Objective To evaluate the dual blood supply of lung adenocarcinoma and squamous cell carcinoma using dualinput perfusion CT.Methods A total of 40 patients confirmed with lung cancer pathologically underwent CT perfusion (CTP) scanning.The pulmonary flow (PF),bronchial flow (BF),perfusion index (PI,PI=PF/[PF+BF])and tumor volume,location were measured and recorded by 2 experienced radiologists.The differences in CTP parameters between lung adenocarcinomas and squamous cell carcinomas,the central lung cancers and peripheral lung cancers were analyzed.The correlation between the tumor volume and CTP parameters was analyzed.Interobserver agreements were assessed with intraclass correlation coefficient (ICC).Results The average of PF,BF and PI of all 40 cases was (54.26± 21.07)ml/ (min · 100 ml),(64.41±22.06)ml/(min · 100 ml) and (43.38±16.07)％,respectively.Tumor histology was consistent with adenocarcinomas in 23 cases and squamous cell carcinomas in 17 cases,lung adenocarcinomas showed lower PI than that of squamous cell carcinomas (t=-2.196,P=0.034).There were 17 peripheral lung cancers and 23 central lung cancers,and the PI of the peripheral lung cancers was higher than that of the central lung cancer (t=2.305,P=0.027).No statistically significant differences were found for BF and PF between two types of lung cancers and central lung cancers and the peripheral cancers (all P＞0.05).Tumor volume was negatively associated with PI (r =-0.39,P=0.01).Good agreement was found between the two observers,the ICC for BF,PF and PI was 0.97,0.93 and 0.91,respectively.Conclusion Dual-input CTP technique can be used to evaluate the differences of blood supply between different pathological types and locations of lung cancer,with PI depending both on tumor size and location.

Objective Using 7.0 T diffusion tensor imaging(DTI) to study myocardial fibers character in isolated rats heart in aspect of water molecular diffusion, myocardial mechanics and microstructure. Methods Fixed male rats heart (n=10) underwent DTI and the myocardial structures were quantitatively measured by Diffusion Toolkit and Matlab. The characteristic of myocardial fibers arrangement was observed and FA values and ADC values of myocardial fibers, myocardial fibers density and length, mean helix angle of left ventricular were calculated as well. Mean helix angle of anterior wall, ventricular septum, lateral wall and posterior wall of epicardium and endocardium were compared by using one?way ANOVA. Results The SD rats' myocardial fibers appeared in compact and inerratic distribution from epicardium to endocardium. Compared with HE staining, regular direction and arrangement in fibers were showed in myocardial fibers tracer map and tensor map in papillary muscle plane. Quantitative analysis showed that ADC value of SD rats' myocardial fibers was (9.6 ± 3.6) × 10-4 mm2/s, FA value was 0.80 ± 0.04, myocardial fibers density was (981±24) tracks/mm3 and myocardial fibers length was (6.18±1.71)mm. Mean helix angle of left ventricular epicardium to endocardium ranged from-81.37° to 0° and then gradually change to 82.83° . There were no significant differences in mean helix angle of anterior wall, ventricular septum, lateral wall and posterior wall of epicardium and endocardium, respectively (F=2.25, 0.40, P>0.05). Conclusions This study shows that DTI is an effective method to quantitatively measure the characteristics of myocardial fibers. This study provides useful information for further study of myocardial fibers in heart disease models.

Objective To examine the correlation between end-tidal carbon dioxide (PetCO2) and arterial CO2 (PaCO2) among patients admitted in neurosurgical intensive care unit (NICU) and the factors affecting the PaCO2-PetCO2 [P (a-et) CO2].Methods Thirty-two intubated or cut-trachea patients who presented in the NICU were enrolled.Arterial blood gas test was done at seven every morning,and values of PetCO2 were compared with simultaneously recorded PaCO2.The normal gap of P (a-et) CO2 was defined as-5 mmHg to 5 mmHg.Concordance between PaCO2 and PetCO2 was analyzed using the Bland-Altman plot.Parameters between the normal and high P(a-et) CO2 groups were compared to identify the factors affecting the P(a-et) CO2,including Glasgow Coma Scale(GCS),blood pressure (BP),heart rate (HR),respiration rate (RR),body temperature (BT),and pulse oxygen saturation (SpO2).Results Allvalues of PaCO2 and PetCO2 were in accordance with normal distribution (r =0.668,P ＜ 0.01) and concordance between PaCO2 and PetCO2 was 69.8％.Patients who had high P(aet) CO2 showed lower initial GCS,lower instant GCS,BT,as well as pH and higher actual bicarbonate (AB) and PetCO2 than the patients with normal P (a-et) CO2.Correlation between PaCO2 and PetCO2 rapidly declined when positive end expiratory pressure(PEEP) was greater than 5 mmH2O(r =0.229,P ＜ 0.01).Conclusions PetCO2 correlates well with PaCO2 and appears to be a useful monitor of respiratory function of the patients consecutively.Initial GCS,BT,AB and PEEP have an impact on P(a-et) CO2,so those factors should be considered when attempting to monitor the hyperventilation with PetCO2.

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

Objective To evaluate whether the gastroesophageal reflux disease (GERD) questionnaire (GerdQ) symptom score could reflect the acid exposure indicated by 24-hour esophageal pH monitoring in patients with GERD, and to further validate the clinical application value of GerdQ.Methods From November 2008 to March 2010, 134 GERD patients from outpatient department with heartburn and acid reflux symptoms were enrolled.All the patients had undergone endoscopy examination, 24-hour esophageal pH monitoring and GerdQ scoring.According to 24-hour esophageal pH monitoring result, acid exposure group and none acid exposure group was divided by the percentage of time that pH was lower than 4 over 4.2% or DeMeester score over 14.72, the difference of GerdQ score was assessed.The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to DeMeester score and the percentage of time that pH was lower than 4 as the gold standard.With SPSS 17.0 statistical software, the ratio was compared with the u test and Chi-square test, comparison between groups with t test.Results The BMI of acid exposure group was higher than that of none acid exposure group(t= 2.365, P= 0.019).The GerdQ score of acid exposure group (8.51± 2.34) was significantly higher than that of none acid exposure group (6.67 ± 2.79), the difference was statistically significant (t = 4.002, P = 0.000) .ROC curve was drawn according to DeMeester score over 14.72 as gold standard; the area under curve (AUC) was 0.70.When the critical value of GerdQ score was 7.5, Youden index was up to 0.3365, the sensitivity of diagnosis was 0.6909 and specificity was 0.6454.The percentage of time that PH was lower than 4 over 4.2% as the gold standard, the AUC of GerdQ score was 0.663.When the critical value of GerdQ score was 7.5, Youden index was up to 0.2790, the sensitivity of diagnosis was 0.6600 and specificity was 0.6190.Conclusions GerdQ score greater than 7.5 can better reflect acid exposure at the lower esophageal.There is stronger association between GerdQ score with the DeMeester acid exposure score over 14.72 than with the percentage of time that pH lower than 4 over 4.2% as the critical value for acid exposure.Obesity may aggravate the transient lower esophageal sphincter relaxation leading to occurrence of GERD symptoms.

The chromatographic fingerprint was established by eluting with the mobile phase consisted of acetonitrile and 0.2% formic acid water on an Agilent TC-C18 (2) column (4.6 mm x 250 mm, 5 microm). Six chromatographic peaks were identified by HPLC-MS/MS method. Ten batches of Glycyrrhizea Radix et Rhizoma Praeparata Cum Melle were determined, and the similarity was arranged from 0.72 to 0.99. Good precision, stability and repeatability were obtained, and this study provides a reference for the quality control of Glycyrrhizea Radix et Rhizoma Praeparata Cum Melle.
China ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Glycyrrhiza uralensis ; chemistry ; Mass Spectrometry ; Quality Control ; Rhizome ; chemistry

Objective To study the attentional deployment strategy of emotion regulation and its processing mechanisms in alexithymia.Methods 21 alexithymia subjects and 22 normal subjects completed attentional deployment task.The reaction time(RT) and accuracy were recorded automatically and the event-related potentials (ERPs) were recorded by neuroscan system.Results ①From the behavioral results,the differences of RT and accuracy to neutral pictures ((1840.17±204.44) ms vs (1845.17±252.97) ms;(0.859±0.073) vs (0.884±0.068)) and negative pictures ((1888.94±200.09) ms vs(1890.38±263.72) ms);(0.845±0.088) vs (0.845±0.091)) in calculation task between two groups were not statistically significant(all P＞0.05).The differences of RT and accuracy in emotion task were not statistically significant(P＞0.05).②In RT and accuracy,the task main effects were statistically significant(F(1,42) =637.40,P＜0.01;F(1,42)=15.00,P＜0.01),the emotion main effects were statistically significant (F(1,42)=30.23,P＜0.001;F(i,42)=47.87,P＜0.01),the interaction effects of task and emotion were statistically significant(F(2,41) =5.20,P＜0.05;F(2,41)=6.01,P＜0.05).③The differences between two groups in P3 amplitude induced by neutral pictures and negative pictures in calculation task were not statistically significant(P＞0.05).P3 amplitude induced by negative pictures were siguificantly greater than those induced by neutral pictures in emotion task((-0.138±0.463) μV vs (0.789±0.541) μV).Conclusion The attentional deployment can effectively regulate the negative pictures processing and occur in the late stage of the picture processing.No attentional deployment defects in alexithymia.

Objective To evaluate the value of increased threshold of SUVmax and delayed imaging on diluted and filled bladder for improving the detection of bladder cancer with 18F-FDG PET/CT.Methods From July 2007 to October 2012,18 F-FDG PET/CT was performed on 63 suspected or treated (with bladder preserved) bladder cancer patients (55 males,8 females,average age 69.1 years).After routine imaging,all patients were given 1 500-2 000 ml of water orally three times and voided three times.Then they underwent delayed pelvic imaging at a full bladder status.The routine images were reanalyzed with increased SUVmax threshold (from 6-8 to 8-20).The final diagnosis was confirmed by pathology or follow-up (＞6 months).The differences of SUVmax in urine,18 F-FDG metabolism in lesions between routine and delayed imaging were compared.Paired t test was used to compare their differences.Results The SUVmax of urine on routine and delayed imaging was 15.11±11.11 and 4.73±2.00 respectively (t=4.15,P＜0.01).Among the 63 patients,there were 15 malignant and 3 benign cases confirmed by pathology,and 45 patients without obvious abnormality during follow-up.All 18 cases were detected by 18F-FDG PET/CT including the 3 benign false positive cases (2 were positive by CT though negative by PET,and 1 FDG-avid cystitis).All 15 true positive cases were confirmed as primary or recurrent bladder carcinoma and 1 false positive case as inflammation.The detection rates of early imaging with routine and increased display threshold of SUVmax were 18.8％(3/16) and 43.8％(7/16),respectively.Conclusion Increased SUVmax threshold for display and delayed imaging with diluted urine under full bladder status could effectively improve the detection rate of primary or recurrent bladder cancer with 18F-FDG PET/CT.

BackgroundFlap creation is one of the most important steps during laser in situ keratomileusis (LASIK). As the microkeratome blade technology is developing, the accuracy, uniformity and reproducibility of corneal flaps created by the microkeratome blade are of high clinical concern. ObjectiveThe aim of this trial was to compare the features of corneal flaps created using the Moria M2 microkeratome 110 μm-knife with regular blade versus the Med-Logics O blade. MethodsA pilot and prospective study was designed. Two hundred and four eyes of one hundred and two patients were enrolled in this clinical trial. The patients were divided into the Moria M2 microkeratome 110 μm-knife with Med-Logics 0 blade group ( 110-0 group) ( 102 eyes) and Moria M2 microkeratome with 110 μm-knife with regular blade group (110 group) (102 eyes),with the matched demography. Fourier-domain optical coherence tomography ( RTVue OCT) was used to measure flap thickness using 28 settings on the 204 corneas at one week postoperatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results There was no statistically significant difference in uncorrected visual acuity and the mean spherical equivalent between the 110-0 group and 110 group ( Z =-0. 375,P =0. 708 ; u =0. 056, P =0. 956 ) one week after LASIK. The mean flap thickness of the 110-0 group was considerably thinner than that of the 110 group ( 133.28+15.41μ m versus 142.81 ±10. 07μm) ( u =-5. 227,P＜0. 001 ). The corneal flaps in both the 110-0 group and in 110 group showed a meniscus shape. The nasal flap thickness of the right eyes was not evidently different from that of temporal ( P＞0. 05 ) , but in the left eyes, nasal flap thickness was obviously thicker than the temporal flap thickness (P＜0. 05) in both groups. The mean deviation between the achieved and attempted flap thickness ( 130 μm) were (17.46±2.28) μm in the 110-0 group and ( 16. 82±6. 12) μm in the 110 group, showing a significant difference between them ( u ==0. 517, P=0. 608 ).ConclusionsThe shape of flaps created using the Moria M2 110-0 is more uniform and closer to the expected thickness of 130 μm than the ones created using the Moria M2 110 microkeratome.

Objective To observe the effects of TLR9 on the nude mouse transplanted tumor growth of human pancreanc cancer and its drug resistance.Methods The nude mouse transplated tumor of human pancreatic cancer PANC-1 was established and randomly divided into 6 groups for conducting the experiment:sterile normal saline group,TLR9 agonist,TLR9 inhibitor group,gemcitabine group,TLR9 inhibitor plus gemcitabine Bin group,TLR9 agonist plus gemcitabine.The tumor size and growth situation were recorded by the vernier caliper.The immunohistochemical method was used to detect tumor TLR9 receptor expression.The tumor growth,metastasis and paracancerous nssue invasion situation were observed by the magnetic resonance imaging (MRI).Results The volume and growth speed of resected tumor mass in the gemcitabine group,TLR9 agonist + gemcitabine group,TLR9 inhibitor plus gemcitabine group was significantly smaller than those in other groups (P＜0.05),which in the TLR9 agonist + gemcitabine group were significantly greater than those in the TLR9 inhibitor plus gemcitabine group and gemcitabine group (P＜0.05),the difference between the TLR9 inhibitor plus gemcitabine group and gemcitabine group had statistical significance (P＜0.05),while the difference among the TLR9 agonist group,TLR9 inhibitor group and normal saline group had no stastistical significance (P＞0.05).The tumor in mice at 7 weeks after planting showed oval shape with clear boundary by MRI observation,no obvious metastais and paracancerous invasion were seen in paracancerous nssues no statistically significant,5 weeks,6 weeks after planting,seven weeks mice observed in MRI,the tumor into an,state clearly that the transfer of the surrounding tissue,no significant vascular invasion,heart,liver,kidney disease.The TLR9 expression on the surface of tumor tissue was detected and identified.Conclusion Pancreatic cancer nude mouse transplated tumor has definitely positive expression of TLR9,TLR9 activation can significantly decrease the sensitivity of pancreatic cancer to chemotherapy,increases the drug resistance of tumor,on contrary promotes the tumor growth.