Objective To investigate the feature of CT perfusion of the lower limb skeletal muscle in patients with diabetic peripheral arterial disease (PAD).Methods It was a prospective study that collected out-patients and in-patients of interventional vascular surgery from January 2008 to January 2013.The patients were divided into three groups,including 27 patients (54 limbs) in diabetic PAD group,27 patients (54 limbs) in common PAD group and 9 patients (18 limbs) in control group.Patients in diabetic PAD group were selected when PAD were diagnosed through CTA and patient had the exact history of diabetes.There were 54 limbs in diabetic PAD group,including 10 limbs in Fontaine Ⅰ class,21 limbs in Fontaine Ⅱ class,14 limbs in Fontaine Ⅲ class and 9 limbs in Fontaine Ⅳ class.Patients in common PAD group were selected when PAD were diagnosed through CTA,patients those had the exact history of diabetes or coronary heart disease were exclusion.Patients in control group were collected with negative CTA results.CT perfusion scans of lower extremities were performed in all patients.Time density curve (TDC),Blood flow (BF),blood volume (BV),mean transit time (MMT) and permeability surface (PS) of skeletal muscle in different pathologic stage were obtained with perfusion software.The differences of perfusion parameters among diabetic PAD group,common PAD group and control group were compared by analysis of variance; and the differences of perfusion parameters among control group and all Fontaine classes in diabetic PAD group were also compared.Results TDC of normal skeletal muscle in control group continued to rise,and raise rapidly at an early stage; TDC of diabetic PAD group and common PAD group continued to rise,but raise slowly; the TDC of ischemia skeletal muscle has smaller slope and lower peak value than that of control group.The values of BF were (10.41±0.92) ml · 100 ml-1 · min-1 in control group,(13.37± 1.15) ml · 100 ml-1 · min-1 in diabetic PAD group and (17.12 ±0.81)ml· 100 ml-1· min-1in common PAD group.The values of BV were (1.04± 0.13)ml/L in control group,(1.23 ±0.16)ml/L in diabetic PAD group and (1.84 ±0.23) ml/L in common PAD group.The values of MTT were (11.63 ± 1.45) s in control group,(7.92±0.35) s in diabetic PAD group and (7.82±0.38) s in common PAD group.The values of PS were (3.46±0.84) ml· 100 ml 1· min-1 in control group,(9.84±0.87) ml· 100 ml-1· min-1 in diabetic PAD group and (12.11 ±0.70)ml· 100 ml-1· min-1in common PAD group.The differences of the values of BF,BV,MTT and PS among the three groups were statistically significant (F values were 10.892,4.492,27.543 and 20.506,P all＜0.05).The differences of the values of BF,BV among control group and all Fontaine classes in diabetic PAD group were not statistically significant(P all＞0.05),the differences of the values of MTT,PS were statistically significant.And the differences of the values of MTT,PS between control group and each Fontaine class in diabetic PAD were statistically significant (P all＜0.05).Conclusions CT perfusion imaging of Lower extremity skeletal muscle can prompt the existence of early skeletal muscle ischemia for diabetic PAD.The method can be valuable for clinical early diagnosis.

Adolescent ; Brain ; pathology ; Brain Diseases ; diagnosis ; pathology ; Child ; Diagnosis, Differential ; Female ; Granulation Tissue ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies

This article briefly summarized conventional k-space technique, partial k-space sampling and key hole technique, then introduced the latest applications during these years.
Magnetic Resonance Imaging

Objective To establish a method for the determination of Bullatine A in Gutongling Babu plaster. Method The Bullatine A was determined by HPLC on Kromasil-C18 column, and the mobile phase consisted of phosphate buffered solution (pH 7.3) - methanol (28∶72), the detection wavelength was 210 nm. Result A good linear relationship of Bullatine A was showed in the range of 0.212 0～4.770 0 ?g (r =0.999 99), and the average recovery was 100.10%, RSD=2.53% (n =6). Conclusion The method is accurate and reliable, and can be used for quality control of Gubitong Babu plaster.

Objective To evaluate the results of Four-Step methods in traditional Chinese medicine Course.Methods 40 five-academic-year clinical medical students and 40 seven-academicyear undergraduate students were randomized assigned into experimental group (n=40, 20 five-academicyear clinical medical students and 20 seven-academic-year students) and control group (n=40, 20 five-academic-year students and 20 seven-academic-year students).The control group received conventional teaching, while four-step teaching break the gap between Chinese medicine and western medicine, build the base, form the framework of Chinese medicine and extend knowledge was implemented in the experimental group.Through questionnaire score, group discussion, the final evaluation of the theory and clinical training evaluation, the learning of the experimental group students and the control group students was compared.SPSS 18.0 statistical software was used and t test was employed to make analysis of the relevant data.Results The questionnaire at the end of the semester showed that the average score of students in the experimental group (36.18 ± 0.96) was higher than that in the control group (26.62 ± 1.00), and the difference was statistically significant (P=0.017).In the discussion at the end of the semester, the experimental group paid more attention to the theory and technology of traditional Chinese medicine's learning persistence in future and its application in their professional practice.Scores in theory test were higher in seven-academic-year students in experimental group (88.40 ± 8.79) than in control group (82.15 ± 6.83) and the difference was statistically significant (P=0.017), but there was no difference in five-academic-year students between experimental group (75A0 ± 12.09) and control group (77.85 ± 11.99), which was not considered statistically significant different (P=0.524).In clinical practice, the rate of outstanding students in the experimental group of seven-academic-year was five percentage points higher than the control group, while the rate of outstanding students in the experimental group of five-academic-year was 10 percentage points higher than the control group.Conclusions Four step teaching is helpful to stimulating the learning enthusiasm of the students of traditional Chinese medicine, expanding students' vision of medical field, and promoting their construction of a more comprehensive medical knowledge framework.

Objective To investigate the common etiologies,sports and learning situation of children in Nantong with short stature,and discuss the relationship between the two. Methods Did a retrospective analysis of 108 cases of children with short stature in Nantong University′s affiliated hospital since January 2012. Through detailed past illnesses, physical examination, laboratory tests, diagnose short stature and clarify the cause. Did a questionnaire to these children with short stature about sports and learning situation. Use statistical methods like multivariate Logis-tic regression analysis and link analysis to analyze sports and learning situation of children in Nantong with short sta-ture and find the relation with the etiology. According to the principle of group matching,the control group elected representative of 108 children. Results In 108 cases, 61 cases were because of growth hormone deficiency (GHD), accounting for 56. 5% ; 47 cases were because of non-growth hormone deficiency (NGHD), accounting for 43. 5% . Logistic regression analysis showed that participation in physical exercise was a protective factor. Rest-less anxiety and inattention were as risk factors,and these make a lot(P < 0. 001, OR = 7. 483, 95% CI = 2. 620 ~21. 374). There was no significant relation between common cause and sports, learning situation ( P > 0. 05). Conclusion Various types of sports (basketball, badminton, running, cycling) are protective factors for children of short stature. Restless anxiety and inattention are risk factors for children with short stature. Whether there is growth hormone deficiency or not, children with short stature should increase the right exercise as much as possible and avoid or reduce exposure to these risk factors.

Objective:To compare the antihypertensive effects of tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up.Methods:A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group,a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table,with 34 cases in each group.Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively.The blood pressure was recorded by benchtop mercury sphygmomanometer before tuina,immediately after tuina treatment,30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room.The total effective rate was observed.Results:The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P＜0.05).The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P＜0.05).Qiaogong (Extra) group had the highest total effective rate though there was no statistical difference in the total effective rate among the three groups (P＞0.05).Conclusion:Treating primary hypertension due to liver-fire flaming-up with tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively,among which Qiaogong (Extra) has the highest total effective rate.

Objective To discuss the preoperative interstitial chemotherapy effect and significance on Ki‐67 and Caspase‐3 in oral squamous cell carcinoma .Methods 60 cases of well‐differentiated oral squamous cell carcinoma were divided into three groups ,non chemotherapy before operation group(n= 30) ,intravenous chemotherapy before operation group (n= 15) and interstitial chemo‐therapy before operation group(n=15) .The expressions of Ki‐67 and Caspase‐3 were determined by immunohistochemical method , then compared between three groups .Results The labelling index of Ki‐67 in tissue of carcinoma were significant differences a‐mong each groups(P< 0 .05) .The labelling index of Ki‐67 in adjacent mucosas of carcinoma were significant differences among three groups(P<0 .05) .The expression rates of Caspase‐3 were significant differences among three groups(P<0 .05) .Conclusion Preoperative interstitial chemotherapy than preoperative intravonous chemotherapy for oral squamous carcinoma more inhibit tumor growth and reduce local recurrence through the inhibition of cell proliferation and induction of cell apoptosis ,thus inhibiting tumor growth .

AIM:To observe the effect of captopril on the genesis and development of gastric cancer , and to explore its clinical treatment feasibility for gastric cancer .METHODS:The human gastric cancer cell line AGS was used to establish a tumor model in nude mice , and the model mice were randomly divided into 3 groups: positive control ( 5-fluorouracil) group, normal control (saline) group and experimental (captopril) group.After intraperitoneal injection or intragastric administration of the drugs , the tumor growth curve was determined , and the tumor tissues were also sampled to detect the expression of Ki-67, STAT3, Bax and Bcl-2 by real-time quantitative PCR and immunohistochemistry .The apop-tosis was detected by TUNEL +DAPI staining .RESULTS: The tumor growth curve showed that the tumor model in the nude mice was successfully established .The tumor volumes among groups showed significantly different after 14 d growth. The increase in the tumor volume in normal control group was significantly faster than that in the other two groups , and that in positive control group was the slowest .The expression of Bax in captopril group increased , and the expression of STAT3, Ki-67 and Bcl-2 was reduced as compared with normal control group and positive control group .Compared with normal con-trol group, the apoptotic rate increased significantly , and the protein expression of p-STAT3 and STAT3 decreased obviously in positive control group and captopril group .CONCLUSION:With better feasibility , angiotensin-converting enzyme in-hibitor captopril has a significant effect on treating gastric cancer in the AGS nude mouse model by regulating the expression of STAT3, Bax, Bcl-2 and Ki-67 to accelerate the apoptosis of cancer cells , thus inhibiting tumor growth .

OBJECTIVE To discuss the role of preservation of great auricular nerve during neck dissection in improving the quality of life of the patients and to study the anatomic marks of the great auricular nerve.METHODS Preservation of great auricular nerve during neck dissection was performed in 157 sides of the neck.The feeling changes in auricular and occipital areas were observed.The anatomic relationship between the great auricular nerve and accessory nerve at the posterior margin of the sternocleidomastoid muscle was measured in 115 sides.According to whether to follow the operative steps decided in neck dissection,72 sides with same neck dissection levels were divided into group A and group B.The surgical time of the two groups were recorded.RESULTS At the posterior margin of the sternocleidomastoid muscle,the great auricular nerve located under the accessory nerve and above the external jugular vein in 100% patients.The distance between the great auricular nerve and accessory nerve was 0.1 to 1.9cm.There was a significant difference in surgical time between the two groups (P