Objective To investigate the influence of intravenous thrombolysis to acute cerebral infarction with cerebral microbleeds (CMB). Methods Eight-nine patients with cerebral infarction in the Neurological Department of the Second Affiliated Hospital of Guangzhou Medical College from January 1st , 2011 to December 31st, 2012 were enrolled in this study. All patients were scanned with MRI and GRE. According to the presence of CMB, the patients were classified into two groups, including CMB group and non-CMB group. Past history of smoking, drinking, hypertension, lacunar infarction, diabetes and leukoaraiosis situation were recorded and risk factors of CMB were explored. All patients were treated with intravenous thrombolysis and rescanned with MRI to compare the total number of CMB 24 hours after thrombolysis. Results In the CMB group, the number of patients with mild CMB decreased and the number of patients with serious CMB increased after thrombolysis. CMB was associated with sex, age, hypertension, lacunar infarction and leukoaraiosis. Conclusions Sex, age, hypertension, lacunar infarction and leukoaraiosis were the risk factors of CMB in acute cerebral infarction. Thrombolysis in acute cerebral infarction augments the incidence of CMB and promotes the hemorrhagic transformation.

PurposeTo investigate the relationship between the serum oxidized low-density lipoprotein (ox-LDL) level and carotid vulnerable plaque in patients with acute cerebral ischemic stroke, and to evaluate the ability of serum ox-LDL in identifying vulnerable carotid plaques.Materials and Methods 181 patients with history of acute cerebral ischemic stroke were recruited. According to the results of carotid ultrasound patients were divided into non plaque group (n=48), stable plaque group (n=38) and vulnerable plaque group (n=95). The serum total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting plasma glucose and ox-LDL were measured. Carotid intima-medial thickness (CIMT), total carotid plaque area (TPA) and the characters of plaque were examined with color Doppler ultrasound.Results The serum ox-LDL and the number of patients with hypertension in plaque group were significantly higher than that in the non-plaque group (P<0.05). The serum ox-LDL and TPA in the vulnerable plaque group were significantly higher than that in the stable plaque group (P<0.05). Serum ox-LDL in patients with acute cerebral infarction was positively correlated with CIMT, serum total cholesterol and LDL-C (r1=0.154,P<0.05;r2=0.338, P<0.05;r3=0.385,P<0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid vulnerable plaque (OR=1.038, 95%CI 1.008-1.069, P<0.01).Conclusion The serum ox-LDL is independently associated with the formation of vulnerable plaque in patients with acute cerebral infarction. This study suggests that ox-LDL can be used as a biomarker in screening for vulnerable carotid plaque in clinical practice. Carotid ultrasound combined with serology can early identify carotid artery vulnerable plaque that may lead to cerebral ischemic events.

Objective To explore the value of time-resolved angiography with interleaved stochastic trajectories (TWIST)in providing hemodynamic indices and morphological imaging of calf arteries in patients with peripheral arterial occlusive disease(PAOD) with 3.0 T MR scanner. Methods Forty patients with confirmed or suspected PAOD underwent TWIST MRA for the calf arteries and conventional contrast-enhanced MRA(CE-MRA) for the whole lower peripheral arteries. TWIST MRA data were used to determine the bolus arriving time of the popliteal artery, the time difference of the bolus arrival in the popliteal artery between the two legs, calf artery transit time, and the mean peak enhancement time of calf arteries. The mean value of peak enhancement time of calf arteries was correlated with ankle-brachial index(ABI). The calf arteries were divided into 13 segments. The visible score of arterial segment was recorded, and the degree of arterial stenosis was graded too. In 16 patients, DSA was used as the gold standard to evaluate the sensitivity and specificity of TWIST MRA and CE-MRA. Results The bolus arriving time of the popliteal artery was (0.7±7.6) s the time difference of the bolus arrival in the popliteal artery between the two legs was (2.1±2.5) s, the calf artery transit time was (35.6±16.9) s, the mean value of peak enhancement time of calf arteries was (52.6±17.6) s. ABI was acquired from 24 patients and 48 legs, which correlated well with the mean value of peak enhancement time in calf arteries (r＝0.627,P＜0.01). The mean visible score was (2.83±0.48) of TWIST MRA images and (2.78±0.43) of CE-MRA images. There was no significant difference between them (P＞0.05). On CE-MRA, there were 38 legs with varying degrees of early venous enhancement; in contrast, there was no venous contamination on TWIST MRA. The sensitivity and specificity of TWIST MRA were 96.7% (118/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 94.1% (32/34) and 96.2% (154/160) in showing severe stenosis, and 94.7% (36/38) and 98.7% (154/156) in showing occlusion. The sensitivity and specificity of CE-MRA were 95.9% (117/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 91.2% (31/34) and 95.6% (153/160) in showing severe stenosis, and 94.7% (36/38) and 98.1% (153/156) in showing occlusion. Conclusion TWIST MRA is a preferable choice for calf arterial occlusive disease, which provided nice morphological images and useful hemodynamic indices with simple operation.

Objective To investigate the association between morniing blood pressure surge (MBPS) and carotid atherosclerosis in elder patients with essential hypertension. Methods According to the results of24h ambulatory blood pressure monitoring, 106 patients were classified as the morning BP surge group (MBPS group,n = 58) ,and nonsurge group (NMBPS group, n = 48). Patients underwent carotid ultrasound and the intima-medial thickness (CCA-IMT) and plaques were examined. Results The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group[(1.27 ± 0. 12)mm vs (0.92 ± 0.33 )mm], P ＜ 0. 05 ) ;②Compared with the NMBPS group,the severity of carotid arteries plaque of the MBPS group was significantly higher (72. 15% vs 54.21% ), ( P ＜0. 01 ) ;③Pearson relation analysis showed CCA-IMT level positively correlated with age (r = 0.288, P ＜ 0.001 ) ,the average of 24h SBP ( r = 0. 768 ,P ＜ 0. 001 ), and MBPS ( r = 0. 768, P ＜ 0.001 ). Conclusion The study showed that MBPS was closely related with carotid atherosclerosis in elder patients with essential hypertension and was an important risk factor in the process of atheresclerosis.

: ObjectiveTo study the correlation between mental status and personality of patients with stroke. Methods103 patients with stroke were surveyed by Symptom Checklist 90 (SCL-90) and Eysenck Personality Questionnaire (EPQ). ResultsThe scores of 7 factors which include total scores, somatisation, compulsion, depression, anxiety, panic and psychosis in SCL-90 were higher than norm, but the inter-personal sensitivity was lower. The scores of neuroticism (N) in EPQ were higher than the domestic norm(P<0.05),the scores of extra-introversion (E) and psychoticism (P) in EPQ were lower than the domestic norm(P<0.05); The N of EPQ was positively correlated with all factors of SCL-90, the E was positively correlated with hostility and paranoia factor, and the P was positively correlated with paranoia factor. ConclusionThe mental status of patient with stroke in acute period was poor. The character of neuroticism and introversion may be its personality background.

【Objective】 To investigate the effects of CSF-1 transport from dorsal root ganglion to spinal cord on activation of microglia in rats with neuropathic pain induced by vincristine. 【Methods】 A total of 54 male 10-12-week old SD rats with successful intrathecal catheterization, weighing 200-230 g, were divided into three groups according to the random number table method(n=18) : Control group(Control), Chemotherapy-induced Neuropathic Pain+intrathecal injection of IgG group(CINP), Chemotherapy-induced neuropathic pain+intrathecal injection of CSF-1 neutralizing antibody(CINP+anti). The animal model of CINP was established by intraperitoneal injection of vincristine 125 μg/kg on four alternate days. Mechanical allodynia and heat hyperalgesia were evaluated by MWT and TWL, respectively. The expression of CSF-1 and microglial marker Iba1 were detected by immunofluorescence chemistry and Western blotting. The mRNA expression of CSF-1 and Iba1 was measured by RT-PCR. The expression TNF-α, IL-6 and IL-1β were determined by ELISA. 【Results】 Compared with Control group, MWT and TWL in CINP group decreased significantly on the 3rd, 5th and 7th day after the first injection of vincristine(P<0.01), MWT and TWL in CINP+anti group increased significantly on the 5th and 7th day compared with CINP group(P<0.01). Compared with Control group, the protein and mRNA expression of CSF-1 in DRG, the mRNA expression of Iba1 in spinal cord, the protein expression of CSF-1 and Iba1 in spinal cord, the immunofluorescence intensity of CSF-1 in DRG and Iba1 in spinal cord , and the expression of TNF-α, IL-6 and IL-1β in spinal cord were significantly up-regulated in CINP group(P<0.01, P<0.001). Compared with CINP group, the protein expression of CSF-1 in DRG and spinal cord, the protein and mRNA expression of Iba1 in spinal cord, the immunofluorescence intensity of spinal Iba1 and CSF-1 in DRG, and the expression of TNF-α, IL-6 and IL-1β were obviously downregulated in CINP+anti group(P<0.05, P<0.01, P<0.001) . 【Conclusion】 The transport of CSF-1 from dorsal root ganglion to spinal cord is involved in the process of neuropathic pain induced by vincristine, and its mechanism may be related to the activation of microglia and inflammatory reaction in rat spinal cord.

OBJECTIVE: To investigate the efficacy and safety of Ji-Tai tablet and Ji-Tai tablet combined with buprenorphine in the treatment of patients with acute withdrawal syndrome of mild heroin dependence. METHODS: A total of 150 patients with mild heroin dependence were recruited, and were randomly assigned to a Ji-Tai tablet group (n=50), a Ji-Tai tablet combined with buprenorphine group (n=50) and a control group (n=50) during a 10-day clinical trial. Opiate withdrawal scale (OWS) was used to measure the severity of withdrawal symptoms. Anxiety symptoms assessments were made at 0 day (baseline), the day 5 (middle), and the day 10 (end) by the Hamilton anxiety scale (HAMA). Symptoms were assessed before and 1 h or 2 h after medication each day. The total withdrawal symptoms scores and the daily reduction rate were used to measure the effect of Ji-Tai tablet vs Ji- Tai tablet plus buprenorphine. Safety evaluation was carried out by the following measures: baseline of treatment, drug side effects after the treatment, vital signs (blood pressure, heart rate, and respiration rate), laboratory examination (routine blood and urine tests and the liver and kidney function tests), and electrocardiograms. RESULTS: A total of 142 mild heroin dependence patients performed the experiments (including 48 in the Ji-Tai tablet group, 48 in the Ji-Tai tablet with buprenorphine group and 46 in the control group). The scores of baseline withdrawal symptoms were 43.520±19.786, 42.640±17.648 and 47.100±24.450, respectively, with no significant differences among the 3 groups (all P>0.05 ). During the 10-day treatment, the reduction rate of acute withdrawal symptoms scores increased daily, the acute withdrawal syndrome scores and the anxiety symptoms scores declined from day 0 to day 10, there was also no significant difference among the 3 groups (all P>0.05). Ji-Tai tablet did not affect vital signs such as blood pressure, heart rate, and respiration rate. CONCLUSION Ji-Tai tablet or Ji-Tai tablet combined with buprenorphine had no effect on acute withdrawal symptoms of mild heroin dependence.
Anxiety ; Buprenorphine ; therapeutic use ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Heroin Dependence ; drug therapy ; Humans ; Substance Withdrawal Syndrome ; drug therapy ; Tablets

BACKGROUND: The maximal problem of patient with serious hepatitis and surgical doctor is whether they can get donator and rational therapy timely. Looking for the suitable preoperative therapy method to enhance the success rate of operation and improve patient's prognosis is the focus of this domain.OBJECTIVE: To investigate the therapeutic effect of artificial liver support system (ALSS) combining with allotransplantation of the liver on patients with serious hepatitis.DESIGN: Retrospective case analysis. SETTING: Organ Transplantation Center, the Third Affiliated Hospital of Anhui Medical University.PARTICIPANTS: Five male patients with serious hepatitis who underwent allograft liver transplantation were selected from Organ Transplantation Center, the Third Affiliated Hospital of Anhui Medical University form June 2004 to May 2005. Their age ranged from 25 to 48 years. Inclusion criteria: The diagnosis was in accordance with phase standard established at the National Infectious Disease and Parasitology Academic Meeting in September 2000; all patients had signs of routine liver transplantation; their patients fiercely requested the operation.METHODS: Plasma exchange (PE) combined with continuous veno-venous hemofiltration (CVVH) technique was used in this study. Donor who supplied lives was from 20-38-year patients. All of them and their family agreed to donate their organ and signed the donate file before operation. All of 5 patients were used classical no-by-pass orthotopic liver transplantation (OLT). MAIN OUTCOME MEASURES: They were follow-up visited for 21-32 months for rechecking liver and kidney function,RESULTS: All of 5 patients' operation was succeeded. One continued coma postoperative and his serum creatinine and urea nitrogen raised up progressively and complicated by pulmonary infection 1 week after operation and died 2 weeks after operation although given medical treatment hemodialysis positively. The rest recovered well. All of them discharged one month after operation smoothly.CONCLUSION: Allotransplantation of the liver is an utilizable method to treat serious hepatitis. ALSS can be used as an effective method of supportive treatment preoperatively.

Objective To analyze cases diagnosed with glomerular minor lesion (GML) by light microscopy and immunofluorescence,uncover their final pathology diagnosis by electron microscopy,and thereby clarify the pathological and clinical meaning of GML.Methods One hundred and forty-eight patients receiving renal biopsy between 2003 and 2008 in Peking Union Medical College Hospital,with diagnosis of GML described by light microscopy and immunofluorescence examination were retrospectively studied.All the clinical data and pathological observation were collected and analyzed,including intact results of electron microscopic examination which were considered as golden standards of pathological diagnosis.Results The 148 patients with GML had heterogenous clinical features,with isolated hematuria as the most common presentation.Electron microscopy revealed various pathological presentations:thin basement membrane nephropathy (TBMN,66.2％),mesangial proliferative glomerulonephritis (MsPGN,20.3％),Alport syndrome (2.7％),membranous nephropathy (MN,3.4％),normal tissue (4.7％).Among GML patients with isolated hematuria,TBMN ranked as the most common pathology (76.9％).Conclusions GML is only an equivocal description of pathological manifestation by light microscopy and immunofluorescence examination.And electron microscopy is necessary to obtain accurate pathology diagnosis for patients undergoing renal biopsies.

Objective To analyze the relationship between renal pathological characteristics and clinical prognosis in type 2 diabetic kidney disease patients,and discuss predictive value of pathological type and indexes for renal function declining rate and related outcome events.Methods Ninety-two type 2 diabetes patients from PUMC Hospital (with macroalbuminuria and followed up no less than 6 months,excluding patients with non-diabetic renal disease) were divided into typical diabetic glomerulopathy group (DG,n=51) and atypical diabetes-related renal disease group(ADRD,n=41) according to renal pathological findings.A retrospective cohort study was performed to investigate renal pathological features and prognosis.Results Total of 29 renal outcome events and 12 death events occurred in DG group and none in ADRD group; the survival rate and kidney survival rate are different between two groups (P ＜ 0.05); DG group,thick GBM,severe vascular and tubular lesion are predicative indicators for renal outcome event; mesangial volume fraction is predicative indicator for renal outcome events independent of age and serum creatinine.Conclusions DG and ADRD patients have different prognosis and might undergo different pathophysiological mechanisms; renal pathological type and mesangial volume fraction could help predicting outcomes of type 2 diabetic nephropathy patients.