Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P ＞ 0.05);in the skin incision,there was statistically significant difference between two groups (P ＜ 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P ＜0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P ＜ 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P ＜ 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P ＜ 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P ＜ 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.

Objective: To explore the impact of arsenic on cholesterol efflux and the expression of ATP-binding cassette, sub-family A, member 1 ( ABCA1 ), ATP-binding cassette transporter G1 ( ABCG1 ), and scavenger receptor class B member I ( SRBI ) in macrophages, so as to provide the evidence for the mechanism of arsenic induced atherosclerosis. Methods: The human myeloid leukemia mononuclear cells ( THP-1 ), induced by phorbol myristate acetate, and mouse primary macrophages were treated with 0, 0.625, 1.25, 2.5 and 5 μmol/L NaAsO2 for 48 hours. Then the cells treated with 2.5 μmol/L NaAsO2 were changed to arsenic free mediums for 48 hours and collected every 12 hours to analyze the time effect of arsenic. The expression levels of ABCA1, ABCG1 and SRBI were determined by quantitative polymerase chain reaction and western blotting. Cholesterol efflux rates were measured by 3H isotope tracer. Results: Arsenic significantly down-regulated the expression levels of ABCA1 and ABCG1, and cholesterol efflux in a dose-dependent manner. The levels of ABCA1 mRNA decreased by 69% and 72%, the levels of ABCG1 mRNA decreased by 42% and 34%, and the rate of cholesterol efflux decreased by 55% and 59% in THP-1 and mouse primary macrophages cells treated with 5 μmol/L NaAsO2 ( all P<0.05 ). Arsenic had no significant effect on SRBI expression ( all P>0.05 ). Arsenic inhibited ABCA1 expression and cholesterol efflux in THP-1 in a time-dependent manner. Compared with cells before the exposure of arsenic, the level of ABCA1 mRNA and the rate of cholesterol efflux in THP-1 bottomed at 48 hours by 43% and 42%, and gradually recovered when arsenic was removed. Conclusions Arsenic inhibits cholesterol efflux by down-regulating the expression of ABCA1 and ABCG1 in macrophages.

Objective To investigate the association of the LIPC-C480T (rs1800588) and lipid levels and dyslipidemia in different age-and-sex groups in Han Chinese population.Methods The serum TC,TG,LDL-C and HDL-C were detected by automatic biochemical analyzer in 2420 health adults (1527 men and 893 women).The genotypes of rs1800588 were detected by M ALDI-TOF MS.According to the age difference (≤44,45-59 and ≥60-year-old),the total samples were divided to young (241 men and 201 women),middle-aged (652 men and 360 women) and older (634 men and 332 women) groups.The effects of genotypes on 4 serum lipid indicators in each age-and-gender group were analyzed by one way analysis of variance (ANOVA),and the odd risk of genotypes on dyslipidemia was estimated by binary Logistic regression analysis.The P value less than 0.05 was considered statistically significant.Results The frequence of allele T for LIPC rs1800588 in this population is 39.4％.In each age group the lipid parameters are quite different between males and females.Compared with those with CC genotype,middle-aged and elder men with CT or TT genotype have higher TC and HDL-C levels,and elder men with TT genotype also have higher TC level ; young women bearing CT genotype have higher TC level,and the CT and TT genotypes have higher HDL-C levels,middle aged women with CT or TT genotype have higher TC and TG levels,and CT genotype also have higher HDL-C level,the elder women with TT genotype have higher HDL-C level.Compared with those CC genotype individuals,the risk for mixed hyperlipidemia and hypercholesterolemia increases 2.318 folds (P =0.004) and 2.571 folds (P ＜ 0.001) respectively,while the risk for low HDL-C decreases 1.908 folds (P =0.029) for TT genotypes individuals among elder males; the hypercholesterolemia risk increasc 1.688 (P =0.036) and 2.099 times (P =0.040) in CT and TT genotypes respectively,and the risks for hypertriglyceridemia and mixed hyperlipidemia are 2.060 (P =0.038) and 2.381 (P =0.019) times higher than those with CC genotype among middle-aged females.Conclusions The LIPC rs1800588 site associates with the lipid levels and dyslipidmia risk in Han Chinese in an age-and-sex model.This SNP site has higher impact on lipid levels and dyslipidemia among elder males and middle-aged females,and the T allele is the risk factor.

Objective To study the hemodynamic changes and pathologic foundation of rabbit models of radiation-induced lung injury (RILI) via 64-slice CT pulmonary perfusion imaging ( CTPI),in order to seek the correlation between the alterations of the hemodynamic parameters and pathophysiology.Methods Seventy-two healthy New Zealand rabbits were randomly classified into two groups:test group ( n =36),received 25 Gy with single fraction irradiation in a whole unilateral lung; control group ( n =36),received sham-irradiation.Each group was divided into 12 subgroups respectively according to post- and pseudo-irradiation time points (1,6,12,24,48,72 h and 1,2,4,8,16,24 w).Each rabbit underwent HRCT and CTPI at every pre- and post-radiation time point.All rabbits were sacrificed,and morphology of specimens was observed using light- and electron microscope. The changing regularity of HRCT,CTPI parameters and pathology were analyzed and compared with each other in order to find the correlation among them.The CTPI parameters of the test and control groups were compared using t test.The CTPI parameters and pathological values were analyzed using linear correlation with two variables,the detection rates of RILI by CTPI and HRCT was compared using Chi-square test.Results ( 1 ) The changes of CTPI parameters from control group after irradiation was relatively stable,but in test group those parameters including rBF,rBV and rPS,at pre- and post-irradiation time points (0,72 h and 2 w),were respectively 1.01 ± 0.09,1.86 ± 0.20,1.43 ±0.12,1.03 ±0.08,1.63 ±0.19,1.56±0.14,0.96±0.12,1.54 ±0.17 and 1.83 ±0.24.The corresponding parameters before and after irradiation were significantly different ( t =2.90-6.37,P ＞ 0.05).(2)In test group,capillary endothelial cells,basement membrane and alveolar epithelial cells,as the main injury targets,showed certain alterations in pathology.There was a significant correlation between the changes of CTPI parameters ( rBF and rBV) and pathophysiology in control group ( r =0.74,0.83,P ＜0.05 ),with the dependent relationship between rPS and the amounts of RBC outside the capillary and the destruction of basement membrane( r =0.87,0.88,P ＜ 0.01 ).(3)The detection rate of RILI with CTPI (72.2％,26/36) was obviously higher than that with HRCT( 16.7％,6/36,x2 =4.37,P =0.036).Conclusions CTPI parameters is capable of revealing the rule of hemodynamic process and reflecting the pathophysiologic state of different stages of RILI.By the time of detecting RILI,the detection rate of CTPI is clearly superior to that of HRCT,which yields potential value in predicting RILL

Objective To investigate the clinical value of multi-slice CT angiography (MSCTA) of lower limbs in patients with peripheral arterial occlusive disease (PAOD) using the test-bolus technique.Methods Forty-four patients with PAOD were enrolled consecutively in the study.In group I, 18 subjects underwent CTA by bolus triggering method and in group 2, 26 subjects underwent CTA by test-bolus technique.During scanning procedure in group 2 subjects, the bolus transit time to aorta ( TAO ), popliteal arteries (Tpop ) and aorto-popliteal bolus transit time (T,) were calculated through dynamic acquisition at their respective level and the delay time were immediately set as TAO and scan time as double Tt.Two independent senior attending physicians with training experience in interpreting CTA determined the quality of each arterial segment visualization based on 5 parameters (1.visible farthest branch, 2.clarity of vessels border, 3.presence of venous contamination, 4.grading of stenosis, 5.CT value at 4 arterial segments).Inter-observer agreement on imaging quality between readers was evaluated using Cohen's k statistic by calculating K values.X2 test and t test were used to compare the quality of images in both groups.Results In group 2 patients,a larger individual variation in transit time of the contrast to reach aorta was obserued [ TAO = ( 17.1 ± 2.6) s with a range of 12.0—22.0 s ] and aorto-popliteal transit time [ Tt = ( 14.8 ± 5.5 ) s with a range of 8.0—24.0 s ].CTA of group 2 patients demonstrated bettor quality over group I patients' CTA, especifieally in the infra-pop|iteal and foot area arteries. There was an excellent inter-observer agreement for group 2 patients ( K ＞ 0.80 ) whereas in group 1 agreement in infra-popliteal segments for venous contamination ( K value 0.60 ) and stenosis degree ( K value 0.50 ) were not satisfactory enough.Group 1 patients were reported to have more severe stonosis in infra-popliteal and foot arteries( X2 = 30.55 and22.41,P＜0.01).Conclusion There was a wide interindividual variation in transit time for contrast medium to reach aorta and pollteal artery. Adaptive method by using two low-dose test bolus injection determined interindividual variation in delay time and scan time and thus above parameters was able to produce better quality images than using bolus triggering technique in below knee and foot region arteries.

Objective To explore the CT and pathological features of renal epithelioid angiomyolipoma (EAML). Methods Clinical data and CT images from ten cases with EAML proved by surgery and pathology were retrospectively analyzed. All cases were performed with plain and contrast enhanced CT scans. Results CT features: higher pre-contrasted density than kidney, bulging from kidney,absent of fat, markedly heterogeneous enhancement ( quick wash-in and slow wash-out), big size without lobular sign, complete capsule with clear margin and mild necrostic area. Pathological features: diffuse sheets of epithelioid cells were found under microscopy with immunohistochemistrical findings including positivity for HMB-45 and negativity for EMA. Conclusion Some specific CT features, which is correlated well with the pathological findings, provide helpful information in the primary diagnosis of EAML.

Objective To establish the rabbit model of radiation-induced lung injury (RILI) for the study of CT perfusion. Methods Forty-eight New Zealand rabbits were randomly divided into two groups, 36 rabbits in test group were administered with 25 Gy of single fractionated irradiation in the whole unilateral lung, and the other 12 rabbits in control group were sham-irradiated. All rabbits were sacrificed at 1, 6, 12, 24, 48, 72 h, and 1,2, 4, 8, 16, 24 week after irradiation respectively, then six specimens were extracted from upper, middle and lower fields of bilateral lungs, respectively. The pathological changes were observed with light and electron microscopies. The expression of TNF-α and TGF-β1 in local lung tissue was detected by immunohistochemistry. Results In test group, RILI occurred at early stage,characterized by acute inflammatory reaction, and featured by the progressing fibrosis at later stage. The expression of TNF-α and TGF-β1 1 and 72 h post-irradiation were statistically different between test and control groups (t = 3.04-14. 95,P ＜ 0. 05 ). Thickness of alveolar wall, density of pulmonary interstitium 12 h of post-irradiation, amount of fibroblast and fibrocyte from interstitium 24 h post-irradiation were statistically different between two groups ( t = 4.44-39. 78, P＜ 0.05 ), and correlated with the time postirradiation (r = 0. 821, 0. 872, 0. 682). There was statistical differences among the relative amount of collagen fibers at time points post-irradiation in test group ( F = 100.31, P ＜0.05), while no difference in control group ( F= 1.00, P ＜ 0.05 ). The relative amount of collagen fibers was statistically different between two groups 72 h post-irradiation (t = 3.07-45.18, P＜0.05 ), and correlated with the time postirradiation (r = 0.993 ). Conclusions Stable and reliable rabbit model of RILI could be established through single fractionated irradiation in whole unilateral lung with 25 Gy of high-energy X-rays, which may simulate the occurrence and development of evolution of RILI.

Objective To determine the expression of CD4+ CD25+ FOXP3+ regulatory T cells(Treg cells) in peripheral blood of patients with hepatocellular carcinoma (HCC) and investigate the clinical significance of Treg cells determination in clinical practice. Methods Flow cytometry was employed to measure the levels of CD4+ CD25+ T cells and CD4+ CD25+ FOXP3+ T cells in peripheral blood of 18 HCC patients, 26 hospitalized patients without HCC (clinical control) as well as 24 healthy persons (healthy control). Results The percentage of CD4+ CD25+ T cells in total CD4+T cells isolated from the HCC patients(4.25% ± 3.98 % ) was elevated significantly compared to that in the clinical control group (1.34% ± 1.14%) or healthy control group (1.29% ±0.95%) (both P＜0.01). There was no difference in the percentage between the clinical control group and the healthy control group (P＞0.05). Meanwhile, the ratio between CD4+ CD25+ FOXP3+ T cells and CD4+ T cells in HCC patients (2.94%0.91%) also increased significantly compared to that in the clinical control group (0.76% ± 0.34%) or healthy control group (0.81% ± 0.29%) ( both P＜0. 001), which showed a more obvious increasing tendency than the ratio of CD4+ CD25+ T cells and CD4+ T cells. No difference in percentage of CD4+ CD25+ FOXP3+ T cells in CD4+ T cells was found between the clinical control group and the healthy control group (P＞0.05). Conclusion As the more accurate regulatory T cells, CD4+ CD25+ FOXP3+ T cells are able to detect the increase of population in HCC patients. Therefore, it is important to determine the levels of CD4+ CD25+FOXP3+ T cells in HCC patients for prevention and treatment of malignancy.

Objective:To investigate therapeutic efficacy and mechanisms of action of oncolytic agent derived from herpes simplex virus type 2 (oHSV2) in a xenograft mouse model bearing CT26 colorectal cancer. Methods:BALB/c mice were subcutaneously inoculated with CT26 cells to establish a xenograft mouse model of colorectal cancer. 1) After intratumoral administration of oHSV2, enzyme-linked im-munosorbent assay was used to determine granulocyte-macrophage colony-stimulating factor (GM-CSF) expression levels in the blood. 2) Model mice were divided into three groups:PBS group (negative control), oHSV2 group, and 5-fluorouracil (5-FU) group (positive control). After drug administration, drug effectiveness was evaluated on the basis of weight, tumor volume, general state, and survival time. 3) Cells from the draining lymph nodes (TDLN) and tumor were surgical y removed and used to quantify mature dendritic cel s (DCs) and T lym-phocytes by flow cytometry. Result:1) In the CT26 xenograft model, level of GM-CSF continuously elevated. At day 8, peak value was attained in the blood at concentration of 3150±327.1 pg/mL. Then, GM-CSF expression gradually reduced as time progressed. 2) In in vivo study, both oHSV2 and 5-FU exerted antitumor effects relative to PBS group (50 days vs. 36 days, P<0.01;51 days vs. 36 days, P<0.01), and oHSV2 proved to be less toxic and safer. At day 28, the 5-FU group presented highly significant difference in mouse body weight compared with that of PBS group (16.61 g vs. 22.07 g, P<0.01). However, oHSV2 group did not show statistical y significant change (al P>0.05). Skin of virus injection region did not present necrosis and ulceration. 3) In the TDLN, the frequency of DC was increased when treated with oHSV2 compared with the control group (6.49%vs. 3.73%, P<0.01). Similarly, the percentage of CD4+and CD8+T-cel s from the oHSV2-treated group was signifcantly higher than mock-treated tumors (15%vs. 8.57%, P<0.01;8.19%vs. 5.15%, P<0.01). However, number of cells in the 5-FU group were significantly reduced with respect to that of the negative group (al P<0.01). Conclusion:oHSV2 exerted potent antitumor effects in a murine colorectal cancer model. Compared with 5-FU, oHSV2 treatment caused fewer side effects. Such antitumor effect may be induced by stimulation of immune activity by GM-CSF production.

Objective Analysis of myocardial microvascular perfusion in patients with chronic total coronary occlusion (CTO) who underwent a coronary artery bypass graft (CABG) use real-time myocardial contrast echocardiography (RTMCE),to provide an effective method of detecting viable myocardium and a reference for the choice of CABG indications.Methods Twenty-seven patients with CTO underwent RTMCE 1 week before CABG,they underwent follow-up echocardiography and coronary artery 256-slice multislice computed tomography aagiography 1 year after CABG.Myocardial viability was defined as a postoperative ultrasound wall motion significantly improved ≥ 1 point.Semi-quantitative analysis of contrast images,myocardial viability was defined as myocardial perfusion score ≤ 2 points.Viable myocardium by quantitative assessment of myocardial blood flow (MBF) was determined by analyses of receiver-operating characteristic (ROC) curves.Results Patients with LVEF increased significantly after CABG (P ＜ 0.01),Of 259 segments with wall motion abnormality,149 (58％) showed wall motion significantly improved ≥ 1 point after CABG,considered viable myocardium,110 (42％) were not observed in wall motion improved,considered to be non-viable.The viable myocardial segments were significantly greater than non-viable myocardial segments in A,β,A × β value (P ＜ 0.01).Compared with the semi-quantitative analysis,quantitative analysis of MBF increased the sensitivity and accuracy of RTMCE for detecting viable myocardium (P ＜ 0.05).Conclusion RTMCE could accurately assess myocardial viability and provide a strong reference for clinical decision making and judging prognosis.