Objective To compare the image quality of portal venous system in the patients with live cirrhosis and portal hyper-tension using two different inj ection methods,so as to investigate the optimization of imaging techniques.Methods Single-phase in-jection (group A)or biphasic injection (group B)was applied by random on 40 patients for portal venous system vascular imaging, and subsequently image quality and technical advantages between the two groups were compared and analyzed respectively.Results 1.There was no significant difference in image quality between the two groups(P>0.05),while contrast agent dosage (90 mL)in group B is less than group A(100 mL).2.The CT value of Portal vein,liver parenchyma and P-L discrepancy in group B were slightly lower than those in group A,however,no statistical difference was noted(P>0.05).After 45 second,the P-L discrepancy of group B was larger than that of group A.The peak times of portal vein,liver parenchyma and the P-L discrepancy in group B were longer than those in group A(P<0.05).3.The graph of P-L discrepancy demonstrated:the threshold interval of P-L discrep-ancy in group B was longer than that in group A.Conclusion Biphasic inj ection methods could not only afford reliable imaging quali-ty on portal venous system vascular imaging in the patients with liver cirrhosis and portal hypertension,but also lead to a less total dose of contrast agent.Therefore,it could be used as an optimal choice of imaging technology for portal venous system vascular ima-ging.

0.05). Conclusions With intravenous injection of low-dose combination, droperidol and fentanyl can produce effective, painless and safe sedation for TEE examination.

OBJECTIVE:To investigate the anti-inflammatory and analgesic effects of mongolian medicine Cymbaria dahurica extract. METHODS:96 KM mice(or SD rats)were randomly divided into model group(water),positive control group(aspirin, 0.5 g/kg),C. dahurica ethanol extract (70% ethanol) low-dose,medium-dose and high-dose groups (0.325,0.650,1.300 g/kg, calculated by crude drug) and C. dahurica aqueous extract of the residue of alcohol extraction low-dose, medium-dose and high-dose groups(0.325,0.650,1.300 g/kg,calculated by crude drug). They were given relevant medicine intragastrically,once a day,for consecutive 7 d. The xylene-induced ear edema method was used to determine the degree of ear edema,and egg white-in-duced paw edema method was used to determine paw edema after inducing inflammation 1,2,4,6 h;anti-inflammatory activity of C. dahurica extract was investigated. 96 KM mice were grouped and given medicine with same method;the number of writhing within 20 min was determined by acetic acid writhing method. Another 64 KM mice were grouped with same method,with 8 mice in each group;except positive control group was given tramadol hydrochloride(0.5 g/kg)intragastrically,other groups were given relevant medicine with same method. Pain thresholds of mice were determined by hot-plate test before and after medication 30,45, 60,90 min,and analgesic effects of C. dahurica extract were investigated. RESULTS:Compared with model group,C. dahurica extract could obviously restrain the ear edema of mice and paw edema of rats 6 h after egg white-induced inflammation. Except paw edema of rats in C. dahurica aqueous extract of the residue of alcohol extraction high-dose group was decreased slightly,there was statistical significance among other groups (P<0.05 or P<0.01). C. dahurica extract decreased the number of writhing in mice within 20 min,and extended pain thresholds of mice 30,60,90 min after medication (P<0.05). CONCLUSIONS:Both C. dahurica ethanol extract and aqueous extract of the residue of alcohol extraction posses certain anti-inflammatory and analgesic effects.

Objective:To detect estrogen receptor ? and ?(ER-?,ER-?) protein expression in different age of mouse thymus.Methods:Protein expression of ER-? and ER-? in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-? and cytokeratin 18(epithelial cell marker) was further tested through fluorescence double-staining.Results:Immunohistochemical analysis revealed that both ER-? and ? protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-? was absence while ER-? was still positive in aged mice,such as 12 months and 16 months old.Double staining further confirmed that lots of ER-?/? positive cells were Foxp3 negative cells.Conclusion:Expression of ER-? is absent while ER-? is still positive in thymus of aged mice,which indicates ER-? is the critical estrogen receptor that involves in thymic involution.Moreover,ER-?/? do not participate in Treg development within thymus.

Objective To explore the different operation modes for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.Method A retrospective analysis was performed on 48 cases of native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney,including 14 cases receiving open surgery (open surgery),22 cases receiving laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision (oblique incision group) and 12 cases receiving modified endoscope assisted Plunk technique (Plunk group).The operating time,amount of bleeding and blood transfusion during operation,recovery of intestinal function,time of indwelling drainage tube and wound suture,the total cost of hospitalization,the hospital stay and the incidence of complications were comparatively analyzed.Result The operating time in open group was shortest.Group of Pluck is better than other groups in the aspects of Time of wound suture and intestinal function time in shorter in Plunk group than the rest two group (P＜0.05),and amount of bleeding and incidence of complication in Plunk group were higher than oblique incision group (P＜0.05).The incidence of complications and amount of bleeding were decreased significantly as compared with the rest groups (P＜0.05).Conclusion The mode of the laparoscopic radical nephroureterectomy with bladder cuff resection through a lower abdomen oblique incision has the advantages of high security,minimal invasion and satisfactory treatment effect.It is especially suitable for treating native renal pelvic and ureteral neoplasms occurring at the same side of transplanted kidney.

Objective: To observe the influence of electroacupuncture with different frequencies on rats swimming endurance and sift out the optimal frequency parameter.Methods: Wistar rats were randomly allocated to control group, non-acupoint group and electroacupuncture with low frequency group (EA with 2 Hz group), electroacupuncture with medium frequency group (EA with 15 Hz group), and electroacupuncture with high frequency group (EA with 100 Hz group), acupoints Zusanli (ST 36) and Taichong (LR 3) were punctured and rats load swimming time was used as an index, and the change of swimming endurance time before and after acupuncture was observed. Results: After electro-acupuncture, swimming time was increased in 15 Hz and 100 Hz groups respectively, with the significant differences between before and after acupuncture (P＜0.05). There was also a significant difference in the percentage of increase in swimming time between 15 Hz group and other groups (P＜0.05).Conclusion: It is suggested that electroacupuncture at acupoints Zusanli (ST 36) and Taichong (LR 3) with a frequency of 15 Hz could enhance rats's swimming endurance, and 15 Hz might be an optimal frequency parameter during the electrical stimulation.

Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.

Objective To investigate the clinical parameters,risk factors,treatment and clinical outcomes of pneumocystis pneumonia(PCP) in children without human immunodeficiency virus(HIV). Methods Retrospective a-nalysis was made for the clinical features,risk factors,treatment and prognoses of the non-HIV infected severe PCP pa-tients hospitalized at Pediatric Intensive Care Unit( PICU) of Children′s Hospital Affiliated to Capital Institute of Pedi-atrics. Results During April of 2010 to April of 2014,there were 10 cases of non-HIV infected severe PCP in PICU of Children′s Hospital Affiliated to Capital Institute of Pediatrics. All of the patients had predisposing diseases,in which 3 cases had connective tissue diseases,2 cases had acute leukemia,3 cases had severe pneumonia and 2 cases had con-genital immunodeficiency. The main clinical manifestations of those 10 patients were fever, cough, tachypnea and obvious dyspnea. All patients developed respiratory failure. The median value of Pediatric Critical Illness Score was 79. The median arterial oxygen pressure was 58 mmHg(1 mmHg=0. 133 kPa). The median oxygenation index was 103 mmHg. The median alveolo-arterial oxygen partial pressure difference was 43. 8 mmHg. The median CD4+T-lympho-cytes counts was 169 ×106/L. Eight patients on admission had mixed infection. Acute respiratory distress syndrome (ARDS) occurred in all of the patients,and 7 cases of them had multiple organ dysfunctions. All of the patients re-quired ventilation support. The median day for invasive mechanical ventilation days was 11 and the median day for non-invasive ventilation days was 6. The pneumothorax occurred in 5 patients. All patients received trimethoprim-Sulfame-thoxazole as initial therapy and Caspofungin treatment in combination in 7 cases of the patients. Six patients had nosoco-mial infection. The median time of PICU stay was 15. 5 days. Six patients survived and the mortality was 40%(4/10 cases) . Conclusions PCP is a kind of fatal diseases which occurred in patients with immunocompromised conditions and concurrent ARDS or multiple organ dysfunctions. Diagnostic suspicion and mechanical ventilation therapy with lung protective ventilation strategies may improve the clinical outcomes of non-HIV-infected PCP in children.

objective To investigate the clinical signiifcance of the changes of angiotensionⅡ(AngⅡ) in children with IgA nephropathy (IgAN). Methods Thirty children diagnosed as primary IgA nephropathy by renal biopsy (IgAN group) and 30 healthy children (control group) were recruited from May 2008 to December 2012. The serum and urine AngⅡwere measured by ELISA and compared between IgAN group and control group. The AngⅡexpression in the renal tissue of IgAN group was detected by immuno-histochemical method, and was correlated with other clinical data.. Results Urine AngⅡwas signiifcantly higher in the primary IgAN group than that of control group (P<0.05);AngⅡexpression in the urine is positively correlated with proteinuria (r=0.37, P=0.046), and is associated with the severity of clinical presentation; AngⅡexpression in kidney tissue increased with the severity of the renal histopathologic grading (r=0.69, 0.79, P=0.000), while AngⅡin blood and proteinuria, AngⅡexpression in kidney tissue were not signiifcantly correlated with the number of crescents. Conclusions Urine AngⅡin children with IgAN is signiifcantly correlated with the severity of the pathologic stage and the level of proteinuria. Urine AngⅡdetection may be useful to assess the progress and prognosis of chronic kidney disease.

Objective: To detect estrogen receptor α and β(ER-α, ER-β)protein expression in different age of mouse thymus.Methods:Protein expression of ER-α and ER-β in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-α and cytokeratin 18(epithelial cell marker)was further tested through fluorescence double-staining.Results: Immunohistochemical analysis revealed that both ER-α and β protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-β was absence while ER-α was still positive in aged mice, such as 12 months and 16 months old.Double staining further confirmed that lots of ER-α/β positive cells were Foxp3 negative cells.Conclusion: Expression of ER-β is absent while ER-α is still positive in thymus of aged mice, which indicates ER-α is the critical estrogen receptor that involves in thymic involution.Moreover, ER-α/β do not participate in Treg development within thymus.