PurposeTo explore the multislice CT (MSCT) and clinical manifestations of diaphragmatic hiatus hernia with hernial sac effusion, in order to improve its diagnostic rate.Materials and MethodsMSCT data were retrospectively analyzed for morphologies and clinical manifestations in 32 patients with diaphragmatic hiatus hernia and hernial sac effusion.Results32 patients included 21 males and 11 females (χ2=0.64,P>0.05). 25 patients were older than 60 years and 7 cases younger than 60 years (χ2=13.58,P<0.01). There were 27 cases with non-viscera hiatus hernia including 23 cases of combined fat-water hernia and 4 cases of simple effusion. 5 cases were of viscera type hiatus hernia (χ2=5.47,P<0.05). 28 cases showed ascites including 23 cases with non-viscera hiatus hernia and 1 case with viscera type hiatus hernia (χ2=9.56,P<0.01). The axial images from different levels of non-viscera hiatus hernia with liquid hernial sac demonstrated quasi-circular, meniscus, ringlike and teardrop shapes.Viscera type hiatus hernia and liquid hernial sac were found to be irregular shape . All patient sufferered from dysphagia, chest distress and epigastric discomfort.ConclusionThe increased pressure gradient between thorax and abdomen driving ascites into supradiaphragmatic hernial sac and clamping by hiatus may be the main mechanism. Quasi-circular, meniscus, ringlike andteardrop were the characteristic signs of diaphragmatic hiatus hernia with hernial sac effusion.

Objective To investigate the gastrointestinal imaging (GI)performance of herniation of pure abdominal omental fat (PAOF)into the esophagus hiatus(EH).Methods 7 cases of PAOF herniated into EH found by GI and MSCT were collected.The performance of GI was analyzed and compared with MSCT.Results 4 cases with large soft tissue shadow around lower segment esophagus,its density are lower,esophageal mucosa was showed coarse disorderly in the range of 2-4 cm of lower segment esophageal in the mucous membrane phase,of which 1 case with the mucosal line of esophagus at the j unction of esophagus and the superior border of the soft tissue slung up.Mild stenosis lumen of flexible wall was displayed in the filling phase,the upper bound of the lesions was often visible.3 cases with obtuse His angle,of which 1 case its change was shown with position.A more larger cystic fat density shadow was showed in MSCT right side of lower segment esophagus.3 cases were almost normal GI performance,among them 1 case of esophageal diaphragmatic ampulla lasting and a smaller cystic fat density shadow was showed in MSCT right side lower segment esophagus.The connection of the lower part of cystic fat density shadow to abdominal fat was showed all in 7 cases by MSCT MPR,and left gastric artery was shown to point to or protruded into EH by arcuate form.Conclusion A slight change of mucous membrane and lumen of lower segment esophagus which bounded above with larger and fade soft tissue density shadow and His angle obtuse variable were the special GI performance of the herniation of PAOF into EH,and the diagnose depended on MSCT.

Objective To investigate the distribution characteristics of pathogens isolated fromcerebrospinal fluid of neurosurgical patients with intracranial infection following open craniotomy and thetherapeutic effect influenced by these pathogens,in order to give a reference to the clinical treatmentmeasures.Methods A retrospective analysis was made on the pathogen distribution and therapeuticeffect of 43 patients with intracranial infection and positive cerebrospinal fluid cultures after open cranioto-my from May 2007 to May 2013.Cerebrospinal fluid was cleared using the intraventricular catheter orlumbar catheter combined with intraventricular (ventricular irrigation) or intraspinal (intrathecalirrigation) injection of antibacterial agents.Results To test bacteria in cerebrospinal fluid pathogencultures,34 cases were infected with single strain (26 Gram-positive bacteria and 8 Gram-negativebacteria) and 9 cases had mixed infection with multiple strains.Fifty-two pathogen strains were isolated,including 32 (62％) Gram-positive bacteria,18 (35％) Gram-negative bacteria,2 (4％) fungi.A totalof 29 cases were cured (67％),7 improved (16％),and 7 ineffective (16％).Conclusions Cere-brospinal fluid pathogen infection is primarily Gram-positive bacterial infection,usually staphylococcusepidermidis and staphylococcus aureus.Gram-negative pathogens are acinetobacter,klebsiella,andpseudomonas aeruginosa.Ventriculoperitoneal shunting surgery and craniocerebral surgery are often asso-ciated with mixed infection of pathogens.Ventricular irrigation allows better results than intrathecal irriga-tion.Indications of intrathecal irrigation treatment used to control intracranial infection after ventriculoper-itoneal shunting surgery and craniocerebral surgery should be strictly performed.

ObjectiveTo discusses the MSCT multiplanar reconstruction manifestation (MPR) of localized fat collection adjaction to subdiaphragmatic inferior vena cava (IVCfat).MethodsThe thoracic and abdominal MSCT scan data of 8246 patients were browsed,45 patients with presumed IVCfat on axial CT scans were further studied prospectively with MSCT MPR.The predisposing position of IVCfat and its relationship with IVC were observed.It was divided into two kinds of intraluminal type and extraluminal type according to the angle of IVCfat with respect of the wall of IVC.The other 50 patients without IVCfat were randomly selected as the control group.The sagittal inclination angle (SIA) and diameter ratio (DR) between supra- and sub-diaphragmatic IVC between the two groups were compared by using t test.Results The detection rate was 0.55％ (45/8246).Of which hepatic vein lacuna 8 patients,subdiaphragmatic gap medial to IVC 28 patients and IVC groove 9 patients.The shape of IVCfat showed mainly for the round,oval and crescents on axial CT scans,of 15 patients intraluminal type,4 showed target signs .The shape of IVCfat showed mainly for half-moon at MPR.The SIA and DR at IVCfat group were 21.62° ± 8.42°and 2.01 ±0.84 respectively,at control group were 16.75° ±7.82°(t =1.594,P ＞0.05) and 1.31 ±0.28(t =2.341,P ＜ 0.05 ) respectively.ConclusionThe round,oval or half of limited fat density shadow adjaction to subdiaphragmatic inferior vena cava which similar to in the lumen is the characteristic performance of IVCfat,it may be an anatomical variation.

Objective To investigate the diagnostic value of multiplanar reformation (MPR)reconstruction for the detection of traumatic diaphragmatic rupture (TDR) in multi-slice CT examination.Methods Thirty six cases with thoracoabdominal trauma, including 21 cases with and 15 cases without TDR confirmed by surgery, received multi-slice CT examination. They were enrolled in this study. Three experienced radiologists retrospectively analyzed the axial and MPR images. The diagnostic criteria for TDR included abnormally elevated hemidiaphragm, diaphragmatic discontinuity, the "collar sign" or "dependent viscera "sign. Referenced to surgical results, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of axial and MPR images in detection of TDR were calculated. The McNemar was used to investigate the differences between axial and MPR images in the detection of diaphragmatic discontinuity and "collar sign", and the differences between axial and MPR images of these two signs in TDR diagnosis. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of axial images in detection of TDR were 71% ( 15/21 ), 80% ( 12/15 ), 83% ( 15/18 ),67% ( 12/18 ) and 75% ( 27/36 ), respectively; of MPR images, they were 86% ( 18/21 ), 93%(14/15), 95% ( 18/19 ), 82% ( 14/17 ) and 89% ( 32/36), respectively. By axial images, twelve diaphragmatic defects or interrupts were identified in nine cases, and "collar sign" was identified in six cases. By MPR, 20 diaphragmatic defects or interrupts were identified in 15 cases ( P = 0.125 ), and "collar sign" was identified in 14 cases (P =0.021 ). The sensitivity and specificity of diaphragmatic defects or interrupts for TDR diagnosis in axial images were 43% (9/21) and 80% ( 12/15 ), respectively;in MPRimages, they were71% (15/21) (P=0.125)and93% (14/15) (P=0.500), respectively.The sensitivity and specificity of "collar sign" for TDR diagnosis in axial images were 29% (6/21) and 100% ( 15/15), respectively; in MPR images, they were 67% ( 14/21 ) (P =0. 021 ) and 100% (15/15)( P = 1.000), respectively. Conclusions MSCT presented good sensitivity, specificity and accuracy for the diagnosis of TDR. MPR images were useful supplements for axial images in TDR diagnosis which improved the diagnosis.

OBJECTIVETo study the activation of platelets in children with Kawasaki disease (KD) at molecular level.

METHODSThe expression of platelet surface glycoproteins CD(41), CD(42a), CD(61), CD(62p) and CD(63) in 20 KD patients was measured by flow cytometry before and at 1, 2, 3 week after treatment with aspirin and high-dose (1 approximately 2 g/kg) intravenous gamma-globulin (IVIG).

RESULTSThe expression of glycoprotein CD(41), CD(42a), CD(61), CD(62p) and CD(63) were higher in KD group than in control group. Aspirin and IVIG could not inhibit these high expression of glycoproteins. Higher expression of CD(62p) was observed in patients with coronary artery injury.

CONCLUSIONPlatelets were highly activated in KD patients which may be one of the most important pathophysiological step in KD. It provided a theoretical basis for treatment of KD with antagonist of glycoprotein of platelets. Obviously increase of CD(62p) can be taken as a criterion for predicting coronary artery injury in KD patients.

Aspirin ; pharmacology ; Blood Platelets ; drug effects ; metabolism ; Child ; Child, Preschool ; Coronary Artery Disease ; complications ; metabolism ; Female ; Humans ; Injections, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome ; metabolism ; pathology ; P-Selectin ; metabolism ; Platelet Activation ; physiology ; Platelet Membrane Glycoproteins ; metabolism ; gamma-Globulins ; pharmacology

Objective To evaluate the effect of small interfering RNA (siRNA)targeting survivin gene on the expression of survivin and proliferation,apoptosis,migration and invasion of a human cutaneous squamous cell carcinoma cell line A431 in vitro.Methods A survivin-specific siRNA was designed and synthesized.Cultured A431 cells were divided into 3 groups to be transfected with 50.0 nmol/L liposome complexes containing survivin-specific siRNA (survivin siRNA group),50.0 nmol/L liposome complexes containing unrelated siRNA (negative control group) and 50.0 nmol/L prepared vesicles (blank control group).Real-time quantitative reverse transcription-PCR (RT-PCR) and Western blot analysis were performed to determine the mRNA and protein expression of survivin in A431 cells,respectively.Methyl thiazolyl tetrazolium (MTT) assay was conducted to evaluate cellular proliferative activity,flow cytometry using annexin-V/propidium iodide (PI) staining to detect cell apoptosis,Transwell assay to estimate migratory and invasive activities of A431 cells,and flow cytometry to detect cell cycle changes.Results At 48 hours after transfection,the mRNA and protein expression of survivin both significantly differed among the survivin siRNA group,negative control group and blank control group (mRNA:0.56 ± 0.15,0.88 ± 0.37,0.90 ± 0.43,F =276.67,P ＜ 0.001;protein:0.59 ± 0.04,0.86 ± 0.05,0.91 ± 0.07,F =243.61,P ＜ 0.001),the survivin siRNA group showed significantly lower mRNA and protein expression of survivin compared with the negative control group and blank control group (all P ＜ 0.05),and there were no significant differences between the negative control group and blank control group (both P ＞ 0.05).Repeated measures analysis of variance showed that the transfection with survivin siRNA could significantly inhibit the proliferation of A431 cells (F =13.19,P =0.004),the proliferation inhibition rate was significantly higher in the survivin siRNA group than in the negative control group and blank control group (both P ＜ 0.05),and no significant difference was observed between the negative control group and blank control group (P ＞ 0.05).At 24 hours after transfection,the apoptosis rate significantly differed among the 3 groups (F =83.97,P =0.002).The survivin siRNA group showed a significantly higher apoptosis rate compared with the negative control group and blank control group (both P ＜ 0.05),and there was no significant difference between the negative control group and blank control group (P ＞ 0.05).At 48 hours after transfection,the survivin siRNA group showed a significantly higher proportion of cells at G2/M phase,but lower number of migratory cells and invasive cells compared with the negative control group and blank control group (all P ＜ 0.05).Conclusion Survivin-specific siRNA can inhibit the expression of survivin gene and the proliferation of A431 cells,promote cell apoptosis,and suppress cell migration and invasion,indicating that survivin may serve as a genetic target for the treatment of cutaneous squamous cell carcinoma.

Objective ToexploretherelationshipbetweenSchizasgradeofthenerverootwithintheduralsacandtheduralsac cross-sectionalarea(DSCA)ofthelumbarspineaswellastheclinicalsignificance.Methods 3.0T MRIexaminationofthelumbar spineof89patientswithlunbarspinestenosis(LSS)from May2016toSeptember2017intheaffiliatedhospitalofNantongUniversitywere collected.Twoexperienceddoctorsindependently measuredthekyphosisdegreeofthethoracolumbarspine,theDSCAofthe2-5 lumbarlevels,vDSCA,dDSCA,andevaluatedSchizasgradeofthenerverootforfourdegradsofA,B(gradeB1:DCSA≥100 mm2, gradeB2 :DCSA<100 mm2 ),CandDaccordingtozygopophysisconnectingline,andfinallyconductedthetestof Kappa consistency.DSCA wasdividedintothreegroupsof≤75 mm2,76-99 mm2and≥100 mm2,andχ2 wasadoptedtoexaminetherateineachSchizas grade.Schizasgradewithd/vvalue(dDSCA/vDSCA)andthekyphosisdegreeofthethoracolumbarspinewerecomparatedbyttest. Forthecorrelationcoefficient,S pear m an analysis wasadopted.Results In89cases with173lumbarlevels,schizasgradeofthenerve rootwere52,51,32and38levelsforgradeA-DrespectivelyI.nDSCA≤75mm2group,SchizasCandDwere18.5%and21.9%respectively, whichweresignificantlyhigherthanthoseforgradeAandB(0% and3.5%,P<0.01);InDSCA=76-99mm2group,Schizasgrade AandBwere8.7% and17.9%,whichweresignificantlyhigherthanthoseofgradeCandD (0% and0%,P<0.05and0.01);In DSCA≥100mm2group,therewere0% and0%forSchizasgradeCandD,whichweresignificantlylowerthanthoseforgradeAand B(21.4% and8.1%,P<0.0SchizasgradesofA-Dgroups,d/vaveragevalueswere0.64±0.29,0.48±0.22,0.42±0.20and0.34±0.11 respectively,in whichgradeCand D weresignificantlylower thanthoseofgradeAandB(P<0.01).Thecorrelationcoefficientof SchizasgradewiththeDSCAandd/vvalueswere0.83and0.87 respectively(P<0.01).Thekyphosisdegreeofthethoracolumbar spinewas(158.7±15.9)°inSchizasgradeB1,and (167.8±11.2)°inothergrades(t=4.37,P<0.05).Conclusion Theclassification ofnerverootSchizasgradeishighlyrelatedtoDCSA,andbothofthemaretheindicatorsforjudgingwhetherthelumbarspinalis stenosisornormal.TheSchizasgradeismoreconvenientandquicker;InordertoavoidconflictwithDCSA,SchizasBshouldbedividedintoB1 andB2 Whenitisusedtodeterminewhetherhavestenosis.

Objective To investigate the expression of hsa_circ_0018574 in colorectal cancer tissues and human colon cancer HT29 cell line, as well as its effect on the proliferation and apoptosis of colorectal cancer cells. Methods The circPrimer 1.2 software was used to draw the circRNA sequence structure. Meanwhile, the circRNA microarray was used to screen differentially-expressed circRNA in colorectal cancer tissues and adjacent tissues, and RNA was extracted from tissue samples. The expression of hsa_circ_0018574 in human colorectal tumors was detected by RT-qPCR. The si-circ_0018574 was transfected into HT29 cells, and the expression of CDK2, CDK4, CDK6, cyclinD1, and cyclinE cyclins were detected by colony formation assay, flow cytometry, and Western blot, respectively. Results The expression of hsa_circ_0018574 in human colorectal tumor tissues was significantly higher than that in adjacent tissues (P < 0.01). Meanwhile, the si-circ_0018574 in HT29 cells could significantly inhibit the proliferation of cancer cells, reduce clone formation and colony formation ability (P < 0.01), and induce tumor cell apoptosis (P < 0.01). The expressions of CDK2, CDK4, CDK6, cyclinD1 and cyclinE cyclins were decreased. Conclusion The hsa_circ_0018574 is highly expressed in colorectal tumors, and si-circ_0018574 could significantly inhibit the proliferation of HT29 cells, reduce cell division, and induce apoptosis.

Objective To investigate the effect of neurotrophin-3(NT-3)on the proliferation and apoptosis of bone marrow mesenchymal stem cells(BMSCs)in rats and possible mechanisms. Methods The NT-3 overexpression and lentiviral transfection of BMSCs were co-cultured with neuronal cells respectively and then they were divided into overexpression control group,NT-3 transfection group and shRNA-NT-3 transfection group(NT-3 silencing group).MTT assay was used to detect the cell culture for 24 h,48 h and 72 h. Cell cycle and apoptosis were detected by flow cytometry for 48 h. Real-time quantitative PCR was used to detect the expression of C/EBPβmRNA.The expression of C/EBPβprotein was detected by Western blot. Results MTT results showed that the proliferation ability of BMSCs in the NT-3 overexpres-sion group was significantly higher than that in the control group(0.650±0.042,0.826±0.074)at 48 h and 72 h(P<0.05).Compared with the control group(P<0.05),the cell cycle and apoptosis of BMSCs in NT-3 silencing group were significantly decreased at 48 h and 72 h(P<0.05). The results of 48 h cell cycle and apoptosis showed that the percentage of G1 phase in BMSCs was decreased,G2 and S were increased and the apoptosis was decreased. The percentage of G1 phase in G2-S phase and the increase of apoptosis were in-creased in NT-3 silencing group. The results of Western Blot showed that C/EBPβ mRNA and protein levels were significantly up-regulated in BMSCs of NT-3 overexpression group and significantly decreased in NT-3 silencing group(P<0.05).Conclusion NT-3 may promote the expression of C/EBP beta and affect the ex-pression of its downstream target genes,which can inhibit the apoptosis of BMSCs cells.