Objective To evaluate the double-arterial phase and portal venous phase scanning in the detection of hepatocellular carcinoma with multi-slice sprial CT (MSCT).Methods Ninety-four patients with hepatocellular carcinoma were examined by abdominal plain CT and early areterial phase (EAP),late arterial phase(LAP),portal venous phase(PVP).Contrast agent of 100 ml (300 mg I/ml) was administrated intravenously by 3 ml/s,for scanning of EAP at 20 to 22 s,LAP at 34 to 37s.and PVP at 60 s.Chi-square test was carried out to compare the sensitivity among various phases.Resuits A total 0f 318 1esions was detected pathologically,with 86 lesions less than 3 cm in size and 232 lesions more than 3 cm.For the early arterial phase,late artefial and portal venous phase,the sensitivity was 39.5%(34),67.4%(58),44.2%(38)respectively for the small tumors,which showed significant differences between phases(X2=15.38,P<0.01).For the large tumors,the sensitivity was 89.6%(208),99.6%(231), 99.1%(230),respectively(X2=39.09,P<0.01).All had positive predictive values of 100%.If the tumors were taken together,the sensitivity was 76.1%(242),90.9%(289),84.3%(268).and the positive predictive value was 88.3%(242/274),86.3%(289/335),93.7%(268/286)for the early arterial phase,late arterial and portal venous phase respectively.There was significant difference of sensitivity and positive predictive value between phases(X2=25.62,9.29,P<0.05).Conclusion Double-arterial phase could improve the detection of tumors,especially for small hepatocellular earcinoma. and late arterial phase scanning is particularly important.

Objective To study the characteristics of DWI in nude mice models of hepatic Bel7402 tumors after treatment with adenovirus-mediated cytosine diaminase-thymidine kinase ( Ad.CD-TK) double suicide gene therapy, and then to identify whether DWI can be used for assessing curative effect of postoperative tumors.Methods Thirty nude mice models of hepatic Be17402 tumors were successfully created using cell suspension method,after the tumor grew to more than 1 cm in diameter,20 tumor models were treated by intratumoral administration of Ad.CD-TK for 3 days plus intraperitonea( i.p.) treatment with 5-Fc and GCV for the duration of the study.Then they were randomly divided into three groups during 5-Fc and GCV treatment.The remaining 10 tumor models were used as controls.MR scanning were performed in 10th day before and after tumor implantation in all models by using EPI-SE series and SENSE technology for treatment group. Tumor volumes and ADC values were calculated pretreatment and posttreatment. Cell apoptosis were determined by using TUNEL method.Analyze the change of ADC and apoptosis index (AI) in different times,t test was used for comparison the difference of AI and ADC values respectively. Results After 10 days,the tumor volumes of the treatment groups and controls were respectively (724.16 ±57.45 ) mm3,( 754.57 ± 66.84 ) mm3,with no significant difference ( t =0.488,P ＞ 0.05 ).The ADC values of the treatment groups were (0.98 ±0.11 ) × 10-3 mm2/s,the ones of the control groups were (0.68 ±0.04) × 10 -3mm2/s;AI of the treatment groups were(23.25 ±6.57)％,the ones of the control groups were (2.57 ± 0.58) ％.There were difference in both groups ( t =4.473,5.874 ; P ＜ 0.01 ).Conclusion DWI can be effectively to monitor the early pathological changes of hepatic Bel7402 tumors after Ad.CD-TK double suicide gene therapy,and provide experimental evidences for clinical application.

Objective To compare the effects of different general anesthesia protocols on perioperative cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer.Methods Ninety ASA Ⅰ or Ⅱ colorectal cancer patients,aged 40-64 yr,weighing 50-85 kg,undergoing laparoscopic surgery were randomly divided into 3 groups (n =30 each):group total intravenous anesthesia (group Ⅰ) ; group inhalational anesthesia(group Ⅱ) and group combined intravenous-inhalational anesthesia (group Ⅲ).Anesthesia was induced with iv midazolam,sufentanil,TCI of propofol and remifentanil and vecuronium in groups Ⅰ and Ⅲ.In group Ⅰ anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecuronium,while in group Ⅲ with inhalation of sevoflurane and intermittent iv boluses of vecuronium.In group Ⅱ anesthesia was induced and maintained with inhalation of sevoflurane and intermittent iv boluses of vecuronium.Narcotrend index was used to monitor depth of anesthesia and maintained at 37-64 during operation.Venous blood samples were taken for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8 +) and natural killer cells at 30 min before induction of anesthesia (T0),2 h after skin incision (T1),at the end of operation (T2) and 24 h after operation (T3).Results The levels of CD3 +,CD4 +,CD4+/CD8+ and natural killer cells were significantly decreased at T2 in group Ⅱ,while the levels of natural killer cells were decreased at T2 in group Ⅲ as compared with the baseline at T0,and were significantly lower than those in group Ⅰ.The levels of CD3+ and CD4+ were significantly lower at T2 in group Ⅱ than in group Ⅲ.Conclusion Intravenous anesthesia with midazolam,propofol,sufentanil,remifentanil and vecuronium has less inhibitory effect on perioperative cellular immune function than inhalational anesthesia and combined intravenous-inhalational anesthesia in patients undergoing laparoscopic surgery for colorectal cancer.

OBJECTIVE:To observe clinical efficacy and safety of Tianqi jiangtang capsules combined with metformin in the treatment of elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions. METHODS:A total of 96 elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions were randomly divided into control group(48 cases)and observation group(48 cases). Control group was given Metformin hydrochloride tablets 0.5 g orally,3 times a day. Observation group was additionally given Tianqi jiangtang capsules 1.6 g orally,3 times a day,on the basis of control group. Both groups received treatment for 4 weeks. Clinical efficacies of 2 groups were observed as well as total score of TCM symptoms,the levels of blood glucose(FPG,2 hPG,HbA1c),blood lipid(TC,TG,HDL-C,LDL-C),hs-CRP,ET-1,blood rheology and oxidative stress indexes(MDA,SOD),the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group(89.58% vs. 70.83%),with statistical significance(P<0.05). After treat-ment,total score of TCM symptoms,the levels of blood glucose,hs-CRP,ET-1,TC,TG,LDL-C,blood rheology indexes and MDA in 2 groups were significantly lower than before;total score of TCM symptoms,the levels of FPG,2 hPG,hs-CRP,ET-1, TC,TG,LDL-C,blood rheology indexes and MDA in observation group were significantly lower than control group;the level of SOD in 2 groups were significantly higher than before,and the observation group was significantly higher than control group,and the level of HDL-C in observation group was significantly higher than before treatment and control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Tianqi jiangtang capsules combined with metformin show significant therapeutic efficacy in the treatment of elderly patients with type 2 diabetes mellitus,and can re-duce the levels of blood glucose and lipid,improve blood rheology and oxidative stress reaction,with goud safety.

ObjectiveTo compare the effects of different general anesthesia protocols on perioperative cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer.MethodsNinety ASA Ⅰ or Ⅱ colorectal cancer patients aged 40-64 yr weighing 50-85 kg undergoing laparoscopic surgery were randomly divided into 3 groups (n ＝ 30 each):group total intravenous anesthesia (group Ⅰ ); group inhalational anesthesia (group Ⅱ ) and group combined intravenous-inhalational anesthesia(group Ⅲ ).Anesthesia was induced with iv midazolam,sufentanil,TCI of propofol and remifentanil and vecuronium in groups [ and Ⅲ.In group Ⅰ anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecuronium,while in group Ⅲ with inhalation of sevoflurane and intermittent iv boluses of vecuronium.In group Ⅱ anesthesia was induced and maintained with inhalation of sevoflurane and intermittent iv boluses of vecuronium.Narcotrend index was used to monitor depth of anesthesia and maintained at 37-64 during operation.Venous blood samples were taken for determination of the levels of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+ ) and natural killer cells at 30 min before induction of anesthesia (T0 ),2 h after skin incision (T1),at the end of operation (T2 ) and 24 hafter operation (T3 ).ResultsThe levels of CD3+,CD4+,CD4+/CD8+ and natural killer cells were significantly decreased at T2 in group Ⅱ,while the levels of natural killer cells were decreased at T2 in group Ⅲ as compared with the baseline at T0,and were significantly lower than those in group Ⅰ.The levels of CD3 + and CD4+were significantly lower at T2 in group Ⅱ than in group Ⅲ.ConclusionIntravenous anesthesia with midazolam,propofol,sufentanil,remifentanil and vecuronium has less inhibitory effect on perioperative cellular immune function than inhalational anesthesia and combined intravenous-inhalational anesthesia in patients undergoing laparoscopic surgery for colorectal cancer.

Objective To observe the effect of tirofiban,aspirin and Clopidogrel Hydrogen triple antiplatelet in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention and the effect on the incidence of major adverse cardiac events.Methods a total of 60 patients with acute myocardial infarction(AMI)in our hospital from January 2015 to-2016 in December were enrolled in this study.All patients were treated with percutaneous coronary intervention(PCI).The patients were randomly divided into control group(n=30)and observation group(n=30).The control group using clopidogrel hydrogen treatment,observation group were treated with tirofiban,aspirin and Clopidogrel Hydrogen triple antiplatelet therapy,the incidence and clinical effects of the two groups of major adverse cardiac events.Results the two groups before treatment,the platelet aggregation rate and platelet count had no statistically significant difference; no significant observation group after treatment compared 30d platelet count difference; observation group 30d after treatment,the platelet aggregation rate was lower than the control group(P<0.05); the observation group after the treatment of 30d MA-ADP on platelet drug reaction the inhibition rate is lower than the control group(P<0.05); the observation group after treatment of AA drugs 30d platelet inhibition rate,the inhibition rate of ADP,higher than that of the control group(P<0.05); the observation group after treatment,the incidence of major adverse cardiac events was 13.33％,33.33％in the control group,two groups of major adverse cardiac events was statistically significant the difference(P<0.05).Conclusion The patients with acute myocardial infarction undergoing primary percutaneous coronary intervention after treatment with tirofiban,aspirin and chlorine Pigre triple antiplatelet ideal treatment effect,can reduce the incidence of major adverse cardiac events,it is worthy of popularization and application.

Objective To compare the genotypes distribution of human papillomavirus (HPV ) infection in tissues of cervical cancers and cervical intraepithelial neoplasias (CIN ) and its clinical significance .Methods The polymerase chain reaction (PCR) and the gene-chips technique were utilized for the detection of 23 kinds of HPV genotypes in the tissue specimens from 192 cases of cervical intraepithelial neoplasia (CIN) and 85 cases of cervical cancers .And the related data of all subjects were analyzed .Results In 192 cases of CIN ,the total positive rate of HPV was 82 .29% (158/192) ,the positive rate of single genotype infection was 46 .88% (90/192) and the positive rate of multiple genotypes infection was 35 .42% (68/192);In 85 cases of cervical cancers ,the to-tal infection rate of HPV was 88 .24% (75/85) ,the positive rate of single genotype infection was 65 .88% (56/85) and the positive rate of multiple genotypes infection was 22 .35% (19/85) .Conclusion PCR combined with the gene-chips technique can be used in the detection of the tissue samples of cervical lesions ,once detection can detect 23 kinds of HPV genotypes with high sensitivity and strong specificity ,which has very important significance to the prevention and treatment of cervical cancer and precancerous lesions and the their vaccine research .

AIM:To explore the therapeutic effect of Buyang-Huanwu decoction (BYHWD) on experimental au-toimmune encephalomyelitis ( EAE) and its immunoregulatory effect on monocyte-macrophages .METHODS: Chronic EAE was induced by myelin oligodendrocyte glycoprotein peptide fragment 35-55 ( MOG35-55 ) in the female C57BL/6 mice, which were randomly divided into saline group and BYHWD group .On day 3 after immunization , the mice in BYHWD group were orally administrated with BYHWD , while normal saline was given to the control mice .The clinical score and body mass were recorded every other day .At day 17 after immunization , the mice were sacrificed and spinal cords were obtained for HE staining and myelin staining .The M1 and M2 macrophage phenotypes of splenic cells were detected by flow cytometry and immunofluorescence staining .The protein expression of iNOS , TNF-α, arginase and IL-10 in the spinal cord macro-phages was determined by Western blotting .RESULTS:BYHWD delayed the onset of EAE , reduced the clinical scores of EAE, inhibited the inflammatory cell infiltration and demyelination in the spinal cord , and promoted the conversion of M 1 macrophages into M2 phenotype in the spinal cord and spleen .CONCLUSION:BYHWD intervention attenuates the be-havioral and pathological changes in the EAE mice , and its mechanism may be related to the macrophage conversion .

In this study,a fluorescent(FL)aptasensor was developed for on-site detection of live Salmonella typhimurium(S.T.)and Vibrio parahaemolyticus(V.P.).Complementary DNA(cDNA)of aptamer(Apt)-functionalized multicolor polyhedral oligomeric silsesquioxane-perovskite quantum dots(cDNA-POSS-PQDs)were used as encoded probes and combined with dual-stirring-bar-assisted signal amplification for pathogen quantification.In this system,bar 1 was labeled with the S.T.and V.P.Apts,and then bar 2 was functionalized with cDNA-POSS-PQDs.When S.T.and V.P.were introduced,pathogen-Apt complexes would form and be released into the supernatant from bar 1.Under agitation,the two complexes reached bar 2 and subsequently reacted with cDNA-POSS-PQDs,which were immobilized on MXene.Then,the encoded probes would be detached from bar 2 to generate FL signals in the supernatant.Notably,the pathogens can resume their free state and initiate next cycle.They swim between the two bars,and the FL signals can be gradually enhanced to maximum after several cycles.The FL signals from released encoded probes can be used to detect the analytes.In particular,live pathogens can be distinguished from dead ones by using an assay.The detection limits and linear range for S.T.and V.P.were 30 and 10 CFU/mL and 102-106 CFU/mL,respectively.Therefore,this assay has broad application potential for simultaneous on-site detection of various live pathogenic bacteria in water.

Objective:To analyze the changes of metabolic indexes and other characteristics in patients with primary aldosteronism (PA) and improve the understanding of PA.Methods:From January 2017 to August 2020, 91 PA patients who were clearly diagnosed and met the inclusion conditions in Tangshan workers Hospital, Hebei Medical University were selected as the observation object (PA group), and 112 patients diagnosed as essential hypertension (EH) in the same period were included as the control (EH group). A retrospective case-control study was conducted to compare the differences of blood glucose, blood lipid, homocysteine, blood potassium, creatinine, uric acid, aldosterone, renin, plasma aldosterone to renin ratio (ARR), blood pressure and waist circumference between the two groups. The measurement data of normal distribution were compared by independent sample t-test. The non normal distribution data are represented by M (Q 1, Q 3), and the rank sum test is used for inter group comparison. Comparison of counting data χ2 inspection. Logistic regression was used in multivariate analysis. Results:Univariate analysis showed that serum potassium, renin and ARR were (3.37±0.39) mmol/L, 1.61 (0.34, 7.23) ng/L and 96.85 (26.06, 506.10) in PA group and (3.91±0.59) mmol/L, 12.81 (1.90, 82.45) ng/L and 13.22 (1.06, 54.63) in EH group ( t=3.35, z=6.24, z=55.40, all P<0.001). In PA group, systolic blood pressure was (190.80±20.30) mmHg, diastolic blood pressure was (117.70±12.89) mmHg, waist circumference was (91.67±9.38) cm, and in EH group, systolic blood pressure was (177.01±12.89) mmHg, diastolic blood pressure was (101.39±9.34) mmHg, waist circumference was (86.59±9.07) cm. There were significant differences between the two groups ( t=5.88, 10.44, 3.90; all P<0.001). Multivariate logistic regression analysis showed that waist circumference (OR=1.065, 95% CI 1.007-1.118, P<0.001), systolic blood pressure (OR=1.053, 95% CI 1.034-1.077, P<0.001), diastolic blood pressure (OR=1.054, 95% CI 1.031-1.077, P<0.001), and ARR (OR=1.170, 95% CI 1.115-1.228, P<0.001) were the risk factors for PA. Conclusion:Compared with essential hypertension, PA patients have higher blood pressure, ARR and waist circumference, lower blood potassium and renin levels. Systolic blood pressure, diastolic blood pressure, ARR and waist circumference are the risk factors of PA. Strengthening the screening and treatment of PA in high-risk groups is helpful to better avoid the risk of target organ damage.