Budd-Chiari Syndrome ; diagnosis ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Circulating tumor cells (CTCs) are present in the peripheral blood,and play an important role in the recurrence and metastasis of lung cancer.As the researches about CTCs and targeted therapy move along,it is found that CTCs can be used as a liquid tumor tissue to guide clinical treatment and have a certain significance in the clinical staging and prognosis evaluation of lung cancer.

Objective To evaluate the significance of intraoperative laparoscopic ultrasonography (IOUS) during hepatobiliary surgery. Methods Sixty-eight cases of hepatobiliary lithiasis (liver disease 23 and cholecystopathy with difficulty in management by preoperative estimation, 45 ) were examined by intraoperative laparoscopic ultrasonography. Results Two CBD stones and one Mirrizi syndrome were found in IOUS. The laparoscopic procedures were successful fulfilled in 68 cases under the guidance of sonography including fenestration on liver cyst, incision and drainage on liver abscess, resection and biopsy on space occupied liver lesion with unknown cause, resection of solitary space occupied mass in liver, destruction of unre-sectable liver cancer by microwave and injection of absolute alcohol and chemotherapy through portal vein catheterization, cholecystectomy in acute cholecystitis, chronic cholecystitis with chiledolithiasis, and broad pedicle polyps in gallbladder etc. Conclusion IOUS has the advantages of non-invasive, fast, repeatable, high accuracy and has important clinical significance in laparoscopic diagnosis and treatment.

Objective The aim of this study was to determine the effects of ulinastatin, a broad spectrum proteinase inhibitor, on fibrinolytic system and platelet function during open heart surgery performed with cardiopulmonary bypass (CPB) .Methods Twenty ASA Ⅰ-Ⅱpatients of both sexes undergoing cardiac surgery under CPB were randomly divided into two groups of ten patients: control group(C) and ulinastatin group (U). In group U patients received ulinastatin 12 000 U?2kg-1 . Half of the dose was given iv 10 min before CPB and the other half was added to the priming solution. In group C patients received normal saline instead of ulinastatin. Blood samples were taken before CPB (T1 ) , 30 min after CPB was started (T2), at the end of CPB (T3), 2 h and 4 h after CPB(T4 , T5) for determination of plasma levels of D-Dimer, ?-granule membrane protein-140 (GMP-140), thromboxane B2 (TXB2) and 6-Keto-prostaglandin F1? (6-Keto-PGF1?) .Results The demographic data, aortic cross-clamping time, CPB time and duration of operation were comparable between the two groups. The plasma levels of D-Dimer, GMP-140, TXB2 and TXB2/6-Keto-PGFl? were significantly increased at T2 , T3 and T4 as compared with the baseline (T1 ) in both groups, but the increase was significantly larger in group C than in group U(P

Objective To evaluate the feasibility,safety,and cosmetic results of single-incision laparoscopic appendectomy by using conventional instruments. Methods From January 2013 to May 2014,clinical data of 52 patients undergoing single-incision laparoscopic appendectomy in our hospital were retrospectively analyzed. The appendectomy was performed by using conventional instruments through three 5-mm trocars via a 2-cm curved incision above the umbilical margin. Results The single-incision laparoscopic appendectomy was successfully completed in all the 52 cases without conversion to conventional laparoscopic or open surgery.The mean operative time was 43 ±7 min (range,30 -90 min).The average postoperative hospital stay was 2.5 ±0.5 days (range,1 -7 days).During follow-up visits for 1 -3 months,there were no postoperative complications.The scars were not obvious in all the patients. Conclusion Laparoscopic appendectomy can be achieved through a single incision by using conventional instruments.This approach is feasible,safe,and concealing.

Objective To explore the effect of combined application of improved microencapsulation and intravenous injection of donor liver cells and spleen cells on pancreatic islet xenografts. Methods New born male pigs and SD rats were selected as donors and recipients respectively, and pig pancreatic islet cells were microencapsulated by static electricity improvement microencapsulation. Islet transplantation was performed after injection of donor liver cells and spleen cells via tail vein. The changes in blood glucose and serum C-peptide, the function-possessed days of islet xenografts and diabetes rats living period were observed. Results In combined application group, the function-possessed days of islet xenografts and diabetes rats living period were significantly prolonged (P

Objective To evaluate the clinical value of spectral CT mode in imaging liver by comparing the radiation dose and image quality between spectral CT and conventional multi-slice spiral CT (MSCT).Methods Thirty patients (group A) underwent three-phasic enhanced CT scans spectral CT mode in the portal phase (PP) and conventional helical mode in other phases (Discovery CT 750 HD,GE Healthcare).Another 30 patients in group B underwent conventional three-phasic enhanced CT on a 64-slice MSCT (VCT,GE Healthcare) with 120 kVp and automatic tube current modulation (ATCM) and noise index of 15.The images in PP from the two imaging modes were retrospectively compared.The contrast-noiseratio (CNR) for the veins was calculated using liver parenchyma as background.For the spectral CT mode,101 sets of monochromatic images were reconstructed from 40 to 140 keV,and the optimal energy level for obtaining the highest CNR was determined using the Gemstone Spectral Imaging (GSI)-viewer software.Image noise (at 70 keV),CNR (at the optimal keV level) for the vein and radiation dose to the patient were obtained for spectral images and statistically compared with those in group B with the conventional MSCT using t test.Results The CTDIw value in PP for spectral CT was 15.64 mGy,30％lower than the (22.44 ± 5.09) mGy for the conventional MSCT (t =29.56,P ＜ 0.01).Image noises on the liver parenchyma were 22.81 ±2.85 and 23.80 ±3.31 for the conventional MDCT and spectral CT images at 70 keV,respectively,with no significant difference (t =0.76,P ＞ 0.05).On the other hand,CNR for the vein at the optimal energy level in spectral CT was 7.17 ± 2.09,which was significantly higher than the 2.76 ± 1.34 for the conventional MSCT (t =7.21,P ＜ 0.01).Conclusion Compared with conventional standard-dose liver MSCT,spectral CT imaging provides improved CNR for vessels,comparable image noise for liver parenchyma with 30％ dose reduction.

A total of 96 patients with Graves'disease(GD)were followed for one and half years to observe the effect of antithyroid drugs(ATD)treatment.Serum TRAb,total iodine concentration and CD80 mRNA expression of peripheral blood monouclear ceils were measured.Logistics regression analysis was conducted with the combination of above parameters.Those GD patients with high level of TRAb,positive family history of GD, increased expression of CD80 and early age of onset were more inclined to relapse after ATD treatment.

Objective To explore the value of magnetic resonance perfusion imaging of 3D arterial spin labeling(3D-ASL)in the diagnosis of transient ischemic attack(TIA).Methods 78 of patients were diagnosed TIA on MR routine scan [T1 WI,T2 WI,T2-FLAIR,diffusion weighted imaging(DWI)],magnetic resonance angiography(MRA)and 3D arterial spin labeling(3D-ASL).The re-sult were analyzed by Chi-square test.Results In 78 patients,the abnormal routine scan was 0 case(0%);abnormal MRA 41 cases (52.6%);abnormal 3D-ASL 47 cases(60.2%);combination with each other were 60 cases(76.9%).29 cases with artery stenosis and abnormal ASL,12 case with artery stenosis and normal ASL,19 cases with normal vascular and abnormal ASL,18 cases with normal vascular and normal ASL.Conclusion 3D-ASL is better than routine magnetic resonance sequences in the diagnosis of TIA,which is convenient and should be a routine scanning sequence of TIA.3D-ASL,MRA and DWI have their own advantages and disadvantages, combination use can improve the diagnosis accuracy of TIA.

Objective To analyze the hepatitis E virus (HEV) infection status and the molecular characteristics of HEV isolated from pregnant women in Zhejiang Province.Methods Totally 98 236 serum samples collected from pregnant women during the year 2013 to 2015 were tested for HEV IgM by enzyme-linked immunosorbent assay (ELISA) and samples positive for IgM were detected for nucleic acid of HEV by nested polymerase chain reaction (PCR).The whole gene of HEV open reading frame 2 (ORF2) was further amplified and the prevalence was analyzed in nucleic acid-positive samples.Results Three hundred and fifty-two out of 98 236 serum samples were tested positive for HEV IgM,with positive rate of 0.36％.All the samples were simple positive of HEV IgM except for two samples co-infected with hepatitis B virus.HEV specific nucleic acid fragments were detected positive from three serum samples.Further phylogenetic analysis revealed that all the three HEV isolates in this study belonged to HEV genotype 4.Three isolates did not cluster in one branch,although they shared high nucleic acid homology and more than 97 ％ of amino acid homology.Variations were found significantly between sample sequence and other published HEV 4 isolates,including two variable regions found in the ORF2 gene (1-460 nucleotide and 620-870 nucleotide).However,the synonymous and non-synonymous substitutions rates in the two regions were similar,and neutral selection was the main evolutionary pressure.Conclusions HEV infection rate in pregnant women of Zhejiang Province is similar with the published data.The HEV isolates obtained in this study belong to genotype 4 with high variation rate.