Objective To evaluate the role of CT in manifestations and differential diagnosis of mass-like hepatic lesion. Methods 310 cases of mass-like hepatic lesion, including hepatocellular carcinoma, metastasis, hemangioma, abscess, cyst, hydatidosis were included. The CT findings including mass location, number, edge and the degree of contrast-enhancement were analyzed. Results On CT, mass-like lesions manifested single or multiple lesions with low density, with sharp edge or without, with contrastenhancement in various degrees or without. In our study, there were characteristic CT manifestations for hepatocellular carcinoma, metastasis tumor, hemangioma, abscess, cyst and hydatidosis. Conclusion The diagnosis and differential diagnosis can be made correctly with CT manifestations in most of mass-like hepatic lesions.

Objective To quantitatively investigate the expression levels of the cytosine deaminases,hA3B,hA3F and hA3G in peripheral blood mononuclear cell(PBMC)of human immunodeficiency virus(HIV)infected patients and to analyze the correlation between cytosine deaminases expression and CD4~+ T lymphocyte counts. Methods Peripheral blood samples were collected from 21 HIV-infected subjects who didn't take antiretroviral therapy(ART-),21 HIV-infected subjects receiving ART(ART+),and 10 HIV-uninfected subjects. PBMC were isolated by Ficoll density gradient centrifugation, followed by RNA extraction and cDNA synthesis.hA3B,hA3F and hA3G mRNA levels were determined by real-time fluorescent quantitative polymerase chain reaction(PCR).CD4~+ T lymphocyte counts were determined using flow cytometry. Data were analyzed by t test, t' test or Wilcoxon rank sum test. Results In HIV-infected subjects without or with ART,HIV-uninfected subjects, the levels of hA3B mRNA were 208.4,365.2 and 563.6,hA3F mRNA were 245.5,316.6 and 442.9,hA3G mRNA were 404.6,360.8 and 638.6,respectively.hA3G mRNA level in HIV-infected subjects was lower than that in HIV-uninfected controls(P=0.0131),but there was no statistical difference between ART+ and ART-groups(P=0.7342).There were no correlations between hA3B,hA3F and hA3G mRNA levels and CD4+ T lymphocyte counts in either ART-or ART+HIV-infected subjects(ART-:r=-0.0104,r=-0.0545,r=0.1623,all P＞0.05;ART+:r=0.3220,r=0.2193,r=0.1455,all P＞0.05).In addition,hA3B,hA3F and hA3G mRNA levels were positively correlated with one another in ART-HIV-infected subjects and HIV-uninfected controls(P＜0.05),but not in ART-HIV-infected subjects(P＞0.05).Conclusions hA3B,hA3F and hA3G expression levels do not directly correlate with CD4~+ T lymphocyte counts in HIV-1-infected patients,hA3B,hA3F and hA3G expression levels in PBMCs tend to he decreased after HIV-1 infection, and ART may increase hA3B and hA3F mRNA expression.

Objective To explore the protein expression of p53 and PTEN in osteosarcoma and the relationship between them and the three-year survival ratios of osteosarcoma patients.Methods The protein expression of p53 and PTEN was detected using immunohistochemical methods in 53 cases of osteosarcoma proved by surgery and pathology. Results There was significant difference between the both kind of relationship with the protein expression of PTEN and the three-year survival ratios of osteosarcoma patients who had negative expression of p53. There was no significant difference between the both kind of relationship with the protein expression of PTEN and the three-year survival ratios of osteosarcoma patients who had positive expression of p53. PTEN expression,which was analysed by logistic regression, was entered the regression model ,but p53 expression was not. Conclusion PTEN expression is more important than p53 expression in predicting the prognosis of the patient with osteosarcoma.

Objective To observe the effects of intensive-swimming training at different intensities on the neurological function and the expressions of protein kinase A after cerebral ischemia-reperfusion in rats,and to explore the possible neuroprotection mechanism of intensive-swimming training after cerebral ischemia-reperfusion in rats.Methods The animal model of cerebral ischemia-reperfusion was established in rats by using the intraluminal thread method to cause left middle cerebral artery occlusion (MCAO) for 2 h and then reperfusion.A total of 120 male model Sprague-Dawley rats were randomly divided into training group 1 (swimming for 5 min once a day),training group 2 (swimming for 10 min once a day),training group 3 (swimming for 20 min once a day) and control group (no training),with 30 rats in each group.Another 30 rats who were assigned to the sham-operation group were subject to no MCAO and no training.At the 3rd,7th and 14th day post operation,10 rats randomly selected from each group were examined for their neurological function by Menzies neurobehavioral test and forelimb placing test.Expressions of protein kinase A were detected by immunohistochemistry method.Expressions of PKA-mRNA were detected by using RT-PCR.Results The neurological function in sham-operation group was normal.The differences between sham-operation group and control group with regard to Menzies test and forelimb placing test scores were statistically significant at all the time points (P ＜ 0.05).The improvement of neurological function in all training groups,were significantly better than those in controls at the 3rd,7th and 14th d after swimming training,especially in training group 3 on the 14th day post-operation (P ＜0.05).At3rd,7th,and 14th days post-operation,the Menziesscores were(1.40±0.55),(1.00 ±0.71)and (0.80 ±0.45),respectively,and the forelimb placing scores were(5.20 ± 0.84),(3.80 ± 1.30) and (2.40 ± 1.14),respectively,in the training group 3.The number of positive cells and the expressions of protein kinase A mRNA were significantly higher in all training groups than those in the controls at the 3rd,7th and 14th days after swimming training,and the increase of positive cells and mRNA of PKA in the training group 3 was significantly more obvious at 14th day compared with other training groups(P ＜ 0.05).Conclusions Exercise training can increase the expression of positive cells and mRNA of PKA in rats after cerebral ischemiareperfusion,hence,it improved the injured neurological function and promote the recover of sensory and motor function,and the more intensive the training,the better the effects.

Objective The analysis of correlation between the occurrence of tourette syndrome with one-child family environment. Methods The authors investigated home environment of two groups. One group included 200 patients with tourette syndrome and is the other group included healthy children of the same age in 3 different primary and secondary schools. By comparing with the home environmental factors, parenting styles and parent emotional factors between two groups. Results The instabilities of home environment included bad family relationship, separation between parents, divorce, scolding and even beating children. It showed that anxiety of the direct supervisors among the sickness group were higher than healthy control group as well. Among the ten factors of the Family Environments Scale, the significant differences showed in six factors of affection,cohesion,expressiveness, conflict, intellectual-culture orientation, active-recreational orientation, organization between the two groups. Conclusion So we concluded that ①There is a correlation between the parents relations,parenting styles and the incidence of tourette syndrome; ②An anxiety of the direct supervisor may initiate, even aggravate the incidence of tourette syndrome; ③It is important to convert the education mode and take family overall treatment in order to reduce the incidence and improve the effectiveness of tourette syndrome.

AIM: To study the time-dependent effects of diabetes mellitus (DM) on the development of cardiac remodeling in untreated streptozotocin (STZ)-induced rats with acute myocardial infarction (MI). METHODS: The left anterior descending coronary arteries were ligated 10 weeks after DM induction without any therapy. Transmission electron microscopy, echocardiography, heart weight to tibial length ratios, histological examination, microarray analysis, and real time-PCR were utilized to monitor the changes up to 56 d. RESULTS: After MI, the diabetic rats experienced lower survival rate compared to non-diabetic animals. The pathophysiologic changes indicated that DM accelerated the cardiac remodeling post-infarction. In primary examination, 164 genes related to cardiac remodeling were found to be candidates for hierarchical analysis, such as leucine-rich PPR-motif containing (interleukin-6 signaling pathway), procollagen type I and III, fibronectin-1, RT1, and TIMP-1, etc. The gene expression profile at 14 d in diabetic rats were comparably similar to both 14 d and 28 d in non-diabetic rats, while such changes at 28 d and 56 d in diabetic rats was also similar to the ones at 56 d in non-diabetic rats. CONCLUSION: The accelerated cardiac remodeling of post-infarction in STZ-induced untreated diabetic rats seems be associated with the different profile of gene expressions.

Objective: To explore the application value and safety of low-dose dobutamine stress echocardiogram (LDDSE) in patients of low-flow/low-gradient aortic stenosis combining left ventricular dysfunction with transcatheter aortic valve replacement (TAVR). Methods: A total of 5 eligible consecutive patients with contradiction of routine surgical valve replacement and going to receive TAVR in our hospital from 2013-10 to 2016-07 were enrolled. The mean aortic valvegradient, maximum flow velocity, each stroke volume and ejection fraction were recorded before and during LDDSE examination. The patients having confirmed diagnosis of true severe aortic stenosis with left ventricular contractile reserve received TAVR, for those without left ventricular contractile reserve received drug therapy or TAVR conditionally. The changes of cardiac function and NT-proBNP level were observed after TAVR. Results: All 5 patients showed positive finding in LDDSE; the mean aortic valve gradient ≥40mmHg and stroke volume≥20% implied that the patients had true severe aortic stenosis with left ventricular contractile reserve. No adverse reaction occurred during and after LDDSE. TAVR was performed in 4 patients and 1 was waiting for TAVR or balloon dilatation since temporary lacking of valve. The post-operative cardiac function was improved in all patients and NT-proBNP level was declined continuously. Conclusion: LDDSE examination could be considered in patients of aortic stenosis combining left ventricular dysfunction, low-flow and low-gradient to clarify ventricular contractile reserve and the severity of aortic stenosis. If the patients with ventricular contractile reserve, TAVR was recommended which was the effective treatment for relevant patients.

Objective:To search, evaluate and integrate the best evidence for lactation maintenance of very low birth weight infant(VLBWI) mothers, and to provide evidence for lactation maintenance.Methods:Up to Date, BMJ best practice, Newborn Services Clinical Guidelines, ABM, NICE, OVID evidence-based database, NGC, Joanna Briggs Institute Library, Cochrane Library, Web of Science, PubMed, CNKI, CBM and Wanfang Data were retrieved by computer on the Maintenance of Mother′s Lactation in VLBWI: Guidelines, Systematic Evaluation, Expert Consensus/Opinions, Evidence Summary Literature screening, quality evaluation, evidence extraction and integration of documents which met the requirements.Results:A total of 10 articles were included, including 3 guidelines, 4 systematic reviews, 1 expert consensus and 2 expert opinions. A total of 41 evidences were summarized from 9 aspects, including lactation support, lactation initiation, lactation monitoring and the application of lactating agents.Conclusion:The evidence of lactation maintenance of VLBWI mothers is sufficient, which can provide a basis for medical staff to make clinical decisions.

To explore the safety and efficacy of levosimendan in treating the patients with severe aortic stenosis and to analyze the cardial function before and after medication in order to guide clinical treatment. Methods: A total of 20 patients admitted in our hospital from 2014-01 to 2015-12 were enrolled with the standard of echocardiography confirmed severe aortic stenosis, left ventricular ejection fraction (LVEF)≤45%, NYHA III-IV and inefficacy for conventional anti-heart failure drug therapy. The patients received intravenous infusion of levosimendan at 0.1μg/(kg·min) by persistent pumping for 24 hours. Echocardiography, LVEF, dyspnea condition, NYHA grading and plasma levels of NT-proBNP were recorded pre- and post-medication to compare the cardiac function and symptoms of levosimendan therapy. Results: After levosimendan treatment, NYHA grade was improved, P=0.025 and NT-proBNP was reduced (9101.6±7368.0) pg/mLvs (13776.5±9503.7) pg/mL, P=0.018. The following parameters were similar before and after levosimendan therapy: LVEF (31.1±7.5)% vs (33.1±8.5)%, P=0.078, the average heart rate (79.6±13.8) bmp vs (82.8±9.5)bmp, P=0.200 and systolic blood pressure (99.6±11.7) mmHg vs (97.2±12.1) mmHg, P=0.071. There were 40% (8/20) patients with obviously improved and 50% (10/20) with improved dyspnea symptoms after levosimendan treatment. Conclusion: Our preliminary study presented that levosimendan could improve NYHA grading, remit dyspnea symptom and reduce blood NT-proBNP level in patients with severe aortic stenosis and heart failure; it had safety and tolerability at certain degree in clinical practice.

Objective: To explore the cardiac function and outcomes in patients of aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) within 6 months in order to provide the guidance for clinical treatment. Methods: A total of 49 consecutive severe AS patients with surgical contradiction or STS high risk score and received successful TAVR in our hospital from 2013-12 to 2015-12 were studied. Echocardiography and blood levels of NT-proBNP were examined at pre- and 1 month, 6 months after TAVR. Left ventricular ejection fraction (LVEF), aortic valve mean gradient (MG), peak gradient (PG) and peak velocity (PV) were recorded. Based on pre-operative LVEF, the patients were divided into 2 groups: Cardiac dysfunction group, LVEF<50%,n=15 (30.6%) and Normal cardiac function group, LVEF≥50%, n=34 (69.4%). Post-operative cardiac function and blood levels of NT-proBNP were compared between 2 groups. Results: In all 49 patients, the following parameters were significantly improved within 7 days after TAVR: LVEF (56.0±14.6) % vs (52.5±13.8)%, MG (11±5) mmHg vs (58±18) mmHg, PG (21.7±9.5) mmHg vs (93.0±28.6) mmHg, PV (2.3±0.5) m/s vs (4.8±0.7) m/s, blood NT-proBNP level [1831 (1098-3363)] pg/ml vs [3842 (1763-8664)] pg/ml and aortic valve area (1.57±0.43) cm2 vs (0.58±0.23) cm2 allP<0.05. Within 6 months after TAVR, LVEF was continuously increasing especially in Cardiac dysfunction group; MG, PV and NT-proBNP level were continuously decreasing, NYHA grade was continuously improving, allP<0.05. Conclusion: TAVR was an effective treatment in AS patients with surgical contradiction or STS high risk score; it may continuously improve cardiac function, especially in patients with left heart dysfunction.