Objective To analyse subtyping of iscbemic stroke by the criteria of Trial of Org 10 172 in Acute Stroke Treatment (TOAST), its distribution, and relationship between TOAST subtypes, its risk factors and recurrence. Methods Clinical data of 441 patients of ischemic stroke were collected prospectively during October 1, 2006 to September 30, 2007. All the patients were classified by TOAST criteria into five major subtypes and followed-up for one year since its first episode. Dates of its recurrence and death due to recurrence were recorded. Results All the 441 patients with ischemic stroke could be subtyped etiologically according to TOAST criteria as follows: etiology undetermined in 42.3 percent, small-vessel occlusion in 30.9 percent, large-artery atherosclerosis in 17.3 percent, cardioembolism in 9.3 percent, and others in 0.2 percent, without statistically significant difference in its gender and age distributions. Recurrence rate of iscbemic stroke in one year since its first episode for varied subtypes was 33.3 percent for cardioembolism, 14. 6 percent for etiology undetermined, 13.7 percent for large-artery atherosclerosis and 6.9 percent for small-vessel occlusion, respectively. There was no significant difference in risk factors for varied subtypes of iscbemic stroke, including history of smoking, hypertension, diabetes, cardiac disease, and serum levels of total cholesterol, low-density lipoprotein cholesterol, fihrinogen and glucose. Conclusions Varied subtypes of iscbemic stroke had different risk factors and recurrence rate by TOAST criteria, which can be used as an etiologic classification for its secondary prevention.

The immune tolerance or immune escape plays important roles in the genesis and progression of malignant gynecological neoplasms.Human leukocyte antigen G(HLA-G)is an important member of major histocompatiblity complex class Ⅰ.HLA-G seems to affect almost every aspect of human immunity.It can inhibit immunological function,and play an important role in immune escape of malignant gynecological neoplasms.

80 years)in China is increasing.As a special type of hypertension,the hypertension in the very elderly has some specificities in pathogenesis,clinical manifestation,treatment and prognosis.The topic to effectively cure and prevent hypertension in the very elderly is increasingly emphasiced.This article presents an overview of recent progress in clinical characteristics,and treatment strategy related to hypertension in the very elderly.

Objective To study MRI features of solid-pseudopapillary tumors of pancreas(SPTP).Methods MR findings of 3 patients with histopathologically proven SPTP were retrospectively analyzed.Results The mean diameter of these tumors was 4.5cm(3.5～8cm).One tumor was predominantly composed of cystic portions,2 tumors were composed of predominantly solid and some cystic portions.Fibrous septa was seen in cystic area in 1 case.One cystic tumor showed low signal intensities on T1WI and high singal intensities T2WI.The solid portions of mass showed moderate hypointensity on T1WI,and moderate hyperintensity on T2WI,and heterogeneous obvious enhancement on T1WI MRI in 2 cases.Conclusion There are some characteristics in MRI manifestation of SPTP.The disease might be correctly diagnosed combined with the clinical feature,and should be differentiated from nonfunctioning islet cell tumor,mucinous cystadenoma or cystcarcinoma of the pancreas,etc.

Notch signaling pathway plays a vital role in cell fate decisions. Notch signals are transferred among adjacent cells through Notch receptors and their ligands, which can regulate differentiation, proliferation and apoptosis of many cell types including stem cells. They can also influence organ formation and morphopoiesis. Genetic mutations in the Notch signaling pathway are related to the emergence and development of many diseases. Notch signaling pathway is increasingly becoming important drug targets for cancer, hereditary disease such as CADASIL and other related diseases. It is also used to develop stem cell therapeutics to treat age or trauma related degenerative diseases such as Alzheimer's disease, Parkinson disease and diabetes.

Clinicians should assume the responsibility of nutritional therapy for satisfactory outcomes. They should master knowledge on nutritional metabolism, and participate in the administration of nutritional support. Clinicians should be acquainted with new concepts and standardized techniques in this field, such as different requirement of energy, understanding of early nutritional support, and optimal regimens of enteral or parenteral nutrition.
China ; Enteral Nutrition ; Humans ; Nutritional Support ; Parenteral Nutrition

OBJECTIVETo explore the clinical effect of Erlong Xizhu acupuncture for retinitis pigmentosa. Methods Sixty patients with retinitis pigmentosa were randomly divided into an Erlong Xizhu acupuncture group and a conventional acupuncture group, 30 cases in each one. In the conventional acupuncture group, Tongziliao (GB 1), Sizhukong (TE 23), Taiyang (EX-HN 5) were acupunctured as the main acupoints by uniform reinforcing-reducing manipulation; acupoints based on syndrome differentiation were coordinated by acupuncture manipulation of reinforcing deficiency and reducing excess. The treatment in the Erlong Xizhu acupuncture group was the same as that in the conventional group, except acupuncture manipulation at the main acupoints replaced by Erlong Xizhu acupuncture. In the two groups, treatment was given once a day, 10 days as one session and there were 2 days at the interval between sessions. The change of the vision and visual field and the efficacy were observed after 3 sessions in the two groups.

RESULTSThe total effective rate on enhancing the vision of patients in the Erlong Xizhu acupuncture group was 93. 10% (54/58), which was superior to 81. 36% (48/59) in the conventional acupuncture group (P<0. 01). And the effective rate on improving the visual field was 91. 38% (53/58) in the Erlong Xizhu acupuncture group, which was better than 83. 05% (49/59) in the conventional acupuncture group (P<0. 01). On the comprehensive effect, the effective rate was 90. 00% (27/30) in the Erlong Xizhu acupuncture group, which was better than 63. 34% (19/30) in the conventional acupuncture group (P<0. 05).

CONCLUSIONThe clinical effect of Erlong Xizhu acupuncture is superior to that of conventional acupuncture for retinitis pigmentosa and it is worthy of promoting.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retinitis Pigmentosa ; physiopathology ; therapy ; Treatment Outcome ; Vision, Ocular ; Young Adult

Objective To investigate effect of propofol total intravenous anesthesia and sevoflurane inhalation anesthesia on perioperative inflammatory response in patients with lung cancer.Methods Forty patients with simple resection of lung cancer were selected in our hospital.They were divided into observation group and control groups according to random sampling method (n=20).Observation group was given propofol total intravenous anesthesia while control group received sevoflurane inhalation anesthesia.The serum concentrations of MMP-9,TNF-α,IL-6 were compared at the T0 (immediately before the induction of anesthesia) , T1 (1 hour after surgery) , T2 (end of the surgery immediately) , T3 (24 hour after surgery) . Results Compared with the T0 period,the serum concentrations of MMP-9,TNF-αand IL-6 at the T1,T2,T3 periods were increased significantly in the both groups(P<0.05);the concentrations of TNF-α, IL-6 were lower significantly in observation group compared with control group (P<0.05) . Conclusion Propofol anesthesia for resection of lung cancer patients can significantly reduce the inflammatory response.

Objective:To explore the effects of combination of epirubicin (EPI) and anti-CD47 antibody on therapy of breast cancer.Calreticulin ( CRT) and CD47 on DC-mediated phagocytosis.Methods: Breast cancer cells MCF-7 and MDA-MB-231 were treated with EPI , and expression of calreticulin ( CRT ) and CD47 on cell surface were detected by flow cytometry or immunofluorescence.DC were isolated from human peripheral blood , and cocultured with epirubicin-treated breast cancer cells in the present of anti-CD47 or anti-CRT antibody ,and the phagocytosis of DC was assessed.Results:Untreated breast cancer cells MCF-7 and MDA-MB-231 did not express CRT on the surface of cells ,but high level of CD47 was detected.After EPI treatment,CRT exposed on the cells surface,and the expression of CD47 was reduced.The results showed that EPI or anti-47 antibody alone increased DC-mediated phagocytosis ,and combination treatment marked enhanced this effects.Further more, in addition of anti-CRT antibody reduced the phagocytosis of DC.Conclusion:EPI could induce CRT exposure on the tumor cell surface ,and enhanced DC-mediated phagocytosis when combination with anti-CD47 antibody.The phagocytosis of DC on tumor cells were modulated by both ecto-CRT and CD47.This study provide a new effective strategy for the use of anti-CD47 antibody among the chemotherapy of breast cancer.