OBJECTIVE:To compare the incidence of cerebral events in patients with ischemic cerebrovascular disease compli-cating with cerebral microbleeds(CMBs)at the last stage of antiplatelet agent use. METHODS:140 patients with ischemic cerebro-vascular disease were selected from Beijing Anzhen Hospital Affilicated to Capital Medical University during Jan. 2013-Jan. 2014, and then divided into CMBs group and non-CMBs group according to whether complicated with CMBs,with 70 cases in each group. After followed up for 1 year(regular use of aspirin 100 mg/d and/or clopidogrel 75 mg/d),the incidence of recurrent cere-bral infarction and cerebral bleeding and mortality were compared. RESUTLS:The incidence of recurrent cerebral infarction was 12.9% in CMBs group and 8.6% in non-CMBs group,without statistical significance(P=0.412);the incidence of cerebral bleed-ing was 10.0% in CMBs group and 1.4% in non-CMBs group,with statistical significance(P=0.029);the mortality of cerebro-vascular event at the last stage was 5.7% in CMBs group and 4.3% in non-CMBs group,without statistical significance (P=0.698). CONCLUSIONS:The risk of cerebral bleeding increase in patients with ischemic cerebrovascular disease complicating with CMBs after the application of antiplatelet agent. For patients with ischemic cerebrovascular disease complicating with CMBs,the application of antiplatelet agent should be based on the complete judgment and weighing of benefit and bleeding risk.

Objective To investigate the efficacies of conventional and modified laparoscopic gastric bypass in the treatment of type 2 diabetes mellitus.Methods The clinical data of 30 patients with type 2 diabetes mellitus who were admitted to the Xijing Hospital of the Fourth Military Medical University from January 2012 to October 2012 were prospectively analyzed.All the 30 patients were randomly divided into the conventional group (15 patients) and the modified group (15 patients) according to the random number table.Patients in the 2 groups received conventional and modified laparoscopic gastric bypass,respectively.The operation time,blood loss,anal exhaust time,duration of postoperative hospital stay,incidence of severe complications,postoperative 3-month body mass index (BMI),fasting plasma glucose (FPG),fasting serum insulin (Fins),fasting serum C-peptide (FC-P) and glycosylated hemoglobin (HbAlc) of the 2 groups were compared.The measurement data were analyzed using the t test,and the count data were analyzed using the Fisher exact probability.Results The operation time of the conventional group and the modified group were (141 ± 22)minutes and (113 ± 26)minutes,with significant difference between the 2 groups (t =3.184,P ＜ 0.05).The volume of intraoperative blood loss,anal exhaust time,duration of postoperative hospital stay,postoperative 3-month BMI,FPG,Fins,FC-P and HbAlc were (65 ±29)ml,(2.5 ±1.2)days,(7.5 ±2.1)days,(27 ±4)kg/m2,(6.7 ±1.5)mmol/L,(18 ± 8) mU/L,(2.0 ± 0.6) μg/L and 5.8％ ± 1.5 ％ in the conventional group,and (57 ± 25) ml,(2.1 ± 1.0) days,(7.1 ± 1.9) days,(28 ± 4) kg/m2,(6.4 ± 2.0) mmol/L,(17 ± 6) mU/L,(1.9 ± 0.6) μg/L and 6.1％ ± 1.4％ in the modified group,with no significant difference between the 2 groups (t =0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P ＞ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAle of the conventional group were (31 ± 4) kg/m2,(11.3 ± 2.3) mmol/L,(13 ± 4) mU/L,(1.4 ± 0.5) μg/L and 8.6％ ± 1.0％,which were significantly different from those at 3 months after operation (t =2.304,6.615,3.109,2.920,5.997,P ＜ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAlc of the modified group were (31 ±4)kg/m2,(11.9±2.4)mmol/L,(12±5)mU/L,(1.4 ±0.6) μg/L and 8.9％±0.9％,which were significant different from those at 3 months after operation (t =2.165,6.711,2.616,2.478,6.571,P ＜0.05).Conclusion The safety and short-term efficacy of modified laparoscopic gastric bypass are comparable to those of the conventional laparoscopic gastric bypass,but the operation time of the modified method is significantly shorter.

Objective To investigate introvoxel incoherent motion (IVIM) sequence features of cervical cancer and to analyze the difference between cervical cancer and normal cervix by using biexponential model parameters of IVIM sequence.Methods MR imaging data of 26 patients with cervical cancer confirmed by surgical pathology and 26 patients of normal cervical confirmed by clinical or MR examination were analyzed retrospectively.All patients underwent routine pelvic MRI sequences,including T1WI,T2WI,DWI (b =800 s/mm2) and IVIM sequence.The IVIM sequence was applied using a biexponential model with factors from 0 to 1200 s/mm2.The standard ADC,slow ADC,fast ADC and fraction of fast ADC values of cervical cancer and normal cervix groups were measured and analyzed by using t test.Diagnostic efficacy of these parameters in cervical cancer group was evaluated by using area under the curve.Results The standard ADC,slow ADC,fast ADC and fraction of fast ADC of cervical cancer group were (0.47 ± 0.09) × 10-3 mm2/s,(0.45 ± 0.09) × 10-3 mm2/s,(5.00 ± 1.68) × 10-3 mm2/s,0.30 ±0.06 and those of normal cervical group were (0.77 ± 0.15) × 10-3 mm2/s (0.61 ± 0.06) × 10-3 mm2/s,(4.29 ±0.57) × 10-3 mm2/s and 0.44 ± 0.04,respectively.The differences of standard ADC,slow ADC value and fraction of fast ADC value between two groups were statistically significant (t =8.841,7.540,10.591,P ＜0.01,respectively).There was no difference of fast ADC between the two groups (t =0.120,P ＞ 0.05).The area under the curve of fraction of fast ADC was the maximum,and it may be the most valuable parameter for the diagnosis of cervical cancer.Conclusions Cervical cancer group has characters on IVIM with lower standard ADC,slow ADC and fraction of fast ADC compared with the normal cervix group.IVIM sequence can reflect diffusion and perfusion of cervical cancer quantitatively.It may play a complementary role in the diagnosis and has some application prospects.

Objective To explore the value of glypican-3(GPC-3)mRNA and paternally expressed 10(PEG10)mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma(HCC). Methods With SYBR Green I as fluorescence signal,real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis(n=8),HCC without metastasis(n=12)and hepatic cirrhosis(n=11),and receiver operator characteristics curve(ROC)and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis(P<0.05),while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis.In single test,the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7%for GPC-3 mRNA and 72.2%for PEG10 mRNA,and the specificities were 91.7%and 91.7%.respectively.The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA.With two markers in parallel test,the sensitivity,specificity,negative likelihood and diagnostic accuracy were 90.7%,84.O%,0.11 and 83.3%,respectively.In serial test,the sensitivity,specificity,positive likelihood and diagnostic accuracy were 60.5%,98.7%,45.5 and 73.3%,respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC,and PEG10 mRNA works better than GPC-3 mRNA.The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.

Objective To detect the mechanism of serum uric acid (UA) in different types of coronary heart disease (CHD).Methods 88 patients were divided into three groups：the control group，stable angina (SA) group and acute coronary syndrom (ACS) group.The levels of UA，alpha-granule membrane protein 140 (GMP-140)，von Willebrand factor(vWF)，plasminogen activator inhabitor typed (PAI-1)，Thromboxane B_2 (TXB_2) and C-reacting protein(CRP) were measured.Results ①UA and CRP in ACS group were higher than that in SA group and control group [(392.1±68.57) μmol/L and (42.2±39.4) mg/L vs (370.50±58.80) μmol/L and (18.9±17.1) mg/L vs (286.00±65.31) μmol/L and (2.5±0.7) mg/L，P＜0.05)].For UA，there was no difference between ACS and SA group(P＞0.05)；CRP was higher in ACS group than in SA group (P＜0.05).②vWF and TXB_2 were higher in ACS[(1.65±0.48)%，(19.73±18.66)ng/L]and SA group[(1.35±0.49)%，(11.18±10.71) ng/L]than in control group[(1.07±0.26)%，(6.46±5.41) ng/L，P＜0.05]，and those were higher in ACS group than in SA group (P＜0.05).③GMP-140 and PAI-1 were higher in ACS [(13.04±0.99) μg/L and (65.65±14.76) μg/L]and SA group[(12.55±0.74) μg/L and (62.69±12.24) μg/L]than in control group [(12.32±0.29) μg/L，(50.78±13.88) μg/L，P＜0.05].There were no differences between ACS and SA group (P＞0.05).④Comparing hyperuricemia group and non-hyperuricemia group in CHD patients：the CRP(71.3±18.9) mg/L，vWF(1.08±0.52) %，GMP-140(13.57±1.11) μg/L，TXB_2 (57.26±47.84)ng/L，PAI-1 (72.12±9.23) μg/L in ACS group possessing hyperuricemia were higher than non-hyperuricemia group [CRP (20.7±17.9) mg/L，vWF (0.84±0.54) %，GMP-140 (13.23±1.07) μg/L，TXB_2 (26.70 + 23.83) ng/L，PAI-1 (61.30±12.07) μg/L](t=7.394，0.008，0.227，7.605，0.421，P＜0.05)；CRP(31.1±18.9)mg/L and TXB2 (21.54±3.90) ng/L in SA group possessing hyperuricemia group were higher than non-hyperuricemia group[(10.9±10.1)mg/L and (5.02±4.93) ng/L，t=0.494，8.669，P＜0.05].Logistic stepwise regression analysis indicated that the related factors with ACS were UA(OR=1.046)，CRP(OR=7.615)，PAI-1(OR=1.301)，PT(OR=0.300)and TG(OR=2.243) (P＜0.05).Conclusions UA is an important risk factor in CHD patients.UA can induce different types of CHD by damaging blood vessel endothelium function，activating platelet，changing coagulation and causing inflammatory.

Objective To summarize the distribution of departments,conditions of diagnosis and treatment of the syphilis patients in the general hospitals,and thus to improve the level of diagnosis and treatment.Methods A retrospective analysis of epidemiology and clinical data of 282 cases with syphilis in recent 5 years were conducted. Results The ratio of male to female was about 1:1.9.Female showed a high incidence in the 21 -50 years old,aver-age (41.68 ±0.96)years old,but for male in the 41 -70 years old,average (53.25 ±1.59)years old.The cases combined with other infectious diseases accounted to 22.0 % (62/282).The cases from the department of obstetrics and gynecology were the most (106 cases),followed by surgery (86 cases)and internal medicine (49 cases).Only 23 cases showed the clinical manifestations of syphilis in the 79 cases,which must be treated.The test rate of TRUST was only 39.0% (110/282).Furthermore,it was very low for the rate of treatment and standard treatment. Conclusion Syphilis is the most in department of obstetrics and gynecology in general hospital,and it is also com-mon in the surgery and internal medicine.The most prominent problems are that the non-special doctors had weak awareness for definite diagnosis of syphilis,and the low rate of treatment and standard treatment.

Transcatheter arterial chemoembolization (TACE) was the preferred method of non-operation treatment for hepatocellular carcinoma (HCC).Radical resection of HCC remains difficult,extrahepatic metastasis was not easy to deal with,and repeated treatment aggravated the liver injury,so the long-term efficacy was poor.Sorafenib could control tumor angiogenesis and block the proliferation of tumor cells.A male patient with primary HCC and in the stage Ⅱb according to the Chinese clinical liver cancer staging system was treated by TACE combined with sorafenib and antiviral treatment in Henan Cancer Hospital.After the treatment,the intrahepatic lesions were inactive,and the pulmonary metastasis was partially relieved.The patient was followed up till May 2012,and the survival time was 39 months.The hepatic function was normal,and the hepatitis B virus (HBV) replication was negative.No intervention treatmentrelated complications were detected,and the KPS score was 100.

Objective:To explore the characteristics of human melanoma-specific antigen peptides by HLA-A2 restricted tumor-infiltrating lymphocytes.Methods:The HLA-A2 protein and polypeptides molecules were purified from the three tumor cell lines(624-Mel, Chap-Mel and JY) by immunoaffinity chromatography, after the peptides bound to HLA-A2 protein solution were acidified with acetic acid and boiled by high temperature, and centrifuged through an Ultra-CL filter, then the peptides extracts were fractionated by revered phase high pressure liquid chromatography(RP-HPLC). Individual fractions were assessed for their ability to reconstitute melanoma-specific epitopes by adding to the HLA-A2 Ag-procceing mutant cell, T2. The biological feature of one of three active peptides from RT-HPLC samples was performed by mass spectrometric analysis. The synthetic peptides identical to active peptide sequences were determined in the reconstitute test.Results:Three prominent peaks(P19, P25 and P31) of the fraction from 624-Mel were observed in the reconstitute test, TIL killing rate was 67% for (P31) peptide fraction. The mass spectrometric analysis of one of active peptides (P31) showed that at mass-to-charge ratio(m/z) 948 has been usually nine residues. The sequence is H+ Ala Lue Trp Lue Phe Phe Gly Val Lue OH-. The peptide synthesized comprising epitopes were verified.Conclusion:These results showed the peptides derived from active fractions were related to human melanoma-specific tumor antigen peptides recognized by HLA-A2-restriced TIL. These peptides could develop novel peptide-based an anti-tumor vaccine for immunotherapy of CTL.

40 cases(control group)with aggressive periodontitis (AgP)received scaling and root planning (SRP)and 38 cases(test group)received SRP followed by oral administration of amoxicillin plus metronidazole for 7 d.Gingival crevicular fluid samples were exam-ined for the levels of MMP-1,MMP-8 and tissue TIMP-1 by ELISA before therapy,3 and 6 months after therapy,TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were calculated.The levels of MMP-1 and MMP-8 were decreased in both groups (P <0.05)at 3 and 6 months after therapy.TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were increased in the 2 groups(P <0.05)after treatment,3 months after therapy the ratio in test group was higher than that in control group(P <0.05).

To determine alpha-linolenic acid and linoleic acid in extract of Portulaca oleracea L. by high performance liquid chromatography (HPLC).