Objective To explore the value of multislice spiral computed tomography ( MSCT ) in predicting the resectability of pancreatic cancer ( PC) .Methods The MSCT images of 102 PC patients ( 62 men, mean age, 61 ±9 years;40 women, mean age, 60 ±9 years) confirmed by postoperative pathology were analyzed retrospectively .The images were analyzed and evaluated by 2 senior radiologists who were double blinded.The relationship between tumor and vessels was investigated based on consensus statement on the radiological diagnosis of PC of the Society of Abdominal Radiology and the American Pancreatic Association in 2014 .The diagnostic criterion on the resectability of PC was based on the 2015 NCCN Clinical Practice Guidelines on PC . Image analysis included the lesion location , size and density , the characteristics of pancreatic and bile ducts , relationship of tumor and adjacent vessels , the extrapancreatic findings as well as T staging and resectability.Results The locations of PC were found in the pancreatic head (n=71,69.6%), body (n=23, 22.5%) and tail (n=8, 7.8%).The long-and short-axis diameter were (28.9 ±8.8)mm and (23.8 ±8.0)mm in head, and respectively, (31.2 ±11.0)mm and (23.8 ±6.3)mm in body and tail, respectively.The imaging findings included hypo-(n=98, 96.1%) and iso-density masses (n=4, 3.9%) on pancreatic phase, intra-and extrahepatic bile duct dilation (n=63, 61.8%), main pancreatic duct cut-off with dilation (n=46, 45.1%), the pseudocyst (n=4), acute pancreatitis (n=1) and chronic pancreatitis (n=2).T staging evaluation by MSCT observed T1 (n=3), T2 (n=7), T3 (n=78) and T4 (n=14), respectively.MSCT assessment for T staging was correct in 98 (96.1%), but wrong in 4 (3.9%), which was quite consistent with pathological T staging (K=0.88, P<0.05).MSCT assessment for the resectability was correct in 98 (96.1%), but wrong in 4 (3.9%).Sensitivity, specificity, positive and negative predictive values, and area under curve of MSCT in the assessment of the resectability were 96.8%, 87.5%, 98.9%, 70.0%and 92.2%, respectively.Conclusions MSCT could improve the diagnostic accuracy for T Staging and resectability of PC .

Objective To investigate the CT and MRI features of the autoimmune pancreatitis (ALP).Methods CT and MRI data of fourteen patients with AIP who were confirmed by histology and/or steroid therapy were retrospectively analyzed.Ten patients underwent CT examination, and seven patients underwent MRI, while three patients underwent both CT and MRI examinations.Results It was showed that diffuse (n =11 ) or local ( n = 3 ) enlargement of pancreas.CT features showed that the hypoattenuation pancreatic lesions on unenhanced CT (n = 10);segmental pancreatic duct could be seen in five patients;stenosis of common bile duct in the head of pancreas was observed in 5 patients;the capsule-like structure around lesions was seen in seven patients.Delayed homogeneous enhancement was showed on enhanced CT.MRI features included homogeneous ( n = 3) and heterogeneous ( n = 4) hyperintense on T1 WI with fat-suppression images and homogeneous ( n = 3 )and heterogeneous (n =4) hyperintense on T2WI with fat-suppression images.Pancreatic duct could be seen in four patients.MRCP showed pancreatic duct stenosis in the head of pancreas ( n = 1 ) and segmental pancreatic duct (n = 2).Stenosis of common bile duct in the head of pancreas was showed in 5 cases.The capsule-like structure around lesions was showed in seven patients.No pancreatic calcification was revealed, and no significant pancreatic duct dilation was detected ( ＞3 mm) in all 14 patients.Conclusions The CT and MRI manifestations of AIP had characteristic features such as sausage-like changes of the pancreas, capsule-like structure around the lesions, diffuse or local pancreatic duct stricture, and stenosis of common bile duct in the bead of pancreas.

Objective To observe computed tomography features of neuroendocrine tumor of the pancreas.Methods Computed tomography scans for 28 patients with pathologically proven neuroendocrine tumor of the pancreas were retrospectively analyzed.The data of tumor locations,diameters of the tumor and internal composition,pattern of enhancement,changes of biliary and pancreatic duct,and lymphatic metastasis,remote metastasis were recorded.Results A total of 32 lesions were detected,24 lesions were single lesions,while 4 lesions were multiple lesions (2 lesions within pancreas).The shapes of these lesions were nodule-like or mass-like.Eighteen lesions were located in pancreatic tail,10 in pancreatic head,2 in pancreatic body,and 2 between pancreatic tail and body.Among the lesions located in pancreatic head,pancreatic duct dilation were detected in 5 cases,bile duct dilation in 1 case,both biliary and pancreatic duct dilation in 2 cases,and no dilation in the remaining 2 cases.The diameters of the tumor ranged from 1.0 to 20.0cm (mean5.1 cm),and the size was ＜2 cmin 1 case,2 ～5 cm in 23 cases; ＞5 cm in 8 cases.After enhancement,the lesions were enhanced to different degrees,and the peak value occurred in the pancreatic phase.Twenty-three lesions invaded adjacent vessels or organs,and lymphatic metastasis was observed in 5 cases,remote metastasis were recorded in 6 cases.Conclusions Neuroendocrine tumor of the pancreas has certain features on computed tomography.It is highly likely to make the pre-operative diagnosis when clinical data is also taken into consideration.

Objective To analyze the psychometric properties of the Fine Motor Function Measure Scale (FMFM) with cerebral palsied children less than 3 years old. Methods Three hundred and seventy-five children less than 3 years old with cerebral palsy were involved. The test-retest reliability, inter-tester reliability, correlation validity and structural validity of the FMFM were analyzed, as well as the responsiveness. Results The test-retest reliability (ICC = 0. 983 3 ) and the inter-tester reliability (ICC = 0. 992 4) of the FMFM were satisfactory. The correlation index between the raw FMFM scores and scores on the Peabody Developmental Motor Scale——Fine Motor was 0.919 9. The FMFM could clearly distinguish differences in fine motor function between the affected side and the intact side in children with hemiplegia. The differences in fine motor function between children with diplegia and quadriplegia could also be distinguished by the FMFM. The effect size of this scale was also good. Conclusion The reliability, validity and responsiveness of the FMFM were satisfying. The fine motor functioning of children with cerebral palsy could be effectively measured using the FMFM scale.

BACKGROUND:As a main antigen of platelet, CD36 antigen is also known as platelet glycoprotein IV (GPIV). The mutation of CD36 gene may result in deficiency of the antigen.
OBJECTIVE:To identify a novel CD36 alele.
METHODS: DNA was isolated from peripheral blood sample, and 12 coding regions of CD36 gene were amplified by PCR. Sequencing-based typing was used to analyze the sequence of the target regions. The derived sequences were aligned with the standard sequence of NG_008192 in GenBank to identify the novel alele.
RESULTS AND CONCLUSION: 1142 T>G mutation was detected in exon 12 of CD36 gene of the proband, and the other regions were consistent with the standard sequence. No data or report about 1142 T>G was found in GenBank or National Center for Biotechnology Information (NCBI), and thus it was reported to GenBank and received by number KM275213. 1142 T>G results in amino acid 381 Leu>Ser of the CD36 protein. There is a big difference in hydrophilia and polarity of the two amino acids. Also the 381 amino acid locates in highly conserved region. Thus it is speculated that 1142 T>G may reduce or vanish the activity of the protein.

OBJECTIVE: To investigate the effect of vitamin D binding protein (DBP) gene polymorphism on susceptibility and prognosis of severe acute pancreatitis (SAP). METHODS: A prospective study was conducted. Eighty-three patients with SAP who were admitted to the department of general surgery of Tianjin Fifth Central Hospital from March 2018 to March 2021 were selected as the research objects, and 83 healthy people in the same period were selected as controls. Peripheral blood RNA was extracted and reverse transcribed into cDNA, and the genotype and allele frequency of DBP gene rs7041 locus were detected by fluorescence quantitative analyzer. Hardy-Weinberg equilibrium was used to test the genetic balance. On the day of admission, serum C-reactive protein (CRP) level was detected by scattering immunoturbidimetry, serum procalcitonin (PCT) level was detected by electrochemiluminescence, serum DBP level was detected by enzyme-linked immunosorbent assay (ELISA), and neutrophil to lymphocyte ratio (NLR) was calculated automatically by the instrument. The length of intensive care unit (ICU) stay, the length of hospital stay and prognosis during hospitalization of patients were statistically analyzed. Multivariate Logistic regression analysis was used to screen the influencing factors of SAP occurrence. RESULTS: The results of Hardy-Weinberg equilibrium test showed that the distribution of gene polymorphisms in the two groups of subjects conformed to the law of genetic equilibrium. The frequencies of TT genotype and T allele of DBP gene rs7041 locus in the patients of SAP group were significantly higher than those in the healthy control group [TT genotype: 34.94% (29/83) vs. 9.64% (8/83), T allele: 55.42% (92/166) vs. 38.55% (64/166), both P < 0.01], and the frequency of GT genotype was significantly lower than that in the healthy control group [40.96% (34/83) vs. 57.83% (48/83), P < 0.05]. There was no significant difference in the frequency of GG genotype between the healthy control group and SAP group [32.53% (27/83) vs. 24.10% (20/83), P > 0.05]. Further multivariate Logistic regression analysis showed that TT genotype [odds ratio (OR) = 2.831, 95% confidence interval (95%CI) was 1.582-5.067, P < 0.001] and T allele (OR = 2.533, 95%CI was 1.435-4.472, P < 0.001) of DBP gene rs7041 locus were independent risk factors for SAP in healthy people, while GT genotype was a protective factor for SAP (OR = 0.353, 95%CI was 0.143-0.868, P = 0.041). The levels of CRP, PCT, NLR and DBP in patients with TT genotype of DBP gene rs7041 locus were significantly higher than those in patients with GG/GT genotype on the day of admission in SAP group [CRP (mg/L): 43.25±13.25 vs. 31.86±12.83, PCT (μg/L): 1.53±0.24 vs. 1.21±0.20, NLR: 3.15±0.53 vs. 2.71±0.48, DBP (μg/L): 87.78±19.64 vs. 70.58±18.67, all P < 0.01]. The length of ICU stay in patients with TT genotype of DBP gene rs7041 locus in SAP group was significantly longer than that in patients with GG/GT genotype (days: 11.35±1.58 vs. 9.71±1.35, P < 0.01). The length of hospital stay of patients with TT genotype was longer than that of patients with GG/GT genotype (days: 23.41±3.64 vs. 23.17±3.57), and the in-hospital mortality was higher than that of patients with GG/GT genotype [34.48% (10/29) vs. 29.63% (16/54)], but the difference was not statistically significant (both P > 0.05). CONCLUSIONS The risk of SAP was significantly increased in patients with TT genotype of rs7041 locus of DBP gene, and the mechanism may be related to the increase of DBP expression. And carrying the TT genotype will prolong the ICU hospitalization time of SAP patients, but the effect on prognosis is not obvious.
Humans ; Polymorphism, Single Nucleotide ; Prospective Studies ; Vitamin D-Binding Protein/genetics* ; Acute Disease ; Pancreatitis/genetics* ; Genotype ; Prognosis

Diazepam ; poisoning ; Humans ; Paraquat ; poisoning ; Pulmonary Embolism ; chemically induced

Objective To explore the difference between laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open preperitoneal hernia repair for the treatment of inguinal hernia under local anesthesia.Methods A total of 64 cases with inguinal hernia underwent hernia repair in Beijing Daxing District Hospital of Capital Medical University from January 2014 to January 2015 were retrospectively analyzed.Thirty-four cases in test group were applied with TAPP and used D(9 * 13) mesh to repair for inguinal hernia,and 30 cases in traditional group with open preperitoneal hernia repair which used D10 mesh to repair for inguinal hernia.Results All operations were successfully completed.There was statistically significant difference in operation time(P =0.000),postoperative activity time(P =0.000),postoperative hospitalization time (P =0.003) and pass flatus time (P =0.000) between these two groups.There was no statistically significant difference in wound seroma(P =0.216),hematoma (P =1.000),analgesics (P =0.090) and recurrence rate of the first year (P =1.000).Conclusions Both TAPP and tension free repair of inguinal hernia under regional anesthesia are safe and effective methods for the treatment of inguinal hernia,which has its advantages.Surgeon should choose the suitable procedure according to patient's condition reasonably.

Objective To explore the CT findings of benign and malignant pancreatic neuroendocrine tumors and improve its diagnostic accuracy.Methods The clinical information and enhanced CT findings of 96 cases with pathologically-proved pancreatic neuroendocrine tumors were retrospectively reviewed.The CT findings were evaluated by several factors,which included tumor size,morphology,location,internal composition,calcification,separation,bile duct and pancreatic duct dilation and CT value.Results All cases were divided into benign or malignant according to pathological grades,and benign group involved 40 cases with 41 lesions,while malignant group involved 56 cases with 59 lesions.The size of malignant lesions was significantly larger than that of benign lesions (median size 6.0 cm vs 2.2 cm),the shape of the lesions was irregular,and was mainly cystic solid,and mottling,curve shape,clumps calcification was present,then the bile duct and pancreatic duct was mild to moderately dilated,and the difference between the two groups was statistically significant (P ＜0.05).But the difference of tumor location,separation was not significant.45.76％ (27/59) of the malignant lesions reached the peak value in arterial phase,and 44.07％ (26/59) reached the peak value in venous phase;while 68.29％ (28/41) of the benign lesions reached the peak value in arterial phase,and 31.71％ (13/41) reached the peak value in venous phase.The CT values of malignant lesions in plain CT scanning,arterial phase,venous phase,balance phase were (39.02 ±7.53),(121.20 ± 54.73),(125.25 ± 40.77),(101.41 ± 28.68) Hu,while they were (41.49 ± 8.59),(144.73 ± 53.95),(157.05 ±44.72),(121.02 ±29.80) Hu in benign group.In plain CT scanning,the difference of CT value between malignant and benign lesions was not significant;but in the enhanced phase,the CT value of malignant lesions was significantly lower than that of benign lesions,and the difference was statistically significant (P ＜ 0.05).Conclusions The lesion with its size ≥ 3.0 cm,irregnlar morphology,cystic necrosis,calcification,pancreatic and bile duct dilatation is suggestive of malignancy tumor.The average CT values of malignant group are lower than those of the benign group in arterial,venous and balance phases.

Objective To investigate the impact of HLA-A antigens carrying Bw4 epitopes on disease course of HIV-1 infection.Methods Three hundred and forty subjects chronically infected with HIV-I were recruited and their HLA-A and B alleles were genotyped with sequence-based high resolution typing assay.HLA-Bw genotypes of these HIV-1 infected subjects were determined and their association with CD+4 T cell counts and viral load were analysed.Results When compared with subjects canting no Bw4 epitopes in HLA-A and HLA-B loci (OBw4) (median of CD+4 T cell counts:294/μ1;plasma viral load median 6.29×104 copies/ml),CD+4 T cell counts in subjects with genotypes of 1Bw4-A and 2Bw4-AA were comparable (307 and 308/μ1,respectively),but higher viral load (1.53×105 and 2.68×105 copies/ml,respectively) was observed.In subjects with Bw4 epitopes in HLA-B alleles but no in HLA-A,significantly higher CD+4 T cell counts (417/μ1,P=0.013) and lower viral load (2.10×104 copies/ml,P=0.007) were observed compared with those without Bw4 in HLA-A and HLA-B.Conclusion HLA-B antigens carrying Bw4 epitope were protective in HIV-1 infection by maintaining higher CD+4 T cell counts and lower viral load,but such protective effect was not observed in HLA-A antigens earring Bw4 epitope.