Objective To investigate the value of diffusion weighted magnetie resonance imaging and apparent diffusion coefficient (ADC) value in the diagnosis of pancreatic cancer.MethodsThe clinical data of 36 patients with pancreatie cancer who were admitted to the Wuxi No.2 People's Hospital from March 2009 to June 2011 were retrospectively analyzed,and the clinical data of 30 healthy volunteers were collected.All candidates received diffusion weighted magnetie resonance imaging examination.The signal intensity ratios ( SIRs ) of the cancer and the pericancerous tissues in the T1 weighted-images (T1WI),T2 weighted-images (T2WI)and diffusion weighted-images (DWI) were compared by using one-way analysis of variance.The ADC values of the cancer and the paricancerous tissues were compared using the paired t test.The differences of the ADC values of the cancer and pericancerous tissues compared with those of healthy individuals were analyzed using an independent sample t test.ResultsThe accuracy rate of preoperative magnetic resonance imaging examination was 92％.The relative SIRs were 0.203 ± 0.190 in the T2 WI,0.399 ± 0.201 in the T1 WI and 0.579 ± 0.291 in the DWI,respectively,with no significant differences across the 3 kinds of images (F=5.92,6.15,6.83,P ＜ 0.05 ),while SIRs of the T1 WI and DWI were significantly higher than that of the T2 WI ( P ＜ 0.05 ).There was no significant difference in SIRs when comparing T1 WI and DWI ( P ＞ 0.05 ).The mean ADC values of the cancer and pericancerous tissues of the pancreatic cancer patients and the pancreatic tissues of healthy individuals were (1.40±0.24) ×10 3 mm2/s,(1.71 ±0.10) ×10-3 mm2/s and (1.73±0.30) ×10-3 mm2/s,respectively,with significant differences across the 3 modes of images (t =10.54,12.08,P ＜ 0.05).ConclusionDWI can show high quality images of the lesions,and ADC value is helpful in the diagnosis of pancreatic cancer.

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

Objective To investigate the protective effect of edaravone against ischemiareperfusion injury in small-for-size rat liver grafts and its possible mechanisms. Methods 40 % small-for-size rat liver transplantation model was established by using modified two-cuff technique, adult male SD rats were used as donors and recipients, and 16 recipient rats were randomly divided into two groups (8 cases in each group), saline control group (control group) and edaravone treatment group (ED group). In the ED group, 3 mg/kg edaravone was given intravenously via penile vein 30 min before transplantation in the recipients. The same amount of saline was given in the control group at the same time points. Serum hepatic function (AST and ALT) and histopathological changes were analyzed; the contents of MDA and SOD, and hepatic myeloperoxidase (MPO) activity in liver grafts after 6 h were determined; and TNF-α levels at 6th h after reperfusion were measured by using enzyme-linked immunosorbent assay (ELISA method). Results As compared with control group,serum AST and ALT levels were significantly reduced at the 6th h after reperfusion in ED group (AST: 825. 50 5±72. 87 vs 1188. 03 ± 124. 04; ALT. 687. 40 5±72. 21 vs 988. 66 ± 91.07, P<0. 01 ).The content of MDA was lower and SOD level was higher in ED group significantly than in control group (P<0. 01). As compared with control group, hepatic TNF-α levels and MPO activity at the 6th h after reperfusion were significantly decreased in ED group (P<0. 01 ). Histopathological analysis revealed disruption of lobular architecture, apparent hepatocelluar degeneration accompanied by focal necrosis, significant edema, congestion and inflammatory cell infiltration in periportal area at the 6th h after reperfusion in control group, but minimal liver damage was observed in ED group. Conclusion Edaravone could ameliorate early ischemia-reperfusion injury in small-for-size liver grafts significantly.The protective mechanisms were mediated in part by increasing antioxidant ability, inhibiting lipid peroxidation, and down-regulating inflammatory reaction.

BACKGROUND:Knee osteoarthritis is characterized by inreversible pathological changes, belonging to arthragia syndrome. The goal of the treatment is to release or relieve symptoms and delay joint degeneration. Jianxi Qianggu Pil is an empirical formula developed by the Third People’s Hospital of Jingzhou, School of Basic Medical Science, Wuhan University, China. This prescription can nourish liver and kidney, eliminate wind and disperse cold, expel wet and dredge the col aterals, consolidate bone and reinforce knee.
OBJECTIVE:To observe the protective effect of Jianxi Qianggu Pil on joint cartilage and expression of bone morphogenetic protein 7 in rabbits with knee osteoarthritis.
METHODS:A total of 36 New Zealand rabbits were randomly divided into three groups, with 12 ones in each. The involved rabbits were applied to establish the model of knee osteoarthritis by using the modified Hulth’s method. At 6 weeks after modeling, the drug group was given 0.1 g/kg Jianxi Qianggu Pil via intragastric administration, while model group and normal control group received equal volume of saline. At 4 weeks after drug administration, rabbit articular cartilage was evaluated with Mankin’s scoring method. The cartilage morphology was observed under electron microscopy, and bone morphogenetic protein 7 expression was detected using immunohistochemistry.
RESULTS AND CONCLUSION:The pathological degeneration degree of articular cartilage in the drug group was significantly lighter, and bone morphogenetic protein 7 expression was significantly higher than the other two groups (P<0.05). Experimental findings indicate that, Jianxi Qianggu Pil can promote the expression of bone morphogenetic protein 7 in articular cartilage of knee osteoarthritis rabbits, thereby promoting articular cartilage regeneration and reducing cartilage deformation or necrosis for the treatment of arthritis.

Objective To analyze the medication rules of the treatment of stroke in Gu Jin Ming Yi Lin Zheng Jin Jian Zhong Feng Juan; To provide references for the clinical treatment. Methods Prescriptions with confirmed efficacy of famous TCM doctors in the history in Gu Jin Ming Yi Lin Zheng Jin Jian Zhong Feng Juan was searched. Excel2003 was used to establish database to analyze medication frequency. SPSS17.0 statistical software was used to conduct cluster analysis, and tree view was used to show results. Results Totally 112 prescriptions for the treatment of stroke of 36 famous TCM doctors were included in the study, including 204 kinds of Chinese materia medica and 1169 times of medication frequency. The high-frequency medicines (>10 times) were Paeoniae Radix Alba, Achyranthis Bidentatae Radix, Angelicae Sinensis Radix, Pinelliae Rhizoma Praeparatum, and Poria. The high-frequency medicine categories were tonifying deficiency medicine (22.58％), pacifying liver and wind medicine (12.31％), activating blood and dispelling stasis medicine (11.89％), clearing heat medicine (11.46％) and dissipating phlegm, cough and asthma medicine (8.72％). Cluster analysis showed that high-frequency medicine (>10 times) could be clustered as 6 categories. Conclusion Gu Jin Ming Yi Lin Zheng Jin Jian Zhong Feng Juan focuses on tonifying deficiency medicine, accompanied with pacifying liver and wind medicine, activating blood and dispelling stasis medicine, clearing heat medicine and dissipating phlegm, cough and asthma medicine, which can be used to guide clinic.

The sterilization effects of constant electromagnetic wave and instant pulse on foods and traditional Chinese medical pills are introduced in this paper. From the velum's voltage variation caused by the outward electric filed,the dielectric properties of membranaceous ion and the pass rate of the membranaceous ion, we could analyze the biological heating effect and the biological non-heating effect. The sterilization effect of constant electromagnetic wave is based on the biological heating effect, while the instant electromagnetic pulse is based on the biological non-heating effect. With the applied electronic field, the voltage of membrane could increase, which results in the gates of K+ open, and the flowing out of K+. And the variation of the membranaceous voltage makes the gates of Ca2+ open. The Ca2+ of large consistency could come into the cell by the gradient of voltage. It could induce the death of the cells. The greater the variation of membranaceous voltage becomes, the higher will be the death rate of the cells.
Electromagnetic Fields ; Electronics ; instrumentation ; Microwaves ; Sterilization ; methods

AIM: To investigate whether rs7903146 polymorphisms in transcription factor 7-like 2 (TCF7L2) gene are associated with susceptibility to type 2 diabetes mellitus (T2DM) in Chinese Uygur population.METHODS: In this case-control study, 935 cases of T2DM patients were recruited in T2DM group, and 971 healthy examination individuals were selected as normal control.The TCF7L2 gene polymorphism was detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrum.RESULTS: Significant differences in the frequencies of CC, CT and TT genotypes and the frequencies of C and T alleles on TCF7L2 rs7903146 were found between T2DM group and control group(P<0.05).As compared with C allele, the patients with T allele had a significantly higher risk of T2DM with OR of 1.190 (95% CI: 1.034~1.371).As compared with CC genotype, the patients with CT genotype had a significantly higher risk of T2DM with OR of 1.374 (95% CI: 1.122~1.683), and the patients with CT+TT genotype had a significantly higher risk of T2DM with OR of 1.307 (95% CI: 1.090~1.567).The levels of fasting plasma glucose, serum creatinine and blood urea nitrogen were higher in all participants with CT+TT genotype of rs7903146 than those with CC genotype, which showed a significant difference (P<0.05).CONCLUSION: The polymorphisms of rs7903146 in TCF7L2 gene may be associated with T2DM in Uygur population from Xinjiang region.The T allele and CT genotype of rs7903146 are the risk factors for T2DM.

Objective To explore the effect on metabolism of glucose and lipids, potential toxicity mechanism and possible biomarker candidates by analyzing urine metabonome changes of rats after oral administration of polychlorinated biphenyl congeners( PCBs) and high fat diet alone or in combination.Methods Male SD rats were divided randomly into control group,high fat diet group, PCBs group and combination group of PCBs and high fat diet.Urine samples were collected after 6-week treatment, 1 H NMR spectra were performed and analyzed by principal component analysis ( PCA) . Results The PCA scores plot of urine 1 H NMR data showed that the combined group could be easily distinguished from the other three groups, suggesting great difference in metabolism.The loading plot of the PCA revealed significant increase in the levels of lactate, glucose, creatine, 2-hydroxy-isovaleric acid and reduction in the levels of citrate, succinate, taurine, hippurate and trimethylamine oxide ( TMAO) in the combined exposure group after six-week exposure.Conclusion The altered levels of metabolites induced by combined exposure of PCBs and high fat diet may be related to the injury to mitochondrial function, reduction of energy metabolism in tricarboxylic acid cycle (TAC).These effects possibly lead to perturbations in the metabolism of glucose, lipid and amino acids.The altered metabolites may be considered biomarker candidates of toxicity induced by exposure to PCBs and high fat diet.

Objective To detect the expression of miR-122 in hepatocellular carcinoma (HCC) cells and tissues,and to explore the role and the underlying mechanisms of miR-122 in HCC cells on invasion and migration.Methods Real-time quantitative polymerase chain reaction of analysis was used to examine the expression of miR-132 in HCC cell lines,a normal liver cell line,HCC tissues and adjacent non-tumor tissues.Over express or inhibit miR-122 by transfection.The invasion and migration of HCC cells were analyzed by Transwell assays.Meanwhile,related mechanism proteins were detected by western blot,including insulin like growth factor 1 receptor(IGF-1 R),E-cadherin,vimentin.Results The expression of miR-122 was decreased in HCC tissue samples compared with the adjacent non-tumor tissues[(20.5 ± 4.2) × 10-4 vs.(30.3 ± 5.6) × 10-4],especially in HCC tissue samples with HBV [(25.6 ± 3.5) × 10-4 vs.(19.1 ±3.2) × 10-4].The same results were observed in HCC cell lines.MHCC-97H cells exhibited lowest level of miR-122 expression[(33.7 ± 1.3) × 10-3],whereas SMMC-7721 exhibited the highest level of miR-122 expression [(65.3 ± 1.3) × 10-3].MiR-122 over-expression suppressed the invasion and migration of MHCC-97H[(218.7±24.0) vs.(418.0 ±23.4),(392.7±12.8) vs.(706.6±19.8)].Knocking down miR-122 promoted the invasion and migration of SMMC-7721 [(233.0 ± 14.4) vs.(145.0-±8.0),(561.3 ±9.6) vs.(218.0 ± 11.3)].Western blot revealed that miR-122 suppressed the expression of IGF-1R,Vimentin and facilitated the expression of E-cadherin.Conclusions The study indicates that miR-122 is downregulated in HCC,especially in HCC tissue samples with HBV.MiR-122 can suppress invasion and migration of hepatocellular carcinoma by regulating IGF-1R and epithelial mesenchymal transition,and may provide a new therapeutic option for HCC.

Objective To evaluate the clinical efficacy of single plate,double plates,and intramedullary nail in treating medial cortical comminuted fractures of the medial distal femur.Methods A retrospective case control study was conducted on 63 cases of medial cortical comminuted fractures of the medial distal femur treated from November 2011 through October 2016.According to the type of internal fixation,19 cases of middle and distal shaft fractures were divided into the single plate group (n =11) comprising four males and seven females,aged averagely 57.5 years,and intramedullary nail group (n =8) comprising five males and three females,aged averagely 56.4 years.Forty-four cases of distal femoral fractures were divided into the single plate group (n =14) comprising six males and eight females,aged averagely 57.6 years,intramedullary nail group (n =9) comprising five males and four females,aged averagely 56.6 years,and double plates group (n =21) comprising 14 males and seven females,aged averagely 55.1 years.The rate and period of racture healing,distal femoral valgus resection (DFVR),femoral angle,change of DFVR and femoral angle,and complications were compared within and between groups.Results All the cases were followed up for 6-37 months (mean,13.4 months).Of 19 cases of middle and distal shaft fractures,there were no statistically significant differences in fracture healing rate and period,DFVR after operation and at the last follow-up,and the amount of change of DFVR between the single plate and double plates group (P ＞ 0.05).With respect to postoperative complications of the two groups,no significant difference was found for the rate of nonunion,infection,internal fixation failure,and mal union (P ＞ 0.05).However,the incidence rate of adverse events in single plate group (46％) was significantly higher than that in intramedullary nail group (0) (P ＜0.05).Of the 44 cases of distal femoral fractures,the pairwise comparisons among three groups showed no statistically significant differences in fracture healing rate,healing period,and the post operative femoral angle (P ＞ 0.05).The femoral angle at the last follow-up in intramcdullary nail group was (80.80 ± 2.93) °,significantly lower than (85.28 ± 5.89) ° in single plate group and (83.55 ± 3.51) ° in double plates group (P ＜ 0.05).Within the intramedullary nail group,no significant difference was found between the femoral angle immediately after operation and at the last follow-up (P ＞ 0.05),but significant difference was detected in both single plate group and double plates group (P ＜ 0.05).The amount of change of the femoral angle in intramedullary nail group [(0.25 ± 1.95) °] was significantly lower than (4.03 ± 3.78) ° in single plate group and (2.60 ± 2.24) ° in double plates group (P ＜ 0.05).With respect to post operative complications in the three groups,no significant difference was found for the rate of nonunion,infection,internal fixation failure,and malunion (P ＞ 0.05).The malunion rate in single plate group (36％) was significantly higher than that in double plates group (14％).The incidence rate of adverse events in single plate group (50％) was significantly higher than that in double plates group (14％) (P ＜ 0.05).Conclusions Three internal fixations have similar clinical results in fracture healing rate and period.For medial cortical comminuted middle and distal shaft fractures,and distal femoral fractures without involving articular surface,intramedullary nail has better results than locking plate.For medial cortical comminuted distal femoral fractures involving articular surface,double plates fixation might be a better option.