Objective To investigate the lung CT findings in patients with primary Sj(o)gren's syndrome (pSS) and clinical significance.Methods Images of lung CT scans of 68 patients with pSS were retrospectively observed.The distribution characteristics of lung lesions were observed.CT visual score were used to quantitatively analyze lung lesions.Binary classification unconditional logistic regression analysis was used to investigate the relationship between pulmonary arterial hypertension (PAH) and anti-SSB seropositivity in Patients with pSS.Results The 68 cases of patients with pSS,PAH in 13 (19％),anti-SSB seropositivity in 25(37％),CT shows normal in 13 (19％),interlobular septal thickening,ground-glass opacity and intralobular interstitial thickening were frequent findings.The lesion distribution was in the peripheral and lower lung fields.Interlobular septal thickening and cysts were associated with PAH in Patients with pSS (OR=1.780,2.513,P＜0.05),cysts was significantly associated with anti-SSB seropositivity (OR =10.530,P＜0.05).Conclusion Lung CT can quantitatively analyze the degree of pSS lung damage,and provide helps for clinical treatment and prognosis.

Objective To evaluate the changes of rectal morphology and its clinical value in internal rectal prolapse.Methods The rectal morphology of internal rectal prolapse in thirty-one patients with functional constipation and ten normal control subjects was analysed with defecography.The data were analysed with Mann-Whitney Unonparametric test and Fisher's exact test.Results 23 cases and 2 cases with rectal intussusception in patients group and control group respectively were found.Fisher's exact test was P=0.007.In patients group and control group,the thicknesses of anterior intussusception were(13.51 ±9.42)mm and(3.68±2.34)mm,and posterior intussusception were(5.36±3.92)mm and(2.82±0.99)mm respectively;the intussuscipiens diameters were (37.19±11.79)mm and(25.32±9.25)mm,the intussusceptum lumen diameters were(14.91±4.74)mm and(19.73±6.36)mm,the ratio of intussuscipiens diameters and lumen diameters were 2.82±1.64 and 1.28±0.12,the maximum rectal diameter were(48.97±9.55)mm and(39.84±8.45)mm at rest state.There were significant differences between patients group and control group in above varied values(P＜0.05).Conclusion Defecography can differentiate whole thickness rectal intussusception from rectal mucosal prolapse,which provides the scientific basis for choosing the reasonable treatment.However,caution is required when selecting patients for treatment interventions based on defecography.

Objective To evaluate the distribution of Schmorl's nodes (SN) in patients with low back pain or radiculopathy,and to analyze the correlation between SN and degeneration of lumbar intervertebral discs.Methods In 2012,1024 patients with low back pain or sciatica were examined by magnetic resonance (MR) scan and plain film.There were 448 males and 576 females,with an average age of (54.3 ± 12.7) years (range,22-90).The features distribution of SN in lumbar endplate on age,sex,segment and the type and grade of intervertebral disc degeneration were analyzed retrospectively.Results Among 5120 lumbar intervertebral segments of the 1024 patients,295 (28.8％) cases and 532 (5.2％) endplates were involved with SN,302 located in the cranial and 230 in the caudal endplate.According to percent prevalence per lumbar segment,L1,2 was the most common level (29.1％),followed by L3,4 (23.7％) and L2,3 (21.1％).The incidence of SN was positively correlated with elder age,but not with sex,body weight,height,or body mass index.SN occurred more often in bulging,extrusion,Modic changes,spondylolisthesis and osteophyte comparing with normal disc or protrusion or high intensity zone.The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent SN.Intervertebral discs with adjacent SN were more degenerated than those without adjacent SN.The number,size and volume of SN were associated with the degrade of intervertebral discs degeneration.SN was divided into two types,i.e.,acute edematous SN and non-acuteSN,according to the signal type on T1-and T2-weighted MR images,and the degeneration of the corresponding intervertebral discs was more severe in the latter than the former group.Conclusion SN occurred more often in the upper lumbar spine and cranial endplate in patients with low back pain or radiculopathy.SN were correlated with elder age and the degeneration of lumbar intervertebral discs.The number,size,volume and signal type on MR images of SN impacted on its correlation with lumbar intervertebral disc degeneration.

Objective Study cisplatin intraperitoneal hot perfusion chemotherapy for colorectal cancer effect a radical cure the prognosis of the patients and the influence of immune function.Methods120 patients who underwent radical resection of colorectal cancer patients, divided into observation group and control group, 60 cases in each group.The observation group were treated with cisplatin in postoperative continuous hyperthermic perfusion chemotherapy (chemotherapy for 200mg/m2 solution to cisplatin and injected with 1L), once a week, continuous treatment three weeks.The control group was treated with mFOLFOX6 intravenous chemotherapy (oxaliplatin 100mg/m2 fluorouracil leucovorin 400mg/m2, 400mg/m2), once every two weeks, 12 times of treatment.After the treatment, observation and analysis of two groups of patients before and after treatment of tumor markers (CEA, cancer antigen 19-9, cancer antigen 242), immune function (CD3+ cells, CD4+ cells, CD8+ cells, CD4+ cell ratio/CD8+ cell natural killer cells), quality of life, and the incidence of recurrence and metastasis.ResultsAfter treatment, the quality of life of patients in the observation group the total effective rate was 91.67%, significantly higher than the control group 70.00% (P<0.05), the recurrence rate is 8.33%, the metastasis rate of 10.00% was significantly higher than the control group 28.33% and 25.00% (P<0.05).The observation group of patients with carcinoembryonic antigen, cancer antigen 19-9, cancer antigen 242 level respectively (3.4±1.1)% and (17.5±7.1)% and (4.7±1.9)% was significantly lower than the control group (10.2±2.8)% and (30.1±10.3)% and (20.3±4.5)% (P<0.05), the observation of immune function effect is improved significantly better than the control group, significant differences (P<0.05).ConclusionChemotherapy after radical resection of colorectal cancer patients using cisplatin intraperitoneal hyperthermic perfusion, can significantly reduce the recurrence rate and metastasis rate, improve immune function, reduce the level of tumor markers, so as to improve the quality of life of patients.

Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.

Objective To study the feasibility of rat models of renal edema based on disease combined with traditional Chinese medicine syndrome yin-deficiency and yang-deficiency types .Methods Gastric gavage of thyroxine and tail vein injection of Adriamycin were performed to induce a rat model of kidney Yin deficiency edema , and intramuscular injection of hydrocortisone and tail vein injection of Adriamycin were used to establish a rat model of kidney Yang deficiency edema .The 24 h urine protein content , triiodothyronine ( T3 ) , thyroxine ( T4 ) , cyclic adenosine monophosphate ( cAMP ) , cyclic guanosine monophosphate ( cGMP ) , estradiol ( E2 ) and testosterone ( T ) and other indicators were assayed to determine whether the rat models were successfully established .Result The rats of Yin deficiency edema group had clinical presentation such as hyperactivity , hair loss, dry stool, weight loss and temperature rise.Compared with the blank group , T3, T4, cAMP, E2, and 24 h urinary protein levels were significantly increased , cGMP and T content decreased , and cAMP/cGMP ratio was significantly increased , showing significant differences ( P<0.05 for all).The Yang deficiency edema animals displayed reduced activity , diarrhea, decreased body weight and body temperature, and other signs of disease.Compared with the blank group, T3, T4, cAMP, and E2 contents were significantly decreased , cGMP, T, and 24 h urinary protein levels were significantly increased , and cAMP/cGMP ratio decreased , showing significant differences ( P <0.05 for all ) .Conclusions The rat model of renal edema disease combined with TCM syndrome yin-deficiency was successfully induced by thyroxine in combination with Adriamycin , and the rat model of renal edema based on disease combined with TCM syndrome yang-deficiency is successfully established by administration of hydrocortisone plus Adriamycin .These two rat models demonstrate similar clinical manifestations of human renal edema based on disease combined with TCM syndrome yin-deficiency and yang-deficiency, respectively, therefore, may serve as useful tools for further research on this disease .

ObjectiveTo explore the short-term curative effect and safety of autologous bone marrow mesenchymal stem cells transplantation in patients with primary brain stem injury.MethodsFifty-four cases with primary brain stem injury were hospitalized during Jul.2007 to Jul.2010 at Liaocheng Brain Hospital,Shandong Province.All cases were randomized into transplantation group( n =30)or control group( n =24 ).The transplantation group was treated with autologous bone marrow mesenchymal stem cell transplantation by subarachnoid space injection (n =30).The control group were selected from primary brain stem injury patients without stem cell transplantation who were hospitalized at the same period with patients from the transplantation group.Respectively,National Institutes of Health Stroke Scale (NIHSS) score was employed to evaluate the condition of patients in the two groups one month after treatment,and Glasgow Outcome Scale (GOS) score was used to evaluate curative effects of the two groups at sixth months after treatment.Meanwhile,some other parameters were observed,including blood routine,clotting mechanisms,biochemicalitemsand tumor markers.ResultsThere was significant difference between the transplantation group and the control group in N IHSS score at one month after treatment [ ( 10.86 ± 7.48) vs.( 18.26 ± 8.74),t =2.681,P ＜ 0.05 ].GOS score was significantly different( Z =2.306,P ＜ 0.05 ) between the transplantation group and the control group at sixth month after transplantation.There was no significant difference between the two groups in the blood examination results during the followed-up period.Conclusion Autologous bone marrow mesenchymal stem cells transplantation is confirmed to be an effective and safe therapy in patients with primary brain stem injury in the short-term.Further evaluation still needs for its long-term efficacy on primary brain stem injury

Objective To study the management of vascular injury.Methods Retrospective analysis was made on the clinical data of 59 cases of vascular injury,including 55 cases of vascular injury in neck and(extremity) and 4 cases of portal vein and vena cava injury.Among them,21 cases had femoral artery injury with infection and 4 cases had vascular injury due to intervention therapy.All patients with vascular wound of extremity or neck had undergone hemostasis by compression and antishock treament before hospital admission.All cases of femoral artery injury with infection underwent hemostasis by arterial ligation and incision and(drainage) of abscess.Vascular anastomosis was performed in 11 cases,vascular grafting in 12 cases,and(vascular) repair in 14 cases.Results There were 2 deaths.5 cases had amputation(including a case of(femoral) embolism due to intervention trerapy).Postoperative intermittent claudication,decreased skin(temperature) and other signs of ischemia occurred in 21 cases of femoral artery injury with infection,but none developed limb gangrene. The other cases were discharged in good health.Conclusions In the treatment of vascular injury,wound hemostasis and antishock treatment should be done first to save the patient′s life and the management of the vascular injury depends on the situation,with the aim to try by all means to save the extremity.Vascular reconstruction is the main method for treatment of vassular injury.Vascular ligation can be done in cases of femoral artery injury with infection.

OBJECTIVETo optimize a compound prescription for treatment of liver fibrosis with an improved therapeutic effect and low toxicity.

METHODSIn rat models of liver fibrosis induced by thioacetamide (TAA), the optimized prescription was screened based on a uniform design with 2-factor 5-level table using Uniform Design 3.0 software and tested using liver content of Hyp as the screening index. To verify the efficacy of the optimized prescription, the rat models of liver fibrosis were randomized into normal control group, model group, colchicine group and optimized prescription group, and the changes of hepatic Hyp content, serum HA, ALT, AST, and ALB levels, and the pathology liver fibrosis were observed after corresponding treatments.

RESULTSThe optimized prescription, which contained 70 mg/kg glycyrrhizin and 70 mg/kg matrine, showed a significant therapeutic effect against liver fibrosis in rats (Plt;0.05), and the effect was equivalent to that of colchicine (P>0.05).

CONCLUSIONUniform design is a valuable method in prescription optimization. The optimized compound prescription of matrine and glycyrrhizin has a significant effect in inhibiting liver fibrosis.

Alkaloids ; administration & dosage ; Animals ; Drug Therapy, Combination ; Female ; Glycyrrhizic Acid ; administration & dosage ; Liver Cirrhosis ; chemically induced ; drug therapy ; Male ; Phytotherapy ; Quinolizines ; administration & dosage ; Rats ; Rats, Sprague-Dawley ; Thioacetamide