Many anorectal opearations may result in damage to anal sphincter function and,as a result,patients have problems when they are defecating.Measuring anal sphincter function not only benefit for operating,but also may help prevent operating complications and do good for rehabilitation.Therefor,measuring anal sphincter function is important.This article will review those measures about anal sphincter function.

Objective To explore the HRCT characteristics of solitary pure bronchioloalveolar carcinoma.Methods Compared with postop pathological appearance,21 patients with 22 affections tumors which were pathologically confirmed pure bronchioloalveolar carcinoma were retrospectively reviewed.Results the histopathological results prior to surgery showed that 20 patients with 21 affections tumors were non-mucilaginous BAC and 1 patient was mucilaginous BAC.Noguchi's classification:Type A 3 cases,Type B 12 cases,Type C 5 cases.(Mucilaginous BAC was not classified)Stage classification:There were 21 cases with stage ⅠA,the maximum tumor diameter was from 0.3 to 3.0 mm (average diameter 1.3 mm).No case showed pleura metastasis,vessel invasion and lymphaticmetastasis.Appearance of HRCT:according to the amount of GGO,all affections were divided into 4 groups.A group(5/22),B group(7/22),C group(7/22),D group(3/22).There were 11 cases with pleura traction,5 cases with clear boundary and trimmed edges and other 17 cases were contradistinction.There were 21 cases with blood vessel or bronchus shadow.Conclusion HRCT can show scan can provide details of structure characteristics of BAC's pathological histology,so it plays an important role in prediction of pathological infiltration of tumor cells and prognosis assessment.

Objective To investigate CT feature after contrast-enhanced and anatomic distribute of the whole body lymph nodes involved by lymphoma. Methods The whole body CT findings in 89 cases (HL 12 cases, NHL 77 cases) of malignant lymphoma were retrospectively analyzed. The contrast-enhanced CT features (size, density and the digree of contrast enhancement) and anatomic distribution of the whole body lymph nodes involved by lymphoma were clarified. Results In the HL group, Diffuse and homogeneous enhancement of the enlarged lymph nodes was found in 9 cases (75.0 %), while homogeneous enhancement of the enlarged lymph nodes with some little necrosis was found in 3 cases (25.0 %). In the NHL group, diffuse and homogeneous enhancement of the enlarged lymph nodes was found in 64 cases (83.1 %), while homogeneous enhancement of the enlarged lymph nodes with some little necrosis was found in 13 cases (16.9 %). There was not statistically significant (Fisher exact probability, P = 0.4461) between the two groups. In the HL group, the enlarged lymph nodes were mixed together in 6 cases (50.0 %), while the enlarged lymph nodes were separate in 6 cases (50.0 %). In the NHL group, the enlarged lymph nodes were mixed together in 8 cases (10.4 %), while the enlarged lymph nodes were separate in 69 cases (89.6 %), there was statistically significant (Fisher exact probability, P = 0.0028). The dominant anatomic distributions of the lymph nodes involved by HL group were neck and mediastinum. The dominant anatomic distributions of the lymph nodes involved by NHL group were neck, mediastinum and abdomen, there was not statistically significant between the anatomic distributions (Fisher exact probability, P =0.110). Conclusion CT can easily demonstrate the involvement and extension of malignant involving the whole body, but CT can not differentiate HL and NHL except for the confluence state.

Objective To investigate the expression levels of the CD14 mRNA and TLR4 mRNA in peripheral blood mononuclear cells from patients with Parkinson disease and to explore the clinical signicance. Methods For?ty-four patients with Parkinson disease and 37 healthy controls were recruited. We recorded age of onset, duration of ill?ness and sex of all recruited patients. PD patients were evaulated using the Hoehn-Yahr stages, Unified Parkinson Dis?ease Rating Scale (UPDRS) Ⅱand UPDRS Ⅲ,non-motor symptoms scale (NMSS) on“off”time. Reverse transcrip?tion-polymerase chain reaction was performed to determine the expression levels of CD14 mRNA and toll-like receptor 4 (TLR4) mRNA. Results The expression levels of CD14 mRNA(1.459±0.658)2-△△CT and TLR4 mRNA (1.408±0.698)2-△△CT was significantly up-regulated (P<0.05) in Parkinson disease compared with controls((1.162 ± 0.631)2-△△CT、(1.122 ± 0.557)2-△△CT). In addition, there was positive correlation between the expression levels of CD14 mRNA in Parkinson dis?ease patients with the Hoehn-Yahr stages. Meanwhile, there was no significant correlation between the expression levels of CD14 mRNA and TLR4 mRNA with other clinical scores. Conclusions There is positive correlation between the ex?pression levels of CD14 mRNA in Parkinson disease patients with the Hoehn-Yahr stages,indicating that CD14/TLR4 positive monocyte may be involved in the pathogenesis of the Parkinson disease.

Objective To evaluate the value of 3.0T magnetic resonance multi-b value diffusion-weighted imaging (DWI) in evaluating the efficacy of chemotherapy for patients with central lung squamous cell carcinoma and atelectasis. Methods Twenty patients with lung squamous cell carcinoma were examined by magnetic resonance imaging (MRI) (including T1WI, T2WI and multi-b value DWI) before chemotherapy, 2 cycles of chemotherapy and 4 cycles of chemotherapy. The images, the tumor volume and changes of apparent diffusion coefficient (ADC) were analyzed. Results In the patients with central lung cancer and atelectasis, the tumor and atelectasis could be distinguished on MRI examination before radiotherapy. It was more easily identified on T2WI images after radiotherapy. In the 20 patients, the ADC values in the effective group (partial remission or complete remission) and the invalid group were increased, but the differences of ADC values in the effective group before chemotherapy, 2 cycles and 4 cycles of chemotherapy were statistically significant [b=800 s/mm2:(1.09 ± 0.52) × 10-6 mm2/s, (1.22 ± 0.59) × 10-6 mm2/s, (1.24 ± 0.52) × 10-6 mm2/s, F = 31.19, P < 0.001]. There was no significant difference in ADC values between before and after chemotherapy (b = 800 s/mm2: (1.10 ± 0.49) × 10-6 mm2/s, (1.16 ± 0.60) × 10-6 mm2/s, (1.20 ± 0.72) × 10-6 mm2/s, F=2.86, P=0.089]. When b=800 s/mm2, the ADC curve slope in the effective group was more stable, better linearity. Conclusions The MRI technique can accurately distinguish the tumor from atelectasis before and after chemotherapy. The change of ADC value after chemotherapy is earlier than that of morphological change. The change rate of b value can better evaluate the curative effect of chemotherapy.

Objective To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma .Methods The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed . 61 patients underwent PET-CT examination, and other 32 underwent DWI examination .With bone marrow biopsy results as “gold standard”, the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed , and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes . Results 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI.The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0%and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6%and 89.5%, respectively.The detection rates of the two imaging techniques for aggressive lymphoma were 37.5%(18/48) and 38.1%(8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1%(3/13) and 27.3%(31/1)], although the differences were not statistically significant (P=0.521, P=0.660).For both aggressive lymphoma and indolent lymphoma , the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000).Conclusions PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma .None of PET-CT and DWI can replace bone marrow biopsy (BMB).However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma .

Objective:To investigate the effects of down-regulation of Krüppel-like factor 5 (KLF5) on biological functions of rat intestinal epithelial cells IEC-6 in response to ionizing radiation.Methods:Rat intestinal epithelial IEC-6 cells were irradiated with 0, 2, 4, 8, 12, 16 Gy of X-rays and 3 h later the expression of KLF5 in IEC-6 cells was detected by Western blot. IEC-6 cells were irradiated to 12 Gy and 0, 0.5, 1, 2, 3, 5, 7 and 24 h later the expression of KLF5 in IEC-6 cells was detected by Western blot. shRNA sequences targeting rat KLF5 gene were designed, synthesized and inserted into the lentiviral vector. The recombinant lentiviral vectors were packaged in human embryonic kidney 293T cells, and the lentivirus titers were determined. IEC-6 cells were infected with the recombinant lentivirus, and the transfection efficiency was observed under fluorescence microscope. Real-time PCR and Western blot were used to detect the expressions of KLF5 mRNA and protein in the transfected cells 72 h post transfection. The consequent experiments included four groups: negative control group, shKLF5 group, radiation group and radiation + shKLF5 group. The cell viability was observed in KLF5 silencing cells irradiated with 8 Gy by using CCK-8 assay. The cell cycle distribution and apoptosis were detected in KLF5 silencing cells irradiated with 8 Gy by flow cytometry. Immunofluorescence staining was applied to visualize the γ-H2AX foci in nucleus of KLF5 silencing cells irradiated with 2 Gy.Results:The expression of KLF5 increased with the different doses. The expression of KLF5 increased first, then decreased and peaked at 5 h post-irradiation with 12 Gy. KLF5 shRNA lentiviral vectors were successfully constructed. The mRNA and protein level of KLF5 were down-regulated in recombinant lentivirus transfected IEC-6 cells 72 h after transfection. Knockdown of KLF5 markedly induced G 2/M phase arrest ( t=11.56, P<0.05), proliferation inhibition, more apoptosis rate [radiation group: (7.42±0.49)%, radiation + shKLF5 group: (12.49±0.63)%, t=10.98, P<0.05], and more γ-H2AX foci in nucleus post-irradiation than negative control ( t=22.07, 23.89, 11.24, 59.97, 20.85, P<0.05). Conclusions:The KLF5 knockdown intestinal epithelial cell line was successfully established. The down-regulation of KLF5 expression could induce cell arrest at G 2/M, suppress the proliferation of irradiated cells and improve the cell apoptosis, enhance DNA double strand breaks and prolong DNA damage repair.

Objective To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma .Methods The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed . 61 patients underwent PET-CT examination, and other 32 underwent DWI examination .With bone marrow biopsy results as “gold standard”, the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed , and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes . Results 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI.The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0%and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6%and 89.5%, respectively.The detection rates of the two imaging techniques for aggressive lymphoma were 37.5%(18/48) and 38.1%(8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1%(3/13) and 27.3%(31/1)], although the differences were not statistically significant (P=0.521, P=0.660).For both aggressive lymphoma and indolent lymphoma , the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000).Conclusions PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma .None of PET-CT and DWI can replace bone marrow biopsy (BMB).However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma .

Objective To study the effect of exosomes ( EXs) released from high expression of miR-132-3p mesenchymal stem cells (MSCs) on hypoxia/reoxygenation (H/R) injured endothelial cell function. Methods MSCs extracted from bone marrow of C57BL/6 mice were cultured primarily. MSCmiR-132-3p was obtained from MSCs infected with lentivirus loaded with miR-132-3p vector. At the same time,MSCNC was obtained by infecting MSCs with control lentivirus loaded with scramble sequence. EXs released from MSCNCand MSCmiR-132-3pwas isolated,and MSC-EXs and MSC-EXsmiR-132-3pwere obtained respectively. The obtained EXs and H/R damaged mouse brain microvascular endothelial cells (bend3) were co-cultured. According to culture conditions,the cells were divided into normal culture group (normal cell culture),H/R group (making a H/R model),MSC-EXs group (MSC-EXs co-culture),MSC-EXsmiR-132-3p group (MSC-EXsmiR-132-3pco-culture), and MSC-EXsmiR-132-3p+ LY294002 group ( before the cells and MSC-EXsmiR-132-3pwere co-cultured,treated by adding phosphatidyl alcohol 3 kinase [ PI3K] signaling pathway blocker LY294002 [20 μmol/L]). Quantitative real-time quantitative polymerase chain reaction was used to detect the expression of miR-132-3p in MSCs,MSC-EXs,and bend3 cells. Angiogenesis kit was used to detect angiogenic ability of bend3 cells,and 3-(4,5-dimethylthiazole-2)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect the proliferative capacity of bend3 cells. Scratch test was used to detect the migration ability of bend3 cells. hochest33258 staining showed cell apoptosis. Western blot was used to detect the phosphorylation level of protein kinase B ( Akt) . Results Compared with the H/R group, the MSC-EXs treatment group significantly improved the angiogenesis,proliferation,migration abilities, and Akt phosphorylation level of bend 3 cell damage induced by H/R (The H/R group were 3 ± 1,0. 275 ± 0. 020,147 ± 8 μm,and 0. 89 ± 0. 12,respectively;the MSC-EXs treatment group were 8 ± 3,0. 358 ± 0. 030,218 ± 10 μm, and 1. 37 ± 0. 25 μm,respectively;all P<0. 01). Apoptosis was significantly reduced (47 ± 2% vs. 63 ± 2%,all P<0. 01). Compared with the MSC-EXs treatment group,the angiogenesis,proliferation,migration abilities,and Akt phosphorylation level of bend 3 cells in the MSC-EXsmiR-132-3ptreatment group were increased (14 ±3,0. 444 ± 0.050,357±10μm,and1.67±0.23,respectively,all P<0.01).Apoptosis was significantly reduced (34±1%,all P<0. 01) . Compared with the MSC-EXsmiR-132-3ptreatment group, cell proliferation, migration, angiogenesis abilities,and Akt phosphorylation level in the MSC-EXsmiR-132-3p+LY294002 group were significantly reduced (5 ± 2,0. 304 ± 0. 050,175 ± 8 μm and 0. 95 ± 0. 11,respectively,all P<0. 01). Conclusion MSC-EXs with high expression of miR-132-3p may improve many physiological functions of H/R-induced damaged cerebrovascular endothelial cells by activating PI3K/Akt signaling pathway.

Objective:To investigate the value of preoperative breast MRI combined with axillary ultrasound in predicting lymphovascular invasion (LVI) of breast invasive ductal carcinoma.Methods:The clinical, pathological and imaging features of 160 female patients [age 25-74(49±10)years] with breast invasive ductal carcinoma from March 2014 to December 2017 in Shanxi Cancer Hospital were retrospectively analyzed. According to the LVI status determined by postoperative pathology, 160 patients were divided into LVI positive group (56 cases) and LVI negative group (104 cases). The clinical characteristics, pathological characteristics and imaging features of LVI positive group and LVI negative group were compared by the independent t test, Mann-Whitney U test or χ 2 test. Multivariate logistic regression analysis was performed to identify independent predictors for predicting LVI and construct a predictive model. The receiver operating characteristic (ROC) curve and area under the curve (AUC) was used to evaluate the discrimination of the prediction model, and the Hosmer-Lemeshow test was used to evaluate its calibration. Results:There was no significant difference in age, menopausal status, estrogen receptor, progesterone receptor, human epidermal growth factor 2, Ki67 index and molecular subtype between LVI positive group and negative group ( P>0.05). Tumor size, peritumoral edema, adjacent vessel sign, multifocality or multicentricity, peritumoral maximum-apparent diffusion coefficient (ADC), peritumour-tumour ADC ratio, MRI axillary lymph node status and ultrasound axillary lymph node status between LVI positive group and LVI negative group showed significantly statistical difference ( P<0.05). Variables with significant difference in the univariate analysis were entered into multivariate logistic regression analysis to explore predictors for LVI. Peritumoral edema (OR=3.367, 95%CI 1.382-8.201, P=0.008), multifocality or multicentricity (OR=4.026, 95%CI 1.268-12.776, P=0.018), high peritumoral-tumor ADC ratio (OR=7.321, 95%CI 2.226-24.079, P=0.001) and positive ultrasound axillary lymph node (OR=6.779, 95%CI 2.819-16.303, P<0.001) were independent predictors for predicting LVI. A logistic regression model was constructed using the above four indicators, and ROC showed AUC of this model for predicting LVI was 0.882, superior to any of the single indicator ( P<0.05); its sensitivity was 80.36% and specificity was 84.62%. Hosmer-lemeshow test showed that the prediction model had good calibration ( P=0.503). Conclusion:The combined prediction model constructed by preoperative breast MRI and axillary ultrasound could help to predict the LVI status of breast invasive ductal carcinoma.