Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in the diagnosis of focal pulmonary ground-glass opacity nodules(fGGO)of 1 cm or less.Methods The MSCT examination data of 95 patients with subcentimeter fGGO was analyzed and compared with pathology results.The different pathological types of fGGP lesion size,internal solid component size,mixed type ground glass nodules (mGGO)proportion and pleural sag,lesion shape,grave leaves,burr,cavitation and the boundary conditions were compared. According to the relationship of the lesions and the surrounding blood vessels,3 types were classified,and the relationship of fGGO and blood vessel were analyzed.Results The minimal lesion was 0.41 cm of 95 cases and the maximum was 0.99 cm.There was statistically signifi-cant difference in the lesion size,solid component sizes,mGGO and lobulation occupied the percentage of the group before infiltrating and the adenocarcinoma group (P <0.05),and there was no statistically significant difference in pleural indentation,lesion shape,burr,vacuoles and boundary conditions (P >0.05).The difference was statistically significant in the leaflet occupied the percentage of the benign group com-pared with the adenocarcinoma group,and the differences of the remaining features were not statistically significant compared with the adeno-carcinoma group(P >0.05).According to the relstionship between fGGO and the vessels,patients in the benign group were type Ⅰ or typeⅡ,type Ⅲ was found in 10 cases of the group before infiltrating (25.6%),and type Ⅲ in 17 cases of the adenocarcinoma group (39.5%), the proportion of type Ⅲ of the group before infiltrating and the adenocarcinoma group was higher than that of the benign group (P <0.05). Conclusion The qualitative diagnosis of pulmonary fGGO is difficult,and the relationship between the morphology of the lesions under the MSCT and the surrounding vessels have some value for the diagnosis of the lesions.

Objective To investigate the effects of glycyrrhizin on gene expression of transforming growth factor(TGF)-?signaling pathway of hepatic stellate cell(HSC)in mice by gene microarray tech- nique.Methods The HSCs were isolated from mice and cultured in vitro.Then the mice were divided into control group,TGF-?_1 group(5 ng/ml) or TGF-?_1(5 ng/ml)combined with glycyrrhizin(100?mol/L) group.The cells were collected after 10 hours to extract RNA.A cDNA microarray(GEArray~(TM) Q) targeting TGF-?/BMP signal transduction was used to screen the genes which showed significant changes in expression of TGF-?pathway of HSC by glycyrrhizin.Results The microarray analysis showed that 16 genes(16.7%),such as Smad2,Smad3,Smad7,CoL3A1,CoL1A2,and PAI-1,were upregulated by TGF-?_1 and then down-regulated by glycyrrhizin.Five genes(5.2%)(including BMP7,IGFbp3 and etc.)downregulated by TGF-?_1,were then up-regulated by glycyrrhizin.Finally,2 genes upregulated by TGF-?_1 were then up-regulated predominantly by glycyrrhizin in HSC(T?R2,betaglycan).Changes in some genes,such as Smad2 Smad3,Smad7,were further confirmed to be coincided with cDNA microarray by semi-quantitative RT-PCR.Conclusions The anti-fibrosis mechanisms of glycyrrhizin may be through to interference of TGF-?signaling pathway,decrease the synthesis and increase the degradation of collagen.

?AlM: To investigate the clinical characteristics and influencing factors of chronic renal failure ( CRF) patients with dry eye, and to provide clinical reference.?METHODS:Sixty-one cases (122 eyes) of patients with CRF ( CRF group ) and 61 cases ( 122 eyes ) of healthy persons ( control group) were carried out on Schirmer ▏test ( S▏t ) , break-up time of tear film ( BUT ) , corneal fluorescein staining ( FL) , test results of two groups were compared and related factors of dry eye in CRF patients were analyzed.?RESULTS: The results of S▏t and BUT in CRF group were lower than that in the control group (P<0. 05). The proportion of tear secretion reduce in CRF group ( S▏t<10mm/5min) was 49. 2% ( 60/122 ), which was higher than that in the control group ( 10. 0%, 12/122 ), the difference was statistically significant ( X2 = 45. 39, P <0. 05). The percentage of instability of tear film in CRF group (BUT≤10s) was 75. 4% (92/122), which was significantly higher than that in the control group (27. 0%, 33/122) (X2=57. 1, P<0. 05). The positive rate of corneal FL was 37. 7% (46/122), which was higher than that of the control group (10. 7%, 13/122), there was a statistically significant difference (X2= 24. 34, P<0. 05).?CONCLUSlON:CRF patients with a decrease in tear film stability and tear secretion are susceptible population to dry eye, clinically should be paid attention to the treatment.

Purpose To compare the CT features of hepatic metastases of gastro-entero-pancreatic adenocarcinomas with and without neuroendocrine differentiation [NED(+) and NED(-)] and to explore the value of CT features in differentiation of the two groups.Material and Methods From January 2009 to December 2015,abdominal CT scans of 17 pathologically proved cases of NED(+) gastro-entero-pancreatic adenocarcinomas with hepatic metastases and 34 pathologically proved cases of NED(-) hepatic metastases with sex,age and primary site matched were retrospectively reviewed.CT features including hepatic metastases number,size,distribution,shape and enhancement were assessed,as well as presence of lymphadenopathy or ascites.Differences of CT features between the two groups were analyzed.Results Compared with NED(-) group,hepatic metastases of NED(+) group more frequently demonstrated a peripheral enhancement on artery phase (94.1％ vs.44.1％,P＜0.05),and more washout on portal venous phase (41.2％ vs.5.9％,P＜0.05),while hepatic metastases of NED(--) group showed more plateau type (91.2％ vs.58.8％).There was no significant difference of other findings between the two groups (P＞0.05).Logistic regression revealed that enhancement area in hepatic artery phase and enhancement changes in portal venous phase were independent factors for differential diagnosis (P＜0.05).The area under the ROC curve of combining the two features was 0.811 (P＜0.05).Conclusion There are some different CT enhancement features between NED(+) and NED(-) hepatic metastases of gastro-entero-pancreatic adenocarcinomas,which are helpful in differential diagnosis.

Objective To investigate the role of Wnt/β-catenin signaling pathway in impaired wound healing of diabetes mellitus.Methods The back skin defect was produced in rats with type1diabetes.All of these rats were divided into normal group, diabetes group, lithium chloride group, and epidermal growth factor (EGF) group.The back wound healing and β-catenin expression were observed.Results There were no signs of infection in the wound of rats after injury.Compared with diabetic group, the wound healing time was shorter,wound healing rate was higher, wound cavity volume was smaller, granulation tissue was more mature, and β-catenin positive cell rate was higher in normal group, lithium chloride group, and EGF group(P＜0.05 or P＜0.01).Conclusions Wnt/beta-catenin signaling pathway is involved in the process of wound healing in diabetic rats.

Objective To evaluate the differential diagnosis value of enhanced multi-slice spiral CT (MSCT) scan on adrenal adenoma and metastases in patients with malignant tumor.Methods Thirty-nine malignant tumor patients complicated with adrenal nodules were chosen, and all patients underwent MSCT plain scan and enhanced scan.Features of adrenal adenomas and metastases of MSCT enhanced were analyzed.Results Forty-nine adrenal gland nodules were found in 39 patients, and 35 adrenal metastasis were found in 25 patients.They were shown quasi-circular, oval or irregular shaped nodules.The average diameter was (2.6 ± 0.7) cm.Part of them were uneven density, and the CT value of the solid part was (32.8 ± 6.1) Hu.The solid part of tumor in enhancement scanning arterial phase was underwent mild to moderate strengthening, and the CT value was (49.5 ±6.9)Hu.The solid part of tumor was underwent further strengthen scanning in the venous phase, and the CT value was (74.9 ±8.0)Hu.The average CT value of solid part in after 3 min scanning tumor was (72.4 ± 7.6) Hu.Fourteen adrenal adenomas were found in 14 patients.CT value was (19.6 ± 4.5) Hu, and tumor diameter was (1.8 ± 0.4) cm.Enhanced scanning the tumors showed mild to moderate homogeneous enhancement in arterial phase, the CT value was (43.8 ± 8.1) Hu.Venous phase enhanced obviously, the average of CT value was (67.7 ±9.2)Hu.The strong degree in the delay period was decreased significantly, the average value of CT was (55.9 ± 8.8) Hu.The adrenal metastasis tumor diameter (t =4.006, P ＜ 0.001), CT value of plain scan (t =7.320, P ＜ 0.001), CT value of arterial phase enhanced scan (t =2.486, P =0.017) , venous phase enhanced scan (t =2.727, P =0.009) and CT value of the delay period (t =6.653, P ＜ 0.001) were higher than those in adrenal adenoma.Conclusion Enhanced MSCT scan can reflect the hemodynamic changes of adrenal lesions, and provide the bases for the differential diagnosis of enhanced MSCT scan on adrenal adenoma and metastases in patients with malignant tumor.

BACKGROUND:There are stil some controversies about lateral compression rotational y unstable pelvic ring injuries and fixed mode. OBJECTIVE:To evaluate the pelvic stability of locking plate fixation pelvic reconstruction repairing lateral compression rotational y unstable pelvic ring injuries. METHODS:We retrospectively analyzed 15 patients with unstable lateral compression rotational y unstable pelvic ring injuries treated with reconstruction locking plates fixation at Suzhou Xiangcheng People’s Hospital between November 2011 and November 2014. The Matta standard was used to evaluate the quality of fracture reduction. Clinical efficacy was evaluated by Majeed score. RESULTS AND CONCLUSION:Fifteen patients were fol owed up for 12-44 months (mean 24 months). According to the standard of Matta, 11 cases were excel ent, 2 cases were good, 2 cases were average, 0 case poor, and the excel ent and good rate was 87%. According to Majeed functional assessment, clinical function outcomes were graded as 9 cases excel ent, 3 cases good, 1 case average, 1 case poor;excel ent and good rate was 80%. There were no patient loss of reduction and internal fixation failure among these 15 patients in the final fol ow-up. No iatrogenic neurovascular injury occurred. Incision superficial infection was detected in 2 patients with a Morel-Laval ee lesion after subjecting to double-tube continuous negative pressure drainage, and healed after wound management. A large area of infection and skin necrosis did not occur. These results confirm that pelvic universal reconstruction locking plates in repair of lateral compression rotational y unstable pelvic ring injuries can maintain a strong and effective fixation. We should pay much attention to the cases of pelvic fractures combined with soft tissue injury around the pelvis.

Objective To investigate the early effect of medium-dose ionic irradiation on the expression of Fos protein in the rat brain. Methods Fos protein was observed in rat brains at times ranging from 24 hours to 4 weeks after hemispheric irradiation (single-fraction maximal dose of 20Gy) with the immunohistochemical technique. Results Compared with that of the un-radiated rats,the expression of Fos protein in the irradiated brain decreased distinctly 24 hours and 1 week after irradiation.However,the quantity of Fos immunopositive cells increased gradually afterwards.At four weeks after radiation,expression of Fos protein recovered progressively in medulla oblongata and pons,in which Fos immunopositive cells were more than those in control group.In contrast,expression level of Fos protein in mesencephalon,diencephalons or telencephalon was still less compared with that of the un-irradiated rats.Conclusion The result suggested that the neuronal activity might be inhibited in certain nuclei of the rat brain in early stages after hemisphere irradiation,and this inhibitory phenomenon was more obviously in higher neural centers.

Objective To explore the suitable range of PT-INR for Chinese people with acute deep venous thrombosis (DVT) treated by warfarin anticoagulation therapy. Methods Eighty seven DVT patients with indications to warfarin anticoagulation therapy were enrolled into the study and divide into two groups randomly. Patients from group A (n=47) took warfarin to adjust the PT-INR to range 1.7-2. 5,and patients from group B (n =40) took warfarin to adjust the PT-INR to range 2. 0-3. 0. The therapeutic effectiveness and the incidence of bleeding complications were compared between two groups. Results Forty-six patients (46/47,98%) had limb swelling symptoms relief in group A with one exception,which was diagnosed as pelvic tumor by ultrasonography,CT and tumor markers examination later. No patient underwent bleeding in group A Thirty eight patients (38/40,93%) had limb swelling symptoms relief in group group B with two exceptions,of which one case had Cockett syndrome and the other one had unknown aetiology. The total effective rate of group B was 95% . As to the complications of this group,3 patients had slight gum and nasal mucous membrane bleeding, 1 patient developed gastrointestinal bleeding. No patients had pulmonary embolism in both groups. Conclusion For Chinese people,anticoagulation therapy of acute deep venous thrombosis to adjust the range of PT-INR to 1.7-2. 5, shows good effectiveness and significantly reduced bleeding complications.

Objective To analyze the clinical, radiological, pathological and microbiological features of invasive pulmonary aspergillosis (IPA) to improve clinical management.Methods Retrospective analysis of 20 pathologically and/or microbiologically confirmed IPA cases in our hospital from January 2005 to August 2008. Results Group A (with underlying diseases) included 13 patients (underlying malignancy in 9 patients, including 5 cases of hematological malignancy, COPD in 2 patients, pulmonary tuberculosis and bronchiectasis in 1 each). Group B (without underlying disease) included 7 patients (2 patients with a long time of fluffy toy contact, another 1 had exposure to moldy rice, and 3 had exposure to polluted water). All these 20 patients had pulmonary invasion revealed by CT imaging. Multiple changes were identified in 16 patients. Bilateral pulmonary infiltrates and/or consolidation were revealed in 7 patients. Multiple nodules were seen in 9 patients. Four patients had solitary lesions, including isolated nodules in 2 patients and segment consolidation in the other 2 patients. Pulmonary cavity without fluid level was found in 8 patients (40.0%). Eighteen cases received antifungal therapy. The overall efficacy rate was 55.6%. The efficacy rate in group A and B was 45.5% and 5/7 respectively. The average time to symptomatic relief was (12.0±2.8) days. The time to lung lesion improvement on CT was (17.4±2.9) days. The time to significant CT improvement was (34.3±9.9) days. The time to the resolution of active lesion was (56.4±6.2) days.Conclusions IPA may occur in immunocompetent patients without underlying disease. Most IPA patients have bilateral multiple pulmonary nodules and cavities on CT. The time to the resolution of active pulmonary lesions is about 6 weeks.