As a pattern of manifestation of cerebral small vessel disease,cerebral microinfarct(CMI) is a very common neuropathological change in old people. It is significantly correlated w ith cognitive decline and dementia. This article review s the meuropathology, neuroimaging and clinical significance of CMI.

Objective To study the relationship between plasma level of tissue factor(TF)and severity of coronary heart disease(CHD).Methods Coronary angiography was performed in 237 patients with suspected CHD,with 149 diagnosed as CHD and 88 excluded.Seventy of stenosis of coronary arteries (CA)was evaluated by modified Gensini score on the basis of angiographic imaging.Blood glucose,serum levels of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],uric acid,high sensitivity C-reactive protein(Hs-CRP),fibrinogen(FIB)and plasma level of TF were determined for all the subjects.Relationship between plasma level of TF and severity of pathological changes in CA was evaluated by linear correlation and multiple regression analyses for controlling other relevant factors.Results Plasma level of TF in patients with CHD[(138±39)ng/L]was significantly higher than that in controls[(61±19)ng/L](P＜0.01).Plasma level of TF obviously correlated with severity of pathological changes in CA(r=0.710,P＜0.01).Partial correlation analysis showed a positive correlation between plasma TF and severity of pathological changes in CA,independent of other potential influential factors,with a partial coefficient of correlation of 0.509(P＜0.01).Multiple stepwise regression analysis indicated that plasma level of TF associated with severity of pathological changes in CA,as well as with diabetes,LDL-C,Lp(a),Hs-CRP and FIB,with coefficients of correlation of 0.172,0.180,0.147,0.308 and 0.175,respectively(P＜0.05).Conclusion Elevated plasma level of TF may be one of important risk factors for CHD,which reflects severity of pathological changes in CA.

The hemodynamic effects of dextran and nitroprusside on acute pericardialtamponade were investigated on dogs. The result showed that dextran increased CO andMSAP significantly (all P

Objective The purpose of this study was to describe the clinical and CT features in Cryptogenic organizing pneumonia(COP),and method of managemant.Methods We reviewed characteristics of clinical,laboratory,chest CT and pulmonary function test of 6 patients with histologically proven COP,and evaluated their therapeutic response to corticosteroids.Results Most patients of 6 cases manifested as a persistent nonproductive cough,exerting dyspnea,pyrexia,malaise,and weight loss clinically.Less common symptoms include pleuritic chest pain and hemoptysis.Chest CT manifestations included ground-glass opacity,consolidation,diffusing reticular infiltration of parenchyma,pleural effusion,cavitation and migration.The patients had high level of peripheral WBC number,erythrocyte sedimentation,and C-reactive protein.Pulmonary function tests showed a impairment of restrictive pattern and diffusion capacity.All but one Patients responsed well to corticosteroids.Conclusions COP is a rapidly developing pneumonia-like illness characterized by lung inflammation,The clinical doctor must always be aware of the full view of COP so as to achieve successful diagnosis.Most of the patient can recover with corticosteroids therapy.

Objective To investigate the intervention of Amlodipine combined with alanine aminotransferase(ALT)-711 on blood pressure and preventing of target organ remodels of Spontaneously Hypertensive Rats(SHR),and to explore an optimized treatment design.Methods A total of 24 SHRs at 12-Week-old male were randomly divided into 4 groups,with 6 SHRs in each group.In the control group(Group A)the SHR were given normal saline 1 ml/(kg · d)via intragastric administration; the SHRs in Group B were treated with Amlodipine 1 mg/(kg · d) via ntragastric administration; the SHRs in Group C were treated with ALT-711 10 mg/(kg · d)via ntragastric administration;the SHRs were treated with Amlodipine 1 mg/(kg · d)combined with ALT-711 10 mg/(kg · d)via ntragastric administration in Group D.All groups were treated for 8 weeks,and the blood pressure in mouse tail were monitored.After 8 weeks,all SHRs were executed in the condition of anaesthedia.Right cervical artery,heart and kidney were measured through immunohistochemistry,histological stain and imagine analysis.The remodeling of vascular,heart,kidney were compared,and collagen volume fraction,advanced glycation end products (AGEs) and fibronectin (FN) expression were measured.Results (1) After treatment for 8 weeks,blood pressure of SHRs in the 4 groups were (184.72 + 15.14),(108.00 ±10.19),(155.64±10.03)and (99.83 ± 12.27) nun Hg in Group A,B,C and D,respectively.The blood pressure in Group D was the lowest in the 4 groups (F =14.6702,P ＜ 0.05),whereas it is not significantly different from Group B (P ＞ 0.05).(2) The mean thickness of carotid arteries were (0.450 ± 0.023),(0.380 ±0.021),(0.420 ±0.019) and (0.320 ±0.020) mm in Group A,B,C and D,respectively.The mean thickness of carotid arteries in Group D was the lowest in the 4 groups(F =4.1463,P ＜0.05).(3).The mean intimal area of carotid arteries were (19.0 + 1.3) × 105,(25.0 ± 1.4) × 105,(29.8 + 1.5) × 105 and (21.3 ±1.3) × l05 μm2 in Group A,B,C and D,respectively.The mean intimal area of carotid arteries in Group D was significantly smallest than the other 3 groups(F =4.4305,P ＜0.05).(4) The collagen content in different organs in the 4 groups after treatment 8 weeks:in carotid arteries,they were (6.25 ± 0.19)％,(3.56 ± 0.03) ％,(4.25 ± 0.12) ％ and (1.32 ± 0.05) ％ in Group A,B,C and D,respectively.The collagen content in Group D were significantly lower than the other 3 groups (F =4.9316,P ＜ 0.01).In myocardia:collagen content in Group A,B,C and D were (6.02 ± 0.21)％,(4.08 ± 0.14)％,(4.44 ± 0.11)％ and (1.13 ± 0.08) ％ respectively,and it was the lowest in Group D (F =4.2469,P ＜ 0.01).In kidney,the collagen content in Group A,B,C and D were (13.23 ±0.51)％,(7.28 ±0.35)％,(8.33 ±0.22)％ and (5.66 ±0.13)％ respectively,and it was the lowest in Group D(F=8.1038,P ＜0.01).(5).Express rate of AGEs in carotid arteries in Group A,B,C and D were (31.48 ±7.30)％,(20.55 ±5.91)％,(10.48 ±0.98)％ and (7.56 ± 0.68) ％ respectively,with the lowest expression in Group D (F =11.4537,P ＜ 0.01).Express rate of FN in carotid arteries in Group A,B,C and D group were (28.18 ±5.66)％,(17.26 ±5.83)％,(18.20 ±1.44) ％ and (15.12 ± 1.03) ％ respectively,with the lowest expression in Group D (F =9.0036,P ＜ 0.01).Conclusion Amlodipine combined with ALT-711 decreased blood pressure more effectively and prevented the remodel of target organ in SHRs than Amlodipine or ALT-711 alone.

Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.

Objective To evaluate the relation of circadian blood pressure rhythm with vascular status in elderly patients with isolated systolic hypertension.MethodsAnkle-brachial index (ABI),brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were measured in 74 elderly patients with non-dipper hypertension (non-dipper group)、78 elderly patients with dipper hypertension ( dipper group),and 72 healthy controls ( control group).Results In comparison with the dipper group,baPWV and IMT of the non-dipper group were significantly increased [ baPWV (1801.61± 314.27) vs (1658.67±274.80) (cm/s)],P＜0.01; IMT:(0.96 ±0.22) vs (0.87 +0.19) (mm),(P＜0.05),while ABI of the non-dipper group was decreased (1.03 ±0.17 vs1.12 ±0.18,P＜0.01).Identification rate was significantly different among 3 groups when baPWV ＞1400 cm/s (x2 =12.57,P ＜0.01) or ABI ＜0.9 ( x2 =9.74,P ＜0.01).The detection of carotid plaques was also significantly different ( x2 =16.49,P ＜ 0.01).Conclusions These findings suggest that vascular damage could be found in elderly patients with isolated systolic hypertension,especially in those with non-dipper hypertension.ABI,baPWV and IMT measurement may be helpful for the assessment of vascular status.

Objective To detect the micro flow signals of carotid plaque by ultrasound B-flow imaging (BFI) and elucidate its relationship with acute cerebral infarction.Methods A total of 63 patients with carotid plaques were divided into 2 groups.acute cerebral infarction (ACI,n =48) and control (n =15).BFI was used to detect the micro flow signals of plaques and comparisons were made with the categorizing results of contrast enhanced ultrasound (CEU).The data were analyzed between two methods.Results The micro flow signals were detected in 15.7％ (22/140)patients in the ACI group vs.2.3％(1/44) in the control group.There were more signals in hypoechoic plaques.The detection percentage of micro flow in grade Ⅲ was significantly higher than that in grades Ⅰ and Ⅱ with CEU (P =0.005,P =0.027).No significant differences existed between grades Ⅲ and Ⅳ (P =1.000).Conclusion BFI can detect effectively the micro flow signals of carotid plaques and this characteristic is correlated with the symptoms of ACI.

AIM: To observe the effect of diammonii glycyrrhizinatis (DG) on collagen synthesis induced by angioplasty in rabbits. METHODS: The right common carotid artery of male rabbits were injured with 3.5F balloon catheter. Four weeks after operation, arterial tissure collagen content, serum procollagen type I(PCI)， procollagen type Ⅲ(PCⅢ) concentration, neointimal thickness and the rate of stenosis were measured.RESULTS: Arterial tissue collagen content, serum PCI, PCⅢ concentration, neointimal thickness and the rate of stenosis of low and high dose DG group is lower than those of injured group.CONCLUSION: DG could inhibit collagen synthesis and neointimal proliferation of rabbits carotid artery induced by angioplasty. It suggests that DG might have clinical potential prespective in prevention and therapy of restenosis.

AIM: To explore the effect and mechanism of endothelin receptor antagonist on local angiotensin system of hypertrophic myocardial tissue. METHODS: Twenty four rats were randomly divided into 3 groups, control group (CG), hypertrophy group (HG) and endothelin receptor antagonist group (EG). The ratios of left ventricle weight to body weight (LVW/BW) and left ventricle weight to heart weight (LVW/HW) were measured to reflect myocardial hypertrophy. Protein expression of AT1R was detected by immunohistochemistry. The concentration of Ang Ⅱ was determined by ria. Activity of ACE was examined by spectrophotometry. A piece of myocardial tissue was observed in light microscope after HE or VG dyeing. RESULTS:(1) In comparison to CG, LVW/BW, LVW/HW, ACE activity, the concentration of Ang Ⅱ and the expression of AT1R of HG were increased significantly (P