Objective:To explore the disease-related impairment of functional and structural connectivity network and their relationship with psychometric hepatic encephalopathy score (PHES) in patients with chronic hepatitis B virus-related cirrhosis (HBV-RC) by combining resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI).Methods:Data of 30 HBV-RC patients [including 13 HBV-RC patients with minimal hepatic encephalopathy (MHE) and 17 HBV-RC patients without MHE (NMHE)] from April 2011 to October 2011 in Guangdong No.2 People′s Hospital were analyzed prospectively, and 38 healthy individuals matched for age, sex, and education with HBV-RC patients (HC group) were included during the same period. Rs-fMR and DTI data as well as PHES data of all participants were collected. Gretna and PANDA software package were used to preprocess the imaging data and construct the functional and structural network respectively. The network-based statistic (NBS) approach was used to compare the differences of the functional and structural connections among three groups. Spearman′s correlation analysis was used to identify the relationship between functional or structural connectivity and PHES. The structural equation modeling (SEM) was used to explore the relationships among functional connectivity, structural connectivity, and PHES.Results:Compared to HC group, both functional and structural connectivity in the whole brain progressively destroyed from NMHE to MHE, mainly involving cognitive control network, default mode network, and limbic network (NBS corrected, all P<0.01). There were significantly negative relationships between functional or structural connectivity and PHES in HBV-RC patients (false discovery rate corrected, all P<0.05). The SEM results showed the influence of structural connectivity on neurocognitive impairment was mediated by functional connectivity ( P<0.05). Conclusion:Both functional and structural networks progressively destroy in HBV-RC patients as the disease advanced and these alterations significantly correlate with PHES. Besides, the influence of structural connectivity on neurocognitive impairment is mediated by functional connectivity.

OBJECTIVE:To systematically review the efficacy and safety of cinacalcet in the treatment of hemodialysis pa-tients with secondary hyperparathyroidism,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Medline,Cochrane Library,EMBase and CBM,randomized controlled trials(RCT)about cinacalcet in the treatment of he-modialysis patients with secondary hyperparathyroidism (SHPT) were collected. Meta-analysis was performed by using Rev Man 5.3.5 software after data extract and quality evaluation by Cochrane systematic Rev Man 5.3.5. RESULTS:Totally 7 RCTs were en-rolled,involving 1 987 patients. Results of Meta-analysis showed cinacalcet can significantly reduce the rate of surgical parathyroid-ectomy[RR=0.23,95%CI(0.06,0.89),P=0.03],incidence of fracture[RR=0.26,95%CI(0.12,0.60),P=0.002] and increase the incidences of hypocalcemia[RR=9.81,95%CI(3.92,4.59),P<0.001],nausea[RR=1.97,95%CI(1.58,2.46),P<0.001] and vomit-ing[RR=1.91,95%CI(1.50,2.42),P<0.001],while it showed no significant effect on the the incidence of all-cause mortality and cardiovascular death. CONCLUSIONS:The clinical efficacy of cinacalcet in the treatment of hemodialysis patients with secondary hyperparathyroidism is good,but there are common adverse reactions such as nausea and vomiting,hypocalcemia.

Objective To discuss the utility of contrast-enhanced ultrasonography (CEUS) in the assessment of treatment efficacy of radiofrequency ablation (RFA) in patients with renal tumors.Methods Forty-seven patients (40 renal cell carcinomas and 7 angiomyolipomas of kidney) with 49 renal tumors were treated with RFA. Tumors were ablated by laparoscopy-assisted (n= 30) and open surgical (n= 17) RFA. The CEUS and contrast-enhanced CT were performed 1 week after treatment to assess the necrotic area. Technical success was defined as elimination of areas that enhanced at imaging within the entire tumor. Results Forty-seven (95. 9%) of 49 tumors were successfully ablated. The mean length of the major axis at the maximal necrotic area was 4. 6 cm. Compared with the lesions before RFA, the necrotic areas were bigger in 45 patients, identical in 3 patients, and smaller in 1 patient. Six lesions showed a residual enhancement at the portion adjacent to the normal renal parenchyma on follow-up CEUS, while 2 were confirmed by CT scans. The sensitivity and specificity of CEUS for detection of residual tumors were 100. 0% and 91.8%, respectively. All patients survived in the follow-up period ranging from 4 to 21 months. Conclusion CEUS combined with CT could be useful for evaluating treatment efficacy of RFA for renal tumors.

Objective To investigate the mechanism of venous reverse-flow flap in the differentperiod after operation.Methods The rabbits wero randomly allocated into 3 groups.In group A,including saphenous artery and venae commutante.In group B,saphenous artery without venae commutante.In group C,surface seeping and saphenous artery and venae commutante.Flap appearance,intravenous pressure,vessel diameter,mierocircular and histological examination were mea8ured.Results The difference of introvenous pressure between group A.B and C was obvious.Reverse flow WaS found in group A and C group through microcirculation observation 2 hours post-operation.Venous valve lose efficacy while the vessel diameter wes at maximum just after the pressure peak.Conclusion Venous retrograde return in reverse-flow island flaps can be achieved more easily through"incompetent valves route"than through "communicating and collaterall by pass route".By pass route is a supplementary way.Surface seeping Can slighfly relieve the venous pressure but can cause infection.

0.05).There were no signifi-cant relation between the expressions of Fas,FasL and bcl-2and IL-8.Conclusion The abnormal expressions of Fas,FasL,bcl-2may play an important role in the pathogenesis of LN.The expression of Fas and FasL may serve as active indexes for SLE and LN.The low level of IL-8may be related to the dysfunction of immunity and needs further research.