Objective To explore the clinic value of magnetic resonance cholangiopancreatography(MRCP)for the diagnosis of biliary pancreatitis(BP).Methods MRCP manifestation of 60 cases of BP proved by clinic records was analyzed retrospectively. Results Of all the 60 cases,41 were found pancreatitis combined with gall bladder stones or biliary cystitis,19 combined with stones in common biliary duct.Dilation of biliary duct was found in 23 cases,dilation of pancreatic duct in 9 cases,dilation of both in 5 cases.Conclusion MRCP can clearly display the signs of biliary pancreatitis,and have high clinic value for its diagnosis.

Objective To explore the expression of caspase-3 in skeletal muscle of the mice in the state of cancer, and to elucidate the relationship between Caspase-3 and apoptosis,consumption of skeletal muscle protein in cancer cachexia.Methods 48 male BALB/c mice were randomly divided into cancer cachexia group and control group (n=24).The mice in cancer cachexia group were inoculated with mouse colon 26 adenocarcinoma cells.The body weights of the mice in two groups were detected daily.Eight mice in each group were executed to test the weight of left gastrocnemius, fiber crosscut area, the expression levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6),Caspase-3 proteins and the apoptotic rate of gastrocnemius cells on day 8,14,and 20,respectively. Results The mice in cancer cachexia group appeared cachectic symptoms on day 14,the non-tumor body weight was decreased more than 20% of that in control group (P<0.05).Compared with control group at the same time, the mouse body weight,non-tumor body weight,the weight of left gastrocnemius and the fiber crosscut area of the mice in cancer cachexia group were obviously decreased with the prolongation of inoculation time (P<0.05 ), whereas the expression levels of TNF-α,IL-6,Caspase-3 proteins and the apoptotic rate of muscle cells were obviously increased after tumor inoculation (P<0.05).The level of Caspase-3 protein was negatively correlated with the weight of gastrocnemius and fiber crosscut area (r=-0.716,P<0.05;r=-0.694,P<0.05),and the level of Caspase-3 was positively correlated with the levels of TNF-αand IL-6 (r=0.742,P<0.05;r=0.675,P<0.05).Conclusion Caspase-3 may be a key factor in the protein comsumption of skeletal muscle in cancer cachexia.

Objective To explore the CT and MR features of cystic nephroma. Methods CT and MRI findings of 8 patients with cystic nephroma comfirmed surgically and pathologically were analyzed retrospectively. Results In all 8 patients, cystic nephromas were unilateral and solitary, and diameter of lesions was 2.92-7.81 cm. The CT and MR scans showed multilocular cystic lesion with clear border. These locules did not communicate with each other. The septa were intact and smooth, and showed slight to moderate and gradual enhancement. The interlocular septa were demonstrated clearly on coronal T2WI, and showed hypointensity signals. The intracapsular liquids were heterogenous in 4 patients on MR images. The CT scanning showed a patchy calcification in 1 case. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epitheial cells, of which hemosiderin depositions were presented in 4 patients. Conclusion CT and MR are valuable in the diagnosis of cystic nephroma, and MRI can reflect the pathology of cystic nephroma more clearly, and supply the accurate reference information for diagnosis.

Objective To explore the feasibility of the double venipuncture instead of central venous catheter as a temporary vascular access in hemodialysis.Methods The upper arm below the 1/3 was tied a tourniquet,and fistula needle directly punctured the vein in the middle of the elbow.After the success of the puncture,elastic bandage was replaced by a tourniquet,and the ball movement was done by imitating the blood donation member for blood donation at hand gripping a ball or elements as the artery blood lead.Another elbow vein or lower limb saphenous vein was punctured.Thirty patients using double venipuncture dialysis or central venous catheter dialysis 2 weeks or more were randomly selected into each group,and biochemical and renal function was measured before dialysis.Results All of 1 282 patients who were newly into the blood dialysis,mature arteriovenous fistula was in 8 patients (0.6％,8/1 282),deep venipuncture to insert the central venous catheter was in 542 patients(42.3％,542/1 282),using the double venipuncture was in 732 patients (57.1％,732/1 282).The flow of blood was 180-200 ml/min,the avalible time was 1-2 months.The serum creatinine,blood urea nitrogen,calcium,phosphorus and carbon dioxide combining power had no significant difference between two groups (P ＞ 0.05).Conclusions The majority of patients with double venipuncture blood flow can satisfy the need of dialysis.Because the operation is simple,no recycling and may reduce the deep venipuncture,it is an ideal temporary vascular access.

Objective: To observe the effects of follistatin (FST)on the skeletal muscle wasting of cancer cachexia mice and the expressions of Mstn, LncRNA-MALAT1 and Caspase-3, and to elucidate its associated molecular mechanisms.Methods:Thirty-two BALB/c mices were randomly assigned into:healthy control (HC) group,FST prevention (FP)group,FST treatment (FT)group and cancer cachexia (CC)group.The murine colon adenocarcinoma CT26 cells were inoculated subcutaneously into the mices in FP, FT and CC groups to establish the cancer cachexia models. The body weight, spontaneous activity and tumor growth were daily monitored.The mice in FP and FT groups were administrated with FST intraperitoneally on day 6 and 12 after inoculation.The samples were collected on day 20.The tumor and gastrocnemius weights of the mice were detected. The biochemical metabolism indexes and myofiber cross-sectional area of gastrocnemius tissue were detected.The mRNA expression levels of Mstn,Caspase-3 and LncRNA-MALAT1 were examined by Real-time PCR.The protein expression levels of Mstn and Caspase-3 were measured by Western blotting method. Results:Compared with CC group,the body weights,spontaneous activities,gastrocnemius weights and myofiber cross-sectional areas were increased (P <0.05);the serum levels of glucose,total protein and albumin of the mice in FP and FT groups were increased (P <0.05).The protein and mRNA expression levels of Mstn and Caspase-3 in gastrocnemius of the mice in CC group were significantly higher and the expression level of LncRNA-MALAT1 was significantly lower than those in HC group (P < 0.05).The mRNA and protein expression levels of Mstn and Caspase-3 in FP and FT groups were reduced and the expression level of LncRNA-MALAT1 was increased compared with CC group (P < 0.05).The prevention effect in FP group is better than FT group (P < 0.05). Conclusion:FST may alleviate the muscle wasting of the mice with cancer cachexia by inhibiting the expression of Mstn,thus upregulating the expression of LncRNA-MALAT1 which in turn to suppress the expression of Caspase-3.

Objective The aim of this prospective observational study was to analyze the prevalence and the predictive factors of hemorrhagic events after abdominal paracentesis in patients with acute-on-chronic liver failure (ACLF).Methods ACLF patients who received at least one episode of abdominal paracentesis were prospectively enrolled between January 2010 to December 2013. Prevalences of intraperitoneal and abdomen hemorrhage complications were examined. t test was performed for continuous variables and chi-square test was performed for categorical variables.Binary Logistic regression was used to analyze the risk factors of hemorrhage.Results A total of 525 abdominal paracenteses were carried out on 185 ACLF patients within a 4-year period,with 289 (55 .0%)for diagnostic purpose and 236 (45 .0%)for therapeutic purpose.A total of 16 (3.0%)hemorrhagic complications were identified, with 4 cases of abdominal wall hematomas and 12 cases of intraperitoneal hemorrhage.Patients were divided into hemorrhage group and non-hemorrhage group according to this complication.Age,gender, Child-Pugh score,volume of ascitic fluid removed,underlying cirrhosis,platelet count and thrombin time were not significantly different between two groups (all P > 0.05 ).Patients with bleeding events had lower fibrinogen levels and higher prothrombin time,international normalized ratio,activated partial thromboplastin time and model for end-stage liver disease score (all P <0.05).After adjustment of other factors,multivariate regression analysis indicated that low fibrinogen level was the only independent predictor of hemorrhagic complication (OR=0.105,95%CI :0.018-0.608,P =0.012).Conclusion Low fibrinogen level is the independent predictor of severe hemorrhagic complications following paracenteses in patients with ACLF.

Objective To investigate the preparation of biodegradable vena cava filter(BVCF) with poly-l-lactic acid (PLLA),and to evaluate its mechanical properties,delivery performance,the ability of capturing thrombus and the degradation property.Methods Three-dimensional design software was used to design the shape of BVCF.The BVCF was prepared by using PLLA with molecular weight of 100 000 unit.Twelve minipigs were used to test the feasibility of this BVCF.They were randomly divided into four groups.At first the BVCFs were placed into the inferior vena cava of pigs in three experimental groups.The fourth group was used as a blank control group.The thrombi were injected into all pigs after 1 week,and CT examinations were performed at different time points to observe the filter locations and pulmonary artery.The animals were sacrificed according to a fixed time table for histopathological assessment.Results The BVCF was successfully designed and produced,which could expand by stretching the center-thread.In vitro test results showed the radial force of BVCF was approximately 1.6 N and could capture the thrombus more than 5 mm in diameter,and it was easy to release.Through the animal experiment confirmed that the filter could capture the lethal thrombus and all 9 pigs of experimental groups were survived,two of those had the symptoms of respiratory frequency and heartbeat accelerated slightly in the operation.In control group,the symptoms such as accelerate of respiratory rate,shortness of breath were observed in varying degree.The pig which was injected with 8 strips of thrombus died in the same day after surgery.Postoperative CT and pathological examinations showed that 2 pigs in the experimental group developed peripheral pulmonary embolism,while the dead pig in the control group developed central pulmona-y embolism.Histological findings showed that the intima covered the BVCF lateral branch partly after one week,and thoroughly after six weeks.The vessel wall structure remained normal and no signs of the obvious inflammatory cells infiltration were detected.Twelve weeks after the implantation,the vessel wall structure was normal,and the lumen was unobstructed,and the collateral of the filter was partly degradated.Conclusions The BVCF has the advantage of good mechanical strength and good biocompatibility.It is easy to release and can capture the lethal thrombus,but its degradation performance remains to be studied.

Objective To explore the diagnosis value of 320-row detector dynamic volume CT in complex congenital heart disease (CCHD)with double outlet right ventricle(DORV).Methods Seventy-eight patients who proveed DORV by surgery in Xinqiao Hospital of Third Military Medical University were reviewed.Thirty-six patients of group A performed 320-row detector dynamic volume CT by using segmental analysis,and were compared with the group B(42 Cases) performed conventional 64-slice CT respectively.Results In 36 cases of DORV confirmed by surgery in group A,MSCT provided accurate qualitative diagnosis in all cases.The accuracy rate of diagnosis of the group B was 90.7％.There was no significant differences compared with the group A (P＞0.05).There were ventricular septal defect in all the 78 cases,pulmonary stenosis in 56 cases,atrial septal defect in 34 cases,pulmonary hypertension in 21 cases,patent ductus arteriosus in 16 cases,coarctation of aorta in 9 cases.Conclusion The 320-row detector dynamic volume CT has important diagnostic value for DORV of the anatomical diagnosis.

pful in decision making of retroperitoneal laparoscopic NSS.

ObjectiveTo evaluate liver reserve function in patients with hepatitis B cirrhosis using indocyanine green (ICG) clearance test, and to investigate the correlation of ICG clearance test with Child-Turcotte-Pugh (CTP) class and the Model for End-Stage Liver Disease (MELD) score in evaluating liver function. MethodsA total of 127 patients with hepatitis B cirrhosis who were hospitalized in The First Affiliated Hospital of Fujian Medical University from January 2012 to January 2015 were enrolled. ICG clearance test was performed for all the patients, and the ICG plasma clearance (K value), effective liver blood flow (EHBF), and ICG retention at 15 minutes (ICG R15) were calculated. CTP class and MELD score were also determined. An analysis of variance was used for comparison between groups, the least significant difference t-test was used for comparison between any two groups, Spearman rank correlation was performed for correlation analysis, and the area under the receiver operating characteristic (ROC) curve was used to compare liver reserve function. ResultsAmong all the patients with hepatitis B cirrhosis, 63 had CTP class A, 45 had CTP class B, and 19 had CTP class C hepatitis B cirrhosis. With the increasing CTP class, ICG R15 gradually increased, while EHBF and K value gradually decreased (F=14696，9126 and 4094，P=0001,0003 and 0005). In the evaluation of liver function, ICG R15 was positively correlated with MELD score and CTP class (r=0.525 and 0.838, both P＜0.01) and was negatively correlated with EHBF and K value (r=-0.703 and -0.901, both P＜0.01). The area under the ROC curve was 0.85 for ICG R15 and 065 for MELD score. ConclusionICG test can accurately and dynamically reflect liver reserve function, and ICG R15 can evaluate liver reserve function better than CTP class and MELD score.