Objective To analyze MRI findings of cesarean scar pregnancy (CSP). Methods The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed,and comparison was made between the MRI findings and surgical results.Results All Gestational sacs (18) were clearly detected by MRI.Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases.In 2 of the 16 cases,gestational sac was found within the myometrium,whereas in the remaining 14 cases,gestational sac was found partially within the myometrium with extension into the uterine cavity.The anteior wall of isthmus uteri became thinner.In the remaining 2 of the 18 cases,gestational sac presented as irregular,multilobolated mass,growing deep inot the myometrium as well as into the uterinecavity. On T2WI,the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T1 WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar.In the area of cesarean scar,the signal of the uterine wall was disconnected,with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T1WI and T2WI.Conclusion CSP has its unique findings on MRI,these specific features can provide useful information in the management of CSP.

Objective To analyse and conclude the MRI features of intracranial germ cell tumours so that to improve the diagnosis of this disease.Methods 15 cases of germ cell tumours verified by operation and pathology were reviewed and analyzed. All cases were undergone plain and contrast-enhanced MRI,the fat restrained sequence was performed if necessary. Results The location of tumors,six were in pineal region, six were in sellar region (germinoma, teratoma and choriocarcinoma in pineal and sellar region were all separately 3, 2 and 1), two were in basal ganglia (germinoma), and one was in right lateral ventricle (teratoma).Conclusion MRI is very valuable in the diagnosis and differential diagnosis of intracranial germ cell tumours.

[Objective] To analyze the stress distribution in facet joint of lumbar spine on normal and degenerative models with biomechanical method during the manipulation. [Methods] The finite element model of lumbar facet joint of L4-5 were reconstructed with finite element method and imaging method. Different movements such as anteflexion, retroflexion, lateral flexion, rotation and compression were loaded on the models and then stress distribution during the mimetic spinal manipulation was analyzed and compared. [Results] The facet joint of lumbar spine has an important role in resisting load, especially in resisting rotation. [ Conclusion ] The strong flexion-rotation manipulation should be avoided for seriously degenerative subject.

Objective To investigate the effects of Xinshang Xuduan Decoction(XXD, mainly composed of Rhizoma Drynariae, Radix Dipsaci, and Eupolyphaga seu Steleophaga) on the proliferation and differentiation of rat osteoblasts and bone morphogenetic protein 2(BMP-2)expression in the osteoblasts . Methods The animal serum containing XXD was prepared by serum pharmacological method and then was mixed together with α-MEM for the cell culture. Osteoblasts were isolated from the skull bone of SD neonatal rats by collagenase digestion and were identified by alkaline phosphatase(ALP) staining and alizarin red staining. The third and fourth generations of osteoblasts were treated with XXD at the volume fraction of 5%, 10%, 20% for 24, 48 , 72 hours respectively, and then the proliferation of the cells was evaluated by Cell Counting Kit-8(CCK-8). In the other test, osteoblasts were cultured with blank control serum, and 10% serum containing XXD, Radix Dipsaci, and Rhizoma Drynariae, respectively, and then the ALP activity was examined by using ALP assay kit and the expression of BMP-2 was investigated by enzyme-linked immunosorbent assay(ELISA). Results XXD had a dose- and time-dependent effect on the proliferation of rat osteoblasts in a suitable volume fraction range from 5% to 20%, and the effect of XXD at 10% was the best. Compared with the blank control serum group, ALP activity was increased in the cells treated with 10% serum containing XXD, Radix Dipsaci, and Rhizoma Drynariae(P<0.01). On culturing day 7, the expression of BMP-2 was increased in 10% XXD group and Rhizoma Drynariae group(P<0.05). Conclusion XXD can increase the ALP activity and BMP-2 expression in the osteoblasts in vitro, so does the single herb of Rhizoma Drynariae. And their therapeutic mechanism in promoting the healing of fractures may be related with the enhancement of osteogenesis of osteoblasts.

The aim of this investigation was to determine whether a PPARgamma2 Pro12Ala polymorphism was associated with insulin resistance, beta-cell function and hypertension in Chinese populations. 289 unrelated Chinese subjects first diagnosed Type 2 diabetes (HbAC1 < 6.0) were investigated, including 132 hypertensive diabetic (HTD) subjects, 157 normotensive diabetic (NTD) subjects. Blood pressure and anthropometric measurements were collected from all participants, as well as several venous blood samples during oral glucose tolerance test (OGTT). Biochemical measurements (high-density lipoprotein (HDL) and low-density lipoprotein-cholesterol (LDL), triglycerides) and PPARgamma2 Pro12Ala genotype were also determined. And insulin resistance and beta-cells function was assessed by HOMA-IR and HOMA-beta respectively. The frequency of subjects bearing the Pro12Ala was lower in the hypertension group (3.03%) than in the non-hypertension group (5.7%) (P < 0.05) after adjusted for age, BMI and gender. Hypertensive diabetic Pro12Ala subjects had lower fasting plasma glucose level (P = 0.0127), and better glucose tolerance 60 min after oral glucose (P = 0.0361). Moreover, plasma insulin concentrations at 60 min was lower than those without A variant (P = 0.0275), and both hypertensive Ala/Pro in HOMA-beta (P = 0.0455) and AUC for insulin (P = 0.0473) were higher, and HOMA-IR was lower (P = 0.0375) as compared with hypertensive Pro/Pro subjects. No association was observed between Pro12Ala genotype and BMI, total cholesterol, HDL- cholesterol or triglycerides in either group. Our findings suggested that the Ala 12 allele of the PPARgamma2 gene may improve insulin resistance and ameliorate beta-cell function reserves in T2DM with hypertension, and protect patients from hypertension in T2DM. As an important thrifty gene, environment factors may exerts an effect of PPAR gamma2 on glucose homeostasis and insulin resistance.
Alanine/genetics ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/*genetics ; Genetic Predisposition to Disease ; Hypertension/*complications ; Hypertension/genetics ; Insulin Resistance/*genetics ; Insulin-Secreting Cells/*physiology ; Mutation ; PPAR gamma/*genetics ; Proline/genetics

Objective To observe the influence of the stress and displacement when the normal sacroiliac joint is exerted load simulating oblique-pulling manipulation, and to analyze the stress and displacement distribution when a three-dimensional finite element model of normal pelvis is exerted by oblique-pulling manipulation. Methods Lateral position was simulated on the three-dimensional finite element model of normal pelvis and it exerted loads horizontally forth and back, then the stress and displacement distribution were calculated. Results When the normal sacroiliac joint was exerted load simulating oblique-pulling manipulation, stress of the pelvis was mainly concentrated on the anterior inferior part of the left iliac fossa from the front view, with a maximum stress of 0.540E+07. The maximum value of internal and external strain of normal sacroiliac joint was 8.682 × 10-4m;the maximum value of anteropostreior strain was 3.337 × 10-4m;and the maximum value of up and down strain of normal sacroiliac joint was 3.284 × 10-4m. Conclusions The focus of the sacroiliac joint stress is mainly on the anterior and posterior superior borders when the normal pelvis exerted oblique-pulling manipulation. The internal and external strain of normal sacroiliac joint is maximal, the anteropostreior strain ranges the second, and the up and down strain is minimal.

Clinical data of 129 young pafienm with lung cancer were analyzed retrospectively.Adenocarcinoma was the main pathologic type of lung cancer(n=62,48.1%),followed by undifferentiated small cell carcinoma(n=35,27.1%),squamous carcinoma(n=20,15.5%).Forty four cases were misdiagnosed at first consultation with a misdiagnosis rate of 34.1%.To avoid misdiagnosis seems to be the key issue for improvement of prognosis in young patients with lung cancer.

A total of 96 patients with Graves'disease(GD)were followed for one and half years to observe the effect of antithyroid drugs(ATD)treatment.Serum TRAb,total iodine concentration and CD80 mRNA expression of peripheral blood monouclear ceils were measured.Logistics regression analysis was conducted with the combination of above parameters.Those GD patients with high level of TRAb,positive family history of GD, increased expression of CD80 and early age of onset were more inclined to relapse after ATD treatment.

Objective:To study the pathological mechanism of the inducible co-stimulator molecular and ligand ( ICOS/ICOSL) in Graves disease animal.Methods:45 out-bred BALB/c mice were randomly divided into three groups with 15 rats in each group;using gene gun to deliver different plasmid injection.Group A was delivered with pCDNA3.0-mICOSL and pCDNA3.0-hTSHR, Group B with pCDNA3.0-hTSHR and null pCDNA3.0 with Group C for immunization as the control group.The concentration of serum free thyroxine immunization was deter mined with immunoassay and serum thyrotropin receptor antibody ( TRAb ) with ELISA, supernatant of IFN-γconcentration in mouse spleen cells was measured with radioimmunoassay,and hTSHR transected CHO cells were incubated to detect the concentration of cAMP to deter mine autoantibody TRAb activity.Results: After plasmid injection serum FT4 level in Group A (0.49±0.25) pg/ml ( q=6.571,P=0.023) was higher than that in Group C,the standard rate was higher than Group B and C (χ2=14.47,P=0.005).IFN-γconcentration of mice spleen cultured supernatant in Group A (1.88±0.41) pmol/L was significantly higher than the other two groups.The activity of autoantibody TRAb in Group A 188.3 (179.7-260.2) %was higher than that in the other two groups ( P=0.027 ) .Conclusion: Exogenous delivery of pCDNA3.0-mICOSL plasmid in GD mice could stimulate the spleen lymphocytes to secrete more IFN-γ,increase the activity of TRAb autoantibodies and might lead to upregulation of immune response in Graves animal model in vivo.

Objective To establish whether Wnt-signaling pathway plays a role in mice β-cell function and/or survival in vitro. Methods Mice NIT-1 beta cells were cultured in media with glucose concentration of 33.3 mmol/L and the cytokines interleukin-1β, interferon-γand tumor necrosis factor-α with or without the addition of purified Wnt3a protein in vitro. Subsequently, β-cell apoptosis by Tunnel and flow cytometry, and β-cell proliferation by BrdU were analyzed. Total RNA was extracted to measure gene expressions by real-time PCR.Results Incubations of NIT-1 cells with high glucose and cytokines resulted in an increase in β-cell apoptosis and decrease in β-cell proliferation (P<0.01). In contrast, treatment with Wnt3a protein protected β-cell from glucose and cytokines-induced apoptosis through up-regulating the expressions of above Pitx2、 TCF7L2. Conclusions Wnt-signaling regulates the proliferation of pancreatic β-cell, and protectes β-cell from glucotoxicity and cytokine toxicity with respect to proliferation and apoptosis.