Molecular imaging develops faster in the field of neuroimaging of ischemic stroke.Many studies have shown that its values in the aspects of cerebral blood flow monitoring during ischemic stroke and brain tissue metabolism.Ischemic penumbra is the basis of reperfusion therapy for acute ischemic stroke.The imaging methods,including magnetic resonance perfusion-weighted imaging/diffusion-weighted imaging mismatch,have been widely used to reveal ischemic penumbra because of their fast and strong availability.However,they can only reveal the blood flow of penumbra tissue.By contrast,molecular imaging technology can describe and measure the in vivo biological processes on the cellular and molecular levels,thus it can more accurately reveal the penumbral tissue.

Objective To assess the influence of atrial fibrillation on post-thrombolytic hemorrhagic transformation and functional prognosis in acute ischemic stroke patients within different time window.Methods We retrospectively reviewed the clinical and imaging data of patients of acute ischemic stroke with intravenous thrombolysis admitted from June 2009 to October 2013.According to onset-to-needle time,we divided patients into 3 groups and then assessed the effect of the comorbidity with atrial fibrillation on the occurrence of hemorrhagic transformation and favorable outcome (defined as modified Rankin Scale score≤2 at 90 days) after thrombolysis within different time window.Results A total of 345 patients were included in this study,among whom 101 (29.3％) were treated by intravenous thrombolysis within 3.0 h (≤3.0 h),157(45.5％) ＞3.0 h and≤4.5 h,87(25.2％) over 4.5 h(＞4.5 h).Atrial fibrillation was observed in 50.5％ (51/101) patients in ≤3.0 h group,37.6％ (59/157) in ＞3.0 h and≤4.5 h group and 40.2％ (35/87) in ＞ 4.5 h group (x2 =4.362,P =0.113).There were no statistically significant differences among these three groups about the rate of hemorrhagic transformation (hemorrhagic infarction:16.8％ (17/101),22.3％ (35/157),20.7％ (18/87),and parenchymal hematoma:5.0％ (5/101),10.2％ (16/157),10.3％ (9/87),x2 =4.278,P =0.370) and favorable outcome (51.5％ (52/101),53.5％ (84/ 157),47.1％ (41/87),x2 =0.913,P =0.633).Multivariate analysis demonstrated that atrial fibrillation was associated with hemorrhagic infarction for patients in ＞ 4.5 h group (OR =3.637,95％ CI 1.101-12.013,P =0.034),and the presence of atrial fibrillation independently predicted parenchymal hematoma for patients in ＞ 3.0 h and ≤4.5 h group (OR =3.757,95％ CI 1.133-12.457,P =0.030).There was no significant association between atrial fibrillation and favorable outcome at 90 days.Conclusions The presence of atrial fibrillation is not associated with the prognosis in thrombolytic patients.However,it enhanced the risk of parenchymal hematoma if patients were treated within the time window ＞ 3.0 h and ≤4.5h.

Objective To compare the postoperative recovery of vaginal and abdominal hysterectomies of non-prolapsed uterus ,in order to offer the advantages, surgical indications and contraindieations ,surgical characteristic and diflieuhy of transvaginal hysterectomies of non-prolapsed uterus. Methods To retrospectively analyze 480 cases transvaginal hysterectomies (TVH) and 440 cases transabdominal hysterectomies (TAH) with similar indications in the corresponding period, and compare the operation duration ,blood lost during the procedure, postoperative analgesic, morbidity, recovery time of the function of intestine, activity time of getting up and hospitalization between those surgi-ca] techniques. Results There were no intraoperation and postoperative complications in group TVH. In group TAH: more blood was lost(P <0.01) ,the function of intestine recovered more slowly(P <0.01) ,more analgesic needed, more morbidity noted (P < 0.01), activity time of getting up is much longer(P < 0.01). The hospital stay after opera-tion was much shorter in group TVH(P <0.01). No statistical difference was found between the two groups in terms of the duration(P 0.05). Conclusion TVH is minimal invasive surgery that include small trauma,reduced pain, no abdomen scar and quick recovery. So the patients are happy to accept it.

Objective To evaluate the relationship between the serum free IGF-1 level and the severity and prognosis in patients with chronic severe hepatitis. Methods Serum free IGF-1 was assessed by ELISA in 44 patients with chronic severe hepatitis, 43 chronic viral hepatitis, 46 liver cirrhosis. At the same time the liver function, prothrombin activity and cholinesterase were also determined. Results Serum free IGF-1 in patients with chronic severe hepatitis, liver cirrhosis and chronic viral hepatitis was 0.24?0.15,0.33?0.17 and 1.06?0.70 (ng/ml), respectively. IGF-1 was significantly decreased in patients with chronic severe hepatitis and liver cirrhosis. IGF-1 level in patients with chronic severe hepatitis at early, middle and advanced stages was 0.28?0.07, 0.27?0.19 and 0.16?0.06 (ng/ml), respectively. The reduction in the value showed a positive correlation with different stages of chronic severe hepatitis. Patients with chronic severe hepatitis having a serum free IGF-1 below 0.2ng/ml had a higher mortality, and those with the value above 0.35ng/ml had a better chance to survive during the follow-up period. There was a significant positive correlation between serum free IGF-1 and prothrombin activity. Conclusion Serum free IGF-1 was decreased in the patients with chronic severe hepatitis. The clinical observation suggested that the serum free IGF-1 might be an important prognostic indicator in patients with chronic severs hepatitis.

TNF gene was transfected into murine LAK cells by retrovirus. Our results showed that TNF gene-transfected LAK cells secreted TNF more than normal LAK cells and control gehe-transfected LAK cells. The in vitro growth ability and cytotoxicity of TNF gene-transfected LAK cells were augmented significantly.The cytotoxicity of ,TNF gene-transfected LAK cells was markedly inhibited by anti - TNF monoclonal antibody, indicating that the, above augmentation was mediated by TNF secreted by transfected LAK cells. Significant therapeutic effect on the ascitic liver carcinoma.-bearing mice was achieved by i.p. injection of low dosage TNF gene transfected LAK cells and IL - 2.

Objective To study the clinical characteristics of Guillain-Barr? syndrome(GBS) and the misdiagnosis and mismanagement in emergency department.Methods According to the diagnosis criteria of Chinese Journal of Neurology and Psychology,145 GBS in-hospital patients in our hospital from January 1,1994 to December 312004 were studied to find characteristics of GBS and auxiliary examinations.The reasons for GBS misdiagnosis and mismanagement were analysis.Results Most of the patients were young,the ratio of male to female was 2.5 to 1.Among them,mild-type was 34.5%,medium-type was 25.5%,severe-type was 13.9%,very severe-type was 7.6%,relapse-type was 4.1%,chronic-type was 12.4% and variation-type was 2.1%.The initial symptoms were multiplie.Bilateral limbs weakness and/or numbess were the most common symptom,and non-specificity asymmetrical weakness and/or numbess,headache,ophthalmalgia,distortion of angle of mouth or weak mastication were uncommon symptoms.Twenty-three patients(15.9%)were misdiagnosed in emergency department.71.3% patients developed albuminocytolgoic dissociation in cerebrospinal fluid.The content of protein in cerebrospinal fluid was correlated to the course of disease and uncorrelated to the patitent's condition.Conclusion GBS was a common cause of clinical acute flaccid paralysis,the mild-type has good prognosis and the mortality of very serere-type is high.GBS should be paid attention to in emergency department.

Objective To investigate the relationship between plasma concentration of osteopontin (OPN) and disease activity in systemic lupus erythematosus (SLE).Methods The plasma concentration of OPN in 28 healthy controls and 38 SLE patients was measured by enzyme-linked immunosorbent assay. Results The plasma concentration of OPN was significantly higher in SLE patients compared to that in the healthy controls (420?203 ng/mL vs 73?14 ng/mL,P＜0.001),in the patients with proteinuria com- pared to that in the patients without proteinuria (623?88 ng/mL vs 288?135 ng/mL,P＜0.001),in the patients with active disease compared to that in those with inactive disease (529?143 ng/mL vs 185?66ng/mL,P＜0.001),in the patients before treatment compared to that in the patients after treatment (556?130 ng/mL vs 142?22 ng/mL,P＜0.001).The plasma concentration of OPN in patients with arthritis was not different from those without arthritis (489?153 ng/mL vs 375?222 ng/mL,P＞0.05).Plasma concentration of OPN showed a significant positive correlation with systemic lupus erythematosus disease ac- tivity index (SLEDAI) (r=0.93,P＜0.001),but a significant negative correlation with serum C3 level (r=-0.49,P＜0.05).There was no correlation between plasma concentration of OPN and antinuclear an- tibody titre,erythrocyte sedimentation rate,or serum level of C4.Conclusions These data show that plas- ma OPN level has some correlation with the SLE activity,renal damage and progression or amelioration of SLE.OPN could be involved in the pathogenesis of SLE.

Diabetes mellitus is a worldwide disease and a growing public health burden.Female sexual function in patients with diabetes mellitus is complex and encompasses physical and emotional well-being across the lifespan.This review aims to discuss the development of sexual dysfunction in women with diabetes,while defining the parameters of dysfunction,and to present suggested risk factors and pathogenetic pathways,while offering evidencebased strategies for the evaluation of sexual dysfunction and management.

Objective To explore the effect of time tracking on speed of tissue-type plasminogen activator treatment in patients with acute ischemic stroke,and the correlation between door to needle time (DNT) and onset to door time (ODT).Methods Time tracking tables had been prospectively collected since October 2012.The data of intravenous thrombolytic candidates with acute ischemic stroke were retrospectively reviewed from June 2009 to September 2013.Baseline characteristics and the correlation between ODT and DNT were assessed respectively before and after the implementation of time tracking.Results Three hundred and forty-two cases were finally included.Before the implementation of time tracking,ODT was negatively correlated with DNT (r =-0.169,P =0.015) ; Patients with transient ischemic attack (TIA)/stoke history (β =-0.168,P =0.020) and ODT (β =-0.246,P =0.001)accounted for the length of DNT independently.Since the implementation of time tracking,the elderly accounted for more (19.4％ (25/129) vs 10.3％ (22/213) ; x2 =5.552,P =0.018),the baseline nervous impairment was NIHSS scores (milder 11.0 ± 6.3 vs 12.5 ± 6.7 ; t =2.065,P =0.040),the proportions of patients taking multi-modality imaging were larger (63.6％ (82/129) vs 51.6％ (110/213) ; x2 =4.638,P =0.031) and the DNT decreased significantly ((87.6 ± 33.2) min vs (108.4 ± 52.4) min;t =4.274,P =0.000),which was especially seen in patients arrived within 1 hour after onset ((90.3 ±21.0) min vs (132.5 ± 46.0) min; t =5.048,P =0.000),and the previous inversely correlated DNT and ODT (r=-0.169,P=0.015) became irrelevant (r=-0.013,P=0.885).Conclusion Implementation of time tracking reduces DNT,and clears up the effect of ODT on DNT.

Objective To investigate the differences in clinical manifestation,laboratory test and imaging between patients with symptomatic and non-symptomatic basilar dolichoectasia (BD).Methods We retrospectively analyzed the patients admitted in our hospital from January 2012 to January 2013,who receiving intracranial computed tomography angiography or magnet resonance angiography.We grouped the patients to symptomatic and non-symptomatic,and further divided the symptoms into vascular events and compressive symptoms.We compared the baseline characteristics of the symptoms in these groups,risk factors of cerebrovascular events,and kidney function between patients with symptomatic and nonsymptomatic BD.Results Comparing with non-symptomatic BD (n--24),the diameter of basilar artery in symptomatic BD patients(n =52) was larger ((4.7 ± 0.9) mm vs (4.2 ± 1.0) mm,t =-2.289,P =0.025),and the level of diastolic blood pressure and uric acid were higher ((94.0 ± 16.7) mmHg vs (86.9--±12.0) mmHg,1 mmHg =0.133 kPa,t =-2.113,P =0.038;(333.3 ± 120.7) μmol/L vs (267.6 ± 84.6) μmol/L,t =-2.724,P =0.008).The group with vascular symptoms (n =18) had greater basilar artery diameter ((4.9 ±0.8) mm vs (4.2 ± 1.0) mm,t =-2.612,P ＜0.05) compared to those without vascular symptoms(n =58).BD patients with compressive symptoms (n =6) had higher level of uric acid ((374.5 ± 51.9) μmol/L vs (281.1 ± 101.6) μmol/L,t =-2.216,P ＜ 0.05) and serum IgA ((1.44 ± 0.28) g/L vs (2.48 ± 0.78) g/L,t =5.660,P ＜ 0.05) than those with non-compressive symptoms (n =70).Conclusions The presence of symptoms in patients with BD is related with the increased diameter of basilar artery.Our results suggest that strict control of blood pressure in the early stage may help to reduce the incidence of the vascular events in BD patients.