Objective To investigate the MSCT(multi-slice computed tomography) manifestation of different kinds of malignant tumor in Renal Sinus.Methods MSCT data of 31 patients with diferent kinds of malignent tumor in Renal Sinus were analyzed retrospectively.Results In our series,15 cases were renal pelvic carcinoma,and central mass in renal sinus with light or middle ehancement were revealed in their MSCT investigation,as well as pelvic filling defect and hydronephrosis to some extent were found in secretory phase of enhanced MSCT.10 cases were renal cell carcinoma with renal sinus invasion,and their MSCT muti-planar reconstruction showed the mass mainly located in renal parenchymal,with dramatical and heterogenous CT enhancement mostly,besides local oppression & latral destruction of pelvic wall were caused by renal pelvic invasion.2 cases leiomyosaocoma in renal sinus were big and had a sharp edge,after adminisration they demonstrated dramatical and heterogenous CT enhancement.3 cases were lymphnode metastasis located in renal sinus or renal gate,appeared as nodular lesion with CT enhancement,and hydronephrosis could be exsisted if renal pelvic were obstructed.1 case were retroperitoneal lymphoma,MSCT muti-planar recon-struction revealed a large retroperitoneal mass derectly invaded into renal sinus,with light or middle homogenous ehancement.Conclusion MSCT has advantages of high speed scan,excellent discrimination,and aplenty post-process technique,and is of diagonotic value to malignant tumor in renal sinus.

Objective To study the characteristics of MR imaging and proton MR spectrscopy(~1H MRS)of stroke-like lesions in MELAS.Methods Clinical,MR imaging and proton spectroscopic findings of stroke-like lesions in 7 patients with confirmed MELAS were analyzed retrospectively.Results A total of 12 MR investigations had been performed in 7 patients.Stroke-like lesions showed by MR imaging included superacute in 12,acute in 12,subacute in 10 and chronic stage in 6.Early stroke-like lesions were demonstrated as focal edematous foci mainly involved cortex/subcotical areas of occipital,temporal and parietal lobes.At MR diffusion imaging,stroke-like lesions in the superacute(＜3 days)stage were showed as well-circumscribed lesions with high signal intensities for cytotoxic edema.During the acute(4～7 days),sub-acute(2～4 weeks)and chronic(＞4 weeks)stages,the lesions gradually expanded,and became blur,and presented with vasogenic edema mainly.Proton spectroscopy showed a prominently elevated lactate,varied decrease of NAA concentration and other brain motabolites in the stroke-like lesions early after onset,and depicted gradual decrease of lactate level and partial recovery of NAA concentration subsequently.Conclusion Stroke-like lesions in MELAS mainly involve the cerebral cortex and subcortical areas,in which cytotoxic edema appears early but for a short period.In ~1H MRS,the lesions are characterized by a double lactate peak with decrease of NAA concentration.

Objective:To explore the relationship between Tongren analysis EV 71 intestinal virus genotyping and humoral immune function ,for further clinical understanding of enterovirus EV 71 provide references.Methods:February to August 2014 Tongren to our hospital for treatment of intestinal virus EV 71 HFMD infected children ,according to the genetic type of virus infection is mainly divided into three groups ,namely group A,there were A type of intestinal virus EV 71 infection,20 patients;group B,there were B-type intestinal virus EV71 infection,20 patients;group C,there were C-type intestinal virus EV71 infection,20 cases of children.Three groups of patients by detecting immunoglobulin levels and TNF-ɑ, IL-6 and IL-10 levels, and to compare different genotypes affect intestinal virus EV71 HFMD children humoral immune function.Results:After testing,A group of patients with TNF-ɑ,IL-6 and IL-10 levels were (285.60 ±30.50) pg/L,(60.50 ±5.60) pg/L,(25.50 ±4.50) pg/L,than those in group B,high levels of three indicators of group C patients ,a significant difference ( P<0.05 ) ,group C patients with TNF-ɑ,IL-6 and IL-10 levels in three groups of patients than B high level indicators ,with a significant difference ( P<0.05 );tested three groups of patients with IgA ,IgG level pairwise comparisons showed that there were significant differences (P<0.05),the highest a group of patients with IgA,IgG level,group C, followed by the lowest level of group B patients;levels of the three groups of patients with IgM pairwise no significant difference ( P>0.05 ) .Conclusion:Different genotypes of enterovirus EV 71 can cause serious foot and mouth disease ,and could significantly improve the level of serum immunoglobulin levels of inflammatory cytokines ,but the intensity of different genotypes of different pathogenic ,there are some differences ,but the specific mechanisms need to be further explored.

Objective To investigate the effect and mechanism of Ghrelin on the contraction and relaxation of rat small intestinal smooth muscle. Methods The effect of different concentrations of Ghrelin (0;20;40;80 μg/kg) on the small intestinal transit in vagotomized rats in vivo and Ghrelin (0.01; 0.1;0.5 ; 1.0 μmol/L) on the contraction and relaxation of rat small intestinal smooth muscle strips in vitro was observed,the locations of Ghrelin receptors (GHS-R1 a) in small intestinal muscle layers were detected by immunofluorescency. Results Ghrelin dose-dependently increases small intestinal transit (( 25.4 ± 1.0)％,(33.7 ± 1.9)％,(39.3 ±2.4)％,(44.7 ±2.1)％),enhances the contraction ((67.0 ±2.4)％,(149.5 ±3.3)％,(187.1 ±4.7)％,(213.5 ±3.4)％) and relaxation ((35.3 ± 1.1)％,(62.9 ± 3.8 ) ％,( 79.6 ± 2.7 ) ％,( 94.6 ± 2.2 ) ％ ) of smooth muscle strips mediated by carbachol.Ghrelin receptors were mainly located on membrane of the nerve cells in the muscle layers,while no receptors exist on membrane of smooth muscle cells. Conclusions Ghrelin enhances the effect of contraction and relaxation of rat small intestinal smooth muscle mediated by cholinergic neurotransmitters activating nerve cells in the enteric plexus.

Objective To explore differences in phototest and photopatch test results, and in skin color?related parameters between healthy subjects and patients with chronic actinic dermatitis (CAD), and to examine their relationship with the melanocortin?1 receptor gene(MC1R)Arg163Gln variant. Methods Phototests were performed by using a sun simulator SUN1000, and skin color was analyzed by using Hexameter MX18 in 25 patients with CAD and 25 healthy subjects. The MC1R genotype at position?163 was determined by PCR. Photopatch tests were performed on 25 patients with CAD and 5 healthy subjects using a standard series of photoallergens(RuiMin)and an ultraviolet (UV)phototherapy equipment, SS?03A. Results Regarding phototest results, both UVA?minimal persistent pigment darkening dose(MPPD)and UVB?minimal erythema dose(MED)were significantly lower in CAD patients compared with healthy controls (both P < 0.05), with the reduction in UVB?MED being particularly notable. Sixteen patients (64%)in the CAD group had positive photopatch reactions, including 13(52%)cases of photoallergy. Skin color?related parameters were measured at four sites. Skin hemoglobin levels on the cheek, forehead, back of hands, inner upper arms were all significantly higher in CAD patients than in healthy controls(all P<0.05). However, skin melanin levels on the cheek, forehead and inner upper arms were similar between the two groups, and only those on the back of hands were significantly higher in CAD patients than in controls(P<0.01). Skin melanin and hemoglobin levels were significantly higher in exposed than in unexposed (inner upper arms) areas in CAD patients (all P < 0.05). The frequency of the CGA genotype at position?163 in the MC1R gene was similar between CAD patients and controls(P>0.05), but that of the CAA genotype differed significantly between the two groups(P<0.01). UVA?MPPD and UVB?MED were both significantly lower in CAD patients with the CAA genotype at position?163 in the MC1R gene than in those without the genotype(P=0.055, 0.325, respectively). Conclusions Skin photobiological testing plays a critical role in the diagnosis of CAD. Further studies are needed to clarify the role of the CAA genotype at position?163 in the MC1R gene in the diagnosis, prevention and treatment of CAD.

Objective To establish the standard values of indicators for care quality evaluation of benign prostatic hyperplasia. Methods To acquire data of nurses configuration in 24 hospitals nationwide by the status survey method. On-spot examination, questionnaire, case-review methods were applied to determine the standard values of 638 benign prostatic hyperplasia patients' care quality in Xi'an three major general hospitals. Department self-report, patients' complaints and quality inspection provided adequate information for determining the standard values. Results The standard values of indicators for care quality evaluation of benign prostatic hyperplasia were successfully established. Conclusions Taking the mean and percentile of indicators as reference can acquire true and reliable results.

Objective To investigate the impact of hyponatremia on the short-term prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).Methods The present study included 324 patients with acute STEMI treated with PCI within 12 hours after admission from March 2014 to May 2016.Patients were divided into three groups according to plasma sodium levels (Na+) at admission:group A with Na+ ＜ 130 mmoL/L,group B with Na + 130-134 mmol/L and group C with Na + ≥ 135 mmol/L (normal plasma sodium level).Clinical data and biochemical variables were compared among the three groups.Logistic regression analysis was used to examine the correlation between plasma sodium levels and short-term prognosis.Results There were significant differences in age,fasting glucose,NT-proBNP,LVEF (left ventricular ejection fraction) and hsCRP (high sensitive C-reactive protein) among the three groups (P ＜ 0.05).The mortality in group A was obviously higher than that in Group B (20.0％ vs.6.3％,P ＜ 0.05) and in group C (20.0％ vs.6.0％,P ＜ 0.05).In addition,there were significant differences in rates of cardiogenic shock and acute renal failure among three groups.Logistic regression analysis showed that old age,low LVEF and hyponatremia were independent risk factors for 30-day mortality (P ＜ 0.05).Compared with group B,patients in group A had significantly high risks of death (OR =3.058,95％ CI:1.339-4.358,P =0.003),suggesting that the high risk of 30-day mortality associated with the severity of hyponatremia.Conclusions At admission,the hyponatremia in patients with acute STEMI treated with PCI is an independent risk factor for 30-day mortality,and prognosis worsens with the severity of hyponatremia.

Objective To observe the metabolic characteristics of an experimental model of chronic pancreatitis,and to investigate its role in the grading of chronic pancreatitis.Methods Thirty-six Wistar rats were injected with dibutyltin chloride (DBTC) solution (8mg/kg) via the tail vein to establish the experimental model of chronic pancreatitis.The 36 rats were divided into 6 groups with 6 rats in each group.On0,7,14,21,28,35 days after modeling,rats was sacrificed and pancreatic tissue of the rats was harvested,and a small part was used for pathologic study,the majority part was kept at-80℃ under liquid nitrogen freezing.Metabolites of pancreatic tissue were determined by high-resolution magic angle spinning nuclear magnetic resonance spectroscopic (HR-MAS NMRS).On the basis of the abnormal structure,tubular complexes,gland atrophy,fibrosis,edema and inflammatory cell infiltration,chronic pancreatitis was graded.Results Pathologic study showed the severity of chronic pancreatitis gradually increased with time after modeling.The 7th,14th day after modeling,the pancreatic change was mild chronic pancreatitis; the 21st,28th,35th day,the pancreatic change was changed into severe chronic pancreatitis.Principal component analysis of HR-MAS NMRS showed that the betaine (Bet) and choline ( Cho)-contained components were significantly increased in severe chronic pancreatitis; while aspartate (Asp),lactate (Lac),isoleucine/leucine/valine (I/L/V) and fatty acid (FA) were significantly reduced when compared with those in mild chronic pancreatitis and normal pancreatic tissue.There was no significant difference in the amount of metabolic characteristics between mild chronic pancreatitis and normal pancreatic tissue.Conclusions HRMAS NMRS was helpful in distinguishing the severe chronic pancreatitis from mild chronic pancreatitis.

Objective:To investigate the effects of TGF-β1 on T lymphocytes of BALB/c mice infected with Echinococcus granulosus( E.granulosus ) in vitro.Methods: The inhibitor group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and SB525334.The control group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and PBS.The blank group:the spleen cells of BALB/c mouse were co-cultured with RPMI-1640 medium and SB525334.The lymphocytes were collected at 48 h post-infection.The T lymphocyte subsets, the number of CD4+CD25+T cells, the number of NK cells, and the expression of NKG2D receptor were detected by flow cytometry.The NK cell activity was determined with the lactate dehydrogenase leakage assay(LDH).Results:The inhibition the TGF-β1 receptors resulted in the increase of in the number of CD4+T cells,the decrease in the number of CD8+T cells,the increase of in the ratio CD4+/CD8+T cells,the decrease of in the number of CD4+CD25+T cells,the increase in the expression of the NKG2D receptors,the increase in the lysis rate of Yac-1 cells by NK cells,and a positive cor-relation between the expression of activity receptor NKG2D and killing activity of NK, which were mediated by E.granulosus.Conclusion: The inhibition of TGF-β1 receptors can enhance the immune response of T lymphocytes against E.granulosus infection in vitro.

BACKGROUND:Biliary stricture following liver transplantation is mainly focus on biliary stoma stricture; while, balloon dilatation temporarily keeps biliary tract open but not works out a solution at all.OBJECTIVE: To discuss the diagnosis and treatment of postoperative biliary stricture after orthotopie liver transplantation by the endoscope technique.DESIGN, TIME AND SETTING: A case analysis, which was performed at Dalian Liver and Gall Surgical Institute. Ten patients hospitalized from the Department of Liver and Gall Surgery of Dalian Friendship Hospital and four patients hospitalized from the Department of Organ Transplantation of Tianjin First Central Hospital were diagnosed as biliary stricture after orthotopic liver transplantation.PARTICIPANTS: Among 14 patients, 10 males and 4 females with mean age of 46 years provided end-to-end biliary anastomose.METHODS: Fourteen cases of postoperative biliary stricture after orthotopic liver transplantation were analyzed and diagnosed by endoscope technique. And by endoscope technique, the stricture was supported with tube after balloon dilatation.MAIN OUTCOME MEASURES: Bile duct mucous membrane under T-tube radiography and endoscope; calculary distribution and bile duct mucous membrane at stoma; healing of biliary stoma of donors and recipients; inflammatory edema and stricture; recheck of above-mentioned parameters after stricture expansion by endoscopic stone extraction technique.RESULTS: Thirteen cases of postoperative biliary stricture after orthotopic liver transplantation were analyzed and diagnosed by endoscope technique, including one was induced by calculus, and one non-stoma stricture. One case was treated with balloon dilation; biliary infection and jaundice occurred in 2 cases after endoscopic sphincterotomy (EST) + basket lithotripsy + endoscopic nasobiliary drainage (ENBD), so operations or fibrocholedochoscope treatments had to be carried out. By T tube radiography, in 1 case there was strip-like negative simulacrum or no stricture, well-healed anastomosis and good mucous membranel transition; poor or no intrahepatic visualization were found in 2 cases, so anastomosis dilation was processed after the calculi removal by fibrocholedochoscope, stricture disappeared in 3 or 4 months; in 8 cases there were blur extrahepatic or intrahepatic biliary visualization, cord-like, column or branch-like negative simulacrum in biliary ducts and sign of non-anastomosis stricture, after removal of calculi, anastomosis stricture and congestion, edema were found, all these disappeared after average 2.5 months of dilation; the other 1 case was found stricture by T the radiography, but no calculi was found with fibrocholedochoscope, finally the Ttube was removed after 2 months of stricture dilation.CONCLUSION: Endoscopy is significant to directly reflect and reliably diagnose postoperative biliary stricture and effectively treat biliary stricture by anastomosis dilation.