Objective Toexplore the findings of bile flow artifacts (BFA)on MR cholangiopancreatography(MRCP). MethodsEighty five patients with normal common bile duct (CBD)and 95 patients with dilated CBD who had MRCP examination were studied retrospectively. Findings of BFA on original thin images of MRCP were recorded. Date were tested by Chi-square test and Spearman ceefficient of rank correlation analysis. ResultsThe rate of BFA in CBD with normal group was 38. 8％ ( 33/85 ), in dilated group was 83.2％ (79/95), there was statistically significant difference between them( x2 ＝ 37. 512,P ＝ 0. 000). BFA was not observed when the diameter of CBD was no more than 4 mm. BFA was partly observed when the diameter of CBD was 4 mm ＜ ψ≤ 8 mm, single- string sign was predominant findings (52.6％ ,30/57 ). Three-string sign was predominant findings in CBD with slight-dilated group ( 85.7％,36/42). Multi-string sign was predominant findings in CBD with medium-dilated group (84. 6％, 22/26 ).There was statistically significant difference between each groups ( x2 ＝ 284. 561, P ＝ 0. 000 ).BFA had different manifestations with CBD of different diameter, there was relative between them ( r ＝ 0. 553, P ＝0. 000). ConclusionBFA can occur in CBD with normal diameter. CBD with dilated group has higher rate of BFA than CBD with normal diameter. Manifestations of BFA are relative with the diameter of CBD.

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP)and its diagnostic value.Methods Imaging examinations and clinical data of 13 patients with AIP were reviewed retrospectively.Results All patients had enlargement of pancreas either diffusely ( n =11 ) or focally in pancreatic head ( n =2 ).The swollen pancreas was of homogeneous density on CT scan ( n =13 ),hypointense on T1-weighted images and mildly hyperintense on T2-weighted images in 4 patients.It was demonstrated as mild enhancement on artery phase of dynamic imaging and progressive enhancement on portal and delayed phase images.Capsule-like enhanced rim was presented around the pancreas in 9 patients.Stricture or obliteration of the common bile duct located in pancreatic head was found in 10 patients accompanied by intrahepatic bile duct dilation.Pancreatic duct was invisible on axial images in 11 cases.Among the 6 patients underwent MRCP,it was showed diffuse and irregular narrowing of the main pancreatic duct and stricture of common bile duct located in pancreatic head in 4 cases.ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 7 cases.Extra-pancreatic lesion included veins around pancreas involvement in 8 cases;multiple low density renal lesions in 6 cases; retroperitoneal fibrosis in 2 cases; stricture of hilar duct,interstitial lung disease and ankylosing spondylitis in 1 case,respectively.Conclusions AIP shows some characteristic imaging features,and imaging examinations play an important role in the diagnosis of AIP.Recognition of extra-pancreatic lesions aids in the correct diagnosis of AIP.

Current attempts to regenerate the damaged myocardium after myocardial infarction have primarily focused on therapies directed at increasing regional perfusion and reducing cell loss. Accumulating evidence suggests that implantation of healthy muscle cells into the damaged myocardium replaces the fibrotic tissue. In addition to muscle cells, stem cells in circulation, from bone marrow or in the myocardium, have recently been documented to have great potential to differentiate into myogenic cells. These neo-myogenic cells in the myocardial scar tissue prevented ventricular dilatation and delayed cardiac dysfunction. Early clinical trials show encouraging data for cellular cardiomyoplasty. Although the beneficial effects of cell therapy for myocardial regeneration after an infarction have lead to phase I clinical trials, the mechanism of the novel therapy is often questioned. Replacing the scar tissue with muscle cells and stimulating neo-vessel formation in the implanted area have been proposed. However, a number of studies recently demonstrated that the survival rate of implanted cells was too low and that number of implanted cells decreased with time after transplantation. The number of surviving cells may not be enough to form adequate new muscle tissue to repair the damaged myocardium. We recently found that extracellular matrix in the myocardium plays an important role in maintaining the ventricular chamber size, and disruption of the matrix network may contribute to the apoptosis of cardiomyocytes leading to dilated cardiomyopathy. We implanted smooth muscle cells into the heart with dilated cardiomyopathy prior to ventricular dilatation. We found that implanted cells survived in the implanted area and altered myocardial matrix metabolism both within and remote from the region of implantation. Matrix metalloproteinase activity decreased in the transplanted group as compared with control group. The matrix structure was maintained and ventricular dilatation was prevented. These data suggest that implanted cells prevented ventricular dilatation through the alteration of matrix metabolism, which is a possible mechanism for implanted cells to improve heart function.

Objective To observe the effects of electroacupuncture at Ganshu (BL18) and Zusanli (ST36) on depression state and gastrointestinal motility and relevant protein expressions in brain of rats with stress-induced depressive functional dyspepsia. Methods Totally 48 Wistar rats were randomly divided into normal, model, electroacupuncture (EA) and sham-operation group, with 12 rats in each group. Depressive functional dyspepsia model was established by chronic unpredictable mild stress protocols. From day 15 to day 28, the EA group was given electroacupuncture at BL18 and ST36, and the sham-operation group was stimulated by electroacupuncture at 1/3 and 2/3 of the tail. Body weight test, open field test and sucrose preference test were measured on day 0, day 14 and day 28. After 14-day administration, gastric residual volume and intestinal propulsion rate of semisolid paste were detected. The expression of βCaMK inⅡ lateral habenulas and BDNF in hippocampus were measured by Western blot. Results Compared with the normal group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus decreased significantly both in the model group and sham-operation group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas increased significantly (P<0.01). Compared with the model group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus increased significantly in EA group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas decreased significantly (P<0.01). Compared with the sham-operation group, the expression of βCaMKⅡ in lateral habenulas decreased significantly, the expression of BDNF in hippocampus increased significantly in EA group (P<0.01). Conclusion Electroacupuncture at Ganshu (BL18) and Zusanli (ST36) can improve depression and gastrointestinal motility of rats with depressive functional dyspepsia, which may be related to the inhibition of βCaMK inⅡ lateral habenulas and the activation of BDNF in hippocampus dyspepsia.

Objective:To analyze the risk factors of neovascular glaucoma (NVG) after 25G pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR).Methods:A retrospective study. From January 2017 to December 2018, 340 PDR patients (340 eyes) with vitreous hemorrhage (VH) who were first treated with PPV in Tianjin Medical University Eye Hospital were included in the study. Among them, 185 were male and 155 were female, with an average age of 55.79±10.82 years. The duration of diabetes was 13.01±7.70 years, the fasting blood glucose was 7.55±2.15 mmol/L. Nineteen patients combined coronary heart disease, and 20 patients combined cerebral infarction. All patients underwent best-corrected visual acuity (BCVA), intraocular pressure (IOP), non-contact fundus examination, and fundus color photographs. BCVA was measured using an international standard Snellen visual acuity chart, and the values were converted to logarithm of the minimum angle of resolution (logMAR) scores for data analysis. The baseline logMAR BCVA was 2.04±0.73, The baseline IOP was 15.45±2.93 mmHg (1 mmHg=0.133 kPa). The duration of VH was 2.98±1.46 months, ranged from 3 weeks to 6 months. Three hundred and forty eyes included 93 eyes of PDR Ⅳ stage (27.35%), 107 eyes of Ⅴ stage (31.47%), and 116 eyes of Ⅵ stage (34.12%), combined tractional retinal detachment (TRD) 83 eyes. All patients underwent 25G standard three channel vitrectomy through the pars plana of the ciliary body. Preoperative anti-VEGF injection was performed in 57 eyes, internal limiting membrane (ILM) peeling in 234 eyes, combined phacoemulsification cataract surgery in 262 eyes and 141 eyes intravitreal anti-VEGF injection at the end of surgery. The patients were followed up for at least 12 months, with an average follow-up time of 10.80±5.79 months. NVG was defined as the presence of neovascularization in the anterior chamber angle or iris with an IOP higher than 21 mmHg after vitrectomy. Kaplan-Meier method and Cox univariate and multivariate regression were used to analyze the relationship between baseline factors, ocular factors, surgical factors and the occurrence of NVG after surgery.Results:Among 340 eyes, 66 eyes (19.41%) developed NVG after vitrectomy during 12 months of observation, NVG occurred from 6 to 335 days after surgery, and the mean period between vitrectomy and developing NVG was 98.00±5.79 days. The incidence of NVG was 11.50%, 15.29% and 20.75%, respectively in the 3rd, 6th and 12th month after PPV. The result of univariate analysis with the Cox regression analysis showed that the development of NVG at 12 months after surgery and age, combined coronary heart disease or cerebral infarction, combined with cataract phacoemulsification, ILM peeling, preoperative anti-VEGF injection had effect on postoperative NVG ( P<0.05). Ocular factors such as PDR staging, combined TRD, preoperative logMAR BCVA, preoperative intraocular pressure, etc. had no effect on the occurrence of NVG after surgery ( P>0.05). Combined cataract phacoemulsification surgery, internal limiting membrane peeling, surgical factors such as intracavity injection of anti-VEGF drugs 3 days before surgery, had an impact on the occurrence of NVG after surgery ( P<0.05). The meaningful variables of the Cox univariate analysis were incorporated into the multivariate Cox proportional hazard model for analysis, and the influencing factors of NVG after surgery were gradually regressed. The results showed that age, coronary heart disease or cerebral infarction, combined with phacoemulsification of cataract, and internal limiting membrane removal during surgery were independent risk predictors of NVG after surgery ( P<0.05). Conclusions:Younger, coronary heart disease or cerebral infarction, combined with cataract phacoemulsification are the risk factors of NVG in PDR patients after PPV. The removal of internal limiting membrane can reduce the incidence of NVG.

Objective: To establish analytical method for the determination of vanadium ( V ), chromium ( Cr ), nickel ( Ni ), selenium ( Se ) and arsenic ( As ) in calcium based toothpastes by microwave digestion-inductively coupled plasma tandem mass spectrometry ( ICP-MS/MS ). Methods: The 21 calcium based toothpaste samples from supermarkets and shops in the urban areas of Hangzhou were digested by 6 mL HNO3 and 1 mL H2O2 in microwave digestion system. Then He-SQ mode and O2-MS/MS mode of ICP-MS/MS were respectively used for the determination of Ni and V, Cr, Se, As. Indium ( In ) was used as internal standard for calibration. Results: Good linear relationships were obtained for these five elements from 1.0 to 32.0 μg/L, with the correlation coefficients ranged from 0.999 3 to 1.000 0. The detection limits of the method ranged from 0.000 25 to 0.006 08 mg/kg. The recovery rates of standard spiking were 80.7%-105.7% when set at 0.4, 0.8 and 1.6 mg/kg, the recovery of standard reference material was 102.2%, and the relative standard deviations were 2.6%-4.8%. The concentrations of V, Cr, Ni, Se and As in 21 calcium based toothpaste samples were 0.024-1.935 mg/kg, 0.085-5.759 mg/kg, 0.090-3.673 mg/kg, <0.002 72-0.016 mg/kg and <0.006 08-0.321 mg/kg. Conclusion Microwave digestion-ICP-MS/MS can effectively reduce the interferences of polyatomic ions and doubly charged ions from the matrix, which is suitable for the determination of V, Cr, Ni, Se and As in calcium based toothpaste.

Two fragments G1 and G2 of the glycoprotein G gene of bovine respiratory syncytial virus(BRSV) were selected for expression in Escherichia coli based on the analysis of glycoprotein G by DNA Star software.Then the two fragments of glycoprotein G were amplified by PCR with synthesized G gene of BRSV as the template.The amplified fragments G1 and G2 are 570bp and 308bp in length,respectively.The PCR products were cloned into pET30a vector and expressed in soluble form in E.coli after induction of cultured E.coli with IPTG.Both of the recombinant proteins G1 and G2 were purified by immobilized Ni ion affinity chromatography under native conditions.Then the purified proteins were analysed by Western blotting.The results showed that the purified recombinant protein G1 retained good antigenicity and specificity.But the purified recombinant protein G2 didn't possess biological activity.Antibodies against BRSV were detected in suspected bovine serum samples in China by using indirect ELISA and Western blotting with the purified recombinant protein G1.The purified recombinant protein G1 might be used as antigen for establishing serological methods for diagnosis of BRSV infection.And the purified recombinant protein G1 might also be used for preparing polyclonal and monoclonal antibodies for research on biological functions of glycoprotein G of BRSV.

Objective To compare the differences of the spectral CT parameters between benign and malignant mediastina lymph nodes and to investigate the value of spectral imaging in the differential diagnosis. Methods According to the follow-up and pathology results, a total of 73 patients were enrolled in this study. One experienced radiologist determined the locations of lymph nodes on CT images corresponding to the surgical pathological ones. A total of 47 malignant nodes and 65 benign nodes were found. The longest and shortest diameters of lymph nodes in mediastina window were measured .The vHU, IC, WC, Zef and the CT values of normal lung, normal muscle and lymph nodes at 40, 70 and 140 keV were measured. The indices were compared between the benign nodes and malignant nodes by independent-samples t test. The Spectral HU curves were drawn. Results The long and short diameter of malignant lymph nodes were (28.8 ± 10.5),(20.3 ± 9.1)cm , while they were were (14.0 ± 4.6),(7.5 ± 1.8)cm for benign lymph nodes. Malignant nodes were significantly larger than benign nodes (t= 6.54, 7.13, respectively, P<0.05), The differences of the CT values at 40, 70 and 140 keV and the vHU, IC, WC, Zef for the normal lung, normal muscle and lymph nodes between the two groups had no statistical significance (P>0.05). The two groups showed similar spectral HU curve slopes (1.86 values 1.73). Conclusion Spectral imaging may not be helpful in the differential diagnosis of malignant and benign lymph nodes.

Objective To explore the CT manifestations of non-functional islet cell tumor(NFICT)Methods The findings of plain and enhancement CT scanning from 17 cases with NFICT,which were confirmed by the surgeries and pathological sections,were analyzed retrospectively.Ninty ml of non-ioniodine contrast reagent with 3ml/s injection flow rate was employed as the enhancer for measuring the arteriovenous double phase CT value of the pancreas and tumor.Results Tumors were found in all the cases who received CT scan.Compared with pancreatic substance in the CT plain scan,tumors with low density were found in 2 cases,tumors with mixed low density in 11 cases and tumors with isodensity in 4 cases.Local calcification in tumor was found in 5 cases.Various degrees of strengthening were showed in 17 cases with enhancement scanning.Obvious enhancement in arterial phase presented in 5 cases,moderate enhancement in 6 cases and slight enhancement in 6 cases.Conclusions CT plain scan of NFICT shows that the tumor margins are clear and some tumors have calcification.All tumors in the CT enhancement scanning show various degrees of enhancement,the persistent enhancement from arterial phase to portal vein phase is the characteristic manifestation of NFICT.

Background T helper cell 17 (Th17),a newly discovered subset of CD4+ T cells,have been found to play an important role in dry eye disease in animal model.Further investigation should be done on the immunopathogenesis of Th17 cells in dry eye patients.Objective This study was to analyze the expression status of interleukin-17 (IL-17) and IL-22 in tear and supernatant of peripheral blood mononuclear cells (PBMCs) of dry eye patients and their correlation with clinical symptom and sign.Methods Twenty Sj(o)gren syndrome (SS)patients,twenty non-Sj(o)gren syndrome (NSS) patients were included in Wuxi Second Hospital from 2010 to 2011,and twenty healthy volunteers were recruited at the same period.All of subjects understood the purpose and procedure of research and written informed consent was obtained form each subject initial of this study.Dry eye symptom questionnairs were self-answered and multiple dry eye disease-related clinical tests,including the breakup time of tear film (BUT),Schirmer Ⅰ test (S Ⅰ t) and corneal fluorescein staining were performed.The periphery blood of 3 ml and tear were collected in all the subjects,and IL-17 and IL-22 levels in supernatant of PBMCs and tear were detected by enzyme-linked immunosorbent assay (ELISA).The correlations between levels of IL-17 and IL-22 with BUT,S Ⅰ t,corneal fluorescein staining and dry eye scores were analyzed.Results The dry eye scores reduced,BUT prolonged,S Ⅰ t increased and corneal fluorescein dye decreased from SS group,NSS group to normal control group,with significant differences among the three groups (dry eye scores:H =40.81,P＜0.01 ; BUT:H =40.15,P＜0.01 ;S Ⅰ t..H=50.07,P＜0.01 ;corneal dye scores:H=40.52,P＜0.01).The concentration of IL-17 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (964.92±124.83)ng/L,(718.85± 115.89)ng/L and (341.95±85.08) ng/L,showing a statistically significant difference among them (F=162.95,P＜0.01).The levels of IL-17 in the tear were (440.69±126.09) ng/L,(364.33±126.85) ng/L and (61.16±11.60) ng/L in the SS group,NSS group and normal control group respectively,exhibiting an elevated level in the SS group and NSS group compared with the control group (F=75.27,P＜0.01).In addition,the levels of IL-22 in the supernatant of PBMCs in the SS patients,NSS patients and normal controls were (98.77± 11.27) ng/L,(79.65 ± 11.01) ng/L and (32.78±9.34) ng/L,and those in the tear were (22.22 ± 8.96) ng/L,(14.92 ±4.35) ng/L and (10.47 ± 2.67) ng/L,with significant differences among the three groups (F =206.27,P＜0.01 ;F =19.87,P＜0.01).The significant correlations were found between the IL-17 and IL-22 concentration in the supernatant of PBMCs and tear with corneal fluorescein staining scores and S Ⅰ t.Conclusions The contents of IL-17 and IL-22 in PBMCs and tear upregulate in the SS and NSS patients,indicating that Th17 plays a key role in the immunity mechanism of dry eye.