This study aims to investigate the effect of lung ischemia reperfusion injury (LIRI) on expression of transient receptor potential vanilloid 1 (TRPV1) in the lung and brainstem of rats. Sixteen adult male Sprague Dawley rats weighing 250-320 g were randomly divided into Sham group and ischemia reperfusion group (IR group). Before ischemia, 0.5 hour and 4 hours after the reperfusion, respectively, arterial partial pressure of oxygen (PaO2) and arterial-alveolar oxygen pressure gradient (A-aDO2) were recorded and calculated, respectively. Left lung tissues and the brainstems were obtained at the end of the experiment. Lung tissue malondialdehyde (MDA), myeloperoxidase (MPO) activities, calcitonin gene related peptide (CGRP) and substance P (SP) levels were assessed. The mRNA and protein expressions of TRPV1 in the lung and brainstem were measured by qRT-PCR and Western blot. Compared with in the Sham group, rats in the IR group had a poorer blood gas exchange (P<0.05) and the MPO activity and MDA level of lung tissues in the IR group were significantly higher than those in the Sham group (P<0.05). CGRP level in the IR group increased remarkably (P<0.05), while SP level did not differ statistically between the two groups (P>0.05). The mRNA and protein expressions of TRPV1 in the lung tissue were upregulated in the IR group (P<0.05), but there were no differences of those in the brainstem between the two groups (P>0.05). The results suggest that LIRI could upregulate the expressions of TRPV1 and evoke CGRP release in the lung.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
【Abstract】ObjectiveTo describe the imaging manifestations of acute necrotizing pancreatitis (ANP) on multidetectorrow spiral CT (MDCT). To investigate the relationship between pancreatic glandular necrosis and retroperitoneal inflammatory spreading and the clinical severity of ANP. MethodsA 16detector row spiral CT was used to perform contrastenhanced abdominal scanning in 90 patients diagnosed as ANP， who were prospectively enrolled into this study. Scoring of the extent of pancreatic glandular necrosis and Balthazar grading based on retroperitoneal inflammatory spreading were done at the same time. For 44 patients who met the criteria of Ranson scoring, both scoring by CT severity index (CTSI) and Ranson criteria. Multiplanar reformation technique was used for image postprocessing. Results①In 40 out of 90 patients, the pancreatic glandular necrosis was less than 30%, in 23 the necrosis was between 30%-50%, and in 27 the necrosis was more than 50%. Peripancreatic fat swelling and thickening of anterior renal fascia were observed in all cases of ANP; Peripancreatic and retroperitoneal phlegmonous fluid collection occurred in 78 patients (86.7%); 12 had fluid collection in lesser sac (13.3%); Thickening and swelling of posterior gastric wall in 71 patients (78.9%); 87 developed intestinal ileus (96.7%) and 35 patients had peritoneal effusion (38.9%); Splenic infarction in 4 patients (4.4%); 82 had pleural effusion (91.1%). ②Twelve patients were classified as Balthazar grade C， 42 as grade D and 36 as grade E. There was a statistically significant positive correlation between the extent of pancreatic glandular necrosis and Balthazar CT grade. ③In 44 ANP patients suitable for Ranson criteria, 12 cases were classified as mild (27.3%), 23 as moderate (52.3%), 9 as severe (20.5%). CTSI grading of these patients was as follows： Mild cases 0, moderate cases 25 (56.8%), severe cases 19 (43.2%). Correlation between the CTSI grades and the clinical severity of ANP was of statistical significance. ConclusionANP can demonstrate a series of imaging manifestations on MDCT. To some extent, the degree of pancreatic glandular necrosis and the extent of retroperitoneal spreading is positively correlated, and CTSI grading based on MDCT imaging features is also positively correlated with the clinical severity of ANP.
ObjectiveTo evaluate the value of spiral CT in diagnosing ischemic bowel changes in systemic lupus erythematosus (SLE) patients presenting with acute abdominal pain. MethodsThe clinical data and spiral CT imaging files of 23 SLE patients presenting with acute abdominal pain were retrospectively reviewed. Sixteen had contrastenhanced spiral CT scanning of the abdomen, the rest had plain CT study. Observation emphasis was placed on the changes of bowel wall (wall thickness, enhancement pattern, lumen size) and mesentery (mesenteric edema, engorgement of mesenteric vessels and their abnormal arrangement pattern). Other abnormal findings (e.g. fluid accumulation, changes of abdominal solid organs, lymphadenopathy) were also observed. ResultsNineteen patients had intestinal wall thickening (19/23, 82.6%), with the “target sign” in 12 patients (12/16, 75.0%); Bowel lumen dilatation was present in 16 patients (16/23, 69.6%). Mesenteric swelling with increased density of adipose tissue was noticed in 21 patients (21/23, 91.3%); 18 patients had engorgement of mesenteric vessels (18/23, 78.3%), with comb like arrangement in 4 patients (4/16, 25.0%). Other abnormal findings included ascites, hydrothorax, hydropericardium, hepatosplenomegaly and so on. ConclusionThe most common CT findings in SLE patients presenting with acute abdominal pain are the signs associated with ischemic bowel disease. Contrastenhanced spiral CT is a preferable imaging method for both the diagnosis and differential diagnosis of ischemic bowel disease associated with SLE.
Objective To evaluate the efficacy and safety of Tongxiening granule （TXNG） in the treatment of diarrhea-predominant irritable bowel syndrome （IBS） （stagnation of the liver-qi attacking the spleen）. Methods In a prospective, randomized, placebo-controlled, double-blind clinical trial, 60 patients with diarrhea-predominant IBS were randomly divided into the TXNG group （TXNG, 5.0g, 3 times daily; n =30） and the placebo group （placebo, 5. 0g, 3 times daily; n =30）. The treatment was administered for 3 weeks, and the follow-up was conducted for 4 weeks.Results （1）Abdominal pain： The cure rates were 57. 7% vs. 16. 0% （ by per-protocol analysis, PP） and 31.0% vs. 7.1% （ by intention-to-treat analysis （ITT） ; and the overall improvement rates were 92.3% vs. 44.0% （PP） and 82.7% vs. 39.3% （ITT） in the TXNG and the placebo groups respectively （ P 〈0. 05）. （2） Diarrhea ： the cure rates were 46. 2% vs. 20. 0% （PP） and 41.4% vs. 17. 9% （ITT） , and the overall improvement rates were 96. 2% vs 48. 0% （PP） and 86. 2% vs 42.9% （ITT） in the two groups respectively （P 〈0.05）. （3）Traditional Chinese medicine symptoms： the cure rates were 30.8% vs. 4.0% （PP） and 27.6% vs. 3.6% （ITT） ; and the overall improevment rates were 92.3% vs. 48.0% （PP） and 82.7% vs 42.9% （ITT） in the two groups respectively （P 〈0. 05）. The pain duration after treatment in the TXNG group was significantly shortened compared with the placebo group （7.6 ±4. 6d vs 14. 4 ±4. 3d, P =0. 0125）. After 4-week follow-up, it suggested that the recrudescent duration in symptoms related to IBS in the TXNG group was longer than that in the placebo group （11.5 ±5.3 d vs 6.2 ±6.9 d, P = 0. 019）. No adverse effects were found in the TXNG group. Conclusion It was demonstrated that TXNG is effective and safe in the treatment of diarrhea-predominant ms （stagnation of the liver-qi attacking the spleen）.