Adult ; Aged ; Humans ; Middle Aged ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; Retrospective Studies

Objective To describe the CT and MR imaging features of hepatic inflammatory myofibroblastic tumor(IMT).Methods The CT(n=12)and MRI(n=2)findings of pathologically proved hepatic IMT in 12 patients were retrospectively analyzed.Results All the tumors of the 12 patients were solitary and located in right hepatic lobe.Six tumors were solid and 4 tumors were solid-cystic.The other 2 tumors were periportal soft-tissue infiltration.The tumors appeared as solid or solid-cystic hypodense mass on CT images.The lesions were dark in T1-weighted sequences and slightly bright on T2-weighted sequences.There was homogeneous or inhomogeneous moderate to significant enhancement in solid portion of the tumors.Honeycomb-like enhancement was demontrated both in the peripheral part and at the intratumoral septa of the solid-cystic mass.Conclusion CT and MRI can provide helpful information for the clinical diagnosis and differential diagnosis of hepatic IMT.

Objective:To explore the effect of different tidal volumes (VT) on the hemodynamics of right heart in acute respiratory distress syndrome (ARDS) rats induced by oleic acid (OA).Methods:Sixty adult male Sprague-Dawley (SD) rats were divided into control group ( n = 20), ARDS model group ( n = 20), low VT (LVT) group ( n = 10) and high VT (HVT) group ( n = 10) by random number table. ARDS model was reproduced by injecting OA 0.15 mL/kg through a jugular vein. The control group was given the same amount of normal saline. The success of modeling was judged by the oxygenation index (PaO 2/FiO 2) 2 hours after modeling, at the same time, the lung tissues were collected, the wet/dry weight (W/D) ratio was determined, and the lung histopathological changes were measured by lung injury score. The rats in the LVT group and HVT group were given mechanical ventilation with VT of 6 mL/kg or 20 mL/kg for 4 hours, respectively at 2 hours after modeling. The rats in the control group and the ARDS model group maintained spontaneous breathing. After mechanical ventilation for 4 hours, the heart rate (HR), right ventricular systolic pressure (RVSP), the maximum rate of rising of right ventricular pressure (dp/dt max), and the blood pressure (BP) were measured. Meanwhile, arterial blood samples were collected for blood gas analysis, including pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2) and PaO 2/FiO 2. Results:The rats in the ARDS model group showed symptoms of respiratory distress 1 hour after modeling, and the lung tissue samples showed obvious patchy bleeding 2 hours after modeling, while the control group showed no such changes. The PaO 2/FiO 2 in the ARDS model group was significantly lower than that in the control group [mmHg (1 mmHg = 0.133 kPa): 294.3±5.9 vs. 459.0±4.4, P < 0.01], and the lung W/D ratio and lung injury score were significantly higher (lung W/D ratio: 8.24±0.25 vs. 4.48±0.13, lung injury score: 0.60±0.03 vs. 0.12±0.02, both P < 0.01). It indicated that ARDS model was successfully reproduced. The arterial blood gas analysis and hemodynamic parameters of the ARDS model group were significantly worse than those of the control group. After 4-hour mechanical ventilation, the blood gas parameters of the LVT group were better than those of the ARDS model group and the HVT group [pH value: 7.36±0.02 vs. 7.24±0.02, 7.13±0.01; PaO 2 (mmHg): 92.4±2.1 vs. 61.8±2.3, 76.6±2.2; PaCO 2 (mmHg): 49.6±1.7 vs. 61.8±1.8, 33.6±1.3; PaO 2/FiO 2 (mmHg): 440.0±10.2 vs. 274.3±21.4, 364.7±10.5; all P < 0.05]. HR, BP and dp/dt max in the LVT group were significantly higher than those in the ARDS model group and the HVT group [HR (bpm): 346.9±5.4 vs. 302.3±10.1, 265.5±12.2; BP (mmHg): 125.4±2.2 vs. 110.0±2.5, 89.2±2.8; dp/dt max (mmHg/s): 1 393.3±30.3 vs. 1 236.4±20.5, 896.1±19.5; all P < 0.05], and RVSP was significantly lower than that in the ARDS model group and the HVT group (mmHg: 31.3±0.4 vs. 34.0±1.0, 38.8±0.9, both P < 0.05). Conclusion:Mechanical ventilation with low VT can improve the hemodynamic parameters of the right ventricle and protect the function of the right heart in ARDS rats.

Objective To discuss the method of interventional intravascular treatment in traumatic carotid cavernous fistula(TCCF)and the significance of clinical application in emergency.Methods In 297 cases of TCCF,36 cases were treated by interventional intravaseular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery.In the 36 cases,serious epistaxis occurred in 22 cases,cortical vein inflow in 9 cases,intracranial hemorrhage in 3 cases,aggravation of eyesight in 3 cases,and limb dysfunction in 2 cases.Results Fistula was successfully embolized and internal carotid artery remained patent in 19 cases.Complete embolization of orificium or internal carotid artery was achieved in 17 cases.The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped.Eyesight recovered in 2 cases and improved in 1 case.Limb dysfunction improved evidently in 2 cases. Conclusion Intravascular embolization treatment is the first therapeutic choice for TCCF,especially in emergency.It is necessary,safe and effective.

Objective To investigate the effects of echocardiography-guided pacemaker parameters optimization in order to enhance the efficacy of cardiac resynchronization therapy(CRT).Methods Seventeen patients with chronic heart failure received biventricular resynchronous pacing therapy.A-V delay and V-V delay was optimized under the guiding of spectral Doppler echocardiography and tissue Doppler imaging.Results The indices of heart function in all patients were significantly improved after the treatment.The NYHA class of the patients was improved from class Ⅲ～Ⅳ to class Ⅱ～Ⅲ.Since PAV/SAV was optimized to 130-180/100-150 ms,left ventricular filling time(LVFT) was increased from (354±147)ms to (420±112)ms,mitral reflux (MR) was decreased from (8.41±4.55)cm2 to (5.36±4.71)cm2.After VV delay was optimized to 4-40ms,standard deviation of time to regional peak systolic velocity (Ts-SD-12) was decreased from (48.4±17.9)ms to (30.2±18.6)ms,left ventricular outflow tract velocity time integral(VTI LVOT) was increased from (20.6±9.0)cm/s to (26.1±3.1)cm/s.Conclusions Echocardiography-guided optimization of the pacemaker parameters is necessary in order to enhance the efficacy of CRT.

Aim To investigate the regulatory effect of p38MAPK signal pathway on the apoptosis of human esophageal cancer cells induced by valdecoxib.Methods The tumor cells were inoculated in the dose of 1?107?L-1.After 6 h,the cells were divided into control group,solution group,400,200,100,50,25 ?mol?L-1 valdecoxib group and various concentration valdecoxib+SB203580 group,cultured for 72 h.FCM and DNA Ladder were used to detect the apoptosis of Eca109 cells.p38 mRNA expression was detected by RT-PCR.The expression of p-p38MAPK protein was detected by immunohistochemical staining and FCM.Results ① Valdecoxib could increased the apoptosis rate of Eca109 cell in concentration-dependent fashion.Apoptosis rate was increased to 48.46% in 400 ?mol?L-1 valdecoxib group at the incubation time of 72 h.DNA ladder was the most recognized marker of apoptosis,and there was obvious DNA ladder in valdecoxib treated group,especially in 400 ?mol?L-1 group.② Valdecoxib could increase the expression of p38MAPK,while SB203580 could inhibit the over-expression induced by valdecoxib,at the same time,the apoptosis rate was been decreased.③ The expression of p38MAPK protein was positively correlated with the apoptotic rate(r=0.822,P=0.000).Conclusions Valdecoxib could activate p38MAPK pathway,thus induce the apoptosis of Eca109 cells,which may be one of the mechanisms for the inhibition of cell growth by valdecoxib.

Aim To investigate the effects and possible mechanism of valdecoxib on apoptosis of cancer in nude mice.Methods The tumor model was established by inoculating 2?106 cell both in the left and right armpit respectively.The mice were divided randomly into control group and valdecoxib group(20 mg?kg-1?day-1).Valdecoxib was dissolved in carboxymethylcellulose sodium and administered from the second day after inoculation.The mice were killed after 4 weeks.The volumn and inhibitory rate were calculated according to the length and width of xenograft tumor.H.E staining was used to observe the cell structure of the stomach and colon.The apoptotic rate was detected by FCM.The expression of COX-2,c-jun and c-fos protein was detected by FCM and immunohistochemical staining.Total RNA was extracted with Trizol method and the expression of COX-2 mRNA was detected by RT-PCR.Results(1) The body weight of nude mice was higher in valdecoxib treated group in a time-dependent manner.(2) Valdecoxib inhibited the growth of tumor.The weight of tumor was decreased from(1.43?0.52)g in control group to(0.93?0.53)g in valdecoxib treated group.The ratio of inhibition on the growth of tumor was 45.80%.(3) Valdecoxib increased the apoptosis rate from(14.15?0.48)% in control group to(29.80?6.35)% in treated group.(4) The expression of COX-2 mRNA and protein decreased in treated group compared with that in control group.FCM and immunohistochemical staining showed that the expressions of c-jun and c-fos were increased in valdecoxib treated group.There was statistical significance compared with control group.(5) There was significantly negative correlation between the ratio of apoptosis and the expression of COX-2(r=-0.726,P=0.008);there was significantly positive correlation between the ratio of apoptosis and the expressions of c-jun and c-fos protein respectively(r=0.603,0.813;P=0.038,0.001);(6) Valdecoxib did not affect cell structure of stomach and colon.Conclusions valdecoxib inhibits the growth of the xenograft tumor in nude mice and induces the apoptosis.Decreasing expression of COX-2 and up-regulating the expressions of c-jun and c-fos may be one of the mechanisms for the apoptosis.

Objective: To investigate the electroencephalogram (EEG) characteristics, cerebral blood fl ow, glucose metabolism, and pathological characteristics in cats kindled by pentylenetetrazol (PTZ). Methods: Ten adult male cats received intramuscular injections of PTZ at a sub-convulsive dose of 25 mg/kg once daily. Cats were considered to be kindled when a class V or above seizure was observed. Subsequently, scalp EEG, 99mTc-ECD-single-photon emission computed tomography (SPECT), 18FDG-positron emission tomography (PET), and Cresyl violet staining were employed to evaluate brain activity, cerebral blood fl ow, glucose metabolism, and pathological characteristics representing epileptic foci during interictal stages. Results: The EEG data revealed bilateral dissymmetry paroxysmal activity in the form of δ and θ waves, as well as paroxysmal spikes and sharp waves instead of symmetric highamplitude rhythm of 8-12 Hz in cats kindled by PTZ compared to controls. In addition, low blood perfusion and low glucose metabolism unilaterally in the temporal lobe were observed in PTZ-kindled cats, in contrast to the bilateral symmetrical blood perfusion and high glucose metabolism observed in control cats. Pathological examinations showed a thickening of white matter in the ipsilateral temporal region and a thinning of gray matter in PTZ-kindled cats. Microscopically, we observed a structure disturbance of hippocampal CA3 area in PTZ-kindled cats. Conclusion: Epileptic foci of PTZ-kindled cats were localized to the unilateral temporal lobe, in a manner highly similar to the pathophysiology of human temporal lobe epilepsy.

Objective To comment the severity of severe hand,foot and mouth disease(HFMD)by pediatric risk of mortality score(PRISM),and assess the performance of PRISM in predicting mortality or complication probability in HFMD.Methods Four hundred and twenty-four severe HFMD pediatric patients were recruited in the study from 1th Jan 2010 to 31th June 2013.Information on the outcome and the varia-bles required to calculate PRISM score were collected.The logistic regression model developed in the learning sample was evaluated in the test sample by calculating the area under the receiver operating characteristic (ROC)curve to assess discrimination pneumorrhagia and death.Calibration across deciles of risk was evalua-ted using the Hosmer-Lemeshow goodness-of-fit χ2 test.Results The area under the ROC curve were 0.87 (95%CI 0.80~0.94 )for PRISM in predicting pneumorrhagia probability.The area under the ROC curve were 0.87(95%CI 0.80~0.95)for PRISM in predicting mortality probability.The PRISM in observed and expected pneumorrhagia did not demonstrate good calibration at ten mortality risk intervals (χ2 =36.66, P<0.001 ).The PRISM in observed and expected mortality did not demonstrate good calibration at ten mortali-ty risk intervals(χ2 =41.11,P<0.001).Conclusion The PRISM score is demonstrated good discrimination of pneumorrhagia and death in HFMD pediatric patients,but the performance of calibration is not good.

Objective To report the clinical and peripheral neuropathological findings in two patients with autosomal recessive Charcot-Marie-Tooth disease 2K(AR-CMT2K).Methods Case one was a nine year-old girl.She had distal weakness of lower limbs for six years, with calf atrophy and contracture of Achilles tendon for three years.Case two was an eight year-old boy.He had distal weakness of lower limbs with contracture of Achilles tendon and calf muscle atrophy for three years, and proximal weakness of low limbs for two years.The motor nerve conduction velocities in median nerves were 48.1 m/s in case one and 47.6 m/s in case two.The compound motor action potential amplitude of median nerves decreased by 46% in case one and 69% in case two.Sural nerve biopsies and gene targeted next-generation sequencing were performed in both patients.Results Density of myelinated fibers was 8 407/mm2 in case one and 7 714/mm2 in case two.The ratio of myelinated fibers with diameter over 8 μm was 2.6% in case one and 0 in case two.Both patients had small regenerating cluster of myelinated fibers.Thin myelinated fibers appeared in case one.In case two, atypical onion bulb formations with focal folded myelin appeared, and electromicroscopy revealed mitochondrial aggregate in axons.Compound heterozygous mutations of ganglioside-induced differentiation associated protein 1 gene were detected in both patients, including c.767A>G(p.H256R) and c.466G>A (p.A156T) in case one and c.767A>G and 845G>A(p.R282H) in case two.Conclusions Contracture of Achilles tendon may appear in early childhood of AR-CMT2K patients.The main pathological changes in sural nerve are loss of large myelinated fibers, mitochondrial aggregate in axons and myelin abnormalities.