Objective To explore the application value of non coherent diffusion weighted imaging(IVIM) model in magnetic resonance body element for differentiating benign and malignant breast cancer.Methods Compar-ison of dynamic enhanced magnetic resonance (DCE -MRI)was conducted in 60 patients with breast occupying lesions,all patients were not treated with biopsy or needle biopsy before MRI scan.The lesions were obtained by oper-ation or biopsy after MRI scan,confirmed by pathology,39 benign lesions(benign group),28 malignant lesions(malig-nant group).IVIM-DWI parameters of two lesions group(D value,D* value and F value)were compared,analyzed IVIMDWI model parameters(D value,D* value and F value)diagnostic efficiency of diagnosis of benign and malig-nant breast lesions.Results Compared with two lesions groups,in the IVIM DWI model parameters,the D value of the malignant group was (0.95 ±0.19)×10 -3 s/mm2 ,which was significantly lower than (1.33 ±0.25)×10 -3 s/mm2 of the benign group (t =3.89,P <0.05),the F value of the malignant group was (8.97 ±2.01)%,which was significantly higher than (7.01 ±2.13)% of the benign group (t =3.93,P <0.05),there was no significant differ-ence in D* values between the two groups (P >0.05).IVIM DWI model in differential diagnosis of breast lesions had high diagnostic efficiency.Conclusion IVIMDWI model in the diagnosis of benign and malignant breast cancer is highly effective,and it has high clinical value.

Objective To establish a protein preparation process for growth differentiation factor 5(GDF5),and explore its role in cartilage injury through in vivo and in vitro experiments.Methods The gdf5 gene was ligated with the pCZN1 vector to construct the recombinant plasmid pCZN1-hGDF5,which was then transformed into E.coli BL21(DE3) pLysS host bacteria.Single colonies were picked to screen for high-expression strains.The strains were induced by IPTG,and the protein expression form was detected by SDS-PAGE.A method for inclusion body washing,denaturation and dilution renaturation was established,and the protein was purified by Ni affinity column chromatography and DEAE ion exchange column chromatography.ATDC5 cells were used as the detection cell line,and the biological activity of rhGDF5 protein in promoting proliferation was determined by MTT method.A model of cell injury induced by interleukin-1β(IL-1β) was established.The expression of cartilage-related genes and proteins was detected by RT-qPCR and Western blot,and the effect of rhGDF5protein on chondrocyte differentiation was analyzed by Alcian blue staining and alkaline phosphatase(ALP) activity determination.Poloxamer 407(P407) and 188(P188) thermo sensitive gels were prepared by cold dissolution method,and detected for their rheological properties by a rheometer.A male C57BL/6J mouse model of osteoarthritis(OA) induced by destabilization of medial meniscus(DMM) was established.The mice were administered by intra-articular injection once a week for four consecutive weeks.The mice were sacrificed and their knee joint tissues were collected.After decalcification,paraffin embedding and sectioning,they were stained with safranin O and fast green and detected by immunohistochemistry,and the OARSI score was determined.Results The results of double enzyme digestion(Nco Ⅰ/BamH Ⅰ) showed that the recombinant plasmid pCZN1-hGDF5 was correctly constructed.The protein expression level of the selected rhGDF5 high-expression strain accounted for 35% of the total protein.The expressed protein mainly existed in the form of inclusion bodies.After refolding and column chromatography,an rhGDF5 homodimer protein with a relative molecular mass of approximately 25 000and an electrophoretic purity of over 95% was obtained.The rhGDF5 protein exhibited a good proliferation-promoting effect on ATDC5 cells within the dose range of 25 to 800 ng/mL,and no cytotoxicity was observed at high doses.The rhGDF5protein could effectively promote the increase in chondrocyte number and proteoglycan secretion,and significantly inhibit the expression of ALP in ATDC5 cells.The results of RT-qPCR and Western blot demonstrated that compared with the IL-1βgroup,the administration of rhGDF5 protein could effectively reverse the inhibition of collagen type 2(COL-2) and SRY-box transcription factor 9(SOX9)(COL-2:t=4.899 and 9.799,respectively,each P <0.05;SOX9:t=4.950 and 10.73,respectively,each P <0.05),and significantly inhibit the expression of matrix metalloproteinase 13(MMP13)(t=6.500 and23.51,respectively,each P <0.05).The poloxamer thermosensitive hydrogel containing 22% P407 and 5% P188 with rhGDF5 protein prepared by cold dissolution method showed the gelation temperature of(30.06±0.16)℃ and the gelation time of 92.67 s.The results of the DMM mouse OA model experiment showed that compared with the control group(0 ng/mL),the injection of rhGDF5 protein-loaded thermo sensitive hydrogel into the joint cavity effectively repaired the damaged joint,with the high-dose group having the best repair effect,with an OARSI score of 1.The medium-dose group had an OARSI score of 1.67,while the low-dose group had no significant effect,with an OARSI score of 5.33.The immunohistochemical results also showed that compared with the control group,the treatment with rhGDF5 protein increased the distribution of COL-2.Conclusion A simple and efficient preparation process for protein renaturation,dimerization promotion and purification of rhGDF5 inclusion body was established,and its effective effect on cartilage was proved through in vivo and in vitro experiments,which provides technical support for further development of OA treatment products.

Objective To observe the therapeutic effect of Jiaji point needling for the treatment of gastroesophageal reflux disease (GRD) with liver-stomach stagnated heat type. Methods Sixty GRD patients were randomly divided into Jiaji point group and conventional point group, 30 cases in each group. Jiaji point group was given needling on bilateral T5 to T10 Jiaji points, and conventional point group was given acupuncture mainly on Zusanli, Zhongwan and Neiguan points, once a day for 10 continuous days. Before and after treatment, the scores of clinical symptoms and gastroscopy results were observed, and then the therapeutic effect and recurrence rate of GRD were evaluated. Results (1) The total effective rate of Jiaji point group was 86.7％, and that of the conventional point group was 83.3％, the difference being insignificant (P > 0.05). (2) After treatment, the scores of clinical symptoms of the two groups were decreased (P < 0.01 compared with those before treatment), and the decrease in Jiaji point group was superior to that in the conventional point group (P < 0.05). (3) After treatment, the mean R value of gastroscopy results in the two groups was lower than that before treatment (P <0.01) , but the difference of the mean R value of gastroscopy results in the two groups was insignificant (P >0.05). (4) After treatment for 2 months, the recurrence rate of Jiaji point group was 23.5％ and that of the conventional point group was 42.9％, the difference being insignificant between the two groups (P > 0.05).Conclusion The short-term effect of Jiaji point needling for the treatment of GRD with liver-stomach stagnated heat type is superior to that of conventional point needling.

Objective To evaluate the clinical efficacy of transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization in the treatment of hepatic metastases from colorectal carcinoma.Methods Sixty-eight cases with hepatic metastases from colorectal carcinoma were equally and randomly divided into two groups.The patients in study group were treated with transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization,while the patients in control group were treated with conventional(normal temperature) transcatheter hepatic arterial chemotherapy lipiodol embolization.Results The effective rate of study group and control group was 65%(22 / 34) and 32%(11 / 34) respectively,the difference between two groups was statistically significant(P

Objective To evaluate the value of narrow band imaging(NBI) in the diagnosis of early squamous esophageal cancer and precancerous lesions.Methods Four thousand and fifty-six patients were examined by routine endoscopy,NBI and iodine chromoscopy,one hundred and fourteen lesions in 82 patients were screened.Of all lesions were detected by NBI with magnification and targeted biopsy.The differences among routine endoscopy,NBI and iodine chromoscopy,and the consistency between IPCL and histological findings were assessed.Results Compared to NBI and iodine chromoscopy,especially flat lesions,there was a high missed diagnosis rate in diagnosis of early squamous esophageal cancer and precancerous lesions by routine endoscopy.With NBI and iodine chromoscopy,the incidence rate of lesions was 78.0% and 79.8%,respectively.For iodine staining,85.7% Grade Ⅰ was high grade intraepithelial neoplasia(HGIN),and 66.0% Grade Ⅱ/Ⅲ was low grade intraepithelial neoplasia(LGIN).For NBI,80.4% Grade Ⅰ was HGIN,but there was no specificity in diagnosis LGIN.In appearance of IPCL,92.9% Type Ⅳ/Ⅴ was HGIN,89.4% Type Ⅱ/Ⅲ was LGIN,and it has a relatively better consistency in IPCL with histological findings.Conclusion There is a high detection rate in diagnosis of early squamous esophageal cancer and precancerous lesions by Lugoul's iodine staining and NBI endoscopy.It's probably that IPCL patterns by NBI with magnification can provide scientific basis for both the endoscopic theraphy of early esophageal cancer and the omen of postoperative recurrence.

Objective: To explore the clinical effcacy and short-term survival rate of partial cardiac auto-transplantation for treating the patients with giant left atrium.
Methods: A total of 7 patients with rheumatic heart disease received partial cardiac auto-transplantation in our hospital from 2012-08 to 2013-05 were retrospectively studied. The patients were at the age of (54.9±5.0) years including 3 male, all of them combined with giant left atrium and pre-operative atrial ifbrillation (AF), 6 of them received radio-frequency ablation. All patients were monitored for their baseline condition, operative status, peri-operative mortality and complication occurrence for clinical analysis.
Results: All 7 patients received mitral valve replacement, 5 had aortic valve replacement and 2 had aortic valve-plasty, the mean aortic cross clamp time was (271.7±29.0) min. The average left atrial diameter decreased from (91.7±3.5) mm to (64.8±8.1) mm, left ventricular ejection fraction (LVEF) improved from (38.3±6.5) % to (47.4±6.1) % at discharge, allP<0.05; 4 patients recovered to sinus rhythm and no peri-operative death occurred. The patients were followed-up for (20.7±3.9) months, 1 year post-operational survival rate was 100%, 1 patient died at 17 months after operation and the average left atrial diameter was (56.3±3.4) mm in rest 6 patients at the last examination during follow-up period.
Conclusion: Partial cardiac auto-transplantation may obviously reduce left atrial diameter with good clinical effect in certain patients with giant left atrium.

Background and purpose:The antitumor drugs produce a marked effect through the induction of apoptosis. The resistance to chemotherapy has been found to be associated with abnormal expression of genes related to apoptosis. We designed this experiment to investigate the role of survivin gene in the resistance to chemotherapy. Methods:After being treated with Hydroxycamptothecine (OPT,21.96mmol/L), the apoptosis in gastric cancer cell line BGC-823 cells were evaluated by either flow cytometry(FCM) or the terminal deoxynucleotidy transfer mediated dUTP-biotin nick end labeling(TUNEL). The expression of Survivin was detected by reverse transcription-Polymerase chain reaction(RT-PCR) and immunohistochemistry.Results:Compared to control group, the OPT can induced apoptosis in BGC-823[(12.68?0.17)% vs (3.35?0.13)% by FCM,(16.00?1.23)% vs (2.78? 0.84)% by TUNEL[, OPT could upregulate survivin expression in BGC-823 cells (1.489?0.041)% vs (0.756?0.037)% in terms of level of mRNA,(0.928?0.046) vs (0.303?0.032) in terms of protein expression).Conclusions:The survivin gene may be associated to the resistance to chemotherapy through the induction of gene expression.

0.05).While compared with the control,the permeation enhancement effects of 5% concentration of Lecithin,Oleic acid,Menthol,Limonene,and Azone were 1.37,2.25,3.71,6.75,and 10.15 times,respectively.CONCLUSION: Compared with Simomenine Hydrochloride,Simomenine free base had excellent transdermal characteristics,and was more suitable for the development of new transdermal preparation.

The Six Meridians inTreatise on Exogenous Febrile Diseases were once thought the same with the six meridians ofThe Inner Canon of Huangdi. With this theory was overthrown, similarities and differences and the correlation between them have gradually been studied. In this paper, we take the Taiyang Median as an example to explain the similarities and differences from two aspects, including clinical symptoms and the understanding of the same disease with different treatment.

Objective:To observe the occlusal changes of patients with chronic periodontitis(CP)after initial periodontal therapy an-alysed by T-scan Ш occlusal analysis system.Methods:26 patients with CP were included.The patients were treated by initial perio-dontal therapy,including scaling,subgingival curettage,root planning and oral hygiene instruction.The occlusion time(OT),disoclu-sion time(DT),center of force trajectory(COFT),the percentage of bite force for maximum movie force at maximum area frame (MABF /MMF)and the bite force distribution balance between the left and right sides (BFDB)were measured by T-scan III occlusal analysis system before and six weeks after the treatment.All the data were statistically analyzed.Results:After initial periodontal treatment,the OT and DT extended for (0.20 ±0.14)s and (0.11 ±0.08)s respectively(P <0.05),the COFT increased by (0.81 ±1.19)mm(P <0.05).Moreover,the MABF /MMF and BFDB decreased by(7.20 ±4.41)% and (8.90 ±7.71)% respectively (P <0.05).Conclusion:Initial periodontal treatment may improve the occlusion of patients with chronic periodontitis.