Objective The present study was performed to evaluate changes of arterial elasticity in elderly patients with metabolic syndrome and its influence factors. Methods Using modified Windkessel model of the circulation and pulse waveform analysis,large artery elasticity indices(C1) and small artery elasticity indices (C2) of 221 old metabolic syndrome patients(the experimental group) and 206 old healthy subjects (the control group) were measured. Correlation of arterial elasticity changes with systolic blood pressure (SBp), diastolic blood pressure (DBp), mean blood pressure (MBp),pulse pressure (Pp), body weight indexes(BMI),body adipic weight, level of serum total cholesterol(TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and glucose was also analyzed. Results C1 and C2 reduced in the experimental, but SBp, DBp, MBp, Pp, BMI, body adipic weight, level of serum total cholesterol ( TC ), triglyceride (TG), low density lipoprotein cholesterol (LDL-C)and glucose were higher. There was a negative association between C1 and C2 and age, SBp, DBp, MBp and Pp and positive correlation with body weight indexes. But C1 and C2 were not correlated with body adipic weight, TG and HDL-C. Conclusions Arterial elasticity of elderly patients with metabolic syndrome were reduced. Arterial elasticity assessment offers a means of risk stratification for the clinical evaluation of vascular structural and functional injuries.

Subclinical hypothyroidism is common in children,but its clinical significance is widely debated.The pathogenesis is not very clear and etiology appears to be multifactorial,such as autoimmune thyroiditis,obesity,antiepileptic drugs and so on.Currently there is no broad consensus on the management of children with subclinical hypothyroidism.In this review,the available evidences regarding to investigation,risk factors,trreatments and outcomes for this disease are summarized.

Objective: To explore the clinical efficacy of positive airway pressure biphasic (BiPAP) non-invasive ventilation for treating the patients with severe pre-eclampsia combining acute heart failure (AHF).
Methods: A total of 84 patients with severe pre-eclampsia combining AHF treated in our hospital from 2008-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Control group, the patients received routine treatment for pre-eclampsia and AHF,n=41 and Observation group, based on routine treatment, the patients received assistant BiPAP ventilation,n=43. The changes at before and 3h after treatment of cyanosis, dyspnea, pulmonary rales, heart rate (HR), respiratory rate (RR), arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), arterial carbon dioxide partial pressure (PaCO2), pH value and plasma levels of BNP were compared between 2 groups.
Results:①Comparison of before vs after treatment in both groups: HR (times/min) in Control group (90±8 vs 110±14) and Observation group (80±6 vs 112±12); RR (times/min) in Control group (24±5 vs 33±8) and Observation group (18±4 vs 35±7); PaCO2 (mmHg) in Control group (41.3±4.3 vs 48.4±5.6) and Observation group (29.7±5.4 vs 47.8±3.9); BNP (ng/L) in Control group (87.50±8.00 vs 133.00±8.00) and Observation group (69.50±8.30 vs 138.00±6.92); SaO2 (%) in Control group (93.0±3.7 vs 80.5±4.7) and Observation group (97.1±3.4 vs 81.2±4.2); PaO2 (mmHg) in Control group (80.3±5.8 vs 80.5±4.7) and Observation group (89.1±6.2 vs 53.2±5.4), allP<0.05.②After treatment, compared with Control group, Observation group presented obviously decreased HR, RR, PaCO2 and BNP; signiifcantly increased SaO2 and PaO2, allP<0.05. PH was similar between 2 groups,P>0.05.
Conclusion: Assistant BiPAP ventilation may treat the patients with severe pre-eclampsia combining AHF, it could improve HF symptom and hypoxia. The clinical signiifcance should be conifrmed by further investigation.

Objective To evaluate the clinical value of 64-slice spiral computed tomography(CT) in detecting coronary artery disease. Methods Twenty-three patients with suspected coronary artery stenosis were analyzed by 64-slice spiral computed tomography coronary angiography and catheter coronary angiography. Results Two hundred and ninety -one segments of the two hundred ninety-nine coronary artery segments in twenty-three patients could be visualized by 64-slice spiral CT,eight segments couldn't be visualized because of calcification and exercising shadow. According to gold standard of selective coronary arteriongraphy,the sensibility,specificity,positive predictive value and negative predictive value to diagnose coronary artery stenosis by 64-slice spiral CT were 88.7%,98.2%,94.0% and 96.4%.Conclusion The coronary artery stenosis diagnosis by 64 -slice spiral CT is a potential detecting method and good clinical value but could not replace selective coronary arteriongraphy.

Objective To explore the pathological characteristics, diagnosis and operative treatment of Mirizzi Syndrome(MS). Methods The clinical data of 95 cases of Mirizzi Syndrome admitted to our hospital in recent 12 years were reviewed retrospectively. Results All of the 95 cases underwent operative therapy. In the 95 patients, simple cholecystectomy was performed in 2 patients, cholecystectomy and choledochotomy with T tube drainage in 58 patients, cholecystectomy and choledoscopic bile duct examination via cystic duct in 15 patients, partial cholecystectomy plus repair of choledochal fistula in 18 patients, and cholecystectomy plus repair of the injured choledochus in 2 patients. 65 cases were folloned up for 1-5 years, and all of them have been in good health. Conclusions Mirizzi Syndrome consists of varied pathology. The selection of rational operation for different types of Mirizzi Syndrome can give satisfactory results.

Objective To study donor liver repair in modified piggyback liver transplantation and its ~relationship to postoperative complications. Methods The relationship between donor liver repair and ~development of complications of 14 cases of modified piggyback liver transplantation,which among 17 cases of orthotopic piggyback liver allotransplantation performed in our hospital,were analyzed retrospectively.In the 14 cases,abnormal hepatic artery was repaired in 2 cases,portal vein interposition shunt was done in 1 case;~repaired ligaments were sutured in 10 of 14 cases,and not sutured in 4 cases.Results None of the 14 ~patients died in the perioperative period. The success rate of the operation was 100%. 3 patients had ~intra-abdominal bleeding,postoperatively,and in 2 cases the bleeding was related to donor liver repair. ~Postoperatively ,there was no thrombosis of hepatic artery or portal vein, and no bile duct necrosis, no hepatic outflow tract occlusion. Conclusions Donor liver repair is an important procedure in liver tramsplantation.The quality of donor liver repair is directly related to the difficulty of operative technique during liver ~transplantation ,and to the development of postoperative complications.In donor liver repair during piggyback liver transplantation,reconstruction of the retrohepatic vera cava is very important.The constructed stoma must be compatible with the donor hepatic vein outflow stoma and be able to effectively prevent the formation of eddy blood flow,ensure patency of the outflow tract and effectively prevent thrombus formation.

Objective To investigate clinical effect of recombinant human growth hormone (rhGH)for inter-venting central precocious puberty in children,to provide reference for clinical treatment.Methods 80 patients with growth deceleration slows CCP were selected,when height growth rate below 4cm/year,40 patients on the basis of joint GnRHa used rhGH treatment were selected as the observation group,and the remaining 40 patients refused to use rhGH,continued to use of GnRHa treatment were selected as the control group.After treatment predicted height,height,bone age,growth rate and other indicators were compared.Results In observation group,the actual height Ht, predicted height PAH,the growth rate Gv,serum insulin -like growth factor -1 (IGF -1 )after treatment were (1 44.48 ±6.59)cm,(1 54.94 ±4.52)cm,(4.43 ±0.64)cm/6months,(1 32.25 ±8.84)ng/mL,compared to before treatment,the differences were statistically significant (t =6.548,P <0.01 ;t =5.734,P <0.01 ;t =28.869,P <0.01 ;t =20.65,P <0.01 ),compared with the control group,the differences were significant (t =3.943,P <0.01 ;t =4.759,P <0.01 ;t =28.247,P <0.01 ;t =20.882,P <0.01 ),there were no differences in other indices;hor-mones FSH,LH and other indicators of the two groups before and after treatment,and blood sugar,thyroid indicators showed no abnormality.Conclusion Recombinant human growth hormone in the treatment of central precocious puberty deceleration in children does not increase bone age,which will help improve the growth rate and predicted height,which worthy of clinical application.

Objective To investigate the reproducibility and influencing factors of relative quantification of phosphorus metabolites with two-dimensional chemical shift imaging (2D CSI) in rabbit liver. Methods Using 2D CSI MRS, 500 ml phosphate (NaH2PO4) solution phantom with 0. 05 mol/E concentration and one healthy rabbit were scanned 30 times respectively in one day and rescanned 30 times in the next day, and the stability of MR scanner and reproducibility of within-run and between-days in the same individual were analyzed. Each of thirty rabbits was scanned and rescanned one time respectively in different days, and the reproducibility of between-days in one group was analyzed. The data were statistically analyzed with t tests. Results (1) Phosphate solution phantom had a good reproducibility of within-run with the coefficient variation (CV) of 4. 92% and 5. 12% respectively in different two days. No significant change of phosphorus metabolites was detected in between-days, which was 16. 68 ± 0. 82 and 16. 56 ± 0. 85 respectively(t = 0. 665, P > 0. 05 ). (2) The CV of metabolites in one healthy rabbit ranged from 8. 04% to 34. 13%. Among the metabolites, β-ATP had the best reproducibility with the CV less than 10%. PME was 0. 88 ± 0. 28 and 0. 88 ± 0. 30, PDE was 4. 35 ± 0. 66 and 4. 35 ± 0, 66, Pi was 0. 95 ± 0.30 and 0.97±0.28, α-ATP was 5.58±0.60 and 5.61±0.61, β-ATP was 2.70±0.22 and 2.71± 0. 22, γ-ATP was 2. 20±0. 63 and 2. 18±0.44 respectively, no significant changes of metabolites were detected in between-days( P >0. 05 ). (3) The CV of metabolites in 30 healthy rabbits ranged from 8.48% to 36. 21%. Among the metabelites, β-ATP had the best reproducibility with CV less than 10%. PME was 0. 84 ± 0. 30 and 0. 79 ± 0. 28, PDE was 4. 29 ± 0.72 and 3.94 ± 0. 84, Pi was 0. 91 ± 0. 28 and 0. 92 ± 0. 31, α-ATP was 5.65±0. 66 and 5. 36±0. 60, β-ATP was 2. 71±0. 23 and 2. 66±0. 25, γ-ATP was 2. 07±0. 29 and 1.99±0. 37 respectively, no significant changes of metabolites were detected in between-days (P > 0. 05). Conclusions The relative quantification of hepatic β-ATP may be most reliable among the phosphorus metabolites for rabbit liver because of its good reproducibility and small CV. The quantification of phosphorus metabolites by 31p MRS with 2D CSI in rabbit liver is affected by many factors.

Objective To investigte the inhibit effects of drug combination of Kanglaite injection(KLT) and TXT on human pulmonary epithelial cells(95D) in vitro,and to find the best time of combination.Method 95D cell growth inhibition was measured with MTT assay.Results Various concentration of KLT and TXT could inhibit the proliferation of 95D cell,and KLT could enchance the sensiti vity of 95D cell to TXT(P

Objective To study the relationship between energy metabolic changes tested by phosphorus-31 magnetic resonance(MR)spectroscopy(31P MRS)and the liver damage score(LDS)in rabbit models and investigate the diagnostic value of 31P MRS in acute hepatic injury.Methods A total of 30 rabbits were received different radiation dose(ranging from 5 Gy to 20 Gy)to establish acute hepatic injury models.31P MRS was than carried out 24 hrs after radiation.The rabbits were divided into mild(LDS≤3 U),moderate(LDS 3-6 U)and severe(LDS＞6 U)hepatie injury groups.Ten healthy rabbits were served as controls.MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.The relative quantification of phosphomonoesters(PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine severe hepatic injury groups were 1.83±0.33,1.55±0.24,1.27±0.07 and 0.98±0.18,respectively,with significant differences(P＜0.05).The ATP level was progressively decreased with the increase of severity Of hepatic injury.The relative quantification of PME and Pi were decreased in severe hepatic injury group compared to control group(P＜0.05).There was no significant difference higher in moderate(1.94±0.50)and severe(1.96±0.72)hepatic injury groups compared to control group(1.43±0.31)and mild hepatic injury group(1.40+0.38)(P＜0.05).No significant difference was found in ratio of relative quantification of other phosphorus metabolites.Conclusions 31P MRS is a useful method in evaluating acute hepatic injury.The relative quantification of hepatic ATP level,which can reflect the severity of acute hepatic injury,is correlated with LDS.