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.

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 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.

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.

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.

This study was aimed to evaluate effect of Qinghua Granules (QHG) on glycometabolism, pancreatic islet function and oxidative stress in type-2 diabetics with heat syndrome. A total of 60 cases of type-2 diabetics with heat syndrome (according to the Syndrome Element Syndrome Differentiation) were enrolled in the clinic of the Department of Endocrinology and Metabolism, Shuguang Hospital Affiliated to Shanghai University of Tradi-tional Chinese Medicine. The average age of enrolled cases was (57.9 ± 6.9) years. Enrolled cases were randomly divided into the treatment group and the control group. The original hypoglycemic plan was continued to use. In the treatment group, QHG was administrated. And in the control group, placebo was given. The administration dosage in both groups was one package per day. The treatment course was 12 weeks. The fasting and postpran-dial (120 min after standard meal) blood samples before and after medication were collected. The main evalua-tion indexes were fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and hemoglobin A1c (HbA1c). The secondary evaluation indexes were homeostasis model assessment (HOMA2-%B, HOMA2-%S, HOMA2%-IR), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), maleic dialdehyde (MDA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL). The anal-ysis of variance was used in the comparison of efficacy between two groups . The results showed that HbA1c in the treatment group was obviously reduced, and HOMA2-%B was obviously increased. There was no significant changes in the control group ( P = 0 . 044 , P = 0 . 016 ) . In the treatment group , SOD increased obviously , MDA reduced obviously. There was no significant change in the control group. There was difference b etween two groups (P = 0.011, P = 0.049). There was no change on blood lipids or other evaluation indexes. It was conclud-ed that QHG is effective in the improvement of glycometabolism, islet β-cell functions and oxidative stress in type-2 diabetics with heat syndrome .

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.

Interleukin-6 (IL-6) is a pleiotropic cytokine which has antitumor activity. In the present study, a model for fibroblasts-mediated IL-6 gene therapy and its immune regulation are described. Human IL-6 cDNA was inserted into plasmid vector BCMGNeo containing a neomycin resistance gene. BCMGNeo-IL-6 was transferred into NIH3T3 fibroblasts by calcium phosphate coprecipitation method. A fibroblast clone (T6.6) secreting 1L-6 at highest level was selected by G418 resistance selection and limiting dilution. When T6.6 was implanted i.p. into mice, IL-6 could be detected in serum after 12 h. Even after 96 h, serum IL-6 still maintained at high level. Lymphocyte proliferation and IL-2 production could be enhanced significantly after in vivo implantation of T6.6. These results demonstrate that fibroblasts -mediated IL-6 gene therapy could augment immune function efficiently and outline a novel strategy for cancer treatment.