Objective To investigate the variations of hepatic artery and its extrahepatic arteries on hepatic arteriogram and to provide benefit for transhepatic arterical chemoemblization.Methods The hepatic arteriograms of 200 cases with unresectable hepatic malignant tumor before interventional therapy were analysed.Two interventional radiologists in common reviewed the incidences of various types according to Michels' classification,the absence of proper hepatic artery,and the variations of extrahepatic arteries originating from hepatic artery.Results The most common hepatic artery variation was Michels type Ⅲ(n=17,8.5%),followed by type Ⅱ(n=10,5.0%) and Ⅴ(n=9,4.5%).Proper hepatic absence was found in 25 cases and appeared as 5 subtypes.5 kinds of extrahepatic arteries were found.The most common extrahepatic artery was the right gastric artery(n=156,78.0%),followed by cystic artery(n=126,63.0%),accessory left gastric artery(n=19,9.5%),the hepatic falciform artery(n=5,2.5%),and accessory left inferior phrenic artery(n=4,2.0%).Conclusion There are some other variations of hepatic artery beside Michels' classification,and there are many variations of extrahepatic arteries originating from hepatic artery,it is important to assure interventional therapy effect for hepatic cancer and prevent complication.

Isolated hepatic perfusion(IHP)is the best re gional chemotherapy modal ity for treatment of unresectable liver primary cancer and liver metastases.The main principle of isolated hepatic chemotherapy is to achieve higher regional d rug concentrations and thus higher exposure of tumor tissue to the agents,resul ting in increased response rates,while shielding the organism from the systemic toxicity because of the much lower concentrations in the systemic circulation.At present the methods of IHP include surgical methods and methods with balloon c atheter technique,which promise to provide a micro-invasive procedure,bu t are not fully mature.The key point of successful IHP is low leakage or leakage-free.The more beneficial aspect of IHP is that it can simultaneously apply hyperthe r my and biologic agent TNF to improve sensitivity of chemotherapy,which is not p ossible in other regional chemotherapy.From previous literatures this overview is to describe the principle,procedure techniques,leakage monitor methods,hyp erthermy application,administration agents,therapeutic reaction,complications and perspective of IHP.

Objective To investigate the early diagnosis of myocardial injury after neonatal asphyxia based on the clinical manifestations of myocardial injury, electrocardiogram (ECG), cardiac enzymes and tissue Doppler echocardiography. Methods From January 1, 2013 to June 30, 2014, 101 cases of neonatal asphyxia in the neonatal intensive care unit of the First Hospital of Tsinghua University, with gestational age> 37 weeks and birth weight > 2 500 g, were enrolled. Apgar scores were used to diagnose neonatal asphyxia. Myocardial damage after neonatal asphyxia was diagnosed according to the hypoxia history, clinical presentation, ECG and cardiac enzymes. According to the umbilical arterial blood gas analysis, severe asphyxia was divided into two groups:the severe asphyxia with severe acidosis group and the severe asphyxia without acidosis group. The incidence of myocardial damage, clinical manifestations associated with myocardial damage, ECG and myocardial enzymes [creatine kinase isoenzyme MB (CK-MB) and cardiac troponin T (TnT); control group involved 50 cases for the same period of admission with newborn jaundice] and echocardiography (control group involved 30 cases for the same period with normal term delivery) were compared among the three groups [mild asphyxia (n=72), severe asphyxia with severe acidosis (n=18) and severe asphyxia without severe acidosis (n=11)]. One-way ANOVA, the LSD test, Kruskal-Wallis test for independent samples, Chi–square test and Fisher's exact test were used for statistical analysis. Results (1) The incidence of myocardial damage after asphyxia was 34.6%(35/101). It was higher in the severe asphyxia group than in the mild asphyxia group [62.1%(18/29) vs 23.6% (17/72), χ2=7.549, P=0.006]; and it was higher in the severe asphyxia with severe acidosis group than in the severe asphyxia without severe acidosis group (14/18 vs 4/11, Fisher's exact test, P=0.048). (2) Clinical manifestations: The proportion of bradycardia was greater in the severe asphyxia with severe acidosis group (13/14) than in the severe asphyxia without severe acidosis group (1/4) and the mild asphyxia group (7/17);the differences were statistically significant (Fisher's exact test, P=0.019 and 0.007). (3) ECG: Eighteen cases (51.4%, 18/35) showed ECG abnormalities. (4) Cardiac enzymes:CK-MB 48 h after birth in the severe asphyxia with severe acidosis group, severe asphyxia without severe acidosis group, mild asphyxia group and the control group were 78.72 (34.63-122.01), 31.71 (21.33-37.12), 23.11 (14.61-36.02) and 11.82 (8.64-18.93) μg/L, respectively. CK-MB in the severe asphyxia with severe acidosis group was higher than in the severe asphyxia without severe acidosis group, mild asphyxia group and the control group (H=48.425, 90.040 and 96.045, respectively, all P<0.01). After treatment for 5-7 days, there was no statistically significant difference in these four groups (H=7.165, P=0.416). TnT 48 h after birth in the four groups was 0.19 (0.12-0.39), 0.11 (0.06-0.34), 0.07 (0.05-0.13) and 0.06 (0.04-0.08) μg/L, respectively. TnT in the severe asphyxia with severe acidosis group was higher than in the other three groups (H=45.753, 44.665 and 61.215, respectively, all P < 0.01). Despite the reduced TnT level after treatment for 5-7 days, TnT in the severe asphyxia with severe acidosis group was higher than that in the other three groups (H=17.520, 21.122 and 43.286, respectively, all P<0.01). (5) Echocardiography:Twenty cases (57.1%, 20/35) showed abnormalities. The values of mitral systolic peak velocity and late diastolic peak velocity in the severe asphyxia with severe acidosis group were lower than those in the control group found by tissue Doppler echocardiography [(3.4±0.3) vs (4.8±0.3) cm/s, (4.1±0.2) vs (6.0±1.1) cm/s, respectively, t=3.293 and 2.542, both P < 0.05]. Conclusions Myocardial damage can occur after neonatal asphyxia. Cord blood pH value should be combined to determine the severity of asphyxia. Myocardial damage is more serious in the severe asphyxia with severe acidosis group. Clinical manifestations should be taken seriously, and laboratory examinations should be improved for early diagnosis and treatment.

Objective To investigate the indications and complications in the treatment of benign and malignant strictures using esophageal stents in order to avoid abusing effects in clinical practice. Methods A series of 20 patients, 12 men, 8 women, aged from 45～72, with esophageal stricutre. There were 3 cases had stricture at the anastomosis site. 4 cases with esophago bronchial fistula. 1 case with esophago mediastinal fistula after surgical operation ten cases used imported stents and another 10 with domestic Nickel Titanium stents. Results Successful stent placement was achieved in all cases. Dysphagia were relieved in most of 20 cases. The fistula vanished in 5 cases of complications with esophago bronchial and esophago mediastinal fistulas. Conclusions The esophageal stent placement is an effective treatment for benign and malignant esphageal strictures. The domestic Nickel Titanium stents is well effective as the imported ones.

Objective To investigate the clinical value of INSURE technology in very low and extremely low birth weight infants requiring respiratory support.Methods From June 2010 to August 2012,83 cases of very low and extremely low birth weight infants who had difficulty in breathing and required respiratory support were admitted into First Hospital of Tsinghua University and divided into two groups:INSURE group (n=41) and mechanical ventilation (MV) group (n=42).Infants in INSURE group accepted intubate-pulmonary surfactant-extubate to continuous positive airway pressure and those in MV group accepted intubation with or without pulmonary surfactant treatment,and mechanical ventilation without extubation.Arterial blood gases at 1 h and 12 h after treatment were compared between the two groups by t test.The incidence of respiratory distress syndrome,ventilator associated pneumonia,air leaking,chronic lung disease,intracranial hemorrhage,retinopathy,leukoencephalomalacia disease were compared with Chi-square test.Hospitalization costs,duration of ventilation,oxygen inhalation and hospital stay were compared by rank-sum test.Results (1) PO2 in INSURE group after one hour of treatment were (78.7 ±11.5) mm Hg(1 mm Hg=0.133 kPa),which were higher than those before treatment [(50.1 ±10.8) mm Hg,t=9.737,P＜0.05]; while PCO2 was lower[(48.3±8.9) mm Hg vs (54.9±11.5) mm Hg,t=-3.428,P＜0.05].PO2 in MV group after one hour of treatment were (80.2±10.0) mm Hg,which were higher than those before treatment [(51.3±9.8) mm Hg,t=10.093,P＜0.05]; while PCO2 was lower[(45.6±9.5) mm Hg vs (57.1±12.8) mm Hg,t=-4.526,P＜0.05].(2) There were no difference in PO2 and PCO2 between the two groups after one hour of treatment (P＞0.05).After 12 hours of treatment,no differences were found in PO2[(89.4±11.5) mm Hgvs (90.2±10.8) mm Hg,t=0.093] and PCO2[(44.2±5.9) mm Hg vs (39.1± 7.3) mm Hg,t=0.126] between INSURE group and MV group (P＞0.05 respectively).(3) The incidence of ventilator associated pneumonia,air leaking,intracranial hemorrhage and chronic lung disease in INSURE group were 7.3％ (3/41),4.9％ (2/41),4.9％ (2/41) and 4.9％ (2/41),which were lower than those in MV group [34.1％ (14/42),x2=27.470; 16.7％ (7/42),x2=8.651;19.0％ (8/42),x2 =8.814; 11.9％ (5/42),x2 =4.275](P＜0.05 respectively).Duration of ventilation,oxygen inhalation,neonatal intensive care unit stay in INSURE group were 5 d (3-7 d),8 d (5-11 d) and 16 d (11-25 d),which were all shorter than those of MV group [8 d (4-12 d),Z=-1.947; 12 d (8-22 d),Z=-2.013; 21 d (12-35 d),Z=-1.782](P＜0.05 respectively).Conclusions INSURE technology could be used in very low and extremely low birth weight infants because of less invasiveness,fewer complications,safety and low-cost.

OBJECTIVE:To describe the clinical pharmacists'way in carrying out pharmaceutical care for cancer pa?tients.METHODS:Combined with the clinical experience in department of oncology,the way of pharmaceutical care was analysed in depth.RESULTS&CONCLUSION:Clinical pharmacists should guide the nurses,lay down nursing plan with nurses and regularly sort out the nursing record so that the existing problems may be discovered and solved.

Objective: To investigate the dietary lead exposure level among children aged 3 to 4 years in Jiading District, Shanghai Municipality, and assess the health risk caused by lead exposure, so as to provide the basis for the management of children's food safety. Methods: Based on the 2023 Dietary and Health Status Surveillance Project in Jiading District, children aged 3 to 4 years from 12 streets (townships) in Jiading District were selected as the subjects using a multi-stage stratified random sampling method. The consumption frequency and daily intake of seven subcategories of four major food groups (beans, tofu), cereals (wheat, rice), meat (animal viscera), and aquatic products (mantis shrimps, bivalves) consumed by children over the past three months were collected using a food frequency questionnaire. Food samples were collected according to the food safety risk monitoring plan in Jiading District, and the lead content was detected. The health risks of dietary lead exposure among 3-4-year-old children were quantitatively assessed using the single-factor pollution index method, the Nemerow comprehensive pollution index method, and the margin of safety (MOS) method. Results: A total of 143 3-4-year-old children were surveyed, including 69 boys (48.25%) and 74 girls (51.75%). A total of 317 food samples were tested, and lead was detected in all seven subcategories of food samples, with an overall detection rate of 77.29%. The detection rates of lead in bivalves and mantis shrimps of aquatic products were relatively high (98.75% and 100.00%, respectively). The mean lead content of various foods ranged from 0.003 4 to 0.090 7, with the highest level found in bivalves. The lead content of all food samples did not exceed the standard. The single-factor pollution index of seven subcategories ranged from 0.017 2 to 0.148 0, and the Nemerow comprehensive pollution index ranged from 0.116 5 to 0.424 4, both of which were less than 0.7. The MOS (mean) ranged from 0.000 3 to 0.003 9, with an overall MOS (mean) of 0.012 2. The MOS (P95) ranged from 0.005 7 to 0.055 9, with an overall MOS (P95) of 0.112 4, both of which were less than 1. Conclusions The lead pollution level in the diet among children aged 3 to 4 years in Jiading District is safe and clean, with an acceptable impact on food safety. However, the detection rate of lead is relatively high, and the main source of dietary lead exposure is aquatic products.

In this paper, the Fourier transform based minimum mean square error (FT-based MMSE) method is used to calculate the regional cerebral blood volume (rCBV) in magnetic resonance (MR) perfusion imaging, and the method is improved to handle the existing noise in the imaging process. In the experiments with signal-to-noise ratio (SNR) of 50 dB, the rCBV values were compared with the results using MMSE method. The effects of different SNRs on the estimation of rCBV were analyzed. The experimental results showed that MMSE was a simple way to filter the measurement noise, and could calculate rCBV accurately. Compared with other existing methods, the present method is not sensitive to environment, and furthermore, it is suitable to deal with the perfusion images acquired from the environment with larger SNR.
Blood Volume ; Brain ; blood supply ; Fourier Analysis ; Humans ; Magnetic Resonance Angiography

Objective To investigate the pathological features and prognostic analysis in endoscopic strip-ping microflap excision of vocal cords leukoplakia.Methods A total of 186 cases with vocal cord leukoplakia and treated by endoscopic stripping microflap excision were retrospectively analyzed,calculated the ratios of recurrence and malignant transformation on keratosis without dysplasia,mild dysplasia,moderate dysplasia and severe dysplasia and carcinoma in situ.Then,the association of histopathological classification with recurrence and malignant transformation in vocal cord leukoplakia were evaluated.Results 87 cases of all 186 patients with vocal cord leukoplakia were kera-tosis without dysplasia,17 cases were recurrenced and 3 cases were developed to carcinoma;64 cases were mild dysplasia,15 cases were recurrenced and 7 cases were developed to carcinoma;29 cases were moderate dysplasia, 13 cases were recurrenced and 10 cases were developed to carcinoma;6 cases were severe dysplasia and carcinoma in situ,all 6 cases were recurrenced and 5 cases were developed to carcinoma.Conclusion The histopathological classi-fication is predictive factor for the risk of recurrence and malignant transformation in vocal cord leukoplakia.

Objective To explore the influence of salinomycin in the growth, apoptosis and invasion of human bladder cancer 5637 cells,and to clarify its possible mechanism.Methods The human bladder cancer 5637 cells cultured invitro at logarithmic growth phase were divided into control group and different doses of salinomycin(15, 30 and 60μmol·L-1 )groups.The inhibitory rate of the growth of 5637 cells in various groups was measured by MTT assay. Flow cytometry was used to detect the apoptotic rates of 5637 cells in various groups. The invasiveness of 5637 cells was tested by Matrigel Invasion Assay.The expression levels ofβ-catenin protein in 5637 cells in various groups were determined by Western blotting method. Results Compared with control group,the inhibitory rates of growth of human bladder cancer 5637 cells in different doses of salinomycin groups were increased significantly(P<0.05);the apoptotic rates were increased(P<0.05).the number of cells passed the Matrigel was decreased(P<0.05),and the expression level ofβ-catenin protein was decreased (P<0.05).Compared with low dose of salinomycin group,the inhibitory rate of growth of 5637 cells in high dose of salinomycin group was increased(P<0.05);the apoptotic rate was increased(P<0.05),the number of cells passed the Matrigel was decreased (P < 0.05 ), and the expression levels of β-catenin protein was decreased (P<0.05). Conclusion Salinomycin can inhibit the growth of 5637 cells significantly,increase the apoptosis,and decrease the cell invasion;the inhibitory effect may act by inhibiting the Wnt/β-catenin pathway.