Objective To evaluate the diagnostic and differential value of triphasic, especially the arterial phase, contrast enhanced CT scans for the hepatocellular adenoma, and to improve CT diagnostic accuracy. Methods Spiral CT scanning of pre and post contrast arterial phase, portal venous phase and delayed phase was performed in 5 patients with hepatocellular adenomas proved surgically and pathologically. The enhancement was administrated with venous injection of 3 ml/sec, totally 100 ml angiografin. Arterial phase of contrast enhanced scanning started 20～30 sec, portal venous phase 60～70 sec and delay scanning 3 min after the injection of contrast medium. The degrees of the enhancement of adnoma and normal tissues of liver in the three contrast enhanced phases were calculated and compared statistically. Results In plain CT, the lesions were iso density in 4 cases and slight hypodensity in 1 case, which was hardly distinguished from the normal tissue. In all 5 cases, the lesions showed marked enhancement in the arterial phase compared with normal tissue of liver (38 HU high), and there were markedly statistical difference ( t =18 94, P 0.05). The mean CT value of hepatocellular adenoma in the arterial phase was much higher than that in portal venous and delay phase, there were statistical differences between them ( F =18.39, P

Objective To investigate the clinical characteristics of the results of coronary artery CT angiography and coronary artery angiography in 36 patients with probable positive results of treadmill exercise test(TET).Methods Thirty-six patients due to chest pain received 1ET and coronary artery CT angiography and coronary artery angiography in 2 weeks after admission.The coronary plaques were categorized as noncalcified and calcified plaque on CTA images.Results In 36 patients with probable positive results of TET.23 patients were confirmed as coronary artery disease by coronary artery angiography,and the other 13patients had normal coronary artery.Of 23 coronary artery disease patients,9 patients were presented as onevessel disease,5 patients were presented as two-vessel disease,and 9 patients were presented as three-vessel disease,29 non-calcified plaques and 23 calcified plaques were demeted On CTA.Conclusion TET was useful in confirming the diagnosis of coronary artery disease.The characteristics of the coronary artery plaque is correlated with probable positive results of TET.

Studies showed that low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) diet can improve the symptoms of gastrointestinal dysfunction of inflammatory bowel disease (IBD) patients, the mechanism may be related to decrease of secretion of intestinal liquid and production of gas.Specific carbohydrate diet and paleolithic diet may be suitable for IBD patients.This article reviewed the advances in study on effects of different diets on gastrointestinal dysfunction in patients with IBD.

Objective To investigate whether the left ventricular delayed contraction site determined by tissue Doppler imaging might be an optimal left ventricular lead position for improved outcomes of cardiac resynchronization therapy (CRT) in patients with non-ischemic cardiomyopathy. Methods Thirty-three patients subjected to CRT were selected, and all were performed conventional ultrasound cardiography and tissue Doppler examinations before operation. The left ventricular delayed contraction site was determined according to the interval between the onset of QRS and the peak systolic velocity. Retrograde coronary venography was performed during operation, and the left ventricular lead site was selected according to the left ventricular delayed contraction site determined by tissue Doppler examination before operation. The coronary sinus lead site was determined under the guidance of X ray of dorsaventral, lateral, right anterior oblique and left anterior oblique positions. Patients were divided into group A(n=20, the left ventricular lead site was in line with the delayed contraction site) and group B (n=13, the left ventricular lead site was not in line with the delayed contraction site). Results There was no significant difference in age, NYHA grading, left ventricular end-systolic volume(LVESV), left ventricular ejection fraction(LVEF), pulmonary arterial systolic pressure, QRS width and Ts-SD between the two groups before operation(P> 0.05). Six months after CRT, there was no significant difference in NYHA grading, LVESV and mitral regurgitation(MR) grading between the two groups(P>0.05), while the increase in LVEF and decrease in LVESV of group A were more significant than those of group B (P<0.01). Conclusion In patients with non-ischemic cardiomyopathy, CRT significantly improves left ventricular performance, and the more favourable outcomes are achieved in those pace at the delayed contraction site. Tissue Doppler imaging may help to guide the implant of left ventricular lead.

We explored the feature and therapeutic methods of cerebral cysticercosis.The effect of different surgical treatment was analyzed on 6 patients with cerebral cysticercosis who had undergone surgery at Fujian Provincial Hospital.Results showed that 2 of 6 cases underwent an excision of ventricle or cisternalcysticercus.Three cases were performed an excision of brain parenchyma cysticercus.The decompressivecraniectomy under bilateral temporalis was performed on 1 patient with cerebral cysticercosis.One case underwent ventriculo-peritoneal shunt because of hydrocephalus after a year of follow-up.The operations of 6 cases were all successfully performed.All patients recovered well after the operation.No newly neurobiological injuries were observed.Timely and accurate neurosurgery contributes to reduce the incidence of complications and cut down disability rate of cerebral cysticercosis,and buy time and fight for an opportunity for drug therapy of cerebral cysticercosis as well.It significantly improves the safety and therapeutic effect of anti-cysticercosis drugs.

Esophagopulmonary fistula is a rare disease in clinic, most esophagopulmonary fistula is diagnosed and treated because of typical cough symptoms after eating or drinking. This case reported no typical symptoms of choking and coughing in eating or drinking water, patients with intermittent hemoptysis for nearly 30 years were diagnosed with bronchiectasis, Because of massive hemoptysis for emergency operation, the esophagus and the left lower lung were found to have abnormal muscular conduits during the operation, so diagnosis of esophagopulmonary fistula.

OBJECTIVETo compare the results of cytogenetic and IPSS grouping of primary myelodysplastic syndromes (pMDS) patients classified by FAB- or WHO classification.

METHODSTwo hundred and thirty seven cases of pMDS who were previously classified according to FAB criteria were reclassified with WHO classification. A comparison was made between the results of the two classifications.

RESULTSFor the detection rates of cytogenetic abnormality and its risks group, there was no difference among the FAB subgroups but the detection rate was different between the WHO refractory cytopenia with multilineage dysplasia (RCMD) and RA subgroups (74.4% and 42.5%, respectively) (P < 0.001). The percentage of good karyotype abnormalities in RA (65.0%) was higher than that in RCMD (24.4%) (P < 0.001), and the percentages of intermediate and poor karyotype abnormalities in RCMD (48.9% and 26.7%, respectively) were higher than that in RA (27.5% and 7.5%, respectively) (P < 0.05). There was a good correlation between the subgroups and IPSS risk groups for both the WHO classification and the FAB classification, but the WHO classification further reflected the differences between RCMD and RA and RAEB-I and RAEB-II subgroups. The percentage of low-risk group in RCMD (1.1%) was lower than that in RA (10.0%) (P < 0.05), and the percentage of high-risk group in RAEB-II (30.5%) was higher than that in RAEB-I(0) (P < 0.001).

CONCLUSIONFor the correlation between subgroups and cytogenetic abnormalities and IPSS risk groups, the WHO-classification is better than the FAB-classification.

Adolescent ; Adult ; Aged ; Bone Marrow ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; classification ; genetics ; pathology ; Prognosis ; Severity of Illness Index ; World Health Organization

Along with the population aging in China, patients with lumbar spinal stenosis(LSS) caused by recessive change incessantly increase. At present, there is no adequate evidence to recommend any specific nonoperative treatment for LSS, and surgery is still an effective method. The cilincal symptoms of the patients without conservative treatment got improvement after surgery, which is the strongest evidence base. Spinal instability after simple decompression promotes the development of fusion technique, and the accelerated adjacent segment degeneration and no relief in symptoms after fusion lead to dynamic fixation technology emerge as the times require. Patients with spinal canal decompression whether need bone fusion or not is still controversial. For the past few years, the operation of simple decompression for LSS obviously decreased, whereas the decompression plus fusion surgery showed sustainable growth. Decompression complicated with fusion was more and more adopted in LSS, in order to reduce the hidden risk of spinal instability and deformity. Although decompressive operation has determinate effect, now it is still unclear if the therapeutic effect of decompression complicated with fusion is better than simple decompression. This article reviews the current studies to explore whether decompression plus bone fusion is applicable for LSS. To further explore the best choice of surgical treatment for LSS, we focused on evidence-based therapeutic options.

OBJECTIVETo observe the efficacy of Chinese herbs for supplementing qi and activating blood circulation (CHSQABC) on patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM) after successful percutaneous coronary intervention (PCI).

METHODSIn this ChiCTR-TRC-00000021, a total of 281 ACS patients complicated with type 2 DM after successful PCI were randomly assigned to the Western medicine treatment group (the control group, treated by routine Western medicine treatment) and the combined treatment group (the treatment group, treated by CHSQABC + routine Western medicine treatment). Patients in the combined treatment group took Xinyue Capsule (2 pills each time, 3 times per day) and Compound Chuanxiong Capsule (2 pills each time, 3 times per day for half a year and 1-year follow-ups). Primary endpoints covered incidence of death, nonfatal myocardial infarction (MI), ischemia-driven revascularization, and secondary endpoints included stroke, heart failure, and rehospitalization for ACS. At the same time scores for blood stasis syndrome (BSS) and the incidence of angina pectoris were evaluated before treatment, at month 1, 3, 6, 9, and 12 after treatment.

RESULTSThe incidence of ischemia-driven revascularization was obviously less in the treatment group than in the control group (P < 0.05). No patient had nonfatal MI in the treatment group, while 5 patients in the control group had it. The incidence of non-fatal MI showed an obvious lowering tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). Four patients readmitted to hospital in the treatment group, while 12 patients readmitted. There existed obvious tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). The incidence of angina was significantly lower in the treatment group at month 6, 9, and 12 than that at month 1 , but it was lower in the control group at 9 months (P < 0.05). The incidence of angina was 15. 4% in the treatment group, obviously lower than that in the control group (26.2%, P < 0.05). Compared with before treatment, scores for BSS were obviously lowered in the treatment group at 1, 3, 6, 9, and 12 months of treatment and in the control group at 3, 6, 9, and 12 months of treatment (P < 0.05). It was obviously lower in the treatment group than in the control group at 3, 6, 9, and 12 months of treatment (P < 0.01).

CONCLUSIONAdministration of CHSQABC combined routine Western medicine treatment could reduce the event of revascularization and post-PCI recurrent angina, and improve scores for BSS of ACS patients complicated with DM after PCI.

Acute Coronary Syndrome ; complications ; surgery ; therapy ; Angina Pectoris ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Incidence ; Medicine, Chinese Traditional ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Qi

Animals ; Arthritis, Rheumatoid ; blood ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Interferon-gamma ; blood ; Phytotherapy ; Tumor Necrosis Factor-alpha ; metabolism