With the development of neuroimaging techniques and the extensive application in clinical practice,the case reports about migrainous cerebral infarction have increased progres- sively,and have received extensive attention.However,its exact pathogenesis still remains unclear.In recent years,with the application of functional neuroimaging techniques,people have a new insight into the pathophysiological mechanisms of migrainous cerebral infarction,This article reviews the advanced in research on the pathogenesis of migrainous cerebral infarction.

Objective To investigate the morphological changes of bone marrow megakaryocytes in patients with bacterial and fungal infection.Methods Totally 76 patients with microorganism infection from the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2008 to August 2009 were enrolled,including 56 bacteria infected patients and 20 fungal infected patients.All patients received bone marrow examinations,and were positive in microorganism culture.Thirty subjects without infection,hematological disease and other severe diseases were randomly selected as controls.The number and function of megakaryocytes were examined retrospectively, and the size, nuclear lobulation, and vacuolar degeneration of megakaryocytes were quantitative analyzed and compared among the groups.Results The size,nuclear lobulation,vacuolar degeneration,and Yat nuclear of megakaryocytes in bacterial infected group were 2.20 ±0.21,2.11 ±0.23,0.51 ±0.11 and 0.74 ±0.11 respectively,those in fungal infected group were 2.21 ±0.16,2.10 ±0.19,0.52 ±0.10 and 0.79 ±0.10 respectively;while those in control group were 1.40 ±0.10,1.36 ±0.12,0.28 ±0.06 and 0.54 ±0.09 respectively.The differences between bacterial infected group and control were of statistical significance(t values were 14.52,12.19,9.33 and 6.61 respectively,P ＜ 0.05),and the differences between fungal infected group and control were of statistical significance(t values were 16.27,12.34,7.85 and 6.49 respectively,P ＜ 0.05).The size,nuclear lobulation,and vacuoles of megakaryocytes in gram-negative(G-)bacteria group were 2.29 ±0.20,2.22 ±0.26 and 0.57 ±0.10,while those in the gram-positive(G+)bacteria group were 2.13 ±0.20,2.04 ±0.18 and 0.46 ±0.09,and the differences were also significant(t values were 2.07,3.03and 3.56 respectively,P ＜ 0.05).The production of platelet by megakaryocytes in bacterial infected group,in fungal infected and the control were 31.4 ±7.6,32.4 ±6.4 and 41.3 ±5.5,and the differences between bacterial infected group and control,fungal infected group and control were significant(t values were 4.78and 3.98 respectively,P ＜ 0.05).The production of platelet in G-bacteria group was 28.0 ± 6.7,while that in G + bacteria group was 34.4 ± 7.2,and the difference was also of statistical significance(t = 2.41,P ＜0.05). Conclusion Bacterial infected patients have increased megakaryocytes cell body,nuclear lobulation,obvious vacuolar degeneration,Yat nuclear and decreased platelet production function,which are more significant in G- bacteria infected group.

The metabolism study of radiolabeled drugs plays an important role in the development of new drugs. It provides information on drug absorption, metabolism, tissue distribution and excretion, and plays an irreplaceable role in the metabolite safety evaluation and mass balance of new drugs. The new guidance draft on clinical trials of radiolabeled drugs recently released by the US FDA puts forward higher standards and has been widely concerned by the industry. In recent years, in the research and development of new drugs in China, ¹⁴C labeled drugs have been used to carry out clinical metabolism studies, which has overcome key technical bottlenecks and accumulated experience. This paper summarizes the above research progress, analyzes the existing problems, and preliminarily looks forward to the future technological development and application.

Objective To assess the effect of levothyroxine , lipoic acid and their combination therapy on improving the cognitive deficit and on the level of oxidative stress in the serum and hippocampus tissue of adult hypothyroid rast .Methods Fifty male SD rats were randomly divided into five groups:normal group , hypothyroidism group [ propylthioaracil ( PTU ) group], the levothyroxine sodium (L-T4) treatment group (PTU +L-T4 group), the lipoid acid(LA) treatment group (PTU+LA group), and the two-drug combination group (PTU+LT-4+LA group).After 8 weeks of treatment, the learn-ing and memory abilities of the rats were evaluated by Morris Water Maze ( MWM ) .The content of malondialdehyde ( MDA) and the activities of superoxide dismutase ( SOD) in the serum and hippocampus were respectively measured using thiobarbituric acid ,and xanthine-xanthine oxidase methods .Results Compared with the normal group , the escape latency was longer(P<0.01), the MDA level was increased and the SOD activity was decreased in the serum and hippocampus in the PTU group (P<0.001).Compared with PTU group, the SOD activity was increased and the MDA level was decreased in the PTU +L-T4 group, PTU +LA group and PTU +L-T4 +LA group(P<0.05).There was significant difference in MWM test score .Conclusion The L-T4 and LA combination therapy can significantly improve the cognitive function of hypothyroid rats.

Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.

BACKGROUND:Due to anisotropic CT volume data, triangular meshes extracted from bone CT images often contain staircase surface, which wil affect the subsequent medical diagnosis. OBJECTIVE:To reconstruct patient-specific bone model based on digital geometry processing technique. METHODS:Firstly, registration was performed in image registration algorithm based on mutual information for bone CT slices, and then contours were extracted by image segmentation and a stack of contours were converted into point clouds. The normals of point clouds were estimated based on Gaussian weighted principal component analysis and the noise from point clouds was removed by trilateral filtering. Final y, bone triangular meshes were constructed by adaptive spherical cover. RESULTS AND CONCLUSION:In this paper, the proposed method could generate smoothing bone surface meshes, triangular mesh shape which was formed by the rules and adaptive distribution, for finite element analysis, computer aided manufacturing and three-dimensional printing to provide accurate three-dimensional models.

Purpose To study the clinicopathological features of the phosphaturic mesenchymal tumors. Methods The clinicopatho-logical data, histology and immunohistochemical findings of 12 cases of phosphaturic mesenchymal tumors were retrospectively analyzed with review of the relevant literature. Results Among the 12 patients studied, 8 were males and 4 were females. Their age at the time of operation ranged from 23 to 63 years (mean=40. 5 years). The duration of symptoms ranged from 1 to 14 years (mean =5. 6 years) . A history of long-standing bone pain, arthralgia, limitation in movement, accompanied with hypophosphatemia and hyperphos-phaturia were present in all cases. The tumors size ranged from 1 to 7. 5 cm ( mean size=2. 7 cm) . The tumors were primarily com-posed of spindle cells, and were accompanied with osteoclast-like giant cells partly. Their background were rich in blood vessels. In addition, there were scattered tufed thick vascular anomaly, thin vascular, islands of mature adipocytes and chondroid cells. In 7 of the 12 cases, there were dystrophic calcification in an unusual flocculent. Spindle epithelium were noted in 2 cases. Mitotic figures were rare in 10 cases. In 2 of the 12 cases however, mitotic figures were commonly encountered, and in 1 of the 2 cases, heterotypic cells were notablely observed as well. On immunohistochemical study, the tumor cells were all positive for vimentin and CD56. The positivi-ty for NSE, CD99, BCL-2 in 11, 8 and 7 cases were expressed in 12 cases. In 4 and 6 of the 12 cases, CD34 and SMA were positive in various degree. Ki-67 proliferation index were less than 5% in 10 cases, and 10% and 25% in 2 cases. The duration of follow-up ranged from 2 to 108 months ( mean=22 months) . 2 cases were recurred at 72 and 84 months after the operation, respectively. So far, the remaining 10 cases had no recurrence and metastasis. Conclusioin The phosphaturic mesenchymal tumors are either benign or low-grade malignant. Their histomorphology are multivariable and short of specificity. It is important to make the correct diagnosis in combination with their common features and clinical datas.

Objective To observe the therapeutic effect of exenatide combined with metformin therapy in type 2 diabetes with nonalcoholic fatty liver disease.Methods 50 patients with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into experimental group and control group with 25 cases in each.The control group were treated with metformin, the experimental group were treated with exenatide on the basis of metformin.Before treatment and at the end of 12-week treatment, patients height, weight, body mass index(BMI), waistline(WC), glycated hemoglobin(HbA1c), fasting blood glucose(FBG),fasting C-peptide(FCP), triglyceride(TG), cholesterol(TCH), high density lipoprotein(HDL), low density lipoprotein(LDL),systolic pressure(SBP), diastolic pressure(DBP), alanine aminotransferase(ALT), superoxide dismutase(SOD), liver lipid contents(LFC) were detected.Results Baseline data were not significantly different between the two groups.Compared to baseline, WC, HbA1c, FBG and LFC in experimental group and control group were obviously improved after treatment(P<0.05), and the experimental group improved more significantly than control group(P<0.05).Conclusion Exenatide combined with metformin has an obvious therapeutic effect on BMI, WC, HbA1c, FBG, FCP, SBP, TG, TCH, HDL, LDL, LFC than mere metformin treatment in treatment of type 2 diabetes with nonalcoholic fatty liver disease.

Objective To observe the protective effect of 11,12-epoxyeicosatrienoic acid(11,12-EET)on immature isolated rabbit hearts.Methods Forty-eight isolated immature rabbit hearts were randomly assigned to two groups: Control group,the hearts were arrested with St.Thomas No.2 solution and stored in the same solution ( n =24);EET group,the hearts were arrested with St.Thomas No.2 plus 11,12-EET solution and stored in the same solution ( n =24). All rabbit hearts were stored for 8,16 and 24 h with 4 ℃ hypothetmia, and underwent 30 min reperfusion ( 37 ℃ ). On the Langendorff perfusion apparatus,left ventricle developed pressure (LVDP),left ventricle end-diastolic pressure (LVEDP),+dp/pt max ,coronary blood effluent (CBE) and arrhythmias score were measured before and after ischemia. Myocardial water content,the value of creatine kinase (CK) and lactic dehydrogenase (LDH) were also measured,and myocardial ultrastructure observed. Results Postischemic recovery of myocardial function and myocardial edema were significantly better in EET group at different time points. The changes of arrhythmias score,CK,LDH and myocardial ultrastructure in EET group were superior to those in control group. After the hearts were preserved for 16 h ,the recovery of myocardial function and arrhythmias score in EET group were basically close to the measured values before heart preservation,while those in control group were significantly decreased. After the hearts were stored for 24 h ,all hearts in EET group beated again during reperfusion,but 5 hearts in control group could not beat anymore.Conclusion Addition of 11,12-EET into the St.Thomas No.2 cardioplegic solution could prolong the storage time and enhance the myocardial protective effect to the isolated immature hearts.

Objective To investigate the pathohistologic features and grading of biopsy mucosae and their correlation with disease severity of active ulcerative colitis(UC). Methods A prospective study was conducted in 133 patients with UC who were divided into three groups based on the degree of severity. Pathologic morphometry and grading with HE staining sections were analyzed. Results Pathologic features of active UC: there were neutrophilic leukocytes (100.0%), eosinophils (99.2%), plasmacytes(91.7%) and lymphocytes (75.2%) infiltration among mucosal epithelial cells, and lymphoid follicular formation(72.2%) and small vessels inflammation(63.9%) and focal hemorrhage(68.4%) in lamina propria. There were crypt abscesses(43.6%), glandular abnormalities (44.4%), goblet cell depletion (18.8%), epithelial cell regeneration (36.8%) , atypical hyperplasia (28.6%) and granulation tissue formation (42.9%) in mucosae. With the increase of severity of UC, there was a significant increasing incidence of small vessel inflammation, fiberoid necrosis of vessel wall, glandular abnormality, epithelial cell regeneration, atypical hyperplasia, goblet cell depletion, granulation tissue formation, fiber tissue hyperplasia, and crypt abscess. There was no significant difference of the incidence of lymphocyte hyperplasia, lymphoid follicular formation, eosinophil and plasmacyte infiltration between the groups. Mild UC was mainly characterized by the lesions of Grade Ⅰ and Ⅱ, moderate UC by those of Grade Ⅱ and Ⅲ and severe UC by those of Grade Ⅲ and Ⅳ. There were significant differences of grades among mild, moderate and severe UC. Conclusions There were some pathologic characters in active UC. The partial of markers and histological gradings can reflect the severity and activity of active UC.