Objective To study CT and MRI manifestation of untypical cystic lymphangioma.Methods CT and MRI findings of 8 cases of cystic lymphangioma proved surgically and pathologically were analyzed retrospectively.7 cases were performed by CT and the other by MRI.Results 3 lesions are located at facies cranii,2 lesions at neck,2 lesions are located at mesostenium and 1 lesion is located at chest wall.CT and MRI findings include:(1)dense mass(5 cases);(2)lesion contain solid and water dense(2 cases);(3)lesion contain high dense hematoma(2 cases);(4)calcification in lesion(2 cases);(5)infiltrate the adjacent tissue(3 cases).Conclusion Most majority cystic lymphangioma can be identified by CT and MRI which also helpful to evaluation lymphangioma before surgical treatment.

Objective To observe the expression of N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin(IL)-6 and TNF(tumor necrosis factor)-α in patients with acute lung injury(ALI),and to evaluate its value in the evaluation of severity and prognosis of lung injury.Methods A total of 76 patients with ALI treated in this hospital from August 2015 to August 2016 were enrolled in this study and 50 healthy subjects were selected as the control group.The levels of NT-proBNP,IL-6 and TNF-α in the serum of the two groups were compared and their relationship with prognosis were evaluated.Results The levels of NT-proBNP,IL-6 and TNF-α in serum of ALI group were significantly higher than those of healthy control group(P<0.05).The levels of NT-proBNP,IL-6 and TNF-α in the patients with severe lung injury were significantly higher than those in the patients with moderate lung injury(P<0.05);and each index in the patients with moderate lung injury was also significantly higher than those in the patients with mild lung injury(P<0.05).The NT-proBNP,IL-6 and TNF-α levels of the patients with ALI in the death group were significantly different from those in the survival group(P<0.05).Conclusion The levels of serum NT-proBNP,IL-6 and TNF-α can not only reflect the severity of lung injury,but also have a high predictive value for prognosis.

Objective To evaluate the value of DWI in detecting active sacroiliitis in patients with axial spondyloarthritis ( SpA) .Methods DWI and conventional MRI examinations were done oblique coronary on bilateral SIJs of 19 participants,involving 8 patients (the case group) underwent clinical and conventional MRI evaluation for axial SpA active sacroiliitis and 11 healthy volunteers(the control group).The conventional MRI,DWI,ADC,EADC images were transmitted to two experienced radiologists respectively to read ,evaluate and measure ( the ADC values and EADC values ) at the workstation under the blind method .The experimental data were inputted and analyzed by statistics software .Results In the control group ,the periarticular bone marrow in the SIJ showed hopyintense signal on the DWI image ,hypointense signal on the ADC image and hyperintense signal on the EADC image .The periarticu-lar bone marrow oedema showed hyperintense signal on the DWI and ADC images , while hopyintense signal on the EADC image.At b values of 300s/mm2 ,the ADC values of the periarticular bone marrow oedema at each side in the case group were significantly higher than those in the control group , while EADC values were lower , the difference were statistically significant(Z=-3.115,-2.814,-3.002,-3.115,-3.115,-2.714,-2.889,-3.115,all P<0.05).Conclusion DWI can directly detect the signal changes ,extent of the periarticular bone marrow oedema , and analyze the severity of oedema quantitively ,which shows the utility in determining the activity and early diagnosis .

Objective To explore the value of water -based material decomposition images for detection of bone marrow edema (BME)in sacroiliitis with energy spectral CT.Methods The sacroiliac (SI)joints of nine spondyloarthropathy patients with sacroiliitis (the research group)and eight healthy volunteers (the control group) were underwent MRI and energy spectral CT.The mixed energy image of energy spectral CT was reconstructed to be mono energy image.Then,the mono image was divided into water -based image and calcium image by material divid-ed and analyzed software.The SI para -articular marrow region water -calcium relative concentration of research group was compared with that of control group.The BME diagnosis efficiency and optimal water -based concentration of energy spectral CT was analyzed by receiver operating characteristic (ROC)curve.Then,the sensitivity,specificity, positive likelihood ratio and negative likelihood ration were calculated.Results The water -based concentration of BME in research group (1 067.43 ±10.84)g/L was higher than that of control group (1 039.43 ±8.01)g/L(t =-3.14,P =0.003).Meanwhile,the calcium -based concentration of research group (68.98 ±20.53)g/L was not different from control group (78.03 ±26.39)g/L(t =1.88,P =0.066).ROC curve showed that the diagnosis efficiency was medium as the area of under curve was 0.75.When the optimal concentration of water -based was 1 052.00g/L,the diagnosis efficiency was the best.The sensitivity and specificity was 84.00%,62.50% respectively. Conclusion There are reference value and potential clinical value with energy spectral CT water -based concentra-tion detection for diagnosis BME in patients with sacroiliitis.

Objective To observe the clinical outcome of modified posterolateral approaches for the treatment of posterolateral tibial plateau fractures. Methods From January 2012 to January 2015,13 patients with posterolateral tibial plateau fractures were identified in the Second Hospital of Changzhou Affiliated to Nan?jing Medical University. All the posterolateral fractures were fixated with a plate. The knee function was evaluated at the last follow?up by the Hospital for Special Surgery( HSS) Score,and the occurrence of postoperative compli?cations were observed. Results Thirteen patients were followed up for an average of 14. 4 months,all patients obtained bony union. There were no significant differences regarding the mean HSS score among 3 months, 6 months and 1 year post?operation((71. 6±1. 5) points, (76. 4±1. 6) points, (83. 2±1. 1) points;P=0. 154) . There were no significant differences regarding the tibial plateau angle and posterior slope angle on radiograph?ies of inside and outsideamong immediate,6 and 12 months postoperation((83. 7±1. 7)°,(84. 3±1. 5)°,(85. 1 ±1. 4)°,(85. 4±1. 5)°;(7. 7±1. 5)°,(7. 7±1. 4)°,(7. 7±1. 3)°,(7. 6±1. 8)°;P=0. 223,0. 191). No com?plications associated with the approach were observed and there was no infection,no malunion or fixation failure either. Conclusion In the treatment of posterolateral tibial plateau fractures,the modified posterolateral approa?ches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating.

Objective To explore the effects of lipoxin A4 ( LXA4 ) on lipopolysaccharide ( LPS)-induced oxidative stress in human umbilical veins endothelial cells(HUVEC) and the possible mechanism.Methods Neonatal umbilical cords were obtained from normal term pregnant women with cesarean section within 4 hours and then were used to isolate HUVEC for subculture.HUVEC were divided into four groups:control group; LPS group ( 10 μg/ml of LPS); LPS + LXA4 group ( 10 μg/ml of LPS and 100 nmol/L of LXA4); LXA4 group (100 nmol/L of LXA4) All expriments were performed after cells treated for 12 and 24 hours respectively.Immunofluorescence was used to detect the expression of Ⅷ foctor and nuclear translocation of nuclear factor-erythroid-2-related factor 2 ( Nrf2 ); the mRNA expression of Nrf2, heme oxygenase 1 (HO-1) and reduced form of nicotinamide-adenine dinucleotide quinone oxidoreductase-1(NQO1) were evaluated by reverse transcription-PCR .Results (1)The flavovirens fluorescence was observed in the cytoplasm under fluorescence microscope, which confirmed the existence of Ⅷ factor which specifically expressed in endothelial cells, especially in HUVEC.(2)Immunofluorescent results showed that in control group, Nrf2 protein expressed in the cytosol rather than in the nucleus.In LPS group, the expression of Nrf2 protein obviously increased in the nucleus while decreased in the cytosol after 12 hours.However, after LPS treatment for 24 hours, Nrf2 expression reduced in the cytosol and nucleus.In cotreatment with LPS and LXA4 group,the expression of Nrf2 protein was much higher than that in LPS group after 12 hours or 24 hours.Furthermore, Nrf2 protein also mostly expressed in the cytosol in LXA4 group.(3) After stimulation for 12 hours, compared with control group, the gene expression of Nrf2 and HO-1 were significantly enhanced in LPS group (0.581 ± 0.019 and 0.081 ±0.009, P ＜ 0.05 ) and in LPS + LXA4group(0.692 ±0.048 and 0.136 ± 0.018, P ＜ 0.05 ), the level of NQO1 mRNA in LPS group and LPS +LXA4 group were 0.381 ± 0.009 ( P ＞ 0.05 ) and 0.574 ± 0.034 ( P ＜ 0.05 ).After treatment for 24 hours,compared with control goup, the gene expressions of Nrf2 and NQO1 were down-regulated in LPS group (0.180±0.017 and 0.472 ±0.064, P＜0.05).But in LPS + LXA4 group the expression of Nrf2 and NQOI were upregulated (0.532 ± 0.051 and 0.830 ± 0.068, P ＜ 0.05, compared with treatment for LPS group).The mRNA expressions of Nrf2, HO-1 and NQO1 were increased in LPS + LXA4 group compared with LPS group ( P ＜ 0.05 ).In addition, there was no markedly difference in the expressions of Nrf2, HO1 and NQO1 between control and LXA4 group after 12 hours and 24 hours ( P ＞ 0.05 ) .Conclusion Through activating nuclear translocation of Nrf2 protein from cytoplasm, LXA4 upregulates the Nrf2downstream enzymes, such as NQO1 and HO-1 to protect HUVEC against the oxidative stress induced by LPS.

Objective To explore whether lipoxin A4 (LXA4)could prevent lipopolysaccharide (LPS)-induced human umbilical vein endothelial cells (HUVEC) monolayer hyperpermeability and its possible mechanism. Methods Human umbilical cords were obtained from women with normal pregnancy immediately after delivery from Tongji Hospital Affiliated of Tongji Medical College. Primary HUVEC were isolated from umbilical veins and subcultured, then, HUVEC were divided into four groups:control group;LPS group (10 mg/L of LPS); LPS + LXA4 group(10 mg/L of LPS and 100 nmol/L of LXA4); LPS +LXA4 + BOC-2 group [10 μmol/L of BOC-2, an effective antagonist of formyl peptide receptor like 1 (FPRL-1)]. All expriments were performed after cells were treated for 24 hours. Endothelial permeability was measured by fluorescein isothiocyan-ate labelled bovine serum albumin (FITC-BSA) clearance across the monolayer; tumor necrosis factor α(TNF-o) mRNA and secretion were detected by reverse transcriplase (RT) -PCR and ELISA assay respectively, and nuclear factor κB(NF-κB) protein change was determined by western blot. Results (1) LPS induced a significant increase in the permeability [Pa value of LPS group was (183.1 ±1.7)%], while co-administrating with LXA4 obviously attenuated this LPS-induced hyperpermeability, Pa value of LPS + LXA4 group was (103.1 ±2.2)%, LPS + LXA4 + BOC-2 group was (162.2 ± 2.8)%, control group was 100%, the permeability of HUVEC monolayer was significantly increased by LPS which was (83.1 ± 1.7)% of control (P <0.01), however, it was notably inhibited by LXA4 (P<0.05); the blockade of FPRL-1 could attenuate the effect of LXA4, that is, there was no difference between the LPS + LXA4 + BOC-2 group and the LPS group. (2) After treatment with different concentration of LPS(0,0.1, 1,10 mg/L), the mRNA expressions of TNF-α were increased (1.11 ±0.11,1.27 ± 0.03, 1.60 ± 0.06, 1.82 ± 0. 04, respectively), compared with the control group, at the concentration of 1,10 mg/L LPS, the difference was statistically significant (P<0. 05). (3) The increased levels of NF-κB and inflammatory mediator TNF-α in the LPS group were both inhibited by LXA4. Levels of NF-κB protein and TNF-o mRNA secretion in LPS treated group (0.53 ±0.06 and 0.81 ±0.09 ,respectively)were both inhibited by LXA4 (0.19 ± 0.05 and 0.41 ± 0.07, respectively, and both had significant difference, P<0.05). (4) Levels of TNF-α in HUVEC culture medium of LPS group [(31.94 ±0.01)ng/L] was significantly higher than the control group [(18.17 ± 0.03) ng/L, P<0.05], LPS + LXA4 group [(15.72 ± 0.07) ng/L] was significantly lower than the LPS group (P<0.05). Conclusion Our findings demonstrated that LXA4 could prevent the endothelial cell hyperpermeability induced by LPS in HUVEC under which the possible mechanism was through inhibiting the expression of NF-κB and its related cytokines through receptor-dependent.

Objective To evaluate the clinical application of CTA in the bronchial artery embolization treatment.Methods TwentyGeight patients undergoing bronchial artery embolization treatment were divided into two groups.Patients with the examination of bronchial artery CTA before interventional treatment were in group A,others in group B.In group A,according to the distribution of the bronchial artery shown by the CTA,the appropriate catheter was selected for the bronchial artery angiography and embolization.In group B,various catheters for the bronchial artery angiography were performed to find the responsible blood vessels for embolization.The total therapeutic effect, operation time,DSA exposure time and contrast agent were compared between the two groups.Results The pretreatment CTA and DSA contrast were compared and the consistency of the bronchial artery was 90.9%.The effective efficiency of group A was 100%, and the effective rate of group B was 83.3 3%.The time of operation was (6 6.9 ± 1 4.5 )min in group A and (1 3 3.5 ± 1 9.4)min in group B,respectively.DSA exposure time was (2 7.9 ± 1 3.8)min and (5 5.1 ± 1 7.2 )min respectively,and the contrast agent dosage was (89.7±1 7.1)mL and (235.1±1 6.6)mL respectively.The differences between the two groups were statistically significant (P＜0.0 1).Conclusion The bronchial artery CTA examination before interventional treatment is an advantage in increasing the success rate,saving time,and improving efficacy.

OBJECTIVE To explore mecha-nisms of imperatorin on regulating P-glycoprotein(P-gp)in blood-brain barrier(BBB)based on net-work pharmacology combined with in vitro experi-ment.METHODS Drug targets were predicted using the Pharmapper and Swiss targets data-bases;disease targets were obtained through the Genecards database;intersections between drugs and disease targets were screened by Cytoscape software;the obtained core targets were used to construct protein-protein interaction(PPI)network,gene ontology(GO)functions,and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.The effects of imperatorin(20,50,100 μ mol·L-1)on P-gp activity were monitored in hCMEC/D3in vitro BBB model,and the effects of imperatorin on the expression of target proteins were verified using Western blot method.RESULTS 55 drug targets and 3102 disease targets were obtained from the network pharmacology screening,and 37 core targets were obtained after the combination.Enrichment analysis showed that core targets were closely related to chemical synaptic trans-mission regulation,neurotransmitter receptor activity,proteinkinaseregulationactivity,G protein-coupled receptor signaling pathway,neural active ligand receptor interaction pathway,PI3K-Akt sig-naling pathway,VEGF signaling pathway,etc..In vitro experimental validation suggested that all tested concentration groups of imperatorin signifi-cantly reduced the activity and expression of P-gp,which were achieved by significantly downregu-lating the phosphorylation levels of PI3K and Akt,and repressing the expression of VEGFR2 pro-tein.CONCLUSION Network pharmacology was used to predict the core targets and signaling pathways of imperatorin on regulating P-gp in BBB and relevant validation was conducted through in vitro experiments,providing a refer-ence basis for further exploration of the mecha-nisms of imperatorin on regulating P-gp in BBB.

Objective To explore the feasibility of in vitro biological soft tissue imaging by using synchrotron radiation phase contrast CT.Methods Three samples of resected human cardia,two samples of resected human esophageal carcinoma and esophagus,as well as two samples of middle cerebral artery tissue extracted from corpses were fixed and airdried at room temperature for synchrotron radiation phase contrast CT imaging.The images of soft tissue structures were observed and compared with pathological findings.Results The images of synchrotron radiation phase contrast CT showed three-layer structure of cardia and esophagus,mucous,submucosa and muscular layer.The surface of mucous layer was smooth.The images of esophageal carcinoma showed cancerous tissue infiltrating esophageal wall.The wall and lumen of cerebral arteries could be also clearly displayed.Conclusion Synchrotron radiation phase contrast CT imaging can clearly display fine structures of in vitro biological soft tissue.