bution probability varied for metastasis of different location. Conclusion WB-DWI was a sensitive method for screening bone metastasis.

Objective To explore the relationship between interleukin-18 (IL-18) and cardiovascular risk factors in patients with systemic lupus erythematosus (SLE),and between SLE and early atherosclerosis.Method A total of 59 female patients with SLE were divided into three groups according to the level of IL-18:＜2× 107g/L (A group,19 cases),2.0-3.2 × 107 g/L (B group,22 cases),≥ 3.2 × 107 g/L (C group,18 cases).The cardiovascular risk factors including body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting insulin and glucose,plasma glucose,plasma lipid,brachial-ankle pulse wave velocity(baPWV) and plasma homocysteine (Hcy) were determined in all patients.Result Plasma levels of insulin,triglyceride,homocysteine and values of homeostasis model assessment insulin resistance (HOMA IR) in SLE patients with IL-18 ≥3.2×107 g/L were significant higher than patients with IL-1＜2× 107 g/L or 2-3.2 × 107 g/L (F =15.61,4.06,11.18,8.49;P ＜ 0.01 or P ＜ 0.05).About 72.88％ patient had hyperhomocysteinaemia which lead to significantly increase the level of IL-18 (P＜0.05).The level of IL-18 of patients in A,B and C groups were (208.75 ± 23.21),(261.20± 17.82) and (339.05 ± 32.54),and it increased significantly as IL-18 increase (P＜0.05).The level of IL-18 was increased as risk factors of SLE including baPWV,level of insulin and IR increased (P =0.019,0.002,0.000).Conclusion The synergistic effects of hyperinsulinaemia,insulin resistance,hyperhomocysteinaemia and vascular stiffness most likely contribute to the elevation of plasma IL-18 concentrations in patients with SLE.

98% amino acid identity.There are 28 different amino acids between them,with 7 of which locating in the region encoded by exon6A or exon6.Alternative splicing of exon18 was not found in the gene cloning of human brain Nav1.5/SCN5A,which was different from human heart Nav1.5/SCN5A,but a novel alternative splicing lacking exon24 was first found.The two variants were detected in similar ratio in brain,but they were proved to relate to age development in heart tissue.The exon24 of human Nav1.5/SCN5A has 54 nucleotides,encoding 30 amino acid residues,and are located in human chromosome 3P21.This alternative splicing was also found in other tissues other than heart and brain.The expression pattern of the two variants in different tissues was different when detected by competitive PCR method and it was also changing with age development.Furthermore,Nav1.5/SCN5A mRNA was detected in 16 different tissue types of Wistar rats(P80) by reverse polymerase chain reaction(RT-PCR) .These results suggest that Nav1.5 Na+ channels in human brain are encoded by new variants of Nav1.5/SCN5A and its mRAN is more widely expressed than previously thought.The study is useful for making further investigation in the functional analysis of Nav1.5 Na+ channels in different tissues.

Laparoscopic cholecystectomy is the gold standard for the treatment of gallstones and chronic cholecystitis.A patient with gallstone was admitted to the 88th Hospital of PLA in August 2012 and received laparoscopic cholecystectomy.She had bile leakage after operation,and had to accept reoperation.Pancreaticobiliary maljunction and aberrant duct upon gallbladder bed were found postoperatively by T-tube cholangiography and pancreatic amylase test in the bile,which led to a complicated treatment and a tortuous recovery.This article analyzed the treatment process for this disease and explore the proper diagnosis and treatment.

Objective To evaluate MRI characteristics of solid papillary carcinomas (SPCs) in situ of the breast.Methods A retrospective study included 5 patients with pathologically confirmed SPC in situ was performed.MRI data before operation including conventional MRI,dynamic contrast enhanced MRI (DCE-MRI) and DWI were analyzed.Results All the lesions showed iso/hypointensity on T1 FSPGR sequence,iso/hyperintensity on FSE T2WI sequence and STIR sequence.Mass enhancements were observed for all lesions with oval or irregular shapes on DCE-MRI.The margin of lesions were circumscribed,and internal enhancements were homogeneous or heterogeneous.Time intensity curve appeared a rapid increase in initial contrast phases and platform or outflow types in delayed phases.All the lesions on DWI showed slightly hyperintensity with the ADC value range from 1.34 × 10-3 mm2/s to 1.96)× 10-3 mm2/s.Conclusion MRI manifestations of SPC are characteristics,which may provide valuable information to distinguish SPC in situ from other invasive breast carcinomas.

Objective To evaluate MR diffusion-weighted imaging (DWI)and MR perfusion-weighted imaging(PWI) in differentiating benign from malignant soft tissue tumors by comparing the related parameters. Methods Fifty patients with soft tissue tumors verified by pathology( benign 24, malignant 26) underwent DWI and dynamic contrast-enhanced T2 * -weighted PWI. DWI and PWI data of benign and malignant soft tissue tumors were acquired at the workstation and their difference was analyzed with t-test. The diagnostic accordance rate was verified with x2-test. Subjective overall performance of two techniques were evaluated with receiver operating characteristic (ROC) analysis. Results ADC values of benign and malignant tumors were (2. 03±0. 36) × 10-3 mm2/s, ( 1.52±0. 39) × 10-3 mm2/s,respectively. The signal intensity decrease of them during the first-pass perfusion (SIdecrease ) were ( 13.54 ± 3.37 )%, (47. 57 ± 5. 21 ) % ,respectively. The maximum linearity slope rate of TIC ( SSmax ) of them were ( 5.51 ± 2. 54 ) %, (7.94 ± 3. 33) %, respectively. There were significant differences between benign and malignant tumors of ADC value and SIdecrease ( t = 2. 515,2. 938 ;P < 0. 05 ), while there was no significant difference in SSmax (t = 1. 272,P >0. 05). When the threshold of ADC value was 1. 866 × mm2/s, sensitivity and specificity for determining malignant tumors were 84. 6% (22/26)and 83.3% (20/24). When the threshold of SIdecrease was 40. 33% ,sensitivity and specificity for determining malignant tumors were 88. 5% (23/26)and 75.0% (18/24). In type Ⅰa of TIC,the proportion of benign soft tissue tumor was 3/24 and malignant tumor was 20/26. In type Ⅰb , benign tumor was 14/24 and malignant tumor was 3/26. In type Ⅰc, malignant tumor was 3/26. In type Ⅱ ,benign tumor was 7/24. The diagnostic accordance rate of DWI and PWI were 84. 0% (42/50) and 82. 0% (41/50), respectively. There was no significant difference between them ( x2 = 0. 8, P >0. 05). The accuracies of them were 81.7% , 83. 6% respectively by the area under the ROC curve (AUC). The sensitivity of PWI in diagnosing malignant soft tissue tumors was higher. Conclusions ADC value and SIdecrease are Valllable diagnostic parameters in differentiating benign and malignant soft tissue tumors. The threshold of these parameters for diagnosing malignant soft tissue tumors are 1. 866 × 10-3 mm2/s and 40. 33%, respectively. The type of TIC can help to distinguish malignant tumors from benign tumors, while the SSmax can not. The accuracies of DWI and PWI in the diagnosis of malignant soft tissue tumors are moderate. Compared with DWI, PWI should be selected firstly because of its higher sensitivity in diagnosing malignant tumors.

Objective To evaluate multiple magnetic resonance (MR) imaging techniques in the differentiation of benign and malignant soft tissue tumors by comparing different information from MR perfusion-weighted Imaging (MR-PWI) and 1 HMR spectroscopy (1 H-MRS).Methods Forty patients with soft tissue tumors underwent conventional MR imaging,dynamic contrast-enhanced T2*-weighted MR-PWI and 1 H proton MR spectroscopy.The differences of perfusion and 1 H-MRS parameters of benign and malignant tumors were analyzed with t test.Results There was significant difference between benign and malignant tumoral tissues of BF value and Cho/Cr ratio(t=2.531,2.927,P < 0.05),while BV,MTT,Cho,Cr or Lip peak value were not.TIC was different between benign group (Ib) and malignant group (Ia).When the threshold value of BF was 4.35 ml ·100 mg-1·min-1,sensitivity and specificity for determining malignant tumors were 81.8%(18/22),72.2%(13/18),respectively.When the threshold value of Cho/Cr ratio was 3.22,Sensitivity and specificity for determining malignant tumors were 86.4% (19/22),88.9% (16/18),respectively.The abnormal wave crest is detected at 2.0-2.1ppm in 5 malignant tumors (2 malignant schwannoma and 3 malignant fibrous histiocytoma),while the other 35 cases were not.Conclusion The BF value and Cho/Cr ratio were both valuable diagnostic parameters in differentiating benign and malignant soft tissue tumors.TIC was helpful to distinguish malignant tumors from benign tumors,while the sensitivity and specificity of 1 H-MRS in diagnosing malignant soft tissue tumors were both higher.

Objective To investigate the value of kinetic features measured by computer-aided diagnosis (CAD)for breast MRI.Methods One hundred and sixty four lesions diagnosed pathologically by operation or biopsy comprised the analysis set.Automated lesion kinetic information from CADStream programs for breast MRI was identified.Three CAD variables were compared for benign and malignant lesions: initial phase peak enhancement (greatest percentage of signal intensity increase on first contrast enhanced sequence),delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent),and delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent).Morphological characteristics of breast lesions were described according to breast imaging and reporting data system (BI-RADS).Initial phase peak enhancement mean values between benign and malignant breast lesions were compared by using Wilcoxon rank-sum test,delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement or by single most suspicious type of kinetics between benign and malignant breast lesions were compared by using Chi-square test.Results There were 72 benign and 92 malignant breast lesions.A total of 123 (75.0％) mass lesions were identified,and the other 41 (25.0％) lesions showed no mass.Thirty lesions were BI-RADS-MRI 2,68 lesions were BI-RADS-MRI 3,43 lesions were BI-RADS-MRI 4,23 lesions were BI-RADS-MRI 5.Initial phase peak enhancement mean values of benign and malignant lesions were 237％ (69％ to 629％)and 336％ (86％ to 793％),respectively.There was no significant difference between benign and malignant lesions in initial peak enhancement mean value (Z =-1.626,P =0.104).Delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent) for benign and malignant lesions were 15,10,47 and 2,3,87 respectively.There was a significant difference between benign and malignant lesions (x2 =23.562,P =0.000).Initial peak enhancement value ＜ 100％ or ≥100％ were 5 and 67 for benign lesions,3 and 89 for malignant lesions,respectively.There was no significant difference between benign and malignant lesions at 100％ threshold (x2 =1.181,P =0.277).Delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent) for benign and malignant lesions were 48,6,18 and 47,15,30 respectively.There was no significant difference between benign and malignant lesions (x2 =4.496,P =0.106).Conclusions Of CAD kinetics analyzed,only delayed enhancement categorized by most suspicious type is helpful for the differentiation between benign and malignant lesions.However,there is significant overlap between initial peak enhancement at 100％ threshold or delayed kinetics categorized by largest percentage enhancement types of benign and malignant lesions,so lesion morphologic features should be considered.

Objective To study the effect of UHRF1 expression inhibition by RNA interference on the radiosensitivity of esophageal cancer cell line TE-1 and its mechanism.Methods Short hairpin RNA (shRNA) targeting UHRF1 gene was introduced into TE-1 cells by lentivector-mediated transfer.The cells were divided into three groups:non-transfected group,negative control (NC)-shRNA-transfected group,and UHRF1-shRNA-transfected group.The mRNA and protein expression levels of UHRF1 in TE-1 cells were measured by RT-PCR and Western blot before and after transfection.After transfection and X-ray radiation,the radiosensitivity of TE-1 cells was evaluated by colony formation assay; the cell cycle and cell apoptosis were determined by flow cytometry; the γ-H2AX (as a marker of DNA damage) level was measured by Western blot.Results After transfection with UHRF1-shRNA,the mRNA and protein expression levels of UHRF1 were significantly decreased in TE-1 cells,as compared with those in the NC-shRNA-transfected group and non-transfected group (0.11 vs 0.96 and 0.98,F =124.21,P =0.000;0.10 vs 0.89 and 0.94,F =125.25,P =0.000).The UHRF1-shRNA-transfected group had sensitization enhancement ratios of 1.53 (D0 ratio) and 1.95 (Dq ratio).X-ray radiation could cause G2/M arrest and increase apoptotic rate and γ-H2AX expression in TE-1 cells.Compared with the two control groups,the UHRF1-shRNA-transfected group showed significantly less G2/M arrest (F =500.15,P =0.000),a significantly higher apoptotic rate (F =100.10,P =0.000),and significantly higher residual γ-H2AX expression (F =61.00,P =0.000) at 24 hours after X-ray radiation.Conclusions RNA interference can effectively inhibit the UHRF1 expression and enhance the radiosensitivity of TE-1 cells.The mechanism may be related to cell cycle regulation,cell apoptosis,and DNA damage repair.

Objective To investigate the correlations of serum eukaryotic translation promoter 2α (eIF2α) and activated transcription factor 4 (ATF4) levels with the degree of renal tissue injury and renal function in patients with diabetic nephropathy (DN). Methods A total of 102 patients with DN (DN group) and 102 patients with simple diabetes (control group) were selected. According to the severe degree of renal tissue damage, the patients with DN were divided into microalbuminuria group (MG group, 35 cases) and dominant albuminuria group (PG group, 41 cases) and renal dysfunction group (RIG group, 26 cases). Serum levels of eIF2α, ATF4, urea nitrogen (BUN), creatinine (Scr), cystatin C (CysC) and estimated glomerular filtration rate (eGFR) were measured. Pearson correlation analysis was used to explore the correlations of eIF2α and ATF4 with BUN, Scr, CysC and eGFR; multivariate Logistic regression analysis was used to explore the risk factors of DN; receiver operating characteristic (ROC) curve was used to analyze the value of eIF2α and ATF4 in diagnostic of DN. Results Serum levels of eIF2α, ATF4, BUN, Scr and CysC in the DN group were higher than those in control group, eGFR was lower than that in control group (P < 0.05). Serum eIF2α and ATF4levels in the RIG group were higher than those in PG and MG groups (P < 0.05). Serum eIF2α and ATF4 levels in DN patients were positively correlated with BUN, Scr and CysC, and negatively correlated with eGFR (P < 0.05). Long duration of diabetes, higher body mass index, high level of eIF2α and high level of ATF4 were risk factors for DN (P < 0.05). The area under the curve of eIF2α and ATF4 in diagnosis DN was 0.770 and 0.799, respectively, and the area under the curve of their combined diagnosis was 0.879, which was higher than that of single diagnosis (P < 0.05). Conclusion Serum levels of eIF2α and ATF4 are increased in patients with DN, which is related to the severity of renal injury and renal dysfunction in DN. The combination of eIF2α and ATF4 is of high value in the diagnosis of DN.