OBJECTIVE：To investigate the effects of dexmedetomidine on regional cerebral oxygen saturation and cerebral function in patients undergoing intracranial aneurysm embolization. METHODS ：Totally 44 patients undergoing intracranial aneurysm embolization in the First Affiliated Hospital of Hunan University of TCM during Jun. 2017-Aug. 2019 were collected and randomly divided into group D （22 cases）and group C （22 cases）. Ten minutes before anesthesia induction ，group D was given intravenous injection of Dexmedetomidine hydrochloride injection 1 μg/kg；group C was given buffered normal saline 20 μL. Both groups were induced with Propofol emulsion injection+Midazolam injection+Fentanyl citrate injection+Cisatracurium besylate for injection. During the operation ，group D was given Dexmedetomidine hydrochloride injection 0.5 μg（/ kg·h）+Fentanyl citrate injection+Benzsulfosum atracurium for injection+Propofol emulsion injection to maintain anesthesia ；group C was continuously pumped with buffered normal saline 0.5 μg（/ kg·h）+Fentanyl citrate injection + Benzsulfosum aratracurium for injection Propofol emulsion injection to maintain anesthesia. Before anesthesia induction （T0）， immediately after anesthesia。induction （T1）， 1 min after tracheal intubation （T2）， immediately after operation finished （T3），immediately afte extubation（T4），the mean arterial pressure（MAP），heart rate 中国药房 2021年第32卷第7期 China Pharmacy 2021Vol. 32 No. 7 ·865· （HR），regional cerebral oxygen satur ation（rSO2）were observed in 2 groups. The levels of neuron specific enolase （NSE）and S100 β protein in serum were measured at T1，T3，6 h after operation （T6）. The recovery time ，intraoperative blood loss ， nitroglycerin amount and the occurrence of ADR were recorded. RESULTS ：MAP and HR of group D at T 2-T4 were significantly lower than those at T 0；MAP and HR of group C at T 2-T4 were significantly higher than those at T 0；the group D were significantly lower than the group C at the same period （P＜0.05）；there was no statistical significance in rSO 2 between 2 groups at T 0-T4（P＞ 0.05）. The levels of serum NSE and S 100β protein in 2 groups at T 3 were significantly higher than at T 1；those in 2 groups at T 6 were significantly lower than at T 3，but those of group D were significantly lower than the group C at T 3（P＜0.05）；there was no statistical significance in the levels of serum NSE or S 100β protein between 2 groups at T 1（P＞0.05）. The recovery time of anesthesia，the amount of nitroglycerin ，the incidence of tachycardia ，nausea and vomiting ，restlessness，shivering and cough in group D were significantly shorter or lower than group C （P＜0.05）；there was no statistical significance in the intraoperative blood loss between 2 groups（P＞0.05）. CONCLUSIONS ：Dexmedetomidine can maintain the hemodynamic stability of patients with intracranial aneurysm embolization during the perioperative period ，has little effect on rSO 2 and brain function ，and has good safety.

Objective To investigate the imaging features of the cerebral complications of infective endocarditis (IE)and the evolution process of infective cerebral infarction.Methods The clinical and imaging data from 5 patients diagnosed as IE with neurological complications were retrospectively and comprehensively reviewed,so that the imaging features of cerebral complications and infective cerebral infarctions were summarized.Results Among the 5 cases,3 showed multiple acute infarctions,including 2 massive ones.All the 5 cases showed multiple hemorrhagic lesions at different stages.The infarction and hemorrhage were mostly located at the corticalGmedullary junction.1 case of subarachnoid hemorrhage and 1 case of meningitis were also observed.Two massive infarctions mentioned above showed irregular patchy shape,which evolved into cerebral abscesses after 1 2 and 1 5 days of neurological symptoms showing up,then abscesses started shrinking after 33 and 3 1 days,respectively.Conclusion MRI can accurately reflect the features of cerebral complications of IE and the evolution process of infective cerebral infarctions,which provides evidences for physicians to make correct diagnoses and the treatment plans.

Objective To investigate the differences of CT features for different subtypes of pulmonary neuroendocrine tumors (PNETs).Methods CT imaging data of 41 patients with PNETs and 5 patients of lung cancer with neuroendocrine differentiation confirmed by pathology were analyzed retrospectively,and the differences in CT features among pathological subtypes were explored. Results Among the pathological subtypes of 41 PNETs,the statistical differences in the CT features including vascular invasion,the metastatic lymphadenopathy in the hilus and mediastinum were found(P<0.05).However,no differences were found in other imaging findings (lesion location,spiculation,bronchial invasion,atelectasis and obstructive pneumonia,and pleural effusion or thickening)among the subtypes (P>0.05).Among those subtypes PNETs and lung cancer with neuroendocrine differentiation,the differences in tumor size,vascular invasion,and metastatic lymphadenopathy in the hilus and mediastinum were also found (P<0.05).However,no differences were found in other imaging findings (P>0.05).In addition,there were differences in tumor size among different enhancement types and different metastastic presences in the lung or outside of the chest (P<0.05).Conclusion CT shows certain differences among the different subtypes of PNETs,which may be helpful for the differential diagnosis but not specific.

Objective To investigate the MRI features of different fibrotic stroma of hepatocellular carcinomas (HCC) and the relationships between them and delayed contrast-enhanced MR findings. Methods Twenty eight patients were enrolled in the study who had undergone dynamic contrast-enhanced MRI scanning. MRI showed largely complete rim-like enhancement in delayed phase in all the lesions which were confirmed by surgery and pathology. Delayed-enhancement in peripheral and internal position of HCC were evaluated and the thicknesses of rim-like enhancement in delayed phase were measured by analyzing the 5 minute delayed images. Among the 28 lesions, 22 were sampled and pathologically analyzed both in peripheral and internal portion of HCC and the remaining 6 were in the internal portion only. The pathological features were observed including distributions of three fibers (elastic, collagen and reticular fibers) in the periphery and internal positions of HCC, degrees of inflammatory cells infiltration outside the capsule and in the internal portion of HCC, the blood vessels in the capsules and thicknesses of fibrous capsule. The pathological features of HCC with different degrees of delayed-enhancement were compared using χ2 test, and differences in the thicknesses of rim-like enhancement of HCC in delayed phase among different pathological features were analyzed using Chi-square test. Results (1) In the periphery:pathological features: the typical fibrous capsules showed in all 22 HCC. And three kinds of fibers were crisscrossed within the capsules without quantitative differences. MRI findings:statistical differences in the amounts of blood vessels in the capsule of HCC among different degrees of delayed-enhancement were found (P<0.05), however, the differences in the thicknesses of fibrous capsule and the degrees of inflammatory cells infiltration were not found (all P>0.05). In addition, the statistical differences in the thicknesses of rim-like enhancement of HCC showed among different thicknesses of fibrous capsule, degrees of inflammatory cells infiltration and amounts of blood vessels (all P<0.05). (2) In the internal positions:pathological features: the amounts of three kinds of fibers in the internal positions were significantly lower than those in the periphery. MRI findings: the statistical differences in collagen fibers, elastic fibers, reticular fibers and the degrees of infiltration of inflammatory cells of HCC were all seen among different degrees of delayed enhancement inside tumors (all P<0.05). Conclusion The delayed MR enhancement of HCC in peripheral and internal positions showed correlation with the fibers and degrees of infiltration of inflammatory cells in the tumor.

Objective To explore the fibrotic stroma characteristics of orthotopic liver cancer in rat and the relationship with MR delayed contrast enhancement.Methods 4 Wistar rats with orthotopic liver cancer underwent conventional triphasal and longer-de-layed contrast-enhancement MR scanning.12 HCC specimens obtained from the four Wistar rats were sliced and stained with HE, picric-sirius red,Verhoeff Van-Gieson elastic fiber,Gordon-Sweets reticular fiber and anti-α-SMA immunohistochemical staining.The relationshp between intratumoral fibrotic stroma and MR delayed phases of the 1 2 tumors were analyzed.Results Collagen fiber was expressed mainly in tumor fibrous septum.Elastic fiber distributed in tumor fibrous septum and the artery wall.Reticular fiber dis-tributed in fibrous septum of the regenerative nodules,portal area and tumor psuedocapsule.Integrated optical density (IOD)value of collagen fiber,elastic fiber and reticular fiber analyzed by Image-pro Plus6.0 were 0.102±0.020,0.063±0.018 and 0.109±0.032, respectively.As a result,the amount of collagen and elastic fibers were statistically different (P<0.01),and so were reticular fibers and elastic fibers (P<0.01).And there was a positive correlation between collagen fiber and MR delayed contrast enhancement (P<0.05).Conclusion MR delayed contrast enhancement of hepatic cancer in rat is closely associated with the collagen fiber,thus this fiber in liver cancer can be evaluated noninvasively by MRI.

Objective To elucidate the correlation between the enhancement degree of renal clearcell carcinoma (RCC) on dynamic contrast-enhanced CT and multiple vascular morphometric characteristics including microvessels and mature vessels.Methods A retrospective review was carried out on the records of 37 patients pathologically diagnosed with RCC who underwent plain and triphasic contrast-enhanced CT.The absolute (enhancement attenuation-pre-enhancement attenuation) and relative(absolute enhancement value÷cortex enhancement attenuation) enhancement values of RCC were measured in arterial,venous and delayed phases.And all lesions were divided into hypervascular and hypovascular groups.The number,mean area,perimeter and diameter,shape factor (4π*area/perimeter2) and the total area of microvessels and mature vessels were obtained by CD34 or a-SMA immunohistochemical staining.Then the correlation of radiographic parameters and various vascular morphometric parameters were analyzed.Results In arterial,venous and delayed phases,the absolute enhancement values were positively correlated with the number and the total area of microvessels and mature vessels (P<0.05),meanwhile the relative enhancement values were positively correlated with the number of microvessels and mature vessels(P<0.05).In venous and delayed phases,there were negative correlations of the relative enhancement values with mean area,perimeter and diameter of mature vessels(P<0.05).However, no correlations were found between other enhancement and vascular parameters (P>0.05).In addition, the significant differences in the number of microvessels and mature vessels between hypervascular and hypovascular groups were found (P<0.05).Conclusion CT enhancement degrees of RCC are related to multiple vascular morphometric indicators,which gives us more insights in the mechanism of RCC enhancement on CT.

Objective To explore diagnostic value of MR perfusion weighted imaging(PWI)on complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy. Methods MR PWI was performed in 31 patients with hypopharyngeal and laryngeal cancer who suffer from tumor recurrence, granulation or infection after operation and radiotherapy. Blood flow (BF), blood volume(BV), mean transit time(MTT) and time to peak (TTP) values were measured in the lesions. Analysis of variance and pair-wise comparison of q test were used for statistical analysis. Results Eleven cases with tumor recurrence,11 case with granulation tissues, 9 cases with infection were confirmed by pathological examinations. Average BF, BV, MTT and TTP values of recurrent tumors were (145.1 ± 29.3)ml · 100 g-1 · min-1,(14.2 ± 3.2)ml · 100 g-1,(5.4 ± 0.6)s,(13.7 ± 1.3)s respectively;Average BF, BV MTT and TTP values of granulation tissues were(109.1±27.4)ml·100 g-1·min-1,(11.1±1.7)ml·100 g-1,(7.7±1.0)s, (19.8 ± 2.1)s respectively;Average BF, BV, MTT and TTP values of infectious tissues were(86.9 ± 7.7)ml · 100 g-1·min-1,(8.8±1.0)ml·100 g-1,(8.0±0.9)s,(19.7±1.3)s respectively. Average BF and BV values of the recurrent tumors group were higher than those of the granulation(q=4.89, 4.64 respectively,P<0.01)and infection group(q=7.52,7.71 respectively,P<0.01)respectively. Average BV values of granulation group was higher than that of the infection group(q=3.31,P<0.05), Average MTT and TTP values of recurrent tumor group were lower than those of the granulation (q=9.38, 12.48 respectively,P<0.01)and infection group(q=9.77, 11.53 respectively,P<0.05). There were no significant difference in average BF, MTT and TTP between the granulation and infection group. Conclusion MR PWI can be helpful in the diagnosis of complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy.

Objective To investigate the significance of modified gold nanocages ( GNCs ) in photothermal therapy and radiosensitivity enhancement for murine mammary carcinoma 4T1 cells.Methods A molecule probe, CD44-PEG-GNCs, was constructed on the basis of GNCs.Inductively coupled plasma mass spectrometry ( ICP-MS) and transmission electron microscopy ( TEM) were used to analyze Au uptake by 4T1 cells.The cell counting kit-8( CCK-8) assay was used to determine the impact of the probe on the viability of 4T1 cells.The CCK-8 assay and the Hoechst/PI double staining were used to evaluate the photothermal killing effects of near infrared laser (NIR).The colony forming assay and the Hoechst/PI double staining were used to measure the viability of 4T1 cells after irradiation with 6 MV of X-ray.Results ICP-MS and TEM showed that 4T1 cells had an uptake of a large number of GNCs, in which the number of CD44-PEG-GNCs taken up by 4T1 was 3-4 times larger than that of PEG-GNCs.The cell toxicity assay revealed that in a certain range of concentration, GNCs showed little effect on the viability of 4T1 cells, which was reduced to 81.2%in 48 hours.The CCK-8 assay, the Hoechst/PI double staining, and the colony forming assay showed that after NIR irradiation and radiotherapy, large-scale apoptosis was induced in CD44-PEG-GNCs-contained tumor cells by photothermal therapy combined with radiotherapy, which had substantially better outcomes than other groups.Conclusions The GNC-based molecular probe actively targets 4T1 cells with little cytotoxicity, indicating that it enhances the sensitivity of tumor towards photothermal therapy and radiotherapy.

Objective To evaluate the clinical value of low-dose scan with 1 6-slice spiral CT in follow-up of the adult patients with secondary active pulmonary tuberculosis.Methods 130 patients with secondary active pulmonary tuberculosis were enrolled CT scans in the study.Routine dose (120 mA)and the following low-dose (1 5-40 mA)scanning was used with the same tube voltage of 120Kv and other factors.Image quality,imaging characteristics of the lesions,CT dose index and dose length product of two scans were evaluated.Meanwhile,the effective dose,quantitative measurement and evaluation of differences were analyzed.Results Between the routine scan and low-dose one,no significant difference in image quality was found(P = 0.121 0).No significant differences were found between two scans in 7 imaging features including ground-glass appearance,tree-in-bud sign,consolidation, cavity,bronchiectasis,bronchial stenosis and intralesional calcification (P >0.05).The X-ray radiation dose was decreased signifi-cantly with low-dose CT.Conclusion Low-dose spiral CT shows more advances in detection of secondary active pulmonary tubercu-losis as good as the conventional doses CT,and is used in the follow-up of the pulmonary tuberculosis.

Objective To investigate the potential value of VEGF-C targeted ultrasmall superparamagnetic particles of iron oxide (USPIO)molecular probe in specific detection of hepatocellular carcinoma (HCC)in a rat model using MRI.Methods The targeted probe was synthesized by conjugating VEGF-C antibody with amino modified USPIO.Cell counting kit-8 assay was conducted to as-certain the probe’s effect on the growth of HepG2 cells.Rat models with HCC were divided into two groups (targeted group with VEGF-C-USPlO and a contrast with USPIO)with 3 rats for each group at random.Pre-and post-contrast enhanced MR imaging with different time points of 0.5,1 and 1.5h was performed with an injection into caudal vein.The signal intensities of the tumor on T2 WI and T2 * WI were measured,and the differences of the signal intensities between pre-and post-enhancements or between both groups were analyzed.The iron particles within the tumors in two groups were confirmed by Prussian blue iron staining.The ex-pression of VEGF-C in HCC was proved by immunohistochemistry.Results The signal intensities of HCC on T2 WI and T2 * WI af-ter VEGF-C-USPI0 injection were decreased obviously with a minimum value at 1 h ,indicating a significant difference (P <0.05). However,those in USPIO group were decreased less without statistical differences (P >0.05).Statistical differences in signal inten-sity on T2 * WI after enhancement between both groups were also showed (P <0.05).Prussian blue staining results showed more iron particles within the tumor tissues in VEGF-C-USPI0 group,whereas less ones in USPIO group.Immunohistochemical results showed that VEGF-C was over expressed in cytoplasm and membrane.Conclusion VEGF-C-USPI0 molecular probes can initiatively target to the liver cancer in rat models with expressed VEGF-C,which may help to achieve the specific MR imaging of HCC,indica-ting a potential of the metastasis.