The non-affiliated hospital’s teaching system in college includes teaching administration system, teaching operation system and teaching quality supervision and evaluation system. It is the significant step for the non-affiliated hospital to assume the clinic teaching duties that constructs the teaching system. The college and hospital should take measures to provide essential guarantee for constructing the teaching system.

Objective To discuss the imaging findings and pathological features of primary pulmonary lymphoepithelioma-like carcinoma (LELC). Methods Imaging and pathological data of 13 patients (9 male and 4 female, age from 17 to 72 years, median age 52 years) with pathology-proven primary pulmonary LELC from January 2010 to March 2015 were retrospectively analyzed. Thirteen patients underwent X-ray examination, two of them underwent non-enhanced CT scan, eight underwent non-enhanced and enhanced CT scans, one underwent non-enhanced MR scan. All imaging data including location, number, shape, size and density of lesions were analyzed by two experienced chest radiologists respectively and reached an agreement after consultations. Surgery was performed in 11 cases and aspiration biopsy in 2 cases. HE staining was performed in all cases and immunohistochemistry staining in 6 cases. Results All thirteen primary pulmonary LELC were unilateral. Nine peripheral tumors and four central tumors were identified. Lobulations (n=11), spiculas (n=7), vessel convergences (n=3), vascular encasements (n=2), pleural indentations (n=4) and punctuate calcification sign (n=1) were seen in the CT images. Thirteen tumors had diameters ranging from 1.3—11.0 cm, average diameter of (4.4 ± 2.7) cm, and all showed homogeneous density in non-enhanced CT. CT value ranged from 22—48 HU, average value of(34± 10)HU, and during arterial phase it ranged from 33—70 HU, average value of(53 ± 13)HU;and during venous phase it ranged from 43—86 HU, average value of(66±14)HU;the tumor had long T1 and long T2 signal in non-enhanced MR scan, and signals were homogeneous. Pathologically, the tumor was from pleomorphic epithelial with large cells, syncytia in the infiltration of lymphocytes or accompanied with collagenzation. Large nucleus showed vacuole-shape. Immunochemistry CK(+), P63(+), CK5/6(+), CK14(-) supported the diagnosis of LELC. Conclusions There are certain imaging characteristics for primary pulmonary LELC. Histopathological and immunohistochemistry examination could provide the definitive diagnose.

Objective To investigate the effects of 5-fluorouracil (5-FU) on the distribution, pro-portion and immunosuppressive activities of myeloid-derived suppressor cells (MDSCs) in a mouse model of liver cancer.Methods Orthotopic transplantation of H22 cell line was performed to establish the mouse model of orthotopic liver cancer.Forty mice were randomly divided into four groups (n=10) on the 7th day after transplantation.Three different doses of 5-FU (10 mg/kg, 30 mg/kg and 50mg /kg) and 0.4 ml of PBS were respectively given to the mice in each group for 10 consecutive days .A control group without canc-er cell transplantation was set up correspondingly .The distribution of MDSCs in mice liver tissues was detec-ted by immunohistochemistry .The proportions of MDSCs in spleen tissues were tested by flow cytometry . The levels of IFN-γand Arginase-I ( Arg-I) in serum samples were analyzed by enzyme-linked immunosor-bent assay.The activities of nitric oxide synthetase (NOS) in serum samples were tested by chemical colori-metry.The proliferation of T lymphocytes was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2, 5-diphenyltet-razolium bromide (MTT) test.Results 5-FU reduced the tumor size and alleviated the adhesion between liver tissues and abdominal cavity in mice with liver cancer in a dose-dependent manner .The proportions of MDSCs in liver and spleen tissues from mice in four model groups were significantly higher than those in con - trol group (P<0.05).The highest proportions of MDSCs were observed in PBS treated group , followed by 10 mg/kg of 5-FU treated group , 30 mg/kg of 5-FU treated group and 50 mg/kg of 5-FU treated group .Ex-cept for comparing between PBS treated group and 10 mg/kg of 5-FU treated group, there were significant differences with the proportions of MDSCs in liver tissues among other groups (P<0.05).The levels of Arg-I and the activities of NOS in mice with liver cancer were higher than those in control group (P<0.05).The mice in PBS treated group showed the highest level of Arg-I and the strongest activities of NOS that were de-creased as concentrations of 5-FU increased( P<0.05).The levels of IFN-γin serum samples from mice with liver cancer were lower than those in control group , and the lowest level was detected in PBS treated group.IFN-γlevels were increased as concentrations of 5-FU elevated.Except for comparing between PBS treated group and 10 mg/kg of 5-FU treated group , significant differences with the levels of IFN-γin serum samples (P<0.05) were observed among other groups .No significant differences with the proliferation of T cells were observed among all groups after 24 hours of culture (P>0.05),but that were decreased in model groups than those in control group after 48 hours of culture (P<0.05).T cells from mice in PBS treated group showed the lowest level of proliferation .T cell proliferation was enhanced upon the treatment of 5-FU in a dose-dependent manner .Except for comparing between PBS treated group and 10 mg/kg of 5-FU treated group, significant differences with T cell proliferation were observed among other groups (P<0.05).The proportions of MDSCs in liver and spleen tissues were positively correlated with the levels of Arg -I and the activities of NOS, but negatively correlated with IFN-γlevel and T cell proliferation at the time point of 48 h.Conclusion To a certain extent , 5-FU could reduce the numbers of MDSCs in liver and spleen tis-sues from mice with liver cancer , inhibit immunosuppressive activities of MDSCs and restrain the growth of the tumor in a dose-dependent manner .

Objective To explore the diagnostic value of MR diffusion weighted imaging (DWI) in the differential diagnosis between encephalitis and acute cerebral infarction.Methods The MR DWI appearances of 23 cases of encephalitis including 14 cases with viral encephalitis, 9 cases with demyelinative encephalitis and 30 cases with acute cerebral infarction were retrospectively analyzed.Results The 30 cases of acute cerebral infarction appeared bright signal in DWI with a ADC values of (0.46?0.13)?10 -3mm2/s. 7 cases with viral encephalitis and 9 cases with demyelinative encephalitis appeared slightly high or high signal intensity in DWI with a ADC values of (0. 98?0.18)?10 -3mm2/s and(0. 89?0.07)?10 -3mm2/s respectively. The ADC values of viral encephalitis and demyelinative encephalitis were higher comparing to acute cerebral infarction(?0.05). However, the ADC values showed higher or lower in different areas in 4 cases, and lower ADC values appearing in 3 cases with viral encephalitis comparing normal parenchyma.Conclusion MR DWI is useful in the differential diagnosis between encephalitis and acute cerebral infarction.

Objective MRI and MR hydrogen proton spectroscopy (1H-MRS) were used to detect the abnormal signal and alteration of metabolites, in order to explore the efficacy of these method in evaluating the damages of central nervous system (CNS) induced by occupational manganese exposure.Methods Eighteen workers exposed to manganese without any manganism symptoms, 12 workers with slightly chronic manganese poisoning, and 19 healthy workers were scanned using routine MRI sequence and 1H-MRS.The blood manganese concentration was also collected for each subject.On cerebral axial T1 WI,the signal intensities of ipsilateral globus pallidus and frontal white matter were measured in the visually brightest area (try to select the signal homogeneous region), and the globus pallidus index (PI) was then calculated.The 1H-MRS data was calculated to get the values of the peak height of N-acetylaspartate (NAA), choline (Cho), inositol (mI) and creatine (Cr) and the ratios of NAA/Cr, Cho/Cr, and mL/Cr were also calculated.One way ANOVA was used to compare the values of PI, NAA/Cr, Cho/Cr, mI/Cr and MnB among the three groups, and the correlations between PI and the time span of manganese exposure or blood manganese concentration were analyzed by Pearson correlation analysis.Eight workers exposed to manganese were followed up one year, and their PI , NAA/Cr before and after follow-up were compared by t test.Results Fourteen of 18 cases exposed to manganese without any manganism symptoms showed symmetrically high intensity signal on T1 WI, while the T2 WI were normal.No high signal intensity was observed on T1WI in any of the healthy workers or manganese poisoning workers.We found that the average PI in manganese exposed group (1.16 ±0.09) was significantly higher (F =24.79 ,P =0.O00)than those of the poisoning ( 1.05 ± 0.07 ) and control groups ( 1.01 ± 0.05 ).The blood manganese concentration in manganese exposed group, the poisoning group and the control group were (0.051 ±0.024), (0.047 ±0.018 ), ( 0.043 ± 0.020 ) μg/ml respectively, which was not significantly different ( F = O.623, P =0.541 ) and did not exceed the upper limit of normal reference value ( < 0.10 μg/ml ).There was a significantly correlation between PI and the time span of manganese exposure ( r = 0.67, P = 0.002 ),however, there was no correlation between PI and blood manganese concentration ( r = 0.20, P = 0.427 ).Furthermore, the NAA/Cr ratio decreased variously in the manganese poisoning group ( 1.22 ± 0.07 ) which was significantly lower( F = 4.120, P = 0.023 ) than those of the poisoning( 1.33 ± 0.13 ) and control groups ( 1.31 ±0.13).No statistical significanees were found in the ratios of Cho/Cr and mI/Cr among these three groups(P>0.05).No obvious changes of the PI and NAA/Cr were found in the 8 manganese exposed workers after 1 year follow-up.Conclusion Manganese exposure could lead to the high intensity signal on T1 WI, therefore the increased PI may be the biomarkers of central nerve system damages caused by the occupational manganese exposure.

Objective To investigate the effects of internal and external biliary drainage on liver regeneration of the obstructive jaundice rats after partial hepatectomy.Methods The rat models of obstructive jaundice with 70％ liver resection were successfully constructed.All the 120 rats were randomly divided into the control group:rats received middle and left hepatic lobectomy; internal drainage group:a drainage tube was placed between the dilated bile duct and the duodenum; external drainage group:a drainage tube was placed in the dilated bile duct.There were 40 rats in each group.Rats in the internal and external drainage groups received middle and left hepatic lobectomy at postoperative day 7.The blood and hepatic tissues were collected at postoperative day 0,1,2,4,12,24,48,72 hours after operation,and the rate of liver regeneration and mitotic index were determined.The expression of proliferating cell nuclear antigen (PCNA) and signal transducer and activator of transcription 3 (STAT3) in the hepatic tissues were detected by immunohistochemistry,and the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by ELISA,and the mRNA expressions of TNF-α and IL-6 were detected by RT-PCR.All data were analyzed using the one way analysis of variance or SNK test.Results Within 72 hours after partial hepatectomy,the rate of liver regeneration of the internal drainage group was 94.86％± 12.72％,which was significant higher than 62.39％±8.01％ of the external drainage group and 45.77％ ± 5.41％ of the control group (F =33.62,P ＜ 0.05).The mitotoic index and PCNA levels of the 3 groups had obvious increase at postoperative hour 12,and the mitotoic index and PCNA levels of the external drainage group reached peak at postoperative hour 24,which were 24.47％ ± 4.01％ and 88.1％ ± 9.2％,respectively,the mitotoic index and PCNA levels of the control group and the external drainage group reached peak at postoperative hour 48,which were 15.80％ ± 1.08％,58.3％ ± 5.8％ and 18.40％ ± 1.12％,70.2％ ± 6.9％,respectively.The mitotoic index and PCNA levels of the internal drainage group were significantly higher than those of the control group and the external drainage group (P ＜ 0.05).The expression of STAT3 expression of the internal drainage group reached peak at postoperative hour 4,which was 42.6％ ± 3.6％ ;the expression of STAT3 expression of the control group and the external drainage group reached peak at postoperative hour 12,which were 22.9％ ± 2.0％ and 29.2％± 3.7％.The peak level of STAT3 of the internal drainage group was significantly higher than those of the control group and the external drainage group (P ＜0.05).The levels of TNF-α and IL-6 of the internal drainage group reached peak at postoperative hour 12,which were (227 ±23)U/L and (256 ± 32)U/L; the levels of TNF-α and IL-6 of the control group and the external drainage group reached peak at postoperative hour 24,which were (309 ± 41) U/L and (388 ± 40) U/L,(287 ± 30)U/L and (346± 33)U/L,respectively.The levels of TNF-α and IL-6 of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).The expressions of TNF-α mRNA of the control group,internal drainage group and external drainage group reached peak at postoperative hour 4,which were 0.92 ±0.14,0.39 ±0.05,0.80 ±0.15,respectively.The expressions of IL-6 mRNA reached peak at postoperative hour 12,which were 0.79 ± 0.07,0.38 ± 0.06,0.63 ±0.10,respectively.The expressions of TNF-α mRNA and IL-6 mRNA of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).Conclusions Both internal and external drainage can improve liver regeneration of obstructive jaundice rats following partial hepatectomy,while the effect of internal drainage is superior.Internal biliary drainage has influence on the expression of STAT3 by decreasing the levels of TNF-α and IL-6,and help to improve liver regeneration of obstructive jaundice rats following partial hepatectomy.

Objective To evaluate the clinical value of CT perfusion (CTP) imaging for providing quantitative information about angiogenesis in patients with lung carcinoma and investigate the correlation of CTP enhancement parameters and histological microvessel density (MVD) with lymphatic involvement in peripheral lung carcinoma. MethodsFifty-three patients with pathology-proved peripheral lung carcinoma underwent CT perfusion scan before operation. The enhancement parameters of CTP were calculated based on the time-density curves (TDC) of fist pass phase. All cases were classified into two groups according to pathologic results: tumor with and without lymph node involvement. Two-sample t test was used for the statistics. The ROC curve was used to assess the efficiency of the enhancement parameters of CT perfusion and MVD for predicting lymphatic involvement.Results Tumors with lymph node involvement had significantly higher value of MVD than those without lymph node involvement (64.69±16.34 and 42.67± 16.78, respectively,t=4.84,P<0.01). Tumors with lymph node involvement had significantly higher value of CTP enhancement parameters (PH, M/A, PV) than those without lymph node involvement [PH= (41.79±15.50) and (29.99±10.91) HU,M/A =0.24±0.09 and 0.15±0.06, PV=(2.14±1.09) and (1.27±0.53) ml·min~(-1)·ml~(-1), t=3.21,3.95, 3.66, P<0.01, respectively]. The CTP enhancement parameters (PH, M/A, PV) of lung cancer correlated positively with the MVD, the highest correlation coefficient was between the PV and MVD (r=0.716, P<0.01). MVD and PV had higher values for predicting lymph node involvement in ROC curve analysis.The sensitivity, specificity and accuracy for predicting lymph node involvement were 80.8%, 81.5% and 81.1% or 84.6% ,85.2% and 84.9% respectively if MVD>52/0.74 mm~2 or PV>1.52 ml·min~(-1)·ml~(-1). ConclusionThe CT perfusion PV and histological MVD have good correlation with lymph node involvement in peripheral lung carcinoma and are important predicting parameters before operation.

Objective:To analyze the correlation between arch width and different vertical facial skeletal types of the adults with individual normal occlusion.Methods:52 adults with individual normal occlusions(females 31,males 21) were included.According to the values of mandibular plane angle MP-FH,SN-MP measured on CBCT image the subjects were divided into 3 groups(13 cases with highangle,19 with average-angle and 20 with low-angle groups).12 parameters were measured for each sample,including maxillary and mandible arch width and alveolar arch width between canines,between first premolars and between first molars,the difference between the maxillary arch width and mandibular arch width were calculated.The data were statistically analyzed by one-way ANOVA and Pearson~ rank correlation test.Results:In the group of high-angle,average-angle and low-angle the alveolar arch width(mm) between maxillary canines was 38.03 ± 1.90,39.65 ± 1.80 and 39.78 ± 2.20 respectively(P ＜ 0.05).The arch width between maxillary first premolars of high-angle group(37.01 ± 1.60) was smaller than that of low-angle group(38.65 ± 1.30).The arch width difference in canine area between maxillary and mandibular alveolar in high-angle,average-angle and low-angle groups was 7.39 ± 1.82,9.04 ± 1.43 and 9.26 ± 1.67 respectively(P ＜0.05);in maxillary first premolars area in high-angle(6.8 ± 1.59) was smaller than that in averageangle(7.79 ± 1.09),maxillary and mandibular arch width showed no statistical difference.Pearson correlation test showed that among 3 groups,upper and lower alveolar arch width difference in canine and first premolars area was negatively correlated with the mandibular plane angle.while upper and lower arch width difference showed no statistical correlation with the mandibular plane angle.Conclusion:The maxillary middle arch width of the subjects with individual normal occlusion was correlated with vertical facial type.

Objective: To explore the value of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced MRI T₁ mapping in diagnosing and distinguishing dysplastic nodule (DN) and hepatocellular carcinoma (HCC) with different degrees of differentiation. Methods: A retrospective study in the first affiliated Hospital of Guangxi Medical University from September 2015 to December 2017 was conducted. Seventy-one patients with HCC or DN (a total of 79 lesions) that confirmed by biopsy or surgical pathology findings. Seventy-nine lesions were divided into DN (n=10), well differentiated HCC (n=15), moderately differentiated HCC (n=36) and poorly differentiated HCC (n=18) according to histopathology. All the patients underwent plain MRI scan and Gd-EOB-DTPA-MRI T₁ mapping before surgery or needle biopsy. The T₁ values of each lesion and non-tumorous liver parenchyma were measured on 20 min hepatobiliary phase (HBP) T₁ mapping after Gd-EOB-DTPA administration, respectively. The increment rate of T₁ value in lesions relative to non-tumorous liver parenchyma were calculated. One-way ANOVA was used to compare the differences of T₁ value and the increment rate of T₁ value of DN and 3 groups of HCC with different degrees of differentiation. Spearman correlation was used to evaluate the correlation between T₁ mapping parameters and the malignancy degree of DN and HCC. Area under the receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T₁ mapping parameters in the differential diagnosis of DN and HCC with different degree of differentiation. Results: Significant differences were found in T₁ value and increase rate of T₁ value of DN and HCC with different degrees of differentiation (P< 0.05). The T₁ value and increase rate of T₁ value showed an increasing trend from DN to poorly differentiated HCC after enhancement. The T₁ value and increase rate of T₁ value were positively correlated with the malignancy of DN and HCC (r=0.418 and 0.634, P<0.01). There were significant differences in the increase rate of T₁ value between well-differentiated HCC and moderately-differentiated, well-differentiated HCC and poorly-differentiated HCC, respectively (P<0.05). The area under ROC curve of T₁ value and the increase rate of T₁ value for differentiating DN from well-differentiated, moderately differentiated and poorly differentiated HCC was 0.933, 0.928, 0.939 and 0.867, 0.961, 0.961, respectively. The area under ROC curve of the increase rate of T₁ value for differentiating well-differentiated HCC from moderately-differentiated, well-differentiated HCC from poorly-differentiated HCC was 0.770 and 0.844, respectively. Conclusions Gd-EOB-DTPA enhanced MRI combined with T₁ mapping can provide valuable diagnostic information for identifying DN and HCC with different degrees of differentiation.

Objective To investigate the correlation between single nucleotide polymorphisms (SNPs) of FOXP3 gene and the susceptibility of hepatocellular carcinoma (HCC). Methods Two SNPs rs2280883 and rs3761549 of FOXP3 gene in 392 HCC patients and 372 healthy controls were analyzed by Matrix-Assisted Laser Desorption/ Ionization Time of Flight Mass Spectrometry (MALDI-TOF).Results At rs3761549,C allele frequency was significantly higher ( OR =1.32,95％ CI 1.03 -1.70,P =0.027) in HCC patients than healthy controls.Compared with healthy controls,HCC patients had higher frequencies of TT genotype (79.6％ ) at rs2280883 or CC genotype (77.6％) at rs3761549 of FOXP3 gene.Patients carrying rs2280883 TT genotype ( OR =1.53,95％ CI 1.10 - 2.14,P ＜ 0.00001 ) or rs3761549 CC genotype ( OR =1.92,95％ CI 1.39 - 2.64,P ＜ 0.00001 ) were more susceptible to HCC.Stratified analysis showed that rs3761549 CC genotype was significantly associated with higher incidence of portal vein tumor thrombus ( x2 =5.578,P =0.018 ),and rs3761549 TT/CT genotype was significantly associated with higher rate of tumor recurrence in HCC patients (x2 =6.561,P =0.010).Conclusions FOXP3 gene polymorphisms at rs2280883 and rs3761549 might be associated with increased susceptibility to HCC. rs3761549,CC genotype and TT/CT genotype were respectively associated with higher incidence of portal vein tumor thrombus and tumor recurrence in HCC patients.