Objective To evaluate the influencing factors on image quality and the value of clinical application of coronary artery angiography with 16-slice spiral CT.Methods 16-slice spiral CT angiography was performed in 31 suspected coronary heart disease(CHD).All patients were examined in ordinary scanning (slice 3 mm) and coronary artery scanning (slice 1 mm)with the technique of retrospective electrocardiography gating,and multiplanar reconstruction(MPR),maximum intensity projection(MIP) and volume reconstruction technology(VRT) were done.The showing rate of coronary arteriae,the detecting rate of CHD and the influencing factors on image quality were evaluated by CT.Results 16-slice spiral CT could clearly show RCA1,RCA2,LAD1,LAD2,,LCX1.The image quality was affected by heart rate,breath movement and much calcification in artery,etc.Conclusion 16-slice spiral CT is of significant value in screening and diagnosing coronary artery disease.

This review summarizes the research related to early rehabilitation after cardiac surgery, Including the methods, programs, evaluation and effects of rehabilitation.It is proposed that individualized early rehabilitation after cardiac surgery should be provided; the effect of early rehabilitation needs to be further explored; future research should focus on the medium and long-term effects of rehabilitation.

OBJECTIVETo evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.

METHODSFifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.

RESULTSAfter hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).

CONCLUSIONEA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

Acupuncture Analgesia ; methods ; Adolescent ; Adult ; Aged ; Anesthesia, General ; Arteries ; Blood Pressure ; Electroacupuncture ; methods ; Endoscopy ; Female ; Gastric Mucosa ; surgery ; Heart Rate ; Humans ; Hypotension, Controlled ; Interleukin-1 ; Interleukin-6 ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; Young Adult

Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.

To observe the effect of Ligusticum wallichii-containing serum on the expressions of Toll-like receptor 4 and myeloid differentiation factor 88 in hepatic stellate cells. Clean-grade SD rats were randomly divided into 5 groups and orally given L. wallichii decoction, colchicine and normal saline for 7 d to prepare L. wallichii-containing serums. Except for the blank group, all of the remaining groups were stimulated with LPS 1 mg x L(-1) for 24 h. After being intervened, the L. wallichii-containing serums were cultured in 5% CO2 incubator at 37 degrees C for 24 hours. The expression of TLR4 and MyD88 were detected by RT-PCR and Western blot. After HSC was stimulated with LPS, TLR4 and MyD88 mRNA and protein expressions were significantly higher than the blank control group (P < 0.01). After being intervened with L. wallichii-containing serum, TLR4 and MyD88 mRNA and protein expressions were notably lower than the model group (P < 0.05 or P < 0.01). In conclusion, L. wallichii-containing serum could regulate the TLR4 signaling pathway and show the anti-fibrosis effect by inhibiting the expression of TLR4 and MyD88 in LPS-induced HSCs.
Animals ; Female ; Hepatic Stellate Cells ; drug effects ; metabolism ; Ligusticum ; Lipopolysaccharides ; pharmacology ; Liver Cirrhosis, Experimental ; drug therapy ; Myeloid Differentiation Factor 88 ; genetics ; physiology ; Phytotherapy ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; genetics ; physiology

Objective To explore the surgical indication,diagnosis and treatment of suspected pancreatic cystic lesions.Methods To-tally 341 patients were admitted into our hospital because of pancreatic cystic lesions from October 2010 to October 2015.Except the 278 confirmed cases,the clinical data of the rest 63 patients with vague diagnosis were retrospectively analyzed.Results The surgical indication of pancreatic cystic lesions were:the lesion diameter was more than 4 cm;the imaging diagnosis was malignant;the lesion was combined with obvious clinical symptoms which can not explain with other diseases;there were asymptomatic pancreatic cystic lesion and main pancre-atic duct dilation without surgical risk factors;the follow-up showed that the desease is in development.Endoscopic ultrasonography guided fine needle aspiration is a useful supplement for more accurate diagnosis.However,it is an uncertain diagnostic value currently.Conclusion Diameter of lesion,uncertain imaging diagnosis,severe abdominal symptoms,obstructive jaundice and abnormal serum tumor markers are the surgical indication for patients.

Objective To investigate the effect of comprehensive intervention therapy of reducing fat on sex hormone and growth hormone(GH) in adolescent girl students with simple overweight and obesity.Methods Girl students with simple obesity were accepted a comprehensive measures composed of aerobicexercise,reasonable diet,behavior modification for 10 monthes,and their sex hormone and GH were detected and analyzed before,during and after test respectively.Results GH and estradiol(E_2) levels were significantly lower in obese subjects than those in normal subjects,but the level of testosterone(T) was highter,and GH and E_2 were increased obviously after reducing fat.Level of T decreased significantly(P

Objective To investigate the feasibility of low-c oncentration iso_osmolar contrast agent together with low tube voltage and iterative reconstruction algorithm in rabbit liver computed tonography (CT) perfusion imaging.Methods A total of 15 bealthy New Zealand rabbits were scanned twice of liver CT perfusion scans each with 24 hours interval.The first scan (routine group) was acquired at 100 kV and 100 mAs with ultravist (370 mg/ml),while the second (double low group) was acquired at 80 kV and 100 mAs with iodixanol (270 mg/ml) at 24 hours after the first scan.The obtained images were reconstructed with filtered back projection (FBP) and adaptive iterative dose reduction (AIDR-3D)algorithms in the controlled and experimental groups,respectively.The perfusion parameters including hepatic artery perfusion(HAP),portal vein perfasion(PVP),hepatic perfusion index(HPI),and total liver perfusion(TLP) and image quality as image quality score,average CT value of abdomen aorta,signalto-noise ratio(SNR),carrier-to-noise ratio(CNR),and figure of merit(FOM) were compared used pair ttest or Mann-Whitney U-test between the two groups wherever appropriate.The effective radiation dose and iodine intake were also recorded and compared.Results The image quality and perfusion parameters had no significantly different between the two groups except for FOM.The effective radiation dose and iodine intake were 38.79％ and 27.03％ lower in the double low group.Conclusions Low concentration iso _osmolar contrast agent (iodixanol,270 mg/ml) together with low tube voltage (80 kV) helps to reduce radiation dose and iodine intake without compromising perfusion parameters and image quality in liver CT perfusion imaging.

Objective:To study the effect of different dose of persicae semen extract extract(PSE) to barrier function of the intestinal mucous membrane and immunologic function in acute pancreatitis rats.Methods:A total of 48 rats were divided into model control group,low dose,medial dose and high dose PSE groups,and there were 12 rats in each group.Another 12 rats were Sham-operation group.After anesthesia recovery,rats in low dose,medial dose and high dose PSE groups respectively received PSE 0.12 g/kg,0.248 g/kg and 0.36 g/kg,and rats in Sham-operation group and model control group receive isovolumetric distilled water,once per 6 h,4 times in 24 hours.All rats were anesthetized by 10%chloral hydrate after in 24th hour after dosing.Thorax and enterocoelia were opened; 5 ml of blood were respectively drawed to EDTA-anticoagulation tube and un-anticoagulation tube from aorta abdominalis.CD4+, CD8+and Treg cells were determined by direct fluorescent-labelded flow cytometry.IgA, IgG and IgM were determined by immunoturbidimetry.Serum amylase was determined by EPS-G7 substrate,D-lactic acid was determined by enzymology, and serum diamine oxidase was determined by active ration of colorimetry method.Pathological examination of small intestine mucous membrane tissue was taken after HE staining.sIgA in small intestine was determined by radioimmunoassay.mRNA of TLR4 and NF-κBp65 in small intestine tissue was determined by RT-PCR.Results:(1) Serum amylase,D-lactic acid and diamine oxidase in medial dose and high dose PSE groups were significantly decreased ( P<0.01 ) , and sIgA in small intestine was significantly increased ( P<0.01).These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(2) CD4+and CD4+/CD8+in medial dose and high dose PSE groups were significantly increased(P<0.01),and CD8+,Treg cells were significantly decreased(P<0.01) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(3) IgA,IgG and IgM in medial dose and high dose PSE groups were significantly decreased(P<0.01) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups(P<0.01).(4) Small intestine mucous membrane tissue in Sham-operation group was not damaged significantly,but that in model control group was damaged significantly.Small intestine mucous membrane tissue in low dose PSE group was similar to that in model control group,and damage in medial dose and high dose PSE groups was decreased significantly.( 5 ) mRNA of TLR4 and NF-κBp65 in small intestine tissue in medial dose and high dose PSE groups were significantly increased ( P<0.01 ) compared with those in low dose PSE group.These indicators were significantly different in medial dose and high dose PSE groups ( P<0.01 ).Conclusion: PSE has protective effect to barrier function of the intestinal mucous membrane,and significantly improve the immunologic function.

Objective To observe the levels of serum leptin in Gaves disease(GD)and thyroiditis(HT)Datients and to discuss the immunological role of leptin in the pathogenesis of autoimmune thyroid disease(AITD).Methods 102 newly diagnosed female AITD patients were divided into 3 groups:GD hyperthyroid group,HT hypothyroid group and subclinical hypothyroid group.Age,sex and BMI-matched 27 euthyroid,healthy subjects served as controis.The levels of FT3,FT4 and sTSH were determined by immunofluorometrie assay.ELISA kit was aDplied to measure the levels of serum leptin.Results Serum FT3 and FT4[(19.74±15.39),(78.25±58.68)pmol/L]levels of GD hyperthyroid patients were obviously higher than those of the controls[(4.87±0.25),(15.96±3.15)pmol/L,P＜0.01],but serum sTSH and leptin levels[(0.15±0.08)mU/L,(8.73±1.92)μg/L]were obviously lower than those of the controls[(3.81±0.19)mU/L,(12.38±3.51)μg/L,P＜0.01or＜0.05].Serum FT3 and FT4[(3.36±0.26),(6.95±3.29)pmol/L]levels of HT hypothyroid patients were obviously lower than those of the controls(P＜0.05),but serum sTSH and leptin levels[(45.48±35.83)mU/L,(17.17±3.82)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Serum FT3 and FT4[(4.67±0.60),(14.87±2.14)pmol/L]levels of subclinical hypothyroid patients had not statistical difference comparing with those of the controls(P＞0.05),but serum sTSH and leptin levels[(13.67±8.66)mU/L,(16.25±3.67)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Conclusions Leptin might have an immuoregulation role in the pathogenesis of AITD.In addition,serum levels of leptin in AITD is also influenced by many other related hormones.