Objective To evaluate the predictive value of functional liver imaging score(FLIS)based on preoperative gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI for post-hepatectomy liver failure(PHLF)in patients with hepatocellular carcinoma(HCC).Methods The data of HCC patients who underwent extensive hepatectomy and preoperative Gd-EOB-DTPA enhanced MRI were analyzed retrospectively.The FLIS was scored based on the three features including liver parenchyma enhancement,biliary excretion and portal vein signal enhancement in hepatobiliary phase images,and the consistency between different observers was evaluated.Logistic regression model and receiver operating characteristic(ROC)curve were used to analyze the ability of FLIS to predict the PHLF.Results PHLF occurred in 29 of 120 HCC patients(24.2%).The intraclass correlation coefficient(ICC)of FLIS evaluated by two observers was 0.944.Multivariate logistic regression analysis showed that FLIS was an independent predictor of PHLF of HCC patients[odds ratio(OR)0.520,95%confidence interval(CI)0.355-0.726;P<0.001].The area under the curve(AUC)of FLIS for predicting the PHLF was 0.709,the optimal diagnostic threshold was 4,and the corresponding sensitivity and specificity were 78.0%and 58.6%.Conclusion Preoperative FLIS can predict the PHLF of HCC patients,which may help to make more accurate treatment plans for HCC patients.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To analyze the MRI findings of pure mucinous breast carcinoma and to investigate the causes of misdiagnosis.Methods MRI findings of 1 3 patients with pure mucinous breast carcinoma were analyzed retrospectively.All patients were verified by surgery and histopathology.Results All the 13 cases were presented as a mass,among which 12 cases (92.3%)had lobular contour and 1 (7.7%) had irregular shape.11 cases (84.6%)showed low or iso-signal intensity and 2 (15.4%)showed heterogeneous iso or high intensity on T1WI.All the 13 cases showed high signal intensity on fat suppression T2WI,and 5 cases(38.5%)showed low signal fiber separation inside. 5 cases (38.5%)showed homogeneous high signal intensity and 8 cases (61.5%)showed heterogeneous high signal intensity on diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)map,the ADC value was (2.002±0.478)× 10-3mm2/s.11 cases (84.6%)showed rim enhancement,among which 8(61.5%)showed persistent enhancement and 2 (15.4%)showed heterogeneous enhancement.Time-signal intensity cure(TIC)of 11 cases(84.6%)were monophasic or biphasic and 2 cases(15.4%0)were wash-out type. 5 cases(38.5%)were misdiagnosed on preoperative MRI.Conclusion There are several MRI features in pure mucinous breast carcinoma,such as lobular contour,high signal intensity on DWI and ADC map,persistent enhancement and monophasic or biphasic on TIC.Comprehending these MRI features is the key to reduce misdiagnosis.

ObjectiveTo evaluate the safety and superiority of dressings and bandage compression method for patients after percutaneous coronary intervention through femoral artery.MethodsA total of 648 patients who received percutaneous coronary intervention through femoral artery were randomly divided into three groups: the modified group (224 cases), the routine group (213 cases) and the haemostat group (211 cases), they each adopted modified dressings and bandage compression method, the traditional oppression hemostatic method, and arterial oppression with hemostat method. The unarmed oppression time, expenditure, braking time, and complications were observed and analyzed statistically.ResultsThere was no significant difference in braking time and local vascular complications of the three groups. Compared with the routine group, the modified group reduced the unarmed oppression time and the medical staffs workload; compared with the hemostat group, it reduced the expenditure.ConclusionsImproved dressings and bandage compression method can reduce the unarmed oppression time and expenditure, it is an ideal local hemostasis method for patients undergoing percutaneous coronary intervention through femoral artery, and is worthy of clinical application.

Allotransplantation of peripheral blood-derived hemopoietic stem cells is the best therapy for acute leukemia. With increases of only-child families, sibling donors are decreasing. Moreover, the probability is low and time consuming is long to search a matched hemopoietic stem cell donor from the Chinese Marrow Donor Program. Haploidentical stem cell transplantation would bring a hope for donor resource. However, difficult transplantation and high incidence of graft versus host disease are two risks. Based on modified regimen and cyclosporine A+short-term amethopterin, mycophenolic acid, interleukin-11, anti-lymphocyte immunoglobulin and hemopoietic stem cells mobilized by recombinant human granulocyte colony-stimulating factor can prevent graft versus host disease. This therapy succeeded in two cases with no severe graft versus host disease.

OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.