Objective To evaluate the value of quantized diffusion-weighted imaging (DWI)in diagnosis of focal liver lesions. Methods A retrospective analysis was performed in 120 patients with focal liver lesions and in 12 healthy controls who underwent DWI and routine non-enhanced MRI at 3.0T.In 120 patients,there were 1 79 focal liver lesions including 53 hepatocellular carcinomas (HCC),61 metastatic tumors,32 hemangiomas and 33 cysts.The DWI and apparent diffusion coefficient (ADC)maps and ADC val-ues of the lesions and the normal liver were analyzed and measured with a b value of 800 s/mm2 ,and the statistical differences be-tween two groups were compared.Results DWI showed 33 hepatic cysts with low signal,and 5 1 hepatocellular carcinomas,61 he-patic metastases and 32 hepatic hemangiomas with high signal,thus the signal difference between hepatic cyst and other lesions was significant (P <0.05).The ADC images of HCC and metastatic tumors were cold colour,and those of hepatic cysts and hemangio-mas were hot colour.The ADC value between HCC,liver metastatic tumors,hepatic hemangioma and cysts were significant different (P <0.05).However,there were no significant differences in ADC value between HCC and metastatic tumors (P >0.05).In addit-on,the ratios of the ADC values of lesion to background liver between hepatocellular carcinoma and metastases were significantly dif-ferent (P <0.05).Conclusion DWI and ADC maps,and ADC value can provide importantly additional information for the diagnosis and differential diagnosis of focal liver lesions.

Objective To investigate the clinical value of GFR, microalbuminuria (mAlb), serum β2-microglobulin (MG) and cystatin C (CysC) for the evaluation of renal function in patients with DN.Methods A total of 150 patients with type 2 DM diagnosed by WHO standard (1999) from December 2012 to December 2015 were retrospectively analyzed.Thirty-three kidney transplantation donors during the same time were chosen as the control group.The urine mAlb, Cr, albumin/Cr ratio(ACR) and SCr, serum β2-MG, CysC, urea, uric acid(UA), fasting blood glucose (FBG), hemoglobin A lc (HbA1c) and C-reactive protein (CRP) were measured.99Tcm-DTPA renal dynamic imaging was performed.The Gates method was used to calculate GFR, and the modification of diet in renal disease (MDRD) method was used to calculate the estimated GFR (eGFR).The relative equation between GFR and eGFR was studied.The clinical stages of renal function in type 2 DM patients were evaluated by Mogenesen standard method.Two-sample t test was used for data analysis.ROC curve analysis was performed to study the diagnostic value of GFR in DN.Results The patients were divided into merely type 2 DM group, early stage DN (Ⅰ, Ⅱ, Ⅲ), and clinical DN(Ⅳ) groups by Mogenesen standard method.GFR and eGFR in the DNⅠstage were higher than those of the merely type 2 DM group (t values:-7.502,-3.629, both P<0.01), and GFR and eGFR decreased with the increased stage of DN.However, serum UA, CRP, FBG and HbA1c, SCr, urea, β2-MG, CysC, mAlb and ACR increased when the stage of DN was higher.GFR and eGFR showed a linear correlation, with the regression equation of y=0.957x+6.823.AUC of ROC in patients with DN Ⅰ was 0.989.With the cutoff value of 125.09 ml/min, the sensitivity and specificity was 96.2%(25/26) and 98.4%(122/124) respectively in diagnosis of DNⅠ.Between high UA and normal UA groups, FBG and HbA1c were not significantly different (t values:-1.010,-1.034, both P>0.05), but the renal function indicators were different (t values:-5.090-2.209, all P<0.01).Compared with the normal CRP group, the FBG, HbA1c and renal function indicators were statistically different in high CRP group (t values:-6.114-7.386, all P<0.01).Conclusions GFR and eGFR show a linear relationship in type 2 DM.GFR is a sensitive, specific diagnostic index in DN Ⅰ period.β2-MG, CysC, mAlb and ACR are conducive to the early diagnosis of DN.High UA is an independent risk factor for the onset of DN, and high CRP is an inflammatory damage factor in DN.

BACKGROUND:Inflamed dental pulp stem cells are a new kind of dental pulp stem cells, and there is no systematic review on the cells by now. OBJECTIVE:To systematical y review the research progress in inflamed dental pulp stem cells. METHODS:A computer-based online search in PubMed, Web of Science, CNKI, WanFang and VIP databases was performed for related articles published from the establishment of the databases to February 2014. The keywords were“(pulptis or inflam*dental pulp*or human dental pulp with irreversible pulpitis) and stem cel*”in English and Chinese, respectively. Hand searching was also done to obtain further information or papers about the studies. The results were qualitatively analyzed to comprehensively summarize the progress in the research of inflamed dental pulp stem cells. RESULTS AND CONCLUSION:Total y 11 papers were involved in result analysis that comprehensively review the research progress in inflamed dental pulp stem cells at the fol owing aspects:the research of history, material origin, cellculture, cel-surface markers, proliferation ability, multi-directional differentiation potential, animal models and clinical use. Researches of inflamed dental pulp stem cells are stil in the initial stage, and cultivating conditions and the establishment of animal models are stil in the exploratory phase. Controversies stil exist in the capacity of proliferation and multi-directional differentiation of the inflamed dental pulp stem cells. And fewer studies have been done in the characteristics of immunity, subpopulation and clinical use of the inflamed dental pulp stem cells.

Objective To determine the expression and distribution of Disabled-2(Dab2) in normal human adrenal glands, and further to study the expression of Dab2 in tissues of different adrenocortical adenomas, and to elucidate whether Dab2 can be a specific molecular marker in the pathology of primary aldosteronism. Methods Real-time PCR and immunohistochemical staining were used to detect Dab2 expression in 10 aldosterone-producing adenoma (APA) samples, 8 cortisol-producing adenoma ( CPA) samples, 8 non-functioning adenoma ( NFA) samples and 6 normal adrenal samples. Results Immunohistochemical staining showed that Dab2 was significantly highly expressed in zona glomerulosa of normal human adrenal glands. Sporadical cluster of ZG cells with moderate Dab2 staining were demonstrated in APAs. In all CPA and NFA tumors, weak dab2 staining was detected. According to the results of real-time PCR, Dab2 mRNA expression was increased significantly in APAs compared with normal adrenal glands. There was no significant difference between normal adrenal glands, CPAs, and NFAs in regard to Dab2 mRNA expression. Compared to nontumor portions, APAs also showed higher Dab2 mRNA expression in the tumor( P<0. 05). Conclusion Dab2 was predominantly localized in zona glomerulosa in normal adrenal gland. Increased Dab2 mRNA expression was detected in APAs compared with normal adrenal glands. Whereas, Dab2 protein expression was just moderate increased in APAs. Weather Dab2 can be a specific molecular marker in the pathology of primary aldosteronism has to be further studied.

Objective To investigate the clinical and pathological characteristics of normotensive pheochromocytomas ( NP) . Methods This retrospective study included 97 patients with a pathological diagnosis of pheochromocytoma at the Drum Tower Hospital Affiliated to Nanjing University Medical School during January 2004 to December 2013. All available clinical, biochemical, and radiological records were reviewed in these patients who were then categorized into hypertensive pheochromocytomas (HP) (n=64) and NP (n=33) groups. 97 cases of Adrenal Gland Scale Score of pheochromocytoma were examined, including tissue microscopic pathology assessment, ki67 and phenylethanolamine-N-methyltransferase ( PNMT ) immunohistochemistry and catecholamine type. Biochemical examinations of 95 subjects with primary hypertension ( PH) were recorded for comparative study. Results The patients with NP showed lower proportion of clinical triad than HP, inapparent metabolic disorders, and lower urinary catecholamine levels than HP, but showed higher results than primary hypertension. The weight of tumor was positively correlated with 24 hour urinary norepinephrine level in patients with HP(Y=1. 376+0. 653X,R2=0. 118, P=0. 028), but not in patients with NP;and the size or diameter of the tumor was negatively correlated with PNMT immunohistochemistry in patients with NP(Y=0. 940-0. 356X, R2=0. 494, P=0. 005), but not in patients with HP, indicating that NP may be misdiagnosed clinically. Conclusion Patients with NP have distinct clinical, biochemical, and pathological phenotypes; the phenotypic changes are closely related with the expression levels of catecholamine pathway products during the occurrence and development of the tumors.

Objective To determine the status of glycemic control in type 2 diabetic patients in Jiangsu province. Methods Survey was conducted among outpatients with type 2 diabetes mellitus from 56 diabetes centers including 23 tertiary hospitals, 18 secondary hospitals and 15 primary hospitals, covering 13 cities in Jiangsu province. Data were obtained by patient interview and by reviewing medical records of the most recent laboratory assessment and clinical examinations. Blood samples were collected during patient′s visits for assessment of HbA1C. Results The mean HbA1Cof 2 966 patients was 7.18%±1.58%. Mean age of patients was(56.4±11.2) years, mean duration of diabetes was(6.3±5.7) years, and mean body mass index was(24.5±3.3) kg/m2. The proportion of good control was 40.2% defined as HbA1C＜6.5%. 42.2% of the patients in the tertiary hospitals, 36.5% of the cases in the secondary hospitals, and 36.2% of cases in the primary hospitals achieved that goal with HbA1C＜6.5%, while age, body mass index, and duration of diabetes revealed no difference among these 3 groups of patients. Conclusions The status of glycemic control in Jiangsu province has been improved as compared with the result from national survey performed 3 years ago. Patients from tertiary hospitals are better controlled than those from secondary and primary hospitals. Structural interventions to improve diabetes care in secondary and primary hospitals are needed.

Objective:To investigate the association between polycystic ovary syndrome (PCOS) and cardiovascular risk factors and evaluate 10-year risk of cardiovascular disease (CVD) in women with PCOS.Methods:239 PCOS patients (PCOS group) and 134 age-matched non-PCOS participants (control) were enrolled in this retrospective study.The general data was collected and biochemical test, glucose tolerance, sex hormones were detected.The Framingham score (FRS) for all women was evaluated according to age, systolic blood pressure (SBP), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and history of smoking.The clinical features, laboratory parameters and FRS of PCOS patients and non-PCOS controls were compared.The correlation between FRS and metabolic indicators and sex hormones was analyzed.Results:①Compared with those of the control group, SBP and diastolic blood pressure (DBP) significantly increased, the glucose and lipid metabolism was moredisordered, and the androgen level was higher in PCOS group (P＜0.05).② The FRS of the PCOS group was higher than that of the control women (P＜0.01).③ FRS were positively correlated with BP, FPG, PBG, FIns, PIns, HOMA-IR, TC, TG, LDL-C.FRS was negatively correlated with HDL-C and SHBG (P＜0.05).Conclusions:PCOS is correlated with major cardiovascular risk factors, such as hypertension, hyperglycemia, and hyperlipidemia.PCOS show a higher risk of 10-year CVD events than individuals without PCOS.The phenomenonis mainly related to blood pressure and glycolipid metabolism but not androgen.

A group of 19 referred hypertensive patients were diagnosed to have primary aldosteronism(PA) with inconclusive computed tomography scan results.Adrenal vein sarmpling (AVS) was performed in all patients.AVS was successful in 16 cases but failed in 3 cases.According to the results of AVS and postoperative pathology,8 cases were diagnosed as aldosterone-producing adenoma (APA) and unilateral adrenal hyperplasia (UAH),and the other 8 cases were diagnosed as idiopathic hyperaldosteronism (IHA).In conclusion,AVS is one of the most crucial methods in typing diagnosis of PA.

Objective To analyze the characteristics and variation trend of respirable dust concentration in the working environment of a coal mine from 2013 to 2020. Methods A large coal mine in Shaanxi Province was selected as the research site. The inspection data regarding the respirable dust concentration across the years were collected. The characteristics and dynamic changes of respirable dust concentration were analyzed. Results The content of free silica in the main workplaces of the coal mine was less than 10% , and the dust was classified as the coal dust. The average annual concentrations of respirable dust varied in different workplaces, with the highest values in the fully mechanized winning and continuous mining face (0.32 mg/m³~18.68 mg/m³) and fully mechanized mining face (0.36 mg/m³~8.11 mg/m³). The average annual concentrations of respirable dust varied among different jobs, with the highest value among continuous miner drivers (1.30mg/m³~18.68 mg/m³), followed by shuttle truck drivers (0.32 mg/m³~14.77 mg/m³), crusher drivers (0.59 mg/m³~8.23 mg/m³), fully mechanized winning machine drivers (0.99 mg/m³~5.05 mg/m³), fully mechanized mining machine drivers (1.10 mg/m³~8.11 mg/m³), and timbermen (1.10mg/m³~6.09 mg/m³). The average concentration of respirable dust increased to the highest level during 2013-2014, then showed a downward trend during 2015-2018, and rebounded to a certain extent during2019-2020. Conclusion Respirable dust was widely distributed in the workplaces and across jobs. The concentrations of respirable dust were high, but the overall trend was downward.

OBJECTIVE： To investigate the effects of different polar parts of 5 kinds of Alpinia on the function of sympathetic-adrenal system in gastric ulcer model rats with cold syndrome， such as the root of Alpinia officinarum， the rhizome and fruit of Alpinia galangal， the seed of Alpinia katsumadai， and the fruit of Alpinia oxyphylla. METHODS： SD rats were given Anemarrhena asphodeloides decoction at 4 ℃ and Glacial acetic acid solution intragastrically to induce gastric ulcer model with cold syndrome； the model rats were randomly divided into model group， Fuzi lizhong pills group （positive control， 9.0 g/kg）， cimetidine group （positive control， 0.003 3 g/kg）， low-dose and high-dose groups of petroleum ether， ethyl acetate， n-butanol and water extraction parts from 5 medicinal materials （hereinafter referred to as “gaoshidi” “gaoshigao” “dashidi” “dashigao” “hongshidi” “hongshigao” “caoshidi” “caoshigao” “yishidi” “yishigao” “gaoyidi” “gaoyigao” “dayidi” “dayigao” “hongyidi” “hongyigao” “caoyidi” “caoyigao” “yiyidi” “yiyigao” “gaozhengdi” “gaozhenggao” “dazhengdi” “dazhenggao” “hongzhengdi” “hongzhenggao” “caozhengdi” “caozhenggao” “yizhengdi” “yizhenggao” “gaoshuidi” “gaoshuigao” “dashuidi” “dashuigao” “hongshuidi” “hongshuigao” “caoshuidi” “caoshuigao” “yishuidi” “yishuigao”， 0.064/0.256， 0.032/ 0.128， 0.008/0.032， 0.075/0.3， 0.1/0.4， 0.064/0.256， 0.108/0.432， 0.16/0.64， 0.064/0.25， 0.125/0.5， 0.056/0.224， 0.108/0.432， 0.08/0.32， 0.2/0.8， 0.3/1.2， 0.14/0.56， 0.032/0.128， 0.028/0.112， 0.05/0.2， 0.087/0.348 g/kg， by mass of extraction parts）， with 10 rats in each group； and the blank group （normal temperature water） was set up. Next day after modeling， blank group and model group were given constant volume of normal temperature water intragastrically； administration group was given relevant solution 2 mL/100 g intragastrically， q12 h， 4 times in total. After last medication， urine contents of 17-OHCS， CAs substances （A， NE， DA） and serum contents of ACTH and D-β-H were determined by ELISA. RESULTS： Compared with blank group， the contents of 17-OHCS， A， NE and DA in urine， the contents of ACTH and D-β-H in serum were decreased significantly in model group （P＜0.01）. Compared with model group， the contents of 17-OHCS （Fuzi lizhong pills group， cimetidine group， gaoshidi， gaoshigao， dashigao， hongshigao， caoshigao and yishigao groups， ethyl acetate part groups of 5 medicinal materials， dazhenggao， hongzhenggao， caozhenggao and yizhenggao groups， gaoshuigao， dashuigao and hongshuigao groups）， A （Fuzi lizhong pills group， cimetidine group， gaoshigao， dashigao， hongshidi， hongshigao， caoshidi， caoshigao and yishigao groups， ethyl acetate part groups of 5 medicinal materials， gaozhenggao， dazhenggao， hongzhengdi， hongzhenggao， caozhenggao and yizhenggao groups， hongshuigao group）， NE （Fuzi lizhong pills group， cimetidine group， petroleum ether part， ethyl acetate part and n-butanol part groups of 5 medicinal materials， gaoshuigao， dashuigao and hongshuigao groups）， DA [Fuzi lizhong pills group， cimetidine group， petroleum ether part （except for gaoshidi group） and ethyl acetate part groups of 5 medicinal materials， gaozhenggao， dazhenggao， hongzhenggao， caozhenggao and yizhenggao groups， hongshuigao group] in urine， serum contents of ACTH [Fuzi lizhong pills group， petroleum ether part （except for gaoshidi， dashidi and caoshidi groups） and ethyl acetate part （except for dayidi and hongyidi groups） groups of 5 medicinal materials， hongzhenggao group， dashuigao group]， and D-β-H [Fuzi lizhong pills group， gaoshigao， dashigao， hongshidi， hongshigao and yishigao groups， ethyl acetate part groups of 5 medicinal materials （except for dayidi， hongyidi and yiyidi groups）， dazhenggao and hongzhenggao groups， hongshuigao group] were increased significantly （P＜0.05 or P＜0.01）. The contents of 17-OHCS and D-β-H in dashigao group， the contents of ACTH and D-β-H in caoshigao group and the contents of D-β-H in gaoshigao and yishigao groups were significantly lower than hongshigao group. The contents of DA in gaoyigao， caoyigao and yiyigao groups as well as the contents of D-β-H in gaoyigao， hongyigao， caoyigao and yiyigao groups were significantly lower than dayigao group； the contents of DA in gaoyigao and caoyigao groups were significantly lower than hongyigao group， the contents of ACTH in gaoyigao， dayigao， caoyigao and yiyigao groups were significantly higher than hongyigao group. The contents of 17-OHCS， DA and ACTH in gaozhenggao， dazhenggao， caozhenggao and yizhenggao groups， the contents of A in dazhenggao， caozhenggao and yizhenggao groups as well as the contents of D-β-H in gaozhenggao， caozhenggao and yizhenggao groups were significantly lower than hongzhenggao group. The contents of 17-OHCS and D-β-H in caoshuigao and yishuigao groups were significantly lower than dashuigao group. The contents of 17-OHCS， DA and D-β-H in caoshuigao and yishuigao groups as well as the contents of DA and D-β-H in gaoshuigao groups were significantly lower than hongshuigao group （P＜0.05 or P＜0.01）. CONCLUSIONS： Different polar parts of 5 kinds of Alpinia can improve gastric ulcer model rats with cold syndrome to different extents； among them， the fruit of A. galangal is the best， followed by the root of A. officinarum. Above medicinal materials can regulate the function of sympathetic-adrenal system by increasing the contents of 17-OHCS， CAs and D-β-H.