Objective To identify the value of multiparametric MR imaging features including diffusion weighted (DW) and dynamic contrast-enhanced (DCE) MR imaging features in differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.Methods Seventy-seven patients were included in this study,including 12 malignant transformation of inverted papilloma and 65 inverted papillomas.Conventional MRI including nonenhanced and static contrast-enhanced imaging,DCE-and the DW-MRI were analyzed.Differences in conventional MRI features,ADCs and DCE-MRI parameters between the two entities were determined by Fisher exact test,independent samples t-test and Mann-Whitney U test,respectively.Results There were significant differences in convoluted cerebriform pattern (P=0.045),necrosis (P=0.003) and orbit involvement (P＜ 0.01) between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.The ADCs of inverted papilloma were significantly lower than those of malignant transformation of inverted papilloma (P＜0.01).There were significant differences in time to peak enhancement (P＜0.01),maximum contrast index (P=0.004) and time intensity curve types (P＜0.01) between the two entities.Conclusions A multiparametric approach using conventional MR imaging with added ADCs and DCE-MRI parameters had the potential to improve the differentiation between inverted papilloma and malignant transformation of inverted papilloma in the sinonasal region.

In spite of much progress on its mechanism, diagnosis and treatment, diabetes mellitus remains a public health challenge. The harm of diabetes is not significantly reduced, instead shows an increasing tendency year by year. To achieve an in?depth and comprehensive understanding of the underlying mechanism, and to develop efficacious, stable and hypoglycemia?risk free drugs, it is crucial to gain more knowledge about diabetes from animal models. In this review, the types of diabetes animal models, modeling methods, the advantages and disadvantages, their applicable scope are discussed aiming to provide a reference for researchers to choose appropriate animal models.

The anaerobic granular sludge from an Internal Circulation (IC) reactor of a paper mill wastewater treatment plant were seeded in an Anammox upflow anaerobic sludge blanket reactor. After 185 days operation, the reactor was finally started up by increasing the influent ammonium and nitrite concentrations to 224 mg/L and 255 mg/L, respectively, with volumetric nitrogen removal rate increasing to 3.76 kg/(m3·d). The physicochemical characteristics of the cultivated Anammox granules were observed by scanning electron microscope, transmission electron microscope and Fourier Transform infrared spectroscopy (FTIR). Results suggested that during the start-up course, the granular sludge initially disintegrated and then re-aggregated. FTIR spectra results revealed that the Anammox granular sludge contained abundant functional groups, indicating that it may also possess good adsorption properties. The ecological structure of the granular sludge, analyzed by the metagenomic sequencing methods, suggested that the relative abundance of the dominant bacterial community in the seeding sludge, i.e., Proteobacteria, Firmicutes, Bacteroidetes, significantly reduced, while Planctomycetes which contains anaerobic ammonium oxidation bacteria remarkably increased from 1.59% to 23.24% in the Anammox granules.
Ammonia ; chemistry ; Bacteria ; Bioreactors ; Nitrogen ; chemistry ; Sewage ; microbiology ; Waste Disposal, Fluid ; methods ; Waste Water ; chemistry

Objective To investigate the short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency.Methods One hundred and twenty patients with heart failure (NYHA Ⅲ-Ⅳ or Killip Ⅲ) were randomly divided into levosimendan group(n =60) and control group(n =60).The patients in levosimendan group were given intravenous levosimendan for 24 hours beside conventional heart failure medications.The patients in control group were given the conventional heart failure medications.The left ventricular ejection fraction (LVEF) was recorded and B-type natriuretic peptide (BNP) were measured before and after treatment.NYHA grade and mortality also were recorded.All patients were followed up for 3 months.Results The LVEF in the levosimendan group after the treatment was (35.6 ± 13.3)％,significantly higher than that in the control group ((31.4 ± 6.7) ％,F =8.952,P =0.002).The BNP in two groups after treatment were lower compared with before treatment(P ＜0.05).And it was more remarkable after treatment in levosimendan group compared with control group (441.0 (212.5,1050.0) ng/L vs.870.0 (435.0,1267.0) ng/L,P =0.014).The change of NYHA grade in levosimendan group was better than that in control group after 5 d.The recovery rate and ineffective or deterioration rate in levosimendan group were 45.0％ (27/60),26.7％ (16/30) and 43.3％ (26/60) respectively,higher than that of control group (28.3％ (17/60),20.0％ (12/60),36.7％ (22/60)) (OR =2.280,95％ CI 1.163-4.468,P =0.016).There was no significant difference in term of mortality between in hospital and 3 months follow-up in the levosimendan and the control group (20％ (12/60) vs.25％ (15/60),28.3％ (17/30) vs.41.7％ (25/60),x2 =1.543,P =0.214 and x2 =2.590,P =0.108).There was a decreasing trend regarding of readmission rate during 3 months in levosimendan group compared with that of the control group (21.7％ (13/60) vs.33.3％ (20/60),x2 =3.591,P =0.058),but mortality or readmission rate was lower than that in the control group (46.7 ％ (28/60)vs.66.7％ (40/60),x2 =4.835,P =0.028).Conclusion The short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency is remarkable better than the traditional treatment.

Objective To evaluate the improvement effect of levosimendan by vein injection on short term cardiac function of patients with decompensated heart failure.Methods One hundred and sixty patients admitted due to heart failure were randomly divided into levosimendan group and control group (80 subjects for each group).Patients in control group were given a regular therapy including diuretics,vasodilators (including the recombinant human brain natriuretic peptide),angiotensin converting enzyme inhibitor(ACEI) or angiotensin Ⅱ receptorantagonists(ARB),β blockers,spironolactone and stain.Patients in levosimendan were administered levosimendan for 24 hours plus regular therapy.The improvements of dyspnoea in 9 days and cardiac function classification in 30 days after therapy were assessed.Mortality of 1 month and 3 month in two group were calculated and compared during follow-up.Results The dyspnoea improvement rate was superior than that of control group during 9 days (OR =1.956,95％ CI:1.156-3.310,P =0.013).The improvements in the levosimendan group were better than in the control group at 1 st day (OR =2.261,95 ％ CI:1.280-3.999,P =0.005),at 3rd (OR =2.002,95 ％ CI:1.111-3.607,P =0.021) and 5th day (OR =1.846,95 ％ CI:1.009 -3.377,P =0.047).However,there was no significant difference in term of improving dyspnoea between the levosimendan group and the control group at 9th day (P =0.126).Similarly,the improvement of cardiac function classification in the levosimendan group was superior than the control group during 30 days (OR =1.933,95％ CI:1.229-3.040,P =0.004).Although no significant difference was seen regarding of improving cardiac function classification between the two groups at 30th day after treatment (P =0.115),the improvements in the levosimendan group were better than in the control group at 3rd (OR =1.986,95％ CI:1.195-3.300,P =0.008),5th (OR =2.268,95 ％ CI:1.329-3.873,P =0.003),9th (OR =2.627,95 ％ CI:1.419-4.860,P =0.002) and 14th day(OR =2.212,95％ CI:1.189-4.112,P =0.012).Moreover,there was a nonsignificant reduction in terms of mortality in levosimendan group during 1-month and 3-month follow-up compared with control group (P ＞ 0.05).Condusion Levosimendan can effectively improve the short-term cardiac function in patients with decompensated heart failure.

Objective To evaluate the short-term clinical efficacy and safety of administration of levosimendan or milrinone added to conventional therapy in patients with decompensated heart failure.Methods A total of 180 patients admitted due to heart failure [NYHA (New York Heart Association) class Ⅲ or Ⅳ] were randomly (random number) divided into control group,milrinone group and levosimendan group (n =60,each group).A continuous infusion of milrinone added to conventional therapy was administered for 72 hours in milrinone group,while administration of levosimendan for 24 hours in levosimendan group.The changes in left ventricular ejection fraction (LVEF),left ventricle end-diastolic diameter (LVDD) and B-type natriuretic peptide (BNP) plasma level were compared between before and after treatment,respectively,and comparisons of improvement in cardiac function (NYHA class) and hospital mortality were carried out among three groups.Patients were further followed up at 3 months after treatment.Results The LVEF in levosimendan group after treatment had significantly more increased than that in control group [(32.0±6.3)％ vs.(30.6 ±5.5)％,P =0.007].Compared BNP before treatment,the sums of BNP deducted were 444.0 (-74.0,1068.0) pg/mL,469.0 (141.5,1151.5) pg/mL and 936.5 (437.8,1566.8) pg/mL in control group,milrinone group and levosimendan group,respectively after treatment (all P ＜ 0.01).Moreover,the deduction in BNP was more dramatic in levosimendan group compared with control or milrinone group (t =3.256 or 2.665,P =0.004 or 0.026).After treatment for 5 days,the probability at least of achieving more effectively better improvement in NYHA class (cardiac function) in levosimendan group was 2.036 times that of control group (95％ CI:1.030-4.028,P =0.041).The incidence of combined end point events (death or readmission) in levosimendan group was significantly lower than that in milrinone group (50％ vs.70％,HR =0.573,95％ CI:0.358-0.917,P=0.020),while in hospital mortality,readmission or 3-month mortality incidence was similar among 3 groups (P ＞ 0.05).Conclusions The short-term clinical efficacy of levosimendan is superior to that of milrinone or conventional therapy in patients with decompensated heart failure.

Objective To determine LDLR gene mutation in 2 clinically diagnosed FH patients from Hubei province and provide basis for gene diagnosis of FH.Methods Clinical data of 2 FH patients and their parents were collected.The promoter region and exon 1 to exon 18 region of LDLR gene were amplified through PCR and the amplified products were analyzed by forward and reverse DNA sequencing.The mutations were identified after comparison with LDLR gene sequence in GenBank.The pathogenic gene mutations were confirmed according to both genotype and phenotype of FH probands.Results The levels of plasma TC of two probands were 12.79 and 11.98 mmol/L.respectively.No gene mutations were detected in region 3 500 to 3 531 of ApoB100. The mutations of LDLR gene were compound heterozygous mutations. The novel mutation 665G > T detected in the exon 4 of No. 1 proband's LDLR gene was heterozygous missense mutation. The novel mutation 1 358 +32C > T was detected in the exon 9 of No. 1 proband's LDLR gene.The mutations 665G > T ( paternal origin) and 1 358 + 32C > T ( maternal origin) were inherited from the parents. A novel mutation 1 257 C > A was detected in the exon 9 of No. 2 proband's LDLR gene, resulting the presence of a premature termination codon, which was different from 1 257 C > G reported in Belgium.Another heterozygous missense mutation 1 879 G > A was detected in exon 13. They were derived from paternal origin and maternal origin, respectively. Conclusions There are three novel gene mutations:665G >T, 1 358 +32C > T, 1 257C > A found in two probands with compound heterozygous mutations in LDLR respectively. They maybe play a potential role in FH pathogensis.

Objective: To study the effect of cardiac autonomic nerve function on body function and weakness in elderly diabetic patients. Methods: A total of 100 patients diagnosed as diabetic autonomic neuropathy in the endocrine ward of Dalian Friendship Hospital from August 2017 to August 2018 were enrolled. The demographics, clinical data, and Activities of Daily Living (ADL) scale of each patient were recorded, and the Instrument Activities of Daily Living (IADL) and the weak score were used to record heart rate variability in each patient. Aweak score of 5 was used as boundaries. Patients with weak score greater than or equal to 5 were divided into weak group, and those less than 5 were divided into non-weak groups. Each indicators were compared between the two groups. The statistically significant variables were used as covariates, and the weak scores were used as dependent variables to perform direct and indirect Logistic regression analysis of covariates and dependent variables and the receiver operation characteristic (ROC) curve. Results: There were significant differences between the two groups in age, diabetes history, heart rate variability, standard deviation of NN intervals (SDNN), standard deviation of sinus RR interval every 5 min (SDANN), triangle index, ultralow frequency (ULF), very low frequency (VLF), activities of daily living (ADL), instrument activities of daily living (IADL) (t=13.45, U=1700, t=-17.52, t=-18.34, U =1204.00, U=3407.56, t=17.90, t=21.89, t=12.21, P< 0.05). Age, diabetes history, heart rate variability, SDNN, SDANN, triangle index, ULF, VLF, ADL, IADL were independent factors of weakness (B=1.14, 0.98, - 0.46, -0.45, -0.79, 0.57, 0.53, -0.67, -0.79, P<0.05). Age, history of diabetes, SDNN, SDANN, ULF, VLF could affect the weak score by indirectly affecting ADL/IADL (B=0.54/0.23, 0.16/0.07, -0.34/-0.04,, -0.54/-0.03, 0.99/0.21, 0.47/0.22, P< 0.05). SDNN, SDANN and ULF could significantly predict weakness, and the sensitivity values of the Yuedeng index maximum were 98ms, 97ms and 236 ms²/Hz, respectively. Conclusions Week score needs to be assessed in patients with diabetic autonomic neuropathy who have a long history of diabetes, and a DANN greater than 98 ms, a SDANN greater than 97 ms, and a ULF greater than 236 ms²/Hz in the heart rate variability index.

Objective To determine the expression of non-muscle myosin heavy chain 9 (MYH9) in osteosarcoma and its effect on the migration and invasion abilities of tumor cell. Methods A total of 65 cases of osteosarcoma and 20 cases with benign osteochondroma who underwent resection operation in the Orthopaedics Department of our hospital from January 1st 2009 to January 1st 2015 were selected. Their mRNA levels of MYH9 were tested by qrt-PCR. Immunohistochemical method was used to examine the expression of MYH9 in osteosarcoma and the correlation between the positive expression of MYH9 and the clinicopathological features of patients was illustrated by statistical analysis. MYH9 was compounded artificially. The expression of MYH9 in SAOS2 osteosarcoma cells was decreased by siRNA. Scratch test was used to determine the change of SAOS2 cell migration ability after MYH9 silence. Transwell assay was employed to detect the change of cell invasion ability after MYH9 silence. Results The expression levels of mRNA of MYH9 and protein in osteosarcoma tissues were significantly higher than those in benign osteochondroma tissues. The high expression of MYH9 in osteosarcoma tissues was apparently related to the high Enneking classification (III classification) and lung metastasis. SiRNA of MYH9 could evidently decrease the expression level of MYH9 in SAOS2. The down-regulated expression of MYH9 could inhibit the migration and invasion abilities of SAOS2 cells. Conclusions MYH9 shows a trend of high expression in osteosarcoma tissues, and its high expression is associated with features such as tumor invasion and metastasis. The down-regulated MYH9 can realize an anti-tumor effect by inhibiting the migration and invasion of osteosarcoma cells.

OBJECTIVE: To observe the long-term effect of tonsillectomy and provide clinical evidence for tonsillectomy. METHOD: One hundred and one patients undergoing tonsillectomy in our department were included. Their satisfaction and symptom change were followed up by telephone. RESULT: 73.3% patients were satisfied with their surgery. Chief complaints such as pharyngalgia, fever, snoring were significantly decreased after surgery, while foreign body sensation still existed. Some patients complaint for dry throat, foreign body sensation or voice change after tonsillectomy. CONCLUSION Most patients were satisfied with the tonsillectomy. While few of them had new complaints after tonsillectomy.
Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tonsillectomy ; adverse effects ; Young Adult