Objective To evaluate the imaging characteristic and the value of application of breath hold two dimensional fast imaging employing steady state acquisition(FIFSTA) sequence, for aortic dissection(AD) magnetic resonance many time phases imaging. Methods To analyze retrospectively the manifestation of 5 cases with aortie dissection diagnosed, Bakey type Ⅰ,Ⅱ, Ⅲ, in 1, 1 and 3, all were examined using ECG triggered, two dimensional FIESTA sequence during end-expiratory breath hold. Scan with the long axes of aortic position(oblique position parallel with aortic arch) and transitional position. The results were analyzed by the soft of workstation AW4.2. Results The display rate of the true lumen and the false lumen of AD were 100% ,the display rate of membrane in aorta was 100% ,4 cases showed the hole of intimal tear,2 cases with thrombus,2 cases with aortic regurgitation,2 cases with ejecting in the hole of intimal tear. Conclusion Need not any contrast media, quickly acquired imaging, high contrast to noise ratio, least artifact,and especially show membrane in aorta and for the hole of intimal tear of aortic dissection(AD) magnetic resonance many time phases imaging with two dimensional FIESTA sequence.

To examine the effect of Gankang Suppository on duck hepatitis B virus (DHBV), the serum biochemistry and hepatic histology in an animal model of DHBV infection, a model of DHBV infection was established by infecting 1-day-old Yingtaogu ducklings with DHBV-positive serum. The successful model was confirmed by PCR assay and 48 ducklings infected with DHBV were randomly divided into 3 groups: a Gankang Suppository treatment group, an acyclovir (ACV) group and a DHBV model group (control), with each group having 16 animals. All the animals were given the medicines for 4 weeks in a row. The serum of the animals was taken 14 and 28 days after the medication and 7 days after drug discontinuation. Real-time PCR was performed to detect the copy numbers of DHBV DNA in the serum. ALT and AST were dynamically monitored. The ducklings were sacrificed on the 7th day after the discontinuation of the treatment and livers were harvested and examined for inflammation and degeneration of liver cells by using HE staining. The results showed that on day 14, 28 after the treatment and day 7 after the withdrawal, the logarithmic values (log) of DHBV DNA copy numbers in ducklings of Gankang Suppository treatment group were significantly lower than that before the treatment (P=0.0092, P=0.0070, P=0.0080, respectively). Compared with DHBV model control group, the ALT level was significantly decreased (P=0.0020, P=0.0019, respectively) on day 28 after the treatment and on day 7 after the withdrawal. The AST level was also reduced on day 14 after the treatment (P=0.0298). Compared with the ACV control group, the level of ALT was lower on day 7 after the withdrawal (P=0.0016). Histologically, the hepatocyte swelling, vacuolous degeneration and acidophilic degeneration in Gankang Suppository treatment group were alleviated 7 days after the withdrawal as compared with model control group (P=0.0282, P=0.0084, P=0.0195, respectively). It is concluded that Gankang Suppository can effectively suppress DHBV replication, reduce the levels of serum ALT and AST and improve hepatic histology.

Objective To explore the effect of coronary artery bypass grafting(CABG) on left atrial (LA) function by strain rate imaging(SRI). Methods Twenty-three patients with coronary heart disease who underwent coronary artery bypass grafting were involved. SRI was performed on those patients to evaluate LA function quantitatively at baseline (before CABG),and at 1 week, 1 month and 3 months after CABG. Peak strain rate(SR) was measured at each segment (septal, lateral, posterior, anterior, and inferior walls) and mean peak systolic SR (SRs),peak early diastolic SR (SRe) and peak atrial systolic SR (SRa) were calculated by averaging data in each segment. Results Compared with the baseline,LV pre-systolic volume(LAVp), maximal volume (LAVmax), minimal volume (LAVmin), LV active emptying fraction (LAAEF) and passive empting fraction(LAPEF) had on significant differences at 1 week (P >0.05). LAVp,LAVmin,LAVmax and LAAEF decreased gradually after CABG, LAPEF increased gradually after CABG (P <0.05). Compared with the baseline, the peaks of SR curve showed no significant differences at 1 week (P >0.05). Nevertheless,the peaks of SR were increased at systole and early diastole,decreased at atrial contraction at 1 month (P <0.05). Those changes were turned more significantly at 3 months (P 0.01). Left ventricular ejection fraction (LVEF) both increased at 1 month and 3 months,and its changing rate correlated inversely with the changing rate of SRa respectively (r = -0.751, -0.783,all P<0.01).Conclusions LA function is affected by CABG, presented as reservoir and pump functions decreased and conduit function increased. SRI can evaluate the atrial function quantitatively and monitor the changing of LA function dynamically after CABG.

Objective To investigate the clinical efficacy and safety of recombinant human B-type natriuretic peptide(rhBNP)in treatreat of patients with acute myocardial infarction(AMI).Methods 80 patients with AMI were randomly divided into control and treatment group.The two groups were accepted the standard foundation treatment(ABCDE)defined by the WHO and PCI therapy.The treatment group was added the rhBNP on the basis.The rhBNP was uniformly injected by intravenous with 1.5 μg/kg in 90s,and then with 0.0075 μg · kg-1 · min-1 in 48h; To investigate the BNP and myocardiolysis maker(Troponin I,cTnI)levels in blood-serum before and after the treatment;To evaluate left cardiac functions and left ventricular remodeling by left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF);To investigate the major cardiovascular events after treatment within 30 days.Results RhBNP could significantly reduce the concentration of the BNP and cTnI in blood-serum after treating one week(all P ＜ 0.05); It could remarkably deflate LV EDV and LVESV,improve LVEF(allP ＜0.05); It could reduce the incidence of major cardiovascular events(P ＜0.05)within 30 days(P ＜ 0.05).Conclusion The rhBNP could improve left ventricular pressure-phore and volume-phore,improve ventricular remodeling,improve myocardial ischemia and reduce major cardiovascular events within 30 days.It was proved that the rhBNP could improve AMI clinical prognosis.

Objective To explore the classification and surgical management of pancreatic duct stones.Methods The clinical data of 54 patients with pancreatic duct stones who were admitted to the People's Hospital of Hunan Province from June 1994 to November 2009 were retrospectively analyzed. Stones were found in the head of the pancreas (type Ⅰ ) in 31 patients, in the body and tail of the pancreas (type Ⅱ ) in 7 patients, and in all the pancreas (type Ⅲ ) in 16 patients. According to the types of the pancreatic duct stones, ten patients (6 with type Ⅰ , two with type Ⅱ and two with type Ⅲ pancreatic duct stones) received opening of the main pancreatic duct + pancreaticojejunostomy or pancreaticogastrostomy ( group A). Twenty-four patients ( 16 with type Ⅰ and eight with type Ⅲ pancreatic duct stones) received pancreaticoduodenectomy (group B). Fifteen patients (nine with type Ⅰ and six with type Ⅱ pancreatic duct stones) received subtotal resection of pancreatic head preserving duodenum (group C). Five patients with type Ⅱ pancreatic duct stones received resection of the body and tail of the pancreas and the spleen (group D). All data were analyzed using the t test. Results The mean operation time, blood loss, length of postoperative stay and hospital charges of group A were (2.2 ± 1.2)hours,( 127 ±24)ml,( 11.4 ±4.3) days and (3.24 ± 1.15 ) × 104 yuan, respectively. Five out of nine patients who were followed up had stone recurrence. The mean operation time, blood loss, length of postoperative stay and hospital charges of group B were (7.6 ± 1.1 ) hours, (409 ± 37 ) ml, ( 18.9 ± 2.5 ) days and (7.93 ± 1.35 ) × 104 yuan, respectively.No stone recurrence was detected in the 21 patients who were followed up. The mean operation time, blood loss,length of postoperative stay and hospital charges of group C were (4. 1 ± 0.7 ) hours, ( 156 ± 63 ) ml, ( 10.3 ±2.1 )days and (4. 12 ± 1.22) × 104 yuan, respectively. No stone recurrence was detected in the 15 patients who were followed up. The mean operation time, blood loss, length of postoperative stay and hospital charges of group D were (3.3 ± 1.4) hours, ( 185 ± 36 ) ml, ( 9.3 ± 2.0) days and ( 3.22 ± 1.05 ) × 104 yuan, respectively. No complication was detected after the operation, and no stone recurrence was detected in the three patients who were followed up. There were significant differences in the mean operation time, blood loss, length of postoperative stay and hospital charges between patients with type Ⅰ and Ⅲ pancreatic duct stones who received pancreaticoduodenectomy and subtotal resection of pancreatic head preserving duodenum (t = 12. 143, 14. 099, 11. 550, 9. 103,P < 0.05 ). Conclusions Classification of the pancreatic duct stones is important for choosing the proper surgical procedure. Subtotal resection of pancreatic head preserving duodenum is ideal for the treatment of patients with type Ⅰ or Ⅱ pancreatic duct stones.

Objective To explore the value of echocardiography in detecting left atrial systolic function in patients with hypertrophic cardiomyopathy(HCM) or hypertensive left ventricular hypertrophy (HLVH). Methods There were 3 groups in this study,the group of HCM, HLVH and control,each group had 30 cases. Left atrial diameter,interventricular septal thickness, posterior left ventricular thickness, peak E and A of mitralis were measured by conventional echocardiography. Left atrial fractional shortening (LAFS) was calculated. Tissue velocity imaging of all patients and controls were accepted in apical two, four and long axis chamber views. Strain rate(SR) imaging was performed on all cases, peak atrial systolic left atrial SR(LASRa) were measured at each segment (septal,lateral, posterior,anterior, and inferior walls of left atrium), mean LASRa was calculated by averaging data in all segments. Results Compared with controls, LAFS and mLASRs of HCM and HLVH were significantly higher ( P ＜0.05). Moreover, LAFS and mLASRs of HCM were significantly higher than HLVH (P ＜ 0.05). mLASRa correlated positively with LAFS of HCM and HLVH respectively ( r =0.81,0.88,all P ＜0.01). Conclusions The change of left atrial function of HCM and HLVH presented as pump function increased.

Objective To investigate the feasibility and safety of transumbilical laparoscopic single-port choledocholithotomy in the treatment of common bile duct stones. Methods The clinical data of four patients who underwent transumbilical laparoscopic single-port choledocholithotomy at Shengjing Hospital of China Medical University from January to June, 2010 were retrospectively analyzed. The operation method and postoperative effects were reviewed. Results All the operations were successfully carried out. The mean operation time was 100 minutes and the mean blood loss was 62. 5 ml. All patients were cured without the occurrence ofcomplications except for one patient who had a peritoneal infection and was cured after surgical drainage. Conclusion Transumbilical laparoscopic single-port choledocholithotomy is safe and feasible, but indications should be strictly followed.

AIM: To study the relationship between the disturbance of nitric oxide/endothelin-1(NO/ET-1) and hepatic ischemia/reperfusion(I/R) injury as well as the regulation of NO/ET-1 system by hepatic ischemic preconditioning(IPC). METHODS: The changes of NO/ET-1 system and their relationship with hepatic I/R injury were compared between I/R group and IPC+I/R group in a rat hepatic I/R model. Two hours after reperfusion, the liver tissues were detected by RT-PCR to see whether there was inducible nitric oxide synthase (iNOS) mRNA expression. RESULTS:In the acute phase of hepatic reperfusion, the ratio of NO/ET-1 was reduced, which was due to a significant reduction of NO - 2/NO - 3 (the metabolic product of NO) and significant elevation of ET-1 in the blood plasma. The content of ALT, AST, LDH and TNF-? in blood plasma, and of MDA in liver tissue were increased but ATP in liver tissue was reduced, the hepatic damage was deteriorated. The protection of the hepatic IPC was concerned with the elevation of the ratio of NO/ET-1 caused by the elevation of NO - 2/NO - 3, and reduction of ET-1 as well. There was no iNOS mRNA detected in the liver tissues.CONCLUSION: Hepatic I/R injury is related to the disturbance of NO/ET-1. The protection of the hepatic IPC in the acute phase might be conducted by its regulation of NO/ET-1 system. The cNOS rather than the iNOS generated the NO in this situation.

Aplastic anemia (AA) is a Tlymphocyte-mediated autoimmune disease. The research on AA was focused on three areas, which were the pathogenesis of immune dysfunction, hematopoietic stem cell damage and abnormal hematopoietic microenvironment. In recent years, more attentions have been paid on abnormal immune mechanisms in the blood. There are complex intracellular cytokine and signal transduction pathway of pathogenesis in AA. And T-bet/IFN-γ signaling pathway plays an important role in development and progression of AA. This article aimed to review T-bet/IFN-γ signaling pathways in AA.

Objective:To investigate the outcomes of applying microvascular anastomotic coupling de-vices in solitary upper extremity artery injury repairs and to optimize parameters for optimal clinical out-come.Methods:From March to September 2013,19 injured arteries from 18 male patients who presen-ted at Department of Hand Surgery,Beijing Jishuitan Hospital with traumatic arterial lacerations of their upper extremities went through rapid repair procedures.COUPLER,a microvascular anastomotic coupling device was applied in these artery injury repair operations.The 19 repaired arteries included 3 brachial arteries,6 ulnar arteries and 10 radial arteries.After the procedures,all the 18 patients were then fol-lowed up by clinical specialists and examined with color doppler flow imaging for the effective recovery of artery circulation and upper extremities functionality.Results:The average time of artery repairs for all the 19 damaged arteries among the 18 patients was 278 s and the average follow-up time was (71.5 ± 40.9)d with the longest follow-up time as 116 d and shortest as 14 d.No patient returned to the opera-ting room after the procedures and after being dismissed from the hospital.None of the 18 cases were re-ported to have problems with circulation and thrombosis formation in their upper extremities.Color Doppler imaging showed that the arterial anastomotic site for all the 19 repaired arteries were unobstructed with artery blood spectrum at both ends.Three patients with radial artery repairs complained about mild pressure pain at the site of vascular anastomosis;while the other 15 patients all expressed satisfactory outcomes of the surgery and recovery.These evidences indicated that the outcomes of our initial evalua-tion for the solitary upper extremity artery injury repairs by using anastomotic coupling devices were posi-tive.Conclusion:Our observations have showed that microvascular anastomotic coupling devices can be used for repairing of solitary upper extremity artery injures.The procedures are quick,effective and safe. The clinical application of this microvascular anastomotic coupling device in artery injures is promising, however,additional evidences through further clinical investigation with more cases are warranted.