Objective To analyze the correlation between the metal components and MRI signal intensities of gallstones, to investigate the causes of gallstone signal features on MRI. Methods The MRI data and the metal components of the gallstones in vivo and in vitro of 30 patients were retrospectively analyzed. The MR sequences, namely 3D fast spoiled gradient-echo with fat saturation T1-weighted imaging (3D-FSPGR-FS T1WI), fast spoiled gradient-echo with fat saturation T1-weighted imaging(FSPGR-FS T1WI), fast imaging employing steady-state acquisition(FIESTA)and fast spin-echo T2-weighted imaging with fat saturation(FSE-FS T2WI), were performed on the gallstones in vivo and in vitro. According to the characteristics of the surface and cross section, gallstones were divided into pigment gallstones( n=16) and cholesterol gallstones(n=14). The MR signal characteristics of the gallstones were observed and the signal intensity rates of the gallstones were calculated. Preoperatively, the signal intensity rates of cholesterol and pigment stones of each MR sequence were compared by using t test and Mann-Whiteney U test. Postoperatively,the signal intensity rates of the fresh,dried and re-soaked gallstones were compared by using paired t test and Wilcoxon test. The correlation between the signal intensity rates of gallstones on the 3D-FSPGR-FS sequence and their metal components was analyzed by using Linear Regression analysis. Results The pigment gallstones showed high signal intensity on the 3D-FSPGR-FS T1WI. The signal intensity rates of the pigment gallstones were higher than the rates of the cholesterol gallstones on the 3D-FSPGR-FS T1WI, which were 2.02 ± 0.53 and 0.51 ± 0.24 (t=10.26,P< 0.01), respectively. On the 3D-FSPGR-FS T1WI, the signal intensity rates of the drying pigment stones were significantly lower than the rates of the fresh ones, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.42±0.35(t=13.49,P<0.01),respectively. The signal intensity rates of pigment gallstones showed significant rebound after re-soaking, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.68±0.86(t=-6.63,P<0.01),respectively. The metal components of pigment gallstones were significantly higher than the cholesterol stones. In the pigment gallstones and cholesterol gallstones, the medians of the Calcium were 28.186 and 2.347 mg/g(Z =-4.66,P< 0.01),respectively.For pigment gallstones, there was a significant correlation between the calcium and the signal intensity rate on 3D-FSPGR-FS T1WI. The regression equation of linear regression analysis was SI=65.40 logCa-166.67. Conclusions The pigment gallstones containing much more water and metal showed high signal intensity on 3D-FSPGR-FS T1WI. The Calcium in the pigment gallstones may be the main cause for this MR appearance.

Objective To investigate the value of diffusion-weighted imaging (DWI) in predicting and monitoring the response of uterine cervix cancer to concurrent chemoradiation. Methods Seventeen patients with uterine cervix cancer underwent conventional MRI and DWI examinations before therapy and at one month and two months after the initiation of concurrent chemoradiation, and 8 of them underwent additional examinations at 15 d after therapy. The longest diameter of tumor before and after treatment was measured on axial T2WI. The mean ADC value among pre- and post-treatment of each group (CR, PR and SD) was compared. Results The mean ADC value before therapy of CR group was statistically lower than that of PR group (P＜0.05). There was negative correlation between mean pretreatment ADC value and percentage size reduction of tumor after concurrent chemoradiation at two months (r=-0.574, P＜0.05). The percentage ADC change of tumor at one month correlated positively with percentage size reduction of tumor at two months after concurrent chemoradiation (r=0.572, P＜0.05). Fifteen days after the initiation of concurrent chemoradiation, the mean ADC value of 8 patients increased significantly, however, the longest diameter of tumor showed no statistically significant changes compared with pre-treatment tumor diameter. Conclusion DWI has the ability to predict the response of uterine cervix cancer to concurrent chemoradiation, and it can monitor the treatment response as well.

Objective To establish an in vitro isolation and culture system for hepatocellular carcinoma (HCC)-associated fibroblast (CAF) and identify based on its specific markers of CAF. Methods CAF was isolated from the tumor tissue of the HCC patients after hepatectomy, by digesting with collagenase enzyme, centrifugation and resuspension. The morphology of CAF was observed by electron microscopy. Immunofluorescence staining was performed for detecting α-SMA and fibronectin as well as other specific markers such as AFP on the surface of HCC cells and CD31 on the surface of vascular endothelial cells. On the basis of the study, the function work between CAF and HCC cell line Huh7, HepG2 was detected under co-culture system. Meanwhile, CCK-8 was used to observe the effect of CAF on the proliferation of Huh7 and HepG2 cells, and Transwell assay was used to analyze CAF effect on the invasion of Huh7 and HepG2 cells. Results Compared with the other cells, the morphological analysis showed that CAF was more elongated or spindle-shaped. Moreover, the cell size and the nucleus were larger than normal epithelial cells. Immunofluorescence staining revealed that the CAF surface specific markers including α-SMA and fibronectin were positive, and mainly were the cell membrane staining. The proliferation and invasion of Huh7 and HepG2 were significantly increased by CAF. The results show that the increasing percentage of cells in 24 hours between blank group and the experimental group was (63 ± 4) %, (78 ± 5) % and (69 ± 5) %, (81 ± 3) %respectively after co-culture with CAF, the difference was statistically significant (P<0.05). In transwell model, the number of cells in the blank group and the experimental group was (59.4 ± 3.1), (162.9 ± 3.9) and (104.8 ± 2.6), (166.4 ± 4.2), and the difference was also statistically significant (P< 0.05). Conclusion The isolated CAF from HCC enhances the ability of tumor's proliferation and invasion.

Objective To explore the value of MRI dynamic contrast-enhanced in differentiating adrenal adenomas from nonadenomas with washout rate of enhancement and the increased SI ratio. Methods Thirty-six patients with 41 adrenal masses enrolled into this study. All these masses underwent conventional T 1WI and T 2WI sequence first, and then FMPSPGR sequence through the center of each mass. Precontrast and dynamic contrast-enhanced FMPSPGR scans were preformed after administration of contrast material of Gd-DTPA intravenously. The signal intensity(SI) of masses was measured on the screen by electronic cursor. The washout rate of enhancement and increased SI ratio were compared between adenomas and nonadenomas. The differentiating adrenal adenomas from nonadenomas were carried out based on combination of the washout rate and the increased SI ratio, meanwhile, the sensitivity and specificity of the diagnosis of adenomas were evaluated well.Results The sensitivity and specificity of the diagnosis of adenomas were 74% and 73%,and accuracy was 73% when the washout ratio was used as a indicator at 5 min. The sensitivity and specificity of the diagnosis of adenomas would be improved markedly when the combination of the washout ratio and the increased SI ratio was used as a indicator.The sensitivity and specificity of the diagnosis of adenomas were 95%, 91% respectively,and accuracy was 93%. Conclusion Using MRI dynamic contrast-enhanced based on combination of washout rate of enhancement and the increased SI ratio,the diagnosis and differentiating diagnosis of adrenal adenoma and nonadenoma can be improved.

Objective To explore the feasibility of blood oxygen level-dependent (BOLD) MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group (n=7) and stage 2 kidney injury group (n=10). All of the enrolled subjects underwent BOLD examination and T2* relaxation rates (R2*) of renal cortex and medulla of split kidney, and the ratio between them (R2*med/cor) were measured separately. One-way analysis of variance (ANOVA) were performed on the control group and chronic hepatitis b patients group (kidney injury stage 1 and stage 2 group) to compare the difference of renal cortical and medullary R2*values and R2*med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2* values and R2*med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were(16.87 ± 0.74)/s,(17.88 ± 0.73)/s,(20.29 ± 2.87)/s, respectively;the medullar R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were (28.07±1.03)/s,(31.14±2.49)/s,(32.81±3.28)/s, respectively;R2*med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant (F values were 17.779, 19.170 and 3.439 , all P<0.05). Furthermore, the renal cortical and medullary R2* values of chronic hepatitis b patients were significantly higher than the control group, and the the renal cortical R2* value of the patients in stage 2 kidney injury group was also higher than the stage 1 kidney injury group. The area under curve (AUC) of ROC of the renal cortical and medullary R2*values and R2*med/cor to diagnose chronic HBV hepatitis-induced early kidney injury were 0.903, 0.949 and 0.526, respectively. Conclusion It's feasible and has great value to use renal BOLD MRI for the diagnosis of chronic hepatitis b-induced early kidney injury, and the renal cortex is more sensitive than the medulla to the kidney injury.

Objective To explore the effect of hepatocyte growth factor (HGF)/c-Met signaling in doxorubicin (DOX) treatment of hepatocellular carcinoma (HCC). Methods Different biologic and genetic characteristics human HCC cell lines, Huh7, HepG2, MHCC97-L and MHCC97H were used in this experiment. Variation in c-Met mRNA expression level among different HCC cell lines was analyzed by RT-PCR. Western blot analysis was performed to detect c-Met and p-Met expression levels in these cell lines. CCK-8 experiment was carried to analyze the DOX sensitivity in various cell lines. t test and repeated measure analysis of variance were used for statistical analysis. Results Both c-Met and p-Met were overexpressed in MHCC97-L and MHCC97-H cell lines and these cell lines were resistant to DOX compared to Huh7 and HepG2. However, treatment of HGF in Huh7 and HepG2 cells activated c-Met signaling pathway and decreased the sensitivity of these two cell lines to DOX [inhibition rate: Huh7 (34.848 ±5.370) vs. (66.409±5.792)%, HepG2 (34.351±3.305) %vs. (62.308±5.453) %, both P=0.002]. Whereas administration of c-Met inhibitor in MHCC97-L and MHCC97-H cell lines significantly increased the sensitivity to DOX [inhibition rate: MHCC97-L (73.106 ±3.472) % vs. (13.636 ±4.097) %; MHCC97-H (64.444 ±4.006) % vs. (6.296 ±2.796) %, both P< 0.001]. Conclusion HGF/c-Met signaling pathway is related the treatment efficacy of DOX in HCC.

Optical coherency tomography (OCT) is one of the powerful optical imaging tools that allows cross-sectional tomography of the microstructure in living subjects with high resolution. With the rapid development of OCT and a wide range of preclinical and clinical tumor imaging, it provides profound insights into the complex physiological, cellular and molecular behaviors of tumors. Preclinical OCT has elucidated many inscrutable aspects of tumor biology, while clinical applications of OCT are revolutionizing diagnosis and therapies. As a new noninvasive optical imaging technique, OCT can realize the intraoperative imaging of tumor and provide meaningful image data, which will provide great help for the diagnosis, classification and boundary determination of tumor diseases in the future.

Objective To investigate on the incidence of gynecological laparoscopic operation complications within ten years.Methods From January 2003 to December 2012,clinical data and the complications of 4 897 cases undergoing gynecological laparoscopic operation in First Hospital of Peking University were studied retrospectively.Those surgeries included 876 cases with hysterectomy,662 cases with myoectomy,3 266 cases with adnexa surgery,93 cases of diagnostic laparoscopy operation.Results The complications occurred in 29 cases,the incidence rate was 0.59％ (29/4 897).The Incidence rate in Hysterectomy group was 1.83％ (16/876),which was significantly higher than 0.60％ (4/662) in myoectomy group and 0.28％ (9/3 266) in adnexa surgery group.Twenty nine cases of complications were 14 cases with organ injures (48％,14/29),5 cases with hemorrhage complications (17％,5/29),8 cases with infectious complications (28％,8/29),2 cases with incisional hernia(7％,2/29).Conclusion The major complication of gynecological laparoscopic operation complication was organs injuries,which was associated with difficulty and scope of the operation.

Objective To discuss the clinical application of reverse dorsal metatarsal artery perforator flap for reconstruction of forefoot soft tissue defects.Methods Since January,2008 to March,2016,43 patients with forefoot soft tissue defect due to various causes were reconstructed with the flap based on dorsal metatarsal artery perforator.Dorsal pedis was used as a donor site with dorsal metatarsal artery perforator as the donor artery.The flap size varied from 2.0 cm × 4.0 cm to 6.0 cm × 8.0 cm.Among them,27,8,4 and 4 cases were reconstructed with flap based on first,second,third and fourth dorsal metatarsal artery perforator flap respectively.Results All the patients were followed-up which ranged from 3 months to 24 months.Six flaps suffered from post operative venous congestion.Out of 6,4 survived with early emergency management while the remaining 2 suffered epidermal necrosis which survived with regular dressing change.Eventually,all the flaps survived.They had good texture and they were elastic,good-looking and very wear-resisting.Walking function was normal.Conclusion Reverse dorsal metatarsal artery perforator flap is an ideal choice in reconstruction of small to medium sized soft tissue defects of forefoot.

Objective To investigate the effect of acupunctures variable with stages on lumbar intervertebral dise protrusion (LIDP). Methods 98 LIDP patients in our hospital from October, 2014 to July, 2015 were randomly divided into control group (n=49) and observa-tion group (n=49) according to the sequence of first diagnosis time. The control group received routine acupuncture, and the observation group acupunctured at Ouch point and Huantiao point (GB30) with different acupuncture according to manifestations and courses. Modified Yang acupuncture was adopted in acute phase, triple acupuncture was used in remittent phase, and lateral needling was used in the recovery phase. They were both treated once a day, 7 days as a course for 3 courses with 2 days of interval. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and clinical effects were assessed before and 1, 2, 3 courses after treatment. Results Both VAS and ODI scores im-proved after treatment (F>7.12, P<0.05), especially in the observation group (t>4.43, P<0.05). The efficiency was higher in the observation group than in the control group (χ2=5.594, P<0.05). Conclusion Compared with normal acupuncture, the acupunctures variable with stages is more effective on LIDP than routine.