Colorectal neoplasms always present with thickness of the intestinal wall or a soft tissue mass in the enteric cavity. Multi-slice computed tomography (MSCT) with high spatial resolution and advanced post-processing techniques can demonstrate the above signs of the tumor, and the invasive signs of adjacent structures and lymph node metastasis. Combined with three dimensional reformation images, MSCT shows a higher sensitivity than that of double contrast barium enema and electronic colonoscope. MSCT is promising in the diagnosis and preoperative evaluation of colorectal neoplasms.

Objective To Analyze the immunity to secondary infection in the elderly with severe acute pancreatitis.Methods Totally 105 old patients were included in the present study.The ratio of CD4+ to CD8+,and serum levels of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10),and interleukin-4 (IL-4) were determined by flow cytometer analysis or ELISA within 3 days after diagnosis of secondary infection.Results Among 105 old patients,58 cases experienced secondary infection.At 3th day after severe acute pancreatitis,the levels of TNF-α,IL-6,IL-4,IL-10,CD4+,CD8+ and CD4+/ CD8+ were (81.3±5.5)ng/L,(141.2±13.7)ng/L,(61.1±7.4) ng/L,(153.8 ±15.2) ng/L,(43.5±5.5)％,(20.7±2.9)％ and (2.4±0.3) in infection group,as compared with those of (50.8±4.7)ng/1,(81.4±11.7)ng/L,(30.8±7.8)ng/L,(100.3± 13.8)ng/L,(31.6±4.6)ng/L,(29.7±3.5)and (1.1±0.4)in control group,respectively,with statistically significant differences betwveen the two groups (t=7.30,6.51,4.87,4.52,2.88,3.41,4.26,all P＜0.05).At 28th day after SAP,the levels of TNF-α,IL-6,IL-4,IL-10,CD4+,CD8 ± and CD4+ /CD8+ were (29.3±5.8)ng/L,(51.7±7.9)ng/L,(33.8±5.1)ng/L,(82.6±9.5)ng/L,(22.1±3.3)％,(47.1±4.3)％ and (0.6±0.3) in infection group,as compared with those of (44.4±5.5)ng/L,(82.2±7.1)ng/L,(65.3±5.5)ng/L,(109.1±9.5)ng/L,(40.5±2.7)ng/L,(33.4±4.5)ng/L and (1.8±0.4) in control group,respectively,showing statistically significant differences between the two groups(t=3.26,4.93,7.32,3.43,7.41,3.81,4.33,all P＜0.05).Conclusions An early excessive immune response and subsequent immune injury is closely related to secondary severe acute pancreatitis.

Objective To investigate the clinical and genetic characteristics of a progressive symmetric erythrokeratoderma (PSEK).Methods The clinical and genetic characteristics of a PSEK were compared and analyzed with clinical collection and review of 17 PSEK families reported in China since 1980.Results PSEK was consistent with autosomal dominant inheritance.PSEK had the feature with incomplete penetrance and variable expression.The clinical features included hyperkeratotic plaques with distinct border and strikingly symmetric distribution pattern on the extremities.Part of patients was extended to other areas of the body.The onset of the disease commonly started in infancy or childhood.The general health condition was not affected.PSEK might be associated with other clinical symptoms.The diseased potential increased in the family of consanguineous marriage.Conclusions PSEK has genetic heterogeneity.Its causative genes have not been determined.Further studies are needed.

Objective To investigate the effectiveness and feasibility of cardiovascular computed tomography angiography(CTA) in 128-slice DSCT with low tube voltage and low dosage contrast media in children with tetralogy of Fallot (TOF). Methods Forty patients with TOF were randomly divided into group A and group B by random number table method, patients in group A received a conventional scan with 80 kVp and contrast media of 1.2 ml/kg, patients in group B, 70 kVp and contrast media of 1.0 ml/kg were used. The injection time of the two groups were both fixed for 12 s. CT attenuation, image noise and signal-to-noise ratio (SNR) of ascending aorta, the main pulmonary artery, left ventricle and right ventricle were quantified. Radiation dose and volume of the contrast medium were recorded. Subjective image quality was assessed by two radiologists in consensus. The Student's t test was performed to analyse the differences between the two groups regarding CT attenuation, image noise, SNR, radiation dose and volume of the contrast medium. The image quality scores between the two groups were compared by using the Mann-Whitney U test. Results No significant difference was found in the attenuation, noise, SNR between the two groups in the same evaluated anatomic regions and no significant difference was found in the image quality. Effective dose (ED) was(0.17±0.05),(0.13±0.04)mSv respectively, there was significant reduction in group B than that in group A (t=2.48, P=0.019). The consumed iodine amount was(10.00±1.84),(8.29± 1.45) ml respectively, there was significant reduction between the two groups (t=2.89, P=0.007). Conclusions In children with TOF, the cardiovascular CTA with diagnostic quality can be adequately acquired with low tube voltage (70 kVp) and low concentration contrast media (1.0 ml/kg), there is significant reduction in radiation dose and contrast medium amount.

Objective To explore the role of type Ⅶ collagen (COL7A1) gene in the pathogenesis of pretibial dominant dystrophic epidermolysis bullosa (DDEB-Pt).Methods Peripheral blood samples were obtained from a sporadic Chinese patient of Han nationality with DDEB-Pt,his parents and 100 healthy human controls.A modified salting-out method was used to extract genomic DNA from the blood samples,and PCR was performed to amplify 118 exons of the COL7A1 gene followed by DNA sequencing.Results A G→A mutation was identified at position 6109 (G6109A) in exon 78 of the COL7A1 gene in this patient,which caused a change from GCT to ACT at codon 2037 in the triple helix region,and resulted in the substitution of glycine (Gly) by arginine (Arg) (p.Gly2037Arg).Conclusion A novel glycine substitution mutation was identified in the COL7A1 gene in the patient with DDEB-Pt,which may be a pathogenic mutation.

Objective To investigate the effect and mechanism of the formation of intrauterine adhesion (IUA) at different dose of estrogen. Methods Thirty-three New Zealand female rabbits were randomly divided into low estrogen group, normal physiological estrogen group, moderate estrogen group and high estrogen group. Animals of the low, moderate and high groups were ovariectomized (OVX) while normal group underwent sham operation. The moderate and high group animals received 0. 5 mg or 1.0 mg estradiol benzoate after OVX twice a week respectively. Two weeks later, all animals received curettage under direct vision. Serum was collected regularly to determine levels of estradiol (E2), transforming growth factor β1 (TGF-β1) and basic fibroblast growth factor (bFGF). Two weeks after curettage, we cut open cavity to collected endometrium for HE and Masson staining to score extent of endometrial fibrosis and IUA.Results The score of extent of endometrial fibrosis in high group (6. 1 ± 1.5) was higher than those in low estrogen group, normal estrogen group, moderate estrogen group (2. 7 ± 2. 1, 1.2 ± 1.8, 2. 7 ± 2. 0; all P <0. 05). The score of extent of IUA in high group (4. 0 ±2. 5) was higher than that in any other groups (0. 3 ± 0. 8, 1.0 ± 1.6, 1.7 ± 1.9; all P < 0. 05). The levels of TGF-β1 and bFGF was correlated with the level of E2 positively (P < 0. 01) and they had positive relationship with extent of endometrial fibrosis and IUA (P <0. 05). Conclusion High estrogen could accelerate endometrial fibrosis and IUA by promoting expression of TGF-β1, bFGF.

Objective To explore the application of low-dose prospective ECG-triggering dualsource CT (DSCT) angiography in infants and children with Kawasaki disease (KD).MethodsNineteen children diagnosed of Kawasaki disease underwent low-dose prospective ECG- triggering DSCT angiography (DSCTA) with free breathing and transthoracic echocardiogram (TTE).The overall imaging quality was graded on a five-point scale. Interobserver agreement in subjective image quality grading was assessed by Kappa statistics.The location,number and size of the aneurysms and dilations were recorded and compared with those of TTE.Pearson correlation analysis was used to evaluate the agreement on measurements between DSCTA and TTE.The average effective dose of DSCTA in all 19 children was calculated.ResultsDSCTA was performed successfully in all 19 children.A total of 91.5 ％ (226/247) segments permitted visualization with diagnostic image quality. Fifteen patients were diagnosed with coronary artery lesions. A total of 28 aneurysms and 15 arterial aneurysmal dilations were detected by DSCTA,while 19 aneurysms and 13 arterial aneurysmal dilations were found by TTE.TTE failed to detect 9 aneurysms (2 in the distal right coronary artery,2 in the posterior descending artery,1 in the middle of left anterior descending artery,1 in the middle of left circumflex artery,2 in the distal of LCX and 1 in the obtuse marginal branch)and 2 arterial aneurysmal dilations (1 at the diagonal branch and 1 at obtuse marginal branch). The concordance of DSCTA and TTE in measurement of diameter and length of these aneurysms and aneurysmal dilatations are good (0.63 ± 0.20) and (0.58 ± 0.20) cm vs ( 1.49 ± 0.83 ) and ( 1.22 ± 0.66) cm ( r =0.989 and 0.965,P ＜ 0.05 ).There was a good agreement on overall image quality ( Kappa =0.87 ). The mean effective dose was(0.24 ± 0.08) mSv.ConclusionProspective ECG-triggering DSCTA with very low effective radiation dose is safe,reliable and more sensitive than TTE on diagnosing of coronary artery lesions,especially in the distal lesions,in infants and children with KD.

Objective To explore the influence of erythropoietin (EPO) on infection induced neonatal rat brain injury at different starting time and its related mechanism.Methods Postnatal day 2 (P2) newborn SD rats were randomly divided into 4 groups:control group (group A),lipopolysaccharide (LPS) group (group B),the early EPO group(group C)and the later EPO group(group D).Pups in group A,B and C were injected different drugs intraperitoneally(group A for saline,group B for 0.6 mg/kg of LPS,and group C for 0.6 mg/kg of LPS and 5 000 U/kg of EPO) once a day for consecutive 5 days(P2-P6).LPS in group D were injected 0.6 mg/kg of LPS intraperitoneally once a day for consecutive 5 days(P2 P6),and with 5 000 U/kg of EPO once a day for consecutive 5 days(P7-P1 1).Rats in each group were given different drugs starting at corresponding time by intraperitoneal injection for 5 consecutive days.Every 10 newborn rats in group A and B were selected randomly on P2(6 h after intraperitoneal injection of drugs for the first time),P7 and P12,the brains were divided into the left and the right hemispheres marked by sagittal suture,using enzyme-linked immunosorbent assay method to evaluate the erythropoietin receptor(EPOR) protein level with the right cerebral hemisphere and reverse transcription-polymerase chain reaction (RT-PCR) method was used to investigate EPOR mRNA level of the left cerebral hemisphere.Immunohistochemical method was adopted to evaluate the expression of myelin basic protein(MBP),glial fibrillary acidic protein(GFAP) and EPOR at specified time point,and HE dyeing for the pathological changes of brain damage in different groups.Results HE staining of the group A presented the normal structure in the neonatal rat brain.Reduced numbers of hippocampal pyramidal cells,expansion of the lateral ventricles and periventricular leukomalacia were found in group B.No leukomalacia or lateral ventricles's expansion in EPO administrated groups and it was more obvious in group C.The EPOR protein and mRNA of group B was increased compared with the group A.The EPOR protein and mRNA levels had a tendency to decline with the increase of age.The MBP expression of group B(107.46 ±3.65)was significantly reduced compared with the group A(146.78 ± 3.13) (P ＜ 0.05),and the expression of EPO groups increased in contrast to the group B,moreover,the group C (126.25 ± 4.42) increased more obviously than that of group D(117.35 ± 3.42) (P ＜ 0.05).The GFAP expression of group B(141.46 ± 11.92 at P7 and 149.48 ± 13.59 at P12) increased significantly than group A(120.63 ± 13.32 at P7 and 119.74 ± 12.48 at P12) (P ＜0.05),the EPO group expressed lower than group B at the P12,and the group C (134.59 ± 12.19) decreased than the group D(137.27 ± 13.87) (P ＞ 0.05).Conclusions EPO shows a protective effect on the cerebral white matter injury caused by postpartum infection,it is superior to administer EPO at early time than later time.The mechanism of the protective effect may be connected with the fact that the infection can induce the expression of brain EPOR and the EPOR expression level has a tendency to decline with the increase of age.

Objective To explore the clinical application of dual-soure CT(DSCT) in coronary artery.Methods 51 patients suspected with coronary artery disease underwent both DSCT coronary arteriography and selective coronary angiography(CAG), the DSCTA results were compared with that of CAG.Results DSCT coronary arteriography in 51 patients at any heart rate was successful.Coronary artery branches and part sub-branches were clearly displayed by DSCT angiography.Stenosis or obstruction of 166 coronary artery branchs in 51 patients were showed ,of them,150 branches were confirmed by CAG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DSCTA were 100%, 90%, 90.4%, 100% and 94.8% respectively.Conclusion DSCT is a valuable method in detecting the diseases of coronary artery with lower dose. The accuracy of the DSCT is approximate to the CAG.

Objective To study the clinical value of color Doppler ultrasonography in the persistent sciatic artery.Methods The ultrasonographic images of eleven patients with persistent sciatic artery diagnosed by CT angiography or digital subtraction angiography were retrospective analyzed,the ultrasonographic features were summarized.Results The sciatic artery showed the enlarged internal iliac artery,which continued into the thigh in a posterior location,the sciatic artery described a tortuous course toward the knee,slowly filling normal-appearing popliteal artery in 8 cases,there were no connection with popliteal artery in 1 cases.The common femoral artery and superficial femoral artery was dysplasia in 7 patients,which was thinner than the popliteal artery.Conclusions The ultrasonography is the effective imaging method for diagnosis of the persistent sciatic artery.