Purpose To investigate the value of arterial spin labeling (ASL) in evaluating renal function in patients with renal cell carcinoma (RCC) after laparoscopic partial nephrectomy.Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively.The patients were performed ASL scan one week before and three months after operation.The correlation between renal blood flow (RBF) value measured by ASL and the glomerular filtration rate (GFR) measured by radionuclide method in the renal cortex of healthy side was analyzed.The RBF values in the kidney of affected side or healthy side were measured,the difference of which between before operation and three months after operation was compared.Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation (r=0.638,P＜0.05).In the affected side of kidney,the RBF value of remaining renal tissue [(291.5 ± 37.3) ml/(100g·min)] compared with that of preoperative renal tissue [(237.8 ± 46.2) ml/(100g·min)]increased about 53.7 ml/(100g · min) (P＜0.05).In the healthy side of kidney,the RBF value of renal tissue [(241.1 ± 50.3) ml/(100 g · min)] compared with that of preoperative renal tissue [(290.4 ± 51.8) ml/(100 g·min)] decreased about 49.3 ml/(100 g·min) (P＜0.05).Conclusion ASL can be used to evaluate renal function,and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.

Objective To observe the short-term quality of life in patients with obstructive hypertrophic cardiomyopathy (OHCM) after percutaneous transluminal septal tunnel myocardial ablation (PTSTMA). Methods The quality of life in patients with OHCM were assessed by the SF-36 before and three months after PTSTMA. Results Three months after the procedure , quality of life was markedly improved at different variances in patients with OHCM as compared with the baseline. The linear regression analysis showed the factors influencing quality of life were character, coexistence with other diseases, and 6-minute walk test. Conclusions Percutaneous transluminal septal tunnel myocardial ablation can improve the short-term quality of life in patients with OHCM. Postoperative psychological counseling and rehabilitation guidance can practically enhance quality of life.

Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories:normal morphology (H-shaped) and abnormal morphology(non H-shaped). The vaginal shape distribution of different prolapse degree(0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage) and types(anterior,middle, posterior pelvic prolapse) were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped (13 cases), W-shaped (26 cases) and O-shaped(4 cases) abnormal morphology. There was significant difference between the two groups(c2=46.137,P<0.01). The area under the curve (AUC) was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different:vaginal morphology of 0 stage prolapse showed H-typed mainly (40/51, 78.4%), Ⅰ stage prolapse showed W-shaped (16/28 57.1%), Ⅱ,Ⅲ stage prolapse all showed non H-shaped (20/20, 100%), Ⅱstage mainly showed W-shaped (9/14), Ⅲ stage mainly showed O-shaped (3/6). Anterior pelvic organ prolapse were manifested mainly with W-shaped vaginal morphology (4/9) and middle pelvic organ prolapse mainly showed O-shaped vaginal morphology (4/7). Conclusions The abnormal vaginal morphology has the prompt value on diagnosing pelvic organ prolapse.Moreover, the different shape probably indicates the different degrees and types of pelvic organ prolapse.

Objective To compare the diagnostic value of Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI and contrast-enhanced ultrasound (CEUS) in detection of small hepatocellular carcinoma (sHCC).Methods A total of 22 patients with 29 lesions who underwent Gd-EOB-DTPA enhanced MRI and CEUS scan,and confirmed as sHCCs by pathology were included in this study.Gd EOB DTPA enhanced MRI pattern for the conclusive diagnosis of sHCC were lesions showed iso or low signal on T1 WI,showed slightly high signal or high signal on T2 WI,showed high signal on DWI and obviously enhanced in the arterial phase and/or clearance in the hepatobiliary phase;CEUS pattern for the conclusive diagnosis of sHCC were rapidly increasing in the arterial phase and showing low echo in the delay phase.Results The diagnostic sensitivity of detecting sHCC by Gd EOB-DTPA enhanced MRI and CEUS were 82.76％ and 65.52％ respectively,and there was no statistical difference (x2 =2.248,P=0.134),the diagnosis specificity were both 100 ％.Conclusion Both of the diagnostic sensitivity and specificity for detecting sHCC by Gd EOB DTPA enhanced MRI and CEUS showed no difference,the value of diagnostic sensitivity of the former is higher.

AIM:To analyze the mechanism of tumor-associated macrophage (TAMs) in the development of cervical cancer and to investigate its correlation with Th1/Th2 and Th17/CD4+ CD25+ Foxp3 + Treg.METHODS:Twenty seven cases of cervical cancer and 53 cases of cervical intraepithelial neoplasias (including 22 cases of CIN Ⅱ and 31 cases of CIN Ⅲ) were selected as subjects.The venous blood of patients before treatment was extracted to detect Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg with flow cytometry,and detect serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels with ELISA Kits.Furthermore,pathological tissues were extracted during operation,and its TAMsCD68 expression was detected by immunohistochemistry technique.RESULTS:The Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg of cervical cancer were both lower than those of CIN Ⅲ,and those of CIN Ⅲ were both lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The serum IFN-γ,IL-4,IL-17A,IL-17F,TGF-β1 and IL-10 levels of cervical cancer were all higher than those of CIN Ⅲ,and those of CIN Ⅲ were all higher than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The TAMsCD68 expression level of cervical cancer was higher than that of CIN Ⅲ,and that of CIN Ⅲ was lower than CIN Ⅱ,the difference between groups had statistical significance (P ＜ 0.05).The correlation analysis results showed TAMsCD68 expression level had negative correlations with Th1/Th2,Th17/CD4+CD25+ Foxp3+ Treg,and serum IL-17A level,whereas presented positive correlations with serum IL-10 and IL-4 level (P ＜ 0.05).CONCLUSION:TAMs is closely related with Th1/Th2 and Th17/CD4 + CD25 + Foxp3 + Treg in cervical cancer,and possibly is mediating the occurrence and development of cervical cancer through influencing the balance of these two systems.

Objective To clarify the impact of pre-and postnatal iron deficiency on children's motor development.Methods This was a longitudinal follow-up study.A total of 114 infants (58 boys,56 girls) born from April 2010 to December 2011 in Fuyang district of Hangzhou were enrolled.Based on cord blood and 9-month iron status,subjects were divided into prenatal iron deficiency (34 children),postnatal iron deficiency (37 children) and non-iron deficiency group (43 children).Peabody Developmental Motor Scale and BOT2-simplified version were used to evaluate the motor capacity in infants and preschoolers at 9 months,18 months and 5 years,respectively.Hierarchical linear modeling (HLM) was used to investigate the trajectory of motor development with age,the influence of different timing of early iron deficiency on children's motor development,and the differences (adjusted for possible confounding factors) in motor development in children with pre-or postnatal iron deficiency or non-iron deficiency in different family educational environment.Results At the age of 9 months,18 months and 5 years,107,109,and 114 children were evaluated respectively.After controlling for a variety of confounding factors,it was found that children with prenatal iron deficiency had significantly lower scores of motor development compared with non-iron deficiency children (52.04 vs.54.05 scores,β =-2.01,P=0.007),and that children with postnatal iron deficiency had similar scores of motor development compared with non-iron deficiency children,showing no significant difference (53.07 vs.54.05 scores,β=-0.98,P=0.180).Regardless of the maternal education status,prenatal iron deficiency children always had lower motor scores than non-iron deficiency children (49.86 vs.52.15 and 49.58 vs.51.58 scores,β=-2.29,-2.00;P=0.031,0.049).Among the non-iron deficiency children,those whose mothers had a higher education level had higher motor scores compared with those whose mothers had a lower education level (52.45 vs.50.46 scores,β=1.99,P=0.035).Conclusions The motor development of children with prenatal iron deficiency did not catch up with their counterparts without iron deficiency by 5 years of age.The results indicate the importance of preventing iron deficiency in the fetus.

Objective:To investigate the molecular mechanism of sorafenib against hepatocellular carcinoma.Methods:Sorafenib efficacy was screened and verified by the hepatocellular carcinoma patient-derived tumor xenograft (PDX) model. Veterinary B-mode ultrasonography and in vivo confocal laser scanning microscopy were used to observe PDX angiogenesis. Immunohistochemistry was used to observe the expression of proliferation and angiogenesis-related proteins in PDX tissue. Real-time quantitative PCR technology was used to observe the RUNX3 gene in PDX tissues. SPSS 17.0 statistical software was used for statistical analysis.Results:Four cases of PDX were used to screen the efficacy of sorafenib. PDX1 had a significant response to sorafenib, with an inhibition rate of 68.07%. Compared with the control group, sorafenib had significantly inhibited PDX1 relative tumor volume (5.76±2.14 vs. 11.71±2.87, P<0.05). Cell division index (39.50±7.72 vs. 67.10±9.14, P<0.05) and Ki67 expression (288.6±43.40 vs. 531.70±55.60, P<0.05) were significantly decreased. Veterinary B-mode ultrasonography showed evident blood flow signals in PDX1 tumors. In vivo confocal laser scanning microscopy results showed that sorafenib had significantly reduced the total vessel length (1573.00±236.21 vs. 2675.03±162.00, P<0.05) and area (11 145.33±1931.97 vs. 20 105.37±885.93, P<0.05)) of PDX1 tumors. Immunohistochemical results showed that sorafenib had significantly down-regulated the protein expressions of CD34 (27.55±3.76 vs. 45.47±5.57, P<0.05), VEGF (16.33±2.86 vs. 22.77±3.20, P<0.05) and MVD (38.75±6.01 vs. 55.50±8.61, P<0.05). Real-time PCR results showed that sorafenib had significantly up-regulated RUNX3 gene expression (2.14±0.71 vs. 1.00±0.36, P<0.05). However, there was a negative correlation between the expression of RUNX3 gene and the ratio of VEGF-positive cells in sorafenib group ( R2=0.509 7). Conclusion:Sorafenib may inhibit the PDX angiogenesis and the growth of hepatocellular carcinoma by regulating the RUNX3-VEGF pathway.

Objective? To investigate the effects of nursing quality improvement in chest pain center on patients with ST-segment elevation myocardial infarction (STEMI). Methods? A total of 93 patients with STEMI who received routine nursing care from July to December 2016 (n=30) and optimized quality nursing care from January to July 2017 (n=63) in the First Affiliated Hospital of He＇nan University of Traditional Chinese Medicine were enrolled to the study. The patients＇ gender, age, and 18-lead ECG completion time, Door-To-Balloon time (D2B), myocardial injury marker report time, and their hospitalization days (d), were compared between the two groups. Results? The differences in the indicators including sex,age and 18-leads ECG completion time were not statistically different (P＞0.05). However, the differences in hospitalization time, D2B time, and myocardial injury marker report time had statistical significance (P＜ 0.05). Conclusions? The optimizing project of nursing quality management, including the optimization of nursing document writing, specialized instrument operation process and ward management index, can reduce patients＇ hospital stay, D2B time, and myocardial injury marker report time, hence improve the overall treatment quality for the patients.

OBJECTIVE To investigate the intervention effect and potential mechanism of breviscapine on hepatic fibrosis （HF） in rats based on the transforming growth factor-β（1 TGF-β1）/Smad2/extracellular signal-regulated protein kinase 1（ERK1） and Kelch-like epichlorohydrin-associated protein 1（Keap1）/nuclear factor-erythroid 2-related factor 2（Nrf2）/heme oxygenase-1（HO-1） pathways. METHODS Totally 60 rats were randomly divided into normal control group， model group， breviscapine low-dose， medium-dose and high-dose groups （5.4， 10.8， 21.6 mg/kg）， and colchicine group （positive control， 0.45 mg/kg）， with 10 rats in each group， half male and half female. Except for the normal control group， HF model of the other groups was induced by carbon tetrachloride. Subsequently， each drug group was given corresponding medicine by gavage once a day for 28 days. The liver appearance of rats in each group was observed and their liver coefficients were calculated. The levels of alanineaminotransferase （ALT） and aspartate aminotransferase （AST）in serum， those of ALT， AST， superoxide dismutase （SOD），malondialdehyde （MDA） and glutathione peroxidase （GSH- Px） in liver tissue were detected. The liver tissue inflammatory and fibrotic changes were observed. The protein and mRNA expressions of TGF-β1， Smad2， ERK1， Nrf2， Keap1 and HO-in liver tissue were detected. RESULTS Compared with the normal control group， the model group showed large areas of white nodular lesions in the liver， obvious inflammatory cell infiltration and collagen fiber deposition. The body weight， the levels of SOD and GSH-Px in liver tissue， the protein and mRNA expressions of Nrf2 and HO-1 were significantly lowered in the model group （P＜0.05）； the liver coefficient， the percentage of Masson staining positive area， ALT and AST levels of serum and liver tissue， MDA level of liver tissue， the protein and mRNA expressions of TGF-β1， Smad2， ERK1 and Keap1 were significantly increased （P＜0.05）. Compared with the model group， the liver lesions of rats in each drug group were improved， and the above quantitative indexes were generally reversed （P＜0.05）. CONCLUSIONS Breviscapine has a good intervention effect on HF rats， which may be related to inhibiting TGF-β1/Smad2/ERK1 pathway for anti-fibrosis and regulating Keap1/Nrf2/HO-1 pathway to inhibit oxidative stress.