Objective To study the correlation of the bone mineral density (BMD) and the body composition components of body mass index (BMI), FAT and LEAN in Chinese obesity. Methods There were 150 cases in obesity group diagnosed by BMI, including 75 males[ median age 46 years, mean weight (89. 64±8. 33) kg] and 75 females[ median age 45 years, mean weight (77.23±6. 85) kg]. There were 150 persons with normal BMI in the control group, including 75 males [ ( median age 47 years, mean weight (62. 34±5.72) kg] and 75 females [ median age 45 years, mean weight (50. 16±5.06) kg]. The body height and weight of 300 persons in two groups were measured respectively and, simultaneously calculated the BMI. These data and the body composition parameters measured by the dual energy X-ray absorptiometry (DEXA) in these two groups were compared and analyzed. The data obtained used two-sample t-test analysis, bi-variable correlation used Pearson linear correlation analysis and multi-variable correlation used multiple linear regression analysis. Results FAT of arms, legs, trunk and total body of male cases in obesity group was (2.90±0.57), (7.48±1.46), ( 15.67±3.05 ), ( 30.92±5.94 ) kg respectively, FAT% was ( 30.9±5.1 ) %, ( 30.6±5.8 ) %, ( 37. 3±4.7 ) %, ( 35.1±4.4 ) % respectively, it was significantly higher than that in control group [ FAT was ( 1.12±0. 64 ), (3.27±1.22), (6. 71±3. 29 ), ( 11.61± 5. 16) kg respectively,FAT% was( 15.4±4. 8)%, ( 16. 5±5.0)%, (21.8±5.8)%, ( 18.6±5. 3)% respectively] ,P <0. 01 ;LEAN of trunk and total body of male cases in obesity group was (27.65±4. 08), (57. 09±7.08 ) kg respectively ; BMD was ( 0. 99±0. 09 ), ( 1.22±0. 09 ) g/cm2 respectively, it was significantly higher than that in control group [ LEAN was ( 22. 89±1.68 ), (48.89 s 3.72 ) kg respectively, BMD was( 0. 89±0. 07 ), ( 1.15±0. 06 ) g/em2 respectively ], P < 0. 01 ; LEAN of arms and legs of male cases in obesity group was(6.22±0.92), (17.31±2.65) kg respectively; BMD was(0.92±0. 04), (1.31±0. 09)g/cm2 respectively,and there were no statistical significance compared with those in control group [ LEAN was ( 5.99±0. 72 ), ( 16. 83±1.67 ) kg respectively, BMD was ( 0. 90±0. 08 ), ( 1.29± 0.09) g/cm2 respectively]. FAT of arms, legs, trunk and total body of females in obesity group was (3.78±1.53), ( 12. 61±3.72), ( 17. 56±2. 59), (33.71±6. 96) kg respectively, FAT% was (33.8± 4.0)%,(40. 1±6.9)%,(43.9±4.9)%, (43.5±4.2)% respectively, LEAN was(7.28±0.94), ( 14. 40 ±2. 05 ), ( 20. 71±3.08 ), ( 43.43±5.69 ) kg respectively, BMD was ( 0. 86±0. 08 ), ( 1.27± 0. 12),(0.95±0. 14), (1.19±0.09)g/cm2 respectively, they were significantly higher than those in control group [ FAT was(2. 04±0. 79), (3.79±0. 94), (6. 89±2. 56), ( 14. 68±3.57) kg respectively, FAT% was (27. 2±4. 5 ) %, ( 29. 6±3.9 ) %, ( 31.0±3.8 ) %, ( 25.9±4. 9 ) % respectively, LEAN was (5. 25±0. 63), ( 10. 65±1.44), ( 16. 65±1.50), (33. 10±3.22) kg respectively, BMD was (0. 78± 0. 04), ( 1.11±0. 09), ( 0. 82±0. 07 ), ( 1.05±0. 07 ) g/cm2 respectively ], P < 0. 01. Conclusion The significantly increasing of fat tissue in all parts of body is a major cause of change of body composition components in obesity. FAT in the trunk increases more obviously than that in other parts of the body in both males and females. The change of distribution of FAT and LEAN can obviously influence BMD.

Objective To investigate the clinicopathologic features and prognostic analysis of intrahepatic mucinous cholangiocarcinoma (IMCC) and intrahepatic cholangiocarcinoma (ICC).Methods The retrospective cohort study was adopted.The clinicopathological data of 20 patients with IMCC and 51 patients with ICC who were admitted to the Fujian Provincial Hospital from March 2003 to March 2014 were collected.The observation indicators included (1) clinicopathologic features:gender,age,clinical symptoms (fever,jaundice,abdominal pain and peritoneal effusion),preoperative laboratory examination [alanine transaminase (ALT),aspartate transaminase (AST),direct bilirubin (DBil),carcinoembryonic antigen (CEA),CA19-9 and alphafetoprotein (AFP)],operation methods (radical resection,palliative resection) and pathological features (tumor location,lymph node metastasis,vascular invasion and pathological stage).(2) The follow-up of outpatient examination and telephone interview was performed to detect the survival of patients up to March 2015.Measurement data with normal distribution were represented as x-± s and comparison between groups was analyzed using t test.Count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.Result The numbers of patients with fever,jaundice,elevated level of AST and DBil,lymph node metastasis,vascular invasion and numbers of patients with stage 0,Ⅰ,Ⅱ,Ⅲ,Ⅳ were 13,11,10,11,3,1 and4,6,2,6,2 with IMCC,12,10,9,2,22,36 and 0,14,5,3,29 with ICC,respectively,showing statistically significant differences in the above indicators (x2=10.830,8.639,7.672,25.059,8.036,24.765,26.601,P ＜ 0.05).All the patients were followed up for a median time of 14 months (range,1-118 months).The survival time and 1-,3-,5-year survival rates were (55 ± 8)months,94.4％,44.0％,16.7％ in 20 patients with IMCC and (30 ±6) months,36.5％,12.5％,4.0％ in 51 patients with ICC,respectively,showing a statistically significant difference (x2 =8.126,P ＜ 0.05).Conclusion The patients with MICC are more easily complicated with fever,jaundice and liver dysfunction,while they have less lymph node metastasis and vascular invasion,earlier pathological stage and better prognosis compared with patients with ICC.

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.

Objective To analyze the sensitivity of auxiliary examinations in different periods of sporadic Creutzfeldt-Jakob disease (sCJD).Methods The clinical data of 53 sCJD patients were retrospectively analyzed including the different stages of skull diffusion-weighted magnetic resonance imaging (DWI),24-hour ambulatory electroencephalogram (EEG),18F-FDG PET/CT (PET-CT)and cerebrospinal fluid 14-3-3 protein.When calculating the sensitivity of an auxiliary examination,the diagnostic criteria were defined by combining the specific clinical manifestations with two or more positive results of other auxiliary examinations.Results There were 24,53 and 22 sCJD patients,respectively,met the criterion of early (E),middle (M) and later (L) stage of disease (some patients fit 2 or 3 stages).The sensitivity ofDWl (E:58.3％ M:85.4％,L:94.7％),EEG (E:45.8％,M:62.7％,L:77.8％),14-3-3 protein in cerebrospinal fluid (E:11.1％,M:52.9％) and PET-CT (E:80％,M:100％) increased gradually with disease progression,The sensitivity of PET-CT was higher than the other auxiliary examinations for E and M stages;no PET-CT was conducted in L stage.High signal regions mainly distributed in the cortex in E and M stages,but in L stage,no significant difference was found on the distribution of high signal regions between cortex and basal ganglia.Conclusions The sensitivities of the auxiliary examinations were different for sCJD patients in different stages.Reexaminations in different periods may improve the sensitivity for sCJD diagnosis.The sensitivity of PET-CT was high,and the combination of PET-CT and other auxiliary examinations may play a key role in the diagnosis of sCJD.

BACKGROUND: Studies indicated that lipid peroxidation due to increase of free radical is the key factor of ischemia/reperfusion injury.Shinyleaf pricklyash root extracts, rutaceae plant, is bitter in taste, no stimulation, which has the effects of promoting qi, relieving pain, promoting blood circulation by removing blood stasis, dispelling wind and dredging collaterals and antioxidation.OBJECTIVE: To observe the influence of nitidine chloride on myocardial ischemia/reperfusion injury in rats and analyze its mechanism.DESIGN: Randomized controlled study.SETTING: Departmentof Pharmacology and Department of Chemistry,Guangxi Medical University.MATERIALS: A total of 60 healthy Wistar rats were selected, half male and half female, with the body mass of 250-300 g. Nitidine chloride was provided by Department of Chemistry, Guangxi Medical University, batch number 20050609. MS4000U biological signal quantitative record analysis system, 722N evident spectrophotometer, hydrochloric acid verapamil (batch number 020701, 2 mL in each), malondialdehyde (MDA) and superoxide dismutase (SOD) kit were purchased from Guangzhou Longfeida Technology Co., Ltd., Shanghai Precision Scientific Instruments Corporation, Shanghai Harvest Pharmaceutical Co, Ltd. and Nanjing Jiancheng Bioengineering Institute, respectively. Hitachi 7170A full automatic biochemistry analyzer was also applied.METHODS: The experiment was performed at the Department of Pharmacology and Department of Chemistry, Guangxi Medical University between June 2004 and May 2006. ①Totally 60 healthy Wistar rats with normal ECG (half male and half female) were randomly divided into 6 groups:sham operation group, model group, 2, 1, 0.5 mg/kg nitidine chloride groups, positive control group with 10 rats in each group. The rats in the sham operation group received threading without deligation, and 90 minutes later the experiment was accomplished. Other 50 rats received left anterior descending branch of coronary artery deligation, ischemia for 30 minutes reperfusion for 60 minutes. 2 mg/kg verapamil, 2,1,0.5 mg/kg, 5 mL/kgnitidine chloride, saline of the same volume were injected into femoral vein in rats of the positive control group, different doses nitidine chloride groups and model group, respectively 10 minutes before deligating left anterior descending branch of coronary artery. ②Monitoring was conducted successively with standard limb Ⅱ lead ECG when performing reperfusion. Type,incidence rate and duration of cardiac arrhythmia were recorded within 60minutes. Change of ST segment was also recorded after reperfusion for 15minutes and 60 minutes. ③At the end of experiment, serum myocardial enzymology indexes were measured wi th full automatic biochemistry analyzer.MDA content and SOD activity in myocardial tissues were examined with thiobarbituric acid(TBA) method and xanthine oxidase (XOD) method, respectively. ④Measurement data and enumeration data between two groups were compared with t test and x2 test. MAIN OUTCOME MEASURES: Occurrence of cardiac arrhythmia, ECG ST segment elevation, change of serum myocardial enzymology indexes, MDA content and SOD activity of myocardial tissues in rats of each group.RESULTS: A total of 60 rats were involved in the result analysis. ①Degree of cardiac arrhythmia and ECG ST segment elevation of rats: The emergency time of cardiac arrhythmia in 1 and 2 mg/kg nitidine chloride groups was significantly later than that in the model group (P ＜ 0.05,0.01). The duration of cardiac arrhythmia in the 1 and 2 mg/kg nitidine chloride groups and positive control group was obviously shorter than that in the model group (P ＜ 0.05-0.01). The incidence rates of various kinds of cardiac arrhythmia were markedly less than those in the model group (P ＜ 0.01). The degree of ST segment elevation at reperfusion for 15 and 60 minutes was remarkably lower than that in the model group (P ＜ 0.05-0.01). ②Serum myocardial enzyme level: It was significantly higher in the model than the sham operation group after 60-minute myocardial ischemia and reperfusion (P?.01). Activity of myocardial enzyme in the 1 and 2 mg/kg nitidine chloride groups was remarkably lower than that in the model group (P ＜ 0.01,P ＜ 0.05). The level of myocardial enzyme decreased with the increase of nitidine chloride. It was lower significantly in the positive control group than the model group (P ＜ 0.05-0.01 ). ③SOD activity of myocardial tissues: It was markedly lower in the model group than the sham operation group after 60-minute myocardialischemia and reperfusion (P ＜ 0.01); It was dramatically higher than in the 1 and 2 mg/kg nitidine chloride groups than the model group (P ＜ 0.01). The activity also increased with the increase of nitidine chloride. ④MDA content of myocardial tissues: It was distinctly higher in the model group than the sham operation group after myocardial ischemia reperftsion for 60 minutes (P ＜ 0.01). It was remarkably lower in the 1 and 2 mg/kg nitidine chloride groups than the model group (P ＜ 0.01). The content decreased with the increase of nitidine chloride. It was obviously lower in the positive control group than the model group (P ＜ 0.05 ).CONCLUSION: ①1 and 2 mg/kg nitidine chloride can reduce the incidence rate of cardiac arrhythmia in rats with myocardial ischemia and reperfusion, postpone the emergence time of cardiac arrhythmia and shorten its duration, decrease the degree of ST segment elevation after reperfusion for 15 minutes and 60 minutes, which have similar effect with verapamil.② 1 and 2 mg/kg nitidine chloride can reduce the release of myocardial enzyme, relieve the severity of oxygen-derived free radicals injury, and has the effect of protecting myocardial injury during ischemia-reperfusion, in which represents a dose-dependent effect.

BACKGROUND: Posterior lumbar non-fusion devices have been developed to control vertebral column movement, change load pattern of instability segment, restrict abnormal action, as well as avoid adjacent segment degeneration.OBJECTIVE: To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar vertebrae instability.METHODS: Ten cases suffering from lumbar instability were selected, including 3 males and 7 females, aged 43-65 years. One patient sustained L_(1/2) and L_(4/5) segmental instability, one was L_(2/3) and another was L_(3/4), and the others were L_(4/5). Two patients complicated with lumbar disc herniation and 7 patients combined with lumbar spinal stenosis at the same affected segment, and 3 patients associated with lumbar spinal stenosis at adjacent segment. All unstable segments were treated with decompression, posterior implantation of Wallis dynamic stabilization system. Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores for low back pain and Oswestry disability index (ODI) were used to evaluate clinical outcomes. In addition, therange of motion (ROM) at the instrumented segment and adjacent segments and posterior disc height (PDH) in standing and extension position at L_(4/5) segment were also measured.RESULTS AND CONCLUSION: All the patients were followed-up for 2-13 months, mean 9.2 months. The mean operation duration was 128 minutes (90-185 minutes), with bleeding volume of 264 Ml (50-600 Ml). Sings and symptoms of all patients were improved significantly after operation, except one patient with recurrence of L_(4/5) lumbar spinal stenosis at 3 month after surgery, whose symptoms relieved by revision with fenestration and decompression. The postoperative VAS was dramatically decreased than that of preoperation (P=0.003); the JOA score was obviously increased (P=0.002), and the ODI score was decreased (p=0.008). The postoperative range of motion decreased significantly (P<0.05). However, there was no obviously difference between preoperative and postoperative L_(3/4), L_5/S_1 and posterior disc height (P>0.05). Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.

Objective To investigate the diagnosis and treatment of liver tumor in children. Methods Among 23 cases,21 cases underwent resection. Results Benign tumors were in 10 cases and malignant tumors in 11 cases. AH patients were followed up for 0. 5 - 3 years. Two cases died during the follow-up. Three year survival rate in benign tumor was 100% ( 10/10) and 82% (9/11 ) in malignant tumor. Conclusions Most malignant liver tumors were embryonal in children. Combination therapy of surgery and chemotherapy improves the prognosis. Prognosis of benign tumors after total resection is satisfactory.

10.3969/j.issn.1000-8179.2013.12.010

Objective To study the correlation of multi-slice CT portography (MSCTP) and digestive endoscopy in the diagnosis and evaluation of esophageal and gastric varices (EGV) caused by cirrhosis.Methods A total of 92 patients with cirrhosis were enrolled in the prospective study.All the patients were examined by endoscopy and 64-slice spiral CT scan in 4 weeks.The types,grading of EGV were observed by endoscopy and MSCTP,and Kappa conformance test was applied with the endoscopic findings as gold standard.The sensitivity,specificity,consistency,and Youden index were evaluated for the diagnosis of sophageal and gastric varices by MSCTP.Results Sixty-five patients were diagnosed to have EGV by endoscopy and 27 were negative.The positive patients included 45 patients of GOV1,19 of GOV2 and 1 patient of IGV1.MSCTP diagnosed 67 cases of EGV and 25 patients of negative results.The positive patients included 46 of GOV1,18 of GOV2 and 3 of IGV1.Two patients of IGV1 varicose veins without positive findings on endoscopy were diagnosed by using MDCTP,which revealed isolated varicose veins under the gastric mucosa.There was high consistency between MSCTP and EGV in the diagnosis of EGV (Kappa =0.732,P ＜ 0.01).The sensitivity of MSCTP was 93.8％,specificity was 77.8％,consistency was 89.1％,and Youden index 71.6％.There was high consistency between MSCTP and EGV in the classification of EGV (Kappa values were 0.743 and 0.763,P ＜ 0.01).Conclusions There is high consistency between MSCTP and digestive endoscopic in the diagnosis and classification of EGV in cirrhosis.MSCTP is superior to endoscopy in the detection of gastric varices.

Objective To investigate MRI manifestations of lumbar and proximal femoral bone marrow changes before and after recombinant human granulocyte colony stimulating factor (rhG-CSF) was subcutaneous injected for healthy adults.Methods Twenty healthy blood stem cell donors without hematologic disease were enrolled in this study. All of them underwent lumbar sagittal and proximal femur coronal MRI examination with spin echo T1 WI and fat-suppressed T2WI.The first examination were performed before subcutaneous injection of rhG-CSF for comparison. In 4-7 days and 30-60 days after injection, the other two examinations were performed. The signal changes of lumbar and proximal femoral bone marrow were investigated by reading pictures and calculating the contrasted noise ratio (CNR).ResultsBefore rhG-CSF injection, all patients presented normal signal intensity of hone marrow. In 4-7 days after injection, all the 20 cases presented homogeneous signal decrease in lumbar vertebral bodys on T1 WI, accompanied by reduced fatty signal. In proximal femur, patchy or stripped hypointensity areas were found in intertrochanteric and subtrochanteric areas on T1 WI. On fat-suppressed T2 WI images, the signal of lumbar and proximal femoral bone marrow changed to equal or slightly-high signal intensity. In all cases,abnormal signal areas presented in lumbar and proximal femoral bone marrow occurred simultaneously in the same case.In the 10 cases received the third MRI during 30-60 days after rhG-CSF injection, signal intensity of lumbar bone marrow turned to normal in all sequence, but abnormal signal intensity areas were still existed and extended to distal part in femoral bone marrow, which appeared as symmetric stripped or patchy equal or slightly-low signal intensity on T1 WI and equal or slightly-high signal intensity on T2 WI. The CNR of lumbar bone marrow to subcutaneous fat before rhG-CSF injection, in 4-7 days and 30-60 days after rhG-CSF injection were 114. 11 ± 15. 11,71.04 ± 12. 25 and 91.64 ± 1 I. 68, respectively. Significant difference was found between before rhG-CSF injection and 4-7 days after injection ( P ＜ 0. 05 ) , but no significant difference between the others( P ＞ 0. 05 ). Conclusion After injection of rhG-CSF, the short-term changes of hematopoietic cells and fat content in bone marrow can be displayed on MRI, which provided non-invasive information for bone marrow transplantation.