This study investigated the role of the nuclear factor of activated T cells c3 (NFATc3) in vascular smooth muscle cells (VSMCs) during aortic aneurysm and dissection (AAD) progression and the underlying molecular mechanisms. Cytoplasmic and nuclear NFATc3 levels were elevated in human and mouse AAD. VSMC-NFATc3 deletion reduced thoracic AAD (TAAD) and abdominal aortic aneurysm (AAA) progression in mice, contrary to VSMC-NFATc3 overexpression. VSMC-NFATc3 deletion reduced extracellular matrix (ECM) degradation and maintained the VSMC contractile phenotype. Nuclear NFATc3 targeted and transcriptionally upregulated matrix metalloproteinase 9 (MMP9) and MMP2, promoting ECM degradation and AAD development. NFATc3 promoted VSMC phenotypic switching by binding to eukaryotic elongation factor 2 (eEF2) and inhibiting its phosphorylation in the VSMC cytoplasm. Restoring eEF2 reversed the beneficial effects in VSMC-specific NFATc3-knockout mice. Cabamiquine-targets eEF2 and inhibits protein synthesis-inhibited AAD development and progression in VSMC-NFATc3-overexpressing mice. VSMC-NFATc3 promoted VSMC switch and ECM degradation while exacerbating AAD development, making it a novel potential therapeutic target for preventing and treating AAD.

Objective To monitor the dynamic changes of radiation-induced parotid damage using T2 ? mapping.Methods Thirty-four patients with nasopharyngeal carcinoma (NPC)were enrolled.All patients underwent T1 WI,T2 WI and T2 ? mapping for bilateral parotid glands at pre-RT (2 weeks before radiotherapy),mid-RT (5 weeks after the beginning of radiotherapy)and post-RT (4 weeks after the completion of radiotherapy).Parotid MR parameters,mean radiation dose and xerostomia degrees of the patients at different time points were recorded.Furthermore,nine healthy volunteers were enrolled,who undergone T2 ? mapping twice with an interval of 4 weeks in order to analyze the reproducibility of T2 ? value.Results From pre-RT to mid-RT and post-RT,parotid volume decreased [atrophy rates,(25.34±11.33)％ and (25.74±9.93)％,respectively]and T2 ? values decreased [change rates,(-5.63±8.86)％ and (-4.81±10.67)％, respectively]significantly (all P < 0.01 ).Parotid normalized T1 signal intensity decreased significantly from pre-RT to post-RT [change rate,(-7.43±10.61)％,P =0.007],and the change rate was correlated inversely with mean radiation dose significantly (r =-0.646, P <0.001).Parotid volume and T2 ? value changed correspondingly with xerostomia degrees of the patients during radiotherapy.Parotid MR parameters showed excellent reproducibility (intraclass correlation coefficient,0.843 -0.993).Conclusion The dynamic changes of radiation-induced parotid damage in patients with NPC can be noninvasively evaluated by routine MRI and T2 ? mapping.

Objective To compare and analyze the supply of blood collection and clinical blood demand in Hangzhou during 2011-2016,and to put forward some countermeasures and suggestions.Methods The related data of blood collection in blood center and the indexs of clinical blood demand in all hospitals in Hangzhou were collected during 2011-2016,and the growth rates of both of them were compared and analyzed.Results 1) The data of blood collection and supply was the lowest in 2012,and then increased year by year.The average annual growth of platelet collection and supply was 8.09％ and 8.47％,respectively,and the other indicators grew relatively gently.In 2016,the rate of blood donation reached 18.28 per thousand people.At the same period,the number of staff in institutions was basically stable.2) During 2011-2016,the blood demand of all hospitals in Hangzhoa maintained rapid growth.In Hangzhou,the number of hospitals increased by 10.65％ annually,and until 2016,there was an increase of 65.87％ over 2011.The average annual growth of the number of beds,the number of emergency patients and the number of inpatients increased by 10.21％,6.09％ and 11.40％ respectively.The growth rate of number of inpatients was higher than that of outpatient and emergency departments.Hospital employees remained at an average annual growth rate of nearly 10％.3) The clinical demand for blood increased significantly more higher than the growth of blood collection and supply.Conclusion Speed up the pace of the construction of blood supply,and keep pace with the construction of hospitals.Strengthening the publicity,health education and promotion models,in order to encourage more people,who are eligible for blood donation,to join the blood donation.And also strengthening personnel team building,improving overall work efficiency and level.

Objective To explore the value of gemstone spectral imaging (GSI)in quantitative evaluation of Lauren classification of gastric cancer.Methods Fifty-two patients with gastric cancer confirmed by gastroscopy underwent contrast-enhanced spectral CT imaging preoperatively.The monoergic and iodine-based images were obtained by GSI Viewer software,CT value and iodine concentration (IC)of the lesions were measured,and normalized iodine concentration (NIC)was calculated.With the reference of postoperative pathology,data were analyzed by LSD method of one-way analysis of variance.Results The IC,NIC,spectrum curve slope of 40-70 keV,40-140 keV and 70-140 keV energy range of intestinal type,mixed type and diffuse type carcinoma in the arterial phase were 12.86±6.80 (100 μg/mL),0.13±0.06 ,2.50±1.26 ,0.99±0.51 ,0.34±0.20 ,18.54±6.49 (100 μg/mL),0.19±0.07, 3.56±1.24,1.42±0.50,0.50±0.18 and 24.52±9.68 (100 μg/mL),0.24±0.09,4.73±1.76,1.90±0.73,0.68±0.29,respectively. The values of intestinal type were all significantly lower than those of diffuse type (P <0.05).Comparison between intestinal-mixed type and mixed-diffuse type,the other parameters were no significant differences except IC between intestinal-mixed type (P=0.037).Conclusion The slope of spectrum curve,iodine concentration,and normalized iodine concentration could be helpful for preoperative evaluation of Lauren classification of gastric cancer.

Objective To assess the histological characteristics of cervical cancer using intravoxel incoherent motion magnetic resonance imaging ( IVIMMRI) and to investigate the performance of IVIMMRI in evaluation of the efficacy of concurrent chemoradiotherapy in the treatment of intermediate/advanced cervical cancer. Methods Pelvic MRI scans, containing T2WI, IVIM (14 b values, b=0?1 000 s/mm2), and contrast?enhanced T1 scans were performed in 23 patients pathologically diagnosed with intermediate/advanced cervical cancer ( stage ≥Ⅱb ) before chemoradiotherapy, after two and four weeks of treatment, and at the end of treatment. The IVIMMRI data were processed with the bi?exponential model to generate three parameters, containing pure diffusion coefficient ( D ) , pseudodiffusion coefficient ( D?) , and perfusion fraction ( f ) . Apparent diffusion coefficient ( ADC ) was obtained using the mono?exponential model. The IVIMMRI parameters were measured at each time point and their dynamics and correlation were analyzed. Results The ADC, D, and f values were significantly higher after complete treatment ( 0?96 × 10-3 vs. 1?77 × 10-3 mm2/s, P=0?000;0?76 × 10-3 vs. 1.34± 0?12 × 10-3 mm2/s, P=0?000;0?14% vs. 0?24%, P=0?012). The above three values significantly increased after two weeks of treatment (all P=0?000) and kept increasing until the end of the treatment. In contrast, the D? value was reduced from the second week to the end of the treatment. Conclusions IVIMMRI can monitor the dynamic functional changes and early tumor responses during chemoradiotherapy for cervical cancer, which holds promise for clinical application.

Objective??To?evaluate?the?feasibility?and?outcomes?of?chimeric?deep?circumflex?iliac?artery?perforator?flap?(DCIAPF)?applied?in?the?simultaneous?reconstruction?of?the?oromandibular?defect. Methods??Six?patients?underwent?simul-taneous?oromandibular?reconstruction?using?DCIAPF?following?segmental?mandibulectomy?in?Xiangya?Hospital?from?March?2014?to?July?2014.?The?skin?paddle?was?designed?to?be?centered?on?the?pre-operative?perforator?mapping.?Retrograde?dissection?was?performed?through?the?underlying?abdominal?wall?to?raise?the?skin?paddle.?The?pedicle?was?isolated?from?the?groin,?and?the?iliac?crest?was?cut.?The?deep?iliac?circumflex?vessels?were?dissected?until?the?skin?paddle?was?reached.?Finally,?the?donor?site?was?strictly?sutured?layer?by?layer?to?avoid?ventral?hernia.?Results??The?skin?paddles?ranged?from?3.5?cm×5.0?cm?to?7.0?cm× 10.0?cm.?The?length?of?the?bone?components?was?5.0?cm?to?11.0?cm.?All?donor?sites?closed?primarily?without?skin?grafting.?DCIAPF?was?harvested?successfully?in?five?patients,?except?for?one?patient?whose?perforator?originated?from?the?superficial?iliac?circumflex?vessels.?An?additional?pair?of?anastomoses?was?performed.?All?iliac?flaps?survived.?However,?slight?skin-edge?necrosis?and?exfoliation?caused?by?flap?thinning?occurred?in?one?patient?and?healed?after?pruning?and?dressing?change.?The?heights?of?all?alveolar?ridges?were?significantly?restored,?and?no?serious?donorsite?complication?was?observed?during?the?three?to?six?months’?follow-up.?Conclusion??DCIAPF?is?a?reconstructive?option?for?mandibular?defects?because?of?its?adequate?bone?tissue?and?rich?blood?supply.?Satisfactory?alveolar?ridge?restoration?greatly?facilitates?future?denture?retention.?DCIAPF?also?has?a?great?degree?of?mobility?between?the?skin?paddle?and?the?bone?component?when?applied?in?composite?oromandibular?defect?reconstruction.

OBJECTIVETo compare the accuracy of CT and MR including diffusion-weighted imaging(DWI) in preoperative diagnosis and T staging of gastric cancer.

METHODSForty-one patients with gastric cancers proved by gastroscopy biopsy from November 2011 to August 2012 were prospectively enrolled. They underwent contrast enhanced CT and MR imaging (including DWI, T2 weighted and dynamic enhanced imaging) preoperatively. Two radiologists interpreted CT and MR images for detecting and staging each patient independently. With the reference of post-operative histopathological findings, T staging accuracy of CT and MR imaging was calculated and compared. Inter-observer agreement was also evaluated.

RESULTSOverall T staging accuracy in MR including DWI was significantly higher than that in CT imaging(87.8% vs. 65.9%, P=0.004). MR had a better inter-observer agreement than CT(Kappa=0.813, 0.603, respectively).

CONCLUSIONMR including DWI can improve preoperative T staging accuracy of gastric cancer significantly, which deserves recommendation for clinical application.

Biopsy ; Contrast Media ; Diffusion Magnetic Resonance Imaging ; Gastroscopy ; Humans ; Magnetic Resonance Imaging ; Neoplasm Staging ; Stomach Neoplasms ; pathology

OBJECTIVETo explore the preoperative diagnostic value of MR diffusion weighted imaging (DWI) for metastatic lymph nodes in patients with gastric cancer.

METHODSBetween December 2011 and December 2012, 52 gastric cancer patients(34 men, 18 women) underwent preoperative MR DWI. The apparent diffusion coefficient(ADC) and short diameter of lymph nodes were measured and compared with the postoperative histopathological findings. Diagnostic value of ADC and short diameter for metastatic lymph nodes in patients with gastric cancer was investigated by receiver characteristic curve(ROC) analysis.

RESULTSA total of 180 metastatic and 57 non-metastatic lymph nodes were detected as hyperintense on DWI obtained from 52 patients. The ADC of metastatic lymph nodes [(1.059±0.196)×10(-3) mm(2)/s] was significantly lower than that of non-metastatic nodes [(1.402±0.285)×10(-3) mm(2)/s, P<0.001]. With ADC threshold of 1.189×10(-3) mm(2)/s, the sensitivity, specificity and area under the curve(AUC) were 78.9%, 72.8% and 0.840, respectively. The overall diagnostic accuracy of preoperative N staging of ADC was 75%(39/52). The short diameter of metastatic lymph nodes [(8.08±3.99) mm] was significantly longer than that of non-metastatic lymph nodes [(6.75±2.70) mm, P=0.005]. With short diameter threshold of 5.05 mm, the sensitivity, specificity and AUC were 88.3%, 29.8% and 0.602, respectively. The overall diagnostic accuracy of short diameter in preoperative N staging was 67.3%(35/52).

CONCLUSIONSMR DWI is a useful technique in diagnosing metastatic lymph nodes in patients with gastric cancer. ADC value and short diameter can be used as diagnostic criterion for the diagnosis of preoperative N staging.

Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; ROC Curve ; Stomach Neoplasms ; pathology

Objective To investigate the feasibility of quantitative measurement of fat concentration by CT spectral imaging in a mice model of fatty liver.Methods Twenty-four mice with different degrees of fatty liver underwent CT spectral imaging.CT values of liver parenchyma under mixed X-ray energy and 65 keV,fat concentration based on various basic material pairs (fat/water,fat/io-dine,fat/calcium)and spectral curves were obtained.Liver specimens were obtained to measure the concentration of triglyceride , and HE staining was performed.Correlations between various CT indexes and triglyceride concentration were analyzed.Results Correlation between fat concentration (fat/water pair)and triglyceride (r =0.91 5 )was better than that between CT values on 65 keV and triglyceride (r=-0.858),as well as polychromatic CT values (r=-0.81 6).All the P values were<0.001.Correlations between fat concentrations based on fat/iodine or fat/calcium pairs and triglyceride were relatively low (r=-0.726,-0.660).CT indexes on 1.25 mm slice thickness performed better than those on 2.5 mm.With fatty liver degree increased,the shape of spectral curve changed gradually.Conclusion Liver fat concentration can be measured by CT spectral imaging noninvasively,accurately and quantitatively in a mice model of fatty liver.