Oral anticoagulants are important for preventing stroke in patients with atrial fibrillation.Compared with the traditional oral anticoagulant warfarin,the novel oral anticoagulants (NOACs) have the characteristics of high efficiency,safety,and no need to monitor coagulation function.However,current clinical reports have showed that the dose is usually low when NOACs were used for preventing stroke in patients with atrial fibrillation.Its main reason may be associated with the risk avoidance and the difference in doctor and patient preferences.The analysis from the aspects of safety and effectiveness,the risk of ischemic stroke or systemic embolism is lower when the dose of NOACs is relatively high,and the risk of hemorrhage is lower when the dose of NOACs is relatively lower.Given the differences between the incidences of different events,the disability rate and the mortality rate,the patient with atrial fibrillation are more suitable for using high-dose drug.When choosing a specific dose,taking into account the specificity,the appropriate dose,intensity,and dosing regimen should be given according to the guideline recommendations,appropriate reference to renal function and patient preferences,and individual differences in order to obtain the best clinical efficacy..

Transcriptomics studies the variety, structure, function and regulation of all transcripts in a given cell and in a given time. It provides a novel procedure for revealing the molecular mechanism and regulatory network of different development stages of nasopharyngeal carcinoma. The progress of isolation, identification and function study of tumor susceptibility/suppressor gene, gene transcription profiling and transcription regulatory networks have been introduced.

LRRC4, a novel member of LRR (leucine-rich repeat) superfamily, is cloned by expressed sequence tag (EST)-mediated positional cloning strategy combined with 5′-RACE technology. Normal expression of LRRC4 is highly specific for brain, whereas absent or significantly down-regulated in primary tumors including glioma, meningioma and pituitary adenoma. LRRC4 is a functional gene in neural development and axon growth, and associated with glioma grade progression. LRRC4 expression is gradually reduced, even absent accompany with glioma grade increase. Absent expression of LRRC4 is involved in the late event of malignant glioma progression.The reexpression of LRRC4 can decrease a series of growth factors/neurotrophic factors (IGF, EGF, PDGF, CNTF, bFGF,GDNF and BDNF) or receptors gene expression to regulate RTK-mediated many signaling transduction pathway, such as K-Ras/c-Raf/ERK/MAPK, PI-3K/AKT/NF-?B, p70S6/PKC, STAT3 and JNK2/c-Jun/mp53, which block U251 cells in late phase of G1 to inhibit glioma cells proliferation and invasion. This inhibitory effect of LRRC4 is dependent on its LRR domain. LRRC4 induces glioma cells to differentiate into astrocyte-like cells more than apoptosis.

Objective To study the effects of ultraviolet(UV)radiation disinfection on purified wecter in water dis-penser.Methods The original structure of water dispenser was modified by installing additional UV lamps.The water samples were collected from the tap of the newly modified water dispenser simulated the practical status of water supply in indoor environment under the different conditions including different intensities of UV lamps and water flow rates.The total counts of bacteria of water samples were determined based on the Sanitary Standard for Bottled Purified Drinking water(GB17324-1998).Results The total counts of bacteria of water samples collected from the tap of the newly mod-ified water dispenser were below20cfu/ml,which was lower than those of control water sample(P

[Objective] To study the effect on the growth of mouse Lewis lung carcinoma and on the expression of VEGF in tumor tissue.[Methods] C57BL/6 mice were inoculated the Lewis lung carcinoma cell at right armpit and divided into groups.Different groups were administered by MAALC(low,normal and high dose),CTX or saline.After 15 days,all mice were put to death to detach the tumors then weighed them.After that,we treated tumor tissue with VEGF immunohistochemistry stain,detected the integral optical density of VEGF expression with image analytical technique.[Results] Compared with model group,the average weight and VEGF expression level of the tumors of the high dose group were less and statistically significant(P

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and vascular edge artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.

Objective As a classical approach for hyperthermic ablation,microwave ablation (MWA) has been widely used in the treatment of tumors that cannot be removed by traditional surgery.MWA devitalizes the neighboring tissue and kills tumor cells by thermal diffusion.In the last two decades,this technique has been improved for treating malignant bone tumor in our institute.In situ ablation has already replaced en bloc resection and achieved satisfactory treatment outcomes.This study explores whether tumor cell death induced by MWA would cause the release of immunogenic tumor antigens and tumor-specific immune responses.Methods Three models of MWA were established using osteosarcoma cell lines from the mouse,rat,and human,respectively.The expression of immunogenic molecules was measured during in vitro and in situ ablation with different ablation time and group design.Results The injection of tumor vaccines made from tumor cells or supernatant treated with in vitro ablation resulted in substantial inhibition of tumor cell growth in tumor-bearing animal models.The CDs + T cells induced by vaccines played a key role in the process.The effector cells released cytokines,IFN-γand TNF-α,to inhibit tumor cell growth and also trigger Fas/FasL-mediated apoptosis.Conclusions MWA-treated osteosarcoma cells can be used to induce specific antitumor immunogenic effects.Therefore,in situ MWA combined with immunotherapy provides an alternative treatment method for patients who have trouble due to their insensitivity to chemotherapy.