Objective To investigate the number changes of the ribbon synapses(RS) in the inner hair cell of C57BL/6J mice with age .Methods The cochlear basilar membrane was obtained from C57BL/6J mice in 2 ,6 ,10 , 12 months old .RIBEYE on the presynaptic membrane and AMPA receptor on the postsynaptic membrane were double labeled by immunofluorescence histochemical technique .The stained sections were observed under a confocal laser-scanning microscope .Then the number of RS of the basilar membrane was calculated by three dimensional reconstruction images using 3DS max software .Results The numbers of RS reduced gradually from the cochlear a‐pex to base in the same developing stages .The numbers of RS in apex and middle turn of cochlea were gradually re‐duced with the age increasing .The number of RS in basilar turn reduced first and increased slowly then .Conclusion The decreases of the number of RS maybe the main pathological change at the early stage of presbycusis .In addi‐tion ,there may be a kind of compensatory mechanism by increaseing the number of RS to delay the hearing deficits .

Objective To study the applied value of MR diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)value in chronic kidney disease(CKD).Methods 10 healthy volunteers and 45 patients with different period of CKD underwent routine MRI and DWI.The DWI features were observed.The ADC values were acquired by using Philips soft package on the ADC images.Results Under different b value(300 s/mm2,500 s/mm2 and 800 s/mm2),the ADC value of CKD were 2.29?0.27,2.07?0.21 and 1.91?0.22,respectively,which were significantly lower than that in normal kidneys,and there was statistical difference between different group of CKD.Conclusion DWI may be a noninvasive method to evaluate the renal function.

Objective To study the differential expression of apoptosis related genes in GJB2 gene conditional knockout mice (cCx26Pax2Cre ) cochlea membranous labyrinth ,and to explore the mechanism of GJB2 gene mutations causing deafness .Methods Two developmental stages of P10 and P18 were selected from the knock out mice and the wild type ones (BALB/C) .The total RNA was isolated from cochlear membranous labyrinth and PCR array was performed using mouse apoptosis PCR arrays .Results Compared with wild -type mice ,significant up or down -regulation in gene expression was detected in 16 genes in cCx26Pax2Cre ones at P10 .Of the 16 genes ,14 ones were down-regulated .Among the 14 genes ,9 ones can be classified as anti -apoptosis or pro -proliferation genes ,5 ones can be classified as pro -apoptosis or pro -inflammation genes .The other 2 genes expression was up-regula-ted ,and their main role was to promote apoptosis .Compared with time -matched controls ,significant up or down-regulation in gene expression was detected in 4 genes in cCx26Pax2Cre mice at P18 .Of the 4 genes ,3 ones expression was down-regulated ,were anti-apoptosis ones .The expression of the other one gene among the 4 ones was up-regulated ,which acted as pro -apoptosis genes .Bcl2l10 and Tnfrsf10b expression showed significant down or up -regulation at both stages . Compared with P10 , the expression of caspase - 8 was up - ragulated at P18 in cCx26Pax2Cre mice .Conclusion It is suggested that GJB2 mutation may up -regulate the expression of DR5 ,which can trigger the death receptor pathway to cause apoptosis in cCx 26Pax2Cre mice cochlea directly .At the same time , caspase-8 in death receptor pathway may activate the mitochondria pathway indirectly and amplify the apoptosis further in cCx26Pax2Cre mice cochlea .The final result of the above activated pathways is the wide range of cochlear cells apoptosis and the profound hearing loss in cCx 26Pax2Cre mice .

Objective To explore the concentration of mannan-binding lectin(MBL ) of patients with chronic hepatitis B virus (HBV) .Methods Serum MBL concentrations of 250 patients(case group) with HBV and 150 healthy controls(control group) were measured .Results The serum MBL concentration in case group was higher than that in control group(t=7 .097 ,P<0 .01) . The serum MBL concentration in high HBV-DNA loading group was higher than that in control group(t=7 .179 ,P<0 .01) .The serum MBL concentration in low HBV-DNA loading group was higher than that in control group(t=4 .404 ,P<0 .01) .Conclusion Detection of serum MBL in patients with HBV will be clinically useful for understanding state of an illness and observing the cur-ative effect .

Liver cirrhosis is a common chronic progressive liver disease,and at present the most effective treatment for advanced liver cirrhosis is liver transplantation.However,main reasons of limiting the wide application of liver cirrhosis are liver source deficiency,expensive cost,graft rejection reaction,the complications caused by long-term application of immunosuppressant and so on.Stem cell transplantation has become a new method for the treatment of liver diseases due to its beneficial to the damaged liver tissue repair,and it can compensate part of liver function.The basis and clinical research progress,the existing problems and prospects of the bone mesenchymal stem cell transplantation for the treatment of liver cirrhosis are summarized,aiming to provide theoretical basis for the further research.

Objective To investigate the effect and safety of topical tranexamic acid (TXA) plus cocktail analgesic for reducing blood loss during total knee arthroplasty (TKA).Methods A prospective case control study was made on 60 patients scheduled to undergo TKA because of knee injuries between August 2015 to June 2016.There were 13 males and 47 females,with the mean age of 65.5 years (range,51-80 years).Traumatic arthritis occurred in 44 patients and degenerative arthritis in 16 patients.The patients were assigned to separate cocktail analgesic group (Group A,n =30) and topical TXA plus cocktail analgesic group(Group B,n =30),according to the random number table.Patients in Group A received multiple-point intra-articular cocktail analgesic injection before implantation of the prosthesis in TKA.While patients in Group B received multiple-point intra-articular TXA plus cocktail analgesic injection before implantation of the prosthesis.Between-group differences were compared with respect to intraoperative blood loss,hemoglobin change (Hb),haematocrit (Hct),postoperative drainage,total blood loss,hidden blood loss,blood transfusion rate,Hospital for Special Surgery (HSS) score,incidence of deep venous thrombosis (DVT) and other complications.Results All patients were followed up for 3 months.Perioperative Hb reduction in Group B was 18.5 (13.0,26.0) g/L,less than 23.0 (21.0,35.5) g/L in Group A (P ＜ 0.05).Hct was reduced by 5.6 (4.1,7.8) ％ in Group B,while 7.2 (6.1,10.7) ％ in Group A (P ＜ 0.05).Postoperative drainage volume,total blood loss and occult blood loss in Group B were 105.0(60.0,223.8) ml,596.0(426.1,795.3) ml,422.3 (228.9,624.0) ml respectively,decreased compared to Group A [162.5 (118.8,245.0) ml,788.3 (583.0,1 082.4) ml,603.2 (435.2,884.7)ml respectively] (P ＜0.05).There were no significant differences in intraoperative blood loss,blood transfusion rate,HSS score and DVT incidence between the two groups (P ＞0.05).Conclusion Topical TXA plus cocktail analgesic can reduce blood loss during perioperative period in TKA,without increasing the risk of DVT.

Objective To evaluate the clinical diagnostic value of magnetic resonance cholangiopancreatography ( MRCP ).Methods MPCP data of 42 cases with pancreatic and bile duct lesion proved by operation and pathology were analyzed retrospectively.MRCP was performed using single-shot-radio SE sequence (SSH/RAD). Of all cases included bile duct lithiasis in 19 , inflammation in 3,congenital cyst in 6 , carcinoma in 12,jaundice caused by diverticulitis of duodenum in 1 and Mirizzi syndrome in 1 .Results MRCP was succeeded at one time in all cases . On MRCP , the visual rate of intrinsic and extrinsic hepatic bile duct was 100% and that of common pancreas duct was 80.58%.The localized and qualitative diagnosis of lesions were up to 100%,88.2% respectively.Conclusion SSH/MRCP/RAD plays an important role in diagnosis of the pancreatic and bile duct lesion in clinical practice.

Objective To analyse the CT features of hepatic abscess in different stages of pathology so that to improve the accuracy of CT diagnosis.Methods The plain CT and triphase contrast-enhanced CT findings of hepatic abscesses in 50 cases proved by surgery or other clinical methods were retrospectively analysed and compared with CT findings of hepatic carcinoma,hepatic metastases and hepatic hemangiomas.Results CT features of hepatic abscesses were divided into three types according to different stages of pathology.Early pyogenic hepatic abscess(10 cases)had two types:small cavitation(9 cases)and mass(1 case).Typical pyogenic hepatic abscess(38 cases)and granulomatous hepatic abscess(2 cases).Conclusion CT findings of liver abscesses are different in different stage of pathologic changes,triphase contrast-enhanced CT is specific in diagnosing hepatic abscess.

Objective To explore CT and MR manifestations and its diagnostic value of liver cystic lesions.Methods The clinical and imaging data of 78 cases with liver cystic lesions were collected,including 21 cases of inflammatory cystic lesions,30 cases of tumor cystic degeneration and 27 cass of congenital growth cysts.Results The detected rate of liver cystic lesions with CT and MRI was all 100%.For inflammatory cystic lesions,tumor cystic degeneration and growth cyst,CT diagnostic accurate rate was 76%,90% and 93%,respectively,and MR was 83%,93% and 100% respectively.CT and MR manifestations:Of all inflammatory cystic lesions,hepatic abscess and liver echinococcosis cyst appeared as cystic occupying lesion,the cysts were of tension,low-density band on CT or water-like signal intensity on MR around the lesions in hepatic abscesses.Liver echinococcosis cysts were of big cyst with small cyst sign and enhanced moderately in cystic wall post contrast-enhanced scan.The metastasis cystic tumors showed single or multiple cystic lesions and mild or moderate circular enhancement.The primary liver tumor's cystc degenerative lesions showed cyst-solid lesions on CT and MR,and were of enhanced manifestations of the primary tumors.Growth cysts were single or multiple low-density or water-like signal intensity,generally there was not enhanced.Conclusion CT and MR have great diagnostic value for the location and nature of cystic lesions.

Objective To evaluate clinical significance of two real-time fluorescence quantitative PCR kits for quantitative detection of HBV DNA and detection performance at different viral load levels.Methods A series of calibrators with different concentrations(1×106,5×105,1×105,5×104,1×104,5×103,1×103,5×102,1×102,1×101 kIU/L) were prepared with AB-type sera using the second generation WHO international standard (NIBSC code:97/750). HBV viral load in the sera of 78 patients,30 healthy blood donors and 10 calibrators were detected by real-time fluorescence quantitative PCR HBV DNA test kit from PIJI Bio-Technical Development Company Ltd (PG kit) and Cobas AmpliPrep/Cobas TaqMan HBV test kit. The correlation of the two methods was evaluated, and the performance of the two kits different viral load levels was evaluated. The false negative rate was analyzed. Negative control, low positive control and high positive control were included in every batch. Results Both two kits showed the correct results for the 10 specimens from the WHO international standards. The lowest detection limit of HBV DNA for Roche Cobas AmpliPrep/Cobas TaqMan HBV test and PG kit were 2.00 (kIU/L, lg) and 3.00 (kIU/L,lg) ,respectively. There was linear correlation between the results from Roche Cobas AmpliPrep/Cobas TaqMan HBV test and PG kit ( R2=0.938 7, P < 0.01 ), the upper limit of Roche kit had coincided with theoretical value. The samples with HBV DNA level above the upper limit of detection were diluted and retested to obtain the precise result. The result form Roche Cobas AmpliPrep/Cabas TaqMan HBV test [(8.35±0.20) kIU/L, lg] was higher than that from PG kit [(7.73±0.42 ) kIU/L, lg] (t=3. 776, P <0.05) . The detection of 108 serum samples showed that the level of HBV DNA detected by Roche Cobas AmpliPrep/Cobas TaqMan HBV test [(5.88±1.64) kIU/L, lg] was higher than that by PG kit [(5.25±1.55 kIU/L,lg] (t=12. 297 ,P <0.01 ). The correlation coefficients were high in samples with high HBV viral load[HBV DNA(>5.00 and≤7.00) kIU/L,Ig,R2=0. 779 7, P <0.01 ;HBV DNA( >7.00 ands≤9.00) kIU/L,lg,R2=0.603 7, P <0.01]. The correlation coefficient was low in samples with low HBV viral load[HBV DNA ( > 3.00 and≤5.00) kIU/L, lg, R2=0. 417 3, P <0.01 )]. When HBV DNA ( >3.00 and≤4.00) kIU/L,lg,the false negative rate was 33.3% (5/15). When HBV DNA ( > 1.08and≤3.00) kIU/L,lg,none of positive samples was detected with PG kit. Conclusions PG kit is not as good as Cobas AmpliPrep/Cobas TaqMan HBV test . The linear correlation between the results from the two kits is good. The correlation between the results detected with PG kit and Cobas AmpliPrep/Cobas TaqMan HBV test is higher in the high viral load groups than in the low viral load group. It is suggested that PG kit had a narrower linear range.