Objective To evaluate the value of dual-phase MSCT with 3D reconstruction in the staging and resectability of gallbladder carcinoma.Methods Forty patients with suspected gallbladder carcinoma by clinical examination and routine sonography were prospectively studied with dual-phase MSCT. Of these patients, only 35 who underwent a laparotomy for extended cholecystectomy or a palliative surgery were included in the study. Three-dimensional volume rendering and multiplanar reformation was used for evaluation of the vascular invasion and anatomy. The staging and resectability of lesions determined by CT and the results were compared with operative findings.Results On the basis of the CT findings, 13 tumors were resectable and 22 were unresectable. On surgery, 17 tumors were found to be resectable and the remaining was unresectable. Overstaging by CT occurred in 4 patients due to overassessment of duodenal infiltration, pancreatic infiltration and colonal infiltration. CT had a sensitivity of 76.5, a specificity of 100, an accuracy of 88.6, a positive predictive value of 100 and negative predictive value of 81.8 in determining resectability of gallbladder carcinoma. For the diagnosis of hepatic and vascular invasion, and involvement of bile duct by the tumor, there was 100 correlation between CT and surgery. Vascular variations were found in six of 17 patients who underwent radical cholecystectomy.Conclusion Dual-phase MDCT with 3D reconstruction can predict resectability of gallbladder carcinoma and determine the vascular road map before surgery.

Objective: To assess the clinical effects of acupuncture treatment for primary dysmenorrhea. Methods: 80 cases of the patients were randomly divided into two groups by single blind to 40 cases in the acupuncture group were treated with acupuncture plus ginger-partitioned moxibustion. 40 cases in the medication group were treated with oral administration of Ibuprofen sustained release capsules. The therapeutic effects were observed after continuous treatment for 3 months. Results: The total effective rate was 85.0% in the acupuncture group and 70.0% in the medication group, with statistical significance in comparison of differences between the two groups (P<0.05) Conclusion: Acupuncture plus ginger-partitioned moxibustion is better than Ibuprofen sustained release capsules in treating dysmenorrhea.

Objective To improve diagnosis of straight back syndrome.Methods 21 patients with straight back syndrome include 12 male and 9 female,and aged 15～36 years old(mean 21 years old).The standard P-A and left lateral chest film were taken and the A-P diameter and transverse diameter of the chest were measured,and the ratio between the both was calculated.Results The A-P diameter of the chest were 5.3 cm～8.5 cm(mean 6.6 cm)in male and 4.2 cm～8.1 cm(mean 6.2 cm)in female.the ratio between the A-P diameter and transverse diameter of the chest were 0.22～0.37(mean 0.34)in male,and 0.19～0.366(mean 0.31)in female.Conclusion The ratio between the A-P diameter and transverse diameter of the chest ≤0.37 is the diagnostic basis of the straight back syndrome.

Purpose To investigate the clinicopathlogic characteristic, diagnosis and histogenesis of pancreatic solid-pseudopapillary tumors ( SPPT) . Methods Combined with relevant literature, the clinical history, histopathological features and immunohistochemi-cal characteristics were analyzed in 11 cases of SPPT. Results There were 10 female patients and only 1 male in total 11 cases, aged from1 7 to 60 years (mean 33). The sizes of tumors were from 3. 2 to 10. 0 cm. Histologically, they were composed of papillary and microcysticsolid structures. Pseudopapillary with a fibrovascular core was remarkable. Immunohistochemically, the tumors expressed EMA (1/11), vimentin (10/11), NSE (11/11), Syn (7/11), CgA (1/11), CD56 (11/11), CD10 (11/11), PR (9/11), CD99 (9/11),α-AT (11/11),β-catenin (11/11), E-cadherin (11/11), Cyclin D1 (11/11), c-Myc (11/11). 6 patients were followed up for a period of 20 to 112 months, and they were all alive and had no recurrence and metastasis. Conclusions SPPT is a tumor with low malignancy of the pancreas that most frequently affect young females. SPPT may be derived from multipotent stem cells and closely related withβ-catenin signaling pathway. Pathological morphology and immunohistochemistry are very important to the diag-nosis and differential diagnosis of SPPT.

Objective The purpose of this research is to study the preventive and therapeutic effects of suramin on lipopolysaccharide (LPS)-induced mouse model of acute lung injury and its molecular mechanism.Methods A total of 24 healthy male C57BL/6 mice were randomly divided into two groups: Control group and suramin group.LPS (5 mg/kg, iv) induced acute lung injury model was used in this study.The severity of lung injury was evaluated using haematoxylin-eosin (HE) staining after the injection of LPS for 0, 24 and 72 hours.The expression of TNF-α and IL-6 mRNA levels were also detected by RT-PCR.In vitro, THP-1 cells were stimulated by LPS (100 ng/mL) with saline or suramin pre-treatment.The expressions of p-ERK1/2, p-JNK and p-P38 were analyzed by Western blot at 10 min, 20 min and 30 min after LPS insult.A 2-tailed Student's t test was used to compare difference between two independent groups.Results Compared with the saline group, the lung tissues injury were significantly decreased in the suramin group of 72 hours after the injection of LPS (saline 3.90 ±0.35;suramin 2.50 ±0.12) (t =7.668, P ＜ 0.01).The expressions of TNF-α (saline 8.35 ± 1.63;suramin 4.62 ± 0.70) (t =4.187, P＜0.01) andIL-6 (saline10.53 ± 2.10;suramin5.53±1.10) (t=4.224, P＜0.01) mRNA were also obviously reduced in suramin group after the injection of LPS for 24 hours.The expression levels of pERK1/2, p-JNK and p-P38 were obviously down-regulated by suramin at 10 min, 20 min and 30 min after LPS stimulation.Conclusion Suramin protected LPS-induced acute lung injury through down-regulating the expression of pro-inflammatory factors, which was closely relative to the inhibition of the MAPK pathway.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

Objective To establish a method for reducing the dose to the eye lens of interventional staff,and provide the data basis for improving radiological protection measures.Methods One piece of interventional equipment coupled with conventional auxiliary protective devices and two types of common neural interventional procedures were selected to monitor 46 and 35 procedures before and after the device modification.The doses to the eye lens of staff were measured with direct-reading dosimeters for analysis of dose trends.Results After modification of the devices,the average dose to the left eye lens decreased from (9.71 ±10.86) to (3.23 ±5.59) μSv for the first operator,from (9.51 ± 12.34) to (0.68 ± 0.78) μSv for the second in cerebral angiography;whereas the dose decreased from (14.83 ± 19.13) to (4.17±4.59) for the first operator and from (14.12±21.76) to (1.23 ±1.57)μSv for the second in embolization procedure,respectively.The left eye lens doses measured before and after the modification showed significant difference (U =-2.760,-2.467,-1.967,-2.655,P ＜0.05).Conclusions The modification of the auxiliary radiological protective devices may effectively reduce the dose to the eye lens dose.This method was shown to be feasible for the improvement of radiological protection of interventional staff.

Objective To observe the effects of ultrashort wave diathermy on the expression of tumor necrosis factor-α (TNF-α) andBcl-2 in hippocampus, striatum and motor cortex of rats with cerebral ischemia/reperfusion. Methods The model of focal ischemia/reperfusionin Sprague-Dawley rats was induced with intraluminal middle cerebral artery occlusion (MCAO) with nylon monofilament suture. Therats were divided into 3 groups: sham group (n=6), model group (n=6) and ultrashort wave diathermy group (n=6). Brain tissue slices wereimmunohistochemically stained (SABC) to observe the expression of TNF-α and Bcl-2. Results The expression of TNF-α and Bcl-2 in lefthippocampus, striatum and motor cortex was higher in the model group than in the sham group (P<0.01). The expression of TNF-α was lowerbut Bcl-2 was higher in the ultrashort wave diathermy group than in the model group (P<0.05). Conclusion Ultrashort wave diathermycan affect the expression of TNF-α and Bcl-2, which may associate to the neuroprotection from focal cerebral ischemia/reperfusion injury.

Objective To investigate the correlation between gene polymorphism within human β defensin 1 (DEFB1) and fungal susceptibility to severe sepsis through case-control association study.Methods A total of211 patients with severe sepsis in ICU were enrolled in the present case control study. Sepsis in this study was diagnosed according to the definition of American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference in 1992 and 2002. Based on the development of fungal infection during ICU stay, all 211 patients were divided into fungal infection group (Group Ⅰ) and control group (Group C). Alleles and genotypes of-1816A/G, -390A/T, -52A/G, -44C/G and-20A/G within DEFB1 gene were assayed in all 211 patients by means of DNA direct sequencing, Allele-specific PCR amplifications or high-throughput site-specific TaqMan assay. Genetic analysis was employed to calculate the distribution frequency of haplotypes. The correlation between the genomic variations (allele,genotype and haplotype) and fungal infection was analyzed by Chi-square test or Fisher's exact test.Odds ratio (OR) was employed to reflect the correlation degree of genetic factor with fungal susceptibility to severe sepsis. Results Group Ⅰ enrolled 80 patients, of whom 43 pstients were male, at age of (60.81 ± 18.30) years. Group C enrolled 131 patients, of whom 80 patients were male, at mean age of (60.42 ± 17.03) years. No significant difference was found between two groups in aspect of gender and age (P＞0.05). The genetic locus of -1816A/G, -390A/T, -52A/G, -44C/G and -20A/G of both groups were in agreement with Hardy Weinberg equilibrium. No significant difference was found between two groups in the distribution of allelic frequencies and genotype frequencies (P ＞0.05). No significant difference was found in the distribution frequency of four common haplotypes of the above five genetic locus such as AAACG, ATGCA, GTGGG and ATACG (all P ＞ 0.05). Conclusions Genetic locus of -1816A/G, -390A/T, -52A/G, -44C/G and-20A/G within DEFB1 gene have no correction with fungal infections in severe sepsis, suggesting that DEFB1 gene polymorphism may not serve as a key genetic marker for the predisposition to fungal infection in severe sepsis.

Objective To explore the effects of Tongfu Huayu Daotan Decoction (通化阏导痰汤)on the serum concentration of S-100β protein, neuron-specific enolase(NSE) and Prognosis in patients with severe craniocerebral injury.Methods Sixty patients with severe craniocerebral injury were randomly divided into a a'eatment group and a control group.The treated group was treated with Tongfu Huayu Daotan Decoction plus conventional treatments including dehydration,antibiotics, organ functional support, nerve nutrition, prevention of complication, etc.; the control group was treated with conventional treatments alone. The concentration of serum S-100β protein and neuron-specific enolase(NSE) in plasma at admission and at24, 36, 72huors, and 5, 7 days after treatment were determined respectively; the Glasgow outcome scale (GOS)and neurological deficits scoring at 2weeks and 4weeks after hospitalization were compared to observe the efficacy of the patients. Results The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at previous treatment and at 24, 36 hours after the treatment had no statistical difference in the two groups(P＞0.05 ), The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at 72huors, 5 and 7 days after the treatment in the Tongfu Huayu Daotan Decoction group were lower than those in the control group, the differences being significant (P＜0.01). The Glasgow outcome scale (GOS) and neurological deficits scoring at 2weeks and 4weeks after the treatment in the Tongfu Huayu Daotan Decoction group were significantly nigher than those in the control group, the differences being significant (P＜0.01) .Conclusion Tongfu Huayu Daotan Decoction can alleviate the plasma concentrations of S-100β protein and neuron-specific enolase (NSE) in patients with severe craniocerebral injury and markedly improve the clinical therapeutic effects. Combined Tongfu Huayu Daotan Decoction and western medicine can significantly reduce mortality and improve the Glasgow outcome scale (GOS), neurological deficits scoring and therapeutic effect.