Objective To investigate the clinical effect of low molecular heparin combined with mesalazine in patients with active ulcerative colitis(UC).Methods 90 cases of patients with UC were randomly divided into three groups:A group,B group and C group,with 30 cases in each group.A group was given oral treatment with sulfasalazine enteric-coated tablets,B group was given oral treatment with mesalazine and C group was given low molecular heparin calcium combined with mesalazine (4100 iu,1 /d).The three groups were treated for 2 weeks. Coagulant function index such as activated partial prothrombin time (APTT),fibrinogen(FIB),platelet count(PLT), platelet maximum aggregation rate(PAG(Max)),D-dimer(D-D),C-reactive protein(CRP)were detected in the two groups before and after treatment of 7 and 14d.Mayo disease activity index score was also recorded before and after treatment of 7 and 14d.And the differences among three groups were compared.Results There were significant differences in APTT,FIB,PLT and PAG(Max)after 7d,14d treatment among A,B and C groups(7d:F value were 17.652,12.427,42.873,14.318 respectively;14d:F value were 43.804,139.172,51.932,79.440 respectively,all P value <0.05).APTT of C group after 7d,14d[(36.32 ±3.56)μg/mL,(40.15 ±4.24)μg/mL]were higher than B group[(32.14 ±2.86)μg/mL,(33.04 ±3.32)μg/mL]and A group [(31.82 ±3.36 )μg/mL,(32.15 ± 3.24)μg/mL];FIB of C group after 7d,14d[(4.07 ±0.41 )g/L,(3.14 ±0.28)g/L]were lower than B group [(4.47 ±0.40)g/L,(4.06 ±0.33)g/L]and A group[(4.58 ±0.44)g/L,(4.23 ±0.37)g/L];PLT of C group af-ter 7d,14d[(262.22 ±60.61)×109 /L,(201.38 ±49.42)×109 /L]were lower than B group[(296.34 ±63.51)× 109 /L,(253.25 ±55.47)×109 /L]and A group[(301.71 ±70.62)×109 /L,(262.05 ±64.11)×109 /L];PAG (Max)of C group after 7d,14d[(0.46 ±0.08),(0.30 ±0.05)]were lower than B group[(0.57 ±0.10),(0.46 ± 0.06)]and A group[(0.59 ±0.12),(0.51 ±0.08)].There were significant differences in CRP,D-D after 14d treatment among A,B and C groups(F value were 91.967,139.172 respectively,all P value <0.05).CRP of C group after 14d[(7.50 ±1.35)mg/L]were lower than B group[(10.80 ±1.37)mg/L]and A group[(12.12 ±1.64)mg/L];D-D of C group after 14d[(0.26 ±0.02)mg/L]were lower than B group[(0.47 ±0.03)mg/L]and A group[(0.51 ± 0.04)mg/L].There were significant differences in Mayo index score,△Mayo index score after 14d treatment among A,B and C groups (F value were 182.170,89.802 respectively,all P value <0.05).Mayo index score of C group after 14d(1.51 ±0.33)were lower than B group(2.93 ±0.46)and A group(3.42 ±0.63);.△Mayo index score of C group after 14d(5.67 ±1.60)were lower than B group(4.25 ±1.32)and A group(3.79 ±1.21);Pearson corre-lation analysis showed that △Mayo Mayo index score were positively correlated with PAG(Max)reduction△PAG (Max),△D-D,△CRP,△PTL(r value were 0.616,0.702,0.734,0.569,respectively,all P <0.05).Multiple step-wise linear regression analysis showed that △PAG(Max),△D-D,△CRP,△PTL were closely related to △Mayo Mayo index score(partial regression coefficient were 4.209,2.451,0.801 respectively;t value were 7.890,4.787, 2.201,respectively,all P <0.05).Conclusion The clinical effect of low molecular heparin combined with mesala-zine in patients with active ulcerative colitis is effective,and the method can significantly improve the inflammation in patients with UC and high coagulation state,improving the clinical symptoms is better than the single drug,and worth clinical recommendations.

Objective: To investigate the protective effects and the mechanism of the preconditioning with hypertonic saline against warm hepatic ischemia-reperfusion (I-R) injury. Methods: Sixty patients who underwent partial liver resection were randomly assigned to 3 groups (n =20): group 1 without Pringle maneuver(NPR); group 2 with Pringle maneuver (PR), and group 3 with 7.5% hypertonic saline 4ml/kg preconditioning (HS) 5 minutes before Pringle maneuver for resection and in group 2 , 4ml/kg normal saline were given. Blood samples were obtained at 3, 15, and 30 minutes before and after liver resection, and 2, 24, and 48 hours following resection of the liver for polymorphonuclear leukocytes (PMN) count and serum alanine transminase levels test. In addition, small pieces of liver tissue were cut from remaining liver before resection and 30 minutes after resection to determine MPO concentrations. Results: Following partial liver resection via NPR, no changes in the concentration of circulating PMN and liver MPO concentrations were observed. But in the PR and HS group PMN counts significantly decreased and liver MPO concentrations significantly increased. Serum ALT levels increased in all groups significantly 24 and 48 hours after resection. All of these changes were most pronounced in the PR group and significantly reduced by hypertonic saline. Conclusion: Preconditioning with 7.5% hypertonic saline can protect liver from warm ischemia reperfusion injury and the possible mechanism was the inhibition of PMN accumulation in the liver.

Objective:To retrospectively analyze the clinical features of intestinal tract metastatic tumors of ovarian cancer,and estimate the feasibility of resection and its relation to prognosis.Methods:64 patients with ovarian cancer associated with intestinal tract metastasis were brought into this clinical analysis.The extent of intestinal tract involvement was evaluated preoperatively.Cytoreduction was defined as the residual lesion less than 1 cm3,at the same time pelvic and paraaortic lymphadenectomy and/or biopsy were implied.Intestinal surgery included tumor stripping surgery and/or intestinal repair,intestinal resection or colostomy.Regular chemotherapy was administrated,postoperative complications as well as prognosis were evaluated.Results:54 cases (84.8%) had rectum/sigmoid colon metastasis,metatsis in other parts of colon were 26 cases,small intestinal metastasis were 18 cases,infiltration of serosal and superficial muscular layer were 47 cases,17 cases had deep muscular layer and mucosal infiltration.Epithelial cancer which had invaded intestinal mucosa were 4 cases (7.7%) ,no invading to intestinal mucosa was detected in germnoma.All the 64 patients were recepted surgical treatment,including tumor stripping surgery in 44 cases,intestinal resection in 20 cases,sigmoidal and rectal resection in 14 cases,and colonost omy in 6 cases.The optical cytoreduction was[FK(WB00018。142mmZQ1mm]achieved in 56 cases (87.5%),and post-chemotherpy regression rate was 58.9%,but the post-chemotherpy regression rate was only 12.5% in 8 patients who got partial resection;regular chemotherapy was finished in 49 cases,and the regression rate was 65.3%,but the regression rate was only 15.4% in those who couldn’t finish regular chemotherapy.Postoperative morbidity was 26.6%,and two patients died of postoperative peritonitis.Conclusion:Intestinal tract is the common metastatic site of ovarian cancer,tumor stripping and intestinal resection are not only feasible but also prerequisite for optimal cytoreduction,postoperative regular chemotherapy can improve prognosis of ovarian cancer.

0.05). Conclusion:The excessive expression of Survivin in gallbladder cancer indicates that Survivin could be not only correlated with the occurrence of carcinoma but an early and common event in gallbladder carcinogenesis. Surviv in will promisingly become a novel tumor marker and can be applied in the clinic al practice for helping the early diagnosis as well as targeting gene therapy fo r gallbladder cancer.

Objective To explore the clinical value of laparoscopy in the treatment of pancreatic diseases.Methods Twelve patients with pancreatic diseases received laparoscopic surgery.Among which 9 patients with cystic diseases,4 cases underwent laparoscopic spleen-preserving distal pancreatectomy,2 cases received distal pancreatectomy and splenectomy,and 3 cases underwent pancreatic cystectomy.Laparoscopic insulinoma enucleation was performed for 2 patients who suffered from insulinoma.Besides,a patient suffered from pancreatic carcinoma recurrence received left thoracoscopic splanchnicectomy.Results All the operations were accomplished successfully,including 8 total laparoscopic surgery and 4 laparoscopic assisted surgery.The average operative time was 225 min(range 100-420 min),and the average volume of blood loss was 80 ml(range 2-150 ml).Pancreatic fistula was observed in 1 patient which was cured by conservative therapy.The postoperative average hospital stay was 7.2 d(range 5-13 d).The patient with recurrent pancreatic carcinoma survived for 6 months after operation and the pain-killing effect was satisfactory.With a follow-up of 10-36 months for other patients,the surgical effects were ideal and no recurrence occurred.Conclusion With the advantages of less trauma,less pain,fast recovery,and low morbidity rate,laparoscopic surgery is an effective and safe method for the treatment of pancreatic diseases,and thus may be widely used in the clinical settings in the future.

Objective To provide accurate bone tunnel positioning reference for clinical individual anterior cruciate ligament (ACL) reconstruction by three-dimensional (3D) reconstruction of femoral and tibial original footprint of ACL.Methods Forty volunteers were selected for this study,including 20 males and 20 females,and aged 18 to 35 years old.3D CT scanning images of knee data were obtained.3D bone models of knee and footprint of ACL were reconstructed.On the 3D reconstruction models,the shape and position of original footprint of ACL were displayed.Statistical significance was compared for their difference.Results Femoral original footprint of ACL,long axis of footprint,distances to the distal margin of the articular cartilage (DDCM),distances to the posterior margin of the articular cartilage (DPCM),double bundle center distance,and tibial original footprint short axis of ACL were significantly different between genders (P ＜ 0.05).However,no significant difference was found between genders for tibial original footprint long axis of ACL (P ＞ 0.05).Conclusions The insertion mark shape and nature position of footprint of ACL could be observed by 3D reconstruction using CT scan images.

Objective To explore the value of gemstone spectral imaging (GSI) with single source dual-energy CT in characterizing the benign and malignant solitary pulmonary nodules (SPN).Methods Totally 32 patients with SPN underwent phaseⅢ enhanced CT scan using single source dual-energy CT by GSI mode.Three types of images were reconstructed for analysis:the water concentration (WC),iodine concentration (IC) and normalized iodine concentration (NIC).Results The IC of lung squamous cell carcinoma lung adenocarcinoma,hamartoma,sclerosing hemangioma,inflammatory pseudotumor were (11.66± 2.72) μg/ml,(12.36±2.97) μg/ml,(10.20±3.11) μg/ml,(16.58±3.58) μg/ml,(21.67±3.76) μg/ml,the IC of lung adenocarcinoma and lung squamous cell carcinoma had no difference (P ＞ 0.05),there were significant differences in the value of iodine material between other nodules (all P ＜ 0.05).The WC of lung adenocarcinoma,lung squamous cell carcinoma,hamartoma,sclerosing hemangioma,inflammatory pseudotumor were (1 021.31±13.83) μg/ml,(1 027.98±12.53) μg/ml,(1 003.42±13.67) μg/ml,(1 029.61±12.06) μg/ml,(1 051.61±13.81) μg/ml,there was no significant difference in the value of water material between nodules (all P ＞ 0.05).Conclusion The spectral CT imaging may be helpful for characterizing the pathological type of SPN.

Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.

Objective To investigate the differences in clinical manifestation,laboratory test and imaging between patients with symptomatic and non-symptomatic basilar dolichoectasia (BD).Methods We retrospectively analyzed the patients admitted in our hospital from January 2012 to January 2013,who receiving intracranial computed tomography angiography or magnet resonance angiography.We grouped the patients to symptomatic and non-symptomatic,and further divided the symptoms into vascular events and compressive symptoms.We compared the baseline characteristics of the symptoms in these groups,risk factors of cerebrovascular events,and kidney function between patients with symptomatic and nonsymptomatic BD.Results Comparing with non-symptomatic BD (n--24),the diameter of basilar artery in symptomatic BD patients(n =52) was larger ((4.7 ± 0.9) mm vs (4.2 ± 1.0) mm,t =-2.289,P =0.025),and the level of diastolic blood pressure and uric acid were higher ((94.0 ± 16.7) mmHg vs (86.9--±12.0) mmHg,1 mmHg =0.133 kPa,t =-2.113,P =0.038;(333.3 ± 120.7) μmol/L vs (267.6 ± 84.6) μmol/L,t =-2.724,P =0.008).The group with vascular symptoms (n =18) had greater basilar artery diameter ((4.9 ±0.8) mm vs (4.2 ± 1.0) mm,t =-2.612,P ＜0.05) compared to those without vascular symptoms(n =58).BD patients with compressive symptoms (n =6) had higher level of uric acid ((374.5 ± 51.9) μmol/L vs (281.1 ± 101.6) μmol/L,t =-2.216,P ＜ 0.05) and serum IgA ((1.44 ± 0.28) g/L vs (2.48 ± 0.78) g/L,t =5.660,P ＜ 0.05) than those with non-compressive symptoms (n =70).Conclusions The presence of symptoms in patients with BD is related with the increased diameter of basilar artery.Our results suggest that strict control of blood pressure in the early stage may help to reduce the incidence of the vascular events in BD patients.

Objective To analyze the CT and MRI performances of chromophobe cell renal carcinoma,to improve the understanding of the disease.Methods The CT and MRI performances of 16 patients with chromophobe cell renal carcinoma confirmed by post-operation pathology were analyzed retrospectively.Results Among 13 cases examined by CT,8 cases had homogeneous lesion including the homogeneous lesions density of 5 cases higher than that of normal renal parenchyma,and the other 5 cases had inhomogeneous density.After enhanced scan,the uneven essence ingredients were markedly enhanced in homogeneous density and inhomogeneous density cases,and the enhancement degree in arterial phase was lower than that of the renal cortex and higher than that of the renal medulla.Among 8 cases checked by MRI,2 cases had signal homogeneity with long T1 weighted imaging and long T2 weighted imaging signal,of which 5 cases appeared high signal in T1 weighted imaging flat lesions.The enhancement mode were similar with CT.In 5 patients examined by CT and MRI at the same time,their density,signal and the pattern strengthening were similar.Conclusions Chromophobe cell renal carcinoma is a rare malignant renal cell carcinoma,and CT and MRI can reflect the composition and hemodynamic changes.When homogeneity and high density or T1WI appeared high signal,disease was large and necrosis was less,and strengthening belt was appeared in lesions,it is value on diagnosis of chromophobe cell renal carcinoma.