Objective:To explore the feasibility and mechanism on changing acoustic environment in tissue (AET) of rabbit liver by HL-1 intravenous injection.Methods:10 New Zealand rabbits were randomly divided into two groups,treatment and control group with 5 rabbits respectively.Before rabbit livers were ablated in vitro by using focused ultrasound(FU)(3.04W,11MHz),HL-1 was injected intravenously via rabbit ear marginal vine for 20 minutes.Rabbits were sacrificed by excessive anesthesia after 1 hour,and small pieces of liver tissue were cut for pathological exammation.Rabbits liver were ablated with FU in the manners of dot scan in different preplanned liver areas with various treatment time of 3s,6s,9s,12s and 15s,and its temperature in each dot was measured immediately after ablation.2 to 3 pieces of non-damaged tissues in each liver were chosen to measure its density after trial.All processes were the same as those of experiment group except replacing HL-1 with saline in control group.Results:Similar time-temperature curve showed in two groups except the temperature was higher in every dot in treatment group than that of control group( P

Objective:To explore the effects of ablation of normal rabbit liver tissue by combination of high intensity focused ultrasound(HIFU) and iodized oil emulsion(HIFU liposome 2,HL-2) and the grey scale changes in target region.Methods:Rabbit liver was ablated with HIFU under certain parameters one hour after HL-2 was injected intravenously in the experimental group.The grey scale in target region and the exposure time were recorded.All processes in control group were the same as those in the experimental group only HL-2 was replaced by saline.Results:The changes of grey scale in the target region were similar in two groups.Typical coagulation necrosis happened both in two groups under gross and histological examination.The energy efficiency factor (EEF)in the experimental group was less than that in the control group(P

Objective To study clinical characteristics,causes of misdignosis and diagnostic and therapeutic methods for primary hyperparathyroidism (PHPT).Methods Retrospective analysis was done for 51 patients of PHPT,47 confirmed by biopsy after surgical operation and 4 without operation diagnosed based on their serum levels of calcium,alkaline phosphatase ( ALP),intact parathyroid hormone ( iPTH ),and computed tomography (CT) or 99mtechnetium sestamibi (99mTcMIB1) imaging at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou during June 1997 to November 2010.Results Bone-related complications were the most common clinical manifestation,accounting for 51％ (26/51 ) of the cases,and adenoma,a benign,enlarged and hyperactive parathyroid gland,in 34 of 47 cases ( 72％ ).In orthotopic lesions,the right inferior was affected in 19 of 46 cases (41％),followed by the left inferior in 13 cases (28％),while 5 of 51 cases (10％) with ectopic parathyroid gland.PHPT was easily misdiagnosed as urolithiasis,rheumatic disease,primary osteoporosis,etc,accounting for 92％ of the cases in our study.Preoperative serum levels of calcium,ALP and iPTH in the patients varied with their clinical type and pathological classification,the highest in patients with urolithiasis-bone-related complications [ (3.22 ±0.35) mmol/L,(1455 ± 1091 ) U/L and (1669 ± 515 ) ng/L,respectively ] and in patients with parathyroid carcinoma [ (3.46 ± 0.40) mmol/L,( 1410 ± 426) U/L and ( 1861 ± 768) ng/L,respectively ].Sensibility of preoperative localization diagnosis using ultrasonography,CT and 99mTcMIBI was 88％ (35/40),97％ (30/31) and 97％ (31/32),respectively.Conclusions PHPT is frequently misdiagnosed as other diseases.Measurement of serum calcium should be included in routine physical examinations,supplemented with measurement of serum ALP and iPTH,as well as medical imaging,which can help avoid misdiagnosis.CT combined with 99mTcMIBI imaging can improve accuracy of preoperative localization diagnosis.

Objective To evaluate the effect of clinic-pathological variables on prognosis and recurrence of the aged women suffered from borderline epithelial ovarian tumors. Methods The clinical and follow-up data of 102 cases were analyzed retrospectively. Univariate and multivariate logistic regression analysis were used to assess independent prognosis and recurrence factors.Results The postoperative accessory treatment, peritoneal implantation and lymph nodes metastasis could influence the 5-year survival rate(χ2=19.311, 11.054, 18. 559, all P＜0.01). The surgery procedure, peritoneal implantation, lymph nodes metastasis and microinvasion could influence the recurrence rate(χ2=23.606, 23.583, 25.774, 23.583, all P＜0.01). The logistic regression model showed that the postoperative accessory treatment and peritoneal implantation were the two independent prognosis factors (OR=0.060, 35.319, all P＜0.01). The surgery procedure,peritoneal implantation and microinvasion were the three independent factors affecting recurrence(OR =0.001, P＜0.05;OR=60.952, P＜0.05;OR=88.874, P＜0.01). Conclusions The early standard treatment on borderline epithelial ovarian tumors of the aged women have an excellent prognosis, the risk of recurrence remains in some patients. We emphasize that these patients with highrisk factors should be main surveillance population.

Objective To obtain a clear and qualified compound glycyrrhiza oral solution by using NaSO3 and EDTA as stabi-lizers and Tween80 as solubilizer so as to solve the problem of morphine content instability. Methods NaSO34g and EDTA 0.6 g as stabilizers,and Tween803 g as solubilizer were added in the traditional method. The pH of the solution was adjusted to 8.0. Then the solution was obtained and filled in the brown polyester bottle. Results The preparation was clear,qualified and the content of mor-phine was steady. Conclusion The improved method is feasible,simple,stabilized and suitable for manufacturing.

Objective A previously reported female diagnosed with type A insulin resistance syndrome bearing a heterozygous missense mutation of R1174W in the insulin receptor gene was followed for 7 years since the age of 16 years. Methods Five-hour oral glucose tolerance tests (OGTT) were done on baseline, the 3rd, 6th and 7th year respectively, with serum insulin and C-peptide measured at the same time points. Areas under of curve (AUC) of glucose, insulin and C-peptide were compared between the years.Acute insulin response (AIR) was determined at baseline and the 7th year. The dose response were insulin secretion rates at each time point during OGTT being plotted over the corresponding glucose levels, and the slopes of which quantified the insulin secretion responding to glucose. Results The follow up data showed that the glucose metabolism of the subject did not deteriorate over time with yearly glycosylated hemoglobin A1c (HbAlc) being normal (4.6%-5.5%), and hyperinsulinemic hypoglycemia was a persistent phenomenon observed at 4-5 hours post-load. The fasting and AUCs of serum insulin and C-peptide tended to decline without simultaneously increase of those of plasma glucose. The AIR decreased by 56% as compared to baseline. The dose response curves shifted downward as years went by. Conclusions It supports that with the alleviation of physiological insulin resistance after puberty, the gross hyperinsulinemia tends to ameliorate, and β-cell secretion does not deteriorate over time as glucose homeostasis maintains.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

Objective To study the effects of rhubarb on the mitogen-activated protein kinase (MAPK) sig-naling transducfon pathway in rats with severe acute pancreatitis (SAP),and to investigate the treatment mecha-nism of rhubarb on SAP. Method One hundred SD rats were provided by from the Animal Center of Nanjing Uni-versity. All animals were randomly divided into sham operation (n=33), SAP (n=33) and rhubarb groups (n=34). SAP model was induced by retrograde injection of 5% sodittm taurocholate. Rhubarb was given with 10% rhubarb decoction (2 mi/100 g) at the time of pancreafitis induction in the rhubarb groups. At 1, 3, 6, and 12 h after the models were established,animals were killed. MAPK activity in pancreatic tissue was examined by West-em blotting and the mRNA levels of TNF-α and IL-6 in pancreatic tissues were detected by RT-PCR. All data were analyzed by SPSS statistical software and statistical differences between values from two sroups were determined by the Student's t -test. Results MAPK activity, TNF-α and IL-6 mRNA levels in pancreatic tissues were signifi-cantly enhanced in the SAP group compared with the sham operation group (all P<0.01). Rhubarb treatment markedlyinhibited MAPK activation,TNF-α,IL 6 mRNA (all p<0.01). Conclusions Rhubarb can alleviate the inflammatory response of SAP by down-regulating MAPK activity.

Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

ABSTRACT:Objective To investigate the effects of total flavones of oldenlandia diffusa (FOD)on epithelial-mesenchymal transition in hepatocellular cancer cell line MHCC97-H.Methods TGF-β1 induced EMT in routinely cultured liver cancer cell line MHCC97-H;then MHCC97-H cell was divided into 5 groups:normal control group, TGF-β1 group,TGF-β1 + FOD group,TGF-β1 + 5-FU group,and TGF-β1 + FOD + 5-FU group.After 48 h of treatment,the invasion ability of MHCC97-H cell was detected by Transwell;the proteins of E-cadherin and vimentin were determined by Western blot.Results Compared with the normal form of MHCC97-H cell line,the cell had obvious long fusiform after TGF-β1 induction,and the invasion ability enhanced (P = 0.02 ).But after treatment,the invasion ability of MHCC97-H cell decreased in FOD group and 5-FU group compared with that in TGF-β1 group (P = 0.03,P = 0.02 ),and decreased more significantly in FOD + 5-FU group (P = 0.01 ).The expression of E-cadherin at the protein level decreased significantly (P = 0.01 )in TGF-β1 group,which was abolished in FOD group (P =0.03 )and 5-FU group (P = 0.02 ).The expression of vimentin at the protein level increased significantly (P =0.01)in TGF-β1 group,which was abolished in FOD group (P =0.04)and 5-FU group (P =0.03)and more obviously in FOD+5-FU group (P =0.01).Conclusion FOD can reverse the invasion of MHCC97-H cells in EMT induced by TGF-β1 through decreasing the expression of E-cadherin protein and inhibiting the epithelial-mesenchymal transition of MHCC97-H cell.