ObjectiveTo explore the protective effects and possible mechanism of different type of proton pump inhibitors (PPIs) in non-steroid anti-inflammatory drugs (NSAIDs)induced small intestinal injury.MethodsSeventy two SD rats were randomly and equally divided into control group,model group,Omeprazole treated group,Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group.Except control group,rats of other groups were gavaged with diclofenac 7.5 mg · kg-1 · d-1,once daily to make NSAIDs related small intestinal injury model.The treated groups were gavaged with Omeprazole 30 mg · kg1· d-1,Esomeprazole 30 mg· kg1 · d-l,Lansoprazole 45 mg · kg1 · d-1 and Rabeprazole 15 mg · kg-1 · d-1 once daily respectively.Continuous administration for five days and then executed,small intestinal tissues were taken and observed for gross and pathological changes.The expression level of nuclear factor erythroid-2-related factor 2(Nrf2) at protein and mRNA level were detected with western blot and real time PCR assay.The qualitative and location of Nrf2 in small intestinal tissue were analyzed by immunohistochemistry staining and the activity of superoxide dismutase (SOD) and malondialdehyde (MDA) in small intestinal tissue were determined with xanthine oxidase method and TBA respectively.ResultsThe successful rate of modeling experiment was 100％.The survival ratio of control group rats,model group,Omeprazole treated group,Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group was 12/12,3/12,2/12,1/12,1/12 and 2/12 respectively.The tissue injure scores of Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group were significantly lower than that of model group (P＜0.05).The activity of SOD in small intestinal of Rabeprazole treated group was obviously higher than that of model group (P＜ 0.05),while the activity of MDA in Rabeprazole and Esomeprazole treated groups were significantly lower than that of model group (P＜0.05).The results of westen blot indicated that the expression of Nrf2in small intestinal tissue was obviously higher in Rabeprazole treated group than in model group (P＜0.05).The real time PCR results suggested that the expression of Nrf2 at mRNA level in small intestinal tissue of Rabeprazole treated group was obviously higher than those of model and control groups (P＜0.05).Conclusions The protection effects of various PPIs are different in NSAIDs related intestinal injury.There is no obvious protection effect of Omeprazole.Rabeprazole may prevent NSAIDs related intestinal injury by up-regulating expression of Nrf2 and promoting its activation.

ObjectiveTo compare the accuracy of the four sequences of MRI in the diagnosis of articular cartilage injury of the knee and to investigate the advantage and shortage of the four sequences. In order to evaluate the most adequate sequence in detecting articular cartilage injury of the knee. Methods36 knee joints of 31 patients,underwent MRI scanning prior to arthroscopy included T1WI-TSE,T2 WI-TSE-SPIR, PDW-TSE-SPIR,3D-WATSC. Divided each knee side of every cartilage into five parts. Investigated and diagnosed the 180 articular cartilage surface according to Recha criteria by detecting and compared with arthroscopic examination respectively. The accurate criteria of the four sequences of MRI was sensitivity, specificity, accuracy. The criteria of correlation was the value of Kappa.ResultsCompared with the arthroscopic result which was the gold standard, the sensitivity, specificity, accuracy and Kappa value of the T1 W-TSE sequence was 63.8％ ,95.3％ ,78.8％ and 0. 403 respectively;The sensitivity,specificity ,accuracy and Kappa value of the T2WI-TSE-SPIR sequence was 56.3％ ,97.6％ ,76.1％ and 0. 353 respectively.The sensitivity,specificity,accuracy and Kappa value of the PDW-TSE-SPIR sequence was 79. 8％, 93.0％ ,86. 1％and 0. 642 respectively; The sensitivity, specificity, accuracy and Kappa value of the 3D-WATSC was 96. 8％,88. 3％ ,92.8％ and 0. 812 respectively. ConclusionThe accuracy and Kappa values of Fat-suppressed three-dimensiunal fast spoiled gradient-echo sequence (3D-WATSC)was superior to other sequences in the diagnosis of articular cartilage injury of the knee. The correlation between 3D-WATSC and arthroscopy in detecting cartilage injury was remarkable. 3D-WATSC had been deemed the most adequate sequence in detecting articular cartilage injury of the knee.

Objective To evaluate the early diagnosis value of MRI combined with DSA in cirrhotic nodules (regenerative nodules, dysplastic nodules) becoming small hepatocellular carcinoma. Methods 40 patients diagnosed as cirrhosis and whose liver nodules detected by ultrasound were followed up as MR dynamic study. All patients were followed up by three dynamic contrast-enhanced MR scanning once every 3 months,and the changes of cirrhotic nodules were observed and analyzed in the signal. If MRI suggested cancerous nodules cirrhosis, hepatic artery DSA would be carried out. Results 40 patients were followed up for 1.5 to 3 years,all patients MR nodules were found in liver regeneration. Follow-up process, the dysplastic nodules were founded in 28 cases and the small hepatocellular carcinoma were founded in 18 patients. 16 cases of 18 patients with small hepatocellular carcinoma carried out routine DSA all had typical of hepatic arterial blood supply and angiogenesis, and were given to Integrated Traditional and Western intervention simultaneously. Conclusion Combined use of MRI-DSA in the evaluation of cirrhotic nodules had a definite value, and could find smaller hepatocellular carcinoma,provide the basis for smaller hepatocellular carcinoma therapy.

Objective To decrease misdiagnosis and to improve the correct diagnostic rate of mammary tuberculosis .Methods 9 cases of mammary tuberculosis proved by operation and pathology misdiagnosed as other diseases were retrospectively analyzed.Results Among 9 cases,5 cases were misdiagnosed as mammary cancer,1 case as chronic mammary inflammation,1 case as mammary abcess,1 case as mammary hyperplasia,1 case as mammary fibroadenoma.Conclusion The reasons leading to misdiagnosis are unsuitable methods of examinations,lack of solid basic knowledge,and lack of experience.