Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography.Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study.One day before CT examination,volunteers were asked to orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging.Air was insufflated by using an inflator in a partially automated and individualized manner.The volunteers were initially asked to assume the right lateral decubitus position,then slowly turn to the supine position.Insufflation rate began at 1.5 L/min,and decreased to 0.5 L/min at later stage.The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images,self-reported sensation of volunteers,and intestinal pressure.Dual-energy CT scanning was performed,and dual-energy blended images were acquired.Compliance of volunteers was statistically analyzed.The effectiveness of colorectal segments distension was statistically analyzed by using Kruskal-Wallis H test.Results No abdominal pain,bloating,nausea or vomiting were noted in the 46 volunteers.All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance.The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%,2.1%,5.1% and 92.8%,respectively.The difference of effectiveness of colorectal segments distension had no statistical significance(χ2=6.19,P=0.288).The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum.Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum.Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of colorectal distension.

Objective To investigate the value of partial hepatectomy and vascular resection in the treatment of hilar cholangiocarcinoma. Methods Seventy four patients with hilar cholangiocarcinoma who underwent hepatectomy of Chinese People' s Liberation Army from January 2008 through December 2011 were analyzed retrospectively.Results Of the 74 patients,33 underwent radical resection and 19 palliative resection,22 received internal or external drainage.In the radical resection group,the median survival time was 27 months,and the overall survival rate at 1,2 and 3 years were 79％,64％ and 49％.In the palliative resection group,the median survival time was 14 months and the overall survival rate at 1,2 and 3 years were 56％,25％,and 19％.In the drainage group,the median survival time was 9 months and the overall survival rate at 1,2 and 3 years were 23％,15％,0.Conclusions Hepatectomy combined with hilar vascular resection helps increase survival rate of patients in radical excision of hilar cholangiocarcinoma and Surgical resection is the most elective method for treatment of hepatic hilar cholangiocarcinoma,and the radical resection might improve the prognosis of the patients with hilar cholangiocarcinoma.

Objective To evaluate the feasibility,safety and efficacy of laparoscopic radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC).Methods Sixty-eight cases of liver cancer lesions were underwent laparoscopic radiofrequency ablation,and their postoperative recovery state,focal necrosis rate were observed.Results All the 68 cases were successfully performed operation,114 lesions were treated including 20 missed lesions at preoperative imaging diagnosis.There were no serious postoperative complications,the average hospital stay was (2.5 ± 1.2) days,focal necrosis rate 3 months after operation was 85.9％,lesion recurrence rate 6 months after operation was 12.2％,the 1-year survival rate was 76.47％.Conclusions Laparoscopic radiofrequency ablation in treatment of hepatocellular carcinoma has high security,few complications,short hospital stay and remarkable clinical effects.It's well worth clinical outreach.

Objective: To investigate influence of isometric exercise (IE) training on number of endothelial progenitor cells (EPCs) and level of vascular endothelial growth factor (VEGF) of circulating blood in patients with coronary chronic total occlusion (CTO). Methods: A total of 20 CTO patients were divided into training group (n=10) and control group (n=10). Both groups received routine medication for three months, training group also received three-month IE training (maximal handgrip was used to induce maximum IE of upper limb muscles, leading to temporary physiological ischemia of skeletal muscle),while control group remained sedentary without exercise training. Flow cytometry was used to measure number of blood EPCs, and enzyme linked immunosorbent assay (ELISA) was used to measure serum concentration of VEGF. Results: Before treatment, the differences of levels of blood EPCs and VEGF between two groups were no significant（P>0.05）. Compared with before treatment, there were significant increase in blood number of EPCs [(0.028±0.009)% vs. (0.044±0.016)%] and VEGF concentration [(65.3±15.1) pg/ml vs. (98.5±17.4)pg/ml] after three-month treatment in training group (P=0.015, P<0.01), and they were significantly higher than those of control group after treatment. Compared with before treatment, there were no significant difference in blood number of EPCs and concentration of VEGF after treatment in control group, P>0.05. The blood numbers of EPCs were positively correlated with VEGF concentration in training group and control group (r=0.727, r=0.785, P<0.05 both). Conclusions: Isometric exercise training can increase blood number of EPCs and VEGF concentration in coronary CTO patients, which may contribute to collateral angiogenesis in remote ischemic myocardium.

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.

OBJECTIVETo investigate the effects of intragastric administration of human interferon-α (hIFN-α)-transformed Bifidobacterium on immune functions of mice.

METHODSThe E.coli-Bifidobacterium shuttle expression vector containing hIFN-α gene was constructed and transformed into Bifidobacterium. The hIFN-α-transformed Bifidobacterium suspension (1010 /ml) was prepared after induction with 0.2% L-arabinose for hIFN-α expression and administered intragastrically in male Balb/C mice at the dose of 0.1 ml every other day for 2 weeks, with the mice receiving empty vector-transformed Bifidobacteria as the negative control and those having an equal volume of saline as the blank control. The percentages of mononuclear cell subsets in the thymus, spleen and blood were detected in the mice by flow cytometry, and the serum levels of IL-4, IL-12, IFN-γ and TNF-α were assayed using mouse cytokine FlowCytomix Kit.

RESULTSThe percentages of CD3⁺CD8⁺ and CD4⁺CD8⁺ cells in the thymus, CD3⁺CD4⁺, CD3⁺CD8⁺ and CD4⁺CD8⁺ cells in the spleen, and CD3⁺CD8⁺ cells in the blood all increased significantly in IFN group as compared with those in the negative and blank control groups (P<0.01 or 0.05). The serum level of IFN-γ also increased significantly (P<0.05) while IL-4 level remained unchanged in IFN group compared with those in the two groups.

CONCLUSIONIntragastric administration of hIFN-α-transformed Bifidobacterium promotes lymphocyte proliferation and maturation and increases the serum levels of Th1 cytokines in mice.

Animals ; Bifidobacterium ; Cell Proliferation ; Genetic Vectors ; Humans ; Interferon-alpha ; pharmacology ; Interferon-gamma ; blood ; Interleukin-12 ; blood ; Interleukin-4 ; blood ; Lymphocyte Activation ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Recombinant Proteins ; pharmacology ; Spleen ; cytology ; Th1 Cells ; cytology ; Thymus Gland ; cytology ; Tumor Necrosis Factor-alpha ; blood

Objective: To investigate the prevalence of depressive symptoms among junior middle school students in Tianjin, and to explore the association between latent classes of health risk behaviors and depressive symptoms, so as to provide clues for identifying high risk groups of depressive symptoms and a scientific basis for comprehensive intervention measures. Methods: By using a multistage stratified cluster sampling method, 8 175 students in 16 districts of Tianjin were investigated with demographic characteristics, depressive symptoms, and health risk behaviors. Latent class analysis was performed by Mplus 8.3. SPSS 23.0. Results: The prevalence of depressive symptoms among junior high school students in Tianjin was 17.8%,the prevalence of depressive symptoms in urban(19.4%) areas was higher than that in rural areas(16.5%),and that of female students( 20.2 %) was higher than that of male students(15.5%)( χ 2=11.62,30.58, P <0.01). Health risk behaviors were classified into three groups: healthy group (84.0%), poor diet group ( 3.8 %) and multiple risk behaviors group (12.2%). After adjusting for region, grade, gender, and family type, multivariate Logistic regression analysis showed that the poor diet group ( OR=2.82, 95%CI =2.17-3.66) and the multiple risk behaviors group ( OR=4.31, 95%CI =3.67-5.05) had a higher risk of depressive symptoms compared with the healthy group ( P ＜0.01). Conclusion Depressive symptoms are prevalent among junior middle school students in Tianjin. Different latent classes of health risk behaviors have different correlations with depressive symptoms. It is important to ensure early detection and personalized intervention for different types of health risk behavior among junior middle school students to maximize cost effectiveness.

The mechanistic target of rapamycin(mTOR)plays a pivotal role in various cellular processes,including growth,proliferation and differentiation.As an essential component of the human immune system,T lymphocytes are regulated by mTOR through metabolic pathways such as carbohydrate metabolism and lipid metabolism.This article summarizes the critical role of mTOR in T cell differentiation and reviews recent advances in natural compounds that modulate T cells via mTOR.These findings contribute to the development of mTOR-targeted therapies for diseases.

Objective:To evaluate the efficacy and safety of anti-programmed cell death 1 (PD-1) receptor monoclonal antibody (MoAb) in patients with advanced hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE) combined with tyrosine kinase inhibitor (TKI).Methods:From February 2019 to February 2020, 56 HCC patients who relapsed after TACE-TKI treatment in Department of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University were enrolled. All patients received anti-PD-1 MoAb (sintilimab injection) and followed up every 6 weeks. According to mRECIST, the curative effect was evaluated as complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). Objective response rate (ORR) and disease control rate (DCR), progression-free survival (PFS) and treatment-related adverse events (TRAEs) were recorded. Univariate analysis by Chi-square test and binary logistic regression model was used to determine the influencing factors of DCR. The Kaplan-Meier method and Cox proportional hazard regression model were used to analyze the survival data.Results:A total of 48 patients were enrolled in this study including 42 males and 6 females, with a median age of 55 years (29-71 years). ECOG scores comprised of 0 in 24 cases, 1-2 in 24 cases. Thirty-six patients were in Child-Pugh grade A of liver function and 12 cases were grade B. The median follow-up time was 4.5 months. There were 2 patients achieved CR, 12 patients with PR and 16 with SD. ORR was 29.2%, DCR was 62.5%. The independent influencing factors of DCR was ECOG score and AFP level ( P=0.031, P=0.012). Median PFS was 4.1 months (95% CI 2.7-5.4 months), and ECOG score was the independent influencing factor of PFS ( P=0.042). Treatment-related adverse events were reported in 70.8% (34/48) patients. Incidence of grade Ⅲ-Ⅳ TRAEs was 22.9% (11/48). Conclusion:In patients with HCC who relapse from TACE and TKI treatment, anti-PD-1 monoclonal antibody is efficacious safe especially in those with ECOG 0 score.