Objective To evaluate the predictive value of diffusion weighted imaging ( DWI) for progres-sion free survival(PFS)in patients with cervix cancer after neoadjuvant chemotherapy (NACT).Methods Thirty two consecutive patients with pathologically confirmed cervical cancer underwent MRI including DWI before and after NACT.Pathologic results and MR images were reviewed .Univariate analysis was applied by Kaplan -Meier method.The Cox proportional hazard model was used to evaluate prognostic variables for multivariate analysis .Re-ceiver operating characteristic ( ROC) curves were used to find optimal cutoff values of independent prognostic fac -tors for disease progression.Results Of 32 patients,10 had disease progression during follow -up period.In uni-variate analysis,FIGO stage,tumor size,the depth of tumor invasion,lymph node metastasis and ADC changes be-tween before and after neoadjuvant chemotherapy (ΔADC) were significantly associated with the disease progres-sion.In multivariate analysis , FIGO stage and ΔADC were the independent prognostic factors for PFS .Optimal cutoff values that determined by ROC curves analyses were FIGO stage ⅡandΔADC 0.31.Area under the ROC curve(AUC)of FIGO stage and ΔADC were 0.841(sensitivity 90.0%,specificity 68.2%)and 0.864(sensitivity 80.0%,specificity 81.8%),respectively.Conclusion In patients with cervix cancer after NACT ,FIGO stage andΔADC are significant predictive values for PFS .

Objective To investigate the effects of matrix metalloproteinase-3 (MMP-3) in the development of neuropathic pain (NP) in rats.Methods One hundred and eighty male Wistar rats weighing 200-250 g were randomly divided into 4 groups (n =45 each):sham operation group (S group),NP group,MMP-3-siRNA group (Msi group) and MMP-3-siRNA negative control group (NC group).NP was induced by ligation of L5 spinal nerve (SNL).Lentivirus with MMP-3-siRNA was injected intrathecally after SNL in group Msi.Lentivirus with NC-siRNA was injected intrathecally after SNL in group NC.The mechanical pain threshold was measured at day 7,14 and 21 after SNL.The rats were then sacrificed after the last measurement of the mechanical pain threshold.The lumbar segment of the spinal cord (L4-6) was removed for determination of the expression of MMP-3 and TNF-a protein and mRNA by RT-PCR and Western blot.Results The mechanical pain threshold was significantly decreased and the expression of MMP-3 and TNF-α protein and mRNA was up-regulated at each time point in groups NP and NC as compared with group S (P ＜ 0.05).The mechanical pain threshold was significantly higher and the expression of MMP-3 and TNF-α protein and mRNA was lower at each time point in Msi group than in NP group (P ＜ 0.05).Conclusion Up-regulation of the expression of MMP-3 activates microglia and induces the release of TNF-α,resulting in NP in rats.

Objective To study the effect of different doses of Zhengan xifeng decoction on Raf-1 mRNA and protein expression in the cardiovascular tissue of spontaneously hypertensive rats( SHR). Methods A total of 50 male SHR,24 weeks old,were randomly divided into the model,low dose,medium dose,high dose of Zhengan xifeng decoction and the compound apocynum groups,10 in each group. Ten homologous male rats( WKY)served as the normal control group. After gavaged for 5 weeks,western blotting and RT-PCR were used to detect the Raf-1 protein and mRNA expression in the cardiovascular tissue,respectively. Results Compared with the model control group,both Raf-1 protein and mRNA expressions significantly increased in all treatment groups( P〈0. 01 ). Conclusion The Zhengan xifeng decoction can stimulate cell proliferation and inhibit cell apoptosis by up-regulating the expression of Raf-1.

Objective To investigate changes and the significance of Th17/Treg immune imbalance in secondary systemic infection in patients with severeacute pancreatitis.Methods We selected 21 patients with severe acute pancreatitis and secondary systemic infection (infection group),25 patients with severe alone (non-infection group),20 healthy cases undergoing annual health checkup (control group) in this study.The expression levels of Th17/Treg cells and related cytokines were compared between groups.Results There were significant differences in mortality rate and duration of ICU stay between infection group and non-infection group [23.8％ vs.4.0％,(11.3±3.4) d vs.(7.5±2.8) d,x2=3.949,t=2.890,P=0.047 and0.045].The percentages of Th17 cell andTreg cell,Th17/Treg ratio,mRNA expressions of IL-6,IL-17,IL-23,TGF-β and orphan receptor γt were higher in infection and non infection groups than in control group [(26.4 ± 1.2) ％,(12.8 ± 0.9)％ vs.(3.1±0.8) ％;(6.7±1.6)％,(4.2±1.3)％ vs.(1.3±0.4)％;(4.3±1.0)％,(3.2±1.1)％ vs.(2.4±0.9)％;(7.1±0.8)ng/L,(5.3±0.7)ng/L vs.(0.2±0.1)ng/L;(22.9±2.4)ng/L,(15.6±2.8)ng/L vs.(10.3± 1.5)ng/L;(15.7±2.1)ng/L,(10.2± 1.5)ng/L vs.(8.3± 1.4)ng/L;(23.6±2.2)ng/L,(16.3±1.7)ng/L vs.(11.6±1.1)ng/L;(0.052±0.014),(0.035± 0.010) vs.(0.004±0.001);F=15.761,55.745,9.437,102.788,21.038,16.239,36.957,23.924,respectively,P=0.555,0.000,0.014,0.000,0.002,0.004,0.000,0.000].The mRNA expressions of IL-10 and Foxp3-T were lower in infection and non-infection groups than in control group [(6.4±1.1)ng/L,(10.5 ± 2.1) ng/L vs.(15.4±2.0)ng/L;(0.005±0.001),(0.020±0.007) vs.(0.032±0.009),F=18.995 and 20.608,P=0.003 and 0.002].Conclusions The secondary infection can aggravate the Th17 / Treg immune imbalance in patients with severe acute pancreatitis,and extend the ICU hospitalization days.

Objective: To investigate the inhibition of tanshinoneⅡA (TanⅡA) on the proliferation of lung cancer cells. Methods: Human lung cancer cell lines A549, SK-MES-1, H446 and H460 were cultured in vitro and treated with TanⅡA at concentrations of 0.3, 0.6, 1.3, 2.5, 5.0, 10.0 mg/mL, while untreated cells served as controls. Cell proliferation was measured by using CCK-8 assay, and apoptosis was measured using flow cytometry, while the expression of apoptosis-related proteins was determined using Western blotting. The apoptotic rate of lung cancer cells was compared between Tan ⅡA-treated cells and untreated cells. Results: Tan ⅡA inhibited lung cancer cell proliferation in a time-dependent and concentration-dependent manner, and the survival rates of A549, SK-MS-1, H446 and H460 cells reduced with the concentration of TanⅡA (t=4.503, 2.114, 2.103 and 3.567; all P<0.05) and the duration of TanⅡA treatment (t=5.189, 3.079, 3.023 and 3.845; all P<0.05). The 48 h half maximal inhibitory concentrations (IC50 values) of TanⅡA were (1.18±0.12), (0.78±0.08), (1.55±0.16) and (1.27±0.14) mg/mL against A549, SK-MES-1, H446 and H460 cells, respectively. Following 48 h treatment with Tan ⅡA at a concentration of 2.5 mg/mL, the apoptotic rates of A549, SK-MS-1, H446 and H460 cells were (34.97±3.78)%, (37.62±2.48)%, (18.27±2.98)% and (19.17±2.30)%, which were significantly significantly higher than those of untreated cells [(4.86±0.36) %, (3.21±0.48) %, (3.25±0.26)% and (2.66±0.19)%, all P<0.05]. Reduced Akt1 protein expression, elevated Bax/Bcl-2 expression ratio, and elevated caspase-9 and caspase-3 protein expression were detected in lung cancer cells treated with 2.5 mg/mL TanⅡA for 48 h relative to untreated cells Conclusion TanⅡA may inhibit lung cancer cell proliferation in a time- and concentration-dependent manner via the Bax/Bcl-2/caspase-9/caspase-3 pathway.

Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space (DIS) of patients with acid-induced non erosive reflux disease (NERD).Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring),acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space (ICS) of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were (2 998±701) Ω vs (3 880±1 054) Ω and (30.1±14.0) Ω/min vs (53.0±14.5) Ω/min,and the differences were statistically significant (t=3.65,5.41;both P＜0.01).Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider (1.03 ± 0.20) μm vs (0.66±0.14) μm,and the difference was statistically significant (t=-6.57,P＜0.01).Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were (2 755±680) Ωvs (3 411±536) Ω and (25.4±13.0) Ω minvs (33.4±9.8) Ω /min,and the differences were statistically significant (t =2.99,2.03;both P＜0.05).The correlation between impedance recovery rate and ICS was negative (r=-0.70,P＜0.01).Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impedance baseline to a certain extent reflected the degree of esophageal mucosal integrity impairment.

Objective To evaluate the effects of unilastatin on brain injury in children undergoing aortic arch surgery under cardiopulmonary bypass (CPB).Methods Twenty ASA physical status Ⅲ or Ⅳ children of both sexes,aged 1-24 months,weighing 3-12 kg,undergoing repair of coarctation of aorta or interrupted aortic arch complicated with intracardiac malformations under CPB,were randomly divided into 2 groups (n =10 each):control group (group C) and ulinastatin group (group U).Ulinastatin 20 000 U/kg was diluted into 10 000 U/ml with normal saline and it was then injected intravenously in 3 parts (1/3 was injected via the internal jugular vein after induction of anesthesia; 1/3 at the beginning of CPB and 1/3 at 5 min before aortic unclamping).In group C the equal volume of normal saline was given instead of ulinastatin.Blood samples were taken from the radial artery after induction of anesthesia (T1),at 10 min after aortic clamping (T2),at 10 min after aortic unclamping (T3),at the end of CPB (T4),and at 6 and 24 h after termination of CPB (T5,T6) for determination of plasma S100B protein and neuron-specific enolase (NSE) concentrations.Results There was no significant difference in plasma levels of S100B protein and NSE at T1 between the two groups (P ＞ 0.05).Plasma S100B protein and NSE levels were significantly increased at T2-5 as compared to the baseline values at T1 in both groups (P ＜ 0.05).Plasma S100B protein and NSE levels were significantly lower at T2-5 in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin can attenuate brain injury in children undergoing aortic arch surgery under CPB.

Purpose　To investigate the significance of tumor suppressor gene p15 and p16 expression in soft tissue leiomyosarcoma(LMS) and leiomyoma(LM). Methods　Expressions of p15 and p16 was studied in 38 cases of LMS and 20 LM with immunohistochemical method. Results　The abnormal expression rates of p15 and p16 in LMS were 18.4% and 42.1% respectively, and were significantly different. p15 abnormal expression rate in LM was 60%, significantly higher than in LMS. The total abnormal expression rate of p15 and p16 was 52.6% in LMS studied. Grade Ⅰ tumor had the significantly higher abnormal expression rate than that of grade Ⅱ or Ⅲ tumor. Fifteen cases of LMS were followed. The abnormal expression rate of p15 and p16 in recurrent group was 75%, significantly higher than that in non recurrent group. Conclusions　Loss of expression of p16 protein is more frequent in LMS than that of p15, whereas deletion of p15 protein is more frequent in LM than in LMS. Loss of functions of p15 together with p16 participates in the tumorigenesis and progression of LMS, and is correlated with pathologic grading and prognosis of LMS.

Objective To analyze the influential factors of clinical pregnancy rate of the frozen-thawed embryo transplantation. Methods The data of 3 192 FET patients in the reproductive medicine center of our hospital up to May 2014 were analyzed retrospectively. According to ages, reasons of infertility, types of infertility, duration of infertility, drug regimen, the number and the time of embryo transplantation, we divided these patients into six groups for comparing the clinical pregnancy rate. Results The FET clinical pregnancy rate of the under 35 years group was higher than the 35~39 years group and the over 39 years group (33.96%vs. 27.58%and 19.35%; P<0.05, respectively). The duration of infertility in the clinical pregnancy group was significantly shorter than the non-pregnancy group (P<0.05). The clinical pregnancy rate in the group with three embryos transplanted was higher than the group with only two embryos transplanted (41.01% vs. 28.75%; P < 0.05). Among the group with the age of over 40 years, those with three embryos transplanted had a higher clinical pregnancy rate than those with only one embryo transplanted (25.49% vs. 0.00%; P < 0.05). The clinical pregnancy rate of the frozen blastocyst transplantation group was higher than that of the cleavage-stage transplantation group (40.00%vs. 26.27%;P<0.05). Conclusion Age, infertility duration, the number and the time of frozen embryo transplantation may affect the clinical pregnancy rate among the FET patients. An individualized transplantation program based on age may improve the patient′s clinical pregnancy rate.

[Objective] The objective of this study was to evaluate the diagnostic accuracy of the 2013 edition of Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon in diagnosing breast categories 3-5 lesions.[Methods] Using our breast ultrasound database from June 2014 to June 2016,we identified 4428 BI-RADS category 3 to 5 lesions with a known pathological diagnosis in 4 428 adult women.The positive predictive value (PPV) of each BI-RADS category was calculated based on the pathological diagnoses and compared with the reference range provided by the American College of Radiology (ACR).[Results] 4 428 lesions from 4428 patients were included in this study.The PPV of each BI-RADS category waswithin the reference range provided by the ACR in 2013.1198 (27.1％) pathological malignant/borderline results were found in the 4 428 lesions,the other 3 230 (72.9％)lesions were diagnosed with benign results.Among the malignant/borderline lesions,the rate of lymph node metastasis gradually increased as the BI-RADS categories were upgraded.Malignant lesions with a diagnosis ofinvasive ductal carcinoma or invasive lobular carcinoma showed an increasing distribution trend from category 3 to 5.[Conclusion] The 2013 editionof BI-RADS ultrasound lexiconhas good diagnostic accuracy and efficiencyin clinical practice.