ObjectiveTo explore the value of MRI in diagnosis of chronic injury of the elbow in young athletes,and to discuss the optimization of imaging sequences.MethodsA total of 34 athletes (40 elbows) aged 6-16 years underwent MR examination on axial,sagittal and coronal planes.The characteristics of MRI were analyzed.ResultsThe anatomy of parenchyma and bones in elbow joint were displayed clearly by using axial TIW,sag T1W,T2W,sag STIR and PDW sequences.The thickening of periosteum and arthroedema were displayed well with sagittal T2W and STIR sequence,while bone marrow,ligament injury and synovitis were displayed well with PDW sequence.ConclusionMRI can display clearly the injury of bones and muscles in young athletes with chronic injury of the elbow.Optimization of imaging sequences is of importance in the depicting and diagnosis of chronic injury of bone and muscles.

To study the relationship between plasma procalcitonin(PCT) level and intestinal mucosal injury in patients with liver cirrhosis(LC), plasma PCT levels in 78 patients with LC were determined by immunoluminometric assay, endotoxin(ET)and the indicator of intestinal mucosal injury-diamine oxidase(DAO)activity were measured by fluorometric assay, TNF-? and IL-6 were measured by ELISA. The results showed that plasma levels of all these factors in LC patients were significantly higher than those of normal controls, and they were also higher in spontaneous bacterial peritonitis (SBP) group than those in non SBP group(P

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy regimens of TA or AC in the treatment of locally advanced triple negative breast cancer. Methods Data of 99 women with stageⅡ/ Ⅲ locally advanced triple negative breast cancer treated in the Centre Hospital of Cangzhou from Jan. 2006 to Dec. 2011 were retrospectively analyzed. These patients were divided into two groups based on the regimen of the neoadjuvant chemotherapy. Fifty-two cases were received TA regimen(Docetaxel 75 mg/ m2 and pirarubicin 50 mg/ m2 )and 47 cases were received AC( pirarubicin 50 mg/ m2 ,cyclophosphamide 600 mg/ m2 ). IV drip infusion was administered in both groups for 4 cycles before surgery,with 3 weeks for each cycle. The efficacy after treatment,the 2 year recurrence rate and overall survival rate after operation were compared between the two groups. Results The response rates in TA group were 88. 46% ,higher than that of AC group(57. 45% ),and the difference was statistically significant(χ2 = 12. 260,P < 0. 001). Furthermore,the rate of pathological grade 4 and 5 in TA group were 42. 3%(22 / 52)was superior to AC group(23. 4%(11 / 47);P = 0. 046). The 2-year recurrence rate and survival rate in TA group were 23. 08%(12 / 52)and 84. 62% ,as same as that in AC group ((27. 66%(13 / 47)and 80. 85% ;χ2 = 0. 400;P = 0. 53). Conclusion TA and AC are both effective in terms of females with stage Ⅱ/ Ⅲ locally advanced triple negative breast cancer treat with neoadjuvant chemotherapy. Moreover,TA is superior to AC. However,there is no statistical difference of 2-years recurrence rate and survival rate between two groups.

Objective To investigate the effects of lovastatin on MAPK activity in MCF 7 breast cancer cells. Methods After MCF 7 cells were treated with 4, 8 and 16 ?mol/L lovastatin for 48～72 h, the expressions of ERK1 and p38 MAPK proteins were detected by Western blotting. Their phosphorylation levels were observed by kinase activity assay. Results MCF 7 cells treated with different doses of lovastatin for 48～72 h had no significant effect on the protein level of ERK1, but the activities of ERK1 and the P38 MAPK proteins were down regulated at 72 h after treatment. Conclusion Lovastatin may down regulate the activity of MAPK in MCF 7 cells by means of inhibiting the mevalonate metabolism pathway and/or affecting phosphorylation levels.

Objective To investigate whether velocity vector imaging (VVI) combined with stress echocardiography could detect potential myocardial impairment of the left ventricle(LV) in diabetic rats.Methods DM rats ( n = 18,administered by STZ at 65 mg/kg) and control rats( n = 12) were performed with VVI and M-mode echocardiography both at rest and after dipyridamole stress 12 weeks later. Twodimensional echocardiographic cine loops and M-mode images of three consecutive beats were obtained from the short-axis views at the mid-LV level. The means of segmental peak systolic velocity(Vs), circumferential strain(εc) ,radial strain(εr), systolic circumferential and radial strain rate (SRc, SRr) and the percent wall thickening (WT% ,derived from M-mode) were obtained. After echocardiograms were performed,the hearts were excised and prepared for HE staining and ultrastructural observations under electron microscopy.Results At rest,only SRc in the DM group was significantly lower than that in the control group( P ＜0.05), the other parameters were statistically comparable between the two groups. After dipyridamole stress,all VVI values in the DM group were significantly lower than those in the control group ( P ＜0.05).However,there was no significant difference in WT% between the two groups either at rest or after dipyridamole stress ( P ＞0.05). Conclusions The VVI parameters combined with dipyridamole stress are more effective in evaluating potential myocardial impairment of the LV walls in diabetic rats. SRc might be more sensitive indices that can be used to detect myocardial impairment at rest.

Objective To observe the effect of Shengmai Chenggu Prescription (SCP) on the damage of endothelial cells (EC) induced by endotoxin. Methods EC obtained from rabbit's aorta were cultured and were treated with endotoxin and serum containing SCP respectively. Histological changes and function of the cultured cells were observed under light microscope and electron microscope and with MTT method . Results Endotoxin could result in the pathologic injury of cultured EC and inhibit the proliferation of the cells. Serum containing SCP could increase the activity of EC and promote its proliferation. Conclusion SCP can protect endothelial cells from damage induced by endotoxin.

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the periopera?tive blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture dis?placement, the patients were divided into two groups:GardenⅠ-Ⅱgroup and Garden Ⅲ-Ⅳgroup, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of opera?tion, the patients were divided into four groups:Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ;Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ;Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden gradeⅢ-Ⅳfemoral neck frac?ture group, the preoperative hidden blood loss was significantly higher than that of the Garden gradeⅠ-Ⅱfemoral neck fracture group (t=2.267, P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss vol?ume and total blood loss volume of hemiarthroplasty groups (402.1 ± 36.8 ml, 641.3 ± 53.2 ml, 880.7 ± 61.7 ml, 1 246.1 ± 76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the de?gree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly.

Objective To investigate the effect of gastrointestinal Roux-en-Y gastric bypass surgery on blood sugar and insulin function of patients with type-2 diabetes mellitus.Methods Twenty-seven cases of gastric cancer patients with type-2 diabetes and undergone Roux-en-Y bypass the gastrointestinal treatment in the centre hospital of Cangzhou were selected as our subject.Body mass index (BMI),Glycosylated hemoglobin (HBA1c),Fasting and glucose (FPG),fasting insulin (FINS),Fasting C-peptide (FCP) levels were measured.Glucose (2 hPG),insulin (2 hINS) and C-peptide (2 hCP) levels were detected after 2 h for oral use 75 g glucose.Homeostasis model was applied to assess insulin resistance index (HOMA-IR).Results No significant change was seen in terms of BMI between before and after surgery.Compared to before surgery,the levels of FPG((7.58 ±0.84) mmol/L),2 hPG((10.43 ± 1.88) mmol/L),HbA1c((7.56 ± 1.15)％) and HOMA-IR(4.55 ±0.76) were lower in patients at 3 months after surgery ((9.93 ± 1.57) mtmol/L,(13.89± 2.13) mtmol/L,(9.88 ± 1.66) ％,(4.55 ± 0.76),respectively,P ＜ 0.05 or P ＜ 0.01).FPG ((6.56± 0.80) mmol/L),2 hPG ((8.57 ± 1.32) mmol/L),HbA1 c ((6.37 ± 1.24) ％),HOMA-IR (4.03 ± 0.45)of patients after 6 months were lower than that of before surgery and 3 months after surgery (P ＜ 0.05 or P＜0.01).However,the levels of FINS ((13.67 ± 1.96) mU/L),FCP((2.62 ±0.87) μg/L),2 hINS((49.91± 5.14) mU/L) and 2 hCP ((6.28 ± 1.65) μg/L) were higher in patients with 3 months after surgery compared to that of before surgery ((11.08 ± 1.69) mU/L,(1.78 ± 0.61) μg/L,(36.05 ± 4.03) mU/L,(4.28 ± 1.48) μg/L,P ＜ 0.01).Meanwhile those indices after 6 months (FINS:(15.88 ± 2.05) mU/L,FCP:(3.30 ±0.68) μg/L,2 hINS:(67.40 ±5.68) mU/L,2 hCP:(9.39 ± 1.52) μg/L) were higher than that of before surgery and 3 months after surgery(P ＜ 0.01).Conclusion Roux-en-Y gastrointestinal bypass can effectively reduce blood sugar level and improve the situation of Pancreatic Beta-cell function of gastric cancer patients with type-2 diabetes.

BACKGROUND:Estrogen signaling pathway for interaction between aromatase and estrogen-related receptor may exist in bone marrow mesenchymal stem cel s, which is used for regulating biological activity of bone marrow mesenchymal stem cel s. OBJECTIVE:To observe the expression of aromatase and estrogen-related receptors in adult bone marrow mesenchymal stem cel s during osteogenic differentiation. METHODS:Bone marrow mesenchymal stem cel s were respectively cultured in low-glucose DMEM medium (control group) and osteogenic induction medium (induction group). Cel proliferation and calcium deposition were determined by MTT assay and alizarin red staining, respectively. The expression of aromatase, estrogen receptorα, estrogen receptorβ, and estrogen-related receptorαduring osteogenic differentiation were determined by real-time PCR and western blot analysis. Estradiol levels in supernatants and lysates were detected by ELISA method. RESULTS AND CONCLUSION:In the induction group, the proliferation ability of bone marrow mesenchymal stem cel s was the strongest at 72 hours of culture;while there were a great amount of calcium nodules formed at 21 days of culture. Results from PCR and western blot assay showed that the expression of aromatase and estrogen receptorαwas improved in the induction group, but the expression of estrogen-related receptorαwas inhibited. There was no difference in the expression of estrogen receptorβbetween the two groups. ELISA results indicated that the level of estradiol in the supernatant of induction group was the highest. These findings indicate that aromatase, estrogen receptorα, estrogen receptorβand estrogen-related receptorαare al involved in osteogenesis of bone marrow mesenchymal stem cel s. Moreover, estradiol can be synthesized and secreted in bone marrow mesenchymal stem cel s, and most likely, promote the osteogenic differentiation of bone marrow mesenchymal stem cel s by related receptor pathway.

Objective To evaluate the safety of enhanced recovery after surgery (ERAS) programs in pancreas surgery.Methods A computer search was performed on databases which included the Wanfang,CNKI,VIP,PubMed,Cochrane Library,Embase and Sciencedirect for randomized controlled trials or case-control studies on ERAS programs in pancreatic surgery published between January 1995 and August 2017.Two researchers independently evaluated the quality of the studies which met the inclusion criteria and performed a meta-analysis using the RevMan5.3.5 software.Results Four randomized controlled trials and twenty one case-control studies which included 4 063 patients entered into the meta-analysis.These patients included the ERAS group (n =2 052) and the control group (n =2 011 who underwent traditional perioperative management).Compared with the control group,the ERAS group had a lower postoperative complication rate (OR =0.57,95％ CI:0.45 ～0.71,P ＜0.05),a lower delayed gastric emptying rate (OR =0.46,95％ CI:0.37 ～ 0.59,P ＜ 0.05),a lower abdominal infection rate (OR =0.68,95％ CI:0.53 ～ 0.88,P ＜ 0.05),a shorter hospital stay (WMD =-4.86,95％ CI:-6.10 ～-3.62,P ＜ 0.05)and intensive care stay (WMD =-1.04,95％ CI:-2.01 ～-0.08,P ＜ 0.05).No significant differences existed in the mortality,readmission and postoperative pancreatic fistula rates between the two groups.Conclusion Perioperative implementation of ERAS programs was safe and effective in pancreatic surgery,and decreased postoperative complication rates and promoted recovery.