Objective To study the conventional MRI features of adult Japanese encephalitis (JE)and explore the early features of diffusion weighted imaging(DWI).Methods Thirty-two patients with adult JE were included.MR scanning including T1 WI,T2 WI and FLAIR were done in all patients,and DWI in 28 patients.Twenty-three patients received DWI in the early stage (within 1 to 7 days),in which the appearances of DWI were analyzed,ADC graphs were obtained and the signal noise ratio and the ADC values of lesions were calculated.Results Twenty-eight cases were abnormal on MRI,and 4 patients were normal.The lesions of JE involved the thalamus in 22 cases,the substantia nigra of midbrain in 13,kellogg’s seahorse in 9,the basal ganglia in 7,the splenium corpo-ris callosi in 4,the pons in 6 and the insular lobe in 2,extensive cerebral edema in 2.The early features of DWI in 23 patients showed cytotoxic edema in 2,vasogenic edema in 12,both two edemas existing in 5,and normal in 3.DWI were superior to T2 WI in 6 cases,and T2 WI were superior to DWI in 9 cases,DWI was similar to T2 WI in 5 cases on showing the size and signal of the le-sions.Conclusion Adult JE often occurs in the thalamus,substantia nigra of midbrain and kellogg’s seahorse.DWI shows vasogenic edema in the early stage.Comprehensive analysis of DWI,ADC and T2 WI details helps to early detection and qualitative adult JE le-sions.

Objective To study the serum levels of homocysteine(Hcy) and the polymorphism of C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene in pregnant women to explore their role in the pathogenesis of pre-clampsia. Methods Fifty pregnant women with preclampsia (study group) including 14 mild pre-eclampsia and 36 severe pre-eclampsia and 40 healthy ones (control group) were selected. Hey concentration was determined by fluorescence polarization immunoassay. The mutations of the 677C→T and 1298A→C of MTHFR were investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The mean level of plasma Hey in the study group was higher than that of control 1(12. 00±4. 59) μmol/L vs (7. 85:1:1.51) μmol/L, P<0.05], and that of the severe pre-eclampsia group was higher E(13. 30±2. 06) μmol/L, P<0. 01]. However, no significant difference was found between the control and the mild pre-clampsia group[(8. 63±3. 94) μmol/L, P>0.05]. There was significant difference in the genotype frequencies of MTHFR 677CT, TT genotype(C/T:42.0% ;T/T:14. 0%)and the total frequency of mutant T (T: 35.0%) allele between the study and control groups (P < 0. 05). Conclusions Hyperhomocysteinemia plays an important role in the pathogenesis of pre-clampsia. The polymorphism of MTHFR C677T might be associated with the development of pre-clampsia as it affects the metabolism of Hey.

Objective To evaluate the clinical application of MRI guided percutaneous biopsy for the lesions of infratemporal space.Methods An open design 0.2T MRI set was used for MRI guided percutaneous biopsy in seven patients with the masses of infratemporal space. Results Of this series, the accuracy of needle puncture was 100% with diagrostic accuracy of 85.7% and no complications.Conclusions MRI guided percutaneous biopsy is helpful in the diagnosis for the lesions of infratemproal space.

Objective To evaluate the surgical procedures and clinical efficacy of endoprosthetic replacement as a salvage procedure for intertrochanteric fracture suffered failure of internal fixation.Methods The study involved 18 intertrochanteric fracture patients that suffered failed internal fixation from 2001 to 2009,including 16 patients with failed dynamic hip screw (DHS) fixation and two with failed proximal femoral nail anti-rotation (PFNA).The patients were at mean age of 76.5 years (range,58-92 years).The treatment methods included total hip arthroplasty in five patients and the bipolar hemiarthroplasty in 13.Harris score was used to evaluate the function outcome during the follow-up.Results The mean operation time lasted for 115 minutes,with intraoperative blood loss of 500 ml.Two patients presented with intraoperative complications.Of all the patients,three patients died within three months after operation and three patients were lost to follow-up.The remaining 12 patients received complete follow-up for a mean of 2.3 years ( range,1-7 years).One patient with hip joint dislocation was treated with closed reduction and distraction for three weeks.At the latest follow-up,the pain disappeared or was reduced in all the patients,including two patients with moderate pain and four with mild pain after some movements.The average Harris score was increased from preoperative 34 points to 83 points at one year after operation.Conclusions Endoprosthetic replacement is an effective salvage procedure for the failed treatment of the intertrochanteric fracture,as it can attain satisfactory pain relief and functional improvement.

Background and purpose:The expression of ERβin triple negative breast cancer(TNBC) might be associated with good prognosis in TNBC patients. ERβand ERαhave considerable homology. FOXA1 plays an important role in ERαexpression and function. The aim of this study was to analyze the expression of FOXA1 and ERβin TNBC and the relationship between them and the clinicopathologic characteristics and prognosis. Methods:The breast cancer samples in Peking Union Medical College Hospital were collected from Nov. in 2011 to Dec. in 2013, and TNBC were screened out based on the expression of ERα, PR and HER-2. Thirty ERβ-negative samples and 30 ERβ-positive samples were selected randomly according to the ERβexpression. We used immunohistochemical method to detect the expression of FOXA1. Finally, 48 TNBC samples were obtained to analyze the results. Results:The total positive rate of FOXA1 was 35.4%(17/48). In the ERβ-positive group, the positive rate of FOXA1 was 35.7%(10/28),and in the ERβ-negative group, the positive rate of FOXA1 was 35% (7/20). The expression of FOXA1 in these 2 groups had no signiifcant difference (P=0.83), which indicated that there was no relation between ERβand FOXA1. The FOXA1 positive group and FOXA1 negative group also showed no signiifcant difference in age, tumor size, and lymphatic metastasis number in axilla, tumor grade, tumor stage, NPI and DFS. However, Ki-67 showed negative correlation with FOXA1 expression (P<0.01). Conclusion:FOXA1 expression had no relationship with ERβexpression in TNBC. Ki-67 showed negative correlation with FOXA1 expression, which might hint that the proliferation of tumor cell was lower in FOXA1 positive TNBC.

Objective To investigate the protective effect of bicyclol tablets on drug-induced hepatic injury in patients with severe psoriasis.Methods One hundred and six patients with severe psoriasis and drug-induced hepatic injury were enrolled in this study,and randomly divided into 2 groups:bicyclol group (53 cases) treated with oral bicyclol tablets (25 mg thrice a day) for 8 weeks,diammonium glycyrrhizinate group (53 cases) treated with diammonium glycyrrhizinate capsules (150 mg thrice a day) for 8 weeks.Serum biochemical indices of hepatic function were measured before and after treatment,therapeutic efficacy was evaluated,and adverse reactions were observed and recorded after treatment.Intergroup and intragroup differences in these parameters were assessed.Results During the treatment,3 patients were lost to follow up.After treatment,serum biochemical indices of hepatic function markedly improved in both the bicyclol group (52 cases) and diammonium glycyrrhizinate group (51 cases) (both P ＜ 0.01),and the bicyclol group showed a better treatment response than the diammonium glycyrrhizinate group (P ＜ 0.01).The marked response rate was 71.15％ and 47.06％ (P ＜ 0.05),and the response rate was 84.62％ and 66.67％ (P ＜ 0.05),respectively,in the bicyclol group and diammonium glycyrrhizinate group.No adverse reactions related to tested drugs were observed in either of the two groups.Conclusion Bicyclol can attenuate antipsoriatic drug-induced hepatic injury with good safety.

Objective To measure the average value of CT lung density at the phase of end inspiration and end expiration in children under 5 years.Methods Sixty patients with normal lungs who underwent chest CT for reasons caused by trauma etc.in our institute from January 2010 to March 2012 were enrolled to the study.All of the patients were divided into end inspiration group and end expiration group through random number table.CT images of the phase of end inspiration and end expiration were taken.Three levels of CT images were chosen to measure the lung density,which were 2 cm above the arch,1 cm below the carina and 2 cm above diaphragm.Lung density was measured at anterior,posterior,lateral,medial and central of the images at each level in each lung.The average lung density of each and entire lung were respectively calculated.The influence of phase,level,location was quantified using analysis of variance methods and LSD method.Results The average lung density at end inspiration was (-766 ±56)HU for the left,right and both lung.At end expiration,the average lung density of the left,right and both lungs was (-625 ± 86),(-647 ± 85) and (-636 ± 86) HU respectively.The average densities at anterior,posterior,lateral,medial and central of the left lung at end inspiration were (-798±63),(-733±68),(-767±64),(-754 ±65),(-775 ±63)HU respectively.The average densities at anterior,posterior,lateral,medial and central of the right lung were (-796 ± 70),(-736 ± 65),(-769 ± 64),(-754 ± 62),(-776-± 59) HU respectively.At end expiration phase,the average densities at anterior,posterior,lateral,medial and central of the left lung were (-692±91),(-555±116),(-639±91),(-598±103),(-640±98) HU respectively.The average densities at anterior,posterior,lateral,medial and central of the right lung were (-712 ± 90),(-575±121),(-657±90),(-619±95),(-670±87) HU respectively.The statistical differences of these five measurement areas were significant at both inspiration and expiration phase (F=12.55,11.29,23.31,25.47,P＜0.01).The posterior lung density was the highest and the anterior was the lowest.As for the other measurement areas,in descending order were medial,lateral,and central.Conclusion The lung density at end inspiration and end expiration in children under 5 years old is described to provide reference for the clinical work.

Objective To explore the difference of autobiographical memory (AM) between depressive patients with and without alexithymia,and correlation between AM and alexithymia in depressive patients with alexithymia.Methods 29 depressive patients with alexithymia,34 depressive patients without alexithymia were enrolled.All patients were measured by autobiographical memory test (AMT),Toronto alexithymia scale-20 (TAS20),Hamilton depression scale-24 (HAMD-24).Results ①The negative overgeneral AM score was higher in depressive patients with alexithymia than those without alexithymia ((3.34± 1.80),(2.51 ± 1.12),respectively t=2.19,P＜0.05).②The total overgeneral AM score was higher in depressive patients with alexithymia than those without alexithymia ((6.14±2.44),(4.86±2.06),respectively t=2.21,P＜0.05).③)The correlation coefficient (r value) between the total score of overgeneral AM and total score of TAS,TAS-Ⅲ scores of TAS in depressive patients with alexithymia were significantly positively correlated (r=0.240～0.611,P＜0.05).However,the correlation coefficient between the total score of specific AM and total score of TAS,TAS-Ⅲ scores of TAS in depressive patients with alexithymia were significantly negatively correlated(r=-0.502～-0.205,P＜0.05).Conclusion Compared with depressive patients without alexithymia,the overgeneral AM in depressive patients with alexithymia is more severe,and the alexithymia can increase the severity of overgeneral AM.

Objective To investigate mRNA expressions of apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3 family (APOBEC3s or A3s) as well as expressions and subcellular distribution of major A3 proteins in HaCaT keratinocytes carrying the genome of human papillomavirus type 11 (HPV11.HaCaT),and to evaluate regulatory effects of exogenous interferon-alpha (IFN-α) on the expressions of A3s.Methods The basal levels of A3A,A3B,A3C and A3H mRNA expressions were measured by real-time fluorescence-based quantitative PCR (qRT-PCR) in HPV11.HaCaT cells and normal HaCaT cells.Cultured HaCaT,HPV11.HaCaT and Hela cells were treated with recombinant human IFN-α 2b (rhIFN-α2b) at concentrations of 104,105 and 106 IU/ml for 6,24 and 48 hours separately,and those receiving no treatment served as the normal control groups.Then,qRT-PCR was performed to measure mRNA expressions of A3A,A3B,A3C and A3H in these cells.Immunofluorescence staining was conducted to observe the expression and distribution of A3A protein in cells after the treatment with rhIFN-α2b for 6 hours.Results As qRT-PCR showed,the basal levels of A3A,A3B and A3C mRNA expressions were all significantly higher in HPV11.HaCaT cells than in normal HaCaT cells (all P ＜ 0.05).After stimulation,the mRNA expressions of the four A3 members increased to different extents with the increase in rhIFN-α2b concentrations,and the increase in A3A mRNA was the most significant.Compared with corresponding normal control groups,the mRNA expression of A3A was significantly increased in HaCaT cells (35.77 ± 5.01 vs.1.00 ± 0.05,P ＜ 0.05),HPV 11.HaCaT cells (15.34 ± 2.14 vs.0.99 ± 0.01,P ＜ 0.05) and Hela cells (24.60 ± 5.45 vs.0.97 ± 0.03,P ＜ 0.05) after the treatment with rhIFN-α2b at 106 IU/ml for 6 hours,while the increase in A3B,A3C and A3H mRNA expressions was no more than 9-fold in these cell lines after that.Enhanced staining for A3A was observed in nuclei and cytoplasm of the 3 cell lines after the treatment with rhIFN-α2b at 106 IU/ml for 6 hours.Conclusions HPV11 transfected into HaCaT cells can activate intracellular A3s,especially A3A.IFN-α may play an immunoregulatory role by inducing high levels of A3A expression.

Objective The calcium oxalate stone is the most common type of the kidney stones.By building the rat renal calcium oxalate stone model, preliminary study the function of CaSR-Claudin14 regulating pathways on renal calcium oxalate stone for-mation model in rats. Methods 30 Male S-D rats were randomly divided into control group (n=15) and model group (n=15). Adult male S-D rats were given ethylene glycol and ammonium chloride to induce urolithiasis.Application of full automatic biochemical analyzer to test rat renal function and the changes of urine biochemical index.Immunohistochemistry was used to detect the expression of CaSR protein;RT-PCR was used to detect the Claudin-14 mRNA expression;Western Blotting was used to detect the expression of CaSR and Claudin-14 protein respectively. Results By observing model group has large stones crystallization under light microsco-py;model group rats 24 h urine calcium are significantly higher than control group([9.66 ±1.10]mmol vs [3.26 ±0.60]mmol, P<0.01); and model group 24 h urine volume are significantly higher than control group ([21.27 ±1.08]mL vs [13.2 ±0.55]mL, P<0.01 ); and urinary PH has no significant difference between the groups( P >0.05 ) .Expression of Claudin-14 mRNA in the model group is significantly higher than normal control group([0.150 ± 0.004] vs [0.047 ±0.008], P<0.01); Expression of Claudin-14 protein in the model group is significantly higher than normal control group([1.526 ±0.089] vs 0, P<0.01).Expression of CaSR protein in the model group is significantly higher than normal control group([6.697 ±0.051] vs [5.016 ±0.053], P<0.05). Conclusion CaSR can raise the expression of Claudin-14, increase re-nal tubular urinary calcium excretion to promote renal calcium oxalate stone formation.