Objective To investigate MR imaging features of parotid gland in Sj?gren′s syndrome ( SS).Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group ( n=21) and non-SS group (n=6) according to the international classification (diagnosis) criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography ( MRS).Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal:Grade 0 (n=2 glands), Grade 1 (n=10), Grade 2 (n=10), Grade 3 (n=6) and Grade 4 (n=14).Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signal intensity were 115.1 ±35.2, 69.8 ±23.5, and 80.1 ±31.4 respectively; the standard deviation of T 1 WI and T2 WI signal intensity of SS group was higher than both non-SS group and control group′s ( F value =13.780 and 13.301, respectively, P <0.01), however, the difference of standard deviation of signal intensity of non-SS group and control group had no statistical significance (P>0.05).Among 42 parotid glands with SS, conventional MRI and MRS showed parotid gland lesions in 40 and 30 respectively , and the difference was statistically significant (χ2 =13.04, P=0.013).There was no false positive result.The combination of the two methods detected all 42 lesions.The consistency of detecting parotid abnormalities with SS between conventional MRI and MRS was poor (Kappa=0.12, P=0.092).Conclusions Diffuse fatty infiltration on conventional MRI and diffuse peripheral duct dilatation on MRS in the parotid gland are characteristic features of SS , and conventional MRI could be used as the preferred technique for the SS.combination with MRS may improve diagnostic accuracy.

Objective:To observe the expression of miR-30c-5p and Toll-like receptor 4(TLR4) in colon cancer tissues and cells, and to explore their relationship with clinicopathological features.Methods:As a prospective study, 30 cases of colon cancer surgical specimens and matched normal tissue samples were selected from the Cancer Hospital of China Medical University from May 2016 to may 2017.The expression of miR-30c-5p mRNA was detected by quantitative real-time polymerase chain reaction(qRT-PCR), and the expression of TLR4 Protein was detected by western blot (WC). The expression differences of miR-30c-5p mRNA and TLR4 protein in different TNM stages, differentiation degrees and diameters were observed.The correlation between the expression of miR-30c-5p and TLR4 Protein was analyzed by Pearson Rank method.Results:The expression of miR-30c-5p was lower in colon cancer tissues(0.311±0.147) than in adjacent normal colon tissues(0.881±0.266)( t=10.613, P<0.001). TLR4 protein was higher in colon cancer tissues(0.729±0.274) than in adjacent normal colon tissues(0.361±0.168)( t=6.310, P<0.001). Expression of miR-30c-5p was lower in colon cancer cell lines(0.394±0.045, 0.435±0.098, 0.533±0.092, 0.272±0.069) than in normal colon epithelial cell line(1.371±0.101)( t value were 6.744, 6.432, 6.865 and 6.201, respectively; P<0.001). The expression of TLR4 protein was higher in colon cancer cell lines(1.108±0.169, 1.035±0.177, 1.114±0.253, 1.116±0.157) than in normal colon epithelial tissues(0.358±0.094)( t value were 5.789, 4.799, 5.311 and 5.292, respectively; P<0.001). Pearson rank correlation showed that miR-30c-5p was negatively correlated with TLR4 protein expression( r=-0.487, 95% CI: -0.721--0.154, P<0.01). MiR-30c-5p was decreased with TNM stage increasing( F=31.406, P<0.001), pathological differentiation degree decreasing( F=9.960, P<0.001), tumor diameter increasing( F=10.267, P<0.001). TLR4 was increasing with TNM stage increasing( F=37.634, P<0.001). TLR4 increased with the decrease of tumor differentiation( F=38.027.35, P<0.001). TLR4 increased with tumor diameter ( F=20.717, P<0.001). Conclusion:The low expression of mir-30c-5p and high expression of TLR4 in colon cancer were correlated with TNM stage and tumor volume.

Objective To evaluate the impact of HIV co-infection with HCV or HBV on the efficacy of highly active anti-retroviral therapy (HARRT). Methods The patients were divided into three groups: HIV + HBV + HCV co-infection group ( 23 patients), HIV + HCV co-infection group ( 166 patients), and HIV-only group (178 patients). HIV RNA, HCV RNA or HBV DNA were detected by real time PCR before treatment and 1,3,6,9 and 12 monthes after treatment, meanwhile the counts of CD4+ T lymphocyte and liver function including ALT, AST and TBil were tested. Results During one-year HAART, HIV RNA of HIV-only group, HIV + HBV + HCV co-infection group and HIV + HCV co-infection group decreased significantly from (6.78 ± 1.08), (6.23 ± 1.34), (6.54 ± 1.23) lg copies/ml to (0.53 ±0.15), (0.67 ±0.16),(0.43 ±0.11 ) lg copies/ml respectively (P＜.001 ). And CD4+ T lymphocyte counts of the three groups elevated significantly from ( 197 ± 127), (184 ± 113), (213 ± 143) cells/μl to (382 ±74), (383 ±70),(378 ±76) cells/μl respectively (P ＜0.001 ). However there were no differences among the three groups in HIV RNA and CD4+ T lymphocyte counts. There were no differences in liver functions including ALT,AST and TBil among the three groups. Conclusiom HIV co-infected with HBV and/or HCV does not impact on the efficacy of HAART. What more, HAART does not impact HCV replication.

Objective To investigate the characteristics of IL-22 in Helicobacter pylori (H.pylori)infection.Methods Thirty H.pyloripositive and fifteen H.pylori negative gastric biopsy specimens were enrolled,IL-22 mRNA expression was detected by real-time PCR and the protein level of IL-22 was determined by ELISA in gastric tissue.The H.pyloriand cell coculture system was established and IL-22 expression was measured by real-time PCR to investigate the main source of IL-22 in gastric tissue.The IL-22-producing T cell was examined by FCM in the gastric mucosa tissue.Results Gastric mucosal IL-22 mRNA and protein levels were significantly higher in H.pylori-positive patients than uninfected patients (P＜0.05).A H.pyloriand cell coculture system was established successfully and gastric epithelial cell and T cell were the main source of IL-22 in gastric tissue.IL-22 was produced by CD4+ and CD8+ T cells and these T cells were increased in H.pylori-infected gastric mucosa (P＜0.05).Conclusion IL-22 took part in H.pyloriinfection induced immune response and increased IL-22-producing T cells was the important feature of H.pyloriinfection.

Objective To summarize our results and experience in dealing with the postoperative intrathoracic gastro-air-way fistulae after esophagectomy for esophageal carcinoma.Methods From January 2010 through February 2012,1490 patients with esophageal carcinoma underwent esophagectomy in our department.The postoperative intrathoracic gastro-airway fistulae were documented in 10 patients,with a frequency of 0.67％.Five of them died.The possible etiology,clinical characters,treatment and prevention of this complication were reviewed.Results The location of the fistulate were 7 at left main bronchus,1 at right main bronchus,and 2 at distal trachea.After 2-3 weeks conservative treatment,1 patient underwent primary surgical repair and cured,1 refused any further intervention and sacrified,8 patients underwent endoscopic insertion of covered stent and only 3 healed.For the remaining 5 cases with failed stent therapy,2 died of severe aspiration and lung infection,3 had surgical repair,one of them successed and 2 died of aspiration and aortic rupture,respecively.Conclusion The development of intrathoracic gastro-airway fistulae was associated with the iatrogenic injuries and suturing material irritation of the gastric tube to the tracheal/bronchial wall.Therefore,a meticulous closure and wapping of gastroplasty and appropriate isolation using artifical patch or great omentum between airway and esophageal substitution could effectively reduce the fistulae.The stent therapy usually fails in treating this entity and surgical repair remains the final and ratical therapeutic option.Primary repaire is suggested and careful preoperative assessment is crucial.

Objective To explore the relationship between tubal intraepithelial carcinoma (TIC) of the fimbria and pelvic high-grade serous carcinoma.Methods All 34 cases of pelvic high-grade serous carcinoma with clear fimbria were evaluated from January 2009 to June 2010,including ovarian carcinoma (n=26),tubal carcinoma (n=7) and peritoneal carcinoma (n=1).Among of these ovarian carcinomas,12 cases were surface deposits and the other 14 cases within ovarian parenchyma.All 42 cases of non highgrade serous carcinoma in this period including 13 endometrioid ovary carcinomas,11 clear cell ovary carcinomas,11 mucinous ovary carcinomas,6 low-grade serous ovary carcinomas,1 low-grade serous tubal carcinoma,were also collected as a reference.The presence of tubal intraepithelial carcinomas was assessed.Based on the presence of TIC,high-grade serous ovary carcinomas were divided into TIC positive (+) and TIC negative (-) groups,and the clinical and pathological features of them were also evaluated.Results Fifteen cases (44％) were identified TIC in 34 high-grade pelvic serous carcinomas,and all of them were in the fimbria only,while none of TIC was found in control cases.There were significant difference between the two groups (x2=23.086,P=0.000).Eleven cases(42％) were identified TIC in all 26 high-grade ovarian serous carcinomas,in which 8 cases with unilateral ovary carcinomas were associated with ipsilateral TIC,2 cases with bilateral ovary carcinomas associated with unilateral TIC and one case with bilateral ovary carcinoma was associated with bilateral TIC.Four TIC (4/7) were identified in 7 cases with high-grade tubal serous carcinomas,and there was no presence of TIC in the 1 high-grade serous peritoneal carcinoma.Of all 26 high-grade ovarian serous carcinomas,6/11 cases were surface deposits,and 5/11 were parenchyma tumors in TIC (+) group while 6/15 cases were surface deposits and 9/15 were parenchyma tumors in TIC (-) group,in which there were correlated in distribution of TIC between the two groups( P＞0.05 ).The average diameter of ovarian cancer were 6.9 and 6.5 cm between the two groups with no significant differences ( t=0.409,P=0.690).Conclusion TIC is specific to high-grade serous carcinomas and maybe have something to do with the pathogenesis of pelvic serous carcinomas.

Objective To improve the different diagnosis between autoimmune pancreatitis(AIP) and pancreatic cancer(PC) by a retrospective analysis of clinical symptoms and serological features.Methods The analysis included 36 patients who had postoperative pathological,serological findings consistent with Asian AIP standards and 95 patients who had postoperative pathological consistent with PC pathological standards.All patients were admitted by the surgery department of our hospital from January,2003 to October,2011.A retrospective comparative analysis of the clinical manifestations,serology data of these AIP and PC patients was conducted.And summary the differential diagnosis characteristics of AIP and pancreatic cancer in the clinical symptoms,the serology.Results The features of different diagnosis:(1) The age of patients with PC was higher than AIP((60.9 ±9.0) years vs.(53.56 ± 14.6) years,t =3.48,P ＜0.05),and AIP preferred to male groups (x2 =2.88,P =0.09).(2) The clinical features of AlP and PC with the age characteristics were easily confused.Both clinical features were relatively typical in younger age which could be found earlier and relatively insidious in the older age which might be found with delay.(3) AIP were often complicated by biliary system inflammations(AIP =47.2％,PC =12.6％,x2 =18.12,P ＜ 0.05),while PC were usually complicated by the cysts in liver and kidney (PC =29.5％,AIP =0,x2 =13.50,P ＜ 0.05).(4) The high titer in CA199 had a higher value in the diagnosis of PC (concentration:group AIP =20.51 (9.55,86.5) kU/L,group PC =326.50 (94.38,10393.00) kU/L; positive rate:group AIP =35.70％ (10/28),group PC =86.70％ (65/75),P =0.000).The high titers in amylase (concentration:group AIP =103.50 (72.00,252.00) U/L,group PC =46.50 (21.65,96.90) U/L; positive rate:group AIP =45.00％ (9/20),group PC =19.40％ (7/36),P =0.043),lipase(concentration:group AIP =340.50(152.05,495.80) U/L,group PC =107.40(23.40,177.26) U/L,P =0.005 ; aspartate aminotransferase (positive rate:group AIP =75.00％ (27/36),group,PC =55.90％ (52/93),P =0.046) andγ-glutamyltranspeptidase (positive rate:group AIP =79.40％ (27/34),group PC =57.10％ (52/91),P =0.022) had higher values in the diagnosis of AIP.The significant increases in CA199 were not the basis which excluding AIP.Conclusion AIP as a unique type of chronic pancreatitis can be distinguished from PC on distinctive clinical,serological characteristics.

Objective To study the regiments of continuous subcutaneous insulin infusion (CSII) in admitted type 2 diabetic patients, and to analyse the factors related to its effectiveness and insulin dosage. Methods A total of 1 276 type 2 diabetic patients were treated by CSII. The total efficacy of CSII was evaluted. The use of CSII was also analysed in the newly diagnosed patients, elderly patients, and patients with obese or infectious disease. Results The excellent control of blood glucose were achieved in (5.7±2.6)days in the dosage more early and quickly in the newly diagnosed group than that in the previously diagnosed group after the blood glucose levels achieved good control. The percentage of the patients reached the clinical relieve was also higher in the newly diagnosed group. The incidence of hypoglycemia was significantly higher in the elderly patients with lower basal insulin dosage at night. The bolus insulin dosage in the obese patients was higher than that in the non-obese patients. The patients with infectious disease usually have a higher basal insulin dosage than those without infectious disease. The days needed for achieving good control of blood glucose and the insulin dosage were related to infectious factors, the basal blood glucose and obesity. Conclusion The application of CSII among the patients is varied with different conditions. Blood glucose level, body mass index and infection factors are important to determine the initial insulin dosage.

The quality of SCI papers is one of the objective indexes of evaluation on scientific and technological strength and research capabilities.This paper introduced a comprehensive management strategy to promote the publication of SCI papers with high impact factors,in terms of such dimensions ass research orientation,financial and technical support,personnel training,and scientific research management platform.The short and long term effects of the comprehensive management strategy system were analyzed using the SCI papers publication data and IF data from 201 1 to 2014 at the hospital,as a reference for building a scientific management system of SCI papers for the administrators.

OBJECTIVETo systematically evaluate the values of 4 serum markers in the diagnosis of rheumatoid arthritis (RA).

METHODSSerum samples were obtained from 278 RA patients and 510 control subjects and the levels of rheumatoid factor (RF), anticyclic citrullinated peptide antibody (CCP), antikeratin antibody (AKA), and glucose-6-phosphate isomerase (GPI) were detected using immune turbidimetry, ELISA, indirect immunofluorescence, and ELISA, respectively. The values of these 4 serum markers and their combinations in RA diagnosis were systemically assessed.

RESULTSIn RA diagnosis using one serum marker, two markers, and three or four markers, RF, RF+CCP, RF+CCP+GPI, respectively, had the highest sensitivity; CCP, CCP+AKA, and RF+CCP+AKA+GPI, respectively, had the highest specificity; CCP, CCP+GPI, and RF+CCP+AKA+GPI, respectively, had the highest positive predictive value; GPI, RF+CCP, and RF+CCP+GPI, respectively, had the highest negative predictive value; CCP, CCP+GPI, and RF+CCP+AKA+GPI, respectively, had the highest positive likely ratio; GPI, RF+CCP, and RF+CCP+GPI, respectively, had the lowest negative likely ratio.

CONCLUSIONCCP, RF+CCP, and RF+CCP+GPI are the most ideal for RA diagnosis using one, two, and three or more markers, respectively. CCP is the essential marker for RA diagnosis, and a combined detection of the serum makers can significantly improve the diagnostic accuracy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid ; blood ; diagnosis ; Autoantibodies ; blood ; Biomarkers ; blood ; Case-Control Studies ; Citrulline ; immunology ; Female ; Glucose-6-Phosphate Isomerase ; blood ; Humans ; Keratins ; immunology ; Male ; Middle Aged ; Rheumatoid Factor ; blood ; Young Adult