Objective To assess the value of spiral and cine CT for the diagnosis of foreign body in trachea in children. Methods Fifty-one consecutive pediatric patients suspected of aspirating radiolucent foreign body underwent chest radiography, 12 of them underwent three-dimensional spiral CT and cine CT scan within 24 h before rigid bronchoscopy. Results Rigid bronchoscopy showed foreign bodies in the main bronchus or bronchus intermedius of 42 patients, while spiral CT localized airway foreign bodies in the same patients. In the remaining 9 patients without foreign body found by rigid bronchoscopy, 6 were true-negative and 3 were false-positive on CT, making the overall sensitivity, specificity, accuracy, and positive and negative predictive values of CT scans was 100% (95% confidence interval, 91%-100%), 66.67% (29%-92%), 94.12% (64%-99%), 93.33% (81%-98%) and 100% (54%-100%), respectively. The cine CT scan correctly diagnosed 9 of 12 patients as true-positive and 3 as true-negative with identification of air trapping and secondary lung changes. Conclusion CT may be used in airway foreign body management of pediatric patients, especially with diagnostic dilemmas, and further prospective evaluations should be considered to assess its overall efficacy.

Objective To explore the clinical value of 18F-FDG PET/CT in the diagnosis of cardiac neoplasm.Methods Between January 2007 and December 2011,18F-FDG PET/CT was performed in 8649 patients in our hospital,and 14 (0.16％ ; 11 males,3 females,average age 46.9 (35-68) years) patients were diagnosed with cardiac neoplasm.18F-FDG PET/CT data of those 14 patients were retrospectively analyzed.Final diagnoses were confirmed by either histopathology (n =5) or follow-up (n =9).Results Accurate tumor localization and diagnoses were made by 18 F-FDG PET/CT in all 14 patients.Among them,13 were malignant (2(14.3％,2/14) primary and 11(78.6％,11/14) metastatic tumors (8 HCC,2 lung cancer,1 esophageal cancer) ; SUVmax 3.2-10.7) and 1 (7.1％,1/14) was benign (myxoma).Conclusion 18F-FDG PET/CT is useful for the detection and staging of primary malignant and metastatic cardiac neoplasms.

Objective To investigate effects of two doses of dexmedetomidine (Dex) on the recovery quality from general anesthesia undergoing thyroidectomy.Methods A prospective randomized controlled double-blind trial was conducted in 90 patients admitted to Shengjing Hospital of China Medical University who were scheduled for thyroidectomy.They were randomly divided into three groups:group D0.4 received Dex 0.4 μg/kg intravenously,group D0.8 received Dex 0.8 μg/kg intravenously,and control group with same volume of normal saline.There were 30 patients in each group,and all the patients received the above drug or saline 30 minutes after intubation.The heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded before Dex administration,at the end of surgery,time of eye opening and extubation,and 10 minutes after extubation.Time of eye opening after surgery and time of extubation after eye opening were recorded.End-tidal partial pressure of carbon dioxide (PETCO2) before and after operation as well as restlessness score (RS),Ramsay sedative score,and visual analogue pain scale (VAS) scores at 10 minutes after extubation were recorded.Events during extubation including cough,nausea and vomiting,respiratory depression were also recorded.Results ① Compared with control group,in D0.4 and D0.8 groups incidence of lowering of HR,SBP and DBP was lower at time of eye opening and extubation,and 10 minutes after extubation.Compared with D0.4 group,D0.8 group had lower HR at the time of extubation and 10 minutes after extubation,SBP was lower at the time of eye opening and extubation,and lower DBP at the time of eye opening.② D0.4 and D0.8 groups showed lower RS and VAS scores than those of control group,Ramsay sedative score in groups D0.4 and D0.8 was higher than that in control group (RS:1.40±0.51,1.20±0.42 vs.1.90±0.56; VAS:1.50±0.52,0.80±0.63 vs.2.50 ± 0.52; Ramsay:2.10 ± 0.56,2.40 ± 0.51 vs.1.60 ± 0.51,P＜0.05 or P＜0.01),and VAS score in group D0.8 was lower than that in D0.4 group (P＜0.01).The time of eye opening and extubation were longer in group D0.8 as compared with those in control and D0.4 groups (minutes:12.50 ± 1.08 vs.10.50 ± 1.58,10.40 ± 1.26; 15.00 ± 0.94 vs.13.00 ± 1.63,12.80 ± 1.13,P＜0.05 or P＜0.01),but there was no significant difference between the latter two groups.No significant difference in PETCO2 was found among three groups before and after surgery.③ The incidence rate of cough,nausea and vomiting in control group (16.7％,13.3％) were significantly higher than those in groups D0.4 (3.3％,0) and D0.8 (0,0).There was no respiratory depression in the three groups.Conclusion Adjunctive infusion of Dex 0.4 μg/kg at 30 minutes after anesthesia induction was recommended as it may result in more steady hemodynamics,with shorter recovery time and extubation time after thyroidectomy.

Objective To investigate the value of 18F-FDG PET/CT in the phasing and grading of renal cell carcinoma (RCC) complicated with vena cava tumor thrombus (VCTT).Methods From December 2011 to September 2015,a total of 72 patients (52 males,20 females,age:36-74 years) were enrolled in this retrospectively study.All patients underwent 18F-FDG PET/CT and contrast-enhanced CT studies,and were diagnosed as RCC.The RCC patients combined with VCTT were classified by Mayo-level.Wilcoxon rank sum test was used to compare the grading of VCTT by PET/CT and contrast-enhanced CT.NM staging on abdominal area level was performed and the results were compared with x2 test.Results VCTT was identified in 18 RCC patients and the grading results by PET/CT were as follows:9 cases in Level 0,4 cases in Level Ⅰ,2 cases in Level Ⅱ,1 case in Level Ⅲ,and 2 cases in Level Ⅳ.When evaluated by PET/CT,20 cases were in N0M0,21 were in N1M0,9 were in N0M1,and 22 were in N1M1.NM staging results by contrast-enhanced CT were as follows:50 cases in N0M0,10 in N1M0,10 in N0M1,and 2 in N1M1.In addition,2 N1 and 2 M1 were found by the whole body PET/CT.The classification results of VCTT and staging of abdominal level by PET/CT were significantly better than those by contrast-enhanced CT (z=-2.462,P＜0.05;x2=32.806,P＜0.01).Conclusion 18F-FDG PET/CT is not only valuable for detecting primary RCC and local metastasis,but also useful for finding where the VCTT extends,which is conducive to therapeutic planning and further clinical treatment.

Objective To establish an assay for the detection of Torque teno sus virus ( TTSuV) strains and to analyze its preliminary application to biologics.Methods Primers and probe were designed according to the conserved sequences.A fluorescent PCR assay for the detection of TTSuV strains was estab-lished.Several parameters including the specificity, linearity, accuracy, sensitivity and anti-interference of the established assay were verified.The fluorescent PCR assay was performed to detect the samples of por-cine blood, cell substrate and rotavirus vaccine.The porcine blood samples positive for TTSuV strains were further genotyped.Results The established fluorescent PCR assay was confirmed to have high specificity as no cross-reactions with parvovirus virus of various species, SV40 and porcine circovirus strains were detec-ted.The linear range of the assay was 1×109-1×103 copies/μl for TTSuV1 genotype and 1×109-1×102 cop-ies/μl for TTSuV2 genotype with a R2 value more than 0.993.The sensitivity of the fluorescent PCR assay was 1×103 copies/μl for TTSuV1 genotype and 1×102 copies/μl for TTSuV2 genotype.The intra-and inter-CVs were both less than 7%in Ct values and less than 25% and 45% respectively in copies.No interfer-ence was found in the detection of TTSuV nucleic acids from cell samples.8 out of 20 porcine blood samples were positive for TTSuV strains, among which one sample was positive for TTSuV1 genotype, four samples were positive for TTSuV2 genotype and the rest were positive for both TTSuV1 and TTSuV2 genotypes.Com-pared with the reference strain, strains genotyped as TTSuV1 and TTSuV2 were respectively shared 98%-99%and 98%homologies in sequences.All of the cell substrate and rotavirus vaccine samples detected by the fluorescent PCR assay were negative for TTSuV strains.Conclusion The fluorescent PCR assay for the detection of TTSuV was established successfully, the application of which would further improve the safety of biologics.

Objective: To explore the relationship between body weight changes from early adulthood to middle age and the prevalence of hypertriglyceridemia by large-scale cardiovascular risk factor investigation.
Methods: A total of 15 population groups from China multi-center collaborative study of cardiovascular epidemiology in 1998 were enrolled. There were approximately 1000 participants in each group including 50% of each male and female at the age of (35-59) years which was deifned as middle age. The participants were surveyed for cardiovascular risk factors including the body weight and body mass index (BMI) at the age of 25 years which was deifned as early adulthood. The participants were divided into 4 groups based on BMI at early adulthood: Low body weight group, BMI < 18.5 kg/m2, Normal body weight group, BMI (18.5-23.9) kg/m2, Overweight group, BMI (24-27.9) kg/m2 and Obese group, BMI ≥ 28 kg/m2. The changes of body weight from early adulthood to middle age were calculated by body weight at present minus body weight at 25 years; according to the differences, participants were divided into another set of 6 groups: differences < -7.5 kg, (-7.5 to -2.6) kg, (-2.5 to 2.5) kg, (2.6 to7.5) kg, (7.6 to 12.5) kg and > 12.5 kg. The relationship between body weight status at 25 years of age with subsequent changes and the prevalence of hypertriglyceridemia were investigated.
Results: A total of 13883 participants finished the investigation.①The prevalence of hypertriglyceridemia by 4 BMI groups were at 22.8%, 26.0%, 27.4% and 30.8% respectively (the trend ofP<0.01).②The prevalence of hypertriglyceridemia by 6 age differences groups were at 12.5 %, 14.0 %, 17.8 %, 24.2 %, 31.5 % and 40.9 % respectively (the trend ofP<0.01). Multivariate Logistic regression analysis indicated that overweight and obesity at the age of 25 years with subsequent weight gain were positively related to the risk of hypertriglyceridemia at the middle age (the trend ofP<0.01).
Conclusion: Overweight and obesity in early adulthood with subsequent weight gain were independently related to the risk of hypertriglyceridemia at the middle age in our survey.

Purpose To investigate the influence on shear wave velocity (SWV) by different probe frequency, scanline angle and ROI depth. Materials and Methods The elasticity QA Phantoms was used in the study. First the SWV was measured by curve probe at depths of 1 cm, 2 cm, 3 cm, 4 cm, 5 cm, 6 cm, 7 cm and 8 cm. The scanline angle changed from 0°from midline, 1°-15°, 16°-30°and 31°-45°. Then the SWV was measured again by using line probe at depths of 1 cm, 2 cm, 3 cm and 4 cm. The measured data were analyzed statistically. Results The SWV showed difference by using the two probes (P<0.05). As depth increased, the measurement by curve probe changed from overestimate to underestimate, while the measurement by line probe always showed underestimate from standard value. When the curve probe was used, the angle and depth affected SWV interactively (F=85.87 and 35.96, P<0.01), and had interactive effects (F=17.63, P<0.01). When the scanline angle was within 15°, the angle had little inlfuence upon the measurement. When the scanline angle was 0 °, the measurement was the closest to the standard value at the depth of 4 cm, and the maximum deviation occurred at the depth of 5 cm. The inlfuence of depth upon measurement had signiifcant difference when the line probe was used (P<0.05). The measurement was the closest to the standard value at the depth of 1 cm, and the maximum deviation occurred at the depth of 4 cm. Conclusion Factors like probe frequency, scanline angle and ROI depth can affect the SWV. When the curve probe is used, the accurate measurement occurs at the depth of 4 cm when the scanline angle is within 15°. When the line probe is used, the accurate measurement occurs at the depth of 1 cm.

Objective Routine perioperative intravenous antimicrobial agents,was administered as surgical prophylaxis.However,whether balanced ultrafiltration during extracorporeal circulation can remove antimicrobial agent remains unclear.The concentrations of antimicrobial agent in plasma and ultrafiltrate samples were measured in this pseudo-extracorporeal circulation model.Methods Extracorporeal circulation consisted of cardiotomy reservoir (Ningbo Fly Medical Healthcare CO.,LTD.Ningbo,China),D902 Lilliput 2 membrane oxygenator (Sorin Group Asia Pte Ltd,Beijing,China) and Capiox (R) AF02 pediatric arterial line filter (Terumo Corporation,Beijing,China).HEMOCONCENTRATOR BC 20 plus (MAQUET Cardiopulmonary AG,Hirrlingen,Germany) was placed between arterial purge line and oxygenator venous reservoir.Fresh donor human whole blood was added into the circuit and mixed with Ringer's solution to obtain a final hematocrit of 24％-28 ％.After 30 minutes of extracorporeal circulation,zero-balanced ultrafiltration was initiated and arterial line pressure was maintained at approximately 100 mm Hg(1 mm Hg =0.133 kPa) with Hoffman clamp.The rate of ultrafiltration (12 ml/min) was controlled by ultrafiltrate outlet pressure.Identical volume of plasmaslyte A was dripped into the circuit to maintain stable hematocrit during 45 minutes of experiment.Plasma and ultrafiltrate samples were drawn every 5 minutes and concentrations of antimicrobial agent (including Cefmetasole and cefotiam) were measured with high performance liquid chromatography.Results All these two antimicrobial agents were detected in ultrafiltrate,demonstrating hemoconcentration may remove antimicrobial agent.The concentration of plasma antimicrobial agent decreased lineally with the increase of ultrafiltrate volume.At end of balanced ultrafiltration,the concentration of plasma cefotiam was (104.96 ± 44.36) μg/ml,which is about (44.38 ± 7.42) ％ of the initial concentration (238.95 ± 101.12) μg/ml; the concentration of plasma cefmetazole decreased linearly to (25.76 ± 14.78) μg/ml,which is about (49.69 ± 10.49) ％ of the initial concentration (51.49 ± 28.03) μg/ml.The total amount of cefotiam in ultrafiltrate is (27.16 ± 12.17)％ of the total dose administered,whereas cefmetasole in ultrafiltrate is (7.74 ±4.17)％.Conclusion Balanced ultrafiltration may remove antimicrobial agent from serum and has significant influence on plasma concentration of antimicrobial agent.The strategy of surgical prophylaxis should consider this unique technique during extracorporeal circulation.

BACKGROUNDTo determine the binding activity of nuclear factor-kappa B (NF-kappa B) and the transcription of transforming growth factor-beta 1 (TGF-beta 1) induced by oxidized low density lipoprotein (Ox-LDL) in rat mesangial cells and to elucidate the mechanism of renal injury of Ox-LDL.

METHODSNF-kappa B binding activity was measured by gel shift assay in mesangial cells with or without inducement of Ox-LDL. Protein kinase inhibitors and activators were then used to determine the signal transduction pathways. In this course I kappa B protein expression was analyzed by Western blot assay. TGF-beta 1 mRNA was measured in mesangial cells exposed to Ox-LDL by RT-PCR assay. TGF-beta 1 promoter from -1551 to +57 were constructed into a pGL3-Basic vector with a luciferase reporting gene. A putative binding site of NF-kappa B was mutated. The wild and mutant promoters activity was analyzed by transfection into mesangial cells.

RESULTSNF-kappa B was activated by Ox-LDL persistently and rebounded in the early period. Ox-LDL induced NF-kappa B activation in a dose dependent way. It also induced I kappa B degradation in 2 hours and resumed to normal levels. NF-kappa B activation was not alleviated by inhibitors of protein kinase A (PKA), extracellular signal-regulated kinase (ERK), and p38 MAP kinase (p38MAPK). Inhibitors of protein kinase C (PKC) and proteinsome inhibited the enhancement of NF-kappa B binding activity. Ox-LDL induced the transcription of TGF-beta1 in a time and dose dependent manner. Mutation of the putative binding site of NF-kappa B reduced the activity of TGF-beta1 promoter.

CONCLUSIONOx-LDL induced activation of NF-kappa B persistently. It was probably regulated by the degradation of I kappa B mediated by PKC pathway. NF-kappa B may be involved in the enhancement of TGF-beta 1 induced by Ox-LDL in rat mesangial cells.

Animals ; Blotting, Western ; Electrophoresis ; Glomerular Mesangium ; cytology ; Lipoproteins, LDL ; pharmacology ; physiology ; Mutation ; NF-kappa B ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription, Genetic ; physiology ; Transfection ; Transforming Growth Factor beta ; genetics ; Transforming Growth Factor beta1

ObjectiveBy studying acupuncture at Neiguan (PC6), Shuigou (GV26), and Baihui (GV20) in septic shock patients, to observe the effect of acupuncture on T cell subsets, vital signs, white blood cell (WBC) count, and procalcitonin (PCT) level in septicshock patients.MethodSixty patients were randomized into a treatment group and a control group. The control group was intervened by symptomatic managements including supplementing blood volume, anti-inflammation, nutrition support, and organ protection, and the treatment group was by acupuncture at Neiguan, Shuigou, and Baihui in addition to the intervention given to the control group. The T cell subsets contents were detected before and after intervention, and serum PCT level, APACHEⅡscore, vital signs, and WBC count were determined on day 1, 3, 5, and 7.ResultIn the treatment group, T cell subsets including CD3﹢, CD4﹢, and CD4﹢/CD8﹢increased significantly after intervention (P<0.01,P<0.05), while CD8﹢dropped significantly afterintervention (P<0.05), and the changes in the treatment group were all markedly superior to that in the control group (P<0.05). The decrease of PCT level in the treatment group was more significant than that in the control group after treatment, the PCTlevel dropped significantly on the 5th day in the treatment group compared to that before treatment, and the inter-group difference was statistically significant after the 3rd day (P<0.01); the APACHEⅡscore in the treatment group was different from that in the control group after 3 d treatment, and the score was significantly changed in the treatment group after 5 d treatment (P<0.05); the body temperature, heart rate, inspiration, WBC count all showed decrease or improvement, and the improvements of vitalsigns in the treatment group were more significant than that in the control group (P<0.01,P<0.05).ConclusionAcupuncture at Baihui, Shuigou, and Neiguan can improve the immune function of septic shock patients, and its treatment effect is confirmed.