Objective To evaluate the imaging exa mination in the diagnosis of periampullary carcinoma. Methods A retrospective analysis of 125 patient s with pathologically proven periampullary carcinomas enrolled in Zhongshan hosp ital between Jan. 1991 and Dec. 2000. Results The accuracy of BUS or CT was higher th an that of ERCP in patients with pancreatic head carcinoma ( P =0.044, P =0. 029, respectively). The accuracy of ERCP was higher than that of BUS or CT in pa tients with duodenal papillary carcinoma ( P =0.005, P =0.03, respectively). The accuracy of ERCP was higher than that of BUS or CT in patients with ampulla ry carcinoma ( P =0.157, P =0.282, respectively). The accurary of MRCP was 8 /8,8/9 respectively in patients with duodenal papillary carcinoma and ampullary carcinoma. Conclusion BUS+CT is the manner of choice in th e diagnosis of pancreatic head carcinoma, ERCP is suitable for nonpancreatic per iampullary cancer. MRCP should be applied widely in the near future.

AIM: To study the efficacy of Xiaoer qingre ning (XQN) combined with Xiaoer shuxiao ganmao ling (XSGL) in the treatment of children acute respiratory infection (AURI). METHODS: 206 cases of AURI were randomly divided into combined group (treating group) and tylenol group. 105 cases in combined group were given XQN orally combined with XSGL, and 101 cases in tylend group were given children tylenol. The treatment of both groups lasted 3 days. RESULTS: The clinical effect in combined group ( 94.3 %) was more than that of tylenol group ( 78.3 %). CONCLUSION: XQN combined with XSGL is both economical and satisfactory in the treatment of children AURI.

AIM: To investigate the value and the effect of tripterygium wilfordii on decreasing proteinuria in the primary and secondary nephropathy synd rome in children. METHODS: 30 patients were confirmed the pathol ogy classification, and given tablets of tripterygium wilfordii by 1.5 kg?d -1 for 4 weeks. 24-hour urine volume and gastrointestinal reaction were obser ved, and regularly the 24-hour proteinuria quantity, hepatic and renal function , peripheral blood, and serum albumin were examined. RESULTS: 14 of 30 patients were effective after the treatment, 12 patients were improved, 7 patients were effective after 1-week treatment, and 9 patients were effective after 2 weeks. Individual patients had moderate gastrointestinal disorder; a few patients had modest ALT increase in early therapy; and all recovered after cont inuous treatment. The value of WBC in 3 patients decreased to 3.5 ?10 9 L -1 in the whole course, but, it did not affected the administration. A ll patients had normal renal function. CONCLUSIONS: Tripterygi um wuilfordii can effectively decrease proteinuria, and improve the symptom of primary and secondary nephropathy syndrome in children.

Objective:To investigate the mechanism of immunoglobulin Y antibodies(IgY) against tumour necrosis factor alpha(TNF-α) and Interleukin-1beta(IL-1β) in treating allergic bronchial asthma through nebulization inhalation.Methods:The allergic bronchial asthma model was established with Hartley guinea pig by ovalbumin nebulizating inhalation.The animals were randomly divided into 4 groups: normal control group(group A)，allergic bronchial asthma group(group B),0.1% anti-TNF-α and IL-1β IgY treating group(group C),1.0% anti-TNF-α and IL-1β IgY treating group (group D).The animals were killed after treatment being accomplished for 2 h,4 h,8 h,24 h and the lungs were made pathological,which were then stained by hematoxylin-eosin(H.E.).The bronchoalveolar lavage fluid (BALF) was collected and the deposited cells were stained by Wright's.Results:①The histological appearance of lung: In group B the histological structure of alveolar ducts and alveolar walls was damaged,the alveolar space was full of transudate and lots of alveolar epithelial cells and leucocytes.The pulmonary interstitial edema,inflammatory cells infiltration,distorted or dilated capillaries and reducing capillary numbers of effective blood stream were observed in alveolar walls.In group C and group D the damage degree of alveolar ducts and alveolar wall was slighter than that in group B and there were few inflammatory cells in alveolar space.In bronchial lumen and pulmonary alveoli the sticky mucus plug was obviously less in group C and group D than in group B.Moreover,inflammatory cell infiltration was seldom observed aroud bronchia,and restoration of bronchial tunica mucosa epithelium was obviously observed in group C and group D.②The cytology appearance of BALF: In group C and group D the numbers of eosinophils,neutrophils,lymphocytes were significantly fewer （2 h,4 h,8 h,P＜0.05）,however,the number of macrophage was significantly more（2 h,4 h,8 h,P＜0.05）than in group B.Conclusion:The anti-TNF-α and IL-1β IgY can obviously alleviate pathological extent of inflammatory reaction in allergic bronchial asthma of guinea pigs by nebulization inhalation therapy.The therapeutic effect of anti-TNF-α and IL-1β IgY between 0.1% and 1.0% concentration is not obvious difference for pathology changes.

Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

Objective To study the strain difference in response to the antidepressant fluoxetine in mouse tail suspension test.Methods Two outbred mouse strains (KM and ICR) and three inbred mouse strains (C57BL/6,Balb/c and DBA/2) were used in this study.They were treated with the selective serotonin reuptake inhibitor (SSRI) fluoxetine or saline and the immobility time in tail suspension test was recorded.Results There was significant difference of baseline immobility time among different stains with C57BL/6 the most immobile((145.0 ±16.8) s) and DBA/2 the least ((34.5 ± 6.1)s).Fluoxetine significantly decreased the immobility time in C57BL/6 ((116.0 ± 10.3) s vs (145.0 ± 16.8) s) of control),Balb/c ((44.3 ± 6.2) s vs (75.3 ± 10.3) s) of control) and DBA/2 mice ((16.6 ± 4.3) s vs (34.5 ± 6.1) s) of control),while the immobile time of KM and ICR mice was not influenced by fluoxetine.Conclusion The effects of fluoxetine in tail suspension test are strain dependent.Fluoxetiue exhibits antidepressant effects in C57BL/6,Balb/c and DBA/2 mice,but not in KM and ICR mice.

Objective To analyze the radiologic characteristics of focal organizing pneumonia (FOP) and discuss its values in diagnosis of FOP.Methods 57 lesions of FOP proved by histological examination were studied retrospectively.All of the lesions could be classified into types of nodule(diameter≤30 mm, n=40) and mass(diameter>30 mm, n=17),which were analyzed to explore the imaging characteristics such as location, margin, internal state, and enhancement features.Results 39 lesions were located in the right lung and 18 lesions in the left lung, and 51 lesions in the peripheral and 6 lesions in the inner or middle of the lung.The differences between the location of lobe and lung field were statistically significant.The radiographic common features included air bronchogram were seen in 28 cases, while loose composition sign in 18 cases and vessel convergence in 21 cases.49 lesions occurred in subpleural region, including 34 lesions broad contract with pleura.In 54 lesions with contrast-enhanced CT scan, the difference between arterial phase and plain scan in CT value was 35 HU and difference of venous phase and plain scan was 45 HU, presenting gradual enhancement.14 lesions were inhomogeneous enhancement in mass type and 25 lesions were homogeneous enhancement in nodule type.There were statistic differences in margin, shape, round-glass opacity, necrosis, cave and the relationship with pleura between the nodule type and mass type.Conclusion FOP has specific radiographic features.Enhanced CT scan combining multi planar reformation images is helpful in differential diagnosis.

Objective To analyze the value of resting state BOLD-fMRI in the early diagnosis of brain injury after nasopharyngeal carcinoma radiotherapy.Methods Four groups of nasopharyngeal carcinoma patients,including before radiotherapy group (G0),0-3 months after radiotherapy group (G1), 3-6 months after radiotherapy group (G2) and 6-9 months after radiotherapy group (G3),were underwent a resting state BOLD-fMRI scan, and Matlab software DPARSF tool was used to analyze and postprocess the data based on G1-G0,G2-G0,G3-G0,G2-G1,G3-G2 and G3-G1.Results Compared with the G0 group,the activity of bilateral hippocampus and temporal lobes was decreased in G1 and G2 groups,and the decreased degree in G2 group was smaller than that in G1 group.Compared with G1 group,brain metabolic activity increased in G2 and G3 group,but did not return to the initial level before radiotherapy.Conclusion Abnormal changes of resting state BOLD-fMRI have an important clinical significance in early diagnosis of radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy.

Objective To analyze the diagnostic value of diffusion tensor imaging (DTI) for early radiation-induced brain injury.Methods We searched CNKI and PubMed and included articles according to the PRISMA statement.FA value, λ||, and λ丄 were pooled, and Forest plot generation, cumulative analysis, sensitivity analysis, and regression analysis were performed.We also used the funnel plot to analyze publication bias.Results A total 11 studies were included for meta-analysis.The results of FA value heterogeneity test were as follows:P=0.000, I2=93.6% in China;P=0.004, I2=82.2% in other countries and regions;P=0.000, I2=91.5% in all regions.The regression analysis of time-dose dependence and study design showed significant and non-significant associations, respectively, with the heterogeneity of these studies (adjusted P=0.026, P=0.005;adjusted P=0.859, P=0.908).The results of λ||and λ丄 heterogeneity tests were as follows:P=0.908, I2=0.0%;P=0.100, I2=56.6%.There was a sign of publication bias by Egger's test (coefficient:-6.26, 95%CI:-9.31 to-3.20, P=0.001) and Begg's test (P=0.004).Conclusions DTI-derived metrics are sensitive and reliable in the diagnosis of early radiation-induced brain injury.