Objective To discuss the spiral CT features of the bowel obstruction induced incarcerated abdominal external hernia and its value in clinical application.Methods The spiral CT feature of the bowel obstmction induced incarcerated abdominal external hernia which were confirmed by surgery in 14 cases were retrospectively analyzed and were compared with surgical results.Results The hernia sac of incarcerated abdominal external hernia in all cases of bowel obstruction were displayed by CT,in which the positions and varieties of the hernia were determined in 12 CaSes.the intestinal images within the hernia SaC were displayed in 10 cases,the epiploon image within the hernia sac was displayed in 1 case.homogeneus soft tissue density shadows were displayed in 3 cases,the intestinal wall thickening within the hernia sac was displayed in 4 cases.in which in 2 cases were involved in delamination of the intestinal wall.The intestinal wall thickening in abdominal cavity was displayed in 2 cases,the nuidify in abdominal cavity was displayed in 3 cases.the volvulus was displayed in 2 cases.Conclusion The spiral CT has an important value in determing the positions of bowel obstruction,varieties of the contents of hernia sac,th blood supply of the bowel within the hernia sac and proximate obstmction and other complieations.

Objective To evaluate the utility of diffusion-weighted MRI(DWI)and the correlation between the abnormalities in DWI and the clinical factors in patients with transient ischemic attack of the brain(TIA).Method Clinical,conventional MRI,and DWI data were collected on 59 consecutive patients with TIA between March and July 2006 within 7 days of the onset of TIA symptoms.The relationship between DWI-detected findings and patients' clinical manifestations was then analyzed.Results DWI-detected abnormalities were displayed in 22 of 59 cases(37%,positive group).Prolonged TIA duration(TIA duration≥30 minutes),repeated episodes,motor deficits,aphasia,history of either stroke or TIA,diabetes mellitus,and atrial fibrillation were observed more frequently in the positive group than in the negative group.In 9 of 22 cases,the identified lesions were not detected by conventional MRI(T2-weighted imaging or fluid-attenuated inversion recovery).In other 13 cases,abnormalities were present on both DWI and conventional MRI.Conclusions In TIA patients,prolonged TIA duration(TIA duration≥30 minutes),repeated episodes,motor deficits,aphasia,history of either stroke or TIA,diabetes mellitus,and atrial fibrillation were significantly correlated with detectable abnormalities on DWI.

Objective Through the establishment of adjacent cabin blast injury model of Beagle dog,to investigate the pathophysiological changes in the experimental animals in this scenario,then speculate on the mechanisms of injury.Methods Several adjacent cabins were built in the same size with the real warship.Seven Beagle dogs were subjected to injuries from the explosion,from whom one was selected randomly to implant intracranial pressure transducers before blast,the others were tested on the pathophysiological changes after blast.The dogs were mounted on the platform of a cabinet in the adjacent cabin,subjected to injury from 650g bare TNT explosive blast.The transducers recorded the value of space and intracranial shock wave pressure.Following blast treatment,the serum levels of IL-6,IL-8,neuron specific enolase (NSE),brain and chest CT and pathological changes of the brain tissue were observed.Results Serum levels of IL-6,IL-8 and NSE were elevated to varying degrees after blast.All of them increased significantly at different time points after blast (P＜0.05).Brain and chest CT examinations did not show any significant positive results.Pathological results showed that there was a little necrosis in the brain,some neurons had karyopycnosis,karyolysis or disappearance of the nucleoli,and the cell boundaries were blurred.The blast wave was blocked greatly by the scalp and skull (about 90％),but could still penetrate them and cause brain injuries.Conclusions Explosion in the adjacent cabin causes mainly mild traumatic brain injuries.Blast wave can be blocked by the scalp and skull greatly.

Objective To explore the dynamic changes of diffusion tensor imaging(DTI) in spinal cord of goats with persistent compression injury. Methods Eighteen goats weighted 20--25 kg were divided into three groups with completely random design: A, B and C. A balloon catheter was inserted into the epidural space at C3-4 level via intervertabral foramen for each goat. The balloon was inflated by injection of variable volumes of saline in group A and B 10 days following operation. The volume of saline was 0. 3 ml in group A and 0. 2 ml in group B,respectively. The compression sustained for 40 days. Group C served as uncompressed control without injection of saline. The locomotor rating score was applied to each group. Conventional MRI and DTI were performed. The apparent diffusion coefficient (ADC)and fractional anisotropy (FA) values were measured. Histopathological assessments of the compressed spinal cord were performed 50 days following operation with light microscope and transmission electron microscopy. Results Before operation, the locomotor rating score was 5, the ADC value was ( 1.23 ± 0. 05 ) × 10-3 mm2/s and the FA value was (0. 72 ± 0. 05 ) each group. Of six goats in Group A, the locomotor rating score severely decreased and reached( 1.5±0. 4)on the 40 th day after compression. The ADC value at compression site decreased soon and reached the minimum (0. 75±0. 04) × 10-3mm2/s on the 5 th day after compression. Then the ADC value increased gradually, restored normal on the 10 th day or so, then became markedly higher than normal and reached( 1.61±0. 05) × 10-3mm2/s on the 40 th day. The FA value at compression site decreased soon, reached(0. 54±0. 04)on the 1st day, then decreased gradually and reached(0. 43 ± 0.05) on the 40 th day. It appeared high signal intensity on T2WI on the 10 th day. In Group B, the locomotor rating score was moderately decreased and reached(3.4±0. 5 )on the 40 th day. The ADC value at compression site decreased slightly firstly, reached( 1.08±0. 04) × 10-3mm2/s on the 1st day, restored normal on the 20 th day or so, then increased gradually, became higher than normal and reached ( 1.27 ± 0. 05) × 10-3mm2/s on the 40 th day. The FA value increased slightly firstly, reached (0. 78±0. 05 )on the 1st day, then decreased gradually, restored normal on the 15 th day or so, became lower than normal and reached(0. 67±0. 05) on the 40 th day. There was no abnormality on conventional MRI. In Group C, the locomotor rating score, ADC value and FA value remained unchanged. There was no abnormality on conventional MRI. There were dynamic changes over time of the ADC value and FA value in Group A and B, which was more marked in Group A than that in Group B ( repeated measurements analysis of variance, F=426. 7 for the ADC value and F =7895.2 for the FA value, P < 0. 01 ). Histopathologically, swelling and degeneration of axons and neurons as well as the disarrangement of myelin sheathes could be seen. The pathological changes were more marked in Group A than in Group B. In Group C, no abnormality could be seen. Conclusion There are dynamic changes of DTI in cervical spinal cord with compressive injury that correlated with the degree and duration of compression. The ADC value decreased firstly, restored normal and then increased. The FA value increased firstly, restored normal and then decreased in mild compression while solely decreased in serious compression.

Objective To improve the understanding of cutaneous intravascular natural killer/T-cell lymphoma (CIVNKTC). Methods Clinical data on five cases of CIVNKTC were collected. The histopathological feature, treatment and prognosis of CIVNKTC were retrospectively analyzed and discussed. Results Of the 5 patients, 1 was male and 4 were female. The age of onset ranged from 38 to 83 years (average, 56.2 years). All the patients presented with multiple plaques and nodules as the primary symptoms. Histopathological examination revealed vasodilatation in the dermis and subcutaneous tissue, as well as atypical lymphoid cells with large hyperchromatic nuclei containing 1-2 small nucleoli in dilated veins. Immunohistochemical studies of tumor cells showed positive staining for CD3ε, cytotoxic proteins (including T cell-restricted intracellular antigen-1, granzyme B and perforin)and Epstein-Barr virus(EBV)-encoded microRNA, but negative staining for cytokeratin, CD20, CD79a, CD4 and CD8. Furthermore, the tumor cells stained positive for CD56 in two patients. Among the 5 patients, only 2 received chemotherapy and the remaining received no treatment. During a 24-month follow-up, 4 patients died, and only 1 survived with the tumor. Conclusion CIVNKTC is a rare extranodal Hodgkin′s lymphoma with distinct histologic manifestations and immunophenotypes, rapid and aggressive clinical course, and poor prognosis.

Objective:To investigate the expression of transcription factor BACH2 on PBMC in patients with coronary artery disease( CAD) and discuss its significance and role.Methods:The circulating levels of BACH2 and TLR4 in PBMC were evaluated by RT-PCR and Western blot separately.Serum levels of signature cytokines of T-helper cells,cytokines and ox-LDL were evaluated by ELISA.The data among groups were analyzed by one-way ANOVA.Correlation between variables were subjected to linear regression analysis.Results:The expression level of BACH2 down-regulated and TLR4 up-regulated significantly in PBMCs of ACS patients had significantly higher concentrations of serum ox-LDL,cytokines of TH1 cells,TH2 cells and TH17 cells and low level of cytokine of Treg cells.Negative correlation exists significantly between BACH2 and TLR4 in patients with CAD and between BACH2 and IFN-γ,IL-4 and IL-17,and between BACH2 and ox-LDL in serum.However, positive correlation exists significantly between BACH2 and TGF-β1.Conclusion:Increased serum concentrations of ox-LDL probably down-regulated the expression of BACH2 in ACS patients by activating TLR4 on PBMC, resulting in promoting production of pro-inflammatory cytokines and suppressing production of anti-inflammatory cytokine and then might cause ACS.

BACKGROUND: Vascular endothelium growth factor (VEGF) is an endothelium mitogen and angiogenic factor with strong potential during recovery from cerebral infarction (CI). Can such therapeutic effect be detected with magnetic resonance diffusion imaging?OBJECTIVE: To study the therapeutic efficacy of VEGF plasmid in treating focal cerebral infarction in a dog experimental model with the aid of diffusion- and hemodynamic-weighted magnetic resonance imaging (MRI),with the morphological results compared with those of immunohistochemical examination.DESIGN: Completely randomized controlled, double blind evaluation,analysis of variance, Pearson correlation analysis, follow-up for 2 weeks.SETTING: Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University.MATERIALS: This study was carried out at the Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University,between April 2001 and March 2002. Totally 18 healthy adult dogs weighing 10-15 kg were randomly divided into control group and experiment group with half in each.METHODS: All dogs were subjected to femoral intubation and then made into CI model by the occlusion of middle cerebral artery with an embolus injected through the internal carotid artery. Dogs in control group were put to death at postoperative 24 hours, 1 week and 2 weeks with three at each time point, while four dogs in experiment group were put to death at postoperative 1 week and five at 2 weeks. Dogs in experiment group received microinjection of 0.5 mL fluid containing pcD2/hVEGF121 (500-600 μg)instantly after operation, which was replaced with physical saline of the same volume at the same time point in control group. Then they were subjected to MRI scanning once an hour for 4 times, with the sequence of T1WI, T2WI, 3D-TOFMRA, DWI and CET1WI, which was repeated at postoperative 24 hours, 3 days, 1 week and 2 weeks. Based on the MR images, pathological focuses were selected for morphological observation of cells with the aid of HE staining, and CD34 IHC staining was used for counting micrangium, as well as VEGF staining for VEGF positive cells.Then the apparent distribution coefficient (ADC) was calculated, and the differences between different time points and groups were analyzed by analysis of variance. The number of capillaries and VEGF positive cells of each high-power field was counted, with the results compared with those of MR scanning so as to explore the correlation between MR signal changes and IHC results.MAIN OUTCOME MEASURES: ① The number of capillaries and VEGF positive cells in each high-power field was counted at postoperative 24 hours, 1 week and 2 weeks; ② MR images of each group.RESULTS: Data of the 18 dogs entered the final analysis. ① Diffusionweighted imaging (DWI) showed higher signals at infarctional region at postoperative 1 hour, which became strengthened as time went by. ②ADC decreased to (5.61 ±1.39) mm2/s at postoperative 3-4 hours, about 43% lower than that of the opposite hemisphere [(9.85±2.04) mm2/s]. It resumed to (9.83±1.11) mm2/s, but was still lower than the normal level.③ The subsequent MR scanning proved that ADC ratio presented an increasing tendency in contrast with the decreasing tendency at super-acute stage. The increment was even more marked in control group and the difference was significant at postoperative 2 weeks (P=0.032, 0.006). ④ The number of capillary positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 2 weeks [(28.80±3.29)/field, (20.70±4.47)/field, (P ＜ 0.01)]. ⑤ The number of VEGF positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 1 and 2weeks [(64.20±9.40)/field, (51.90±5.74)/filed; (72.70±6.98)/filed,(58.40±6.35)/field, (P ＜ 0.01)].⑥ The results of MR scanning and IHC were subjected to correlation analysis and revealed that ADC ratio was closely correlated with the number of capillary positive cells, with Pearson correlation coefficient being 0.679 (P ＜ 0.01). Moreover, the number of capillaries and the number of VEGF positive cells were significantly correlated (r=0.668, P ＜ 0.01).CONCLUSION:Morphological observation and IHC revealed that both the local capillaries and VEGF protein content increased markedly in timedependant manner due to VEGF plasmid gene therapy.Meanwhile,the change of ADC ratio was found to be closely correlated with the number of VEGF positive cells and the number of capillaries.

Objective To understand the prevalence of senile dementia in the elderly aged ≥ 60 years in China between 2000 and 2015.Methods Publications between 2000 and 2015 were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Databases,Chinese Science and Technology Journal Databases (VIP) and PubMed.Observational studies on prevalence of senile dementia were included.Meta-analysis was carried out by using R software.Results A total of 25 papers were included in this study.The total number of participants investigated was 76 980,with 4 295 dementia cases identified.The prevalence of senile dementia in the elderly was 5.15％ (95％CI:4.21％-6.09％);Subgroup analysis showed that the women had a higher prevalence (6.08％) than the men (4.10％);and the prevalence was significant increased with age (The senile dementia prevalence was 1.01％ in age groups 60-64 years,but 23.60％ in age group ≥85 years).The prevalence of Alzheimer's disease (3.56％) was higher than that of cerebral vascular dementia (1.11％).The senile dementia prevalence in the illiterate was 8.74％,higher than 3.17％ in the literate.The prevalence of senile dementia in the unmarried was 6.83％,higher than that in the married (3.95％).Conclusion The prevalence of senile dementia was high in the population aged ≥60 years in China.Age,sex,education level and marital status might influence the prevalence of senile dementia.

Objective To evaluate the therapeutic effect of poloxamer hydrogel loaded with exosomes derived from human dental pulp stem cells genetically modified with human hepatocyte growth factor against radiation skin injuries.Methods Human dental pulp stem cells derived exosomes(DPSC-Exo)and hepatocyte growth factor modified DPSC-Exo(HGF-DPSC-Exo)were extracted via ultracentrifugation separation,identified in terms of particle size and morphology,and analyzed separately by means of nanoparticle tracking analysis and scanning electron microscopy(SEM),while exosome marker proteins were determined by Western blot.Then,the effect of exosomes on radiation-damaged skin cells was assessed.The poloxamer hydrogel was prepared and its safety was evaluated with CCK-8.A mouse model of injury combined with radiation injury was established,and the therapeutic effect of hydrogel loaded with exosomes was determined based on wound size,HE and Masson staining.Furthermore,the underlining therapeutic mechanism was explored with Tunnel assay,malondialdehyde content and peroxidase activity.Results The diameter exosomes ranged from 30 to 150 nm and their morphology was a disc-shaped vesicle under SEM.Moreover,CD9,CD63 and TSG101 were expressed.The results of cellular experiments showed that exosomes significantly promoted the proliferation and migration of radiation-damaged skin keratinocytes and fibroblasts,and reduced their apoptosis.HGF modification enhanced the healing effect of exosomes.Poloxamer hydrogel showed good temperature-sensitive properties and biocompatibility.The results of animal experiments showed that exosomes significantly accelerated the healing of radiation-combined injuries in mice,inhibited inflammatory infiltration and mitigated collagen deposition in the wound.Interestingly,the healing effect in the group treated with hydrogel loaded with exosomes was the best.The underlining mechanism was possibly related to promotion of cell proliferation and inhibition of apoptosis and oxidative stress.Conclusion A novel poloxamer hydrogel loaded HGF-DPSC-Exo has been prepared and its therapeutic effect against radiation combined injury has been proved,thus providing a new strategy for the treatment of radiation skin injury in clinic.

Objective To explore the effect of virtual reality(VR)technology on relieving intraoperative pain in patients receiving transcatheter hepatic artery chemoembolization(TACE).Methods A total of 76 patients,who received TACE from June 2023 to January 2024,were enrolled in this study.Using random number table method,the patients were divided into control group(n=38)and study group(n=38).Intraoperative routine nursing was carried out for the patients of the control group,while on the basis of routine nursing additional VR technology was adopted to relieve the intraoperative pain for the patients of the study group.The degree of intraoperative pain,anxiety symptoms,incidence of intraoperative adverse reactions and patient satisfaction with nursing were compared between the two groups.Results The degree of intraoperative pain in the study group was lower than that in the control group,but the difference between the two groups was not statistically significant(P＞0.05).The analgesic effect of VR was much obvious in patients aged≤55 years and in patients with vascular invasion of liver cancer(P＜0.05).The anxiety score in the study group was lower than that in the control group,the patient satisfaction score in the study group was higher than that in the control group,and the differences between the two groups were statistically significant(both P＜0.05).No statistically significant difference in the incidence of adverse reactions existed between the two groups(P＞0.05).Conclusion Immersive VR technology can effectively reduce the degree of intraoperative pain in patients receiving TACE,especially in patients aged ≤55 years.Besides,VR technology can also reduce the anxiety degree of patients,and improve the degree of intraoperative patient satisfaction with nursing.