Objective:To evaluate the effects of endovascular embolization and microsurgical clipping on cognitive function in patients with intracranial aneurysm.Methods:A total of 80 patients with intracranial aneurysms,who were treated in Chongqing Hospital of Traditional Chinese Medicine from March 2014 to September 2015,were selected and randomly divided into control group(n=40) and experimental group (n=40).The control group was treated with microsurgical clipping,and the experimental group,with endovascular embolization.The postoperative cognitive function was assessed by the mini mental state examination scale (MMSE),and length of stay,in-hospital mortality rate,mortality rate in 1 year and the incidence of postoperative adverse reactions were compared between the two groups.Results:The total score (26.78± 0.85) of MMSE in the experimental group was higher than that (22.25± 0.63) of the control group (P＜0.05).The cognitive dysfunction rate (37.50％) of the experimental group was lower than that (55.00％) of the control group (P＜0.05).The length of stay [(6.7± 3.9) days] of the experimental group was lower than that [(9.6± 4.5) days] of the control group(P＜0.05).There were no significant differences in in-hospital mortality rate and mortality rate in 1 year,and the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Endovascular interventional therapy can improve the cognitive function of the patients with intracranial aneurysms and shorten the length of hospital stay.

Cerebral apoplexy is one of the main causes of death in the middle-aged and elderly population,which has higher mortality and disability rate.The incidence of the disease is increasing year by year and it is a serious threat to human life and health.Therefore,it is of great significance to find an effective target for the diagnosis and treatment of stroke.Thioredoxin (Trx) is the major thiol reducing agent in the cells,it is involved in many signal transduction pathways in the cells by regulating the redox state of the cell.It has disulphide reductase activity,which can reduce the oxidative stress injury in the rats after the stroke.Thioredoxin interacting protein (TXNIP) is an endogenous inhibitor of Trx,it can destroy the redox balance and promote the oxidative stress by binding/inhibiting the activity of Trx,while the inhibition or knockdown of TXNIP has obvious neuroprotective effects.Recent studies suggest that Trx/TXNIP may be involved in the pathophysiology of cerebral apoplexy by a variety of pathways.This article analyses the research status of Trx/TXNIP and studies the localization of Trx system in the central nervous system and the progress of Trx system in ischemic cerebral apoplexy.It reviews the mechanism of Trx/TXNIP in cerebral apoplexy and prospectes the signaling pathways involved in the pathophysiological process of Trx/TXNIP to provide new ideas for the treatment of cerebral apoplexy.

Objective To discuss the application of spiral computed tomography and reconstruction technology for patients of depressed nasal bone. Methods The patients of transsection location were backlying on the scan bed and continuously scanning in spiral, and baseline was acou-infraorbital line. The reconstructed image with 2mm layer thickness and 1.5mm overlap can be selected SSD liminal value as bone -wide and surface threshold. Results SSD image can be clearly demonstrated than general nasal bone cross-section profile in the shape, location, size and suitability of filled composite. Conclusion The surface shadow display can be shown nasal bone structure realistically, the three-dimensional anatomic structure images of vessels and the effect of bionics. The bone of volume, distance and angle can be measured exactly by clinical physician, and made the best treatment plan based on the images.

Objective To investigate the spiral CT findings in hemopathic patients with druginduced pulmonary injury.Methods CT images obtained in 11patients with drug-induced pulmonary injury were retrospectively analyzed.Six patients had antineoplastic agent-induced pulmonary injury and 5 patients had non-neoplastic agent-induced pulmonary injury (immunosuppressor in 2 patients,antifungal in 2 patients,antineoplastic immunomodulators in 1 patient).CT findings were reviewed by a chest radiologist.Results All 11patients had parenchymal abnormalities on MSCT scans,including ground-glass opacities( n =8 ),consolidation( n =5 ),interlobular septal thickening( n =3 ) and focal fibrosis ( n =2 ).The abnormalities were bilateral and asymmetric in all patients.They were mainly in the peripheral lung regions in 6 patients,in the central lung regions in four,and irregularly located in one.The abnormalities involved mainly the lower lung zones in six patients,the upper lung zones in two,and all lung zones homogeneously in three.One patient had fluid in bilateral pleural cavities.Three patients were given the same agent once more after the imaging turned to normal,and they presented with same clinical symptoms and similar but more serious imaging findings.Conclusions Drug-induced pulmonary injury usually manifests as areas of ground-glass opacity and consolidation,which most commonly involves the peripheral lungs and lower lung zones.Drug-induced pulmonary injury shows reproducible but more serious lesions when the patient is given the same agent once more.

Objective To investigate the changes of quantitative parameters of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapy,and compare them with the traditional evaluation criteria,in order to find the parameters which can be exploited for timely,objective evaluation of the effect of targeted therapy.Methods The study included 21 patients with targeted therapy who had received dynamic enhanced CT before and after treatment.Enhancement time-density curves were obtained based on the CT values of the lesion at individual time points,and the functional indices:peak height (PH),the time to peak height (Tp),the ratio of PH of the mass to aorta (M/A) and perfusion value were calculated.The effects of the treatment on these indices were evaluated and compared with the effect of the treatment on lesion diameter. Results Twenty-one patients had 33 rechecking results. There was a statistically significant agreement between lesion diameter-based treatment evaluation and perfusion-based treatment evaluation ( U =8.761,P ＜ 0.01 ). The perfusion value decreased in patients with disease regression[before treatment:(0.28 ±0.11 ) ml · min-1 · ml-1,after targeted therapy(0.18 ±0.09) ml ·min-1 · ml-1,t =- 3.2722,P =0.0042],but increased in patients with disease progression[before treatment(0.21 ±0.08) ml · min-1 · ml-1,after targeted therapy:(0.34 ±0.11 ) ml · min-1 · ml-1,t =2.6064,P =0.0403].Conclusions On dynamic enhanced CT in non-small cell lung cancer patients after targeted therapy,perfusion value changed in the same trend as the diameter of tumor.The effectiveness of targeted therapy may be evaluated by perfusion value changes.

Objective To analyze the characteristics of breast cancer blood supply before and after chemotherapy with low-dose CT perfnsion. Methods Fifteen patients with breast cancer underwent CT breast perfusion examination, which was performed before and after chemotherapy within 1 week on Siemens Sensation 4 scanner with 120 kV and 50 mAs, 50 ml of nonionic contrast agent (320 mg I/ml) was injected at a flow rate of 4 ml/s with a power injector, Scan started after 8 seconds delay and data acquisition duration was 50 seconds. The blood flow ( BF), blood volume (BV) and mean transfer time (MTT) of lesion and contralateral normal breast gland were calculated using Basama perfusion 3 software package before and after chemotherapy. At the same time, the tumor size before and after chemotherapy were measured and correlated with the BF values. The t test and non-parametric test were used for the statistics. Results ( 1 ) The mean BF、BV and MTT of breast cancer were (33.20±4. 17) ml · min-1 · 100 ml-1 , (8. 31±2.43) ml · 100 ml-1 and ( 15. 31 ± 4. 31 ) s respectively before chemotherapy, and ( 13.65 ± 6. 04) ml · min-1 100 ml-1, (5.04±2. 33) ml · 100 ml-1 and (25. 97±9. 07) s respectively after chemotherapy and there were statistically significant (P =0. 000). The mean BF、BV and MTT of normal breast were (4. 31 ± 2.23) ml · min-1 · 100 ml-1, (1.38±0.75) ml · 100 ml-1 and (19.25±3.94) s respectively before chemotherapy, and (4.03±2.35) ml · min-1 · 100 ml-1、(1.44±0.84) ml · 100 ml-1、(22.56 ± 7.71 ) s respectively after chemotherapy and there were not statistically significant (P >0. 05). (2)The BF of breast cancer was higher than the normal breast before chemotherapy ( P < 0. 01 ). (3) There was a positive correlation between the BF values and tumor size before and after chemotherapy ( r = 0. 902, P = 0. 000). Conclusion The BF value has a positive correlation with tumor size after chemotherapy, CT perfusion is more sensitive for the evaluation of chemotherapy response than morphologic assessment.

Objective To evaluate the possibilities of using circulating miR-155-5p, miR-21-5p, miR-29a and miR-142-5p as biomarkers for the diagnosis of active pulmonary tuberculosis (TB).Methods Plasma samples were collected from 60 healthy subjects, 40 patients with active pulmonary TB and 20 sub-jects with latent tuberculosis infection ( LTBI) to extract miRNAs.The levels of miR-155-5p, miR-21-5p, miR-29a and miR-142-5p in plasma samples were detected by using reverse transcription-quantitative PCR. Results The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were re-spectively 10.13, 7.34 and 2.74 times as much as those in healthy subjects(P<0.05).No significant differences with the level of miR-142-5p were observed between the two groups.The receiver operating char-acteristic (ROC) curve analysis of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB and healthy subjects showed that the areas under the curve (AUC) were respectively 0.905, 0.830 and 0.687.The level of miR-155-5p in patients with LTBI was 3.1 times than that in healthy subjects ( P<0. 05).No differences with miR-21-5p, miR-29a and miR-142-5p were found between patients with LTBI and healthy subjects.The levels of miR-155-5p, miR-21-5p and miR-29a in patients with active pulmonary TB were respectively 3.26, 6.69 and 1.98 times than those in patients with LTBI (P<0.05).The rate of LTBI was 40.58%in people who were in close contact with patients with active pulmonary TB.Conclusion Sig-nificant differences with the levels of miR-155-5p, miR-21-5p and miR-29a were observed among healthy subjects, patients with active pulmonary TB and patients with LTBI, but no difference with the level of miR-142-5p was observed among them.miR-155-5p, miR-21-5p and miR-29a could be used as the potential bio-markers for the diagnosis of active pulmonary tuberculosis and latent tuberculosis infection.People who were in close contact with patients with active pulmonary TB could have a higher LTBI rate.

Objective To study the imaging features and possible aetiology of osteonecrosis in adults with acute leukemia.Methods Ten adult patients with acute leukemia for osteonecrosis were reviewed retrospectively.All the lesions were confirmed with MRI.Results Four patients with ALL had accepted chemotherapy contained corticosteroids,two of them were performed HSCT,and one patient suffered GVHD.Six patients with AML had accepted chemotherapy without steroids,five of them were performed HSCT,and four patients suffered GVHD.One patient with AML-M3 had accepted chemotherapy including four courses of ATRA.The mean time between diagnosis of osteonecrosis and leukemia was 25.1 months.Nine cases had multiple lesions,one case had single lesion.The lesions involved femurs,tibias,patellas,iliums,and lumbars.Plain radiographs in six patients can not detect any lesion.Circinal reaction ossification could be detected in CT images of four cases.All the cases had typical feature in MRI.Conclusions In adult leukemia patients,osteonecrosis is a complication after chemotherapy or HSCT.Steroids in chemotherapy protocols or treatment for GVHD,ATRA for APML,chemotherapy-induced direct cytotoxic effect or leukemia itself can be the possible risk factor.For the diagnosis,MRI is the most effective way,and CT features of osteonecrosis in leukemia patients are different from those in non-leukemia patients.

ObjectiveAnalyze preoperative clinical relevanted factors of acute type A aortic dissection with hypoxemia according to a group clinical data.MethodsFrom January 2011 to June 2011,we have collected 54 preoperative cases of acute type A aortic dissection,including 42 males,12 females,aged 28-73 years old,onset to treatment time is 0.4-14.0 days.General information:age,gender,time of onset,body mass index,hypertension,diabetes mellitus,smoking,drinking,heart ejection fraction,prothrombin time,quantitative fibrinogen,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time,length of hospital stay.According to the blood gas analysis of quiet state case without oxygen,with PaO2 ＜ ( 100-age ×0.33 ±5) mm Hg is for the hypoxemia group,equal or higher than this is no-hypoxemia group.ResultsNo-hypoxemia group has 14 cases,11 males,3 females,average aged (51.14 ± 14.24) years old,including 12 operation patients ( no death) and 2 no-operation patients(2 cases death).Hypoxemia group has 40 cases,31 males,9 females,average aged (50.53 ± 9.73 ) years old,including 33 operation patients(2 cases death) and 7 no-operation patients(7 cases death).There is no significant difference in age,gender,time of onset,hypertension,diabetes mellitus,smoking,drinking,cardiac ejection fraction,prothrombin time and fibrinogen.There is statistically significant on body mass index,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time and length of hospital stay time ( P ＜ 0.05 ).ConclusionPreoperative hypoxemia with acute type A aortic dissection is associated with obesity,excessive inflammation and activation of coagulation and fibrinclytic system,and hypoxemia may prolong the time of operative patients with acute type A aortic dissection in ICU and hospital.

Objective This study aimed at exploring the causative genes and summarizing the clinical characteristics in two Chinese families with thoracic aortic aneurysm and dissection ( TAAD ) .Methods The whole exome capture and high throughput sequencing were applied to identify the causative gene.Family members were examined for features of syndromic ge-netic diseases by clinician and geneticist.Results Four known TAAD candidate genes were identified in family TAA01:rs140598(FBN1), rs185661462(MYH11), rs77620762(MYLK3), and rs111426349(TGFBR1).The TGFBR1 mutation (c.1459C>T) had been confirmed to co-segregate with the TAAD phenotype in all affected family members.Early onset of aortic root dilatation was significant in this family , and the average age at diagnosis of aortic root dilatation or aneurysm was23. 2 years.ACTA2(c.445C>T) was proved in family TAA02, and livedo reticularis was confirmed.Conclusion The causa-tive genes were identified via whole exome capture and high throughput sequencing in two TAAD families .Early onset of aortic root aneurysm was proved in TAA01, while livedo reticularis was found in TAA02.