Constitution is an important factor to determine the susceptibility and the occurrence of disease. This article analyzed causes and characteristics of damp-heat constitution, the change of damp-heat constitution to damp-heat syndrome, the relationship between damp-heat constitution and the occurrence and development of diabetes mellitus. It reached the conclusion that damp-heat constitution is one of the important factors of diabetes mellitus, that damp-heat syndrome is always accompanied with the development of diabetes, and proposed the treatment methods of lifestyle intervention, elimination of pathogens through purgation and diuresis, nourishing yin and dredging the collaterals. It also proposed the new ideas and thoughts of early intervention in damp-heat constitution and distinguishing constitution therapy for the prevention and treatment of diabetes mellitus.

Prevention and treatment of tumor metastasis are important for the therapy of colon cancer. The discovery of stem cell markers provides a new approach for radical treatment of cancer. So far,the colon cancer stem cell markers discovered included several membrane protein molecules,transcription factors and related signal pathway. Exploration of colon cancer stem cell markers could contribute to the treatment of colon cancer and improve the survival rate and life quality of patients. This article reviewed the advances in study on colon cancer stem cell markers.

Objective To summarize the features of computed tomography (CT) and magnetic resonance imaging (MRI) of autoimmune pancreatitis (AIP) and investigate the key points of diagnosis and identification.Methods The retrospective and descriptive study was conducted.The clinical data of 21 patients with AIP who were admitted to the Affiliated Hospital of Inner Mongolia Medical University between February 2012 and February 2015 were collected.All the patients underwent plain and enhanced scans of CT and MRI,and magnetic resonanced cholangio-pancreatography (MRCP),and then received hormone therapy.Eleven patients with pancreatic cancer and 11 normal subjects who were diagnosed by MRI in the same period were selected,and apparent diffusion coefficient (ADC) was calculated and compared.Observation indicators:(1) situation of imaging examination:① pancreatic manifestations:density,signal,atrophy,calcification and enlargement of pancreas,change of pancreatic duct,② manifestations out of pancreas:changes of biliary tract system and kidney,③ diffusion weighted imaging (DWI) and ADC:comparisons of ADC among AIP,pancreatic cancer and normal pancreas;(2) diagnosis;(3) treatment and follow-up.The follow-up using outpatient examination and telephone interview was performed to detect the clinical symptoms and signs up to February 2016.Measurement data with normal distribution were represented as (-x)-± s.Comparisons among groups were done using one-way ANOVA.Pairwise comparison was analyzed by Dunnett'T3 test.Results (1) Situation of imaging examination:Of 21 patients,17 received scan of CT and 11 received scan of MRI (7 combined with scan of CT).① Pancreatic manifestations:14 patients had diffuse enlargement of pancreas,with full edge and “sausage-like” change.Plain scan of CT showed uniform isodense shadow,and enhanced scan showed that reduced enhancement in arterial phase and gradually homogenous enhancement in portal vein phase and lag phase with no enhancement in edge of pancreas.Plain scan of MRI showed lesions were manifested as slight hypointensity on T1 weighted imaging (T1WI),slight hyperintensity on T2WI and hyperintensity on DWI.Enhanced scan of MRI showed delayed enhancement,edge of lesions was manifested as slight hypointensity on T1WI and T2WI,without enhancement.Atrophy and calcification of pancreas:3 patients had atrophy of pancreatic parenchyma in which scattered calcification were seen.Enlargement of pancreas:4 patients had localized enlargement of pancreas showing “false tumor-like” change,including 2 with localized enlargement in head of pancreas.Change of pancreatic duct:MRCP showed that diffuse stenosis,local stenosis and local dilatation of pancreatic ducts were respectively detected in 4,3 and 1 patients.② Manifestations out of pancreas:11 patients had changes of biliary tract system,showing intrahepatic bile duct and common bile duct dilation,partial stenosis and extensive bile duct wall thickening.Enhanced scan of MRI showed there was obvious enhancement of bile duct wall.MRCP of 4 patients showed that the beak-like stenosis was seen in the distal common bile duct.Three patients had kidney changes,enhanced scan of CT showed that kidney demonstrated patch-shape hypodense shadow in arterial phase and homogenous enhancement of patch-shape hypodense shadow in lag phase,and plain scan of MRI showed that kidney lesions demonstrated equal signal on T1WI fat suppression (FS) and patch-shape low signal on T2WI FS.Lesions had gradually homogenous enhancement in substance phase and lag phase.③ DWI and ADC:lesions in patients with AIP and pancreatic cancer demonstrated high signal on DWI (b =1 000 s/mm2) compared with adjacent tissues (no involvement in pancreas or normal pancreatic parenchyma),ADC of pancreas in patients with AIP,with pancreatic cancer and with normal population was (0.001 30 ± 0.000 35)mm2/s,(0.000 80 ± 0.000 14) mm2/s and (0.001 60-± 0.000 24) mm2/s,respectively,with a statistically significant difference (F =30.409,P ＜ 0.05).There were statistically significant differences between patients with pancreatic cancer and patients with AIP or normal population (P ＜ 0.05) and no statistically significant difference between patients with AIP and with normal population (P ＞ 0.05).(2) Diagnosis:11 patients were diagnosed by CT examination,with a diagnostic accuracy of 11/17.Eight patients were diagnosed by MRI examination,with a diagnostic accuracy of 8/11.One patient was misdiagnosed as cancer of pancreatic head by CT and MRI examinations,and 1 was misdiagnosed as cancer in the distal common bile duct.(3) Treatment and follow-up:21 patients underwent regular hormone therapy,and 40 mg prednisolone was given orally a daily for 3-4 weeks and then gradually reduced to 5 mg up to complete relief of the symptoms.All the 21 patients were followed up for 12-45 months.Of 17 patients with abdominal pain and distension,symptoms of 7 patients disappeared and symptoms of 10 patients decreased or occasionally occurred.Of 10 patients associated with jaundice,symptoms of 7 and 2 patients disappeared and decreased,respectively,and symptoms of 1 patient subsided.Conclusion CT and MRI examinations of pancreas demonstrate “sausage-like” and “false tumor-like” changes,the non-neoplastic bile and pancreatic duct stenosis combined with IgG4 related diseases in other organs is an important imaging evidence for diagnosis and differential diagnosis of AIP.

The nano-magnetic ferrofluid was prepared by chemical coprecipitation and its acute toxicology was investigated. The effective diameter (Eff. Diam. ) of the magnetic particles was about 19.9 nm, and the concentration of the ferrofluid was 17. 54 mg/ml. The acute toxic reaction and the main viscera pathological morphology of mice were evaluated after oral, intravenous and intraperitoneal administration of the nano-magnetic ferrofluid of different doses respectively. Half lethal dose (LD50) > 2104. 8 mg/kg,maximum non-effect dose (ED0) = 320. 10mg/kg with oral; LDs,> 438. 50 mg/kg, EDo = 160. 05 mg/kg with intravenous route; and LDso >1578. 6 mg/kg, ED0 = 320. 10 mg/kg with intraperitoneal administration. Degeneration and necrosis of viscera were not found. So the nano-magnetic ferrofluid, of which toxicity is very low, may be used as a drug carrier.
Ferrosoferric Oxide/chemical synthesis ; Ferrosoferric Oxide/*toxicity ; Magnetics ; Nanostructures/*toxicity

Objective To summarize the features of computed tomography (CT) and magnetic resonance imaging (MRi) of hepatic cystic echinococcosis, and investigate the key points of identification and diagnosis.Methods The clinical data of 58 patients with hepatic cystic echinococcosis who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from August 2011 to August 2014 were retrospectively analyzed.Patients received plain and enhanced scan of CT and MRI.Hepatic cystic echinococcosis was divided into the 5 types according to the literatures, including unilocular echinococcasis in type Ⅰ, multivesicular hydatid cysts in type Ⅱ, anechoic content with detachment of laminated membrane from the cyst wall in type Ⅲ, calcification of lesions in type Ⅳ and mixed echinococcosis in type Ⅴ.Patients who were diagnosed as with definite or suspected hepatic cystic echinococcosis underwent surgery.The follow-up including observing the recurrence of hepatic cystic echinococcosis was performed by outpatient examination and telephone interview at postoperative month 3, 6, 12 for 1 year and then once every year up to August 2015, and was ended if there was no recurrence for more than 5 years.Results (1) The results of CT and MRI examinations: of the 58 patients, 54 received scan of CT and 21 received scan of MRI.Seventeen patients were detected in type Ⅰ with clear-boundary and low-density cystic lesions by CT examination;MRI examinations showed there were single or multiple, round or oval abnormal signal including low T1WI signal, high T2 WI signal and low T1 WI and T2WI signal of cyst wall.Thirteen patients were detected in type Ⅱ, CT examination showed the daughter cysts of multiple sizes were found in the mother cyst, arranged in honeycomb or wheel shape;MRI examination showed there were lower T1 WI signal in the daughter cyst and higher T2 WI signal in the daughter cyst compared with signal in the mother cyst, and low signal in the cyst wall of the daughter cyst and mother cyst.Six patients were detected in type Ⅲ with capsule in capsule sign and water snake sign by CT examination and ribbon sign by MRI examination.Thirteen patients were detected in type Ⅳ, CT examination showed there were irregular high-density calcified shadow with the performances for return sample or sample volume skins changes.Nine patients in type Ⅴ had more than 2 kinds of lesions.(2) Diagnosis: 4 patients were misdiagnosed by CT examination including 3 with preoperative diagnosis of hepatic cyst and 1 with preoperative diagnosis of metastatic carcinoma of liver, with an accurate rate of diagnosis of 92.6％ (50/54).Two patients with preoperative diagnosis of hepatic cystic adenocarcinoma were misdiagnosed by MRI examination, with an accurate rate of diagnosis of 90.5％ (19/21).(3) Treatment and follow-up: 58 patients underwent surgery, including 40 undergoing internal capsule removal with external capsule suturing (31 with open operation and 9 with laparoscopic operation), 10 undergoing partial hepatectomy and 8 undergoing external capsule enucleation.Of 58 patients, 3 were complicated with effusion of residual cavity, 2 with unclosed external capsule, 1 with bile leakage and then was cured after 4-8 week drainage.Fifty patients were followed up for 12.0-48.0 months with a median time of 27.1 months and a follow-up rate of 86.2％ (50/58).During the follow-up, 1 patient undergoing internal capsule removal had recurrence at postoperative month 8 and was cured by CT-guided interventional therapy using absolute alcohol, and other patients had no recurrence.Conclusions There was a higher accuracy in CT and MRI examinations for hepatic cystic echinococcosis.Honeycomb and wheel shapes are characteristic findings of hepatic cystic echinococcosis in type Ⅱ.The characteristic performances of CT examination for hepatic cystic echinococcosis in type Ⅲ are capsule in capsuleand water snake signs, and characteristic performances of MRI examination is ribbon sign.The ring-like enhancement of edge by MRI examination is an essential of identification and diagnosis between hepatic cystic echinococcosis and hepatic cyst, and irregular calcification is a differential point between hepatic echinococcosis and hepatic tumor.

Objective To investigate the incidence,clinical characteristics and risk factors of upper gastrointestinal bleeding (UGIB) in patients with acute coronary syndrome (ACS) who were administrated with aspirin and clopidogrel dual antiplatelet therapy after percutaneous coronary intervention (PCI).Methods ACS patients who had undergone PCI in the cardiovascular institute of Guangdong General Hospital from September 2009 to August 2014 were retrospectively enrolled.The incidence of UGIB and clinical characteristics of ACS patients on dual antiplatelet therapy for 1 year after PCI were analyzed.Risk factors of UGIB were screened in the cohort of patients and sex and age matched controls with ratio 1:3.Results A total of 9 118 ACS patients had undergone PCI and UGIB occurred in 189 patients (2.07％,189/9 118) from September 2009 to August 2014.UGIB patients with history over one year,gastrointestinal tumors or varices or negative endoscopy were excluded.Thus the revised incidence of UGIB occurred was 0.61％ in 56 patients (0.61％,56/9 118) and appeared to decline year by year.Most patients (91.07％,51/56) had melena or stool occult blood positive (OB +),while others had bloody stool or haematemesis.Most UGIB were ulcer-related which was proved by endoscopy,accounting for 67.86％(38/56).There were 24 cases with duodenal ulcer,13 with gastric ulcer and 1 with complex ulcer,while others were gastric erosion,gastritis and duodenitis.The risk factors of UGIB were previous history of peptic ulcer (P ＜ 0.01) and renal impairment (P ＜ 0.01).On the other side,PPI intake was a protective factor (P ＜ 0.05).The incidence of new-onset ACS was 1.44％ (50/3 464) in PPI group,compared with 1.34％(76/5 654) in no PPI group (P ＞ 0.05).PPI use for the prevention of UGIB after PCI didn't increase the recurrence of ACS.Conclusions The incidence of UGIB is 0.61％ in ACS patients on dual antiplatelet therapy (aspirin and clopidogrel) for 1 year after PCI and falls year by year.Administration of PPI after PCI protects patients from UGIB,especially in those with precious history of peptic ulcer and renal impairment.

Objective To evaluate the image quality and obtained by the tube current modulation base on time bolus peak in low voltage in CTPA.Methods 30 consecutive patients suspected pulmonary embolism(PE)were prospectively enrolled,and satisfy the following conditions.The study was performed by 64-slice spiral CT system (lightspeed VCT-XT,GE healthcare),Tube voltage was set at 80 kV.Tube current settings related to the attenuation of ROIs by test bolus peak.The injection parameters were set up by injection flow rate (4 mL/s),contrast medium dose (28 mL),and saline flushing dose (40 mL).All images were evaluated by two observers blinded to pulmonary CTA protocol,including attenuation,noise,SNR and CNR.The image quality was evaluate by 4-score.To evaluate the relationship between influential factor and image quality using Pearson correlation analysis.A P-value <0.05 was considered to indicate a statistically significant difference.Results The time bolus peak was statistically significant influence on attenuation(r=0.398,P =0.029).There was no statistically significant influence on noise (r=0.104,P =0.583),signal-to-noise ra-tio (r=0.263,P =0.1 60)and contrast-to-noise ratio(r=0.299,P =0.109).The other factors(BM,BMI and BSA)was no statisti-cally significant influence on the image quality(P > 0.05 ).The mean attenuation,noise,SNR and CNR on pulmonary trunk was (628.63±146.46)HU,(53.92±14.07)HU,12.02±3.1 7 and 10.81±3.10,respectively.The percentage of assessable pulmonary arteries was 95.82%.Conclusion The tube current modulation base on time bolus peak in low voltage could offer assessable image quality and raise image stability.

This study examined the mRNA expression of NALP3 in the spleen of the mice with hypersplenism due to portal hypertension (PH). The mouse hypersplenism models were established by oral administration of tetrachloromethane (2 mL/kg/week for 12 weeks by oral gavage). All the mice were randomly divided into a control group and an experimental group. The blood routine test was conducted, spleen index was calculated and spleen was histologically examined. Portal vein sera were taken for detection of the level of uric acid. The mRNA expressions of NALP3 and IL-1beta in the spleen were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). The results showed that the platelet count was significantly lower in the experimental group [(674+/-102)x10(9)/L] than in the control group [(1307+/-181)x10(9)/L] (P<0.05), while the spleen index was significantly higher [(9.83+/-1.36) mug/g] in the experimental group than in the control group [(4.11+/-0.47) mug/g] (P<0.05). The histopathological changes of spleen followed the pattern of congestive splenomegaly. No significant difference was found in the uric acid level in the portal vein between the control group and the experiment group. The mRNA expressions of NALP3 and IL-1beta were up-regulated significantly in the spleen in the experimental group as compared with those in the control group (P<0.05). It was concluded that NALP3 and IL-1beta may play important roles in the pathogenesis of hypersplenism.

Objective To investigate the change of peripheral blooe T cell subsets,NK cells ane serum soluble interleukin-2 receptor(sIL-2R)concentration in patients with gastric cancer before ane after surgery,ane to uneerstane immune function status ane changes of perioperative gastric cancer patients. Methods One huneree ane thirty-five perioperative gastric cancer patients were selectee as our subjects who hospitalizee from May 2009 to May 2011 in Tumor Hospital of Shanxi Province,ane they were servee as treatment group,while 50 healthy subjects were selectee as controls. The number of CD3 + ,CD4 + ,CD8 + T cells,rate of CD4 + / CD8 +ane the NK cell ratio in blooe cells were eetectee by flow cytometry. ELIAS was appliee to measure serum sIL-2R concentration. Observee the above ineexes of control group at the same perioe,ane comparee the ineexes before operation of 1 e of the treatment group. Results The rate of NK cells,CD3 + T cells ane CD4 + / CD8 +ratio in patients at pre-operation were(10. 11 ± 3. 64)% ,(55. 60 ± 9. 61)% ,(30. 22 ± 6. 17)% ,1. 14 ± 0. 35,respectively,lower than that of control group(( 28. 39 ± 5. 81 )% ,( 68. 65 ± 7. 39 )% ,( 47. 87 ± 4. 85)% ,1. 82 ± 0. 24 respectively;t = - 5. 9,8. 6,8. 2,12. 7;P < 0. 01). CD8 + T positive rate of cells increasee from(27. 05 ± 7. 86)% to(34. 26 ± 6. 23)%(t = - 6. 5,P < 0. 01). At 14th eay after surgery,the cell immune function of the patients recoveree graeually,ane there were statistically significant eifferences in the above ineexes comparee with pre-operation(P < 0. 05). The eramatic changes were seen among patients with the late Gastric cancer TNM staging. Comparee with patients with stage Ⅳ,all above ineex were significant eifferent from that of patients with stageⅠ,Ⅱ(P < 0. 05),ane no significant eifferences was seen in patients with stageⅢ(P > 0. 05). The concentration of serum sIL-2R in patients with gastric cancer before operation was(575. 71 ± 34. 77)U/ L,higher than that of healthy persons((428. 26 ± 21. 77)U/ L,t = - 7. 9,P < 0. 01),ane serum sIL-2R levels in patients with stage Ⅲ,Ⅳ was lower than that of patients with stage Ⅰ,Ⅱ patients with low(P< 0. 05). Conclusion The immune function of patients with gastric carcinoma is relatee to tumor loae size ane eifferent pathological staging. The ineex of the ratio of NK cells ane T lymphocyte subsets,serum sIL-2R levels can be servee as ineicators for monitoring perioperative evaluation of prognosis of gastric cancer.

Objective To evaluate the clinical results of total laparoscopic hepatectomy for hepatolithiasis. Methods The clinical data of 72 patients with intrahepatic lithiasis receiving total laparoscopic hepatectomy in our hospital from July 2005 to April 2009 were retrospectively analyzed. Results The mean age of the 72 patients was (43. 8±21.7) yrs (16-65 yrs). For laparoscopic hepatectomy, it was anatomical left liver resection in 34 patients, anatomical resection of left lateral liver in 19 and resection of S6 in 16. The operative duration was (262.5± 115.5)min (125-320 min). The median intraoperative blood loss was 150 ml (50-400 ml). The occurring rate of postoperative complications was 12.50 %. Complications included bile duct infection in 8 patients, bile leakage in 6, gastroparesis in 1,postoperative early inflammatory ileus in 1 and subcapsular fluid collection of liver in 1. All the complications were cured by non-surgical means. Conclusion In the era of minimally invasive surgery, total laparoscopic hepatectomy has gradually become the prominent treatment for hepatolithiasis.