The Ca2+-ATPase of sarcoplasmic reticulum is a Ca2+ pump that plays a key role in regulating cytosol calcium concentration in muscle cells. It undergoes a sequential conformational transition during the transport process. According to the classical E1/E2 theory, in the E1 state the binding sites have high affinity and open to the cytoplasm, whereas in the E2 state the binding sites have low affinity and face the luminal side. Crystal structures of several states during the reaction cycle of Ca2+-ATPase have been solved recently, including a Ca2+-bound form (E1-2Ca2+), a Ca2+-unbound form stabilized by a potent inhibitor thapsigargin (TG) (E2-TG), an ATP-bound form (E1-ATP), an E1-P-ADP state, and an E2-Pi state. The details of these crystal structures and the relationship between structure and function of Ca2+-ATPase during reaction cycle were summarized, and the issues to be addressed in future research were raised.

Objective To investigate the reproducibility and influencing factors of relative quantification of phosphorus metabolites with two-dimensional chemical shift imaging (2D CSI) in rabbit liver. Methods Using 2D CSI MRS, 500 ml phosphate (NaH2PO4) solution phantom with 0. 05 mol/E concentration and one healthy rabbit were scanned 30 times respectively in one day and rescanned 30 times in the next day, and the stability of MR scanner and reproducibility of within-run and between-days in the same individual were analyzed. Each of thirty rabbits was scanned and rescanned one time respectively in different days, and the reproducibility of between-days in one group was analyzed. The data were statistically analyzed with t tests. Results (1) Phosphate solution phantom had a good reproducibility of within-run with the coefficient variation (CV) of 4. 92% and 5. 12% respectively in different two days. No significant change of phosphorus metabolites was detected in between-days, which was 16. 68 ± 0. 82 and 16. 56 ± 0. 85 respectively(t = 0. 665, P > 0. 05 ). (2) The CV of metabolites in one healthy rabbit ranged from 8. 04% to 34. 13%. Among the metabolites, β-ATP had the best reproducibility with the CV less than 10%. PME was 0. 88 ± 0. 28 and 0. 88 ± 0. 30, PDE was 4. 35 ± 0. 66 and 4. 35 ± 0, 66, Pi was 0. 95 ± 0.30 and 0.97±0.28, α-ATP was 5.58±0.60 and 5.61±0.61, β-ATP was 2.70±0.22 and 2.71± 0. 22, γ-ATP was 2. 20±0. 63 and 2. 18±0.44 respectively, no significant changes of metabolites were detected in between-days( P >0. 05 ). (3) The CV of metabolites in 30 healthy rabbits ranged from 8.48% to 36. 21%. Among the metabelites, β-ATP had the best reproducibility with CV less than 10%. PME was 0. 84 ± 0. 30 and 0. 79 ± 0. 28, PDE was 4. 29 ± 0.72 and 3.94 ± 0. 84, Pi was 0. 91 ± 0. 28 and 0. 92 ± 0. 31, α-ATP was 5.65±0. 66 and 5. 36±0. 60, β-ATP was 2. 71±0. 23 and 2. 66±0. 25, γ-ATP was 2. 07±0. 29 and 1.99±0. 37 respectively, no significant changes of metabolites were detected in between-days (P > 0. 05). Conclusions The relative quantification of hepatic β-ATP may be most reliable among the phosphorus metabolites for rabbit liver because of its good reproducibility and small CV. The quantification of phosphorus metabolites by 31p MRS with 2D CSI in rabbit liver is affected by many factors.

Objective To analyze CT features of xanthogranulomatous cholecystitis(XGC)so that to improve the accuracy of diagnosis.Methods The data of CT,clinic and operation in 11 cases with XGC proved pathologically were analysed.The following CT features were analyzed:the cholecystic wall thickness,intramural hypoattenuated nodules,inner wall,mucosal line,patterns of enhancement of thickened wall,involved liver tissue and the presence of stones.The changes around the gallbladder were also noticed.Results The gallbladder wall was thickened and intramural hypoattenuated nodules were seen in all patients.The inner wall of gallbladder was smooth in 9 patients,the mucosal line was observed in 6 cases,the size of gallbladder was enlarged in 3 while 4 gallbladders were smaller than normal.Stones were found in 4 gallbladders.There were hepatic involvement in 6,pericholecystic infiltration in 3 and dilatation of biliary tract in 6 cases.Conclusion CT features of thickened gallbladder wall with intramural hypoattenuated nodules(sandwich sign)and continuous mucosal line were characteristic of XGC.

Objective To observe the efficacy of Ramulus Cinnamomi , Poria capsules combined with mifepristone in the treatment of hysteromyoma .Methods 60 patients with hysteromyoma were treated with drugs ,and according to the outpatient number they were randomly divided into three groups .Ⅰgroup ( n=20) were orally given mifepristone in a dosage of 12.5mg once daily for three months.Ⅱgroup (n=20) were orally given Cassia Tuckahoe Capsule for three months ,and Ⅲ group ( n=20 ) were orally given Cassia Tuckahoe Capsule for three months after given mifepristone in a dosage of 2.5mg once daily for one month.The size of hysteromyoma,FSH,LH,E2 and P were detected before and after treatment .The changes of clinical symptoms and adverse drug reactions were observed . Results The size of hysteromyoma of Ⅰ group and Ⅲ group [(2.41 ±1.03)cm3,(2.69 ±0.97)cm3]reduced significantly(P<0.05).FSH,LH,E2 and P in blood of Ⅰgroup reduced significantly(P<0.05),which inⅡgroup and Ⅲ group had no statistically significant differences between before and after treatment ( all P >0.05 ) . Conclusion Mifepristone combined with cassia tuckahoe capsule in treatment of patients with hysteromyoma is better than those only using mifepristone or cassia tuckahoe capsule .This combination therapy is indicated for preoperative medication or perimenopausal patients for conservative treatment of hysteromyoma .

Objective To investigate the efficacy of vascular endothelial growth factor (VEGF) gene therapy in coronary occlusion of animal Methods 19 swine underwent left thoracotomy followed by the ligation of left anterior descending coronary artery Constructed pcD 2/hVEGF 121 eukaryotic expression plasmid was directly injected into the swine myocardium RT PCR, immunohistochemistry of VEGF and factor Ⅷ related antigen were used to detect VEGF gene expression and biological effect Coronary angiography was done to evaluate collateral circulation of the occluded artery Results High levels of VEGF mRNA and protein expression were detected There was a significant increase in the number of capillaries when compared with control group Coronary angiography showed better collateral circulation in VEGF group Conclusion Direct injection of pcD 2/hVEGF 121 eukaryotic expression plasmid can transfect the myocardium and express VEGF protein This gene product can increase capillary number and enhance collateral circulation of the occluded coronary

Objective:To provide references for encouraging translation of medical and pharmaceutical research outcomes from a policy perspective.Methods:In view of characteristics of such translation and using policy tools, the authors introduced the innovation value chain and innovation entity chain to create a three-dimensional analysis framework. The three dimensions refer to policy tools(supply side, environment side and demand side), innovation value chain(research and development, clinical research and pilot application, and commercial industrialization), and innovation entity chain(colleges, medial institutions, enterprises, government, and third parties). A three-dimensional framework was introduced for textual quantitative analysis, centering on 70 policy documents on such translation released from 2015 to 2019.Results:Excessiveness was found in the environment side and supply side policy tools usage, while the demand side was deficient relatively; clinical research and pilot applications constitute the policy support weakness in innovation value chain; policy frequency on medical institutions and third parties was weak in the innovation entity chain dimension.Conclusions:Based on the three-dimensional framework analysis results and sector specifics, the paper proposed such policy recommendations as highlighting features of medical and pharmaceutical sector, activating incentives of hospitals and colleges, and expanding resources for clinical research.

Objective To investigate the application value of percutaneous sinus-tract cholangioscopy in the diagnosis and treatment of residual intra-and extra-hepatic bile duct stones.Methods The retrospective cross-sectional study was conducted.The clinical data of 1 045 patients with intra-and extra-hepatic bile duct stones who underwent percutaneous sinus-tract cholangioscopy or stone extraction in the Second Affiliated Hospital of Zhejiang University from January 2003 to June 2016 were collected.Patients received percutaneous sinus-tract cholangioscopy or stone extraction at 6-8 weeks after T tube drainage.Observation indicators:(1) diagnosis and stone extraction situstions:cases with residual stones,stone extraction frequency and clearance rate;the critics of clearance rate are no residual stone dnring operation combined with B ultrasound or T-tube cholangiography;(2) postoperative complications:incidence and management of postoperative complications,prognosis and ClavienDindo classification for postoperative complication;(3) follow-up situation.T-tube was removed when there was no residual stone.Patients were followed up by outpatient examination up to April 2017.B ultrasound reexamination was performed to detect the recurrence of stone once every 3-6 months.Results (1) Diagnosis and stone extraction situstions:among 1 045 patients,results of cholangioscopy showed 147 wihout bile duct stones and 898with bile duct stones.Of 898 patients,2 618 times cholangioscopic explorations for stone extraction were performed,with a maximum frequency of 16 times,and 851 had stones clearance,with a overall clearance rate of 94.77％(851/898).The clearance rates of extra-and intra-hepatic bile duct stones were 100.00％(221/221) and 93.06％(630/677).Of 47 patients with residual stones,16 didn't receive cholangioscopy due to branches stricture or occlusion of intrahepatic duct,13 failed to take out stone due to T-tube dislodgement (9 cases) and improper placement (4 cases) induced closed T-tube sinus tract,7 had T-tube sinus tract duodenal fistula,6 gave up stone extraction,3 was due to longer sinus tract induced bending and 2 was due to T-tube sinus tract fracture.(2)Postoperative complications:among 1 045 patients,297 had level Ⅰ-Ⅱ mild complications and 13 had level Ⅲand above severe complications.The common complications included fever,vomiting,diarrhea and so on;the special complications included T-tube sinus tract duodenal fistula of 13 patients,T-tube sinus tract fracture of 4 patients,rupture of broken stones pole of 3 patients,massive hemobilia of 2 patients,acute pancreatitis of 2patients and cardiac arrest of 1 patient.The above complications were improved by symptomatic and supportive treatments.(3) Follow-up situation:among 1 045 patients,558 received long-term follow-up,with follow-up time of 10-171 months and a median time of 79 months.Eight-four patients had stone recurrence.Of 13 patients with recurrence of extrahepatic bile duct stones,7 took out stones by endoscopic retrograde cholangio pancreatography (ERCP) and 6 underwent reoperations.Of 71 patients with recurrence of intrahepatic bile duct stones,43underwent reoperations and 28 received conservative treatment.Conclusions Percutaneous sinus-tract cholangioscopy for residual intra-and extra-hepatic bile duct stones is safe and effective,with good diagnosis and treatment values and a high clerance rate.The integrity of T-tube sinus-tract is a key of complete stones removal.

Objective To study more reasonable method of radiation barrier for cervical cancer treated with external radiation. Methods The distance from cervical canals to tumor's margin in x axis was measured by B ultrasonic, around uterus were evaluated by physical examination.and the dose around uterus for patient who used fixed lead brick for radiation barrier when treated with external radiation were calculationed by TPS, in 39 case of cervical cancer treated with external radiation combine with intracavitary irradiation. Pay attention to the lower dose area around uterus. Results It might bring about lower dose area around uterus who used fixed lead brick for radiation barrier when treated with external radiation,and mass might be in above area. Conclusion Cervical cancer treated with external radiation with source axial distance (SAD), and radiation barrier with lead brick individuate may help for to avoid the lower dose area around uterus.

Objective To study the relationship between energy metabolic changes tested by phosphorus-31 magnetic resonance(MR)spectroscopy(31P MRS)and the liver damage score(LDS)in rabbit models and investigate the diagnostic value of 31P MRS in acute hepatic injury.Methods A total of 30 rabbits were received different radiation dose(ranging from 5 Gy to 20 Gy)to establish acute hepatic injury models.31P MRS was than carried out 24 hrs after radiation.The rabbits were divided into mild(LDS≤3 U),moderate(LDS 3-6 U)and severe(LDS＞6 U)hepatie injury groups.Ten healthy rabbits were served as controls.MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.The relative quantification of phosphomonoesters(PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine severe hepatic injury groups were 1.83±0.33,1.55±0.24,1.27±0.07 and 0.98±0.18,respectively,with significant differences(P＜0.05).The ATP level was progressively decreased with the increase of severity Of hepatic injury.The relative quantification of PME and Pi were decreased in severe hepatic injury group compared to control group(P＜0.05).There was no significant difference higher in moderate(1.94±0.50)and severe(1.96±0.72)hepatic injury groups compared to control group(1.43±0.31)and mild hepatic injury group(1.40+0.38)(P＜0.05).No significant difference was found in ratio of relative quantification of other phosphorus metabolites.Conclusions 31P MRS is a useful method in evaluating acute hepatic injury.The relative quantification of hepatic ATP level,which can reflect the severity of acute hepatic injury,is correlated with LDS.

OBJECTIVETo estimate the diagnostic accuracy of magnetic resonance(MR) in restaging of rectal cancer after preoperative chemoradiotherapy(CRT).

METHODSComprehensive search of literature concerning the diagnosis of MR for rectal cancer after preoperative CRT was performed from databases of PubMed, EMbase, OVID and WOK. Sensitivity and specificity of MR on restaging of rectal cancer after preoperative CRT were investigated by SAS and MetaDiSc software.

RESULTSThirteen articles including 749 patients were enrolled in this meta-analysis. For T3-T4 stage, sensitivity of MR was 82.1%(95%CI:67.9%-90.9%), specificity was 53.5%(95%CI:39.3%-67.3%), and diagnostic odds ratio(DOR) was 5.34(2.73, 6.59). For lymph node involvement, sensitivity of MR was 61.8%(95%CI:50.7%-71.8%), specificity was 72.0%(95%CI:61.3%-80.7%), and DOR was 4.33(95%CI:2.84-6.59). For circumferential resection margin(CRM) by MR, pooled sensitivity was 85.4%(95%CI:60.5%-95.7%), specificity was 80.0%(95%CI:57.4%-92.3%), and DOR was 27.62(95%CI:13.03-58.55).

CONCLUSIONSRestaging accuracy of T3-T4 and lymph nodes involvement of rectal cancer after preoperative CRT by MR is not high. MR may be a good method to make reassessment of CRM. To avoid overtreatment for T0-T2, negative lymph node and circumferential resection of rectal cancer, restaging by MR after preoperative CRT is important.