Objective To study the related factors of arrhythmia in patients with different types of coronary heart disease(CHD).Methods 330 patients with coronary heart disease were studied,including acute coronary syn-drome(ACS)of 210 cases (ACS group)and chronic ischemic syndrome (CIS)in 120 patients(CIS group).The slow arrhythmia occurrence types were detected by the dynamic electrocardiogram(DCG),and analyzed the correlation of different types of CHD occurrence of arrhythmia and serum brain natriuretic peptide BNP,left ventricular ejection fraction(LVEF),LVDD,serum potassium level and the number of diseased coronary artery.Results There were no significant differences in the incidence of atrial arrhythmias and ventricular arrhythmias between the two groups(χ2 =0.982,2.136,all P>0.05),and there were no significant differences in the proportion of all kinds of arrhythmia(all P>0.05).ACS patients with arrhythmia types and BNP and LVEF,LVDD level and coronary artery lesion counts had no significant differences(χ2 =0.044,0.061,0.347,all P>0.05).Related to the type of arrhythmia and serum potassium levels,patients in a low blood potassium levels,the incidence of ventricular arrhythmias increased signifi-cantly(χ2 =4.376,P<0.05).And increased BNP level,LVEF decreased and LVDD,atrial arrhythmias occurred rate were significantly higher than those of ventricular arrhythmias(all P<0.05),gradually increased with the number of diseased coronary artery,cardiac arrhythmia occurred rate increased.CIS patients arrhythmia type with BNP and LVEF,LVDD level (all P <0.05 ).And elevated BNP levels,LVDD and LVEF decreased levels increased and ventricular arrhythmia occurrence rate was significantly higher than that of the atrial arrhythmia(χ2 =5.811,5.968, 4.060,all P<0.05).The rhythm types of arrhythmia and serum potassium levels and coronary artery disease variable count had no significant difference(χ2 =2.336,P>0.05).Conclusion The arrhythmia types of ACS are irrelevant with BNP,LVEF,LVDD and coronary artery lesions,and hypokalemia patients prone to ventricular arrhythmia.CIS is related with BNP increase,LVEF decrease and LVDD increase,prone to ventricular arrhythmias,low blood potassium patients prone to atrial arrhythmias.

Objective To assess the image quality of coronary CT angiography(CCTA) by using high-pitch spiral CT under 80 kV in patients with a normal body mass index(BMI), and to investigate the feasibility of low radiation dose.Methods 60 patients,who suspicious coronary artery diseases and BMI between 18.6-25.0 kg/m2 underwent CCTA in our hospital.All patients were randomly divided into group A and group B(each with 30).Patients in group A were given 100 kV CCTA and filter back-projection algorithm (FBP), and patients in group B were given 80 kV CCTA and iterative reconstruction(IR).CT values of aortic root, right coronary artery (RCA), left anterior descending artery (LAD), left circumflex (LCX) and standard deviation (SD) were measured.Then signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.All images were given quality subjective scoring by using 3-score method.The CT dose index was recorded and effective radiation dose (ED) was calculated.Results ED of group A and group B was 0.8 mSv and 0.41 mSv, respectively.Statistically significant difference was found between these two groups.In the study, SD was (28±6) HU in group A and (46±9) HU in group B, and the difference was statistically significant between the two groups.The CT values of aortic root, RCA, LAD and LCX under 80 kV were significantly increased, and the difference was statistically significant between the two groups.There was no statistically significant difference between two groups in RCA-SNR, LAD-SNR and RCA-CNR.But in LCX-SNR, LAD-CNR, LCX-CNR, there was statistically significant difference between two groups.There was no significant difference between the two groups in coronary artery segments which could be used for diagnosis.Conclusion For patients with a normal BMI, CCTA using Flash spiral CT under 80 kV could diagnose coronary artery disease and significantly reduce the radiation dose.

Objective To investigate the imaging features of primary hepatic neuroendocrine carcinoma.Methods The imaging features of primary hepatic neuroendocrine carcinoma confirmed by pathology in 5 patients were reviewed retrospectively.Among the patients,plain and contrast enhanced CT in 4 and plain and contrast enhanced MRI in 1 were performed.Results CT showed a single lesion in 2 patients and multiple lesions in other 2 with the maximum diameter of 5.5 cm-10 cm.On plain CT,all lesions were hy-podensity with clear boundary and lower area in the center.The enhanced CT showed the lesions with obvious enhancement in arteri-al phase and gradually increasing enhanced area in portal vein and delayed phases but without enhancement in the lesion center.MRI showed the only one lesion in 1 patient with heterogenerous hypointensity on T1 WI,hyperintersity on T2 WI and DWI,and with mild to moderate delayed enhancement.The maximum diameter of the lesion was 5.0 cm,accompanied by a small round cystic structure at the periphery.The compression and displacement of peripheral blood vessels by the lesion without thrombus,and no lymphade-nopathy were also identified.Conclusion CT and MRI may show the imaging characteristics of the primary hepatic neuroendocrine carcinoma,which is helpful for the diagnosis of the tumor.

Objective To evaluate the feasibility of low dose CT perfusion imaging of brain using the tube voltage of 70 kV.Methods Twenty New Zealand white rabbits underwent cerebral CT perfusion imaging with tube voltage 70 and 80 kV separately,and the interval between two scans was 24 h.The effective dosage (E),cerebral perfusion parameters (CBF,CBV,MTT) and image quality indicator (SNR) of middle cerebral artery of each protocol were acquired and compared statistically.Results The effective dosage of70 kV group was 1.91 mSv,34.8％ lower than that of 80 kV group with the dose of 2.93 mSv.There were no significant differences between the cerebral perfusion parameters acquired at different corresponding ROI.SNR of 70 kV group and 80 kV group were (23.15 ± 5.98) and (21.23 ±9.18) with no significantly statistical difference.Conclusions The effective dosage of 70 kV cerebral CT perfusion imaging could be dramatically reduced with no significant influence on the results of perfusion parameters and image quality.

OBJECTIVE: Analysis of the correlation between telomerase and expression of its related proteins may provide insight into the molecular mechanism of nasopharyngeal carcinogenesis. Here, we investigate the effect of short hairpin RNA (shRNA) specific for human telomerase reverse transcriptase (hTERT) mRNA on the expression of proliferating cell nuclear antigen (PCNA) and Caspase-3 in nasopharyngeal carcinoma (CNE) cells. METHOD: shRNA expression vectors targeting the mRNA of hTERT were constructed. Cells were treated with the constructed expression vectors and telomerase activity was measured by telomeric repeat amplification ELISA (TRAP-ELISA). Cell viability was examined using the MTT assay. Cell apoptosis was detected by TUNEL method. The expression of PCNA and Caspase-3 proteins, was determined by Western blotting. RESULT: shRNA specific for hTERT mRNA significantly inhibited telomerase activity, suppressed cell viability and induced apoptosis in CNE cells. In addition, the expression of PCNA was inhibited, while the expression of Caspase-3 was up-regulated. CONCLUSION Our results suggest that shRNA directed against hTERT inhibits cell viability by regulating telomerase activity and its related protein expression in NPC cells. Therefore, RNA-interfering technology may be a promising strategy for the treatment of nasopharyngeal cancer.
Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Survival ; Humans ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; Proliferating Cell Nuclear Antigen ; metabolism ; RNA, Small Interfering ; Telomerase ; genetics ; Transfection

Objective To evaluate the feasibility of high-pitch spiral coronary CT angiography (CCTA) under low tube voltage and low contrast agent concentration for the patients with normal body mass index (BMI).Methods Ninety patients suspected with coronary artery diseases and with BMI of 18.6-25 kg/m2 underwent high-pitch CCTA and were randomly divided into three groups (each=30).Group A used iohexol (350 mg I/mL) 60 mL;Group B used iopromide (300 mg I/mL) 60 mL;Group C used iopromide (300 mg I/mL) 45 mL.All of them were scanned under Flash spiral pattern with 80 kV tube voltage,and the original data was calculated with sinogram affirmed iterative reconstruction algorithm(SAFIR).CT values and noises of the aorta root,right coronary artery (RCA),left anterior descending artery (LAD),and left circumflex (LCX) were measured,then signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.All of images were subjectively assessed by using 3-score method.The effective radiation dose (ED) and total iodine were recorded.Results ED of the three groups were all about 0.4 mSv,and there was no statistically significant.Compared with group A,the total iodine in group C decreased by 35.6 ％ and there was significant difference.There were no significant differences in image noise,SNR and CNR between group A and group B.Between group B and group C,there were significant differences in CT values of coronary,LCX-SNR and LCX-CNR,but there were no significant differences in image noise,SNR and CNR of RCA and LAD.There was no significant difference in the number of coronary artery segments for diagnosis among the three groups.Conclusion For the patients with normal BMI,application of high-pitch spiral CCTA with iopromide (300 mg I/mL)45 mL under 80 kV tube voltage could meet the requirement for clinical diagnosis,and the radiation dose and total iodine were significantly decreased.

OBJECTIVETo explore efficacy and safety of modified FOLFIRINOX (mFOLFIRINOX) regimen by dose attenuation in locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer(MPC).

METHODSBetween April 2014 and October 2015, 35 patients with LAPC (n=18) or MPC (n=17) were treated with mFOLFIRINOX regimen (irinotecan 135 mg/m(2), oxaliplatin 68 mg/m(2), 5-FU 2 400 mg/m(2), no bolus of 5-FU, leucovorin 400 mg/m(2)) in the Second Affiliated Hospital of Zhejiang University School of Medicine. The primary end point was progression free survival. The second end points were overall survival, objective response rate, adverse effects, surgical resection rate for LAPC.

RESULTSAmong 35 patients, 6 patients (17.1%) who dropped out and received less than 2 cycles were excluded for response analysis. Among the other 29 patients, 9 patients had grade 3 or 4 adverse effects. No patients ceased treatment due to adverse effects. The 29 patients received 5 (2-13) cycles were evaluated by efficacy and found partial remission in 16 cases, stable disease in 10 cases, progression disease in 3 cases. Response rate was 55.2%. Nine patients with LAPC accomplished surgery after neoadjuvant treatment without perioperative complication and death, and 6 patients accepted R0 resection.

CONCLUSIONSThe mFOLFIRINOX regimen used in the study is well-tolerated in Chinese population with high treatment efficacy on patients with LAPC and MPC. Further investigation of efficacy and adverse effects on more advanced pancreatic cancer patients is necessary.

Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; administration & dosage ; analogs & derivatives ; Disease Progression ; Disease-Free Survival ; Fluorouracil ; administration & dosage ; Humans ; Leucovorin ; administration & dosage ; Neoadjuvant Therapy ; Organoplatinum Compounds ; administration & dosage ; Pancreatic Neoplasms ; drug therapy ; Tertiary Care Centers ; Treatment Outcome

The 13th World Congress of the International Hepato-Pancreato-Biliary Association was held from 4th to 7th September 2018 in Geneva,Switzerland.Thousands of wellknown specialists and scholars from 96 countries around the world were invited for the great event.The congress aimed to explore the latest achievements of diagnosis and treatment of hepatobiliary and pancreatic diseases from both the clinical and basic perspective.In this article,authors reviewed and analyzed the up-to-date research information and combined clinical researches of the author team,in order to share the experience and achievements in the field of hepato-pancreato-biliary surgery with colleagues and provide new information and inference for optimization of diagnosis and treatment in this field.