Objective To investigate the relationships between the parameters of intravoxel incoherent motion (IVIM)DWI at 3.0 Tesla and T staging of moderately differentiated adenocarcinoma of rectum.Methods Clinical data and MRI findings including con-ventional imaging and IVIM-DWI were collected in a total of 37 patients with moderately differentiated adenocarcinoma of rectum proven by pathology.The patients were divided into two groups without (staging T1 and T2)or with myometrial invasion (T3 and T4).The D,D? ,f and ADC values of rectal cancer and normal rectal wall were measured and were compared between the lesion and normal rectal wall,between both groups and among different T stages.The relationships of the parameters of IVIM-DWI and ADC values with the T staging of moderately differentiated adenocarcinoma of rectum were analyzed.Results The D,D? ,f and ADC val-ues of rectal cancer were lower than those of normal rectal wall with statistical differences in D,f and ADC values (P <0.05).The differences in D and D? values among different T stages were statistically significant,and LSD Duncan test showed that the differ-ence in D? value between T1 and T4 (P =0.01 7)and between T3 and T4 (P =0.003)and in D value between T2 and T3 (P =0.005) were statistically significant.The D,f,D? and ADC values of noninvasion group and invasion one were (0.93±0.1 6)×10 -3 mm2/s versus (0.77±0.1 9)×10 -3 mm2/s,(27.1±2.94)% versus (24.6 ±4.13)%,(12.6±2.44)×10 -3 mm2/s versus (12.3±3.49)× 10 -3 mm2/s,and (0.95±0.09)×10 -3 mm2/s versus (0.87 ±0.12)×10 -3 mm2/s respectively,and the difference in D value was statistically significant (t=2.5 12,P =0.01 7).Conclusion The parameters of IVIM-DWI and the ADC values are different in rectal cancer and normal rectal wall,and the D value may help to identify the tumor invasion into the muscularis propria.

Objective To determine the surgical procedures and effects of ultra-distal tibial intramedullary nails combined with blocking screws in treatment of distal tibial fractures.Methods From April 2008 to September 2012,21 cases of distal tibial fractures were treated with ultra-distal tibial intramedullary nails combined blocking screws.All fractures were statically locked and closed using undreamed technique.For relatively simple fracture,blocking screws were considered when the reduction and stability was not satisfied after the insertion of intramedullary nails; for severe comminuted fractures,blocking screws were inserted directly under C-arm fluoroscopy.Partial weight-bearing was permitted 3 weeks after surgery.Quality of reduction,fracture union,and function assessment were measured at follow-up.Results No skin necrosis and soft tissue and bone infections occurred after a mean follow-up of 17.5 months (range,12-22 months).All fractures were healed with an average healing time of 12 months (range,8-26 months).X-ray findings revealed the fracture of ＜ 5° angulation on coronal and sagittal planes.There was no deformation or breakage of blocking screws and intramedullary nails.According to the criteria of Tormetta,the results were excellent in 19 cases and good in 2.Conclusion Blocking screws assists reduction and improve the fixation stability by narrowing the canal in treatment of distal tibial fractures and expands the application of intramedullary nails.

Objective To investigate the role of CRKL activity in leukemia cells with muhidrug resistance and find new factor related to multidrug resistance. Methods By flow cytometry, CRKL activity was compared in K562, HL-60 cells and its resistance cells. The change of CRKL activity was observed in sensitive cells treated with and withdrawal daunorubicin. Results With the comparison of K562, HL-60 sensitive cells, in K562, HL-60 resistant cell lines, the level of CRKL phosphorylation in K562, HL-60 resistance cells treated with daunombicin 72 hours increased markedly. The level of CRKL phosphorylation was time-dependent with chemotherapy drugs, not change of CRKL activity was found in Jurkat ceils.Conclusion The level of CRKL activity is new factor related to muhidrug resistance in leukemia cells.

An online enrichment-separation system of C18 and inductively coupled plasma-mass spectrometry (ICP/MS) with flow injection （C18-FI-ICP/MS） was established for the determination of trace heavy metals in seawater. The optimized experimental parameters including pH，C18 column，concentration of methol in elute and the velocity of elute were investigated. This system was applied to the online preconcentration , separation and determination of trace heave metals in seawater samples successfully. The detection limit　(3σ) for Cd, Pb, Co, Ni and Zn was 0.03, 0.09, 0.1, 0.1, 0.3 μg/L respectively. The RSD of Cd, Pb, Co, Ni, and Zn for six measurements of seawater was 6.8%，3.4%，1.3%，2.6%，0.5%，respectively. The accuracy was verified with spiked recovery test. The recovery for five elements was 91.3%，95.1%，100.4%，100.3%，95.2%, respectively.

To investigate the effect of OGT expression inhibited by RNAi on the alteration of tau phosphorylation and glycosylation level in HEK293T cells.The siRNAs targeting OGTgene(OGT-siRNA1～3) were designed and chemically synthesized.The OGT-siRNA1～3 were transfected into HEK293T cells via lipofectamine2000.The efficacy of RNA interference was detected by RT-PCR.The fluorescence of GFP/OGT was counted by fluorescence microscopy after pEGFP/OGT and OGT-siRNA1～3 cotransfected to HEK293T cells for 24 h.The level of tau phosphorylation and glycosylation were detected by Western blot after Plasmid pCI/tau441 and the siRNA cotransfected HEK293T cells for 48 h.OGT-siRNA3(100 nmol/L) could effectively downregulate the expression of OGT gene compared with Mock group(80.0% at mRNA level and 51.3% at protein level).The level of phosphorylation at various sites of the tau was significantly upregulated and the glycosylation was downregulated following the inhibition of OGT gene expression.There is an apparent negative correlation between the modification of phosphorylation and glycosylation of tau protein, the deficient in glucose uptaken/metabolism may be an important pathogenesis of AD.

Objective To investigate the association of serum C peptide concentration with the severity and the outcome of diabetic foot ulcer (DFU). Methods The clinical data of 257 inpatients with DFU were collected, including fasting and postprandial 2h C peptide levels and C peptide area under curve (AUCCP ). The patients were followed up on the outcomes of ulcers and death. The associations of serum C peptide concentration with the Wagner degree, infection severity, and healing rate were analyzed. Results The medians of fasting and 2h postprandial serum C peptide as well as AUCCP were 1. 37(0. 02 ~ 9. 00) nmol/ L, 3. 22(0. 02 ~ 29. 61) nmol/ L, and 511. 65 (3. 60 ~ 2 691. 30)nmol·min-1 ·L-1 respectively, which were lower than general levels. The time of follow-up in our study was 2. 8 (1. 0 ~ 5. 1) years. By the end of study, the wound of 75. 88% patients was healed, 3. 5%undergone major amputation, and 23. 74% died. After adjusting for relative factors, there were no significant associations of serum fasting and postprandial C peptide levels and AUCCP with Wagner degree and infection severity (P>0. 05). Cox regression analysis showed that the fasting plasma C peptide and hemoglobin were the independent protective factors for the healing of ulcers; old age, male, higher infection degree, and diabetes family history were their independent risk factors ( all P < 0. 05). Conclusions The lower plasma fasting C peptide concentration in patients with DFU is not correlated with Wagner degree and infection severity, but closely related with healing rate.

Background and purpose: Hepatocellular carcinoma (HCC) is a hypervascular tumor associated with a poor prognosis and lack of effective treatments. Consequently, identifying novel therapeutic strategies are urgently needed. We have previously shown that the kringle 1 domain of human hepatocyte growth factor (HGFK1) is a more effective anti-angiogenesis molecule than angiostatin. In this study, we observed the effects and mechanisms of HGFK1 gene on the HCC. Methods: A recombinant adeno-associated vires carrying the HGFK1 gene (rAAV-HGFK1) was constructed.HCC of rat was induced by McA-RH7777. rAAV-HGFK1 was used to treat the rat, median survival time and metastasis rate were observed. Results: Ten days after tumor cell inoculation, surgery were performed to confirm the tumor formation, PBS, rAAV-EGFP or rAAV-HGFK1 was injected directly into the tumor nodule followed by portal vein injection. Results from our study demonstrated that rAAV-HGFK1 treatment significantly prolonged the median survival time of the HCC bearing rats from 30 days (PBS and rAAV-EGFP groups) to 49 days (rAAV-HGFK1 group). More importantly rAAV-HGFK1 inhibited tumor growth and completely prevented liver, lung and peritoneal metastasis. In the controlled PBS and AAV-EGFP group, liver and peritoneal metastasis rate were both 100%, and lung metastasis rate was 100% and 83%, respectively. While there was no metastasis found in treatment group, with only 33% of ascites happened. This was most possibly due to the primary tumor in liver but not due to the metastasis. Moreover, at a higher magnification (1000×), it was clear that the HGFK1 protein was expressed mainly in the cytoplasma of liver cells. In parallel, IHC staining of CD31 also demonstrated a significantly lower level of microvessel density (MVD) (6.21±1.6) in the liver tumor of the AAV-HGFK1 treatment group, as compared to the two control PBS and AAV-EGFP groups (25.1±2.1 and 26.8±2.5, respectively, P<0.01). HE staining showed that AAV-HGFK1 treatment induced large areas of necrosis in the tumor tissues, while minimal areas of necrosis were observed in the tumor tissue in the control groups. In addition, no toxicity appeared when high dosage (4.8× 1012 vg/rat) of rAAV-HGFK1 was administered in rats. Conclusion: Results from this study demonstrated that HGFK1 inhibited the growth and metastasis of HCC and prolonged the survival time of animals with HCC through anti-angiogenesis effects. No obvious toxicity was observed. It might be the novel promising treatment for HCC and other cancers.

Objective To investigate the appearance of solid papillary carcinoma (SPC)of breast on MRI and mammography correlated with histopathological features.Methods Fifteen patients with breast SPC diagnosed from January 2011 to January 2013 were enrolled.Their MR and mammography imaging findings were retrospectively reviewed,15 patients had MRI and 11 patients had mammography.The correlation between pathological characteristics and imaging findings was made.Results All the SPC displayed a solid-papillary growth pattern together with Luminal A type,and 14 cases showed neuroendocrine markers.On mammography,only three cases showed the abnormality.The most frequently seen MRI feature was its location in the posterior of areola (11 cases),ductal ectasia on T1WI (11 cases) and high signal intensity on T2WI.The enhancement patterns included non-mass-like enhancement (10 cases),mostly manifested as ductal with clumped enhancement (5 cases) and segmental with pebble shaped enhancement (4 cases),whereas mass-like enhancement (5 cases) exhibited as annular heterogeneous enhancement.Conclusions SPC is difficult to detect on mammography,but the MRI features may suggest its distinct histological type as papillary tumor.The ultimate diagnosis still depends on histopathology and immunohistochemical results.

Objective To assess the characteristic of normal tension glaucoma (NTG) patients with mild cogni?tive impairment (MCI). Methods This study included twenty-six cases of normal tension glaucoma patients who were diagnosed at ophthalmology department of Peking University Third Hospital. All the participants were examined by us?ing the scales of Montreal Cognitive Assessment (MoCA), mini-mental state examination(MMSE), clinical dementia rat?ing (CDR), activities of daily living (ADL), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), Pitts?burgh Sleep Quality Index (PSQI) and polysomnography (PSG). The patients were then divided into Group with MCI (16 cases) and Group without MCI (19 cases). Results There was no difference between the two groups in gender, age, edu?cation, depression, anxiety and body mass index (BMI) (P>0.05), but significant difference in MoCA scores (P<0.05). The incidence rate of sleep disorder of PSQI in was 28.6%(10/35 patients) of total NTG patients, 43.8%(7/16 patients) in Group with MCI, and 15.8% (3/19 patients) in Group without MCI, respectively. The PSQI score was higher in Group with MCI than in Group without MCI (P<0.05). Sleep efficiency was higher in Group without MCI than in Group with MCI (P<0.05), but no difference was found between the two groups in six other indexes of PSQI (P>0.05). The in?cidence rate of sleep structure disorder of PSG in all the NTG patients was 85.7%(30/35 patients), 87.5%(14/16 pa?tients) in Group with MCI, and 84.2%(16/19 patients) in Group without MCI. Sleep time of NREM-N3 was significant?ly shorter in Group with MCI than in Group without MCI (P<0.05), but no difference was found between those groups in total sleep time, sleep efficiency, sleep latency and REM time (P>0.05). Conclusion NTG patients with mild cogni?tive impairment are more prone to sleep disorders, especially sleep structure disturbance and short NREM-N3 time may affect cognitive function.

Objective To evaluate the results of thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection.Methods From September 2005 to January 2013,30 patients with chronic type B aortic dissection received TEVAR.All patients were followed for 2-90 months [mean (33 ±25) months].Results All of the procedures finally achieved technical success.However,during TEVAR,there were transient endoleaks in 8 patients including type Ⅰ endoleaks in 3 patients,type Ⅱ endoleaks in 5 patients and persistent endoleaks in 3 patients which are type Ⅳ endoleaks.Type Ⅰ and type Ⅱ endoleaks were successfully managed during the procedures.There was no mortality or major complication during the perioperative period.Three patients died during follow-up:one patient died of carcinoma of the colon and two patients died of the complications of secondary interventions related to aortic dissection.Totally there were seven patients receiving secondary interventions.The Kaplan Meier actuarial survival curve showed a 5-year survival rate of 87.9％ and the 5-year survival rate without secondary intervention was 72.8％.Conclusions Early and midterm results showed that TEVAR was effective in treating chronic type B aortic dissection.