Objective To investigate the value of MR multiparameter imaging for the clinical classification of chronic pancreatitis. Methods 65 patients with confirmed chronic pancreatitis by follow-up and pathologic examinations ( 14 mild, 37 moderate and 14 severe according to MANNHEIM system) and 20healthy volunteers were included in this study. MR examination including routine T1WI, T2WI, MRCP and dynamic enhanced MRI. The data were measured and statistical analysis was applied in four groups. Two radiologists assessed pancreatic duct diameter, pancreatic size, pancreatic cyst, pancreatic stone and pancreatic signal intensity on MRCP, T1-weighted and T2-weighted images. Pancreatic signal intensity were also measured on dynamic enhanced MR. Results Mean values of pancreatic signal intensity ratio on T1WI (rT1)in the pancreas were significantly reduced in patients with moderate and severe CP compared with volunteers.There was significant difference among four groups ( normal, 0. 98 ±0.27; mild, 0. 84 ±0. 12; moderate,0.81 ±0. 16; severe, 0.75 ±0.24). Mean values of pancreatic signal intensity ratio on T2WI (rT2) in the pancreas were no difference among four groups ( normal, 1.28 ± 0.3; mild, 1. 46 ± 0. 44, moderate, 1.46 ±0.55; severe, 1.76 ± 0.72). Pancreatic duct diameters were significantly increased in mild, moderate and severe CP groups [ mild (5.3 ± 2.4) mm; moderate ( 6.5 ± 3.3 ) mm; severe ( 8.1 ± 4.1 ) mm ] compared with patients without CP[ (2.0 ±0.6) mm; P < 0.01 ]. Severe degree of Cambridge classification was graded as mild in 4 (29%), moderate in 33 (89%), severe in 13 (93%). Pancreatic calcification was graded as mild in 2 ( 14% ), moderate in 11 (30%), severe in 5 (36%). Pancreatic pseudocyst was graded as mild in 0, moderate in 6 ( 16% ), severe in 3 (21.43%). Pancreatic parenchymal atrophy was graded as mild in 4 (29%), moderate in 22 (59%), severe in 10 (71%). They did not vary among CP groups. Parenchymal/arterial phase enhanced ratio (P/A) in the pancreas were significantly increased in patients with mild,moderate and severe CP (mild, 1. 10 ±0.08; moderate, 1.37 ±0.15; severe, 1.48 ±0.53) compared with patients without CP (0.88 ± 0.08, P < 0. 05 ). Significant correlation was present between the severity level of CP and the change of rT1, severe degree of Cambridge classification, the pancreatic duct diameter and P/A (r=0. 34, 0.41, 0. 62, - 0. 43; P < 0. 01 ). ROC analysis showed the presence of pancreatic duct diameters more than 2.5mm, rT1 less than 0. 8 and P/A more than 0. 8 had a sensitivity and specificity of diagnosing chronic pancreatitis of 94% and 79%, 90% and 48%, 95% and 47% respectively. Combined with the three variables, the specificity of diagnosing chronic pancreatitis can be improved to 95%.Conclusions T1-weighted, MRCP and dynamic enhanced MRI imaging can accurately evaluate the clinical severity of chronic pancreatitis. MRCP had the highest sensitivity and specificity, followed by T1-weighted and dynamic enhanced MRI imaging.

Objective: In order to study how to accelerate the reconstitution immunofunction in BMT mice, first of all, we established a immunodeficiency model of BMT in BALB/C mice. Then BMT mice were injected with PCD-hIL-2 directly into skeletal muscle, and treated with traditional Chinese medicine. Methods: The experiment groups are designed as（A）Chinese medicine + PCD-hIL-2;（B）PCD-hIL-2;（C）Chinese medicine +hIL-2;（D）Chinese medicine;（E）hIL-2;（F）BMT;（G）normal control;（H）radiation control. Results: We compared groups A B C D to E or F groups, found（1）The splenocytes/thymocytes count increase obviously.（2）Killing activity of NK cell rises obviously in vivo.（3）The response of splenocytes、thymocytes、BM cells to mitogen goes up.（4）The reactivity of splenocytes to foreign IL-2 goes up. （5）CFU-GM count is increased. Conclusion: The expression of hIL-2 is very low by nude DNA injection ,but it is enough to have biological function and therapeutic effect .If only Chinese medicine was applied, the immunological condition was obviously recovered.

Objective To investigate the clinical value of combined detection of H‐FABP with cTnI in the diagnosis of myo‐cardial damage caused by hypoglycemia .Methods Levels of blood H‐FABP and cTnI were examined at 0 to 3 h ,24 h ,48 h after hy‐poglycemia diagnosed ,and were compared with the control group .The levels of H‐FABP and cTnI at 24 h after hypoglycemia diag‐nosed were compared among different groups separated according to the decreasing extent of blood sugar (1 .0 to 2 .1 mmol/L ,<1 .0 mmol/L group) ,the duration of hypoglycemia (< 24 h ,≥ 24 h group) and clinical feature of hypoglycemia (symptom and no symptom group) .The sensitivity and specificity of H‐FABP and cTnI in myocardial damage was also statistical analyzed in this study . Results The statistic difference of the increasing H‐FABP levels was found for 0 to 3 h(P<0 .01) and 24 h (P<0 .01) ,but not found for 48 h(P>0 .05) .The statistic difference of the increasing cTnI levels existed for 24 h (P<0 .01) and 48 h (P<0 .01) ,but not for 0 to 3 h (P>0 .05) .The increasing extent of H‐FABP and cTnI levels was obvious for group with blood sugar <1 .0 mmol/L ,duration of hypoglycemia ≥24 h and have hypoglycemia symptom ,these data have obvious statistic difference compared with other groups(P<0 .05 ,P<0 .01 ,P<0 .01) .The sensitivity and specificity of H‐FABP methods were higher than those of cTnI ac‐cording to the 0 to 3 h and 24 h detection data ,while the opposite result was found for 48 h .Conclusion Combined detection of H‐FABP with cTnI could be well applied in the diagnosis of myocardial damage caused by hypoglycemia .

Objective:To investigate regulatory immune response induced by DNA vaccination encoding T cell receptor V?5.2 or V?2.1 chain predominantly displayed on ovalbumin (OVA)-specific T cell clone.Methods:BALB/C mice were vaccinated with pcDNA3.1 encoding T cell receptor (TCR) V?5.2 or V?2.1 chain respectively.Using RT-PCR,transcription of the recombined plasmids was analysed. Cell proliferation was measured by 3H-TdR incorporation.CTL response was assayed by JAM test.Immuno-fluorescent assay was used to examine the anti-TCR antibody level and the number V?2 +T cells.Results:RT-PCR analysis showed that the recombined plasmids can be transcripted in vivo and in vitro.DNA vaccine with TCR variable chain effectively induced TCR-specific humoral and cellular immune response,V?2 +T cells was not depleted by V?2.1 TCR-DNA vaccination,but rather was anergy.Conclusion:Regulatory immune response can be induced by DNA vaccination encoding TCR V? or V? region in normal mice.

Objective: To explore the sensitivity of Kit or PDGFRA mutants related to gastrointestinal stromal tumor (GIST) to Gleevec.Methods: The recombinant plasmids of KIT Del559-560, KIT Ins IPYD579, PDGFRA D842V and PDG-FRA L839P gene mutants were transiently transformed into the CHO cells by liposome methods.Western blot was used to detect the expression of the related protein and their phosphorylated forms after the cells were incubated with Gleevec for 90 min.At 72 hours after incubation with Gleevec, MTT was used to detect cell proliferation.Results: Western blot results showed that Gleevec at 0.1 μM can notably reduce phosphorylation of KIT Del559-560.Gleevec at 1μM completely blocked phosphorylation of KIT Ins IPYD579 and PDGFRA L839P, but did not affect PDGFRA D842V phosphorylation.MTT analy-sis indicated that growth of CHOPDGFRA L839P was inhibited by Gleevec at 1μM, however, CHOPDGFRA D842V was re-sistant to Gleevec at 5 μM.Conclusion: Gleevec can decrease the expression of phosphorylated protein CHOPDGFRA L839P and CHOKIT Ins IPYD579, and can remarkably inhibit the proliferation of cells containing PDGFRA L839P mutant.

Objective: To investigate whether Vigconic VI-28 capsule, a formulated traditional Chinese medicine containing radix Ginseng, cornu cervi pantotrichum and semen cuscutae, can assist tumor chemotherapy in a mouse model. Methods: Female C57BL/6 mice were s. c. injected with viable Lewis lung cancer ( LLC) cells (106 cells/mouse) . The mice were then treated with cyclosposphamide (Cyp, 40 mg/kg bodyweight, once every other day). One group was intra-gastrically given 2% VI-28 (0.5 ml/mouse, every other day) during the course of the chemotherapy. By day 28, the mice were sacrificed and their thymic indices and tumor indices were calculated and compared. Splenocytes were collected for analysis of their immunological status. Histological study was carried to examine the solid tumors. Results: Fourteen days after the injection of LLC cells, solid tumors developed in most of the animals, reaching 1 ~ 1.8 cm diameters by 28 th day Compared with mice of the LCC + Cyp group, thymus glands from the LLC + Cyp + VI-28 group were significantly heavier. Splenocytes of the same group responded better to ConA stimulation in vitro. Histochemical examination of the tumor tissues revealed that tumors of the Cyp + VI-28 group were better differentiated (less aggressive) than that of the Cyp group. Conclusion: Vigconic VI-28 capsule can promote recovery of immune system in mice undergoing chemotherapy and help Cyp to control the growth of tumor cells in vivo.

Objective To evaluate the risk factors of failure in pain resolution in chronic pancreatitis(CP)after endoscopic treatment.Methods We undertook a retrospective cohoa study of subjects with pain caused by CP,who underwent endoscopic treatment from January 1997 to December 2006.Cox proportional-hazards model was used for multivariate analysis of the variables that were possibly related to failure of treatment.Results Follow-up data were obtained from 172 patients(114 males and 58 females,mean age 39.4 yr.Pain resolution after endoscopic treatment was achieved in 148(86.0%).Cox proportional-hazards model showed risk factors of failure in pain resolution after endoscopic treatment were onset age(＞36 years,hazard rate(HR)=3.5),mild and moderate abdominal pain before endoscopy(HR=2.4),no decrease in amount alcohol consume(＜50%,HR=1.9)and inappropriate diet(HR=2.8).Conclusion Patients with CP should abstain from alcohol and have low-fat diet,especially for those with pain onset at older ages (＞36 years)and with mild and moderate abdominal pain before endoscopic treatment.

Objective To investigate the regulatory role of programmed death ligand-1 (PD-L1) on acute lung injury (ALI), and its molecular mechanism. Methods Twenty C57BL/6 male mice and 20 PD-L1 knock out male mice were collected, and they were divided into two groups by random number table, respectively: namely sham group and ALI group, 10 mice in each group. The model of ALI was reproduced by two-hit of hemorrhagic shock and sepsis, and the mice in sham group were only got bilateral femoral artery exposure and ligation without bleeding, cecal separation without ligation and perforation. The mice were sacrificed 24 hours after model reproduction, and the lung tissue and bronchoalveolar lavage fluid (BALF) were collected. The mRNA and protein expression levels of PD-L1 in the lungs were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR) and Western Blot. The pathological changes were observed with microscopy. The protein levels in BALF were determined. The granulocyte differentiation antigen 1 (Gr1) positive cells was determined by cytometry, and myeloperoxidase (MPO) activity in lung tissue was determined. The levels of proinflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and chemotatic factors keratinocyte chemoattractant (KC), macrophage inflammatory protein-2 (MIP-2) in lung homogenates and BALF were determined by enzyme-linked immunosorbent assay (ELISA). Results Compared with sham group, the mRNA and protein levels of PD-L1 in lung tissue of C57BL/6 mice in ALI group were significantly elevated [PD-L1 mRNA (2-ΔΔCt): 3.20±0.76 vs. 1.01±0.03, PD-L1 protein (A value): 0.98±0.16 vs. 0.15±0.04, both P < 0.05]. It was shown by light microscopy that the alveolar wall was thickened, congestive, edema and spot bleeding with a large number of inflammatory cell infiltration in the lung tissue of C57BL/6 mice in ALI group, and an obvious protein leakage was found in BALF (ng/L: 0.18±0.06 vs. 0.05±0.01, P < 0.05). The lung injury degree of PD-L1 knockout ALI mice was significantly less than that of C57BL/6 ALI mice, and the protein leakage was significantly reduced in BALF (ng/L: 0.11±0.02 vs. 0.18±0.06, P < 0.05). Compared with corresponding sham group, the number of Gr1 positive cells, MPO activity in lung tissue as well as the levels proinflammatory factors and chemotatic factors in lung tissue and BALF in ALI group were significantly increased. However, when compared with C57BL/6 ALI mice, above parameters in lung homogenates and BALF were significantly decreased in PD-L1 knockout ALI mice [number of Gr1 positive cells: (39.0±4.0)% vs. (45.0±8.0)%, MPO activity (U·μg-1·min-1): 2.85±0.62 vs. 4.52±1.16; lung IL-6 (ng/g): 461±111 vs. 728±28, TNF-α (ng/g): 1 123±175 vs. 1 500±327, KC (ng/g): 150±34 vs. 250±28, MIP-2 (ng/g): 1 263±468 vs. 1 763±323; BALF IL-6 (ng/L): 134±22 vs. 258±38, TNF-α (ng/L): 598±102 vs. 889±139, KC (ng/L): 934±286 vs. 1 258±336, MIP-2 (ng/L): 650±130 vs. 950±256; all P < 0.05]. Conclusion PD-L1 may play an important protective role in the immunological mechanism of ALI, which may be mediated by decreasing chemotactic factor KC and MIP-2 and mitigating neutrophil chemotaxis in lung tissue.

Objective To analyze the characteristics of change in plasma cholesterol level in patients with sepsis, and to explore its relationship with prognosis and its clinical significance. Methods A retrospective analysis was conducted. 568 patients with sepsis admitted to Department of Critical Care Medicine of Beijing Friendship Hospital Affiliated to Capital Medical University from August 2013 to August 2015 were enrolled, and 475 patients without sepsis hospitalized in the same period served as the control. The basic clinical data of the two groups were collected, and the results of blood fat and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with multivariate logistic model regression analysis. Results Compared with non-sepsis patients, the levels of plasma total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) in the patients with sepsis were significantly lower [TC (mmol/L): 2.5±1.2 vs. 3.4±1.4, t = 4.274, P = 0.021; HDL-C (mmol/L): 1.6±0.9 vs. 2.5±0.8, t = 3.413, P = 0.018], and that of low density lipoprotein cholesterol (LDL-C) showed no statistically significant difference (mmol/L: 1.9±0.9 vs. 2.1±0.9, t = 0.749, P = 0.614). In the patients with sepsis, the patients in death group (n = 227) were older than those of the survival group (n = 341, years: 74.3±15.5 vs. 65.5±17.5, t = 4.037, P = 0.012), serum creatinine (SCr) was higher than that of survival group (μmol/L: 251.0±115.6 vs. 167.4±108.7, t = 3.254, P = 0.023), the levels of plasma TC, HDL-C and LDL-C were significantly lower than those of survival group [TC (mmol/L): 2.2±1.6 vs. 2.9±1.1, t = 3.057, P = 0.023; HDL-C (mmol/L): 1.4±0.8 vs. 1.9±0.8, t = 4.692, P = 0.016; LDL-C (mmol/L): 1.7±0.7 vs. 2.0±0.8, t = 2.541, P = 0.038]; there was no significant difference in the proportion of male, body mass index (BMI), based disease, intensive care unit (ICU) hospitalization time, the severity of the disease and other biochemical indexes between two groups. With single factor analysis with indicators of statistical significance as a covariate into binary logistic regression equation, the results show that age was the risk factor of death in patients with sepsis [odds ratio (OR) = 1.024, 95% confidence interval (95%CI) = 1.010-1.048, P = 0.009], and TC was the protective factor on the prognosis of patients with sepsis (OR = 0.747, 95%CI = 0.682-0.811, P = 0.013). Conclusions Plasma cholesterol levels in patients with sepsis were significantly lowered, and the levels in death group was significantly lower than that in the survival group. TC may be used as a clinical indicator to assess the outcome of patients with sepsis.

Objective To investigate the risk factors of multiple recurrent bile duct stones in patients with common bile duct (CBD) stones and received endoscopic sphincterotomy (EST ) treatment . Methods From June 1st ,2007 to June 1st ,2011 ,the patients received EST treatment were followed up , the follow‐up time was three to seven years .A total of 2 738 patients were successfully followed up , including 24 patients with two or more than two times of recurrent bile stone after EST who were enrolled in multiple recurrence group .One hundred patients without recurrence were randomly selected by table of random number as control group .The clinical data of two groups were compared by t test or Chi‐square test .The factors were analyzed with multivariate Logistic regression analysis and try to find out the risk factors of multiple recurrence .Results The comparative analysis between two groups showed that the three factors of juxtapapillary duodenal diverticula [17 .0% (17/100 ) vs 41 .7% (10/24 )] ,history of biliary tract surgery [13 .0% (13/100) vs 45 .8% (11/24)] and the angle enclosed between the horizontal portion of the CBD and the horizontal plane (angleofbile duct) less than 45° [2 .0% (2/100) vs 20 .8% (5/24)] were statistically significant (χ2 = 6 .914 、13 .37 、9 .595 ,all P < 0 .01 ) . Furthermore , logistic regression analysis indicated that juxtapapillary duodenal diverticula (B = 1 .421 ,OR = 4 .142 ,P = 0 .01) , history of biliary tract surgery (B = 1 .612 ,OR = 5 .011 ,P= 0 .004) and the angle of bile ductless than 45° (B= 2 .661 ,OR= 14 .31 ,P= 0 .005) were risk factors of multiple recurrence .Conclusion Juxtapapillary duodenal diverticula , history of biliary tract surgery , and the angle of bile duct less than 45° are independent risk factors of multiple recurrence of CBD stones .