Objective:To evaluate the value of 64-slice CT portal venography(CTPV)in demonstrating portal system and its collaterals in portal hypertension.Methods:50 cases of portal hypertension were included in the study and undergone upper abdomen examination with 64-slice CT,image post-processing techniques such as MIP,MPR and VR were applied to display the portosystemic collaterals of portal venous system.Results:CTPV simultaneously depicted fourth or fifth branches of the intrahepatic portal veins and provided images of entire portosystemic collaterals,on CTPV images,left gastric varices were seen in 48 patients(96%),esophygeal and/or fundic varices in 46(92%),paraesophageal varices in 41(82%),shnrt gatric veins or posterior gastric veins in 19(38%),shunt between spleen/gastric-renal vein in 14(28%),abdominal wall and paraumblical varices in 20(40%),retroperitioneal varices in 19(38%),portal sponge degeneration in 8(16%).Conclusion:CTPV can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension.An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease,and may play a significant role in marking a clinical treatment plan.

Objective:To analyse the findings of MRI and CT in the diagnosis of spine metastases in 52 cases,and compare their sensitivity and specificity,in order to increase the early diagnosis rate of spinal metastases.Methods:The most common sources of skeletal metastases were carcinomas of lung,breast,nasopharynx.MRI and CT were performed in 52 patients with metastatic tumor.The detectability for vertebral metastasis was compared between the two modalities.Results:Of the 52 cases,there were destructions of 176 vertebral bodies,76 lesions of spinal canal involvement,68 paravertebral soft tissue.masses and pathological fractures of 47 vertebral bodies.In the cases of stage Ⅰ spinal metastases:21 were detected by MRI and nothing was detected by CT.In the cases of stage Ⅱspinal metastases:86 were detected by MRI;52 were detected by CT.In the cases of stage Ⅲ spinal metastases:68 were detected by MRI;61 were detected by CT.The sensitivity of spinal metastases by MRI(99.4%) higher than CT(64.2%).MRI demonstrated decreased signal intensity(86.9%)and other abnormal signal intensity(13.1%)on T1WI and increased signal intensity(60.8%)and other abnormal signal intensity(39.2%)on T2WI.Conclusion:The sensitivity and specificity of MRI is higher than that of CT.Two methods are complementary to each other,so MRI combined with CT can improve the sensitivity and accuracy in the diagnosis of spinal metastases.

BRAF gene has the highest mutation rate and plays an important role in the occurrence,development,invasion and metastasis of melanoma.The frequency of the mutation varies in different clinical phenotypes,clinical pathology classifications and stages of malignant melanoma,which indicate a certain association of BRAF gene with the growth and prognosis judgment in malignant melanoma.BRAF gene mutation is the new direction of treatment in malignant melanoma molecular target therapy.

Objective To explore the relationship between the expression of NF-κB and VEGF and the biological behaviors of prostatic carcinoma.Methods Immunohistochemical method was used to examine the expression of NF-κB and VEGF in 40 cases of benign prostatic hyperplasia (BPH) and 53 cases of prostatic carcinoma.Results The positive rates of NF-κB and VEGF in prostatic carcinoma and BPH were 64.2％ and 69.8％,12.5％ and 37.5％ respectively.There are more cases with positive NF-κB and VEGF expression in prostatic carcinoma group than in the BPH group( x2 =24.976,9.655,P ＜ 0.01 ).The expression of VEGF and NF-κB in prostatic carcinomas increased significantly with the decrease of tumor differentiation and advance of the TNM stages(x2 =15.936,18.459;4.316,14.205,P ＜0.01 or P ＜0.05);The expression of VEGF in prostatic carcinoma was positively correlated with NF-κB ( r =0.297,P =0.027 ).Conclusion The expression of VEGF and NF-κB in prostatic carcinoma are highly correlated with each other and may be suggestive to understand the biological behavior of prostatic carcinoma.

Objective To explore the effect of oxidative stress on intermittent hypoxia induced-hip-pocampal injury in rats. Methods 30 adult male Sprague-Dawley rats were random divided into three groups ( 10 rats in each group), control group( CON group), intermittent group( IH group), and melatonin group( MEL group). The levels of MDA and SOD were detected by colorimetric method, and RT-PCR was used to examine the mRNA levels of the Cu/ZnSOD, GPx, CAT in hippocampal tissues. Results The level of MDA in IH group was ( 1. 68 ±0. 23) μmol/g, and it was obviously higher than that in control group (1.25±0.14)μmol/g and MEL group(1.35 ±0.18) μmoL/g ( P ＜0.05, P ＜0.01). In IH group, the activity of SOD and the mRNA levels of the Cu/ZnSOD,GPx and CAT were 43.01 ±4. 96 103NU/g, 0.25±0. 02,0. 34 ±0. 09,0. 38 ±0. 03 respectively, which were significantly lower than those in control group(61.12 ±5.68 103NU/g protein,0. 48 ±0.06,0. 55±0.07,0.57 ±0.04) and MEL group (55.98 ±4.65 103 NU/g,0.43 ± 0.08,0.54 ± 0.05,0.53 ± 0.07 ) ( P ＜ 0.05, P ＜ 0. 01 ). Conclusion Intermittent hypoxia can induce hippocampal injury in rats by oxidative stress, and melatonin can inhibit intermittent hypoxia induced-oxidant stress, so it can protect intermittent hypoxia induced-hippocampal injury in rats.

Objective To explore the application efficacy of scalp nerve block combined with sevoflurane in craniotomy.Methods Fifty-five patients undergoing craniotomy in pingdingshan second people's hospital of henan province from Mar 2013 to Mar 2015 were randomly divided into observation group (n =28) and control group (n =27).The scalp nerve block combined with sevoflurane was performed in observation group and the sevoflurane intravenous inhalational combined with sufentanil was performed in control group.The changes of MAP and HR were observed before induction,5min after induction,skin incision,break the meninges,operation end and 5rmin after catheter removal.The agitation scale after operation,anesthesia duration,awaking time and dosage of sufentanil were compared.Restults MAP and HR at skin incision,break the meninges,operation end and 5min after catheter removal in control group were significantly increased than those before operation,and significantly higher than those in observation group at same stage of operation,with statistically significance differences (P ＜0.05).The agitation scale of observation group was lower than that of control group,with statistically significance difference (P ＜0.05).There was no significance difference between two groups in anesthesia duration (P＞0.05),the awaking time in observation group was significantly shorter than that in control group and the dosage of sufentanil was significantly reduced in observation group (P＜0.05).Corclusion Scalp nerve block combined with sevoflurane used in craniotomy has advantages in stable vital signs,rapid awaking,less dosage of sufentanil and lower score of agitation,which is suitable for clinical application.

Acute kidney injury(AKI) is a common clinical severe emergency in children,with high morbidity,mortality and poor prognosis.The traditional indicators such as serum creatinine and urine can't diagnose early.Recently,with the deepening research of AKI,many higher specific and sensitive biomarkers have been found.But the study of biomarkers in children is behind the adult,and the etiology,pathophysiology of AKI in children have great difference from adult.So this paper will show the advances of biomarkers in children of AKI.

Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

Objective To compare the efficiency of acute physiology and chronic health evaluation (APACHE)Ⅱ and Ⅳ in mortality risk prediction of severe acute pancreatitis (SAP).Methods From January 2013 to December 2014,SAP patients admitted to intensive care units (ICU) were retrospectively analyzed in single center.The clinical data of the first 24 hours since the patients admitted into ICU were collected.The modified Marshall score,APACHE Ⅱ and APACHE Ⅳ score were calculated.The mortality risk predictive value of each patient was calculated by APACHE Ⅱ and APACHE Ⅳ.According to the final clinical outcome of patients,Hosmer-Lemeshow was performed to compare real mortality rate with predictive mortality rate,and calibration of APACHE Ⅱ and APACHE Ⅳ in the mortality risk of each patients was evaluated.The resoluation of the two scoring systems was compared by the area under the receiver operator characteristic curve (AUC).Results In the end,192 patients (152(79.2％) survivors and 40(20.8％) dead) were enrolled.Modified Marshall score,APACHE Ⅱ score and APACHE Ⅳ score of patients in dead group was 6.30±0.36,21.3±8.0 and 88.1± 30.2,respectively;and those of survival group was 3.70 ± 0.20,12.3 ± 5.6 and 53.4 ± 19.0,respectively,and the differences between two groups were statistically significant (t-6.436、-6.683、-6.913,all P＜ 0.01).The results of Hosmer-Lemeshowin calibration of APACHE Ⅱ and APACHE Ⅳ indicated that both two systems could predict mortality risk of SAP patients well (P＞ 0.05).The AUC of APACHE Ⅱ score (cut-off ≥26) and APACHE Ⅳ score (cut off≥91) was 0.81(95％CI 0.74 to 0.89) and 0.83(95％CI 0.75 to 0.90),respectively,and the difference was not statistically significant (x2 =0.21,P=0.644),which indicated that there was no statistically significant difference in calibration.Conclusions APACHE Ⅳ scoring system is not better than APACHE Ⅱ scoring system in prognosis prediction of SAP patients.The prognosis of SAP patients could be accurately evaluated by APACHE Ⅱ.

Since it is one of the hotspots to discover the new knowledge in life science in data-intensive scientific discovery by integrating the biomedical literature and scientific data that can provide an open environment for their interactive operation , the mining of foreign and domestic biomedical literature and integration of scientific data were analyzed , the corresponding systems for different integration methods were investigated , the development trend in biomedical literature and scientific data integration was predicted .