Objective:To evaluate the influence factors of the peak time in computed tomography (CT) portal venography.Methods:Twenty-eight patients who underwent CT perfusion (CTP) examination in Minhang Hospital Affiliated to Fudan University from October 2020 to December 2021 were retrospectively collected. The CT enhancement time-density curves of the main portal vein trunk and abdominal aorta were obtained at the cross section of the left and right branches of portal vein. The peak time of portal vein and abdominal aorta, the enhanced CT attenuation of the liver and spleen parenchyma enhancement at the peak value of portal vein were measured. Pearson correlation and regression analysis were performed.Results:The peak time of abdominal aorta was (16.39±2.68)s, and portal vein was (27.12±4.65)s. The enhanced CT attenuation of liver and spleen parenchyma were (84.64±20.21)HU and (142.28±25.15)HU, respectively. The peak time of portal vein was positively correlated with the peak time of abdominal aorta ( r=0.825, P<0.001), and there was no statistical correlation with the enhanced CT values of liver and spleen. Multiple linear regression analysis showed that the peak time of abdominal aorta was an independent factor affecting the peak time of portal vein ( b=1.326, t=5.874, P<0.001). The regression equation was the peak time of portal vein=4.185+ 1.451× the peak time of abdominal aorta. The peak time of portal vein in cirrhosis group was (27.78±4.48)s, and that in noncirrhosis group was (26.8±4.81)s, with no significant difference between the two groups ( P=0.614). Conclusions:There was a linear correlation between the peak time of portal vein and the abdominal aorta, and the results could be helpful to optimize the setting of delay time before CT portal venography.

Objective:To investigate the effects of different local complications of acute pancreatitis (AP) on the microcirculation of multiple organs in the upper abdomen.Methods:A dynamic volume perfusion computed tomography (DVPCT) scan in the upper abdomen was prospectively conducted in 101 patients with AP and 24 patients with neither AP nor other obvious upper abnominal lesions diagnosed in People′s Hospital of Deyang City from April 1 to October 31, 2019, 86 patients with AP (AP group) and 21 controls (control group) were enrolled in the study. AP patients were divided into no local complications group (21 cases), acute peripancreatic fluid collection (APFC) group (19 cases), acute necrotic collection (ANC) group (27 cases), walled-off necrosis (WON) group (11 cases) and walled-off necrosis with infection (WONI) group (8 cases). The blood flow (BF) of pancreas, liver, spleen, two kidneys and adrenal glands was measured by deconvolution. The hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic perfusion index (HPI) of each group were calculated by maximum slope. T test was used for statistical analysis. Results:The BF of pancreas, spleen and left adrenal gland of ANC group was (139.89±34.28), (141.42±47.85) and (107.87±26.41) mL·min -1·(100 g) -1, respectively, the BF of pancreas, spleen and left adrenal gland of WON group was (130.00±44.83), (106.12±38.16) and (98.38±41.39) mL·min -1·(100 g) -1 respectively, and the BF of pancreas, spleen and left adrenal gland of WONI group was (127.91±35.86), (102.09±23.73) and (105.66±27.01) mL·min -1·(100 g) -1, respectively, which were all lower than those of control group ((161.22±31.60), (174.00±62.73) and (134.53±36.36) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.440, 2.043, 2.943; 2.296, 3.796, 2.548; 2.448, 4.479, 2.154; all P<0.05). The BF of left kidney cortex of WONI group was lower than that of control group ((247.44±39.32) mL·min -1·(100 g) -1 vs. (294.80±39.13) mL·min -1·(100 g) -1), and the difference were statistically significant ( t=2.910, P<0.05). The HAP of ANC group, WON group and WONI group was (18.63±9.54), (19.10±7.47) and (19.51±6.26) mL·min -1·(100 g) -1, respectively, and the HPI was (25.01±15.51)%, (45.98±31.42)% and (35.92±24.95)%, respectively, which were all higher than those of control group ((12.18±5.14) mL·min -1·(100 g) -1 and (13.44±6.49)%), and the differences were statistically significant ( t=2.997, 3.088, 3.235; 3.503, 3.397, 2.517; all P<0.05) . The HPP of ANC group, WON group and WONI group was (72.37±21.76), (48.83±35.10) and (57.55±29.45) mL·min -1·(100 g) -1, respectively, which were all lower than that of control group ((86.43±17.98) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.391, 3.331 and 3.226, all P<0.05). The HAP and HPI of APFC group were both higher than those of control group ((18.67±10.24) mL·min -1·(100 g) -1 vs. 12.18±5.14) mL·min -1·(100 g) -1 and (23.75±20.41)% vs. (13.44±6.49)%), and the differences were statistically significant ( t=2.572 and 2.108, both P<0.05) . Conclusions:AP complicated with ANC, WON and WONI can reduce the BF of pancreas, spleen and left adrenal gland, and WONI can induce the decrease of BF of left kindney cortex. AP complicated with ANC, WON and WONI can increase HAP and HPI, but decrease HPP. Furthermore, AP complicated with APFC can increase HAP.

Objective:To evaluate the application of one-stop dynamic volume perfusion CT (dVPCT) in upper abdomen, and its feasibility of replacing conventional enhanced CT, perfusion, and angiography.Methods:A total of 94 patients with upper abdominal perfusion examinations were retrospectively enrolled in Deyang People's Hospital of Sichuan Province from April 2017 to June 2019. The data of another 64 patients underwent routine upper abdominal enhancement with 64-slice CT (28 patients) and dual-source CT (26 patients) were analyzed in the same period. The radiation dose and image quality were compared. According to different contrast agent concentration and dosage, 4 perfusion groups and 2 conventional enhanccement groups were divided, including 60 ml iohexol group (350 mg/ml) and 60 ml ultravist group (370 mg/ml), 60 ml and 80 ml iomeprol group (400 mg/ml), 64-slice routine group and dual-source CT routine group. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the liver, pancreas and abdominal aorta images in the arterial and portal vein phases were measured by two radiologists in a blinded way. Subjective image quality was evaluated by two radiologists using a 5-point Likert Scale in a blinded method. Statistical analysis was performed using analysis of variance and kappa test. Imaging findings and typical cases of perfusion were retrospectively analyzed.Results:Radiation dose: the effective dose of each perfusion group was lower than that of the 64-slice spiral CT scan, but higher than that of the dual-source CT routine scan. The SNR and CNR of the 80 ml iomeprol dVPCT group were better than that of 64-slice spiral CT and dual-source CT routine scan ( P<0.05), and were better than that of 60 ml iohexol, ultravist and iomeprol dVPCT groups ( P<0.05). However, the subjective index was lower than that of the dual-source CT routine scan group ( P<0.05). The comprehensive information of multi-phase images, vascular images and perfusion quantitative parameters of volume perfusion data reconstruction in this group is superior to conventional enhanced CT in the detection of lesions, visualization of normal tissues and blood vessels. Conclusion:One-stop dVPCT imaging of the upper abdomen has lower radiation dose with good image quality and more diagnostic information. dVPCT with 80 ml Iomeprol (400 mg/ml) can obtain much better images.

Objective:To compare the cognitive functions in patients with depressive disorder,hyperlipidemia disorder,and comorbid both of the disorders.Methods:A cross-sectional study was performed in age,gender and education year matched patients with depressive disorder (n =51)(according to the ICD-10),hypedipidemia(n =38) (according to the Chinese adult lipid guideline),comorbid both of the disorders(n =40) and normal controls (n =56) were recruited in this study.All subjects received a battery of neuropsychological tests to access the anxiety and depression symptoms and cognitive function.Results:The scores of MoCA were lower in the patients with comorbid both disorders and patients with depression than patients with hypedipidemia [(24 ± 3),(24 ± 4)vs.(26 ± 3),Ps ＜0.05],and were lower in patients with depression than in normal controls(25 ±3),P ＜0.05.Stroop color test amends numbers were higher in patients with comorbid disorder than in the other three groups (Ps ＜0.05).The scores of immediate and delayed logical memory were higher in patients with hyperlipidemia than in other three groups (Ps ＜0.05).The total number of words in verbal fluency test were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia (Ps ＜0.05).Wisconsin card sorting test category completes were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜ 0.05).The scores of persistent errors were higher in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜0.05).Conclusion:In this study,patients with depressive disorder have impairment of cognitive function,while hyperlipidemia may probably do not impair cognitive function.

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

In order to determine immunogenicity and protective effect in chickens, we used the IBDV (Infectious bursal disease virus)-Vp2/Lactobacillus casei as antigen transfer system. First, the immunized and control chickens were challenged by IBDV/DQ at lethal dose to determine the protective ratio. Second, chickens were orallyand intranasally vaccinated twice with 10(9) CFU/mL pLA-VP2/L. casei, pLA/L. casei and PBS as negativecontrol and commercial vaccine as positive control. The bursa injury and the lesion score wererecorded post challenge. The level of specific IgG and sIgA in pLA-VP2/L. casei and positive control groups was significantly higher than that in negativecontrol groups. The protection efficacy in pLA-VP2/L. casei oral group was higher than that inintranasal group. The SI. of pLA-VP2/L. casei oral group was significant higher than other groups. The lesion score indicated the pLA-VP2/L. casei was safer than commercial vaccine for bursa. Collectively, the pLA-VP2/L. casei could be a vaccine candidate for IBDV.
Animals ; Antibodies, Viral ; blood ; Antibody Formation ; Birnaviridae Infections ; prevention & control ; veterinary ; Chickens ; Infectious bursal disease virus ; Lactobacillus casei ; Poultry Diseases ; prevention & control ; Recombinant Proteins ; immunology ; Viral Structural Proteins ; immunology ; Viral Vaccines ; immunology

Objective To investigate the protective effect of flos puerariae flavonoid on adriamycin (ADR)-induced toxic myocarditis and its mechanisms from morphological,biochemical and molecular levels.Methods 96 healthy Kunming male mice were randomly divided into 6 groups:normal control group,ADR model control group,ADR+low dose of flos puerariae flavonoid group(50 mg/kg),ADR +middle dose of flos puerariae flavonoid group(100 mg/kg),ADR +high dose of flos puerariae flavonoid group(200 mg/kg),and Vit E positive control group(40 mg/kg),16 in each group.The drugs were orally administered for consecutive 15 d and the model of toxic myocarditis was induced by intraperitoneal injection of ADR(3 mg/kg)in mice from day 2,one time every other day,for 7 times Colorimetry was used to measure the changes of marker enzymes about myocardial injury and inducible nitric oxide synthase(iNOS)activity in serum and tissue;immunohistochemical method was adopted to detecte the expression of myocardial apoptosis related proteins Bax and bcl-2;HE staining was conducted to observe the pathological changes of cardiac structure.Results Compared with normal control group,ADR(3 mg/kg,ip,7 times)induced the elevation of serum creatine kinase (CK),lactate dehydrogenase (LDH),aspartate transaminase(GOT)and iNOS activity increased significantly in mice(P<0.01).Meanwhile myocardial superoxide dismutase(SOD)activity decreased, and the malondialdehyde(MDA)content increased(P<0.01).Myocardial cell apoptosis in mice increased significantly,and the apoptosis rate was(40.5 ± 5.2)%;the expressions of Bax and Bcl-2 were significantly increased(P<0.01),However,the Bcl-2/Bax ratio decreased.The flos puerariae flavonoid (50,100,200 mg/kg,ig,15 d)and Vit E positive control group could reverse the changes induced by ADR,decrease serum CK,LDH,GOT and iNOS activities,increased myocardial SOD activity,lower MDA content and the expression of bax protein,and elevated Bcl-2/Bax ratio,in a dose-dependent manner.Light microscopy confirmed that flos puerariae flavonoid significantly alleviated the changes of myocardial microstructure.Conclusion ADR could induce myocardial cell apoptosis and lead toxic myocarditis in experimental mice.The flos puerariae flavonoid has protective effect on ADR-induced myocardial injury and the mechanism may be related to elevating myocardial SOD activity and anti-lipid peroxidation,inhibiting the expression of Bax protein and adriamycin-induced cardiomyocyte apoptosis.

Objective To assess the effects of positions on circulation and neonatal during Caesarean section under epidural anaesthesia. Methods Eighty healthy parturients undergoing selective Caesarean section were randomly allocated in four groups with 20 cases each, who were positioned in supine (group S), left oblique 30 degress(group L), left oblique 15 degrees with 15 degrees Trendelenburg(group LT), or supine with 15 degrees Trendetenburg (group ST) position. MAP, HR,SpO_2 were recorded before and at 5 min, 10 min, 15 min during anesthesia. Apgar scores of 1-and 5-min were observed as well. Results MAP in groups of S, LT and ST was significantly lower at 10 min during anesthesia than that before or group L(P<0. 05) There was no significant difference in 1-and 5-min Apgar scores among four groups. Conclusion The left oblique 30 degrees position could effectively reduce the incidence of hypotension during Caesarean section under epidural anaesthesia

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To study the expression levels of B7.1 and B7.2 in the macrophagus of rats infected with the Plasmodium yoelii sporozoites and investigate the roles of these costimulators in parasite infection immunity. Methods The mammal model was established by infecting rats with the sporozoites, then macrophagus was separated from the rat abdominal cavity 2, 12, 24, 48, 72 h after infection. The expressions were quantitative analyzed by immunofluorescence staining and laser scanning confocal microscopy. Result The expressions of B7.1 and B7.2 were upregulated after infected with the sporozoites. The expression of B7.1 was slowly induced and then descended at 72 h. B7.2 was rapidly induced and maximally expressed at 48 h and downregulation at 72 h. The expression of B7.2 was significantly higher than that of B7.1 at all time points assayed after stimulation (P