Objective:To investigate the MRI manifestation of recurrent pyogenic cholangitis accompanied with intrahepatic cholangiocarcinoma.Methods: A total of 230 patients with recurrent pyogenic cholangitis were selected from our hospital. 64 patients were made a diagnosis with intrahepatic cholangiocarcinoma by pathology and MRI and were brought into our research. Their clinical data was analyzed to investigate their MRI manifestation. Results: Compared with non-atrophy liver lobes, the morbidity of cholangiocarcinoma was higher in atrophy liver lobes (78.18%vs.28.77%,P<0.001).Compared with liver lobes without hepatic portal vein blocking, the morbidity of cholangiocarcinoma was higher in liver lobes with hepatic portal vein blocking (78.18%vs.28.77%,P<0.001). Compared with liver lobes without hepatolith, the morbidity of cholangiocarcinoma was higher in liver lobes with hepatolith (65.00%vs.36.76%,P=0.001).Conclusion: Recurrent pyogenic cholangitis accompanied with intrahepatic cholangiocarcinoma mainly occurs in atrophy liver lobes, liver lobes with hepatic portal vein blocking and liver lobes with hepatolith. The main MRI manifestation of cholangiocarcinoma is less blood supply, but few neoplasms have much blood supply.

Objective To assess the diagnostic value of Logistic model in differentiating between malignant and benign ovarian lesions. Methods Thirty-five indexes of clinical and ultrasound data were recorded in 601 ovarian lesions confirmed by surgical pathology. The Logistic model was developed on a training set( n - 400) and tested on a test set( n = 201). Results Variable selection resulted in a set of 10 variables for the models: personal history of ovarian cancer, maximal diameter of the lesion, maximal diameter of the solid component, multilocular-solid tumor, solid tumor, ascites, flow within papillation, irregular walls, very strong intratumoral blood flow (i. e. color score 4) and acoustic shadows. Test set area under the receiver-operating characteristics curve was 0.963 with a sensitivity 93.9% and a specificity 93. 1 %. Conclusions Logistic model can accurately separate malignant from benign ovarian masses.

Objective To compare the clinical effects between the two-level ladder ultrafiltration and sequential dialysis for hemodialysis patients with excessive water retention.Methods According to our hospital standard,23 patients with water retention during treatment with dialysis from January 2010 to September 2011 were selected.And they conducted a total of 198 dialysis.Both the two-level of high-level segment and sequential ultrafiltration step dialysis were set for 1 hour.Ultrafiltration accounted for one-third of the total,and the remaining two-thirds of the amount of ultrafiltration was completed in the remaining time.The blood pressure,ultrafiltration volume completed,plasma osmotic pressure,detection of vascular access pressure,and other observed indicators during dialysis were compared.Results The occurrence of hypotension and muscle spasms in two-level ladder ultrafiltration was slightly more than that in sequential dialysis,ultrafiltration volume completed actually in two-level ladder ultrafiltration was a little less than sequential dialysis.However,the difference was not statistically significant ( P ＞ 0.05 ).It took more time during sequential dialysis simple ultrafiltration,occasionally dialysis fluid stopped flowing and dialyzer and the trail tube lack of incubation,and some patients could not adapt to it.Amount of heparin( [7.48 ± 1.73 ] mg/h vs[6.25 ± 1.36] mg/h,t =5.374,P ＜ 0.01 ),venous pressure ( [ 128.62 ± 10.53 ] mm Hg vs [ 96.35 ± 11.84 ] mm Hg,t =20.166,P ＜ 0.01 ),trausmembrane pressure( [ 236.84 ± 23.65 ] mm Hg vs [ 175.94 ± 24.72] mm Hg,t =17.516,P ＜ 0.01 ) were significantly higher than those in the high level of ultrafiltration period.Mean arterial pressure ( MAP ) ( [ 100.48 ± 5.78 ] mm Hg vs [ 102.54 ± 5.39 ] mm Hg,t =2.571,P ＜ 0.05 ) and plasma osmotic pressure ( [ 311.42 ± 7.36] mOsm/( kg · H2O ) vs [ 3 1 7.31 ± 6.89 ] mOsm/( kg · H2O ),t =5.774,P ＜ 0.01 ) in high level period were significantly lower than those in the singal ultrafiltration period,and the MAP difference was higher than that in the singal ultrafiltration period ( [ 11.46 ± 6.53 ] mm Hg vs [ 9.42 ± 5.46 ] mm Hg,t =2.385,P ＜ 0.05 ).There is less symptomatic hypotension and other adverse reactions.Conclusion Two dialysis ultrafiltration method can both be used for patients with excessive water retention,they can reduce the ultrafiltraion complications and achieve ultrafiltration targets.Two-level ladder ultrafiltration with dialysis and ultra.filtration unity is more likely to be adopted by the clinic.

Objective To observe and assess the effect of different dosages of aspirin on inflammatory biomarkers, hemorheology (platelet aggregation rate) and clinical prognosis in patients with acute coronary syndrome ( ACS). Methods ACS patients were randomly assigned to receive different dosages of aspirin treatment orally. Patients in group A,B and C took 100 mg, 500 mg and 1000 mg of aspirin per day respectively. They were treated and followed-up for 1 year. High-sensitivity C-reactive protein ( hsCRP) , IL-6, tumor necrosis TNFot and platelet aggregation rate were examined and major adverse cardiac events( MACE) were recorded. Results A total of 312 patients with ACS were enrolled in the study. The baseline characteristics of the three groups were not different with respect to age, gender, cardiovascular risk profile, level of inflammatory biomarkers and concomitant treatment before and after randomization. The levels of baseline serum hsCRP, IL-6 and TNFa were higher in subjects of the study as compared with normal reference value (P<0. 05, <0. 05, <0. 01) and they decreased significantly after therapy with 3 different doses of aspirin (detected at 30 days, 6 months and 12 months, P <0. 001 ) , but there were no significant differences among the three groups( P >0. 05) . Rehospitalization , MACE and the change of platelet aggregation ratio were not significantly different among the three groups. The incidence of gastrointestinal complaints was significantly higher in groups B and C than in group A ( P < 0. 05 ). Conclusions The levels of serum inflammatory biomarker increase in patients with ACS. Aspirin therapy may decrease the level of inflammatory markers significantly, but increasing the dosage of aspirin from 100 mg to 1000 mg daily does not decrease the level of inflammatory markers and the clinical MACEs further. However, the incidence of gastrointestinal complaints increase significantly with the increase of aspirin dosage.

BACKGROUND:Acel ular dermal matrix has good biocompatibility and absorbability and exhibits superiority in the guided bone regeneration. OBJECTIVE:To compare the histological changes and osteogenic effects in bone defects after guided bone regeneration with acel ular dermal matrix and Bio-Gide membrane. METHODS:Mandibular second, third and fourth premolars and the first molars bilateral y were extracted from 12 beagle dogs. Three months later, four three-wal bone defect models in the mandible of each dog were made, and randomized into acel ular dermal matrix plus bone graft group (acel ular dermal matrix group), Bio-Gide plus bone graft group (Bio-Gide group), bone graft group, and blank control group (no treatment). In the former two groups, acel ular dermal matrix and Bio-Gide were used to cover the bone grafts, respectively. RESULTS AND CONCLUSION:After surgery, al the beagle dogs recovered wel . Al the groups except the control group showed dramatical improvement in histological changes and percentage of new bone area, and this improvement was more significant in the Bio-Gide and acel ular dermal matrix groups. Moreover, there was no significant difference between the Bio-Gide and acel ular dermal matrix groups. Therefore, the acel ular dermal matrix can be a candidate for bone repair instead of Bio-Gide membrane in the clinical practice.

Aim To investigate the molecular mecha-nism of Gab2 in the invasion and metastasis of breast cancer and provide a theoretical basis for clinical pre-vention of breast cancer invasion and metastasis. Methods The Gab2 , MMP-2 and MMP-9 expressions in 80 cases of breast cancer were detected by immuno-histochemistry . Western blot was used to detect the ex-pression of Gab2 protein in MDA-MB-231 cells and MCF-7 cells. The siRNA plasmid was used to transfect MDA-MB-231 cells. Western blot was used to detect the proteins expression of Gab2 , MMP-2 and MMP-9 . Transwell in vitro experiment was used to detect the in-vasion ability of each group transfected MDA-MB-231 cells, Western blot was used to analyze phosphorylation of Akt and ARK5 induced by epithelial growth factor ( EGF ) in transfected cells ( SiGab2/MDA-MB-231 and Scr/MDA-MB-231 ) . Results The expression of Gab2 protein in invasive ductal carcinoma was signifi-cantly higher than in normal breast tissue ( P<0. 01 ) . The expression of Gab2 was dramatically correlated with lymph node metastasis, ER expression, tumor his-tological grade, MMP-2 and MMP-9 (P<0. 05). The expression of Gab2 protein in MDA-MB-231 cells was higher than in MCF-7 cells. The expression of Gab2, MMP-2 and MMP-9 decreased in SiGab2/MDA-MB-231 cells and the invasion ability of SiGab2/MDA-MB-231 cells was significantly decreased ( P<0. 05 ) , and after 5 minutes’ stimulating by EGF, the phosphoryla-tion of Akt and ARK5 was significantly reduced. Con-clusion Gab2 can promote the invasion and metasta-sis of breast cancer by effecting the expression of MMP-2 and MMP-9 through PI3 K/ Akt /ARK5 signal path-way.

Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.

Objective To explore the correlation between NF-κB signaling pathways activated by IL-18 in CD4+ T cells and the pathogenesis of PBC.Methods We detected the expression of IL-18 mRNA in PBMCs,IL-18 level in plasma,receptor IL-18R on surface of CD4+ T cell,proliferation rate of CD4+T cell and its NF-κB signaling pathway protein IκBα and NF-κB p65 by qRT-PCR,ELISA,flow cytometry,MACS and Western blot on 32 cases of patients with PBC (PBC group) and 32 healthy people (control group) in Guizhou provincial people′s hospital.Results The level of IL-18 in PBC group was significantly higher than that in control group (P<0.05).The relative expression of IL-18 mRNA in PBC group was significantly higher than that in control group (P<0.05).The percentage of CD4+T cells expressing IL-18Rα in PBC group was higher than that in control group (P<0.05).The proliferation rate of CD4+T cells stimulated by IL-18 in PBC group was significantly higher than that in healthy control group (P<0.01).The relative expression levels of NF-κB p65 protein were up-regulated in IL-18,and the expression of IκBα protein in each group was significantly increased,especially in PBC group (P<0.01).Conclusion IL-18 can activate NF-κB signal pathway in CD4+ T cells and participate in the pathogenesis of primary biliary cirrhosis.

Objective To study the effect of black granule capsules(BGCs) on growth of transplanted mouse hepatocarcinoma cells, cell proliferation cycle and apoptosis.Methods KM mouse were subcutaneously inoculated with Hepatocarcinoma cells (H22) and randomly divided into the model control group, the positive control group, the low, medium and high does of BGC group after 24h. The positive control group received intraperitoneal injection with 30 mg/kg cyclophosphamide. Mice of BGC groups were intragastricaly with different dosage of BGC (400, 800, 1 600 mg/kg). The model control group received intragastricaly with normal saline. The drugs were administrated once a day for seven days. The tumor inhibition rate was calculated at 24 h after the last administration. Flow cytometry was used to detect changes of cell cycle and apoptosis in harvested H22 tumor cells.Results The group of high does showed significant inhibitory effect on the growth of transplanted H22 tumor cells withthe inhibitory rate 38.78% (male) and 43.57% (female). Compared with model control group, groups of different dosages decreased time of G0-G1 phase (58.06% ± 9.65%, 55.10% ± 5.89%, 61.36% ± 15.95%vs. 74.47% ± 2.63%), increased tiem of Sphase (33.96% ± 11.90%, 32.67% ± 4.04%, 33.89% ± 9.82%vs. 14.37% ± 4.92%), and increased the apoptosis rate (31.12% ± 1.85%, 31.89% ± 2.16%, 40.64% ± 0.55%vs.21.75% ± 2.64%).Conclusion BGC has antitumor effect on mouse hepatocarcinoma H22 tumor cells, and its mechanism was to regulate cell proliferation cycle and induce the apoptosis.

Objective To establish the reference ranges for fetal cardiac axis in the mid-second trimester and to evaluate the use of fetal cardiac axis in prenatal diagnosis.Methods 6744 unselected singleton pregnancies were enrolled from September 2008 to October 2010.Routine screening scan of second trimester and fetal echocardiography were performed at 18- 23+6 weeks gestation.Fetal cardiac axis was measured on the four-chamber view of the heart.Results The 6744 fetuses had a mean cardiac axis of (37.03 ± 6.10)°,ranging from 9.80° to 102.41°. Using above or below 95％ range of population (26.63° -49.40°) as a cut-off,there were significant difference of cardiac axis between normal group [(36.96 ± 5.91)°,P ＜0.01] and the group with heart defects [(43.12 ± 15.67)°,P ＜0.01],the group with intrathoricic anomalies or abdominal wall defect [(51.74 ± 15.97)°].ConclusionsThe reference ranges of fetal cardiac axis for local population in mid-second trimester may helpful for detecting congenital defects.Presence of an abnormal cardiac axis in the fetuses is associated with a substantial risk of congenital heart disease and/or other extra cardiac defects.