Objective To evaluate the role of magnetic resonance angiography ( MRA ) in diagnosing peripheral hemangioma andvascular malformation . Methods 61 cases of hemangioma and vascular malformations in peripheral soft tissue were undergone MRAexamination.Results Of 13 patients with hemangioma,the arteries within hemangioma were increased and gradually fine from proximal to distal in 7 cases and in company with arteriovenous fistulae in 2 cases,there were no arteries within hemangioma in 6 cases.Vascular malformations were found in 48 patients,arteries and veins of vascular malformation were showed in 35 cases,but arteries of vascular malformations were only showed in one case.Arteries of vascular malformation were showed in 5 cases and the arteries were pressed on arterial angioyraphy in 23 cases.On MR venography(MRV),the shallow malformed veina were showed in 25 cases and in company with deep malformed veina in 13 cases,only the shallow and deep veina increased and thickness be showed in 2 cases.Arterioveinous fistulae could be seen in 8 cases on MR aterio-venography.There were no vessel be showed in 12 cases within the losions.Conclusion MRA is of significant value in diagnosis and differential diagnosis of peripheral hemangioma and vascular malformations.

Objective To study MRI differential diagnosis of peripheral hemangioma and vascular malformations.Methods MRIfindings of peripheral hemangiomas and vascular malformations proved by operation in 61 cases were retrospectively analyzed in comparison with pathological results.Results In 29 cases of peripheral hemangiomas,20 cases showed equal signal intensity (equal to muscle) and 9 cases showed heterogeneous signal intensity on T1-weighted images; 24 cases showed increased signal intensity (approach fat signal) and 5 cases showed markedly increased signal intensity (increase fat signal) on T2-weighted images,25 cases had septa as low signal network on T2-weighted images,4 cases showed enhancement separated mass enhancement after intravenous contrast injection.In 32 cases peripheral vascular malformations,16 cases showed equal signal intensity and 16 cases showed heterogeneous signal intensity on T1-weighted images.3 cases showed high signal intensity and 29 cases showed markedly increased signal intensity on T2-weighted images,15 cases showed inhomogeneous enhancement after intravenous contrast injection.Conclusion MRI plays an important role in differential diagnosis of peripheral hemangiomas and vascular malformations.

Objective To investigate the differential expression levels and significance of regulatory T cell (Treg) and T helper 17 (Th17) related immunologic factors in peripheral blood of arsenic-exposed rats.Methods Thirty-two Wistar rats were numbered by weight,randomly divided into four groups [control,low (1.25 ml/kg),medium (2.50 ml/kg),and high (5.00 ml/kg)],8 rats per group.Rats in control group were given oral gavage of deionized water,and low,medium and high arsenic exposed groups were given oral gavage doses of 2.00 g/L sodium arsenite (NaAsO2) according to their body weight for 6 days every week.After 4 months,the urine and peripheral blood samples of rats were collected,urinary arsenic (uAs) was detected by inductively coupled plasma-mass spectrometry (ICP-MS),the results were shown in [median (minimum and maximum)],uAs was corrected by urinary creatinine (uCr),the unit was μg/g Cr;enzyme-linked immune-sorbent assay (ELISA) was applied to detect the levels of Treg,Th17,T lymphocytes activation related immunologic factors [interleukin-10 (IL-10),transforming growth factor beta1 (TGF-31),IL-17,IL-6,IL-2],the results were shown in (x) ± s.Results The uAs of the rats was compared between control,low,medium,and high arsenic exposed groups [7.50 (3.16-9.81),72.34 (62.34-106.63),209.15 (154.41-232.20),369.73 (289.50-516.55) μg/g Cr],the differences were statistically significant (F =337.55,P ＜ 0.05).IL-10 [(85.03 ± 7.11),(93.96 ± 8.14),(97.48 ± 6.23),(93.47 ± 4.41) ng/L],TGF-β1 [(72.88 ± 2.96),(81.45 ± 8.15),(86.08 ± 7.55),(90.29 ± 5.35) ng/L],IL-17 [(18.15 ± 3.66),(25.54 ± 5.59),(31.48 ± 5.74),(37.25 ± 7.36) ng/L],IL-6 [(83.68 ± 8.48),(85.14 ± 7.11),(89.78 ± 5.36),(93.48 ± 5.77) ng/L],and IL-2 [(80.65 ± 6.90),(73.86 ± 8.00),(69.93 ± 7.77),(62.06 ± 9.82) ng/L] of the rats were compared between control,low,medium,and high arsenic exposed groups,the differences were statistically significant (F =5.094,11.054,16.249,3.474,5.119,all P ＜ 0.05).There were positive correlations between uAs and TGF-β1,IL-17 concentration (r =0.723,0.605,all P ＜ 0.01),while IL-2 showed a negative correlation (r =-0.484,P ＜ 0.05).Concltsion Arsenic exposure could affect the secretion of Treg and Th17 related immunologic factors,so as to the imbalance of anti-inflammatory and pro-inflammatory,which may play a role in the formation and development of arsenic-related immune injury.

ObjectiveTo investigate the effect of FUT8-siRNA on transforming growth factor β (TGF-β)-Smad2/3 signalling pathway in renal tubular epithelial cells.MethodsHK-2 cells were divided into six groups:normal group,negative control group,TGF-β1 group,TGF-β1 with FUT8 interference group,TGF-β1 with negative control group,FUT8 interference group.RNAi was performed to silence the expression of FUT8 gene,then immunofluorescent analysis was used to detect the expression of core fucose in the HK-2,immunoprecipitation and lectin blotting were performed to detect the core fucosylation of TGF-βR Ⅱ and ALK-5,and detect the change of Smad2/3 and p-Smad2/3 in HK-2 cells after FUT8 gene was silenced.ResultsCompared with the normal and negative control group,incubation with 5 μg/L TGF-β1 for 48 h could significantly up-regulate the core fucosylation of HK-2 cells,enhance the protein expression of TGF-βR Ⅱ and ALK-5 (P＜0.05),markedly increase the expression level of p-Smad 2/3 (P＜0.05) and cause it to nuclear translocation in HK-2 cells.While FUT8siRNA could inhibit the above up-regulation of TGF-βR Ⅱ and ALK-5(P＜0.05),suppress the increase of p-Smad 2/3(P＜0.05) and its nuclear translocation without disturbing the protein expression of TGF-βR Ⅱ and ALK-5.Conclusion FUT8-catalized core fucosylation of TGF-βR Ⅱ and ALK-5 is needed to fulfill their functions,and blocking core fucosylation of TGF-βR Ⅱ and ALK-5 leads to the inhibition of TGF-β-Smad2/3signalling pathway in HK-2 cells.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

ObjectiveTo investigate the value of nasobiliary cholangiography in the diagnosis of residual common bile duct stones after endoscopic retrograde cholangiopancreatography (ERCP) and the risk factors for residual stones. MethodsA retrospective analysis was performed for the clinical data of the patients who underwent ERCP and nasobiliary cholangiography after endoscopic nasobiliary drainage in Peking University First Hospital from January 1, 2018 to December 31, 2019. The chi-square test was used for comparison of categorical data between groups, and a logistic regression analysis was used to investigate independent risk factors for residual stones. ResultsA total of 366 patients underwent ERCP and nasobiliary cholangiography and 27 patients were suspected to have residual stones, among whom 25 had residual stones confirmed by ERCP. The rate of residual stones after ERCP was 6.8% (25/366), and nasobiliary cholangiography had a positive predictive value of 92.6% (25/27) in predicting residual common bile duct stones. The univariate analysis showed that there were significant differences between the two groups in multiple stones, common bile duct diameter ≥1.5 cm, and mechanical lithotripsy (χ2=5014, 7.651, and 9.670, all P＜0.05). The multivariate logistic regression analysis showed that multiple stones (odds ratio ［OR］=2713, 95% confidence interval ［CI］: 1.002-7.345, P=0.049) and mechanical lithotripsy (OR=9.183, 95% CI: 2.347-35.925, P=0.001) were independent risk factors for residual stones. ConclusionPost-ERCP nasobiliary cholangiography is an effective method to detect residual common bile duct stones. Multiple stones and mechanical lithotripsy during ERCP are independent risk factors for residual stones.

Objective To detect the expression levels of tumor necrosis factor alpha induced protein 3(TN-FAIP3)and LINC00887 in clear cell renal cell carcinoma(ccRCC)tissue,and to study their relationship with clinical pathological parameters and prognosis.Methods A total of 101 ccRCC patients admitted to the hospi-tal from January 2013 to October 2018 were selected.The expression levels of TNFAIP3 and LINC00887 were detected in ccRCC cancer tissue and paired adjacent tissues,respectively.The relationship between TNFAIP3 and LINC00887 expression and clinical pathological parameters and prognosis of ccRCC patients was analyzed,and the influencing factors of poor prognosis in ccRCC patients were also analyzed.Spearman correlation coef-ficient was used to analyze the correlation between TNFAIP3 and LINC00887 expression.Results The posi-tive rate of TNFAIP3 expression in ccRCC(37.62％)was significantly lower than that in adjacent tissues(52.48％),and the difference was statistically significant(X2=4.500,P=0.034).The expression level of LINC00887 in ccRCC(1.38±0.61)was significantly higher than that in adjacent tissues(1.03±0.43),and the difference was statistically significant(t=5.396,P＜0.001).The positive rates of TNFAIP3 protein in pa-tients with maximum tumor diameter ≥4.5 cm and TNM stage Ⅲ-Ⅳ were lower than those in patients with maximum tumor diameter＜4.5 cm and TNM stage Ⅰ-Ⅱ,and the differences were statistically significant(P＜0.05).The positive rates of LINC00887 in patients with maximum tumor diameter ≥ 4.5 cm,pathologi-cal grading Ⅲ-Ⅳ,and TNM stage Ⅲ-Ⅳ were higher than those in patients with maximum tumor diameter＜4.5 cm,pathological grading Ⅰ-Ⅱ,and TNM stage Ⅰ-Ⅱ,and the differences were statistically signifi-cant(P＜0.05).Compared with the TNFAIP3 high expression group,the TNFAIP3 low expression group had a poorer prognosis,and the difference was statistically significant(x2=5.118,P=0.024).Compared with the LINC00887 low expression group of,the LINC00887 high expression group had a poorer prognosis,and the difference was statistically significant(x2=4.638,P=0.031).Low expression of TNFAIP3,high expres-sion of LINC00887,pathological grade Ⅲ-Ⅳ,and TNM stage Ⅲ-Ⅳ were risk factors for poor prognosis in ccRCC patients(P＜0.05).Spearman rank correlation analysis showed that there was a negative correlation between TNFAIP3 and LINC00887 expression in ccRCC tissue(r=-0.638,P=0.012).Conclusion TN-FAIP3 expression is down-regulated and L1NC00887 expression is up-regulated in ccRCC tissue,and there is a negative correlation.They may jointly regulate the occurrence and development of ccRCC,and have the poten-tial to become tumor markers for evaluating the prognosis of ccRCC patients.

Objective:To develop and validate a MRI-based radiomics nomogram combining with radiomics signature and clinical factors for the preoperative differentiation of benign parotid gland tumors (BPGT) and malignant parotid gland tumors (MPGT).Methods:From January 2015 to May 2020, 86 patients with parotid tumors confirmed by surgical pathology in the Affiliated Hospital of Qingdao University were enrolled as training sets, and 35 patients in the University of Hong Kong-Shenzhen Hospital from January 2013 to January 2020 were enrolled as independent external validation sets. The logistic regression was used to establish a clinical-factors model based on demographics and MRI findings. Radiomics features were extracted from preoperative T 1WI and fat-saturated T 2WI (fs-T 2WI), a radiomics signature model was constructed, and a radiomics score (Rad-Score) was calculated. A combined diagnostic model and nomogram combining with the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The receiver operating characteristic (ROC) analysis was used to evaluate the performance of each model and DeLong test was used for comparison of area under the ROC curve (AUC). Results:The logistic regression results showed that deep lobe involvement (OR=3.285, P=0.040) and surrounding tissue invasion (OR=15.919, P=0.013) were independent factors for MPGT and constructed the clinical-factors model. A total of 19 features were extracted from the joint T 1WI and fs-T 2WI to build the radiomics signature model. The combined diagnostic model and nomogram incorporating deep lobe involvement, surrounding tissue invasion and Rad-score were established. The AUCs of the clinical-factors model, radiomics signature model and combined diagnostic model for differentiating BPGT from MPGT for the training and validation sets were 0.758, 0.951, 0.953 and 0.752, 0.941 and 0.964 respectively. The AUCs of the radiomics signature model and the combined diagnostic model were significantly higher than those of the clinical-factors model for both training and validation sets (training set: Z=3.95, 4.31, both P<0.001; validation set: Z=2.16, 2.67, P=0.031, 0.008). There was no statistical difference in AUCs between the radiomics signature model and combined diagnostic model (training set: Z=0.39, P=0.697; validation set: Z=1.10, P=0.273). Conclusions:The MRI-based radiomics signature model and radiomics nomogram incorporating deep lobe involvement, surrounding tissue invasion, and Rad-score showed favorable predictive efficacy for differentiating BPGT from MPGT.

BACKGROUND:Hydrogen,as an antioxidant,can reduce oxidative stress induced by strenuous exercise and achieve the effect of improving fatigue.Several studies have been reported on the potential effects of hydrogen-rich water or hydrogen-rich gas on improving exercise fatigue and athletic performance. OBJECTIVE:To investigate the effects of hydrogen-rich gas inhalation prior to high-intensity exercise on proprioception and muscular endurance performance after exercise fatigue. METHODS:Through a randomized,double-blind,crossover,and repeated measurement experimental design,24 healthy men were randomly divided into group A and group B,with 12 in each group.In the first phase of the crossover experiment,group A inhaled hydrogen-rich gas(hydrogen group)for 20 minutes and group B inhaled placebo gas(air;placebo group)for 20 minutes.Then,cycle ergometers were used to establish the fatigue model.Visual analog fatigue scale,heart rate variability,knee joint proprioception(passive position perception,joint motion perception,and muscle force perception)and isometric knee extension muscle endurance were tested before and after intervention.After a 7-day washout period,two groups exchanged intervention methods and the above tests were performed again in the second phase of the experiment.Differences between the results of groups A and B in the two phases were compared,and finally the results of the two phases were integrated to compare the overall differences between hydrogen intervention and placebo intervention. RESULTS AND CONCLUSION:In the first phase of the crossover experiment,the visual analog fatigue scale score of the hydrogen group after intervention was significantly lower than that of the placebo group(P<0.01).The root mean square of the difference between the adjacent R-R,mean low-frequency output power,mean high-frequency output power,and isometric muscle endurance after intervention in the hydrogen group were significantly higher than those in the placebo group(P<0.05).Passive position perception and joint motion perception after intervention in the hydrogen group were significantly better than those in the placebo group(P<0.05).There was no significant difference in muscle force perception between the two groups(P>0.05),but muscle force perception in the placebo group after intervention was significantly worse than that before intervention(P<0.01).The difference trend of all test results after intervention in the two groups in the first phase of the experiment showed the same results in the second phase of the experiment.The integrated results also showed that the hydrogen group had better test values for the above indicators than the placebo group(P<0.05).Linear regression analysis showed a positive correlation between post-intervention visual analog fatigue scale scores and passive position perception results(r=0.327,P=0.023),i.e.,the higher subjective fatigue level after high-intensity exercise indicated the worse passive position perception results.To conclude,inhaling hydrogen-rich gas before high-intensity exercise can reduce the degree of fatigue after exercise,thereby improving proprioception and muscle endurance performance,which may be a new strategy to reduce the occurrence of injury.And its effectiveness can be achieved repeatedly.

BACKGROUNDVon Hippel-Lindau (VHL) disease is a hereditary tumor disorder caused by mutations or deletions of the VHL gene. Few studies have documented the clinical phenotype and genetic basis of the occurrence of VHL disease in China. This study armed to present clinical and genetic analyses of VHL within a five-generation VHL family from Northwestern China, and summarize the VHL mutations and clinical characteristics of Chinese families with VHL according to previous studies.

METHODSAn epidemiological investigation of family members was done to collect the general information. A retrospective study of clinical VHL cases was launched to collect the relative clinical data. Genetic linkage and haplotype analysis were used to make sure the linkage of VHL to disease in this family. The VHL gene screening was performed by directly analyzing DNA sequence output. At last, we summarized the VHL gene mutation in China by the literature review.

RESULTSA five-generation North-western Chinese family afflicted with VHL disease was traced in this research. The family consisted of 38 living family members, of whom nine were affected. The individuals afflicted with VHL exhibited multi-organ tumors that included pheochromocytomas (8), central nervous system hemangioblastomas (3), pancreatic endocrine tumors (2), pancreatic cysts (3), renal cysts (4), and paragangliomas (2). A linkage analysis resulted in a high maximal LOD score of 8.26 (theta = 0.0) for the marker D3S1263, which is in the same chromosome region as VHL. Sequence analysis resulted in the identification of a functional C>T transition mutation (c. 499 C>T, p.R167W) located in exon 3 of the 167 th codon of VHL. All affected individuals shared this mutation, whereas the unaffected family members and an additional 100 unrelated healthy individuals did not. To date, 49 mutations have been associated with this disease in Chinese populations. The most frequent VHL mutations in China are p.S65 W, p.N78 S, p.R161Q and p.R167 W.

CONCLUSIONSThe results supported the notion that the genomic sequence that corresponds to the 167 th residue of VHL is a mutational hotspot. Further research is needed to clarify the molecular role of VHL in the development of organ-specific tumors.

Adolescent ; Adult ; Asian Continental Ancestry Group ; China ; Female ; Haplotypes ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Pedigree ; Retrospective Studies ; Von Hippel-Lindau Tumor Suppressor Protein ; genetics ; Young Adult ; von Hippel-Lindau Disease ; diagnosis ; genetics