PurposeTo prospectively investigate the effect of gadolinium contrast media on the quality of intravoxel incoherent motion (IVIM) MRI images and the quantification of corresponding parameters for abdominal solid organs, and to explore the appropriate time for abdominal IVIM scan.Materials and MethodsTwenty patients underwent the same abdominal IVIM scan before and after gadolinium contrast administration. The signal-to-noise ratio (SNR) of liver, spleen, pancreas and kidneys were measured on diffusion-weighted imaging (DWI) images at b=50 s/mm2, 300 s/mm2 and 800 s/mm2. SNR and contrast-to-noise ratio (CNR) of hepatocellular carcinoma (HCC) (n=16) were also calculated. Apparent diffusion coefficient (ADC) value and IVIM parameters including pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) of liver, spleen, kidneys parenchyma and HCC were measured and compared. ResultsSNR of liver on post-contrast DWI at b=50 s/mm2 were significantly lower than that of pre-contrast (t=2.397,P<0.05). CNR of HCC increased significantly on b=300 s/mm2 DWI images after contrast (t=-3.380,P<0.01). SNR of kidneys on DWI of any b value decreased after contrast administration (Z=-2.675--2.201,P<0.05). SNR of spleen, pancreas and HCC were not statistically different between pre-contrast and post-contrast images (t orZ=-1.324-1.104,P>0.05). As for IVIM parameters, only ADC and D values of kidneys demonstrated a significant reduction after contrast (ADC:t=3.569,P<0.01; D:Z=-3.053,P<0.01). No significant differences were detected for all parameters of liver, spleen and HCC between pre-contrast and post-contrast images (t=-1.102-1.689,P>0.05). ConclusionAdministration of gadolinium contrast media may result in decrease of SNR of liver on low b value DWI and SNR of kidneys at any b value, but it increases CNR of hepatic lesions on medium b value DWI. Administration of gadolinium contrast media does not make a significant effect on SNR of spleen, pancreas and hepatic lesions. Furthermore, ADC and D values of kidneys decrease after administration of gadolinium contrast media. There is no significant influence of contrast medium on DWI and IVIM parameters of liver, hepatic lesions and spleen.

Objective To investigate the CT and MRI features of desmoid-type fibromatoses(DF).Methods The images of 29 ca-ses with DF proved by pathology were reviewed retrospectively.CT and MRI examinations were performed in 1 5 cases respectively, and both in 1 case.Results The median age was 33.0 years with a male-to-female sex ratio of 1 ︰ 2.2.36 lesions were discovered,among which 26 cases were solitary while 3 cases had multiple focus.1 9 lesions were extra-abdominal,14 ones in the abdominal wall and 3 ones intra-abdominal.The largest diameter of tumors was 13 -1 75 mm.27 lesions displayed ovoid or elongated shape while 9 ones were irregular .The boundary could be clear or unclear.25 lesions extended along muscle planes with consistent long axis.23 focuses grew aggressively,1 6 of which crossed the muscle clearance,while 13 lesions grew expansively.On CT,20 lesions appeared iso-den-sity or slightly hypo-density compared with normal muscles,mostly homogeneous(1 5/20).Most lesions exhibited gadually moderate or obvious enhancement on post-contrast CT,and the enhancement was homogeneous or heterogeneous.1 7 lesions were found on MRI,which presented signal intensity similar to or slightly higher than that of muscles on T1 WI and most were homogeneous(12/1 7);on T2 WI,all were heterogenous with slightly high or high intensity.All lesions demonstrated obvious enhancement on MRI after contrast administration ,and most were heterogeneous(12/1 7).Sheets or bands of low signal were detected within 1 1 lesions with no enhancement.Conclusion DF has some characteristics on CT and MRI,which are valuable for accurate pre-operative diagnosis,and for evaluation of the lesion extent and involvement of adjacent structures.

Objective To observe and assess the effect of different dosages of aspirin on inflammatory biomarkers, hemorheology (platelet aggregation rate) and clinical prognosis in patients with acute coronary syndrome ( ACS). Methods ACS patients were randomly assigned to receive different dosages of aspirin treatment orally. Patients in group A,B and C took 100 mg, 500 mg and 1000 mg of aspirin per day respectively. They were treated and followed-up for 1 year. High-sensitivity C-reactive protein ( hsCRP) , IL-6, tumor necrosis TNFot and platelet aggregation rate were examined and major adverse cardiac events( MACE) were recorded. Results A total of 312 patients with ACS were enrolled in the study. The baseline characteristics of the three groups were not different with respect to age, gender, cardiovascular risk profile, level of inflammatory biomarkers and concomitant treatment before and after randomization. The levels of baseline serum hsCRP, IL-6 and TNFa were higher in subjects of the study as compared with normal reference value (P<0. 05, <0. 05, <0. 01) and they decreased significantly after therapy with 3 different doses of aspirin (detected at 30 days, 6 months and 12 months, P <0. 001 ) , but there were no significant differences among the three groups( P >0. 05) . Rehospitalization , MACE and the change of platelet aggregation ratio were not significantly different among the three groups. The incidence of gastrointestinal complaints was significantly higher in groups B and C than in group A ( P < 0. 05 ). Conclusions The levels of serum inflammatory biomarker increase in patients with ACS. Aspirin therapy may decrease the level of inflammatory markers significantly, but increasing the dosage of aspirin from 100 mg to 1000 mg daily does not decrease the level of inflammatory markers and the clinical MACEs further. However, the incidence of gastrointestinal complaints increase significantly with the increase of aspirin dosage.

Objective To investigate the prevalence and influential factors of workplace violence (WPV) against nurses in general hospitals of Suzhou. Methods A total of 2110 staff nurses from 13 general hospitals in Suzhou were investigated with the Modified Version of Hospital Workplace Violence Questionnaire. Results During the past one year,68.9% (1454/2110) nurses investigated suffered from WPV.Working departments,marital status, strong support,etc,were the leading impact factors of WPV. Conclusions Nurses′experience of WPV is a prevalent phenomenon in general hospitals of Suzhou. It is urgent for hospital administration to raise attention to WPV and take effective measures,to reduce the occurrence of WPV.

ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.

Objective The molecular etiology of hearing impairment in Guangdong District has not been thor-oughly investigated.SCL26A4 gene mutation and relevant phenotype were analyzed in this study.Methods The coding exons of SLC26A4 were analyzed in 59 EVA cases.Those SLC26A4 gene mutations patients were examined by temporal bone CT.Results Fifty-nine cases were SLC26A4 mutations deafness patients,and 21 cases (35. 59%)and 38 cases (64.41%)patients with SLC26A4 biallelic allele (compound homozygous or heterozygous)and monoallelic gene mutation,including 16 cases of SLC26A4 gene IVS7-2 A> G homozygous mutations,2 cases of 2168A>G homozygous mutations and 3 cases of IVS7-2A>G,2168 A > G compound heterozygous mutations in children with CT showing bilateral enlarged vestibular aqueduct or other types of inner ear malformations.Thirty-one patients were IVS7-2A>G heterozygous for SLC26A4 mutation and seven 2168 A > G heterozygous muta-tion.Four patients with SLC26A4 gene mutations were confirmed to have enlarged vestibular aqueduct with Mondini dysplasia.Two patients with normal phenotype ,and others were enlarged vestibular aqueduct.Conclusion Muta-tions in the SLC26A4 gene with enlarged vestibular aqueduct patients were frequently found in Guangdong District.IVS7-2A>G mutations rate were highest,followed by 2168 A > G.We established the new strategy that detects SLC26A4 mutations prior to the temporal bone CT scan to find enlarged vestibular aqueduct and inner ear malforma-tion patients .

Objective To investigate the effect evaluation of self-nursing on the stent-tract in the discharged patients with orthopedic external fixation support. Methods A total of 112 patients with orthopedic external fixation support were selected, and designed the self-nursing material. Before discharging guidance, make sure that the patient or patients′ family mastered the operation methods and nursing key points. After discharge, the continuing nursing support was provided. Results The incidence of infection was 4. 46%. All the 112 patients, the times of return visits were 432, and the times of changing the dressing were 3 940, with the mean times of 35. 2;The reducing the costs were 43 340, with the mean reducing of 387. Conclusions The self-nursing on the stent-tract in the discharged patients with orthopedic external fixation support can save the human resource, time and medical costs of the patients and patients′ family, it can also help the doctors with discharged treatment and reduce the work of nurses.

Objective To establish rabbit model bearing VX2 liver tumor using improved technique,and to analyze the relevant impact factors of hepatic artery and portal vein catheterization.Methods Transplanted liver tumors of 60 healthy New Zealand white rabbits were established through open abdominal puncture and hepatic artery and portal vein catheterization.The rabbits were divided into A group (survival) and B group (death) according to whether a short-term (within 7 days after surgery) death occurred or not.The univariate analysis of the factors which could lead to the death of rabbits were analyzed.The Logistic regression models were established with parameters which were significantly different between the 2 groups,and independent risk factors which could lead to the failure of the experiment were analyzed.Results VX2 tumors were successfully implanted in the liver to all 60 rabbits.Nine (9/60,15.00 ％) rabbits died within 7 days,while 51 (51/60,85.00％) rabbits survived,weight ＜ 2.5 kg,additional intraoperative anesthesia,operation time ≥60 min,length of incision ≥5 cm and blood loss of operation ≥25 ml were impact factors (all P＜0.05).Weight ＜ 2.5 kg,additional intraoperative anesthesia and the blood loss of operation ≥25 ml were independent risk factors for death (P＜0.01).Conclusion Relative high success rate of building rabbit models bearing VX2 liver tumor may achieved using hepatic artery and portal vein catheterization.Larger weight of rabbits,training of surgical skills,less intraoperative blood loss are helpful to avoid intraoperative additional anesthesia,thus reducing mortality of rabbits.

Objective To construct eukaryotic expression vector of small hairpin RNA vector targeting hepatitis B virus core protein in HepG2.2.15 cells,and to verify the interfering effect.Methods To design and synthesize small interfering RNA sequence against HBc gene (ayw subtype) which locates between 2147 bp to 2165 bp in the HBV genome.The siRNA fragment were inserted into pSilencer3.1-H1 neo vector.The recombinants were transformed into E.coli DHSα successfully.The recombinant plasmids were identified by Eco RI enzyme digestion and sequenced.Finally,The HepG2.2.15 cells were transfected with the vector by using lipofectamine method to identify its interfering effect.Results The eukaryotic expression vector containing small hairpin RNA targeting HBV core protein was constructed successfully and named as pshRNA-HBc.The recombinant plasmids were identified by SalI or EcoRI enzyme digestion and sequenced.The silencing effect was detected by using revere transcription polymerase chain reaction (RTPCR) and the secretion of HBsAg and HBeAg in the supernatant of HepG2.2.15 cells.The result showed that the interfering effect was specific and efficient.Conclusion The small interfering RNA targeting HBV core protein in HepG2.2.15 cells was constructed successfully,which may be useful for studying the biological functions of HBc in the future.

OBJECTIVTo investigate the potential value of urine hepatitis B virus (HBV) DNA as a new noninvasive diagnostic indicator for HBV-associated glomerulonephritis (HBV-GN).

METHODSA total of 152 patients including 66 with HBV-GN, 66 with non-HBV-GN, and 20 with chronic hepatitis B (CHB) without renal disease were examined for serum and urine HBV DNA levels using polymerase chain reaction (PCR) and for 5 serum HBV markers using enzyme-linked immunosorbent assays.

RESULTSTwenty-two patients (33%) in the HBV-GN group, but none in the other two groups, were found positive for urine HBV DNA. In the diagnosis of HBV-GN, urine HBV DNA had a high specificity (0.98), a good positive predictive value (PPV, 0.96), and a modest negative predictive value (NPV, 0.60). Urine HBV DNA, alone or in combination with serum HBeAg, was superior in the diagnosis of HBV-GN to the combination of urine HBV DNA with serum HBV DNA, hepatitis B surface antigen and the hepatitis B e antigen.

CONCLUSIONUrine HBV DNA may be one of the new noninvasive diagnostic criterion for HBV-GN.

Biomarkers ; blood ; urine ; DNA, Viral ; blood ; urine ; Enzyme-Linked Immunosorbent Assay ; Glomerulonephritis ; diagnosis ; virology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; Humans ; Polymerase Chain Reaction ; Predictive Value of Tests ; Sensitivity and Specificity