Objective To evaluate different measurement methods in histogram for the diffusion and perfusion parameters from intravoxel incoherent motion (IVIM) MR imaging of different types of uterine fibroids.Methods 63 patients with confirmed uterine fibroids (80 in total) were examined with MR imaging.3D T2WI and IVIM imaging were performed for those patients.The fibroids were classified into three types (type 1, 2, 3) on the basis of different signal intensities on T2WI according to Funaki's theory.Real diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were calculated using IVIM analysis.25%,50% and 75% of those parameters (D25,D50,D75,D*25,D*50,D*75,f25,f50 and f75) as well as mean values (Dmean,D*mean and fmean) were calculated using histogram method.ANOVA was used to compare the IVIM parameters among the three types of fibroids.Results There were 44 type 1,24 type 2 and 12 type 3 fibroids in the total of 80 fibroids.There was significant difference among all the diffusion parameters from histogram and mean values of different types of fibroids, and only one perfusion parameter D*75 value showed significant difference (P<0.05).There was no significant difference among all the f values from histogram and mean values.Conclusion Different measurements of parameters from IVIM histogram showed no added value for diffusion features in different types of fibroids compared to mean value.While the perfusion parameter D*75 value from histogram can distinguish the features of perfusion within different types of fibroids compared to mean value.

To explore the feasibility of mesenchymal stem cells (MSCs) acting as seed cells in tissue engineering, we isolated human bone marrow MSCs and differentiated them into vascular endothelial-like cells (ELCs) in vitro. Bone marrow mononuclear cells (BMSCs) were isolated by the method of percoll density centrifugation, and seeded in Dulbecco Modified Eagle Medium supplemented with 10% fetal bovine serum. MSCs were purified through multiple adherent cultures, and differentiated into ELCs induced by endothelial cell growth medium-2 (EBM-2) medium containing vascular endothelial growth factor (VEGF), human fibroblast growth factor (hFGF), insulin like growth factors 1 (IGF-1), and human epidermal growth factor (hEGF). The relative biologic characteristics of ELCs including cell morphology and phenotype were studied by inverted microscope and flow cytometry. The induced cells were identified by immunofluorescence with CD31 and Von Willebrand factor (vWF). The results showed that the morphology of MSCs was long-spindle and vortex-like growth. After induction of differentiation, the cells were round, and similar to vascular endothelial cells (ECs). Flow cytometric analysis revealed that ELCs expressed ECs specific surface markers of CD31 and vascular endothelial cadherin (VE-cadherin), but not CD133. Immunofluorescence results also confirmed that ELCs expressed CD31 and vWF. The results suggested that ELCs possed similar cell biological characteristics with ECs. In one word, human MSCs derived from bone marrow have the potential to differentiate into ECs in vitro, and show clinical feasibility acting as ideal donor cells of vascular tissue engineering.
Antigens, CD ; metabolism ; Bone Marrow Cells ; Cadherins ; metabolism ; Cell Culture Techniques ; Cell Differentiation ; Cells, Cultured ; Culture Media ; chemistry ; Endothelial Cells ; cytology ; Epidermal Growth Factor ; pharmacology ; Fibroblast Growth Factors ; pharmacology ; Flow Cytometry ; Humans ; Insulin-Like Growth Factor I ; pharmacology ; Mesenchymal Stromal Cells ; cytology ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tissue Engineering ; Vascular Endothelial Growth Factor A ; pharmacology ; von Willebrand Factor ; metabolism

To discuss the etiology, pathogenesis, therapies and prescriptions of psycho-cardiological abnormality of patients with coronary heart disease. According to the advance in modern diagnosis and treatment, the authors believed that psycho-cardiological abnormality of patients with coronary heart disease is closely related with mental stresses, like anxiety, depression and insomnia. It is mostly caused by emotional injury and expressed in heart, liver, spleen and kidney. The pathogenesis is heart-liver hyperactivity, yin deficiency in heart and kidney, and insufficiency in heart and spleen. The full recognition of etiology and pathogenesis of psycho-cardiological abnormality of patients with coronary heart disease and the combined treatment of disease and syndromes are of great significance to reduce mental stress and other risk factors, prevent and treat coronary heart disease and improve prognosis.
Coronary Disease ; drug therapy ; psychology ; Humans ; Medicine, Chinese Traditional ; Stress, Psychological ; drug therapy ; etiology

With the wide spread of sex and reproductive health knowledge and the deep influence of various cultures,there has been made rapid progress in the study and spread of sex knowledge in our country.It is quite necessary to add courses on sexology in medical higher schools.After a systematic study,students will master the related medical knowledge about sex in a full and scientific way,which will help them lay a solid foundation in their future study of sexology,gynecology and obstetrics,male science and family planning and carry out effective clinical diagnosis treatment for the patients with sex and related diseases.

Islet transplantation is effective in treating diabetes, however, its clinical use is highly restricted by a series of influencing factors. This review elucidates the non-immune factors including islet purification, instant blood-mediated inflammatory response and revascularization deficit on the development of islet transplantation, and also highlights the application and perspective of islet xenotrasplantation in the treatment of diabetes.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.

Objective To investigate the neuroprotective effects and mechanisms of 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ IMP cyclohydrolase(AICAR) supplement (AMPK activator) in different stages of neonatal rats sufferring from hypoxia-ischemia encephalopathy ( HIE). Methods Neonatal rat hypoxia-ischemia brain injury model was employed in this study. A total of 160 neonatal rats were distributed into five groups: sham, model control,AICAR30 min, AICAR24 h and AICAR72 h. The neuroprotective effects of AICAR supplement (30 min, 24 h, 72 h post operation) were compared by cresyl violet staining; Expressions of P-AMPK,AMPK in the brain tissue were measured by Western blotting.Foot-faults method was used to evaluate the long-term prognosis of the rats. Results Compared with the sham group, the survival of rats brain in model control group was significantly decreased [(100.0± 0.1)% and (45.3± 6.3)%, P< 0.05]. AICAR had neuroprotective effects when treated at 30 min and 24 h post operation,while the protective effects disappeared when treated later (72 h post operation) (P>0.05). Compared with the sham group, the expression of P-AMPK significantly increased about three times, while ATP level decreased close to the same. Conclusion Early AICAR treatment can protect hypoxia-ischemia brain injury by increasing AMPK-ATP level.

Objective To determine the dynamic changes in adenosine monophosphate-activated protein kinase (AMPK) in neurons of neonatal rats suffering from hypoxic ischemic brain injury.Methods Twenty-four-hour old and seven-day old neonatal rats were used in this study.A classic primary cortical neuron oxygen glucose deprivation (OGD) model and neonatal rat hypoxic ischemic encephalopathy (HIE) model were employed.Lactic dehydrogenase (LDH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) were used to evaluate neuron viability and damage.The expression of phosphorylated adenosine monophosphate-activated protein kinase (P-AMPK),phosphorylated activated protein kinase (P-Akt) and Cleaved Caspase-3 in neurons and brain tissue was measured by Western blot at different time points after OGD or HIE.The Student-t test was used for statistical analysis.Results (1) Compared with the control group,LDH levels at 2,4,8 and 24 h after OGD were higher (all P＜0.05) and optical absorption levels of MTT were lower (all P＜0.05).(2) Levels of P-AMPK in the OGD group were higher than those in the control group,and showed a time-dependent increase at 30 min and 2,4,8 and 24 h (all P＜0.05).The expression levels of P-AMPK in the HIE group were higher than those in the control group (0.345 ± 0.038,0.387 ± 0.112 and 0.618 ± 0.075 at 1,3 and 7 days after HIE,and 0.132±0.032 in the control group,all P＜0.05).(3) The levels of P-Akt increased above the control levels at 30 min (0.991 ±0.134 vs 0.304±0.050),reached a maximum level at 2 h (1.183± 0.107),and then gradually declined,whereas the levels of Cleaved Caspase-3 started to increase at 30 min,and remained elevated at 24 h (all P＜0.05).Conclusion Following hypoxic ischemic brain damage,the expression of P-AMPK is significantly increased in both in vivo and in vitro studies in a time-dependent manner.

Objective To evaluate CT in the diagnosis of olfactoryneuroblastoma.Methods The CT characteristics of 7 cases with esthesioneuroblastoma proven by surgery and biopsy were analyzed retrospectively.Results According to Kadish staging,there were 6 cases with stage C,1 case with stage B.All the tumor located in nasal cavity and invaded ethmoid sinus(7 cases),orbit(3 cases),maxillary sinus(2 cases),sphenoid sinus (2 cases),frontal sinus(1 cases).Intracranial invasion occurred in 3 cases.Among 4 cases of enhanced CT scanning,3 cases were obviously and heterogeneously enhanced,1 case was moderately enhanced.Conclusion CT scanning can define the area of tumor involvement and tumor staging,it is useful for clinical treatment.

Objective To investigate the effects of early parenteral feeding with glutamine on nitrogen balance and clinieal prognosis in Pationts with acute severe pancreatitis.Methods120 acute severe pancreatitis patients with Ranson scale≥3 were studied.Patients were randomized to receive either an early parenteral diet(control group,n=60) or the same formula with glutamine added(study group,n=60).The diets were isocaloric and isonitrogenous [35 kcal ? kg-1 ? day-1 and 1.5g of protein/(kg-1 ? d)].Main outcome measures were the APACHE-Ⅱ scale,incidence of infection,the length of stay in the intensive care unit and the number of days requiring mechanical ventilation,and monitor the nitrogen balance.ResultsThe two groups were homogeneous in gender,age,nutritional status and admission.There was no mortality during the study period.The two group have no statistic defference in nitrogen balance of 4.7 day.The median(range) number of infections per patient was significantly greater(P