Objective:To investigate the value of diffusion-weighted imaging (DWI) quantitative parameters with different b values in the diagnosis of prostate cancer and its correlation with prostate cancer diagnosis to determine the optimal b values.Methods:Forty-one patients with pathologically confirmed prostate cancer who were admitted by Yuyao People's Hospital from May 2019 to April 2021 were included in this study. Forty-seven foci were selected to undergo 1.5T MR high-resolution T 2-weighted imaging (T 2WI) and DWI. Four different b values (800, 1 000, 1 500, 2 000 s/mm 2) were applied to DWI. The apparent diffusion coefficient (ADC) values and areas of tumor region were measured on different b-value ADC maps. Tumor signal intensity and area were measured on DWI. The same area in the same layer was selected as the reference area to calculate and analyze the signal intensity. Results:The ADC values of tumor area were 0.93 ± 0.21, 0.87 ± 0.19, 0.76 ± 0.17 and 0.68 ± 0.14 when b values were 800, 1 000, 1 500 and 2 000 s/mm 2, respectively, which were significantly different from the ADC values of the reference area (1.59 ± 0.26, 1.50 ± 0.27, 1.28 ± 0.25, and 1.08 ± 1.84, t = 13.53, 13.08, 11.79, 7.30, all P < 0.01). However, there was no significant difference in the signal intensity ratio (-0.26, -0.27, -0.25, -0.22) on the ADC maps of tumor area under different b values ( P = 0.52). The DWI signal intensities of tumor region were 68.2 ± 19.1, 59.5 ± 18.8, 47.9 ± 17.7, and 50.1 ± 11.5, respectively when b values were 800, 1 000, 1 500, and 2 000 s/mm 2, respectively, which were significantly different from the DWI signal intensities of reference area (49.1 ± 17.7, 38.7 ± 11.3, 25.3 ± 6.9, 19.6 ± 4.5, t = 5.02, 6.50, 9.43, 16.93, all P < 0.01). DWI signal intensity ratio of tumor region at the b value of 800 s/mm 2 was significantly different from that at the b value of 1 000, 1 500 and 2 000 s/mm 2 (0.16 vs. 0.21, 0.30, 0.33, t = 10.84, 23.27, 22.85, all P < 0.01). DWI signal intensity ratio at the b value of 1 000 s/mm 2 was significantly different from that at the b value of 1 500 and 2 000 s/mm 2 ( t = 12.34, 14.10, both P < 0.01). Conclusion:High b-value DWI ( b ≥ 1 500 s/mm 2) has a remarkable advantage in the diagnosis of prostate cancer over low b-value DWI.

Objective:To explore the advantages of the modified right renal artery dissection in the laparoscopic resection of right renal carcinoma combined with venous tumor thrombus.Methods:From January 2016 to June 2016, a retrospective analysis of the three-dimensional CT images of renal blood vessels in 70 patients with full abdominal CT plain scan plus enhanced scan from Shandong Provincial Hospital Affiliated to Shandong First Medical University was performed. On the sagittal plane of the right margin of the aorta, the right renal artery was detected to locate above the left renal vein in 14 cases (20.0%), posterior in 33 cases(47.1%), and below in 23 cases(32.9%). In addition, on the sagittal plane of the left margin of the inferior vena cava, the right renal artery was detected to locate above the left renal vein in 1 case (1.4%), posterior in 26 cases(37.1%), and below in 43 cases (61.4%). Based on this finding, 11 patients with right kidney cancer combined with venous tumor thrombus, admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from June 2016 to December 2019, were retrospectively analyzed. The average age of the patients was(58.7±6.8)(45-68) years old. The CT three-dimensional reconstruction of the renal blood vessels was shown on the sagittal plane of the right margin of the aorta before the operation, and the right renal artery was detected to locate above the left renal vein in 0 cases, posterior in 7 cases, and lower in 4 cases. On the sagittal plane of the left margin of the inferior vena cava, the right renal artery was detected to locate above the left renal vein in 0 case, behind in 3 cases, and below in 8 cases. Renal tumors are located in the upper middle in 5 cases and in the lower middle in 6 cases. The maximum diameter of the tumor to be resected was 8.5-12.0 cm, with an average of (10.0±1.4) cm. Among them, 4 cases had Mayo grade 0 tumor thrombus, 4 cases were grade Ⅰ tumor thrombus, and 3 cases were grade Ⅱ tumor thrombus. All 11 cases underwent transperitoneal laparoscopic surgery. During the operation, it was found that the relationship between the right renal artery and the left renal vein was consistent with the preoperative three-dimensional reconstruction of renal blood vessels. The modified right renal artery dissection method was used, that is, the right renal artery was detected and ligated between the inferior vena cava and the aorta, using the left renal vein as a mark, and then the right kidneys and vein tumor thrombi were removed.Results:All of the 11 operations in this group were completed successfully. The operation time was (110.5±29.8)(70-150) min, the average time of right renal artery dissection was(28.5±5.8)(16- 33) min, and the amount of intraoperative bleeding was(112.7±83.5)(20-300) ml. No serious complications occurred during the operation in 11 cases. Postoperative pathological examination showed 10 cases of clear cell carcinoma and 1 case of papillary cell carcinoma. The postoperative hospital stay was 4.2 (4.18±0.75) days. There were no complications such as secondary bleeding, infection, lower extremity venous thrombosis or pulmonary embolism. All 11 patients were followed up for 3 to 42 months, with an average of(19.5±12.1) months. One patient died 23 months after the operation, and no tumor recurrence or metastasis occurred in the remaining patients.Conclusions:When the right renal artery runs to the left edge of the inferior vena cava, it is mostly behind the left renal vein. In the laparoscopic resection of right renal cancer with venous tumor thrombus, the modified right renal artery dissection method can quickly find and dissociate the right renal artery. The operation time is short, the intraoperative bleeding is less, and no postoperative complications occur.

Objective: To investigate the clinical value of endoscopic ultrasonography (EUS) and Multi-slice Spiral CT (MSCT) in the preoperativestaging of tumor(T) and lymph node (N) metastasis in patients with SiewertⅡand Ⅲ typeadenocarcinoma of esophagogastric junction(AEG). Methods: Clinical data of 145 Siewert Ⅱ and Ⅲ type AEG patientswithout preoperative chemoradiotherapy were retrospectively reviewed. Theyall received preoperative EUS and MSCT examination and underwent surgical resection, and the results of EUS and MSCT were compared with their postoperative pathologic staging. Results: The sensitivity, specificity, and accuracy of EUS for T stage in Siewert Ⅱ and Ⅲ type AEG were higher than those of MSCT. The total accuracy of EUS and MSCT were 90.3% and 63.5%, respectively, and the difference was statistically significant (χ²=29.52, P<0.01). The sensitivity of EUS for T1, T2 and T3 were 89.5%, 91.1% and 85.2%, respectively, which were significantly higher than 42.1%, 66.7% and 29.6% of MSCT (χ²=9.47, P<0.01 for T1; χ²=8.07, P<0.01 for T2; χ²=17.40, P<0.01 for T3). In addition, the total accuracy of EUS and MSCT for lymph node metastasis status of Siewert Ⅱ and Ⅲ type AEG were 75.9% and 64.8%, respectively, showing a statistically significant difference(χ²=4.23, P=0.04). The sensitivity of EUS for N1 and N2 were 82.1% and 79.2%, respectively, which were significantly higher than 53.6% and 60.4% of MSCT (χ²=5.24, P=0.02; χ²=4.48, P=0.03). There was no statistical significance for sensitivity of EUS and MSCT in N0 and N3 (P>0.05). Conclusion EUS diagnosis of T and N staging in Siewert Ⅱ/Ⅲ type AEG showed significantly greater performance than MSCT.

Objective To explore the diagnostic value of the concentration of plasma circulation microRNA155 (miRNA155) in ulcerative cilitis (UC) and its correlation with clinical characteristic of UC.Methods From October 2010 to August 2012,a total of 136 patients diagnosed as UC were enrolled,and at same time,170 healthy individuals were set as healthy control.The blood samples of all participants were obtained and plasma was isolated.The adsorption column was used for RNA extraction according to miRNeasy kit instruction.RNA was reverse-transcribed into cDNA with miScript reverse transcription kit.cDNA was a template and miRNA155 real-time quantitative polymerase chain reaction (PCR) was performed with miScript SYBR Green PCR kit.The relative quantity of miRNA155 expression was calculated with 2-△△Ct method.Analysis of variance were performed for comparison between groups.Receiver operating characteristic curve analysis was used for the diagnostic value of miRNA155 concentration in UC.Multiple linear regression analysis was used for the correlation between miRNA155 concentration and clinical characteristics of UC.Results The concentration of plasma circulation miRNA155 of patients with UC ((1357.43±326.15) fmol/L)was higher than that of healthy controls ((1140.70 ± 312.47) fmol/L) and the differences were statistically significant (F=35.56,P＜0.01).The area under receiver operating characteristic curve of the concentration of plasma circulation miRNA155 of patients with UC was 0.847,and the 95 ％CI was 0.806 to 0.888 (P＜0.01).When the concentration of plasma circulation miRNA155 was 1404.51 fmol/L,its specificity in the diagnosis of UC was 94.7％,and sensitivity was 40.4％.There was correlation between the concentration of plasma circulation miRNA155 and the disease activity in patients with UC (F=12.91,P＜0.05).However there was no correlation with the severity and location of the disease (both P＞0.05).Conclusion Plasma circulation miRNA155 highly expressed in patients with UC,and its concentration is correlated with the disease activity.

Objective To investigate the effects of nephroblastoma overexpressed (NOV) on proliferation,adhesion,migration and invasion of remal cell curcinomai (RCC) cells. Methods We constructed a NOV expression plasmid and transfected the plasmid into RCC cell line 786-O and analyzed the effects of NOV expression on proliferation,adhesion,migration and invasion of RCC cells by growth curve assay,WST-1 assay,cell adhesion assay,matrigel invasion assay and transwell migration assay. Results The stable NOV transfected 786-O cells (786-O-NOV) showed decreased growth rate,at 48 h and 72 h,the proliferation activities of 786-O-NOV cells were inhibited by 29.14％ and 32.46％ the proliferation activities of empty vector cells were inhibited by 9.25％ and - 8.16％,respectively,compared to 786-O cells (P ＜0.05); while the 786-O cells transfected with empty vector (786-O-mock) had no difference with 786-Ocells.Adhesion assay indicated significantly increased adhesion of 786-O-NOV cells to fibronectin (0.26 ±0.03) and laminin (0.28 ±0.04),compared to 786-O cells (0.15 ±0.01,0.12±0.10) and 786-O-mock cells (0.14 ±0.02,0.13 ± 0.08).Invasion assay displayed that the numbers of cells penetrated through matrigel membrane were significantly higher in 786-O-NOV cells (240.25 ± 23.12) compared to 786-O cells ( 56.16 ± 6.25 ) and 786-O-mock cells ( 50.28 ± 7.13 ).Migration assay displayed that the numbers of cells passed through polycarbonate filters were significantly higher in 786-O-NOV cells (267.25 ± 20.94) compared to 786-O cells ( 66.10 ± 5.68 ) and 786-O-mock cells ( 56.28 ± 4.11 ).Conclusion NOV exhibits anti-proliferative effects on RCC cells; however,it promotes adhesion,migration and invasion of RCC cells.

Objective To collect data and analyze the current status and prevalence changes of Crohn's disease (CD) in mainland China in recent decades. Methods A computer-based literature search was previously performed by using 50-year (1950 to 2002) of records of CD from the Chinese Database of Biology and Medicine (CBM) (1979 to 2002) and a manual year-by-year search of the literature ( 1950 to 1978). Using similar method, descriptive epidemiological data from 2003 to 2007 were collected, analyzed and compared with previous research. Results Four hundred and seventeen relevant papers during 2003 and 2007 were collected and 62 papers were eligible for inclusion. Within 62 papers, a total of 2149 cases with CD from 2003 to 2007 have been reported nationwide, comprising 1288 male and 861 female patients, result (ie,1526 cases from 1950-2002). There were no obvious changes in incidence age (younger and middle age were main components) and sex ratio ( number of male was still larger than that of female). The extrapolated CD incidence and prevalence rates were 1.21/100 000 person ? year and 2.29/100 000, respectively, which were higher than that of year 1950-2002, 0.28/100 000 person ? year and 1.38/ 100 000, respectively. Conclusions The incidence and prevalence rates of CD have been increasing rapidly, but these rates are still lower than those in Western world.

Objective To investigate the gene polymorphism of inhibitory killer cell immunoglobulin- like receptor (iKIR) in patients with inflammatory bowel disease (IBD) and whether the iKIR gene polymorphisms were associated with IBD.Methods Peripheral blood DNA samples were isolated from 100 patients with ulcerative colitis (UC),52 patients with Crohn's disease (CD) and 106 randomly ethnically matched healthy controls.The iKIR gene polymorphisms were analyzed by sequence specific primer polymerase chain reproduction (PCR-SSP).Phenotypic frequency and gene frequency of iKIR gene were calculated,and differences were compared between IBD patients and healthy controls.Results iKIR genes (including KIR2DL1,KIR2DL2,KIR2DL3,KIR2DL4,KIR2DL5,KIR3DL1,KIR3DL2, KIR3DL3) were found to be present in all subjects at different levels.Interestingly,phenotypic frequencies of KIR2DL1 and KIR2DL3 were significantly lower in UC patients than those in healthy controls (P = 0.001),while phenotypic frequencies of KIR2DL2,KIR2DL4,KIR2DL5,KIR3DL1, KIR3DL2 and KIR3DL3 were no difference between UC patients and healthy controls (P>0.05).The phenotype frequency of KIR2DL1 was significantly decreased in CD patients compared with healthy controls (P = 0.007),while phenotypic frequencies of other iKIR were observed to be no significant change between CD patients and healthy controls (P>0.05 ).Conclusions The KIR2DL1 and KIR2DL3 gene phenotype frequencies are decreased in UC patients,which suggests that these gene polymorphisms are associated with the susceptibility of UC,and the polymorphism of KIR2DL1 gene is involved in the susceptibility of CD.

American doctor Koretz and his colleagues have collected the documents on randomized control test(RCT) of total parenteral nutrition(TPN) during past 30 years since 1974.With stringent standard,Dr.Koretz et al performed the Meta-analysis to evaluate the efficacy of TPN.This article summarized the result of Koretz's Meta-analysis and also reviewed the efficacy of TPN on some special clinical conditions such as acute pancreatitis,HIV infection,respiratory disease,burns,home TPN et al.The result couldn't determine the curative effect of TPN.TPN is usually not recommended to be routinely applied on hospital patients,but applicable to selective patients.

Crohn's disease (CD) is a chronic,relapsing and disabling inflammatory bowel disease.Although the cause is unknown,defects in innate and adaptive immune pathways have been identified and biological therapies that target key molecules have been designed and dramatically improved treatment of CD patients.The disease is currently increasing in China.The symptoms of CD are heterogeneous but commonly include abdominal pain,diarrhea and weight loss,which are largely dependent on the stages (early,active,remitted,and chronic active stages,respectively) of the disease.A single gold standard for the diagnosis of CD is not available.The diagnosis is confirmed by clinical evaluation and a combination of endoscopic,histological,radiological,and/or biochemical investigations.Behavior of the disease varies substantially during its course.About 13%～20% of patients with CD have a chronic active course of disease.67%～73% have a chronic intermittent course for several years.After 20 years most patients will need surgery.The life expectancy is slightly reduced.

Objective To assess the value of combined assays of anti Saccharomyces cerevisia antibody (ASCA) and perinuclear antineutrophil cytoplasmic antibody (pANCA) in differential diagnosis of inflammatory bowel disease (IBD). Methods Nineteen patients with IBD, including 9 patients with Crohn's disease(CD) and 10 patients with ulcerative colitis(UC), and 18 healthy subjects were enrolled into study. Serum levels of pANCA and ASCA (IgG and IgA) were measured by indirect immunofluorescence technique and a standardized ELISA, respectively. Results The serum levels of ASCA IgG and ASCA IgA in CD patients (18.51? 6.38 and 11.74 ? 5.46 ) were significantly higher than those in UC patients ( 6.98 ? 5.24 and 3.88 ? 3.52 ) and healthy subjects( 5.90 ? 4.12 and 4.62 ? 3.21 )respectively (P