Objective To study MRI features of solid-pseudopapillary tumors of pancreas(SPTP).Methods MR findings of 3 patients with histopathologically proven SPTP were retrospectively analyzed.Results The mean diameter of these tumors was 4.5cm(3.5～8cm).One tumor was predominantly composed of cystic portions,2 tumors were composed of predominantly solid and some cystic portions.Fibrous septa was seen in cystic area in 1 case.One cystic tumor showed low signal intensities on T1WI and high singal intensities T2WI.The solid portions of mass showed moderate hypointensity on T1WI,and moderate hyperintensity on T2WI,and heterogeneous obvious enhancement on T1WI MRI in 2 cases.Conclusion There are some characteristics in MRI manifestation of SPTP.The disease might be correctly diagnosed combined with the clinical feature,and should be differentiated from nonfunctioning islet cell tumor,mucinous cystadenoma or cystcarcinoma of the pancreas,etc.

Objective　To observe the influence of pre-infarction angina on ventricular function and prognosis of first acute myocardial infarction in old people. Methods　76 first acute myocardial infarction old patients was divided into two groups: angina pectoris group (n=42); no angina pectoris group (n=34). Global left ventricular function was assessed by echocardiography, arrhythmia, cardiogenic shock, heart failure, post-infarction angina and mortality was observed in hospital. Results　The rate of cardiogenic shock and heart failure and mortality was lower in angina pectoris group (33.3% vs 58.8%; 2.4% vs 23.5%), LVEF and E/A was higher in angina pectoris group (0.52±0.056 vs 0.45±0.03,0.86±0.29 vs 0.54±0.35), P<0.05. Conclusion　pre-infarction angina possesses the protecting effects on ventricular function of first acute myocardial infarction in old people, and can improve the prognosis of first acute myocardial infarction in old people.

Objective To study the effects of malondialdehyde (MDA), superoxide dismutase (SOD) and tumor necrosis factor-? (TNF-?) on brain tissue in rats with pancreatic encephalopathy (PE). MethodsThirty-six Wistar rats were randomly divided into control group (n=6) and PE model group (n=30). In control group, rats were injected with normal saline by internal carotid artery (0.1 ml/100 g) and were killed on the first day after the injection. In PE model group, rats were injected with phospholipases A2 (0.1 ml/100 g, 1 000 U/0.1 ml) by internal carotid artery, to establish animal model of PE in rat and 10 rats were killed on day 1, 3, 7 respectively after the injection. The changes of water content in the brain were measured. Leucocytes aggregation and margination in the microvessels, and the changes of cerebral cells and nerve fibers were observed. The levels of MDA, TNF-? and the activity of SOD were tested in the brain homogenate in rats. ResultsIn PE model group, water contents of brain increased; The phenomena of leucocytes accumulation and margination, cellular edema of neurons and demyelination of nerve fibers became more obvious; The levels of MDA and TNF-? increased significantly than those in the control group, while the activity of SOD reduced (P

Objective To investigate the present situation of living and living quality of the elderly living in communities of Xi'an City.Methods By using quality of life(QOL) questionnaire,the elders living in two communities in Xi'an were investigated regarding their physical,psychological,social and material functions as well as overall living quality.Results Psychological and social functions scored significantly higher in both male and higher-income groups than those in the others.The scores of physical and social functions in the lower-income elderly were significantly higher than those in high-income ones.The scores of overall living quality of those elderly having spouses,living with their family members,taking an active part in social activities,having hobbies and enjoying medical insurance were significantly higher than those of the others.The well-educated elderly scored significantly higher in social function than those with lower education level;adverse events prominently decreased the quality of life of the elderly.More than 80% of the elderly were satisfied with their living environment.The highest incidence of chronic diseases in the communities was hypertension.Conclusion The quality of life of the elderly living in communities of Xi'an City is good.Health status,family environment,educational level,income and marital status are the main factors that affect the quality of life of the elderly.

Objective To retrospectively compare CT and MR features of hepatocellular adenoma with pathologic findings.Methods Twelve patients with histopathologically proved hepatocellular adenoma were classified on the basis of pathologic and genotype phenotype findings into four groups:steatotic type,cytological abnormality type,telangiectatic adenoma with inflammatory infiltrates type and atypical adenoma type.The CT and MR features of each type were reviewed retrospectively compared with the pathological results.Results In this retrospective study,12 patients were examined with CT (8 patients) and MR (8 patients).Among 12 patients,4 patients showed a steatotic type.One patient showed hypo-density on the non-enhanced CT and 3 patients demonstrated hypo-density on all phases of the post-contrast scans.Two lesions showed iso-intense signal on the in-phase T1 WI with signal dropout on the out-of-phase T1WI,and hypo-intense signal on the T2 WI with fat suppression sequences.One lesion demonstrated moderate hypointense signal on all phases of the post-contrast MRI scans.Two patients with the telangiectatic adenoma irflammatory infiltrates type were found.One patient showed hypo-density on the non-enhanced CT scans and hyper-density on all phases of the post-contrast CT scans.One patient demonstrated iso-intense signal and the other hypo-intense signal on the T1 WI,and both displayed moderate hyper-intense signal on the T2WI with fat suppression sequences and hyper-intense signal with gradual enhancement on all phases of post-contrast MR scans.There were 3 patients with a cytological abnormality type.One patient appeared hypodensity and 1 patient showed uniform iso-density on non-enhanced CT scans.All patients who had undergone contrast-enhanced CT scans were found to have hyper-density on the hepatic arterial-dominant phase and became slightly lower on the portal venous phase.On the delay phase the density reduced further.One mass showed iso-intense signal on the T1WI and hyper-intense signal on the T2WI with fat suppression sequences.There were 3 patients with an atypical adenoma type.One patient appeared uniform hypo-density on the nonenhanced CT and hyper-density on the hepatic arterial-dominant phase and became iso-dense on the portal venous phase.On the delay phase,it was slightly hyper-dense.Two out of the three lesions showed isointense and one hypo-intense signal on the in-phase T1 WI,and hypo-intense,hyper-intense,and iso-intense signal on the T2WI with fat suppression sequences,respectively.Two patients examined on all phases of post-contrast MRI scans.The result was similar to the CT findings.Conclusion The imaging features of hepatocellular adenoma are closely associated with pathological characteristics.

Objective To explore the predictive value of response to neoadjuvant chemotherapy(NAC)in local advanced breast cancer with contrast-enhanced ultrasound(CEUS)of axillary lymph node.Methods CEUS of metastatic axillary lymph nodes in 58 patients stacng Ⅱ-Ⅲ breast cancer was performed before and after NAC treatment. The enhancement patterns and parameters of time-intensity curve were assessed and compared with the pathology.Results The clinic response evaluation were drug-effective in 35 cases and no change in 23 ones.There Were no significant differences in enhancement patterns between no-change and drugeffective groups.Lymph node cortex arriving time was longer in drug-effective cases than that in no-change ones after NAC,whereas it showed no significant differences before NAC.Statistical significant difierence in enhancement duration(ED)was found between the two groups before NAC,which decreased markedly in drug-effective case8 after NAC.Histopatholngic response could be predicted with a sensitivity of 77% and a specificity of 90% by standardized ED below 275 seconds after NAC.No significant difference was found in time to peak(TP),peak intensity(PI)between the two groups.Conclusion The perfusion pattern of axillary lymph node CEUS after NAC Was insufficient to predict curative effect.But the lymph node cortex arriving time and enhancement duration may be of value in the prediction of clinical response to chemotherapy.

Objective To investigate the dynamic expression of SOCS-3, TNF-α in live and spleen of mice induced by AOPP, and to discuss the mechanism of MODS induced by AOPP, so that to give some intervention method over MODS in the future. Method Thirty-six adult BALB/c mice were divided into 3 groups randomly: AOPP group (n=12). Water normal group (n=12) and normal group (n=12). After post poison 2 hours, 6 hours, 12 hours and 24 hours,the fiver and the spleen tissue were taken out. The expression of SOCS-3 and TNF-α were detected by RT-PCR. And data were analyzed with ANOVA. Results After AOPP of 2,6,12,24 hours, the mRNA expression of SOCS-3 increased obviously in the liver and spleen compared with the normal group (P<0.05), it reached peak at the 24th hour in liver,and reached peak at the 12th hour in spleen, then descended at 24th hour (P<0.05). The mRNA expression of TNF-α increased obviously in the liver and spleen than normal group (P<0.05), and reached peak at the 12th hour,then descended at 24th hour (P<0.05), the electro-phoresis image of RNA was 5 s 15 s and 30 s,RT-PCR amplification of β-actin showed,the expression of SOCS-3, reached peak at the 24th hour in liver and it reached peak at the 12th hour in spleen, then descended at 24th hour (P<0.05), TNF-α reached peak at 12th hour in the liver and spleen, then descended at 24th hour. By statistic analysis, positive correlation was indicated among SOCS-3 and TNF-α mRNA expression in liver (y=0.089+0.758x, r=0.939, F=252. 168, P<0.01) positive correlation was indicated among socs-3 and TNF-α mRNA expression in spleen (y=0.057+0.361x,r=0.953,F=336.122, P<0.01). Conclusions At different point of time after Aopp,the mRNA expression of socs-3 and TNF-α showe the same trend in liver and spleen,the levels of SOCS-3, TNF-α all increase significenfly.

Objective To investigate the efficacy of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation in the treatment of the MRL/lpr mice. Methods Twenty four 18-week-old MRL/lpr female mice were divided into 3 groups:group 1 (G1) were transplanted with 1×106 UC- MSCs through caudal vein, group 2 (G2) were transplanted with 1×106 UC- MSCs three times and group 3 (G3) were treated with 0.5 ml normal saline as controls. Enzyme linked immunosorbent assay (ELISA) was used to measure the levels of serum anti-dsDNA antibodies. Twenty-four hours proteinuria and body weight were assessed every two weeks. The histopathology changes of the kidneys and lungs were observed. Results ① At the 25th weeks, the 24 hours proteinuria in group G1 (2.3±1.9) mg and G2 (1.8±1.4) mg was decreased than that in the control group (3.8±2.1) mg (P<0.05), and at the 27th weeks, that of groups G1 (2.5±1.5) mg and G2 (1.9±1.2) mg was also significantly decreased than in the control group (5.4±2.4) mg (P<0.01); ② From the 24th week, the body weight of groups G1 and G2 increased significantly than that of the control group (P< 0.05). At week 29, serum creatinine decreased significantly in both groups G1 (7.2±3.2) μmol/L and G2 (6.2±2.8) μmol/L than in the control group (12.5±2.3 ) μmol/L (P<0.05); ③One week after transplantation, the levels of anti-dsDNA antibodies in group G1 (46±11)×102 U/ml and G2(49×43)×102 U/ml were bothsignificantly decreased than those of the control groups (99±42)×102 U/ml (P<0.05) and the difference between group G2 (36±15)×102 U/ml and the controls (68±32)×102 U/ml was statistically significant; ④The nephron crescent formation in group G1 (0.12±0.07) and G2 (0.08±0.02) was significantly lower that of the control group (0.20±0.06) (P<0.05) and that of group G2 was significantly less that of froup G1 (P<0.05); ⑤ The interstitial pneumonitis was singnificantly milder in group G1 than group G2. Conclusions UC- MSCs is very effective in treating MRL/lpr mice. It is safe and free of rejection reactions.

Abstract: Objective　To analyze the clinical characteristics of Chlamydia psittaci pneumonia and improve the diagnosis and treatment skills of clinicians on this disease. Methods The clinical data of thirty-nine Chlamydia psittaci pneumonia cases detected by metagenomic next-generation sequencing (mNGS) from September 2020 to January 2022 at the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. Results There was a history of poultry exposure in 89.7%(35 cases) of the patients. The most common clinical manifestations were high fever (92.3%, 36), cough (76.9%,30), muscle soreness (48.7%,19), headache (38.5%,15), etc. Laboratory examinations showed 76.9% of patients had a normal leukocyte count, and 76.9% had decreased lymphocyte count, often accompanied by elevated C-reactive protein (100%), procalcitonin (97.4%), interleukin-6 (95.8%), interleukin-10 (95.8%), alanine aminotransferase (74.4%), and aspartate aminotransferase (84.6%). Univariate analysis indicated that there were statistically significant differences in the levels of aspartate transaminase, blood urea nitrogen, C-reactive protein, and procalcitonin between severe pneumonia patients and non-severe pneumonia patients（P<0.05）. Multivariate logistic regression analysis showed that an elevated blood urea nitrogen (OR=4.899) had guiding significance for predicting the occurrence of severe pneumonia. Bronchoscopy examination showed no abnormalities in 53.6% of the patients. The imaging manifestations of pulmonary lesions were mainly lobar pneumonia (61.5%) and air bronchograms (94.9%). Therapeutically, it was sensitive to tetracyclines, macrocyclic lactones, and fluoroquinolones. A total of 84.6%(33 cases) of the patients were cured and discharged from the hospital at the end of the treatment. Conclusion Chlamydia psittaci pneumonia is a zoonotic disease that can be detected by mNGS. An elevated blood urea nitrogen level has guiding significance for predicting the occurrence of severe pneumonia. Empirically-selected regimens based on doxycycline are effective for the treatment of Chlamydia psittaci pneumonia.

Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A:After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically signifi-cant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the prob-lem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47 ±5.23) vs. group B (84.09 ±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treat-ment ability. It can be used as an effective complement to clinical practice teaching.