Objective To evaluate the feasibility of histogram analysis of susceptible signal intensity in differentiating papillary (pRCC) from chromophobe renal cell carcinoma(ChRCC). Methods Thirteen cases with pRCC and 9 cases with ChRCC, who underwent susceptible-weighted imaging(SWI), MR common scanning and enhancement, were assessed retrospectively. The histogram parameters of susceptible signal intensity were measured, including maximum, minimum, mean, median, skewness and kurtosis. The independent samples t test(normal distribution) and Mann-Whitney rank sum test(skewed distribution) were used to compare the differences in SWI parameters between pRCCs and ChRCCs. Receiver operating characteristic curve was used to evaluate the efficiency of the whole-tumor SWI parameters in differentiating pRCCs from ChRCCs. Results The significant differences of the minimum, mean, median and skewness between pRCCs and ChRCCs were present(P<0.05), and there was no significant differences in maximum and kurtosis between between pRCCs and ChRCCs(P>0.05). In all the histogram parameters, the area of ROC curve of mean value was largest(0.80). The sensitivity of minimum value (84.62％) was the highest and and the specificity of skewness(100.00％) was the highest. Conclusion Histogram analysis of susceptible signal intensity can help differentiate pRCCs from ChRCCs.

AIM:To anylsis the chemical constituents of the Caulis of Schisandra from different harvesting time in Jiaohe prefecture for comprehensive utilization of shizandra berry's resource.METHODS:Dexyschisandrin,monosaccharide and oligosaccharide,polysaccharide were taken as statistical indicator and in combination with cluster analysis to compare among them.RESULTS:With colligational comparison,contents of climbing stem collected in November and July approached that of schisandra fruit.Deoxyschisandrin content was the highest in stem in July,polysaccharide content in November,oligosaccharide content in September.CONCLUSION:Chemical pattern recognition can play a role in comparing content of multicomponent of the Caulis of Schisandra and the best harvesting time.

OBJECTIVE To investigate the significance of expression of p53, Mdm2 and p21WAF/ CIP1 proteins and their relationships. METHODS Pathological specimens from thyroid carcinoma, adjacent non-tumor thyroid tissues and thyroid benign lesions were examined for p53, Mdm2 and p21WAF/CIP1 proteins by tissue microarray technique and immunohistochemistry method. RESULTS The positive expression rate of p53, Mdm2 and p21WAF/CIP1 in thyroid carcinoma was 50.6 %(37/73), 63.0 %(47/73) and 38.4 %(28/73) respectively. The expression of p53 and Mdm2 increased(P

Objective To explore the value of susceptibility weighted imaging (SWI) in the quantitative analysis of ischemia-reperfusion injury (IRI) of the rabbit kidneys . Methods Thirty New Zealand white rabbits were randomly assigned to IRI group (n=24, operation with clamping) and Sham group (n=6, operation without clamping). Left renal ischemia-reperfusion was performed by occlusion (calmping) of the left renal arterial for 60 minutes, followed by reperfusion. All the rabbits underwent MRI including T2WI and SWI before and 0.5 h, 12 h, 24 h and 48 h after the establishments of models . Three rabbits in IRI group were randomly sacrificed 0.5 h, 12 h, and 24 h after the establishment of model. The rest of the rabbits in IRI group and 6 rabbits in sham group were sacrificed for pathological examination 48 h after the establishment of model All specimen were cut into slices and stained with hematoxylin-eosin (HE). Region of interest ( ROI) was manually created by outlining the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex, then relative signal-to-noise ratio of the kidney (rSNR) to muscle in SWI sequence was recorded. and compared with histopathologic features. One-way ANOVA was performed to compare difference of rSNR to muscle in respective location at 5 time-points between Sham group and IRI group, and the differences between groups were tested using repetitive measure analysis of variance, repetitive measure analysis of variance was performed to compare difference of rSNR to muscle in respective location at respective time-points between Sham group and IRI group. Results rSNR value in the inner medulla 0.5 h, 12 h, 24 h and 48 h after the establishments of models were 0.28 ± 0.04, 0.98 ± 0.14, 0.69 ± 0.07, 0.57±0.06, 0.43±0.03, respectively (F=69.82,P<0.01), the inner stripe of outer medulla at the five time-points 0.08 ± 0.03, 0.57 ± 0.05, 0.32 ± 0.07, 0.16 ± 0.02, 0.04 ± 0.01, respectively(F=16.59,P<0.01), the outer stripe of outer medulla were 0.31 ± 0.04, 0.86 ± 0.09, 0.65 ± 0.07, 0.55 ± 0.06 0.43 ± 0.04(F=67.52,P<0.01), respectively,the cortex 0.05±0.01, 0.80±0.04, 0.68±0.07, 0.47±0.07, 0.36±0.08, respectively(F=118.96,P<0.01). The difference of the rSNR was statistically significant in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex at the five different time-points. The differences between two groups were significant (F=206.29, 14.25, 42.8, 39.12, P all<0.05). The pathological findings in Sham group included normalglomerular structure l, clear cavity of tubular, no interstitial hyperemia and edema. The pathological findings in IRI group demonstated, at 0.5 h after IRI, Bowman's capsule cavity expansion, glomerular shrinkage, swelling of renal tubular epithelial cells, vacuoles degeneration, the tube cavity expansion, interstitial edema and congestion ecta became slender, andat 12 h after IR, Bowman's capsule expansion became more obvious, foam degeneration of renal tubular epithelial cells, apoptosis, partial loss of the brush border of the proximal convoluted tubule, formation of protein cast, and a small amount of inflammatory cells appeared in the renal interstitium, swelling of endothelial cells of the vasa recta, congestion of small vessels, and at 24 and 48 h after IRI, more serious injury of renal tubular in the outer stripe of outer medulla , massive necrosis of renal tubular epithelial cells, apoptosis, parts of the renal tubular had the contour lines, and renal tubular outline, increment in inflammatory cells, red cell and protein cast. Conclusion rSNR of SWI in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex of the kidney varies with the degree of IRI over time, and is consistent with corresponding pathological feature, suggesting SWI is useful imaging tool to detect early damage of renal IRI quantitatively.

Objective To explore the clinical value of transnasal high volume oxygen therapy in the treatment of patients with acute heart failure.Methods From January 2016 to January 2018,61 cases with acute heart failure in Huxi Hospital Affiliated to Jining Medical College were selected.The patients were randomly divided into control group and treatment group according to the digital table,31 cases in the control group and 30 cases in the treatment group.The two groups were routinely given control of fluid volume,analgesia,strong heart,diuresis,vasodilator,anti-platelet aggregation,camp support and so on.The control group was given conventional oxygen therapy,and the treatment group was treated with high flow oxygen through nose.Before treatment and 12h,24h,48h,72h after treatment,the left ventricular ejection fraction (LVEF),oxygen index (PaO2/FiO2),serum lactic acid (Lac),B type sodium and titanium (BNP) in serum,and the application rate of non-invasive mechanical ventilation and invasive mechanical ventilation in 7d were observed in the two groups.Results Compared with the control group,the LVEF of the treatment group in each time point increased [(35.58 ± 3.64) ％ vs.(37.77 ± 3.76) ％,(37.87 ± 3.58) ％ vs.(40.07 ±3.36)％,(44.94 ±3.19)％ vs.(46.83 ±3.21)％,(47.55 ±3.45％)％ vs.(40.07 ±3.36％)％,t =-2.308,-2.466,-2.316,-2.487,all P ＜ 0.05].The PaO2/FiO2 of the treatment group increased significantly at each time point after treatment [(177.39 ± 10.62) mmHg vs.(184.17 ± 10.49) mmHg,(188.00 ± 11.72) mmHg vs.(198.57 ± 18.47) mmHg,(204.06 ± 17.69) mmHg vs.(221.40 ± 23.80) mmHg,(265.23 ± 34.51) mmHg vs.(290.37 ± 26.72) mmHg,t =-2.507,-2.678,-3.236,-3.174,all P ＜ 0.05].The BNP level of the treatment group decreased significantly at each time point after treatment [(2 462.90 ± 288.00) ng/mL vs.(2 264.53 ± 366.44) ng/mL,(1 646.61 ± 377.19) ng/mL vs.(1 474.07 ± 214.03) ng/mL,(991.94 ± 242.95) ng/mL vs.(811.90 ±258.67) ng/mL,(653.77 ± 147.671) ng/mL vs.(526.47 ± 127.87) ng/mL,t =2.355,2.187,2.803,3.594,all P ＜ 0.05].The Lac level of the treatment group decreased significantly at 12h and 24h after treatment [(5.05 ± 0.69) mmol/L vs.(4.55 ± 0.80) mmol/L,(3.68 ± 0.89) mmol/L vs.(3.13 ± 0.77) mmol/L,t =2.610,2.601,all P ＜ 0.05],but there were no statistically significant differences between the two groups at 48h and 72h after treatment [(1.62 ± 0.65) mmol/L vs.(1.53 ± 0.65) mmol/L,(1.36 ± 0.64) mmol/L vs.(1.26 ± 0.46) mmol/L,all P ＞ 0.05].In the control group and the treatment group,the incidence rates of non-invasive mechanical ventilation in 7d were 35.48％ (11/31),13.33％ (4/30),respetively,the difference was statistically significant (x2 =4.034,P ＜ 0.05).In the control group and the treatment group,the incidence rates of invasive mechanical ventilation in 7d were 12.90％ (4/31),3.33％ (1/30),respetively,the difference was statistically significant (x2 =4.957,P ＜ 0.05).Conclusion Nasal high flow oxygen therapy has better clinical effect on patients with acute heart failure.It is a more active treatment measure,and is worthy of clinical application.

Objective: To observe the relationship between the dynamic changes of plasma levels of urotensin II (UII) and the stability of coronary atherosclerotic plaque in patients with acute coronary syndrome (ACS).
Methods: Our research included 2 groups: ACS group,n=135 consecutive patients treated in our hospital from 2013-03 to 2013-08 that including unstable angina pectoris (UAP) sub-group,n=7, non-ST segment elevation myocardial infarction (NSTEMI) sub-group,n=22 and STEMI sub-group,n=106. In addition, there was a Control group,n=48 healthy subjects. Plasma levels of UII, hs-CRP and NT-proBNP were examined and compared among different groups at different time points.
Results: Compared with Control group at immediate admission, ACS group had increased plasma level of UII (39.82 ± 22.28) pg/ml vs (26.88 ± 6.09) pg/ml,P<0.001; UII level in STEMI sub-group was lower than NSTEMI sub-group (37.41 ± 22.74) pg/ml vs (48.07 ± 15.82) pg/ml,t=2.092,P <0.05. In ACS patients, UII had no correlation to hs-CRP (r=0.041, P=0.639) and NT-proBNP (r=0.112,P=0.261) at immediate admission. There were 58 ACS patients finished the 3 months follow-up study and their UII level was increased than immediate admission as (56.52 ± 20.70) pg/ml vs (51.58 ± 18.70) pg/ml,t=-2.366,P<0.05.
Conclusion: Plasma levels of UII have been changing in different type of ACS patients at immediate admission, UII presented decreasing trend from UAP to NSTEMI to STEMI, while it had increasing trend upon stabilized condition; the admission level of UII had no correlation to inflammatory marker hs-CRP and ventricular overload marker NT-proBNP. UII is not only related to the extent of atherosclerosis, but also related to the nature of atherosclerosis or the stability of plaques.

Objective To evaluate the feasibility and curative effect of extracorporeal liver perfusion (ECLP) in treatment of acute liver failure (ALF) in pigs. Methods The experiments were carried out in healthy pigs (weight 20-30 kg) under general anesthesia. All of the pigs were randomly divided into 3 groups. ALF model was established by liver blood supply obstructing and portal-systemic shunting. ALF group (n=5): ALF pigs were killed 8 h after establishing. ALF+ECLP group (n=5): ALF pigs were perfused with ECLP for 4 h and killed 8 h after establishing. Normal liver+ECLP group (n=4): normal pigs were dealt with just as ALF+ECLP group. The data of PT, AST, TNF, blood ammonia were collected in all groups. Pathologic changes in liver and brain were detected. Results The levels of PT, AST, TNF, blood ammonia, RBC and HCT in the ALF+ECLP group were lower than those in the ALF group (P

Objective:To investigate the clinical efficacy of hemoperfusion in the treatment of severe organophosphorus poisoning and its effect on diaphragm function.Methods:Eighty-five patients with severe organophosphorus poisoning who received treatment in Affiliated Huxi Hospital of Jining Medical University (Shanxian Central Hospital), China between January 2018 and January 2020 were included in this study. They were randomly divided into treatment ( n = 43)and control ( n = 42) groups. The control group was given conventional treatment including gastric lavage, catharsis, and application of reactivators and anticholinergic drugs. The treatment group was subjected to three times of hemoperfusion, with an interval of 24 hours between two hemoperfusion interventions based on the conventional treatment used in the control group. Before and after three times of hemoperfusion, serum levels of cholinesterase (CHE), interleukin-6 (IL-6), arterial partial pressure of oxygen (PaO 2), and arterial partial pressure of carbon dioxide (PaCO 2) were measured. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and oxygenation index (OI) in each group were calculated. Right diaphragmatic activity, diaphragmatic thickness at the end of inspiration (DTei) and diaphragmatic thickness at the end of expiration were measured by bedside ultrasound. The diaphragmatic thickening rate (DTF) and diaphragmatic rapid shallow breathing index (D-RSBI) were calculated. Serum CHE and IL-6 levels, OI, diaphragmatic activity, DTF and D-RSBI were compared between the treatment and control groups. The incidence of intermediate syndrome, tracheal intubation rate, 28-day mortality rate, and hospital stay were compared between the two groups. Results:Before hemoperfusion, there were no significant differences in serum levels of CHE and IL-6, OI, right diaphragmatic activity, DTF, and D-RSBI between the treatment and control groups (all P > 0.05). After three times of hemoperfusion, serum IL-6 level and D-RSBI in the treatment group were (37.9 ± 6.2) ng/L and (0.77 ± 0.20) times /min/mm, which were significantly lower than those in the control group [(45.9 ± 5.3) ng/L, (0.90 ± 0.16) times/min/mm ( t = -6.295, -3.382, P < 0.001, P = 0.001)]. Serum CHE level, OI, DE and DTF in the treatment group were (2.29 ± 0.52) kU/L, (264.5 ± 24.3) mmHg, (16.5 ± 1.9) mm, (27.2 ± 4.7) %, respectively, which were significantly higher than those in the control group [(1.96 ± 0.39) kU/L, (252.6 ± 27.2) mmHg, (14.3 ± 1.6) mm, (23.5 ± 4.1) %, t = 3.258, 2.141, 5.598, 3.877, all P < 0.05]. The incidence of intermediate syndrome, tracheal intubation rate, hospital stay in the treatment group were [4.7% (2/43)], [2.3% (1/43)] and [(11.8 ± 1.8) days], respectively, which were significantly lower than those in the control group [23.8% (10/42), 19.0% (8/42) and (12.9 ± 1.8) days, χ2 = 6.432, P = 0.011; χ2 = 6.276, P = 0.012; t = -2.932, P = 0.004]. There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Conclusion:Hemoperfusion can improve diaphragmatic function, reduce inflammatory reaction and shorten hospital stay in patients with severe organophosphorus poisoning.

Objective To investigate the effects of early mobilization therapy on gastrointestinal function and respiratory mechanics in mechanical ventilation patients with chronic obstructive pulmonary disease (COPD). Methods A prospective randomized controlled study was used. Eighty-five patients with COPD who had stable hemodynamics and required invasive mechanical ventilation from January to December 2017 were enrolled. The patients were divided into treatment group with 43 cases and control group with 42 cases according to the random number table method. The patients in both groups received conventional basic treatment, but the treatment group received early mobilization therapy. The conditions of acute gastrointestinal injury (AGI), incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation, 28-day mortality and respiratory mechanics indexes before and after treatment including airway resistance (Raw), lung dynamic compliance (Cd), lung static compliance (Cs), intrinsic positive end expiratory pressure (PEEPi) were compared between 2 groups. Results There were no statistical difference in Raw, Cd, Cs and PEEPi before treatment between 2 groups (P＞0.05). The PEEPi and Raw after treatment in treatment group were significantly lower than those in control group:(6.51 ± 1.46) cmH2O (1 cmH2O=0.098 kPa) vs. (7.30 ± 1.61) cmH2O and (19.23 ± 2.62) cmH2O/(L·s) vs. (20.54 ± 2.50) cmH2O/(L·s), the Cs and Cd were significantly higher than those in control group:(53.14 ± 5.07) ml/cmH2O vs. (49.16 ± 5.10) ml/cmH2O and (26.63 ± 3.28) ml/cmH2O vs. (24.54 ± 1.97) ml/cmH2O, and there were statistical differences (P＜0.05 or＜0.01). The incidences of AGI, duration of AGI, duration of mechanical ventilation and incidence of VAP in treatment group were significantly lower than those in control group: 44.2% (19/43) vs. 66.7% (28/42), (3.56 ± 1.22) d vs. (4.26 ± 1.62) d, (6.79 ± 1.92) d vs. (7.64 ± 1.89) d and 2.3% (1/43) vs. 14.3% (6/42), the severity of AGI was significantly lower than that in control group (patients of gradeⅠ,Ⅱ,ⅢandⅣin treatment group were 11, 6, 1 and 1 case respectively, and patients of grade Ⅰ, Ⅱ, Ⅲ and Ⅳ in control group were 7, 12, 8 and 1 case respectively), and there were statistical differences (P＜0.05). There was statistical difference in 28-day mortality between 2 groups (P＞0.05). Conclusions The incidence of AGI in mechanical ventilation patients with COPD is high. Early mobilization therapy can reduce the incidence and duration of AGI in mechanically ventilated patients with COPD, and reduce airway resistance, increase Cd and Cs, reduce PEEPi, improve respiratory function, shorten mechanical ventilation time, and reduce the incidence of VAP, which is worthy of clinical promotion.

Objective To investigate the effect of early activities on risk factors of acute gastrointestinal injury (AGI) in patients with chronic obstructive pulmonary disease (COPD) induced by mechanical ventilation.Methods A total of 118 mechanically ventilated non-diabetic patients with chronic obstructive pulmonary disease who were admitted to our hospital from August 2017 to April 2018 were enrolled in the study.The patients were divided into AGI group (71 cases) and non-AGI group (47 cases) according to the presence or absence of AGI.The examined data were collected in the patients prospectively such as preprocalcitonin (PCT),D-lactic acid,serum albumin (ALB),fasting plasma glucose (FPG),fasting insulin (FINS),and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores were calculated.The homeostasis model insulin resistance index was used (HOMA-IR) to assess the subjects' insulin resistance.Logistics regression analysis screened for risk factors that affected patients' AGI.The AGI patients were divided into treatment group (36 cases) and control group (35 cases) according to the random number table method.On the basis of the same conventional treatment,the treatment group were received early mobilization.The differences of PCT,D-lactate,FPG,HOMA-IR,APACHE Ⅱ scores,and AGI grades before and after treatment for 3 days were observed for both groups of patients.Results The PCT,D-lactate,FPG,HOMA-IR,and APACHE Ⅱ scores were higher in the AGI group than in the non-AGI group [(2.72 ±0.54)ng/ml vs (1.81 ±0.62)ng/ml;(17.43 ±2.63)mg/ml vs (13.61 ± 1.6)mg/ml;(10.1 ±l.0)mmol/L vs (8.4 ±0.9) mmol/L;(2.4 ±0.5) vs (1.7 ±0.4);(23.8 ±2.9) point vs (21.7 ±4.3)point],and the ALB were lower than non-AGl group [(29.1 ±2.2)g/L vs (30.6 ±3.2)g/L],with statistically significant difference (P ＜ 0.05).Multivariate logistic regression analysis showed that PCT,D-lactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores were risk factors for AGI in mechanically ventilated non-diabetic patients with COPD (regression coefficients were 4.337,1.226,5.106,4.469,0.584 respectively,P ＜0.05).There were no significant difference in PCT,D-lactate,FPG,HOMA-IR,APACHE Ⅱ scores between the treatment group and the control group before treatment (P ＞ 0.05).The PCT,D-lactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores in the treatment group were significantly lower than those in the control group after early treatment [(2.00 ± 0.49) ng/ml vs (2.34 ± 0.34) ng/ml;(15.38 ± 1.71)mg/ml vs (17.38 ±2.88)mg/ml;(8.9 ±0.9)mmol/L vs (9.6 ±0.7)mmol/L;(1.9 ± 0.4) vs (2.2 ± 0.4);(21.0 ± 1.8) point vs (22.2 ± 2.7) point],and AGI severity was reduced (There were 8,18,6,3 and 1 cases of 0,Ⅰ,Ⅱ,Ⅲ,and Ⅳ in the treatment group,and4,12,9,7 and 3 in the control group respectively),with statistically significant differences (P ＜ O.05).Conclusions PCT,Dlactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores were risk factors for AGI in mechanically ventilated non-diabetic patients with COPD.Early mobilization could reduce the level of these risk factors and the severity of AGI.