Objective To analyze the MRI characteristics of hematospermia seminal vesiculitis(HSV) and evaluate the diagnostic value of MRI in HSV. Methods The MRI parameters of 25 HSV patients underwent magnetic resonance imaging(MRI) imaging with SE T 1WI(TR/TE 558/14ms), Flash 2D water excitement(TR/TE 18.5/5.2ms), TSE T 2WI(TR/TE 4000/99ms) and fat suppression sequences were retrospectively analyzed. Results The bilateral seminal vesicles in all 25 patients with HSV enlarged. On SE T1-weighted images, intraseminal vesicle hemorrhage appeared as high signal intensity, which appeared more bright on Flash 2D water excitement sequence. The hypointensive duct wall of seminal vesicles could be clearly seen because of hyperintensive hemorrhage. On TSE T2-weighted images, intraseminal vesicle hemorrhage appeared as relatively lower signal intensity, and the duct wall of seminal vesicles could not clearly be depicted for being covered with relatively hypointensive hemorrhage. Conclusion Hematospermia seminal vesiculitis could be identified by MRI, and MRI was the best imaging method for examining hematospermia seminal vesiculitis.

Objective　To study the changes of quantitative expression,adhering activity and genomic density polymorphism of complement type 1 in erythrocytes (CR1) of patients with liver cancer (104 patients) and their clinical significance.Methods　Polymerase chain reaction (PCR),HindIII restriction enzyme digestion,the quantitative assay of ECR1 and the adhering activity assay of CR1 in erythrocytes were used.Results　No difference was observed between the patients with liver cancer (29.8%) and healthy individuals (25.3%) in the spot mutation rate of CR1 density gene (χ2 =0.537,P>0.05).The number and the adhering activity of CR1 in patients with liver cancer (0.83±0.22 and 47.1±6.5) were significantly lower than those in healthy individuals (1.26±0.33 and 62.4±7.6; t=10.5,P<0.0001).The number and the adhering activity of ECR1 in high expression genomic type (HH) liver cancer were obviously lower than those of healthy individuals,expecially those of the patients with advanced liver cancer.There was a good relationship between quantitative expression,adhering activity of ECR1 and liver cancer development.Conclusion　Defective expression of CR1 in liver cancer is mostly acquired through central peripheral mechanisms.The changes of CR1 quantitative expression and adhering activity are consanguineously related to the severity and the activity of the development in patients with liver cancer.

Objective To investigate the influence of the core-veneer interfacial surface roughness on the flexural strength and failure mode of bilayered lithium-disilicate ceramic structure.Methods Forty IPS e.max Press bar-shaped specimens were fabricated and divided randomly into 4 groups.The core-veneer interfacial surfaces of the core materials were ground to specific surface roughness with silicon carbide papers of various grits.Specimens of the groups A,B and C were ground by silicon carbide papers of 1000 grits,600 grits and 320 grits,respectively.While specimens in group D were sandblasted without any grinding as recommended by the manufacturer's instruction.After veneer application and sintering,the flexural strength of bilayered specimens were measured utilizing three-point bending test,and the failure mode was observed using stereomicroscopy.Results The mean flexural strength value of bilayered specimens for groups A,B,C and D were (164.27±15.02),(159.21± 15.72),(156.14±17.10) and (152.97±15.61) MPa,respectively.However,there was no significant differences in fracture strength between groups (P＞0.05).All specimens demonstrated cohesive failure of veneer porcelain right underneath the indenter,without any core-veneer delamination.Conclusions The influence of core-veneer interfacial surface roughness on flexural strength of bilayer lithium-disilicate-based ceramics is not significant.The superior bond between core and veneer provides a reliable interface.

Objective To study the value of CT and MRI in diagnosis of Caroli disease. Methods CT and MR findings in 10 patients with histologically proved Caroli disease were retrospectively reviewed. All the patients underwent both liver plane CT and contrast-enhanced CT. Five of 10 patients underwent MR imaging with Flash 2D T_1WI(TR/TE 148/4ms), True Fisp T_2WI(TR/TE 5.8/2.9ms) and MRCP(TR/TE 1120/86ms) sequences. Results The imaging paremeters of Caroli disease were multiple saccular/columnar dilatation of intrahepatic biliary ducts and communication with each other, which only partly were depicted at CT, however, all imaging findings were depicted at MRI True Fisp and MRCP without contrast-enhanced scanning. Of 10 patients, 4 cases were type Ⅰ of Caroli disease with hepatolith, but without hepatic cirrhosis and portal hypertention; 6 cases type Ⅱ,all complicated with hepatic cirrhosis and portal hypertension. Of 6 patients with type Ⅱ Caroli disease, 4 cases had not hepatolith, and 2 cases had hepatolith. Of 10 patients, 3 cases had bilateral sponge kidney. Conclusion Caroli disease could be identified by CT or MRI, but MRI was superior to CT in depicting Caroli disease.

Problem-based learning(PBL)plays an improtant role in fostering the ability of problem-solving,creative thinking and active learning of medical undergraduates.Based on the present clinical education resources,how to implement PBL at the largest advantages is the main issue we should concern.

ObjectiveTo estimate the cognitive function of subarachnoid hemorrhage patients with negative digital subtraction angiography(DSA),and analyse its relevant factors and clinical characteristics.Methods 96 subarachnoid hemorrhage patients were selected,and the disease condition were classfied into different grades by Fisher scale,Hunt-Hess scale and the cognitive function were estimated by mini-mental state examination (MMSE),then calculated its incidence,analysed the relationship between the classification and cognitive impairments.ResultsThe incidences of cognitive impairment in subarachnoid hemorrhage patients with negative DSA were 51.04％.Cognitive impairment was closely related to Hunt-Hess and Fisher grade (P＜ 0.01 ).ConclusionSubarachnoid hemorrhage patients with negative DSA exist different extent of cognitive impairment.The higher Hunt-Hess or Fisher grade,the more serious cognitive impairment.

Objective To investigate renal expression of ApoE in human lupus nephritis (LN) and its relationship with renal damages.Methods Renal expression of ApoE was examined in 40 LN patient biopsy samples by immunohistochemieal staining.The relationship between ApoE levels" and renal pathologic changes,renal injuries was analyzed.Results Only weak ApoE expression was found in normal renal tissue.The expression of ApoE was significantly higher in LN patients [ glomerular:(31.2±11.0) vs (3.0±1.6);tub-ular:(71.64±8.90) vs (0.60±0.06)].The expression of ApoE was higher in class IV than non-class IV LN [glomerular: (38.4±4.5) vs (18.0±4.6);tubular: (77.6±2.5) vs (60.0±3.2)].Spearman's relation-ship analysis showed that the expression of ApoE in glomerular and tubular was closely related to the renal histological score activity index and functional changes in LN (P＜0.01).Conclusion The expression of ApoE is high in renal tissues of LN,especially in class IV,and the high expression may be associated with LN activity and progressive renal dysfunction.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

Objective To study the effect of phonophoresis on transdermal delivery of sinomenine hydrochloride ( SH ) gel in vitro. Methods Ultrasound at one of two frequencies ( 800 kHz or 1 MHz) was applied with a sonicator with a transducer in this study. The skin of male Sprague-Dawley rats was used as the model and SH gel was used as the ultrasound couplant. The permeation rate of SH was detected using a modified Franz diffusion cell maintained at 32±0.5℃ and filled with 20% polyethylene glycol 400 physiological saline solution. The transdermal phonophoresis experiments were carried out in five groups: Group Ta, f=800 kHz, / = 0.75 W/cm2, t = 10 min:Group Tb,f=1 MHz,I=0.7 W/cm2, t=10 min; Group Tc,f=1 MHz,I=0.35 W/cm2, t=10 min; Group Td,f=800 kHz, I = 1.5 W/cm2, t = 10 min and Group Tc,f=800 kHz, I=1.5 W/cm2,t=5 min. There was also a control group (C) in which the SH was allowed to diffused passively. Samples were withdrawn at the indicated intervals and the concentration of SH was determined by high-performance liquid chromatography. The transdermal parameters such as average accumulated delivery quantity per unit area Q8h, average transdermal steady delivery rate J, and Tlag were calculated. Results The Q8h and Js of the control group were 20.65±10.23 μ/cm2 and 3.02±0.11μ/cm2/h respectively. The phonophoresis parameters in groups Ta and Tb were, on average, significantly higher than in the control group. The parameters in group Tb were significantly larger, on average, than in Te. In group Td the parameters were significantly larger than in groups Ta and Te. Conclusions The results show that phonophoresis can enhance the transdermal delivery of SH. Phonophoresis variables such as frequency and time influence its effects on drug permeation. Almost no change was observed in the structure of the skin after phonophoresis, though under a scanning electron microscope the surface of the corneum appeared rough and porous. Phonophoresis is there-fore an effective and safe method for SH transdermal delivery, and the effect is positively relation with the applied intensity and exposure time.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.