Objective To describe the MRI findings in patients with Acquired hepatiocerbral Degeneration(AHCD) and evaluate the role of MRI in dignosis of AHCD. Methods 26 patients with chornic hepatic failure under went brain MRI scan. Eight of these patients had abdominal MR digital subtract angiography(MRDSA) examnation. 25 patients had plasma ammonia levels test two weeks after MR exmnation. Results 22 patients had abnormal MRI findings, T 1WI demonstrated incresed signal in the globus pallidus (22/26), putmen (4/26), mesencephalon surrounding red nucleus(15/26),and in the anterior pituitary (12/26). While T 2WI demonstraied no corresponding alteration in signal intensity. Eight patients which had MRDSA showed obvious portal systemic shunts. There was positive correlation between plasam ammonia level and abnormal signal( r = 0.521 6, P

Objective To investigate the prognostic values of neutrophil to lymphocyte ratio (NLR) and platelet count before and after chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).Methods From October 2011 to December 2012,70 patients with advanced NSCLC in Anyang Cancer Hospital of Henan Province were collected.NLR and platelet were calculated from complete blood counts in laboratory test before and after 2 cycles of chemotherapy.The patients were divided into two groups according to the NLR and platelet count:low NLR group (≤3.43)and high NLR group (>3.43);normal group (100 ×109 /L

OBJECTIVE:To provide reference for implementing relevant policies and measures,and promote rational drug use. METHODS:The cognition(questionnaire)and application(prescription spot checks)about antibiotics and glucocorticoids by 191 rural doctors from 14 township hospitals and 18 health room in area A,B and C(representing the economically developed areas, moderately developed areas and undeveloped areas)were investigated,and the results were statistically analyzed. RESULTS:Total-ly 382 questionnaires were sent out(191 for antibiotics and 191 for glucocorticoids),and 382 were effectively received with effec-tive recovery of 100%;and 2 300 prescriptions were checked. Results of questionnaire showed,there were still some misunder-standings and blindness among the rural doctors'cognition and application about antibiotics and glucocorticoids,the usage of β-lac-tam was not fully grasped,part of the empirical use of antibiotics and drug treatment was still not entirely clear,more than 40%had no clear ideas about the classification and contraindications of hormones,and more than half of them didn't know the Glucocor-ticoids Clinical Practice Guidelines;results of prescription spot checks showed,there were regional differences about the proportion of antibiotics and glucocorticoids,area A had the highest proportion among 3 areas,accounting for 60.9% and 18.9%,respective-ly. And area C showed highest proportion about unreasonable prescriptions,accounting for 22.5%. CONCLUSIONS:The cognition and reasonable use of rural doctors for antibiotics and glucocorticoids still needs to be strengthened. It is suggested to take effective measures,formulate and implement the corresponding supervision system,strengthen antibiotics and glucocorticoids knowledge training for rural doctors and fully implement the the principles of rational drug use to improve the rational drug use.

Objective To evaluate the value of MRI diagnosis in Stewart-Treves syndrome(STS).Methods The 48 STS nodules proved by pathology were retrospectively studied,which compared the MRI findings and pathological results.Results All nodules were solid and more than 4 mm in diameter.According to the expression of D2-40 and CD31,all nodules were divided into two types.The 47 nodules were divided into STS type I(hemangiosarcoma).The MRI findings showed slightly low signal on T1 WI and slightly high signal on T2 WI,while were higher than the muscular signal.Additionally,all nodules of STS type I were remarkably enhanced.The 1 mass-like-shape cases wsa divided into STS type Ⅱb (mixed lymphangiosarcoma).The MRI findings showed heterogeneous signal on both T1 WI and T2 WI,in which the high signal was leading.And the enhancement showed the low-level inhomogeneous signal.Conclusion MRI could be a valuable tool for the diagnosis in STS because of the characteristic signal on MRI.And if combined with the history of chronic upper limb lymphedema,the diagnostic accuracy could be improved before surgery.

Objective To investigate the diagnostic value of determination of the genotypes in codon 12 and 13 of K-ras oncogene in blood samples of patients with pancreatic carcinoma(PC).Methods Blood samples were obtained from 54 patients with pathologically confirmed PC,and 33 healthy controls.The DNAs were obtained in these samples.and then genotype of K-ras mutation was detected by using the PNA-clamping real-time quantitative PCR.Then the correlation between the K-ras genotypes of blood DNA and the clinical characteristics was analyzed.Results K-ras mutations were found in 74.1%(40/54)of patients with PC.There was no such mutation in control samples.The mutations of K-ras was associated with age,lymph node and vessel invasion.poorly differentiated tumor,CA19-9,while it was not associated with sex,tumor location,size of tumor,clinical staging and pathological type.Conclusions The one-step method was highly sensitive for detecting K-ras mutation in blood samples.Detection of circular blood cells harboring K-ras mutation suggested the tumor was highly invasive with poor prognosis.

Objective To explore the potential role of monocyte chemotactic protein-1 ( MCP-1 ) gene in the pathogenesis of acute lung injury (ALI) in early acute necrotizing pancreatitis (ANP). Methods Forty SD rats were randomly divided into control group, ANP 3, 6, 12 h group with 10 rats in each group according to a number table. ANP was induced by intraperitoneal injection of 15% L-arginine solution at a dose of 2.0 mg/g body weight. Pathological changes of pancreases and lungs were observed. Lung wet/dry weight ratio was measured. Intrapulmonary expression of MCP-1 mRNA was evaluated by RT-PCR. Results After intraperitoneal injection of 15% L-arginine solution, the rat's pancreas presented with bleeding, necrosis comparable with pathological changes of ANP. Pulmonary tissue edema was obvious. At ANP 3, 6, 12 h group, the pathological scores of the lung were 3.75±0.58,5.50 ±0.63,5.86 ±0.54, the wet/dry weight ratios were 4.85 ±0.38,4.97 ± 0.47,5.03 ± 0. 46, the MCP-1 mRNA expressions were 0.36 ± 0.08, 0. 56 ± 0. 15, 0. 72 ± 0.21,which were significantly higher than those in the control group (0.12 ±0.05,4.32 ±0.33,0.21 ±0.05, P＜0.05 or ＜0.01 ). The MCP-1 mRNA expression in lungs was significantly correlated with the degree of lung damage and wet/dry weight ratio of lungs (r=0.75,r=0.89,P＜0.05).Conclusions MCP-1 mRNA expression was up-regulated in the early phase of ANP in the lungs, and it may play an important role in ALI during ANP.

Objective To investigate whether determination of CEA and CA19-9 levels in EUS-FNA pancreatic samples can be useful in detecting pancreatic adenocarcinoma and differentiating pancreatic adenocarcinoma from chronic pancreatitis.Methods Levels of CEA,CA19-9 were examined by chemiluminescence immunoassay analysis in EUS-FNA specimens obtained from 25 patients with chronic pancreatitis and 65 patients with pancreatic adenocarcinoma,and compared with those of their peripheral serum.Twelve patients with suspected pancreatic adenocarcinoma while with negative EUS-FNA pathological findings were followed up.Results First,the levels of CEA,CA19-9 in EUS-FNA specimens were higher than those in serum obtained from same patient with pancreatic adenoearcinoma(P＜0.01),but there was no difference in these variables of EUS-FNA specimens and serum obtained from patients with chronic pancreatitis.Second,in the EUS-FNA samples,the levels of CEA,CA19-9 in pancreatic adenocarcinoma were higher than those in chronic pancreatitis(P＜0.01).On the contrary,in serum samples,there was no significant difference in CEA level between pancreatic adenocarcinoma and chronic pancreatitis(P=0.079).CA19-9 level in serum of Dancreatic adenocarcinoma was higher than that of chronic pancreatitis(P＜0.01). Finally,during the follow-up,of all the 12 patients with suspected pancreatic adenocarcinoma,10 patients were diagnosed as having pancreatic adenocarcinoma and 2 patients as having chronic pancreatitis.Diagnostic accuracy of serum CEA and CA19-9were 30%and 70%respectively,while sensitivity of CEA and CA10-9 determined by EUS-FNA was both above 90%.Conclusion The method of measuring CEA and CA19-9 levels in samples obtained by EUS-FNAcan be useful in detection of pancreatic adenocarcinoma and differentiation of malignant pancreatic tissue from chronic pancreatitis.

ObjectiveTo investigate the protective effects of p38MAPK inhibitor SB203580 on acute necrotizing pancreatitis associated lung injuries in rats.Methods Fifty-four SD male rates were randomly divided into 3 groups,including control group,ANP group,SB203580 group with 18 rats in each group.ANP was induced by intraperitoneal injection of L-arginine solution. Rats in control group were intraperitoneally injected with same amount of saline.Before ANP induction,the rats in SB203580 group received 10 μmol/L SB203580 dissolved by dimethyl sulfoxide at a dose of 5mg/kg weight via intraperitoneal injection.The rats were sacrificed at 3,6,and 12 h after operation,the serum levels of amylase,TNF-α,IL-6 was determined.Pathological changes of pancreas and lung were observed.The wet/dry (W/D) weight ratio of lung and MPO were measured.CINC mRNA of lungs was determined by RT PCR. Expression of phosphated-p38MAPK (p-p38MAPK) protein was evaluated by Western blotting.ResultsThe serum levels of amylase,TNF-α,IL-6and wet/dry (W/D) weight ratio of lung,MPO activity,CINC mRNA and p-p38MAPK protein expression of lungs were (1035 ±73)U/L,(0.94 ±0.16)μg/L,(4.77 ±0.86) μg/L,3.92 ±0.29,(0.39 ±0.02)U/g,0.28 ±0.04,0.09 ±0.04 in control group at 6 h after operation,and the corresponding values were (5848 ±656) U/L,(3.84 ±0.32)μg/L,(103.54 ± 15.32)μg/L,4.97 ±0.47,(1.03 ±0.08) U/g,0.62 ±0.06,0.52 ±0.14 in ANP group,while they were (4259 ±286) U/L,( 1.64 ±0.21 ) μg/L,(76.56 ± 11.46) μg/L,4.32 ±0.34,(0.78 ±0.05)U/g,0.37 ±0.04,0.27 ±0.08 in SB203580 group.The values in ANP group were significantly higher than those in control group,and the values in SB203580 group were significantly lower than those in ANP group,but they were still significantly higher than those in control group ( P ＜ 0.01 ).ConclusionsSB203580 may attenuate injury of lung and pancreas in ANP by blocking p38MAPK signal transduction pathway,and decreasing the production of inflammatory cytokines.

Objective To investigate the effect of caffeine citrate in the treatment of neonatal apnea and the corresponding intervention measures. Methods A total of 88 children with apnea were enrolled in this study from December 2015 to February 2017, and were randomly divided into control group and study group, 44 cases in each group.The study group on the basis of conventional therapy plus caffeine citrate, the control group on the basis of conventional therapy plus aminophylline group, two newborns with apnea were duration of treatment should be 7 for 7 days, record the treatment effect and the incidence of adverse reactions. Results The total effective rate was 88.64％ in the study group and 72.73％ in the control group (P<0.05). The incidence of adverse reactions was 11.36％ in the study group and 40.91％ in the control group (P<0.05). Conclusion The application of caffeine citrate treatment of apnea with clinical efficacy and safety of the ideal of the newborn, in the course of treatment given targeted clinical nursing intervention is conducive to the protection of newborns with apnea of quality of life and life safety.

Objective To investigate the diagnostic value of a quantitative detection of K-ras mutation in samples from endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)of pancreatic cancer.Methods Samples taken by EUS-FNA from 53 pancreatic occupying lesions were collected, and the copies of wild-type and mutated K-ras gene was measured by PNA-clamping real-time quantitative PCR. The results were analyzed with refer to cytological findings to evaluate its clinical values. Results According to cytological finding, a total of 37 cases were diagnosed as pancreatic cancer, and 16 were non-malignant lesions. Kras mutation was detected in 83.8% of cancer cases, and 18. 8% of non-cancer cases, which was significantly different ( P ＜0. 05 ). Sensitivities of cytology and K-ras examination were 59. 5% and 83.8%, respectively, while that of combination of cytology and K-ras examination was 89. 2%. Conclusion Quantitative analysis of the mutant K-ras gene in samples taken by EUS-FNA is a useful tool for diagnosing the pancreatic carcinoma.