Objective To evaluate the feasible of dual-energy coronary artery CTA combined with affirmed iterative reconstruction technique for overweight patients.Methods 60 cases underwent dual-energy coronary artery CTA were enrolled in this reasearch.Patients were divided into two groups according to different reconstruction arithmetic model:group A with FBP reconstruction model,while group B with SAFIRE reconstruction model and monoenergetic images from 65 to 90 keV (with increment of 5 keV).All the data were measured by one doctor worked in CT department for more than 5 years,and the image quality were analyzed and evaluated by two senior radiologists.Randomized block ANOVA analysis was used to compare objective evaluation indices of different monoenergetic images from 65 to 90 keV to get the best keV level.The comparative t-test was applied to objective evaluation indices(CT values,SD,SNR,CNR and image quality score) of group A and B and comparative x2-test was applied to image quality score at the best keV level.Results There were significant differences in CT value,SD,SNR,CNR of different keV images (P ＜0.05).For objective evaluation of image quality,the SNR and CNR of group B were significantly higher than group A,and SD was significantly lower than group A (P＜0.05).For subjective evaluation of image quality,there were statistically significant difference between group B and group A (P＜0.05),the segment score of group B was superior to group A.Radiation dose:the DLP value was (238.7±30.82) mGy · cm,and the ED value was (3.3±0.43) mSv.Conclusion SAFIRE combine with purified single spectrum technique can improve the image quality and reduce radiation dose in dual-energy coronary artery CTA,and 75 keV is the best single energy level.

S100A8 and S100A9 are abundantly expressed in neutrophils cytoplasm,they are calciumbinding proteins and they often exist as S100A8/A9 heterodimer.Previous studies have shown that the biological functions of S100A8 and S100A9 are associated with chronic inflammatory diseases and a variety of cancers.They are important to inflammation by binding and activation Toll-like receptor4 (TLR4) and receptor for advanced glycation end products(RAGE),and mediating intracellular inflammatory signaling transduction.This review summarizes the studies on functions and molecular mechanism of S100A8 and S100A9 in autoimmune diseases,which might propose new strategies for diagnosis,treatment and suggested disease activity.

Objective: To study the effects ot intravenous 1％ procaine on cortex. Method: Ten patients,aged 29-59 years,for elective surgical operations,were observed the changes of spectral edge frequency(SEF), medium power frequency (MPF)and ? rate(?R)on power spectral analysis and bispectral index(Bl)on bispectral analysis during intravenous propofol 4 mg?kg~(-1)? h~(-1) purely for 15 min,intravenous combination of 1％ procaine 1mg?kg~(-1)?min~(-1) and propofol for 30 min, then intravenous propofol 4mg?kg~(-1)?h~(-1)purely for 15min. Result: SEF,MPF and BI values during combination stage were lower significantly (15.46?1.87Hz, 7.21?2.01Hz, 68.77?7.99 respectively)than the values during other two stages(stage 1 and stage 2 were 21.36?2.79Hz,11.55?2.62Hz,85.6?8.84 and 20.59?3.10Hz, 9.5?3.44Hz, 84.97?8.71 respectively, P

Objective To study the effect of metoprolol combined with benazepril on cardiac structure and heart function in patients with heart failure and the treatment of hypertension in the elderly. Methods 120 cases of elderly hypertensive patients with heart failure from June 2011 to June 2015 were studied, according to the random number table method, they were randomly divided into combination group and control group.The two groups were given symptomatic and supportive therapy, the control group on the basis of conventional treatment were given antihypertensive drugs of benazepril; combination treatment group were given metoprolol on the basis of control group. After treatment, the clinical efficacy of the two groups were evaluated, the changes of cardiac structure in the two groups were recorded and analyzed before and after treatment, and the blood pressure and cardiac function were analyzed. Results The total effective rate of the combined group was 91.67%, the control group was 78.33%, there was significant difference between the two groups (χ2=4.1830, P=0.0408). After 6 months of treatment, the blood pressure, cardiac structure and 6min walking distance were significantly improved in the two groups (P<0.05). The above indicators in combination group were significantly better than those in the control group (P<0.05). The complication rate in combination group was 8.33%, 13.33% in the control group, there was no statistically significant between two groups (χ2=0.7764, P=0.3782). Conclusion Metoprolol combined with antihypertensive treatment can significantly improve the clinical efficacy of the treatment, improve the cardiac structure and function.

AIM: To explore the anti-LPS mechanisms of ?-melanocyte-stimulating hormone (?-MSH), the effects of ?-MSH on the expression of SOCS-3 mRNA and the production of NO in murine peritoneal macrophages induced by LPS were investigated. METHODS: BALB/c mouse peritoneal macrophages were cultured in vitro and induced by LPS, ?-MSH and LPS with ?-MSH, respectively. The expression of SOCS-3 mRNA was detected using reverse transcription polymerase chain reaction (RT-PCR). NO produced in macrophages was tested with Griess reagent. RESULTS: The level of NO and the expression of SOCS-3 mRNA were significantly increased in macrophages stimulated with LPS.?-MSH markedly decreased the expression of SOCS-3 mRNA and almost completely inhibited the production of NO induced by LPS. CONCLUSION: These results suggest that the negative regulative circuits operated by SOCS are activated during the inflammation induced by LPS, but SOCS might not be involved in the anti-LPS mechanism of ?-MSH.

BACKGROUND: Gallie, Brooks steel wire, and Halifax vertebral plate clamp are tools for internal fixation of atlas-axis joint. They can keep the flexion-extension stability of atlas-axis joint, but weaken the ability to against lateral bending and rotation. Magerl+Gallie implantation shows good biomechanics stability, but cannot well prevent axial dislocation. OBJECTIVE: To introduce the surgical technique from posterior approach for atlas, and explore the effect on biocompatibility and biomechanics of implants. RETRIEVAL STRATEGY: The articles related to atlas-axis joint dated between January 1970 and June 2007 were retrieved through Pubmed, PML, OVID and Wanfang database using of "atlas, axis, dislocation, fixation, posterior" and "atlas, dislocation, internal fixation, implant, posterior approach, biocompatibility, biomechanics" in Chinese. All collected articles were selected firstly and the articles related to implants, surgical skills, and biomechanics were selected. For articles in identical field, only those published in recently or in authoritative journals were selected. Repetitive articles and Meta analysis were excluded. 127 articles met the criteria and 30 of them were involved. LITERATURE EVALUATION: The articles involved were related to the surgical treatment of dislocation of atlas-axis joint. Of 30 articles, 3 were review articles, 3 were monographs, and the others were clinical or basic researches. DATA SYNTHESIS: ①Lateral mass and pedicle screw implantation techniques can achieve three-dimensional fixation. ②The screw entrance points of atlantoaxial pedicle screw implantation is higher than lateral mass technique, it is unnecessary to expose C1, posterior arch and other deep parts of anatomic structures. C2 nerve root and venous plexus are not separated completely, which reduce injury rate and blood loss. In addition, screw passage of pedicle screw is longer than Harms technique, so screw can completely contact with skeleton to enhance the fixation. CONCLUSION: Atlantoaxial fixation by posterior pedicle screw implantation shows good biomechanics and biocompatibility. It may become the optimal approach for atlantoaxial short segmental fixation.

Objective To assess the incidence rate of postoperative nausea and vomiting (PONV) after total intravenous anesthesia (TIVA) with propofol versus sevoflurane-based anesthesia with or without ondansetron in patients undergone gynecological laparoscopy. Methods Totally 138 patients were randomly divided into three groups: sevoflurane group (Sev group) sevoflurane-ondansetron group (Sev-O group),and propofol TIVA group (TIVA group),with 46 cases in each. In the Sev and Sev-O groups,anesthesia was maintained by inhalation of 50% N2O and sevoflurane;in the Sev-O group,8 mg of prophylactic ondansetron was given intravenously 30 minutes prior to the end of the operation. In the TIVA group,target-controlled infusion of propofol and remifentanil were used. In each group,the incidence of nausea and vomiting and use of antiemetic drugs in 24 hours after the surgery were recorded. Results In 0 to 2 hours after the operation,the incidence rate of nausea and vomiting in the TIVA group was significantly lower than that in the Sev group [22% (10/46) vs 54% (25/46),?2=10.376,P=0.001] and Sev-O group [50% (23/46),?2=7.986,P=0.005]. In 2-6 hours,the rate in the Sev-O group was lower than that in the Sev group [22% (10/46) vs 46% (21/46),?2=5.887,P=0.015]. The total incidence rate of nausea and vomiting in 24 hours after the operation was 57% (26/46) in the TIVA group,which was significantly lower than that in the Sev group [80% (37/46),?2=6.093,P=0.014]. In the Sev,Sev-O,and TIVA groups,there were 13 (28%),6 (13%),and 6 (13%) cases respectively received antiemetic drugs after the surgery. Conclusions Compared with sevoflurane-based anesthesia,propofol TIVA results in a lower rate of PONV after gynecological laparoscopy.

Background and purpose: Mouse osteosarcoma model was widely used in osteogenic malignant tumor research, and it was helpful for studying the invasion and metastasis of the tumor cells when it was well marked in vivo. The purpose of this study was to establish mouse sarcoma cell lines (S180) that were infected with enhanced green fluorescent protein(EGFP). Methods: EGFP-S180 expressing strong EGFP fluorescence was acquired by electroblot, and supplemented with G418 (800 mg/mL), c-Myc was detected by laser scanning confocal microscopy. Meanwhile, the cancer-bearing model was established subcutaneously within the abdominal cavity. Results: EGFP-S 180 cells were cloned. There was no significantly difference between c-Myc expressions in S180 cells and those in EGFP-S180 cells (P>0.05), and between the cancer-bearing time subcutaneously and the time within abdominal cavity (P>0.05). Conclusion: According to in vitro and in vivo assay, it showed that EGFP-expressing S180 cells could be used for studying further the tumor biological behavior with fluorescence technology.

Objective To evaluate the reliability of using imipenem,meropenem,cefoperazonesulbactam,piperacillin-tazobactam in the treatment of hospital-acquired Gram-negative bacterial infections with Monte Carlo simulation(MCS).Methods The MIC of the four agents collected from hospital-acquired infections were detected in accordance with broth dilution method of Clinical and Laboratory Standard Institute (CLSI).MCS were conducted with MICs and the pharmacokinetics parameters of the four agents based on conventional dose regimens.The cumulative fraction of response (CFR) of time over MIC target attainment in different dosing regimen were generated.Results A total of 2 541 strains,including 2 093 strains of Enterobacteriaceae and 448 strains of glucose non-fermentative bacilli were collected.The MIC90 of imipenem and meropenem against Enterobacteriaceae were less than 1 mg/L in general,whereas MICg0 of two agents with β-1actamase inhibitors was around 64 mg/L.As to glucose non-fermenting bacteria,MICs of all the four agents were very high,especially to Acinetobacter baumannii,which indicated MIC50 more than 32 mg/L.MCS revealed that carbapenems had significantly higher CFR than those with β-1actamase inhibitors.Imipenem and meropenem (1 g,q8 h) obtained CFRs of 74.69％ and 81.42％,respectively.The CFR of cefoperazone-sulbactam (2 g,q8 h) and piperacillin-tazobactam (4 g,q6 h) (both excluding β-1actamase inhibitors) were just 49.59％ and 27.66％ respectively,which increased after excluding A.baumannii in piperacillin-tazobactam.Conclusions The conventional dose regimens of imipenem and meropenem are reliable for the empiric therapy of Gram-negative hospital-acquired bacterial infections.Piperacillin-tazobactam is suggested to use with higher doses or prolonged infusion time to satisfy the time of drug concentration exceeded the MIC (T ＞ MIC) requirement.More clinical studies of cefoperazone-sulbactam should be conducted to optimize its regimen and guarantee its efficacy.

Objective To compare the therapeutic efficacy and adverse effects between transcather arte-rial chemoembolization(TACE) and comprehensive therapy in primary advanced heptocellular carcinoma(HCC).Methods 216 patients with primary HCC were arranged randomly into two groups:104 (group A) were treated with TACE alone,the rest(group B)were treated with TACE combined with intraperitoneal perfusion chemothera-py, Chinese herbs and immunotherapy.The therapeutic efficacy and adverse effects were analysed and compared between two groups.Results The CR + PR rates were 28.84% in group A and 34.82% in group B.The 4-year survival rates were 1.92% in group A and 3.87% in group B(P < 0.05).There were no severe side effects in both groups.Conclusions The short-term effective rate and 4-year survival rate in comprehensive treatment group were superior to the control group.Therefore, the comprehensive treatment is worthwhile to use in primary advanced hepatocellular carcinoma.