Objective To investigate whether non-critical coronary stenosis can be detected by coherent contrast imaging(CCI) at rest without stress.Methods Three degrees of stenosis were made in left anterior descending of 12 dogs.Myocardial contrast echocardiography(MCE) was performed with CCI and the correlation among the variables of MCE curve and the degrees of stenosis were analyzed by cubic regression.Results The time to peak was significantly prolonged with progressive coronary stenosis (P＜0.01) and related to the degree of stenosis (R~2=0.991,P＜0.001).Conclusions CCI could be used to detected non-critical coronary stenosis at rest without stress.

Objective To explore the value of susceptibility weighted imaging (SWI) in the quantitative analysis of ischemia-reperfusion injury (IRI) of the rabbit kidneys . Methods Thirty New Zealand white rabbits were randomly assigned to IRI group (n=24, operation with clamping) and Sham group (n=6, operation without clamping). Left renal ischemia-reperfusion was performed by occlusion (calmping) of the left renal arterial for 60 minutes, followed by reperfusion. All the rabbits underwent MRI including T2WI and SWI before and 0.5 h, 12 h, 24 h and 48 h after the establishments of models . Three rabbits in IRI group were randomly sacrificed 0.5 h, 12 h, and 24 h after the establishment of model. The rest of the rabbits in IRI group and 6 rabbits in sham group were sacrificed for pathological examination 48 h after the establishment of model All specimen were cut into slices and stained with hematoxylin-eosin (HE). Region of interest ( ROI) was manually created by outlining the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex, then relative signal-to-noise ratio of the kidney (rSNR) to muscle in SWI sequence was recorded. and compared with histopathologic features. One-way ANOVA was performed to compare difference of rSNR to muscle in respective location at 5 time-points between Sham group and IRI group, and the differences between groups were tested using repetitive measure analysis of variance, repetitive measure analysis of variance was performed to compare difference of rSNR to muscle in respective location at respective time-points between Sham group and IRI group. Results rSNR value in the inner medulla 0.5 h, 12 h, 24 h and 48 h after the establishments of models were 0.28 ± 0.04, 0.98 ± 0.14, 0.69 ± 0.07, 0.57±0.06, 0.43±0.03, respectively (F=69.82,P<0.01), the inner stripe of outer medulla at the five time-points 0.08 ± 0.03, 0.57 ± 0.05, 0.32 ± 0.07, 0.16 ± 0.02, 0.04 ± 0.01, respectively(F=16.59,P<0.01), the outer stripe of outer medulla were 0.31 ± 0.04, 0.86 ± 0.09, 0.65 ± 0.07, 0.55 ± 0.06 0.43 ± 0.04(F=67.52,P<0.01), respectively,the cortex 0.05±0.01, 0.80±0.04, 0.68±0.07, 0.47±0.07, 0.36±0.08, respectively(F=118.96,P<0.01). The difference of the rSNR was statistically significant in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex at the five different time-points. The differences between two groups were significant (F=206.29, 14.25, 42.8, 39.12, P all<0.05). The pathological findings in Sham group included normalglomerular structure l, clear cavity of tubular, no interstitial hyperemia and edema. The pathological findings in IRI group demonstated, at 0.5 h after IRI, Bowman's capsule cavity expansion, glomerular shrinkage, swelling of renal tubular epithelial cells, vacuoles degeneration, the tube cavity expansion, interstitial edema and congestion ecta became slender, andat 12 h after IR, Bowman's capsule expansion became more obvious, foam degeneration of renal tubular epithelial cells, apoptosis, partial loss of the brush border of the proximal convoluted tubule, formation of protein cast, and a small amount of inflammatory cells appeared in the renal interstitium, swelling of endothelial cells of the vasa recta, congestion of small vessels, and at 24 and 48 h after IRI, more serious injury of renal tubular in the outer stripe of outer medulla , massive necrosis of renal tubular epithelial cells, apoptosis, parts of the renal tubular had the contour lines, and renal tubular outline, increment in inflammatory cells, red cell and protein cast. Conclusion rSNR of SWI in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex of the kidney varies with the degree of IRI over time, and is consistent with corresponding pathological feature, suggesting SWI is useful imaging tool to detect early damage of renal IRI quantitatively.

Objective To explore the value of abnormal imaging findings on susceptibility weighted imaging (SWI) in delayed graft function (DGF). Methods The conventional MRI and SWI images of 26 cases with DGF and 20 cases with normal renal function of transplanted kidneys were retrospectively analyzed. Patients with cysts and angiomyolipomas were excluded. Normal structures of transplanted kidney were identified. If lesions of abnormal signal intensity were found in the transplanted kidney, the location, border and signal intensity compared to renal cortex would be analyzed. The differences in signal intensity between the abnormal signal lesions and normal renal cortex in the same SWI layer of DGF were compared by using independent-sample t test. The differences in positive detection rate of discovering the abnormal signal lesions in DGF between conventional MRI and SWI were compared by using McNemar test. Results Of the 26 cases with DGF, one case was found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on both conventional MRI and SWI images. Ten cases were found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images only. Fifteen cases exhibited no abnormal signal lesions on both conventional MRI and SWI images. Twenty cases with normal renal function of transplanted kidney, no abnormal signal lesions were found on both conventional MRI and SWI images. The differences in signal intensity between the abnormally low signal lesions (130±20) and normal renal cortex (177±25) in the same SWI layer of 11 cases with DGF were statistically significant (t=-4.582,P<0.01). The differences in positive detection rate of discovering the abnormally low signal lesions in DGF between conventional MRI [3.8%(1/26)] and SWI [42.3% (11/26)] were statistically significant (χ2=8.100,P=0.002). Conclusions Abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images suggest the presence of DGF. Compared with conventional MRI, SWI appears to be superior in detecting the abnormally low signal lesions.

Lung cancer is currently one of the most common malignant tumors in the world. The occurrence and development of lung cancer, especially non-small cell lung cancer (NSCLC), are closely related to the abnormal expression of long non-coding RNA (lncRNA). lncRNA with a transcript of more than 200 nucleotides is involved in chromatin modification, transcription activation, transcription interference and other regulatory processes, and has varying degrees of regulation on the proliferation, migration, and invasion of tumor cells. It is characterized by up-regulation or down-regulation of expression. At present, there are a large number of studies on lncRNA, because lncRNA has considerable application prospects in the diagnosis, clinical treatment, drug resistance research and prognosis evaluation of NSCLC. In this paper, the overview of lncRNA, the up-regulation or down-regulation of NSCLC-related lncRNA expression, NSCLC clinical treatment and drug-resistant lncRNA were summarized.

Objective:To explore the relationship between MRI texture features with the histopathology in early renal ischemia-reperfusion injury (IRI).Methods:Forty-eight healthy New Zealand rabbits were randomly divided into the IRI group ( n=40) and the sham group ( n=8). As for the IRI group, rabbits underwent the left kidney surgery by clamping the left renal artery for 60 mins and then releasing the clamp to establish renal IRI model. The rabbits in the sham group underwent the same operation, but without clamping the left renal artery. MR examination were performed before and at 1 h, 12 h, 24 h, and 48 h after the operations. As for the IR group, eight rabbits were randomly sacrificed at each time point immediately after MR exam. The eight rabbits in the sham group were sacrificed after MR exam at 48 h after the operation. The left kidney was harvested for histopathological examination. The single item score of the histopathological features, the microvessel density (MVD), and the pathological total score were calculated. Differences in the single item score of the histopathological features, MVD, and the pathological total score among IRI group with different time points and sham group were determined using the Kruskal-Wallis test. MRI texture features of the left kidney were extracted. Multiple dimensionality reduction for MRI texture features were performed, and the features associated with the pathological total score were selected. The relationship between MRI texture features with the single item score of the histopathological features and MVD was assessed by Pearson correlation coefficients. Results:There were significant differences in renal tubular brush border destruction, renal tubular epithelial edema, necrosis, cast, interstitial inflammatory cell infiltration, MVD, and the pathological total score in IRI group among the different time points (all P<0.05). T 2WI_S (3, -3) InvDfMom had the highest correlation with renal tubular brush border destruction, renal tubular epithelial edema, necrosis, and cast ( r=0.56, -0.58, 0.62, 0.69, all P<0.01). BOLD_S (4, -4) Correlat had the highest correlation with interstitial inflammatory cell infiltration ( r=0.63, P<0.01). SWI_S (4, 4) DifEntrp had the highest correlation with MVD ( r=0.61, P<0.01). Conclusion:MRI texture analysis can provide valuable information for evaluating early renal IRI.

Objective To investigate the effect and the mechanism of epithelial-mesenchymal transition (EMT) in renal tubular cells induced by uric acid.Methods Normal rat kidney tubular cell line (NRK-52E) were exposed to different concentrations of uric acid (100,200,400,600,800 μmol/L UA) for 48 hours to induce EMT.Morphological changes of the NRK-52E cells were examined under an inverted phase contrast microscope.The protein expression of E-cadherin,α-SMA,p-Akt and Akt were detected by Western blotting.The distribution of E-cadherin and α-SMA were detected by immunofluorescence.NRK-52E cells were pretreated by different concentrations of LY294002(0,2.5,5,10,15 μmol/L),the inhibitor of PI3K/p-Akt signaling pathway,and then processed by uric acid (400 μmol/L) for 48 hours.Western blotting was used to detect the protein expression of p-Akt and Akt.NRK-52E cells were then divided into four groups:normal group (N),uric acid group (UA),LY294002 group (LY),uric acid with LY294002 group (UA + LY).The protein expression of E-cadherin and α-SMA were detected by Western blotting,the distribution of E-cadherin,α-SMA and p-Akt were detected by immunofluorescence.Results There was abundant cellular expression of E-cadherin in unstimulated renal tubular cells whereas its expression was significantly decreased in uric acidstimulated cells (P ＜ 0.05).In addition,uric acid induced de novo expression of α-SMA in contrast to almost negative staining in untreated cells (P ＜ 0.05).p-Akt were obviously increased in high uric acid group (P ＜ 0.05) and Akt changed not significantly (P ＞ 0.05).NRK-52E cells transformed into elongated fibroblast-like cells from cuboidal clustered epithelial cells.These indicated that uric acid has induced EMT and activated PI3K/p-Akt signaling pathway in NRK-52E cells.However,the above effects of uric acid were abolished when p-Akt was blocked by the PI3K inhibitor (10,15 μmol/L LY294002),indicated that LY294002 has reversed the trend of EMT.Conclusions High uric acid induces phenotypic transition of renal tubular cells probably via activating PI3K/Akt signaling pathway.

Objective To assess the impact of physical training on physiological function of adult renal transplant recipients by meta-analysis and to provide theoretical guidance for clinical practice.Methods Randomized controlled trials of physical training for the treatment of renal transplant recipients until October 2017 were searched in the database of Cochrane library,PubMed,Embase,Web of Science,Wanfang Data and CNKI.Data extracted from the literatures were analyzed with RevMan software (version 5.3).Results A total of 10 studies in 10 manuscripts met the inclusion criteria,and 557 cases were included.Meta-analysis results were as follows.Compared with the control group (routine drug therapy),the level of peak exercise oxygen uptake (peak VO2) was significantly increased in physical training group (routine drug therapy and physical training) (MD=2.40,95％ CI 0.15-4.64,P=0.04).However,there was no statistically significant difference in the change of blood lipid,blood pressure,hemoglobin and serum creatinine between the two groups (all P ＞0.05).Conclusions Physical training can improve cardio respiratory fitness of renal transplant recipients in the early stage,but it has no obvious effect on blood pressure,blood lipid,hemoglobin and blood creatinine.

Objective: To understand the awareness of HIV testing results before having sex among men who have sex with men （MSM） . Methods: The MSM from a gay bar in Zhejiang Province were recruited through convenience sampling method. A questionnaire survey was conducted to collect the information about demographic characteristics,sexual behaviors,awareness of HIV status between sexual partners and HIV testing results during August of the year 2016. The awareness of HIV testing results before having sex among MSM and the influencing factors were analyzed . Results: A total of 124 MSM were recruited in this study,56.56% of whom aged from 25 to 39 years,and 61.29% were single,divorced or widowed. The number of sexual partners they had in the last year ranged from 1 to 40,with median of 8. The MSM who had casual sexual partners accounted for 70.97%. The MSM who had regular HIV testing accounted for 90.32%,yet who would like to share the HIV testing reports with partners only accounted for 18.55%. Whether asking about the HIV status before having sex or not was associated with age,marriage status,the number and characters of sexual partners（P<0.05）. The MSM who were informed of the HIV status of commercial partners,casual partners and regular partners accounted for 0,5.10% and 19.77%,respectively. The main reasons for MSM not knowing about the HIV status of their sexual partners were“condom use would prevent HIV infection”（78.38%）,“never thought about HIV infection”（53.15%）,and “there was no need to ask as the partner looked healthy”（36.94%） . Conclusion The proportion of MSM who were aware of HIV testing results before having sex was not high and was associated with age,marriage status,the number and characters of sexual partners. Lack of knowledge about HIV infection might contributed to this low proportion.

Objective:To establish a mortality risk prediction model of severe bacterial infection in children and compare it with the pediatric early warning score (PEWS), pediatric critical illness score (PCIS) and pediatric risk of mortality score Ⅲ (PRISM Ⅲ).Methods:A total of 178 critically ill children were selected from the PICU of the Children's Hospital of Nanjing Medical University from May 2017 to June 2022. After obtaining the informed consent of the parents/guardians, basic information such as sex, age, height and weight, as well as indicators such as heart rate, systolic blood pressure and respiratory rate were collected from all children. A standard questionnaire was used to score the child 24 h after admission to the PICU. The children were divided into the survival and death groups according to their survival status at 28 d after admission. A mortality risk prediction model was constructed and nomogram was drawn. The value of the mortality risk prediction model, PEWS, PCIS and PRISM in predicting the risk of death was assessed and compared using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).Results:Among the 178 critically ill children, 11 cases were excluded due to severe data deficiencies and hospitalization not exceeding 24 h. A total of 167 children were included in the analysis, including 134 in the survival group and 33 in the death group. A mortality risk prediction model for children with severe bacterial infection was constructed using pupillary changes, state of consciousness, skin color, mechanical ventilation, total cholesterol and prothrombin time. ROC curve analysis showed that the AUCs of mortality risk prediction model was 0.888 ( P<0.05). The AUCs of PEWS, PCIS and PRISM Ⅲ in predicting death in children with severe bacterial infection were 0.769 ( P< 0.05), 0.575 ( P< 0.05) and 0.759 ( P< 0.05), respectively. Hosmer-Lemeshow goodness-of-fit test showed the best agreement between risk of death and PEWS predicted morbidity and mortality and actual morbidity and mortality (χ 2 = 5.180, P = 0.738; χ 2 = 4.939, P = 0.764), and the PCIS and PRISM Ⅲ predicted mortality rates fitted reasonably well with actual mortality rates (χ 2= 9.110, P= 0333; χ 2 = 8.943, P= 0.347). Conclusions:The mortality risk prediction model for predicting the death risk has better prognostic value than PEWS, PCIS and PRISM Ⅲ for children with severe bacterial infection.

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.