Objective To evaluate the inter-rater reliability and validity of Chinese version Consortium to Establish a Registry for Alzheimer's Disease: Neuropsychological Assessment Battery (CERAD-NAB) in discriminating mild cognitive impairment (MCI). Methods 52 old people (31 normal elderly, 21 MCI, according to the Petersen's criterion) were assessed with CERAD-NAB-C. The intra-class correlation coefficient (ICC), receiver operating characteristic (ROC) curve, and area under the curve (AUC) were analyzed. Results The ICC was 0.945~1 in subtests of CERAD-NAB. The AUC was 0.747, the sensitivity and specificity of total score was 0.52 and 0.90 respectively at a cut-off score of 62.5. J3, J8, and total score had higher AUC than other subtests in discriminating MCI from normals. Conclusion The inter- rater reliability of CERAD-NAB was perfect, and the validity was satisfactory in discriminating MCI from normals

Objective To establish a stable and reproducible experimental method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage (ICH) in rats, and to study its validation. Methods Seventy male Sprague-Dawley rats were randomly divided into ICH groups and sham-operated groups. ICH was produced by microinjection of 40 ?l fresh autologous blood or saline into the right caudatum. Dynamic CT perfusion imaging in measurements of regional cerebral blood flow adjacent to hematomas was performed. Then, rats were sacrificed, and the TTC stain and histopathological examination were carried out. The ratios of side-to-side were measured at the regions around the hematomas by personal computer aided mapping. Results The gradient of perihematomal hypoperfusion was revealed by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) maps in ICH groups. The alternation of rCBF around the hematomas were fluctuated, and rCBF reduction was most pronounced at 1 hour after ICH, then, the rCBF gradually returned, and returned to the peaks at 6 hours and 24 hours after ICH respectively. TTC stain did not show infarction around the hematoma. Histopathological study demonstrated there was a transitional zone between ICH and the normal brain tissue, and the astrocytic swelling and neuronal degeneration were observed in the peri-ICH regions. The inflammatory cell infiltration and capillaries hyperplasia were also seen around the ICH. Conclusion The method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage in rats is stable and accurate. Perfusion CT and its parameter analysis may play an increasing role in delineating the hypoperfusion around hematomas. The experimental method is suitable and validated to the study of secondly injury after ICH in vivo.

Objective To investigate the imaging and pathological features of atypical teratoid/rhab doid tumor (AT/RT)occur-ring in the central nervous system (CNS).Methods The CT and MRI findings of 1 6 patients with CNS AT/RT were retrospectively analyzed,and their pathological and immunohistochemical results were studied.Results There were 12 males and 4 females. Tumors located is at supratentorial in 10 and infratentorial in 6.Cystic changes in tumors were noted in 12 cases.The solid portion of tumors was isointense on T2-weighted images relative to normal brain grey matter in 9 patients.Extensive peritumoral edema was observed in 1 1 lesions.The tumors showed bandlike rim of significant enhancement in 10 cases.The incidence of hemorrhage and calcification in tumors were 43.8% and 41.7% respectively.Histopathologically,AT/RT was characterized by the presence of rhab-doid cells associated with variable components of epithelial,primitive neuroectodermal and mesenchymal differentiation.Conclusion Atypical teratoid/rhabdoid tumor is several imaging findings which are relatively specific on CT and MR images.CT and MRI may provide valuable information for pre-operation diagnosis and prognostic evaluation in patients with CNS AT/RT.

AIM: To investigate whether three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) can be used as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease before stent implantation. METHODS: Thirty-three patients with suspected intracranial arterial stenosis received 3D TOF MRA and digital subtraction angiography (DSA) examinations in Chaoyang Hospital Affiliated to Capital Medical University between March 2007 and April 2008,and were included for this study. Two physicians blindly estimated stenosis,patient history,and clinical information of 363 vascular segments from 33 patients,including bilateral internal carotid artery (ICA),anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery,and basilar artery (BA). Stenosis was categorized as 30%-49%,50%-69%,70%-99%,and 100%. For each kind of stenosis,sensitivity,specificity,positive predictive value,negative predictive value,K and P values of MRA were calculated,respectively,as compared to DSA. RESULTS: A total of 42 diseased vascular segments were identified. Compared to DSA,for intracranial stenosis 50%-69%,3D TOF MRA showed sensitivity 100%,specificity 96.8%,positive predictive value 62.1%,negative predictive value 100%,K value 0.751,and P value 0.000; For intracranial stenosis 70%-99%,the corresponding value was 100%,98.6%,70.6%,100%,0.821,and 0.000,respectively; For intracranial stenosis 30%-49%,it was 25.0%,99.7%,66.7%,98.3%,0.356,and 0.000,respectively.CONCLUSION: For high sensitivity and specificity to intracranial stenosis 100%,70%-99%,or 50%-69%,compared to DSA,3D TOF MRA is a reliable screening tool for preoperational evaluation of intracranial vascular stenosis and occlusive disease.

Intrahepatic cholangiocarcinoma is the second most common intrahepatic primary liver tumor after hepatocellular carcinoma (HCC).Epidemiological study suggests a strong correlation between HBV infection and ICC development.This review focused on the potential mechanisms of HBV-induced ICC and gives a primary summary of suggested hypothesis,which included:(1) HBV infection of liver stem/progenitor cells will indirectly lead to HBV infection of intrahepatic biliary epithelial cells and lead to the development of ICC; (2) the changed microenvironment of intrahepatic biliary epithelial cells by HBV infection eventually results in carcinogenesis ; (3) the HBV infection of hepatic sten/progenitor cell can transform into tumor-like stem cells and ultimately differentiate into ICC-like tumor cells.

Objective To investigate the progress of pathology of the perihematomal tissue, and to study the relationship between the pathology and the changes of regional cerebral blood flow after intracerebral hemorrhage(ICH) in rats. Methods ICH was produced by microinjection of fresh autologous blood into the right caudatum in rats. CT perfusion imaging and computer-aided mapping in measurements of regional cerebral blood flow adjacent to the hematomas were performed in seventy SD rats at 1h, 3h, 6h, 12h, 24h, 48h and 72h respectively after the ICH. The parameters of regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV) and mean transit time(MTT) were calculated respectively. After the CT examination, the histopathological examination of TTC, HE and ultrastructure staining were carried out. Results The gradient of perihematomal hypoperfusion was revealed on CT perfusion maps. The rCBF and rCBV around the hematomas reduced pronouncedly, and the MTT delayed. TTC staining did not show infarction around the hematoma. Histopathological study demonstrated the astrocytic swelling and neuronal degeneration in the peri-ICH regions. The inflammory cell infiltration and capillaries hyperplasia were also observed around the ICH. Under the electronic microscope, the pathological changes of ultrastructure were revealed. In the early stage of ICH, there existed swelling of astrocytes, loosing of myelin sheath lamina, but no clear changes occurred in neurons. With the delay of ICH, the cellular injury around hematomas exacerbated progressively, more swelling of astrocytes, slight degeneration of neurons and local fragmentation of myelin sheath lamina were observed.Conclusion The perihemorrhagic and distant ischemic injury can be induced by the pronounced reduction of cerebral blood flow in the early stage of ICH. The cellular injury around hematomas exacerbates progressively in the acute stage of ICH. There is a perihematomal penumbra affecting multiple mechanisms of cellular injury.

Objective To observe the tendency of the plasma concentration of plasminogen activator inhibitor type-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) before and after thrombolytic treatment of acute ST elevation myocardial infarction (STEMI) and to explore their recanalization predictive value of PAI-1 and TAFI for acute myocardial infarction patients with thrombolytic treatment.Methods Sixty patients,who received thromobolytic treatment from January 2007 to March 2009,were prospectively recruited.The blood sample were collected within 2 hours of thromobolytic treatment ( 0,0.5 h,1 h,1.5 h and 2 h).The plasma concentration of TAFI and PAI-1 were test by ELISA.16 healthy people were recruited as control group.Results The plasma levels of PAI-1 in STEMI patients before thrombolytic treatment were higher than those of Control group ( P ＜0.01 ),however the same significant change of TAFI level was not seen.The levels of TAFI were no significant difference before and after thrombolytic therapy during whole observation periods.However,the level of PAI-1 increased at 1.5 h and 2 h after thrombolytic therapy (P ＜ 0.01 ).The plasma PAI-1 levels of no - revascularigation group at 2 h after thrombolytic therapy were significant higher than that in revascularization group ( P ＜ 0.05 ).The levels of TAFI were not significantly different between two groups (P ＞ 0.05).Conclusions The decrease of plasma PAI-1 from high level within 2 hours after thrombolysis treament may be exploring the predictive value for revascularization.The tendency of TAFI can' t forecast the result of revascularization.

Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) during prenatal checkup. They were randomly divided into two groups: intervening group( n= 36, newborn group A) was treated with levothyroxine ( L-T4 ), and non-intervening group ( n= 19, newborn group B) was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group (newborn group N). Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group ( P＜0.05 ). Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups (P＜0. 05 or P＜0.01 ). The cord blood TSH levels of the neonates in both group B [(7.06 ± 1.31 ) mIU/L] and group A [(6.23 ± 1.26 ) mIU/L] were significantly higher than that of group N [(5.48±1. 17) mIU/L, P＜0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [(3.21±0.70)mIU/L] in group B was significantly higher than those in group N [(2.72±0.51)mIU/L] and group A [(2.78±0.42) mIU/L, all P＜0.05]. The serum TSH level in group B [(2.99±0.57) mIU/L] was still higher than those in group N [(2.48±0.68) mIU/L] by 8 to 10 weeks postpartum (P＜0.05 ). Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusion When differences in thyroid function exist in pregnant women, these differences also reside in their offspring. The thyroid function in neonates correlates with both the thyroid autoantibodies and thyroid function of their mothers.

Objective To investigate current status of knowledge-attitude-behavior about unplanned extubation (UEX) of central venous catheter among infusion nurses in Guangdong Province.Methods The nurses who attended the 2015 intravenous therapy nursing training provided by Guangdong Nursing Association were selected as participants.A self-designed questionnaire about nurses' knowledge-attitude-behavior about UEX of central venous catheter was used to investigate 450 nurses.Results The proportion of nurses who reached good level in knowledge were 41.1％,nurses who had positive attitude were 71.0％,nurses who had positive behaviors were 30.0％.There were significant differences among nurses with different educational background,different titles and different hospital ranks(P＜0.05).Conclusion The knowledge-attitude-behavior of nurses are not satisfactory,especially those who are junior or have lower education or work in non-tertiary hospital.