Objective To evaluate the effects of endoscopic ultrasonography ( EUS) combined with cyst fluid analysis, cytology, histopathology based on endoscopic ultrasound guided fine needle aspiration ( EUS?FNA) on pancreatic cystic lesions ( PCLs) . Methods Clinical data of 45 patients were analyzed ret?rospectively from January 2006 to April 2015 including MRI, EUS?FNA, MRCP. The results of conventional imaging and EUS?FNA were compared based on postoperative pathology. Results There were 8 cases of non tumor pancreatic cystic lesions, 4 cases of serous cystadenoma (SCN), 11 cases of mucinouscystadenoma ( MCN) , 8 cases of intraductal papillary mucinous tumor ( IPMN ) , 5 cases of solid pseudopapillary papilloma ( SPN) , 9 cases of non pancreatic cystic lesions ( nPCLs) . The diagnostic accuracy rate of tradi?tional imaging tests ( B?ultrasound, CT, MRI, MRCP ) and EUS?FNA were 42?2% ( 19/45 ) and 77?8%(35/45) (P<0?05). The diagnostic value of EUS?FNA of PCLs was higher than that of traditional imaging tests, with specificity, sensitivity, positive predictive value ( PPV) and negative predictive value ( NPV) of 58?3% ( 7/12 ) , 97?0% ( 32/33 ) , 86?5%( 32/37 ) , 87?5% ( 7/8 ) and 41?7% ( 5/12 ) , 87?9%(29/33), 80?6% (29/36), 55?6% (5/9),respectively. Conclusion EUS?FNA is more valuable than traditional imaging tests for the diagnosis of PCLs.

Objective: To study the serum sex hormone level and outer behavior changes of the rats that had gestated one fetus and been used to imitate the Gan qi adverseness of PMS. Methods: Selecting the appropriate time to stimulate the rats by impulse current to make the model and mensurating serum sex hormone level by radioactive kit. Results: The PRL level of the rats that were in the anaphase of their estrus raised evidently and the levle of E 2 and P reduced evidently.Conclusion: The model approximately reflected the clinical feature and pathological changes of the liver qi invasion of PMS. The model was made successfully.

Objective Visceral pain in patients with inflammatory bowel disease (IBD) may be associated with the abnormal processing of pain in the central nervous system.The aim of the study is to investigate the characteristic changes of brain functions in the IBD patients using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) algorithm.Methods This study included 27 cases of IBD treated in our hospital from December 2015 to August of 2016 and 21 healthy volunteers as normal controls.We recorded the high-resolution structure imaging and rs-fMRI data, compared the brain activities of the two groups patients by ALFF analysis, and evaluated the correlation of the ALFF values with the clinical parameters of the IBD patients.Results Compared with the normal control group, the IBD patients showed significantly decreased ALFF values in the medial frontal gyrus, right putamen, right insula, left middle cingulate gyrus (MCC), and bilateral supplementary motor region (P<0.05), increased ALFF values in the middle frontal gyrus, left superior frontal gyrus, and medial prefrontal lobe region (P<0.05).The ALFF values in the inferior parietal lobule, precuneus and MCC of the IBD patients were correlated negatively with the blood sedimentation rate (r=-0.537,-0.588, and-0.588, P<0.05), disease course (P<0.05), and C-reactive protein (CRP) level (P<0.05), while that in the medial frontal gyrus positively with the CRP level (r=-0.623, P<0.001).Conclusion IBD patients have abnormal ALFF values in various brain regions, mainly in those involved in the processing of visceral pain and emotion.

[Abstract ] Objective Stenosis is a common complication of Crohn′s disease (CD), different treatments for different cau-ses.The article aimed to investigate bowel stenosis by the application of MRI diffusion-weighted imaging(DWI) and explore its value of identifying CD. Methods From Jan 2014 to Jun 2014, 31 patients with histologically proven CD (18 males and 13 females;mean age:38.90 ±13.65 years) were recruited in this approved retrospective study .All patients underwent conventional 3.0T MRI and DWI sequences .According to the most serious stenosis part identified by MRI , DWI sequence examination was added and the apparent diffusion coefficient (ADC) of the lesion was measured.All patients would undergo colonoscopy in 24 hours.According to the endo-scopic manifestations and pathological results , the patients were divided into inflammatory group (n=21) and fibrotic group (n=10). We observed the difference of ADC between two groups and worked out the cutoff points . Results In the inflammatory group , the ADC value andthe mean ADC value of stenosis bowel wall were (1.01 ±1.83) ×103 mm2/s and (1.40 ±0.23) ×103 mm2/s, whereas (0.53 ±1.03) ×103 mm2/s and (0.80 ±0.16) ×103 mm2/s in the fibrotic group(P<0.05).The area under receiver operating characteristic curve was 0.981 (95%confidence interval 0.943-1.000), taking 1.11 ×103mm2/s as the cutoff point.The sensitivity of low ADC values in detecting inflammatory bowels was 90.5%, and the specificity of high ADC values in excluding inflammatory bowels was 100%. Conclusion Different pathological components limit the movement of water molecular at different degrees , therefore quantitative parameters can be acquired by measuring ADCs , which contributes to the identification and diagnosis of CD secondary bowel stenosis.

Objective To explore the correlation of fatigue and life quality of lung cancer patients after chemotherapy. Method A survey was conducted among 54 lung cancer patients after chemotherapy with revised piper fatigue scale ( PFS ) and medical outcomes study (SF-36). Result The total score of PFS of lung cancer patients was (6.44 ± 1.62). The score of SF-36 related area include physical dimension (58.47 ± 5.48), psychological dimension (55.04 ± 4.91) and social dimension (49.21 ± 4.77) environment dimension (52.86 ± 4.98). The total score of PFS was negatively correlated with physical, psychological and environmental dimensions (P<0.05), and not correlated with social dimension (P<0.05). Conclusions The cancer-related fatigue and life quality of lung cancer patient is at medium-severe level, and their life quality is at low level. Positive and effective psychological intervention and psychological nursing can reduce cancer-related fatigue and improve their life quality.

We studied the effect of the Mycobacterium tuberculosis prokaryotic ubiquitin-like protein-proteasome system on mono-resistant to rifampin resistance to M.tuberculosis.A resazurin-based assay was employed to evaluate minimum inhibitory concentration (MIC) and comparative research on mono-resistant to rifampin MTB with Pup,Dop,PafA,Mpa genes expression and deletion of the difference.Above testing strains,respectively,carbonyl cyanide chlorobenzene hydrazone (CCCP),reserpine (RP),verapamil (VP)and chlorpromazine (CPZ) were tested.We compared and analyzed the change of rifampicin MICs on the various strains.Compared with rifampin resistant MTB,overexpression of Pup,Dop,PafA and Mpa genes were able to make monorifampicin of M.tuberculosis to enhance resistance to rifampin.Deletion of Pup gene,Mpa gene,Dop gene,PafA gene significantly decreased the resistance to rifampicin alone MTB,and the P value was ＜0.05.Results indicated that 4 kinds of efflux pump inhibitors can reduce the degree of rifampin MIC in different strains.Through the factorial analysis,there were some interactions between MTB and PPS efflux pump inhibitors,and the P value was ＜0.05.MTB PPS has influence on mono-rifampin resistance to MTB and it may regulate the efflux pathway related protein to influence its resistance.

Objective To investigate the role of fibromodulin (FMOD) in the xidative stress induced activation of pancreatic stellate cells (PSCs).Methods Lentivirus containing ShRNA targeting FMOD (sh-FMOD) was transfected into PSCs,and then the prooxidant menadione (MND) was used to treat PSCs for 24 h (MND + sh-FMOD group).Lentivirus transfected PSCs cells treated by a equal volume of DMSO served as shFMOD group,parent cells as control group and PSCs treated by MND as MND group.RT-PCR were used to detect the mRNA expression of the markers of activated PSCs including α-SMA,Col3α1,Col1α1,TIMP1 and α1-integrin.Chronic pancreatitis (CP) rat model was induced by DBTC infusion into the tail vein.Immunohistochemical (IHC) staining was used to detect the protein expression of FMOD,FN,α-SMA,SOD and MDA in normal pancreatic tissue and CP tissue.Results FMOD mRNA expression of the PSCs in FMOD group was obviously lowerer than that in control group (0.16 ±0.03 vs 1),and the difference was statistically significant (P ＜ 0.01),indicating that FMOD was successfully silenced.The mRNA expression of FMOD,α-SMA,Col3α1,Col1α1,TIMP1 and α1-Integrin of PSCs in MND group was obviously higher than those in control group,which in MND + sh-FMOD group was lower than those in MND group,and the difference was statistically significant (P ＜0.05 or ＜0.01).Compared with those in normal pancreatic tissue,the protein expression of FMOD,α-SMA,SOD and MDA in CP tissue was up-regulated,and the difference was statistically significant (all P ＜ 0.05).Conclusions Oxidative stress can facilitate the activation of PSCs through the induction of fibromodulin expression.

Objective:To explore the expression of miR-216a in patients with acute pancreatitis (AP) associated with acute lung injury (ALI) and its influence on endothelial cells permeability.Methods:40 AP patients admitted in Department of Gastroenterology of the First Affiliated Hospital of Navy Medical University from December 2015 to March 2016 were collected and were classified into AP with ALI (AP-ALI group, n=13) and AP without ALI (AP group, n=27) according to the presence or absence of ALI. 8 normal volunteers were enrolled in the control group. Blood samples were collected and the plasma samples were separated. Plasma RNA was extracted. miR-216a level in plasma was detected by RT-PCR. Plasma exosomes were extracted by exosome extraction kit and identified by the electron microscopy. Exosome RNA was extracted. miR-216a level in exosome was detected by RT-PCR. Plasma exosomes of AP-ALI patients were co-cultured with human umbilical vein endothelial cells (HUVEC, AP-ALI-HUVEC group) and anti-miR-216a transfected HUVECs (AP-ALI-anti-miR-216a HUVEC group) for 24 hours, respectively, and untreated HUVECs served as control group. Trans-endothelium electrical resistance (TEER) was measured by Millicell Ers-2 epithelial volt-ohmmeter to evaluate the cell permeability. Results:RT-PCR results showed that the expression level of plasma miR-216a in AP-ALI group (14.45±1.64) was significantly higher than that in AP group (11.08±1.6) and the control group (5.37±1.54) ( P<0.01). Under electron microscope, plasma exosomes were goblet like vacuoles, with the size of about 50-90 nm. The plasma exosomal miR-216a level in the AP-ALI group (14.03±1.58) was significantly higher than that in the AP group (10.86±1.31) and the control group (5.01±0.79), and the difference was statistically significant ( P<0.01). The resistance value of HUVEC in the control group was referred as 1, and the resistance ratio of HUVEC in AP-ALI-HUVEC group was 0.74±0.04, which was significantly lower than that of HUVEC in AP-ALI-anti-miR-216a HUVEC group (1.02±0.08), the difference was statistically significant ( P<0.01). Conclusions:miR-216a was highly expressed in plasma exosomes of AP patients with ALI. miR-216a can increase endothelial cell permeability, which may be associated with ALI during AP.

Objective To assess the value of carcinoembryonic antigen (CEA) level,liquid based cytology examination and combining 2 methods in predicting advanced pancreatic cystic neoplasms (PCNs).Methods The clinical data of 78 patients pathologically confirmed with PCN who underwent surgical resection after EUS-FNA and cyst fluid analysis in Shanghai Changhai Hospital,from January 2006 to June 2017 were collected and analyzed,including 32 (A-PCNs) patients and 46 non A-PCNs patients.The comparisons on the CEA level in the cyst fluid and liquid based cytology between the two groups were performed.ROC curve for CEA level in cyst fluid was applied and under curve area was calculated.Sensitive,specificity and accuracy were applied to assess the diagnosis value of 2 methods in predicting A-PCNs.Results In 35 patients,the difference on cyst fluid CEA level was statistically significant between 9 A-PCNs and 26 non A PCNs patients) [(1419.9 ± 1416.9) μg/L vs (316.0 ± 475.2) μg/L,P =0.049].Based on ROC curve,CEA ＞ 418.9 ng/ml could help to predicting A-PCNs with the sensitivity of 85.7％,specificity of 73.1％,and accuracy of 75.8％ as the cutoff value,and the area under ROC curve was 0.863.Liquid based cytology were performed in 27 A-PCNs patients and 33 non A PCNs patients,and the positive rate had statistical difference between 2 groups (48.1 vs 9.1％,P =0.001).The sensitivity,specificity and diagnostic accuracy for liquid-based cytology for diagnosing A-PCNs were 48.1％,90.9％,and 55.1％.Cyst fluid CEA combined with liquid based cytology can effectively diagnose A-PCN,and the sensitivity,specificity,and diagnostic accuracy were 100％,64.7％ and 76.0％.Conclusions Liquid-based cytology and cyst fluid CEA level were useful in predicting A-PCNs to a certain degree.Combining 2 methods could improve the sensitivity and accuracy in predicting A-PCNs.

Objective:To analyze the results of the joint screening of newborn hearing and deafness genes in Dalian to provide a reference for the prevention and control of hereditary deafness.Methods:Eight hundred and forty-two neonates born in Dalian Women and Children′s Medical Group from January 1, 2022 to May 30, 2022 were screened retrospectively, using AABR (automatic brainstem evoked potential). And 20 mutation sites of common genetic deafness 4 genes , including GJB2, GJB3, SLC26A4 (PDS) and mitochondrial genes associated with drug-induced deafness (MT-RNRI)(12SrRNA), were detected by high-throughput sequencing.Results:Among the 842 newborns, 840 passed hearing screening (99.8%); 36 cases (4.3%) passed the hearing screening but not the hearing loss gene screening; 804 cases passed through the both screening (95.5%); 2 cases (0.24%) failed in the both screening. 38 cases of deafness gene mutations were detected, with a total carrying rate of 4.51% (38/842). Among them, the carrying rates of heterozygous mutations in GJB2, GJB3, SLC26A4 (PDS), MT-RNRI (12SrRNA) were 1.90%, 0.24%, 1.30%, and 0.95%, respectively. The carrying rates of GJB2/GJB3 composite heterozygous mutations were 0.12%.Conclusions:The combined screening of neonatal hearing and deafness genes can reduce the missed rate of hearing screening. The carrier rate of neonatal deafness gene in Dalian is 4.51%, with the highest GJB 2 carrier rate, followed by SLC26A4 (PDS) carrier rate.