Objective To evaluate the advantages of MR LAVA multi-phase dynamic contrast enhancement in abdominal MRI.Methods 42 cases which clinically suspected liver lesions and 15 normal volunteers underwent MRI examination,including routine T_1WI and T_2WI scan,T_1W 2D and 3D FSPGR,LAV A multi-phase contrast enhancement.The detecting rates of 2D,3D and LAVA images were analysed and the signal noise ratio(SNR)of the liver and spleen was observed.Results 68 lesions were detected by LAVA sequence,the detecting rate was 100%,the accurate rate of diagnosis was 95.6%(65/68),while the detecting rates of the lesions were 91.2%(62/68)and 89.7%(61/68)with 3D T1W FSPGR and 2D T1W FSPGR,respectively,the accurate rates in diagnosing the lesions were 76.5%(52/68)and 70.6%(48/68)with 3D and 2D sequences,respectively.The SNR of liver,spleen of 15 normal volunteers were:29.68±2.31 in liver,36.21 ±3.67 in spleen at LAVA plain scan,46.21 ±5.32 in liver,58.75±4.68 in spleen at 2D T_1W FSPGR,19.79±2.23 in liver,23.63±2.14 in spleen at 3D T_1W FSPGR,41.75±5.13 in liver,57.96±6.13 in spleen at LAVA contrast enhancement,56.33±5.63 in liver,63.21±5.32 in spleen at 2D contrast enhancement,29.05±4.68 in liver,46.37±5.17 in spleen at 3D contrast enhancement sequence.Conclusion LAVA multi-phase dynamic contrast enhancement is more predominant than T1W 2D and 3D and 3D FSPGR in displaying the lesions and blood vessels of liver.

The history of Western Pacific Region Index Medicus (WPRIM), and advances in its journal selection, retrieval service platform construction and data acquisition were described.The daily record of users showed that WPRIM is of certain international influencing power, but is not a matured regional international index medicus. Suggestions were put forward for its popularization, project development funds, journal review and data acquisition.

Objective To evaluate the advantage of video-assisted mini thoracotomy for patients with esophageal cancer compared with routine open thomcotomy.Methods Perioperative clinical results were compared between 24 csses received VAMT(test group)and 26 cases underwent routine open thoracotomy(control group)during the same period.All the cancer stages were T2-3N0-1M0.Results This study showed that VAMT Was a minimally invasive swgew with shorter operation time(40.0±3.3)min vs.(70.3±3.2)min,P＜0.05)and had less bleeding volume both during and after operation compared to the control group(108.1±15.2)ml V8.(200.1±11.3)ml,(380.8±45.4)ml vs.(780.1±52.2)ml,P＜0.05).No significant differences were observed in the two groups with respect to complication occurrence rate(4.2%vs.19.2%,P＞0.05).Conclusion It is suggested that VAMT is safe,reliable and less invasive in the treatmem of esophagus carcinoma.

Objective To investigate the significance of preoperative and postoperative enteral nutrition support in gastric cancer patients with nutritional risk.Methods The clinical data of 72 gastric cancer patients with nutritional risk admitted in our department were analyzed.All the patients were randomly allocated into two groups.36 patients in the control group received only intravenous nutrition postoperatively (PN group).36 patients in the treatment group received enteral nutrition support from the fifth day before operation to eighth day after operation (EN group).The body weight,total protein,albumin,transferrin and prealbumin were measured on the fifth day before operation,the operation morning,the first day and the eighth day after operation.Results On the operation morning,the transferrin and prealbumin of the EN group were higher than those in PN group significantly(P ＜0.05).In the eighth day after operation.the treatment group patients showed significant increase in the body weight,total protein,albumin,transferrin and prealbumin compared with those in the control group(P ＜ 0.05).On the operation morning,the transferrin and prealbmnin of EN group were increased significantly than on the fifth day before operation(P ＜ 0.01).Conclusion The preoperative and postoperative enteral nutritional support can improve the nutritlonal condition in the gastric cancer patients with nutritional risk.The preoperative enteral nutritional support can improve the patients' nutritlonal condition and reserves before operation,and reduce adverse reaction of enteral nutrition.

ObjectiveTo research the hepatitis B virus (HBV) replication and immune tolerance status of transgenic mice for elucidating the pathogenesis of hepatitis B and evaluating new drugs against HBV.Methods SPE grade HBsAg negative nontransgenic and transgenic mice with the same genetic background were recruited in this study.HBsAg,HBeAg and HBV DNA were detected by chemiluminescent method.Pre-S1 and HBcAg were detected by enzyme linked immunosorbont assay (ELISA).Liver pathology was examined and HBsAg expressions at different stages were determined by immunohistochemical staining.The lymphocyte proliferation of mice was detected by flow cytometry and interferon (IFN)γ-producing T lymphocytes was determined by enzyme linked immunospot (ELISPOT).The expressions of Toll-like receptor (TLR)2 and TLR9 in splenocyte suspension and splenic dendrite cells (DC) were determined by double-labeling immunofluorescence.The data were analyzed by t test and F test.ResultsHBsAg,preS1,HBeAg,HBcAg were expressed and HBV DNA was replicated in HBV transgenic mice,while anti-HBs,anti-HBc,and anti-HBe were all negative.There were no obvious pathological changes in liver tissues.HBsAg was expressed in cytoplasm and HBcAg in nucleus of hepatocytes.After stimulated with HBsAg,T lymphocyte proliferation capacity of HBV transgenic mice was (697.6±67.3) cpm,which was much lower than that of nontransgenic mice [( 1315.5 ±191.6) cpm].The number of spot forming cells of IFNγ-producing splenocytes from transgenic mice after HBsAg stimulation was 8.25 ± 1.10,which was obviously lower than that of nontransgenic mice (28.50±4.21) (F=155.967,P=0.000).The expressions of CD11c+,TLR2 and TLR9 on DC from both HBV transgenic and nontransgenic mice were not different significantly (all P＞0.05).The HBsAg expressions in liver tissues were observed in 18-day-old fetal mice and 1-day-old newborn mice.ConclusionsThe HBV transgenic mice can express HBV-related antigens,and are immune tolerant to the antigens.The innate and acquired immunity of the HBV transgenic mice are normal,which is similar to chronic asymptomatic HBV carriers of human.Therefore,HBV transgenic mouse is an ideal animal model.

ObjectiveTo observe the effect of acupuncture plus rehabilitation training on the function recovery of patients with post-stroke depression.MethodNinety-eight patients with post-stroke depression were randomized into two groups to receive conventional management and anti-depressants. The control group was intervened by sham-acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training, while the observation group was by acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training. Prior to the intervention and after 8-week treatments, the depression state, motor function and activities of daily life (ADL) were evaluated by using Hamilton Depression Scale (HAMD), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). The indexes and quality of life were also determined during the 3-month follow-up study.ResultBefore intervention, there were no significant differences in comparing HAMD, FMA and MBI scores (P>0.05). After 8-week treatment, the HAMD, FMA and MBI scores were significantlyimprovedin both groups (P<0.01,P<0.05). After treatment, the HAMD, FMA, and MBI scores in the observation group were significantlydifferent fromthat in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the observation group versus 79.2% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study showed significant differences in comparing the indexes between the two groups (P<0.05, P<0.01).ConclusionAcupuncture plus rehabilitation training benefits the improvement of depression state, motor function, cognitive function and quality of life in patients withpost-stroke depression, and is worth promotion.

Purpose To investigate the feasibility of 30 ml low-dose contrast medium in reducing the accumulation of contrast medium in venous system while maintaining enough artery enhancement in 256-slice CT angiography (CTA) of intracranial and cervical arteries.Materials and Methods Sixty patients with head and neck CTA were recruited prospectively,and they were randomly divided into group A and group B.The scan parameters of the two groups were identical,but the protocol of contrast medium injection was different.Group A was injected 60 ml contrast medium and 30 ml saline successively with the rate of 4.0 ml/s.Group B was injected 30 ml contrast medium and 50 ml saline successively with the rate of 5.0 ml/s.CT attenuation values of aortic arch,common carotid artery,subclavian artery,cerebral middle artery,superior vena cava,innominate vein,subclavian vein,internal jugular vein were measured,and the image quality was evaluated.Results The average CT values of superior vena cava,right innominate vein,right subclavian vein in two groups had significant differences (P＜0.05).The average CT values of left brachial vein,left subclavian vein,left and right internal jugular vein in two groups had no significant differences (P＞0.05).The average CT values of aortic arch,left and right common carotid artery,left and right subclavian artery,left and right cerebral middle artery in two groups had significant differences (P＜0.05).The scores of image quality in two groups also had significant difference (P＜0.05).Conclusion Head-and-neck CTA with 30 ml low-dose contrast medium is feasible and the images are satisfactory for diagnosis,which can reduce the dose of contrast medium and accumulation of contrast medium in venous system,while maintaining enough artery enhancement.

Objective To evaluate the effect of intravenous Gd-DTPA on 3.0T proton MR spectroscopy (MRS) water suppression and shimming. Methods Prospective study of proton MRS was performed with GE Signa Excite HD 3.0T system and eight-channel phased-array coils with PRESS sequence (head, liver and kidney, respectively). Routine auto prescan program was operated to record full width half maximum (FWHM) and water suppression (WS%). Routine scan was performed after injection of Gd-DTPA, then prescan program was reoperated to record FWHM and WS%. The data of FWHM and WS% in head, liver and kidney were compared between before and after injection of Gd-DTPA with the Wilcoxon matched pairs signed test. Results WS% of spectroscopy of head and liver after administration of Gd-DTPA decreased significantly (T_+=12, T_-=66, P=0.02; T_+=0, T_-=45, P=0.007). The effect of shimming of kidney after administration of Gd-DTPA was poor (T_+=0, T_-=435, P<0.001) and WS% of spectroscopy of kidney after administration of Gd-DTPA decreased significantly (T_+=0, T_-=435, P<0.001). Conclusion WS% of spectroscopy in head, liver and kidney can be impacted negatively by Gd-DTPA. Gd-DTPA has great influence on shimming of spectroscopy of kidney, but has little influence on shimming of spectroscopy of head and liver. It is better to acquire MRS data before administration of contrast medium in kidney.

Objective To observe the effect of full width half max (FWHM) on spectra signal-to-noise ratio (SNR), NAA/Cr, Cho/Cr and water suppression at 3.0T MR. Methods GE Signa Excite HD 3.0T MR scanner with 8 channel phrased-array head and neck coil was used. The respective study of liver 1H-MRS was performed using PRESS sequence. A total of 49 spectrums were obtained with parameters of TR 1500 ms, TE 30 ms, NSA 128. FWHM and water suppression were recorded automatically and the subjects were divided into better shimming group (FWHM<10 Hz) and worse shimming group (FWHM≥10 Hz). Independent t test was used to analyze the Cr_SNR, NAA/Cr, Cho/Cr, water suppression and volume of interest (VOI). Results Compared with worse shimming group, better shimming group could provide better Cr_SNR (t=5.976, P<0.001), higher NAA/Cr (t=2.469, P=0.017), lower Cho/Cr (t=-4.460, P<0.001) and smaller VOI (t=3.862, P<0.001). Conclusion When single voxel proton spectroscopy of head is adopted with 3.0T MR, small VOI is easy to achieve effective shimming, and better shimming is helpful to improve SNR, the ratio of main metabolites as well as water suppression.

OBJECTIVE:To explore the method for promoting drug circulation management of online pharmacies. METH-ODS:Hazard analysis and critical control point (HACCP) was applied to identify the critical control points (CCPs) and explore the effective method for drug circulation management of online pharmacies. RESULTS & CONCLUSIONS:According to the HAC-CP principle,four CCPs of drug circulation management of online pharmacies are supplier qualification,acceptance method,main-tenance and storage scheme and distribution system. It is suggested to adopt correct measures of drug circulation quality manage-ment of online pharmacy. Firstly,the supplier’s legal qualification should be determined and the quality of the drug should be regu-larly checked;secondly,drug retailers should improve the acceptance method of drugs and improve the sampling rate of drug;then,the three three four scientific conservation which required the medicine to be divided into three parts according to the pro-portion of 30%,30%,40% and checked monthly should be implemented to improve the storage and maintenance program;finally, the independent distribution system should be established to ensure the full process of the appearance inspection.