood cell(WBC) count, platelet(PLT) count, levels of alanine transaminase(ALT), creatinine(Cr), blood glucose, electrolytes(potassium, sodium, chloride, calcium), creatine kinase isoenzyme(CK-MB), etc. were examined and recorded. All the patients were immediately arranged for bedside chest X-ray examination, and the chest X-ray lung injury scores were recorded. By univariate and multivariate logistic regression analyses, the receiver operating characteristic curve(ROC curve) was drawn to evaluate the diagnostic value of the clinical risk factors.Results Sixty-two cases consisting with the standard criteria of enrollment were collected in the study, 36 cases being in intensive group and 26 cases in non-intensive group. The univariate analysis showed that the differences in pulse rate, respiratory rate, PaO2/FiO2, WBC, SaO2, Lac, pH, and lung injury score were statistically significant(P<0.05 orP<0.01). Logistic multiple regression analysis showed that PaO2/FiO2, WBC, Lac and chest X-ray lung injury score were the four indexes for predicting the independent risk factors of severe acute inhaled organic fluorine poisoning. The area under ROC curve(AUC) of PaO2/FiO2 was the highest(0.884), 95% confidence interval(95%CI) was 0.784 - 0.984, the critical value was 96.5 mmHg(1 mmHg=0.133 kPa), with the sensitivity of 75.6%, specificity of 95.2%, positive predictive value(PPV) of 92.3% and the negative predictive value(NPV) of 71.4%, in sequence, the rest were WBC(AUC 0.846, 95%CI 0.728 - 0.965, the criticalvalue 12.15×109/L), Lac(AUC 0.800, 95%CI 0.662 - 0.938, the critical value 4.2 mmol/L), chest X-ray lung injury score(AUC 0.795, 95%CI 0.652 - 0.938, the critical value 2.50), the sensitivity of the above three items was 90.2%, 83.6%, 88.5%, specificity was 90.2%, 83.6%, 88.5%, the PPV was 86.7%, 82.4%, 85.8% and NPV was 72.0%, 73.9%, 69.2% respectively.ConclusionThe blood WBC count, Lac, PaO2/FiO2 and chest X-ray lung injury score can be used as the early clinical risk factors of severe acute inhaled organic fluorine poisoning.

Objective To investigate the expression and clinical significance of platelet activating factor [PAC]-1, CD62P and TPP hi severe sepsis. Method Patients with severe sepsis who were admitted into the EICU of Subei People's Hospital from April 2007 to March 2008 were included. Patients with severe sepsis (Group Ⅲ)were treated according to the treatment guidelines for severe sepsis, and were divided, according to their clinical records, into those who survived and those who died within 28 days of admission. Patients admitted during the same period with symptoms of infection but without severe sepsis were included as the General Infected Group (Group Ⅱ). A Control Group (Group Ⅰ) comprised patients who visited the hospital over the same period for physical examination or the healthy volunteers. The group members were all included randomly, and the gender and sex of patients in all three groups were similar. Patients with acute brain infarction, acute coronary syndrome,serious diabetes, hyperlipidemia, malignant tumor, leukemia, primary liver, renal and hematopoietic system dis-eases,long-term bedridden patients, pregnant women, and patients taking hormone treatment or hranunosuppres-sants were excluded from the study. Morning venous blood was collected and ELISA and Flow Cytometry performed on the fwst day of admission for Groups Ⅰ- and Ⅱ, and on the first, third and fifth day after admission for Group Ⅲ, to determine the TpP,PAC-1 and CD62P respectively; and the Marshall score was determined. Data were ana-lyzed by SPSS 12.0 software. For continuous variables, comparisons among groups were analyzed by ANOVA.Levene's and LSD test were applied to assess homogeneity. Bivariate test is applied to Correlation Analysis. P<0.05 was regarded as a statistically significant difference. Results There were a total of 20 patients each in GroupⅠ-and GroupⅡ, and 30 in Group Ⅲ; of these, 19 were classed as survivors and 11 died during the 28-day peri-od. On the first day of admission, there were no significant differences in PAC-1, CD62P or TpP expression between Groups Ⅰ- and Ⅱ(P>0.05); however, Group Ⅲ was significantly different compared with both Group Ⅰ and Group Ⅱ (both:P<0.05). The expression of PAC-1, CD62P and TpP tended to decline in the survivor group,and became normal with the treatment process, while the expression of PAC-1 ,CD62P and TpP in the patients who died remained high, and even increased significantly over time. On the first day, the expression of CD62P and TpP in the patients who survived and in those who died was not significantly different (P>0.05); on the third day,however, a significant difference appeared with values of (2.89±1.48) % vs. (5.04±2.57) % (P<0.01) for CD62P, and (5.24±2.22) mg/L vs. (9.20±1.93) mg/L (P<0.01) for TpP. The expression of PAC-1 was significantly different between the two subgroups on the first day, with values of (3.15±0.42)% vs. (5.30±.48)% (P<0.01). The Marshall score of the two groups showed similar changes. Correlation analysis showed that PAC-1, CD62P and TpP were significantly correlated with the Marshall score. Conclusions Platelet activation and microthrombosis existing in the early stage of severe sepsis work together in the early hypercoagulable state.They both play important roles in disease development and progression. The dynamic detection of CD62P and TpP is beneficial to the diagnosis and prognosis of severe sepsis.PAC-1 appears to hold a risk stratification effect, as pa-tients with high expression of PAC-1 in the early stage show poor prognosis. Therefore, PAC-1 could be used as a marker of severe sepsis and poor prognsis.

Objective To investigate the diagnostic value of calcification and cystic lesion of CT findings in differentiating pancreatic head ductal carcinoma (PHDA)from mass-forming chronic pancreatitis (MFCP)of the pancreatic head.Methods The clinic data and CT findings of 30 cases with PHDA and 24 cases with MFCP of the pancreatic head,which were confirmed by surgery and pathology were analyzed retrospectively.The images were reviewed independently by two expert radiologists with a double-blind method.An independent sample t test and chi-square test were used to compare the data of imaging findings between two groups.Results ① Calcification was found in 14 cases (58.33%)with MFCP and in 3 cases (10%)with PHDA (P＜0.001).The percentage of patchy,punctate and mixed calcification were 28.57% (n=4),14.29% (n=2)and 57.14% (n=8)in MFCP,0% (n=0),66.67% (n=2)and 33.33% (n=1) in PHDA,respectively.② Necrotic cyst was founded in 7 cases (29.17%)with MFCP and 18 cases (60%)with PHDA(P＜0.05). Pseudocysts were demonstrated in 14 cases (58.33%)with MFCP and in 3 cases (10%)with PHDA (P＜0.001).Honeycombed change with tension within or around the lesion were demonstrated only in patients with MFCP.In addition,normal tissue of the pancreas was found within the lesion in 11 cases (45.83%)of MFCP and none in PHDA,which showed significant difference between two groups.Conclusion Mixed calcification and honeycomb with tension of CT findings are of significant value in differentiating PHDA from MFCP of the pancreatic head.

Objective To evaluate CT vs.MRI in the intrapancreatic and relevant extrapancreatic findings of acute pancreatitis (AP).Methods The clinical data and image findings of 52 AP cases from Jan 2015 to Jun 2017 were analyzed retrospectively.Results CT is comparable to MRI in the diagnostic value of pancreatic enlargement and pancreatic necrosis (all P ＞ 0.05).Compared to CT,MRIwas superior in detecting the peripancreatic exudes,thickening of renal fascia,pleural effusion and abdominal wall edema (all P ＜ 0.01).In favor of MRI,there was significant difference in detection of gallbladder stones and choledocholithiasis,and hepatic swelling,hepatic fatty infiltration.Conclusions Both CT and MRI are significantly helpful to the early precise diagnosis of AP,while MRIis superior in showing etiology,pancreatic hemorrhage and necrosis,extrapancreatic lesions.