ObjectiveTo investigate the effect of Gegen Qinliantang （GGQLT）-medicated serum on free fatty acid （FFA）-induced nonalcoholic steatohepatitis （NASH） in vitro model of human hepatoma cells HepG2. MethodNASH model of HepG2 cells was established in vitro， and the cells were intervened with different volume fractions of GGQLT-medicated serum and resveratrol. Intracellular lipid deposition in each group was detected by oil red O staining， the level of reactive oxygen species （ROS） in each group were detected by flow cytometry， the levels of glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， triglyceride （TG） and malondialdehyde （MDA） in each group were detected by kits. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to measure the mRNA expression levels of nuclear transcription factor （NF）E₂-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， quinone oxidoreductase 1 （NQO1）， Kelch-like epichlorohydrin-associated protein-1 （Keap1）， NF-κB， thioredoxin interacting protein （TXNIP）， interleukin-1β （IL-1β） in HepG2 cells of each group. The protein expression of Nrf2， TXNIP in cells of each group was detected by Western blot. ResultFFA induced large accumulation of intracellular lipids. Compared with the normal group， the activities of GSH-Px and SOD were significantly decreased （P<0.01） and the contents of TG， ROS and MDA were significantly increased （P<0.05， P<0.01） in the model group. Compared with the model group， all GGQLT groups and resveratrol group could elevate intracellular SOD activity to different degrees （P<0.05， P<0.01） and significantly reduce the levels of intracellular ROS and MDA （P<0.05， P<0.01）， GGQLD high- and medium-dose groups and resveratrol group significantly elevated GSH-Px activity （P<0.01）， GGQLD medium- and low-dose groups and resveratrol group significantly decreased TG content （P<0.05， P<0.01）. Compared with the model group， GGQLT high- and medium-dose groups and resveratrol group could significantly upregulate the mRNA expression levels of Nrf2， HO-1 and NQO1 （P<0.01）， all GGQLT groups and resveratrol group could significantly downregulate the TXNIP protein expression level， as well as significantly downregulate the mRNA expression levels of Keap1， NF-κB （P<0.05， P<0.01）. Nrf2-siRNA transfection of cells revealed that Nrf2 expression was significantly downregulated （P<0.01） in the Nrf2-siRNA group of cells by comparing with NC-siRNA group at the corresponding dose of drugs， and the inhibitory effects of GGQLT and resveratrol on TXNIP， IL-1β were attenuated. ConclusionFFA induces the production of ROS and inflammatory factors in HepG2 cells， and GGQLT can improve the anti-inflammatory and antioxidant capacities of cells， and its mechanism may be related to the regulation of Nrf2/TXNIP signaling pathway， so as to improve NASH.

Objective:To investigate the specific chest computed tomography(CT) features of corona virus disease 2019 (COVID-19) and to evaluate its clinical diagnostic value.Methods:The clinical data of 35 cases with suspected COVID-19 from Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine and Shanghai East Hospital Affiliated to Tongji University from January 1 to February 14, 2020 were retrospectively analyzed. A total of 17 cases with positive results of two times of real time polymerase chain reaction (RT-PCR) for 2019 novel coronavirus (2019-nCoV) were evaluated as the case group, and the remaining 18 cases with negative results of two times of RT-PCR for 2019-nCoV were evaluated as the control group. The features of chest CT images of 35 cases were obtained. The frequencies of four CT imaging indicators including ground glass opacities (GGO), crazy paving, heterogeneous consolidation and mutiple subpleural lesions were analyzed. The sensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) for COVID-19 were calculated.Results:In the case group, there were 11 cases with GGO, seven cases with crazy paving, six cases with heterogeneous consolidation, and 16 cases with mutiple subpleural lesions, while in the control group, there were seven cases with GGO, one case with crazy paving, six cases with heterogeneous consolidation, and five cases with mutiple subpleural lesions. When multiple subpleural lesions or any two of the CT imaging indicators were used as the characteristic indicators, the diagnosis efficiencies were better, with the sensitivity, specificity, PPV, NPV and Youden index of 94.12%, 72.22%, 76.19%, 98.86% and 0.66, respectively, and 88.24%, 77.78%, 78.95%, 87.50% and 0.66, respectively.Conclusions:Chest CT indictors are of high clinical diagnostic value for COVID-19. Any two of the four CT indicators (GGO, crazy paving, heterogeneous consolidation and mutiple subpleural lesions) or the single characteristics (mutiple subpleural lesions) are of high diagnostic efficacy.

Objective: To analyze the CT manifestations of the 2019 novel coronavirus pneumonia (NCP) combined with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) literature review, and to summarize the characteristics of CT imaging, so as to improve the ability of rapid and accurate diagnosis. Methods: CT manifestations of two confirmed cases of NCP were reported, meanwhile the literatures on SARS and MERS imaging performance were reviewed and summarized. Results: The two cases of NCP were both in acute stage, the CT imaging showed multiple and scattered ground-glass opacity (GGO) in both lungs, which is similar to the CT performance of SARS and MERS in acute stage. Conclusions The CT features of 2019 novel coronavirus pneumonia are similar to SARS and MERS. It has certain characteristics and changes rapidly with the course of the disease. In the acute stage, GGO and paving stone sign were the main manifestations. In the acute phase, GGO and crazy paving are the main manifestations. In the progress stage, the interlobular septal thickening and consolidation appeared. During the absorption period, the lesions disappeared or fibrosis was left behind, with lung structure distortion and bronchiectasis. Lymphadenopathy and hydrothorax were rare.

Objective To investigate the expressions of epidermal growth factor receptor (EGFR),heat shock protein 90A (HSP90A) and cathepsin D in nasopharyngeal carcinoma and their relationship with tumor invasion and metastasis.Methods From January 2014 to December 2015,58 patients with nasopharyngeal carcinoma (group A) in the First Affiliated Hospital of University of South China were selected,and the positive expression rates of EGFR,HSP90A and cathepsin D in biopsy specimens of nasopharyngeal carcinoma were detected by immunohistochemistry method.The positive expression rates of EGFR,HSP90A and cathepsin D in biopsy chronic rhinitis tissues of 30 patients with chronic rhinitis (group B) were also detected.T staging,N staging and lymphatic vessel density (LVD) of patients in group A were analyzed.In group A,the T staging,N staging and LVD of between patients with positive expression of EGFR,HSP90A and eathepsin D and those with negative expression of these indicators were compared,and the correlations of the expression of EGFR,HSP90A and cathepsin D to T staging,N staging and LVD were analyzed.Results The positive expression rates of EGFR,HSP90A and cathepsin D in group A were 86.21％,82.76％ and 87.93％ respectively,which were higher than 30.00％,26.67％ and 33.33％ in group B (P＜0.05).In group A,the percentages of patients on T3-T4 and N2-N3 stages and LVD of patients with positive expression of EGFR,HSP90A and cathepsin D protein respectively were higher than those of patients with negative expression of corresponding protein (P ＜ 0.05).Spearman correlation analysis showed that the positive expression rates of EGFR,HSP90A and cathepsin D in nasopharyngeal carcinoma were positively correlated with the T staging,N staging and LVD (EGFR:r=0.844,0.795,0.785;HSP90A:r=0.862,0.825,0.822;eathepsin D:r=0.842,0.815,0.863,P＜0.05).Conclusion EGFR,HSP90A and cathepsin D expression in nasopharyngeal carcinoma are closely related to invasion and metastasis of tumor,which may be used as reference indexes for the evaluation of tumor invasion and metastasis in nasopharyngeal carcinoma.

Objective To evaluate the feasibility of chest limit low dose CT in children using Philips iCT scanner as an example.Methods A total of 28 consecutive children aged between 1 month and 7 years(median age 8 months)who were claimed CT exam by clinicians and received limit low dose CT scans were enrolled.The limit low dose CT were undertaken on a 256-slice CT scanner(Brilliance iCT,Philips)with parameters as 80 kV,10 mAs,0.625 mm×128,and pitch＝1.Firstly,lung algorithm group and standard algorithm group 4 mm slice-thickness image series were reconstructed with lung and standard algorithm respectively using iterative reconstruction(IR)algorithm(iDose44).Then a series of 0.67 mm slice-thickness images were reconstructed with IR(iDose44)and smooth A algorithm,and was transformed into transverse 4 mm images(image transformation group)and coronal multiple planar reformatted(MPR)and volume-rendered(VR)images along the central airway.The transverse images in above three groups were displayed in the same lung window for SD measurement and subjective image quality evaluation on a 5-point scale.The dose length product(DLP)was recorded and the effective dose(E)was calculated.Results The SD values of lung algorithm group,standard algorithm group and image transformation group were 26.7 ±7.6,15.1 ±5.5 and 16.7 ±4.9,respectively,which showed statistically significant difference(F＝29.6,P＜0.05).The noise of lung algorithm group was higher than those of standard algorithm group and image transformation group(mean difference values were 11.6 and 9.6,respectively,P＜0.05),but there were no significant difference between standard algorithm group and image transformation group(P ＞0.05).All images had enough diagnostic image quality.The coronal MPR and VR images were helpful for interpretation of axial images.The mean DLP and E were(8.65 ± 2.97)mGy· cm and(0.21 ±0.10)mSv,respectively.The lowest DLP and E were 4.40 mGy· cm and 0.08 mSv,respectively.Conclusions Using Philips iCT scanner as an example,chest limit low dose CT scanning was feasible for children.Combining with IR and image transformation,the image quality was fully guaranteed and 3D images increased diagnostic confidence.

Objective To investigate the brain magnetic resonance imaging (MRI) features and clinical manifesta-tions of the patients with citrullinemia, and to promote awareness of, early diagnosis of and better treatment for the disease.Methods One case with citrullinemia was reported, and other eight cases reported in the literature in nearly 14 years were reviewed.Results The case was a 15-month-old girl with type I citrullinemia diagnosed by the mutation analysis of the ASS1 gene performed in local hospital after birth. The patient was admitted to our hospital for recurrent lethargy for a year and the high level of blood ammonia (311 μmol/L, normal range 9-33 μmol/L). The blood ammonia reduced to normal on the 11th day after arginine treatment. On MRI scans, the diffusion weighted imaging (DWI) showed diffuse hyperintensity on bilateral frontal, parietal and temporal cortex, which indicated restricted diffusion due to cytotoxic edema. On the follow-up MRI after 10 day's treatment, the affected regions was similar but the intensity decreased compared to the previous scan,which accompanied by cere-bral atrophy. Eight cases in the literature were reviewed, and the clinical manifestations in these patients were lack of speciifcity, the most common features included feeding dififculties, lethargy, and vomiting. Brain MRI was performed on 7 cases, computed tomography (CT) was performed on 1 case, with the result of cytotoxic edema in 3 cases and atrophy in 2 cases.Conclusions Citrullinemia often lacks of speciifc symptoms in the early phase. Brain MRI could provide the clinician a valuable help for early diagnosis and treatment of this disease.

Objective To evaluate the expression level of cathepsin D protein in nasopharyngeal carcinoma (NPC) and to determine its relationship with clinic pathological characters. Method Immunohistochemistry was performed to detect the expression of cathepsin D in 72 cases of primary NPC and 28 cases of normal nasopharyngal epithelial tissue ( NNET), and the correlation of its expression level with clinicopathologic features and clinical outcomes was evaluated. Results Significant down-regulation of cathepsin D was observed in NPC versus NNET(x2 = 13. 55, P ＜0. 01 ). In addition, cathepsin D down-regulation was significantly correlated with poor histological differentiation ( x2 =41.47, P ＜0. 01 ). Type Ⅰ and Ⅱ (well-moderately differentiated) NPC showed more intense immunoreactivity of cathepsin D compared with type Ⅲ (poorly differentiated) NPC. Cathepsin D up-regulation was significantly correlated with clinical stage, recurrence, and lymph node and distant metastasis (x2 = 13.43,22. 86,21.61,14. 32, P ＜0. 01 ).Tumors with cathepsin D up-regulation tended to have advanced clinical stage, frequent recurrences, and metastasis to lymph node and distant organ. Conclusion The expression of cathepsin D was closely related with the differentiation, clinical stage and pathological grade of NPC. Cathepsin D could be served as an effective differentiation marker for the histopathological grading of NPC and a possible therapy target.

To search for nasopharyngeal carcinoma (NPC) biomarkers,laser capture microdissection (LCM) was used to purify the target cells from NPC and normal nasopharyngeal epithelial tissues (NNET). Two-dimensional gel electrophoresis (2-DE) was performed to separate the total proteins of microdissected NPC and NNEC,PDQuest software was applied to analyze 2-DE images,and the differential protein spots between the two types of tissues were identified by both MALDI-TOF-MS and ESI-Q-TOF-MS. The expression of cytokeratin 8(CK8),one of the differential proteins,in the microdissected NPC and NNEC as well as 4 NPC cell lines with different differentiated degrees and/or metastatic potentials was detected by Western blot. Immunohistochemistry was also used to detect the expression of CK8 in paraffin-embedded tissues including 63 cases of primary NPC,28 cases of NNET and 20 cases of cervical lymphonode metastasis. In the present study,2-DE patterns of microdissected NPC and NNEC were established,and 29 differential proteins in the above two tissues were identified,of which 15 only expressed or up-regulated in NPC and 14 only expressed or up-regulated in NNET. The expression level of differential protein CK8 between the NPC and NNET was selectively confirmed,and was found to be related to the differentiation and/or metastasis of NPC cell lines. Significant down-regulation of CK8 was observed in NPC compared with NNET,and significant up-regulation of CK8 was also observed in lymphonode metastasis compared with primary NPC. The data suggest that CK8 may be related to the differentiation and lymphonode metastasis of NPC,and may serve as molecular biomarkers for metastasis and differentiation of NPC.

The aging process of human colonic epithelium involves a slow decline in physiological vigor and an increasing susceptibility to age-related diseases, especially, colon cancer, but the molecular mechanisms of the aging and susceptibility of aged colonic epithelium to carcinogenesis is still unclear. Identification of aging related proteins in colonic epithelium will help to reveal the molecular mechanisms of colonic epithelial aging and age-related colonic diseases. Therefore, the total proteins of human normal colonic epithelial tissues from 10 young and 10 old men were separated by two-dimensional gel electrophoresis(2-DE), respectively. PDQuest software was applied to analyze 2-DE images, the differentially expressed protein spots of colonic epithelium between young and old groups were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS), and the expression levels of partial identified proteins were determined by real-time quantitative PCR and immunohistochemistry. Well-resolved, reproducible 2-DE maps of human colonic epithelial tissues from young and old men were established, 17 aging related proteins were identified by MALDI-TOF-MS, and the differential expression levels of partial identified proteins were confirmed by real-time quantitative PCR and immunohistochemistry. The results indicate that injury of mitochondrial function and decline of antioxidant capability are important reasons for the aging of human colonic epithelium, and four differential proteins (guanine nucleotide-binding protein beta subunit-like protein, stress-70 protein, 40 S ribosomal protein SA and chloride intracellular channel protein1) may be involved in susceptibility of aged colonic epithelium to carcinogenesis.