Objective:To evaluate the value of 64-slice CT portal venography(CTPV)in demonstrating portal system and its collaterals in portal hypertension.Methods:50 cases of portal hypertension were included in the study and undergone upper abdomen examination with 64-slice CT,image post-processing techniques such as MIP,MPR and VR were applied to display the portosystemic collaterals of portal venous system.Results:CTPV simultaneously depicted fourth or fifth branches of the intrahepatic portal veins and provided images of entire portosystemic collaterals,on CTPV images,left gastric varices were seen in 48 patients(96%),esophygeal and/or fundic varices in 46(92%),paraesophageal varices in 41(82%),shnrt gatric veins or posterior gastric veins in 19(38%),shunt between spleen/gastric-renal vein in 14(28%),abdominal wall and paraumblical varices in 20(40%),retroperitioneal varices in 19(38%),portal sponge degeneration in 8(16%).Conclusion:CTPV can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension.An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease,and may play a significant role in marking a clinical treatment plan.

Objective:To analyse the findings of MRI and CT in the diagnosis of spine metastases in 52 cases,and compare their sensitivity and specificity,in order to increase the early diagnosis rate of spinal metastases.Methods:The most common sources of skeletal metastases were carcinomas of lung,breast,nasopharynx.MRI and CT were performed in 52 patients with metastatic tumor.The detectability for vertebral metastasis was compared between the two modalities.Results:Of the 52 cases,there were destructions of 176 vertebral bodies,76 lesions of spinal canal involvement,68 paravertebral soft tissue.masses and pathological fractures of 47 vertebral bodies.In the cases of stage Ⅰ spinal metastases:21 were detected by MRI and nothing was detected by CT.In the cases of stage Ⅱspinal metastases:86 were detected by MRI;52 were detected by CT.In the cases of stage Ⅲ spinal metastases:68 were detected by MRI;61 were detected by CT.The sensitivity of spinal metastases by MRI(99.4%) higher than CT(64.2%).MRI demonstrated decreased signal intensity(86.9%)and other abnormal signal intensity(13.1%)on T1WI and increased signal intensity(60.8%)and other abnormal signal intensity(39.2%)on T2WI.Conclusion:The sensitivity and specificity of MRI is higher than that of CT.Two methods are complementary to each other,so MRI combined with CT can improve the sensitivity and accuracy in the diagnosis of spinal metastases.

Adult ; Arsenic Poisoning ; Arsenicals ; Humans ; Indium ; Male ; Occupational Exposure ; Young Adult

Acute kidney injury(AKI) is a common clinical severe emergency in children,with high morbidity,mortality and poor prognosis.The traditional indicators such as serum creatinine and urine can't diagnose early.Recently,with the deepening research of AKI,many higher specific and sensitive biomarkers have been found.But the study of biomarkers in children is behind the adult,and the etiology,pathophysiology of AKI in children have great difference from adult.So this paper will show the advances of biomarkers in children of AKI.

Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

Since it is one of the hotspots to discover the new knowledge in life science in data-intensive scientific discovery by integrating the biomedical literature and scientific data that can provide an open environment for their interactive operation , the mining of foreign and domestic biomedical literature and integration of scientific data were analyzed , the corresponding systems for different integration methods were investigated , the development trend in biomedical literature and scientific data integration was predicted .

120 cases of nuchal ligament strain were treated with Tuina at the nape, tapping Dazhui (GV 14) with plum-blossom needle, and cupping Dazhui(GV 14). Clinical observation was made after 14-day treatments. Eighty-seven cases got cure, 28 cases improvement and 5 cases failure; the total effective rate was 95.8%.

Objective To explore the feasibility of constructing literature exchange platform between TCM libraries of Across-Straits, focusing on current situation of TCM libraries. Methods Originally scattered,multivariant, and isomeric TCM literature resources were united to one whole through simple and effective mode for the purpose of increasing literature usage. Results The exchange platform between TCM libraries of Across-Straits was established. Conclusion This platform was suitable for scientific research, teaching,clinical practice and science popularization.

Objective To explore the effect of oxidative stress on intermittent hypoxia induced-hip-pocampal injury in rats. Methods 30 adult male Sprague-Dawley rats were random divided into three groups ( 10 rats in each group), control group( CON group), intermittent group( IH group), and melatonin group( MEL group). The levels of MDA and SOD were detected by colorimetric method, and RT-PCR was used to examine the mRNA levels of the Cu/ZnSOD, GPx, CAT in hippocampal tissues. Results The level of MDA in IH group was ( 1. 68 ±0. 23) μmol/g, and it was obviously higher than that in control group (1.25±0.14)μmol/g and MEL group(1.35 ±0.18) μmoL/g ( P ＜0.05, P ＜0.01). In IH group, the activity of SOD and the mRNA levels of the Cu/ZnSOD,GPx and CAT were 43.01 ±4. 96 103NU/g, 0.25±0. 02,0. 34 ±0. 09,0. 38 ±0. 03 respectively, which were significantly lower than those in control group(61.12 ±5.68 103NU/g protein,0. 48 ±0.06,0. 55±0.07,0.57 ±0.04) and MEL group (55.98 ±4.65 103 NU/g,0.43 ± 0.08,0.54 ± 0.05,0.53 ± 0.07 ) ( P ＜ 0.05, P ＜ 0. 01 ). Conclusion Intermittent hypoxia can induce hippocampal injury in rats by oxidative stress, and melatonin can inhibit intermittent hypoxia induced-oxidant stress, so it can protect intermittent hypoxia induced-hippocampal injury in rats.

Objective To compare the efficacy of ultrasound -guided bilateral superficial cervical plexus block combined with general anesthesia and single general anesthesia in patients undergoing thyroidectomy.Methods 60 patients with ASAI ~II undergoing thyroidectomy,in accordance with the random number table,were divided into bilateral superficial cervical plexus block combined with general anesthesia group (group A)and single general anesthesia group(group B),30 cases in each group.In group A,the patients were provided ultrasound -guided bilateral superficial cervical plexus block with 0.4% ropivacaine 40 ml(20 mL for each side)before general anesthesia induction.In group B,the patients were directly induced for general anesthesia.The patients of the two groups had the same general anesthesia induction drugs.SBP,DBP and HR were monitored and recorded at the time of pre -anesthesia,skin incision, postoperation and extubation.The cumulative amount of propofol and remifentanil during the operation were recorded. The extubation time was recorded and each patient was assessed 1,2,3,4h after surgery for resting VAS score. Results Blood pressure and heart rate at the different time points during operation were higher than pre -anesthesia significantly in group B[skin incision SBP (134.8 ±8.5)mmHg,the end of operation SBP (123.4 ±5.1)mmHg, tracheal extubation SBP (138.7 ±8.5)mmHg vs preanesthesia SBP (117.3 ±9.8)mmHg,t =7.39,3.02,9.04,all P =0.00;skin incision DBP (86.7 ±7.6)mmHg,the end of operation DBP (80.6 ±7.8)mmHg,tracheal extubation DBP (87.4 ±5.8)mmHg vs preanesthesia DBP (75.6 ±6.6)mmHg,t =6.04,2.68,7.35,all P =0.00;skin incision HR (92.4 ±6.5)times/min,the end of operation HR (86.8 ±6.3)times/min,tracheal extubation HR (96.9 ± 7.2)times/min vs preanesthesia HR (78.9 ±6.8)times/min,t =7.86,4.67,9.96,all P =0.00].The cumulative amount of general anesthesia during operation in group A was less than that in group B,the extubation time in group A was shorter than that in group B[propofol doses of group A (650.6 ±50.3)mg vs group B (762.3 ±43.5)mg,t =9.2,P =0.00;remifentanil doses of group A (0.61 ±0.08)mg vs group B (0.95 ±0.06)mg,t =18.62,P =0.00;extubation time of group A (10.6 ±5.1)min vs group B (15.5 ±5.2)min,t =3.68,P =0.00].The resting VAS score at the different time points after surgery in group A was less than that in group B[the resting VAS score at 1,2, 3,4h after surgery in group A vs group B,(0.99 ±0.81)vs (1.75 ±1.23),t =2.83,P =0.00;(1.23 ±1.02)vs (3.45 ±0.84),t =9.2,P =0.00;(2.80 ±0.85)vs (3.71 ±1.19),t =3.41,P =0.00;(3.11 ±1.02)vs (5.19 ± 1.36),t =6.7,P =0.00],there were statistically significant differences.Conclusion Ultrasound -guided bilateral superficial cervical plexus block combined with general anesthesia used in patients undergoing thyroidectomy can maintain the intraoperative hemodynamic stability effectively,reduce the amount of general anesthetics,shorten the extubation time,and ease the early postoperative pain,the efficacy is significantly better than single general anesthesia.