Objective To observe the value of MRI for differential diagnosis of ovarian granulosa cell tumor(OGCT)and ovarian thecoma-fibroma(OTF).Methods Data of 37 females with OGCT(OGCT group)and 74 with OTF(OTF group)were retrospectively analyzed.MRI parameters were compared between groups.Multiple logistic regression analysis was performed,and the efficacy of each parameter alone and their combination for distinguishing OGCT and OTF were observed.Results Significant differences of cystic-solid classification,degree of cystic changes,the maximum diameter of cyst area of lesions,T2WI signal,enhancement degree and apparent diffusion coefficient(ADC)of the solid part of lesions,presence of honeycomb sign/cheese sign,presence of tumor blood vessels and bleeding were found between groups(all P＜0.05).Degree of cystic changes,ADC and presence of honeycomb sign/cheese sign were impact factors of MRI for distinguishing OGCT and OTF.The area under the curve(AUC)of the above three for distinguishing OGCT and OTF was 0.834,0.868 and 0.744,respectively,and of the combination was 0.934,greater than any alone(all P＜0.05).Conclusion MRI features such as degree of cystic changes,ADC and presence of honeycomb sign/cheese sign were helpful for distinguishing OGCT and OTF.

Objective:To study the role and possible molecular mechanism of neural precursor cell-expressed developmentally down-regulated gene 4-like ( NEDD4 L) in the replication of hepatitis B virus (HBV). Methods:Small interfering RNA (siRNA) targeting NEDD4 L, plasmid expressing NEDD4 L with hemagglutinin(HA) C-terminal tag (pcDNA3.1- NEDD4 L-HA), plasmid expressing 1.3×HBV genome (pGEM-HBV1.3) and poly (dAT: dAT) were respectively transfected into HepG2 cells using Lipofectamine2000. HepG2.2.15 cells, a cell line that can stably express HBV, were used as control. The mRNA levels of NEDD4 L, interferon (IFN)-α, IFN-β, interferon-stimulated gene 56 ( ISG56), myxovirus resistance protein A ( MxA), oligoadenylate synthetase ( OAS), and the levels of HBV DNA or 3.5 kb HBV RNA were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Western blot was used to detect the silence and over-expression of NEDD4 L, and the protein levels of the related signaling molecules. The amount of IFN-β in the cellular supernatant was measured by enzyme linked immunosorbent assay (ELISA). Student t test was used for comparison of continuous data between groups. Results:The levels of NEDD4L mRNA and protein in HepG2.2.15 cells were 10.53±0.47 and 4.17±0.43, respectively, which were both statistically higher than those in HepG2 cells (1.00±0.05, t=3.27, P=0.008 and 1.26±0.25, t=1.68, P=0.030, respectively). In HepG2 cells with knockdown of NEDD4 L, the expression level of HBV DNA in cellular supernatant was 0.32±0.09, which was statistically lower than that in the control (1.00±0.05, t=-0.93, P=0.020), and the expression level of 3.5 kb HBV RNA was 0.49±0.11, which was statistically lower than that in the control (1.00±0.05, t=-0.68, P=0.040), while the mRNA levels of IFN-β and downstream effector molecules ( ISG56, MxA and OAS) were all significantly increased compared with the control ( t=4.66, 9.38, 7.29 and 7.01, respectively, all P<0.01). With poly (dAT: dAT) treatment and vesicular stomatitis virus (VSV) stimulation, the levels of IFN-β in HepG2 cells with knockdown of NEDD4 L were (776.41±115.49) ng/L and (961.21±130.19) ng/L, respectively, which were both statistically higher than those of the control group ((320.15± 56.05) ng/L, t=2.43, P=0.020; (440.17±67.82) ng/L, t=2.85, P=0.030, respectively). With poly (dAT: dAT) treatment and VSV stimulation, the levels of IFN-β in HepG2 cells with overexpression of NEDD4 L were (156.18±26.47) ng/L and (176.67±34.51) ng/L, respectively, which were both statistically lower than those of the control group ((320.38±49.39) ng/L, t=-2.03, P=0.040; (440.59±68.83) ng/L, t=-1.93, P=0.030, respectively). Western blot showed that the replication of HBV reduced the protein level of melanoma differentiation-associated protein 5 (MDA5), a key molecule in upstream of IFN-β, but the down-regulation was not obvious in cells with the knockdown of NEDD4 L. Conclusion:The replication of HBV could promote the up-regulation of NEDD4L protein and subsequently reduce the protein level of MDA5, thereby inhibiting the production of IFN-β, which facilitates HBV to escape the innate immune response.

Objective To introduce a new method of trans-superior limb of cerebellopontine fissure approach for exploring and managing superomedial responsible vessels of facial nerve of patients with hemifacial spasm.Methods Clinical data of 21 patients with hemifacial spasm among 183 consecutive patients were analyzed retrospectively in our hospital from February 2009 to December 2013.Dissection of the superior limb of the cerebellopontine fissure was performed to explore the distribution and the severity of compression of the superomedial responsible vessels of the facial nerve,and microvascular decompression was performed.Results Neurovascular compression was found in all of the patients,primary responsible vessels were found in 13 patients,and secondary responsible vessels were found in 8 patients.Complete spasm alleviation was achieved immediately after operation in 18 patients,and complete spasm alleviation was achieved in all of the patients 3 months after operation.No severn complications occurred and no patient died.No recurrence was noted after an average 56 months of follow-up.Conclusion The trants-superior limb of cerebellopontine fissure approach could avoid the defects of standard suboccipital retrosigrnoidal approach,which allows easy identification and management of the superomedial responsible vessels of the facial nerve of patients with hemifacial spasm;thus,high consistent successful rate and low complication rate could be found.

ABSTRACT:Objective To explore the role of HIF‐1αin the pathogenesis of hepatopulmonary syndrome (HPS) and its relationship with GRP78 .Methods The HPS model in rats was induced by multiple pathogenic factor .The samples were assessed by using Western blotting analysis for HIF‐lα, GRP78 and VEGF164 . The expressions of VEGFR‐2 and CD105 were observed by using immunohistochemical staining .Results The protein level of HIF‐1αwas significantly increased in HPS group at week 8 compared with that at week 4 and 6 groups and corresponding normal control groups .With the development of HPS ,protein level of GRP78 was gradually increased at each time point significantly and reached the highest level at week 8 ;protein level of VEGF164 showed a similar change with GRP78 ,but the peak was at week 6 .Immunohistochemical results showed that the protein expressions of VEGFR‐2 and CD105 were gradually increased in lung tissue as HPS progressed .The protein level of GRP78 was positively correlated with HIF‐1α,VEGF164 ,VEGFR‐2 and CD105 ,respectively (P<0 .05) .Conclusion HIF‐1αis most likely together with GRP78 to play a critical role in promoting pulmonary microvascular remodeling in the pathogenesis of HPS in rats .

China ; Counseling ; Female ; HIV Infections ; diagnosis ; Humans ; Pregnancy

OBJECTIVETo investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture, Sichuan province.

METHODSA retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System. Cox proportion hazard regression model was used to identify impact factors related survival time.

RESULTSAmong 8 310 ART AIDS patients who initially received ART, their mean age was (34.59 ± 9.10) years old, 65.50% (5 443 cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68 ± 21.69) months. 436 cases died of AIDS related diseases, 28.67% (125 cases) of them died within the first 6 months of treatment. The cumulative survival rate of receiving ART in 1, 2, 3, 4 5 years were 97.11%, 93.41%, 90.61%, 88.81%, 86.02%, respectively. Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR = 1.57, 95% CI: 1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR = 1.64, 95% CI: 1.20-2.24), before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR = 1.53, 95% CI: 1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases (HR = 1.80, 95% CI: 1.39-2.34). The patients with baseline CD4 (+) T lymphocytes cell counts < 50/µl (HR = 9.79, 95% CI: 6.03-15.89), 50-199/µl (HR = 3.26, 95% CI: 2.32-4.59), 200-349/µl (HR = 1.69, 95% CI: 1.22-2.34), were at a higher risk death than those with CD4 (+) T lymphocytes cell counts ≥ 350/µl.

CONCLUSIONAccumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province. AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4 (+) T lymphocyte count have higher risk of death.

Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adult ; Anti-Retroviral Agents ; therapeutic use ; Asian Continental Ancestry Group ; China ; Female ; Humans ; Lymphocyte Count ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Substance Abuse, Intravenous ; Survival Rate ; Tuberculosis ; complications

Technologies for glycomics usually involve methods for separation and purification of poly-saccharides, and separation, structure resolution, quantification, property investigation and function comment of glycan chains. Because of the different biochemical properties of glycoproteins, proteogly-cans and glycolipids, the separation and purification of polysaccharides involve corresponding fractional precipitation, boric acid affinity, titanium dioxide, affinity chromatography, size exclusion method, and gel filtration chromatography column chromatography methods. The lectins, water affinity chromatogra-phy , solid phase extraction and other technologies could be applied to the oil enrichment of high pure and specific glycan chains. The structure of glycan chains can be analyzed using lectin microarray technolo-gy, mass spectrometry, and derivatization markers of glycan chains. lsotope labelling and metabolic labeling can be used to quantify glycan chains. The glycan biological function can be better understood using glycan chain structure analysis software and database of glycan chains by bioinformatics.

Objective To evaluate TriVex based transilluminated powered phlebectomy (TIPP)three-stage management for lower limb venous ulcers.Methods This retrospective study included 86 patients with 103 diseased limbs treated in our hospital from October 2005 to July 2013.All received TriVex TIPP three-stage management.Results After therapy there was no acute cellulitis,skin necrosis nor lower limb deep venous thrombosis.There were 2 cases of subcutaneous ecchymosis,1 case of subcutaneous hematoma,1 case of skin abnormal sensation and 1 case of subcutaneous induration.Ulcers healed within one month postoperation in all cases,while skin abnomalities were alleviated with no ulcer recurrence during the follow-up ranging from 4 to 48 months.Conclusions TriVex TIPP centered threestage management is a good option for lower limb venous ulcer,with shortened healing time,low recurrence rate.

Objective To investigate the value of electronic rectosigmoidoscopy in health examinations.Methods Based on retrospective analysis of 30 250 patients who received electronic rectosigmoidoscopy in the Physical Examination Center of our hospital from May 2010 to Dec.2013,the incidence of anal disease and sigmoid colon disease were analyzed.Results The highest detection rate of common diseases was hemorrhoids,followed by proctopolyps,hypertrophy of anal papilla,proctitis,anal fissure,melanosis coli and colonic tumor.The detectable rate of them were 55.57％ (16 810/30 250),10.57％ (3 196/30 250),5.03％ (1 523/30 250),0.69％ (210/30 250),0.54％ (162/30 250),0.29％ (87/30 250),0.09％ (28/30 250),0.04％ (13/30 250),0.02％ (6/30 250).Conclusion Electronic colonoscopy for colorectal polyps,rectal cancer,colon melanosis and proctitis detection rate was significantly higher than the anus digital rectal examination,the difference is statistically significant,and it also has merits of simplicity,noninvasiveness and rapidity.

Objective:To explore the correlation among risk factors of hypertension and waist-to-height ratio (WHtR) in officers of regiment and above in troops stationed in Zhejiang .Methods :A total of 2641 officers of regi-ment and above from troops stationed in Zhejiang ,who participated in annual physical examination in our hospital from 2012 to 2013 ,were selected .Correlation among body mass index (BMI) ,waist circumference (WC) ,WHtR , waist/hip ratio (WHR) and blood pressure were analyzed ;receiver operator characteristic curve (ROC) was used to compare and analyze the predictive value of above four indexes on hypertension and judge the optimal cut-off point . Results :(1) Pearson correlation analysis indicated that WHtR was positively correlated with WC ,BMI ,WHR ,sys-tolic and diastolic blood pressure (r=0.25~0.94 ,P<0.005~ <0.001);(2) Among above four indexes ,WHtR had the largest area under the ROC curve 0.697 (95% CI 0.676~0.718) and the optimal cut-off point was 0.51 ;and it's 0.651 (95% CI 0.639~0.662) for BMI ,0.689 (95% CI 0.664~0.751) for WC and 0.685 (95% CI 0.672~0.698) for WHR ;for morbidity risk of hypertension ,compared with BMI ,WC and WHR ,WHtR possessed the most balanced sensitivity (60.68% ) and specificity (70.74% ) ,and the largest OR 4.12 (3.71~4.59) .Conclusion:(1) Among officers of regiment and above in troops stationed in Zhejiang ,anthropometric indexes are closely relat-ed to blood pressure ,which can be regarded as simple indexes for predicting and assessing morbidity risk of the popu-lation ;(2) Waist-to-height ratio may be the best anthropometric index evaluating risk of hypertension in these popu-lation and its optimal cuf-off point is 0.51 for predicting hypertension .