Many studies have shown that the embolism caused by vulnerable atherosclerotic plaque is one of the major causes of ischemic stroke. However, there is still not a simple and precise method to identify the vulnerable plaques yet. This article reviews the various methods for detecting vulnerable plaques from the aspects of serology and imaging.

Idiopathic intracranial hypertension,which often occurs among adult overweight women,is a kind of chronic intracranial hypertension without any certain causes.The patient usually present with headache and papilloedema,and normal of brain structure and the cerebrospinal fluid composition.As visual loss is the only serious outcome,both dietary management and medical treatment are helpful in the early time,but surgery should be required as soon as visual loss occurs.The recent clinical study on idiopathic intracranial hypertension was reviewed.

Objective To investigate the effect of continuous renal replacement therapy (CRRT) combined with Rhubarb at early stage on inflammatory cytokine in the treatment of severe acute pancreatitis.Methods Fifty two patients with SAP were randomly divided into three groups,the conventional treatment group,the CRRT group,and the combined group.CRRT was inplemented in 48 h after the diagnosis of SAP.APACHE-Ⅱ score,mortality were compared before and after treatment.Double sandwich ELISA method was used to detect the levels of interleukin 22 (IL 22),IL-18 and tumor necrosis factor α(TNF-α).Results The clinical effect in combined group was better than other groups,and the mortality was lower than other groups,but the difference was not statisticaly different(P＞0.05).The levels of IL-22,TNF-α and IL-18 were not significantly different among three groups before treatment (P＞0.05).After treatment,the inflammatory factors decreased in all groups.The levels of IL-18,TNF-and IL-22 in CRRT group and combined group were significantly lower than those in control group (P＜0.05),and the combined group decresed most abviously(P＜0.05).There was no significant difference in APACHE Ⅱ score among the three groups before treatment (P＞0.05),while the APACHE-Ⅱ scores were significantly decreased after treatment,the difference was statistically significant (P＜0.05).After treatment,the APACHE-Ⅱ score of the combined group were significantly lower than the other two groups(P＜0.05).Conclusion The therapy of CRRT combined with Rhubarb at early period in SAP patients can better clean up inflammatory cytokines of IL-22,TNF-,IL-18,so that patients with SAP can get more clinical benefits.

Objective T o explore the num ber of necrophagous flies and seasonal distribution of com m on necrophagous flies at present in B eijing. Methods T he specim ens of necrophagous flies w ere collected by the m ethods of anim al carcass, trapping and feeding. A nd the specim ens w ere observed and counted after the classification and preservation. Results T he necrophagous flies in B eijing belonged to 4 fam i-lies, 9 subfam ilies, 21 genera and 46 species, and 12 species of them w ere the first records in B eijing. T he necrophagous flies had the characteristics of regional and seasonal distribution. Conclusion T he data of seasonal distribution of necrophagous flies and com m on necrophagous flies in B eijing can provide refer-ence for related research.

Stiff-person syndrome(SPS) is a rare neurologic disorder with autoimmune features.It is characterized by progressive,severe muscle rigidity or stiffness most prominently affecting the spine and lower extremities.It is frequently associated with diabetes and other autoimmune diseases.The diagnosis of SPS is based on clinical grounds,however,aided by electromyography and high serum titers of antibodies against glutamic acid decarboxylase.Intravenous immunoglobulin infusions,plasmapheresis and steroids provide additional and lasting benefit.Moreover,benzodiazepines,baclofen,tiagabine and botulinum toxin A can afford symptomatic relief.

BACKGROUND: The skill to culture osteoblasts primarily has been well developed, however, variousdigestive enzymes can affect membrane protein of osteoblasts when they are used on primary tissue separately.OBJECTIVE: To avoid the damage from enzyme to cell as best possible,digest cranial osseous tissue with collagenase in DMEM containing fetal bovine serum and carry out in vitro culture of osteoblasts, then observe the effect of collagenase in DMEM containing fetal bovine serum on the digestion of osteoblasts.DESIGN: Control experiment.SETTING: Department of Orthopaedic Surgery, Tongji Hospital Affiliated to Huazhong University of Science and Technology.MATERIALS: This experiment was carried out in the Department of Orthopaedic Surgery, Tongji Hospital Affiliated to Huazhong University of Science and Technology from March to December 2004. Two Japanese white rabbits with big ears that were pregnant for 28 days were used in the experiment.METHODS: Type I collagenase with the same batch number was prepared into 0.1% collagenase with fetal bovine serum and 0.1% collagenase without fetal bovine serum by using culture medium containing 0.15 volume fraction of fetal bovine serum and DMEM solution respectively, serving as the enzyme digestive juice A and B for experimental group and control group respectively. Abdominal delivery was performed to take ont the fetal rabbit which was at embryonic 28 days under aseptic condition.Then, craniums of fetal rabbits were dissected, rinsed and chipped into pieces. 5 mL solution A and 5 mL solution B were added into the experimental group and control group at 37℃, respectively. Culture solution containing 0.15 volume fraction of fetal bovine serum was gradiently diluted into 0,1,2 and 4 folds in each group, and continued to digest and culture osteoblasts. The cellular survival rate was measured with trypan blue staining, and the osteoblast and its purity were identified with alkaline phosphatase(ALP) staining. Cellular growth was observed under the microscope.MAIN OUTCOME MEASURES: ①Cellular survival rate of two groups was detected with trypan blue staining. ② Cellular purity of two groups was detected with ALP staining in the cells. ③Cellular growth was distinguished by observing cellular morphology under the microscope.RESULTS: ① Results of trypan blue staining: Through cell counting, the rate of cells, which refused to be stained, of the experimental group reached 98%, and the cellular survival rate was high; that of control group reached 95%, and the cellular survival rate was also very high. ② Results of ALP staining in the cells: The area of ALP staining positive of experimental group was not less than 95%, and cellular purity was very high; but that of control group was not more than 75%, and cellular purity was very low. ③ Observation results under the microscope: Cells of experimental group were well stacked, convex and stereoscopic, they grew prosperously and had enough nutrition; while those of control group were not significantly in comparison with experimental group.CONCLUSION: Collagenase containing fetal bovine serum is used to digest the osseous tissue of cranium of fetal rabbits, and the cultured osteoblasts have typical properties of osteoblasts with simple component and high survival rate.

Objective To look for a method for isolation and cultivation of mesenchymal stem cells from human adipose tissue in vitro. Method The adipose tissue was obtained from the omentum of abdominal surgery patients under the aseptic condition. The fat then was minced and digested with 5ml 0 25% trypin for 30 minutes in a 37℃ water bath under constant agitation. The layer with monoclear cells was aspirated and supplemented with albumin, then was cultured in DMEM with 15% calf serum. Immunocytochemistry was used to determine the surface molecule CD44, HLA DR and VWF. Result There was a large amount of mesenchymal stem cells in human adipose tissue. Immunocytochemical staining showed that most of the cultured cells were CD44 positive, few HLA DR positive and VWF positive, indicating that most of the cultured cells were MSC, and the others were fibroblasts and endothelial cells. Conclusion A simple and convenient method to isolate and culture the adipose tissue derived mesenchymal stem cells was successfully established, providing the foundation for the future use of ADMSCs in the treatment of cardiovascular diseases.

Objective To investigate the difference of the morbidity rate of hypertension among patients with sleep apnea syndrome (SAS) in different stages, and the change in the blood levels of some vasoactive substances and their correlations with severity of SAS, in order to further explore the mechanism of hypertension caused by SAS. Methods 63 patients suspected to suffer from SAS were enrolled, and they were divided into normal, mild, moderate, and severe SAS groups according to respiratory disorder index (RDI) obtained by polysomnography (PSG) monitoring. The diagnosis of hypertension was made by the measurement of blood pressure and 24-hour dynamic measurement of blood pressure. Blood levels of angiotesnin Ⅱ (Ang Ⅱ), endothelin-1 (ET-1), throboxane B2 (TXB2), calcium gene related protein (CGRP), 6-keto-protagladin factor1?(6-keto-PGF1?) were determined with radioimmunoassay. Results The mobidity rate of hypertension was significantly higher in moderate and severe SAS group than that in the normal group (P0.05). Correlative analysis showed that the blood levels of Ang Ⅱ, ET-1, TXB2 were positively correlative to RDI (r=0.594, 0.523, 0.574, respectively, P0.05). Conclusion SAS is significantly related to the incidence of hypertension. Vasoactive substances with vasoconstrictive effect such as Ang Ⅱ, ET-1, TXB2 play an important role in the pathogenesis and development of hypertension in SAS patients than those with vasodilative effect such as CGRP and 6-keto-PGF1?.

Objective To evaluate the clinical value of retroperitoneal laparoscopic and open radical nephrectomy.Methods Clinical data of 12 cases of retroperitoneal laparoscopic radical nephrectomy(Retroperitoneal Group) and 13 cases of open radical nephrectomy(Open Group) from March 2004 to March 2005 in this hospital were retrospectively analyzed and compared in respect of operation time,hemorrhage volume in operation,postoperative hospitalization,and occurrence of complications.Results The two groups of procedure were successfully completed.The operation time was significantly longer in the Retroperitoneal Group(111.1?20.9 min) than in the Open Group(90.1?10.2 min)(t=3.234,P=0.004).The intraoperative hemorrhage volume was significantly less in the Retroperitoneal Group(96.3?15.5 ml) than in the Open Group(150.0 ?25.8 ml)(t=-6.240,P=0.000).The length of postoperative hospital stay was significantly shorter in the Retroperitoneal Group(8.3?2.0 d) than in the Open Group(11.7?2.2 d)(t=-4.031,P=0.000).Conclusions Retroperitoneal laparoscopic radical nephrectomy has advantages oves open nephrectomy in intraoperative hemorrhage volume and postoperative recovery,but operation time is longer and the cost is more expensive.

Objective　To investigate radiographic features of pneumocystis carinii pneumonia(PCP)or Kaposi sarcoma(KS),which were the most common complications of AIDS after renal transplantation.Methods　Radiographic diagnosis and differential diagnosis of 2 cases with PCP and KS comfirmed by pathology were discussed by analysing the chest X-ray findings combined with revieuw of reference literature.Results　The two cases with anti-HIV antibody all had mediasinal lymphopathy.In the case of KS,the omental tuber or tubercle shadows and pleural effusion were found on both pulmonary fields.Conclusion　No characteristic chest radiographic meanifestations in AIDS,the definitive diagnosis depends on clinical laboratory examination and pathological examination.