Objective To study CT characteristic findings of pancreatic rupture caused by closed abdominal trauma.Methods The clinical and CT data of 6 patients with pancreatic rupture caused by closed abdominal trauma were analyzed retrospectively.CT plain scan and the tripple-phased enhancement scan were performed,multi-planar reformation(MPR)and maximum intensity projection(MIP)were used after CT scanning.Thin slice of CT scan and post-processing technique of imaging were used furthermore.Results The rupture of pancreatic neck and tail were shown in 2 cases,the rupture of pancreatic head and body in 1 case.Main CT findings were such as following:(1)Hematomas in pancreas or in pancreatic surrounding tissues were shown in 6 cases,they were hyperintensity or slight hyperintensity in plain scan and were not enhanced in three-phase dynamic scan of pancreas.(2)Pancreatic splits,which were relative hypointensity after administration of CT contrast agent in the pancreatic phase,were found in 6 cases,they were like slit-shaped or wedge-shaped or pancreas separated completely in situs.In the pancreatic phase,pancreas parenchyma enhanced obviously but hematoma in the splits did not enhanced,and this drew the outline of pancreatic splits clearly.(3)Contrast agent in the pancreatic hematomas,which leaked from vessels of pancreas,were shown in two patients,like dot or nodule or pond,were highly intensity in artery phase,and there were more leaking of contrast agent in the pancreatic phase,whose intensity was same as abdominal aorta in the same slice image.In the delayed phase,the volume of leaking contrast agent enlarged and they had higher intensity while intensity of abdominal aorta in same slice image decreased obviously.(4)Dilation of the Wirsung duct,which was like curved-tube,was shown in one patient.(5)Meanwhile the contusion of liver,kidney or spleen with pancreatic rupture were found in 4 patients.Conclusion The pancreatic rupture has typical CT findings.It is helpful to improve the accuracy rate of diagnosis with reasonable scanning techniques and understanding correctly CT appearances of pancreatic rupture.

Objective: To find out the prognostic influencing factors of patients undergoing continuous renal replacement therapy (CRRT) for refractory acute left heart failure. Methods: Through the medical system and hemodialysis system in Foshan First People's Hospital, all patients who received CRRT for refractory acute left ventricular heart failure from January 1, 2012 to January 1, 2019 were searched. All patients were divided into two groups by the final outcome: survival group and death group. Age, sex, initial mean arterial pressure (MAP), primary heart disease, use of vasoactive drugs, urine output before treatment, hemoglobin, serum creatinine, serum albumin, C-reactive protein(CRP), brain natriuretic peptide (BNP), cardiac ejection fraction (EF) and CRRT treatment time were analyzed to find out the prognostic influencing factors. Results: A total of 130 cases were collected, including 96 cases in the survival group and 34 cases in the death group, with a total mortality rate of 26.15%. Compared to that in the death group, there were higher proportion of males (71.88% vs 50.00%, χ²=5.366, P=0.021), significantly higher initial MAP (t=4.677, P<0.001), much more urine output before treatment (Z=3.904, P<0.001), significantly higher serum creatinine (Z=2.866, P=0.004) , significantly lower hemoglobin (Z=-2.587, P=0.011), significantly shorter time of CRRT (Z=-3.447, P=0.001) in the survival group. Multivariate logistic regression analysis showed that female (OR=2.950, 95%CI 1.102-7.898, P=0.031) and higher levels of hemoglobin (OR=1.024, 95%CI 1.004-1.045, P=0.019) were the risk factors of death in patients undergoing CRRT for refractory acute left heart failure, while higher levels of mean arterial pressure before treatment (OR=0.959, 95%CI 0.930-0.989, P=0.008) and urine volume before treatment (OR=0.998, 95%CI 0.997-0.999, P=0.004) were the protective factors for patients' prognosis. Conclusion The mortality of patients with refractory acute left heart failure undergoing CRRT therapy is still very high. Female and higher level of hemoglobin are the risk factors for death, while more urine volume before treatment and higher MAP before treatment are protective factors for survival.

OBJECTIVE To establish an modified model of osteonecrosis in the rat and observe the clinical, pathological and imaging manifestations dynamically. METHODS Healthy male SD rats were divided into 5 groups randomly, including the control group (N, 8 rats), and radiation groups (a, b, c and d, 6 rats each group). For radiation groups, the left mandible of each rat was irradiated at doses of 7.0 Gy for 5 fractions, other rats were sham irradiated, serving as control groups.7 days after irradiation, the left mandibular molars of all rats were extracted. The radiation groups rats were sacrificed at 7, 14, 21, 28 days after irradiation randomly, the 2 rats in control group were sacrificed respectively. All the rats' mandibles were taken and examined by clinical manifestation and Micro-CT and histology methods. The data was analyzed with SPSS 18.0 software package. RESULTS In clinical observation, ulcers were seen in the irradiated site at the 7th day, after then, alopecia, occlusion disorder, and pus discharged from buccal side were seen. Weight loss rightly after radiation and weight gain were seen at the 14th day. In pathological observation, marrow cavity changed first. Many adipose cell was first seen at the 7th day, and inflammations, necrosis, and fibrosis were found in medulla in the irradiated groups after that. Significant increment of empty lacunae and decrement of osteocytes were observed in all irradiated groups at the 7th day. Necrotic bone of the irradiated mandible was only found at the 28th day. Lack of new bone formation within the socket was seen in the Micro-CT three-dimensional at 28th day, and there are no more changes at the early-stage in this model. CONCLUSION An modified rat model of osteoradionecrosis was successfully established, which can shorten experimental period, and this model early stage and deserved to be further researched. Can be used to observe clinical, pathological and imaging magnification, which play a basic role in the protection in early stage and deserved to be further researched.

Objective:To compare the effects of phenoxybenzamine and doxazosin on intraoperative hemodynamics in patients with normotensive pheochromocytoma.Methods:Perioperative data of patients who underwent surgery for normotensive pheochromocytoma in Peking University First Hospital from January 1, 2004 to December 31, 2017 were collected.Patients were divided into phenoxybenzamine group and doxazosin group according to the type of preoperative α-blockade.The primary endpoint was intraoperative hemodynamic fluctuations.Secondary endpoints included postoperative circulatory support, complications, mortality, and etc.Results:Sixty-one patients were included in the study, with 24 cases in phenoxybenzamine group and 37 cases in doxazosin group.There was no significant difference in the area under the curve of intraoperative blood pressure fluctuation between the two groups ( P>0.05). The area under the curve of intraoperative heart rate >110 bpm was significantly greater in phenoxybenzamine group than in doxazosin group ( P<0.05). There was no significant difference in the secondary endpoints between the two groups ( P>0.05). Conclusion:The effect of preoperative administration of doxazosin or phenoxybenzamine on blood pressure fluctuation has no significantly statistical difference in patients with normotensive pheochromocytoma, and the patients took phenoxybenzamine preoperatively have an increased risk of intraoperative tachycardia.

In Vivo Dosimetry ; Radiotherapy Dosage ; Radiometry/methods* ; Electronics ; Radiotherapy, Intensity-Modulated/methods* ; Phantoms, Imaging ; Algorithms

ObjectiveTo investigate the therapeutic effect of Qingmei compound on acute gouty arthritis （AGA） in rats and preliminarily clarify its mechanism. MethodForty male SD rats were randomly divided into a blank group， a model group， a colchicine group （0.3 mg·kg^-1）， and low- and high-dose Qingmei compound groups （200 and 400 mg·kg^-1）， with eight rats in each group. The AGA model was induced by injecting 50 g·L^-1 monosodium urate （MSU） into the ankle joint of the rats except those in the blank group. The ankle swelling index was measured before and 6， 24， and 48 h after modeling. The pathological changes in the joint tissues of AGA rats were observed by hematoxylin-eosin （HE） staining. The expression of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the joint tissues of rats was detected by immunohistochemistry. The protein expression of NOD-like receptor protein 3 （NLRP3） pathway and key proteins in the joint tissues of rats was detected by Western blot. ResultCompared with the blank group， the model group showed increased ankle swelling index， synovial hyperplasia， and inflammatory infiltration， and up-regulated expression of IL-1β， TNF-α， and NLRP3 proteins in the ankle joint and the ratio of Caspase-1 shear body to Caspase-1 precursor protein （Caspase-1 p20/Caspase-1） （P<0.01）. Compared with the model group， the Qingmei compound groups showed reduced ankle swelling index of AGA rats， especially the low-dose Qingmei compound group （P<0.01）. Meanwhile， Qingmei compound inhibited synovial hyperplasia and inflammatory infiltration （P<0.01） and reduced the levels of IL-1β， TNF-α， and NLRP3 proteins and Caspase-1 p20/Caspase-1 in joint tissues （P<0.01）. ConclusionQingmei Compound can significantly alleviate the joint swelling and inflammatory infiltration of AGA， and its mechanism may be related to the inhibition of the NLRP3 signaling pathway.