Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.

Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.

0.05).At the T1,T3,T4,T7 time point,changes of the MAP and HR were more stable in TCI group than those in control group.The awakening time and extubation time in TCI group was obviously shorter in than that in control group.The OAAS scores after extubation were higher and the VRS scores 30 min after extubation were lower in TCI group than those in control group(P

[Summary] To investigate the effect of microRNA126 on glucose metabolism in the normal liver cell lines. In vitro, the chang liver cell lines were cultured. Under the most effective transfection conditions ascertained above, microRNA126 mimic, microRNA126 inhibitor, and relative negative control were transfected into the cultured normal liver cells. And the transfection efficiency was tested by realtime fluorescent quantitative PCR. After 48 hours, the cells were stimulated with synthetic insulin ( 100 nmol/L ) and respective substrates for 2 hours. Then the glycogenesis, gluconeogenesis, and glycolysis in cells were measured. The level of microRNA126 of the microRNA126 mimic group was higher than the other groups, and the difference was statistically significant ( P<0. 05 ). MicroRNA126 mimic group significantly decreased glucose utilization, reduced glycogen synthesis, effectively increased the account of gluconeogenesis, reduced lactate production, and pyruvate kinase activity ( all P<0. 05). The over-expressing microRNA126 in hepatocytes may reverse the function of glucose metabolism, and enhance output of hepatic glucose.

AIM: To investigate the effects of non-invasive ischemic preconditioning on nitric oxide (NO)/endothelin-1 (ET-1) imbalance and gas exchange impairment following limb ischemia reperfusion in patients undergoing unilateral lower extremity surgery with tourniquet. METHODS: Twenty-seven patients aged 25-65 years, whose tourniquets duration varied from 1 h to 1.5 h and matched American Society of Anesthesiologists Physical Status Ⅰ-Ⅱ, were randomized into two groups: a control group (n=14) and a ischemic preconditioning group (IPC group, n=13) in which patients received three cycles of 5 min of ischemia/5 min of reperfusion before tourniquet inflation. Radial arterial blood gas, plasma malondialdehyde (MDA) and NO, serum ET-1 and interleukin-6 (IL-6) were measured just before tourniquet inflation(T_0), 1 h after inflation(T_1), and 0.5 h(T_2), 2 h(T_3), 6 h(T_4), 24 h(T_5) after tourniquet deflation. Meanwhile NO/ET-1 ratio, alveolar-arterial oxygen gradient (P_(A-a)DO_2) and intrapulmonary shunt (Qs/Qt) were calculated. RESULTS: In control group, arterial partial pressure of oxygen (PaO_2) were decreased, while P_(A-a)DO_2 and Qs/Qt were increased significantly at T_4 compared to the baselines at T_0 (P<0.01). Plasma NO levels and NO/ET-1 ratios decreased gradually after tourniquets deflation and statistical significances were observed at T_3 (P<0.01) with a valley at T_4 (P<0.01) and recovered to baselines at T_5. Serum ET-1, IL-6 and plasma MDA began to increase remarkably after T_3 (P<0.05 or P<0.01), peaked at T_4 and dropped slightly at T_5. The changes above-mentioned could be well attenuated by the application of IPC (P<0.05 or P<0.01) except PaO_2 (P>0.05). CONCLUSION: Clinical application of unilateral tourniquet within safe time limit (1.5 h) may lead to limb ischemia reperfusion and further pulmonary gas exchange impairment, which could be partially attenuated by the application of IPC via alleviating NO/ET-1 imbalance.

OBJECTIVETo investigate the effect of Shenmai injection on vascular endothelial active facters nitric oxide (NO) and endothelin-1 (ET-1), and pulmonary gas exchange induced by tourniquet deflation in patients undergoing lower extremity surgery.

METHODTwenty-six patients scheduled for unilateral lower extremity surgery were randomly divided into 2 groups: control group (group C, n = 14) and Shenmai injection group (group SM, n = 12). All the patients agreed to a combined spinal-epidural anesthesia at the L2-L3 interspace and a radial artery catheter was placed for sampling. Patients in group SM were injected Shenmai injection 0.6 mL x kg(-1) and physiological saline 100 mL, while patients in group C were injected equal volume of normal saline instead 15 min before tourniquet inflation. Blood samples which were used for blood gas analysis and measurement of nitric oxide (NO) and endothelin-1 (ET-1) were taken before tourniquet inflation (T0, baseline) and 30 min (T1), 2 h (T2), 6 h (T3), 24 h (T4) after tourniquet deflation.

RESULTCompared with the baseline values at T0, in group C at T3 P(a) O2 and the levels of NO were significantly decreased, while P(A-a) DO2 and the levels of ET-1 at T3 were significantly increased (P < 0.05 or P < 0.01), in group SM, the levels of NO at T3 were significantly decreased (P < 0.05). Compared with group C, the changes of P(a)O2, P(A-a) DO2, NO and ET-1 were significantly mitigated in group SM.

CONCLUSIONThe concentrations of NO and ET-1 is connected with the pulmonary gas exchange impairment induced by tourniquet application. Shenmai injection can improve the pulmonary gas exchange based on rising the level of NO, reducing the level of ET-1.

Adult ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Endothelin-1 ; blood ; metabolism ; Endothelium, Vascular ; drug effects ; metabolism ; physiopathology ; Female ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Nitric Oxide ; blood ; metabolism ; Pulmonary Gas Exchange ; drug effects ; Tourniquets ; adverse effects