Objective To observe the MSCT features of invasive pulmonary tuberculosis,and to investigate its effect on the prognosis.Methods 60 patients with invasive pulmonary tuberculosis were selected as the study subjects.The gold standard was in sputum culture and histopathology.The clinical value of MSCT in the diagnosis of invasive pulmonary tuberculosis was evaluated.The distribution and morphological characteristics of the lesions in the invasive pulmonary tuberculosis were observed and analyzed.The patients were divided into the treatment group and the death group.The morphological changes of lung lesions were compared between the two groups.Results In 60 patients,a total of 45 patients with invasive pulmonary tuberculosis were diagnosed,MSCT of infiltrating pulmonary tuberculosis diagnostic sensitivity,specificity,positive predictive rate,negative predictive rate,correct rate,misdiagnosis rate,missed diagnosis rate,diagnostic accordance rate were 93.3%,80.0%,93.3%,80.0%,73.3%,20.0%, 6.7%,90.0%,respectively.On the lung multiple patchy shadow,real change shadow,multiple nodules,cavity shadow, on the unilateral lung syndrome,and branch sign and halo sign is the main sign of invasive pulmonary tuberculosis. Before treatment,MSCT signs of deterioration of chest between the treatment group and death group had no statistically significant difference(P>0.05).After 4 weeks of treatment,the proportion of effusion lesions in the treatment group was significantly decreased compared with before and during the same period of treatment(37.5%vs 76.9%;3.1%vs 92.3%),the differences were statistically significant(χ2 =5.750,16.541,all P<0.05).After 8 weeks of treat-ment,the proportions of effusion,nodules and cavity lesions in the treatment group were significantly lower than those in the deteriorated group(3.1% vs 92.3%;0.0% vs 15.4%;6.2% vs 38.5%),the differences were statistically significant (χ2 =16.541,5.152,7.302,all P<0.05).Conclusion Morphological changes of MSCT in invasive pulmonary tuberculosis have certain characteristics.In the diagnosis,differential diagnosis and therapeutic evaluation of invasive pulmonary tuberculosis,MSCT has high value.

Obesity is a major risk factor for the generation and development of diabetes, atherosclerosis, hyperlipidemia and cancer. Obesity is accompanied with remodeling of adipose tis-sue, such as changed cell component and function, angiogene-sis, extracellular matrix remodeling and infiltration of inflamma-tory cells. It is important for the prevention of obesity to study adipose tissue remodeling. This review summarizes recent ad-vances in adipose tissue remodeling.

Objective To investigate whether the protection of ischemic preconditioning (IPC) against myocardial ischemia/reperfusion (I/R) injury is mediated by toll-like receptor 4(TLR4)/NF-kB pathway,and whether these effects are related to the release of calcitonin gene-related peptide (CGRP).Methods Sprague-Dawley rats were subjected to 60 min of ligation of the left anterior descending coronary artery followed by 3 h of reperfusion to induce I/R injury.IPC was performed by 4 cycles of 3-min left coronary artery occlusion followed by 5-min reperfusion before the I/R.The expression of TLR4 mRNA was determined by RT-PCR.TLR4 and NF-kB protein expression were analyzed by immunohistochemistry.Myocardial infarct size,CGRP concentration in plasma and activity of creatine kinase in serum were also measured.Results IPC significantly reduced the infarct size and creatine kinase activity concomitantly with the increase in plasma CGRP concentration.The expressions of TLR4 protein and mRNA and NF-kB protein were increased by myocardial I/R injury,and dramatically inhibited by IPC.Conclusion IPC protects against myocardial I/R injury by inhibition of TLR4/NF-kB pathway.These effects are related to the increased the release of CGRP.

AIM:To put forward three-level design(Box-Behnken design)for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of binomial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was-4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.

AIM:To put forward three-level design(Box-Behnken design) for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of bino-mial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was -4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.

Objective:To investigate the correlation between preoperative blood platelet-to-lymphocyte ratio (PLR) and clinico-pathological features, as well as the effect of PLR on the prognosis of non-small cell lung cancer (NSCLC) patients after surgical resec-tion. Methods:Retrospective analysis was performed for 255 cases with histologically confirmed NSCLC that underwent curative re-section from January 2004 to December 2007. All patients were classified into two groups based on the median value of PLR. The rela-tionship between PLR and clinicopathological features was studied. Univariate and multivariate analyses were performed to assess the prognostic effect of preoperative PLR. Results:The median value of preoperative PLR was 130 (range:45.45 to 272.66). Based on the cut-off value of 130, all patients were divided into two groups:low PLR (≤130, n=127) and high PLR (>130, n=128). PLR was corre-lated with tumor site, T stage, and clinical stage. Five-year survival rates of low and high PLR patients were 49.6%and 33.6%, respec-tively, which indicated a statistically significant difference (χ2=12.577, P<0.001) between the two groups. Univariate analysis showed that smoking status, histological differentiation, clinical stage, T stage, N stage, postoperative adjuvant therapy and PLR were associat-ed with survival (P<0.05 for all). Multivariate analysis identified N stage, postoperative adjuvant therapy, and PLR as independent prog-nostic factors of all the patients. In addition, stratified analysis showed that the five-year survival rate of the low PLR group was higher than that of the high PLR group with or without lymph node metastasis, and the differences were statistically significant (P=0.020 and 0.037). Conclusion:An elevated blood preoperative PLR indicates poor prognosis in NSCLC patients. Preoperative PLR is an indepen-dent prognostic factor of NSCLC after curative resection.

Profilin-Ⅰis a small actin monomer-binding protein involved in regulating actin polymerization.It plays an important role in cell proliferation,differention,motility and signals transduction in different cell types including endothelial cells and vascular smooth muscle cells.This article recapitulates the wealth of information on structure,function of profilin-Ⅰand its potential role in the genesis and development of cardiovascular diseases.

Objective To evaluate the nutrition status of the elderly patients with type 2 diabetes. Methods The nutrition status of 100 elderly patients〔male 52, female 48, aged 60-83 yrs, with average of (69.2?0.7)yrs〕 with type 2 diabetes was investigated by analyzing nutrient content in daily diet, body measurement and laboratory examinations. Results Compared with the ideal body weight, total calorie intake was suitable for the elderly patients〔male: (1592?216) kCal, female: (1320?172) kCal〕, fat intake 〔male:(67?12) g, female:(65?13)g〕 was higher than the standard for diabetics(P

ObjectiveTo explore the early diagnosis and effective treatment of redundant colon,and to reduce the misdiagnosis and shorten the medical treatment time before the diagnosis.MethodsClinical data of twentyseven patients with redundant colon from February 2005 to December 2011 were retrospectively analyzed in General Surgery Department of 117th and 322th People's Liberation Army Hospital.ResultsThe clinical symptoms of 27 patients nainly as early recurrent intractable constipation,bloating,abdominal pain,weight loss and other symptoms,were likely to be in a misdiagnosis.In addition to three patients with redundant sigmoid colon concurrent reverse came to hospital emergency with surgery,twenty-four cases' symptoms persisted and came to many hospitals with medical treatment up to 32 years,diagnosed by the out-patient barium enema.After surgical resection disease bowel,7-11 months follow-up,patients abdominal distension,abdominal pain,constipation,weight loss and other systemic unwell symptoms disappeared.ConclusionThis disease is rare,we must raise the medical staff's awareness of this disease.X-ray examination with barium enema is the best way to diagnose this disease.After diagnosis,surgery is the most effective treatment.

Objective To evaluate the operative techniques and the methods of the renal function protection in laparoscopic nephron sparing surgery for the treatment of renal tumors.Methods Thirty-six renal tumor patients accepted transperitoneal laparoscopic partial nephrectomy at the 70 degree lateral decubitus position.There were 17 tumors in the upper pole,13 in the lower pole and 6 in the center of kindey.The mean tumor diameter was 2.6 cm(from 0.8 to 4.0 cm).Peke forceps were used to clamp the renal artery and achieve warm ischemia.Cold scissors was used to resect tumors and Hem-o-lok was used to clamp and control the artery bleeding in surgical bed instead of ligature when suturing the kidney parenchyma.Ulinastatin was used to prevent and relieve the ischemical reperfusion injury.The operative time,estimated blood loss,warm ischemia time,intraoperative and postoperative complications and the operative efficacy were recorded.Results All operations were completed successfully,no case was converted to open surgery.The mean operative time was 128 min(95 to 186 min),mean estimated blood loss was 130 ml (40 to 600 ml),mean warm ischemia time was 21 min(16to 28 min).There was no hemorrhage and urinary leakage after surgery.The post-operative renal function was normal in all the cases.The histopathological examination showed that 36 cases were renal cell carcinoma including 31 pT1a,cases and 5 pT1b cases.There was no positive surgical margin.The mean follow-up time was 16 months (from 6 to 30 months).There was no recurrence and metastasis found and renal function was normal in all cases during the follow-up.Conclusions Laparoscopic nephron sparing surgery for renal tumors is a safe and feasible treatment option.This procedure can resect tumor safely and preserve renal function efficiently.The use of Hem-o-lok instead of ligature can significantly reduce the operative time.Ulinastatin can help reducing the ischemical reperfusion injury and thus preserve renal function.