Objective To determine the expression of sodium-hydrogen exchanger (NHE) 1 in gastric carcinoma tissue,and investigate the relationship between NHE1 expression and clinicopathological characteristics.Methods The expression levels of NHE1 mRNA and protein were detected in both gastric carcinoma tissue (48 cases) and paraneoplastic tissue (40 cases) by reverse transcription polymerase chain reaction (RT-PCR) and Western blot.The relationship between the expression levels of NHE1 mRNA and protein and the clinicopathological characteristics was analyzed.Results The relative expression levels of NHE1 mRNA and protein in gastric carcinoma tissue were 0.791 ± 0.286 and 1.475 ± 0.142,in paraneoplastic tissue were 0.352 ± 0.069 and 0.329 ± 0.048,and there were statistical differences (P ＜ 0.01).The expression level of NHE1 mRNA was positively correlated with NHE 1 protein in the gastric carcinoma tissue (r =0.375,P ＜ 0.05).The expression levels of NHE1 mRNA and protein were associated with the depth of invasion,lymph node metastasis and TNM staging (P ＜ 0.05).However,the expression levels of NHE1 mRNA and protein were no associated with age,gender and tumor differentiation (P ＞ 0.05).Conclusion The expression levels of NHE1 mRNA and protein are significantly up-regulated in gastric carcinoma tissue,which may be involved in the development of gastric carcinoma.

Objective To study the application of multidector spiral CT(MSCT) in the diagnosis of pulmonary embolism(PE).Methods The clinical and MSCTPA data of 15 cases with suspected PE were analyzed retrospectively.Results Of 15 cases,14 cases(93.3%)were diagnosed as PE.849 branches(82%) of pulmonary arteries were showed in 1035 branches.PE was detected in 130 branches(15.3%) of 849 branches of pulmonary arteries.438 branches(73%) were showed in 600 branches of subsegmental pulmonary arteries,PE was showed in 43 branches(9.8%)of 438 branches.Direct signs of PE included central filling defect in 3 cases;eccentric filling defect(n=9);embolism attached to the wall of host artery(n=2) and total occlusion of the pulmonary arteries(n=3).Indirect signs includedmosaic sign in 1 case;subpleural infarction(n=3);pulmonary hypertension(n=5);Westermark sign(n=8) and pleural effusion(n=6).Conclusion MSCTPA is a fast,effective,security and non-invasive diagnostic method for PE,it may replace the pulmonaryangiography and will be the first choice for diagnosis of PE.

To summarize the imaging characteristic of parotid lymphoepithelial carcinoma (LEC) by retrospective analyses of computed tomography (CT) and magnetic resonance imaging (MRI) findings for 6 cases of parotid LEC confirmed by operation and pathology and review the relevant literatures.All lesions were located in unilateral parotid.There were single (n =5) and multi-module fusion (n =1).All were located in superficial lobe of parotid gland.And deep lobe (3/6) was involved.An infiltration of casting shape was found along superficial parotid (4/6).There was an irregular margin with small spines,uniform density and signal and above moderate enhancement.An infiltration of casting shape along superficial lobe,uniform density and signal and rich blood supply suggest a diagnosis of LEC.

Objective: The pilot study was to explore the possibility of discriminating schizophrenia from the normal with combination of multiple tests. Methods: Forty medication-naive (25 cases) or medication-free for at least three weeks (15 cases) patients with schizophrenia and 41 healthy normal controls matched with sex, age, headedness, and education, were recruited in the study. The Structured Clinical Interview (SCID) was used to render the DSM-Ⅳ diagnoses for schizophrenia or schizophreniform disorders. The intrahemispheric coherences between the parietal and frontal electrode pairs (left: F3/P3; right: F4/P4) and interhemispheric coherences between frontal leads (F3/F4) and parietal leads (P3/P4) in the wide-band alpha frequency and peak frequency of photic driving were calculated at rest and during 1Hz light stimulation, respectively. Tests of exploratory eye tracking movement test (ETM), Wisconsin Card Sorting Test (WCST), and Continuous Performance Test (CPT) were finished in the same working day. Stepwise discriminant function analyses were chosen to re-classify the patients and controls. Results:In the discriminant analyses, 61.7% of the subjects could be correctly classified into groups of patients or normal controls using the EEG coherence alone, 77.27% with ETM measures alone, and 70.6% when WCST and CPT parameters were combined. The correct discriminate rate increased to 81.5% when all the above variables were taken into consideration.Conclusion:In consideration of the heterogeneity of schizophrenia, it is suggested necessarily to combine multiple tests to make discrimination of schizophrenia.

Objective:To provide references for encouraging translation of medical and pharmaceutical research outcomes from a policy perspective.Methods:In view of characteristics of such translation and using policy tools, the authors introduced the innovation value chain and innovation entity chain to create a three-dimensional analysis framework. The three dimensions refer to policy tools(supply side, environment side and demand side), innovation value chain(research and development, clinical research and pilot application, and commercial industrialization), and innovation entity chain(colleges, medial institutions, enterprises, government, and third parties). A three-dimensional framework was introduced for textual quantitative analysis, centering on 70 policy documents on such translation released from 2015 to 2019.Results:Excessiveness was found in the environment side and supply side policy tools usage, while the demand side was deficient relatively; clinical research and pilot applications constitute the policy support weakness in innovation value chain; policy frequency on medical institutions and third parties was weak in the innovation entity chain dimension.Conclusions:Based on the three-dimensional framework analysis results and sector specifics, the paper proposed such policy recommendations as highlighting features of medical and pharmaceutical sector, activating incentives of hospitals and colleges, and expanding resources for clinical research.

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied.

Objective To evaluate the CT and MRI findings and their diagnostic value of central nervous system complications of leukemia (CNSCL). Methods The CT and MRI findings of 18 adult patients with CNSCL proved by clinical features or pathology were retrospectively analyzed. Among 18 cases,7 were acute lymphocytic leukemia, 10 acute non-lymphocytic leukemia and 1 chronic myelomonocytic leukemia. Eleven cases underwent plain CT scan with one of them also receiving contrast-enhanced CT scan enhancement, 16 cases underwent plain MR scan with 11 of them receiving contrast-enhanced MR scan.Results Intracranial lesions in 14 cases: (1)intracranial hemorrhage was found in 7 cases, including intracerebral hematoma in 4 cases, micro-haemorrhage in 2 cases, and intracerebral hematoma accompanying by multiple intracerebral micro-haemorrhage foci in 1 case. All cases with intracerebral hematoma showed multiple lesions, which demonstrated high-density on CT images, and low or mixed signal on T1 WI, high- or intermediate signal with low-signal rim on T2 WI and ring enhancement or no evident enhancement. Microhaemorrhage manifested as multiple mini-mottling and strip hypointense foci on susceptibility weighted imaging, on which the detection rate of micro-haemorrhage foci was much higher than that on CT and other sequences of MRI. Among the 7 cases, one also had cerebral infarction and one subarachnoid hemorrhage.(2) Intracranial mass was found in 5 cases, among which two appeared as masses under or bestride cranium in the left frontal region with hypointensity on T1 WI, mixed signal on T2WI, strong homogeneous enhancement and dural tail sign;one showed a mass in saddle area, with high density on CT, slightly low signal on T1WI, high signal on T2WI and heterogeneous enhancement; one case displayed a mass near lateral ventricle with iso-intensity on T1 WI and T2WI and strong homogeneous enhancement; and one case manifested as cystic mass in the left fronto-apical lobe, with thick wall and ring enhancement (3)Obstructive hydrocephalus was found in 1 case, manifesting dilation of ventricles above the aquaeductus mesencephali. (4) Meningopathy was found in 1 case, manifesting diffuse thickening of meninges with strong homogeneous enhancement on MRI. Pathological changes of spinal canal was found in 4 cases among which two showed para-spinal mass involving vertebral canal and causing bone destruction of adjacent ribs; one case showed fusiform mass posterior to vertebral canal with high and intermediate signal on T1 WI and low and iso-signal on T2WI without enhancement; one showed zonale leison in thoracic cord with high signal on T2WI and fluid attenuated inversion recovery. Conclusion The radiologic manifestations of adult CNSCL are various and the role of CT and MRI for the diagnosis of CNSCL may complement each other. SWI is suggested as routine examination for patients of leukemia, in whom intracerebral lesions were suspected in order to find micro-haemorrhage as early as possible and reduce the risk of intracerebral hematoma occurrence.

Objective To study the relationship between energy metabolic changes tested by phosphorus-31 magnetic resonance(MR)spectroscopy(31P MRS)and the liver damage score(LDS)in rabbit models and investigate the diagnostic value of 31P MRS in acute hepatic injury.Methods A total of 30 rabbits were received different radiation dose(ranging from 5 Gy to 20 Gy)to establish acute hepatic injury models.31P MRS was than carried out 24 hrs after radiation.The rabbits were divided into mild(LDS≤3 U),moderate(LDS 3-6 U)and severe(LDS＞6 U)hepatie injury groups.Ten healthy rabbits were served as controls.MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.The relative quantification of phosphomonoesters(PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine severe hepatic injury groups were 1.83±0.33,1.55±0.24,1.27±0.07 and 0.98±0.18,respectively,with significant differences(P＜0.05).The ATP level was progressively decreased with the increase of severity Of hepatic injury.The relative quantification of PME and Pi were decreased in severe hepatic injury group compared to control group(P＜0.05).There was no significant difference higher in moderate(1.94±0.50)and severe(1.96±0.72)hepatic injury groups compared to control group(1.43±0.31)and mild hepatic injury group(1.40+0.38)(P＜0.05).No significant difference was found in ratio of relative quantification of other phosphorus metabolites.Conclusions 31P MRS is a useful method in evaluating acute hepatic injury.The relative quantification of hepatic ATP level,which can reflect the severity of acute hepatic injury,is correlated with LDS.

Objective To investigate the application value of percutaneous sinus-tract cholangioscopy in the diagnosis and treatment of residual intra-and extra-hepatic bile duct stones.Methods The retrospective cross-sectional study was conducted.The clinical data of 1 045 patients with intra-and extra-hepatic bile duct stones who underwent percutaneous sinus-tract cholangioscopy or stone extraction in the Second Affiliated Hospital of Zhejiang University from January 2003 to June 2016 were collected.Patients received percutaneous sinus-tract cholangioscopy or stone extraction at 6-8 weeks after T tube drainage.Observation indicators:(1) diagnosis and stone extraction situstions:cases with residual stones,stone extraction frequency and clearance rate;the critics of clearance rate are no residual stone dnring operation combined with B ultrasound or T-tube cholangiography;(2) postoperative complications:incidence and management of postoperative complications,prognosis and ClavienDindo classification for postoperative complication;(3) follow-up situation.T-tube was removed when there was no residual stone.Patients were followed up by outpatient examination up to April 2017.B ultrasound reexamination was performed to detect the recurrence of stone once every 3-6 months.Results (1) Diagnosis and stone extraction situstions:among 1 045 patients,results of cholangioscopy showed 147 wihout bile duct stones and 898with bile duct stones.Of 898 patients,2 618 times cholangioscopic explorations for stone extraction were performed,with a maximum frequency of 16 times,and 851 had stones clearance,with a overall clearance rate of 94.77％(851/898).The clearance rates of extra-and intra-hepatic bile duct stones were 100.00％(221/221) and 93.06％(630/677).Of 47 patients with residual stones,16 didn't receive cholangioscopy due to branches stricture or occlusion of intrahepatic duct,13 failed to take out stone due to T-tube dislodgement (9 cases) and improper placement (4 cases) induced closed T-tube sinus tract,7 had T-tube sinus tract duodenal fistula,6 gave up stone extraction,3 was due to longer sinus tract induced bending and 2 was due to T-tube sinus tract fracture.(2)Postoperative complications:among 1 045 patients,297 had level Ⅰ-Ⅱ mild complications and 13 had level Ⅲand above severe complications.The common complications included fever,vomiting,diarrhea and so on;the special complications included T-tube sinus tract duodenal fistula of 13 patients,T-tube sinus tract fracture of 4 patients,rupture of broken stones pole of 3 patients,massive hemobilia of 2 patients,acute pancreatitis of 2patients and cardiac arrest of 1 patient.The above complications were improved by symptomatic and supportive treatments.(3) Follow-up situation:among 1 045 patients,558 received long-term follow-up,with follow-up time of 10-171 months and a median time of 79 months.Eight-four patients had stone recurrence.Of 13 patients with recurrence of extrahepatic bile duct stones,7 took out stones by endoscopic retrograde cholangio pancreatography (ERCP) and 6 underwent reoperations.Of 71 patients with recurrence of intrahepatic bile duct stones,43underwent reoperations and 28 received conservative treatment.Conclusions Percutaneous sinus-tract cholangioscopy for residual intra-and extra-hepatic bile duct stones is safe and effective,with good diagnosis and treatment values and a high clerance rate.The integrity of T-tube sinus-tract is a key of complete stones removal.

Objective To investigate acute CT radiation injury on rabbit liver after the whole body CT scans with high-dose abdominal CT scan model.Methods The forty-six New Zealand white rabbits were randomly assigned into 3 groups.High-dose CT scanning groups included one-off CT scanning group(group 1)and repeated CT scanning group (group 2)with high-dose abdominal CT scan modes,and 18 rabbits in each group.The other two groups were routine-dose CT scanning group(n=5)and control group(n=5).Rats in both group 1 and 2 were divided into 6 subgroups(n= 3).Four to twenty-four times of continuous or discontinuous CT scans with 240 mAs and 140 Kv were performed on every rabbit.The liver samples of every animal were eoUected at 48 h or 24 h after CT scans and pathological examination and immunohistochemistry assay of Cpp32 and Bax expression were performed.Results(1)Light microscope showed①in group 1,slight hepatic injury occurred at 6 times of continuous CT scanning;after 6～18 times of continuous CT scanning,hepatocytes were slight swelling at first,followed by hydropic or fatty degeneration,constriction or emphraxis of hepatic sinuses,puncture necrosis of hepatocytes,and local hepatic hemorrhage;②in group 2:slight hepatic injury occurred at 8 times of CT scanning,and after 8～24 times of CT scanning,hepatocytes were slight or mild swelling at first,followed by moderate or diffuse swelling,hydropic degeneration,and dispersed karyopyknosis of hepatocytes near central vein.(2)Immunohistochemistry assay showed:①in group 1,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were observed in part of liver samples,the expressions of Bax and Cpp32 were correlated with CT radiation dose;②in group 2,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were found in every subgroup,but the expression was not correlated with CT scan times.(3)The hepatic tissues of routine-dose CT scanning group were normal under the light microscope and immunohistochemistry assay.Conclusion Routine-dose CT scanning on liver is very safe,but high-dose CT scanning with non-routine scan times may cause acute pathological hepatic injury and hepatocyte apoptosis.