Objective To explore and evaluate the method and feasibility of applying the contrast agent fluorescein sodium to enhance the efficiency of Cerenkov radiation energy transfer (CRET).Methods Fluorescein sodium was employed as the energy transfer receptor of 18 F-FDG Cerenkov radiation (CR) to achieve stronger signal.18F-FDG was mixed with fluorescein sodium of different concentrations:0.05,0.10,0.20,1.00,2.00,4.00,8.00 mmol/L.Optical signal strength was quantified by ROI analysis.The influence of fluorescein sodium concentration on CRET efficiency and the optimal concentration that could achieve most optical signal augmentation were studied.The optimal concentration of fluorescein sodium was mixed with 1.85-11.10 MBq 18F-FDG for CLI.Linear regression was performed to investigate the range of 18F-FDG dose with most optical signal augmentation and the influence of 18F-FDG dose on CRET efficiency.A tumorbearing nude mouse was imaged after intravenous injection of 18F-FDG and then imaged again after injection of fluorescein sodium post 18 F-FDG injection.These two sets of images were compared to evaluate the CRET efficiency in vivo.Results In vitro study showed that 1.00 mmol/L fluorescein sodium was the optimal concentration for 18F-FDG dose ranging from 1.85 MBq to 11.10 MBq.The signal from 18F-FDG mixed with fluorescein sodium was 3.7 times stronger than that from 18F-FDG alone.Experiment in vivo suggested that 18F-FDG mixed with fluorescein sodium could effectively enhance the signal strength by CRET.Conclusion 18F-FDG mixed with fluorescein sodium may improve the efficiency of CRET,therefore,can enhance the signal strength,reduce the exposure time and achieve better signal to noise ratio.

Objective To approch the characteristic of diagnosis and treatment of optic nerve injury in double wall optic canal.Methods Six patients,with double wall optic canal found by CT,were treated by drug,operation and visual rehabilitation training.The results of CT,vision-evoked potential and visual recovery were analysed.Results In 6 patients,4 were holo-double wall optic canal and 2 were mero-double wall optic canal,4 were found having bone fracture.All the 6 cases were effective to treatment including 3 patients whose vision was over 0.1.Conclusion In double wall optic canal,the degree of optic nerve injury is slight,visual recovery is better by drug,operation and visual rehabilitation training.

OBJECTIVETo elucidate how chronic prostatitis affects the expression and activity of the plasminogen activator (PA) system and relates to male infertility.

METHODSTwenty-three normal fertile males and 80 chronic prostatitis patients (40 fertile and 40 infertile) were included in this research. SDS polyacrylamide gel electrophoresis and fibrin overlay method were used to estimate the total PA, and tissue PA (tPA), urokinase type PA (uPA) in semen.

RESULTSTotal PA, tPA and uPA highly expressed in normal males, but decreased in the semen of the chronic prostatitis patients of both the fertile and infertile groups. However, there was no significant difference in total PA between the fertile and infertile patients.

CONCLUSIONChronic prostatitis reduces the secretory function and PA synthesis and secretion of the prostate, but the decrease of PA alone does not cause infertility. PA may be one of the tools for estimating the function of the prostate.

Adult ; Case-Control Studies ; Chronic Disease ; Humans ; Infertility, Male ; metabolism ; Male ; Prostatitis ; metabolism ; Semen ; metabolism ; Tissue Plasminogen Activator ; biosynthesis ; Urokinase-Type Plasminogen Activator ; biosynthesis

Objective To evaluate the endoscopic features and treatment of gastrointestinal carciholds. Methods Data of 44 patients diagnosed as gastrointestinal carcinoid from 2002 to 2009, including clinical manifestation, endoscopic findings, treatment and follow-up, were analyzed retrospectively. Results Most common presentations were abdominal pain and changes in bowel habits, while some patients (n = 7 ) did not have any symptoms. Most lesions were elevated submucosal ones with normal mucosal pit pattern of type Ⅰ . Larger lesions appeared as polyps with mucosal pit pattern of type Ⅲ and 1 malignant carcinoid as type Ⅴ. Endoscopic ultrasonography were performed in 29 patients and all lesions were presented as submucosal hypoechoic masses with distinct borders. Endoscopic fulguration with high frequency current was applied in 12 patients and endoscopic mucosal resection (EMR) in 32. One patient with malignant carcinoid accepted multiple EMRs and died from lung and liver metastasis 6 months after last procedure. No recurrence was observed in other 43 patients during the follow-up visit of 3 months to 5 years. Conclusion Gastrointestinal carcinoid is lack of specific symptoms, and the diagnosis is made by endoscopic and pathologic findings.

Objective To study the characteristics of heterotopic pancreas (HP) in upper gastrointestinal tract (UGIT) under endoscopy and endoscopic sonography ( EUS), and its endoscopic managements. Methods Data of 67 patients with pathologically confirmed HP in our hospital from March 2004 to November 2009, including clinical and endoscopic manifestations and sequelae after endoscopic resection,were retrospectively studied. Results Heterotopic pancreas were most commonly found as a single lesion in gastric antrum (62/67, 92. 5% ) and in gastric angle and duodenum as well, which were characterized by protrusion, with intact mucous membrane and centrally umbilicated. Of the 67 patients, 59 underwent EUS before endoscopic resection. Findings were heterogeneous and mixed echogenic lesions with indistinct borders involving both the second and third layers of the gastrointestinal wall, sometimes even involving the first and fourth layers. Most lesions (n =60) were removed by endoscopic mucosal resection (EMR), with basal residues in 25 cases, in which fourth layer involvement was observed in 23 cases (92. 0% ). Delayed bleeding occurred in 1 case at 3rd day after the procedure, and no other complications were observed. Complete removal was achieved in 8 cases ( including one receiving EMR previously ) with endoscopic submucosal dissection (ESD) , and there was no such severe complications as perforation. Postoperative pathological examinations revealed that the consistent rate of preoperative diagnosis with EUS was 91.5% (54/59). Conclusion Endoscopy combined with EUS is critical in diagnosis of HP in UGIT. EMR, especially with cap assistance, is the best method for those without involvement of muscularis propria, while ESD or endoscopic surveillance is a better alternative for those with 4th layer involvement.

Objective:To compare the recurrence of common bile duct stones (CBDS) in patients with gallstones and concurrent CBDS treated by two surgical approaches: synchronous laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) (LC+LCBDE) and synchronous LC combined with intraoperative endoscopic sphincterotomy (IO-EST) (LC+IO-EST).Methods:From Apr 2013 to Apr 2020, the clinical data of 903 patients with gallstones with CBDS who were admitted to the Clinical Medical College, Yangzhou University were retrospectively analyzed.Results:Based on the chosen surgical method, we categorized 389 cases into group A (LC+LCBDE) and 514 cases into group B (LC+IO-EST). Our findings revealed that group A had a significantly lower rate of CBDS recurrence and re-recurrent CBDS compared to group B (4.4% vs. 8.4%, P=0.024; 0.8% vs. 3.1%, P=0.010). Moreover, Logistic regression analysis after inverse probability of treatment weighting, revealed that the surgical approach implemented in group A was an independent protective factor of recurrent CBDS and second recurrence of CBDS ( OR=0.482, 95% CI: 0.365-0.637, P<0.001; OR=0.118, 95% CI:0.080-0.173, P<0.001). Conclusion:LC+LCBDE is an optimal treatment option to LC+IO-EST for patients with gallstones combined with CBDS and common bile duct ≥8 mm.

Objective: To summarize and discuss the clinical effect of Shiquan Dabu Decoction combined with nitroglycerin in the treatment of heart failure after acute myocardial infarction. Methods: From January 2016 to June 2017, 110 patients with heart failure after acute myocardial infarction admitted to the Department of Cardiology of Lishui Hospital of Traditional Chinese Medicine were selected as study objects.The patients were randomly divided into observation group and control group according to the digital table, with 55 cases in each group.The control group was treated with routine nitroglycerin therapy, while the observation group was treated with routine nitroglycerin therapy combined with Shiquan Dabu Decoction.The therapeutic effect of the two groups after one week of treatment was observed. Results: The total effective rate in the observation group was 92.73%, which was significantly higher than that of the control group(78.18%), and the difference between the two groups was statistically significant(χ²=4.681, P<0.05). The HR level of the observation group[(82.5±6.5)times/min] was significantly lower than that of the control group[(102.6±3.9)times/min](t=19.655, P<0.01). The levels of SBP[(116.5±6.4)mmHg]and SpO₂[(95.2±1.6)%] in the observation group were significantly higher than those in the control group[(108.8±5.2)mmHg, (92.5±1.2)%], there were statistically significant differences between the two groups(t=6.925, 10.012, all P<0.01). The incidence of adverse reaction in the observation group was 10.91%, which was higher than that in the control group(3.64%), but there was no statistically significant difference (χ²=2.157, P>0.05). Conclusion For patients with heart failure after acute myocardial infarction, the combination of traditional Chinese medicine Shiquan Dabu Decoction in clinical routine treatment has better effect and is worthy of popularizing.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

【Objective】 To discuss the early clinical effect of percutaneous pedicle screw fixation combined with oblique lateral interbody fusion（OLIF） of 3D printed lateral fusion cage for lumbar spondylolisthesis. 【Methods】 Total 21 patients with lumbar spondylolisthesis were enrolled in our study during September 2018 to August 2020. All the patients were treated with percutaneous pedicle screw fixation combined with OLIF of 3D printed lateral fusion cage. The time of operation， blood loss and complications were recorded. Clinical symptoms including low back pain and leg pain were evaluated using a visual analog scale （VAS）， the Oswestry disability index （ODI）， and the MOS item short from health survey （SF-36） before，1 week， and 6 months after surgery. CT and MRI images were evaluated before， 1 week， and 6 months after surgery. Disk height， interforaminal height， degree of upper vertebral slip and intervertebral fusion were evaluated with CT. Sagittal and axial diameters and cross-sectional areas of the spinal canal were evaluated with MRI. 【Results】 The average operation time of all the patients was （110.0±22.8） min， and the average intraoperative blood loss was （56.8±21.6） mL. All the patients were followed up 6 months after operation. The VAS score of lower back pain， VAS score of leg pain and ODI decreased from （6.8±1.6）， （5.6±1.8） and （57.6±13.4）% to （1.5±1.0）， （1.5±0.9） and （13.1±5.2）%， respectively. The differences were statistically significant （P<0.001）. The PCS and MCS scores of SF-36 increased statistically significantly from （27.3±11.8） and （52.4±14.6） before operation to （57.6±10.5） and （76.1±12.0） at follow-up， respectively （P<0.001）. Six months after operation， the height of intervertebral space， the height of intervertebral foramen， the percentage of slip， the sagittal diameter and axial diameter， and cross-sectional area of spinal canal were significantly different from those before operation （P<0.001）. Six months after operation， the fusion rate of the upper and lower interfaces of the 3D printed interbody fusion cage was 100%. There were no serious complications such as nerve or vascular injury after operation. 【Conclusion】 Posterior minimally invasive pedicle screw reduction and fixation technique combined with oblique lateral approach implantation of 3D printing lateral fusion cage in the treatment of lumbar spondylolisthesis has satisfactory early clinical results. This technique can provide a new choice for minimally invasive treatment of lumbar spondylolisthesis.