0bjective To summarize the experience of postoperative and mid-term echocardiographic evaluation of modified Blalock-Tasussig(BT)shunts. Methods During 2003-2006,thirty five consecutive patients received modified BT shunts and survived postoperative 6 months were enrolled in this study.Transthoracic echocardiography was utilized to evaluate the patency of shunts and the change of pulmonaryarteries(PA)and left ventricle(LV). Results Three patients received the emergence surgery for the intervention for the BT shunts. The follow-up was (21.2±11.3) months. During the follow up,the obstruction of shunts occurred in 7 cases. After the placement of shunts,the mean size of PA increased by 31.2%,meanwhile,the size of LV increased by 25.6%. Nineteen patients received the followed definitive repair or palliative operations. Compared with the patients still waiting for the growth of PA,the patients who receiving the second staged procedure achieved the more appropriate PA growth. Furthermore,for the above patients,there was no significant difference between the angiographic and echocardiographic evaluation for the PA size. Conclusions Echocardiography could accurately diagnose the patency of shunts and record the growth of PA and LV following BT shunts. Echocardiography is a highly reliable noninvasive approach for the perioperative evaluation and mid-term follow-up for the modified BT shunts.

Objective To explore if only single-phase enhanced CT can be used for pre-treatment staging of hypopharyngeal and laryngeal carcinoma.Methods The double phase enhanced CT images in 47 cases with hypopharyngeal or alryngeal carcinoma were retrospectively studied.CT number of tumor,vocal cord and sternocleidomastoideus muscle was measured on plain,early-phase,and late-phase enhanced CT scan,and the definition of tumor margins, small-vessel artifacts and mucous artifacts was recorded. The effective radiation dose of patients was calculated for 16DCT and HCT according to dose-length product (DLP).Results There was no significant difference between the density of tumor and the vocal cord on plain CT scan. There were more mucous artifacts and/or small-vessel artifacts in early-phase enhanced CT images. The definition of tumor margin in late-phase enhanced CT image was better than or almost same as that in early-phase enhanced CT image. The effective radiation dose with 16DCT was 1.5 times to that with HCT at the same scanning range. Conclusion Only late-phase enhanced CT imaging is recommended to be performed for the staging of hypopharyngeal or laryngeal carcinoma, and it will reduce the effective radiation dose received by patients.

Objective To investigate CT value in diagnosing hypopharyngeal and laryngeal disease.Methods The clinical data and CT images of 76 patients with hypopharyngeal and laryngeal tumors and tumor-like lesions were retrospectively reviewed.There were malignant lesions in 66 cases and benign lesions in 10 cases.CT findings in these patients were evaluated and correlated with surgical and pathologic findings.First,we used a CT features were qualitatively analysed using logistic regression model for predicting the lesion to be malignant or benign.Then,two experienced radiologists who were unknown the results of final diagnosis of these patients,retrospectively analyzed all CT images and made their diagnosis.Finally,CT images of 10 benign and 10 randomly selected malignant patients were reviewed by the other two experienced radiologists,who known the component ratio of the cases and unknown the final results.Interobserver agreement of the two reviewers was assessed by calculation of Kappa value for their diagnosis.Results The logistic regression model revealed that the location of lesion and the surrounding structure infiltrated by the tumor were the only significant factors for predicting the malignancy.Of the two factors,the surrounding structure infiltrated by the tumor had the accuracy of 55% with sensitivity 53% and specificity 80%.When most of the cases were malignant(66/76),there was a moderate interobserver agreement for the two radiologists in diagnosis of the diseases.When the malignant and benign cases were equal,there was a poor interobserver agreement(Kappa=0.20) for the two reviewers,and the diagnostic accuracy was slightly higher than the rate by random selection.Conclusion It is difficult to use the CT features in qualifying the hypopharyngeal and laryngeal diseases.

Objective To study the findings of expiratory HRCT of the lungs and to determine the effect of pulmonary function on quantitative index.Methods Inspiratory and expiratory HRCT were performed in 26 healthy adults and 29 patients.The mean value difference(VD) and area decrease rate(AD)within threshold of bilateral lungs were calculated.The patients were divided into two groups due to PFT results.Statistical study was carried out in the control group and the two patient groups.Results PFT results were normal in 13 patients and abnormal in 16 patients.Statistical study revealed significant difference between the patient group with abnormal PFT results and the other two groups(?

Drinking a great amount of alcohol over a long period of time has serious effect on people's health and their families.It has been the chief concern for many experts to find ways to help people to give up alcohol.Radix pueraria is the most typical traditional Chinese herb to help giving up driking alcohol.Some experts had done some deep-seated pharmacological researches on the effect of puerarin and daidzin,the contents distilled from Radix pueraria,on treating alcohol-dependence disease.The present paper is a general survey of recent developments of this research.

Objective To investigate the methods of preparation and quality control for FU FANG QIN KUN Cream. Methods Baicalin, hydroquinone and vitamin E were serving as main raw material to produce O / W cream by adding suitable emulsifier, HPLC method was used to determine content of baicalin in the cream. Results FU FANG QIN KUN Cream is stable without irritation. The assay method was rapid and accurate. When the dosage of Baicalin was controlled in 0.25μg to 2.5 μg, the sample volume and absorption area percentile showed a good linear relationship. The average recovery was 98.9% and the RSD was 0.73% (n=5). This result was accurate and reproducible. Conclusion The formulation and preparation of FU FANG QIN KUN Cream are reasonable and its quality can be well controlled.

Objective To investigate the effects and possible mechanisms of platelet-activating factor (PAF) on the invasion of ovarian cancer cells and to provide a potential target for ovarian cancer therapy.Methods ( 1 ) Serous type ovarian cancer cell line OVCA429 with platelet-activating factor receptor (PAFR) positive and mucinous type cell line RMUG-L (PAFR negative) were treated with 100 nmol/L of the PAF,cell invasion ability was determined by transwell cell migration assay.(2) For determination of the optimal PAF concentration,ovarian cancer cell OVCA429 was treated by 0,0.1,1,10,100,and 1000 nmol/L of PAF for 10 minutes or 24 hour,respectively.To observe the different time point of protein changes,OVCA429 were treated by 100 nmol/L of PAF for 0,5 minutes,10 minutes,30 minutes,1 hour or 12 hours,respectively.The total proteins of treated cells were extracted according to standard protocol.The expression of p38 mitogen-activated protein kinase (p38 MAPK),phosphorylated p38 MAPK (p-p38 MAPK),transcription factor response element-binding protein (CREB),phosphorylated CREB (p-CREB) and matrix metalloproteinase-2 (MMP-2) were detected by western blot.(3) To verify the pathway involved in the PAF induction of the cancer cell invasion,we repeated the experiments by adding the inhibitors when treating cells with PAF.The inhibitors used were as follows,PAFR inhibitor-WEB2076 (50 μmol/L),pp38 MAPK inhibitor-SB203580 (10 μmol/L),CREB binding protein (CBP)-CREB interaction inhibitor217505(25 μ mol/L).All treated cells were divided into 6 groups:control group,PAF group,PAF + WEB2076 group,PAF + SB203580 group,PAF + 217505 group and PAF + SB203580 + 217505group.Results ( 1 ) By transwell assay,100 nmol/L of PAF could improve the invasion ability of OVCA429 cell significantly [ PAF:( 118 ± 23 ) cells vs.control:(36 ± 8 ) cells,P ＜ 0.0l ],while the same treatment had no effect on RMUG-L cells [PAF:(45 t 13) cells vs.control:(53 ±9) cells,P＞0.05].(2) Even a very low concentration of PAF (0.1 nmol/L) could increase the expression of p-CREB and MMP-2,while the most effective concentration of PAF was 100 nmol/L.The highest p-CREB protein expression was detected at 10 minutes after administration of 100 nmol/L PAF,as well as the expression of p-p38 MAPK protein.Even 12 hours after treatment the p-p38 MAPK protein could be detected,while there was no significant difference in the expression of CREB ( P ＞ 0.05 ).(3) As compared with PAF group,both in PAF + WEB2076 group and PAF + SB203580 group,the expressions of p-p38 MAPK,p-CREB and MMP-2 protein were decreased significantly; in PAF + 217505 group,although the expression of p-p38 MAPK and p-CREB protein was significantly higher than the control group,the expression of MMP-2 protein was significantly lower; in PAF + SB203580 + 217505 group,the expression of these three proteins were also significantly lower,but there was no significant difference as compared with that in the PAF + WEB2076 or PAF + SB203580 group.Conclusion PAF could induce MMP-2 expression and contributed to PAFR positive ovarian cancer cell invasion via activation of CREB by phosphorylating of p38 MAPK.

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Objective:To investigate the risk factors of low anterior resection syndrome (LARS)after low anterior resection of rectal cancer (Dixon).Methods:This retrospective study was conducted in Peking University First Hospital and Traditional Chinese Medicine Hospital of Shanxi Provice from Jan 2012 to Jun 2019. A cohort of 504 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data were analyzed retrospectively. Univariate analysis using χ 2 test. Logistic regression analysis was used to screen the influencing factors of LARS, and the Nomogram method was used to score each factors. Results:Univariate analysis showed that BMI≥28 kg/m 2(χ 2=9.450, P=0.002), the distance from the lower edge of the tumors to the anus <6 cm (χ 2=12.070, P=0.001), high ligation of the inferior mesenteric artery (IMA) (χ 2=8.279, P=0.004), preoperative neoadjuvant therapy (χ 2=11.230, P=0.001), postoperative anastomotic leakage (χ 2=11.840, P=0.001) were associated with severe LARS.Multivariate analysis showed that the distance from the lower edge of the tumors to the anus <6 cm ( OR=1.861, 95% CI: 1.289-2.688, P=0.001), BMI≥28 kg/m 2 ( OR=1.747, 95% CI: 1.022-2.987, P=0.041), high IMA ligation ( OR=1.688, 95% CI: 1.157-2.463, P=0.007), preoperative neoadjuvant therapy ( OR=2.719, 95% CI: 1.343-5.505, P=0.005) were independent risk factors for LARS. Nomogram model showed that the total factor ranged from 2 to 212, and the corresponding risk rate ranged from 30% to 80%. The patients with higher score have greater risk for severe LARS. The area under the predictive power curve of Nomogram model (AUC) was 0.749 (95% CI: 0.705-0.793, P<0.001). Conclusion:Lower tumor location, obesity, preoperative neoadjuvant therapy, high IMA ligation and postoperative anastomotic leakage increase the risk of severe LARS.

Human herpesvirus-6 (HHV-6) is a ubiquitous virus. The incidence of HHV-6 after liver transplantation is estimated to be 22% ? 54%; it may present with fever, hepatitis, pneumonia, encephalitis, and myelosuppression and has a poor prognosis. HHV-6(+) recipients had a mortality rate of 29%, significantly higher than that of HHV-6(?) recipients (6%). Since most infections are asymptomatic, HHV-6 monitoring is not routinely performed in clinical practice, which means clinicians often ignore the diagnosis of HHV-6 and eventually delay diagnosis and treatment. In this paper, a case of human herpesvirus 6B encephalitis after liver transplantation was retrospectively analyzed, and the literature related to this disease was reviewed to improve the understanding of this disease.