Objective Exploring the design and optimizing factors of picture archiving and communication system (PACS) network architecture. Methods Based on the PACS of shanghai first hospital to performed the measurements and tests on the requirements of network bandwidth and transmitting rate for different PACS functions and procedures respectively in static and dynamic network traffic situation, utilizing the network monitoring tools which built in workstations and provided by Windows NT. Results No obvious difference between switch equipment and HUB when measurements and tests implemented in static situation except router which slow down the rate markedly. In dynamic environment Switch is able to provide higher bandwidth utilizing than HUB and local system scope communication achieved faster transmitting rate than global system. Conclusion The primary optimizing factors of PACS network architecture design include concise network topology and disassemble tremendous global traffic to multiple distributed local scope network communication to reduce the traffic of network backbone. The most important issue is guarantee essential bandwidth for diagnosis procedure of medical imaging.

Objective To discuss the scheme and implementing for workstation configuration of medical imaging information system which would be adapted to the practice situation of China. Methods The workstations were logically divided into PACS workstations and RIS workstations, the former applied to three kinds of diagnostic practice: the small matrix images, large matrix images, and high resolution grayscale display application, and the latter consisted of many different models which depended upon the usage and function process. Results A dual screen configuration for image diagnostic workstation integrated the image viewing and reporting procedure physically, while the small matrix images as CT or MR were operated on 17 in (1 in =2.54 cm) color monitors, the conventional X ray diagnostic procedure was implemented based on 21 in color monitors or portrait format grayscale 2 K by 2.5 K monitors. All other RIS workstations not involved in image process were set up with a common PC configuration. Conclusion The essential principle for designing a workstation scheme of medical imaging information system should satisfy the basic requirements of medical image diagnosis and fit into the available investment situation.

Objective To explore the management model and realizing of PACS image data flow. Methods Based on the implementing environment and management model of PACS image data flow after full digital reengineering for radiology department in Shanghai First Hospital was completed, analysis on image data flow types, procedure, and achieving pattern were conducted. Results Two kinds of image data flow management were set up for the PACS of Shanghai First Hospital, which included image archiving procedure and image forward procedure. The former was implemented with central management model while the latter was achieved with a program that functionally acted as workflow management running on the central server. Conclusion The image data flow management pattern, as a key factor for PACS, has to be designed and implemented functionally and effectively depending on the performance environment, the tasks and requirements specified to particular user.

Objective To observe the development of hematopoietic stem cell and the apoptosis of ICM(intermediate cell mass) in folic acid deficient zebrafish embryos and investigate the mechanism by which folic acid deficiency induces abnormal hematopoiesis.Method The folic acid deficient zebrafish model was induced by both using the dihydrofolate reductase antagonism methotrexate(MTX) and knock-down dihydrofolate reductase gene.The development of embryos was observed under microscope.The blood cells were detected by O-dianisidine staining.Whole-mount in situ hybridization and real-time PCR were performed to examine the expression of FLK-1,GATA1and GATA2.Apoptosis in intermediate cell mass(ICM) was examined by TUNEL(terminal-deoxynucleotidyl transferase mediated nick end labeling) method.Results The abnormal developments of ICMs were observed both in MTX treated embryos and DHFR knock-down embryos.O-dianisidine staining revealed that folic acid deficiency resulted in the decreasing number of blood cells.In folic acid deficient embryos,the expression of FLK-1、GATA1and GATA2 was reduced and the apoptosis in ICMs was increased.Conclusion The abnormal hematopoiesis in zebrafish induced by folic acid deficiency is related with the increasing apoptosis in ICMs and decreasing expressions of FLK-1,GATA1and GATA2.

Objective To investigate the effects and mechanisms of hydrogen inhalation on serum levels of pro-inflammatory factors and intestinal injury in severe septic mice. Methods 176 male ICR mice were randomly divided into four groups: sham operation group, hydrogen control group ( sham + hydrogen inhalation ), model group ( severe sepsis model ) and hydrogen treatment group ( severe sepsis model+hydrogen inhalation ), with 44 mice in each group. Severe sepsis model was reproduced by cecal ligation and puncture ( CLP ). 2%hydrogen inhalation was given for 1 hour at 1 hour and 6 hours after sham or CLP operation. Twenty animals in each group were selected and observed for 7-day survival rate. Six animals in each group were selected and sacrificed at 6, 12, 24 and 48 hours after sham or CLP, the concentrations of tumor necrosis factor-α ( TNF-α), interleukins ( IL-6, IL-10 ) and high mobility group box 1 ( HMGB1 ) in serum were determined, the intestinal histopathological changes and scores were evaluated by light microscopy, and the activities of myeloperoxidase ( MPO ) and caspase-3 were determined. Results The 7-day survival rate of severe sepsis mice was 0; the 7-day survival rate was increased to 60% in hydrogen treatment group, with statistical significance in variables compared with model group ( P<0.05 ). Compared with sham operation group, the serum concentrations of TNF-α, IL-6, IL-10 and HMGB1 were obviously increased, the intestine were heavily injured along with higher histopathological scores, and the intestinal MPO and caspase-3 activities were significantly enhanced at different time points after CLP in model group ( all P<0.05 ). Compared with model group, the serum concentrations of TNF-α, IL-6 and HMGB1 were significantly decreased [ TNF-α( ng/L ):6 hours:110.34±9.28 vs. 440.55±25.78, 12 hours: 82.29±8.43 vs. 448.36±32.54, 24 hours: 79.68±9.04 vs. 346.42±22.24, 48 hours: 80.79±10.06 vs. 368.94±31.58; IL-6 ( ng/L ): 12 hours: 58.68±8.55 vs. 158.28±16.73, 24 hours: 46.98±7.58 vs. 146.74±18.02, 48 hours: 38.67±8.22 vs. 136.45±15.45; HMGB1 (μg/L ): 6 hours: 15.75±4.32 vs. 55.56±10.04, 12 hours:32.02±9.33 vs. 89.65±15.65, 24 hours: 35.87±8.54 vs. 86.44±20.33, 48 hours: 23.85±9.83 vs. 98.33±18.88, all P<0.05 ], the serum concentrations of IL-10 ( ng/L ) at 24 hours and 48 hours after CLP were obviously increased ( 24 hours:135.44±16.43 vs. 79.22±12.03, 48 hours:110.92±12.54 vs. 74.47±11.18, both P<0.05 ), the intestinal injury were ameliorated with decreased histopathological scores ( 12 hours: 1.70±0.06 vs. 3.23±0.44, 24 hours:2.12±0.31 vs. 4.51±0.58, 48 hours:2.03±0.42 vs. 4.27±0.58, all P<0.05 ), and the intestinal MPO and caspase-3 activities were significantly decreased [ MPO ( U/g ):6 hours:13.75±4.21 vs. 25.56±5.34, 12 hours:14.72±4.22 vs. 30.53±6.87, 24 hours:11.62±3.14 vs. 33.58±7.24, 48 hours:11.33±4.03 vs. 38.57±8.12;caspase-3 ( fluorescence intensity ): 6 hours: 0.37±0.07 vs. 0.69±0.23, 12 hours: 0.42±0.07 vs. 0.86±0.13, 24 hours: 0.53±0.11 vs. 1.36±0.23, 48 hours:0.50±0.08 vs. 1.48±0.15, all P<0.05 ] in hydrogen treatment group. Conclusion Hydrogen inhalation can down-regulate the systemic inflammatory response to ameliorate the intestinal injury, and it may improve the septic process and increase the survival rate of mice with severe sepsis.

Objective To evaluate the effect of hydrogen gas (H2) on intestinal Ras homolog gene (Rho) /Rho-associated coiled coil-forming protein kinase (ROCK) signaling pathway in septic mice.Methods Sixty-four male ICR mice,weighing 20-25 g,aged 6 weeks,were randomly divided into 4 groups (n =16 each) using a random number table:sham operation group (group SH),H2 group (group H2),sepsis group (group S) and sepsis+H2 group (group S+H2).Sepsis was produced by cecal ligation and puncture (CLP).H2 and S+H2 groups inhaled 2％ H2 for 1 h starting from 1 and 6 h after CLP operation,respectively.Eight mice of each group were selected at 20 h after CLP operation,and gavaged with fluorescein-isothiocyanate-conjugated dextran (FITC-dextran),4 h later blood samples were obtained by cardiac puncture,and the concentration of FITC-dextran in serum was measured.The left 8 mice in each group were sacrificed at 24 h after CLP operation.After anesthesia,the sterile samples of blood,liver,spleen and kidney were obtained and cultured for bacterial growth to evaluate the condition of bacterial translocation.The intestinal tissues were obtained for examination of the epithelial ultrastructure (by transmission electron microscope),and of the pathological changes which were scored (by light microscope) and for determination of the expression of Rho,ROCK1 and ROCK2 (by Western blot).Results Compared with group SH,the serum concentration of FITC-dextran and pathological scores were significantly increased,the colony-forming units in bacterial culture plates of blood,liver,spleen and kidney were increased,and the expression of Rho,ROCK1 and ROCK2 was up-regulated in S and S+H2 groups,and no significant change was found in the parameters mentioned above in H2 group.Compared with group S,the serum concentration of FITC-dextran and pathological scores were significantly decreased,the colony-forming units in bacterial culture plates of blood,liver,spleen and kidney were decreased,and the expression of Rho,ROCK1 and ROCK2 was down-regulated,and the pathologic changes of intestines were mitigated in group S+H2.Conclusion The mechanism by which H2 alleviates the intestinal injury is related to inhibition of the activation of Rho/ROCK signaling pathway in septic mice.

Objective To evaluate the effects of hydrogen on oxidative stress injury induced by high glucose in Schwann cells and its relationship with PARP-1-dependent cell death (parthanatos).Methods Primary rat Schwann cells were cultured in 96-well plate (1×104 cells/ml,200 μl/well) or in 6-well plate (1 × 106 cells/ml,2 ml/well) with RSM culture medium and were randomly divided into 5 groups (n=30 each):control group (group C),hydrogen group (group H2),high glucose group (group HG),high glucose plus hydrogen group (group HG+H2) and high osmotic control group (group M).The cells were cultured in the common culture medium in C,HG and M groups.The cells were cultured in hydrogen-rich culture medium in H2 and HG + H2 groups.In HG and HG + H2 groups,50 mmol/L of glucose was added to the culture medium.In C and H2 groups,the equal volume of normal saline was added to the culture medium.In M group,mannitol 44.4 mmol/L was added to the culture medium.The cells were then incubated for 48 h.After 48 h of incubation,the cell viability was measured using CCK-8 assay,intracellular reactive oxygen species (ROS) level was detected by flow cytometry,the concentration of 8-hydroxy-2-deoxy Guanosine (8-OHdG) was determined by ELISA,and the expression of poly (ADP-ribose)-polymerase-1 (PARP-1),cleaved-PARP-1,poly (ADP-ribose) (PAR),and apoptosis-inducing factor (AIF) in the total protein and nucleus was measured by Western blot.PARP-1 activity (cleaved-PARP-1/PARP-1) and AIF nuclear translocation were recorded.Results Compared with C and H2 groups,the cell viability was significantly decreased,and PARP-1 activity,expression of ROS,8-OhdG and PAR,and AIF nuclear translocation were increased in HG and HG + H2 groups.Compared with HG group,the cell viability was significantly increased,and PARP-1 activity,expression of ROS,8-OhdG and PAR,and AIF nuclear translocation were decreased in HG+H2 group.There was no significant difference in each parameter between M and C groups.Conclusion Hydrogen can reduce oxidative stress injury induced by high glucose in Schwann cells,and the mechanism is related to inhibition of parthanatos.

Objective To explore a compatible approach to detect and classify the lesions of inferior vena cavas (IVCs) on sonogram in patients with Budd-Chiari syndrome(BCS).Methods Ultrasonogram of the IVCs were observed detailedly in 300 patients with BCS by using trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections.Transducers usually used for heart examination were applied in the latter.Lesions of the IVCs found in 277 out of 300 patients were classified.All lesions were confirmed by digital subtraction angiography (DSA) and among them,52 cases underwent computed tomography angiography (CTA).Results Lesions of IVCs were classified into 3 categories as follows:membranous type,segmental type,and ex-pressed type.① Membranous type (thickness ≤ 15 mm) included membranous stenosis type and membranous occlusion type.On the basis of the thickness,the membranous stenosis type was further classified into thinner membranous stenosis type (thickness ≤5mm) and thicker membranous stenosis type (5 mm＜thickness≤ 15 mm).The membranous occlusion type was further classified into thinner membranous occlusion type (thickness ≤5 mm) and thicker membranous occlusion type (5 mm＜thickness ≤15 mm).② Segmental type (lengtb ＞ 15 mm) was consist of segmental stenosis type and segmental occlusion type.Based on the length of the lesion,the segmental stenosis type was further divided into longer segmental stenosis type (length ＞ 30 mm) and shorter segmental stenosis type (15 mm＜length ≤30 mm).The segmental occlusion type was further divided into longer segmental occlusion type (length ＞ 20mm) and shorter segmental occlusion type (15 mm＜ length ≤20 mm).③ Ex-pressed type of IVCs was mainly caused by compression of intumescent caudate lobes.Corresponding sonographic features were demonstrated in each type.Conclusions Ultrasonogram of trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections could accurately classify the lesions of IVCs.It is of important significance for the clinical treatment.

Objective To investigate the effect of inhalation of hydrogen (H2) on the inflammation response during sepsis-induced acute lung injury in mice.Methods Forty-eight male ICR mice,aged 5 weeks,weighing 20-25 g,were randomly divided into 4 groups (n =12 each):sham operation group (group A),sham operation + H2 group (group B),sepsis group (group C) and sepsis + H2 group (group D).Sepsis was produced by cecal ligation and puncture (CLP).Groups B and D received 1 h inhalation of 2 ％ H2 at 1 and 6 h after CLP or sham operation.The behavior was assessed and scored at 24 h after CLP.Arterial blood samples were taken for blood gas analysis.Oxygenation index was calculated.Venous blood samples were taken for determination of the levels of serum tumor necrosis factor-α (TNF-α),interleukin-1 (IL-1β),high mobility group protein B1 (HMGB1) and interleukin-10 (IL-10).The mice were then sacrificed and lungs were removed for determination of the levels of TNF-α,IL-1β,HMGB1 and IL-10 in lung tissues.The apoptotic index was calculated.Results Compared with group A,the behavior score,apoptotic index and levels of TNF-α,IL-1β,HMGB1 and IL-10 were increased,and the oxygenation index was decreased in groups C and D,and no significant change was found in the parameters mentioned above in group B.Compare with group C,the oxygenation index and level of IL-10 were significantly increased,and the behavior score,apoptotic index and levels of TNF-α,IL-1β and HMGB1 were significantly decreased in group D.Conclusion Inhalation of H2 can regulate the balance between pro-and anti-inflammatory cytokines,inhibit the inflammation response and alleviate sepsis-induced acute lung injury in mice.

ObjectiveTo investigate the effect of hydrogen (H2 ) on acute lung injury (ALI) in septic mice.MethodsOne hundred and twelve male C57BL/6 mice,aged 5 weeks,weighing 20-25 g,were randomly divided into 4 groups ( n =28 each):sham operation group (group A),sham operation + H2 group (group B),sepsis group (group C) and sepsis + H2 group (group D).Sepsis was produced by cecum ligation and puncture (CLP).Groups B and D received 1 h inhalation of 2％ H2 at 1 and 6 h after CLP operation or sham operation.Twenty animals in each group were selected and observed for the 7 d survival rate.The left 8 animals in each group were sacrificed at 24 h after CLP operation.Venous blood samples and lung tissues were obtained to determine the levels of superoxide dismutase (SOD),catalase (CAT) and 8-iso-prostaglandin F2alpha (8-iso-PGF2α) in the serum and lungs,the concentration of protein in bronchoalveolar lavage fluid (BALF),and the activity of myeloperoxidase (MPO) in the lungs.The lung injury score (LIS) was assessed and W/D lung weight ratio was calculated.ResultsCompared with group A,the 7 d survival rate and activities of SOD and CAT in the serum and lungs were significantly decreased,and LIS,W/D ratio,the concentration of protein in BALF,MPO activity and 8-iso-PGF2α level in the serum and lungs were significantly increased in group C ( P ＜ 0.05 ).Compared with group C,the 7 d survival rate and activities of SOD and CAT in the serum and lungs were significantly increased,and LIS,W/D ratio,the concentration of protein in BALF,MPO activity and 8-iso-PGF2α level in the serum and lungs were significantly decreased in group C ( P ＜ 0.05).ConclusionH2 can alleviate ALI in septic mice via inhibiting oxidative stress response.