Objective: To observe the effectiveness of combinative use of gentamycin, metronidazole and rifampin in the treatment of ulcerative colonitis and explore the etiology of the disease.　Methods: 30 and 26 patients were allocated to treatment group and control group, respectively. Maintained clysis with a combination of gentamycin, metronidazole and rifampin in warm normal saline were administered to those in the treatment group twice a day for two weeks, while SASP and prednisone were administered to those in the control group for two weeks.　Results: The alleviation rate of the treatment group is higher than that of the control group.　Conclusion: Combinative use of gentamycin, metronidazole and rifampin for maintained clysis is a effective treatment for ulcerative colonitis.

The effects on frozen-thawed sperm survival rate of 16 different cryoprotective media containing different ratio of glycerol (0%, 2.5%, 5% and 7%) and sucrose (0,25,50 and 100 mmol/L) were compared. The results showed that glycerol-sucrose cryoprotective media had better effect on cryoprotection of spermatozoa than that of traditional glycerol protective medium, and appropriately increasing the concentration of sucrose and decreasing the concentration of glycerol could improve sperm motility, and especially benefit to preserve sperm linear motility at 12h postthawed. Using 5% glycerol combined with 50 mmol/L sucrose as cryoprotective medium, the sperm survival rate at 0, 6, 12h postthawed was 85.38%, 51.22%, 33.38%, respectively, the linear moving sperm survival rate was 83.74%, 33.33%, 18.38% respectively.

Objective:To explore the effect of total parenteral nutrition and combined resection of involved organs on gastric cancer. Methods: The clinical data of 67 patients with advanced gastric cancer who had accepted total parenteral nutrition(TPN)and combined resection of involved organs between June,2001 and November,2006 were reviewed and compared with no TPN patients. Results: Combined resection organs included spleen and pancreas tail(19 cases), spleen(12 cases), gallbladder(8 cases), transverse colon(7 cases), etc. No patient died in hospital in both TNP group and no TNP group. Compared with the control group, the levels of blood transferrin, albumin, and natural killer cells increased in TPN group in 7 days after operation (P

Objective:To evaluate the value of ultrasound Doppler renal blood flow measurement in diagnosing early renal damage of hypertension. Methods:Eighty patients with hypertension and 20 normotensive subjects were included in this study. They were classified into four groups according to blood or urine β2-MG contents and urinary albumin excretion rate(UAER). All patients were measured by ultrasound Doppler renal blood flow. Correlation analysis was performed between β2-MG or UAER and the parameters of renal blood flow measurement. Results:(1)Peak velocity in systole(Vs)、end diastolic velocity(Vd) decreased and pulsed index(PI)、resistance index(RI) of segmental and interlobar artery increased in all hypertensives with early renal damage. PI of interlobar artery more than 1.00 and/or RI more than 0.60 is associated with early renal damage in hypertensives;(2)Hypertensives with diabetes and early renal damage have higher Vs and lower Vd and significant increased RI、PI. Compared with hypertensives with early renal damage，hypertensives with diabetes had more serious renal damage at the equivalent DBP level. Conclusion:Ultrasound Doppler renal blood flow measurement may be clinically useful in the noninvasive evaluation of early renal damage of hypertension.

Objective To explore the correlation between the expression of hypoxia-inducihle factor-1α (HIF-1α) in the tissue of gastric cancer and the recurrence of gastric cancer after surgery.Methods A total of sixty patients with gastric cancer who received curative gastrectomy with complete follow-up data and recurrence after the surgery were taken as recurrence group.At same period,48 patients with gastric cancer treated and followed up for five years without recurrence were set as control group.The expressions of HIF-1α,CD34 and vascular endothelial growth factor (VEGF) in the gastric tissue section of recurrence group and control group were detected by immunohistochemistry streptavidin-peroxidase (S-P) staining.Chi-square test and Spearman correlation analysis were performed for the correlation analysis between the positive rates of HIF-1α and clinical pathological features.Kaplan-Meier method and Log-rank test were used for the analysis of survival condition in recurrence group.The independent prognostic factors of gastric cancer were analyzed by univariate analysis and Cox regression model.Results In recurrence group,the positive rate of HIF-1α expression was higher in cases with higher degree of gastric cancer differentiation,deeper invasion,lymph node metastasis,ascites,vascular invasion,lower TNM-stage and positive expression of VEGF.The differences were statistically significant (x2 =4.781,6.591,6.567,5.138,5.320,5.881 and 7.365,all P＜0.05).The positive rate of HIF-1α expression of recurrence group was correlated with the positive expression of VEGF and microvascular density (MVD) (r=0.350 and 0.317,both P＜0.05).The positive rate of HIF-1α expression of recurrence group (78.3％,47/60) was higher than that of control group (58.3 ％,28/48) and the difference was statistically significant (x2 =5.027,P＜0.05).The overall survival period of recurrence was nine months and one-year survival rate was 30.0％.Of which,the overall survival period and one-year survival rate of cases with negative HIF-1α expression were 18 months and 53.8％ and with positive expression were eight months and 21.3％.HIF-1α expression was independent prognostic factor of gastric cancer (OR =2.166,95％CI:1.183 to 3.965).Conclusions The expression of HIF-1α plays an important role in the angiogenesis of gastric cancer and is closely related with gastric cancer recurrence.Its expression can be considered as an indicator of gastric cancer recurrence and prognosis.

[Objective] To reduce misdiagnosis and underdiagnosis rate of pulmonary embolism,the prediction of the revised Geneva score and Wells score for pulmonary embolism were compared and analyzed by receiver operating characteristic curves.[Methods] Sixty-five cases with suspected pulmonary embolism (PE) were collected in the Third Affiliated Hospital of SUN Yat-sen University from January 1998 to October 2008.Of which 44 cases with PE were clinically confirmed.Relevant clinical data were recorded,summarized and the analysis variables were input to SPSS11.0 for statistical analysis.ROC curves was used to evaluate the probability of PE predicted by the Wells and the revised Geneva scores.[Results] Twenty-four patients had a low clinical probability of PE (Wells score ＜ 2 points ),of which 8 (33.3%) had proven PE.The prevalence of PE was 87.2% in the 39 patients with intermediate probability (2-6 points) and 100% in the 2 patients with high probability (＞ 6 points) (P ＝ 0.000).The confirmed PE was 22.2% in the 18 patients with a low probability (Geneva score 0-3 points),82.1% (32/39) in intermediate probability (4-10 points),100% (8/8) in high probability (score ≥11 points) (P ＝ 0.000).The area under curve (AUC) of the ROC curve in the Wells and Geneva scores was 0.785 ± 0.060 and 0.900 ± 0.038,respectively (P ＝ 0.000).The optimal cutoff value was 2 points in the Wells score and 6.5 points in the Geneva score.The Wells score more than 2 points predicted PE with a sensitivity of 81.8% and specificity of 76.2%.The Geneva score more than 6 points predicted PE with a sensitivity of 72.7% and specificity of 100%.The comparison of the area under curve between the Wells and the Geneva score had a significant difference statistically (P ＜ 0.05).[Conclusion] The Wells score and the revised Geneva score are beneficial to predict pulmonary embolism.The revised Geneva score is roughly superior to the Wells score both in sensitivity and specificity.

Objective To explore the value of gemstone spectral imaging (GSI)in quantitative evaluation of Lauren classification of gastric cancer.Methods Fifty-two patients with gastric cancer confirmed by gastroscopy underwent contrast-enhanced spectral CT imaging preoperatively.The monoergic and iodine-based images were obtained by GSI Viewer software,CT value and iodine concentration (IC)of the lesions were measured,and normalized iodine concentration (NIC)was calculated.With the reference of postoperative pathology,data were analyzed by LSD method of one-way analysis of variance.Results The IC,NIC,spectrum curve slope of 40-70 keV,40-140 keV and 70-140 keV energy range of intestinal type,mixed type and diffuse type carcinoma in the arterial phase were 12.86±6.80 (100 μg/mL),0.13±0.06 ,2.50±1.26 ,0.99±0.51 ,0.34±0.20 ,18.54±6.49 (100 μg/mL),0.19±0.07, 3.56±1.24,1.42±0.50,0.50±0.18 and 24.52±9.68 (100 μg/mL),0.24±0.09,4.73±1.76,1.90±0.73,0.68±0.29,respectively. The values of intestinal type were all significantly lower than those of diffuse type (P <0.05).Comparison between intestinal-mixed type and mixed-diffuse type,the other parameters were no significant differences except IC between intestinal-mixed type (P=0.037).Conclusion The slope of spectrum curve,iodine concentration,and normalized iodine concentration could be helpful for preoperative evaluation of Lauren classification of gastric cancer.

Objective:To evaluate efficacy and safety of multiple-dose tropisetron plus dexamethasone (DXM) versus palonosetron plus DXM for chemotherapy-induced nausea and vomiting. (CINV) in patients received multiple day-based highly emetogenic chemotherapy. Methods:Cancer patients who were receiving multiday-based highly emetogenic chemotherapy were randomly assigned to AB or BA groups. A randomized, cross self-control ed method was applied. Patients in AB group received palonosetron (0.25 mg) 30 min before chemotherapy on day 1 and 3 or additional day 5 in the first cycle;and with tropisetron (5 mg) 30 min before chemotherapy on day 1, 2, and 3, or sup-plementary days (day 4 and 5) in the second cycle. Patients in BA group were treated with tropisetron in the first cycle and with palonosetron in the second cycle. Tropisetron and palonosetron were administered with DXM (10 mg) on day 1, followed by additional doses (5 mg) on days 2 to 5. Palonosetron group comprised patients in the AB group in the first cycle and BA group in the second cycle, whereas tropisetron group included patients in the AB group in the second cycle and BA group in the first cycle. Efficacy and safety of tropisetron versus palonosetron in preventing CINV were evaluated. Results:Ninety-one patients were included in analyses. At day 3, 4, and 5, incidence rates of nausea in the palonosetron group reached 28.6%, 30.8%, and 24.2%, respectively, and those of the tropisetron group totaled 42.8%, 47.3%, and 39.6%, respectively (P<0.05). At day 4, 5, and 6, incidence rates of vomiting in the palonosetron group measured 28.6%, 18.7%, and 5.5%, respectively, and those of the tropisetron group reached 42.9%, 34.1%, and 14.3%, respectively (P<0.05). From day 4 to day 5, day 6 to day 7, and day 1 to day 7, the palonosetron group yielded significantly lower incidence rates of nausea and vomiting than tropisetron group (P<0.05). Rate of rescue treatment in the palonosetron group was lower than that in tropisetron group (13.2%vs. 24.2%, P=0.057). No statistical difference in toxicities was observed between the two groups. Conclusion:Palonosetron plus DXM features better efficacy than that of tropisetron plus DXM against delayed CINV induced by multiple day-based highly emetogenic chemotherapy, which was well tolerated in the two treatments.

In recent years,mechanical thrombectomy has been the most important research progress in the treatment of acute cerebral infarction,especially the positive results of five endovascular therapy studies in 2015 has rewritten its clinical guidelines.However,the focus of these studies was mainly on the small vessel infarction(SVI),and the inclusion criteria of these studies include the following aspects:ASPECTS ≥6 points,Alberta Stroke Program Early CT Score within 6 hours after stroke onset,the infarct volume＜70 mL within 6-24 hours after stroke onset,and the presence of image mismatch or the presence of mismatch between clinical condition and perfusion imaging.The above studies excluded patients with ASPECTS＜6 points or infarct volume ≥70 mL of large core infarction(LCI).With the continuous progress of the endovascular treatment of acute ischemic stroke(AIS),the mechanical thrombectomy therapy strategy has crossed from the"time window"to the"tissue window",meanwhile,the therapeutic goal of mechanical thrombectomy has also moved from treating SVI to a new era of treating LCI that has been a very hot topic recently.Whether endovascular treatment is beneficial for patients with LCI remains uncertain.This paper aims to make a comprehensive review concerning the relevant research progress in endovascular therapy for anterior circulation large core ischemic stroke,including the imaging determination and study inclusion criteria of LCI,the postoperative blood pressure management,and the factors influencing ineffective recanalization and prognosis.(J Intervent Radiol,2023,32:1256-1262)

OBJECTIVETo compare the accuracy of CT and MR including diffusion-weighted imaging(DWI) in preoperative diagnosis and T staging of gastric cancer.

METHODSForty-one patients with gastric cancers proved by gastroscopy biopsy from November 2011 to August 2012 were prospectively enrolled. They underwent contrast enhanced CT and MR imaging (including DWI, T2 weighted and dynamic enhanced imaging) preoperatively. Two radiologists interpreted CT and MR images for detecting and staging each patient independently. With the reference of post-operative histopathological findings, T staging accuracy of CT and MR imaging was calculated and compared. Inter-observer agreement was also evaluated.

RESULTSOverall T staging accuracy in MR including DWI was significantly higher than that in CT imaging(87.8% vs. 65.9%, P=0.004). MR had a better inter-observer agreement than CT(Kappa=0.813, 0.603, respectively).

CONCLUSIONMR including DWI can improve preoperative T staging accuracy of gastric cancer significantly, which deserves recommendation for clinical application.