Objective To investigate the diagnostic values of direct lymphangiography for the thoracic duct outlet obstruction.Methods The image data of direct lymphangiography were retrospectively analyzed in 124 patients with lymphedema,Chylothorax,chylous ascites,chyluria and intestinal lymphangiectasis,and compared with the results of neck thoracic duct surgical exploration,2 radiologists reviewed DLG DSA images in a double blind manner.The number of neck stem,subclavian stem,bronchialmediastinal stem and TD terminal into blood obstruction on the operation side showed by DLG were assessed using Kappa analysis.Results Of 124 patients,80 patients had the left cervical lymphatic stem reflux on DLG,75 patients with the left subclavian lymphatic stem reflux,30 patients with the left bronchial-mediastinal lymphatie stem reflux,118 patients showed the thoracic duct outlet barrier into the blood.The consistency rate of DLG were 89.9％ (80/89),92.6％ (75/81),90.9％ (30/33) and 95.2％ (118/124) compared with the neck thoracic duct surgical exploration.Tow radiologists had a high degree of diagnostic consistency (K =0.82,P ＜ 0.05).In addition,114 patients (91.9％) had tortuous,dilated waist lymphatic stem,only 10 patients (8.1％) were normal.The cisterna chyli reflux were found in 92 patients (74.2％),intestinal stem reflux in 16 patients (12.9％),reflux to the kidney area in 11 patients (8.9％),to the pericardium reflux in 5 patients (4.0％),vaginal lymphatic leakage in 7 patients (5.6％),retroperitoneal lymph leakage in 2 patients (1.6％),pleural lymphatic leakage in 3 patients (2.4％),tracheal lymph leakage in 1 patient (0.8％).Conclusion Direct lymphangiography has a high consistency with the cervical thoracic duct surgical exploration in displaying thoracic duct outlet obstruction.

Objective To evaluate the correlating clinical factors of coronary artery calcification score(CACS).Methods 141 patients suspected of coronary artery disease were included.They underwent multi-slice row computed tomography,pulse wave velocity ( PWV ),UCG and blood biochemistry within a period of 3 months.The subjects were divided into three groups according to CAC score:A(CACS =0-10),B ( CACS = 11-400),C ( CACS > 400).Results CACS was significantly associated with age,history of hypertension and diabetes mellitus.It was also associated with the presence of mitral annular calcification and aortic valve calcification,low ankel brachial pressure index(ABI) and high mean artery pressure(MAP) as well as high values of brachial ankel PWV (baPWV) and Upstroke time (UT).Muhifactorial logistic regression analysis showed that the presence of aortic valve calcification and mitral annular calcification,the history of diabetes mellitus and high value of UT were independently correlated with severe coronary artery calcification.Conclusions Aortic valve calcification,mitral annular calcification,history of diabetes mellitus,high value of UT were independently correlated with severe coronary artery calcification.Measurement of PWV and UCG should be performed before muhi-slicerow computed tomography,because the assessment of coronary artery lumen narrowing with multi-slice row computed tomography can not be carried out accurately in the presence of severe coronary artery calcification.

Objective To explore the correlation between CT characters and epidermal growth factor receptor (EGFR) gene mutations in lung adenocarcinoma. Methods Two hundred and three lung adenocarcinoma patients (from September,2014 to March,2015) confirmed by pathology were divided into effective mutation group (97 cases) and non?effective mutation group (106 cases) on the basis of the site and the response to tyrosine kinase inhibitors. Among all the CT characters, rank?sum test was adopted to analyze the difference of diameter between the two groups; Fisher's exact test was applied to explain the difference of density type and Chi?square test was applied to analyze the difference of lobulation, spiculation, necrosis, pleural indentation, cavitation and air?brochogram signs. Logistic regression was used to analyze the significant signs and evaluate the odds ratio (OR). Results There were 65, 67, 45, 74 cases of lobulation, spiculation, necrosis, pleural indentation in the EGFR gene effective mutation group and 56, 51, 26, 61 cases in non?effective mutation group with statistically significant difference between the two groups (χ2=4.230, 9.141, 10.646, 7.986, P<0.05). However, there were no significant difference between the two groups in the diameter, density, cavitation and air?brochogram (P>0.05). Logistics regression analysis showed that, spiculation (OR=2.120), necrosis (OR=2.853) and pleural indentation (OR=2.094) were in correlation with EGFR effective mutations, and lobulation was not in correlation with EGFR effective mutations. Conclusions Among all the CT sings, spiculation, necrosis and pleural indentation were in correlation with EGFR gene effective mutation, they were more likely to appear in lung adenocarcinoma patients with EGFR gene effective mutation.

Objective To investigate the distribution of femoro-popliteal artery chronic totally occlusions (CTO) and to analyze the influence of different risk factors on the distribution of lesions. Methods A total of 47 patients with CTA and DSA proved femoro-popliteal artery CTO, who were admitted to the Affiliated Beijing Shijitan Hospital of Capital Medical University during the period from January 2013 and May 2015, were enrolled in this study. In order to make a clear description about the distribution characteristics of the lesions, the superficial femoral artery was averagely divided into three segments (F1-F3), and the popliteal artery was also divided into three segments (P1-P3) according to the bony landmarks. Based on the CTA images (including 3D reconstruction images) and DSA images, the distribution of CTO lesions was determined. The factors that might influence the distribution of CTO lesions were collected, and the results were analyzed using multivariable logistic regression analysis. Results A total of 59 femoro-popliteal artery CTO lesions detected in 47 patients were included in this study. The average length of lesion segment was (12.91 ± 10.13) cm. According to the 6-section division method of femoro-popliteal artery, the lesions involved F1 (n=23), F2(n=34), F3(n=48), P1(n=18), P2(n=6) as well as P3(n=5) segments. Multivariable logistic regression analysis reveals that F1 segment was most prone to be affected by CTO lesions in patients with hypertension (RR=3.21) and in patients who had cigarette smoking habit (RR=1.76). In male patients, P1segment was more easil y involved by CTO lesions (RR=1.98). In patients with diabetes mellitus, the RR value was gradually increased from the proximal to the distal end of the blood vessel, indicating that the lesion was more likely to involve distal vessels. Conclusion The distributions of femoro-popliteal artery CTO lesions have certain characteristics, which are closely associated with femoro-popliteal artery hemodynamics and atherosclerosis risk factors.

To study the clinical efficacy of Pihui Fanggan Sachet (PHFGS), a sachet of traditional Chinese herbs, in preventing influenza and its immune regulation on mice.

The mitochondria in liver tissue not only provides energy for substance metabolism in hepatocytes, but also participates in hepatocellular injury and even apoptosis. It also plays an important role in several pathological processes closely associated with hepatocellular injury and apoptosis, such as hepatitis, hepatic fibrosis, precancerous lesion, and liver cancer. This article elaborates on the association between mitochondria and hepatocellular injury from the following aspects: the important role of the change in mitochondrial membrane permeability in hepatocellular injury, hepatocellular injury accelerated by ATP synthesis disorder and consumption, and the association of abnormal Ca2+ homeostasis in hepatocellular mitochondria with hepatocellular injury, in order to provide a theoretical basis for mitochondria-targeted prevention and treatment of chronic liver diseases due to hepatocellular injury.

Aim To explore the expressed level of ini-tiative key factors TSLP and IL-33 in a human kerati-nocyte cell line,HaCaT cells were chosen to be stimu-lated by different stimulants,and develop a stable and effective in vitro model to observe allergic sensitization. Methods HaCaT cells were cultured in K-SFM with different stimulants to screen out the stimulants which could significantly improve the expressed level of TSLP and IL-33.Expressed level of TSLP and IL-33 was an-alyzed by ELISA kits and immunofluorescence.Re-sults (1 )The dose-response relationship of single stimulant indicated that both Poly(I:C)and TNF-αcould significantly improve expressed level of TSLP and IL-33 in HaCaT cells,but the rest of stimulants was not observed significant stimulation in concentration range of this experiment.(2)Dose-effect relationship of combined stimulants indicated that poly(I ∶C)1 00 mg·L -1 combined with TNF-α20 μg·L -1 was the most efficient.(3)Time-effect relationship of the a-bove-mentioned combined stimulants showed that 1 2 h was the optimal time of stimulation.Conclusions Different stimulants and different time result in various expressed levels of TSLP and IL-33 in HaCaT cells.1 2 h stimulus duration of Poly(I:C)1 00 mg·L -1 com-bined with TNF-α20 μg · L -1 is the most efficient stimulating way.This result provides an effective in vitro model to study the pathomechanism and drug effi-cacy of allergic sensitization.

The development and progression of liver cancer have the stages of hepatitis, liver cirrhosis, precancerous lesion, and liver cancer, among which the malignant transformation of precancerous lesions of liver cancer is closely associated with the activation of hepatic stellate cells (HSC). By describing the activation of HSC, the generation of precancerous cells of liver cancer, the formation of inflammatory fibrotic microenvironment, and the association between HSC activation and precancerous lesion, this article points out that microRNAs can affect the malignant transformation of precancerous lesion of liver cancer by regulating the expression of related target genes and HSC activation, and the research in this field is expected to provide new ideas and targets for the prevention and treatment of liver cancer.

Excessive lipid deposition, liver injury, and insulin resistance are hallmarks in the development and progression of nonalcoholic fatty liver disease (NAFLD). Liver X receptor (LXR) is a transcriptional regulator, and its two cell subtypes, LXRα and LXRβ, play a key role in regulating cholesterol metabolism, inducing anti-inflammation, and reducing insulin resistance. This article reviews the structure and function of LXR and its association with the pathogenesis of NAFLD, in order to provide new ideas and methods for the prevention and treatment of NAFLD.

Autophagy can regulate liver physiology and balance liver metabolism. Autophagy activation has a double-sided and complex effect on liver injury, and it is regulated by many factors and is associated with many protein pathways. This article summarizes the role of mTOR in the regulation of autophagy, which can inhibit or enhance autophagy through the PI3K/Akt upstream signaling pathway and participate in the physiological and pathological changes of related liver diseases. Therefore, this article reviews the research advances in the mTOR/PI3K/Akt autophagy pathway in liver injury, in order to provide new therapeutic targets for related liver diseases.