Objective To discuss the nonoperative management strategy to prevent the conversion of acute pancreatitis to the severe form.Methods In recent 4 years,286 patients with mild acute pancreatitis admitted to our hospital were divided into control group and treatment observation group;routine conservative management was performed in control group,and the strategy of improving pancreatic microcirculation and preventing cell Ca~2+ overload and inhibiting pancreatic protease was added to the treatment observation group.Results Among the 144 patients with mild acute pancreatitis in control group,conversion to severe acute pancreatitis occurred in 20 patients,and 14 of the 20 patients with severe acute pancreatitis developed systemic complications.Among the 142 cases in treatment observation group,the conversion of mild to severe acute pancreatitis occurred in 8 patients,and 2 of the 8 patients developed systemic complications.Serum C-reactive protein levels and Balthazar CT severity index were significantly decreased at each time point in treatment observation group compared to control group.Conclusions In addition to routine management,improving pancreatic microcirculation,preventing cell Ca~2+ overload and inhibiting pancreatic protease might serve as a benificial strategy for preventing the progression of mild acute pancreatitis to the severe form.

Objective:To establish the quality standard for Tangzhixiao capsules. Methods: The qualitative identification of Salvia miltiorrhiza,Atractylodes and Hawthorn was detected by TLC, and the quantitative determination of salvianolic acid B was determined by HPLC. The HPLC determination was performed on a YMC-Triart C18 (250 mm × 4. 6 mm, 5μm ) column with the mobile phase consisted of acetonitrile-0. 1% phosphoric acid (24∶ 76) at the flow rate of 1. 0 ml·min-1 , the column temperature was 30℃ and the detection wavelength was set at 286 nm. Results: The TLC spots were fairly clear, and the negative samples showed no interference. The concentration of salvianolic acid B within the range of 0. 012-0. 120 mg·ml -1 was linear with peak area(r = 0. 999 5), the average recovery was 100. 06% and RSD was 0. 83%(n = 6). Conclusion: The method is accurate, reliable and reproducible, which can be used in the quality control of Tangzhixiao capsules.

Objective To investigate the feasibility and clinical value of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV in chest CT scan.Methods A total of 60 patients of clinical diagnosis with lung tumor were enrolled.Those patients were randomly divided into test group and control group.Control group underwent a scan protocol with lateral scout scan combined with Care Dose 4D and Care kV,while anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV were performed in test group.The signal-to-noise ration (SNR),contrast-to-noise ratio (CNR),and overall image quality of two groups of images and diseased tissues were analyzed and evaluated by two high-grade radiologists using double-blind method.Effective doses (E) were also calculated.Results All the 60 patients had successfully completed the chest CT scans.Test group overall image quality (4.57 ± 0.45) and control group overall image quality (4.73 ± 0.45) had no statistically significant difference (P ＞ 0.05).The control group image SNR,CNR and diseased tissue SNR,CNR compared with test group had no statistical significance difference (P ＞ 0.05).The difference of the volume CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) of test group and control group was statistically significant (t =8.514,8.464,8.464,P ＜ 0.001).Compared with control group,the effective dose of test group decreased by 33.3％.Conclusions Compared with lateral scout scan,the technology of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV can decrease radiation dose without reducing the image quality.This technology can therefore be considered as a regular imaging modality for chest CT scan.

Objective To investigate the therapeutic effect and safety of microneurosurgery associated with Gamma Knife radiosurgery on the large meningiomas in sellar region, and to clarify its clinical curative effect. Methods The clinical data of 34 patients with large meningiomas in sellar region underwent microsurgery were retrospectively analyzed.All of them underwent microsurgery,and then treated with Gamma Knife radiosurgery in one month after operation if there were residual tumors.The tumor removal of situation,complication,rate of symptom remission,and recurrence rate were analyzed.Results Among the 34 patients,total resection (7 cases of Simpson grade Ⅰ and 12 cases of Simpson grade Ⅱ)was achieved in 19 cases (55.9%),subtotal resection (Simpson grade Ⅲ )in 14 cases (41.2%), and partial resection (Simpson grade Ⅳ )was achieved in 1 case (2.9%).The major complications were cranial nerve injuries (such as oculomotor nerve, trochlear nerve and abducens nerve,n=6),the contralateral limb paresis (n = 2),postoperative bleeding (n = 1),CSF leak with infection (n=3),and secondary epilepsy (n = 3 ); no death occurred postoperatively. All these patients were followed up for about 3 to 48 months.Postoperative headache disappeared in 24 cases (80%),and 6 cases were alleviated (20%);postoperative vision improved in 12 cases (80%),remained unchanged in 2 cases (13.3%)and deteriorated in 1 case (6.7%); postoperative olfactory function improved in 5 cases (62.5%) and 3 cases unchanged (37.5%); 5 cases recoverd from the ocular motility disorder (71.4%), and 2 cases unchanged (28.6%);7 cases recoverd from thehemiplegia (100%).One of the total resection cases (5.2%)and two of the non-total resection (13.3%)suffered from tumor recurrence.All of the non-total resection cases were treated with Gamma Knife radiosurgery.Conclusion The clinical effect of microneurosurgery associated with Gamma Knife radiosurgery in treatment of large meningiomas in sellar region is satisfactory.

Objective: To understand the current situation of suicidal ideation among middle school students in Taiyuan City and its correlation with exposure to social ecological risk factors, so as to provide a reference basis for exploring the causes of suicidal ideation among middle and high school students and formulating effective preventive measures. Methods: A questionnaire survey was conducted among 2 639 middle school students in urban and rural areas of Taiyuan City by multistage stratified random cluster sampling, including general demography characteristics, social ecological risk factors and suicidal ideation. SPSS 26.0 software was used for Chi squared test and binary Logistic regression analysis. Results: The overall detection rate of suicidal ideation was 24.7 %. There were statistically significant differences in the detection rate of suicidal ideation among middle school students in different gender, grade, family residence, maternal education level, perceived family economic conditions, number of close friends, self-perceived academic burden ( χ 2=38.17, 13.44, 10.77, 8.15, 19.76, 18.95, 59.75, P <0.05). After adjusting the general demography characteristics, the binary Logistic regression showed that moderate and high risk in the individual, family and cultural dimension, and high risk in the school dimension of the social ecology were all positively correlated with suicidal ideation among middle school students ( OR=1.38, 2.28, 1.97, 3.28, 1.48, 2.15, 1.71, P <0.05). Conclusion The suicidal ideation among middle school students is related to individuals, families, and schools in the social ecological microsystem, as well as the cultural environment in the macro system. It is necessary to conduct intervention in suicidal ideation at the individual, family, and school levels, meanwhile, strengthening social and cultural construction to reduce the impact of adverse factors on the mental health among adolescents.

OBJECTIVETo observe the effect of SSd on reversing the malignant phenotype of HepG2 cells and to investigate its mechanism in order to prove that SSd is a new choice to prevent and treat HCC.

METHODSHepG2 cells were cultured and treated by different concentration (0 mg/L, 2.5 mg/L, 5.0 mg/L, 10.0 mg/L and 20.0 mg/L) of SSd for 24 h, and treated by 10 mg/L of SSd for 0 h, 6 h, 12 h, 24 h, 48 h and 72h respectively. The cell inhibition rates were measured by MTT assay. Then cells were treated by 10 mg/L SSd for 48 hr in experimental group and treated by no SSd as a control, their morphological changes were observed by contrast phase microscope. The concentrations of ALB and AFP in clear supernatant liquid of cells were detected by radio-immunity and chemiluminescence. The cell migration rates were observed by transwell method, the relative expression levels of p27 mRNA were measured by RT-PCR.

RESULTSThe inhibitive effect of 10 mg/L SSd was the most significant among different concentrations ( F = 265.06, P less than 0.01). The shape of HepG2 from experimental group turned into small and round, and their volume ratios of nucleus to plasma decreased. ALB in supernatant liquid of HepG2 was higher ( t = 7.83, P less than 0.05, and its AFP was lower ( t = -10.72, P less than 0.01) as compared to control group. Cells migrated were fewer and p27 mRNA expression of HepG2 was higher in experimental group than that in control group (t = 22.00, P less than 0.05).

CONCLUSIONSSd could reverse the malignant phenotype of HepG2 cells. It was suggested that the up-regulation of p27 mRNA expression play an important role in the differentiation of HepG2 cells treated by SSd.

Carcinoma, Hepatocellular ; pathology ; Hep G2 Cells ; drug effects ; Humans ; Liver Neoplasms ; pathology ; Oleanolic Acid ; analogs & derivatives ; pharmacology ; RNA, Messenger ; genetics ; Saponins ; pharmacology

OBJECTIVETo investigate the cognitive characteristics in early school-age children with attention deficit hyperactivity disorder (ADHD) using event-related potential (ERP) and Achenbach Child Behavior Checklist (CBCL), as well as the correlation between ERP and behavioral problems.

METHODSA total of 22 children aged 6-7 years with ADHD and 19 healthy children matched by age were enrolled. Continue Performance Test-AX (CPT-AX) was performed for ERP test. The amplitude and latency of N2 and P3 of Go and Nogo were compared. The CBCL was completed by the parents, and the correlation between behavioral factors and ERP was analyzed.

RESULTSThe ADHD group had a significantly higher number of ERP omissions than the normal control group (10±8 vs 5±4; P<0.05), while the reaction time and number of commission errors showed no significant differences between the two groups (P>0.05). The ADHD group showed a significantly lower Go-N2 amplitude than the normal control group (-8±5 μV vs -10±4 μV; P<0.05). In the ADHD group, the detection rates of hyperactivity, attack, and discipline violation were 27%, 27% and 9% respectively. The scores on attack and discipline violation subscales were negatively correlated with the Go-N2 amplitude of ERP (r=-0.43 and -0.48 respectively; P<0.05), while the score on hyperactivity subscale was positively correlated with the latency of Go-P3 (r=0.50, P<0.05).

CONCLUSIONSThe early school-age children with ADHD show the tendency to the impairment of attention/executive function, but the inhibition function defect has not been noted. In early school-age children with ADHD, the behavioral problems such as hyperactivity, attack, and discipline violation are associated with ERP.

Attention Deficit Disorder with Hyperactivity ; physiopathology ; psychology ; Child ; Child Behavior Disorders ; etiology ; Evoked Potentials ; physiology ; Humans

Objective To explore the clinical application value of second-generation dual-source CT combined with intelligent modulation and iterative reconstruction in emergency aortic dissection imaging.Methods A total of 40 emergency patients with clinical suspected aortic dissection were included in this study.Conventional scanning was performed in the control group,and large-pitch intelligent modulation and iterative reconstruction were performed in the test group.The mean CT value,mean noise,signal noise ratio(SNR),contrast noise ratio(CNR),effective dose,image quality and aortic root image quality were evaluated and analyzed.Results Totally 40 patients successfully completed CT aortic dissection imaging.There was no difference in image quality between the two groups (P＞ 0.05).The quality of aortic root images in the test group was better than that in the control group,and the difference was statistically significant(x2=22.556,P＜0.05).The mean CT value and mean noise of aorta in the control group were slightly higher than those in the test group.However,SNR and CNR in the test group were higher than those in the control group,and the difference was statistically significant (t =-21.042,-15.924,8.530,11.495,P＜0.05).The effective dose of the control group [(10.59±3.89)mSv] was significantly higher than that [(6.39±0.81) mSv] of the test group,the difference was statistically significant (t =-12.327,P＜0.05).Conclusions The combined intelligent modulation technique and iterative reconstruction technique with dual-source CT large pitch scanning can meet the requirements of image quality and reduce the effective dose,and can be used as a conventional imaging method for emergency CT of aortic dissection.

OBJECTIVE: To investigate the diagnostic value of diffusion kurtosis imaging (DKI) histogram analysis in hepatic fibrosis staging. MATERIALS AND METHODS: Thirty-six rats were divided into carbon tetrachloride-induced fibrosis groups (6 rats per group for 2, 4, 6, and 8 weeks) and a control group (n = 12). MRI was performed using a 3T scanner. Histograms of DKI were obtained for corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC). Mean, median, skewness, kurtosis and 25th and 75th percentiles were generated and compared according to the fibrosis stage and inflammatory activity. RESULTS: A total of 35 rats were included, and 12, 5, 5, 6, and 7 rats were diagnosed as F0–F4. The mean, median, 25th and 75th percentiles, kurtosis of D map, median, 25th percentile, skewness of K map, and 75th percentile of ADC map demonstrated significant correlation with fibrosis stage (r = −0.767 to 0.339, p < 0.001 to p = 0.039). The fibrosis score was the independent variable associated with histogram parameters compared with inflammatory activity grade (p < 0.001 to p = 0.041), except the median of K map (p = 0.185). Areas under the receiver operating characteristic curve of D were larger than K and ADC maps in fibrosis staging, although no significant differences existed in pairwise comparisons (p = 0.0512 to p = 0.847). CONCLUSION: Corrected apparent diffusion of DKI histogram analysis provides added value and better diagnostic performance to detect various liver fibrosis stages compared with ADC.
Animals ; Carbon ; Diagnosis* ; Diffusion* ; Fibrosis* ; Liver ; Liver Cirrhosis ; Magnetic Resonance Imaging* ; Rats ; ROC Curve

Objective To investigate the feasibility of chemical exchange saturation transfer (CEST) imaging in the measurement of myocardial creatine (Cr) metabolites in phantom model using 3.0 T MR. Methods Five phantoms were made according to the volume percentage of Cr ranging from 10 to 50 mmol/L with an interval of 10 mmol/L. 3.0 T MR examinations with base protocol sequence,sequence with and without ECG were performed. Signal to noise,CrEST effect and Z spectra were analyzed. Comparison of signal noise ratio (SNR) among the three methods was performed using an analysis of variance. Bivariate correlations were obtained through Pearson analysis. Results Phantom studies demonstrated that different concentrations of Cr exhibited significant CEST effect with the three sequences. The SNR obtained by sequences with and without ECG were both higher than that of base sequence (both P<0.05). Moreover,no significance of SNR was found between sequences with and without ECG (P>0.05). There were positive correlation of MTR between sequences with ECG,sequences without ECG and base protocol sequence (r2= 0.974 and 0.997, both P<0.05). Conclusion Compared with base protocol sequence, the optimized sequence with ECG can acquire higher SNR CrEST images,indicating that myocardial CrEST imaging could be performed in clinical practice.