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 protective effects and underlying molecular mechanisms of hydrogen (H2) on high glucose-induced poly (ADP-ribose) polymerase-1 (PARP-1) dependent cell death (PARthanatos) in primary rat Schwann cells. Methods Cultured primary rat Schwann cells were randomly divided into five groups: blank control group (C group), H2 control group (H2 group), high osmotic control group (M group), high glucose treatment group (HG group), and H2 treatment group (HG+H2 group). The cells in H2 group and HG+H2 group were cultured with saturated hydrogen-rich medium containing 0.6 mmol/L of H2, and those in three control groups were cultured with low sugar DMEM medium containing 5.6 mmol/L of sugar, and the cells in HG and HG+H2 groups were given 44.4 mmol/L of glucose in addition (the medium containing 50 mmol/L of glucose), the cells in C group and H2 group were given the same volume of normal saline, and the cells in M group were given the same volume of mannitol. Cytotoxicity was evaluated using lactate dehydrogenase (LDH) release rate assays after treatment for 48 hours in each group. The contents of peroxynitrite (ONOO-) and 8-hydroxy-2-deoxyguanosine (8-OHdG) reflecting oxidative stress injury and DNA damage were detected by enzyme linked immunosorbent assay (ELISA). Poly (ADP-ribose) (PAR) protein expression was analyzed by Western Blot, and immunofluorescence staining was used to determine the nuclear translocation of the apoptosis-inducing factor (AIF). Results The cytotoxicity in HG and HG+H2 groups was significantly increased as compared with that of C group [LDH release rate: (61.40±2.89)%, (42.80±2.32)% vs. (9.92±0.38)%, both P < 0.01], the levels of ONOO- and 8-OHdG were markedly elevated [ONOO- (ng/L): 853.58±51.00, 553.11±38.66 vs. 113.56±14.22; 8-OHdG (ng/L): 1 177.37±60.97, 732.06±54.29 vs. 419.67±28.77, all P < 0.01], and the PAR protein expression was up-regulated (A value: 0.603±0.028, 0.441±0.010 vs. 0.324±0.021, both P < 0.01). The cytotoxicity, the levels of ONOO- and 8-OHdG, and PAR expression in HG+H2 group were significantly lower than those of the HG group (all P < 0.01). There were no significant differences in above parameters between H2 group as well as M group and C group. It was shown by immunofluorescence that AIF was expressed in the cytoplasm in C group, H2 group and M group, AIF was expressed in the whole cell in HG group, and the expression in the nucleus was particularly increased. A small amount of AIF expression was found in the nucleus of HG+H2 group, which indicated that high glucose could promote the AIF nuclear translocation, and that hydrogen-rich medium could prevent the process of translocation. Conclusions High glucose levels could enhance DNA damage that enhance PARthanatos in primary rat Schwann cells. However, H2 can not only reduce DNA damage of injured cells, but also inhibit the special death process, reduce the cell toxicity, all of which have protective effects.

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 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 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 investigate the effects of hydrogen-rich medium on lipopolysaccharide (LPS)-induced intestinal epithelial barrier dysfunction of human intestinal epithelial (Caco2) cells. Methods Caco2 cells (passages 28-35) were purchased from the Cell Bank of the Shanghai Institute of Cell Biology, Chinese Academy of Sciences in Shanghai, China, and they were cultured in Dulbecco minimum essential medium (DMEM) containing 20% fetal bovine serum. These cells were randomly divided into four groups: control group (group A), hydrogen-rich medium group (group B), LPS group (group C) and LPS + hydrogen-rich medium group (group D). Cells were cultured with normal medium in group A and group C or with hydrogen-rich medium in group B and group D. Meanwhile, 1 g/L LPS was simultaneously added into group C and group D, while an equivalent volume of normal saline was added into group A and group B instead. In vitro intestinal epithelial models were reproduced with monolayer filter-grown Caco2 and intestinal epithelium. The trans-epithelial electrical resistance (TEER) in models of each group was measured at different incubation times (0, 3, 6, 12, 24 and 48 hours). Cell viability and cytotoxicity were assessed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and lactate dehydrogenase (LDH) release assay, respectively, after incubation for 24 hours. The expression levels of claudin-1 and occludin were respectively determined at 6, 12 and 24 hours of incubation by Western Blot assay. The morphological structure of claudin-1 and occludin was respectively observed after incubation for 24 hours with immunofluorescence staining. Results There was no statistical significance in variables between group A and group B. Compared with group A, it was shown that TEER was time-dependently decreased in groups C and D after 6 hours. Compared with group C, TEER in group D was increased after 6 hours. Compared with group A, the cell viability was significantly reduced in group C [(67.2±7.9)% vs. (100.0±0.0)%, P < 0.05] and cell injury was obvious [LDH release rate: (38.5±2.1)% vs. (1.2±0.3)%, P < 0.05]; the expression levels of claudin-1 and occludin at 6, 12, 24 hours were significantly down-regulated [claudin-1 (gray value): 0.351±0.079, 0.272±0.075, 0.190±0.049 vs. 0.518±0.030; occludin (gray value): 0.416±0.044, 0.290±0.062, 0.226±0.019 vs. 0.602±0.038, all P < 0.05], and the structure of claudin-1 and occludin were profoundly disrupted. Compared with group C, it was shown that the cell viability was significantly increased in group D [(88.8±7.4)% vs. (67.2±7.9)%, P < 0.05] and cell injury was significantly abated [LDH release rate: (16.4±4.3)% vs. (38.5±2.1)%, P < 0.05]; the expression levels of claudin-1 and occludin were significantly up-regulated at 24 hours [claudin-1 (gray value): 0.428±0.046 vs. 0.190±0.049, occludin (gray value): 0.466±0.071 vs. 0.226±0.019, both P < 0.05]; the disrupted structures of claudin-1 and occludin were partially recovered. Conclusion Hydrogen-rich medium can effectively attenuate LPS-induced dysfunction of intestinal epithelial barrier in human Caco2 cells by ameliorating cell viability as well as regulating claudin-1 and occludin expression and structure.

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.