Early diagnosis and accurate stage of liver fibrosis are important for conducting the clinic therapy and assessing the therapeutic outcome. Functional magnetic resonance imaging (fMRI), as a noninvasive and effective method, plays an important role in diagnosis and stage of liver fibrosis. This review focuses on the advances in fMRI evaluation of liver fibrosis.
Humans ; Liver Cirrhosis ; diagnosis ; Magnetic Resonance Imaging

OBJECTIVE:To evaluate the clinical outcome of arterial perfusion with chemotherapy medicine together with elemenum emulsion injection solution via Port-Catheter System(PCS)in treating middle-late malignant tumors.METHODS:A total of63patients with middle-late malignant tumors were enrolled,31were randomly assigned to receive arterial perfusion of chemotherapeutics in combination with elemenum emulsion(group A),and32cases to receive single arterial perfusion of chemotherapeutics(group B),the short-term curative effects of the2groups were then compared.RESULTS:The total effec_ tive rate of group A and B were66.7%and46.7%,respectively with one-year survival of which respectively at56.7%and43.3%.There was significant difference between two groups(P

Objective To investigate the effects of rapid colloid and crystalloid infusions on the plasma concentration of propofol( Cp) during target-controlled infusion.Methods Thirty-six patients were randomly assigned to three interventions(12 patients per group).At least 30 min after the start of propofol infusion,the hydroxyethyl starch solution group(HES)received HES of 24 mL/(kg· h),on the former 20 min,the sodium acetate Ringer’s injection group(AR)received AR of 24 mL/(kg· h),while HES group and AR group of later 20 min and the control group of whole course received AR of 2 mL/(kg· h).The plasma concentrations of propofol were recorded per 2 min and a half.The cardiac outputting,blood volume and clearance of indocyanine green were measured by pulsed dye density analyzer,the effective hepatic blood flow( EHBF) were obtained.Results The varying of Cp with time showed a significant treatment factor(F[2,33] =14.14,P<0.001)and time factor(F[16,528] =10.37,P<0.001)and interaction between the above factors(F[32,528] =2.82,P <0.001) by ANOVA for repeated measurement;the difference of Cp among each group,Cp in HES group was significantly lower than AR group(5-40 min)or control group(10-40 min),with significant difference(P<0.05).The varying of EHBF with time showed a significant treatment factor(F[2,28] =3.68,P=0.038)and time factor(F[2,56] =5.37,P=0.007)and interaction between the above factors(F [4,56] =3.67,P=0.010);while there was no significant difference in other groups.Conclusion Rapid HES infusion increases the effective hepatic blood flow,resulting in a decrease of propofol concentration during target-controlled infusion.Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.

Objective To study the effect of glucagon-like peptide 2 (GLP-2) on the absorption- related genes [ sodium dependent glucose transporter 1 (SGLT1) and dipeptide transporter 1 (PEPT1)] mRNA expressions of residual small bowel in a rat model of short bowel syndrome. Methods Rats undertaken 75% small bowel resection were randomly assigned into 3 groups: short bowel control (SBC) group, growth hormone (GH) group and GLP-2 group. Another weight-matched normal rats with normal diet was used as normal (NC) group. All rats were given normal chow on the 1st postoperative day (POD). On the 6th POD, partial segment of terminal ileum was harvested to evaluate the mRNA expressions of SGLT1 and PEPT1 by semiquantified reverse transcription polymerase chain reaction. Results The mRNA expressions of both SGLT1 and PEPT1 in SBC group were significantly higher than that of NC group(P0.05). Conclusions A short term GLP-2 adiministration in early postoperative days may has no significant effect on mRNA expressions of SGLT1 and PEPT1 in residual ileum in rats with short bowel syndrome.

Objective: To explore the protections of GLP-Ⅱ pretreatment on mouse intestinal mucosal immunity after ischemia/reperfusion insult. Methods: Thirty ICR mice were randomly divided into three groups: namely normal control (N), control (C) and GLP-Ⅱ pretreatment (P). Group C and group P were inflicted with ligation of superior mesenteric artery for twenty minutes. The morphology of distal ileum mucosa, the rate of intestinal bacteria translocation, the level of plasma endotoxin and intestinal IgA were determined. Results: After ischemia/reperfusion insult, there were obvious damage at distal ileum mucosa in group C and obvious proliferation in group P.The rate of intestinal bacteria translocation and the level of plasma endotoxin were significantly increased (P

Objective To observe the effects of chronic angiotensin Ⅱ blockade on gene expression of extracellular matrix at different segments of nephron in aged rats. Methods Glomeruli and tubules of rat kidney were isolated by laser microdissection and pressure catapulting system. Gene expression level of transforming growth factor (TGF-? 1) and fibronectin (FN) were assessed. Fifteen -month-old male Wistar rats were treated with the valsartan (25mg/kg) until sacrificed at age 24 months, and their TGF-? 1 and FN expression levels were compared with that of young and aged controls. Results Compared with young rats, TGF-? 1 mRNA and FN mRNA expression were both up-regulated in isolated glomeruli and tubules in aged rats. Although Valsartan had no effect on the gene expression of TGF-? 1 in isolated glomeruli, it down regulated TGF-? 1 mRNA in tubules of aged rats. Valsartan also down regulated FN mRNA in both glomeruli and tubules of aged rats. Conclusion The results indicate that changes in TGF-? 1 and FN expression might be involved in the aging related changes of gomeruli and tubules. Activation of RAS at the different segments of nephron in aged rats might regulate the gene expression of ECM through diverse mechanisms.

Objective To observe the effect of restrictive transfusion in colon cancer surgery in elderly patients on postoperative VAP (ventilator-associated pneumonia). Methods Forty cases of elderly patients with colon cancer intending to undertake surgery were randomly divided into restrictive transfusion group (group R) and standard transfusion group (group S) with 20 cases in each group. In group R, patients were administered one third of accumulative fluid loss in the first 60 minute, then the infusion rate were 4 mL/(kg·h) and central venous pressure was maintained at 5 ~ 7 cmH2O. In group S, rate of fluid administration = CVE + deficit +maintenance + loss + third space. Blood gas index including lactic acid and volumes of fluid administered, blood loss, urine volume and thoracic fluid count (TFC) were recorded in the operation. Clinical pulmonary infection score(CPIS) was recorded respectively before operation, 1 day, 3 day, 7 day after operation to evaluate the risk of VAP. Results Compare with those in group S, there were significantly less TFC and intraoperative volumes of fluid administration in group R. The CPIS was significant lower at day1, day3, day7 after operation in group R. There was no significant difference in MAP, HR, CO and urine volume between two groups. Conclusions In colon cancer surgery for elderly patients, restrictive transfusion can maintain hemodynamic stability, ensure the tissue oxygenation, reduce conjunction edema, shorten the recovery and hospital stay and reduce the incidence of VAP.

Objective To analyze the application value of MSCT enhanced scanning in diagnosis of gastrointestinal mucoca associated lymphoid tissue(MALT) lymphoma.Methods 11 cases of gastrointestinal MALT lymphomas confirmed by pathology were analyzed retrospectively.The clinical data and imaging features of 11 cases were analyzed,including lesion sites, morphologic features and enhancement patterns of tumors,positions of lymph nodes,involvement of extranodal site excluding gastrointestinal tract.Results For morphologic features,8 cases (72.7%) were gastrointestinal wall thickening type, among them, 5 cases occurred in the stomach and 3 cases in the intestine;3 cases (27.3%) were localized mass/nodule type, among them, 2 cases occurred in the stomach and 1 case occurred in the intestine.The sign of aneurysmal dilatation was showed in 2 cases, which occurred in the intestinal tract.There was 1 case of localized mass/nodule MALT lymphoma in the ileocecal junction with local intestinal lumen stenosis.For the manifestations of enhanced scanning,10 cases (90.9%) of tumors were moderately or obviously enhanced, 9 cases (81.8%) showed homogeneous enhancement.For the involvement of lymph nodes and other extranodal organs, regional lymph nodes were involved in 5 cases(45.5%), regional lymph nodes and distant lymph nodes were involved in 1 case(9.1%), lymph nodes of both sides of the diaphragm were involved in 1 case (9.1%), extranodal sites excluding gastrointestinal tract were involved in 2 cases (18.2%).9 cases (81.8%) were classified as stage Ⅰ-Ⅱ, 2 cases (18.2%) were classified as stage Ⅳ.Conclusion MSCT enhanced scanning can provide a reliable basis for the diagnosis and staging of gastrointestinal MALT lymphoma.The chest and abdominopelvic cavity enhanced scanning is recommended as a routine examination.

Objective To investigate the activity and mRNA expression of plasminogen autivator inhibitor (PAI 1) and tissture plasmin activator (tPA) stimulated by low density tipoprotein (LDL) on cultured human proximal tubular cell (HKC), which was a cell line of human proximal tubular cell. To show whether LDL can lead to the activation of nuclear factor ?B NF ?B, and weather the effect can be reversed by Lovastatin, a kind of 3 hydroxy 3 methylglutaryl coenzyme, a reductase inhibitors (HRI). Methods Chromogenic substance was used to show the activity of tPA and PAI 1, RT PCR showed the mRNA expression of PAI 1 and tPA. The expression of P65 in nuclear was showed by Laser confocal microscopy. Results LDL could up regulate the activity of PAI 1 , down regulate the activity of tPA, which was decreased from 6.22?0.52 IU/ml to 4.9?0.11 IU/ml (in control vs LDL, P

Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.