Objective To investigate the value of dual-source CT perfusion imaging in evaluation of liver fibrosis stage.Methods Liver fibrosis models were established with 35 rabbits (experimental group)which were intraperitoneally injected with carbon tetra-chloride.Meanwhile,other 5 rabbits were regarded as control group which were intraperitoneally inj eced with physiological saline.7 rabbits of experimental group and 1 of control group were undergone dual-source CT perfusion scan at 4,6,8,10,12 weeks respec-tively.Arterial liver perfusion (ALP),portal venous perfusion (PVP),total hepatic perfusion (THP),hepatic perfusion index (HPI)were recorded,and staging of liver fibrosis were assessed by pathological method.Results With the increase of liver fibrosis degree,HPI showed an upward trend,whereas PVP was opposite.HPIs of S2,S3 and S4 stage were significantly different com-pared to that of control group respectively.The differences of HPI between S3,S4 stage to S0 and S1 stage were significant.PVP between S2,S3,S4 stage to S0 stage and S1 stage were also significant different.Conclusion HPI and PVP can reflect the perfu-sion changes of liver fibrosis stages.Combination of HPI and PVP may help the diagnosis of S2,S3 or S4 stage of liver fibrosis.

Purpose To investigate the clinical value of MR PROSET technique in showing and diagnosing in lumbarsacral nerve root diseases.Materials and Methods Conventional MRI sequence and PROSET sequence coronal images were performed in lumbosacral nerve roots of 15 healthy volunteers and 47 low back pain patients,each case performed 3D maximum intensity projection (3D MIP) post-processed.Spinal nerveroots were observed.Results The PROSET could show dura,dura sheath,spinal nerveroot,ganlias,segments of the nerves posterior to the ganglions well and could be observed from multiple aspects by the 3D MIP.Among the 47 cases of luber nerve root disease,PROSET could show the level of the invasion and compression to the ganglias.Conclusion According to the PROSET technique and conventional MRI picture,can provide the satisfied proof to the diagnosis of lumbosacral nerve root diseases.

Objective:To compare the effects of rotational night shifts on the micturition patterns of fe-male nurses.Methods:A total of 58 nurses without lower urinary tract symptoms were recruited,who worked in the Peking University People’s Hospital during January and June in 2014.The nurses aged 20 -43 years were divided into two groups,the night-shift group (n =28)and the non-shift group (n =30).The alcohol or coffee intaking were forbidden.In the night-shift group,nurses had worked on rota-tional shifts for at least 6 months.Their average age was (26.75 ±4.11)years.In the non-shift group, nurses took regular day-time work,whose average age was (27.80 ±5.60)years.A voiding diary was kept for 7 consecutive days at the end of 6 months,starting 2 days before their night duties until 4 days after completion of their night duties.For comparison,the non-shift group with regular shifts completed a 7-day voiding diary.In the 7-day recording voiding diary,the nurses were required to have the normal in-take of liquid about 1 500 -2 000 mL/d.The frequency volume charts of nocturia,the 8-hour interval urine production and frequency were compared between the two groups.Results:Nocturia frequency was increased in the night-shift group [0.5 (0 -2.4)]compared with the non-shift group [0 (0 -2),P =0.02].The volume of nocturia was increased in the night-shift group [125 mL (0 -660 mL)]compared with the non-shift group [0 mL (0 -340 mL),P <0.01].The 8-hour interval indices showed that urine production changed with shift (P <0.01).In the consecutive 7 days,the nocturnal volume of the night-shift group increased on the day after night shift.When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high,and the frequency of noctu-ria also increased significantly (P <0.05).Compared with the 8-hour interval indices,the night-shift group’s voiding volume [(542.35 ±204.66)mL]and voiding frequency (2.24 ±0.69)were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm).During the 8 h interval night time (from 10 pm to 6 am),the volume of nocturia in the night-shift group [(309.74 ±162.74) mL]was more than that in the non-shift group [(199.38 ±153.98)mL,P =0.01];the frequency of nocturia in the night-shift group (1.31 ±0.52)was increased than that in the non-shift group (0.82 ± 0.55,P <0.01).Conclusion:The rotational shifts affect the micturition patterns of nurses who go through the night shift work,which increases the volume and frequency of the nocturia.

Objective To detect the expression of extracellular matrix protein 1 ( ECM1 ) in primary liver cancer tissues, and explore its clinical significance in liver cancer metastasis. Methods Sixty cases of primary liver cancer tissues and adjacent tissues from 60 patients who were admitted to the Affiliated Provincial Hospital of Anhui Medical University from June 2008 to December 2009 were collected, and nine cases of normal liver tissues were collected from patients with liver trauma as control. The expression of ECM1 and the relationship between ECM1 and clinicopathological features of liver cancer were detected and analyzed using the immunohistochemistry and Western blot. All data were analyzed using the chi-square test, Fisher exact test and t test. Results ECM1 was mainly expressed in the cytoplasm of liver cells. The positive expression rate of ECM1 in liver cancer tissues was 73%, which was significantly higher than those in adjacent tissues (20%) and normal liver tissues (22%)( x2 = 34.286, 7. 044, P ＜ 0.05 ). The expression of ECM1 was correlated with liver cancer metastasis and TNM stages ( x2 = 5. 455, 4.275, P ＜ 0.05), while not with sex, age, size, capsule and differentiation of the tumor,alpha fetoprotein level and the expression of hepatitis B surface antigen ( x2 = 2. 841, 0. 014, 0. 000, 0. 734,0.075, 0.000, 0.031, P＞0.05). The result of Western blot indicated that the relative content of ECM1 in the liver cancer tissues was 25.49 ± 4.61, which was significantly higher than those in adjacent tissues (3.00 ±0.37) and normal liver tissues (2.94 ± 0.21 ) ( t = 31. 962, 31. 699, P ＜ 0. 05 ). Conclusions The expression of ECM1 in liver cancer tissues is higher than those in adjacent and normal liver tissues, and ECM1 expression is correlated with metastasis of liver cancer and TNM stages, which indicate that ECM1 may play a role in the metastasis of liver cancer, and it could be used as an indicator for liver cancer metastasis.

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.

Objective To study the applications and outcomes of using autogeneic cartilage in hearing recon-struction surgery in patients with chronic otitis media or cholesteatoma .Methods A total of 165 patients (173 ears) in whom autogeneic cartilage was used were analyzed retrospectively .Forty -three patients (48 ears) had simple tympanic membrane perforations ,61 patients (61 ears) had cholesteatomas including 12 retraction pockets ,23 pa-tients (23 ears) had tympanoscleroses and 38 patients (41 ears) had otitis media with granulations .The cartilage grafts were used for tympanic perforation reparing in 133 patients (139 ears) ,for ossiculoplasty in 102 patients (104 ears) ,for attic reconstruction in 31 patients (31 ears) and for canal wall reconstruction of external auditory canal in 3 patients (3 ears) .The auditory outcome (0 .5 ,1 ,2 ,and 4 kHz pure tone average hearing threshold ,the average air-bone gap) and local architecture status were followed up for 1 year after surgery .Results In 133 patients (139 ears) with tympanic perforation ,the rate of successful repair of a tympanic membrame perforation in one -stage was 97 .84% with perforation repair in 136 ears and postoperative perforation in 3 ears .In 102 patients (104 ears) of os-siculoplasty ,there was no ossicular prostheses prolapse .In 31 patients (31 ears) of attic reconstruction ,no local graft shift or collapse was found .In 3 patients (3 ears) of external auditory canal repair ,no canal wall collapse occurred . In myringoplasty group (43 patients ,48 ears) ,preoperative and postoperative air -bone gap (ABG) was 23 .8 ± 3 .1 dB and 11 .6 ± 8 .7 dB ,respectively .In cholesteatoma group (61 patients ,61 ears ) ,preoperative and postoperative ABG were 39 .2 ± 24 .7 dB and 19 .0 ± 12 .1 dB ,respectively .In tympanosclerosis group (23 patients ,23 ears) ,pre-operative and postoperative ABG were 31 .2 ± 12 .4 dB and 19 .8 ± 11 .2 dB ,respectively .In otitis media with granu-lation group (38 patients ,41 ears) ,preoperative and postoperative ABG were 41 .6 ± 9 .9 dB and 15 .3 ± 13 .4 dB ,re-spectively .Conclusion Autogeneic cartilage is very valuable in hearing reconstruction surgery ,especially in compli-cated tympanic perforation ,combination with ossiculoplasty prostheses ,or reconstruction of mastoid cavity or exter-nal call wall defect .

Objective To study the clinical significance of vires infection and serum interleukin-2 (IL-2)Ievels in recurrent childhood idiopathic thrombocytopenic purpura(ITP).Methods The cytomegalovirus(CMV),epstein-Barrvirus(EBV)-adenovirus(ADV),herpesvirus(HSV)antibodies ISM and IL-2 levels were determined in the serum of 4 childhood with recurrent childhood ITP as well as in 40 normal controls with ELISA and RIA.Re-sults The CMV-lgM positive cases were 18,EBV-IgM were 14-ADV-IgM were 5,HSV-lgM were 3.In the controls,those were 3,2,1,and 0 respectively(P<0.05 or P<0.01).The serum IL-2(0.35±0.12)μg/L levels were sig-nificantly lower than those in the controls[(0.61±0.17)μ/L,P<0.05].Conclusion DNA virus antibodies and IL-2 levels can reflect virus infection and immune condition of diseases in recurrent childhood ITP.It is impor-rant to comprehend the mechanism of recurrent childhood ITP for guiding clinical treatment.

Tumor metastasis and recurrence have become a key to curative effect and long-term survival, and a hotspot of eurrent clinical oncology research. Recently, a survey of extracellular matrix protein 1 (ECM1) expression in different tumors indicated that ECM1, although not tumor specific, is significantly el-evated in many malignant epithelial tumors that gives rise to metastases, emphasizing its relevance in the cancer process. Herein, this article reviews the research progress of ECM1 in tumor.

OBJECTIVE:To evaluate the curative effect and safety of dexamethasone for severe asthma and severe sepsis systematically. METHODS:Randomized controlled trials about dexamethasone for severe asthma and severe sepsis were retrieved from database,such as Cochrane library(1996～2007),PubMed(1966～2007),EMCC(1995～2007),CHKD(1994～2007)and pertinent literatures. The qualities of included studies were evaluated and extracted data were analyzed by Meta-analysis respectively. RESULTS:11 trials containing 1 435 cases were up to included standard. Therapy results of severe asthma:(1)in remission rate of the total symptom,difference between dexamethasone and prednisone was not statistically significant [OR 1.44,95%CI(0.75, 2.75);P=0.27];(2)In the incidence rate of ADR,dexamethasone was lower than prednisone [OR 0.13,95%CI(0.04,0.44);P= 0.001];(3)In the recurrence rate,no statistical significance was noted in difference between dexamethasone and prednisone [OR 0.58,95%CI(0.25,1.31);P=0.19]. Therapy results of severe sepsis:(1)In the mortality,difference between dexamethasone and placebo was not statistically significant [OR 0.85,95%CI(0.41,1.78);P=0.67];(2)In the incidence rate of ADR,no statistical significance was noted in difference between hydrocortisone and placebo [OR 1.05,95%CI(0.51,2.19);P=0.89]. CONCLUSION: Dexamethasone is similar to prednisone in the treatment of severe asthma but better than prednisone in drug safety. The safety of dexamethasone is similar to placebo in the treatment of severe sepsis.