Objective To analyze the treatment effects on the central bronchogenic carcinoma by means of interventional chemotherapy and embolization. Methods There were 60 pathologically proved cases of central bronchogenic carcinoma in mid or late period. After detecting the nourishing arteries of bronchogenic carcinoma with angiography, anticancer drugs were poured into the nourishing arteries. Then silk thread and gelform were used to embolize these arteries. Results The total effective rate of the treatment was 100% and the obvious effective rate was 80%. 33 cases were operated and chemotherapy performed after operation. 27 cases were given synthetic treatment. No one died in the follow up of 18-34 months. Conclusion Interventional chemotherapy and embolization is an effective and safe method in the treatment of central bronchogenic carcinoma. If synthetic treatment is taken, the treatment effect would be much better.

OBJECTIVE:To determinate the metabolites of ranolazine in rats by LC-MSn.METHODS:Rats were given 80 mg?kg-1 ranolazine by i.g.During 0～24 h after intragastrical administration,the sample of urine was collected and extracted by solid phase column.Extracts were determined by LC-MSn.The mobile phase consisted of acetonitrile,10 mmol?L-1ammonium acetate and glacial acetic acid at a flow rate of 0.5 mL?min-1.Fragmentation ions of ranolazine and its metabolites were determined in positive electrospray ionization by using MS,MS2 and MS3 full scans.RESULTS:Twelve phaseⅠ metabolites (O-demethylation,O-dearylation,hydroxylation,N-dealkylation and amide hydrolysis) and nine phase Ⅱ metabolites(O-glucuronidation and sulfation) were found in the sample.CONCLUSION:Ranolazine is extensively metabolized in rats.

Objective To evaluate the characteristics of leptomeningeal metastasis of gliomas on magnetic resonance(MR) imaging and to provide evidence for clinical early diagnosis and treatment.Methods Twenty-one cases of intracranial gliomas with leptomeningeal metastases were scanned with conventional spin echo(SE) and fast spin echo(TSE),8 cases with fluid attenuated inversion recovery(FLAIR),and all of cases were operated with enhancement.Results ⑴ With MR plain scan,18 cases revealed vary range of distortion and illegibility structure of cerebral cistern and sulcus,and 6 cases revealed the asymmetrical enhancement of the wall of ventricle.Eleven meningeal neoplasms nodes were found in subarachnoid space in 7 cases,and some of the appearances could be seen in several cases.Eight cases of them were added with FLAIR,and the neoplasms nodes were showed more clearly and higher signal than TSE-T2W imaging.⑵ With MR enhancement,all cases with encephalic gliomas showed obvious enhancement with vary features of the enhancement of leptomeningeal metastasis,including tail sign(5/21),line sign(10/21),strip sign(3/21),node sign(7/21) and a few of cases included two signs.Conclusion It was very important for clinician to improve the cognition of MR imaging characteristics of leptomeningeal metastases of glioma,and to choose the proper MR imaging scan technique to increase the detection rate of early meningeal diseases.

Objective to determine the basal levels of several pancreas-related endocrine hormones in patients with chronic pancreatitis.Methods according to inclusion and exclusion criteria,consecutive patients from February 2016 to August 2016 in Department of Gastroenterology,Changhai Hospital,Second Military Medical University and ten healthy control (matched for age and gender) were included.Basal levels of glucagon-like peptide 1,pancreatic polypeptide,Secretin,glucagon,somatostatin between groups of CP vs healthy control,CP with abnormal glycometabolism vs CP with normal glycometabolism and alcoholic CP vs non-alcoholic CP were compared.Results a total of 53 patients with chronic pancreatitis and 8 healthy subjects were included in this study.(1) CP vs healthy controls:the level of secretin in healthy control patients is significant lower than that in CP patients;(2) CP with abnormal glycometabolism vs CP with normal glycometabolism:the level of triglyceride and somatostatin is significant lower than that in CP patients;the prevalence of patients with chronic alcohol consumption and the level of glucagon-like peptide 1 in CP with abnormal glycometabolism is significant higher than that in CP with normal glycometabolism;(3) the prevalence of abnormal glycometabolism in alcoholic CP group is significant higher than that in non-alcoholic CP.The results above are all of statistical significance.Conclusions in addition to dysfunction of islets/3-cells,CP also easily affects the level of other pancreas-related hormones such as secretin,somatostatin and glucagon-like peptide 1.Otherwise,chronic alcohol consumption is also strongly related with abnormal glycometabolism,the mechanism deserves further researches.

OBJECTIVE: To investigate the significance of the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters of diffuse spinal bone marrow infiltration in patients with hematological malignancies. MATERIALS AND METHODS: Dynamic gadolinium-enhanced MR imaging of the lumbar spine was performed in 26 patients with histologically proven diffuse bone marrow infiltration, including multiple myeloma (n = 6), acute lymphoblastic leukemia (n = 6), acute myeloid leukemia (n = 5), chronic myeloid leukemia (n = 7), and non-Hodgkin lymphoma (n = 2). Twenty subjects whose spinal MRI was normal, made up the control group. Peak enhancement percentage (Emax), enhancement slope (ES), and time to peak (TTP) were determined from a time-intensity curve (TIC) of lumbar vertebral bone marrow. A comparison between baseline and follow-up MR images and its histological correlation were evaluated in 10 patients. The infiltration grade of hematopoietic marrow with plasma cells was evaluated by a histological assessment of bone marrow. RESULTS: Differences in Emax, ES, and TTP values between the control group and the patients with diffuse bone marrow infiltration were significant (t = -11.51, -9.81 and 3.91, respectively, p < 0.01). Emax, ES, and TTP values were significantly different between bone marrow infiltration groups Grade 1 and Grade 2 (Z = -2.72, -2.24 and -2.89 respectively, p < 0.05). Emax, ES and TTP values were not significantly different between bone marrow infiltration groups Grade 2 and Grade 3 (Z = -1.57, -1.82 and -1.58 respectively, p > 0.05). A positive correlation was found between Emax, ES values and the histological grade of bone marrow infiltration (r = 0.86 and 0.84 respectively, p < 0.01). A negative correlation was found between the TTP values and bone marrow infiltration histological grade (r = -0.54, p < 0.01). A decrease in the Emax and ES values was observed with increased TTP values after treatment in all of the 10 patients who responded to treatment (t = -7.92, -4.55, and 5.12, respectively, p < 0.01). CONCLUSION: DCE-MRI of spine can be a useful tool in detecting diffuse marrow infiltration of hematological malignancies, while its parameters including Emax, ES, and TTP can reflect the malignancies' histological grade.
Adolescent ; Adult ; Aged ; Bone Marrow Neoplasms/pathology ; Child ; Contrast Media/*diagnostic use ; Female ; Gadolinium DTPA/diagnostic use ; Hematologic Neoplasms/*pathology ; Humans ; Image Enhancement/methods ; Leukemia/*pathology ; Lymphoproliferative Disorders/*pathology ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Observer Variation ; Prospective Studies ; Spinal Neoplasms/*pathology ; Young Adult

Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.

Objective To assess the effectiveness of Z-axis automatic tube current modulation ( ATCM) technique with respect to dose reduction and image noise in the thyroid regional tissues during neck computed tomography angiography (CTA). Methods A total of 140 patients underwent neck CTA with 64-slice spiral CT, and were randomized into fixed-tube current group and ATCM group. Objective noise, CTDIw, DLP and mA of each group were recorded. Results The image qualities of all the patients were diagnostically acceptable, though the objective noise of neck in the ATCM group was higher than that in the group of fixed-tube current (P＜ 0.05 ). The radiation doses in the ATCM group [ CTDIw (35.99±1.31 ) mGy, DLP (11 121.39 ±5.51) mGy·cm] were significantly inferior to those in the group of fixed tube current [ CTDIw (43.22±1.42) mGy, DLP (1514.45±5.56) mGy·cm]. Conclusions Compared with fixedtube current technique, ATCM technique could significantly reduce the radiation dose in neck CT with diagnostic acceptability of the image quality.

OBJECTIVETo observe and explore the antagonism of rhizoma gastrodiae (RGT) to the impairment of learning and memory ability induced by lead in rats.

METHODS36 Wistar rats were randomly divided into 3 groups, 12 rats in every group, (1) control group: treated with distilled water; (2) lead group: treated with lead acetate (0.1 g.kg-1.d-1); (3) lead-RGT group: lead acetate (0.1 g.kg-1.d-1) + RGT(4.0 g.kg-1.d-1). The ability of learning and memory of the rats was measured monthly by swimming test; 3 months later, the rats were decapitated and nitric oxide(NO) and total antioxidative capacity(TAOC) in hippocampus were measured immediately and the examination for pathology was also made.

RESULTS(1) In swimming test, the number of seeking for anchorage in lead group(1, 2, 3 month: 10.10 +/- 1.10, 7.80 +/- 1.32, 5.40 +/- 0.97 respectively) were significantly decreased, compared with the control(P < 0.01); the number of seeking for anchorage in RGT-lead group(1, 2, 3 month: 11.90 +/- 0.95, 10.90 +/- 0.95, 9.70 +/- 0.96 respectively) were significantly increased, compared with lead group(P < 0.01). (2) NO (0.733 +/- 0.015) mumol/g pro and TAOC (0.945 +/- 0.017) U/mg pro in hippocampus of lead group were significantly decreased compared with the control(P < 0.01) whereas NO(0.769 +/- 0.021) mumol/g pro and TAOC(0.986 +/- 0.010) U/mg pro in hippocampus of RGT-lead group were significantly increased compared with lead group(P < 0.01). (3) Pathological examination showed that in lead group, marked atrophy in hippocampus, cellular denaturation and necrosis, dissolution and disappearance in axon were found. In lead-RGT group, the atrophy of hippocampus was not obvious, the cell morphology was nearly normal, no obvious abnormal changes were seen.

CONCLUSIONRGT is antagonistic to the impairment of hippocampus and of learning and memory ability induced by lead.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; metabolism ; pathology ; Lead ; toxicity ; Learning ; drug effects ; Memory ; drug effects ; Nitric Oxide ; analysis ; Rats ; Rats, Wistar ; Swimming

Objective To analysis the clinical features of dorsal pancreas agenesis ( DPA) and the associated diabetes, pancreatitis and other congenital organ malformations.Methods Chinese databases of Sinomed, CQVIP and CNKI using the term of short pancreas, pancreas agenesis, bulbar pancreas and dorsal pancreas, and English databases of PubMed using the term of dorsal pancreas agenesis, short pancreas and pancreas hypoplasia were searched.The clinical manifestation, pancreatic head characteristics and associations with diabetes, pancreatitis and other congenital organ malformations were analyzed.Results Six related publications from Chinese databases were searched and 21 patients were included with 2 cases excluded.Sixty-one publications from English database were searched and 71 patients were included.Thus, a total of 91 patients with DPA were analyzed.Abdominal pain was the most common manifestation, which was reported by 61.5% of the patients. 15.3% patients were identified during regular physical examination. Other manifestations including jaundice, fatigue, abdominal discomfort and diabetes were rare.After removing cases with insufficient information, 39 patients (61.9%) carried abnormal pancreatic head.Prevalence of diabetes or impaired glucose tolerance was 56.7% and the percentage of insulin-dependent diabetes in patients with abnormal glycaemia was 47.3%(n=18).20 patients (26.7%) were associated with pancreatitis, including 15 patients (75.0%) with acute pancreatitis, 1 patient (5.0%) with recurrent pancreatitis, and 4 patients (20.0%) with chronic pancreatitis. Thirty-three patients ( 36.2%) suffered other congenital organ malformations, including 21 patients (63.6%) with splenic malformation, 8 patients (24.2%) with heart malformation, and 17 patients (51.5%) with multi-organs malformations like gastrointestinal malformation, azygos vein and inferior cava vena fusion, duodenal and biliary atresia and renal absence.Conclusions The main diagnostic criteria of DPA was the absence of dorsal pancreatic duct.Diabetes was the most common complication followed by pancreatitis.

Objective To analyze the changes of the intima-media thickness(IMT)of carotid and femoral arteries, serum advanced glycosylation end-products(AGEs),and AGEs soluble receptor(sRAGE)after intensively controlling blood glucose, blood pressure, and lipid. Methods One hundred and thirty-two type 2 diabetic patients were divided into 3 groups and followed for 5 years: 20 patients were treated with intensive control of blood glucose and blood pressure, 80 patients with intensive control of blood glucose, blood pressure, and lipid; and 32 patients with conventional therapy. AGEs, sRAGE, and IMT of carotid and femoral arteries were measured and compared among different groups. Results The IMT of carotid and femoral arteries and serum level of AGEs were significantly decreased after intensive treatment. The ratio of sRAGE and HbA1C(sRAGE/HbA1C)were negatively correlated with the mean of HbA1Cin the past five years(r=-0.417, P＜0.001)and the fluctuation of HbA1C(r=-0.309,P＜0.001). Multinomial regression analysis showed that AGEs were the important risk factors of IMT of femoral artery(β=0.152,P=0.068). Conclusion Intensive treatment is significant in controlling the growing IMT of carotid and femoral arteries, while decreasing serum level of AGEs.