Liver fibrosis can be caused by chronic liver injury arising from various etiological factors and it is a reversible process.The activation of the hepatic stellate cell(HSC)is the central event in liver fibrosis,since we know that cytokines secreted from Kupffer cell participate in HSC proliferation,apoptosis and ECM metabolism.In this paper we focus on the relationship between HSCs,Kupffer cell,cytokines and the course of hepatic fibrosis.Elucidating this relationship will benefit research on the role of Kupffer and HSCs in hepatic fibrosis.

Liver fibrosis can be caused by chronic liver injury arising from various etiological factors and it is a reversible process. The activation of the hepatic stellate cell( HSC) is the central event in liver fibrosis,since we know that cytokines secreted from Kupffer cell participate in HSC proliferation,apoptosis and ECM metabolism. In this paper we focus on the relation-ship between HSCs,Kupffer cell,cytokines and the course of hepatic fibrosis. Elucidating this relationship will benefit research on the role of Kupffer and HSCs in hepatic fibrosis.

Mitogen activated protein kinase(MAPK)is one of the four biggest signal transduction systems which contain four subtribes named p38,ERK5/BMK1,ERK and JNK/SAPK respectively.Previous studies have shown that MAPK pathway is involved in growth,cell differentiation,perishing,the synchronization of cell function and so on.ERK/MAPK,one of the members of MAPK family,and Sma-and MAD-related(Smad)play important roles in the proliferation of fibroblast,modulating inflammation mediator production as well as transferring factors activity in the process of pulmonary fibrosis(PF).This review focuses on relationship between Smads and ERK in the pathogenesis and progression of PF.

Objective To explore the MRI diagnostic value for pernicious placental abnormalities.Methods MRI findings of 1 5 patients with pernicious placenta previa were retrospectively analyzed after cesarean section.Results Among all cases,total placenta previa was,1 1 cases and partial placenta previa was 4 cases.The placenta located in the anterior wall in 8 cases,posterior wall in 4 cases,lateral wall in 3 cases.4 cases were diagnosed as normal placenta,6 cases as adhesion,4 cases as implanted,and 1 case as penetrating.These cases had certain special MR features.Conclusion MRI is helpful in diagnosing the location and type of the perni-cious placenta,and showing whether complicated with previa implantation and penetrating.

Mitogen activated protein kinase(MAPK) is one of the four biggest signal transduction systems which contain four subtribes named p38,ERK5/BMK1,ERK and JNK/SAPKrespectively.Previous studies have shown that MAPK pathway is involved in growth,cell differentiation,perishing,the synchronization of cell function and so on.p38MAPK,one of the members of MAPK family,plays an important role in the activation of inflammation-related cells to release inflammation mediator,modulating enzyme production as well as transferring factors activity in the process of chronic bronchitis(CB).This review focuses on multiple roles of p38MAPK in the pathogenesis and progression of CB.

Lead poisoning has become a big threat to public health in China. Traditional treatments usually use chelators to accelerate the excretion of lead by forming complex compounds with it. However, chelators exhibit side effects and have little therapeutic effect on lead-induced impairment so that better drugs are needed. As antioxidants are effective for the treatment of lead poisoning, with lasting effect and little side effect, they have been the focus of increasing studies. This review provides a detailed account of updates on the effects of antioxidant drugs in the therapy of lead poisoning, and of the progress in antioxidant activity of puerarin, quercetin, curcumin, allicin and melatonin in treatment of lead poisoning. To some extent, these five types of drugs can reduce lead poisoning by accelerating lead excretion and antioxidant, increase the body′s antioxidant enzyme activity, reduce oxidative stress and repair damage, which promises some clinical value.

Objective To understand the distribution and antimicrobial resistance of pathogenic bacteria isolated from patients in the department of infectious diseases in Xiangya Hospital.Methods The distribution and antimicrobial susceptibility testing results of pathogenic bacteria isolated from patients in this department in 2011 -2015 were analyzed retrospectively.Results A total of 560 strains were isolated during 5 years,of which gram-posi-tive bacteria and gram-negative bacteria accounted for 44.1 % (n =247)and 55.9%(n =313)respectively.69.8%(81/116)of coagulase-negative staphylococcus and 24.3%(9/37)of Staphylococcus aureus were methicillin-resistant (MRCNS,MRSA)respectively.Enterococcus was highly susceptible to vancomycin,linezolid,and phosphonomy-cin (>81 %).Enterobacteriaceae remained highly susceptible to carbapenems (88.9%-100.0%),and was suscep-tible to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam (>84%).Acinetobacter baumannii was the major isolated multidrug-resistant organism (MDRO),isolation rate of imipenem-resistant Acinetobacter baumannii increased from 50.0% in 2011 to 77.8% in 2015,its resistance rate to imipenem was 64.9%.Conclusion The majority of clinically isolated pathogenic bacteria from this department is gram-negative bacilli,and detection rate of MDROs showed an upward trend;antimicrobial agents should be chosen according to distribution and antimicrobial resistance of pathogenic bacteria.

Objective To explore distribution and genetypes of plasmid-mediated quionlone resistance genes qnrA.qnrB and qnrS in Enterobacteriaceae isolates iu Renmin Hospital of Wuhan University.Methods The qnrA,qnrB and qnrS genes in Enterobaeteriaceae isolates including nonrepetitive 129 isolates of E.coli.13 isolates of E.cloacae and 37 isolates of k pneunoniae were detected by PCR.Antibiotic suseeptibility testing for 15 antibiotics were also performed by K.B in virto.MICs of ciprofloxacin were determined by agar dilution methed.Plasmid conjugatable test wag applied to examine whether qnrA,qnrB and qnrS genes were located in conjugatable plasmid.For qnr-positive strains,integrase I and SHV-1,TEM-1,CTX-M,OXA-I,OXA-Ⅱ,OXA-Ⅲ,DHA and EBC β-lactamases genes were examined.Results 25 qnr-positive isolates were detected among 179 Enterobaeteriaceae isolates,including 6 qnrA-positive isolates,9 qnrB-positive isolates and 10 qnrS-positive isolates,which were presented in 3.35%.5.02%,and 5.59%respectively.All positive isolates were susceptible to imipenem but resistance to some other drugs.2 qnrA-positive isolates and 4 qnrB-positive isolates of them were susceptible to Quinolones.The plasmid wag eonjugatable in 2 qnrA-positive isolates and 4 isolates carrrying qnrB and qnrS.23 qnrA-positive isolates harbored type 1 Integrase,but one isolate with both qnrB and qnrS did not carry Type 1 Integrage.14 isolates of them were TEM-1 producing strains.6 isolates were OXA-Ⅲ-producing strains.and 7 isolates of them were EBC-producing strains.Conciusions In HuBei province,a low prevalence of qnrA,qnrB and qnrS wag determined in Enterebacteriaceae isolates.Muhidrng-resistance was found in qnr-pesitive isolates and qnr genes were detected in quinolone susceptible strains.Extendedspectrum β-lactamages could be presented in qnr-positive isolates too.

Objective To prospectively and directly compare the capability of whole-body DWI,MRI and/or CT (MRI-CT),and whole-body DWI with MRI-CT for assessment of lymphatic metastases in non-small cell lung cancer (NSCLC) patients.Methods The institutional review board approved this study; informed consent was obtained from patients.A total of 56 NSCLC patients underwent whole-body DWI and thoracic CT scan prospectively.Conventional MRI was performed in suspicious lymphatic metastases parts within one week after inspection.Final diagnosis of the lymphatic metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.Two chest radiologists independently assessed all examination results and used a five-point visual scoring system to evaluate the probability of metastases.Final diagnosis based on each of the methods was made by consensus of two readers.Receiver operating characteristic (ROC) analysis was used to compare the capability for lymphatic metastases assessment among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT.The detection abilities of lymph nodes with different size were compared with x2 test.Value of apparent diffusion coefficient (ADC) in the differential diagnosis of benign and malignant lymph nodes was compared with the variance analysis.Results (1) Lymph nodes metastases were divided into 3 groups according to the length diameter (＜ 2,2-3,＞ 3 cm).A statistically significant difference (x2 =13.819,P ＜ 0.01) was found in detection of lymph nodes (＜ 2 cm) among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT(within the 123 lymph nodes,109,98 and 117 were detected respectively),whole-body DWI with MRI-CT was superior to conventional MRI-CT(x2 =13.324,P＜0.01).There were no statistically significant difference between the other 2 groups (in the length diameter 2-3 cm group,43,40 and 45 of all 46 lymph nodes were detected respectively by whole-body DWI,MRI-CT and whole-body DWI with MRI-CT,x2 =3.816,P ＞ 0.05,while in the length diameter ＞ 3 cm group,all of the 27 lymph nodes were detected by each of them.(2) Conventional MRI-CT was superior to whole-body DWI in the diagnosis of lymph node metastasis in NSCLC.The area under ROC curve value of whole-body DWI with MRI-CT(Az =0.978),the sensitivity,specificity,accuracy (97.4％ 、88.9％ 、86.3％ respectively) were significantly higher than conventional MRI-CT or whole-body DWI.(3)The ADC value of malignant lymph nodes were significantly lower than those of benign [(0.79 ± 0.15) × 10-3 mm2/s vs (1.59--0.15) × 10-3 mm2/s,F =332.813,P ＜ 0.01].The sensitivity,specificity,accuracy were 100％ with the cut-off value of 1.06 × 10-3mm2/s.Conclusions Whole-body DWI is the beneficial supplements of MRI-CT and can be used as a earlier clinical technique in patients with suspected NSCLC lymph node metastasis.Combined with ADC value,it can be used for assessment and differential diagnosis of lymphatic metastases in NSCLC patients.

Objective To investigate the application of whole-body diffusion-weighted imaging (WB-DWI),and to detect bone metastasis in malignant tumor patients.Methods A total of 118 malignant tumor patients prospectively underwent WB-DWI,standard MRI/CT in suspicious bone metastases parts within one week after inspection.Final diagnosis of the bone metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.The differential diagnosis value of apparent diffusion coefficient (ADC) in benign and malignant bone metastases was compared with the variance analysis.Results Area under ROC curve value of WB-DWI with standard MRI/CT (0.999) was larger than that of WB-DWI (0.944) and standard MRI/CT (0.983),and the specificity,accuracy and positive predictive value were also the highest(100.0 ％,97.4 ％,100.0 ％).The ADC values of malignant bone metastases were significantly lower than those of benign lesions[(0.71±0.15)×10-3 mmTs vs (1.50±0.23)×10-3 mm2/s] with a statistically significant difference(F =261.587,P ＜ 0.001).Conclusion WB-DWI is the beneficial supplements of standard MRI/CT.Which can be used for assessment and differential diagnosis of bone metastases in malignant tumor patients combined with ADC value.