Objective To analyze the characteristics of blood lipid metabolism in patients with Wilson's disease(WD)and understand the influencing factors of abnormal blood lipid.Methods The clinical data of 170 patients with WD and 59 healthy people were collected from June 2021 to March 2023,the blood lipids of the two groups were compared.To compare the characteristics of blood lipid metabolism in WD patients with different gender,age,body mass index(BMI)and disease types.According to whether the blood lipid was abnormal or not,WD patients were divided into normal blood lipid group and abnormal blood lipid group,and the biochemical indexes of the two groups were compared.The general situation and biochemical indicators were included in the single factor regression analysis,and the related factors that might affect blood lipid metabolism were screened out.The related factors of single factor screening were included in multivariate Logistic regression analysis to determine the abnormal factors affecting blood lipid.Results The triglyceride(TG)level of WD patients was lower than that of healthy controls,the difference was statistically significant(P<0.05).The rate of dyslipidemia in WD patients was 40.59%.Low density liporotein cholestrol in female WD patients was significantly lower than that in male WD patients(P<0.05).The values of BMI,alanine aminotransferase(ALT)and uric acid(UA)in dyslipidemia group of WD patients were significantly higher than those in normal group(all P<0.05).Multivariate Logistic regression analysis showed that BMI 24～28(OR=4.526,P<0.05),BMI>28(OR=6.360,P<0.05),UA(OR=1.006,P<0.01)and hyaluronic acid(HA)(OR=1.003,P<0.01)were associated with the high risk of dyslipidemia,with statistical significance.Conclusions WD patients have a high incidence of abnormal lipid metabolism,mainly with low high density liporotein cholestrol and high TG.The dyslipidemia in WD patients is affected by many factors.BMI,UA and HA are independent risk factors for dyslipidemia in WD patients.

OBJECTIVE: To establish the optimum extraction technique and high performance liquid chromatographic (HPLC) method to simultaneously quantify nine compounds of gallic acid, hydroxy-paeoniflorin, catechin, albiflorin, paeoniflorin, pentagalloylglucose, benzoic acid, benzoylpaeoniflorin and paeonol in . METHODS: Linear gradient elution was applied using water containing 0.1%phosphoric acid and acetonitrile as the mobile phase with a flow rate of 0.8 mL/min, column temperature of 30℃ and wavelength of 230 nm. The method of ultrasound extraction was used. Methanol and ethanol were used as extraction solvents, and three factors and three levels of orthogonal experiments was designed using L (3 ) table to investigate the effects of solvent concentration, ratio of liquid to material and extraction time on the total content of nine components of . RESULTS: HPLC method was verified to have high specificity, sensitivity and accuracy through methodological validation, and it could be used for simultaneous quantitative analysis of nine components of . The results showed that the optimum extraction technology of nine components of was using 70%ethanol as extraction solvent, ratio of liquid to material was 200 mL/g and ultrasound extraction time was 30 min. CONCLUSIONS HPLC method for the simultaneous determination of nine components of is established, and the optimum extraction technology is confirmed.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Paeonia

Objective To explore prenatal MRI findings of fetal midline dural sinus malformation(DSM).Methods Eleven fetuses of midline DSM were collected.Abnormalities in the fetal occipital or cerebellar area were found from 21 to 27 weeks of gestation.Then MR scanning in the following week was performed.Of all 11 fetuses,9 were pathologically proved to be midline DSM,and the other 2 were followed up and proved after birth.The imaging findings and pathological features were analyzed.Results MRI of 11 fetuses showed cystic dilation of the occipital cranium of torcular herophili area,with the size of 10 mm× 15 mm to 35 mm× 55 mm,and the adjacent sinuses were also dilated.On axial or coronal images,the lesions were cuneiform,while on sagittal images,the lesions were spindle-or crescent-shaped.The lesions displayed isointensity or slightly hyperintensity on T1WI,while slightly hypointensity,isointensity or slightly hyperintensity on T2WI.In 9 of the 11 fetuses,class round or bar thrombosis on the side wall of the cystic mass were observed,which were hyperintensity on T1WI and isointensity and hypointensity,isointensity or hyperintensity on T2WI.Hemosiderin deposition was observed around the thrombi in 6 fetuses.Lesion diameters in 2 fetuses were more than 30 mm,and the adjacent brain tissue was significantly dislocated.Nine fetuses of postmortem pathology after induced labor showed deformed and dilated venous sinuses,in which eccentric thrombi were seen in 7 fetuses with side branches around them.Normal brain development was observed in 2 live birth newborns.Conclusion Prenatal MRI can accurately diagnose fetal midline dural sinus malformation,and estimate the development of fetal brain,which may be helpful to prognosis prediction.

Objective To observe imaging features of uterus duplication combined with mesonephric duct dysplasia related abnormalities.Methods Imaging data of 17 female with uterus duplication and renal dysplasia were retrospectively analyzed.Seven patients underwent CT and 10 patients underwent MR scanning.Results The basic abnormalities in 17 patients were uterus duplication combined with unilateral renal-ureter dysplasia with/without other associated malformation which were further classified as follows:①7 patients presented as basic abnormalities without other associated malformations,include 5 (CT diagnosed 1,MR diagnosed 4) with uterus duplex and unilateral renal-ureter agenesis,2 (CT 1,MR 1) with uterus bifidus and unilateral renal-ureter dysplasia;②2 patients (CT 1,MR 1) presented as basic abnormalities accompanied with ectopic ureter orifice,uterus duplex and unilateral renal dysplasia with ectopic ureter orifice opening in vagina;③5 patients (CT 3,MR 2) of Herlyn-Werner-Wunderlich syndrome presented as uterus duplication,oblique vagina septum as well as unilateral renal-ureter dysplasia,which shown as uterus duplex,oblique vaginal septum with hematocolpos,also unilateral renal-ureter agenesis;④2 patients presented as basic abnormalities accompanied with mesonephric residual cyst,CT showed one with uterus duplex and unilateral renal-ureter agenesis with ipsilateral mesonephric residual cyst,MRI showed as the other one with Herlyn-Werner-Wunderlich syndrome combined with mesonephric residual cyst opening in vagina;⑤MRI showed 1 patient with basic abnormalities and a nephrogenic adenoma,which demonstrated as uterus duplex combined with left renal-ureter agenesis,and a tumor on the left wall of bladder accompanied with endometriosis.Conclusion Further classification into 5 types from simple to complex based on uterus duplication combined with unilateral renal-ureter dysplasia with/without other associated malformations is helpful to the diagnosis and treatment of these abnormalities.

Objective:To investigate the clinical effect of dexamethasone combined with urokinase on the tuberculous pleurisy.Methods:From August 2013 to May 2016,190 cases of tuberculous pleurisy patients in our hospital were selected.All the patients were randomly divided into the observation group and control group with of 95 patients in each group,both groups were treated with anti tuberculosis treatment,the control group was given urokinase treatment,the observation group was given dexamethasone combined with urokinase treatment,both groups were treated for 1 month.After treatment,the total effective rate,incidence of adverse reactions,total drainage time of pleural effusion,total amount of pleural effusion,thrombin time and prothrombin time of two groups were compared.Results:All patients were well tolerated with injection during the treatment and there was no severe complication after treatment;the total effective rates in the observation group and the control group were 88.4％ and 72.6％,which was significantly higher in the observation group than that of the control group (P＜0.05).The total drainage time and total amount of pleural effusion in pleural effusion in the observation group were 7.56± 2.44 d and 2867.33± 456.10 mL,the control group were 9.44± 2.89 d and 1989.92± 444.20 mL,the total drainage time in the observation group was significantly shorter than that of the control group,and the total amount of pleural effusion was significantly higher than that of the control group(P＜0.05).After treatment,the pleural effusion thrombin time and prothrombin time in both groups were significantly higher than those before treatment (P＜0.05),which were higher in the observation group than those of the control group (P＜0.05).Conclusion:Dexamethasone combined with urokinase could prolong the thrombin time and prothrombin time,shorten the time of drainage of pleural effusion,increase the pleural effusion amount,with good safety and clinical effect in the treatment of tuberculous pleurisy.

Objective To investigate the imaging characteristics of female Skene-gland (periurethral glands) disease. Methods A retrospective analysis of preoperative imaging findings was performed in 15 female patients with surgical-pathological proven Skene gland disease. MRI scans were performed in 8 cases, CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases. Imaging characteristics were observed and summarized.Results There were 3 types of diseases,including:(1) Skene gland cyst (n=3), located in the distal and posterolateral urethra or close to the proximity of urethra, presenting as cystic lesions with teardrop shape on sagittal images, which appeared as hypo-attenuation on non-enhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI, and without enhancement. One case complicated with infection presented as hyper-intensity on T1WI and gaseous intensity inside,with thickened cystic wall and enhancement.(2)Urethral diverticulum communicating with Skene gland (n=10), located in the middle or distal and posterolateral urethra, presented as a horseshoe shaped cystic lesion partially surrounding the urethral(n=3)or spoke wheel-like cystic lesion with multiple septum completely surrounding the urethra (n=7). They appeared as fluid attenuation on unenhanced CT, and hypo-intensity on T1WI, hyper-intensity on T2WI and without enhancement. Heterogenous signal or attenuation and enhanced septum or cystic wall were found in 6 cases complicated with infection. (3) Malignant tumor (n=2, one adenocarcinoma and one neuroendocrine carcinoma), presented as cystic-solid mass surrounding the urethral, showing heterogenous low attenuation on nonenhanced CT and iso-to hyper-intensity on T2WI and hypo-to iso-intensity on T1WI with significant enhancement.Conclusions Female Skene-gland disease has specific occurrence location and imaging characteristics.

Objective To explore imaging findings and pathological features of ovarian collision tumors. Methods A retrospective analysis of preoperative imaging findings was performed in 8 female patients with surgical-pathological proven ovarian collision tumors. CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases, and non-enhanced MR scans were performed in 1 pregnancy woman. Imaging results were compared with pathologic findings. Results Ovarian collision tumors in the eight patients consisted of 2 types tumors, originated from different ovarian tissues including surface epithelial cells, germ cell, or sex cord-stromal cell. Of the 8 ovarian collision tumors, 5 were located in the left ovary, and 3 in the right ovary. Ovarian collision tumors consisted of surface epithelial tumor and germ cell tumor (n=6) including mucinous cystadenoma and teratoma (n=4), mixed cystadenoma and teratoma (n=1), and serous cystadenoma and struma-ovarii (n=1). Ovarian collision tumors in two cases consisted of surface epithelial tumor and sex cord-stromal tumor, and were mucinous cystadenoma and fibroma, respectively. Imaging findings included:all tumors in the 8 cases presented big or huge multiple complicated cystic mass with 9 to 26 cm in diameter. Germ cell tumor or sex cord-stromal tumor in collision tumor was smaller and located inside the tumor (n=3) and on the tumor wall (n=5). The boundary between two types of tumors in ovarian collision tumor was distinct and clear. Typical imaging features and densities (signals) of different tumors in ovarian collision tumors can be found on CT or MRI. Conclusions Ovarian collision tumors has some specific imaging and pathological characteristics. Imaging examination is helpful for most accurate diagnosis of ovarian collision tumors.

Objective To explore the expressions and distributions of glial cell line -derived neurotrophic factor (GDNF)and itstyrosine kinase receptor RET in the terminal rectums of fetal rats with congenital anorectal malfor-mations (ARM)at different gestationalage,and to explore their effects on the enteric nervous system in the terminal rectum of ARMfetal rats.Methods Thirty -five SD pregnancy rats were divided into a saline group (n =1 0)and an ethylenethiourea experiment group (n =25)by simple randomized study.The fetal rats were removed from the pregnant rats at the gestational 1 6 d,1 8 d and 20 d.The fetal rats were divided into the saline control group,the ethylenethiourea control group (fetal rats without ARM)and the ethylenethiourea malformation group (ARM fetal rats)by the naked eye and dissecting microscope.HE staining was used to observe the morphology and the intestinal ganglion cells in the terminal rectum were counted.The immunohistochemical staining and Western blot methods were used to observe the distributions of GDNF and RET in the rectum at the gestational 1 6 d,1 8 d and 20 d.The quantitative real -time poly-merase chain reaction (qRT -PCR)was used to detect the expression of GDNF mRNA in the fetal rats in the terminal rectum at the gestational 1 6 d,1 8 d and 20 d.Results HE staining:the development of anorectal terminal in 3 groups of fetal rats was unclear at the gestational 1 6 d.A small amount of scattered nerve plexuses were observed in the muscu-lar layer.The nuclei were small and sparse.The axons and cytoplasms were less.The serosal layer,muscular layer,sub-mucosa,mucosal layer and glands in the terminal rectum were gradually clear in the saline control group and the ethyle-nethiourea control group at the gestational 1 8 d and 20 d.The intermuscular submucosal nerve plexuses increased gra-dually (1 1 .400 ±3.1 34 and 1 1 .200 ±3.425 at the gestational 1 8 d;66.1 00 ±4.954 and 67.600 ±5.481 at the gesta-tional 20 d).While,the layer was unclear in the ethylenethiourea malformation group and the nerve plexus was less (7.800 ±1 .989 at the gestational 1 8 d,and 25.200 ±3.048 at the gestational 20 d),and the difference was statistical-ly significant compared with 2 control groups (F =7.591 ,271 .833,all P <0.05).Immunohistochemistry satning:the expressions of GDNF and RET in all layers of the intestinal wall in the 3 groups of fetal rats were unclear at the gesta-tional 1 6 d and only a few positive cells were observed.The GDNF and RET were expressed in the mucosal layer and submucosa of the terminal rectum as well as intermuscular nerve plexus in the saline control group and the ethylene-thioured control group at the gestational 1 8 d and 20 d.With the continuous development of the embryo,their expression intensities were gradually increased.The expressions of GDNF and RET positive cells were decreased gradually in the ethylenethiourea malformation group.The difference was significant statistically compared with 2 control groups (all P <0.05).qRT -PCR:the expressions of GDNF mRNA showed no statistical difference among 3 groups at the gestational 1 6 d (P >0.05);the expressions of GDNF and RET protein were 1 03.624 ±27.533 and 1 05.1 84 ±1 9.634 at the ges-tational 1 8 d;1 51 .496 ±33.622 and 1 50.738 ±21 .423 at the gestational 20 d in 2 control groups.Compared with the ethylenethiourea malformation group (79.1 69 ±1 1 .697 at the gestational 1 8 d;94.873 ±1 1 .309 at the gestational 20 d),and the difference were statistically significant (all P <0.05).Conclusions The expressions of GDNF and its tyrosine kinase receptor RET had a certain temporal correlation in the terminal rectum of normal fetal rats at different gestational ages and ARM.Moreover,the abnormal expressions of GDNF and its tyrosine kinase receptor RET in the dis-tal rectum of ARMfetal rats can affect the development of enteric nervous system.

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.