Objective To explore the effects of baicalin on the expression of ICAM-1 in lung injury induced by severe acute pancreatitis(SAP). Methods SAP model was induced by injection of 62mmol/L sodium taurocholate solution into biliopancreatic duct. A total of 72 SD rats were randomly divided into 3 groups: sham operation group, SAP group and SAP treated with BA group. Myeloperoxidase(MPO) activity in lung tissue was examined at 3, 6 and 12h. The expression of ICAM-1 in lung tissue was determined by immunohistochemical technique. The pathological changes of pancreas and lung tissue were examined under optical microscope. Results The levels of MPO activity, which were similar between SAP group and Baicalin group in the early 3 hours, were dramatically lower in Baicalin group at 6h, 12h(P

Objective To observe and compare the function of peripheral blood derived dendritic cells (DC) in white hair black eyes (WHBE) rabbits and Japanese white (JW) rabbits with allergic rhinitis (AR) induced by ovalbumin (OVA),and to explore the mechanism of sensitivity to allergen in WHBE rabbits.Methods For the AR induction,rabbits were sensitized intraperitoneally everyday with OVA emulsified in Al(OH)3 followed from day 17 onward by 5 times nasal challenges with OVA in each nostril.General symptoms and histopathological changes of the nasal mucosa were observed.Expressions of CD86 on cell surface and antigen uptake of peripheral blood-derived dendritic cells were detected by flow cytometry at 6 days of culture.The mannose receptor (MR) mRNA expression was tested by real-time PCR.Proliferation of CFSE [5-(and 6-)-carboxyfluorescein diacetate succinimidyl ester]-labelled T cells stimulated by DC were observed by flow cytometry.Results The rabbits sensitized by OVA showed typical AR symptoms and pathological changes.Expressions of CD86 on the cell surface of dendritic cells in WHBE rabbits with AR were significantly upregulated not only compared with the normal control (NC) rabbits,but also with the JW rabbits with AR (P<0.01).The result of real-time PCR assay showed that MR mRNA expression of DC in the NC group of WHBE rabbits were significantly higher than that of the JWrabbits(P<0.01).Moreover,MR mRNA expression of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits (P<0.05),but also higher than that in the JW rabbits with AR (P<0.05).Meanwhile,OVA647 internalization percentages of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits,but also obviously higher than that in the JW rabbits with AR (P<0.01).Conclusions The sensitivity of WHBE rabbits to allergen may largely depend on the function of dendritic cells with high expression of mannose receptor and their strong ability of maturation and antigen uptake.

Objective To summarize the CT characteristics of tumor deposition adjacent to colorectal cancer (CRC),and provide the evidences for differential diagnosis.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 26 CRC patients who were admitted to the Wuxi Second People's Hospital of Nanjing Medical University from May 2015 to April 2017 were collected.Patients underwent preoperative multi-slice spiral CT scan and double-phase enhanced scan,and then received open surgery.Observation indicators:(1) characteristics of multi-slice spiral CT scan;(2) differential comparisons;(3) follow-up.Follow-up using telephone interview was performed to detect patients' prognosis once every 3 months up to May 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups and among groups were respectively analyzed using the t test and the one-way ANOVA.Pairwise comparison was done using the SNK method.Results (1) Characteristics of multi-slice spiral CT scan:of 26 patients,17 underwent double contrast enhanced scans of chest,abdomen and pelvic and 9 underwent double contrast scans of abdomen and pelvic.Primary tumors of 18 and 8 patients respectively located in the colon and rectum.Forty-one tumor deposits of 26 patients were collected,with number of tumor deposits of 1.6±0.9 per case,and number of tumor deposits ＜ 3 and ≥3 respectively were found in 20 and 6 patients.Tumor deposits were often isolated in the fat spaces around the rectum or colon and unconnected with the surrounding primary tumor or lymph node.Distance to the center of primary tumor was (2.6±l.0)cm (range,0.2-5.0 cm),the distance ＜2.6 cm and ≥2.6 cm were respectively detected in 22 and 19 patients.Thirty-three tumors showed signs of lobulation,22 showed signs of burr and 7 showed liquefaction necrosis,and there was a combination of multiple imaging characteristics in the same tumor deposit.The maximum width,minimum width,maximum diameter,plain scan value of CT,CT enhancement values in the arterial phase and venous phase in 41 tumor deposits were respectively (1.15 ± 0.60)cm,(1.11±0.44)cm,(1.13±0.49)cm,(27±13)HU,(28±14)HU and (49±19)HU.Of 41 tumor deposits,34 demonstrated homogeneous density in the plain scan,and obviously enhancement in early enhanced scan,with homogeneous enhancement;7 demonstrated heterogeneous density in the plain scan,with internal liquefaction necrosis,and enhanced scans showed no enhancement in the areas of necrosis and obviously early enhancement in the areas of non-necrosis.(2) Differential comparisons:26 patients underwent open surgery,including 8 with right hemectomy,2 with transverse colon resection,4 with left semicolon resection,2 with simple sigmoid resection,2 with abdominoperineal resection of rectal cancer and 8 with low anterior rectal resection,and all patients received postoperatively individualized treatment.Fifty-two lymph nodes with distance to center of primary tumor ＜ 5.0 cm that were confirmed by pathological examination were collected,including 19 metastatic lymph nodes.Of 41 tumor deposits,33 were irregular,and 8 were regular and round-like or oval-like shape.Of 19 metastatic lymph nodes,16 were regularly round-like shape,1 showed irregular shape and edge blur,and 2 were irregular with a mutual integration.The maximum width,minimum width and maximum diameter of 19 metastatic lymph nodes were respectively (1.09± 0.33) cm,(1.01 ± 0.23) cm and (1.05 ± 0.20) cm,with statistically significant differences in the above indicators between metastatic lymph nodes and tumor deposits (t =5.48,4.80,7.75,P＜0.05).The plain scan value of CT,CT enhancement values in the arterial phase and venous phase were respectively (12±7) HU,(18± 12) HU,(42± 15) HU in 19 metastatic lymph nodes and (33±6) HU,(31 ±15) HU,(53± 14)HU in 26 primary tumors,showing statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase among tumor deposits,metastatic lymph nodes and primary tumors (F=24.43,4.46,P＜0.05),and no statistically significant difference in CT enhancement value in the venous phase (F=2.41,P＞0.05).There were statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase between tumor deposits and metastatic lymph nodes (q =5.48,2.50,P＜0.05) and between metastatic lymph nodes and primary tumors (q =6.82,2.84,P＜0.05),and no statistically significant difference between tumor deposits and primary tumors (q =2.15,0.65,P＞0.05).Of 19 metastatic lymph nodes,11 demonstrated homogeneous density in plain scan,with a lower density compared with tumor deposits and primary tumors,and relatively homogeneous enhancement in the arterial phase of enhanced scan;8 demonstrated heterogeneous density with internal liquefaction necrosis,and ring-shaped enhancement in enhanced scan with no enhancement in the areas of necrosis.The density and enhancement range in the arterial phase and venous phase of tumor deposits were similar to primary tumors.(3) Follow-up:24 patients were followed up for 1-25 months,with a follow-up rate of 92.3％(24/26) and a median time of 17 months.Of 24 patients,2 were dead,and survival time were respectively 9 months and 21 months;22 had good survival.Conclusions Multislice spiral CT examination of tumor deposits demonstrates larger and irregular shape,with the signs of lobulation and burr,and the density in plain scan is similar to the primary tumor,with obviously enhancement in early enhanced scan.The metastatic lymph nodes are mostly round-like shape,diameter is smaller than that of tumor deposits,density in the plain scan and CT enhancement values in the arterial phase are lower than that of tumor deposits.

Objective To evaluate the clinical value of Fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission temography-computed tomography (PET-CT) examination in intrahepatic cholangiocarcinoma (ICC) staging.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 190 patients with ICC who were admitted to the Eastern Hepatobiliary Surgery Hospital Affiliated to Naval Military Medical University from September 2013 to June 2016 were collected.There were 107 males and 83 females,aged from 37 to 79 years,with an average age of 57 years.There were 90 cases without distant metastasis undergoing surgery treatment and 100 with distant metastasis undergoing non-surgical treatment.Patients underwent preoperative CT,magnetic resonance imaging (MRI),and PET-CT examination,and then received surgery or non-surgery according to preference of patients and their family members.Observation indicators:(1) imaging features on preoperative CT,MRI,PET-CT examination;(2) treatment;(3) evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation;(4) evaluation of regional lymph node metastasis by three tests in ICC staging of patients undergoing operation;(5) evaluation of distant metastasis in ICC staging by three tests.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed by single factor ANOVA and paired comparison was analyzed by SNK method.Measurement data with skewed distribution were described as M (range).Count data were described as absolute number or percentage,and comparison between groups was analyzed using the chi square test.Results (1) Imaging features on preoperative CT,MRI,PET-CT examination:all the 190 patients received routine upper abdominal CT,MRI,and systemic PET-CT examination before treatment.CT imaging of ICC showed inhomogeneous low density on plain scan,peripheral enhancement in arterial phase,persistent enhancement of tumor margin in portal phase,and sometimes mild to moderate centripetal enhancement.MRI imaging showed heterogeneous low signal on T1-weighted imaging,uneven high,and slightly high signal on T2-weighted imaging.Reinforcement on MRI is the same as CT.Transverse images,fusion transverse images and maximum intensity projection images of PET-CT imaging showed abnormal high FDG uptake around the tumor.(2) Treatment:81 out of the 90 ICC patients with surgery treatment underwent hepatectomy and lymphadenectomy,and 9 underwent only tumor tissue biopsy and lymph node biopsy due to intraoperative finding of abdominal metastasis.Of the 100 non-operated patients,30 received systemic chemotherapy,23 received local radiotherapy,and 47 gave up treatment.(3) Evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation:the tumor diameters of ICC on CT,MRI and PET-CT were (6.8±2.8)cm,(6.9±2.9)cm,(7.2±2.8)cm,respectively.There was no significant difference among the three methods (F=0.085,P＞0.05).CT,MRI,PET-CT had similar accuracy of 80.0％ (72/90),78.9％ (71/90),72.2％ (65/90) on diagnosing multiple tumors,87.8％(79/90),92.2％ (83/90),94.4％ (85/90) for macrovascular invasion,and 93.3％ (84/90),95.6％ (86/90),96.7％ (87/90) for vascular and bile duct invasion,respectively,there was no significant difference in the above indicators between the three groups (x2 =1.801,2.662,1.131,P＞0.05).(4) Evaluation of regional lymph node metastasis by three examinations in ICC staging of patients undergoing operation:the accuracy of CT,MRI and PET-CT examination for lymph node metastasis was 62.2％ (56/90),68.9％(62/90),86.7％ (78/90) and sensitivity was 40.0％ (16/40),47.5％ (19/40),80.0％ (32/40),respectively,showing significant differences between the three groups (x2 =14.446,14.666,P＜0.05),showing a significant difference between CT and PET-CT examination (x2=14.134,13.333,P＜0.05),showing a significant difference between MRI and PET-CT examination (x2=8.229,9.141,P＜0.05).The sensitivity of CT,MRI and PET-CT examination for lymph node metastasis was 80.0％ (40/50),86.0％ (43/50),92.0％ (46/50),showing no significant difference between the three groups (x2=2.990,P＞0.05).(5) Evaluation of distant metastasis in ICC staging by three tests:there were 27,34 and 100 cases with distant metastasis evaluated by CT,MRI and PET-CT examination,including 40 with supraclavicular lymph node metastasis,32 with bone metastasis,30 with mediastinal lymph node metastasis,20 with hilar lymph node metastasis,17 with pulmonary metastasis;77 patients had more than 2 sites of metastasis.The accuracy of CT,MRI and PET-CT examination for distal metastasis in 190 ICC patients was 61.58％ (117/190),65.26％ (124/190),98.42％ (187/190),respectively,with a significant difference between the three groups (x2=83.639,P＜0.05),with a significant difference between CT and PET-CT examination (x2=80.592,P＜0.05),between MRI and PET-CT examination (x2=70.284,P＜ 0.05).Conclusion PET-CT examination makes up for the deficiency of CT and MRI in judging regional lymph node metastasis and distant metastasis,and contributes to the clinical staging of ICC.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology* ; Creatinine ; Heart Failure/complications* ; Humans ; Hypertension, Pulmonary/complications* ; Nitrates ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Factors ; Stroke Volume ; Ventricular Function, Left