Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.

OBJECTIVETo study the characteristics of blood flow in common hepatic tumors by 256-slice spiral CT whole-liver perfusion imaging.

METHODSSeventy-one patients with hepatic tumors were examined retrospectively by 256-slice spiral CT whole-liver perfusion. Among them, twenty-seven cases were of primary hepatic cancer, twenty-four cases of hepatic hemangioma, and twenty cases of hepatic metastases.Regions of interest (ROIs) were placed in the tumor parenchyma (Area A), peritumoral hepatic parenchyma (Area B), and normal hepatic parenchyma (Area C), respectively. The time density curves (TDC) were drawn, and perfusion parameters including hepatic arterial perfusion(HAP), portal venous perfusion(PVP), total liver perfusion(TLP) and hepatic erfusion index(HPI) were obtained. The values of ROIs were measured, and the perfusion parameters in the areas A, B, C of different hepatic tumors were statistically analyzed.

RESULTSThe values of HAP, PVP, HPI in the tumor parenchyma of primary hepatic carcinoma were (20.00 ± 11.41)ml · min(-1) · 100 ml(-1,) (32.31 ± 21.06)ml · min(-1) · 100 ml(-1,) (52.31 ± 30.55)ml · min(-1) · 100 ml(-1,) and (39.67 ± 11.19)%, showing significant difference as compared with those in peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, TLP, and HPI in the tumor parenchyma of hepatic hemangioma were (40.39 ± 29.23)ml · min(-1) · 100 ml(-1,) (132.72 ± 132.65) ml · min(-1) · 100 ml(-1,) and (35.51 ± 15.12)%, were significantly different as compared with those in the peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, PVP, HPI in the tumor parenchyma of hepatic metastases were (17.43 ± 12.27)ml · min(-1) · 100 ml(-1,) (36.19 ± 34.99) ml · min(-1) · 100 ml(-1,) and (37.86 ± 14.49)%, significantly different as compared normal hepatic parenchyma (P<0.05). The HAP, PVP, and TLP of tumor tissue and the PVP and HPI of peritumoral tissue in different hepatic tumors were statistically significantly different (P<0.05).

CONCLUSIONSThe multi-slice spiral CT whole-liver perfusion has certain value in the diagnosis of common hepatic tumors. Perfusion parameters in different areas of common hepatic tumors have their own hemodynamic characteristics.

Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Hemangioma ; blood supply ; diagnostic imaging ; Hepatic Artery ; diagnostic imaging ; physiology ; Humans ; Liver ; blood supply ; Liver Neoplasms ; blood supply ; diagnostic imaging ; secondary ; Perfusion Imaging ; Portal Vein ; diagnostic imaging ; physiology ; Regional Blood Flow ; Retrospective Studies ; Tomography, Spiral Computed

ObjectiveTo investigate the promotional effect of astragaloside on the repair and healing of chronic non-healing wounds and its mechanism. MethodA total of 60 male SD rats were constructed with full-layer skin defect wounds on the back， and except for the control （Con） group， the rest were constructed with non-healing wounds， which were then randomly divided into the sham-operation （sham） group， the low-dose astragaloside group， the high-dose astragaloside group， the astragaloside + LY294002 ［phosphatidylinositol 3-kinase （PI3K） inhibitor］ group， and the astragaloside + EX527 ［silencing regulatory protein 1 （SIRT1） inhibitor］ group. The percentage of wound area in each group was observed on the 2nd， 4th， 6th， and 8th days after wound molding. Collagen type Ⅰ alpha 1 （COL1A1） and alpha smooth muscle actin （α-SMA） expressions in the wound tissue were detected by immunofluorescence. Hematoxylin and eosin （HE） staining was performed to determine the pathological structure of the wound. The mRNA expression of inflammatory factors in the wound was measured by real-time polymerase chain reaction （Real-time PCR）， and the expression of proteins related to the SIRT1/ nuclear factor （NF）-κB and PI3K/protein kinase B （Akt） signaling pathways in the wound was tested by Western blot. ResultCompared with the sham group， the percentage of postoperative wound area of rats in both low-dose and high-dose astragaloside groups gradually decreased with time， and the efficacy of the high-dose astragaloside group was better. Compared with the Con group， the fluorescence intensity of COL1A1 in wound tissue of the sham group decreased， while the expression of α-SMA increased. The epithelial tissue was severely damaged， with an increase in the thickness， and a large number of inflammatory cells were seen in the infiltration. The mRNA expression of tumor necrosis factor （TNF）-α， interleukin （IL）-1β， IL-6， and inducible nitric oxide synthase （iNOS） was elevated. The protein expression of NF-κB p65， p-PI3K/PI3K， and p-Akt/Akt was elevated， while SIRT1 expression was decreased （P<0.05）. Compared with the sham group， the fluorescence intensity of COL1A1 and α-SMA increased after astragaloside treatment. The number of epithelial cells increased， and the thickness decreased. The inflammatory cells decreased， and the amount of collagen increased. The mRNA expression of TNF-α， IL-1β， IL-6， and iNOS was decreased， and the protein expression of NF-κB p65， p-PI3K/PI3K， and p-Akt/Akt was decreased. SIRT1 was elevated， and the effect was better in the high-dose astragaloside group （P<0.05）. Compared with the high-dose astragaloside group， inhibition of the PI3K/Akt and SIRT1 pathways by LY294002 and EX527 prevented the therapeutic efficacy of astragaloside on chronic non-healing wounds. ConclusionThe topical application of astragaloside significantly promotes the healing of chronic non-healing wounds in rats， and the mechanism may be related to the activation of the PI3K/Akt pathway and the SIRT1/NF-κB pathway.

Objectives:To analyze the consistency of evaluating left ventricular hemodynamics (HDF) based on single plane and multi plane cine sequences of magnetic resonance mitral valve orifice.Methods:A prospective study was conducted on 48 healthy adults, and two methods were used to measure the mitral valve diameter and calculate HDF parameters. The first method was to measure the diameter of the mitral valve opening in the left ventricular three chamber cine sequence; The second method is to measure the mitral valve diameter using cine sequences of two chamber, three chamber, and four chamber hearts, and then take the average value. Paired t-tests were used to compare the differences in HDF measured by two methods, and Pearson correlation coefficient ( r), intra group correlation coefficient ( ICC), and Bland-Altman analysis were used to test the consistency and reproducibility of the two methods. Results:The root mean square (RMS) of longitudinal HDF calculated using single plane and multi plane mitral valve diameters were [(17.28±4.41)% vs (17.21±4.61)%] ( P=0.379) for the entire cardiac cycle, [(21.45±5.54)% vs (21.49±5.68)%] ( P=0.646) for systolic phase, and [(12.78±4.10)% vs (12.54±4.24)%] ( P=0.106) for diastolic phase, respectively. The difference in the calculation results of HDF parameters related to ventricular function was not statistically significant (all P>0.05), and there was good consistency ( r=0.924-0.996, ICC=0.924-0.995). The two HDF parameters related to atrial function were sensitive to the measurement method of mitral valve orifice diameter [RMS of longitudinal HDF during active atrial emptying: (3.26±1.51)% vs (3.32±1.55)%, P=0.006; longitudinal HDF pulse during active atrial emptying: (-2.60±1.28)% vs (-2.76±1.30)%, P<0.001]. Conclusions:The ventricular function related HDF parameters obtained from the analysis of mitral valve orifice diameter using single plane and multi plane methods have good consistency, and can be evaluated using relatively simple single plane methods for left ventricular HDF.

Chinese medicine entered a significant period from foundation to maturity between Han and Tang dynasties when the Chinese traditional stomatology was a key stage. Sorting and analysis of existing literature and research outcomes have showed that current research on stomatology between Han and Tang dynasties focuses on oral physiology, pathology, diagnosis and treatment, and health care. It also involves stomatology history and explanation of termino-logies related to mouth and teeth recorded in medical books, use of simple methods, and thinking with citation and analysis of literature simply listed and reasoning preliminarily deducted. From the macro perspective, current research has not unveiled the whole picture of stomatology between the two dynasties and left a series of key issues unresolved. Thus, new methods should be developed and employed to carry out medical research on stomatology between Han and Tang dynasties given that is has a prosperous future.
Mouth ; Oral Medicine ; Cognition ; China ; Medicine, Chinese Traditional