In recent years, the incidence of pancreatic cancer shows rising trend and higher mortality. Pancreatic cancer lacks early diagnostic methods with high sensitivity and specificity, and the surgical resection rate is 10 %-20 % with high operation mortality, poor long-term curative effect and less than 5 %survival rate within 5 years. At present, researchers indicate that radiotherapy can improve the quality of life, increase tumor local control rate and prolong the overall survival time of patients with pancreatic cancer in different levels. Diffusion weighted imaging (DWI), as a functional imaging technology of magnetic resonance imaging (MRI), is the only way to react cell levels. This paper will summarize the application of DWI in radiotherapy of pancreatic cancer.

Adiponectin is recently described as an adipocyte secreting cytokine,which is abundant in human plasma,Adiponectin plays important roles not only in glucose and lipid metabolism but also in the development and progression of several obesity-related malignancies.Vascular formation is a key step in the cancer growth and metastasis.Current reserches find that the effect of adiponectin in cancer vascular growth still has great differenees.This review discusses the effect of adiponectin in malignant tumor neovascularization,and reveals that adiponectin can be a new vasoinhibitor.

Objective To study the changes of amplitude of low-frequency fluctuation (ALFF) of the resting state fMRI in heroin abuser (HD), and discussed its underlying neurophysiological mechanism.Methods The resting state fMRI data of 15 heroin abusers and 15 normal volunteers were analyzed by ALFF.The amplitude of the blood oxygenation level dependent activation of the resting state brain was investigated.The brain structures showing increased and decreased ALFF in TLE patients were demonstrated by comparing to normal subjects with 2-sample t -test with threshold of P＜0.05.Results Compared with normal subjects,the regions showing decreased ALFF in HD patients were distributed in right temporal lobe(45, - 30, -21 ) ,left hippocampus( - 36,- 33, - 6), right thalamus ( 24, - 12,27 ), left posterior cingulum gyrus ( - 15, - 54,24 ), right parietal lobe /precuneus ( 21, - 51,36 ), right inferior parietal lobule ( 21, - 48,78 ) and dorsal lateral aspect of the right frontal lobe(21, - 48,78) ,while ALLF of left(45, - 42,63 ) lateral frontal cortex(0 ,39,72) in HD patients was significantly higher.Conclusion HD shows abnormal brain functional organization in resting state, which may play an important role in the production, maintenance and relapse after withdrawal of heroin abuse.

Objective To explore how the severity of periventricular-intraventricular hemorrhage (PIVH)impact on physique and neurodevelopment in premature infants.Methods A total of 80 preterm infants with PIVH admitted to NICU of Qingdao Women and Children's Hospital from December 2013 to June 2015 were eligible.According to the Papile classification,the premature infants were divided into 4 groups.They were grade Ⅰ PIVH group,grade Ⅱ PIVH group,grade Ⅲ PIVH group and grade Ⅳ PIVH group.The infants with grade Ⅰ PIVH and grade Ⅱ PIVH belong to the low-grade PIVH group.The infants with grade Ⅲ PIVH and grade Ⅳ belong to the severe-grade PIVH group.All of them were regularly followed up for 12 months.Neurodevelopmental outcomes of infants at 6 and 12-month correction age were assessed by using the 20 items neuromotor assessment applying for 0-1 year old and the Bayley scales of infant development-Ⅱ.The differences in physical and neurophysical development of premature infants among 4 groups were compared.Results There were no significant differences in physical growth indicators such as body weight,body length and the incidence of weight growth retardation among 4 groups (all P＞0.05).The incidence of neurobehavioral abnormalities in infants with grade Ⅲ-Ⅳ PIVH was significantly higher than that of infants with grade Ⅰ-Ⅱ PIVH at 12-month correction age (21.05％ vs 3.28％,x2 =4.284,P=0.038).Physical development index(PDI) of grade Ⅰ-Ⅱ PIVH infants was significantly higher than that of grade Ⅲ-Ⅳ PIVH infants at 6-month correction age(F=11.500,P＜0.05).At 12-month correction age,grade Ⅰ-Ⅱ PIVH infants showed a significant higher mental development index(MDI) scores and PDI scores than those of grade Ⅲ-Ⅳ PIVH infants(F=14.227,16.515,all P＜0.05).Of the 80 cases assessed,infants with grade Ⅲ-Ⅳ PIVH had significantly higher rates of cerebral palsy(21.05％ vs 1.64％,x2 =6.300,P=0.012) and developmental delay (26.32％ vs 4.92％,x2=5.185,P=0.023) compared with grade Ⅰ-Ⅱ PIVH infants.Conclusions The severe PIVH can have negative effect on the neurodevelopmental outcomes of preterm infants and might induce mental retardation,cerebral palsy and other neurodevelopmental disabilities.Therefore,the regular follow-up and early intervention in preterm infants with PIVH should be implemented to improve the quality of their lives.

Objective To investigate pulmonary function of tidal respiration in late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term. Methods A total of 26 late premature infants with non-mechanical ventilation treatment at corrected gestational age of full term were collected from Qingdao Women and Children′s Hospital between April and December 2013,and saved as the late premature infant group. Also, a total of 31 full term infants with hyperbilirubinemia or neonatal ABO hemolytic disease were recruited and treated as the full term group. Then the parameters of pulmonary func-tion of tidal respiration were compared between the two groups. The late premature infant group was equally allocated into extrauterine growth retardation and non-extrauterine growth retardation groups according to the increase in weight and the ratio of time to peak tidal expiratory flow and total expiratory time(TPEF/TE) and the ratio of expiratory volume at peak tidal expiratory flow and total expiratory volume( VPEF/VE) were respectively compared in these two groups. Another correlation analysis between body weight and TPEF/TE was carried out in the non-extrauterine growth retardation group. Results (1)Gestational age difference had no significant significance between late premature infant group and full term group ( P <0. 05 ) . The body weight[(2. 39 ± 0. 44)kg vs. (3. 21 ± 0. 43) kg] and height[(46. 51 ± 3. 22) cm vs. (50. 16 ± 2. 14) cm] in late premature infant group were still lag behind that in full term group and the difference had significant significance(P<0. 05,respectively). (2)The comparison of parameters of pulmonary function of tidal respi-ration:the TPEF/TE [ ( 41. 74 ± 10. 94 )% vs. ( 48. 17 ± 11. 79 )%] , VPEF/VE [ ( 42. 66 ± 9. 66 )% vs. (48. 31 ± 9. 94)%],VPEF[(8. 02 ± 2. 85) ml vs. (10. 23 ± 3. 56) ml] and minute ventilation[(0. 76 ± 0. 23) L/min vs. (1. 00 ± 0. 44) L/min] in late premature infant group were significantly lower than those in full term group(P<0. 05,respectively). (3)The TPEF/TE and VPEF/VE all had significant significance in both late premature infant group and full term group(late premature infant group:r=0. 958,P=0. 000; full term group:r=0. 950,P=0. 000). (4)The TPEF/TE and VPEF/VE in non-extrauterine growth retardation group were closer to those in full term group. The TPEF/TE and VPEF/VE in extrauterine growth retardation group were lower than those in non-extrauterine growth retardation group(t= -2. 775,-2. 109,P=0. 011, 0. 047). Conclusion Airway(especially small airway) resistance of late preterm infant group is higher than that of term infants. Extrauterine growth retardation influences the airway(especially small airway) resist-ance.

Objective To investigate pulmonary function in terms of tidal respiration and the influencing factors on it in ＜ 34 weeks premature infants with RDS at corrected gestational age of 40 weeks.Methods A total of 49 of ＜ 34 weeks premature infants with RDS (RDS group) and 36 of ＜ 34 weeks premature infants without RDS (non-RDS group) followed throughout entire twelve months were collected fromn December 2013 to October 2015.Of them,35 RDS patients and 20 non-RDS patients had the pulmonary function examination.A total of 26 full term infants with hyperbilirubinemia (full term group) were recruited for comparison study.The differences in parameters of tidal respiration were compared among the three groups.The RDS patients were further divided into the mild RDS subgroup and severe RDS subgroup according to the severity of illness.Result ①The TPEF [(0.17 ± 0.04) s vs.(0.23 ± O.09) s],VPEF [(6.74±2.70) mLvs.(9.33±2.92) mL],TPEF/TE [(29.06±4.21)％ vs.(38.27± 7.16) ％],VPEF/VE [(32.54 ± 4.43) ％ vs.(39.64 ± 5.88) ％] in RDS group were significantly lower than those in full term group (P ＜0.05).The TPEF [(0.19 ±0.06) s vs.(0.23 ±0.09) s],TPEF/TE [(30.31 ±11.53)％ vs.(38.27±7.16)％],VPEF/VE [(34.39±8.44)％ vs.(39.64±5.88)％] in non-RDS group were significantly lower than those in full termn group (P ＜ 0.05).The TPEF,TPEF/TE,VPEF/VE in RDS group were lower than those in non-RDS group,but the differences were not significant (P ＞ 0.05).②The TPEF,VPEF,TPEF/TE,VPEF/VE in mild RDS group were higher than those in severe RDS group,but the differences were.not significant (P ＞ 0.05).③ Logistic regression analysis indicated that the gestational age was the protective factor of pulmonary function in premature infants with RDS.Conclusions Small airway resistance in ＜ 34 weeks premature infants with RDS is higher than that in full term infants.There was no significant difference in pulmonary function between RDS premature infants and non-RDS premature infants.The gestational age was the influencing factor of pulmonary function in premature infants with RDS.

Objective:To investigate the effect of exposure to histological chorioamnionitis(HCA) on premature infants with respiratory distress syndrome(RDS)complicated with bronchopulmonary dysplasia(BPD).Methods:The clinical data of premature infants with gestational age<32 weeks and survival>14 days who were born in the department of obstetrics and admitted into NICU at Qingdao Women and Children′s Hospital from January 2018 to December 2020 were collected.According to placental pathology, they were divided into positive HCA + positive RDS group(observation group)and negative HCA + positive RDS group(control group). T-test, rank sum test and χ2 test were used to analyze the occurrence and clinical characteristics of BPD between the two groups.For premature infants with positive HCA who were diagnosed as BPD, Spearman rank correlation was used to analyze the correlation between HCA stage and BPD severity. Results:There were a total of 162 premature infants with RDS.The average gestational age at birth was 29.29(28.29, 30.43) weeks, and the average birth weight was 1.32(1.13, 1.55)kg; the incidence of BPD was 69.8%(113/162), and the mortality rate of BPD was 2.7%(3/113). There were 114 cases in the observation group and 48 cases in the control group.The incidence of BPD in the observation group was 76.3%(87/114), which was higher than that in the control group(54.2%, 26/48), and the difference was statistically significant( P<0.05). Further study of 87 premature infants with positive HCA who were diagnosed as BPD showed that, the correlation between the stage of HCA and the severity of BPD had not been confirmed( rs=0.062, P=0.571). Serum C-reactive protein before the mother used antibiotics and procalcitonin on the first day after birth in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). Among 113 premature infants with RDS who were diagnosed as BPD, the time of antibiotic use, length of stay in intensive care unit and hospitalization cost in positive HCA group were higher than those in negative HCA group, and the differences were statistically significant( P<0.05). Conclusion:HCA exposure will increase the risk of BPD in premature infants with RDS.In addition, HCA also increases the intake period of antibiotics, length of stay and cost of intensive care unit in premature infants with BPD.

Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years (6.5 ± 1.5 months). MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal invasion are critical for the operation safety.

Objective To explore the abnormalities in the posterior cingulated cortex structure by voxel based morphometry(VBM)and changes of functional connectivity by resting-state functional magnetic resonance imaging(fMRI)in long-term heroin addictions.Methods High-resolution volumetric T1-weighted images and resting state fMRI examination were performed on 13 long-term heroin addicts and 14 matched healthy volunteers.The T1-weighted images were processed using optimized voxel-based morphometry to investigate abnormalities in the gray matter,at the sarne time,the posterior cingulated cortex was setted as the region-of-interest(ROI)seed,with which a whole-brain voxel temporal correlation in low frequency fMRI fluctuations was calculated,to find changes of the posterior cingulated cortex functional connectivity.Results Compared with the control group,gray matter concentration significantly decreased in the posterior cingnlated cortex,at the same time,the functional connectivity between the left posterior cingulated cortex and the right temporal lobe was increased,but the functional connectivity between the left posterior eingulated cortex and the left thalamus,the left parietal lobe,the left cerebrum were all decreased in heroin addicts.At the same time,the functional connectivity between the fight posterior cingulated cortex and the left thalamus,the left parietal lobe,the left frontal lobe were decreased in heroin addicts(t testing,P<0.01).Conclusion The structure and the functional connectivity in posterior cingulated cortex in long-term heroin addicts are changed,which may affect the dysfunction of the addictive brain and the function of reward mechanism.

In order to affirm the cardioactive components in Fuzi, we identified a group of aminoalcohol- diterpenoid alkaloids in Fuzi using ultra high-performance liquid chromatography coupled with electrospray ionization mass spectrometer (UPLC-ESI-MS) method. Among a total of forty-one isolated ingredients, thirteen major aminoalcohol-diterpenoid alkaloids were identified by comparing their retention times and MS spectra with those of the reference substances. Moreover, Fuzi samples from different places of origin and with different processing methods were examined and their components displayed a pattern of high similarity, though the relative abundance varies probably due to their different processing methods. Furthermore, the cardiac effect of each identified alkaloid was individually evaluated using the isolated bullfrog heart perfusion experiment. Among the thirteen aminoalcohol diterpenoid alkaloids tested, six of them significantly enhanced the amplitude rates. Taken together, we affirm that the cardioactive components in Fuzi are aminoalcohol-diterpenoid alkaloids, shedding light on future studies of the mechanisms and development of these cardioactive compounds.