Objective To evaluate the value of MRI in diagnosis of prostate diseases.Methods Clinical data and MRI findings of prostatic carcinoma(PC) in 43 cases and benign prostatic hyperplasia(BPH) in 33 cases confirmed pathologically were reviewed blindly by two radiologists and compared with that of pathology.The sensitivity,specificity,positive predictive value(PV+),negative predictive value(PV-) and accuracy of MR imaging were also calculated.Results The sensitivity,specificity,PV+,PV-and accuracy of MR imaging in diagnosing prostatic lesions were 90.7%,84.8%,88.6%,87.5% and 88.2% for PC,84.8%,90.7%,87.5%,88.6% and 88.2% for BPH,respectively.PC located in the peripheral zone were 67.4%(29/43 cases),in the central zone were 9.3%(4/43 cases),the prostates presented irregular enlargement with diffuse low signal intensity in 16.3%(7/43 cases),7.0%(3/43 cases) lesions did not found by MRI even after getting pathological results.The size of the mass ranged from 0.3~10.0 cm,mean 2.4 cm.All of 40 cases,the lesions showed low signal intensity without border and capsule.The affected structures around the lesions inculuded prostatic capsule(n=34),seminal vesicle(n=24),muscle(n=8),rectal(n=5),bladder(n=6) and ilium(n=1),lymph nodes metastasis(n=11),bone(n=13) and lung(n=2).The lesions of BPH located in the central zone were 87.9%(29/33 cases),showing enlargement of the central zone with inhomogeneous signal intensity,the other 4 cases in peripheral zone showed low signal intensity with border and 2 cases with capsule.Conclusion MRI has higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy in diagnosis of prostatic diseases.

Objective:To investigate the common reasons for the failure of radical mastoidectomy in order to improve the result of treatment and obtain a dry ear.Method:Twenty-eight cases,who achieved no dry ear after radical mastoidectomy,underwent secondary surgery.Result:All cases obtained dry ear without vertigo or facial paralysis after operation and postoperative dressing.Conclusion:The reasons for the failure of radical mastoidectomy result from the incomplete clearance of lesions, the insufficient ventilation of mastoid cavities, the inappropriate postoperative dressings or the residual foreign bodies in surgical cavity.It is the key points to achieve skeletonization adequately, to eliminate the pathological tissues thoroughly under microscope, and to ensure unobstructed drainage of surgical cavities for preventing secondary surgery.

Registration of serial images plays an increasingly important role in medicine. A novel registration method used for serial images matching is proposed, which is based on the joint histogram. After thresholding the two images to be registered, the joint histogram is divided into four separate regions. Then the criterion function is defined as bin counting in a specific region of the joint histogram, which simplifies the computation of the criteria function greatly and speeds up the alignment process significantly. We choose the Powell optimization algorithm to calculate the registration parameters. The comparison of the results from both mutual information and our method shows that the new method based on segmentation and counting is a fast, simple, efficient and accurate registration method.

Objective To explore the clinical value of 13C-methacetin breath test for the assessment of liver disorder and to analyze its predictive value to the severity of liver function injury in children.Methods Eighteen healthy children served as healthy control group,and 40 patients with different etiology and severity served as experimental group,and then the latter were divided into 2 subgroups,28 patients in Child-Pugh classification A,and 12 cases in below B(11 cases in B and 1 case in C).An oral dose of 2 mg/kg tracer 13C-methacetin was administered to each subject for the 13 C-methacetin breath test.At the same time,serum liver function markers including serum transaminase,bilirubin,albumin and prothrombin time were measured.The acquired data were analyzed by SPSS 17.0 software.Results (1) Metabolisation velocity (MV) max30 and cumulated dose (CUM) 120 in experimental group (46.64 ± 27.93,59.29 ± 30.73) were much lower than those of the healthy control group(73.56 ± 26.03,102.97 ± 41.80) (t =2.450,3.165,all P ＜0.05);(2) MVmax30 and CUM120 were closely correlated with the liver function markers of albumin,total bilirubin,direct bilirubin,prothrombin time (P ＜ 0.05);(3) MVmax30 and CUM120 could predict liver diseases in children,especially the CUM120.With CUM120 =85.80 as a cut-off value to predict liver diseases,the Youden index was 0.578 at its maximum,and the sensitivity and specificity were 77.8％ and 80.0％;(4) Compared with the Child-Pugh classification A,the CUM120 in Child-Pugh classification B and lower B was significantly lower(P ＜ 0.001);(5) CUM120 could predict the severity of liver diseases.With CUM120 =56.15 as a cut off value to predict the severity of liver diseases,the Youden index was 0.857 at its maximum,and the sensitivity and specificity were 85.7％ and 100.0％.Conclusion 13C-methacetin breath test index of CUM120 could predict liver diseases in children and the severity of liver function.

Objective To evaluate the effects of sevoflurane preconditioning and postconditioning on the activity of NF-κB during lung ischemia-reperfusion (I/R) in rats.Methods Fifty-four adult male Sprague-Dawley rats,weighing 300-350 g,were randomly divided into 3 groups (n =18 each) using a random number table:sham operation group (S group),I/R group and sevoflurane preconditioning and postconditioning group (SPP group).Lung I/R was induced by clamping the left pulmonary hilum for 45 min followed by 120 min reperfusion in I/R and SP groups.The left pulmonary hilum was only isolated but not ligated in group S.In group SP,2.1％ sevoflurane was inhaled for 30 min followed by 10 min washout,the left pulmonary hilum was then ligated for 45 min,and 2.1％ sevoflurane was inhaled for 30 min again starting from onset of reperfusion.Six rats were chosen at 30,60 and 120 min of reperfusion and sacrificed in each group,lungs were removed for determination of wet/dry lung weight (W/D) ratio and content of tumor necrosis factor-α (TNF-α) (by ELISA) and expression of nuclear transcription factor κB (NF-κB) p65 of nuclear protein (by Western blot) and for microscopic examination of the pathologic changes of lungs (with light microscope).Results Compared with S group,W/D ratio,TNF-α content and nuclear protein NF-κB p65 expression in lung tissues were significantly increased at each time point of reperfusion in I/R and SPP groups.Compared with I/R group,W/D ratio,TNF-α content and nuclear protein NF-κB p65 expression in lung tissues were significantly increased at each time point of reperfusion,and the pathological changes of lungs were attenuated in SPP group.Conclusion Sevoflurane preconditioning combined with postconditioning can reduce the lung I/R injury in rats through inhibiting NF-κB activity in lung tissues.

Objective To understand the relationship between Toxoplasma gondii infection and pet-breeding and hygienic status. Methods One or two districts were chosen from Jining City, Za-ozhuang City and Linyi City as study areas and the questionnaire surveys were carried out for hygienic status, etc. The pet-breeders and non-pet-breeders were paired by sex, age, living place and occupation so on in a ratio of one to one. Blood samples taken from each were tested for antibodies against T. gondii with ELISA in a double-blind method. Results The total infection rate was 14. 25%, much higher than that investigated ten years ago (1. 53%). The mean positive infection rate was 19.91% in the pet-breeding groups and 8.60% in the control groups (x2 = 11.57, P

Objective To evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy( IMRT)for postoperative mediastinal lymph node metastasis in esophageal cancer. Methods A total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group(A group,31 cases)and the capecitabine combined with IMRT group( B group,31 cases). Both of two groups received IMRT radiotherapy with a total dose of 60-66 Gy, 30-33 times in 6-6. 5 weeks. The patients in B group were treated with capecitabine(1 250mg/ m2 ,2 f/ d, d1-d14,21 d × 2 cycle). Results Group A:there were 7 cases of complete response(CR),12 of partial response(PR),10 of stable disease(SD),and 2 of progressive disease(PD);the effective rate was 61. 3%(19 / 31). Group B:there were 10 cases of CR,16 of PR,4 of SD,and 1of PD;the effective rate was 83. 9%(26 / 31). There was a statistical significance between the effective rates of A group and B group(χ2 = 3. 971, P < 0. 05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29. 0% and 38. 7%(χ2 = 0. 648,P = 0. 421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19. 4% and 25. 8%(χ2 = 0. 369,P = 0. 544). The different incidence of the two adverse reactions between group A and B had no statistical significance. Conclusion Compared with IMRT alone,IM-RT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis.

Objective To provide a scientific basis for early clinical diagnosis and treatment as well as secondary and tertiary protection through 10 years inquiry of multiple organ failure in the elderly(MOFE).Results Among 153 MOFE cases,the first inducement of 89.5%(137/153) patients was infection,among which 93.4% (128/137) was pulmonary infection.The vertical percentage of the first failure organ was as follows: pulmonary (39.0%,60/154),heart (19.5%,30/154),brain (14.9%,23/154),kidney (10.4%,16/154),alimentary canal (8.4%,13/154),liver (6.5%,10/154);while the horizontal percentage was as follows: pulmonary (42.9%,60/140),heart (40.9%,56/137),kidney (32.6%,30/92),brain (21.9%,23/105),alimentary canal ( 14.5%,9/62).The survival time of the first organ failure from shortness to length was as follows: pulmonary,brain,heart,kidney.Conclusions Most MOFE cases have pulmonary failure at first.The organs failure sequence is pulmonary,heart,brain and kidney in order.

Aim To investigate the effects of DGK in-hibitor R59022 on ET-1-induced myocardial hypertro-phy and autophagy, and explore the possible mecha-nisms. Methods Myocardial hypertrophy was in-duced by ET-1 in cultured rat neonatal cardiomyo-cytes. Western blot was used to detect the expression of microtubule-associate protein 1 light chain 3 ( LC3 ) , beclin-1, p62, p-Akt and Akt. mRNA expression of brain natriuretic peptide ( BNP) and beta mysion heav-y chain (β-MHC) and the cell size of cardiomyocytes were detected by RT-PCR and immunofluorescence, respectively. Results Treatment cardiomyocytes with ET-1(10 -7 mol·L-1 ) for 24 h induced the myocardi-al hypertrophy in cultured neonatal rat cardiomyocytes with the activation of autophagy as evidenced by the in-creased expression of autophagy-related proteins LC3-II/I and beclin-1 , as well as the increased p62 degra-dation. While, myocardial hypertrophy induced by ET-1 , including the increased myocardial cell size and the mRNA expression of fetal gene BNP and β-MHC, could be reversed by autophagy inhibitor 3-methyl ade-nine (3-MA) and chloroquine ( CQ) ,but promoted by autophagy agonist rapamycin ( RAPA ) . Pretreatment cardiomyocytes with R59022, an inhibitor of DGK, en-hanced ET-1-induced myocardial hypertrophy by en-hancing autophagy in cardiomyocytes. Furthermore,ET-1 treatment inhibited the activation of Akt by the down-regulation of the Akt phosphorylation, and R59022 en-hanced the effect of ET-1 on the activation of Akt. Conclusions Enhanced autophagy contributes to car-diomyocyte hypertrophy. R59022 deteriorate ET-1-in-duced myocardial hypertrophy by activating autophagy. The possible mechanism may be related to the inhibi-tion of activation of mTOR signaling pathway by inhibi-ting the activation of Akt.

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.