Objective To explore the role of ppk1 gene in E.coli CFT073 strain during urinary tract infection (UTI). Methods C57BL/6 mouse models of acute UTI with the wild-type(CFT073) and ppk1 mutant (△pk1) infected, were used to compare the bacteria colonization and inflammation induction abilities of bladder tissues. Results In the mouse models, the △pk1 strain showed a significantly lower infection rate (73.3% vs 93.3%) and lower adhesion frequency of bladder (0.01%vs 0.5%) than those of the CFT073 strain. The expression of IL-6 and TNF-αwere reduced in the bladder of △pk1 infected group (P<0.05). Hematoxylin-Eosin tissue staining showed that the damage degree of bladders in △pk1 infected mice were less serious than the CFT073 infected mice. Conclusion ppk1 gene plays an important role in E.coli colonization to bladder and the inflammation induction ability.

Objective To summarize the echocardiographic characteristics and clinical signiifcance of prenatal diagnosis of coronary artery ifstula (CAF). Methods Images and follow-up results of ifve fetuses with CAF diagnosed by fetal echocardiography between January, 2011 and December, 2012 in our department were reviewed. Results Echocardiographic characteristics of CAF were a dilated coronary artery in the four chamber view and the left ventricular outlfow tract view. Track the course of the dilated coronary artery can conifrm the oriifce of the ifstula. Among the ifve cases, the oriifce of the ifstula included the aortic root of left ventricular outlfow tract, right atrium side of interatrial septum, the entrance of superior vena cava to right atrium, right ventricular apex and right ventricle cone. The colour Doppler lfow imaging showed turbulence in the dilated coronary artery. The spectral Doppler with the sampling gate in coronary artery showed the characteristic bidirectional lfow pattern. One case was associated with other complex intracardiac abnormalities and one case with persistent left superior vena cava. Among the ifve cases of CAF diagnosed by fetal echocardiography, one case was missed and four cases were conifrmed by postnatal echocardiography. Conclusion Coronary artery ifstula has special fetal echocardiographic characteristics. The fetal echocardiography plays an important role in early detection, diagnosis and treatment of CAF.

ObjectiveTo investigate whether the T1-weighted dynamic contrast-enhanced perfusion magnetic resonance imaging (DCEPMRI) technique can help to delineate the clinical target volume of brain glioma patients.MethodsThe DCE T1-weighted images from 28 glioma patients were collected after GdDTPA was injected.After the acquired images were processed and analyzed using modified Tofts-Kermode'two compartment analysis model and de-convolution method,the value and its pseudo mapping of quantitative parameter Ktrans related to microvascular permeability were obtained.The tumor size in the largest diameter slice measured both in routine enhanced MRI and Ktrans mapping of T1-weighted DCEPMRI were compared.ResultsThe vascular permeability and tumor infiltration was lower in low grade glioma,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 0.2％ -0.3％ there was significant difference of tumor size between T1 -weighted DCEPMRI and routine enhanced MRI ( grade Ⅰ and Ⅱ grade with 2.93 cm2∶2.46 cm2(t=6.90,P=0.000) and 4.18 cm2∶3.21 cm2(t=10.22,P=0.000) ).While in high grade glioma,the vascular permeability and the tumor infiltration were higher,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 25％ - 26％( the size of grade Ⅲ and Ⅳ were 6.46 cm2 vs 5.48 cm2 ( t =10.83,P =0.000) and 8.26 cm2 vs 6.52 cm2(t =18.53,P =0.000) ).ConclusionsThe pseudo mapping of quantitative parameter Ktrans related to microvascular permeability acquired by T1-weighted DCEPMRI reflect the infiltrating circumscription in glioma,T1-weighted DCEPMRI can provide more information in delineation the clinical target volume,and it can be used as a new method for tumor volume evaluation.

Objective To analyse the clinical significance of LHRH exciting test in the differential diagnosis of constitutional delayed puberty (CDP) and hypogonadotropic hypogonadism (HH). Methods Eighty-one cases from 1982 to 1998 were investigated and followed up. They were all at genital stage Ⅰ. After injection of 100 ?g LHRH, the blood samples (3 ml) were taken at -15, 0, 15, 30, 45, 60, 90 and 120 min. The serum LH and FSH levels were determined by radioimmunoassay. Then they were followed up every 3-24 months. After they received LHRH exciting test, they were followed up until over 18 years old. According to their puberty development status, they were divided into 3 groups, normal group (n=34),CDP group (n=16) and HH group (n=31),andthemeanage,whenthey received LHRH exciting test, was (10.2?0.9, range 9-14) years, (16.0?1.0, range 14-18) years and (17.1?1.4, range 16-22) years respectively. Results There were no significant differences in serum LH baseline level and peak time in normal, CDP and HH groups, but the serum LH peak level, LH increment (peak LH level minus baseline LH level), LH increment ratio (peak level/baseline level of LH) and the area under LH curve (AUC LH ) of normal group were significantly higher than those of CDP group and HH group (all P

Objective To investigate effects of hormone replacement therapy with conjugated equine estrogen (CEE) in different doses combined with medroxyprogesterone acetate ( MPA) on mammographic density among postmenopausal women and its clinical significance. Methods Ninety eligible postmenopausal women were randomized into three groups with varied treatment continuously for one year, Croup A receiving 0.3 mg CEE with 2 mg MPA and caltrate 600 mg and vitamin D 125 U daily; Group B receiving 0. 625 mg CEE combined with 2 mg MPA and caltrate 600 mg with vitamin D 125 U daily; and Group C receiving caltrate 600 mg and vitamin D 125 U daily. Mammographic density was analyzed using Wolfe and semi-quantitative methods for all of them and compared each other one year after treatment, as well as mammographic density before and after treatment in Groups A and B. Results One year after treatment, mammogrphic density reached the highest in postmenopausal woman of Group B and the lowest in those of Group C, with significant difference among the three groups (P ＜ 0. 01) and between Groups A and C (P ＜ 0. 01) and between Groups B and C ( P ＜ 0. 05 ). Mammogrphic density with semi-quantitative method increased significantly in Group A ( P ＜ 0. 05 ) and Group B ( P ＜ 0. 01 ), respectively, after treatment as compared with that before it. Change in mammografic density before and after treatment was greater in Group B than that in Group A, but not reaching statistically significant level (P ＞ 0. 05). Conclusions Hormone replacement therapy can cause the increase of mammographic density in postmenopausal women, possibly in a dose-dependent pattern, which suggest that HRT has side effect on breast tissue and the lowest effective dose of estrogen should be selected in HRT. Mammographic density can be used as an indicator to monitor side effect of HRT on breast.

Objective: To determine the potential diagnostic value of miRNA-29 (miR-29) for malignant tumor. Methods: A systematic search of literature regarding miR-29 was performed in three English databases (PubMed, Web of Science, and Embase) and two Chinese databases (Chinese National Knowledge Infrastructure [CNKI] and WanFang). The retrieval was ended until September 15, 2018. Search terms included miRNA-29 (miR-29), tumor, cancer, serum, plasma, diagnosis, etc. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was carried out to evaluate the quality of the selected articles. STATA12.0 was used to calculate the combined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR). Subgroup analysis and Meta-regression analysis were carried out to explore the origin of heterogeneity. Results: Twenty eligible articles were selected from 1 172 literatures related to tumors and miR-29. The combined sensitivity was 0.76 (95%CI: 0.68-0.83), combined specificity was 0.83 (95%CI: 0.74-0.89), combined PLR was 4.5 (95%CI: 2.7-7.4), combined NLR was 0.28 (95%CI: 0.20-0.41), DOR was 16 (95%CI: 7-35), and theAUC was 0.86 (95%CI: 0.83-0.89). The combined specificity of plasma samples was higher than that of serum samples, and the difference was statistically significant (P<0.01). There was a higher diagnostic value of miR-29 for breast cancer and pancreatic cancer (DOR=101.52, 11.22), but lower diagnostic value for colorectal cancer and non-small cell lung cancer (DOR=5.05, 6.57); miR-29b showed a high diagnostic value for cancer (DOR=60.91). The publication bias was not obvious in this study (P>0.05). Conclusion: This systematic review and Meta-analysis suggests that miR-29 family is a potential biomarker in the diagnosis of cancers with great sensitivity and specificity.

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of total anomalous pulmonary venous connection (TAPVC). Methods Fetal echocardiographic images of 13 fetuses with TAPVC conifrmed by pathology or postnatal echocardiography were reviewed. Echocardiographic features and clinical signiifcance of prenatal diagnosis of TAPVC were summarized. Results Twelve fetuses with TAPVC were diagnosed prenatally by fetal echocardiography, including seven cases of supracardiac type, three cases of infracardiac type and two cases of intracardiac type. The common echocardiographic characteristics of 12 fetuses with TAPVC included slightly size discrepancy of left heart and right heart, large foramen ovale with increased shunting at the atrial level, increased distance between left atrium (LA) and descending aorta, absent insertions of pulmonary veins in the LA, presence of pulmonary venous conlfuence on the top of LA and dilatation of vessels where pulmonary venous conlfuence drained. One case was missed prenatally and intracardiac type TAPVC was diagnosed by postnatal echocardiography. Among the 13 cases, three were isolated and the other ten were all in association with other abnormalities. Conclusions There are fetal echocardiographic characteristics of TAPVC. Fetal echocardiography plays an important role in prenatal diagnosis of TAPVC.

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.

Objective To investigate the fetal ultrasonographic features in pregnancies with Toxoplasma (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus (HSV) infection. Methods From January 2011 to March 2013, prenatal ultrasound examination was performed in 545 fetuses with mothers of speciifc positive IgM of TOX, RV, CMV and HSV, detected by enzyme-linked immune sorbent assay (ELISA) in Nanjing Medical University Affiliated Suzhou Hospital. Ultrasonographic features were summarized and pregnancy outcome was followed up in fetuses with abnormal ifndings. Results Among the 545 fetuses, 56 cases with abnormal sonographic ifndings:6 cases with central nervous systerm abnormalities (2 intracranial calcifications, 4 hydrocephaly);9 cases with digestive system abnormalities (1 intrahepatic calcifications, 8 echogenic bowel);2 cases with heart abnormalities (1 interventricular septal defect, 1 right heart enlargement);17 cases with abnormal amniotic fluid volume (16 polyhydramnios, 1 oligohydramnios);3 cases with placental abnormality (1 thick placenta, 2 placenta abnormal calciifcation);13 cases with urinary systerm abmormality appearing as renal sinus separation;and 6 cases with other systerm abnormalities (1 neck lymphatic hygroma, 1 single umbilical artery, 1 sacrococygeal teratoma and 3 intrauterine growth restriction);2 cases of complicated abnormalities. Conclusions Prenatal ultrasonography is signiifcant in detecting serious fetal malformations, such as hydrocephaly, heart abnormalities and characteristic ultrasound features such as intracranial calciifcations, echogenic bowel, placenta abnormal calciifcation complicated with TOX, RV, CMV and HSV infection, providing valuable information for further clinical treatment, such as induced labour.

BACKGROUND: Microglia play an important role in immune surveillance in their quiescent state, but the role of the activated microglia is under discussion. OBJECTIVE: To analyze the mechanism of activated microglia in acute cerebral infarction. METHODS: Totally 96 male Kunming mice were selected and randomly divided into four groups, including transplantation, placebo, blank control and sham operation groups. Permanent occlusion of the middle cerebral artery was performed using suture method in the mice of the transplantation, placebo and blank control groups, followed by injection of microglia suspension via subclavian vein, medium containing the same volume of microglia, and nothing, respectively, at 12 hours after modeling. In the meanwhile, the same amount of microglia suspension was injected into the mice of the sham operation group. The Zea-longa scale and brain-derived neurotrophic factor expression at 12, 24 and 72 hours after modeling, the volume of cerebral infarction and the number of nerve cells positive for microtubule-associated protein-2 at 72 hours after modeling were detected. RESULTS AND CONCLUSION: The Zea-longa scale score was 0 point in the sham operation group, which was significantly lower than that in the other three groups at each time point after modeling (P < 0.01). The Zea-longa scores in the transplantation group were significantly lower than those in the placebo and blank control groups at 24 and 72 hours after transplantation (P < 0.01). The positive expression rate of brain-derived neurotrophic factor in the transplantation group was significantly higher than that in the other three groups after transplantation (P < 0.01). The sham group showed no infarction, while the size of cerebral infarction in the transplantation group was significantly lower than that in the placebo and blank control groups (P < 0.01), and the microtubule-associated protein-2 positive rate was significantly higher than that in the placebo and blank control groups (P < 0.01). These results manifest that the activated microglia can improve the survival rate of nerve cells, promote the recovery of cerebral nerve function and reduce the size of cerebral infarction.