Objective To investigate the clinical value of heart-type fatty acid-binding protein ( H-FABP) and N terminal probrain natriuretic peptide (NT-proBNP) in sepsis patients with myocardium injury. Methods 118 sepsis patients were included as survivor group (68 cases) and death group (50 cases) according to their prognosis outcome. 50 healthy people were selected as control group. Creatase, H-FABP, NT-proBNP, APACHEⅡscore and 28 day morbidity of control group and sepsis patients were assessed at 1 h, 6 h after admission by physical examination . Results At 1 h after admission , APACHEⅡscore , H-FABP and NT-proBNP level in sepsis patients were significantly higher than control group (P < 0.05); APACHEⅡscore, H-FABP, NT-proBNP and cTnI level at 6 h after admission were higher than that at 1 h (P < 0.05); APACHEⅡscore, H-FABP and NT-proBNP level in death group were higher than survivor group at 1, 6 h after admission (P < 0.05), cTnI level at 6 h after admission was higher in death group (P < 0.05). Futhermore, H-FABP, NT-proBNP and cTnI at 6 h after admission were positively correlated with each other (both P < 0.05). At 6 h after admission , H-FABP showed a better predictive value of 28-day mortality than NT-proBNP and APACHEⅡscore (P < 0.05). Conclusion H-FABP and NT-proBNP may suggest important significance in early diagnosis and prognosis prediction of sepsis patients with myocardium injury.

Objective To optimize the preparation technology of chrysophanol loaded polybutylcyanoacrylate nanocapsules by interfacial polymerization,sieve the optimal technology conditions of preparation,and study its quality. Methods Based on the single factor experiment,the formulation was optimized by L9(34) orthogonal design with entrapment efficiency as reference index. The factors including agitating speed,pH value of aqueous phase,amount of ?-butylcyanoacrylate (BCA) and of ethyl acetate were screened. At last,its shape,particle size,the encapsulation efficiency,and the drug loading were investigated as its quality inspection. Results When the ammunt of chrysophanol was 5 mg,the optimum preparation conditions were established as follows:the agitating speed was 800 r/min,the pH value of aqueous phase was 2,the amount of ?-BCA was 13 ?L and ethyl acetate was 0.6 mL. Under this optimum condition,the mean entrapment ratio was 82.19%,and the mean drug loading was 21.48%,the mean diameter of the nanocapsule was 246 nm. The particle size was well-distributed showed by electron microscope pictures. Conclusion The prepared chrysophanol loaded polybutylcy-anoacrylate nanocapsules has small size,high encapsulation efficiency,and drug loading. The preparation technique established in this study is stable and feasible. It also can be used for iv injection.

Objective To detect the influence of rapamycin on the expression of 4 kinds of miRNAs and the effect cell autophagy.To study the relationship of miR-144 and Beclin-1 gene.Methods SKOV-3 cells were treated with 50 ng/mL rapamycin 2 hours and 10 nmol/L 3-methyl adenine 12 hours,the expression of miR-17,miR-20a,miR-144 and miR-155 was detected by RT-qPCR in SKOV-3 cell of different groups,the protein expression of Beclin-1 was detected by Western blot.The targeting effect of miR-144 on Beclin-1 gene was verified by the dual-luciferase reporter assay,Western blot and RT-qPCR.Results The expression of miR-17,miR-144 and miR-155 were in creased compared with NC groups in rapamycin group (P＜0.05);miR-17,miR-20a and miR-144 were down regulated compared with NC group in 3-MA group(P＜0.05);the protein of Beclin-1 was down expression compared with NC group in rapamycin group.miR-144 could suppress Beclin-1 expression by targeting the specific 3'untranslated region sequence of Beclin-1 gene.Conclusions miR-144 can inhibit the autophagy-related gene Beclin-1 expression and regulate the autophagy process in SKOV-3 cells.

[Objective To explore the effect of problem-based learning(PBL) in biochemistry teaching in medical college. Methods Totally 128 students(2011 grade) of medical laboratory major were derived into experiment group(n=64)and control group(n=64). Lecture-based learning(LBL) was used in control group and PBL was used in experiment group.In control group,teachers did teaching design according to the needs of curriculum standards,employed multimedia courseware,explained the basic content of each chapter,class exercises and homework after class. In experimental group,PBL was conducted through establishing biochemistry teaching website based on school's teaching platform. Teach-ing process in experiment group included:grouping-selecting appropriate cases-consulting data-group discussing-summarizing by teachers. Theory test was carried out after the course and questionnaire was conducted for students in experiment group . Data were analyzed using the independent sample t test . Results Average test scores were higher in PBL group than in traditional group,with statistically signif-icant differences[(83.15±11.87)vs. (76.15±12.48)]. Questionnaire survey showed that more than 90.0%students in experiment group were interested in the PBL teaching method and thought that the PBL teach-ing method can enhance the enthu-siasm of learning, independent learning ability and comprehensive analysis ability. Conclusions PBL teaching method can improve the quality and the effect of biochemi-stry teaching and culture students' comprehensive ability. It is worthy of further study and popularization.

Objective To evaluate the value of quantitative 3T dynamic contrast enhanced MRI in the diagnosis of breast lesions. Methods One-hundred and eighteen patients suspected of breast lesions underwent MRI examination. A 3.0 T MR scanner was used to obtain the quantitative MR pharmacokinetic parameters: Ktrans( volume transfer constant), Kep (exchange rate constant) and Ve (extravascular extracellular volume fraction). The mean Ktrans, Kep and Ve of malignant, benign and normal glandular tissues were calculated and compared each other using LSD method. Independent sample t test was used between invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included). Finally, the areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were compared. Results The mean Ktrans, Kep and Ve of malignant lesions (n=87) were (1.010±0.580) min-1, (1.634 ± 1.481) min-1 and (0.735 ±0.273); the mean Ktrans, Kep and Ve of benign lesions (n=23) were (0.331±0.192) min - 1, (0.417±0.324) min - 1 and (0.847±0.291); and the mean Ktrans, Kep and Ve of normal glandular tissues (n =83) were (0.051 ±0.028) min-1, (0.133±0.125) min-1 and (0.597±0.354), respectively. There were significant differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions, benign and malignant lesions in Ktrans (t=9.681, 11.189, 5. 590, respectively, P ＜ 0. 01 ), normal glandular tissues and malignant lesions, benign and malignant lesions in Kep(t =5. 287, 3. 874, P＜0. 05). There were a statistic differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions in Ve(t =2. 932, 2. 562 ,P ＜0. 05). There were no significant differences between normal glandular tissues and benign lesions in Kep, benign and malignant lesions in Ve ( t = 0. 760, 0. 832, P ＞ 0.05 ),invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included) in Ktrans, Kep and Ve(t =0.834,0.075,0.454,P＞0.05). The areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were 0. 934, 0. 941 and 0. 659. The sensitivity of Ktrans, Kep and Ve were 77.01% ,91.95% ,56. 32% and the specificity of Ktrans, Kep and Ve were 95. 65%, 86. 96%, 78.26% for the differential diagnosis of breast lesions if taken the maximum Youden's index as cut-off. Conclusion The differential diagnosis of benign and malignant breast lesions by Ktrans, Kep is applicable.

ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3％ (4/28),53.6％ (15/28) and 32.1％ (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P ＜ 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4％ (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.

Objective To describe the radiological features of mastitis.Methods Imaging findings were retrospectively reviewed in 58 women with mastitis,which was confirmed by pathological results.The imaging features were described according to the BI-RADS (breast imaging reporting and data system).All 58 patients had preoperative MRI,while 49 of them were examined with sonograms and 30 with mammograms preoperatively.Results Overall,no remarkable findings were reported on 6 mammography and 2 sonography examinations,but all 58 lesions were identified on MRI in our study.Asymmetrical density (n =16,53.3％) on mammograms and solitary or multiple separated/contiguous hypoechoic mass-like lesions (n =34,69.4％) on ultrasound were the most common signs of mastitis.On enhanced MR images,82.8 ％ (48/58) patients showed non-mass-like enhanced lesions.Multiple,regional enhancement (66.7％,32/48) and separated or contiguous,clumped,rim-like enhancement (63.1％,31/48) were the most common manifestations in non-mass-like enhanced lesions.Of the 58 patients,type Ⅰ and type Ⅱ timesignal intensity curve were detected in 48.3％ and 50.0％ of the patients,respectively.BI-RADS 0 had the highest frequency in reports on mammography (33.3％,10/30),while category 4a was most frequent on sonography (36.7％,18/49) and also on MRI (56.9％,33/58).Conclusion The imaging findings from mammography and US are non-specific for mastitis,therefore,MR can be helpful in the diagnosis,especially in the presence of non-mass-like enhancement that are multiple,regional,separated,or contiguous,clumped,and tim-like.

Objectives To detect the carotid artery intima-media thickness (CIMT)with color Doppler ultrasound and to investigate the relationship between CIMT and new ischemic cerebrovascular disease. Methods From May 2012 to October 2013,the cluster random sampling method was used to consecutively enroll 4 412 60 -70 year old residences in Reqiu City for prospective study,including face to face health questionnaire survey,human body measurement,laboratory test,and neck vascular color Doppler ultrasonography. According to whether having new ischemic cerebrovascular disease,the patients who had ischemic cerebrovascular disease in 2013 were divided into either a case group (n = 251)or a control group (n =4 161). The single factor analysis,such as baseline data and CIMT levels in both groups were compared, and the related risk factors for ischemic cerebrovascular disease were analyzed. Results (1)The detection rates of hypertension,cerebrovascular disease,taking antiplatelet agents,carotid artery plaque of the case group were higher than those of the control group (62. 2% [n = 156]vs. 44. 2% [n = 1 838],45. 0%[n = 113]vs. 14. 9% [n = 622],55. 0% [n = 138]vs. 40. 0% [n = 1 663],and 65. 7% [n = 165]vs. 54. 5% [n = 2 266],all P < 0. 05). The systolic blood pressure,insulin,and CIMT levels were higher than those of the control group (158 [141,177]mmHg vs. 152 [137,169]mmHg,8. 07 [4. 77,12. 48]μU/ L vs. 6. 93 [4. 27,11. 60]μU/ L,0. 950 [0. 900,1. 000]mm vs. 0. 925 [0. 900,1. 000]mm,all P <0. 05). The cholesterol level was lower than that of the control group (4. 59 [4. 17,5. 26]mmol/ L vs. 4. 78 [4. 20,5. 36]mmol/ L,P < 0. 05). There were significant differences between the 2 groups. (2)Multivari-ate logistic regression analysis showed that histories of hypertension and cerebral vascular disease and CIMT thickening were the independent risk factors for new ischemic cerebrovascular disease (hypertension:OR, 1. 534,95% CI 1. 166 -2. 017,P = 0. 002;history of cerebral vascular disease:OR,3. 940,95% CI 2. 997 -5.180,P =0.000;and CIMT thickening:OR,12.122,95%CI 2. 327 -63. 163,P =0. 003). Conclusion CIMT, hypertension,and cerebrovascular disease are the independent risk factors for ischemic cerebrovascular disease in Renqiu City,and the monitoring of CIMT is very important.

Objective To evaluate the clinical value of 18F-FDG PET/CT for detecting tumor on physical examination people with unexplained elevated serum carcinoembryonic antigen (CEA). Methods A total of 100 physical examination people with unexplained elevated serum levels of CEA in our hospital from June 2010 to December 2014 were involved in the study. All the people were detected with 18F-FDG PET/CT. The pathology, clinical follow ups and conventional medical imaging results were combined to evaluate the value of 18F-FDG PET/CT in diagnosing tumor. The doubling time (DT) of CEA was calculated in the patients who were received more than twice of serum CEA detection. The relationships between serum CEA levels, CEA DT and 18F-FDG PET/CT imaging were analyzed. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of serum CEA. Results Twenty-seven patients were confirmed with malignant tumor, and the rest of 73 cases were excluded. The 18F-FDG PET/CT reported one false positive and one false negative respectively. The sensitivity, specificity, accuracy, positive and negative predictive values of 18F-FDG PET/CT in diagnosing malignant tumors were 96.3%, 98.6%, 98.0%, 96.3% and 98.6% respectively. The median serum CEA levels were significantly higher in the positive 18F-FDG PET/CT patients than those in the negative patients (Z=5.796, P<0.05). The prevalence of 18F-FDG PET/CT positive patients was higher with an increase in absolute CEA levels (χ2=37.823, P<0.05). The median DT of serum CEA levels was shorter in the positive 18F-FDG PET/CT patients than that in the negative patients (Z=4.301,P<0.05). The positive rates of 18F-FDG PET/CT in patients with 0 d180 d and DT<0 d (χ2=17.472 and 17.325, both P<0.05). There was no significant difference in the positive rate of 18F-FDG PET/CT between patients with DT>180 d and patients with DT<0 d (χ2=0.255,P>0.05). The area under the curve (AUC) of serum CEA was 0.894, the optimal diagnostic cutoff value was 14.24μg/L. Conclusion 18F-FDG PET/CT is a useful image modality for detecting malignant tumors in patients with unexplained elevated serum CEA, especially for patients with CEA≥14.24μg/L and increase progressively.

Objective:To analyze the association between gene single nucleotide polymorphisms ( SNP) of methylenetetrahydrofo-late reductase ( MTHFR) gene and lower extremity atherosclerotic disease ( LEAD) . Methods:The clinical data and peripheral blood were collected from 384 participants (224 LEAD cases and 160 normal controls) from Han population of Minnan Fujian. LEAD was detected with ankle brachial index ( ABI) , toe brachial index ( TBI) , color Doppler ultrasonic examination and the other imaging stud-ies. The SNP genotypes including rs1801133, rs1801131, rs2274976, rs4846048, rs3737966, rs1537515, rs4846049, rs3834044, rs13306561 and rs3737964 in the MTHFR gene were detected by matrix-assisted laser desorption ionization-time of flight ( MALDI-TOF) . Results:The genotype distributions of the ten loci were in accordance with Hardy-Weinberg equilibrium. There were 37 obvi-ous linkage disequilibrium, including the association between rs4846048 and rs3737966 (D′>0. 9) and so on. There were significant differences (P=0. 02) in GCCTCGGAAT haplotypes of MTHFR gene groups between LEAD cases and the normal groups. The results from chi-square test of allele frequencies suggested rs1801131 (OR=1. 287),rs4846048 (OR=1. 844,P=0. 02), rs3737966(OR=1. 339),rs4846049 (OR=1. 314) and rs3737964 (OR=1. 522). Significant differences (P<0. 05) were observed between LEAD and the normal groups in Cochran- Armitage trend test and Dominant gene action test of rs4846048. Conclusion: The SNP of rs1801131,rs4846048,rs3737966,rs4846049 and rs3737964 might be associated with the susceptibility of LEAD,and rs4846048 gene mutation might serve as a risk factor for LEAD in the community-based population.