Objective The study was to evaluate DWI for quantifying liver fibrosis. Methods A total of 12 volunteers, 47 patients who had chronic HBV or HCV hepatitis and underwent liver biopsy [Scheuer score for fibrosis(S) and inflammation(G)] were enrolled in this study. They were scanned using a 1.5 T MR unit with b value of 0,250,500,750, 1000 s/mm~2. ADCs at b_(250-1000) and b_(500-1000) were the average ADCs of b=250, 500, 750, 1000 s/mm~2 and b=500, 750, 1000 s/mm~2. The studied the correlation between Scbeuer scores and ADC values, and conducted Mann-Whitney U test and Logistic regression to evaluate ADC for prediction of fibrosis scores. Results The average ADCs were (1.41± 0.11),(1.37±0.09), (1.27±0.05), (1.26±0.04), (1.22±0.06) mm~2/s respectively from SO to S4, stage at b=750 s/mm~2 (F=18.31, P<0.01). With the increase of fibrosis score, the average ADC decreased gradually, the two were better negatively correlated at b_(250-1000)(r=-0.727, P<0.01) than other b values. Using b_(750) and the two combined b values, the found significantly lower ADCs in S2 or greater versus S1 or less and in S3 or greater versus S2 or less fibrosis (P<0.01). The best predictor for S2 or greater was b_(750) with the largest AUC of 0.909, sensitivity of 85.7%, and specificity of 100.0% (ADC ≤1.35×10~(-3) mm~2/s). The best predictor for S3 or greater was b_(250-1000) with the largest AUC of 0.864, sensitivity of 69.6%, and specificity of 95.8% (ADC≤1.53×10~(-3) mm~2/s). Conclusion DWI can be a good predictor for scoring liver fibrosis for S2 or S3 stage above, while b_(750) and the combined b values are suitable for evaluation.

Objective To evaluate the value of GeneXpert MTB/RIF assay in the clinical diagnosis of tuberculosis and tuberculosis associated rifampin resistance. Methods A total of 851 patients admitted to the Guangxi Longtan Hospital from September 22, 2015 to May 25, 2016 were enrolled. The smear microscopic examination, solid culture test, and GeneXpert MTB/RIF assay was performed on each patient. Drug sensitivity test of rifampicin using proportion method was done on patients infected with mycobacterium tuberculosis isolated by solid culture, and rifampicin resistance detection was performed on GeneXpert MTB/RIF positive patients. Bacteriological positive consistency test was performed on GeneXpert MTB/RIF and solid culture, and rifampicin resistance detection was compared bwtween GeneXpert MTB/RIF and drug sensitivity using proportion method. Culture and drug susceptibility testing were used as the gold standard, and the MTB sensitivity and specificity of smear microscopic examination, solid culture, and GeneXpert MTB/RIF assay was compared. Results Culture was used as the gold standard. Compared with culture, the sensitivity, specificity, positive predictive value, and negative predictive value of GeneXpert MTB/RIF was 95.48%(211/241), 94.91%(559/569), 87.55%(211/241), and 98.24%(559/569) respectively. The sensitivity of Xpert MTB/RIF for culture positive smear positive specimens and culture positive smear negative specimens was 98.78% (162/164) and 85.96%(49/57) respectively. Drug susceptibility testing was used as the gold standard. Compared with drug susceptibility testing, the sensitivity, specificity, positive predictive value, and negative predictive value of rifampin resistance measured by GeneXpert MTB/RIF was 98.70%(152/154), 92.98%(53/57), 97.44%(152/156) and 96.36%(53/55) respectively. The consistency rate of GeneXpert MTB/RIF and solid culture was 93.83% (Kappa = 0.847), and that of GeneXpert MTB/RIF rifampin resistance detection and proportion method for drug sensitivity was 96.38% (Kappa = 0.904). Conclusions The GeneXpert MTB/RIF detection is easily operated with high sensitivity and specificity compared with smear microscopic examination and solid culture, and it also possesses good consistency with solid culture and traditional drug sensitivity. Moreover, it could also be applied to diagnose the resistance to rifampin, which is very promising in application.

This research was a part of the investigation of traditional Chinese medicine resources survey in Markam. The medicinal plants in natural reserve were studied for the first in this paper. There were 300 species in 202 genera of 54 families, among them there were 7 species of ferns in 5 genera of 5 families, 6 species of gymnosperms in 4 genera of 3 families, and 287 species of angiosperms in 194 genera of 61 families. There were 166 species Tibetan medicinal plants in 102 genera of 47 families. Quantitative analysis was carried out in 6 aspects of family and genus composition, medicinal parts, drug properties, flavour of a drug, Tibetan medicine, toxicity and new plants. The concrete suggestions of protection and exploitation were put forward, which provided scientific basis for the sustainable utilization of medicinal plants in this area.
Biodiversity ; Conservation of Natural Resources ; Medicine, Tibetan Traditional ; Plants, Medicinal ; Tibet

Objective To investigate the surgical techniques and clinical efficacy of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery in the treatment of talus neck fractures.Methods From March 2008 to June 2011,12 cases with talus neck fractures were treated with cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery.External fixation in functional position for 12-14 weeks,and the load time was determined by X-ray fracture healing.Functional results were assessed according to AOFAS (American Orthopaedic Foot and Ankle Society) score at last follow-up.Results Twelve cases were followed up for an average of 24 months (12 to 48 months).One case of skin flap necrosis healed by dressing.All the fractures healed,and the mean healing time was 20 weeks (16 to 24 weeks).AOFAS ankle and hindfoot mean postoperative score was 82.5 (ranging from 55 to 96) points.Among them 4 cases were excellent,good in 5 cases,fair in 3 cases.Two cases presented with mild posttraumatic subtalar arthritis and pain relief after oral anti-inflammatory analgesic.One case with avascular necrosis of talus body,and X-ray displayed sclerosis of talus body,but no collapse,and the patient was told to reduce weight and regularly followed up.Conclusion The application of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery for the treatment of talus neck fractures is an effective treatment,which can improves the blood supply of the talus body and reduces the occurrence of avascular necrosis of the talus.

Objective To study the effects of cooking practice education on their status of nutrient intake and blood glucose control in patients with type 2 diabetes mellitus (T2DM) over 60 years old.Methods Four-hour cooking practice education lecture was offered per month for 57 patients with T2DM over 60-year old based on balance diet and food exchange list,with features including requiring patients joining the lecture with their family members together,demonstration of raw and fresh dietary materials and cooked food,choice of food to eat by the patients themselves according to their own dietary regimen.Sixty patients with T2DM who were only educated by outpatient department of nutrition for 35 minutes were selected as control.After twelve months of education,indices such as scores of awareness of knowledge of food exchange list,status of nutrient intake and blood glucose control,and so on,were compared between the two groups to evaluate the effects of cooking practice education.Results After 12- month education,score of knowledge of food exchange list in the experiment group increased significantly,as compared to that in the control group.Intake of energy [(6304?826) kJ] and fat [(46?6) g] decreased significantly in the experimental group [(6921?860) kJ and (63?9) g,respectively],and fasting blood glucose [(7.1?0.8) mmol/L],postprandial blood glucose [(11.2?1.1) mmol/L] and glycosylated hemoglobin A1c [(6.2?0.5)%] were decreased significantly,as compared to those in the control group [(7.8?0.9) mmol/L,(12.4?1.2) mmol/L,and (6.5?0.7)%)],respectively.Conclusions Cooking practice education is effective to correctly use diet regimen and improve status of nutrient intake and control of blood glucoses for over-60-year patients with T2DM.

12 strains of H2-producing bacteria were isolated and purified from anaerobic sludge, aerobic sludge and river bottom sludge by Hungate method. A new species of high efficient hydrogen production bacterium Enterococcus sp. LG1 (registration number: EU258743 ) was studied deeply. It was showed that the Enterococcus sp. LG1 was an anaerobic and Gram-negative bacterium. Sequence analysis of this type of clones showed that it was affiliated with the genus Enterococcus and it was not reported yet in other paper at present. Meanwhile, batch tests of anaerobic fermentative hydrogen production by Enterococcus sp. LG1 were investigated by using sterilization pretreated sludge as substrate. The changes of soluble COD, protein, carbohydrate and pH value during hydrogen fermentation were monitored. It was found that only hydrogen and carbon dioxide were produced by this strain and no methane was detected during fermentation. The maximal hydrogen yield was 36.48 mL/g TCOD and the hydrogen concentration in the gas phase was 73.5%. The Enterococcus sp. LG1 was a butyrate fermentation bacteria analyzed by metabolites.

Background:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum.Seldom study has compared the application of three-dimensional (3D) printing technology and traditional methods of contouring plates intra-operatively for the surgical treatment of both-column acetabular fractures.We presented the use of both 3D printing technology and a virtual simulation in pre-operative planning for both-column acetabular fractures.We hypothesized that 3D printing technology will assist orthopedic surgeons in shortening the surgical time and improving the clinical outcomes.Methods:Forty patients with both-column acetabular fractures were recruited in the randomized prospective case-control study from September 2013 to September 2017 for this prospective study (No.ChiCTR1900028230).We allocated the patients to two groups using block randomization (3D printing group,n =20;conventional method group,n =20).For the 3D printing group,1:1 scaled pelvic models were created using 3D printing,and the plates were pre-contoured according to the pelvic models.The plates for the conventional method group were contoured during the operation without 3D printed pelvic models.The operation time,instrumentation time,time of intra-operative fluoroscopy,blood loss,number of times the approach was performed,blood transfusion,post-operative fracture reduction quality,hip joint function,and complications were recorded and compared between the two groups.Results:The operation and instrumentation times in the 3D printing group were significantly shorter (130.8 ± 29.2 min,t =-7.5,P ＜ 0.001 and 32.1 ± 9.5 min,t =-6.5,P ＜ 0.001,respectively) than those in the conventional method group.The amount of blood loss and blood transfusion in the 3D printing group were significandy lower (500 [400,800] mL,Mann-Whitney U=74.5,P ＜ 0.001 and 0 [0,400] mL,Mann-Whitney U =59.5,P ＜ 0.001,respectively) than those in the conventional method group.The number of the approach performed in the 3D printing group was significantly smaller than that in the conventional method group (pararectus + Kocher-Langenbeck [K-L] approach rate:35％ vs.85％;X2 =10.4,P ＜ 0.05).The time of intra-operative fluoroscopy in the 3D printing group was significantly shorter than that in the conventional method group (4.2 ± 1.8 vs.7.7 ± 2.6 s;t =-5.0,P ＜ 0.001).The post-operative fracture reduction quality in the 3D printing group was significantly better than that in the conventional method group (good reduction rate:80％ vs.30％;X2 =10.1,P ＜ 0.05).The hip joint function (based on the Harris score 1 year after the operation) in the 3D printing group was significantly better than that in the conventional method group (excellengood rate:75％ vs.30％;x2 =8.1,P ＜ 0.05).The complication was similar in both groups (5.0 ％ vs.25 ％;x2=3.1,P =0.182).Conclusions:The use of a pre-operative virtual simulation and 3D printing technology is a more effective method for treating bothcolumn acetabular fractures.This method can shorten the operation and instrumentation times,reduce Mood loss,blood transfusion and the time of intra-operative fluoroscopy,and improve the post-operative fracture reduction quality.

OBJECTIVETo evaluate the immunophenotype conversion of fibroblasts and its clinical significance in the process of breast tumor stromal remodeling.

METHODSCD34, FAP-α, p63 and a-SMA were detected by immunohistochemistry in 273 breast biopsies, including 60 normal breast tissues, 46 atypical ductal hyperplasia (ADH), 60 ductal carcinoma in situ (DCIS), 47 DCIS microinvasive carcinoma (DCIS-MI) and 60 invasive ductal carcinoma (IDC).

RESULTSThe positive expression rates of CD34, FAP-α and α-SMA in the stromal fibroblasts of normal breast tissues were 93.3%, 6.7% and 18.3%, respectively. Those in the stromal fibroblasts of ADH tissues were 95.7%, 4.3% and 10.9%, respectively. Those in the stromal fibroblasts of DCIS tissues were 95.0%, 8.3% and 15.0%, respectively. Those in the IDC tissues were 35.0%, 85.0% and 93.3%, respectively. The expressions of CD34, α-SMA and FAP-α in the stromal fibroblasts of normal, ASH and DCIS breast tissues did not show significant differences (χ(2) = 1.142, P = 0.896). The main immunophenotype of stromal fibroblasts in the tumor-host interface at the invasive front of ADH and DCIS lesions was CD34(+)α-SMA(+)FAP-α(+). There were statistically significant differences in the expression of CD34, α-SMA and FAP-α between IDC and ADH, DCIS and normal breast tissues (χ(2) = 8.351, P < 0.001). The immunophenotype of stromal fibroblasts in the IDC and DCIS-MI breast tissues was CD34(-) α-SMA(+) FAP-α(+).

CONCLUSIONSImmunophenotype conversion from CD34(+) α-SMA(-) FAP-α(-) to CD34(-) α-SMA(+)FAP-α(+) may be a sensitive indicator to judge whether DCIS has microinvasion. Detection of the immunophenotype conversion of stromal fibroblasts may be helpful to determine the presence of microinvasion, and to improve the diagnostic accuracy rate of DCIS.

Breast ; Breast Neoplasms ; immunology ; pathology ; Carcinoma in Situ ; Carcinoma, Ductal, Breast ; Carcinoma, Intraductal, Noninfiltrating ; Fibroblasts ; immunology ; Gelatinases ; metabolism ; Humans ; Hyperplasia ; Immunohistochemistry ; Immunophenotyping ; Membrane Proteins ; metabolism ; Serine Endopeptidases ; metabolism

OBJECTIVETo detect the expression of proliferating cell nuclear antigen (PCNA) in severely damaged intestinal mucosa due to high-dose 5-FU exposure.

METHODSThirty-two adult C57BL/6J mice were subjected to daily intraperitoneal high-dose 5-FU injection at 150 mg/kg for 5 consecutive days, and on days 1, 3, and 5, the mice were sacrificed to obtain the small intestinal tissue for HE straining and immunohistochemistry for detecting PCNA expression. Another 8 mice with intraperitoneal PBS injection served as the control group.

RESULTSHigh-dose 5-FU exposure of the mice resulted in severe intestinal mucous damage, with complete destruction of the villi and crypts and significantly increased cells positive for PCNA expression (P<0.01).

CONCLUSIONHigh-dose 5-FU treatment can significantly increase the PCNA index, and the cells expressing PCNA can be closely associated with regeneration of the severely damaged mucosa due to the exposure.

Animals ; Antimetabolites, Antineoplastic ; adverse effects ; Fluorouracil ; adverse effects ; Intestinal Mucosa ; drug effects ; metabolism ; pathology ; Intestine, Small ; drug effects ; metabolism ; pathology ; Mice ; Mice, Inbred C57BL ; Proliferating Cell Nuclear Antigen ; metabolism