Objective To determine the diagnostic value and necessity of excretory phase of CT urogrphy (CTU). Methods One hundred and one cases with 197 sides of cohort CTU studies were enrolled from PACS system retrospectively, and 44 cases had the records of radiation dosage. Three different seniority senior radiologists reviewed the images and diagnosed 2 times blindly with the clinical information. At the first time, plane scan, contrast enhanced renal cortical phase and renal parenchymal phase images (Diag. A) were reviewed. At the second time, with 3 kinds of images mentioned above plus excretive phase images (Diag. B) were reviewed, with interval of 3 months between the two reviews. With Diag. B as reference standard, accordance rate of diagnoses of Diag. A was calculated. The difference of the 3 rediologists's accordance rates were analyzed with Chi-square test, and the lesions with accordance rate ≤80% were recorded. The cases of 197 urinary tracts were divided into 4 groups: lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion. The filling of contrast media in the urinary tract was recorded with 5-scale scoring system. The differences of the urinary tract filling among the 4 groups were analyzed with Kruskal-Wallis test. The effective radiation dosages of CTU with and without excretory phase scan were recorded and calculated, and the difference was analyzed with t test. Result The diagnostic accordance rate of CTU with and without excretory phase of the 3 radiologists was 95.4%(188/197), 93.9%(185/197), 92.4%(182/197)respectively(χ2=1.60, P>0.05). Lesions with diagnostic rate≤80%were parapelvic cyst and caliceal diverticulum. The median score of urinary tracts filling in the lesions of renal pelvic and ureter, lesions of bladder, lesions of kidney and extra-urinary tract, without lesion group were 2, 3, 3, 4, and the differences were significant (HC=31.7, P<0.05). The effective radiation dosages of CTU with and without excretory phase scan were (32.36±11.04)mSv and (41.47±14.27) mSv respectively (t=3.35, P<0.01). Conclusions No significant effect of excretive phase imaging is found on the diagnosis of most urinary system diseases. Poor contrast filling and high rate of failure of filling of the urinary tract with intra luminal pathologies, and increase of the radiation dosage make the excretory phase scan in CTU less useful and it should be used carefully and selectively.

Objective To investigate the effects of nitric oxide (NO) and cholecystokinin (CCK) on the regulation of the motility of sphincter of Oddi (SO).Methods The basal pressure,action rate and contraction range of the SO were examined before and after the injection of CCK,sodium nitroprusside (SNP) and NG-nitroL-argininemethyl ester hydrochloride (L-NAME).The expression of neurons with positive expression of NO synthase was detected by immunohistochemical staining.The measurement data were analyzed by using the t test.Results The basal pressure,contraction rate and contraction range of the SO were (27 + 10)mm Hg (1 mm Hg =0.133 kPa),( 10 ± 3 ) times/minute and (32 + 8 ) mm Hg before injection of CCK,and (61 + 14) mm Hg,(64 +21 ) times/minute,(44 ± 15 ) mm Hg after injection of CCK of 20 ng/kg.After injection of CCK of 100 ng/kg,the basal pressure,contraction range and contraction rate of the SO were (77 ± 31 )mm Hg,(69 ± 18 ) times/minutes,(79 + 14) mm Hg when the inhibition effect of CCK reached peak,and were ( 140 ± 21 ) mm Hg,( 129 ± 25 )times/minutes,( 173 ± 63 ) mm Hg when the excitatory effect of CCK reached peak.After injection of SNP into the common bile duct,the basal pressure,contraction range and contraction rate of the SO decreased significantly ( t =3.706,5.183,P ＜ 0.05),while the 3 indexes increased significantly after injection of SNP (t =5.859,3.588,P ＜O.05).Conclusion Different from physiological dose (20 ng/kg) of CCK,large dose of CCK enhances motility of SO intensively.NO relaxes SO,which may play an important role in the inhibitor pathway of CCK.

Objective To observe the curative effect of pure 1 25 I treatment to non-small cell lung cancer combined obstructive pneumonia.Methods 28 cases with non-small cell lung cancer combined obstructive pneumonia were enrolled.Treatment planning system was used to calculate the dosage of tumor and make up the therapeutic plan.CT-guided radiation treatment of particle im-plantation was then conducted.Follow-up was done to evaluate the curative effect one to two months after treatment.Results The total effective rate of therapeutic evaluation was 89.3%.Clinical symptoms including chest distress,hard breathing and fever were ameliorated remarkedly.Life quality score of appetite and fatigue was also improved.White blood cell reduced significantly in blood routine examination.Conclusion There is a definite curative effect of pure 1 25 I treatment to non-small cell lung cancer combined ob-structive pneumonia.

Purpose To investigate the significance of procedural arteriography in interventional embolization of adrenal metastasis, due to the fact that it is usually difficult to seek feeding arteries in the treatment of adrenal metastasis using interventional embolization. Materials and Methods Eighteen patients with adrenal metastasis were treated with procedural arteriography and interventional embolization therapy, the source and number of feeding arteries was retrospectively analyzed. Results The total success rate of procedural arteriography was 95.5%. The abnormal feeding arteries which were discovered by procedural arteriography accounted for 29.0%. The number of feeding arteries was two, which were mainly derived from inferior suprarenal artery and superior suprarenal arteries. Conclusion The source of feeding arteries of adrenal metastasis is abundant and the variability is obvious, thus procedural arteriography should be used to the greatest extent during operation of digital subtraction angiography to avoid omission of feeding arteries.

This study was aimed to investigate the research on pharmacological effects, relevant ideas and methods of Guangdong native heat-clearing and toxin-removing herbs. Literatures on pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs were collected, summarized and analyzed. The results showed that most Guangdong native heat-clearing and toxin-removing herbs had obvious effects of anti-microbial, anti-bacterial endotoxin, anti-inflammatory, and antipyretic effect. It also had obvious antivenomous and analgesia effect. Based on research ideas and methods of Guangdong native heat-clearing and toxin-removing herbs, we clarified the confusion species as soon as possible, and adhered to the whole animal experiments in combination with in vitro experiments and computer molecular docking simulations for the complementation of each other. It was concluded that the study on pharmacological effects of Guangdongnative heat-clearing and toxin-removing herbs provided strong support in its clinical application. Ideas and methods provided in this article was the main way to explain pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs.

[ABSTRACT]AIM:ToobservehowfarnesoidXreceptor(FXR)functionedinconcanavalinA(ConA)-induced hepatitis (CIH) and the regulation of FXR-thyrotropin embryonic factor (TEF) pathway.METHODS:C57BL/6 mice were injected with Con A to induce hepatitis .The expression of FXR and TEF in the liver specimens was determined by qRT-PCR and Western blotting .The concentrations of serum ALT/AST and inflammatory cytokines IFN-γ, TNF-α, IL-4 and IL-2 in the blood samples were tested after Con A injection .RESULTS:FXR was down-regulated in CIH mice .TEF was up-regula-ted when FXR was activated by chenodeoxycholic acid (CDCA).Activation of FXR reduced the levels of aminotransferases and inflammatory cytokines IFN-γ, TNF-α, IL-4 and IL-2 in the CIH mice induced by Con A injection .CONCLUSION:FXR activation attenuates CIH mouse liver injury and reduces inflammatory cytokines .FXR activation results in TEF up-regu-lation.The FXR-TEF pathway may play a protective role in autoimmune hepatitis .

Objective:To investigate the risk factors for preoperative hypoxemia in geriatric patients with hip fracture.Methods:A case-control study was used to analyze the clinical data of 99 geriatric patients with hip fracture admitted to Zhongda Hospital affiliated to Southeast University between November 2020 and August 2021. There were 29 males and 70 females, aged 67-96 years [(82.6±6.2)years]. The patients were divided into hypoxemia group ( n=51) and non-hypoxemia group ( n=48) using partial arterial partial pressure of oxygen (PaO 2)<80 mmHg while breathing room air at emergency as the reference standard. The two groups were compared in terms of sex, age, fracture types, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, pulmonary diseases diagnosed by preoperative chest CT [atelectasis, pleural effusion, chronic obstructive pulmonary disease (COPD)], time from injury to visit, New York Heart Association (NYHA) classification, Barthel index, KATZ index, modified Medicine Research Council (mMRC) dyspnea scale, numeric rating scale (NRS), smoking, drinking, comorbidities (hypertension, diabetes mellitus, Parkinson′s disease, Alzheimer′s disease, cerebral infarction, coronary atherosclerotic heart disease), body temperature, blood routine test at first examination (erythrocyte count, leukocyte count, C-reactive protein, hemoglobin), biochemistry (serum albumin, blood glucose, blood creatinine, blood urea nitrogen), electrolyte (serum potassium, serum sodium), and other related examinations [D-dimer, brain natriuretic peptide (BNP), lactic acid]. Univariate analysis was performed to the correlation of those indicators with preoperative hypoxemia. Multivariate Logistic regression analysis was used to identify the independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture. Results:Differences in sex, age, fracture types, BMI, pulmonary diseases diagnosed by preoperative chest CT, time from injury to visit, Barthel index, KATZ index, NRS, smoking, drinking, comorbidities, body temperature, first laboratory results of erythrocyte count, biochemistry, electrolyte and other related examinations were not statistically significant between the two groups (all P>0.05). The two groups showed statistical differences in ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination, C-reaction protein and hemoglobin (all P<0.05). Univariate analysis indicated that ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination and C-reaction protein were correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture (all P<0.05). Multivariate Logistic regressions analysis indicated that higher mMRC dyspnea scale ( OR=2.30, 95% CI 1.10-4.81, P<0.05), higher leukocyte count at first examination ( OR=1.24, 95% CI 1.05-1.45, P<0.05), higher level of C-reaction protein ( OR=1.02, 95% CI 1.01-1.03, P<0.05) and higher level of hemoglobin ( OR=1.04, 95% CI 1.01-1.07, P<0.05) were significantly correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture. Conclusion:Higher mMRC dyspnea scale, higher leukocyte count, higher level of C-reaction protein and higher level of hemoglobin are independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture.