Objective To discuss the clinical application of MSCT-guided BARD gun biopsy in diagnosing pulmonary lesions. Methods Under MSCT-guidance percutaneous transthoracic biopsy of lung with BARD gun was performed in 68 patients with pulmonary lesions. Results All the procedures were well performed with the technical successful rate of 100%. The final diagnosis was based on the pathological findings or clinical follow-up observation. The accuracy of the qualitative diagnosis was 94.1%. Of 68 patients, squamous cell carcinoma was found in 30, adenocarcinoma in 21, metastases in 7, inflammatory pseudotumor in 3, lung abscess in 2, and tuberculosis in one. The false-negative rate in making diagnosis was 5.9%. The complication occurrence was 8.8%. Conclusion BARD gun has the advantage of making coaxial- multipoint biopsy. With the help of MSCT-guidance and the full use of the operating advantage of BARD gun, this technique is safe and reliable, with higher accuracy and less complications.

Objective To investigate the efficacy and safety of ERCP for biliary stricture with duct stone after liver transplantation.Methods Clinical data of 60 patients undergoing ERCP for biliary stricture with duct stone after liver transplantation between January 2013 and June 2014 were retrospectively analyzed.Results ERCP was successfully performed 78 times in 60 patients.Bile duct stenosis was cured in 24 cases (40％),improvement was observed in 27 cases (45％) and was not obvious in 9 cases (15％).Bile duct stones were successfully removed in 39 patients (65％).Incidence of post-ERCP complications was 13％ (8/60),including mild pancreatitis in 1 case,hyperamylasemia in 5 cases,biliary tract infection in 2 cases,which were all resolved after conservative treatment.Conclusion ERCP is a safe and effective treatment for biliary stricture with duct stone following liver transplantation.

OBJECTIVETo observe the effect of anisodamine (Ani) injection on the survival rate and histologic result of flaps with ischemia-reperfusion injury, so as to demonstrate the protective effect of Ani on the flap survival.

METHODSA total of 48 healthy male Wistar rats were randomly divided into model control, normal saline(NS) and anisodamine groups, with 16 rats in each group. An 3 cm x 6 cm axial flap was formed at the right lower abdomen with abdominal superficial blood vessel as the pedicle. 0.5 cm x 0.5 cm skin tissue was taken from the middle part of flaps in each group, immediately after operation, 12, 18, 24 h after operation. The superoxide dismutase (SOD), nitric oxide (NO), nuclear factor-kappaB contents in the specimens were detected. The histologic study was also performed. The flap survival rate was recorded 7 days after operation.

RESULTSFlap survival rate was (78.6 +/- 7.3) % in Anisodamine group. 12, 18, 24 h after reperfusion injury, the SOD was (103.3 +/- 3.9), (82.6 +/- 3.8), (67.5 +/- 4.6) U/mg; the NO was (5.33 +/- 2.05), (4.75 +/- 1.68), (4.15 +/-1.59) nmol/mg; the NF-kappaB was 0.211 +/- 0.039, 0.313 +/- 0.033, 0.096 +/- 0.028. The contents of SOD, NO and NF-kappaB had the statistical difference of at different time. The skin pathological changes in Anisodamine group was obviously better than those in NS group. Flap survival rate in Anisodamine group was significantly higher than that in NS group.

CONCLUSIONSIn the flap with ischemia-reperfusion injury, Anisodamine can reduce the damage of free radical, increase the blood flow, reduce the production of NF-KB, decrease inflammatory reaction. So Anisodamine can increase the survival rate of flaps with ischemia reperfusion injury.

Animals ; Graft Survival ; drug effects ; Male ; NF-kappa B ; analysis ; Nitric Oxide ; analysis ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Superoxide Dismutase ; analysis ; Surgical Flaps ; blood supply ; pathology ; Vasodilator Agents ; therapeutic use

Objective To explore the correlation and clinical diagnostic significance between EGF ,PAF‐AH on henoch‐schonlein purpura (HSP) renal damage in children ,in order to provide a new way of thinking for early diagnosis and clinical prog ‐nosis for HSP nephritis(HSPN) .Methods Totally 86 cases of children with HSP from September 2013 to January 2014 in hospital were collected .According to the presence of renal damage ,the patients were divided into non‐HSPN group and HSPN group ,50 ca‐ses of healthy children as control group ,and 30 casea were diagnosied as bronchial pneumonia .Using PCR technique to detect the change of blood EGF and PAF‐AH ,and using ELISA to detect the change of blood EGF ,PAF‐AH and urine EGF .Results Detec‐tion of blood PAF‐AH mRNA ,EGF mRNA in case group obviously higher than control group ,and detection of blood PAF‐AH mRNA in HSPN group were also hgher than non‐HSPN group(P< 0 .05) .Detection of blood EGF mRNA in HSPN group higher were than non‐HSPN group ,but there was no statistically significant difference (P> 0 .05) .Detection of serum PAF‐AH ,EGF and urine EGF in case group obviously higher than control group and the case group significantly lower recovery than acute stage (P<0 .05) .Conclusion Blood EGF ,PAF‐AH and urine EGF process involved in the pathogenesis of HSP ,and is related to renal dam‐age .

Objective To investigate dynamic change of anterior pituitary hormones (APHs), thyroid func-tion (TF) and genital hormones (GnHs) in patients with traumatic brain injury (TBI) and their clinical signifi-cance. Method APHs, TF and GnH were tested in 93 patients with TBI,who were admitted to Zhejiang Provin-cial People's Hopital from March 2006 to June 2007. Patients with primary injury in the hypothalamic and pituitary regions, as detected by CT and/or MR/examination, as well as those with tumors or immune diseases in the CNS,endocrine or urinogenital systems, were excluded. The clinical data were analyzed according to Glasgow coma scores (GCS), type and degree of injury, and whether there was any secondary cerebral injury. Twenty healthy people acted as controls. The data were analyzed by the Hotelling T2 test and t-tests using SAS 11.5. A P value of less than 0.05 indicated statistical significance. Results The levels of adrenocortieotropic hormone (ACTH),luteinizing hormone (LH) and prolactin (PRL) were markedly higher in all 93 TBI patients than controls, while those of thyroid-stimulating hormone (TSH), thyroid hormone T3,T4 and FT3 were significantly lower in TBI pa-tients in the early stage after injury than in those at follow-up and controls (P<0.05). The ACTH and PRL val-ues reached (33.33±6.86) and (31.74±5.51), respectively, and the LH value was (9.48±1.14) in the secondary cerebral injury group.The TSH value (1.26±0.17) in the brain injury group was significantly lower than those in controls (P<0.05). With the exception of TSH, PRL, testosterone (T) and E2, other APHs were markedly lower in TBI patients at following-up than in controls (P<0.05). The incidence of traumatic hypothala-mus-pituitary insufficiency (THPI) associated with low levels of more than three APHs was 3.2%, while 13.8% of THPI patients showed low levels of at least one APH. The ratio of sick euthyroid syndrome (SETS) was 14.0%. Conclusions A low level of a single APH is the prevalent pattern in THPI patients. Secondary cerebral injury, such as acute high intracranial pressure, brain edema and ischemia after TBI, may be the chief causes of THPI. Early hyperprolactinemia is an important indication for presaging THPI. The dynamic levels of neurcen-docrine hormones can serve as an important index for determining the suitability of TBI patients for treatment with hormone therapy.

Objective To evaluate the value of MSCTA in combination with CTV in diagnosis of pulmonary embolism and deep venous thrombosis (DVT) of lower limb. Methods 47 patients with pulmonary embolism proved clinically were examined with MSCTA using 120 kV,210 mA,collimater of 0.75 mm and the automatic bolus traching technique,the speed of contrast agent infu-sion was 3～4 m/s after 170 s delayed,venous scan of lower limbs was performed. Results 47 cases were well perform the trunk of bilateral pulmonary artery, pulmonary lobar artery, pulmonary segemental artery, pulmonary inferior segmental artery could be showed by MSCTA, MPR, MIP and VRT. 363 arterial segments were involved and 31 cases accompanied with DVT. Conclusion MSCTA in combination with CTV is of significant value in detecting pulmonary embolism accompanied with deep venous thrombo-sis.

Objective To investigate the role of recombinant Vibrio vulnificus cytolysin (rVvhA) in inducing THP-1 cells damage and study the pathway of associated calcium influx .Methods Inverted mi-croscope, CCK-8 cell proliferation kit, Fluo3/AM staining and caspase activity detection were performed to analyze the damage of THP-1 cells induced by rVvhA and the pathway of calcium influx .Results rVvhA had cytotoxic effects on THP-1 cells in a dose-dependent manner .The concentrations of extracellular K +and LDH were respectively up-regulated after 1 h and 6 h of 12 μg/ml rVvhA intervention .Verapamil , Mibe-fradil and SKF-96365 could not prevent the influx of free Ca 2+induced by rVvhA .The activities of caspase-3 and caspase-9 were singanificantly enhanced by rVvhA in a time-dependant manner .Conclusion rVvhA can induce THP-1 cells damage through triggering extracellular calcium influx via porous channel on cell membrane.Moreover, rVvhA might induce THP-1 cell apoptosis through activating caspase-9/3-dependent pathway .

Objective To investigate the clinical heterogeneity of Parkinson's disease in the early stages.Methods Clinical data of demographic,motor phenotype,disease progression,cognitive,mood,autonomic and hallucination variables were collected from 143 patients with PD in the early stages.The patients' subtypes were explored with statistical cluster analysis of the clinical data.Results The analysis indicated four main subtypes:1.the younger-onset subtype(n=40);2.The tremor dominant subtype(n=57);3.the non-tremor dominant subtype with fast progression(n=17);4.The non-tremor dominant subtype with mild depression(n=29).Age at onset,posture-instability scores,the ratio of tremor scores to non-tremor scores,rate of progression and apathy scores all differentiated patients of respective subgroups.Conclusion The patients with early Parkinson's disease have marked heterogeneity in the clinical phenotype.

OBJECTIVE: To evaluate the efficacy of standardized medication for patients with chronic rhinosinusitis. METHOD: According to the diagnosis and treatment guidelines on chronic rhinosinusitis formulated in 2008, by means of prospective study, we studied 54 patients suffering from chronic rhinosinusitis treated with standardized medication including, a combination of local intranasaI corticosteroids, macrolides, mucus discharging agent and nasal irrigation treatment and followed up for 3 months. Visual analogue scale (VAS), sino nasal outcome test-20 Chinese version scales (SNOT-20 CV), Lund-Mackay CT and Lund-Kennedy endoscopy methods were employed to conduct the subjective and objective assessment and comprehensively evaluate the clinical efficacy before and after treatment. RESULT: (1) After three months of standardized medication, the patients' total scores of VAS, SNOT-20 CV, CT and endoscopy were improved significantly compared with those before-treatment (P < 0.01 for all these scoring systems). (2) There was statistically significant difference between the clinical efficacies of chronic rhinosinusitis patients with and without nasal polyps groups (P < 0.01). After 3 months of standardized medication, the effective rates of the CRSwNP group evaluated by subjective assessment and CT evaluation were 66.7% and 94.4% respectively, while those of the CRSsNP groups were 91.7% and 97.2% respectively. (3) Betwecn CRSwNP and CRSsNP groups, there was no significant difference in the improvement rate or inefficiency rate in subjective assessment except for the cure rate, while there were significant differences in both cure rate and improvement rate in CT evaluation. (4) The CRS patients' self-testing-based questionnaires results showed positive correlation with objective assessments. CONCLUSION The standardized medication with combination of intranasal local glucocorticoid, macrolides (14-membered ring), the mucus discharging agent and nasal irrigation on CRS was effective.
Administration, Intranasal ; Adult ; Aged ; Chronic Disease ; Female ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Macrolides ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Rhinitis ; drug therapy ; Sinusitis ; drug therapy ; Treatment Outcome ; Young Adult

Objective:To find the possible mechanisms of endovascular radiation in the prevention of restenosis in rabbits following carotid endarterectomy and to observe the dose effect relationship.Methods:Twenty four rabbits were randomly divided into three groups following carotid endarterectomy (each n=8) and were allocated to receive a radiation dose of 0,10,20Gy( 32 P)respectively.Changes in the levels of plasma nitric oxide(NO) and endothelin 1(ET 1)were measured 3 day before operation and 3,7,14,28 day after operation.Results:The plasma NO was markedly increased and ET 1 was markedly decreased in endovascular radiation groups compared to control groups.The results were similar in the two groups(10Gy versus 20Gy).Conclusion:The endovascular radiation may inhibit smooth muscle cell proliferation and migration,and thus prevent restenosis by increasing NO and decreasing the level of ET 1.Changes of the levels of plasma NO and ET 1 is a practicable methods to detect the effect of therapy.