Background/Objectives: This study aims to investigate the effects of 4-methylumbelliferone (4-MU) on islet morphology, cell phenotype and function, and to explore possible mechanisms of β cell regeneration. Methods: The Type 1 diabetes (T1D) model was induced by continuous dose injection of streptozotocin (STZ), and mice were treated with 4-MU for 3 weeks. Plasma insulin level, islet cell phenotype and immune infiltration were determined by IPGTT, ELISA, HE and immunofluorescence. The Ins2Cre/+/Rosa26-eGFP transgenic mice model was used to detect β identity change. Primary rodent islets were incubated with 4-MU or vehicle in the presence or absence of STZ, AO/PI staining, and a scanning electron microscope (SEM), PCR and ELISA were used to evaluated islet viability, islet morphology, the specific markers of islet β cells and insulin secretion. Results: Treatment with 4-MU significantly decreased blood glucose and increased plasma insulin levels in STZ-induced diabetes. The plasma insulin level in the STZ group was 7.211 ± 2.602 ng/mL, which was significantly lower than the control group level (26.94 ± 4.300 ng/mL, p < 0.001). In contrast, the plasma insulin level in the STZ + 4-MU group was 22.29 ± 7.791 ng/mL, which was significantly higher than the STZ group (p < 0.05). The 4-MU treatment increased islet and β cells numbers and decreased α cell numbers in STZ-induced diabetes. Conclusions: Islet inflammation as indicated by insulin and CD3 was caused by infiltrates, and the β cell proliferation as indicated by insulin and Ki67 was boosted by 4-MU. β cell dedifferentiation was inhibited by 4-MU as assessed by insulin and glucagon double-positive cells and confirmed by Ins2Cre/+/Rosa26-eGFP mice. In cultured primary rodent islets, 4-MU restored islet viability, protected islet morphology, inhibited β-cell dedifferentiation, and promoted insulin secretion. The benefits of 4-MU in T1D have been proved to be associated with β cells self-replication, dedifferentiation inhibition and immune progression suppression, which help to maintain β cell mass.

Background The tumour microenvironment (TME) has occupied a potent position in the tumorigenesis and tumor progression of hepatocellular carcinoma (HCC). Radiogenomics is an emerging field that integrates imaging and genetic information, thus offering a novel class of non-invasive biomarkers with diagnostic, prognostic, and treatment response. However, optimal evaluation methodologies for radiogenomics in patients with HCC have not been well established. Therefore, this study aims to develop a radiogenomics models, associating contrast-enhanced computed tomography (CECT) based radiomics features and transcriptomics data with TME, to increase predictive precision for overall survival (OS) in patients with HCC. Methods Transcriptome profiles of 365 patients with HCC from The Cancer Genome Atlas (TCGA)-HCC cohort were used to obtain TME-related genes by differential expression analysis. TME-related radiomics features of 53 patients with HCC from The Cancer Imaging Archive (TCIA)-HCC cohort matched with the TCGA-HCC cohort were screened via correlation analysis. Furthermore, a radiogenomics score-based prognostic model was constructed using the least absolute shrinkage and selection operator (LASSO) Cox regression analysis in the TCIA-HCC cohort. Finally, the ability to predict prognosis and the value of the model in identifying the abundance of immune cell infiltration were investigated. Results A radiogenomics prognostic model was developed, which incorporated 1 radiomics feature [original_gray-level co-occurrence matrix (glcm)_inverse difference normalized (Idn)] and 3 genes [spen paralogue and orthologue C‑terminal domain containing 1 (SPOCD1); killer cell lectin like receptor B1 (KLRB1); G protein-coupled receptor 182 (GPR182)]. The model performed satisfactorily in the training and test sets [1-year, 2-year, 3-year area under the curve (AUC) of 0.81, 0.85 and 0.87 in the training set, respectively; and 0.73, 0.83, and 0.84 in the test set, respectively]. Moreover, the model showed that higher radiogenomics scores were associated with worse OS and lower levels of immune infiltration. Conclusions The novel CECT-based radiogenomics model may provide valuable insights for prognostic stratification and TME assessment of patients with HCC.

目的 比较经导管肝动脉化疗栓塞术(TACE)联合阿帕替尼与单纯TACE治疗中晚期原发性肝细胞癌(HCC)的临床效果及安全性.方法 收集本院2017年1月-2020年1月收治的52例中晚期HCC患者的临床资料,按治疗方法不同分为观察组及对照组,每组26例.观察组行TACE和阿帕替尼治疗,对照组行单纯TACE治疗,比较两组治疗后1、3、6个月时的客观缓解率(ORR)、不良反应发生情况和无进展生存期(PFS).结果 治疗1、3个月时两组ORR比较,差异无统计学意义(P＞0.05);治疗6个月时观察组ORR高于对照组,差异有统计学意义(P＜0.05);两组AFP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P＜0.05);观察组PFS高于对照组,差异有统计学意义(P＜0.05);观察组高血压、手足综合征、腹泻发生率高于对照组,差异有统计学意义(P＜0.05);不良反应经剂量调整及对症处理后均较前缓解.结论 TACE联合阿帕替尼治疗中晚期HCC的中远期疗效优于单纯TACE治疗,且安全有效.

目的 探讨子宫动脉栓塞术(UAE)治疗瘢痕妊娠(CSP)的效果.方法 选取我院2018年1月-2021年10月收治的CSP患者64例,按随机数字表法分为实验组和对照组,每组32例.对照组常规采用清宫术治疗,实验组采用UAE联合清宫术治疗,比较两组术中出血量、术后第3天β-hCG水平、β-hCG恢复正常时间及住院满意度评分,分析实验组术中灌注成像灌注参数值,记录灌注成像的TDC参数变化.结果 实验组患者清宫术中出血量、住院天数、β-hCG恢复正常时间均优于对照组,差异有统计学意义(P＜0.05);栓塞前后,实验组患DSA灌注成像TDC各参数均发生变化,差异有统计学意义(P＜0.05).结论 子宫动脉栓塞术治疗瘢痕妊娠效果良好,可提升清宫术的效果和安全性,值得临床应用.

Gene-engineered vascular endothelial cells have acquired satisfactory ischemia therapy in animal models. However, its clinical process is still severely limited by the hurdle of transfection-structure-toxicity and single therapeutic pathway. To this end, inspired by green process, we innovatively introduced “green” concept into gene delivery. “Green” means fully utilizing carrier and gene via simple, economic and nontoxic process. Herein, the combined strategy of “bioactive carrier” and “CO2-modification” was proposed. On the basis of the cascaded expression from ZNF580 to endothelial nitric oxide synthase (eNOS), we designed cationic peptide based on L-arginine as bioactive carrier to deliver pZNF580. Furthermore, CO2-bubbling was performed to endow bioactive carrier with pH-sensitive nanobomb effect. The carrier dramatically enhanced endo/lysosomal escape via nanobomb effect for high pZNF580 delivery and expression. In turn, carrier changed “enhanced vehicle” identity into NO substrate after completing gene delivery and further was catalyzed by transfection-triggered eNOS overexpression, which greatly amplified NO generation via their synergistic promotion. This simple design obtained dual-high results of ZNF580 (to mediate angiogenesis) and NO (to mediate angiogenesis and anti-inflammation) level. In critical hind limb ischemia (CLI) mice, the strategy simultaneously promoted angiogenesis and mitigated inflammation, which co-worked to recover blood flow and rescue limb. Besides, it was nontoxic to muscle tissue. The multi-pathways achieved significant CLI treatment. Taken together, we established a positive feedback between CO2-enhanced bioactive carrier and target-gene expression via green design and process. This can maximize and expand the output of gene therapy through simplifying the input of gene complexes, thus guaranteeing high transfection, simple structure and low toxicity. We believe that this green strategy will provide a novel viewpoint for gene delivery.

目的 通过对比分析肝脏恶性肿瘤介入栓塞术前与术后,病变区域DSA灌注成像各参数的变化情况,探讨DSA灌注成像技术在肝恶性肿瘤介入栓塞术中的应用价值.方法 选取31例肝恶性肿瘤患者,进行选择性肿瘤供血动脉栓塞术.每例患者术前、术后均进行DSA灌注成像,获得术前、术后病变区DSA灌注成像时间密度曲线及灌注参数;然后采用配对t检验对两组参数进行统计学分析.以P ＜0.05为差异有统计学意义.结果 31例患者术前、术后病变区DSA灌注成像时间密度曲线各参数变化明显,差异有统计学意义(P＜0.05).结论 肝恶性肿瘤介入栓塞术前、术后各组灌注参数存在差异,能够作为栓塞效果的评价依据,具有重要的临床应用价值.

目的 探讨常规CT征象及MaZda纹理分析技术在鉴别肺纯磨玻璃结节(pure ground glass opacity,pGGO)侵袭性的诊断价值.方法 选取93例(97个pGGO)肺腺癌患者,分为侵袭前组及侵袭性组.用Mazda软件对CT平扫肺窗图像进行纹理分析:分析方法(直方图、绝对梯度、游程矩阵、共生矩阵、自回归模型和小波转换);提取特征参数方法(费希尔算法、分类误判率+平均相关系数法、相关信息测度);B11判别方法(主成分分析法、线性判别分析、非线性判别分析),得到鉴别pGGO侵袭性的误判率并进行ROC检验,CT及临床资料进行SPSS统计分析.结果 Fisher+ LDA组合误判率最低,为2/97(2.06％).筛选得到10个最优纹理参数(均值、五个百分位灰度值、三个逆差距、非零化百分比),P值均＜0.01.CT征象鉴别pGGO侵袭性在结节大小、形状、毛刺征、胸膜凹陷征、血管走行关系中差异有统计学意义(P＜0.01).结论 常规CT征象及MaZda纹理分析用于鉴别肺pGGO侵袭性是可行的.

目的 评估125I粒子植入联合支气管动脉灌注化疗治疗中晚期非小细胞肺癌(NSCLC)患者前后癌胚抗原(CEA)及细胞角蛋白19片段(CYFRA21-1)水平变化及临床疗效.方法 回顾性分析87例中晚期NSCLC患者的临床资料,根据治疗方法的不同分为两组:联合组42例行125I粒子植入联合支气管动脉灌注术,灌注组45例行支气管动脉灌注化疗术,比较两组血清CEA、CYFRA21-1浓度的动态变化及对临床治疗效果的影响.结果 联合组和灌注组术后1、3、6、12月缓解率分别为14.3％、54.7％、66.6％、72.2％和8.8％、28.8％、38.6％、39.3％,联合组缓解率高于灌注组,术后两组CEA及CYFRA21-1浓度均较术前下降,联合组血清CEA及CYFRA21-1浓度低于灌注组(P＜0.05).联合组及灌注组中位生存时间分别为20个月和15个月,中位无进展生存时间分别为1 1个月和7个月,联合组生存率显著高于灌注组(x2=11.028,P=0.001),差异有统计学意义.术后血清CEA和CYFRA21-1降低组有效率及生存率均明显高于CEA和CYFRA21-1增高组(P＜0.05).结论 125I粒子植入联合支气管动脉灌注化疗治疗中晚期NSCLC疗效确切,可有效降低患者血清中CEA、CYFRA21-1的浓度,且CEA、CYFRA21-1的动态变化可预测患者的预后.

目的:探讨利用CT平扫与动脉期图像纹理分析在鉴别膀胱乳头状瘤和膀胱癌中的应用价值.方法:回顾性纳入自2016年1月至2020年1月在安徽医科大学第三附属医院就诊的经病理证实的64例膀胱肿瘤患者的病例资料,其中良性病变32例,恶性病变32例.所有患者均行CT三期动态增强扫描,选择其平扫与动脉期图像来进行研究.使用MaZda纹理分析软件对扫描图像上的膀胱病变进行纹理特征的提取,再用费希尔参数(Fisher)法、最小分类误差与最小平均相关系数法(POE+ACC)及相关信息测度法(MI)分别筛选出鉴别膀胱良恶性病灶的10个最佳纹理参数,使用Mazda的B11工具的主成分分析法(PCA)、线性判别分析法(LDA)和非线性判别分析法(NDA)对选取的最佳纹理特征进行分析,计算出其鉴别膀胱良恶性肿瘤的最小误判率(R),对最小误判率所对应的最佳纹理参数进行ROC检验,筛选出最有辅助鉴别意义的可量化参数来对膀胱良恶性肿瘤进行鉴别诊断.结果:基于CT平扫时以MI+NDA组合的误判率最低(1.56％),所筛选的最佳纹理参数分别为WavEnHH_s-1(高高频小波系数转换s-1)、Horzl_Fraction(水平游程图像分数)、Horzl_ShrtREmp(水平短游程补偿)、Sigma(参数σ)、Variance(方差),对应的AUC值分别为0.932、0.897、0.902、0.935和0.849,P值均小于0.01,联合这五项指标综合分析的AUC值为0.985,特异度96.87％,敏感度96.87％.在动脉期以POE+ACC+NDA组合的误判率最低(1.56％),所筛选的最佳纹理参数分别为WavEnHH_s-1(高高频小波系数转换s-1)、WavEnHH_s-2(高高频小波系数转换s-2)、135dr_ShrtREmp(短游程补偿135方向)、GrVariance(绝对梯度方差),对应的AUC值分别为0.916、0.711、0.797和0.793,P值均小于0.01,联合这四项指标综合分析的AUC值为0.916,特异度84.37％,敏感度81.25％.联合平扫+动脉期所有最佳纹理参数综合分析的AUC值为0.997,特异度93.75％,敏感度100％.结论:利用CT平扫与动脉期图像纹理分析对膀胱乳头状瘤和膀胱癌的鉴别具有一定的应用价值.

Objective To investigate the modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer.Methods The clinical data of 187 patients,including 99 male cases and 88 female cases with the average age (64.5 ± 10.8) years old (ranged from 37 to 87 years),with radical resection of rectal cancer were analyzed retrospectively in Anqing Hospital Affiliated of Anhui Medical University between August 2014 and October 2018,and the occurrence of early postoperative complications was analyzed according to the modified Clavien-Dindo grade system.The relationship between 32 variables and complications in the data was analyzed by single factor and multiple factors in order to explore the risk factors of early postoperative complications.Results One hundred and eighty seven patients with radical proctectomy,54 cases (28.9％,54/187) had early postoperative complications,including 15 cases of serious complications (8.0％,15/187),3 cases were performed second surgeries under general anesthesia (1.6％,3/187).Postoperative modified Clavien-Dindo Grade:12 cases with grade Ⅰ,27 cases with grade Ⅱ,11 cases with grade Ⅲ a,3 cases with grade Ⅲ b,1 case with grade Ⅳ a,no case with grade Ⅳ b and Ⅴ.The results of single factor analysis showed age (x2 =4.788,P =0.029),ASA grade (x2 =26.903,P =0.000),multiple organ resection (x2 =4.749,P =0.029),pT stage (x2 =8.080,P =0.044),pTNM stage (x2 =6.29,P =0.043),total harvested lymph node number (x2 =5.542,P =0.019).The occurrence of early complications after radical proctectomy,multi-factor analysis found that ASA grade (OR =3.539,P =0.000),pTNM stage (OR =1.846,P =0.034) was an independent risk factor for early postoperative complications of rectal cancer.The area (AUC value) under the curve of the prediction of early postoperative complications in patients with ASA grade and pTNM stage was 0.708 (95％ CI:0.625-0.791,P =0.000) and 0.555 (95％ CI:0.469-0.642,P =0.235).Conclusions Early complications after radical resection of rectal cancer are closely related to ASA grade and tumor pTNM staging.ASA grade can be used as a significant predictor of early complications after radical proctectomy in rectal cancer.

目的:探讨肝动脉化疗栓塞(TACE)术前天冬氨酸氨基转移酶与淋巴细胞比值(ALRI)对肝癌患者预后的影响.方法:收集78例肝癌患者TACE术前临床相关资料,计算患者术前ALRI,绘制ROC曲线确定临界值,采用Kaplan-Meier和Cox回归模型对肝癌患者行单因素及多因素生存分析,确定无进展生存期(PFS)和总生存期(0S)的独立预测因素.结果:ALRI=22.82时对于预测生存状态具有最大的敏感度和特异度.Kaplan-Meier生存分析表明ALRI>22.82的肝癌患者平均OS、PFS时间均显著短于术前ALRI≤22.82,差异均有统计学意义(P<0.05).Cox回归模型分析显示ALRI是影响患者PFS和OS的独立预测因素(P<0.05).结论:术前ALRI可以作为预测TACE术后肝癌患者预后的独立因素,患者TACE术前ALRI较低往往提示该患者的预后较好.

目的:探讨早期胃癌(EGC)的临床病理特征和淋巴结转移的关系以及淋巴结转移对EGC患者预后的影响.方法:对安徽医科大学附属安庆医院2010年10月-2018年12月手术治疗的186例EGC患者临床资料进行回顾性分析.结果:186例EGC患者中,17例(9.1％)出现区域淋巴结转移.单因素分析显示,黏膜下癌(T1b)患者淋巴结转移率高于黏膜内癌患者(T1a) (15.1％vs.4.2％,x2=5.177,P=0.023);病灶最大径＞2 cm患者淋巴结转移率高于病灶最大径≤2 cm患者(14.3％vs.5.5％,x2=4.190,P=0.041);伴有脉管浸润患者淋巴结转移率高于无脉管浸润患者(50.0％vs.6.8％,x2=21.247,P=0.000);总淋巴结清扫≥15枚患者淋巴结转移率高于淋巴结清扫＜15枚患者(12.5％vs.0,x2=6.879,P=0.009);患者性别、年龄、肿瘤部位、大体类型、分化程度、手术方式与淋巴结转移均无明显关系(均P＞0.05).多因素分析结果显示,伴有脉管浸润是EGC淋巴结转移的独立危险因素(RR=6.886,95％ CI=1.399～33.898,P=0.018).173例(93.0％)患者具有完整随访资料,随访时间2～95个月.全组EGC患者3、5年累计生存率分别为96.1％、92.4％,其中无淋巴结转移患者分别为97.1％、95.5％,有淋巴结转移患者分别87.5％、65.6％,尽管前生存率优于后者,但差异无统计学意义(x2=2.478,P=0.115).结论:黏膜下层浸润、病灶最大径＞2 cm、伴有脉管浸润的EGC患者有更高的区域淋巴结转移风险,因此对EGC要进行规范的淋巴结清扫以准确的判断术后病理分期及决定后续治疗.淋巴结转移对EGC患者预后的影响还需进一步的长期随访研究确定.

Objective To investigate the correlation between neutrophil/lymphocyte ratio (NLR) and prognosis in patients with advanced non-small cell lung cancer (NSCLC). Methods The clinical data of 68 patients with advanced non-small cell lung cancer who underwent interventional therapy from January 1, 2014 to January 1, 2017 were retrospectively analyzed. The preoperative NLR values were calculated and divided into high NLR group (NLR≥3.8) and low NLR group (NLR＜3.8) by establishing ROC survival curve. The progression-free survival time and total survival time of the two groups were compared, and the patients may be affected. The prognostic risk factors were analyzed by single factor and multivariate factors. Results The median overall survival was 421 d in all patients after interventional therapy. The median overall survival was 292 d in the high NLR group and 506 d in the low NLR group,the difference was statistically significant(P＜0.05); at the same time, the median progression-free survival time was 152 d in the high NLR group and 341 d in the low NLR group, the difference was statistically significant(P＜0.05). In the univariate analysis, the presence of distant metastasis, the number of interventional procedures ＜3 times and NLR ≥ 3.8 were risk factors affecting the overall survival time and progression-free survival time (P＜0.05); in the multivariate analysis, there was a distant place. Metastasis and NLR≥3.8 were independent risk factors for the overall survival time (P ＜0.05). The presence of distant metastasis, the number of interventional procedures ＜3 times and NLR≥3.8 were independent risk factors for progression-free survival (P＜0.05).Conclusion Preoperative NLR can be used as a prognostic indicator for patients with advanced NSCLC. The prognosis of NLR is poor.

Objective Ischemia-reperfusion (IR) injury is a leading cause of flap compromise and organ dysfunction during free-tissue transfer,and remains a great challenge for plastic surgeons.Thioredoxin-1 (Trx-1) was proved to protect the IR flap by mitigating the oxidative stress,and inhibiting the activation of apoptosis signal-regulating kinase-1 (ASK-1) and mitogen-activated protein kinase (MAPK) pathway.The aim of this study is to investigate the distinction of Trx-1 expression,apoptosis indices in different layers of IR flaps,and the feasibility of tissue-layer-specific administration of Trx-l.Methods Ten patients' specimens of IR flaps for DIEP breast reconstruction were collected and assessed for apoptosis and Trx-1 expression.Twenty mice were used to establish the IR flap model.The mice were sacrificed twenty-four hours after reperfusion.The flap tissues were harvested and tested by immunohistochemistry staining and TUNEL assay.The tissue-layer-specific dermoprotective effect of Trx-1 and the molecular mechanisms were assessed by an in vitro epithelial skin cell hypoxia-reoxygenation model.The statistics were conducted by t test and ANOVA using SPSS 20.0.Results Trx-1 expression and apoptotic cells were observed mainly located in the basal layer of epidermis and the papillary layer of dermis in human IR flaps and mice models.Trx-1 depletion was 24.19 ％± 2.23％ in the basal layer of epidermis and the papillary layer of dermis of patient IR flaps,decreasing significantly compared with 70.71％ ± 6.38％ in control group (t =27.54,P＜ 0.001).Similar tissue-layer-specific down regulation of Trx-1 also displayed in mice IR flap models (19.83％ ± 2.34％ vs.76.59％ ± 4.88％;t =34.71,P＜0.001).The apoptotic index in human samples significantly increased from 1.32％ ± 1.52％ in control group to 43.71％± 3.17％ in IR group (t =38.23,P＜0.001);while it was proved to be dramatically raised in mice models from 0.86％ ± 1.15％ in control group to 41.14 ％± 4.21％ in IR group (t =36.96,P ＜ 0.001).Western Blot analysis revealed Trx-1 down regulation and a significant increase in ASK-1,p-p38,and c-PARP abundance in the hypoxia-reoxygenation-treated HaCaT cells (P ＜ 0.01).Supplementation of recombinant human Trx-1 significantly reduced the apoptosis-related protein expression.Conclusions The basal layer of epidermis and the papillary layer of dermis are the main damaged tissue layers in the early stage of skin flap ischemia-reperfusion injury.The IR flap can be protected by precisely replenishing the vulnerable layers with Trx-1.

目的 了解脑分水岭梗死(CWI)可能的发生机制.方法 选取经磁共振弥散加权成像(DWI)及磁共振血管成像(MRA)检查证实过的45例超急性或急性期CWI患者进行对照研究.结果 在所有的45例超急性或急性期CWI患者中,7例(15.6％)为皮质前型,8例(17.8％)为皮质后型,26例(57.8％)为皮质下型,4例(8.9％)为混合型,所有患者的脑动脉病变中都存在有一支或多支脑动脉严重狭窄、闭塞或分支减少.45例CWI患者中33例只有一支动脉发生变窄,包括颈内动脉(ICA)变窄者9例,大脑前动脉(ACA)变窄者2例,大脑中动脉(MCA)变窄者22例,未发现大脑后动脉(PCA)变窄患者.结论 CWI与脑内动脉血管狭窄显著相关,脑动脉血管严重狭窄、闭塞以及远端分支减少引起血流灌注的减少是重要发病原因,特别是ICA和MCA血管病变更易发生.

目的 探讨如何提高胸肺部DSA图像质量.方法 回顾性评价20例患者胸肺部DSA图像质量的影响因素,作为对照组.采取改善影响图像质量的措施,再行胸肺部DSA检查21例,作为观察组.将两组图像质量进行比较.结果 对照组的图像质量评分是(1.83±0.75)分;观察组的图像质量评分为(2.90 ±0.84)分;后者图像质量高于前者(t=-9.02,P＜0.05).结论 通过控制影响图像质量因素,能够提高胸肺部DSA图像质量.

Objective To analyze the imaging features of endometrial carcinoma derived from multimodal MRI.Methods MRI scan was performed in 45 patients with biopsy-proved endometrial carcinoma,including conventional MRI,diffusion weighted imaging(DWI),dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI),and time-signal curve (TIC).Results The diagnosis rate of DCE-MRI combined with DWI was 93.3%, and that of conventional MRI was 77.8%.Tumor differentiation was negatively correlated with ADC and rADC, and significant difference was found between G2 and G3 as well as G1 and G3 (both P<0.05).There was no significant difference between G1 and G2 (P>0.05).Of the 45 cases, 43 showed TIC type Ⅰ and type Ⅱ, and 2 showed TIC type Ⅲ, while the normal myometrium was mainly type Ⅲ curve.The difference of signal intensity of each phase (D), and enhancement rate (ER) of the lesions were lower than those of the normal myometrium.The difference was statistically significant at the phase of >30 s(P<0.05),the peak time of the former was (50±10) s.Conclusion Multimodal MRI is of great value in preoperative staging and grading of endometrial carcinoma.

Objective The study was to validate the effectiveness of ART scoring system in the overall survival of hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolization (TACE) and TACE-guided retreatment.Methods Between Jan 2005 and Jan 2014,54 patients with HCC underwent ≥2 TACE sessions within 90 days at our Hospital.They were investigated for their performance of the ART score in the context of overall survival (OS).Results The median OS of all 54 patients was (18.6 ± 2.4) months,and 37 patients showed a low ART score (0 ～ 1.5),and 17 had a high ART score (≥ 2.5);the median OS was 23.7 ± 2.2 and 7.5 ± 2.8 months,respectively (P ＜ 0.001),the difference was statistically significant.And the radiologic tumor responses (P =0.001) were significantly associated with OS.Conclusion ART scoring system would be a suitable prediction for the overall survival of HCC patients who underwent ≥ 2 TACE sessions within 90 days in China,and guide clinicians when to terminate TACE.Besides,radiologic tumor response is an independent prognostic factor of HCC patients.

Objective To summarize the clinical curative effect and preliminary experience of using spring coil endovascular embolization in the treatment of diffuse pulmonary arteriovenous fistula (PAVF).Methods Two patients with diffuse PAVF,with father and daughter relationship,underwent the enhanced CT.Both patients had diffuse PAVF as evidenced by CT and confirmed by selective pulmonary artery angiography.Then,they were subjected to the divided selective embolization of arteriovenous fistula with the spring coils.Th adult patient was received 3 times of successive thrombosis embolism and the child was received 2 times of successive thrombosis embolism.The intra-operative embolization was preferred to carry out on the large quantity of shunt lesions.One month post-operation,the blood oxygen saturation and blood routine were tested and the follow-up was conducted via the enhanced CT one year after surgery Results The operation was performed smoothly.The intra-operative pulmonary artery angiography showed that the lesions were embolized completely.No any complications occurred.one month later,the blood oxygen saturation increased by 78％,75％ to 91％,86％,correspondingly.The blood cells decreased from 8.17 × 1012/L,7.27 × 1012/L to 6.63 × 1012/L,6.28 × 1012/L.The hemoglobin decreased from the 254 g/L,199 g/L to 186 g/L,161 g/L.One year after the operation,the re-examination showed no arteriovenous fistula.The child was found to have the cerebral venous malformation complicated with cerebral hemorrhage.Conclusion Intravascular embolization is an effective method for the treatment of diffuse PAVF,with less trauma and significant recent effect.

To develop a new nanobiosystem based on folate-functionalized silica-coated gold nanorods and to investigate its cellular uptake and intra-organ biodistribution in vitro and in vivo.