Objective To develop a nomogram for predicting the risks of early anastomotic recurrence(EAR)after primary bowel resection in patients with Crohn's disease(CD).Methods The patients with CD under-going preoperative magnetic resonance enterography(MRE)and primary bowel resection were enrolled in this retrospective study and divided into an EAR group(18 patients)and EAR-free group(12 patients).The EAR group included the patients having an endoscopic Rutgeerts score of≥I2 month or the need for anastomotic resection within 12 months after surgery.All the 38 indexes including preoperative demographic characteristics,laboratory examina-tions,multi-parameter MRE features of the resected intestine and its adjacent mesentery,histological findings,and postoperative pharmacotherapy were analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate binary logistic regression analysis were performed to identify independent risk factors to be incorpo-rated into the nomogram for predicting the risks of early anastomotic recurrence and the prediction performance was evaluated.Results Mesenteric creeping fat index on MRE and comb sign were independent risks of EAR,with a concordance index of 0.882(95%CI:0.764～1).The calibration plot revealed a strong relationship between actual observation and predicted probability of EAR.Conclusions The preoperative MRE-based nomogram may be a potential tool for predicting EAR following surgery in patients with CD,which is beneficial to individual management in those patients.It provides reference for the formulation of early postoperative individualized drug adjuvant therapy in patients at high risk of EAR.

[Objective]To explore the efficacy of T2* mapping for evaluating inflammatory activity in the patients with Crohn disease(CD).[Methods]A total of 98 CD patients underwent MR enterographywith T2*WI. T2* values were measured by put-ting regions of interest on the thickening bowel wall on T2*mapping. The activity of bowel segment was scored by magnetic resonance index of activity(MaRIA),to analyze the relationship between T2*values with CD activity.[Results]A total of 160 bowel segments were evaluated and includedinactive(MaRIA<7,n=26),mild(7≤MaRIA<11,n=23),and moderately-severe(MaRIA≥11, n = 111)active lesions. The differences in T2* values amongthese three groups were significant(all P < 0.05). T2* values of 160 bowel segments correlatedclosely withMaRIA(r=0.743,P<0.05). High accuracy of T2*values was shown for differentiating inac-tive from active CD(AUC=0.877)anddifferentiating inactive-mild from moderate-severe CD(AUC=0.848). The threshold T2*value of 20 ms allowed differentiation of mild from moderate-severe CD with74.5%sensitivity and 84%specificity.[Conclusions]T2*values, as thequantitative indexof T2*mapping,correlate well with CD activity and showsatisfiedefficacy for diagnosing inflammatoryactivity.

Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.
Child, Preschool ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal/*diagnosis/pathology/ultrasonography ; Renal Veins/pathology/*radiography ; Thrombosis/pathology/radiography ; *Tomography, X-Ray Computed ; Vena Cava, Inferior/pathology/*radiography

OBJECTIVETo assess the value of MDCT with vessel probe(VP) in the diagnosis and treatment of isolated superior mesenteric artery dissection (ISMAD).

METHODSClinical and imaging data of 15 patients with ISMAD admitted to the First Affiliated Hospital of Sun Yat-Sen University from June 2008 to May 2013 were retrospectively reviewed. Relationship among radiograpic features, clinical symptoms and therapeutic options of ISMAD was examined based on the imaging of 64-MDCT with VP.

RESULTSThe dissection crevasse of all the 15 patients located in anterior arterial wall, and the distance was(24.3±9.7) mm from the origin of SMA. Meanwhile dissection crevasse of 73.3%(11/15) patients located in the zone within 1 cm of proximal end and 1 cm of distal end of the proximal SMA curvature. There were significant differences between patients without abdominal pain(8 cases) and those with abdominal pain(7 cases) in dissection length, minor diameter ratio of true lumen to false lumen, major diameter ratio of true lumen to false lumen(all P<0.01). According to classification of Yun, there were 5 patients of typeI( and 3 type II(a, whose conservative treatment were successful. In other 7 patients of type II(b, 3 patients received successful conservative treatment, and 4 patients had symptom remission after turning to interventional treatment or surgery.

CONCLUSIONS64-MDCT with VP can clearly depict the image manifestation of ISMAD, which provides evidence for the diagnosis and therapeutic options of ISMAD.

Abdominal Pain ; Humans ; Mesenteric Artery, Superior ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To assess the value of MDCT with vessel probe (VP) in the diagnosis and treatment of isolated superior mesenteric artery dissection (ISMAD). Methods Clinical and imaging data of 15 patients with ISMAD admitted to the First Affiliated Hospital of Sun Yat-Sen University from June 2008 to May 2013 were retrospectively reviewed. Relationship among radiograpic features, clinical symptoms and therapeutic options of ISMAD was examined based on the imaging of 64-MDCT with VP. Results The dissection crevasse of all the 15 patients located in anterior arterial wall, and the distance was (24.3 ±9.7) mm from the origin of SMA. Meanwhile dissection crevasse of 73.3%(11/15) patients located in the zone within 1 cm of proximal end and 1 cm of distal end of the proximal SMA curvature . There were significant differences between patients without abdominal pain (8 cases) and those with abdominal pain (7 cases) in dissection length, minor diameter ratio of true lumen to false lumen, major diameter ratio of true lumen to false lumen (all P<0.01). According to classification of Yun, there were 5 patients of typeⅠand 3 typeⅡa, whose conservative treatment were successful. In other 7 patients of typeⅡb, 3 patients received successful conservative treatment, and 4 patients had symptom remission after turning to interventional treatment or surgery. Conclusions 64-MDCT with VP can clearly depict the image manifestation of ISMAD , which provides evidence for the diagnosis and therapeutic options of ISMAD.

Objective To assess the value of MDCT with vessel probe (VP) in the diagnosis and treatment of isolated superior mesenteric artery dissection (ISMAD). Methods Clinical and imaging data of 15 patients with ISMAD admitted to the First Affiliated Hospital of Sun Yat-Sen University from June 2008 to May 2013 were retrospectively reviewed. Relationship among radiograpic features, clinical symptoms and therapeutic options of ISMAD was examined based on the imaging of 64-MDCT with VP. Results The dissection crevasse of all the 15 patients located in anterior arterial wall, and the distance was (24.3 ±9.7) mm from the origin of SMA. Meanwhile dissection crevasse of 73.3%(11/15) patients located in the zone within 1 cm of proximal end and 1 cm of distal end of the proximal SMA curvature . There were significant differences between patients without abdominal pain (8 cases) and those with abdominal pain (7 cases) in dissection length, minor diameter ratio of true lumen to false lumen, major diameter ratio of true lumen to false lumen (all P<0.01). According to classification of Yun, there were 5 patients of typeⅠand 3 typeⅡa, whose conservative treatment were successful. In other 7 patients of typeⅡb, 3 patients received successful conservative treatment, and 4 patients had symptom remission after turning to interventional treatment or surgery. Conclusions 64-MDCT with VP can clearly depict the image manifestation of ISMAD , which provides evidence for the diagnosis and therapeutic options of ISMAD.

OBJECTIVETo investigate the effect of tetrandrine (Tet) on the expression of bax, bcl-2, and transforming growth factor-β2 (TGF-β2) mRNA in cultured human fibroblasts of Tenon's capsules (TCFS) and explore its possible mechanism.

METHODSThe third passage of TCFS cultured in vitro were exposed to 1×10(-5) mol/L Tet for 24 h, and real-time fluorescence quantitative PCR was used to detect the changes in the expressions of bax, bcl-2, and TGF-β2 mRNA.

RESULTSThe expression level of bax mRNA was obviously higher, while bcl-2 and TGF-β2 mRNA levels were significantly lower in Tet-treated TCFS than those in the control cells (P<0.05).

CONCLUSIONTet can inhibit the proliferation of TCFS possibly by reducing the expressions of bcl-2 and TGF-β2 mRNA, enhancing the expression of bax mRNA and inducing cell apoptosis, suggesting its potential in preventing fibrous scar formation after glaucoma filtration surgery.

Apoptosis ; Benzylisoquinolines ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix ; metabolism ; prevention & control ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Tenon Capsule ; cytology ; Transforming Growth Factor beta2 ; genetics ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

BackgroundExcessive conjunctival scar formation is a main cause of filtering surgical failure in glaucoma.It has been reported that the failure rate of filtering surgery is a tough problem in the research of glaucoma.Research showed that tetrandrine (Tet) suppress the proliferation of cultured human fibroblasts of Tenons capsule (TCFs) in vitro,but its possible mechanism is still unclear up to now.ObjectiveThe aim of this study is to investigate the inducement effects of Tet on the apoptosis of fibroblasts of Tenons capsule and mechanism.MethodsThe Tenon's capsule was obtained from donor eyes of Zhongshan Eye Center Eye Bank for further use.Human Tenon's capsule fibroblasts were cultured by explant culture method in mixed medium in vitro and the third to seventh generations of cells were collected for the experiment.The subcultured cells were identified by morphology observation and Vimentin staining.The apoptosis of cultured fibroblasts in Tet-treated group and control group was studied by using TUNEL (TdT- mediated dUTP nick end labling,TUNEL),flow cytometry (FCM) and transmission electron microscope.The cell number in different cellular cycle was calculated in Ted-treated group and control group.Results The cultured cells reached confluence in two weeks after cultured and presented the spindle or triangle shape with the radial-like or vortexin-like arrangement .The cells showed the positive staining for Vimentin.Apoptosis changes of cultured cell and apoptosis bodies were seen under the transmission electron microscope.Apoptotic cell nuclei were observed in Tet group by TUNEL.FCM result showed that the cells at G_0/G_1 phase decreased by 22.2%,and the cells at S and G_2/M phases increased by 20.53% and 1.6% in Ted-treated group.Significant differences in the numbers of cells in different cellular cycles and cell numbers of apoptosis were found between Tet-treated group and control group(P=0.000).ConclusionTet can inhibit the proliferation of human TCFs by inducing apoptosis in vitro.

Objective To investigate the effect of Mongolian medicine naru-3 on the apoptosis of mouse hepatic cells induced by radiation. Methods Kunming mice were radiated with 60Coγ-irradiation, the 30-day survival rate of mice and the average life span of dead mice post-irradiation were observed. The apoptosis of hepatic cells from irradiatied mice was detected by FACS and TUNEA expression level of p53 was examined. Results Administration of the medicine resulted in increase of 30-day survival rate and prolongation of average life span of the dead mice. The apoptosis rate of spleen cells from mice treated with Mongolian medicine naru-3 decreased significantly and the ex pression level of p53 was also inhibited significantly. Conclusion The results indicated that Mongolian medicine naru-3 had radio protective function and its mechanism might be related to the suppression of apoptosis of radiationsensitive cells.