Diabetic retinopathy(DR)is a kind of microvascular disease caused by the long-term influence of diabetes mellitus(DM),and it is one of the main cause of global visual impairment and blindness.Its typical characteristics include microaneurysms,hard exudates,macular edema(DME)and neovascularization.Its pathogenesis is diverse,and the root cause is oxidative stress and advanced glycosylation end products.The nuclear red blood cell related factor 2(Nrf2)signa-ling pathway plays an important role in preventing various diseases.As one of the characteristics of DM,hyperglycemia will activate the generation of reactive oxygen species(ROS)in mitochondria.These oxidative stress factors activate the nucle-ar transcription factor κB pathway,becoming the main inducement of various complications of DM.This pathway will in-duce increased transcription of proinflammatory cytokines,including tumor necrosis factor-alpha,transforming growth fac-tor-beta and interleukin-1.The active ingredients of traditional Chinese medicine have significant antioxidant,anti-inflam-matory,anti-apoptotic and angiogenesis-promoting effects,and can block the progression of DR through various mecha-nisms.In this article,the research status of traditional Chinese medicine targeting the Nrf2 signaling pathway in the preven-tion and treatment of DR is reviewed to guide clinical and scientific research.

Diabetic retinopathy(DR)is a kind of microvascular disease caused by the long-term influence of diabetes mellitus(DM),and it is one of the main cause of global visual impairment and blindness.Its typical characteristics include microaneurysms,hard exudates,macular edema(DME)and neovascularization.Its pathogenesis is diverse,and the root cause is oxidative stress and advanced glycosylation end products.The nuclear red blood cell related factor 2(Nrf2)signa-ling pathway plays an important role in preventing various diseases.As one of the characteristics of DM,hyperglycemia will activate the generation of reactive oxygen species(ROS)in mitochondria.These oxidative stress factors activate the nucle-ar transcription factor κB pathway,becoming the main inducement of various complications of DM.This pathway will in-duce increased transcription of proinflammatory cytokines,including tumor necrosis factor-alpha,transforming growth fac-tor-beta and interleukin-1.The active ingredients of traditional Chinese medicine have significant antioxidant,anti-inflam-matory,anti-apoptotic and angiogenesis-promoting effects,and can block the progression of DR through various mecha-nisms.In this article,the research status of traditional Chinese medicine targeting the Nrf2 signaling pathway in the preven-tion and treatment of DR is reviewed to guide clinical and scientific research.

Objective: To investigate the feasibility of parameter-optimized magnetic resonance imaging (MRI) as the first choice for imaging examination in patients with acute ischemic stroke (AIS), and to assess the effects of quality improvement (QI) measures on shortening the door-to-needle time (DNT). Methods: A retrospective case-control study was conducted. A total of 69 AIS patients hospitalized at the Department of Neurology of the People's Hospital of Wuzhou from August 2015 to July 2018 were enrolled in the study, and the head MRI was used as the first choice for imaging examination. All patients received the intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). Patients with AIS undergoing intravenous thrombolysis from August 2015 to March 2017 were included in the control group, and those receiving intravenous thrombolysis after QI measures from April 2017 to July 2018 were included in the experimental group. QI included informing the stroke team in advance by emergency physicians, treatment process changing from serial procedure to the parallel one, optimization of MRI scanning parameters, and use of rapid test instruments. The MRI scanning time was compared between the two groups. The DNT of the two groups was compared, and paired-samples t test was used. The proportion of patients who underwent MRI scan and DNT<60 min was compared between the two groups, and the χ² test was used. Results: Compared with the control group, the proportion of patients undergoing MRI scan in the experimental group was increased (82% vs 58%, χ²=4.58, P=0.032); MRI scanning time was shortened (4 min 37 s vs 10 min 21 s); DNT (min) was shortened (59.32±10.19 vs 93.48±24.81, t=7.189, P<0.01); and the proportion of patients with DNT<60 min was significantly increased (68% vs 6%, χ²=27.190, P<0.01). Conclusion Parameter-optimized MRI as the first choice for imaging examination in AIS patients with the onset time <4.5 h was feasible, and the DNT was significantly shortened by QI measures.

Objective To compare the quality of life at baseline and at 3 months after coronary artery bypass grafting(CABG) and investigate the related risk factors. Methods The prospective study included 121 consecutive patients reaching inclusion criteria and undergoing CABG between June 2009 and May 2016. Health status survey was measured with short form-36(SF-36)at baseline and at 3 months after CAGB. Change of quality of life and influencing factors and quality of life were analyzed. Results Eight domains including physical functioning ,role-physical ,bodily pain,general health,vitality,social functioning,role-emotional and mental health and two component summaries including physical component summary(PCS)and mental component summary (MCS)of SF-36 were significantly improved at 3 months following CAGB(all P<0.01). Moreover,advanced age, women,diabetes mellitus,assisted ventilation time,hospital stay and use of t-PA were relative to the PCS after CAGB. Conclusions The findings demonstrate quality of life is significantly improved at 3 months post CAGB. Advanced age,underlying disease,serious disease,women and lower PCS score prior to CAGB are linked with low PCS after CAGB.

Objective To probe into the clinical application value of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion weighted imaging (DWI) in identifying benign and malignant breast lesions.Methods 60 patients with clinically suspected breast lesions underwent MR examination.Morphologic features,early enhancement rate,time-signal intensity curve (TIC),apparent diffusion coefficient (ADC) value,as well as the differences between ADC values of the surrounding normal tissues and these of the lesions were compared and analyzed.Results The areas under the receiver operating characteristic curves (AUC) of the early enhancement rate,TIC,ADC value,ADC difference value were 0.741,0.808,0.882 and 0.959,respectively;the best diagnostic thresholds for the early enhancement rate,ADC value,and ADC difference value were 163％,1.30× 10-3 mm2/s and 0.47× 10-3 mm-2/s,respectively.The sensitivity of morphologic features,early enhancement rate,type Ⅲ curve,type Ⅱ and type Ⅲ curve,ADC value and ADC difference value in differentiating benign and malignant breast lesions was 53.1％,59.4％,43.8％,90.6％,93.8％ and 96.9％,respectively;the specificity was 85.7％,82.1％,89.3％,57.1％,75.0％ and 82.1％,respectively;the positive predictive values were 81.0％,79.2％,82.4％,70.7％,81.1％ and 86.1％,respectively;the negative predictive values were 61.5％,63.9％,58.1％,84.2％,91.3％ and 95.8％,respectively;and the accuracy was 68.3％,70.0％,65.0％,75.0％,85.0％,90.0％,respectively.Conclusion DCDMRI and DWI play important roles in differential diagnosis of benign and malignant breast lesions,among which ADC difference value is associated with the highest diagnostic capability.Combination of multiple imaging diagnostic methods is necessary to improve the diagnostic accuracy of breast lesions.

Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0％).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.

Purpose To investigate the CT and CTA findings of intracranial hemanigoperiocytoma. Materials and Methods The CT and CTA data of 7 cases of pathologically confirmed intracranial hemanigoperiocytoma were retrospectively reviewed. Results All the 7 cases were extra-axial and supratentorial location. Six were lobulated and 1 were oval in shape. Three were iso-density to the parenchyma and 4 were inhomogeneous with clear margins. Five had perifocal edema. On contrast scan, all showed homogeneous or inhomogeneous enhancement. Five had dilated tortuous vessels and 4 were identified as feeding artery inside or around the tumors. Conclusion The CT findings of intracranial hemanigoperiocytoma are similar to meningioma but CTA is helpful for the differential diagnosis.

The protein HTRP (human transcription regulator protein) is encoded by the differential gene htrp and induced by Herpes simplex virus type 1 (HSV-1) infection in KMB-17 cells. HTRP was found to interact with SAP30 (mSin3A Association Protein), one of the components of co-repressor complex mSin3A, which is part of the deacetylation transfer enzyme HDAC. To reveal the biological significance of the interaction between HTRP and SAP30, real- time PCR and a dual-luciferase detecting system was used. The results indicate that HTRP could inhibit the transcription of a viral promoter, whose interaction with SAP30 synergistically affects transcriptional inhibition of the viral genes, and is related to HDAC enzyme activity. ChIP experiments demonstrate that HTRP could promote HDAC activity by increasing the deacetylation level of lysine 14 and lysine 9 in histone H3.

Purpose:To assess MRI and MRS features of intracranial hemangiopericytoma.Materials and Methods: The imaging data of MRI and MRS were analyzed retrospectively with seven cases of hemangiopericytoma.MR examinations were performed on seven cases,MRS on 4 cases.Results: The position of lesions were all located at the supratentorial area and extraaxial region.Six masses were lobulated in shape.Of seven cases,3 cases were isointense with cortical gray matter,3 iso- and hypointense,l hypointense with localized hyperintense resulted from hemorrhage on T1WI: 2 cases demonstrated isointense with cortical gray matter,4 iso- and hyperintense,1 complex hyperintense on T2WI.Five tumors had prominent internal or surficial serpentine signal voids.3 tumors showed homogeneous marked enhancement,4 heterogeneous enhancement.MRS of four tumors showed marked elevated Cho peak,Lip peak and diminished or disappeared NAA peak.Two cases were companied with marked elevated MI peak.Conclusion:The MR imaging findings of hemangiopericytoma has some characteristics,which can help differentiation from meningioma combined MRS.

Objective To assess the clinical value of 16-slice spiral CT in the diagnosis of multiple carcinomas in unilateral upper urinary system. Methods The imaging findings of 16-slice spiral CT of 10 patients suffered from multiple carcinomas in the unilateral upper urinary system proven pathologically were analyzed. Results Among 10 cases, 6 cases had multiple carcinomas in the unilateral renal pelvis and ureter and simultaneously involved urinary bladder, 3 cases had the multiple carcinomas in the unilateral renal pelvis and ureter, and 1 case had the multiple carcinomas in the lower and middle ureter and involved urinary bladder. CT images clearly presented the thickened irregular renipelvic and ureteric wall with stenosis and/or mass in the renipelvic and ureteric cavity. The urinary bladders involved by carcinoma were depicted as thickened irregular wall of urinary bladder or the mass in the wall of urinary bladder. The images of curved reconstruction clearly showed the extention of the multiple carcinomas and the changes of the urinary tract involved by the multiple carcinomas. Enlarged retroabdominal lymph nodes were detected in 3 cases simultaneously, and 2 of them were proved metastasis, the imaging findings were absolutely identical to that of the operation and pathological examination. Conclusion Sixteen slice spiral CT can clearly and accurately depict the location and extention of multiple carcinomas in the unilateral upper urinary system.