Objective To investigate the changes of clinical symptoms and liver or lung functions after inferior vena cava stent implantation in Budd Chiari syndrome patients. Methods 35 cases of Budd Chiari syndrome patients were enrolled and retrospective analysized, such as ascites, edema of lower limbs, abdomen wall of varicose veins and serum total bilirubin, serum albumin, prothrombin time, FVC, MVV, PEF, FEV1.0, FEV1.0/FVC and other pulmonary functional changes were analyzed before and 1 months after inferior vena cava stent implantation. Results Ascites, edema of lower limbs, abdominal varicose veins and other clinical symptoms were significantly reduced or disappeared, the total serum bilirubin significantly decreased, serum albumin significantly increased, and prothrombin time significantly reduced 1 month after surgery in patients with Budd Chiari syndrome, (t = 1.95, 2.31, 2.07, P < 0.01). FVC, MVV, PEF, FEV1, the indexes of FEV1/FVC improved obviously after surgery (t = 1.83, 2.69, 1.47, 1.69, 1, 97, P = 0.041, 0.029,0.046, 0.043, 0.043, 0.038). Conclusion Inferior vena cava stent implantation could effectively improve the clinical symptoms of patients with Budd Chiari syndrome.

[ABSTRACT]OBJECTIVETo assess the upper airway and related structures in different patterns of the upper airway obstruction on cine magnetic resonance (CMR) imaging in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSCMR images of upper airway were obtained in 30 male patients with severe OSAHS during waking state and natural sleep. The midsagittal plane images were obtained. Patients were classified into 3 groups based on the upper airway obstruction patterns at apnea events and the reference data of the upper airway were measured.RESULTSDuring natural sleep, the diameter of retropalatal region, retroglossal region, retroepiglottic region and the length of suprahyoid muscles were significantly shorter than those during waking state (P<0.01). The maximum angle between the suprahyoid muscles and the apex of the tongue during natural sleep was significantly larger than that during waking state (P<0.01). During wakefulness, there was a significantly difference in the diameter of retropalatal region among 3 obstruction patterns (P<0.01). During natural sleep, there were statistical difference in the diameter of retropalatal region and the upper tongue, the angle between the hard palate and soft palate, the maximum angle between the suprahyoid muscles and the apex of the tongue, and their change values among 3 obstruction patterns (P<0.05). CONCLUSIONThe measurements of the upper airway and related structures on CMR imaging in OSAHS patients could provide useful information in assessing upper airway.

Baicalein-nicotinamide(BE-NCT)co-crystal was chosen as model drug to investigate the thermody-namic characteristics.Solubilities of BE in NCT solutions in ethyl acetate at different temperatures were deter-mined in order to explain the complexation behavior of BE-NCT co-crystal.Thermodynamic parameters of co-crys-tal formation progress were calculated.Ternary phase diagrams (TPDs)of the BE-NCT-ethyl acetate systems at various temperatures were established.The non-linear fitting equation according to 1 ∶1 complexation mechanism of BE-NCT co-crystal demonstrated a good correlation between calculated and experimental data (R2 >0.98). Co-crystal formation is a spontaneous process(ΔG°<0).Increase in temperature resulted in the increase of Ksp;decrease of K11 and a narrowed co-crystal zone.The degree of spontaneous reaction also decreased with increased temperature.The spontaneous reaction no longer carried out if the temperature reached T* =315 K sinceΔG°=0(ΔH°=-6.314 ×10 -2 kJ/mol;ΔS°=-0.200 5 J/mol.K).A drop in temperature favors the complexation between BE and NCT in ethyl acetate.Since NCT has higher solubility than BE in ethyl acetate;the TPDs of co-crystal was asymmetric.The DSC diagrams of products prepared via three presupposed methods confirmed that the BE-NCT co-crystal could be generated in solutions of nonstoichiometric compositions.

Professor OUYANG Hui-qing's gradually formed her own teaching concept of traditional Chinese medicine through long-term teaching practice:the most important teaching aim is to cultivate talents of traditional Chinese medicine.Clinical practice together with classroom teaching can promote the growing knowledge of medical students.Clinical practices are necessary and should penetrate culture and academic tradition of traditional Chinese medicine.OUYANG Hui-qing's concepts on talents are:cultivating teaching faculties is the key to the development of the teaching team,the core of construction of the teaching and research section,and the basis of construction of the discipline.OUYANG Hui-qing's management concepts are:the dean of the teaching and research section is the practitioner of personnel training practice and the undertaker of teaching team development.

Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.

Objective To establish a rapid and accurate method, and to determine the density of mice and rats sperm with enzyme-labeled instrument.Methods ①The optimal wavelengths and the regression equation set up: After six Kunming mice and six Sprague-Dawley rats were sacrificed, the left epididymis was separated and fully cut up in phosphate buffer saline.With water bath, the sperm were fully dissociated.Using the enzyme-labeled instrument to detect the wavelength absorbance respectively under different wavelength and fitting absorbance curve.The best wavelength will be the most close to 1 of the correlation coefficient ( R2 ) and the standard deviation of minimum.After ten Kunming mice and ten Sprague-Dawley rats were sacrificed,the sperm suspension of different concentration gradient were got.The regression equation of the sperm density and absorbance was established by using enzyme-labeled instrument and haemocytometer.②The test of sperm absorbance stability: Mice and rats,six respectively,were used to make the sperm suspension.Samples were put in room temperature (25℃) or 37℃water bath continued,and after water bath about 0,20,30,40,50, 60 min,the change of absorbance was recorded.③The regression equation verification:The mice were administrated orally with 20% ethanol solution for 30 days to make oligospermia.In order to verify the new method, two different method were used to get the sample sperm.Results The optimal absorbancy-sperm density curve could be established at 380 nm.The means of KM mice sperm count ( x1 ) and absorbance ( y1 ) are showed to be the linear function,and the linear regression equation is y1 =2 ×10 -9 x1 +0.0648, R2 =0.9743.The means of SD rat sperm count ( x2 ) and absorbance (y2) are showed to be the linear function,and the linear regression equation is y2 =5 ×10 -9x2 +0.0621,R2 =0.9940.SD rat sperm suspension liquid after 60 min in water bath, absorbance value at 0 min significantly decreased(P<0.05), but at room temperature after 40 min significantly increased ( P<0.05); KM mice sperm suspension in the water bath and under the condition of normal temperature after 50 min, compared with the 0 min, absorbance value increased significantly(P<0.05).Compared with control group, sperm density of ethanol oligozoospermia group by enzyme standard detector and standard curve calculation were significantly decreased ( P <0.05 );compared with absorbancy-sperm density equation, determination of ethanol oligozoospermia group of sperm density by cell counting plate method had not significant difference.The results suggested absorbancy-sperm density equation could effectively detect the reduction of the mice sperm in oligospermia.Conclusion Using enzyme-labeled instrument to set up the curve of absorbancy-sperm density equation can estimate the sperm density of mice and rats rapidly and exactly.

Objective To investigate the CT findings of histocyticnecrotizing lymphadenitis(HNL)in the neck.Methods CT data of 10 patients with pathologically confirmed HNL in the neck were retrospectively analyzed,7 males and 3 females,aged from 4 to 75 years old(median age 26 years old).Nine patients had plain CT scans and 5 of them had contrast scans.One case had only contrast CT scan.Results Totally,127 lymph nodes were identified in the neck,mainly located in the area of Ⅱ,Ⅲ,Ⅳ and Ⅴ.The maximum diameter of the involved lymph nodes ranged from 0.5-3.6 cm,1.3 cm in average.One hundred and eight lymph nodes were homogeneous and 8 were heterogeneous in plain CT images.Seventy nine lymph nodes had homogeneous enhancement and 27 had heterogeneous enhancement One hundred and ten lymph nodes had unclear margins and the surrounding fat was blurred.Conclusion CT findings of HNL of the neck are variable and non-specific.Clinical findings and laboratory examination may be helpful for the diagnosis and differential diagnosis.

Objective To investigate image quality and radiation dose of prospective ECG-gated coronary combined with carotid and cerebrovascular angiography and compare it with common coronary CTA and carotid-cerebrovascular CTA at a 256-slice spiral CT.Methods Fifty-seven patients were included in the study.The data was analyzed retrospectively and divided into 3 groups.Group 1 underwent coronary combined with carotid CTA ( n =17 ),which included a wide range of prospective ECG-gated coronary,carotid and cerebral vascular one-stop angiography.Group 2 underwent coronary CTA ( n =20),which was routine prospective ECG-gated coronary angiography.Group 3 underwent routine carotid and cerebrovascular CTA (n =20).Mean CT image attenuation and image noise were measured in the ascending aorta root,proximal parts of the bilateral common carotid artery and vertebral artery,and in the internal carotid artery at sellae level in the axial plane.Coronary artery image quality was rated using a four-point ordinal scale and carotid cerebral vascular image quality was rated using a three-point ordinal scale.Radiation dose were calculated.Mean CT image attenuation,image noise and radiation dose were compared among the 3 groups using t test.Using Mann-Whitney U,the coronary artery imaging quality was compared between group 1 and 2,and image quality of cerebral vessels was compared between group 1 and 3.Results Mean CT image attenuation [ (427 ±50) HU in group 1 and (426 ±86) HU in group 2] and image noise of the ascending aorta root [ (30 ± 9) HU in group 1 and (31 ± 9) HU in group 2 ] showed no statistical difference between group 1 and 2 (t =0.058,-0.325,P ＞0.05).There were no non-diagnosis coronary segments in group 1 and 2.And coronary segments with excellent or good image quality reached 98.1％ (202/206) in group 1 and 99.6％ ( 244/245 ) in group 2.It showed no significant difference between group 1 and 2 ( Z =-0.572,P ＞ 0.05 ).There were significant differences of mean CT image attenuation in the common carotid artery between group 1 [ ( 474 ± 70 ) HU ] and group 3 [ ( 348 ± 81 ) HU ],and in the vertebral artery between group 1 [(447 ±83)HU] and group 3 [(328 +66) HU] (t =5.043,4.869,P＜0.05).However,there was no significant difference of mean CT image attenuation in the internal carotid artery [ (370 ± 92) HU in group 1 and ( 367 ± 97 ) HU in group 3 ] ( t =0.111,P ＞ 0.05 ).There was a significant difference of image quality scores of carotid and cerebrovascular arteries between group 1 and 3 (Z =- 3.306,P ＜ 0.05 ).Effective radiation dose of groups 1,2,3 were ( 7.0 ± 0.8 ),( 3.1 ± 0.4 ) and (5.0 ± 0.3) mSv respectively.Conclusion The prospective ECG-gated coronary combined with carotid and cerebrovascular angiography is able to obtain diagnostic image quality of coronary,carotid and cerebral vascular at the 256-slice spiral CT.It is a simple,fast,noninvasive way to assess coronary and carotid cerebrovascular arteries,with advantages of less contrast medium and low radiation dose.

Objective To compare the image quality and patient radiation dose of coronary computed tomography angiography (CCTA) received by prospectively-gated step-and-shoot (SAS) technique with those obtained by retrospectively-gated spiral (RGS) technique on a 256-slice CT scanner. Methods A total of 200 patients were enrolled in this study. One hundred patients underwent CCTA with SAS mode were subdivided into two groups: ( 1 ) 50 patients with an average heart rate (HR) ≤70 bpm were scanned with a data acquisition time window centered at the 75％ of the R-R cycle ( group A) and (2) 50 patients with HR ＞ 70 bpm were scanned with the data acquisition time window centered at the 45％ of the R-R cycle, including a phase tolerance of ±％ (group B). Other 100 patients underwent CCTA with RGS mode and ECG-based tube current modulation were also subdivided into two groups: (3) 50 patients with HR ≤70 bpm were scanned with cardiac dose right set to phase of 75％ (group C) and (4) 50 patients with HR ＞ 70 bpm were scanned with cardiac ose Rdight set to phases of 45％ and 75％ (group D). All patients were grouped in randomized order. The image quality of CCTA were evaluated using a rank scale from 1 to 4 ( 1 : excellent ; 4 : non-assessable ) .Radiation dose of the four groups received was also estimated. The image quality between groups was compared by Mann-Whitney U test.The radiation dose between groups was compared by t test. For the 100 patients received by prospective ECG-gated CCTA, the receiver operating characteristic curve (ROC) was used to analyze the CCTA image quality and average heart rate to determine the uppercutoff of HR for obtaining diagnostic coronary images with SAS mode. A spearman correlation analysis was also performed to analyze the correlation of HR and image quality in patients underwent CCTA with SAS mode.Results Of 2338 coronary artery segments, excellent or good image quality( score of 1 or 2) was achieved in 96. 5％ (585 of 606) in group A, 77.7％ (445 of 573 ) in B,96. 1％ (548 of 570) in C, and 85. 7％ (505/589) in D, with no significant difference for A vs C(Z ＝- 1. 351 ,P ＞0. 05) and with significant differenceS for B vs D (Z＝ -2. 236,P ＜0. 05). Linear correlation analysis indicated a significant degradation of image quality with the increase of heart rate using SAS mode (Spearman correlation, r ＝ 0. 577, P ＜0. 01 ). ROC analysis established an upper HR threshold of 78 bpm for obtaining diagnostic image quality using SAS mode( AUC ＝ 0. 827, P ＜ 0. 05 ). The average radiation dose in group A [ ( 2. 6 ± 0. 5 ) mSv]reduced 75 ％ comparing with that in group C [ ( 10. 6 ± 2. 3 ) mSy], and the average radiation dose in group B [ ( 4.0 ± 0. 7 ) mSy]reduced 69％ comparing with that in group D [ ( 13.0 ± 1. 4) mSv]. ConclusionUsing SAS mode to perform low-dose CCTA with 256-slice helical CT could keep the image quality and reduce radiation dose significantly. Our preliminary experience suggests a good promise of this technique which could be applied to a wider group of patients such as with higher heart rates.

Objective To explore the life experiences of donors undergoing pediatric living related liver transplantation and elucidate it 's the influencing factors of quality-of-life .Methods A qualitative study was performed with a phenomenological-hermeneutic approach .Twelve living related liver transplantation donors were face-to-face interviewed by a semi-structured interview and 7-step Colaizzi method was applied for data analysis .Results Four domains and 9 sub-domains were summarized as follows :body disturbance (pain ,discomfort & physical changes) ,sense of uncertainty (recipient-dependent sensitive ,self-doubt & confusion under family pressure ) ,role conflict (patient-carer & family-social) and contentment & gratitude (willing to sacrifice ,living in the present &benefiting from social funds ) .Conclusions The levels of quality-of-life vary greatly in different donors .Body disturbance ,sense of uncertainty ,role conflict ,contentment and gratitude are the major influencing factors of quality-of-life for donors undergoing pediatric living related transplantation .