Objective To explore the value of the apparent diffusion coefficient (ADC)of MRI diffusion-weighted (DW)in diag-nosing pathologic stage and histologic grade of bladder cancer.Methods 42 patients with confirmed bladder cancer underwent pelvic MRI examination including T2 WI and diffusion-weighted imaging (b values of 0 and 1 000 s/mm2 )Based on pathologic results,42 cases of bladder cancer were divided into three groups of Ta-T1 stage (non-muscle invasive),T2 stage (muscle invasive)and T3-T4 stage (around the bladder and other organizations invasive).Of 42 bladder cancers,36 urothelial carcinomas were divided into papillary urothelial neoplasm with low malignant potential (PUNLMP),low grade urothelial carcinoma and high grade urothelial carcinoma group.Tumor diameter and ADC were measured on DW imaging,and compared among different groups.Results The mean size of high grade tumors (4.52 ± 1.61)cm was significantly larger than that of PUNLMP (2.28 ± 0.51)cm and low grade tumors (1.69 ± 0.53)cm.The mean ADC of high grade tumors (0.83 ± 0.27)×10-3 mm2/s was significantly lower than that of PUNLMP (1.46 ± 0.30)×10-3 mm2/s and low grade tumors (1.17±0.11)×10-3 mm2/s (P<0.01).T3-T4 stage tumors showed significantly lower ADC (0.82±0.21)×10-3 mm2/s than T2 (1.01 ± 0.09)×10 -3 mm2/s and Ta-T1 stage tumors (1.24 ± 0.13)×10 -3 mm2/s (P <0.01).Conclusion DW ima-ging combined with conventional MR sequences is useful for displaying morphology of bladder cancer.DW imaging and ADC are use-ful in evaluation of pathologic stage and histologic grade of bladder cancer.

Objective To explore the feasibility of home-based fecal occult blood self-test (home FOBTself-test) in the community colorectal cancer (CRC) screening,thereby to improve the community's compliance with colorectal cancer screening.Method Community medical staff and residents in Dongcheng District was recruited by means of self-reported questionnaires about personal wishes for home FOBT self-test screening since August 2013 to January 2014.Finally,using x2 test and logistic regression analysis to analyze the results of the final questionnaire.Of the total of 6,147 copies of the questionnaire,5 943 copies were valid questionnaires (Community medical staff:resident=114:5 829).Results 88.6％ of community medical staff and 69.1％ of community residents expressed willingness to choose home self-test FOBT.Univariate analysis showed that wishes of community medical staff for FOBT screening were unrelated with gender (P=0.635),age (P=1.000),CRC high-risk or not (P=0.418),awareness of home self-test FOBT(P=0.693).The wishes of community residents for FOBT screening related with gender (P=0.012),age (P=0.000),CRC high-risk or not (P=0.000),awareness of home self-test FOBT (P=0.000).Colorectal cancer risk was the greatest impact on wishes for FOBT screening (OR 值 (95％ CI) =8.594 (7.279-10.148)).Conclusions Home FOBT self-test was simple,fast,easy to use and widely accepted in CRC screening of community residents,therefore it may improve the community's compliance with colorectal cancer screening.Screening for CRC is strongly recommended.

Objective To retrospectively analyze medical data of patients with colorectal cancer (CRC) so as to provide evidence for clinical use of opportunistic screening.Methods A total of 2450 CRC patients (male 1377,female 1073) who were treated at five hospitals in North China during October 2001 and September 2011 and had complete medical records and pathological results were recruited.The correlations of incidenceofCRCwithage,gender,tumorlocationandhistologicaltypeswere analyzed.Results Of all the CRC patients,those less than 50 years old accounted for 18.14％ ; and the incidence of CRC was substantially increased in those over 50 years old.Seventy-three percent of tumor occurred at the rectum and sigmoid colon,6％ at descending colon,7％ at transverse colon and 14％ at ascending colon.Moderately,well or poorly differentiated adenocarcinoma accounted for 50.33％,40.35％and 9.32％,respectively.Histological differentiation was not correlated with age and gender ( P ＞ 0.05 ).Conclusions Age and gender should not be considered a determination of opportunistic screening for CRC.Colonoscopy is recommended as an alternative CRC screening procedure.

Objective To confirm the correlation between pre or post processing semen parameters and clinical pregnancy rate in infertile couples with male factors undergoing intrauterine insemination (IUI) .Methods The pregnancy rate based on ovulation in‐ducing agent in infertile couples with male factors infertility per the 2010 world health organization criteria treated with IUI was e‐valuated .One hundred and twenty eight cycles were divided into pregnant group (16 cycles) and non‐pregnant group(112 cycles) . The pre or post processing semen parameters were retrospectively evaluated .Results The overall pregnancy rate was 12 .5% .All parameters in this study has no statistically significant difference between the two groups (P>0 .05) .Logistic multivariate analysis showed that there was no significant correlation between semen parameters and clinical pregnancy rate (P> 0 .05) .Conclusion There are no significant correlations between semen parameters and clinical pregnancy rate when the normal forms of patients with male infertility was 4% or higher .No semen parameters could predict results of clinical pregnancy .

Objective To study the effects of carpesium abrotanoides petroleum ether fraction on phagocytic function of macrophages and antibody forming cell in mice.Methods The extract carpesium abrotanoides petroleum ether fraction,forty five mice were divided into the control group and low and high dose groups of carpesium abrotanoides petroleum ether fraction by random number table method,15 mices in each group.The low-dose and high-dose groups of carpesium abrotanoides petroleum ether fraction were given 50 mg/kg and 100 mg/kg respectively by gavage for 10 days.The spleen weight,growth index,the phagocytosis of macrophages and the number of antibody-forming cells in peritoneal macrophages of mice were detected by chicken erythrocyte phagocytosis test and hemolytic plaque test.Results Compared with the control group,the spleen weight (192.4 ± 11.49 mg,204.6 4 10.59 mg vs.117.6 ± 10.89 mg),the growth index (6.04 ± 0.54,6.06 ± 0.40 vs.3.89 ± 0.14),antibody forming (1 216.4 ± 94.1,1 548.8 ± 86.4 vs.361.0 ± 11.7),phagocytosis percentage of macrophages (58.60％ ± 2.60％,72.0％ ± 3.08％ vs.35.49％ ± 1.64％),and Phagocytosis index (2.01 ± 0.10,2.69 ± 0.15 vs.0.37 ± 0.06) of the groups of low doses and high doses of Carpesium abrotanoides Petroleum ether fraction significantly increased (P＜0.05).Conclusions The low doses and high doses of Carpesium abrotanoides Petroleum ether fraction can enhance the mice's specific and nonspecific immune function,and protect the immune system of mice.

Objective:To analyze the characteristics of laboratory test results and multimorbidities in elderly patients with rheumatoid arthritis(RA)and thus to provide a basis for the treatment of RA in the elderly.Methods:Retrospective analysis was performed on RA patients admitted to the Second Affiliated Hospital of Nanjing Medical University from March 2018 to December 2020.Patients were divided into an elderly RA(ERA)group(≥60 years)and a non-elderly RA(NERA)group(<60 years).The prevalences of multimorbidities and laboratory results were compared between the two groups, and influencing factors of multimorbidities in ERA patients were analyzed by using binary Logistic regression.Results:There were 215 patients in this cohort, of whom 156 patients were in the ERA group and 59 patients were in the NERA group.The prevalences of comorbid hypertension, diabetes mellitus, coronary heart disease(CHD)and interstitial lung disease in the ERA group were higher than those in the NERA group( χ2=19.890, 6.977, 5.964, 7.484, all P<0.05).The disease duration in the ERA group was longer than that in the NERA group[117.5(36.0, 240.0)months vs.72.0(10.5, 123.5)months, Z=3.142, P=0.002], and the levels of serum C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), urea, creatinine and cystatin C were higher than those in NERA group[9.7(3.2, 24.8)mg/L vs.3.1(3.0, 8.3)mg/L, 31.0(13.0, 53.3)mm/h vs.17.0(11.0, 31.5)mm/h, (5.38±1.54)mmol/L vs.(4.75±1.46)mmol/L, (63.82±15.33)μmol/L vs.(57.31±11.38)μmol/L, (1.23±0.42)mg/L vs.(0.90±0.23)mg/L]( Z=4.275, 2.770, t=2.714, 2.966, 5.714, all P<0.05).The levels of serum magnesium, albumin and hemoglobin were lower than those in the NERA group[(0.84±0.08)mmol/L vs.(0.86±0.06)mmol/L, (37.46±5.32)g/L vs.(40.77±4.95)g/L, (114.52±18.06)g/L vs.(124.32±16.40)g/L]( t=2.653, 4.147, 3.648, all P<0.05).Correlation analysis showed that the level of serum CRP in the ERA group was negatively correlated with serum albumin and magnesium( r=-0.449, -0.329, all P<0.05).Uric acid was positively correlated with rheumatoid factor(RF), cystatin C, urea, age and disease duration( r=0.259, 0.416, 0.210, 0.232, 0.179, all P<0.05), but negatively correlated with hemoglobin and magnesium( r=-0.262, -0.207, all P<0.05).RF was positively correlated with uric acid, urea, total cholesterol, low density lipoprotein, the 28-joint Disease Activity Score(DAS28 score), age and disease duration( r=0.259, 0.177, 0.205, 0.234, 0.248, 0.225, 0.211, all P<0.05), but negatively correlated with albumin and hemoglobin( r=-0.301, -0.182, all P<0.05).Serum magnesium was negatively correlated with CRP, ESR, urea, uric acid and cystatin C( r=-0.273, -0.192, -0.175, -0.207, -0.315, all P<0.05).These correlations were not found in the NERA group.Multivariate Logistic regression analysis showed that factors affecting hypertension in ERA patients were age, RF and albumin.Influencing factors of CHD were age, disease duration, serum magnesium and triglycerides.Factors that affect interstitial lung disease were RF, DAS28 score and albumin. Conclusions:Compared with NERA patients, ERA patients show an elevated level of systemic inflammation and poorer nutrition assessed by relevant parameters.CRP, RF and uric acid have complex correlations with serum magnesium, hemoglobin, and albumin.ERA patients have higher prevalences of multimorbidities.Age, disease duration, RF, triglycerides, DAS28 score, serum magnesium and albumin affect the occurrence of multimorbidities in ERA patients.

During the novel coronavirus pneumonia (COVID-19) pandemic from 2020 to 2021, lung transplantation entered a new stage of development worldwide. Globally, more than 70 000 cases of lung transplantation have been reported to the International Society for Heart and Lung Transplantation (ISHLT). With the development of medical techniques over time, the characteristics of lung transplant donors and recipients and the indications of pediatric lung transplantation recipients have undergone significant changes. Application of lung transplantation in the treatment of COVID-19-related acute respiratory distress syndrome (ARDS) has also captivated worldwide attention. Along with persistent development of lung transplantation, it will be integrated with more novel techniques to make breakthroughs in the fields of artificial lung and xenotransplantation. In this article, research progresses on the characteristics of lung transplant donors and recipients around the world were reviewed and the development trend was predicted, enabling patients with end-stage lung disease to obtain more benefits from the development of lung transplantation technique.

Objective:To explore the value of the static and dynamic pelvic floor MRI and diffusion tensor imaging (DTI) in evaluating the morphology and function of urethra in patients with stress urinary incontinence (SUI).Methods:From July 2020 to February 2021, a total of 28 patients with SUI and 45 age-matched healthy controls were prospectively collected at the First Affiliated Hospital of Zhengzhou University. The static and dynamic pelvic floor MRI and DTI were performed for all subjects. The thickness of internal and external sphincter of middle urethra were measured on static MRI images. The functional urethral length (FUL) was measured both on static and maximal strain phase of dynamic MRI images, then the difference of FUL was calculated. The presence of bladder neck funneling and urethra opening were observed on static and dynamic MRI. The muscle fiber bundle image of urethral sphincter complex was obtained by post-processing of DTI original images. The anisotropy fraction (FA), apparent diffusion coefficient (ADC) and three eigenvalues (λ1, λ2, λ3) of annular sphincter and central longitudinal muscle in middle urethra were measured. The independent sample t test and chi-square test were used to analyse the difference of measured parameters in MRI, parameters of DTI and imaging signs between the two groups. Results:Compared with healthy controls, the SUI patients showed that the thickness of external sphincter in middle urethral and FUL in static status and maximal strain phase were significantly decreased ( t=-3.95, -5.72, -8.41, all P<0.001), the difference of FUL between static status and maximal strain phase was significantly increased ( t=4.41, P<0.001). The positive rate of bladder neck funneling in static status and maximal strain phase, urethral opening in maximal strain phase of SUI group increased significantly (χ2=23.09 , 22.25, 26.59, all P<0.001). In SUI group, the FA value of middle urethral annular sphincter decreased significantly ( t=-3.48, P=0.001), while the ADC, λ2 and λ3 values increased significantly ( t=3.19, 2.15 , 2.06, and P=0.002, 0.038 , 0.046, respectively). There was no significant difference in DTI parameters of middle urethral longitudinal muscle between the two groups (all P>0.05). Conclusions:Static and dynamic MRI and DTI techniques can objectively evaluate the changes of urethral morphology and function of SUI patients. The thinning of the external sphincter in the middle urethra, shortening of the FUL and the destruction of the microstructure of the annular sphincter fiber bundle were the main alterations of SUI patients.

Objective To evaluate the effect of interleukin (IL)-10 on donor lung function after ex vivo lung perfusion (EVLP) in rats of cardiac death. Methods Twenty adult male SD rats were randomly divided into the simple perfusion group (group A, n=10) and modified perfusion group (group B, n=10). Perfusate A (without IL-10) and perfusate B (supplemented with IL-10) was administered in group A and B, respectively. The EVLP rat models of cardiac death were established. The appearance of donor lung, dry-to-wet (D/W) ratio of donor lung tissues, the function and metabolism of donor lung, the morphology of donor lung and the levels of inflammatory markers of donor lung were statistically compared between two groups. Results After perfusion, evident edema of the whole donor lung, poor compliance and a large amount of edema fluid discharged from the airway were observed in group A, whereas no obvious edema and good compliance were found in group B. Compared with group A, the D/W ratio of lung tissues in group B was higher (P < 0.05). In both groups, the pulmonary vein partial pressure of oxygen reached the peak at 2 h after perfusion, which did not significantly differ between two groups (P > 0.05). In group B, the pulmonary artery pressure was increased at a lower speed and significantly lower after perfusion, and the lactic acid level in the perfusate was significantly lower than those in group A (all P < 0.05). In group A, the alveolar structure was largely destroyed and the cells was rare. In group B, the alveolar structure was relatively normal without evident cell edema. The incidence of cell apoptosis of donor lung was high in group A, whereas no obvious cell apoptosis of donor lung was noted in group B. After perfusion for 4 h, the levels of monocyte chemoattractant protein (MCP)-1 and IL-6 were significantly increased, the IL-4 levels were remarkably decreased (all P < 0.05), but the levels of tumor necrosis factor (TNF)-α, IL-1α and inducible nitric oxide synthase (iNOS) did not significantly change in both groups (all P > 0.05). Conclusions IL-10 may improve the function of donor lung after EVLP in rat of cardiac death by reducing cell apoptosis.

BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.