Objective To investigate the utilization of liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for liver function evaluation.Methods Fifty-five patients who received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed.Images were obtained before injection and in hepatobiliary phase (5,10,and 20 minutes after Gd-EOB-DTPA injection).The patients were assigned into two subgroups according to individual liver function (n =35 in Group 1:normal liver and Child-Pugh class A; n =20 in Group 2:Child-Pugh class B and C).The relative liver enhancement (RE) was calculated at different time point.The general data (age,sex) and relevant laboratory results were recorded.Independent sample t-test was conducted to compare the RE between two groups at different time point.ROC curve was used to determine the best time point and RE threshold that can reflect the differences between two groups.Univariate analyses was performed to analyze the relationship between RE at the best time point and laboratory results.Multivariate analyses was performed to screen the independent influencing factor for RE at the best time point.Results The differences of RE between two groups were statistically significant at all time points (P ＜ 0.0001).10 minutes was the best time point for detecting the differences of liver function between two groups.When an RE cutoff value (＞ 1.52) was applied,normal or Child-Pugh class A could be predicted with sensitivity of 74.3％ and specificity of 90％.RE at the best time point was significantly related with total serum bilirubin level (TBil),serum albumin level (Alb) and prothrombin time (PT).And TBil was an independent influencing factor.Conclusion RE can be used to evaluate the liver function,and 10 minutes is the best time point that can be used to differentiate patients with normal or mild liver damage from those with moderate or severe liver damage.

Objective To study the effect of liver transplantation using right liver lobe Ⅴ and Ⅷ segments with middle hepatic vein(MHV) and without main MHV on the regeneration of liver transplantation. Methods 25 pair of donors and receptors of liver transplantation were divided in to two groups:with M HV group (group A, n= 14) and without main MHV (group B, n=11). The volumes of Ⅴ and Ⅷ segments of liver were measured in donors presurgicaUy,half month and 3 month in receptors postsurgically, the rates of regeneration of the Ⅴ and Ⅷ segment were calculated half month and 3 months postsurgically and compared between two groups. Results In group A,the regenerate rates of the Ⅴ,Ⅷ segment were 0.360±0.043 and 0.853±0.059 half month after surgery,0.253±0.043 and 0.708±0.059 three months after surgery respectively. In group B, the regenerate rates of the Ⅴ,Ⅷ segment were 0.306±0.049 and 0.815±0.066, respectively half month after graft, 0.161±0.049 and 0.627±0.066, respectively three months after surgery. There were no statistically significant differences in regenerate rates of the Ⅴ, Ⅷ segment of graft be-tween the two groups (P= 0.685 ,P>0.05 and P= 0.738, P>0.05). Conclusion The right lobe living donor liver transplantation, maintaining the MHV or reconstruct MHV tributaries without MHV has similar effects on the regeneration of Ⅴ,Ⅷ segment of graft.

[ABSTRACT]OBJECTIVETo investigate the expressions of Endoglin (CD105) and Galectin-3 protein in laryngeal squamous cell carcinoma (LSCC) as well as the relationship between their expressions and the clinicopathological factors of LSCC.METHODSThe expressions of CD105 and Galectin-3 protein were detected in 76 samples of LSCC and 25 normal laryngeal tissues (NLT) by immunohistochemical staining (S-P).RESULTS 1.The mean of Microvessel density (MVD) value marked by CD105 in LSCC was 10.33±2.29, which was significantly higher than that in NLT (1.20±1.04) (P<0.05). The expression of MVD marked by CD105 (CD105-MVD) was correlated with histological grading, T stage, clinical stage, lymph node metastasis, recurrence and prognosis in LSCC (P<0.05). 2.The positive expression rate of Galectin-3 protein in LSCC was 86.84%, which was significantly higher than that in NLT (36%)(P<0.05). The expression of Galectin-3 was correlated with T stage,clinical stage, lymph node metastasis, recurrence and prognosis in LSCC (P<0.05). 3.There was a positive correlation between CD105 and Galectin-3 protein. 4.Survival analysis indicated that the expressions of CD105 and Galectin-3, histological grading, lymph node metastasis,T stage and recurrence were independent factors for tumor prognosis in LSCC (P<0.05). CONCLUSIONThe expressions of CD105 and Galectin-3 protein have a positive correlation in LSCC. They may play important roles in the tumorigenesis, malignant progression and poor prognosis of LSCC. Combined detection of them may be great value in diagnosis and predicting prognosis of LSCC.

Objective To assess the value of MSCT in the evaluation of the anatomy and variation of hepatic veins for living donor liver transplantation (LDLT) donors and the significance of vessel variation in surgical operation. Methods A total of 238 subjects who wanted to be the donors of LDLT underwent MSCT plain and enhanced examination, and the hepatic veins were evaluated. Results Among all 238 subjects, according to Nakamura's classification of hepatic veins, 164 were type Ⅰ, 60 were type Ⅱ, 14 were type Ⅲ. The left hepatic vein (LHV) shared a common trunk with the middle one in 167 subjects. Branches of Ⅷ going along the cross section and diameter larger than 5 mm were detected in 105 subjects. The Ⅳ segment veins drained into MHV in 68, into LHV in 7 subjects. Right inferior hepatic vein with diameter larger than 3 mm was found in 108 subjects, while the distance between RHV and IRHV were larger than 4 cm in 55 subjects. Conclusion MSCT can offer details and exact information about the donors pre-operation, and is an important non-invasive method for the evaluation of hepatic veins of potential LDLT donors.

Objective To evaluate the effect of liver function on liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI.Methods Sixty-seven patients who suffered from cirrhosis and received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed,and divided into three subgroups according to ChildPugh score(45 patients in group A,20 in group B,5 in group C).All the individuals of both groups had MRI before injection,and hepatobiliary phase images were obtained at 5,10,and 20 minutes after bolus administration of Gd-EOB-DTPA.The relative enhancement(RE) was calculated by dividing the signal intensity of liver(SI) at t min after injection(SIt) by precontrast SI(SI0).The total serum bilirubin level(TB),serum albumin level(Alb) and prothrombin time(PT) were recorded.The one-way ANOVA was used to compare the RE among three groups at 5,10 and 20 minutes.SNK was used for further pairwise comparison.The effect of liver function on RE was assessed with the generalized linear model.Pearson correlation coefficients were measured between each biochemical test result(TB,Alb,PT) and RE at different time points.Results The RE at 5,10 and 20 minutes were 1.59±0.20,1.65±0.22,1.69±0.25 of group A; 1.47± 0.14,1.48±0.18,1.50±0.22 of group B,1.35±0.07,1.27±0.06,1.26±0.06 of group C.There were statistically significant differences of RE among groups at 5,10 and 20 minutes(F=5.854,11.207,9.666,P＜0.01).Statistically pairwise comparison differences of RE were found between group A and C at 5,10 and 20 minutes(P＜0.01),between B and C at 10 and 20 minutes(P＜0.05),between A and B at 10 minutes(P＜ 0.05).There were statistically significant differences of TB,Alb and PT among groups(P＜0.01).RE at 10 and 20 minutes had moderate negative correlation with TB(r=-0.483,-0.500; P＜0.01),low negative correlation with PT(r=-0.326,-0.351;P＜0.01) and weak positive correlation with Alb(r=0.290,0.292;P＜0.05).Conclusions There are differences of RE among patients with different liver function,and the RE is associated with TB,Alb and PT.Thus,it may allow us to estimate the liver function.

0.05).The median survival time was 32 weeks in group A compared to 27 weeks in group B(P

Objective To evaluate the protecting effects of matrine on chemotherapy related hepatic lesion and its possible mechanism.Methods The positive rate and severity of hepatic lesion were compared between pa- tients being treated with or without matrine during chemotherapy processes.Furthermore,the difference of liver pro- tecting effect of this Chinese medicine between hepatitis B virus(HBV)infection chemotherapy patients and disinfec- tion patients were also analyzed.Results Both the rate of hepatic lesion and level of ALT in matrine treated group were much lower than those in untreated group in chemotherapy patients.The rate of hepatic lesion and level of ALT in HBV infection patients were higher than those in HBV disinfection patients in untreated group,while the signifi- cant difference of these two parameters between HBV infection patients and disinfection patients were disappeared in matrine treated group.Conclusion Matrine has hepatic protecting effect in chemotherapy related liver lesion.

OBJECTIVETo observe the effect of salidroside on tic behavior and in vivo dopamine DA) and serotonin (5-HT) levels in Tourette syndrome (TS) model rats.

METHODSForty rats were randomly divided into the blank control group, the TS model group, the haloperidol-treated group (0.5 mg/kg x d(-1)), and the salidroside-treated group (50 mg/kg x d(-1)), 10 in each group. TS rat model was induced by imino-dipropio-nitrile (IDPN). Peritoneal injection of haloperidol and salidroside was started from the 4th day of modeling in the haloperidol-treated group and the salidroside-treated group respectively. Normal saline was peritoneally injected to rats in the blank control group and the TS model group respectively. Stereotyped behavior was scored, and changes of DA and 5-HT levels in blood and striatum were measured before modeling, after modeling, and after intervention.

RESULTSCompared with the blank control group, the score of the tic behavior was elevated (P < 0.01) , levels of DA and 5-HT in plasma and striatum were reduced in the model group (P < 0.01, P < 0.05). Compared with the same group after modeling, the tic behavior score decreased and plasma DA levels increased in the two treated groups after intervention (P < 0.01). 5-HT content increased in the salidroside-treated group (P < 0.01). Compared with the model group after intervention, the tic behavior score was significantly reduced (P < 0.01), and DA levels in plasma and striatum were elevated (P < 0.01, P < 0.05) in the salidroside-treated group and the haloperidol-treated group. Compared with the haloperidol-treated group, the tic behavior score increased (P < 0.01), DA levels in plasma and striatum were lowered (P < 0.01, P < 0.05), the 5-HT level increased in plasma and striatum (P < 0.01, P < 0.05) in the salidroside-treated group.

CONCLUSIONSIn the salidroside-treated group, the tic behavior was significantly reduced, and DA levels in plasma and striatum were elevated. Its mechanism might be related to regulating activities of dopamine neurons in striatum.

Animals ; Corpus Striatum ; Dopamine ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Glucosides ; pharmacology ; therapeutic use ; Haloperidol ; Phenols ; pharmacology ; therapeutic use ; Rats ; Serotonin ; Stereotyped Behavior ; Tics ; drug therapy ; Tourette Syndrome ; drug therapy

Objective BK virus-associated nephropathy ( BKVAN) after kidney transplantation is a key factor that influence the prognosis of transplant kidney .To our knowledge , it is believed to be associated with immune suppression .We observed the cura-tive effect and influencing factorsof anti-rejection scheme that Leflunomide was administered instead of Mycophenolate Mofetil ( MMF) on transplant kidney BKVAN .. Methods This study included 15 kidney transplant recipients with pathologically confirmed BKVAN in Nanjing General Hospital of Nanjing Military Region form March 2007 to March 2013 .Leflunomide was administered instead of Myco-phenolate Mofetil ( MMF) .Serum creatinine level , renal allograft loss rate and side effects of leflunomide were monitored after medica-tion switch.The patients were divided into two groups , which were renal allograft loss group and renal allograft survival group , for fur-ther analyses . The differences between each groups in clinical characteristics as well as histochemical features of the transplanted kidneys were analyzed to determine the cause of renal allograft loss in patients with BKVAN . Results Six patients experienced renal al-lograft loss after switching to leflunomide and needed hemodialysis , and 9 patients had stable renal allograft function , renal allograft loss rate was 40.0%.Hyperuricemia occurred in 8 patients in the period before the medication switch and in 5 patients after the switch;a decrease in blood white cell orplateletcount was found in 2 patients during both periods;an increase in Alanine aminotransferase ( ALT) level occurred in one patient after the medication switch .There were no statistically significant differences in any of the above parame-ters before and after the medication switch.Compared to allograft survival group, serum creatinine level[(1.80 ±0.53)mg/dL vs (2.74 ±0.58)mg/dL, P=0.007], the number of B lymphocytes [(206.44 ±144.96) vs (439.67 ±267.77), P=0.047] and CD68[(588.44 ±271.80) vs (944.67 ±259.32), P=0.025] in renal allograft tissue were significantly higherin the allograft loss group. ConclusionLeflunomide is a safe and effective medication for BKVAN .Patients with significantly increased serum creatinine level might have a poorer prognosis .Significantly increased B lymphocytes and CD 68 cells in renal allograft tissue might indicate a poor prognosis.

Objective To explore the characteristics of dipyridamole 201 Tl myocardial perfusion imaging (MPI) SPECT in patients with dilated cardiomyopathy. Methods Thirty patients with dilated cardiomyopathy underwent pharmacological stress 201Tl MPI SPECT after intravenous infusion of dipyridamole (0. 56 mg/kg) for 4 min. The early and delayed SPECT images were acquired respectively at 10 and 240 min after 201Tl injection. The images were analyzed and reported by two or three experienced nuclear medicine physicians. Results All patients were found to have abnormal perfusion patterns at delay imaging, however 90.00% (27/30) were also abnormal at early images. Six patients had reverse redistribution. Conclusion Dipyridamole 201Tl MPI SPECT imaging may be of some value for the assessment of patients with dilated cardiomyopathy.