Objective To explore the role of ppk1 gene in E.coli CFT073 strain during urinary tract infection (UTI). Methods C57BL/6 mouse models of acute UTI with the wild-type(CFT073) and ppk1 mutant (△pk1) infected, were used to compare the bacteria colonization and inflammation induction abilities of bladder tissues. Results In the mouse models, the △pk1 strain showed a significantly lower infection rate (73.3% vs 93.3%) and lower adhesion frequency of bladder (0.01%vs 0.5%) than those of the CFT073 strain. The expression of IL-6 and TNF-αwere reduced in the bladder of △pk1 infected group (P<0.05). Hematoxylin-Eosin tissue staining showed that the damage degree of bladders in △pk1 infected mice were less serious than the CFT073 infected mice. Conclusion ppk1 gene plays an important role in E.coli colonization to bladder and the inflammation induction ability.

Objective To investigate effects of hormone replacement therapy with conjugated equine estrogen (CEE) in different doses combined with medroxyprogesterone acetate ( MPA) on mammographic density among postmenopausal women and its clinical significance. Methods Ninety eligible postmenopausal women were randomized into three groups with varied treatment continuously for one year, Croup A receiving 0.3 mg CEE with 2 mg MPA and caltrate 600 mg and vitamin D 125 U daily; Group B receiving 0. 625 mg CEE combined with 2 mg MPA and caltrate 600 mg with vitamin D 125 U daily; and Group C receiving caltrate 600 mg and vitamin D 125 U daily. Mammographic density was analyzed using Wolfe and semi-quantitative methods for all of them and compared each other one year after treatment, as well as mammographic density before and after treatment in Groups A and B. Results One year after treatment, mammogrphic density reached the highest in postmenopausal woman of Group B and the lowest in those of Group C, with significant difference among the three groups (P ＜ 0. 01) and between Groups A and C (P ＜ 0. 01) and between Groups B and C ( P ＜ 0. 05 ). Mammogrphic density with semi-quantitative method increased significantly in Group A ( P ＜ 0. 05 ) and Group B ( P ＜ 0. 01 ), respectively, after treatment as compared with that before it. Change in mammografic density before and after treatment was greater in Group B than that in Group A, but not reaching statistically significant level (P ＞ 0. 05). Conclusions Hormone replacement therapy can cause the increase of mammographic density in postmenopausal women, possibly in a dose-dependent pattern, which suggest that HRT has side effect on breast tissue and the lowest effective dose of estrogen should be selected in HRT. Mammographic density can be used as an indicator to monitor side effect of HRT on breast.

ObjectiveTo investigate whether the T1-weighted dynamic contrast-enhanced perfusion magnetic resonance imaging (DCEPMRI) technique can help to delineate the clinical target volume of brain glioma patients.MethodsThe DCE T1-weighted images from 28 glioma patients were collected after GdDTPA was injected.After the acquired images were processed and analyzed using modified Tofts-Kermode'two compartment analysis model and de-convolution method,the value and its pseudo mapping of quantitative parameter Ktrans related to microvascular permeability were obtained.The tumor size in the largest diameter slice measured both in routine enhanced MRI and Ktrans mapping of T1-weighted DCEPMRI were compared.ResultsThe vascular permeability and tumor infiltration was lower in low grade glioma,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 0.2％ -0.3％ there was significant difference of tumor size between T1 -weighted DCEPMRI and routine enhanced MRI ( grade Ⅰ and Ⅱ grade with 2.93 cm2∶2.46 cm2(t=6.90,P=0.000) and 4.18 cm2∶3.21 cm2(t=10.22,P=0.000) ).While in high grade glioma,the vascular permeability and the tumor infiltration were higher,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 25％ - 26％( the size of grade Ⅲ and Ⅳ were 6.46 cm2 vs 5.48 cm2 ( t =10.83,P =0.000) and 8.26 cm2 vs 6.52 cm2(t =18.53,P =0.000) ).ConclusionsThe pseudo mapping of quantitative parameter Ktrans related to microvascular permeability acquired by T1-weighted DCEPMRI reflect the infiltrating circumscription in glioma,T1-weighted DCEPMRI can provide more information in delineation the clinical target volume,and it can be used as a new method for tumor volume evaluation.

Objective To summarize the echocardiographic characteristics and clinical signiifcance of prenatal diagnosis of coronary artery ifstula (CAF). Methods Images and follow-up results of ifve fetuses with CAF diagnosed by fetal echocardiography between January, 2011 and December, 2012 in our department were reviewed. Results Echocardiographic characteristics of CAF were a dilated coronary artery in the four chamber view and the left ventricular outlfow tract view. Track the course of the dilated coronary artery can conifrm the oriifce of the ifstula. Among the ifve cases, the oriifce of the ifstula included the aortic root of left ventricular outlfow tract, right atrium side of interatrial septum, the entrance of superior vena cava to right atrium, right ventricular apex and right ventricle cone. The colour Doppler lfow imaging showed turbulence in the dilated coronary artery. The spectral Doppler with the sampling gate in coronary artery showed the characteristic bidirectional lfow pattern. One case was associated with other complex intracardiac abnormalities and one case with persistent left superior vena cava. Among the ifve cases of CAF diagnosed by fetal echocardiography, one case was missed and four cases were conifrmed by postnatal echocardiography. Conclusion Coronary artery ifstula has special fetal echocardiographic characteristics. The fetal echocardiography plays an important role in early detection, diagnosis and treatment of CAF.

Objective To analyse the clinical significance of LHRH exciting test in the differential diagnosis of constitutional delayed puberty (CDP) and hypogonadotropic hypogonadism (HH). Methods Eighty-one cases from 1982 to 1998 were investigated and followed up. They were all at genital stage Ⅰ. After injection of 100 ?g LHRH, the blood samples (3 ml) were taken at -15, 0, 15, 30, 45, 60, 90 and 120 min. The serum LH and FSH levels were determined by radioimmunoassay. Then they were followed up every 3-24 months. After they received LHRH exciting test, they were followed up until over 18 years old. According to their puberty development status, they were divided into 3 groups, normal group (n=34),CDP group (n=16) and HH group (n=31),andthemeanage,whenthey received LHRH exciting test, was (10.2?0.9, range 9-14) years, (16.0?1.0, range 14-18) years and (17.1?1.4, range 16-22) years respectively. Results There were no significant differences in serum LH baseline level and peak time in normal, CDP and HH groups, but the serum LH peak level, LH increment (peak LH level minus baseline LH level), LH increment ratio (peak level/baseline level of LH) and the area under LH curve (AUC LH ) of normal group were significantly higher than those of CDP group and HH group (all P

Objective: To determine the potential diagnostic value of miRNA-29 (miR-29) for malignant tumor. Methods: A systematic search of literature regarding miR-29 was performed in three English databases (PubMed, Web of Science, and Embase) and two Chinese databases (Chinese National Knowledge Infrastructure [CNKI] and WanFang). The retrieval was ended until September 15, 2018. Search terms included miRNA-29 (miR-29), tumor, cancer, serum, plasma, diagnosis, etc. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was carried out to evaluate the quality of the selected articles. STATA12.0 was used to calculate the combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR). Subgroup analysis and Meta-regression analysis were carried out to explore the origin of heterogeneity. Results: Twenty eligible articles were selected from 1 172 literatures related to tumors and miR-29. The combined sensitivity was 0.76 (95%CI: 0.68-0.83), combined specificity was 0.83 (95%CI: 0.74-0.89), combined PLR was 4.5 (95%CI: 2.7-7.4), combined NLR was 0.28 (95%CI: 0.20-0.41), DOR was 16 (95%CI: 7-35), and theAUC was 0.86 (95%CI: 0.83-0.89). The combined specificity of plasma samples was higher than that of serum samples, and the difference was statistically significant (P<0.01). There was a higher diagnostic value of miR-29 for breast cancer and pancreatic cancer (DOR=101.52, 11.22), but lower diagnostic value for colorectal cancer and non-small cell lung cancer (DOR=5.05, 6.57); miR-29b showed a high diagnostic value for cancer (DOR=60.91). The publication bias was not obvious in this study (P>0.05). Conclusion: This systematic review and Meta-analysis suggests that miR-29 family is a potential biomarker in the diagnosis of cancers with great sensitivity and specificity.

Objective To compare DHS(dynamic hip screw )with PFNA(proximal femoral nail antirotation) treatment for intertrochanteric fractures and to analyze their postoperative complications .Methods A total of 107 patients with inter-trochanteric fractures were treated with DHS and PFNA fixation respectively .The type of fracture , postoperative complica-tions and overall efficacy were compared .Results After the follow-up of 28(24 to 36) months.DHS group had a higher overall incidence of postoperative complications than the PFNA group and the difference was statistically significant ( P<0.05).Conclusion In order to reduce the intertrochanteric fracture fixation complications , the type of fracture, osteoporo-sis and biomechanical fixation characteristics need to be considered when selecting surgical procedures .Postoperative func-tional rehabilitation is to be improved .The curative effect of PFNA is better than that of DHS .

Objective To investigate the clinicopathological characteristics of retransplantation for intrahepatic recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).Methods In a center hospital of organ transplantation setting,9 patients after primary liver transplantation had intrahepatic recurrence and received retransplantation,and 12 patients in control group were not subjected to LT over the same period.The follow-up period was 10 to 58 months.Results As compared the pathological characteristics of secondary transplanted liver with primary thansplanted liver,there was significant difference in tumor differentiation (grade Ⅱ,Ⅲ and Ⅳ)between primary group (33％,67％ and 0) and secondary group (22％,22％ and 56％) (P＜0.01).After primary liver transplantation,median of tumor free survival was 15.0 months.After secondary liver transplantation,median of survival was 5.8 months,and median of tumor free survival was 2.5 months.In control group,median of tumor free survival was 13.0 months,and total survival survival was 17.6 months.In transplantation group and control group,1-,2-,and 3-year cumulative survival rate was 89％,44％,33％ and 91％,45％,9％ respectively,with the difference being not statistically significant (P ＞ 0.05).Conclusion It is high risk of vascular invasion for tumor recurrence.The differentiation grade of recurrent tumor is lower.The sign of intrahepatic recurrence of HCC after liver transplantation may be early and local clinical characteristics of tumor cell disseminating and metastasis before and during operation,and it is not recommended to perform retransplantation.

Objective To investigate the effect of femoral head replacement for the treatment of intertrochanteric frac -tures among elderly patients .Method There were 38 cases that received intertrochanteric fracture hemiarthroplasty and 35 patients were treated with open reduction and dynamic hip screw ( DHS) plate internal fixation .After follow-up, their opera-tion duration,blood loss, postoperative drainage flow , postoperative ambulation time , hospitalization time were compared according to the Harris score to assess the effect of postoperative follow-up.Results After the mean follow-up time of 18 months (12 to 36 months),the hemiarthroplasty group was superior to the open reduction and DHS plate fixation group ,as shown by the earlier postoperative ambulation time , fewer complications , and better fracture reduction , with an excellent rate of 94 .7%.Conclusion For patients with intertrochanteric fractures , hemiarthroplasty surgery is effective and can re-duce the incidence of postoperative complications .

Objective To identify the changes of body composition with acromegaly before and after pituitary adeno-ma surgery,and to evaluate the relationship between these changes and serum growth hormone(GH),insulin-like growth factor-1(IGF-1).Methods Serum GH with OGTY,IGF-1 levels,BMI,fat percentage,FFM and total body water(TBW) in patients were measured in active and relieved period of the disease.Results The BMI and FFM with active acromegalic males were significantly higher,but fat percentage was significantly lower than that of healthy males.After the disease was relieved by surgery,serum GH and IGF-1 concentrations of patients were sig-nificantly reduced to normal level,but their BMI was still significantly higher,the fat percentage increased and the FFM decreased was correlated with serum nadin GH and IGF-1 levels.The BMI and FFM with active acromegalic females were significantly higher than healthy females,but the fat percentage had not significant change after sur-gery,and FFM decrease was correlated with reduced serum GH level.The fat percentage did not change signifi-cantly.Conclusion There was significant change of body composition with acromagely before and after treatment,and a relationship between these changes and serum GH and IGF-1 levels was identified.