Objective To elucidate significance of hyperintense vessel signs(HVS)on FLAIR MRI in patients with cerebral infarction. Methods Two hundred and sixty-two patients with cerebral infarction admitted in our hospital were included in this study. We retrospectively defined HVS on FLAIR MRI in these patients in comparison with time of flight(TOF)on MR angiograms(MRA), hyperintense lesions on diffusion-weighted images(DWI). Results HVS on FLAIR MR[were identified in 117 patients with cerebral infarction(45.4%), of which 47 patients(83.9%)were obtained within 24 hours of symptom onset. HVS on FLAIR MRI were detected in 74 patients at sylvian fissure(62.2%), 11 at cortical sulci (9.2% ,11/119),34 at the posterior circulation regions(28.6% ,34/119). HVS on FLAIR MRI coincided well with ischemia of TOF on MRA and lesion patterns on DWI (χ2 test,P<0.01, respectively). Conclusion HVS on FLAIR MRI is helpful to evaluate abnormal major cerebral arteries of patients with cerebral infarction.

Objective To investigate efficacy of citalopram on pathological crying after cerebral infarction.Methods 106 patients with pathological crying after cerebral infarction were randomly divided into two groups,treatment group(54 cases) and control group(52 cases).Control group received conventional treatment of cerebrovascular disease.Treatment group taken citalopraml0-20mg orally one time per day for three months based on conventional treatment.The total response rate,effectual time,and Hasegawa Dementia Scale (HDS) scores were compared between two groups after treatment.Results There were significant differences in total response rates (94.4％ and 38.5％,respectively),effectual time(1.98 ± 1.24 and 78 ± 17.95,respectively) and HDS(8.43 ±2.21 and 6.24 ±2.02,respectively) between treatment group and control group (P ＜ 0.01).Conclusion The study suggests that it is effective to treat pathological crying with citalopram and its effect is quick.Citalopram can not only control patient’s pathological crying,but also improve cognitive function.

Objective To measure the levels of caspase-1 and its downstream factor interleukin (IL)-18 and IL-33 in rheumatoid arthritis (RA) and explore their possible mechanisms.Methods Blood samples were drown from 56 patients with RA and 22 healthy subjects.Serum levels of caspase-1,IL-18 and IL-33were tested by the method of enzyme linked immunosorbent assay (ELISA).Kruskal-Walls and Mann-Whitney test were used to compare the levels of caspase-1,[L-18 and IL-33 and Spearman's correlation test was used for correlation analysis.Results The level of caspase-1 was significantly increased in RA group compared to healthy group [(32±26) ng/ml vs (15±6) ng/ml,P＜0.01].Meanwhile,the active disease groups showed a higher level than the remission group,and level in the untreated group was higher than the treated group [(47±27) ng/ml vs (25±22) ng/ml,P＜0.01].The levels of IL-18 and IL-33 were significantly increased in RA group compared to healthy group [(121±121) ng/L vs (58±33) ng/L,(1032±1011) ng/L vs (510±231)ng/L,respectively,P＜0.05].Meanwhile,the active disease groups had a higher level than the remission group and the untreated group had higher levels than the treated group [IL-18 and IL-33 were (172±139) ng/L vs (97±106) ng/L,(1469±1039) ng/L vs (825±941) ng/L,respectively,P＜0.05].Caspase-1 was correlated withIL-18 and IL-33 (r=0.824,0.854,P＜0.01) and IL-18 was correlated with IL-33 (r=0.800,P＜0.01).But neither of the three factors was related with clinical indexes including disease duration,RF,anti-CCP antibody,tender joints count and swollen joints count.Conclusion Caspase-1 and its downstream factor IL-18,IL-33 increase in RA,and they may play important roles in RA.

Objective To investigate the significance and characteristics of T lymphocyte subsets and co-stimulatory CD28 in peripheral blood of patients with primary biliary cirrhosis. Methods Tri-colour flow-cytometry was used to detect the levels of T lymphocyte subsets in peripheral blood in 98 patients with primary biliary cirrhosis and 30 age and gender matched healthy controls. Results Compared to control group the percentage of CD4+ T increased and CD8+ T lymphocyte decreased in the PBC group. The CD4+/CD8+ ratio in the PBC group was higher than that in the control group (P<0.05). And the percentage of CD4+CD28- T cells and CD8+CD28- T cells increased, too (P<0.05). Conclusion There are immunological abnormalities in PBC and the expression of co-stimulator CD28 is significantly decreased. CD8+CD28-T lymphocytes may have immune regulatory effect in PBC.

AIM: To investigate the effects of curcumin (Cur) on the expression of High mobility group box 1 protein (HMGB1), interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α) in amyloid-β(Aβ)-induced primary rat microglial cells.METHODS: Microglia were derived from the cerebral cortices of postnatal rat brains.The cells were i-dentified by immunocytochemistry using mouse anti rat Iba-1 monoclonal antibody.A cell model using primary rat microgli-al cells incubated with Aβ25-35 as an inflammation model of Alzheimer’s disease (AD) was set up.The morphological char-acters of primary rat microglial cells were observed.The concentration of Aβ25-35 and the treatment concentration of curcumin were selected by CCK-8 assay.Cultured primary rat microglial cells were divided into 5 groups: normal cell group, Aβ25-35 group, Cur group, Aβ25-35 +Cur group and Aβ25-35 +DMSO group.The expression of HMGB1, NF-κB, and receptor for advanced glycation end products (RAGE) was detected by Western blot.The levels of HMGB1, IL-1β, and TNF-αin the culture supernatant were measured by ELISA.RESULTS: The purity of primary microglias determined by Iba-1 immuno-fluorescence was more than 95%.The protein levels of HMGB1, RAGE and NF-κB were significantly increased after Aβ25-35 stimulation.After treatment with Cur, the protein levels of HMGB1, RAGE and NF-κB were significantly decreased (P <0.05).The levels of HMGB1, IL-1βand TNF-αin the supernatant were significantly increased after Aβ25-35 stimula-tion.Cur significantly decreased the level of HMGB1, IL-1βand TNF-αin the supernatant.CONCLUSION: Curcumin significantly inhibits neuroinflammation stimulated by Aβ25-35 in primary rat microglial cells.

Objective To evaluate the effectiveness of intravenous immunoglobulin (IVIG) in critical hand-foot-mouth disease (HFMD).Methods The data from PubMed, MEDLINE, EMBASE, EBSChost, Cochrane Library, Cochrane Central Register of Controlled Trials, Ovid, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, Chinese Citation Database, and other references and grey literatures were retrieved, screening out all those related to clinical trials on treating critical HFMD by IVIG.Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials.Meta analysis was performed with Rev man 5.3 software.Results Eleven trials including 967 cases were investigated.The meta analysis showed that IVIG had significantly clinical efficacy (OR =6.84,95％ CI:3.74-12.52 ,P ＜ 0.05).IVIG could significantly decrease duration of fever (MD =-1.94,95％ CI:-3.07--0.81 ,P ＜0.05) ,hospitalization time (MD =-4.56,95％ CI:-8.95--0.17,P ＜0.05).There was no significant difference in duration of fever (MD =-0.28,95 ％ CI:-0.59-0.03, P ＞ 0.05), duration of herpes (MD =0.18,95％ CI:-0.22-0.59, P ＞ 0.05), hospitalization time (MD =-0.12,95％ CI:-0.47-0.23, P ＞ 0.05) when the dosage of injection was adjusted.Conclusions IVIG is recommended for treating critical HFMD because it is effective in decreasing the duration of fever and hospitalization.Well designed studies with more sample in multi-center are required in further study to explore the efficacy and safety of IVIG on critical HFMD.

Objective To observe the effects of total flavone from litchi chinensis sonn (TFL) on the liver function in-cluding p16 protein, pro collagen type 3 (PC3) and pro collagen typeⅠ(PCⅠ) in model rats with liver fibrosis induced by bile duct ligation. Methods Forty rats were randomly divided into four groups:sham operation (SO) group, bile duct liga-tion (BDL) group, TFL group and silibinin (SIL) group. Rats were gavaged with saline (5 mL·kg-1·d-1) in SO and BDL group, rats were gavaged with TFL (200 mL·kg-1·d-1) in TFL group and rats were gavaged with SIL (5 mL·kg-1·d-1) in SIL group for four weeks. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin direct (BILD) and bilirubin total (BILT) were detected in four groups. The liver tissues were stained by HE and Masson methods. The ex-pression levels of p16, PC3 and PCⅠin liver tissues were determined by Western blot assay. Results The serum levels of ALT (44.6 IU/L±8.0 IU/L), AST (103.8 IU/L±18.1 IU/L), BILD (0.76 μmol/L±0.28μmol/L) and BILT (1.48μmol/L±0.35μmol/L) were lower in SO group. There was a higher level of ALT in BDL group (147.4 IU/L±86.3 IU/L) than that of TFL group (92.9 IU/L±47.3 IU/L). The serum level of ALT was higher in AST group (362.7 IU/L±106.6 IU/L) than that of TFL group (290.1 IU/L ± 171.7 IU/L) and SIL group (250.2 IU/L ± 54.9 IU/L). The serum level of BILD was lower in BDL group (99.71μmol/L±40.87μmol/L) than that of SIL group (137.01μmol/L±38.86μmol/L). The serum levels of BILD and BILT were significantly lower in TFL group (81.48μmol/L±47.50μmol/L, 106.64μmol/L±61.04μmol/L) than those of SIL group (P<0.05). There were small amount of new bile duct and no obvious cells degeneration, small amount of infiltration of in-flammatory cells and collagen deposition in TFL group. The liver fibrosis improved significantly in TFL group than that of BDL group. There were more new bile duct in hepatic portal area in SIL group than those of TFL group. The expression levels of p16, PC3 and PCⅠwere significantly higher in BDL group than those of TFL group. The expression level of PC3 was significantly lower in BDL group than that of SIL group. The expression level of PCⅠwas significantly higher in BDL group than that of SIL group (P<0.05). There was no significant difference in the expression level of p16 between BDL group and SIL group. The expression levels of PC16 and PC3 were significantly lower in TFL group than those of SIL group (P<0.05). There was no significant difference in the ex-pression level of PCⅠbetween TFL group and SIL group. Conclusion TFL can improve the liver function in model rats with choles-tatic liver fibrosis and reduce liver fibrosis, which may be related with inhibitory effects on the expressions of p 16, PC3 and PCⅠ.

Objective To establish a long-term surviving model of ventilator induced lung injury ( VILI) in piglets with large tidal volume ventilation. Methods A total of 21 piglets were randomly( random number) divided into trial experiment group (group A,n =9), injury group ( group B,n =6) and control group ( group C, n = 6). Each piglet was intubated orotracheally and intravascular cannulae were inserted both into carotid artery and external jugular vein. The tidal volume in 60 - 80 ml/kg was given to rats of group A and 50 ml/kg to rats of group B, and free breath to rats of group C. Vital signs, pneumatic mechanics, blood-gas analysis and hemodynamics were monitored every hour ( group A and group B from just after the model established 0 h, group C from 0 ～6 h). The t test or ANOVA test was used for statistical analysis. Left lung tissue was sent to biopsy after experiment. Results About 6 hours after mechanical ventilation with large tidal volume, PaO2/FiO2 lower significantly both in A and B group in comparison with control group (P ＜0.05 ) and histological changes hit the ALl criteria. Piglets ventilated with 50 ml/kg of tidal volume could survive for long-term. Conclusions The model of VILI in piglets made with 50 ml/kg of tidal volume ventilation was established successfully and survived for long-term.

Objective To demonstrate the spectrum of multi-detector spiral CT (MSCT) findings of drug-induced liver injury (DILI). Methods From May 2008 to January 2010, DILI was identified in 10 cases based on their clinical and pathological results. The spectrum of CT findings was analyzed retrospectively. Results According to the CT features, DILI were divided into three types. ( 1 ) Two cases presented diffuse hepatic injury, which appeared as homogeneous hypo-attenuation in precontrast CT scan and mild enhancement after contrast injection. The histopathological findings of the involved 1ivers include hepatocellular steatosis, neutrophil and eosinophil infiltration, punctiform necrosis and canalicular cholestasis. (2) Six cases presented focal hepatic injury, including massive wedge-shaped necrosis in 4,multiple small necroses in 1 and multiple regenerated nodules in 1. In precontrast CT scan, hepatic necroses were seen as inhomogeneous hypo-attenuation areas, which turned to hyper-attenuation after contrast injection and presented "flip-flop" sign between precontrast CT scan and portal venous phase scan. In the case with regenerated nodules, slight hyper-attenuation lesions were detected with diffuse distribution in liver in precontrast CT scan, which showed enhancement in hepatic arterial phase and turned to iso-attenuation in portal venous phase and equilibrium phase. The histopathological changes included massive necrosis or bridging necrosis with abundant neutrophil and eosinophil infiltration in 5 cases, nodular regeneration with cholestasis and feathery degeneratin in 1 case. (3) Two cases presented liver cirrhosis. CT displayed obvious nodularity of liver, which complicated with splenomegaly, ascites and collateral veins. The histopathological changes of these two cases included punctiform necrosis, canalicular cholestasis and pseudolobular formation. Conclusion CT signs of DILl have certain characteristics, which may help in detecting and determining the severity of liver damage.

Objective To investigate the clinical effects and mechanism of naloxone treatment in drowing children.Methods A total of 97 drowing children were divided into treatment group(n=45)and control group(n=52)depending on whether the naloxone was administrated.General treatment was adopted in two groups.Treatment group Was given naloxone.The clinical effects were observed and the levels of betaendorphin(β-EP)in blood plasma were measured with radioimmunoassay(RIA)before and after treatment respectively.Results The total effective rate of treatment group(93.3%,42/45)Was significantly higher than that of control group(76.9%,40/52)(P＜0.05).As compared with that of control group(65.0%,26/40),nervous system disability rate in treatment group(33.3%,14/42)decreased significantly(P＜0.01).Continuous days of poor blood circulation,abnormal respiratory rhythm,convulsion and coma in treatment group were significantly shorter than those of control group respectively(P＜0.01).The level of β-EP was significantly lower in treatment group than that of control group(t=17.1,P＜0.01).Conclusion Clinical use of naloxone in the drowing children has curative result by reducing the level of blood plasma β-EP.