Objective To evaluate if high energy spectral CT images of contrast-enhanced phase could replace the plain scan for radiation dose reduction in children with solid tumor in abdomen.Methods Thirty children with solid tumor in the abdomen underwent CT scan.Plain CT scan was performed as usual,and the contrast-enhanced scan was performed with spectral CT imaging mode.Eleven sets of monochromatic images were reconstructed from the enhanced spectral CT with energies from 40 to 140 keV with 10 keVinterval.CT values for liver,spleen,kidney,pancreas,muscle,vessel and tumors were measured on both the plain and contrast-enhanced spectral images and were statistically compared.Two board-certified radiologists reviewed both plain and contrast-enhanced spectral images for image quality,calcification and tumor characterization.Radiation dose was recorded(CTDIvol,DLP).Pair t test was used to analyze the difference.Results At 140 keV,CT values of the contrast-enhanced spectral images had good correlations with those of plain scan for various organs.The paired CT values between the 140 keV and plain phaseimages were (62.8± 1.1 vs.59.8±4.0),(69.4±2.6vs.63.1 ±5.6),(52.7 ±5.1 vs.51.4±4.0),(35.4± 5.9 vs.35.7 ±5.3),(51.4±8.6vs.50.0±5.7),(55.5±6.6vs.54.7±5.7) and (33.2± 10.4vs.35.4± 12.1) HU for vessel,liver,spleen,kidney,pancreas,muscleand tumor,respectively.There was no significant difference between two groups(t=0.335 to 2.127,P＞0.05).140 keV images of the contrast-enhanced spectral scan in pediatric tumor patients provided adequate image quality (4.4±0.8 points and 3.7±0.5 points)for describing solid tumor features and calcification.The radiation dose of plain phase and contrast-enhanced phase were [CTDIvol (1.6±0.8) mGy,DLP(46.4±36.8)mGy·cm and CTDIvol(12.7±0.1)mGy,DLP(378.6±91.4)mGy·cm.Conclusion It isfeasible to replace plain CT with 140 keV contrast-enhanced spectral images to reduce 10％ radiation dose.

Objective To investigate the capability of cardiomyoganic differentiation of human umbilical cord perivascu- lar cells induced by 5-azacitidine in vitro.Methods Human umbilical cord perivascular colls were harvested from the umbilical cords of consenting full-term caesarian section patients,which were digested by collagenase,and were purified, expanded through repeating passaging in time in vitro.The HUCPV cell of passage 3 were treated with 5-azacytidine(5 -aza,5?10~(-6)nmol/L) for 24 hours and continued to be cultured under the previous condition for 4 weeks.The prolifera- tion and differentiated phenotype of HUCPV cells were observed.Results The isolation method of the UC vasculature and enzymatic digestion of its perivascular tissue to rapidly harvest a highly proliferative HUCPV cells.After treated with 5 -aza for 4 weeks,the passage 3 HUCPV cells formed the spindle-shaped cells and rate of nuclear and cytoplasm de- creased.Myotube-like structures were found in some cytoplasm.Immunohistochemistry results showed that the HUCPV cells were similar to MSC by stained positively for CD44 and negtively for CD34.The HUCPV cells induced by 5-aza were stained positively a-cardiac action and cardiac Troponin by immunohistochemistry.Furthermore,the expression of a -cardiac action and cardiac treponin gene as detected positively by RT-PCR after HUCPV cells were induced by 5- aza.Conclusion The HUCPV cell was a valuable material for cell-based therapies and can be induced into cardiac- like cells by treatment with 5-aza.

BACKGROUND:At present, a heparin-coated extracorporeal circulation pipe is used widely, but the price is expensive and limits its wide application.
OBJECTIVE:To screen the optimal coating condition of oxidated sodium alginate as a coating material to coat the medical polyvinyl chloride pipe and to evaluate the anticoagulant properties and the stability of the coated pipe.
METHODS:Oxidized sodium alginate was prepared with sodium periodate, and the mole ratio of sodium periodate and sodium alginate was 1:8, 1:10 and 1:12, respectively. Oxidized sodium alginate with different
degree of oxidation was coated on the surface of medical polyvinyl chloride pipes by chemical methods, then to select the best degree of oxidation. The optimal coating condition was screened through an orthogonal
experiment based on concentrations of sulfuric acid, polyethyleneimine and oxidized sodium alginate, and pH
value and temperature of oxidized sodium alginate. Additional y, the anticoagulant properties and expulsion rates of the prepared pipes were evaluated in comparison with the blank control group and heparin-coated group.
RESULTS AND CONCLUSION:The optimal oxidation degree for oxidized sodium alginate was 1:10 for the mole ratio of sodium periodate and sodium alginate. The best coating conditions were 50%concentrated sulfuric acid, 0.05%polyethyleneimine, 40 ℃ of reaction temperature, 2 g/L oxidized sodium alginate, and pH value=3.5. The oxidized sodium alginate coating group had a similar trend compared with heparin-coated group in the expulsion rate. The anticoagulant properties of oxidized sodium alginate coating group were little weaker than those of
heparin-coated group (P<0.05), but significantly better than those of the blank control group. The oxidized sodium alginate-coated extracorporeal circulation pipe has a good anticoagulant property and stability.

Objective To discuss the effectiveness of anterolateral thigh propeller flaps for treatment of inguinal skin and soft tissue defects.Methods From June,2009 to October,2014,12 patients with inguinal skin and soft tissue defects were treated with anterolateral thigh propeller flaps pedicled with perforator of descending branch of lateral circumflex femoral artery.Of them there were 8 males and 4 females,aged from 22 to 51 years.The left side was involved in 3 cases and right side 9 cases.Defects were caused by traffic accident injury in 5 cases,crash injury of heavy object in 7 cases.There were mere skin and soft tissue in 2 cases,combined with bone fractures,nerves,vessels and muscles injury in 10 cases.The area of defects ranged from 9.0 cm×5.0 cm to 22.0 cm×9.0 cm.During operation,anterolateral thigh propeller flaps ranging from 11.0 cm×7.0 cm to 24.0 cm×1 1.0 cm were used to repair the wounds.Results All flaps and skingrafts survived after operation and the wounds obtained primary healing.After 8-24 months follow-up,all flaps were characterized by soft texture,good color,and satisfactory appearance.According to the Britain's Medical Research Council at 8 months after operation,the sensation of the flaps were recovered to S2 ～ S3+,No obvious scar contracture and chromatosis were observed at donor site.Conclusion Anterolateral thigh propeller flaps pedicled with artery descending branch of lateral circumflex femoral perforator is an ideal choice for the reconstruction for inguinal skin and soft tissue defects.

The renal toxicity of rats after a single dose ofMeng-Gen-Wu-Su (mercury) processed products,Meng-Gen-Wu-Su (mercury)-18-composition pill, mercuric sulfide, mercuric chloride, and mercurous chloride was studied. Fifty-four male Wistar rats were randomly divided into nine groups according to body weights (6 rats in each group): normal control group, low and high dose groups (0.033, 0.33 g·kg-1·d-1) ofMeng-Gen-Wu-Su (mercury) processed products, low and high dose groups (0.29, 2.9 g·kg-1·d-1) ofMeng-Gen-Wu-Su (mercury)-18-composition pill, simplified prescription ofMeng-Gen-Wu-Su (mercury)-18-composition pill group (0.26 g·kg-1·d-1), mercuric sulfide group (17.39 mg·kg-1·d-1), mercuric chloride group (4.06 mg·kg-1·d-1) and mercurous chloride group (35.3 mg·kg-1·d-1). After acclimation for one week, once oral administration was given to each group of rats. After 24 h, function and morphological changes of liver and kidney were detected. Mercury accumulation in kidney was determined by inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma source mass spectrometer (ICP-MS). Apoptosis of renal cell was determined by terminal-deoxynucleoitidyl transferase mediated Nick End Labeling (TUNEL). Renal typeⅢ collagen protein's expression was determined by immunohistochemical (HIC) method and expression changes of MT-1, MT-2 mRNA in kidney were also determined by real-time fluorescence quantitative PCR (real-time-PCR). There was no significant difference of ALT, AST in serum between normal control group and other groups (P>0.05). CREA and UREA in mercurous chloride group were apparently higher than normal control group and low dose group of Meng-Gen-Wu-Su processed products (P<0.01). Hepatic and renal pathologic examination results showed that liver cell of low dose groups ofMeng-Gen-Wu-Su processed products andMeng-Gen-Wu-Su-18-composition pill swelled to a low degree and glomerular disease was not obvious. In high-dose groups ofMeng-Gen-Wu-Su processed products,Meng-Gen-Wu-Su-18-composition pill and mercuric sulfide group, liver and kidney appeared some pathological changes and such changes were more significant in mercuric chloride and mercurous chloride groups. Compared with normal control group and low dose group ofMeng-Gen-Wu-Su processed products, the mercury kidney volume in mercuric chloride and mercurous chloride groups increased significantly (P<0.01). The apoptosis rate of renal cell and expression of typeⅢ collagen protein increased significantly in the groups of mercuric sulfide, mercuric chloride and mercurous chloride (P<0.01). MT-1and MT-2 mRNA gene expression rised significantly in the groups of mercuric chloride and mercurous chloride (P<0.05 orP<0.01). In summary, the rats renal toxicity after a single dose ofMeng-Gen-Wu-Su (Mercury) processed products or MongolianMeng-Gen-Wu-Su (Mercury)-18-composition pill were both far less than that of mercuric chloride or mercurous chloride.

Blood-brain barrier (BBB) is a kind of important barrier system in the body. It can have a choice to prevent certain substances from entering the brain, in order to maintain the relative stability of internal environment of the central nervous system (CNS). However, it also became an important restriction factor for the treatment of CNS diseases. Traditional Chinese medicine (TCM) had good curative effects on several kinds of CNS diseases, which illustrated that effective composition of TCM can pass through or influence the function of BBB. This paper summarized the research progress of literatures on current pharmacological and clinical trials for the effect of TCM on BBB.

Objective To analyze CT and MR features of malignant peripheral nerve sheath tumor (MPNST)of children. Methods Sixteen patients with histologically proven MPNST were retrospectively reviewed.There were 8 male and 8 female, ages from 0.3 to 11.0 years, and median age was 2.5 years. Sixteen cases were performed with CT plain scan, and eight cases with CT enhancement scans, and three with MR examination. The imaging data were analyzed by two highly experienced doctors and obtained agreements after mutual consultation. Results Among 16 cases, 3 cases were located at neck, 5 cases at waist and back,3 cases at abdominal and pelvic, 2 cases at foot, 1 case at left clavicle, 1 case at right mediastinum, 1 case at right orbit. Fifteen cases appeared as solid masses and 1 case showed a diffuse growth. CT plain scan showed 8 cases were solid-appearing masses and 7 cases were cystic-solid mass. Enhanced CT showed enhancement of solid component was moderate to marked and gradually delayed enhanced while cystic component had no any enhancement. One was located on the left side of the neck and appeared as diffuse growth. Two cases of solid mass type appeared as hypo-intensity on T1WI and hyper-intensity on T2WI, and obviously high signal intensity of cystic component on T2WI, and with significantly heterogeneous enhanced.One case with diffuse growth appeared as hypo-intensity on T1WI and slightly hyper-intensity on T2WI, and with significantly enhanced. Sixteen cases appeared as invasive growth, 11 caseswith multiple organic metastases and recurrences, and 4 cases with neurofibromatosis type I and scoliosis.Conclusion CT and MR appearances of MPNST have certain characteristic features, and can demonstrateaggressive performance and multiple organic metastases, which is helpful for definite diagnosis and treatment plan.

Objective To evaluate the effect of stellate ganglion block (SGB) on postoperative synaptic structure in hippocampal CA3 region in aged rats.Methods Seventy-two male Sprague-Dawley rats,aged 20-22 months,weighing 550-650 g,were randomly divided into 3 groups (n =24 each) using a random number table:control group (group C),operation group (group O) and SGB + operation group (group SGB).Group SGB received right SGB with 0.25％ bupivacaine 0.15 ml.Groups O and SGB underwent 30 min of exploratory laparotomy starting from 15 min after the end of administration.Y-maze test was performed on 1 day after operation in 6 rats chosen from each group for assessment of cognitive function.The frequency of standard training and standard time were recorded.Six rats were chosen from each group on 1,3 and 7 days after operation and sacrificed and the hippocampal CA3 region was isolated for microscopic examination and for measurement of synaptic structure.Results Compared with group C,the standard time was significantly prolonged,and the frequency of standard training was increased in groups O and SGB,the width of synaptic cleft was increased,the thickness of post-synaptic density was decreased,the length of active zones was shortened,and the curvature of the synaptic interface was decreased on 1,3 and 7 days after operation in group O (P ＜ 0.05),and no significant changes were found in each synaptic structure parameter in group SGB (P ＞ 0.05).Compared with group O,the standard time was significantly shortened,the frequency of standard training was decreased,the width of synaptic cleft was decreased,the thickness of the post-synaptic density was increased,the length of active zones was prolonged,and the curvature of the synaptic interface was increased on 1,3 and 7 days after operation in group SGB (P ＜ 0.05).Conclusion The mechanism by which SGB improves the postoperative cognitive dysfunction in aged rats may be related to inhibition of changes of synaptic structure in hippocampal CA3 region.

Objective To observe the difference between skeletal age of hand and wrist and chronological age and explore the reliability of CHN radiographic atlas method to assess the skeletal age of hand and wrist in children and adolescent.Methods Total 1397 healthy children (666 boys,731 girls;age range,1.0-18.0 years old) with hand and wrist injury from 2007 to 2011 were selected.Forty groups (n =20 for boys and girls,respectively) were classified according to CHN radiographic atlas method.The radiographs of hand and wrist were assessed by CHN radiographic atlas method,the relations between skeletal age and chronological age were investigated by using Wilcoxon signed ranks test.Results According to the CHN radiographic atlas method,the difference in 1.0 to 3.9 years old,7.0 to 7.9 years old and 9.0 to 15.9 years old boy groups between skeletal age and the chronological age had statistical significance (P ＜0.05) ; the difference in 1.0 to 2.9 years old,8.0 to 11.9 years old,12.6 to 14.9 years old,and 17.0 to 18.0 years old girl groups between skeletal age and the chronological age had statistical significance (P ＜ 0.05).Besides,these skeletal age was higher than the chronological age.Conclusions Skeletal age assessed by the CHN radiographic atlas method in a majority of age groups was higher than chronological age.It should be cautious to estimate the contemporary Chinese children skeletal age of hand and wrist when using the CHN radiographic atlas method.

10.3969/j.issn.2095-4344.2013.25.015