Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective: To investigate the hemodynamic changes of ophthalmic artery(OA) and central retinal artery(CRA) in patients with primary angle-closure glaucoma(PACG) and the effects of intraocular pressure(IOP) on retrobulbar hemodynamics. Methods: Following the measurement of IOP by non-contact tonometry,hemodynamic changes of OA and CRA were examined by color Doppler imaging(CDI) in 45 patients(90 eyes) with PACG,who were divided according to IOP into a hypertension(38 eyes) and a normal tension group(52 eyes).Observations were made of the peak systolic velocity(PSV),end-diastolic velocity(EDV),pulsatility index(PI) and resistance index(RI).Results: Significant differences were found between the PACG patients and the normal controls in CRA-EDV(P

Objective To observe the CT features of ovary Brenner tumor. Methods CT manifestations of 5 patients with ovary Brenner tumor confirmed with pathology and clinical follow-up were retrospectively analyzed, and the masses were described for location, size, configuration, enhancement pattern, presence of calcification and metastatic spread. Results There were 7 tumors in 5 patients, 3 patients had unilateral tumors and 2 had bilateral Brenner tumors (left side 3 and right side 4), with tumor size ranging from 1.52 to 16.25 cm (mean 7.36 cm). Five masses in 4 patients were benign, 2 (bilateral tumors in 1 patient) were malignant. All tumors had well-defined margin. One patient with bilateral benign tumors had large pleural effusion and seroperitoneum. Five tumors in 4 patients (5/7, 71.43%) were solid and had calcification, 2 tumors in 1 patients (2/7, 28.57%) were mainly cystic, with septa in the tumors. The solid part of all tumors were inhomogeneous and had mild enhancement. Conclusion CT findings of ovary Brenner tumor have some characteristics. Combining with clinical manifestations, CT is helpful for the diagnosis of ovary Brenner tumor.

Objective To investigate the MR imaging findings of colonic carcinoma and the diagnostic value of MRI. Methods Multi-planar and multi-sequence MRI scanning, before and after contrast enhancement, were performed in 40 patients with colonic cancer. The patients were fasted for 12 hours, prepared with clean clysis or senna at night before study, given 10 mg of anisodamine 10 minutes before study, and then infused with 800～1 000 ml physiological saline immediately before study by anus. Dukes staging and resectability evaluation were made in 32 patients before surgery and meanwhile the results were compared with pathology. Results Colonic anatomy and surrounding organs were clearly demonstrated on MRI in 40 patients with colonic cancer, particularly in recta and sigmoid flexure. The tumours showed iso-intensity on T 1WI, iso-intensity or slight high-intensity signal on T 2WI, and high-intensity signal on SPIR. Remarkable enhancement was seen in 35/40 (87.5%). Invasion of surrounding organs occurred in 8/40(20.0%)and MRI revealed 6; Meanwhile, MRI revealed lymph node metastasis in 8 out of 12 cases. 32 patients were regarded as resectable before surgery, and 8 patients as unresectable. Four patients were overestimated, the accuracy of preoperative evaluation for the resectability was 87.5%, and the detecting rate of colonic cancer was 100.0%. Conclusion MRI can clearly show the colonic wall thickness, anatomic structure and surrounding anatomy. For the diagnosis of colonic cancer, MRI can not only demonstrate all its morphologic features, such as mass, thickened wall, and invasion of adjacent organs, but also swollen lymph node and metastasis in abdominal cavity. MRI is very helpful in the diagnosis, staging, and respectability evaluation of colonic cancer.

Objective To explore the application of CARE kV technique in the adult chest CT and the value of reducing radiation dose.Methods Sixty-nine patients were divided into two groups by random number generators:group A(39 cases) and group B(30 cases).Group A was examined by using CARE kV technique and group B was examined at routine 120 kV.CT dose index(CTDIvol),dose length product (DLP) and effective dose (E) were compared between the two groups,and analyzed the correlation between tube voltage selection and patient body mass index (BMI) of group A was analyzed.Results The average CTDIvol [(11.00 ± 3.89) mGy],DLP[(294.05 ± 91.17) mGy·cm] and E[(4.12 ± 1.28) mSv] of group A were lower than those of group B (16.64 ± 1.20) mGy,[(475.99 ± 41.16) mGy · cm],[(6.66 ±0.58) mSv].With statistically significant difference (t =-7.653,-10.151,-10.150,P ＜ 0.05).Compared with routine 120 kV technique (group B),the CARE kV technique (group A) could reduce the total radiation dose about 38.14％.Compared obese patients(BMI≥28 kg/m2) with non-obese patients in group A and B,the mean E of non-obese patients was lower than that of obese patients in group A,which reduced the total E about 31.74％ (t =4.322,P ＜0.05),while E in group B was no significant different between non-obese patients and obese patients.Conclusions In adult chest CT,CARE kV technique can select optimum scanning voltage automatically according to the patients with different BMI and anatomical regions,which can reduce the overall radiation dose while maintaining image quality.

Objective To evaluate the left ventricular systolic synchrony in hemodialysis depended(HD)patients by tissue synchronization imaging(TSI).Methods GE Vivid 7 ultrasound system with TSI and Q-analyze software was performed in 70 HD patients and 35 control individuals.According to the left ventricular enddiastolic diameter(LVDd),HD patients were divided into left ventricular enlarged group(HD1,LVDd＞55 mm)and non-left ventricular enlarged group(HD2,LVDd≤50 mm).Systolic asynchrony was determined by measuring the time to peak systolic velocity of all 12 segments corrected by the heart rate(Tc).Results ①The mean Tc and the Tc of most segments were greater in both the HD1 and HD2 groups than in controls(both P＜0.05).②The Tc was prolonged in 463(463/840)segments in HD group and left ventricular systolic asynchrony was detected in all patients(70/70).③The mean peak systolic velocity(PSV)and the PSV of most segments in HD group were lower than those in the control group(P＜0.05).④Compared with HD2 group,Tc was increased and PSV was decreased in partial segments of HD1 group(P＜0.05),but no significant differences in mean Tc and mean PSV were found between HDI and HD2 groups(P＞0.05).Conclusions Left ventricular systolic synchronicity was impaired in hemodialysis depended patients.TSI was shown to be useful for the detection of myocardial abnormalities and asynchrony in such patients and provided reliable parameters for clinical therapy.

Objective To evaluate the effect of dorsal dual-plate fixation for unstable distal radius fractures.Methods Twenty-two cases of unstable distal radius fractures undergone dorsal fixation with a 2.4 mm plate from June 2010 to June 2012 were enrolled.There were 16 males and 6 females with mean age of 54.5 years (range,22-75 years).According to the AO fracture classification,there were 12 cases of type B2,6 type C1 and 4 type C2.Five cases had autologous or allogeneic bone grafting.Results Mean period of follow-up was 14 months (range,5-30 months).According to Gartland-Werley score,the result was excellent in 13 cases,good in 5 cases and fair in 4 cases,with the excellent and good rate of 82％.Volar inclination [(11.07 ± 1.77) °],ulnar declination [(22.30 ± 3.13) °],and radial height [(11.40 ±1.51) °] showed statistical differences from that [(-1.50 ± 7.59) °,(11.90 ± 3.87) °,and (5.20 ±1.55) ° respectively] before operation (P ＜ 0.05).Conclusions Dorsal dual-plate fixation can be a reliable and effective technique for AO-B2 shear fractures with intact volar-cortex and dorsal criticallycomminuted fractures of the distal radius.Active bone grafting should be performed for bone defection to promote bone healing.

Objective To analyze the clinical application of monoenergetic technique of dual-energy CT in removing metal artifacts for patients with fractures fixed with metal fixer.Methods Fofly-five patients with fractures fixed with metal fixer underwent dual-energy CT scanning for the fractures.Two different data were collected in one-time scanning using dual-energy scanning sequence.With monoenergetic technique,two different data at 100 and 140 kilovolts were used for subtraction to removing metal artifacts based on different densities.Raw data were reconstructed with monoenergetic technique(group A)and conventional simulation method(group B),respectively.And,all data were reconstructed with multiplanar reconstruction (MPR),volume rendering(VR)and maximum intensity projection(MIP),respectively.Wilcoxon signed rank test was applied for the comparison of imaging quality and artifacts between the two groups.Results There were fewer artifacts on the images due to the application of monoenergetic technique in dual-energy CT scanning.In group A,the rate of high-quality images reached to 91.9%(124/135);and,in group B,it was 59.3%(80/135).There were statistical diference between the two groups(Z=-12.541.P<0.01).The images without artifact reached to 89.6%(121/135)in group A;whereas,it was 45.2%(61/135)in group B.There was statistical difference between the two groups(Z=-11.910,P<0.01).Conclusion Using monoenergetic technique,metal artifacts were removed effectively and the fine structure of fracture was clearly displayed.

OBJECTIVE:To investigate the correlation of total saponins and total polysaccharides content in the roots of Pari-dis rhizoma genus plants with Arbuscular mycorrhizal fungi(AMF)infection rate and rhizosphere soil nutrients. METHODS:Tak-ing 16 pieces of Paridis rhizoma herbs and rhizosphere soil in Three Gorges Reservoir Area as the research object,mycorrhizal in-fection rate and infection intensity,the contents of total saponins and total polysaccharides in roots and stem,and rhizosphere soil nutrient contents were all determined. SPSS18.0 software was adopted for data multiple comparison and correlation analysis. RE-SULTS:Paridis rhizoma genus plants roots in Three Gorges Reservoir Area could form a good symbiotic relationship with AMF. In-fection rate ranged from 85.19% to 99.80%,and infection intensity ranged from 16.55% to 72.27%. Paridis rhizoma from differ-ent origins and varieties had significant difference in the contents of total saponins and total polysaccharides (P<0.05). Soil pH was moderate,the average content of total nitrogen was in insufficient level,the average concentration of the remaining nutrients belonged to middle levels or above. Correlation analysis showed that the mycorrhizal infection rate and infection intensity of Paridis rhizoma were not significantly correlated with its quality. The total saponins were significantly negatively correlated with organic matter and available nitrogen. The total saponins and total polysaccharides were positively correlated with available phosphorus,po-tassium and pH value,but they were not significantly correlated with the other soil nutrients. CONCLUSIONS:Paridis rhizoma is selective to different soil nutrients. Rich soil available phosphorus and potassium supply are in favor of the synthesis and accumula-tion of total saponins and total polysaccharides in Paridis rhizoma roots.

Objective To evaluate the clinical efficacy of staged treatment of complex tibial plateau fractures with temporary transarticular external fixation and delayed plate fixation.Methods Enrolled in this study were 44 cases of complex tibial plateau fracture who had been treated from January 2011 to January 2014.Temporary transarticular external fixation and delayed plate fixation was adopted in 22 patients (observation group),involving 14 men and 8 women with an average age of 45.5 ± 11.4 years,and 10 left sides and 12 right sides.By the Schatzker classification,13 cases were type Ⅴ and 9 type Ⅵ.Calcaneal traction and plate fixation was adopted in the other 22 patients (control group),involving 13 men and 9 women with an average age of 43.8 ± 10.4 years,and 8 left sides and 14 right sides.By the Schatzker classification,12 cases were type Ⅴ and l0 type Ⅵ.The 2 groups were evaluated by the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume,hospitalization time,healing time,complications and Hospital for Special Surgery (HSS) scoring at the final follow-ups.The 2 groups were compatible with no significant differences regarding the preoperative general data (P ＞ 0.05).Results The 44 patients were followed up for 12 to 30 months (mean,18.6 months).There were significant differences between the 2 groups in the time from hospitalization to plate fixation,operation time,intra-operative bleeding volume and hospitalization time (P ＜ 0.05).There was also a significant difference in the complications rate (4.5％ (1/22) for the observation group versus 27.3％ (6/22) for the control group) (P ＜ 0.05),but there was no significant difference in the good to excellent rate by HSS scoring [86.3％ (19/22) versus 81.8％ (18/22)] (P ＞ 0.05).Conclusions Although both methods can treat complex tibial plateau fractures,temporary transarticular external fixation and delayed plate fixation may be preferable because it can lead to decreased hospitalization time,less intra-operative bleeding volume,fewer surgical complications and good functional recovery of the knee.