BACKGROUND:To introduce the scanning technique and imageologieal signs of multi-slice spiral CT angiography in the diagnosis of venous thromboembolism,and concomitantly evaluate its apphcadon value and advantage in the early diagnosis of venous thromboembolism.METHODS:Using the terms"venous thromboembolism,pulmonary thromboembolism,CT angiography",the authors computer-retrieved Medline to identify studies published between January 1998 and October 2007 in the English language.At the same time,we searched the Wanfang database with the same terms in the Chinese language by hand and computer forstudies between January 2000 and October 2007.A total of 228 manuscripts Were obtained,and 24 of them corresponded to the inclusive criteria.RESULTS:Using collection technique and in conjunction with high-quality three-dimensional reconstructed images,multi-slice spiral CT can clearly reveal the distal branches of pulmonary artery,achieving subsegmental-level diagnosis of Duhnonary thromboembolism.There was no remarkable difference in the sensitivity for diagnosing pulmonary thromboembolism between thin-slice spiral CT and pulmonary artery angiography.The sensitivity and specificity of thin-slice spiral CT is higher compared to pulmonary ventilation-perfusion radioisotope scanning.When eliminating acute pulmonary thromboembolism,spiral CT is a promising first-ehoicemethod.CONCLUSION:Spiral CT is characterized by rapid scanning,clear image,and without omission of small foci.Spiral CT angiography is a safe,rapid,non-invasive,and effective method for the diagnosis of venous thromboembolism.

Objective To evaluate the efficacy of ginkgo biloba extract injection combined mecobalamine treatment of diabetic peripheral neuropathy.Methods CNKI, CBM, VIP, Wanfang, PubMed, Cochrane library and Google academic search and other databases were searched, the RCT related ginkgo biloba extract injection combined mecobalamine treatment of diabetic peripheral neuropathy were collected.Meta analysis, drawing forest map and funnel plot by using Rev.Man 5 software.Results A total of 21 RCTs involving 1745 patients were obtained, 905 cases in experimental group and 840 cases in control group.Meta analysis showed that the total effective rate of the experimental group was better than that of control group ( RR=1.40, 95%CI:1.31-1.48), the conduction velocity of motor nerve median nerve(MD=5.39, 95%CI:3.90-6.87), common nerve(MD =5.33, 95%CI:3.82-6.83), sensory nerve median nerve (MD =4.31, 95%CI: 2.89-5.74)and common nerve (MD =4.10, 95%CI: 2.67-5.54)in experimental group were better than those of control group, the difference was statistically significant (P<0.05).Conclusion Ginkgo biloba extract injection plus cobalt-amine peripheral neuropathy in patients with diabetes treatment RCT design flaws, affecting the results of the authenticity and reliability; ginkgo biloba extract injection combined mecobalamine can improve the clinical efficacy and improve nerve conduction speed;due to less number of included studies, research quality is not uniform, still need to carry out more high quality randomized controlled trials to further validate the results.

Objective To study the regulation of iodine solution dissemination through the portal vein duo to compression of liver tissue in SD rat models.Methods SD rats were divided into three groups:liver segment blocking group,non-liver segment blocking group and placebo group.Right anterior segments of liver were blocked by blocking ribbon before the compression of liver tissue in liver segment blocking group,the liver tissue was pressed in 20 times.The procedures were all the same with blocking groups in non-liver segment blocking group except that the liver tissue is free from blocking.Placebo group only was opened and closed the abdomens.The iodine solution was injected into the liver tissue in right anterior segments and iodine ball should be confirmed under the X-ray in every experimental rats.The severity of the iodine predations in the liver was divided into four degree:Degree A indicated the iodine ball was in situ;no predations;Predations were in right anterior segments only in degree B;Degree C was found iodine spots in other liver segments except right anterior segments;Degree D indicated iodine spread to other organs.The iodine balls were pressed under the pressure between 10 and 15 mm Hg.Results Majority of iodine balls(36/45,80%)were formed successfully in liver tissues.Compression of the iodine balls in liver tissues can cause iodine predations in the vessels in liver.The severity of the dissemination was related to the pressure and the range of the pressings.The blocking of the liver segments before the operation can reduce the predations of iodine.Conclusion Pressing of the liver tissue can caused the iodine balls disseminate in vessels,cancer cells or cause thrombus disseminate in the vessels,Which can be reduced by avoiding the compression of the liver or tumom during the operation.

Guanylin family, described in recent 10 years, is a series of small peptides (including guanylin, uroguanylin and lymphoguanylin) with structural and functional similarities to heat-stable enterotoxins (STs) elaborated by various pathogenic bacteria. They are abundance of cysteines and are endogenous activators of guanylyl cyclase-C (GC-C) receptors. Immunoreactive guanylin family peptides are localized in many human organs and tissues, especially in gastrointestinal tract and kidney, and play an important role in regulation of water and salt homeostasis. Recent studies showed that the mRNA levels of guanylin family peptides were down-regulated in colorectal cancers; oral intake of uroguanylin might suppress polyp formation in Apc(Min/+) mouse, and ~(111)In-labeled-ST peptide analog might specifically target human colon cancers. These evidences highlight that guanylin family may have a potential application in diagnosis and therapy effects of colorectal cancers.

Objective To compare RNA interference (RNAi) with imatinib in killing K562 cells. Methods Design effective shRNA sequences special for bcr-abl silencing and insert them into the eukaryotic expression vector for RNAi by gene engineering. The recombinant plasmi(ts were then transfected into K562 cells. 48 hours later, the efficiency of transfection was identified by fluorescent microscope, bcr-abl mRNA level was detected by RT-PCR. Another group of K562 cells were treated respectively by imatinib with different concentration. All groups of K562 cells were finally analyzed in apoptosis, cell proliferation and phosphotyrosine-containing proteins. Results Both RNAi and imatinib induced apoptosis, decreased proliferation and reduced phosphotyrosine-containing proteins. Conclusion BNAi can kill K562 cells successfully as imatinib, and it may be a promising way to treat CML patients in clinic, especially for those who fail in imatinib or other chemotherapy.

The study aims to solve the instability problem of methylphenidate (MPH) in plasma, and establish a LC-MS/MS method for simultaneous determining of MPH in human plasma. The stabilities of MPH in different media were studied, and the degradation characteristics of MPH in these media were also investigated by HPLC and LC-MS/MS. To a 200 microL aliquot of freshly collected plasma sample, 10 microL 2% formic acid was added immediately to prevent the hydrolysis of MPH in human plasma samples. Chromatographic separation was performed on a Sapphire C18 column using the mobile phase of methanol - 5 mmol.L-1 ammonium acetate buffer solution containing 0.1% formic acid (46 : 54). MPH was quantified by tandem mass spectrometry operating in positive electrospray ionization mode with multiple reaction monitoring. The detection used the transitions of protonated molecules at m/z 234.2-->84.1 for MPH and m/z 260.3-->183.1 for propranolol (IS), separately. The intra- and inter-assay precisions were all below 5.0%. The accuracies were all in standard ranges. The linear calibration curve was obtained in the concentration range of 0.035-40 ng.mL-1. The methods fulfilled the demand. The method was used to determine the concentration of MPH in human plasma after a single dose of 36 mg MPH tablet to 6 healthy Chinese volunteers. The method is suitable for the precisely determination of MPH and for pharmacokinetic study of MPH in human plasma.

Objective To study the clinical manifestations and influencing prognostic factors of children with acute paraquat in-toxication ,and to search for reasonable and effective treatments .Methods Retrospectively analyzed the clinical data of 68 children with acute paraquat intoxication from March 2005 to June 2012 .According to the amount of toxic dose and clinical symptoms ,all of them were divided into 3 groups ,mild type(22 cases) ,severe type(26 cases) and fulminant type(14 cases) ,retrospective analysis on clinical manifestation ,auxiliary examination and prognosis among the groups and following up the survival of these patients ,the risk factors which may affect the prognosis were explored .Results 66 cases were poisoned by taking orally and the other 2 cases were poisoned by the skin absorption .Gastrointestinal symptoms were the most common .Among 68 cases ,6 cases was lost the following up ,20 cases died(32 .26% mortality):all children from mild type survived ;8 patients from severe type and 12 patients from fulmi-nant type(30 .77% ,85 .71% ,mortality respectively ) .As the degree of the clinical classification deteriorated ,the mortality in-creased ,there was statistical signification between each other and so did the blood urea nitrogen and serum creatinine (P<0 .05) .By following up ,children who once passed the acute stage can recovery and the pulmonary fibrosis might be reversed by the chest CT follow-up .The logistic regression analysis indicated that children who had been diagnosed with acute kidney injury and multiple or-gan dysfunction syndrome showed the worse prognosis .Conclusion Acute kidney injury is a very important factor for the short term prognosis of paraquat intoxication ,while pulmonary fibrosis determine the long-term outcomes ,lung injury may be reversed in the course of the disease ,so we should take active treatments .

Objective To compare the effects of expectoration by high frequency back tapping with both hands and traditional expectoration by tapping back with a single hand on pulmonary complications in esophageal cancer patients having undergone radical resection with video-assisted thoracoscopic surgery (VATS). Methods Sixty patients after radical resection for esophageal cancer with VATS from May 2013 to January 2014 were set as the control group, in which expectoration by tapping the back with a single hand. Another 60 patients after radical resection for esophageal cancer with VATS from February 2014 to July 2014 were set as the observation group, in which the expectoration by high frequency tapping the back with both hands. The two groups were compared in terms of pulmonary complications. Result The incidence of atelectasis and pulmonary infection in the observation group were lower than those with a single hand in the control group (all P<0.05). Conclusion For the patients having undergone radical resection of esophageal carcinoma with VATS, the expectoration with high frequency back tapping with both hands is more effective in lowering atelectasis rate than that with a single hand.

Objective To assess the sleep disturbance in patients with early-stage idiopathic Parkinson's disease of different clinical subgroups. Methods Four hundred and eighty-six Chinese PD patients were selected as our subjects. Their clinical data including demographics,a broad spectrum of motor variables and non motor features,including tremor,rigidity,hypokinesia,PIGD,motor phenotypes,disease progression,fatigue, constipation,apathy,depression,global cognitive function and L-dopa complications were collected and analyzed by cluster analysis. The PD subtypes were classified by using k-means cluster analysis according to the clinical data. The cluster analysis indicated four main subtypes:subtype 1 was mildly affected in all domains;subtype 2 was severely affected on all motor and non motor symptoms;subtype 3 showed intermediate severity in most domains;subtype 4 characterized by short disease duration and rapid disease progression. Then compared the sleep disturbance among different subtypes with Pittsburgh Sleep Quality Index( PSQI). Results Two hundred and thirty-six cases(48. 6%)were identified as suffering from sleep disturbance. Of which,female PD with sleep disturbance rate was 55. 1%( 130/236 )and male was 44. 9%( 106/236 ). Female was prone to develop sleep disturbance at early stage than male. PSQI scores in subtype 1,2,3 and 4 were(6. 09 ± 3. 72),(9. 36 ± 4. 24), (7. 82 ±4. 35)and(9. 09 ± 4. 73)respectively and the difference was significant(F =14. 503,P =0. 000) . Conclusion Sleep disturbance occurs frequently in patients with early-stage Parkinson's disease and exist clinical heterogeneity.

Objective The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Aim of this study is to assess the severity of depression in patients with PD of different clinical subtypes. Methods A broad spectrum of motor variables and nonmotor features, including tremor, rigidity, hypokinesia, postural instability gait disorder, fatigue, constipation, apathy, depression, global cognitive function, as well as the clinical data and demographics, including age, gender, age at disease onset, course of disease, were collected in 600 Chinese PD patients. The PD subtypes were classified using k-means (k=4) cluster analysis according to the clinical data. Their depression was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Results The cluster analysis indicated 4 main subtypes: Subtype 1 was mildly affected in all domains, and the ratio of tremor score to non-tremor score was the highest among the 4 clusters. Subtype 2 was severely in all motor and nonmotor symptoms. Subtype 3 showed intermediate severity in most domains. Subtype 4 was characterized by short course and rapid progression of disease. 43.5% of cases were identified as in depression. There was significant difference in scores of CES-D among the 4 subtypes (P<0.05). Conclusion Depression occurred frequently in patients with PD with some clinical heterogeneity.