Objective To study the role of monochromatic energy images from spectral CT in diagnosing X-ray negative biliary stones.Methods 32 patients who were diagnosed to have X-ray negative biliary stones were retrospectively studied.They were examined by spectral CT scanning and the spectral CT data were loaded into a spectrum analysis software.The optimal contrast-to-noise ratio (CNR) of the monochromatic energy images were exposed and the contrast ratio between the X-ray negative stones and bile on the optimal monochromatic and hybrid energy CT images were compared,respectively.The monochromatic and hybrid energy CT images for diagnosing X-ray negative biliary stones were validated by two senior radiologists based on postoperative histology.Results The corresponding KeV of optimal CNR for X-ray negative stones were not quite consistent.They were 140KeV in 19 patients,40KeV in 8 patients,53KeV,57KeV,62KeV,64KeV and 73KeV in one patient each.The contrast between the negative stones and the adjacent bile were (6.4 ±5.6) HU on hybrid energy CT images and (50.4 ±24.4) HU on optimal monochromatic energy CT images.The Eff-Z of negative stones and bile were 6.6 ± 0.6 and 7.9 ± 0.2,respectively.In our study,the diagnostic accuracy of hybrid energy CT images was 34.38％ and that of optimal monochromatic energy CT images was 78.13％.Conclusion The optimal monochromatic energy CT images were more valuable in diagnosing X-ray negative bile duct stones,which were obviously better than the hybrid energy images from traditional CT.

Objective To investigate the effect of dexamethasone on the toxicity of bupivacaine in murine neurons.Methods Murine neuroblastoma cell line N2a was obtained from ATCC cell bank (USA). The cells were cultured in 10% fetal cow serum/MEM culture medium and divided into 4 groups voup I control (Con); group II bupivacaine ( Bup); group Ⅲ dexamethasone (Dex) and group IV Dex + Bup. The culture medium contained bupivacaine 900 μmol/L in group Bup and dexamethasone 1 μmol/L in group Dex respectively. In group Dex + Bup ( IV ) Bup was added to the culture medium with a final concentration of 900 μmol/L at 12 h after pretreatment with Dex 1 μmol/L. The cells were inoculated in 24 well plates (0.5 ml in each well, 24 wells in each group) and 10 cm culture dishes (7 ml in each dish, 4 dishes in each group). The release rate of LDH was calculated and the morphology of the cells and nucleus condensation (by Hoechst 3334224 fluorescent staining) was detected at 9 h of incubation in 24 well plates. The mitochondrial transmembrane potential (by JC-1 assay) and phosphorylation of Akt and ERKs (by Western blot) were measured at 5 h of incubation in 24 well plates and in culture dishes respectively. ResultsBupivacaine caused severe damage to the N2a cells as evidenced by increase in LDH release and nucleus condensation (apoptosis), dephosphorylation of Akt and ERKs, decrease in mitochondrial transmembrane potential and severe morphological changes. Dexamethasone pretreatment significantly attenuated bupivacaine-induced neurotoxicity. Conclusion Dexamethasone can protect N2a cells from bupivacaine-induced neurotoxicity through stabilization of mitochondrial transmembrane potential and inhibition of dephosphorylation of Akt and ERKs.

Objective To explore the value of computed tomography (CT)and magnetic resonance imaging (MRI)in the diagno-sis and delineation of the extent of malignant external otitis (MEO).Methods Clinical manifestations and imaging features of 10 pa-tients with definite diagnosis of MEO were collected and analyzed.Plain and contrast-enhanced CT of the ear were performed on all 10 patients,of which 6 patients also received MRI scans.Results Abnormal soft tissue opacity within the external auditory canal and involvement of surrounding structures were found in all 10 patients.Bone erosion of the external auditory canal was showed in 7 pa-tients.Other CT findings included bone erosion of skull base and intracranial involvement.Abnormal soft tissue of the external audi-tory canal,effusion in the mastoid cavity and medullary abnormalities were showed very well on MR images in 6 patients while the cortical bone erosion was not well showed.Conclusion Imaging features of the lesions in the external auditory canal,bone erosion of skull base and intracranial involvement play crucial roles in the diagnosis and delineation of the extent of the lesion in patients with MEO.

Objective To investigate the clinical distribution situation and drug resistance change of Klebsiella pneumoniae in the Navy General Hospital during 2011‐2015 in order to provide reference for rational use of antibacterial agents in clinic .Methods The clinically isolated Klebsiella pneumoniae in this hospital during 2011‐2015 were selected and performed the analysis on the de‐tection rate ,department distribution ,specimens source ,resistance of antibacterial drugs and change trend of resistance to carbapen‐em antibacterial drugs .Results The number the detected Klebsiella pneumoniae strains and isolation rate during 2011 -2015 showed an increasing trend year by year ,the specimens sources were mainly from 10 departments of intensive care units(ICU) ,hy‐perbaric oxygen department ,respiratory department ,radiation oncology department ,kidney disease department ,etc .;the submitted specimens were dominated by sputum and urine ,accounting for 59 .7% and 21 .4% of submitted specimens ;the drug resistance of Klebsiella pneumoniae during 2011‐2015 showed the increasing trend year by year .Klebsiella pneumoniae had higher resistance rates to piperacillin ,ampicillin ,ampicillin/sulbactam and cefuroxime and had lower resistance rate to amikacin ,imipenem ,meropen‐em and tobramycin ;the resistance rates to imipenem and meropenem were increased year by year ,and pan‐drug resistant Klebsiella pneumoniae showed a rapidly rising trend .Conclusion The drug resistance of Klebsiella pneumonia is serious ,especially carbapene‐ms‐resistant Klebsiella pneumoniae is significantly increased in the recent years ,therefore its drug resistance monitoring should be strengthened for guiding rational drug use in clinic .

Objective To study the GPⅡb/Ⅲa gene mutations of eight glanzmann thrombasthenia(GT) pedigrees. Methods Responses of eight probands to different agonists were observed by platelet aggregation test and the amount of αⅡb and β3 was determined by flow cytometry. All the exons of Ⅱb and Ⅲ a genes were amplified by PCR followed by sequencing for mutational screening. Further analysis of the normal population excluded the possibility of mutational sites as a polymorphism. Results Eight probands showed normal PLT counts, dispersion of the platelet particles without aggregation, prolonged bleeding time and severely reduced platelet aggregation in response to the physiological agonists- ADP, epinephrine, and collagen, but relatively normal aggregation of PLT in response to ristocetin. Flow cytometry showed that all probande were Ⅰ type GT, except that proband 2 was Ⅲ type GT and proband 6 was Ⅱ type GT. The sequencing results showed that twelve different types mutations were present in eight probands, including GIOA, Gl412T, GII99A, 1525deiC, G2223T, C2671T, 2930delG, IVSI5 (-1) delG, A2334C, C1750T, 69-79del and CA70A. We were not able to detected any mutations in GP Ⅱb/Ⅲa gone on proband 3. Conclusions GT is mainly caused by GPⅡb/Ⅲa gene mutations. G10A, 69-79del, C470A,G1412T, G2223T, C2671T and 1525delC were the novel mutations causing GT.

Objective To identify the gene mutations of platelet membrane glycoprotein Ⅱ b,Ⅲa(GPⅡb/Ⅲa)in three Chinese pedigrees with Glanzmann thrombastIlenia.Methods All exons and exonintron boundaries of GP Ⅱ b/Ⅲ a gene were amplified by PCR analysis followed by DNA sequencing.DNA sequencing was used to exclude gene polymorphisms.Results The probands in the three pedigrees had a normal platelet count,coagulation profiles,scattered platelets on the blood film,a prolonged cutaneous bleeding time,and impaired or minimal ex vivo platelet aggregation in response to ADP,thrombin,collagen,adrenaline and arachidonic acid,but normal platelet aggregation in response to ristoeetin.Both FACS and Western blotting demonstrated trace content of αⅡb in the platelets from proband 1 and proband 3,who were classified as type Ⅰ GT,and a small amount of αⅡb in the platelets from proband 2,who was classified as type Ⅱ GT.Compound heterozygous mutations,T2255G(Leu721Arg)and C2671T(Gln860Stop)were identified in proband 1.The proband 2 had homozygous A2334C(Gln747Pro)missense mutation.Nonsense mutations C1750T (Arg584Stop)and 69-79 deletion mutation were identified in proband 3. Conclusions Compound heterozygous mutations T2255G and C2671T of αⅡb gene lead to type Ⅰ Glanzmann thrombasthenia for proband 1. Homozygous mutation A2334C of αⅡb gene leads to type Ⅱ Glanzmann thrombasthenia for proband 2. Compound heterozygous mutations C1750T and 69-79del αⅡb gene lead to type Ⅰ Glanzmann thrombasthenia for proband 3. T2255G,C1671T and 69-79del aye novel mutations for αⅡb gene.

Objective To investigate the effect of total flavonoid of Herba Pyrolae(TFHP) on the changes of ECG in rats with acute myocardial ischemia as well as the mechanism of the action.Methods Acute myocardial ischemic model was established by intravenous injection of pituitrin in rats,and ECG was recorded.Acute myocardial infarction model was established by the ligation of left descending coronary artery in rats,and serum level of nitric oxide(NO) and free fatty acid(FFA) was determined with spectrophotometrical method besides ECG.Results In comparison with the model controls,TFHP antagonized the decreased T wave by pituitrin and ligating coronary artery,and increased NO level and reduced FFA concentration in the serum of rats with acute myocardial ischemia.Conclusion TFHP protects the myocardium from ischemic injury possibly through increasing NO release and decreasing FFA production.

Objective To explore the effect of anti-retroviral therapy on interleukin(IL)-7/IL-7R in human immunodeficiency virus(HIV) infected patients in China.Methods Cases were divided into 2 groups:HIV-infected group (35 cases),and control group (30 cases).IL-7 in serum,IL-7R(CD127) expression in CD4 +T cells,and CD4 +T cells count were detected and compared between two groups before and after treatment for 1 year.Results IL-7 level in the serum of HIV infected group before treatment [(8.98 ±3.77) pg/ml] was significantly higher than that in control group [(3.84 ±0.86) pg/ml] (P ＜0.05).The counts of CD4+T cells [(202.65 ± 121.54)/μl],CD4 + CD127 + T cells [(60.25 ± 11.75) ％],and CD8 + CD127 + T cells [(46.27 ± 12.10)％] in HIV-infected group were significantly lower than those in control group [(766.99 ± 103.21)/L,(76.89 ± 20.01) ％,(81.27 ± 12.35)％] (P ＜0.05).After anti-retroviral therapy (ART),IL-7 level in the serum of HIV-infected group[(5.55 ± 1.35) pg/ml]was decreased,and CD4+T cells [(450.58 ± 15)/μl],CD4 + CD127 +T cells [(69.82 ± 15.24)％],and [CD8 + CD127 + T(59.23± 14.73) ％] cells was increased in HIV-infected group,with a significant difference between two groups (P ＜0.05).Conclusions ART could improve the IL-7 level in the serum and IL-7R(CD127)expression in CD4 +T cells of HIV-infected patients.However,they still cannot become normal level.

Objective To explore the efficacy and side effects of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients with different CD4+ cell counts.Methods The clinical data of HIV-infected patients who accepted TDF (tenofovir disoproxil fumarate) + 3TC (lamivudine) + EFV (efavirenz) treatment were retrospectively collected in Jiangmen region.All patients were divided into group A(350/μl ≤ CD4 + ＜ 500/μ1),group B (200/μl ≤ CD4 + ＜ 350/μl) and group C(CD4+ ＜ 200/μl)according to their CD4+ cell counts.The efficacy and side effects in different groups were compared.Results A total of 132 clinical cases was collected,including 32 cases in group A,42 cases in group B,and 58 cases in group C.No statistically difference was found among three groups in terms of gender,age,or route of transmission.CD4 + cell counts after treatment was significantly higher than that before treatment in each group (P ＜ 0.05).The increase of CD4 + cell counts in groups A,B,and C was 75.6 ± 52.1,80.5 ± 58.7,and 97.5 ± 78.7 after 6-month HAART,respectively ; and 71.4 ± 58.9,110.8 ± 71.6,and 113.7 ± 88.3 after 12-month HAART,respectively.Statistical analysis showed no significant difference among three groups (P ＞ 0.05).The incidence of side effects in groups A,B,and C was 4/32,14/42,and 32/58 in 3-month HAART,respectively; and 1/32,8/42,and 22/58 in 3 ～ 12 month HAART,respectively.Statistical analysis showed significant difference among three groups (group C ＞ group B ＞ group A,P ＜ 0.05).Conclusions It was effective to begin the anti-retroviral treatment in all stages.The incidence of side effects may be less if anti-retroviral treatment began in early period.

PURPOSE: Uridine-cytidine kinase (UCK) 2 is a rate-limiting enzyme involved in the salvage pathway of pyrimidine-nucleotide biosynthesis. Recent studies have shown that UCK2 is overexpressed in many types of cancer and may play a crucial role in activating antitumor prodrugs in human cancer cells. In the current study, we evaluated the potential prognostic value of UCK2 in breast cancer. METHODS: We searched public databases to explore associations between UCK2 gene expression and clinical parameters in patients with breast cancer. Gene set enrichment analysis (GSEA) was performed to identify biological pathways associated with UCK2 gene expression levels. Survival analyses were performed using 10 independent large-scale breast cancer microarray datasets. RESULTS: We found that UCK2 mRNA expression was elevated in breast cancer tissue compared with adjacent nontumorous tissue or breast tissue from healthy controls. High UCK2 levels were correlated with estrogen receptor negativity (p<0.001), advanced tumor grade (p<0.001), and poor tumor differentiation (p<0.001). GSEA revealed that UCK2-high breast cancers were enriched for gene sets associated with metastasis, progenitor-like phenotypes, and poor prognosis. Multivariable Cox proportional hazards regression analyses of microarray datasets verified that high UCK2 gene expression was associated with poor overall survival in a dose-response manner. The prognostic power of UCK2 was superior to that of TNM staging and comparable to that of multiple gene signatures. CONCLUSION: These findings suggest that UCK2 may be a promising prognostic biomarker for patients with breast cancer.
Biomarkers ; Breast Neoplasms* ; Breast* ; Dataset ; Estrogens ; Gene Expression ; Humans ; Neoplasm Metastasis ; Neoplasm Staging ; Phenotype ; Prodrugs ; Prognosis* ; RNA, Messenger ; Uridine Kinase*