PurposeTo explore the gemstone CT with low tube voltage and low concentration contrast medium in evaluating renal artery imaging of preoperative living renal transplantation donor.Materials and Methods Fifty cases of living kidney donor underwent spiral CT angiography of renal artery before operation. The patients were randomly divided into double-low group (25 patients) with 100 kV and Visipaque (270 mg/ml), and control group (25 patients) with 120 kV and Iopromide (370 mg/ml). Image reconstruction of 40% ASiR was used in both groups. The image quality score, CT values of renal arteries, contrast-to-noise ratio (CNR), noise, radiation dose and the amount of contrast agent of the two groups were recorded and compared.ResultsKappa coefifcient analysis showed that the consistency in evaluating image quality between two radiologists was excellent (Kappa=0.82). The CT value of the renal arteries and image quality did not show signiifcant difference between the two groups (t=1.05, 0.07 and 1.62,P>0.05). The CNR, noise and average radiation dose were statistical different between the two groups (t=2.92,-6.95 and-2.21,P<0.05). The contrast medium dosage of double-low group was decreased by 27% when compared with that of the control group.Conclusion Satisfied image quality of renal artery CTA can be obtained with low tube voltage (100 kV) and low concentration contrast medium (270 mg/ml) combined with iterative reconstruction algorithm. It can be used as a routine method in preoperative examination of living renal donors.

OBJECTIVE:To observe the effects of Cholinesterase inhibitor combined with Compound haishe capsule on prog-nosis of patients with Alzheimer’s disease (AD). METHODS:210 AD patients were divided into donepezil group,rivastigmine group,galantamine group,Compound haishe capsule group,donepezil + Compound haishe capsule group,rivastigmine + Com-pound haishe capsule,and galantamine + Compound haishe capsule group,30 cases in each group according to visiting order. Donepezil group received Donepezil hydrochloride tablet 5 mg(<1 month)before going to bed,10 mg(≥1 month),po,qd;riv-astigmine group received Rivastigmine hydrogen tartrate capsule 1.5 mg(<1 month)before going to bed,3.0 mg(≥1 month), po,bid;galantamine group received Galantamine hydrobromide tablet 2 mg (<2 weeks),4 mg (2-4 weeks),6 mg (>4 weeks),po,bid;Compound haishe capsule received Compound haishe capsule 3 casuples,po,tid;donepezil + Compound haishe capsule group received Donepezil hydrochloride tablet 5 mg,po,qd + Compound haishe capsule 3 casuples,po,tid;galantamine+ Compound haishe capsule group received Rivastigmine hydrogen tartrate capsule 1.5 mg,po,bid + Compound haishe capsule 3 casuples,po,tid;galantamine+Compound haishe capsule group received Galantamine hydrobromide tablet 4 mg,po,bid+Com-pound haishe capsule 3 casuples, po, tid. The treatment course for all groups was 3 months. Mini-mental state examination (MMSE),AD dementia rating scale (ADAS-cog) and ability of daily life (ADL score) before and after treatment,and TESS score after treatment in all groups were observed,and the occurrence of ADR was observed. RESULTS:There was no statistical significance in MMSE, ADAS-cog and ADL score between 2 groups before treatment (P>0.05).After treatment, MMSE, ADAS-cog and ADL score in all groups were obviously improved;MMSE scores in ChEI combined with Compound haishe cap-sule groups were obviously higher than appropriate ChEI alone groups and Compound haishe capsule alone group,ADAS-cog and ADL scores were obviously lower than appropriate ChEI alone groups and Compound haishe capsule alone group;TESS scores in-cidence of adverse reactions in Compound haishe capsule alone group or combined with ChEI groups were obviously lower than ap-propriate ChEI alone groups and Compound haishe capsule group,the differences were statistically significant (P<0.05). CON-CLUSIONS:ChEI combined with Compound haishe capsule can effectively improve the mental state of AD patients,cognitive function and life activity,with higher safety.

Objective To explore the features of ambulatory blood pressure in patients with primary glomerular disease and their correlation with target organ damage (TOD).Methods Patients with primary glomerular disease admitted to the Nephrology Department,the Third Affiliated Hospital of Sun Yat-sen University from May 2010 to May 2015 were enrolled.Ambulatory blood pressure monitoring (ABPM),clinical BP,ultrasonographic assessment and other clinical data were collected.Univariate and multivariate analyses were used to ascertain the relationship between ABPM results and clinical parameters.Results 808 patients were enrolled.Patients turned out to have a higher level of 24-hour systolic blood pressure (SBP),day-time SBP,and night-time SBP as their kidney function declined (r,=0.547,0.538,0.546,P ＜ 0.01).Compared with that in CKD 1-3,The percentage of dipper blood pressure pattern decreased and that of reversed dipper blood pressure pattern increased in CKD stage 4-5 (P ＜ 0.05).A higher level of 24 h SBP was independently associated with kidney function damage (OR=1.069,P ＜ 0.01),and a higher level of night-time SBP was an independent factor affecting left ventricular hypertrophy (OR=1.033,P ＜ 0.01) and reduction of diastolic function of left ventricle (OR=1.019,P ＜ 0.01) after multivariate logistic regression analyses.Conclusion With advancing CKD stage,the level of 24 h SBP,day-time SBP,and night-time SBP was higher and the percentage of reversed dipper blood pressure pattern was higher.The parameters of ABPM were closely related to renal damage and cardiovascular injuries.

Objective To observe the effect of methylene blue on the expression of liver inducible nitric oxide synthase (iNOS) in rats with different stages of sepsis.Methods One hundred and twenty-six adult female Wistar rats were randomly divided into three groups: sham operation group, sepsis group and methylene blue group, each group was again subdivided into 0, 6, 12, 18, 24, 30, 36 hours subgroups, each subgroup6 rats. The model of sepsis was established by cecal ligation and puncture (CLP) method, and in the sham operation group, the abdominal incision was performed and the intestinal mesentery was separated only, without ligation and perforation. In methylene blue group, 15 mg/kg methylene blue was injected into a caudal vein at 0, 6, 12, 18, 24, 30, 36 hours after CLP in the rats in corresponding subgroups, respectively; in the sepsis and sham operation subgroups, the same amount of 0.9% normal saline was given. After administration for 6 hours in various groups, the rats were sacrificed and the liver tissue was harvested immediately. The expression of iNOS mRNA of liver tissues was determined by the real-time fluorescent quantitative reverse transcription-polymerase chain reaction (qRT-PCR),and the protein expression of iNOS was determined by Western Blot.Results Compared with sham operation group, the liver tissue expression of iNOS mRNA was significantly up-regulated in sub-sepsis groups at 0, 6, 12 and 18 hours after CLP (2-ΔΔCt: 16.66±2.81 vs. 1.00±0.36, 12.26±5.78 vs. 1.00±0.30, 6.08±1.33 vs. 1.00±0.18, 2.42±0.64 vs. 1.00±0.12, allP < 0.01), after 24 hours the expression of iNOS mRNA had no significant change; the liver tissue expression of iNOS protein was obviously up-regulated in sub-sepsis groups at 6, 12 ,18 and 36 hours after CLP (gray value: 0.350±0.011 vs. 0.210±0.005, 1.460±0.085 vs. 0.090±0.005, 0.230±0.012 vs. 0.18±0.008, 0.310±0.017 vs. 0.200±0.010, allP < 0.01). Compared with sepsis group, the expression of the liver tissue iNOS mRNA was down-regulated in methylene blue subgroups at 0, 12 and 18 hours after CLP (2-ΔΔCt: 9.90±3.06 vs. 16.66±2.81, 1.56±0.58 vs. 6.08±1.33, 1.11±0.15 vs. 2.42±0.64, allP < 0.05), and the expression of iNOS protein was down regulated in methylene blue subgroups at 6, 12, 18 and 36 hours after CLP (gray value: 0.150±0.008 vs. 0.350±0.011, 0.950±0.009 vs. 1.460±0.085, 0.150±0.007 vs. 0.230±0.012, 0.170±0.009 vs. 0.310±0.017, allP < 0.05).Conclusion Zero-24 hours after CLP, the expressions of mRNA iNOS and protein in liver of septic rats are significantly increased; methylene blue can markedly inhibit the expressions of iNOS mRNA and protein in the liver of rats with sepsis.

Objective To explore the risk factors of and the influence of different hepatitis B virus (HBV) DNA load on paternal vertical transmission of HBV.Methods Totally,161 HBsAg negative women,whose husband was HBsAg positive,attended the antenatal clinics of the Provincial Maternity and Child Health Hospital of Fujian from September 2007 to December 2008 and their newborns were selected,and the epidemiologic information,the duration of being a HBV carrier,the first class HBV family history of the fathers,HBV markers,HBV DNA load,HBsAb of the gravidas,the outcomes of the newborns were all collected.Cord blood was sampled after delivery for HBV DNA quantification and those with HBV DNA load ≥1.0×103 copy/ml were chosen as the case group and those ＜ 1.0×103 copy/ml as control.Results (1) Among the 161 newborns,36 HBV DNA positive cord blood samples were detected,giving a rate of 22.4% (36/161) for paternal vertical transmission of HBV.The HBV DNA positive rate in cord blood was 32.0% (23/72) in HBeAg-positive fathers and 14.6% (13/89) in HBeAg-negative fathers.(2) Univariate analysis showed that HBeAg-positive,HBV DNA positive,first class family history of HBV and the duration of being a HBV carrier of the fathers were risk factors of paternal HBV vertical transmission[X2= 6.892,29.916,29.499 and 23.821,OR = 2.7,5.2,8.3 and 1.4 (P＜0.01)].(3) Multivariate analysis found that paternal serum HBV DNA positive and the first class family history of HBV of the father side were risk factors of paternal vertical transmission of HBV (OR = 11.1,95% CI;4.6-27.1;OR = 17.1,95% CI:3.5-82.6).(4) According to the different serum HBV DNA load of the HBsAg-positive father,7 groups were divided.A dose dependent effect was found that the HBV DNA positive rate of the cord blood increased with the rising of HBV DNA load.No HBV DNA positive cord blood was detected when paternal HBV DNA load was＜1.0×104 copy/ml,while 100% of the cord blood were positive when paternal HBV DNA load≥1.0×108 copy/ml.(5) The average birth weight of the newborns in the two groups was the same (3.3±0.4) kg.And the delivery mode,gestational age at delivery,height and Apgar score of the newborns at 1 minute,neonatal pathological jaundice and other complications had no significant difference between the two groups (P ＞ 0.05).No relationship was found between the neonatal outcomes and the paternal HBV vertical transmission (P＞0.05).Conclusions HBV DNA load in the serum of HBsAg-positive father,and the paternal first class family history of HBV are risk factors of paternal HBV vertical transmission.When the serum HBV DNA load in HBsAg-positive father is≥1.0×107 copy/ml,the possibility of paternal vertical transmission of HBV would increase.

Objective To study the effects of eliminating free radical and increasing antioxidative capacity of glutathione peroxidase 1(GPX1) on PC12 cells. MethodsGPX1 recombinant plasmid and Plncxplasmid were transfected into PC12 cells and PC12 cells highly-expressing GPX1 stably were sieved by G418 solution. PC12 ceils were treated with different concentrations of amyloid β-protein (Aβ25-35) for 48 h, to decide the optimal concentration of Aβ25-35 and construct ideal cell model. GPX1/pLNCX/PC12 group, pLNCX/ PC12 group and PC12 group were treated with optimal concentration of Aβ25-35 ,respectively for 48 h, and their absorbance (A) value by MTT conversion was compared among three groups.ResultsCell clone highly expressing GPX1 stably were obtained by G418 selection. The increment of cell inhibition ratio was 24.7 ％ after 20 μmol/L Aβ25-35 treatment for 48 h, compared with control group (P＜0.01). Thus the optimization concentration of Aβ25-35 was 20 μmol/L. After treatment with 20 μmol/L for 48 h, the A value was significantly higher in GPX1/pLNCX/PC12 group than in pLNCX/ PC12 group and in PC12 cells group(0.53±0. 02 vs. 0.44±0.02;0.53±0.02 vs. 0.39±0.07, P＜0.01). Conclusions Transfection of GPX1 recombinant plasmid may protect cell against injury from free radical and reverse the decrease of PC12 cell survival rate impaired by Aβ25-35.

Objective:To investigate the influence of unilateral periacetabular osteotomy (PAO) on the bony birth canal (BBC) in female patients with developmental dysplasia of the hip (DDH) by using pelvic 3D-CT maximum-inscribed-sphere (MIS) method.Methods:A total of 62 female DDH patients of childbearing age were included in the present study. The DICOM data of their pre- and post-operative pelvic CT was collected. The diameters of the MIS in 25 layers of the BBC were measured on the Medical Imaging Interaction Toolkit (MITK) platform. Lateral center edge angle (LCE), T?nnis angle and the distance between the medial margin of the femoral head and Kohler's line were measured on standing anteroposterior pelvic radiographs before and after unilateral PAO. Patients were divided into severe (LCE≤0°) and non-severe group (0°0.05). The anterior margin of acetabular fragment (1-13th layer) narrowed significantly (4.23-5.95 mm) after unilateral PAO with the narrowest part (5.62-5.95 mm) locating at the inferior margin of pubic ramus and the region superior to the lateral margin of obturator foramen (5-10th layer). The narrowest part of BBC before and after the surgery occurred at the level of bilateral sciatic spines (20th layer). The diameter of MIS changed significantly from 105.34±7.16 mm pre-operatively to 104.47±7.06 mm post-operatively ( t=2.198, P=0.032). There was a positive correlation between the inward displacement of the hip center and the narrowing of the 1-20th layer of the BBC. The decrease of T?nnis angle was positively correlated with the narrowing of the 1-10th layer of the BBC. The increase of LCE was negatively correlated with the narrowing of 2-5th layer of the BBC ( P<0.05). The standardized coefficients were with statistical significance when comparing the distance between the Kohler's line and the medial margin of the femoral head to the size of the 1-20th layer of the BBC ( β=0.27-0.50, P<0.05). The height was positively correlated with the size of the narrowest part of the BBC before and after the surgery ( r=0.565, r=0.586, P<0.001). There was no difference between severe group and non-severe group in their extent of BBC narrowing before and after surgery ( t=-0.685-0.655, P>0.05). Conclusion:Unilateral PAO results in mild narrowing of the BBC superior to the sciatic spine. The narrowest part of the BBC is located at the sciatic spine. Unilateral PAO has slight effects on the narrowest position of the BBC. Normal delivery of a healthy fetus in female patients with DDH of childbearing age could not be affected by unilateral PAO in normal BBC settings.

Objective:To investigate the clinical characteristics and outcome of novel coronavirus pneumonia (COVID-19)patients with different body mass index (BMI), and to provide the basis for disease assessment and prognosis.Methods:The clinical data of 541 patients with COVID-19 diagnosed in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 16 to March 28, 2020 were collected. The patients were divided into normal weight group, overweight group, and obesity group according to BMI. The clinical characteristics and outcomes of the three groups were compared. The correlation between BMI and clinical classification was analyzed by ordinal logistic regression.Results:There were 288 cases (53.23%) in normal weight group, 193 cases (35.67%) in overweight group, and 60 cases (11.09%) in obesity group. Compared with normal weight group, overweight and obesity groups displayed higher proportion of hypertension, with increased levels of white blood cells, neutrophils, C reactive protein, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and triglyceride in laboratory test results, and higher proportion of severe and critical illness ( P<0.05 or P<0.01). After adjusting for age, gender, and underlying diseases, regression analysis showed that higher BMI predicted more severe clinical classification ( OR=1.079, 95% CI 1.010-1.154). Conclusion:In COVID-19 patients, overweight and obese patients are more likely to develop into severe and critical illness, suggesting that obesity may be an important risk factor affecting the clinical outcome of COVID-19.

OBJECTIVETo study the dispersivity of baicalin solid dispersion by Raman spectrometry and infrared spectrometry in order to obtain a new and simple method in examining the dispersivity of solid dispersion.

METHODBaicalin solid dispersion was prepared by solvent method. The Raman spectra, infrared spectra and X-ray powder diffraction patterns of crude baicalin, PVP K30, physical mixture, solid dispersion were acquired by Raman and Fourier transform infrared spectrometers and X-ray powder diffractometry. Then the spectra were compared with each other in order to find out the differences between baicalin solid dispersion and other materials.

RESULTThe result of Raman spectrometry was that amorphous baicalin presented in the solid dispersion, which was in agreement with that of X-ray powder diffractometry.

CONCLUSIONRaman spectrometry which is fast, direct and non-destructive is an ideal method for examining the dispersivity of solid dispersion.

Hereditary diffuse leukoencephalopathy with neuroaxonal spheroids (HDLS) is a rare autosomal dominant leukoencephalopathy disease, and colony stimulating factor 1 receptor (CSF1R) is the only gene in which mutations are known to cause HDLS. HDLS should be suspected in individuals with progressive neurological decline, characteristic MR imaging findings, and positive family history. This article reviews recent advance in imaging findings, clinical manifestations, genetic counseling and management in HDLS.
Brain ; diagnostic imaging ; Humans ; Leukoencephalopathies ; diagnosis ; diagnostic imaging ; genetics ; physiopathology ; Radiography ; Spheroids, Cellular ; cytology