Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.
Computer-Assisted Instruction ; Education, Distance ; Education, Medical, Continuing ; Humans ; Internet ; Radiology ; education ; Radiology Information Systems ; Singapore ; User-Computer Interface

AIM: To investigate the mechanism of proliferation effect induced by (R,R)-XY-10 and (S,S)-XY-10 on retinal pigmented epithelial cells(ARPE-19).METHODS: Human retinal pigmented epithelial cells(ARPE-19) and human umbilical vein endothelial cells (HUVECs) were used to investigate the effect of (R,R)-XY-10 and (S,S)-XY-10 on cell growth,and their mechanisms of proliferative action by using ERK、 AKT、PI3K、Protein kinase C (PKC)and Nitric oxide synthase (NOS) inhibitors.RESULTS: (R,R)-XY-10 and (S,S)-XY-10 dose-dependently increased ARPE-19 cell proliferation,but not on HUVECs. When treated with proliferative inhibitors,H7(5μmol/L)、hypericin(20μmol/L)、PD98059(2μmol/L)、LY294002(50μmol/L)、SH-5 (10μmol/L) and L-NAME (100μmol/L),the proliferative effect was reduced by H7、hypericin、PD98059 and LY294002,but not by SH-5 and L-NAME.CONCLUSION: (R,R)-XY-10 and (S,S)-XY-10 can induce cell proliferation through MAPK and PI3K dependent pathway. KEYWORDS: age-related macular degeneration; (R,R)-XY-10; (S,S)-XY-10; ARPE-19 cells; human umbilical vein endothelial cells; proliferation

Functional dyspepsia (FD) is a common functional gastrointestinal disease which bears a significant burden on society and individuals. Despite the high prevalence of FD, its pathophysiology remains poorly understood and the treatment options are limited and unsatisfactory. In the absence of effective pharmacological treatments for FD, non-pharmacological approaches, including: reassurance, lifestyle modification, psychotherapy, dietary interventions, medical food, acupuncture, and electrical stimulation and modulation are sought after by many physicians and FD patients. In this article, we review clinical studies which investigate nonpharmacological therapies for FD. We will also discuss potential mechanisms involved in the therapeutic effects of these nonpharmacological approaches. Though the evidences to support the routine use of the non-pharmacological management is still lacking, the non-invasive nature and potentially minimal side-effects of these therapies may be attractive in the FD management. In order to confirm the clinical effectiveness of these non-pharmacological approaches, more well-conducted, methodologically rigorous, and large-scaled clinical trials are required.

OBJECTIVE To establish the fingerprints of dried Houttuynia cordata and its decoction pieces ，conduct chemometrics analysis and determine the contents of 5 flavonoids such as neochlorogenic acid. METHODS High performance liquid chromatography （HPLC）method was adopted. Using quercitrin as reference ，HPLC fingerprints of 10 batches of dried H. cordata and its decoction pieces were drawn. The similarity evaluation was conducted by Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition），the common peaks were also confirmed. SIMCA-P 14.1 software was applied for principal component analysis （PCA）and partial least square-discriminant analysis （PLS-DA），and the variable importance in projection（VIP）value more than 1 was considered as a standard to screen the differential components affecting the quality of these two products ；meanwhile，the contents of 5 components such as neochlorogenic acid in both products were determined by the same HPLC method. RESULTS There were 20 common peaks in 10 batches of dried H. cordata and 10 batches of its decoction pieces with the similarity values more than 0.960. A total of 5 common peaks were identified ，which were neochlorogenic acid （peak 1）， chlorogenic acid （peak 3），cryptochlorogenic acid （peak 4），rutin（peak 7）and quercitrin （peak 11）. The results of PCA and PLS-DA showed that dried H. cordata could be distinguished from its decoction pieces obviously ；the common peaks with VIP value greater than 1 were as follows ：peak 7（rutin），peak 20，peak 5，peak 13，peak 2，peak 18，peak 3（chlorogenic acid ）， peak 14，peak 17 and peak 19. The linear range of neochlorogenic acid ，chlorogenic acid ，cryptochlorogenic acid ，rutin and quercitrin were 3.77-60.29 μg/mL（r＝0.999 7），1.40-22.42 μg/mL（r＝0.999 5），3.76-60.22 μg/mL（r＝0.999 9），2.19-35.06 μg/mL （r＝0.999 9）and 25.49-407.88 μg/mL（r＝0.999 7），respectively. RSDs of precision ，stability（24 h）and reproducibility E-mail：20190394@njucm.edu.cn tests were all lower than 3％. The average recoveries of the above components in these two products were 98.72％-101.12％ and 98.86％ -100.63％ with RSDs less than 3％（n＝9）. In dried H. cordata ，the average contents of 5 components were 0.87，0.33，0.59，0.61 and 6.17 mg/g，while the average contents were 0.42，0.11，0.26，0.23 and 3.16 mg/g in its decoction pieces ，respectively. CONCLUSIONS HPLC fingerprint and the method of content determination are stable and feasible ，which could be used for the quality control of dried H. cordata and its decoction pieces. Besides ，rutin and other components may be the differential components which could affect the quality of these two products ；the average contents of the 5 flavonoids such as neochlorogenic acid in dried H. cordata all decrease after processing.

INTRODUCTIONThe 2005 American Association for Study of Liver Diseases (AASLD) diagnostic criteria allow non-invasive diagnosis of hepatocellular carcinoma (HCC) based on their enhancement pattern but we have observed a high incidence of atypical enhancement characteristics in HCC associated with portal vein thrombosis. This study seeks to examine the radiological features of this particular subgroup.

MATERIALS AND METHODSPatients with HCC and portal vein thrombosis who underwent pre-treatment multiphasic CT imaging were drawn from a surgical database. The arterial, portal venous and delayed phase images were assessed qualitatively and quantitatively (with region of interest [ROI] analysis) for lesion hypervascularity and washout. The background enhancement of the left and right lobes of the liver was also quantifi ed by ROI analysis.

RESULTSTwenty-fi ve lesions in 25 patients were selected for analysis. Qualitative analysis showed that 10/25 (40%) lesions demonstrated arterial hypervascularity while 16/25 (64%) lesions showed washout. Ten out of 25 (40%) lesions demonstrated both arterial hypervascularity and washout. Quantitative analysis showed that the average absolute lesion enhancement from precontrast to arterial phases was 49.1 (± 17.1) HU for hypervascular lesions compared to 23.8 (± 16.6) HU for non-hypervascular lesions (P <0.01). The mean absolute enhancement of the background liver parenchyma in the arterial phase was 13.79 (± 7.9) HU for hypervascular lesions compared to 36.6 (± 30.6) HU for non-hypervascular lesions (P = 0.03).

CONCLUSIONA large proportion of HCC with portal vein thrombosis lack characteristic arterial hypervascularity, which may be secondary to compensatory increased arterial supply to the background liver. This is a potential pitfall when applying imaging criteria for diagnosis of HCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; complications ; diagnostic imaging ; Female ; Humans ; Liver Neoplasms ; complications ; diagnostic imaging ; Male ; Middle Aged ; Pattern Recognition, Automated ; Portal Vein ; diagnostic imaging ; physiopathology ; Retrospective Studies ; Tomography, X-Ray Computed ; methods ; Venous Thrombosis ; diagnostic imaging ; etiology

BACKGROUND/AIMS: Patients with irritable bowel syndrome (IBS) are characterized by abnormal central processing with altered brain activation in response to visceral nociceptive signals. The effect of electroacupuncture (EA) on IBS patients is unclear. The study is set to study the effect of EA on brain activation during noxious rectal distension in IBS patients using a randomized sham-controlled model. METHODS: Thirty IBS-diarrhea patients were randomized to true electroacupuncture or sham acupuncture. Functional MRI was performed to evaluate cerebral activation at the following time points: (1) baseline when there was rectal distension only, (2) rectal distension during application of EA, (3) rectal distension after cessation of EA and (4) EA alone with no rectal distension. Group comparison was made under each condition using SPM5 program. RESULTS: Rectal distension induced significant activation of the anterior cingulated cortex, prefrontal cortex, thalamus, temporal regions and cerebellum at baseline. During and immediately after EA, increased cerebral activation from baseline was observed in the anterior cingulated cortex, bilateral prefrontal cortex, thalamus, temporal regions and right insula in both groups. However, true electroacupuncture led to significantly higher activation at right insula, as well as pulvinar and medial nucleus of the thalamus when compared to sham acupuncture. CONCLUSIONS: We postulate that acupuncture might have the potential effect of pain modulation in IBS by 2 actions: (1) modulation of serotonin pathway at insula and (2) modulation of mood and affection in higher cortical center via ascending pathway at the pulvinar and medial nucleus of the thalamus.
Acupuncture ; Acupuncture Therapy ; Brain ; Cerebellum ; Electroacupuncture ; Humans ; Irritable Bowel Syndrome ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Neural Pathways ; Pain Perception ; Prefrontal Cortex ; Pulvinar ; Salicylamides ; Serotonin ; Thalamus

OBJECTIVETo investigate whether green tea consumption can reduce the risk of adult leukemia.

METHODSA hospital-based matched case-control study was conducted in 2005 - 2006. We recruited 107 confirmed leukemia cases and 110 inpatient controls with orthopedic disease without leukemia or other malignancy matched on gender, age and hospitals that patients stayed. Related information were gathered on quantity, duration and frequency of tea consumption, demographic characteristics, exposure to radiation and occupational hazards, medications, using a validated questionnaire by face-to-face interview. Univariate and multivariate unconditional logistic regression analysis were used to estimate odds ratios (ORs) and associated 95% confidence intervals (CIs) with SPSS 11.5 software.

RESULTSCompared with non-tea-drinkers, the OR of those who consumed green tea was 0.58 (95% CI:0.34-1.00, P< 0.05) under univariate statistical analysis. The OR was 0.52 ( 95% CI: 0.28- 0.98, P = 0.04), using logistic regression to count for age, gender, residential area, smoking, level of education, exposure to radiation, benzene and organo-phosphorus. Compared with non-drinkers, the risk of adult leukemia declined with increasing quantity, duration, and frequency of green tea consumption. Tests for trend on dose-response was statistically significant (P < 0.01).

CONCLUSIONA higher consumption of green tea seemed to be associated with a declined risk of adult leukemia. Tea consumption might be of help to human health planning projects.

Adult ; Case-Control Studies ; Humans ; Leukemia ; epidemiology ; prevention & control ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Surveys and Questionnaires ; Tea

OBJECTIVETo explore the preventive effect of etomidate-induced myoclonus by different concentrations of target-controlled infusion of remifentanil.

METHODSA total of 120 cases undergoing general anesthesia were randomly divided into 4 groups according to different concentrations of target controlled infusion of remifentanil using plasma target controlled infusion ( Minto model) , in which the target concentration was set as 1 f.Lg/L ( group A) , 2 f.Lg/L ( group B) , 3 f.Lg/L ( group C) , and 4 f.Lg/L ( group D) . Five minutes after the balance of effect compartment, induction with etomidate 0. 3 mglkg was conducted intravenously. The intensity and duration of myoclonus was recorded.

RESULTSThe incidence of etomidate-induced myoclonus was 70.9%, 33.3%, 26.7%, and 0 in groups A, B, C, and D, respectively. Along with the increase of the remifentanil concentration, the incidence of severe myoclonus gradually reduced, which was significantly lower in group B and C than in group A ( P < 0. 05). When the concentration reached 4 f.Lg/L, bradycardia and apnea appeared.

CONCLUSIONMyoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration.

Adult ; Anesthetics, Intravenous ; administration & dosage ; adverse effects ; Etomidate ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myoclonus ; chemically induced ; prevention & control ; Piperidines ; administration & dosage

OBJECTIVETo compare the clinical outcome of transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) with pedicle screw fixation on the treatment of spondylolisthesis.

METHODSOne hundred and twenty patients with spondylolisthesis who were managed in our department were retrospectively evaluated. They were categorized into TLIF group and PLIF group according to the surgical methods, with 60 cases in each group. The slippage rate, the height of intervertebral space and intervertebral foramen were measured in each patient before and after operation and were compared between the two groups correspondingly. The interbody fusion rate, JOA score and complications after operation were also determined.

RESULTSAll the 120 patients were followed up for an average of 23 months (range, 16 to 35 months). Interbody bony fusion was achieved in every case and cage excursion or subsidence occurred in not any case. JOA score was rated as good or excellent in 83.3% of the TLIF cases and in 81.7% of the PLIF cases. There were no difference between the two groups (P > 0.05). Postoperative slippage rate was significantly less than preoperative ones in both groups (P < 0.01). No difference in lost of reduction at the final follow-up was found between TLIF and PLIF groups (P > 0.05). Significant increases in the height of intervertebral space and intervertebral foramen after operation were approved in both groups (P < 0.01), but no difference in these increases was confirmed between the two groups (P > 0.05). The lost of the height of intervertebral space and intervertebral foramen at the final follow-up were also similar between the two groups (P > 0.05).

CONCLUSIONSTLIF and PLIF are good methods for the treatment of spondylolisthesis, both leading to satisfactory clinical outcomes. However, TLIF is relatively safer owing to its unilateral approach for interbody fusion.

Adult ; Aged ; Bone Transplantation ; methods ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Spondylolysis ; surgery ; Treatment Outcome

ObjectiveTo investigate the clinical types and features of chronicity of drug-induced liver injury (DILI). MethodsThe patients who were diagnosed with DILI in Beijing You′An Hospital, Capital Medical University from January 2011 to December 2013 were screened, and a retrospective analysis was performed for 84 patients with chronic DILI. The case report form was filled out for each patient, and the data were entered into a database, including demographic features, underlying diseases, types of drugs, cardinal symptoms and signs, and laboratory examinations. ResultsOf all patients, 63 (75.0%) were female. The chronicity of DILI could be divided into six clinical types according to disease progression and recovery of liver function; of all patients, 64 (762%) had a recurrent type, 4 (4.8%) had a delayed recovery type, 4 (4.8%) had a recurrent fluctuation type, 6 (7.1%) had a chronic cholestasis type, 5 (6.0%) had a type of rapid progression to liver cirrhosis, and 1 (1.2%) had a type of drug-induced autoimmune hepatitis. Among all the 84 patients, 56 (66.7%) had underlying diseases; 51 (60.7%) had DILI induced by a single drug, mainly traditional Chinese medicine (47.0%), antipyretics and analgesics (10.6%), and antitubercular agents (9.1%); as for the type of liver injury, 52 (61.9%) had hepatocyte injury, 8 (9.5%) had cholestasis, and 5 (6.0%) had a mixed type. Liver biochemistries showed abnormal results in 19 patients (22.6%). ConclusionThe chronicity of DILI can be divided into six clinical types, of which the most common type is the recurrent type, and the other clinical types include delayed recovery type, recurrent fluctuation type, chronic cholestasis type, rapid progression to liver cirrhosis, and drug-induced autoimmune hepatitis.