Atherosclerosis is a chronic inflammatory vascular disease developing from early fatty streaks to highly rupture-prone unstable plaques.Many cellular and molecular events are involved in each step.With the development of targeting probe technology,molecular magnetic resonance imaging techniques are expected to revolutionize the treatment strategies of atherosclerosis in the near future.Many desirable molecular probes targeting various components of plaque have emerged in recent years.This article reviews the molecular magnetic resonance imaging techniques of atherosclerosis and their application.

ObjectiveTo investigate the effects of vascular endothelial growth factor (VEGF) and dexamethasone on mRNA expressions of surfactant protein B (SP-B) and transforming growth factor-β1 (TGF-β1) of type Ⅱ alveolar epithelial cell (AECⅡ). MethodsAECⅡ were isolated and purified from fetal rat lung tissues,then cultured with different dose of VEGF (25,50 and 100 ng/ml) and dexamethasone (25,50,100 and 200 nmol/ml).The mRNA levels of SP-B and TGF-β1 were detected by real-time quantitative polymerase chain reaction (RT-PCR) and expression of TGF-β1 protein was detected by immunocytochemistry.ANOVAor q-test wasappliedtocompare the difference among groups.ResultsCompared with control group,SP-B mRNA levels in 25 ng/ml VEGF group and 25,50,100 and 200 nmol/ml dexamethasone groups were higher (13.500±3.172,3.547±0.690,5.219±0.782,3.493±0.335,and 3.981 ± 1.133 vs 1.001 ± 0.059,q=-5.286,-4.943,- 7.228,- 9.906 and - 3.525 respectively,P＜0.05) ; TGF-β1 mRNA expression of 25 ng/ml VEGF group,50,100 and 200 nmol/ml dexamethasone group was lower (0.451 ± 0.078,0.579±0.019,0.422 ± 0.020 and 0.769 ± 0.025 vs 1.019±0.226,q=4.110,3.356,4.551 and 1.901 respectively,P＜0.05) ; other groups had no significant differences compared with control group (P＞0.05).Immunocytochemistry showed that the positive rate of TGF-β1 expression in 25 ng/ml VEGF,50,100 and 200 nmol/ml dexamethasone group was 23％,26％,22％ and 29％,respectively,while in the control group,the expression of TGF-β1 was positive in most of the AECⅡ (80％).ConclusionsBoth VEGF and dexamethasone could increase the expression of SP-B at mRNA level at appropriate concentrations.At the same time,the expression of TGF-β1 is inhibited.It is suggested that both VEGF and dexamethasone might increase the mRNA expression of SP-B by inhibiting the expression of TGF-β1.

OBJECTIVE To investigate the drug resistance of Gram-positive organisms infection in our hospital and offer scientific basis for reasonable usage of antibiotics.METHODS The 318 strain organisms were isolated from the specimens of Aikang Hospital since Jan 2001 to Dec 2005.Gram-positive organisms were isolated from the specimens by the routine methods.The drug susceptivity was tested by K-B method.We got the results by 1999 standard of NCCLS.RESULTS Among the 318 strains,Staphylococcus aureus were 128 strains,40.3% of the total organisms;coagulase-negative S.aureus were 69 strains,21.7% of the total organisms;Enterococcus faecalis were 67 strains,21.1% of the total organisms;meticillin-resistant S.aureus(MRSA) were 32.8%;Meticillin-resistant coagulase-negative S.aureus(MRCNS) were 29.0%.The results of drug sensitivity test showed the drug resistant rate of Gram-positive strains for commonly used antibacterials was lower than in Shenzhen,Beijing,Shanghai,Wuhan,Guangzhou and other cities.CONCLUSIONS We should attach in our city importance to supervise the drug-resistance of Gram-positive organism,and preclude dissemination and epidemic of drug resistant strains.

OBJECTIVE To study the distribution and characteristic about drug resistance of extended-spectrum ?-lactamases(ESBLs) producing Klebsiella pneumoniae and Escherichia coli for guiding the clinical drug using. METHODS Using K-B agar diffusion method and confirmed test to detect the drug resistance and distributions of ESBLs-producing K.pneumoniae and E.coli. RESULTS Among 582 K.pneumoniae and E.coli isolates,128(22%) were ESBLs-producing strains.For E.coli,the ratio was 17.5%,while K.pneumoniae was 28.3%.The sensitive rate of K.pneumoniae to imipenem was 100%. CONCLUSIONS ESBLs-producing K.pneumoniae and E.coli are the most common species causing infections,and imipenem is the best choice.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

ObjectiveTo evaluate the clinical effects of early pain intervention provided by an acute pain service team on the efficacy of postoperative patient-controlled analgesia ( PCA).MethodsOne thousand four hundred and sixty-seven patients receiving postoperative PCA in November and December 2011 were enrolled in this study.Patients were excluded from the study if they were ＜ 12 yr,unconscious or uncoorperative.The patients were divided into control group (group C,n =725) and intervention group (group 1,n =742).Group 1 received preoperative systematic pain education on the significance and conect use of PCA including pharmacology of analgesic (sufentanil 100 μg in normal saline 100 ml) by an acute pain service team made up of anesthesiologists and nurses specializing in pain management.The education was repeated immediately before operation and when the patients were discharged from recovery room.While in grup C the correct use of PCA was explained routinely before operation by anesthesiologists and nurses taking care of the patients.The incidence of incomplete analgesia and adverse reactions and patient' s satisfaction were rated.ResultsThe incidence of incomplete analgesia was significantly lower and the patient's satisfaction higher in group 1 than in control group.There was no significant difference in adverse reactions between the two groups.ConclusionEarly pain intervention provided by an acute pain service team is effective in improving the efficacy of postoperative PCA and patient's satisfaction.

Objective To evaluate the prostate imaging reporting and data system(PI-RADS) version 1 and version 2 for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (MpMRI) in a consecutive cohort of patients with magnetic resonance imaging/transrectal ultrasonography (MRI-TRUS) fusion-guided biopsy.Methods 30 suspicious lesions including 15 prostate cancer and 15 non cancer at 3.0 T MpMRI were scored according to the PI-RADS V1(≥ 3 scores in at least one MRI sequence)system before MRI-TRUS fusion guided biopsy and correlated to histopathology results.PI-RADS V2 and Likert scores were determined retrospectively,diagnostic accuracy was determined using receiver operating characteristic curve analysis.Results The PI-RADS score of the dominant lesion was significantly higher in patients with PCa compared to patients with negative histopathology (PI-RADS V1:12.10±2.60 vs 7.47±1.98,P<0.05;PI-RADS V2:4.21±1.18 vs 2.79±0.92,P<0.05);Using a Likert score cut-off ≥ 4,a sensitivity of 73.7%,a specificity of 78.9%, positive predictive value of 77.74% and a negative predictive value of 75.00% (AUC=0.778,95%CI:0.63-0.93), a PI-RADS V1 cut-off ≥ 10,a sensitivity of 73.7%,a specificity of 94.7%,positive predictive value of 93.29% and a negative predictive value of 78.26% (AUC=0.911,95%CI:0.82-1.00) and PI-RADS V2 cut-off ≥ 4,a sensitivity of 57.9%, a specificity of 100%, positive predictive value of 100% and a negative predictive value of 73.37% (AUC=0.837,95%CI:0.70-0.97) were achieved.Conclusion The described fusion system is dependable and efficient for targeted MRI-TRUS fusion-guided biopsy.MpMRI PI-RADS scores combined with a novel real-time MRI-TRUS fusion system facilitate sufficient diagnosis of PCa with high sensitivity and specificity,PI-RADS scores appears to be the preferable method for the evaluation of prostate cancer than Likert score, while V2 does not perform better than V1.

Objective To compare the difference of three methods testing the antibiotic susceptibility of mucoid Pseudomonas aeruginosa in order to provide accurate and reliable antibiotic susceptibility result for clinic.Methods A total of 630 mucoid Pseudomonas aeruginosa were collected from Linyi People′s Hospital during January 2015 to December 2016.They mainly come from respiratory medicine and the most common specimen source was sputum.All specimens were examined in 2 h.The strains isolated from the same patient were discarded.Antibiotic susceptibility was tested by the automatic microorganism analyzer VITEK2 compact, E-test, which was reference method, and K-B disk.The results of three methods were analyzed and compared by χ2 test.Results The result of E-test showed that antibiotic sensitivity of 630 mucoid Pseudomonas aeruginosa was above 52.7% except for Cefepime (39.2%).The result of K-B disk was compared with E-test, the antibiotic sensitivity of mucoid Pseudomonas aeruginosa to imipenem (72.4% vs 52.7%) and amikacin (48.6% vs 71.1%)had significant difference (χ2=8.283 7 and 10.533 8, P<0.05).The result of VITEK2 compact showed that the antibiotic susceptibility of mucoid Pseudomonas aeruginosa to imipenem(70.8% vs 52.7%), cefepime(60.8% vs 39.2%), gentamicin (87.6% vs 74.1%)and levofloxacin(81.3% vs 65.4%) was significant higher than the result of E-test (χ2=6.935 2,9.331 2,5.885 6 and 6.466 5, P<0.05).For tobramycin, piperacillin/tazobactam and ciprofloxacin, the result of three methods is more consistent.Compared to VITEK2 compact, the consistency between K-B disk and E-test was higher.The rate of very major error and major error were between 0.0%-4.8% (Amikacin 12.2%) and minor error was 4.6%-20.3%.Conclusions The drug sensitivity of mucoid Pseudomonas aeruginosa is different between various methods.The result of K-B disk and E-test using blood MH is more reliable than VITEK2 compact.

Objective Because of local infiltrated growth and spread,the operative resection of hilar (cholangiocacinoma) is very difficult. Recently,combined extended hepatectomy and vascular resection had been performed for treatment of hilar cholangiocarcinoma and has greatly increased the resection rate and survival rate.However, it is associated with high operative morbidity and mortality. The aim of this study is to explore a reasonable hepatic resection strategy, that is safe and beneficial for the patient. Method Sixteen (consecutive) cases of hilar cholangiocarcinoma with involvement of hilar vessels have been treated in our hospital since 1977. En bloc resection of the hilar tumor that included hepatic segment I,IV and involved blood (vessel), as well as hepato-duodenal ligament skeletonization was performed in 15 patients. Results All 15 cases were successfully operated on with a resection rate of 93.8%, and 12 cases with R_0 resection. The operative mortality and in-hospital mortality rate were 0. Temporary bile leak and abdominal infection (respectively) developed in 1 patienteach,with an overall morbidity of 13.3%,and both were cured by non-(operative) therapy. No case of liver failure occurred. Follow up showed the median survival was 22 months and 7 are still alive. Conclusions (1)The resection rate and survival rate for hilar cholangiocarcinoma could be improved by combination of liver and hilar vascular resection.(2)Hilar cholangiocarcinoma mainly spreads to the medial segment(S4) and caudate(S1), and these segments need to be resected in the combined (operation).(3)Although resection of the middle part of liver takes little more time than hemi-hepatectomy and trisegmentectomy, it could preserve more liver parenchyma and reduce postoperative morbidity (such as liver failure) and mortality rates.(4)The resection of the hilar blood vessel involved by tumor was necessary to improve the resection rate and cure rate. Reconstruction of the blood vessel was made selectively by taking the circumstances into consideration.

Objective:To study the effiacious based on our experience of precise anatomical hemi-hepatectomy strictly guided by the middle hepatic vein (MHV) for regional to treat intrahepatic hepatolithiasis.Methods:A retrospective analysis was conducted on the data of 47 patients with regional hepatolithiasis treated with hemihepatectomy from July 2015 to July 2019 at the Department of Hepatobiliary and Pancreatic Surgery, The University of Hong Kong-Shenzhen Hospital. The study included 15 males and 32 females, aged (42±15) years. The exposure and preservation of the MHV was included in the precision surgery group ( n=26), and failure to fully expose the MHV or damage to the MHV was included in the control group ( n=21). The operation time, intraoperative blood loss and other surgical data and postoperative complications of the two groups were compared. Results:All patients successfully completed the operation. There was no patient who developed liver failure, and no patient died 90 days after the operations. The operation time (5.2±1.8) h and intraoperative blood loss (620.5±450.8) ml of the precision surgery group were not significantly different from those of the control group (4.9±2.3) h and intraoperative blood loss (760.5±540.2) ml ( P>0.05). A total of 19 patients (40.4%) (7 in the precision surgery group and 12 in the control group) developed 36 post operative complications of various types. The postoperative complication rate in the control group was higher than that in the precision surgery group [47.6%(10/21) vs 19.2% (5/26)], the difference was significant ( P<0.05). All 47 patients were followed-up for 6 to 30 months. For postoperative long-term complications: 5 patients in the control group had residual stones, biliary tract infection, liver abscess, and biliary-enteric anastomosis stenosis with recurrence of stones, and only 2 patients in the precision surgery group were found to have residual stones and biliary-enteric anastomotic stenosis. Stone recurrence, (the incidence of long-term complication) in the control group was significantly higher than that in the precision surgery group [23.8% (5/21) vs 7.7% (2/26)], ( P<0.05). Conclusions:Precise anatomical hemi-hepatectomy strictly guided by MHV for regional hepatolithiasis could more fully remove stones and lesions, and reduced the rate of stone recurrence. It was safe and feasible with favorable efficacy.