Objective:To explore the effects of scout scanning parameters (projection angle and tube potential) on image quality and radiation dose in chest CT and to provide guidance for the selection of scanning parameters in clinical practice.Methods:Different parameter combinations were selected to acquire the scout view of the anthropomorphic adult chest phantom. Fifteen scout views were obtained under parameter combinations of the projection angle (0/90/180 degrees), tube potential (70/80/100/120/140 kV) and tube current (25 mA). And then, chest spiral scans were performed according to the scout views. The other parameters were Assist kV, smart mA (maximum range), 80 mm detector width, 0.992∶1 pitch, 0.5 s rotation time, 330 mm scanning length, 5 mm thickness, NI (noise index) 10. The radiation dose modulation index (ASiR-V) was 30%, and the iterative level was 50%. Volume CT dose index (CTDI vol) and tube current at 4 body levels (pulmonary apex, trachea bifurcation, mammary level and diaphragmatic dome) were recorded. The thermoluminescent dosimeters (TLDs) were used to measure the organ dose of the breast glandular. Regions of interest (ROIs)were selected at the trachea bifurcation and diaphragmatic dome to calculate the contrast noise ratio (CNR). Results:The tube potential of the spiral scanning was automatically selected as 80 kV when the projection angle was 0 degree. The changing of the tube potential for the scout had little influence on the tube current at the four body levels, and the variation range was 0-2% (5/230). The tube potential in the spiral scanning was automatically selected as 100 kV when the projection angles were 90 and 180 degrees. The changing of the tube potential for the scout had a great influence on the tube current at the slice of trachea bifurcation and the variation range was from 14%(29/210)to 44%(93/210). According to the angle projection, there were statistical differences in CTDI vol( P< 0.017), organ dose of the breast glandular, and CNR at the slices of trachea bifurcation and at diaphragmatic dome ( F=13.027, 24.727, 10.630, P< 0.05). According to the tube potential in the scout scanning, there were no significant differences in CTDI vol, organ dose of the breast glandular and CNR at both levels ( P> 0.05). Conclusions:In chest CT, the influence of the projection angle in scout scanning on the image quality and radiation dose was more significant than that of the tube potential.

Objective To study the effect of three different modes of non-invasive positive pressure ventilation on cardiac indices of premature infants with respiratory distress syndrome (RDS).Method From January 2014 to October 2015,preterm infants who had RDS received intubation-pulmonary surfactantextubation in the neonatal intensive care unit of the Hospital were randomly assigned (by random number table) to three groups based on the primary mode of ventilation:nasal continuous positive airway pressure (NCPAP),bi-level positive airway pressure (BiPAP),and synchronized bi-level positive airway pressure (SBiPAP).The mean airway pressure (MAP) were about 6 cmH2O in the three groups.The level of plasma B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI),and correct QT intervals dispersion (QTcd) were monitored before and 42-54 h after non-invasive ventilation.Result There were 173 cases in our study,59 of which in NCPAP group,56 in BiPAP group,and 58 in SBiPAP group.The plasma BNP level at 42-54 h after non-invasive ventilation in the three groups were all higher than that before non-invasive ventilation [NCPAP group:(247.9 ± 137.9) ng/L vs.(182.5 ± 1 10.7) ng/L,P =0.007;BiPAP group:(258.5 ± 131.2) ng/L vs.(182.6 ± 105.0) ng/L,P ＜ 0.001;and SBiPAP group:(260.9 ± 159.7) ng/L vs.(177.5 ± 101.5) ng/L,P =0.002].After 42-54 h non-invasive ventilation,there were no significant changes of plasma cTnI level and QTcd in all the three groups (all P ＞ 0.05).The level of plasma BNP,cTnI,and QTcd among the three groups before and after 42-54 h non-invasive ventilation all showed no significant differences statistically (all P ＞ 0.05).Conclusion Longer duration (42-54 h) of non-invasive positive pressure ventilation (MAP:6 cmH2O) in preterm infants with RDS may lead to increased plasma BNP level,and may affect their cardiac function.However,it may not lead to serious myocardial damage and abnormality of ventricular repolarization.There were no significant differences in cardiac indices of premature infant with RDS among NCPAP,BiPAP,and SBiPAP group with the same MAP.

Objective To explore the application of tissue-explant technique in culturing rat submandibular gland cell(RSGC)and the characteristics of RSGC.Methods RSGCs were cultured using tissue-explant technique.The cells were purified by enzymatic digestion and differential adhesion.The cell phenotype was identified by cytokeratin-8 immunohistochemical staining.Cellular morphology was observed and photographed under inverted microscope.The cell viability and growth were determined by a double-staining procedure using FDA-PI and MTT assay,respectively.Results Cytokeratin-8 was positive stained in the immunohistochemical staining.The cell viability was more than 95%.The cell growth curve showed that RSGCs were in logarithmic phase since day 5.Conclusion Tissue-explant technique is an easy way to purify plentiful RSGC with normal functions,and it can be used in further research of tissue engineering of submandibular gland.

AIM:To determine the therapeutic efficacy of recombinant adenovirus containing hyper-interleu-kin-6 (HIL-6) and hepatocyte growth factor (HGF) (Ad-HGF-HIL-6) on acute-on-chronic liver failure (ACLF) in rats u-sing that of recombinant adenovirus HIL-6 or HGF ( Ad-HIL-6 or Ad-HGF) for comparison.METHODS:The rat model of ACLF was established and the model rats were randomly divided into model group, Ad0 group, Ad-HGF group, Ad-HIL-6 group and Ad-HGF-HIL-6 group.The sera and liver tissues were collected for biochemical, pathological and molecular bio-logical examinations.RESULTS:Compared with Ad0 group, prothrombin time ( PT) and the serum levels of alanine amin-otransferase (ALT), tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ) and high-mobility group box-1 (HMGB1) were markedly reduced in the ACLF rats treated with Ad-HGF, Ad-HIL-6 and Ad-HGF-HIL-6, and similarly, reduced he-patic damages and apoptotic activity, reduced Bax at protein level, and increased expression of Ki67 and Bcl-2 at protein levels were observed.Among them, treatment with Ad-HGF-HIL-6 showed the most significant therapeutic efficacy without obvious side effects.CONCLUSION:The therapeutic efficacy of Ad-HGF-HIL-6 is more potent than that of Ad-HGF or Ad-HIL-6 alone on ACLF rats with no significant side effects.

Objective To evaluate the accuracy of the transcutaneous bilirubin (TcB) at different sites including the chest (covered and uncovered),forehead and scapula,compared with total serum bilirubin (TSB) before and after phototherapy.Method Neonates who underwent blood test of TSB together with the average TcB at chest over 6 mg/dl from September 2015 to July 2016 in our Hospital were enrolled in our study.TcB measurements were done by the transcutaneous bilirubinometer (JH20-1 C) at the sites of the chest,forehead and scapula within 30 minutes after venous or arterious blood sampling for testing TSB after admission.An area of 2 cm diameter over the left chest was covered during phototherpy.TSB was tested immediately and within 12 ～ 24 hours after phototherapy,while TcB was measured within 0.5 hour after blood sampling at the covered sites over the left chest,right chest,forehead and scapula.IBM SPSS 20.0 software was used for data analysis.Data were compared via Pearson correlation analysis,ANOVA of repeated measurement data,student's t test and Bland-Altman analysis.Result A total of 437 data were collected from 364 neonates were enrolled in our study.Before phototherapy,the values of TcB at different sites were highly correlated and consistent with TSB (P ＜ 0.05),especially taken from the chest (the difference value of TcB and TSB-1.2 ± 2.3 mg/dl).Immediately and within 12 ～ 24 hours after the phototherapy,the values of TSB and TcB taken from the covered left chest showed the highest consistency (-1.2±2.3 mg/dl and-0.5 ± 1.6 mg/dl).When TSB exceeded 15 mg/dl before phototherapy,the difference between TSB and TcB taken from chest was 1.5 ± 1.6 mg/dl,while if TSB was below 15 mg/dl,the difference was-1.9 ± 1.9 mg/dl.They were significantly different (P ＜ 0.001).And difference between TSB and TcB taken from chest was not affected by gender gestational age,birth weight,days of birth and different measurements.When TcB taken from the covered or uncovered chest was less than the TSB threshold value of 3.3 mg/dl for phototherapyl,or the TcB of the left covered sternum lower than the threshold value of 2.6 mg/ml for cessation of phototherapy,97.5％ of the TSB would not exceed the corresponding value.Conclusion The TcB values of both uncovered chest before phototherapy and covered chest after phototherapy were highly consistent with TSB,and could be applied in the replacement of TSB in the assessment and management of neonatal jaundice.

The varicela-zoster virus(VZV) infection causes central vasculopathy,and then leads to stroke onset. This article review s the correlation betw een VZV infection and stroke onset in order to conduct a comprehensive assessment of patients w ith VZV infection, thereby reducing the risk of stroke after VZV infection.

In this study,we summarized the results from the retrospective investigation on endemic situation of schistosomia-sis that was implemented in nine provinces(autonomous region),China in 2009,demonstrated the role of these retrospective in-vestigations in accelerating the progress of schistosomiasis control in China,and clarified the great significance of the investiga-tion for summarizing the experiences for the control of schistosomiasis,and analyzing the changing patterns and affecting factors of endemic status of schistosomiasis in China. In addition,these retrospective investigations provide reliable evidence for revis-ing the Criteria of Schistosomiasis Control and Elimination,and for the more accurate and scientific assessment of the effec-tiveness of schistosomiasis control in China.

BACKGROUND:The research at home and abroad for appropriate immature myocardial cardioplegia has no breakthrough, and it may be a better mean to improve the protection effect of existing cardioplegia on immature myocardial by adding ingredients. Adenosine can reduce ischemia and neutrophil-mediated reperfusion injury, and salvia miltiorrhiza can reduce the content of ischemic myocardial lipid peroxide and increase the scavenging of myocardial cells to oxygen radical. OBJECTIVE:To investigate the protection effect of improved myocardial protection fluid containing adenosine and salvia miltiorrhiza on the heart, liver and kidney. METHODS:Sixty cases of infant open heart operation of the first time were randomly divided into three groups, 20 cases in each group. The adenosine group received the improved myocardial protection fluid added with adenosine, the combination group received the improved myocardial protection fluid added with adenosine and miltiorrhiza salvia, and the control group received the improved myocardial protection fluid in the same volume. The blood samples were taken at the time before anesthesia induction, 30 minutes after cardio pulmonary bypass beginning, 1 hour after cardio pulmonary bypass end and 24 hours after cardio pulmonary bypass end. The serum levels of the creatine kinase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, tumor necrosis factor-α, interleukin-6, interleukin-8 and interleukin 10 were detected. RESULTS AND CONCLUSION:The serum levels of the alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and creatine kinase in three groups were increased, but the control group was increased significantly (P<0.01), and there were significant differences between adenosine group and combination group (P<0.05);the levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 were significantly increased after operation (P<0.05). The levels of tumor necrosis factor-α, interleukin-6 and interleukin-8 in the control group were significantly higher than those in the adenosine group and combination group before induction and at the same time point (P<0.01);at 3 minutes and 24 hours after cardio pulmonary bypass, the level of interleukin-10 was increased in three groups, but the level of interleukin-10 in the adenosine group was significantly higher than that in the control group (P<0.01). The results indicate that improved myocardial protection fluid has great protection effect on immature myocardial, and can significantly reduce the serum levels of tumor necrosis factor-α, interleukin-6 and interleukin-8, promote the secretion of interleukin-10 that can inhibit inflammatory cytokine and can significantly reduce the inflammatory response caused by cardiopulmonary bypass. So the improved myocardial protection fluid has protection effect on important organs, such as heart, lung, liver and kidney.

Background and purpose: Postoperative chemotherapy targets the metastatic cancer in the remaining lymph nodes, but the heterogeneity in multidrug resistance (MDR) of metastatic cancer cells is a main factor affecting chemotherapeutic efficacy. Recent studies only examined the primary lesion of esophageal squamous cell carcinoma(ESCC). There is no report about heterogeneity between the primary tumor and metastases lymph node. The purpose of this study was to explore the heterogenous expression and clinical signiifcance of multidrug resistance (MDR) associated proteins in primary tumors and metastatic lymph nodes in patients with thoracic ESCC. Methods:The expressions of lung cancer associated resistance protein (LRP), P-glycoprotein (P-gp), topoisomeraseⅡ(TOPO-Ⅱ), thymidylate synthase (TS), glutathione S-transferase-π (GST-π) were examined by immunohistochemistry in primary lesions and corresponding metastatic lymph nodes in 54 patients with thoracic ESCC. The differences between expression of primary lesions and matched metastatic lymph nodes were compared and analyzed in relationship with tissue differentiation degree. Results: The discordant rates of the expression and drug resistance between primary lesions and corresponding metastatic lymph nodes in LRP, P-gp, TS, TOPO-Ⅱ and GST-π were 63.0% and 26.9%, 42.6%and 22.2%, 48.1%and 25.9%, 50.0%and 29.6%, 18.5%and 1.9%respectively. The expression of LRP showed signiifcant difference between the primary tumors and lymph nodes (P=0.026). No signiifcant differences were found for the other four proteins, and GST-πwas expressed in all patients in both the primary tumors and lymph nodes. Protein expression was not associated with degree of differentiation. Conclusion:There is evident of heterogenous expression of MDR associated proteins in metastatic lymph nodes compared to the primary tumors of ESCC. The examination of expression levels of MDR associated proteins in metastatic lymph nodes is helpful to select the postoperative rational chemotherapy plan.

Objective To observe the uhrasenographical characters of liver and spleen of residents and their changes in endearic areas of schistosomiasis japonica in Poyang Lake region.Jiangxi Province and to explore the value of ultrasonography for assessment of the morbidity of the disease.Methods All permanent residents aged above 3 years old were examined by ultrasonography and Kato-Katz method.Results The schistosome positive rates of fecal examinations decreased obviously from 16.29%in 1995 to 8.54%in 2007(P<0.01).However,the rates of hepatomegaly and splenomegaly between 1995 and 2007 were not significantly changed(P>0.05),with the rates of 8.82% and 20.33% in 1995 and 8.54% and 21.34% in 2007,respectively.The abnormal rate of portal vein diameter decreased significantly.from 32.47%in 1995 to 6.50% in 2007.The abnormal rate of liver parenehyma increased remarkably(P<0.01),from 34.85% to 51.83%.The changes of liver parenchyma Grade I showed a bidirectional trend,29.90% of them chased into Grade 0(normal image on ultrasonngraphy),and 34.02% changed into Grade 2 and above.The abnormality of various indices of uhrasonography examinations were related to age,occupation and schistesome infection status.Conclusions Ultrasonography can show the damages of liver and spleen of patients infected with Schistosoma japonicum directly.but it is necessary to study further on the sensitive indices that reflecting early pathological changes and the best combination of the indices for the assessment of schistosomiasis-related morbidity.