Objective To compare the conventional non-enhanced and virtual non-enhanced images of dual-energy computed tomography (CT) in evaluating solitary pulmonary nodules (SPNs).Methods Forty-seven patients with SPNs proved by pathology underwent conventional and enhanced thoracic DECT.The virtual non-enhanced CT images and iodine images were reconstructed based on the enhanced imaging data.The mean CT number,noise,signal to noise (SNR),nodual diameter of SPNs were compared between the true non-contrast CT(TNCT) and the virtual non-contrast CT (VNCT),with paired t test.The image quality and detectability of calcification were also compared.The diagnostic accuracy for malignant nodulesbased on the increased CT values and iodine-enhanced image were compared.The independent t test was used to compare the increased CT number of SPNs and iodine images.The single-phase radioation dose of the single energy,was compared with dual energy scan.Results No significant difference in the mean CT Number(t =1.556,P ＞ 0.05),noise (t =-0.357,P ＞ 0.05),SNR (t =0.767,P ＞ 0.05) on TNCT and VNCT.The mean CT Number,the noise,and SNR were (29.90 ± 12.43)vs (27.52 ± 16.67) HU,(9.60 ±3.74) vs (9.88 ± 2.90),and (3.07 ± 1.93) vs (2.76 ± 2.36),respectively.The increased CT number ofSPNs with TNCT and VNCT from baseline were(18.63 ± 8.03) and(20.45 ± 9.13) HU.The CT number of iodine image was(23.82 ± 9.20)HU.A significant difference was observed between the TNCT and iodineed image (t =-2.371,P ＜ 0.05).The quality scores of VNCT image wasslightly worse than TNCT image.The detectability rate of calcification on VNCT was 92.3％ (72/78).The iodine image carried the highest diagnostic sensitivity rate and accuracy rate,82.3％ (28/34)and 74.5％ (35/47),respectively.The highest specificity rate was 76.9％ (10/13) from the increased CT number with VNCT.No significant difference in single-phase radiation dose was observed between TNCT and VNCT,(5.68 ± 1.31) vs.(4.89 ± 1.27)mSv.Conclusions VNCT could be obtained with similar image quality as TNCT.This methods might favor a reduction in radiation exposure.

Hepatoid adenocarcinoma of the stomach ( HAS) belongs to one of the rare cases in gastric cancer types ,which has extremely high malignant degree and poor prognosis .Lymph node metastasis and liver me-tastasis are common in HAS.In this article,we reported alpha-fetoprotein-high-producing hepatoid adenocar-cinoma of the stomach(HAS),and reviewed the related literature at home and abroad in order to improve clinical physicians understanding of these diseases and treatment experience .

Purpose: Observe the varities of lymphocyte subgroup of patients suffering from primary hepatic carcinoma ( PHC) during the treatment by hepatic arterial chemoembolization (TACE) and Hyperthemia Peritoneal Perfusion (THPP). Methods: Twenty seven patients were treated with TACE and THPP a week after TACE. We tested for lymphocyte subgroup three times with the flow cytometry (FCM) for pre-TACE, post-TACE and THPP a month later. The control group, twenty seven patients, were also tested for lymphocyte subgroup three times with the TACE. Results: The lymphocyte subgroup among the patients suffering from PHC were disordered. CD4+,CD4+/CD8+.CD19+NK+ were decreased, (P

Anion Exchange Protein 1, Erythrocyte ; metabolism ; CD56 Antigen ; metabolism ; Desmin ; metabolism ; Desmoplastic Small Round Cell Tumor ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Lymphoma ; metabolism ; pathology ; Male ; Middle Aged ; Rhabdomyosarcoma ; metabolism ; pathology ; Sarcoma, Ewing ; metabolism ; pathology ; Testicular Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Forty women with polycystic ovary syndrome( PCOS) were enrolled. Basal plasma and urine cortisol, pituitary hormones, homeostasis model assessment for insulin resistance, and plasma cortisol in 0. 25 mg dexamethasone inhibition test were determined. In over-weight or obese PCOS patients, cortisol levels before and after inhibition test were increased (P<0. 05 or P<0. 01 ). The results suggest that the feed-back regulation of glucocorticoids to hypothalamas-pituitary is impaired and the change in hypothalamic-pituitary-adrenal axis is associated with insulin resistance.

Objective: To study the role of activating transcription factor 2 (ATF-2) in the growth of mandibular condyle cartilage. Methods: Primary chondrocytes of condyle were cultured. Expression plasmid of ATF-2 and plasmid bcl-2 promoter were transfected into chondrocytes. Luciferase assay and Western blot were used. Results: The absence of ATF-2 in mandibular condyle chondrocytes resulted in a decline in bcl-2 promoter activity, reduction in bcl-2 protein level. Conclusion: The results strongly imply that ATF-2 is required for adequate bcl-2 expression, and play a significant role in controlling growth plate chondrocyte progression.

Objective To summarize the experience in surgical management of bile duct injury. Methods The clinical data of 683 patients with bile duct injury who were admitted to the Hunan People's Hospital from August 1990 to December 2008 were retrospectively analyzed. Of all the patients, seven received hepatectomy +T tube drainage, two received liver repair + T tube drainage, four received external biliary drainage + hepatectomy,27 received liver repair or hepatectomy + silicone support, 233 received temporary portal triad clamping + gelatin sponge hemostasis, 72 received biliary repair + T tube drainage, 248 received hepatobiliary basin Roux-en-Y anastomosis, 22 received external biliary drainage, 61 received long arm T tube drainage, two received pancreaticoduodenectomy and five received hepatectomy + T tube drainage. The surgical outcomes were evaluated by analyzing the results of the follow-up. Results The surgical outcomes were ranked excellent, good and poor according to the condition of patients and the results of imaging examination. Six hundred and twelve patients were followed up for 8 months to 19 years, and the surgical outcomes were excellent in 337 patients (55.1%), good in 214 patients (35.0%) and poor in 61 patients ( 10.0% ). Conclusion The surgical outcome of bile duct injury could be satisfactory if the approach of the surgery is properly selected.

Objective To evaluate the indications and intraoperative management of nephron-spar- ing surgery (NSS) for renal cell carcinoma (RCC).Methods A total of 53 patients (32 men and 21 women;age range,21 -76 years) with unilateral RCC and a normal contralateral kidney underwent NSS.The disease course ranged from 1 week to 13 months.The unilateral RCCs were detected by B-uhrasonography. Partial nephrectomy was performed on 38 cases of polar RCC and wedge nephrectomy was performed on 15 cases of central RCC.Both renal vein and artery were blocked for 10 - 15 min,and unclamped for 1 -2 min if necessary.The resections were finished within 7 -21 min (mean,12 min).No inosine and regional hypo- thermia were used during operation.Absorbable hemostatic gauze and terylene flake were used to suture renal wound surface.After operation all patients were treated with interferon hypodermic injection of 5 000 000 U every other day for 3 months.Results The diagnosis of RCC with negative cutting margin was confirmed by pathological examination in all patients.The greatest dimension of the renal cancers were＜4 cm except for one of 6 cm.The clinical stage was T_1N_0M_0 in all patients.During the follow-up of 6 -48 months,all pa- tients were alive without recurrence and had normal renal function.Conclusions NSS can be rapidly per- formed for T_1 stage renal cancer＜4 cm or single clearly localized cancer＞4 cm in diameter.The follow-up results are satisfactory.

Objective:To investigate the effects of pre-existing antibody on seroconversion rate after influenza vaccination.Methods:This study recruited 1 900 healthy volunteers to receive influenza split vaccines in Xinjiang Uygur Autonomous region and Yunnan Province from September 2009 to October 2018. Hemagglutinin agglutination inhibition assay was used to detect the titers of specific antibodies in blood samples collected before vaccination and 28 d after vaccination and the effects of pre-existing antibody on the seroconversion to different influenza vaccine components were analyzed.Results:Trend analysis showed that with the increasing titer of pre-existing antibody, the seroconversion rates to A/H1N1, A/H3N2, B/Victoria and B/Yamagata vaccine components were gradually decreased (χ 2=121.76, P<0.001; χ 2=67.58, P<0.001; χ 2=45.25, P<0.001; χ 2=54.55, P<0.001). After adjusting for factors such as region, gender and age, multivariate logistic regression showed that pre-existing antibody titer equal to or higher than 40 was an independent factor that affected the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, and the adjusted OR (95%CI) values were 2.50(2.00-3.13)、1.64(1.35-2.00) and 2.50(1.79-3.45), respectively. Conclusions:The seroconversion rate to each vaccine component was negatively correlated with the pre-existing antibody titer. The factor that pre-existing antibody titer equal to or higher than 40 was detrimental to the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, but had no significant influence on B/Yamagata seroconversion.

OBJECTIVETo explore the effect of Sedum sarmentosum Bunge Extract (SSBE) on severe acute pancreatitis (SAP) induced acute lung injury (ALI) model rats and their excessive inflammatory reactions.

METHODSForty-two healthy adult male Sprague-Dawley (SD) rats were randomly divided into 3 groups, the sham-operated control group (C), the SAP group (SAP), and the SSBE treated group (SSBE), 14 in each group. SAP induced ALl rat model was induced by retrograde injection of 5% sodium taurocholate (1 mL/kg) into the pancreatic duct. SSBE (100 m/kg) was administrated subcutaneously after the establishment of the SAP model. Equal dose of SSBE was injected again 12 h later. Equal volume of normal saline was administrated in the same way for rats in the C group and the SAP group. Rats were sacrificed after successful modeling and samples taken at 12 and 24 h. Pathological changes in the pancreas and the lung tissue were observed under light microscope. The ascites, serum amylase (AMS), wet/dry proportion (W/D) of the lung tissue, activities of myeloperoxidase (MPO), interleukin-1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-alpha) were also measured.

RESULTSAscites and serum AMS activities significantly increased; MPO, IL-1, IL-6, TNF-alpha contents, and W/D ratio also significantly increased in the SAP group, when compared with the C group (P<0.05). Compared with the SAP group, those parameters were all attenuated in the SSBE group at 12 and 24 h (P<0.05, P<0.01). Pathological changes in the pancreas and the lung tissue were alleviated in the SSBE group under light microscope. The injury degree ranged between that of the C group and the SAP group.

CONCLUSIONSSBE could relieve the ALl in SAP model rats, which could be achieved through alleviating inflammation responses of SAP rats.

Acute Lung Injury ; drug therapy ; etiology ; Animals ; Drugs, Chinese Herbal ; therapeutic use ; Interleukin-1 ; Interleukin-6 ; Lung ; Male ; Pancreas ; Pancreatitis ; complications ; drug therapy ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Sedum ; Taurocholic Acid ; Tumor Necrosis Factor-alpha