Perfusion computed tomography (CT) imaging is a kind of functional imaging technique to evaluate and determine the hepatic and portal blood flow noninvasively.It offers the significant clinical advantages in the early diagnosis,evaluation of treatment response,and prognosis assessment in chronic liver diseases.In this article,we reviewed the principle,scanning protocol,clinical applications,and advances in chronic liver diseases of hepatic perfusion CT imaging.

This review discusses the relationship between autophagy and hepatocellular carcinoma (HCC).It will focus on the definition and mechanism of autophagy,the effects of autophagy on carcinogenesis,the reaction that chemotherapy and radiotherapy have on autophagy,developments of novel therapeutic methods aimed at autophagy,and will emphasize the bipolar role of autophagy in HCC.

Objective To establish the culture of Blastocystis hominis in vitro in Medium 199 for further research on the biological characteristics of this intestinal parasite.Methods The growth, reproduction and relevant factors of B.hominis under different culture conditions including pHs, sorts and concentrations of serum, and the number of inoculation were compared. Results The optimal conditions for the continuously anaerobic culture of B.hominis in Medium 199 were as follows: concentrations of new born bovine serum (or human serum and horse serum) ranged from 10%-20%, the number of inoculation was no less than 1?10~5 organisms per tube, pHs ranged from 7.0-8.0, penicillin, streptomycin should be added, anaerobic cultured at 37 ℃.The reproductive peaking-days were 4, 8 at pH 7.0; 3, 6, 9 at pH 7.5 and 2, 4, 7, 9 at pH 8.0. Conclusion B.hominis could be continuously cultured in vitro in Medium 199.

There has been no specific therapeutic measures for acute lung injury /acute respiratory distress syndrome ( ALI/ARDS) , a disease of high fatality rate.Besides having good curative effects for the cardiovascular system diseases, cancer, obesity and preventing aging, traditional Chinese herbal medicines also have obvious therapeutic effects on ALI/ARDS.In this paper, we summari-zes the protection and the underlying mechanisms of traditional Chinese herbal medicines on ALI/ARDS.

Objective To investigate the value of multi-slice spiral CT image texture analysis in differentiating metastatic (MLN) from non-metastatic lymph nodes (NLN) in patients with rectal cancer.Methods Thirty five patiets with rectal cancer who were pathologically confirmed by total mesorectum excision were included retrospectively,with regional lymph nodes (short-axis diameter of larger than 3 mm)found in preoperative CT images.All the patients underwent preoperative abdominal and pelvic dynamic contrast-enhanced CT scan.Regional lymph nodes were identified according to pathological findings,and were divided into MLN and NLN groups.The short-axis diameter,short-to long-axis diameter ratio of lymph nodes were manually measured and calculated,and the texture features,including skewness,kurtosis,variance,entropy and inverse difference moment,were analyzed.The above parameters between MLN and NLN groups were compared using independent sample t test or Mann-Whitney U test.ROC curve analysis was performed regarding the statistically significant parameters and the areas under curve (AUC) were calculated.Multivariate Logistic regression analysis was accomplished to obtain the independent predictive factor of diagnosing regional lymph nodes.Results A total of 68 regional lymph nodes were obtained and consisted of 31 MLNs and 37 NLNs.The short-axis diameter,kurtosis,and entropy of the MLN group were significantly higher than those of the NLN group (all P＜0.05).Whereas,the short-to long-axis diameter ratio,skewness,variance,and inverse difference moment did not differ significantly between the two groups (all P＞0.05).The AUC for distinguishing MLN from NLN of the short-axis diameter,kurtosis and entropy were 0.79,0.67,and 0.85,respectively.Multivariate logistic regression analysis showed that only entropy (odds ratio=8.48,95％ confidence interval was 3.01 to 23.92,P＜0.01) was screened out as the independent variable,which suggested that the entropy was the unique predictor for characterizing regional lymph nodes of rectal cancer.Conclusion Multi-slice spiral CT images texture analysis can facilitate the accurate differentiation between MLN and NLN in patients with rectal cancer,and especially the entropy has the optimal reference significance.

This study aimed at investigating the effects of Guttiferone K (GUTK),a polycyclic polyprenylated acylphloroglucinols (PPAPs) compound isolated from Garcinia yunnanensis,on the cell proliferation of human prostate cancer LNCaP cell line.Human prostate cancer LNCaP cells in the period of logarithmic phase were treated with GUTK.MTI assay was used to detect cell proliferation.Flow cytometry of propidium iodide (PI) staining,BrdU assay and immunocytochemistry were adopted to analyze the cell cycle phase distribution.Protein levels of Cyclin A,p27 and SKP2 were detected by western blotting.The results showed that GUTK inhibited the proliferation and induced G0/1 arrest of LNCaP cells in a time and dose dependent manner.The protein levels of Cyclin A and SKP2 were decreased,while p27 was increased by GUTK in human prostate cancer LNCaP cells.It was concluded that GUTK,a compound isolated from G.yunnanensis,presented the effect of inhibiting the cell proliferation by inducing G0/1 arrest of human prostate cancer LNCaP cells,with potential anti-prostate cancer action.

Objective To evaluate the accuracy of enhanced spiral CT scans on the clinical staging of renal cell carcinoma.MethodsThe enhanced CT and clinical data of 48 patients with renal carcinoma verified by surgery and pathology in Chongqing Donghua hospital were retrospectively analyzed.Robson's classification was used to determine the clinical stages of CT data,and the staging findings based on CT data were compared with the postoperative and pathological outcomes.Results The results showed that the accuracy of preoperative CT on the staging was 91.7％.Enhanced scanning by spiral CT was useful to identify the boundaries of tumor and the filling defect of renal vein or inferior vena cava.Conclusion Enhanced scanning using the spiral CT can improve the accuracy of clinical staging for renal carcinoma,which provides guidance about the clinical therapeutic schedules for patients with renal carcinoma.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

Objective To evaluate the effect of domestic wire-reinforced epidural catheter on the occurrence of adverse events during epidural block.Methods Three hundred ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 41-78 kg,scheduled for elective operations under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =100 each):polyvinyl chloride epidural catheter group (group A),imported wire-reinforced epidural catheter group (group B) and domestic wire-reinforced epidural catheter group (group C).Combined spinal-epidural anesthesia was performed routinely.The corresponding epidural catheter was inserted in each group.The catheterization without difficulty,paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,intravascular catheter insertion,injection obstruction,easiness during removal of the catheter,bleeding after removal,postoperative paresthesia and epidural hematoma within 1 week after operation were recorded.Results Compared with A group,the incidences of paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,injection obstruction and postoperative paresthesia were significantly decreased (P ＜ 0.05),and no significant change was found in the other parameters in B and C groups (P ＞ 0.05).There was no significant difference in all the parameters between B group and C group (P ＞ 0.05).Conclusion Domestic wire-reinforced epidural catheter can decrease the occurrence of catheterization-induced damage to the nerve and blood vessels and the efficacy is comparable with that of imported wire-reinforced epidural catheter.

Objective To investigate the diagnostic value of plasma B-type natriuretic peptide(BNP) in left to right shunt congenital heart disease accompanied by heart failure in PICU.Methods We retrospectively reviewed the clinical data of 52 cases diagnosed left to right shunt congenital heart disease in the PICU of Shengjing Hospital of China Medical University from January 2012 to June 2014.The cases were divided into negative control group(n=18) and heart failure group(n=34) according to the criteria for the diagnosis of pediatric heart failure.We respectively compared plasma BNP,size of heart defects,left ventricular end-diastolic volume index(LVEDVI),ratio of left ventricular early diastolic filling blood flow velocity and left ventricular late diastolic filling blood flow velocity(E/A),left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP),and cardiothoracic ratio between the two groups.We analyzed the correlation between plasma BNP and the size of heart defects,LVEDVI,E/A,cardiothoracic ratio,LVEF,PASP.The receiver operating characteristic curve was used to determine the optimal cut-off value of plasma BNP to diagnose heart failure.Results Plasma BNP were 87.7(22.7,165.7)pg/ml in negative control group and 716.5(326.8,1813.0)pg/ml in heart failure group.The plasma BNP level of heart failure group was significantly higher than that of negative control group(Z=5.3,P<0.01).Size of heart defects were 5.0(3.0,6.8) mm in negative control group and 7.4(5.5,9.0)mm in heart failure group.Size of heart defects of heart failure group was significantly higher than that of negative control group(Z=3.5,P<0.01).LVEDVI were (44.6±18.3)ml/m3 in negative control group and (70.8±38.4)ml/m3 in heart failure group.LVEDVI of heart failure group was significantly higher than that of negative control group(t=2.7,P=0.01).E/A were 1.3±0.3 in negative control group and 1.1±0.3 in heart failure group.E/A of negative control group was significantly higher than that of heart failure group(t=2.2,P=0.04).Plasma BNP had a positive relation with cardiothoracic ratio(r=0.49,P=0.01) and a negative correlation with E/A(r=-0.28,P=0.04).The optimal cut-off value of plasma BNP was 181.8 pg/ml.The sensitivity of diagnosis of heart failure was 94% and the specificity was 88%.The area under the receiver operating characteristic curve was 0.951.Conclusion Plasma BNP may comprise a sensitive marker for heart failure of left to right shunt congenital heart disease.It is recommended that 181.8 pg/ml is the optimal cut-off value to diagnose heart failure of left to right shunt congenital heart disease.