Sclerosing cholangitis includes a spectrum of chronic, variably progressive cholestatic liver disease characterized by inflammation, fibrosis and stricture of the intrahepatic and extrahepatic bile ducts. Sclerosing cholangitis can be divided into primary sclerosing cholangitis of unidentified etiology and secondary sclerosing cholangitis caused by various identifiable etiologies, including immunoglobulin G4-related sclerosing cholangitis, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndromerelated cholangitis and eosinophilic cholangitis. In this article, we describe the imaging findings of the various spectrums of sclerosing cholangitis with anemphasis on a systemic approach in differential diagnosis. It is very important for magnetic resonance cholangiography and endoscopic cholangiography in imaging diagnosis and differential diagnosis of sclerosing cholangitis. We also discuss the clinical significance and therapeutic options for treating sclerosing cholangitis.

The liver specific contrast agent gadolinium ethoxybenzyldiethylenetriaminepe ntaacetic acid (Gd-EOB-DTPA) is routinely used in clinical magnetic resonance imaging. It combines assessment of tissue perfusion during the vascular phase with hepatocyte specific imaging during the hepatobiliary phase. This combination of imaging properties has been shown to provide excellent results in the detection and differentiation of liver lesions. The enhancement characteristics of Gd-EOB-DTPA in hepatocellular carcinoma, regenerative nodules and degenerated nodules were summarized in this review. Liver cell specific contrast agent can further improve the diagnostic ability.

Adolescent ; Adult ; Catheterization, Central Venous ; instrumentation ; Device Removal ; Humans ; Male ; Vena Cava, Inferior ; Vena Cava, Superior

砄bjectives:To observe the difference of programmed cell death (PCD) and the expression of related gene p 53 in the development of normal palate and in the formation of cleft palate.Methods:The model of the development of cleft palat was estabished with retinoid acid (80 mg?kg 1 for each pregnant mouse). The palate samples were obtained at GD13 14 (at 13rd day 14 hours of prenancy),13 22 ,14 8,14 14 ,14 33 ,15 8,15 22 and 16 8 respectively.PCD was detected with TUNEL staining,while the mRNA transcription of p 53 was observed by in situ hybridization.Rssults:In early development of palate process,the positive index of PCD in the cleft palate samples was significantly higher than that in the normal ( P 0.05) between the two groups.Conclusion:The proliferation of mesenchymal cells of the early developmental palate process may be inhibited due to the abnomal PCD in the formation of cleft palate.The mechanism of PCD in this study may be a p 53 independed pathway.

OBJECTIVE To explore the canonical prevention and management method to improve the control quality safety of hospital infection in operating room,and the medical care quality.METHODS The key points included infection institution,nosocomial control,operating room management,effective infection disinfection,isolation and other measures.RESULTS According to canonical scientific management available to quality safety of infection prevention,it could prevent infection in operating room.CONCLUSIONS In order to prevent nosocomial infection the accomplishment of effective disinfection and isolation measures during contaminated operation in hospital operating room is an important guarantee to the medical care quality.

Objective:To evaluate the clinical value of 16-slice spiral CTA and methods of diagnosis of cerebral aneurysms.Methods: Fifty six cases of cerebral aneurysms with CTA image data were retrospectively analyzed from July 2012 to July 2014. Omnipaque (350 mgI/100 ml) as contrast agent was used in all cases with injection speed of 4.0 mL/s. The methods of VR, SSD, MIP, MPR, CPR and VE were involved in CTA images reconstruction and processing were implemented with workstation ADW4.2. The diagnosis value of cerebral aneurysms with different methods of vessel reconstruction was analyzed.Results: The location and the size of intracranial aneurysms could be clearly showed with 16-slice spiral CTA. The diagnosis time of methods VR and MIP was shortest and the mean time was 4.3 minutes and 5.1 minutes respectively. There was significant difference between the image and actual size in berry aneurysms with SSD method.Conclusion: The synthetic application of multimethod can improve the diagnostic value of 16-slice spiral CTA in cerebral aneurysms.

Adult ; Aortic Aneurysm, Thoracic ; complications ; diagnosis ; Hoarseness ; diagnosis ; etiology ; Humans ; Male

OBJECTIVE To explore the canonical prevention and management method to improve the control quality and safety against hospital infection in outpatient operating room. METHODS To strengthen infection institution,nosocomial control,and operating room management actually,constitute effective disinfection,isolation,and deal of measure. RESULTS By strengthening quality of hospital outpatient operating room,to improve the medical care quality. CONCLUSIONS According to canonical scientific management,to favor the quality and safety of infection prevention in operating room.

Objective To identify the changes of outpatients/emergency visits at Nanjing Children′s Hospital since introduction of the general pricing reform at public hospitals.Methods Fluctuations of outpatients/emergency visits at Nanjing Children′s Hospital before and after the reform in 2015 were compared,and an empirical analysis was made in view of the overall structural changes,demand price elasticity and cross-price elasticity of various outpatients/emergency visits.Results The change of total outpatients/emergency visits was minimal,yet the composition registered significant changes.Monthly average of common outpatients totaled 7 072 visits,a growth of 12.6%;that of senior specialists totaled 3 035 visits,a growth of 48.4%.The price elasticity was<1,while the demand for various outpatients/emergency visits services and cross-price elasticity appeared inelastic.Conclusions The one year reform has witnessed the hospital in smooth operations as yet.Given the sizable rise of examination prices for both outpatients/emergency visits,patient volume remains stable instead of drastic decrease,evidencing the strong demand for children′s medical services.

Objective:To optimize the determination technology for the total amino acids in Runing pills. Methods:The process was optimized by L9 (34 ) orthogonal design using the hydrolysis temperature, hydrolysis time and hydrochloric acid concentration as the evaluation factors,and the content and yield of total amino acids as the evaluation indices. Results: The optimal determination condi-tions were as follows:the hydrolysis temperature was 110℃, the hydrolysis time was 22 h and the hydrochloric acid concentration was 6 mol·L-1 . Conclusion:The optimal determination technology can be applied in the total amino acids from Runing pills,which pro-vides the basis for the further research of Runing pills.