Objective To explore role of 64-slices spiral CT in differetiation of acute chest pains.Methods Thirty six patients with acute chest pains were performed 64-slices spiral CT chest angiography.Two-dimensional and three-dimensional reconstruction was performed in all patients by means of multiplanar reconstruction(MPR)(coronal,sgittal oblique),curved planar reformation(CPR), maximum intensity projection(MIP),and volume rendering(VR).All images were blindly reading by two experienced radiologist.DSA were performed at the same time in 16 cases.Results The coronary artery branches,pulmonary artery and aortic artery in all patients were showed clearly,The acute myocardial infarction were showed in 10 cases,The pulmonary artery embolism in 14 cases,The aortic dissection in 6 cases respectively,The Coronary embolism in One case ,pneumothorax In One case The constrictive pericarditis in 1 case respectively.Normal findings in 4 cases.Conclusion 64-slices spiral CT is a useful and noninvasive examination in acute chest pain.

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

BACKGROUNDThe role of the cerebral venous system (CVS) in intracranial pressure (ICP) regulation remains largely unclear. In the present study, the interaction between ICP and the cerebral venous system and its possible mechanism were investigated with respect to the biological characteristics of the cerebral venous system and its hemodynamic response under increased ICP.

METHODSWe created intracranial hypertension animal model, measured and calculated the venous flow velocity and diameter of the outflow terminal of the CVS with color ultrasonic system and recorded the vascular morphology by 3-dimensional anatomical microscopy. Patients who suffered from raised ICP underwent MRI and digital subtraction angiography (DSA) examination to show the length in the vertical direction of the wall of the bridging vein representing the diameter value. Pathological autopsy was performed from bodies of patients who had died from non-cerebral causes to observe the juncture part between the venous sinuses and tributary vertical brain veins.

RESULTSUnder increased ICP conditions, venous drainage through the outlet cuff segment, a unique structure between the bridge vein and sinus, was obstructed and in turn venous blood became congested. Therefore, the increased blood volume worsened the pre-existing ICP according to the well-accepted theory regarding volume-pressure relationship. This phenomenon was described as concurrent "venogenic intracranial hypertension", which is characterized by intracranial venous blood stasis responsive to and together with the original increased ICP.

CONCLUSIONSThe existence of this special pathophysiological process is prevalent, rather than rare, in various intracranial disorders. This finding would definitely provide new insight into the area of cerebral venous system research.

Adult ; Cerebral Veins ; pathology ; physiopathology ; Cerebrovascular Circulation ; physiology ; Female ; Hemodynamics ; physiology ; Humans ; Intracranial Hypertension ; pathology ; physiopathology ; Intracranial Pressure ; physiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

BACKGROUNDDoppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease (KD). However, the diagnostic accuracy for the whole coronary artery lesions is limited. The purpose of this study was to compare the diagnostic value of dual-source computed tomography (DSCT) and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.

METHODSSixteen patients, 12 with typical KD and 4 with atypical KD, underwent DSCT and Doppler color echocardiography. The position and internal diameter of each coronary artery lesion was measured. Correlation analysis was used to compare the diagnostic value of the two imaging modalities.

RESULTSIn the typical KD group, seven patients did not have any coronary artery lesion as confirmed by both DSCT scans and Doppler color echocardiography; in four patients proximal coronary artery injuries were identified by both modalities; in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography. In the atypical KD group, three cases showed the same results with both modalities, while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography. There was a good correlation between the two imaging modalities (Kappa value, 0.768 (>or= 0.75)).

CONCLUSIONDSCT coronary artery angiography is an accurate, non-invasive, and valuable technique for detecting and following up coronary artery lesions in patients with KD.

Adolescent ; Child ; Child, Preschool ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Echocardiography, Doppler, Color ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To analyze the clinical efficacy of the Qianyang Fengsui Dan(combined with flying needle therapy)in the treatment of kidney-yang deficiency type of insomnia.Methods A retrospective study was conducted to select 82 patients with insomnia admitted to the Department of Traditional Chinese Medicine of Dezhou Hospital of Traditional Chinese Medicine from November 2020 to November 2021,and they were divided into an observation group and a control group according to whether or not they were treated with Qianyang Fengsui Dan combined with flying needle therapy,with 41 cases in each group.The control group was treated with Estazolam,while the observation group was treated with Qianyang Fengsui Dan combined with flying needle therapy on the basis of the treatment of the control group,and the course of treatment was 1 month.The changes of Pittsburgh Sleep Quality Index(PSQI)scores and Epworth Sleepiness Scale(ESS)scores,as well as polysomnographic parameters were observed before and after treatment in the two groups.The changes of γ-aminobutyric acid(GABA),glutamate(GA),substance P(SP),and neuropeptide Y(NPY)levels were compared before and after treatment between the two groups.And followed up for 1 year to compare the incidence of relapce of the two groups of patients.Results(1)The total effective rate was 95.12%(39/41)in the observation group and 63.41%(26/41)in the control group,and the efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,PSQI scores and ESS scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving PSQI scores and ESS scores,and the differences were statistically significant(P＜0.05).(3)After treatment,sleep efficiency,awakening time,sleep latency,REM,and total sleep time were significantly improved in the two groups(P＜0.05),and the observation group was significantly superior to the control group in improving sleep efficiency,awakening time,sleep latency,REM,and total sleep time,and the differences were statistically significant(P＜0.05).(4)After treatment,the serum GABA,GA,SP,and NPY levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the serum GABA,GA,SP,and NPY levels,and the differences were all statistically significant(P＜0.05).(5)After treatment,follow-up for 1 year,the recurrence rate of the observation group was 0,and there were 7 cases of recurrence in the control group,and the recurrence rate of the control group was 17.07%(7/41),and the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion The combination of flying needle therapy and Qianyang Fengsui Dan can effectively relieve insomnia and fatigue in patients with insomnia,reduce daytime drowsiness,regulate the release of blood monoamine neurotransmitters,and reduce the relapse rate,and its efficacy is superior to that of simple western medicine treatment.

Aim To observe the effect of Salvianolic-aid B ( Sal B ) on the progression of hepatic fibrosis-carcinoma in mice induced by diethylnitrosamine ( DEN ) and investigate the mechanism of Sal B in-volved in the shift between pSmad 3 C/p21-mediated tumor suppressive signaling and pSmad 3L/PAI-1/c-Myc-mediated pro-fibrogenic/oncogenic signaling . Methods A total of 100 male Kunming mice were randomly grouped , DEN-induced hepatic fibrosis-car-cinoma model of mice was established , which was in-tragastrically treated by Sal B with two dosages ( 15 , 30 mg · kg -1 ) and colchicine with one dosage ( 0.2 mg· kg -1 ) , respectively.The mice were sacrificed at 12th week or 16th week after the start of DEN adminis-tration.Pathological changes of livers in each group were assessed by liver biopsy , hematoxylin-eosin ( HE ) staining and Van Gieson ( VG ) staining .The protein expressions of pSmad3C, pSmad3L, p21, plas-minogen activator inhibitor-1 ( PAI-1 ) and c-Myc in liver tissues were assayed by Western blot .Results In the normal control group , the surface of mouse liver was smooth and soft , and the structure of the hepatic lobule was intact.In the DEN alone group, at 12th week, the surface of mouse liver was rough and hard , the hepatic lobule was encysted or separated by colla-gen bundles, and pseudolobules emerged.At 16th week, the surface of mouse liver in the DEN alone group was rough with some nodules. HE and VG staining showed that the hepatocytes of nodules with obvious atypia and hyperchromatic nuclei were veri-fied.However, these pathological changes were evi-dently improved in Sal B treatment groups compared with the DEN group , which was proved by reductive cirrhotic nodules and alleviative fibrosis at 12th week, and decreasing cancerous nodes and ameliorative dif-ferentiation via Sal B treatment at 16th week.Western blot results showed that the protein expression of pS-mad3C, pSmad3L, PAI-1 were less, and c-Myc ex-pression was scarcely found in normal group; in DEN alone group, at 12th week, the protein expression of pSmad3C had no significant change , while the protein levels of pSmad3L, PAI-1, p21 were up-regulated, and at 16th week, the protein expressions of pS-mad3C, pSmad3L, p21, PAI-1 and c-Myc increased. In Sal B treatment group, the expressions of p21 and pSmad3C increased significantly , pSmad3L and PAI-1 protein levels markedly decreased at 12th week, the expression of pSmad3C increased obviously , p21 was almost unchanged , and the expression of pSmad 3L, PAI-1 and c-Myc were significantly reduced at 16th week .Conclusions Sal B could delay the progression of hepatic fibrosis-carcinoma in mice induced by DEN , and the mechanism may involve mediating the shift of pSmad3C/p21 and pSmad3L/PAI-1/c-Myc signaling.

The plants of Chloranthaceae are widely distributed and rich in resources in our country, records of ancient herbs indicaded that various species of plants of Chloranthaceae can be used for medicinal purposes, especially the Sarcandra glabra which with the least toxicity and possessed the function of clearing heat and cooling blood, activating blood to eliminate spots and removing wind and dredging collaterals. Based on the theory of herbage and by the method of consulting the past herbal literature, we summarized and analyzed the medicinal history, distribution characteristics of herbage geography, characteristics of herbage ecology, standard collection situation and the modern toxicology research of Chloranthaceae plants. Therefore we explained the scientificity for selection of medicinal herbs of Chloranthaceae plants, and provided a theoretical and scientific basis for further research of Chloranthaceae plants.

OBJECTIVETo evaluate the influence on frequency, intensity and the amount of current flow produced by electroacupuncture sensation of acupoints with different distributions (meridian category, tissue type and nerve innervations).

METHODSTwenty-one healthy volunteers were enrolled. According to the different tissue of acupoints, paired acupoints were grouped: Zusanli (ST 36) vs Yanglingquan (GB 34) (different meridian categories), Neiguan (PC 6) vs Daling (PC 7) (different tissue types), Zusanli (ST 36) vs Shuidao (ST 28) (different nerve innervations), Guanyuan (CV 4) vs Zhongwan (CV 12) (different nerve innervations), and Zusanli (ST 36) vs Guanyuan (CV 4) (different meridian categories, tissue types and nerve innervations). The electric frequency was 15 Hz. The electric current was under the participant's tolerance without sharp pain; the electroacupuncture was applied for three times with interval, 90 seconds totally. Soreness, numbness, fullness, heaviness, tingling, pressure, dull pain, warmness, coolness and amount of current flow were recorded, and the frequency, intensity and current amount between the paired acupoints were compared.

RESULTSThere were no significant differences in frequency of needling sensations between paired points (all P > 0.05). In the 9 electroacupuncture sensations, fullness, numbness and soreness were most commonly seen and obvious, heaviness, pressure and tingling came second, and dull pain, warmness, and coolness occurred at lower frequency. There were differences in the intensity of acupuncture sensation between paired acupoints in part of them, the soreness, fullness and heaviness at Zusanli (ST 36) were stronger than those at Shuidao (ST 28) (all P < 0.05 ); fullness and numbness at Zusanli (ST 36) were stronger than those at Guanyuan (CV 4) (both P < 0.01); fullness at Guanyuan (CV 4) was stronger than that at Zhongwan (CV 12) (P < 0.05 ); the current flow of electroacupuncture was similar between paired acupoints (all P > 0.05).

CONCLUSIONIn the situation that there is no obvious difference in amount of current flow caused by electroacu puncture sensation, the obvious correlations between frequency of electroacupuncture sensation and tissue properties of acupoints are not appeared, and the difference of sensation intensity between paired acupoints may be associated with different nerve innervations. The frequency and intensity of electroacupuncture sensation at one acupoint are stable at different times.

Acupuncture Points ; Adult ; Electroacupuncture ; Humans ; Male ; Sensation ; Young Adult

Central neurocytomas (CNs), initially asymptomatic, sometimes become huge before detection. We described and analyzed the clinical, radiological, operational and outcome data of 13 cases of huge intraventricular CNs, and discussed the treatment strategies in this study. All huge CNs (n=13) in our study were located in bilateral lateral ventricle with diameter ≥5.0 cm and had a broad-based attachment to at least one side of the ventricle wall. All patients received craniotomy to remove the tumor through transcallosal or transcortical approach and CNs were of typical histologic and immunohistochemical features. Adjuvant therapies including conventional radiation therapy (RT) or gamma knife radiosurgery (GKRS) were also performed postoperatively. Transcallosal and transcortical approaches were used in 8 and 5 patients, respectively. Two patients died within one month after operation and 3 patients with gross total resection (GTR) were additionally given a decompressive craniectomy (DC) and/or ventriculoperitoneal shunt (VPS) as the salvage therapy. Six patients received GTR(+RT) and 7 patients received subtotal resection (STR)(+GKRS). Eight patients suffered serious complications such as hydrocephalus, paralysis and seizure after operation, and patients who underwent GTR showed worse functional outcome [less Karnofsky performance scale (KPS) scores] than those having STR(+GKRS) during the follow-up period. The clinical outcome of huge CNs seemed not to be favorable as that described in previous reports. Surgical resection for huge CNs should be meticulously considered to guarantee the maximum safety. Better results were achieved in STR(+GKRS) compared with GTR(+RT) for huge CNs, suggesting that STR(+GKRS) may be a better treatment choice. The recurrent or residual tumor can be treated with GKRS effectively.
Antineoplastic Agents ; therapeutic use ; Combined Modality Therapy ; Humans ; Neurocytoma ; therapy ; Radiotherapy ; Surgical Procedures, Operative

Objective:To investigate correlations between blood lipid levels and clinical characteristics of patients with psoriasis vulgaris (PsV) in Fujian province.Methods:Totally, 245 PsV patients were enrolled from Department of Dermatology of the First Affiliated Hospital of Fujian Medical University from March 2019 to March 2022, and 250 gender-, age-, and body mass index-matched health checkup examinees served as controls. Their biochemical indicators, such as blood lipids, liver function, and kidney function, were evaluated. Clinical data, such as disease courses, involvement of specific sites, history of smoking and alcohol consumption, and family history of psoriasis, were collected from the PsV patients, and correlations between these clinical data and dyslipidemia were analyzed. Measurement data were compared using t test or Mann-Whitney U test, and enumeration data were compared using chi-square test. Results:There were 122 (50.8%) patients with dyslipidemia in the PsV group and 94 (37.6%) in the control group, and the prevalence of dyslipidemia significantly differed between the two groups ( χ2 = 7.48, P = 0.006). The prevalence of hypo-high-density lipoprotein cholesterolemia was significantly higher in the PsV group (29.8%) than in the control group (18.8%; χ2 = 8.15, P = 0.004). The PsV group showed significantly decreased serum levels of total cholesterol (4.5[3.9, 5.2] mmol/L), high-density-lipoprotein cholesterol (1.1[1.0, 1.3] mmol/L), and apolipoprotein A1 (1.2[1.1, 1.4] g/L) compared with the control group (4.9[4.3, 5.4] mmol/L, 1.3[1.1, 1.5] mmol/L, 1.3[1.2, 1.5] g/L, respectively; all P < 0.001). The proportions of males, patients with a history of alcohol consumption, and patients with involvement of the palmoplantar sites were significantly higher in the PsV patients with dyslipidemia (92.6%, 13.1%, 13.8%, respectively) than in those without dyslipidemia (70.7%, 6.0%, 5.0%, respectively; all P < 0.001). Multifactorial logistic regression analysis showed that "male" and "BMI ≥ 25 kg/m 2" were independent risk factors for dyslipidemia in the PsV patients ( OR [95% CI]: 3.94 [1.74, 9.74], 3.18 [1.71, 6.09], respectively), and "involvement of the palmoplantar sites" was independently associated with increased risk of hyperlipidemia ( OR [95% CI]: 3.38 [1.18, 11.01]) . Conclusion:The prevalence of dyslipidemia was higher in PsV patients than in healthy populations, and PsV patients being males, having BMI ≥ 25 kg/m 2 and with involvement of palmoplantar sites may be prone to develop lipid metabolism disorders.