Objective To evaluate the potential high risk factors of femoral head necrosis after femoral neck surgery in adult patients. Methods From January 2009 to October 2014,390 patients with femoral neck fractures in our hospital were treated with multiple hollow compression screws. All patients were followed up for 12 to 60 months. Then retrospectively analyzed the incidence rates of femoral head nec-rosis and the clinical data about age,gender,fracture side,Garden index,fracture shift condition,internal medicine complications,whether to do lower limb preoperative traction,restoration method,postoperative load time and whether take out hollow compression screw internal fixa-tion,so as to explore the higher risk factors for femoral head necrosis. Results Among the 390 cases,352 cases got followed up. There were 45 cases of them ended with nonunionand 49 cases ended with femoral head necrosis. The univariate regression analysis results showed that the age,fracture shift condition,internal medicine complications,postoperative load time and Garden index,whether take out internal fixation were risk factors for femoral head necrosis (P<0. 05). The multi-factor results showed that aged from 40 to 60 years old,transfered fracture, seriously complications,time of loading less than 3 mouths,Ⅲ and Ⅳ Garden index,take out internal fixation were the high risk factors for femoral head necrosis (P<0. 05). Conclusion Patients who aged from 40 to 60 years old and having transfered fracture,seriously complica-tion,early weight bearing,high Garden index and internal fixation take-out would increase the risk of femoral head necrosis.

Objective To summarize the clinical characteristics and management of eosinophilic esophagitis (EoE) in China and improve the recognition of clinical doctor for this disease.Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients.Data were enrolled according to the admission criterion,which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology.Results Data of 38 patients with EoE from 6 studies were included and analyzed.There were 24 males and 14 females.The age of onset was (47.2 ± 10.9)years.The process of the disease was (1.5 ± 1.8) years.The main symptoms included dysphagia (24/38,63％) and retrostemal pain (22/38,58％).Total 19 patients (83％,19/23) had allergy history and 20 patients (80％,20/25) had elevated blood eosinophil count.Lesions located at the mid-inferior esophagus mainly.Endoscopic manifestation included hyperaemia,erosion and fragile mucosa,and others such as mucosal nodular,ulcer,plaque and white exudates (18/38,47％).Eosinophil count in esophageal mucosa was (45.8 ± 34.1) numbers/HPF.Main treatment included corticosteroid and acid inhibitory medicine.Conclusions EoE is rare in Chinese people.EoE is more common in middle-aged males with chronic onset.Dysphagia and retrosternal pain is the common symptoms.Endoscopy and biopsy pathology are the methods for definition diagnosis.Corticosteroid and acid inhibitory medicine are the main treatment.

Background and purpose: Syndecan-1 and HPA-1 may be involved in the progression of invasion and metastasis of many malignant tumors, but there are few reports about the relationship between the two gene expressions in gastric carcinomas. This study was aimed to explore the expression of Syndecan-1 and HPA-1 mRNA in gastric carcinoma and their relationship with the invasion and metastasis of gastric carcinoma. Methods: Real-time polymerase chain reation (RT-PCR) was used to detect mRNA of Syndecan-1 and HPA-1 in 58 cases of gastric carcinoma, 58 paired adjacent gastric carcinoma (2 cm from carcinoma), and 58 surgical marginal normal gastric mucosa tissues (5 cm from carcinoma). Then we analyzed their relationship with clinico-pathological characteristics of gastric carcinoma. Results: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa (98.3%) than that in paired adjacent mucosa (25.9%) and gastric carcinoma (5.2%) (all P<0.001).The upregulation of Syndecan-1 mRNA was significantly higher in paired adjacent mucosa than that in gastric carcinoma (all P<0.05). The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma (86.2%) than that in paired adjacent gastric carcinoma (27.6%) and normal gastric mucosa (5.2%) (P<0.001). The upregulation of HPA-1 mRNA was significantly higher in paired adjacent gastric carcinoma than that in normal gastric mucosa (all the same P<0.05). The downregulation of Syndecan-1 and the upregulation of HPA-1 had relationship with the degree of differentiation, depth of infiltration, lymph node metastasis, distant metastasis and TNM staging of gastric carcinoma (P<0.05). Conclusion: The upregulation of Syndecan-1 mRNA was significantly higher in normal gastric mucosa. The upregulation of HPA-1 mRNA was significantly higher in gastric carcinoma. Also, the expression of Syndecan-1 and HPA-1 could predict the invasion and metastasis of gastric carcinoma. Determination of Syndecan-1 and HPA-1 may be of value in the treatment as well as in the prediction for prognosis of gastric cancer.

In this study, metabolism of nobiletin in rats was studied using ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). As a result, seven major metabolites were found in bile, urine and serum of rats. Three phase I products were assigned to be demethyl and di-demethyl products, and other four phase II products were assigned to be glucuronic and sulfonic conjugates. The four phase II metabolites were reported for the first time. Among the metabolites found in the present study, the glucuronic conjugates of demethyl-nobiletin played a predominant role in the metabolic pathway, indicating that its potential role for glucuronidation-related factors, such as gene polymorphism, drug-drug interaction, etc., in changing the active and toxic effect of nobiletin and that it should be paid more attention in further development.

The patient-derived orthotopic xenograft (PDOX) model better maintains the genetic characteristics of the primary tumor, and keep stable in histology, transcriptome, polymorphism and copy number variations. It also retains the interaction between the tumor mesenchyma, microvessels and stroma, and the tumor metastatic properties. Therefore, PDOX model can predict disease prognosis more accurately and can be used to screen appropriate individualized treatment strategies, thus, shows perfect prospect in clinical application. However, due to the differences between mouse and human microenvironment, morphological distinctions between orthotopic xenograft tumors and primary tumors still exist, and tumor metastasis can not be ensured by orthotopic xenograft. Thus, in order to construct the individualized PDOX model and to promote its clinical translation, it is necessary to analyze the histomorphology of orthotopic xenografts, to establish database of the transplantation model and share the information of the model. In this review, we will summarize the main features of PDOX models with its advantages and limitations, and looking forward to its application in the future.

Objective To investigate the effect of image registration on quantitative measurements of free breathing diffusion kurtosis imaging (DKI) in normal human kidney. Methods Twenty healthy volunteers were prospectively enrolled to undergo DKI imaging with a 3.0 T MR scanner. Three b values (0, 500, and 1 000 s/mm2) were adopted,with image registration performed after image acquisition. Acquired images were fitted using the DKI fitting model to generate the DKI metric maps,which were performed on both the pre-registration images and post-registration images. Image quality of the derived metric maps (before and after image registration,respectively) was assessed by two radiologists. Measurements of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (D|), axial diffusivity (D⊥), mean kurtosis (MK), radial kurtosis (K|) and axial kurtosis (K⊥) were conducted. The inter-observer reproducibility of the image quality assessment was analyzed using intra-class correlation coefficient(ICC). Wilcoxon signed-rank test was used to evaluate the difference in the subjective scores of the metric maps between those obtained before registration and those after registration. While paired t test or Wilcoxon signed-rank test was performed to analyze the difference in the quantitative measurements of DKI metrics of the renal cortex and medulla between those obtained before registration and those after registration.Results For the inter-observer reproducibility, satisfactory ICCs were obtained for the quantitative metric measurements (pre-registration:0.784 to 0.821;post-registration:0.836 to 0.934). Significant difference was notice between subjective scores for the quality of metric maps (P<0.05 for each comparison). In both the renal cortex and medulla, significant difference was noticed between each metric value obtained with pre-registration images and that with post-registration images (P<0.05 for each comparison). Conclusion Image registration can not only offer higher quality DKI metric maps,but also has effect on the quantitative measurements of obtained metric maps.

Objective To establish and evaluate a patient-derived orthotopic xenograft ( PDOX ) model of pancreatic cancer. Methods Tissues of patient-derived pancreatic tumor were transplanted into nude mouse pancreas by surgery. The PDOX models were evaluated by the small animal near infrared fluorescence ( NIRF) optical imaging and PET/CT. The traceability of PDOX models was detected by STR technology, and the pathological changes were observed by H&E staining, immunohistochemistry, and serum level of CA19-9 was detected by ELISA. Results Apparent NIRF were observed to be accumulated in pancreatic site by optical imaging system. The location and size of the xenografts tumor were revealed by fluorescence intensity. The PET/CT images with 18F-FDG molecular probe confirmed the tumor's location and size. Ex vivo NIRF imaging of isolated organ further showed the tumor formation. The traceability of PDOX models was 99. 99% with human origin. H&E staining pathology and immunohistochemistry indicated the pancreatic cancer characteristics. The high serum level of ca19-9 confirmed the mice bearing tumor. Conclusions Pancreatic PDOX models are successfully established in this study, and it can be evaluated comprehensively by NIRF optical imaging and PET/CT, providing an appropriate platform for further research of pancreatic cancer.

OBJECTIVETo investigate the clinical and imaging characteristics of severe acute respiratory syndrome (SARS), and to study their relationship.

METHODSForty-six SARS confirmed patients were admitted to our hospital from February to April, 2003. X-ray examination documents were available in all cases and chest CT scanning was acquired in 6 cases, which were analyzed retrospectively, accompanied by their clinical features.

RESULTSFever was found in 97.8% of the patients. Clinical symptoms were mild, but X-ray and CT findings were distinct. CT scanning demonstrated ground glass like lesions and large patchy exudation and consolidation at the early stage in 6 cases. Different findings on radiography and CT were related to the different phases of the disease. After treatment, most lesions were absorbed completely, but slowly in patients with multi-lobe consolidation and/or extensive interstitial infiltration.

CONCLUSIONSpecial clinical and imaging findings could be found in SARS cases. The prognosis of SARS patients is related to the degree of lesions detected by radiography and CT.

Adolescent ; Adult ; Aged ; Diagnostic Imaging ; Humans ; Male ; Middle Aged ; Prognosis ; Radiography ; Severe Acute Respiratory Syndrome ; diagnostic imaging

Objective To evaluate the therapeutic effect of chemotherapeutic drugs on pancreatic carcinoma based on patient-derived xenograft(PDX)models,and to screen an individualized treatment strategy. Methods Fresh human pancreatic carcinoma tissues were subcutaneously transplanted into nude mice to establish PDX models which could be stab-ly passaged. The traceability of PDX models was determined by STR analysis. The PDX models were treated with three dif-ferent clinical chemotherapeutic drugs oxaliplatin, gemcitabine and irinotecan, respectively, and the tumor volumes were measured at different times. The therapeutic effect of those drugs was assessed by TGD mathematical model and plasma CA19-9 test. Results The traceability of patient-derived xenograft samples was up to 99.99%. Compared with the con-trol group,the treatment with irinotecan and gemcitabine inhibited tumor growth significantly(P=0.001), and gemcit-abine had even better result. The minimum toxic effect in the mice was induced by irinotecan treatment,followed by gem-citabine treatment. Conclusions Pancreatic carcinoma PDX models are successfully established and can be stably pas-saged. Gemcitabine shows the most inhibitory effect on tumor growth based on TGD mathematical model assessment, and deserves to be recommended as the preferred drug for individual treatment of pancreatic carcinoma.

ObjectiveTo study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.Methods We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi.Plasma riboflavin levels were quantified in 445 ESCC patients,689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.ResultsThe plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [ (731.69 ± 330.67 ) μg/L vs ( 1090.43 ± 445.08 ) μg/L,(731.69 ± 330.67) μg/L vs ( 897.58 ± 177.78) μg/L,respectively,all P ＜ 0.05 ],and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P ＜ 0.05).ConclusionPatients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi,there exists a lack of riboflavin in ESCC patients,but the specific mechanism needs further study.