Background:As the incidence of acute pancreatitis( AP)is increasing and the mortality remains high,early identification and early intervention of patients at risk of severe acute pancreatitis(SAP)is of great clinical significance. Aims:To investigate the value of commonly used AP-related serum biochemical markers for early prediction of severity of AP. Methods:Retrospective analysis was performed in 205 AP patients in Renmin Hospital of Wuhan University from Jan. 2014 to Dec. 2014,and 92 healthy subjects were served as controls. Patients with AP were divided into mild(n = 92), moderately severe(n = 72)and severe AP(n = 41)groups. The demographic characteristics,history of chronic diseases, serum biochemical markers within 48 hours after admission,Ranson score,BISAP score and other related clinical data were collected and compared between the four groups. The diagnostic performance of these indices in predicting SAP was evaluated by ROC curve,and the correlation of these indices with SAP was assessed by Logistic regression analysis. Results:There were significant differences in Ranson score,BISAP score,D-dimer,blood calcium,procalcitonin(PCT), CRP,hypersensitive CRP(HS-CRP),triacylglycerol and blood glucose between the four groups(P < 0. 05). The area under curve(AUC)of blood calcium was 0. 838 for early prediction of SAP,which was second to that of Ranson score and BISAP score. The accuracies of PCT and D-dimer were acceptable but inferior to blood calcium,while the accuracies of other indices were considerably low. Logistic regression analysis revealed that the odds ratio of risk for SAP of Ranson score,PCT and HS-CRP were all greater than 1 000,while that of blood calcium and D-dimer were 0. 013 and 19. 479, respectively. Conclusions:Of the AP-related serum biochemical markers,blood calcium,D-dimer and PCT are the preferred early predictors for severity of AP.

Background:Acute kidney injury(AKI)is one of the early serious complications of acute pancreatitis(AP). Early identification and intervention have important clinical significance. Aims:To investigate the early predictive value of clinical indicators found within 48 hours after admission for AKI in patients with AP. Methods:A retrospective analysis of 205 AP patients from January 2014 to December 2014 at Renmin Hospital of Wuhan University was performed. AP patients were divided into AKI group and non-AKI group according to the KDIGO standard,the demographic characteristics,history of chronic diseases and indicators defined within 48 hours after admission such as Ranson score,BISAP score and biochemical indices were compared. The early predictive value of clinical indicators for AKI was evaluted,and strength of association between clinical indicators and AKI was assessed. Results:Compared with non-AKI group,Ranson score, BISAP score,D-dimer,PCT,blood glucose,triacylglycerol were significantly increased in AKI group(P < 0. 05),and calcium was significantly decreased(P < 0. 05). The accuracies of D-dimer,PCT,calcium were high for early prediction of AKI,and the AUC were 0. 881,0. 803 and 0. 782,respectively. Logistic regression analysis showed that D-dimer, PCT,calcium had marked correlation with AKI(OR all > 7)(P < 0. 05). Conclusions:D-dimer,PCT and calcium are effective and economical clinical indicators for the early prediction of AKI in patients with AP.

Objective To study the changes of neutrophil surface molecule CD64 and inflammatory factor levels in patients with burn infection. Methods 46 cases of patients with burn infection who were treated in the department of burn in our hospital between March 2010 and October 2015 were selected as the observation group. Meanwhile, 46 cases of healthy people who underwent physical examination in our hospital during the same period were included in the control group. The levels of neutrophil surface molecule CD64, C-reactive protein (CRP), white blood cell count (WBC) and inflammatory factor [interleukin IL-6 (IL-6), interleukin (IL-8), tumor necro-sis factor (TNF-α) in the two groups of subjects were determined by flow cytometry and were compared. Results In the observation group, the levels of CD64, CRP, WBC and inflammatory factors were significantly higher than those in the control group (P < 0.05). Conclusion The levels of CD64, CRP, WBC and inflammatory factors in patients with burn infection are significantly higher than those in healthy people , which indicates that neutrophil surface molecule CD64, inflammatory factors and burn infection are closely correlated.

[Objective] To investigate the clinical value of using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and dose technology.[Methods]A total of 60 patients (heart rate≤ 75 bpm and normal heart rhythm) with suspected aortic disease or post-operation were randomly divided into 2 groups:G1 (n =30;tube voltage:80 kV;contrast medium injection rate:3 mL/s;contrast medium dose:0.65 mL/kg)and G2 (n =30;tube voltage:120 kV;contrast medium injection rate:4 mL/s;contrast medium dose:1.2 mL/kg).The two groups underwent aorta angiography with prospective ECG-gating Helical protocol by using 320-detector CT.The mean CT values and standard deviation of aorta,coronaries and adjacent adipose tissue were measured,signal to noise ratio (signal-to-noise ratio,SNR)and contrast to noise ratio (contrast-to-noise ratio,CNR) were calculated.The subjective quality scoring of 3-d post-processing images were evaluated independently by 2 senior radiologists.The mean CT values and standard deviation of aorta,coronaries and adipose tissue,SNR,CNR,subjective quality scoring,contrast medium dose and radiation dose were compared and analyzed.[Results] The abnormal and normal rate of aorta in two groups were 83.33％ (25/30),16.67％ (5/30) and 86.67％ (26/30),13.33％(4/30);while the abnormal and normal rate of coronary arteries in two groups were 43.33％ (13/30),56.67％ (17/30) and 53.33％(16/30),46.67％ (14/30).SNR values of ascending aorta,descending aorta,abdominal aorta,superior mesenteric artery,bilateral renal artery,left main coronary artery,left anterior descending branch,left circumflex branch,right coronary artery and CNR values of abdominal aorta,superior mesenteric artery,bilateral renal artery,left anterior descending branch,left circumflex branch had no statistical significance,while the other indicators were significant differences between the two groups.The radiation dose and the contrast medium dose of G1 was significantly lower than G2 (P ＜ 0.05).There was no difference in the subjective image quality of 3D post-processing images between the two groups (P ＞ 0.05).[Conclusions] Using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and low contrast medium dose technology can help to reduce radiation and contrast medium dose without impacting on the imaging quality satisfactorily.

Objective : To explore the value of 18 F ⁃FDG PET/CT dynamic imaging in the diagnosis of primary liver cancer and liver metastases. Methods : In this study , the data of 94 patients with hepatic malignant lesions [hepatocellular carcinoma group (25 cases) , cholangiocellular carcinoma group (27 cases) , and liver metastases group (42 cases)] imaged by whole⁃body dynamic 18 F ⁃FDG PET/CT were used as the research subjects , and the methods of (ANOVA) and subjects ′ working characteristic curves (ROC) were applied to examine the patients with liver malignant tumours of different pathological types SUV max , MRFDG , TBR and d max were statistically analysed as imaging features. Results : Among 94 patients , the differences in SUV max , MRFDG , TBRSUV max and TBRMRFDG were statistically significant in the hepatocellular carcinoma , cholangiocellular carcinoma and hepatic metastasis groups (SUV max : F = 48. 773 , P < 0. 001 ; MRFDG : F = 26. 334 , P < 0. 001 ; TBRSUV : F = 41. 314 , P < 0. 001 ; TBRMRFDG : F = 20. 821 , P < 0. 001) . The AUCs for the differential diagnosis of primary hepatocellular carcinoma and hepatic metastases for SUV max , MRFDG , TBRSUV max , and TBRMRFDG were 0. 836 , 0. 851 , 0. 827 , and 0. 847 , respectively. There was a positive correlation between SUV max , MRFDG , and the hepatic malignant lesions ′ There was a positive correlation between SUV max , MRFDG and the maximum diameter d max (SUV max : r = 0. 4 , P < 0. 05 ; MRFDG :r = 0. 2 , P < 0. 05) , and the difference was statistically significant. Conclusion 18 F ⁃FDG PET/CT dynamic imaging has good differential diagnostic efficacy in different pathological types of liver malignant tumors. There is a positive correlation between SUV max , MRFDG and d max in different pathological types of liver malignant tumors.

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

The EtOH extracts of the whole plants of afforded 17 new jatrophane diterpenoid esters, helioscopianoids A-Q (-), along with eight known compounds (-). Their structures were elucidated by extensive spectroscopic methods and Mo(OAc)-induced ECD analysis, and the structures of compounds , , and were confirmed by X-ray crystallography. Compounds - were evaluated for inhibitory effects on P-glycoprotein (P-gp) in an adriamycin (ADM)-resistant human breast adenocarcinoma cell line (MCF-7/ADR) and neuroprotective effects against serum deprivation-induced and rotenone-induced PC12 cell damage. Compounds and increased the accumulation of ADM in MCF-7/ADR cells by approximately 3-fold at a concentration of 20 μmol/L. Compound could attenuate rotenone-induced PC12 cell damage, and compounds , , and showed neuroprotective activities against serum deprivation-induced PC12 cell damage.