Objective To investigate the association between expression of the epithelial?to?mesenchymal transition(EMT)biomarkers and the malignant progression of gastric cancer in primary tumors and metastases and their possible correlation with progression of gastric cancer(GC). Methods The EMT biomarkers including E?cadherin,β?catenin,N?cadherin,Snail and TGF?β1 were detected by immunohistochemical method for 145 cases of gastric cancer(GC),25 cases of abnormal hyperplasia,13 cases of intestinal metaplasia,42 cases of lymph node metastasis and 40 cases of normal gastric mucosa tissues. Results Positive rates of TGF?β1,Snail,E?cadherin,β?catenin and N?cadherin were 73.5%,65.5%, 14.5%,53.1%and 35.9%,respectively,in gastric cancer tissues and 100%,100%,0%,27.5%and 2.5%,respectively,in normal gastric tissues, with a significant difference between the two groups(P<0.05). The decreased expression of E?cadherin andβ?catenin and the increased expression of TGF?β1 were related to the depth of invasion of gastric cancer(P<0.05). The expression of E?cadherin was correlated positively with the expres?sion ofβ?catenin,but negatively with the expression of TGF?β1. Whereas,the expression of N?cadherin was correlated positively with the expression of TGF?β1(P<0.05). The expression of E?cadherin andβ?catenin in lymph node metastasis was significantly higher than that in gastric cancer tis?sues,while the expression of TGF?β1 was lower than in gastric cancer tissues(P<0.05). Conclusion The increased expression of TGF?β1 and Snail and the decreased expression of E?cadherin,β?catenin,and N?cadherin are involved in the processes of invasion and metastasis of GC. The transformation of E?cadherin to N?cadherin and the expression of TGF?β1 may play an important role in the development of GC. In lymph node me?tastasis,the phenomenon of mesenchymal?to?epithelial transition(MET)occurs.

Objective To evaluate the accuracy of multi-detector spiral CT (MSCT) semiautomated volumetric measurement of right lobes and its value in living donor liver transplantation (LDLT). Methods Fifty-six donors underwent four phases MSCT. Pre-operative liver volumes of two measurements [IQQA(R)-liver semi-automated (Vs) and manual volume (Vm) measurements] in portal vein phase were compared with intra-operative measurement (Vio) by means of water displacement. Results Correlation analysis and Bland-Altman tests were used for statistical analysis.Results Pre-operative measurements of grafts resulted in a mean Vs, Vm, Vio of (818. 60 ± 161.43)cm3 , (880. 16 ± 169. 92) cm3 and (669. 84 ± 141.37) cm3 respectively. All corresponding pre-and intra-operative data were correlated significantly with each other. There was a good correlation between Vs and Vio(r= 0. 778, P＜0. 05), so did Vm and Vio(r= 0. 746, P＜0. 05). The equations of linear regression were Vio = Vs × 0. 681 + 112. 26, and Vio = Vm × 0. 620 + 123. 81 respectively. Exact 95 % CIs and the extent of concordance were 121.57-175. 95 cm3, -354. 135-56. 62 cm3 for semiautomated measurements, and 180. 09-240. 56 cm3 , - 438. 66-18. 01 cm3 for manual measurements,respectively. Conclusion Semi-automated method for the volumetric measurements of the right liver lobes in LDLT is more accurate than the manual method.

Objective To study the effect of liver transplantation using right liver lobe Ⅴ and Ⅷ segments with middle hepatic vein(MHV) and without main MHV on the regeneration of liver transplantation. Methods 25 pair of donors and receptors of liver transplantation were divided in to two groups:with M HV group (group A, n= 14) and without main MHV (group B, n=11). The volumes of Ⅴ and Ⅷ segments of liver were measured in donors presurgicaUy,half month and 3 month in receptors postsurgically, the rates of regeneration of the Ⅴ and Ⅷ segment were calculated half month and 3 months postsurgically and compared between two groups. Results In group A,the regenerate rates of the Ⅴ,Ⅷ segment were 0.360±0.043 and 0.853±0.059 half month after surgery,0.253±0.043 and 0.708±0.059 three months after surgery respectively. In group B, the regenerate rates of the Ⅴ,Ⅷ segment were 0.306±0.049 and 0.815±0.066, respectively half month after graft, 0.161±0.049 and 0.627±0.066, respectively three months after surgery. There were no statistically significant differences in regenerate rates of the Ⅴ, Ⅷ segment of graft be-tween the two groups (P= 0.685 ,P>0.05 and P= 0.738, P>0.05). Conclusion The right lobe living donor liver transplantation, maintaining the MHV or reconstruct MHV tributaries without MHV has similar effects on the regeneration of Ⅴ,Ⅷ segment of graft.

Objective To study the relationship of the levels of serum interleukin-6 (IL-6) and C-reactive protein (CRP) with insulin resistance in normal glucose tolerant first-degree relatives (NGT) of type 2 diabetics.Methods A total of 218 normal glucose tolerance subjects , including 136 NGT of type 2 diabetes , and 82 normal control ( NC) without type 2 diabetes family history were enrolled.The levels of blood glucose, hemoglobin A1c (HbA1c), lipid, insulin, IL-6, and high-sensitivity C-reactive protein (hs-CRP) were measured.Results ⑴Compared with NC, the levels of homeostasis model assessment of insulin resistance (HOMA-IR), hs-CRP , and IL-6 in NGT were significantly increased [1.03~1.94 vs 0.42~0.95 , P <0.01;0.46~2.78 mg/L vs 0.39~1.56 mg/L, P <0.01;(13.6 ±8.99) pg/ml vs (8.08 ±3.67) pg/ml, P <0.01];⑵In NGT, hs-CRP was positively correlated with HOMA-IR and IL-6 ( r =0.326 , P <0.01;r =0.258 , P <0.05 );IL-6 was positively correlated with HOMA-IR ( r =0.350 , P <0.01).Conclusions IL-6 and CRP may correlate with the degree of insulin resistance in NGT of type 2 diabetics.

Objective To investigate the expression of aquaporin-3 (AQP3) in tongue tissues of rats with experimental severe acute pancreatitis (SAP) and regulating effects of emodin. Methods Rat models with SAP were established by injecting 5% sodium taurocholate retrogradely into gallbladder and pancreas. SD male rats were randomly divided into sham-operation group, model group, and emodin group. After model establishment, rats in the emodin group received gavage with emodin 20 mg/kg each day, while rats in the model group and sham-operation group received gavage with normal saline. The mental state, thick greasy tongue fur and mortality of rats were observed every day after model establishment, and 5 days later, protein and genetic expression of AQP3 were detected by Western blot and RT-PCR. Results Compared with the model group, the mortality and the thick greasy tongue fur significantly decreased, the protein and genetic expression of AQP3 significantly decreased in the emodin group (P<0.05). On the 5th day, 11 rats in the model group survived, and 5 rats had thick greasy tongue fur. Compared with the sham-operation group, the protein and genetic expression of AQP3 in the model group were higher (P<0.05). Conclusion Emodin can improve the severity of SAP and decrease the incidence of thick greasy tongue fur significantly by reducing the protein and genetic expression of AQP3.

Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P ＜ 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P ＜ 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P ＜ 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.

Objective To summarize the diagnostic efficacy of ADC value for differentiation of benign and malignant lymph nodes on diffusion MRI with Meta-analysis. Methods Published papers on differentiation of benign and malignant lymph nodes with ADC value were searched and reviewed.Quality evaluation was performed for the eligible papers before data extraction.Test for heterogeneity was performed first,then appropriate model was selected to calculate the weighted mean difference,sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,pretest and posttest probability.The potential of ADC value for differentiation of benign and malignant lymph nodes was assessed qualitatively and quantitatively.Results Fifteen papers including 735 cases and 1963 lymph nodes were selected.According to Meta-regression analysis,subgroup analysis and robust analysis,two studies with benign lymph nodes in patients with benign lesion and one study using chemical shift saturation technique were excluded because of their impact on the robustness of the pooled results. The weighted mean difference (WMD) between malignant and benign lymph nodes was -0.355 × 10-3mm2/s[95％ confidence interval (CI):-0.423 ×10-3- -0.288 × 10-3 mm2/s].Although the cutoff of ADC value for differentiation in each study was different,the diagnostic efficacy was stable,the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and area under summarized receiver operator's curve were 0.87 (95％ CI:0.79-0.92),0.87 (95％ CI:0.82-0.90),6.5 (95％ CI:4.7-9.2),0.15 (95％ CI:0.09-0.25 ),43 ( 95％ CI:21-87 ),0.93 ( 95 ％ CI:0.90-0.95 ).The posttest malignancy probability of benign lymph node indicated by ADC was 6％,while that of malignant lymph node was 72％.Conclusion The ADC value can be used to differentiate benign and malignant lymph nodes with good sensitivity and specificity noninvasively.

Objective To investigate the voxel-based correlation of mini-mental state examination(MMSE) score with apparent diffusion coefficients(ADC) and fractional anisotropy (FA) derived from diffusion tensor imaging(DTI) in the patients with Alzheimer disease. Methods 12 patients aged (70.0± 10.5) years and 16 normal control aged (66.5±6.7) years were enrolled in this study.DTI was performed based on sequence and 32-channel head coils.ADC and FA images were calculated and normalized to the same space and smoothed with 8 mm Gaussian Kernel. With statistical parameter mapping software SPM5 package,the independent two sample t-test with general linear model were performed to detect ADC and FA differences between AD patients and normal control.Correlation analysis was performed between MMSE score and FA or ADC. Results AD patients showed elevated ADC value and decreased FA value in bilateral temporal lobe and anterior cingulate,which was more pronounced in the left than in the right.There was elevation of ADC value but no FA decrease in bilateral posterior cingulate.The abnormal ADC area was larger than that of FA.There was negative correlation between MMSE score and ADC of the right hippocampus(r=-0.9474,P=0.0232) and a tendency towards positive correlation between MMSE score and FA of the right hippocampus(r=0.5414,P=0.5853). Conclusions ADC value may be more sensitive than FA value in DTI. Right temporal lobe microstructure involvement is less severe,but has a stronger relationship with neuropsyehological abnormality.

Objective To systematically evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in the investigation of bile duct anatomy of liver transplantation living donors.Methods A search in Cochrane library,MEDLINE,EMBASE,CBMdisc (China Biology Medicine disc) was performed to identify relevant English and Chinese-language abstracts,supplemented by Springer,OVID,Sciencedirect full text database,etc.Criteria for inclusion were based on validity criteria for diagnostic research published by the Cochrane collaboration.With Meta analysis package for Stata10.1,heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity,positive likelihood ratio,negative likelihood ratio. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally,sensitivity analysis was performed.Results Seventeen articles with 34 studies were included.Heterogeneity analysis revealed heterogeneity between studies and the source was MRCP imaging methods spotted by meta-regression analysis. Subgroup analysis according to MRCP imaging methods showed homogeneity within subgroups.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odd ratio of breath-holding thick slice MRCP,3D MRCP,the combination of the prior two methods,contrast enhance MRCP were 0.89,0.78,4.1,0.14,29; 0.92,0.80,4.5,0.10,45;0.95,0.82,5.2,0.06,85; and 1.00,0.76,4.1,0,1228,respectively with fixed effect model analysis.The area under the SROC curve was 0.83,0.92,0.96 and 0.99 respectively.Conclusion The combination of thick slice and 3D MRCP is a practical and effective method with good sensitivity and specificity to investigate bile duct anatomy of living liver transplantation donors,which fully meets the requirements of the preoperative assessment of bile duct structure.

Objective To explore the imaging features of liver tumors with real-time tissue elastography.Methods Eighty-five liver lesions in 67 cases were scanned with conventional ultrasonography and elastography using HI-Vision900 system and then assessed with grade scores.Results on ultrasound were compared with those on pathology.Results Majority of lesions with grade a-b on elastography were identified as benign on pathology, while most of masses with grade c-e on elastography were confirmed as malignant on pathology.The sensitivity, specificity and accuracy were 93.5%, 87.0% and 91.8% for elastography to detect malignant lesions,74.2% ,73.4% and 74.1% for conventional ultrasound.The Kappa value of two doctors on elastography in group Ⅰ (the depth of the lesion ≤10cm) was significantly higher than group Ⅱ (the depth of the lesion ＞10cm).Conclusions Real-time tissue elastography of liver tumors provides a new convenient,non-invasive diagnostic methods,contribute to identify the benign and malignant live tumors.