Objective To research the changes of calcium regulation hormone and bone mineral density (BMD) in type 2 diabetes mellitus (T2DM ) patients and analyze the main impact factors. Methods 117 T2DM patients (T2DM group ,M/F=52/65 ,age 40~79 years) and 63 age‐ and gender‐matched healthy people (NC group) were selected in this study. According to the course of diabetes ,blood glucose control and the value of BMD ,T2DM patients were divided into subgroups :course≤10 years ,and>10 years ;HbA1 c≤8% ,and>8% ;normal BMD ,osteopenia ,and osteoporosis (OP). Serum 25‐hydroxy vitamin D3 [25(OH)D3 ]and Parathormone (PTH) were measured and BMDs of lumbar spine (L1 ~L4 ) , femoral neck ,total hip ,and whole body were evaluated for all the subjects. Result (1)Compared with NC group ,the level of serum 25(OH)D3 and BMDs of femoral neck and total hip decreased significantly in T2DM group[ (35.57 ± 12.30)nmol/L ,(0.848 ± 0.136)g/cm2 ,(0.873 ± 0.150)g/cm2 vs(44.94 ± 17.40) nmol/L ,(0.927 ± 0.173)g/cm2 ,(0.934 ± 0.140)g/cm2 ,respectively ,P<0.01 or P<0.05)]. The level of PTH increased in T2DM group[ (8.50 ± 4.15) vs(5.62 ± 3.93)pmol/L ,P<0.01]. (2)Compared with the group duration of diabetes≤10 years ,BMD of femoral neck and total hip decreased in patients with duration of diabetes>10 years[ (0.814 ± 0.148) ,(0.840 ± 0.157) vs (0.882 ± 0.111) ,(0.908 ± 0.139) g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(10.55 ± 9.09) vs (7.06 ± 3.74)pmol/L , P<0.05)]. 25(OH)D3 and total body BMD have no significant difference(P>0.05). (3)Compared with HbA1c≤8% group ,BMD of femoral neck and total hip in HbA1c> 8% group decreased [(0.830 ± 0.131) ,(0.832 ± 0.161) vs (0.891 ± 0.130) ,(0.949 ± 0.130)g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(9.96±8.80) vs (7.21±3.98)pmol/L ,P<0.05]. 25(OH)D3and total body BMD have no significant difference(P> 0.05). (4)The rates of OP and osteopenia (41.03% ,47.86% ) in T2DM were higher than those in NC group (26.98% ,33.33% ) (χ2 =4.367 ,4.669 ,P<0.05). The duration of diabetes and the levels of HbA1c and PTH were longer or higher in OP group than those with normal BMD or osteopenia (P<0.05). (5)Logistic regression analysis showed that BMD negatively correlated with the duration of diabetes ,HbA1c ,and PTH (β= 0.076 ,0.213 ,0.112 ,respectively ,P< 0.05) ,and positively correlated with 25(OH)D3 (β= -0.043 ,P<0.05). Conclusion The values of BMD decreased and the incidence of OP is higher in T2DM patients ,particularly in patients with longer diabetic duration and poor glycemic control.

To assure the clinical quality and requirement of CT shelter used in field environment, the factors related with the practical application were studied. The evaluation indicators of CT equipment were investigated. Based on the technical modification of vehicle shelter CT, the scanning conditions of shelter CT were analyzed. Moreover, the comparative study was done between shelter CT and common CT in hospitals. In result, in order to meet maneuverability application in the field, vehicle shelter CT was restrictive by the field conditions, traffic impacts and running requirement. The application of vehicle shelter CT was affected by the factors, such as mechanical stabilization, moving precision, power fluctuations and variations of temperature and humidity, etc. The results were helpful to improve the clinical quality of vehicle shelter CT and made a base for the quality control study in the future.
Humidity ; Temperature ; Tomography, X-Ray Computed ; instrumentation

Objective To evaluate the clinical value of spectral CT mode in imaging liver by comparing the radiation dose and image quality between spectral CT and conventional multi-slice spiral CT (MSCT).Methods Thirty patients (group A) underwent three-phasic enhanced CT scans spectral CT mode in the portal phase (PP) and conventional helical mode in other phases (Discovery CT 750 HD,GE Healthcare).Another 30 patients in group B underwent conventional three-phasic enhanced CT on a 64-slice MSCT (VCT,GE Healthcare) with 120 kVp and automatic tube current modulation (ATCM) and noise index of 15.The images in PP from the two imaging modes were retrospectively compared.The contrast-noiseratio (CNR) for the veins was calculated using liver parenchyma as background.For the spectral CT mode,101 sets of monochromatic images were reconstructed from 40 to 140 keV,and the optimal energy level for obtaining the highest CNR was determined using the Gemstone Spectral Imaging (GSI)-viewer software.Image noise (at 70 keV),CNR (at the optimal keV level) for the vein and radiation dose to the patient were obtained for spectral images and statistically compared with those in group B with the conventional MSCT using t test.Results The CTDIw value in PP for spectral CT was 15.64 mGy,30％lower than the (22.44 ± 5.09) mGy for the conventional MSCT (t =29.56,P ＜ 0.01).Image noises on the liver parenchyma were 22.81 ±2.85 and 23.80 ±3.31 for the conventional MDCT and spectral CT images at 70 keV,respectively,with no significant difference (t =0.76,P ＞ 0.05).On the other hand,CNR for the vein at the optimal energy level in spectral CT was 7.17 ± 2.09,which was significantly higher than the 2.76 ± 1.34 for the conventional MSCT (t =7.21,P ＜ 0.01).Conclusion Compared with conventional standard-dose liver MSCT,spectral CT imaging provides improved CNR for vessels,comparable image noise for liver parenchyma with 30％ dose reduction.

BACKGROUND:There are some disadvantages in harvesting and transferring cells in the traditional tissue engineering technique,and it is difficult to form dense tissues,which significantly limits the development of tissue engineering.OBJECTIVE:To explore the culture and fabrication of dog bone marrow mesenchymal stem cell(BMSC)sheet in vitro.METHODS:Bone marrow was extracted from dogs following anesthesia.BMSCs were isolated with the method of density gradient centrifugation in vitro.BMSCs at passage 4 at a density of 1×10~9/L were incubated in the temperature-responsive culture dishes with a diameter of 3.5 cm,and cultured in an incubator at 37 ℃,5% CO_2 and saturated humidity.The temperature of the incubator was changed from to 37 V to 20 ℃ to prepare BMSCs cell sheet for 20 minutes.Cell morphological changes and cell sheet formation were observed under an inverted microscope.RESULTS AND CONCLUSION:Dog BMSCs following 24 hours of primary culture presented ellipse or polygonal shape.Most cells adhered at hour 72,and cell colonies were visible at day 7.Cells showed long spindle and completely confluence at day 12,with unclear boundary.BMSCs in the temperature-responsive culture dishes presented short spindle shape,and gradually separated from the dish bottom,forming entire cell sheet containing extracellular matrix at 20 V.These verified that dog BMSCs can be effectively obtained with method of density gradient centrifugation.Complete cell sheet layer can be fabricated with temperature-responsive culture dishes.

Objective To construct a T-bet response reporter gene, for the detection of T-bet tran-scriptional activity and application in high-throughput screening for the functional genomies. Methods The cis-acting DNA element, ThRE, based on CNS-22 T box site of IFN-γ gene, was recombined into a reporter vector pLUC-MCS. The reporter gene was transfected into HEK 293T cells to detect its response to T-bet. And the binding of T-bot to TbRE was identified with electrophoretic mobility shift assay(EMSA). Results ThBE was successfully cloned into pLUC-MCS, named as TbRE-LUC. Using a luciferase assay, expression of the reporter gene is found to be induced by T-bet in a dose dependent manner and correlate with T-bet ex-pression positively with activation up to 20 folds. Moreover, the binding specificity of T-bet to TbRE is vali-dated by EMSA. Conclusion We successfully constructed a T-bet response reporter gene, ThRE-LUC, which responds to T-bet keenly and specifically. TbRE-LUC will be a useful tool in high-throughput screen-ing for human genes associated with transcription activity of T-bet.

Objective To investigate the application of automatic biopsy gun in CT-guided percutaneous biopsy for the diagnosis of pulmonary sub-centimeter nodules (≤1 cm).Methods A total of 78 patients with pulmonary sub-centimeter nodules were enrolled in this study. Under CT guidance, percutaneous multi-point and multi-sampling puncture biopsy with automatic biopsy gun was carried out in all patients. The success rate of puncturing, the complications and pathological results were analyzed. Results The success rate of puncturing was 91.0% (71/78). The incidence of pneumothorax was 17.9% (14/78) and the incidence of hemorrhage was 30.8%(24/78). In all patients, no pulmonary infection, tumor tract seeding or metastasis was observed during the follow-up period. Among the 71 patients who had a successful biopsy, squamous cell carcinoma was detected in 7, adenocarcinoma in 25, small cell carcinoma in 5, metastatic lesion in 3, chronic interstitial lung inflammation in 13, granulomatous inflammation in 12, pulmonary fungus in 4, pneumoconiosis nodule in one and pulmonary hamartoma in one. Conclusion For CT-guided percutaneous puncture biopsy of pulmonary sub-centimeter nodules, the use of automatic biopsy gun is safe and reliable with higher success rate.

Objective To explore the correlations between renal artery resistance index (RRI) and renal function in patients with thrombotic microangiopathy (TMA) so as to provide the clinical basis for predictable diagnosis and treatment in patients with acute kidney injury (AKI).Methods Patients diagnosed with thrombotic microangiopathy admitted to department of emergency of Peking Union Medical College Hospital between August 1st,2014 and March 31th,2015 were enrolled.Intrarenal arteries resistive index of right kidney was detected in all cases on admission by color Doppler flow image.The serum creatinine (SCR) and glomerular fihration rate (GFR) were measured at the same time.According to the diagnostic criteria of the guideline of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients were divided into non-AKI group and AKI group.The intergroup difference was compared and the correlation between RRI and SCR as well as between RRI and GFR were assessed.RRI,SCR and GFR were measured again at the most severe stage of kidney injury.The above index were marked as RRI*,SCR and GFRmin.At the same time,△RRI (RRI*-RRI),△SCR (SCRmax-SCR) and △GFR (GFR-GFRmin) were calculated.According to the stage classification of KDIGO-AKI 2012,36 patients diagnosed with AKI during their hospitalization were divided into KDIGO-1 group (n =10),KDIGO-2 group (n =10) or KDIGO-3 group (n =16).The intergroup difference of RRI* was compared and the correlation between △RRI and △SCR as well as between △RRI and △GFR were assessed.Results When RRI ＞ 0.7 was used as the diagnostic threshold for AKI,the sensitivity was 92.3％ and the specificity was 80.1％.RRI was positively correlated with SCR (r1 =-0.728,P＜0.01;r2=-0.709,P＜0.01) and negatively correlated with GFR (r1 =-0.728,P＜0.01;r2 =-0.709,P ＜0.01) in all patients at the time of admission and the most severe stage of kidney injury.While there was a significant difference in the RRI* among KDIGO-1,KDIGO-2 and KDIGO-3 groups (F =37.979,P =0.Q01),and there was no significant difference in △RRI (F =0.634,P =0.537).The △RRI was not correlated with △GFR or △SCR.Conclusions RRI can be used as a marker for diagnosis of AKI and the evaluation of renal function in patients with TMA,but it is not helpful to reflect the trends of renal injury especially for the critically ill patients.

Objective To explore the correlations between septic acute kidney injury (SAKI) and immune condition and provide the clinical basis of predictable diagnosis and treatment in patients with SAKI.Methods Patients diagnosed with sepsis admitted to department of emergency intensive care unit of Peking Union Medical College Hospital between January 1st,2013 and September 30th,2014 were retrospectively studied.A total of 91 patients with sepsis were included,and they were divided into secondary immune deficient (SID) group (n =46) or control group (n =45).According to the diagnostic criteria and stage of the guidelines of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients in each group were divided into non-SAKI group (n1 =16,n2 =23)、KDIGO-1 group (n1 =15,n2 =13)、KDIGO-2 group (n1 =11,n2 =1) or KDIGO-3 group (n1 =4,n2 =8).The morbidity of each stage and the renal index along with the progression of SAKI was also compared in patients with SAKI in two groups.Results While there was a significant difference in the morbidity of KDIGO-2 (23.9％ vs.2.2％,x2 =0.321,P =0.002) in patients with SAKI between immune deficient group and control group,the morbidity of KDIGO-1 and KDIGO-3 had no significant difference (KDIGO-1:32.6％ vs.29.8％,x2 =0.040,P =0.701;KDIGO-3:8.7％ vs.17.8％,x2 =-1.805,P =0.200).There was also no significant difference in the renal index (△Scr、△eGFR) and progression of SAKI (elapsed days from the diagnosis of sepsis to the occurance and most severe stage of SAKI) in patients with SAKI in two groups (P ＞ 0.05).Conclusion There was no significant difference of the severity of septic acute kidney injury in patients with and without secondary immune deficiency.Inflammatory mediators-induced kidney injury in the process of immune response may not be the main mechanism in SAKI.

Objective To explore the impact of abdominal situs inversus on the diagnosis and treatment of abdominal diseases.Methods Clinical data and course of 13 abdominal situs inversus cases from January 2012 to December 2016 were retrospectively analyzed.Results A total of 13 cases accounting for 1.5/10 000 of all cases who had abdominal CT were diagnosed situs inversus.6 of them were diagnosed for routine physical examination,4 of them for urinary tract symptoms,and the other 3 for digestive complaints.Conservative treatment or follow-up was prescribed for 8 patients who were asymptomatic and healthy;Five patients received operation,including 2 nephrecctomy,1 pancreatico duodenectomy,1 laparoscopic cholecystectomy,and 1 endoscopic retrograde cholangiopancreatography.All the cases recovered uneventfully.Conclusions Abdominal situs inversus is rare,non-disease entity,usually an incidental finding during clinical examination.It does not affect the therapeutic principle of concurrent primary disease.

Aim To study the antipsychotic effects of l-Scoulerine ( l-SLR) . Methods NMDAreceptorantag-onist MK-801 was used to induce the positive and neg-ative symptoms of schizophrenia and cognitive impair-ment in animal models. The effects of l-SLR were eval-uated on schizophrenia induced by MK-801 and on ex-trapyramidal system. Results l-SLR (10,15 mg · kg - 1 , ip) could suppress pre-pulse inhibition damage in rats induced by MK-801 (0. 3 mg·kg - 1 , ip); l-SLR(30 mg·kg - 1 , ip) could inhibit climbing behav-iors in mice induced by apomorphine, which suggested that l-SLR had significant inhibiting effects on the posi-tive symptoms of schizophrenia by MK-801 and apo-morphine. l-SLR could also induce social contact inhi-bition and cognitive impairment induced by MK-801 (0. 2 mg · kg - 1 , ip), which proposed that l-SLR could improve the negative symptoms and cognitive im-pairment by MK-801. Catalepsy in mice could be caused by the treatment dose of haloperidol (0. 8 mg· kg - 1 , ip), not by that of l-SLR(30 mg·kg - 1 , ip). Conclusion I-SLR has significant effects on the posi-tive and negative symptoms of schizophrenia and cogni-tive impairment and, the effect of l-SLR under effective dose on extrapyramidal system is obviously much less than that of haloperidol and l-SPD.