Objective To investigate the CT and MRI manifestations and clinical features of liver fluke granuloma.Methods A retrospective analysis was performed for the clinical and imaging data of 5 patients with pathologically confirmed liver fluke granuloma who were hospitalized in The First Affiliated Hospital of Guangxi Medical University from January 2010 to September 2015.Results Liver fluke granuloma had slightly low density on CT plain scan,as well as a slightly low signal on T1 weighted images and a slightly higher signal on T2 weighted images of MRI plain scan.Three-phase contrast-enhanced CT scan showed delayed enhancement with mild dilatation of the intrahepatic bile duct,and normal vessels ran through the lesion.Conclusion Liver fluke granuloma is a rare disease in chnical practice.A history of eating raw fish,delayed enhancement on three-phase contrast-enhanced CT scan,and normal vessels running through the lesion all contribute to the diagnosis of liver fluke granulomas.

Objective To evaluate clinical application value of DWI and reservation of liver function in patients with chronic liver disease. Methods Thirty cases of healthy control group, and 60 case group with chronic liver disease,including both 30 chronic hepatitis B and 30 cirrhosis. liver function in case group was analysed by venous blood samples. Case groups were divided into three groups according to MELD score: ＜30 group in 27 cases, 30 to 36 group in 17 cases, ＞36 group in 16 cases. All cases underwent liver magnetic resonance DWI. Among the case group, 15 cases were followed-up twice of pre- and aftertreatment. DWI images were read, ADC values of liver parenchyma were measured and standardized with the cephalospinal fluid (CSF) at the same slice. Used SPSS 13.0 for windows to treat the data, group comparison of ADC values were treated by one-factor analysis of variance, interclass comparison each other by SNK method, comparison between pretherapy and post-treatment by paired-samples t test. Results Healthy liver parenchyma of the control group is homogeneous signal on DWI. ADC pseudo-color pictures showed green on the homogeneous areas. Slightly restricted area of chronic hepatitis B showed irregular scattered patchy in DWI images, 25 cases in right and left lobes, 5 cases only in right lobe of the liver. ADC pseudo-color pictures reaveled blue region in proliferation-constrained areas. Restricted areas of the liver parenchymal become more evident, also showed an irregular liver edge in 30 cases of cirrhosis. The standarized ADC average values were: the healthy group (0. 47 ±0. 02) × 10-3 mm2/s, chronic hepatitis B group (0. 37 ±0. 03) × 10-3 mm2/s, cirrhosis group (0. 36 ±0. 04) × 10-3 mm2/s( F =97.05,P ＜0. 05).The difference between healthy group and patients group was statistically significant (P ＜ 0. 05 ). No statistically significant difference between groups of chronic hepatitis B and liver cirrhosis ( P ＞ 0. 05 ).Average ADC values of MELD score among groups of ＜ 30, 30 to 36, ＞ 36 were ( 0. 38 ± 0. 02 ) ×10-3 mm2/s,(0.35 ±0.02) × 10-3 mm2/s, (0.32 ± 0.03) × 10-3 mm2/s respectively. There is a significant difference among the three groups (P ＜0. 05). After treatment, DWI of 15 patients with chronic liver disease showed reduction in restricted areas, and the average ADC value from pre-treatment (0. 33 ±0. 03) × 10-3 mm2/s increased to(0. 38 ±0. 03) × 10-3 mm2/s, MELD score from pre-treatment 36. 01 ±6. 00 reduced to 27. 83 ± 4. 86. Conclusion DWI of chronic liver disease showed patchy diffuse restricted areas; more severe of the liver cell damage was, more worse the liver function was and lower ADC values was. ADC values increased after effective treatment, liver function recoved and diffuse restricted areas of liver parenchyma reduced.

Objective To observe the prokinetic effect of domperidone on esophagus and lower esophageal sphincter (LES), and compare its effect with that of mosapride and cisapride. Methods In vivo experiments: forty rats were divided into control, domperidone, mosapride, and eisapride groups. Strain gauges were planted in proximal esophagus, distal esophagus and LES to record the activities of esophagus and LES in conscious rat. In vitro experiments: in the thermostatic muscle bath, the prokinetic effect of domperidone, mosapride, and cisapride on the contractility of rat muscle strips from esophagus body and LES were recorded by tone-transducers. Results In vivo experiments, ① In the interdigestive period of resting conscious rats, only mild contraction activities were recoded in esophagus bodies. In LES, typical interdigestive migrating motor complex (MMC) with phase Ⅰ,Ⅱ,Ⅲ,and Ⅳ was recorded. The contraction amplitude of LES was much greater than esophagus body. ② Domperidone significantly enhanced the contraction of esophagus body and LES. The mean contraction amplitude of proximal esophagus, distal esophagus, and LES increased by 63.24%±7.17%, 75.54%±5.27%, and 85.81%±6.02%, respectively, compared with controls. The prokinetic effect showed a dose-effect relation. Mosapride at the same dosage increased the mean contraction amplitude of proximal esophagus, distal esophagus, and LES by 29. 71%±4.15%, 40.15%±3.30%, and 35.24%±5.36%, respectively, compared with controls. The prokinetic effects of mosapride on esophagus and LES were much less than domperidone. Cisapride at the same dosage increased the mean contraction amplitude of proximal esophagus, distal esophagus, and LES by 59.84%±6.55%, 70.11%±5.62%, and 75.13%± 5.10%, respectively, compared with controls. The prokinetic effects of cisapride were similar as domperidone. In vitro experiments. ① Domperidone perfusion could significantly increase the contraction of esophagus body and LES muscle strips by 87.74%±7.65% and 92.44±7.17%, respectively, compared with Krebs-Ringer (KR) solution perfuslon. Mosapride at the same dosage increased the mean contraction amplitude by 35.42%±5.02% and 31.12%±4.32%, respectively, compared with KR controls. The prokinetic effects of mosapride were much less than domperidone. Cisapride of the same dosage showed a similar prokinetic effect as domperidone. ② Atropine and tetrodotoxin could block the prokinetic effects of domperidone on esophagus and LES. Conclusions Domperidone can significantly enhance the esophagus body contraction and LES motility. The effects of domperidone are similar as cisapride and much greater than mosapride. The prokinetic effects of domperidone on esophagus and LES are not only through well-known dopaminergic receptor blockade, but also through the cholinergic nerves of the enteric nervous system.

To observe the expressions of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in rats with pulmonary fibrosis (PF) induced by bleomycin, and to explore the mechanisms of Shenlong Decoction in preventing and treating PF.

Objective To investigate the changes of tumor necrosis factor-?(TNF-?) and platelet-derived growth factor(PDGF) in gallbladder carcinoma (GA) patients with cell wall-deficient bacleria(L-form) infection .Methods The levels of TNF-? in gallbladder mucosa were detected by radioimmunoassay and the activity of PDGF was detected by bioactivity assay in patients with GA or cholecystitis and normal gallbladder(control group).Results The positive detection rates of L-forms in gallbladder mucosa of gallbladder carcinoma , chronic cholecystitis, and control group were 80.0%(16/20),82.5%(33/40) and 0(0/20), respectively.The TNF-? and PDGF levels in patients with L-form infection-positive gallbladder carcinoma were significantly higher than those in patients without L-form infection and in control group.The levels of TNF-a and PDGF in patients with L-form infection positive chronic cholecystitis were significantly higher than those in patients without L-form infection and in control group.Conclusions L-form may be one of the direct factors leading to the increase in PDGF during gallbladder oncogenesis,and there is positive correlation between PDGF and gallbladder oncogenesis when L-form induces inflammatory reaction and predisposes gallbladder mucosa to develope neoplasms.

Objective To investigate the effect of CTLA4-Ig chimera protein on mice mortality, histopathological changes, viral fiters, expression of CTLA4 protein on infiltrated T lymphocyte and the balance of Thl/Th2 in mice myocarditis caused by coxsackie virus B3 (CVB3). Methods A total of 106 four to six week-old male BALB/c mice were used in the experiments, which were divided into CTLA4-Ig group (n = 16), CVB3 group (n=40), IgG group (n =40) and normal control group(n = 10) randomly. The mice in CVB3 group, IgG group and CTLA4-Ig group were inoculated intraperitoneally with 0. 15 ml CVB3 and the mice in norreal control group with 0. 15 ml Eagle. The mice in IgG group and CTLA4-1g group were inoculated with IgG (0. I mg/kg) and CTLA4-Ig(0. 1 mg/kg) at 6 h and 72 h post inoculation(p, i. ), respectively, The surplus mice in each group were sacrificed at day 7 p.i. Light microscope was used to quantify the inflammation. The expression of CVB3 mRNA in mycardium were semi-quantified by real-time quantitative polymerase chain reaction (RQ-PCR). The expression of CTLA4 protein were analyzed by immunohistochemistry. The levels of IL-2, IL-4 and 1FN-γ in serum were measured by ELISA. Results The mice mortality, histopathological score and CVB3 mRNA in CTLA4-Ig group were lower than that in CVB3 group ( P < 0.05, P < 0.01, P < 0. 05, respectively). The expression of CTLA4 was significantly increased in CTLA4-Ig therapy group (P < 0.05 ). The serum level of IFN-γ of mice in CVB3 group were significantly higher than that in normal control group( P < 0.01 ). The serum level of IL-4 of mice in CVB3 group were much lower than that in normal control group( P < 0.01 ). The serum level of IL-2 in CVB3 group had no statistical significance with that in normal control group ( P > 0.05 ). The serum level of IFN-γ in mice of CTLA4-Ig group were much lower than that in CVB3 group ( P <0.01 ) and lgG group (P < 0. 01 ). The serum level of IL-4 of mice in CTLA4-Ig group were significantly higher than that in CVB3 group (P<0.01) and IgG group (P<0.01). The serum level of IL-2 in CTLA4-Ig group had no statistical significance with that in CVB 3 control group and lgG group ( P > 0. 0 5 ) . Conclusion CTLA4-Ig may relieve inflammation and reduce mice mortality by blocking the costimulation signals for T lymphocyte activation and reinforcing Th2 response.

Objective This study aimed at exploring the causative genes and summarizing the clinical characteristics in two Chinese families with thoracic aortic aneurysm and dissection ( TAAD ) .Methods The whole exome capture and high throughput sequencing were applied to identify the causative gene.Family members were examined for features of syndromic ge-netic diseases by clinician and geneticist.Results Four known TAAD candidate genes were identified in family TAA01:rs140598(FBN1), rs185661462(MYH11), rs77620762(MYLK3), and rs111426349(TGFBR1).The TGFBR1 mutation (c.1459C>T) had been confirmed to co-segregate with the TAAD phenotype in all affected family members.Early onset of aortic root dilatation was significant in this family , and the average age at diagnosis of aortic root dilatation or aneurysm was23. 2 years.ACTA2(c.445C>T) was proved in family TAA02, and livedo reticularis was confirmed.Conclusion The causa-tive genes were identified via whole exome capture and high throughput sequencing in two TAAD families .Early onset of aortic root aneurysm was proved in TAA01, while livedo reticularis was found in TAA02.

Objective To evaluate the clinical value of emergency bedside-echocardiography in neonatal intensive care unit.Methods Six hundred and sixty-eight infants with cardiac pathological murmurs,cyanosis and shortness of breath were detected by emergency bedside echocardiography (Sonosite Micromax 1 portable ultrasound or Philips iE33 ultrasonic systems) during January 2007 to July 2011.The accuracy of emergency bedside-echocardiography in the diagnosis of neonatal heart diseases was evaluated according to the results of surgical exploration.Results Among 668 enrolled neonates with the mean age of (7.2±1.3) d,there were 347 males and 321 females,and 309 term infants [mean gestational age (39.1±0.6) weeks (37.0～42.1 weeks)] and 359 premature infants [mean gestational age (33.7±0.91) weeks (28.9～36.9 weeks)].Totally,507 cases were found cardiac abnormality by emergency bedside-echocardiography,including 268 cases of patent ductus arteriosus (232 premature and 36 term infants),115 congenital heart disease,99 persistent fetal circulation and 25 arrythmia.Surgeries were performed on 54 infants and invasive therapy was performed on one infant,and none of them received CT,magnetic resonance imaging or invasive examinations before operation; among which,51 surgeries successed and 4 infants died.Other 452 infants were treated with medications,392 infants recovered and discharged,26 infants did not recover,14 cases died and 20 cases left the hospital before recovery.The accuracy rate of Micromax 1 portable ultrasound in diagnosing congenital heart diseases was 94.5％ (52/55),while 96.4 ％ (53/55) for philips iE33 ultrasonic systems.Conclusions Emergency bedside-echocardiography could provide instant and valuable information of cardiovascular system,which would be helpful in making quick clinical decisions.

ObjectiveTo investigate the value of biliary score and hepatic signal intensity-to-muscle signal intensity ratio （HMR） obtained by multiphase contrast-enhanced MRI scan using Gd-EOB-DTPA in evaluating the pathological grade of liver fibrosis. MethodsA retrospective analysis was performed for the MRI and clinical data of 51 patients with chronic hepatitis B liver fibrosis in Wuming Hospital Affiliated to Guangxi Medical University from January 2020 to May 2023. The 51 patients with liver fibrosis were divided into low-grade group （S1-S2） and high-grade group （S3-S4）. GE Architact 3.0T MR scanner was used to perform MRI scans， including routine plain scan and contrast-enhanced scan at arterial phase， portal venous phase， delayed phase， hepatobiliary phase， and excretory phase， and biliary score and HMR were measured for the patients with different grades of liver fibrosis. The t-test was used for comparison of continuous data between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The receiver operating characteristic （ROC） curve was plotted to evaluate the value of MRI indicators in determining the pathological grade of liver fibrosis. ResultsAmong the 51 patients with liver fibrosis， there were 30 patients in the low-grade group and 21 in the high-grade group. Compared with the high-grade group， the low-grade group had significantly higher biliary score （3.67±0.55 vs 2.57±0.75， t=6.05， P<0.001） and HMR at portal venous phase （2.38±0.76 vs 1.97±0.18， t=2.41， P=0.020）， delayed phase （2.48±0.70 vs 1.99±0.27， t=3.09， P=0.003）， and hepatobiliary phase （4.10±0.63 vs 3.16±0.47， t=5.81， P<0.001）. The above indicators had an area under the ROC curve （AUC） of 0.86， 0.79， 0.82， and 0.88， respectively， in distinguishing low- and high-grade liver fibrosis， with a positive rate of 70%， 63.3%， 83.3%， and 96.7%， respectively， and a negative rate of 90%， 95.2%， 74.1%， and 100%， respectively， in the diagnosis of high-grade liver fibrosis. Biliary score combined HMR had an AUC of 0.95， with a positive rate of 85.7% and a negative rate of 96.7%. ConclusionBiliary score and HMR at hepatobiliary phase obtained by multiphase contrast-enhanced MRI scan using Gd-EOB-DTPA has a relatively high diagnostic efficacy in distinguishing between low- and high-grade liver fibrosis and a certain guiding value for the diagnosis and treatment of liver fibrosis in clinical practice.

Hyperthyroidism is a clinically common endocrine disease. It often has no specific clinical symptoms in the early stage and is easily overlooked. The long-term effects of excessive thyroid hormones in the body can alter cardiovascular hemodynamics, which may lead to heart enlargement, atrial fibrillation, and heart failure. Cardiovascular disease is one of the common complications of hyperthyroidism, but it is the main cause of death. This article focuses on the related cardiovascular diseases of hyperthyroidism, and summarizes the molecular mechanism of thyroid hormone on the heart, the mechanism of hyperthyroidism induced heart failure, atrial fibrillation, pulmonary hypertension, and the treatment and prognosis of hyperthyroidism. In addition, we also analyzed the association between subclinical hyperthyroidism and the occurrence of cardiovascular disease. When combined with risk factors, subclinical hyperthyroidism patients need early treatment. It should be noted that long-term use of amiodarone can cause secondary hyperthyroidism, which should be used with caution in clinical use.