Objective To investigate the relationship between positive peritoneal exfoliated cancer cells and the clinicopathological features of patients with hepatocellular carcinoma before any invasive treatment.Methods Of the 92 patients with hepatocellular carcinoma who underwent laparotomy,ascites fluid was collected in the patients with peritoneal ascites; and peritoneal lavage fluid was collected in those patients without peritoneal ascites.Then,shedded cancer cells in these fluid samples were detected.Results The positive rates of peritoneal cancer cells were associated with the TNM stage,tumor location and tumor size.The positive detection rate of cancer cells in TNM stage Ⅲ and Ⅳ was significantly higher than stage Ⅰ and Ⅱ (38.1％ vs 8.0％ ; P =0.0005).The positive detection rate was higher in tumors located closer to the surface (P =0.0 002),and with larger diameter (P =0.00 007).Conclusion Peritoneal cancer cells were significantly correlated with tumor stage,tumor location and size in hepatocellular carcinoma.

Objective To explore the effect of quality control circle (QCC) on reducing the incidence of complications in the patients with peritoneal dialysis (PD). Methods Eighty-nine patients who underwent peritoneal dialysis after discharge were divided into QCC group (45 cases) and control group (44 cases) according to random sampling method. Both groups were followed up regularly, QCC activity was applied in patients of the QCC group on the basis of the QCC activity procedure. The intervention time was 1 year. The blood pressure, standard rate of urea clearance index, peritonitis incidence, catheter drift rate, infection incidences of external orifice of catheter, admission rate of complications and peritoneal dialysis withdrawal incidence between 2 groups were compared. Results After interference, the systolic and diastolic blood pressure in QCC group were significantly lower than those in control group:(124.11 ± 13.07) mmHg (1 mmHg=0.133 kPa) vs. (132.68 ± 12.09) mmHg and (72.13 ± 10.51) mmHg vs. (78.91 ± 11.79) mmHg, and there were statistical differences (P<0.05). The standard rate of urea clearance index in QCC group was significantly higher than that in control group:95.56%(43/45) vs. 81.82%(36/44), and there was statistical difference (P<0.05). After interference, the peritonitis incidence and admission rate of complications in QCC group was significantly lower than those in control group: 2.22% (1/45) vs. 13.64% (6/44) and 0 vs. 9.09% (4/44), and there were statistical differences (P<0.05). There were no statistical differences in catheter drift rate, infection incidences of external orifice of catheter and peritoneal dialysis withdrawal incidence between 2 group (P>0.05). The Spearman correlation analysis result showed that peritonitis was negatively correlated with education level (r = -0.28, P < 0.05), and standard rate of urea clearance index was positively correlated with education level (r = 0.21, P < 0.05). Conclusions The QCC management model can reduce the incidence of complications in patients with peritoneal dialysis.

Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

Objective This study investigated a method to rapidly inactivate tumor cells on surgical instruments intraoperatively.Methods Tumor cells were collected by immersing and washing the surgical instruments in 37 ℃ saline.The precipitation was collected by low speed centrifugation and then was cultured to harvest the tumor cells.The tumor cells were immersed in saline and distilled water of different temperatures for different duration of time.Inverted microscopy was used to investigate the changes in morphology.Results After immersion in 55 ℃ distilled water for 60 seconds,the tumor cells were swollen,the cell membranes disappeared,the sizes of the nuclei were reduced,the chromatin was condensed,and some cells lysed and separated from each other.Additionally,these tumor cells floated in the culture medium and lacked any living cells adhering to the walls of the bottle.In the group of tumor cells treated with 55 ℃ saline for 60 seconds,there were no obvious morphological changes of the tumor cell or nucleus.Conclusion The intraoperative immersion of surgical instruments in 55 ℃ distilled water for 60 seconds could completely inactivate tumor cells.

Objective To evaluate the valuations of the intracranial vertebrobasilar arteries using CT angiography (CTA) in order to improve the understanding of various variants in intracranial vertebrobasilar arteries.Methods The CTA images of 435 subjects were analyzed retrospectively.The data were collected by a 16-slice CT scanner.All the CTA images were processed technically by the maximum intensity projection and volume rendering.The intracranial vertebrobasilar arteries were measured and analyzed.Results Among the 435 subjects,bilateral intracranial vertebral arteries (V4) showed symmetry in 183 (42.07％) and dissymmetry in 252 (57.93％).Hypoplasia were found in 27 subjects (6.21％) on the left V4 segments and 36 (8.28％) on the right V4 segments,and a total of 21 (4.83％) were directly continued as the ipsilateral posterior inferior cerebellar arteries on the unilateral V4 segments.There were 2 subjects (0.46％) with vertebrobasilar dolichoectasia.There were 32 subjects (7.36％) had fenestration variation,3 of them (0.69％) were on the V4 segments,10 (2.30％) at the junctions,and 19 (4.37％) in the basilar arteries.Two subjects (0.46％) had persistent trigeminal arteries.Conclusions The variations of intracranial vertebrobasilar arteries mainly include angiodysplasia,vertebrobasilar dolichoectasia,fenestration variation,and persistent trigeminal artery.As a noninvasive vascular imaging method,CTA may accurately and visually assess the anatomic variation of intracranial vertebrobasilar artery,and provide imaging guidance for the preoperative evaluation of posterior fossa surgery.

Objective To investigate w hether the iterative reconstruction (iDose 4 ) technique improves imaging quality of the low-radiation-dose w hole brain CT perfusion (CTP). Methods Thirty-five consecutive patients w ith clinical y suspected ischemic stroke w ere col ected. Bril iance 256 iCT w as used to perform low-radiation-dose w hole brain CTP, and the filtered back projection (FBP) and iDose 4 algorithm w ere used to conduct image reconstruction. The noise and signal to noise ratio of the 2 kinds of reconstruction algorithms, as w el as the imaging quality of each parameter map w ere compared. Results The effective dose of the w hole brain CTP w as 2.2 mSv. Compared w ith FBP, the noise of each region of interest in the iDose4 Tmax map was decreased significantly ( P<0.05) and the signal to noise ratio was increased significantly (P<0.05). The imaging quality scores (median, interquartile range) reconstructed by FPB group w ere significantly low er than by iDose 4 for cerebral blood flow (CBF) map ( 5.00 [3.00-6.00]vs. 6.00 [5.00-6.00]; Z= -2.784, P=0.005), cerebral blood volume (CBV) map ( 6.00 [5.00-6.00] vs. 6.00 [6.00-7.00]; Z= -3.674, P<0.001), and mean transit time (MTT) map (4.00 [3.00-5.00] vs. 5.00 [4.00-6.00]; Z=3.394, P=0.001). The proportions of the poor quality in CBF map ( 34.3%vs. 11.4%;χ2 =7.036, P=0.030), CBV map (11.4%vs.2.9%; χ2 =7.485, P=0.024 ) and MTT map (28.6%vs.11.4%;χ2 =5.318, P=0.070) reconstructed by FBP w ere significantly higher than by iDose 4 . Conclusions The iDose4 technique may improve imaging quality of low er-radiation-dose CTP.

Objective To evaluate the effect of intravenous administration of gadolinium-DTPA on diffusion weighted imaging (DWI)of breast lesions and apparent diffusion coefficient(ADC)values,and to evaluate the diagnostic performance of post-contrast ADC for differentiating benign from malignant lesions in breast.Methods Thirty-eight histopathologically-confirmed breast lesions were analyzed.We examined the signal to noise ratio(SNR)of normal breast tissue and lesions and evaluated the contrast to noise ratio(CNR)of each lesion.We also assessed the relation between pre-and post-contrast ADC values.Results SNRs and CNRs of DWI before and after contrast were not significantly different.The mean post-contrast ADC values for malignant lesions significantly decreased after contrast injected (mean of -1 1.6%),while ADC values in the benign lesions were not significantly different before and after contrast.Conclusion Post-contrast ADC values may be a better indicator of potential breast tumors than pre-contrast ADC values.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.

[Objective]To investigate the micro-structural alterations within whole brain white matter(WM) in cough syrup abuse addiction patients containing codeine,and to explore the correlation between aberrant WH and abuse time of cough medicine abuse patients.[Methods]Thirty cough syrup abuse addiction patients containing codeine and 30 controls participated in the study. Structural changes in FA and(mean diffusivity)MD were examined in cough syrup abuse addiction patients containing codeine which derived from DTI tractography. Pearson correlation analysis was performed to compare the mean FA value and duration of cough syrup abuse addiction in patients.[Results]Cough syrup abuse addiction patients containing codeine had lower FA value in bilateral anterior limb of internal capsule(ALIC)and higher MD in the bilateral hippocampus and insula,right anterior cingulate cortex(ACC)and superior temporal gyrus,compared to the controls. Cough syrup abuse addiction group also had positive correlation between mean FAvalues and duration of cough syrup abuse addiction in patients.[Conclusion]Micro-structural alterations within whole brain white matter(WM)are found in cough syrup abuse addiction patients containing codeine. This disturbance progresses as duration increases of cough syrup abuse addiction in patients.

Objective:To investigate effects of hydrogen sulfide (H2S) on inducible nitric oxide synthase (iNOS) in kidneys of Type 1 diabetic rats.Methods:Thirty-two male SD rats were randomly divided into four groups:A normal control (NC) group,a diabetes mellitus (DM) group,a NaHS (NaHS+DM) group,and a NaHS control (NaHS) group (n=8 per group).Type 1 diabetes was induced by a single intraperitoneal injection of streptozotocin (55 mg/kg).After successful establishment of models,the rats in NaHS+DM and NaHS groups were injected with NaHS solution (56 μmol/kg) intraperitoneally.Eight weeks later,the activities of total nitric oxide synthase (T-NOS) and iNOS,as well as the level of nitric oxide (NO) were detected in serum and renal tissues,respectively,The activity of glutathione peroxidase (GSH-Px) was determined in renal tissues,The ultrastructures of renal tissues were observed by transmission electron microscope,The protein expression ofiNOS in renal tissues was detected by Western blot.Results:Compared with the NC group,there was no significant difference in the various indexes in the NaHS group (P＞0.05).However,in the DM group,the activities of T-NOS and iNOS,and the level of NO were all increased significantly in serum and renal tissues,while the activity of GSH-Px was decreased in renal tissues.Under the electronic microscope,the thickening of the glomerular capillary basement membrane,the proliferation of mesangial matrix,and the foot fusion were observed.The protein expression ofiNOS was increased obviously in renal tissues in the DM group (P＜0.01).Compared with the DM group,the activities of T-NOS and iNOS and the level of NO were all decreased in serum and renal tissues,while the activity of GSH-Px was increased in renal tissues in the NaHS+DM group (P＜0.01).The renal ultrastructural damages were ameliorated obviously.The protein expression ofiNOS was decreased significantly (P＜0.01).Conclusion:H2S exerts a protective effect on kidney injury in type 1 diabetic rats.The mechanism might be related to inhibition of iNOS activity and protein expression,in turn leading to reduction of NO content in renal tissues.