Objective To evaluate the diagnostic value and clinical significance of preoperative staging in gastric cancer with induced pneumoperitoneum in spiral CT (SCTPP). Methods Both routine SCT and SCTPP were performed in 52 lean patients suffered from gastric cancers, and comparison was made between SCT findings and surgical and histopathologic findings. Results The accuracy of routine SCT and SCTPP in determining the T-staging was 72% and 96%, respectively (?2=8.0, P0.05). The sensitivity in determining M-staging was 61% and 100%, respectively (?2=0.04, P

Purpose　To evaluate the clinical safety of ionic contrast media made in china and compare with nonionic contrast media being imported. Methods　Among contrast-enhanced CT 1096 cases, 76% meglumine diatrizoate were administed in 864 cases and ultravist in 232 cases , comparative studies on adverse drug reactions(ADRs) and image quality were performed. Results　In 76% meglumine diatrizoate group , the prevalence of overall and mild -middle ADRs was higher than in the ultravist group , the prevalence of severe and potentially life-threatening ADRs was approximate in the ultravist group , the image quality was well than in the ultravist group.Preventive inoculation alleviated ADRs at all levels. Conclusion　Ionic contrast media made in china was safe and effective in patients without hyperthyroidism after preventive inoculation.

Objective To investigate the combining anticancer effect of tamoxifen(TAM) and ?-interferon on breast cancer cells in vitro and its mechanism.Methods MCF-7 ER-positive breast cancer cell lines were treated with tamoxifen alone,or in combination with ?-interferon and/or estrogen in vitro.Cell proliferation was evaluated by MTT assay;FCM was used to determine the distribution of cell cycle,cell apoptosis and protein expression of Bcl-2,Bax,Fas,FasL,Caspase-8,and the activity of Caspase-3.Results TAM inhibited the proliferation of ER-postive breast cancer cells with cell cycle arrest in G0/G1 phase and with induction of apoptosis,and the proliferation-promoting effect of estrogen on MCF-7 was blocked by TAM.Anticancer effect of TAM was enhanced when cells were pretreated with ?-interferon for 24 hours.Bcl-2 protein expression was down-regulated and Caspase-8 was up-regulated by TAM and/or ?-interferon,but these drugs did not affect Bax,Fas,FasL protein expression and the activity of Caspase-3.Conclusions TAM has anticancer effect by inhibiting proliferation and inducing apoptosis in ER-positive breast cancer cells in vitro,and ?-interferon can enhance anticancer effect of TAM on breast cancer cells.The mechanism of these effects may be related with the down-regulation of Bcl-2 expression and up-regulation of Caspase-8 by TAM and ?-interferon.

Objective To evaluate the value of gated ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging in detection of myocardial ischemia in hypertrophic cardiomyopathy.Methods Sixty-nine patients with clinically proven hypertrophic cardiomyopathy were divided into 2 groups using coronary angiogram as "gold standard":positive group(n=19,narrowing≥50%) and negative group (n=50,narrowing＜50%).Gated ~(99)Tc~m-MIBI myocardial perfusion imaging was performed and positive in all 69 patients (41 males,28 females,aged 35-75 years).Comparative analysis between the two groups was carried out using t-test.Results In the positive group,reversible and irreversible perfusion defects were detected in 9 and 10 patients,respectively.Left ventricular ejection fraction (LVEF) increased to (69.1±2.8)% in 8 patients and decreased to(42.8±2.1)% in 11 patients.In the negative group,reversible and irreversible perfusion defects were found in 37 and 13 patients,respectively.LVEF increased to(70.8±4.0)% in 38 patients and decreased to(48.9±2.7)% in 12 patients.The values of ischemic area,severity and extent of perfusion defect,and LVEF were significantly different between the two groups(t=9.28,16.51,2.65;P＜0.001,＜0.001,＜0.01,respectively).Conclusions Gated ~(99)Tc~m-MIBI myocardial perfusion imaging is valuable in assessing patients with hypertrophic cardiomyopathy.Detection for the presence or absence of coexisting coronary artery disease and myocardial ischemia has an important prognostic indication and management indication for these patients.

Objective To investigate the pregnancy opportunity and outcome of patients with sysmetic lupus erythematosus (SLE).Methods We carried out a retrospective analysis of the clinical information of patients who suffered from SLE complicated with pregnancy and were hospitalized to People's Hospital of Peking University from December of 1992 to February of 2012.Chi-square test were used for statistical analysis.Results Forty-nine cases of patients with SLE complicated with pregnancy had 52 pregnancies in total.In 27 cases of planned pregnancies,24 cases(89％ )resulted in live births and 5 cases( 18％ ) had flares during pregnancy.Of the 24 live births,3 cases( 12％)were premature deliveries and 4 cases(17％) had low birth weight infants.In 25 cases of unplanned pregnancies,12 cases (48％) resulted in live births and 20 cases (80％) had flares during pregnancy.Of the 12 live births,6 cases(50％ ) were premature deliveries and 6 cases (50％) were low birth weight infants.The patients in the planned pregnancy group tended to have flares during pregnancy more frequently than those in the unplanned group (P＜0.01),the former were more likely to have live births than the latter (P＜0.01) and were less likely to have premature delivery (P＜0.05).Conclusion Patients with SLE should have planned pregnancy and need collaborative supervision of both rheumatology and immunology department and obstetric department to improve live birth rate,decrease premature delivery and the activity of SLE during pregnancy.

Objective To investigate the value and usefulness of optimized multislice CT enterography (MSCTE) with orally administered isosmotic mannitol (2. 5%) as negative contrast in demonstrating the small bowel and its abnormality. Methods Forty patients suspected of intestinal tumors were randomly divided into two groups and underwent conventional or optimized MSCTE. The expansion degree of bowel lumen and the thickness of bowel wall were evaluated for the six segments of the small intestine. The other 20 patients suspected of gastrointestinal diseases underwent gastrointestinal CT imaging.The expansion degree of bowel lumen and the wall thickness of bowel wall were statistically analyzed with Chi-Square test and t test. Results The wall thickness of the stomach, ileum and colon were (2. 56 ±0.52) ,(1.41 ±0. 15),(1.46 ±0. 13),(1.91 ±0. 25), (1.97 ±0.26),(2.01 ±0. 19), (2. 04 ±0.24)and (2. 05 ±0. 18)mm. Optimized method was superior to conventional method in the expansion degree of the second and third segments of the small intestine (P ＜ 0. 05) . There was no significant differences between two groups in the expansion degree and depiction of mucosa for the other segments of small intestine (P ＞ 0. 05). The gastrointestinal CT imaging was poor in the depiction of the duodenum and jejunum, but stomach, ileum and colon were fully illustrated. Conclusion Optimized MSCTE was superior to conventional method in demonstrating the small bowel, and gastrointestinal CT imaging can expand diagnostic scope because of good observation of whole gastrointestinal tract.

OBJECTIVETo invesitigate the clinical effects of percutaneous closed reduction and cannulated screw internal fixation combined with external fixation in the treatment of unstable pelvic fractures.

METHODSFrom April 2006 to May 2009,29 patients with pelvic fractures of rotatory instability were treated with closed reduction and screw internal fixation combined with external fixation. There were 19 males and 10 females with an average age of 31 years old (ranged from 19 to 53 years). Based on the Tile classification,17 cases were type CI and 12 case were type C2. Tornetta standard and Majeed score were used to evaluated the clinical effect after operation.

RESULTSAll patients were followed up from 10 to 24 months with an average of 16 months. There were no nerve injuries and other organ injuries, only one case of infection was found and it was cured with wound dressing. Time of fracture union was from 14 to 18 weeks with the mean of 16.2 weeks. No loosening, slippage or breakage of the screw were found. According to the Tornetta standards,14 cases obtained excellent results, 10 good, 4 fair and 1 poor. The Majeed score was 87.2 ± 11.3, 16 cases got excellent results, 9 good and 4 fair.

CONCLUSIONClosed reduction and screw internal fixation combined with external fixation is an effective way to treat unstable pelvic fractures with Tile type C1 and Tile type C2.

Adolescent ; Adult ; Child ; External Fixators ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery

BACKGROUND: Although improvement could be achieved after the first operation, limb symptoms of patients would aggravate with the progress or reoccurrence of Parkinson disease (PD), thereby second operation would become necessary if symptom could not be controllel by medication.OBJECTIVE: To investigate the improving rate of symptoms and complications of patients with PD after the second operation.DESIGN: Case analysisSETTING: Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Totally 387 primary PD patients were collected from Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical College of Chinese PLA from October 1997 to December 2002.Totally 350 patients received two operations in the same hospital, and other 37 patients received the first operation at other hospital and the second operation in our hospital. The intervals of two operations were within half a year in 36 cases, 0.5-0.9 year in 72 cases, 1.0-1.9 years in 108 cases and 2.0-5.0 years in 171 cases respectively.METHODS: Under the stereotactic microelectrode-guidance, the targets of all patients were subjected to iconographical orientation, microelectrode record, microelectrode stimulation and exploration and radio frequency microelectrode verification before just stage bilateral posteroventral pallidotomy (PVP) or thalamus ventral intermediate nucleus damage(TVIND),unified Parkinson's disease rating scale (UPDRS) was used at preoperative and postoperative "on" state (at the beginning of medication, patients move freely and stays in "on" state) as well as "off" state (when medication loss function, patients displays moving disability and stays in "off" state).complication between two operation .RESULTS: Data of 387 patients were remained in the results analysis.operation was lower than that of first operation (tremor 95.4%, 96.9%;rigidity 94.6%, 95.1%; bradykinesia 88.9%, 92.3%; gait 62.3%, 67.1%;balance 65.1%, 69.4%, akinesia and cramp 95.8%, 98.0%), but no diffor UPDRS were lower than that of preoperative scores (P ＜ 0.01). The mean total UPDRS scores improved by 46.8% in the "on" state and 53.5% in the "off" state after second operation, lower than that of first tive complications: The occurrenceof complications that was specific for the second operation including fatigue, salivation, reduced voice, fake bulbar paralysis, lethargy, hiccough, urinary incontinence, urinary retention were found higher than that of after the first operation (P ＜ 0.05).The occurrence of cerebral hemorrhage was also lower than that of after first operation.UPDRS were lower in the second operation, which may be due to that PD of postoperative complications which was specific for the second operation was obviously increased, which possibly associated with age, state of illness, constitution, operation type and interval between operations. But occurrence of non-specific postoperative complications was basically the same in two operations (cerebral hemorrhage and inflammation), suggesting that hemorrhage risk did not increased due to the second operation.

Objective To determine Haemophilus influenzae type b strains in molecular level using PCR,and to study the immunogenicity of capsular polysaccharide conjugates in mice.Methods Extracting genomes using bacterial DNA extract kit from Hoemophilus influenzae type b strains,and PCR for determining the strains through serotyping-specific and capsular genotyping primers respectively.Various capsular polysaccharides conjugated TT respectively,and the conjugates were administered subcutaneously to mice through dilution.After vaccination with two doses,blood samples were collected for the detection of antibody levels to polyribosylribitol phosphate ( PRP),the capsular polysaccharide of Hib.Results All five Haemophilus influenzae type b strains contain type-specific(482 bp) and capsular type (343 bp)DNA fragment through PCR detecting.The DNA fragments were sequenced.BLAST show that these sequences are 100％ homology comparing the above strains respectively,and are 99％ and 100％ homology comparing the GenBank X78559.1 and M19995.1 respectively.The immunogenicity of mice from various capsular polysaccharide conjugates (PRP-TT) was not significantly different by ELISA detecting.Conclusion Through PCR,Haemophilus influenzae type b strain can be determined in molecular level.The immunogenicity of mice from purified capsular polysaccharide conjugates was not different.The study provides a detection means for the features and heredity stability of Haemophilus influenzae type b strain and reference data for the immunogenicity of different polysaccharide conjugates in vaccine research and development and production.

Object To study the adsorption function of macroporous resin AB 8 for the purification of total flavones in Sophora flavescens Ait and the effects of concentration, pH, flow rate of the adsorbate and eluant Methods UV spectrophotometry was used to analyze the content of total flavone in S flavescens Results The appropriate adsorption conditions were: concentration of Sophora extract, 0 285 mg/mL ; pH=4; flow rate 3 BV/h, when 50% alcohol was used as eluant, the effect of desorption was satisfactory Conclusion AB 8 resin can be used to refine the total flavone in S flavescens