Objective To explore CTA characteristics of diabetic lower extremities arterial disease (LEAD) with different Fontaine stage.Methods Data of 100 patients clinically diagnosed as diabetic LEAD and underwent lower limbs arterial CTA were analyzed retrospectively.The patients were classified into grade Ⅰ-Ⅳ according to Fontaine classifications.Lower extremities arteries were graded according to CTA.Stenosis degree of lower extremity arteries in different Fontaine stages were analyzed.Results The grades of lower extremity arteries stenosis in different Fontaine stages had statistically significant difference (x2 =186.24,P＜0.001).There had statistically significant difference of stenosis degree in different lower extremity arterial levels among different Fontaine stages (superior genicular artery:x2 =69.24,P＜0.001;inferior genicular artery:x2 =111.59,P＜0.001;dorsalis pedis and arteriae plantaris:x2 =94.15,P＜0.001).Grades of stenosis between superior genicular arteries and inferior genicular arteries,superior genicular arteries and dorsalis pedis and arteriae plantaris had statistically significant differences (Z=12.59,P＜0.001;Z=10.47,P＜0.001).There was statistically significant difference of stenosis grades between inferior genicular artery and dorsalis pedis and arteriae plantaris (Z=12.66,P＜0.001).Occluded inferior genicular arteries usually associated with collateral vessels.Conclusion CTA can reflect the clinical stages of LEAD,which is the ideal method in diagnosing of diabetic LEAD.

Objective To investigate the influence of different intervention models on autism spectrum disorder (ASD) children. Methods Eighty-eight children aged from 12-46 months and newly diagnosed ASD were randomly assigned to different intervention models, including standard intervention group (T1, n=55), non-standard intervention group (T2, n=11), and family intervention group (T3, n=22). The intervention data was recorded including time and methods. Chinese revised version of Psycho-Educational Profile (C-PEP) and social adaptive behavior scale were used to test the development quota?tion (DQ) before and after intervention. Results There were significant statistical differences in C-PEP scale and pathologi?cal score before and after intervention in T1 group (P<0.01). There were significant differences in the pathological score, in?terpersonal and cooperative behaviors, sensory patterns and language barriers after intervention in T2 group (P<0.05). And there were no significant changes in the developmental quotient. The perception, gross motor, cognitive performance and the developmental quotient of oral cognition were significantly reduced after the intervention in T3 group (P<0.05). There was no significant change in pathology score. Results showed that there were significant differences in the imitation, perception, cognitive performance, oral cognition and general development before and after the intervention between three groups ( P<0.05). Conclusion A significant effect is found in children with autism spectrum disorder after standard intervention.

Objective To study the value of three-dimensional pseudo-continuous arterial spin labeling(3D pCASL) for estimating collateral flow after middle cerebral artery(MCA) stenosis.Methods 3D pCASL was performed in 28 cases of negative diffusion weighted imaging(DWI) patients with MCA stenosis for estimating collateral vessels formation.The post-labeling delay(PLD) of 3D pCASL was set to 1.5 s and 2.5 s.The cerebral blood flow (CBF) of 3D pCASL with two PLD was calculated by AW workstation respectively.Nineteen normal persons were regarded as the control group.The 95% confidence interval of the ratio of left/right side of CBF of control group was set as reference value.The characteristic of the ratio of stenosed/contralateral side of CBF was analyzed.The characteristics of collateral flow was investigated with digital subtraction angiography(DSA).Results Abnormal perfusion was found in 28 patiens.Two types of abnormal perfusion were found, including typeⅠ: rCBF(PLD=1.5 s) decreased,rCBF(PLD=2.5 s) was normal (n=16);typeⅡ:rCBF(PLD=1.5 s) decreased,rCBF(PLD=2.5s) decreased (n=12).On brain DSA, abundant of collateral flow supply was found in 16 patients with typeⅠabnormal perfusion,whereas deficiency of collateral flow supply was found in 12 patients with typeⅡ.Conclusion 3D pCASL with two PLDs may provide important reference value for estimating collateral flow after middle cerebral artery stenosis.

Objective To assess the effectiveness and safety of non-insufflation intra-abdominal compression as a prehospital hemostatic technique in treatment of liver injury.Methods Twenty-nine male Wistar rats were enrolled and randomly assigned into four experimental groups:IAP0 group ( n =8 ),IAP5 group (n =8),IAP10 group (n =8) and IAP15 group (n =5).Then,the anticoagulated rat models of severe liver injury were established with different intra-abdominal pressures ( 0,5,10 and 15 mm Hg) by using a non-expansible insufflated gas bag.Once the mean artery pressure (MAP) was less than 95 mm Hg,Lactated Ringer' s solution was infused through the right jugular vein at speed of 3.3 ml · min-1 · kg-1 until MAP reached 100 mm Hg.Thirty minutes later,the animals were killed by intravenous injection of 0.2 ml saturated potassium chloride solution to measure the intraperitoneal total blood loss,liver weight,volume of infused solution and MAP.Results No death was observed in IAP0,lAP5 and IAP10 groups and four rats (4/5) died at 10-15 minutes following exposure to the 15 mm Hg intra-abdominal pressure in IAP15 group.Total blood loss was reduced to ( 54.20 ±11.30)ml/kg in IAP0 group,(43.98 ±9.2) ml/kg in IAP5 group,(32.49 ±7.40) ml/kg in IAP10group and (25.77 ± 14.16) ml/kg in IAP15group ( P ＜0.01 ).The infused volume of resuscitation solution was (31.06 ± 3.14) ml in IAP10 group,which was higher than (24.94 ±6.67) ml in IAP0 group,(23.06 ± 7.98) ml in IAP5 group and (16.50 ±7.27) ml in IAP15 group (P ＜0.05).Liver weight was ( 11.18 ± 1.45) g in IAP5 group,( 12.13 ± 0.96) g in IAP10 group and ( 11.41 ± 1.20) g in IAP15 group,which was significantly higher than (10.03 ±0.58) g in IAP0 group (P＜0.05).The MAP was (64.81 ± 19.65) mm Hg in IAP5 group and (65.80 ± 15.36) mm Hg in IAP10 group ( insignificant difference between groups,P ＞ 0.05 ),which was higher than (41.22 ± 10.00) mm Hg in IAP0 group and (44.50 ±28.60) mm Hg in IAP15 group (P ＜0.05).Conclusions Non-pneumatic intra-abdominal compression can effectively control bleeding in rat models of severe liver injury,while the adverse effect of intra-abdominal hypertension should be avoided.

Objective To explore the value of T-SPOT.TB test in diagnosis of tuberculous pleurisy by comparing the T-SPOT.TB test, adenosine deaminase (ADA) of hydrothorax and tuberculosis antibody (TB-Ab). Methods 62 pleural effusion patients are included in the research , of which 32 cases have tuberculosis and 30 cases have no tuberculosis. All patients underwent T-SPOT.TB, pleural effusion ADA, and TB-Ab test. The results were compared with final clinical diagnosis for sensitivity and specificity evaluation. Results The sensitivity of T-SPOT.TB, ADA, TB-Ab were 90.6%, 71.9% and 62.5% respectively. The specificity of T-SPOT. TB, ADA, TB-Ab were 90.0%, 83.3% and 86.7% respectively. The sensitivity of T-SPOT.TB was the highest one among the three methods. The sensitivity of T-SPOT.TB has statistically significant difference compared with TB-Ab (P < 0.05), but no statistically significant difference compared with ADA (P > 0.05). Conclusions The T-SPOT.TB test had higher sensitivity and specificity for the diagnosis of tuberculous pleurisy , and had important reference value in early diagnosis of patients with tuberculous pleurisy. The T-SPOT.TB and TB-Ab combination examination had a complementary effect.

BACKGROUND:Antisense gene therapy offers immense promise for the management of human cerebral arteriovenous malformation through inhibiting expression of vascular endothelial growth factor and angiogenesis in endothelial cells.OBJECTIVE: To observe the inhibitory effect of vascular endothelial growth factor-antisense oligonucleotide (VEGF-ASODN) on the proliferation of vascular endothelial cells in human cerebral arteriovenous malformation.DESIGN: Observational contrast study.SETTING: Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Neuromedical Institute, General Hospital of Shenyang Military Area Command of Chinese PLA from August to December 2006. A total of 18 patients with human cerebral arteriovenous malformation were selected from Department of Neurosurgery, Shenyang General Hospital of Military Area Command of Chinese PLA. There were 12 males and 6 females and their mean age was 40 years. Cerebral arteriovenous malformation was classified based on Spetzler grade: grade Ⅱ (n =10) and grade Ⅲ (n=8). All cases were diagnosed with whole cerebral angiography before operation and they provided the confirmed consent. Main reagents were detailed as follows: endothelial cell growth supplements (ECGS, Sigma, USA), 391 DNA automatic synthetic device (Shanghai Shenggong Liyong Company, PE, USA), anaerobic incubator (DY-1, Zhejiang), human vascular endothelial growth factor enzyme-linked kit (TBD Company, Beijing), 96E enzyme-labeling device (ERMA, INC), cell cycle analytical reagent kit (BD Company), and flow cytometer (FACS Calibur, BD Company).METHODS: ①Experimental procedure: Tissue explants adherent method was used to culture vascular endothelial cells from human cerebral arteriovenous malformation. The third generated cells were used and randomly divided into antisense group, sense group and control group with four bottles of cells in each group. Sense and antisense phosphorothioate oligodeoxynucleotides of artificial vascular endothelial growth factor selected from the antisense group and the sense group were covered with positive liposomes, and then they were used to transfected vascular endothelial cells cultured from human cerebral arteriovenous malformation; however, cells in the control group were not dealt with any treatments. Cells in the three groups were incubated in anaerobic incubator (including 0.95 volume fraction of N2 and 0.05 volume fraction of CO2) at 37 ℃ for 2, 4 and 8 hours, respectively. ② Experimental evaluation: Cell cycles were measured, protein content of vascular endothelial growth factor was measured, and mRNA expression of vascular endothelial growth factor was also detected.MAIN OUTCOME MEASURES: Expression of mRNA and protein of vascular endothelial growth factor and proliferation exponent at different times of hypoxia.RESULTS: ①mRNA expression of vascular endothelial growth factor: At 2, 4 and 8 hours after hypoxia, mRNA expression of vascular endothelial growth factor was higher than that before hypoxia in the control group (P ＜ 0.05);however, mRNA expression was lower in the antisense group than that in the control group (P ＜ 0.05). ② Protein content of vascular endothelial growth factor: At 2, 4 and 8 hours after hypoxia, protein content of vascular endothelial growth factor was higher than that before hypoxia in the control group (P ＜ 0.05); however, protein content was lower in the antisense group than that in the control group (P ＜ 0.05). ③ Proliferation exponent: At 4 and 8 hours after hypoxia,proliferation exponent of endothelial cells cultured from human cerebral arteriovenous malformation was higher than that before hypoxia in the control group (P ＜ 0.05); however, proliferation exponent was lower in the antisense group than that in the control group (P ＜ 0.05).CONCLUSION: Hypoxia may induce gene expression of vascular endothelial growth factor in endothelial cells at the transcriptional level. Antisense vascular endothelial growth factor can obviously inhibit gene expression of vascular endothelial growth factor cultured from human cerebral arteriovenous malformation and proliferation under hypoxic conditions.

Objective To explore the value of intravoxel incoherent motion (IVIM) imaging in evaluating diffusion and perfusion variations in subacute brain infarction.Methods MRI data of 35 patients with subacute brain infarction were analyzed retrospectively,including routine DWI,IVIM imaging and three-dimensional arterial spin labeling (3D-ASL) sequence.The ADC maps were obtained by routine DWI sequence.Pure molecular-based diffusion coefficient (D) maps,pseudo diffusion coefficient of perfusion (D*) maps and perfusion fraction (f) maps were obtained by IVIM sequence.Cerebral blood flow (CBF) maps were obtained by 3D-ASL sequence.ADC,D,D*,f,CBF values and the relative values (rADC,rD,rD*,rf,rCBF) of brain infarction lesion and contralateral mirror area were calculated.All the parameters between brain infarction lesion and contralateral mirror area were compared.The correlations were analyzed between rADC value and rD,rD*,rf values respectively,as well as between rCBF value and rD,rD*,rf values respectively.Results Quantitative analysis showed significant decreases of ADC,D,D*,f and CBF values in the brain infarction lesion compared with those in the contralateral mirror area (all P＜0.05).There were positive correlations between rADC value and rD,rf values (r=0.687,0.601,P=0.005,0.018).And the positive correlation was found between rCBF value and rf value (r=0.581,P=0.022).Conclusion IVIM imaging can concurrently provide the perfusion and diffusion informations of subacute brain infarction patients,which is helpful to further elucidate the mechanisms of subacute brain infarction.

Objective To compare the diagnostic significance of pleural SLPI,IFN-γ and ADA for differenti-ating TPE from pleural effusions with the other etiologies. Methods Pleural effusion samples were obtained from 93 patients who were divided into the following groups: tuberculous pleural effusion,malignant pleural effusion, bacterial pleural effusion and transudative pleural effusion. The pleural effusion and/or serum levels of SLPI , IFN-γand ADA were determined. Results 1.The concentrations of SLPI, IFN-γand ADA in tuberculous pleural effusion was higher than that in malignant group, bacterial group and transudative group. 2. The diagnostic value of SLPI, IFN-γor ADA for the diagnosis of tuberculous PE is high respectively. The combinations of SLPI, IFN-γand/or ADA gained the more valuable diagnostic performance. Conclusion Pleural SLPI, IFN-γand ADA may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusion. The combinations of SLPI or/and IFN-γor/and ADA further increased diagnostic value.

Objective To study the effect of transgelin-2 expression on biological characteristics of colon cancer cells.Methods RT-PCR and Western blot were used to observe mRNA and protein expression of transgelin-2 in five colon cancer cell lines,screen for cell line with lower transgetin-2 expression;Transient transfection was performed to establish over-expression of transgelin-2 colon cancer cell line;The effect of transgelin-2 over-expression on the proliferation,apoptosis and the ability of migration and invasion of colon cancer cell were detected by CCK-8,low cytometric analysis and transwell method respectively.Results There was no statistical difference in proliferation and apoptosis in colon cancer cells with transgelin-2 over-expression compared with the controls;Enhanced ability of migration and invasion was found in colon cancer cells with transgelin-2 over-expression.After 15 hours culture in serum free medium,more transgelin-2 over-expressed colon cancer cells went through the transwell chamber bottom mnembrane than that in control group and empty vector transfected group 207 ±62 vs.114 ±29 vs.120 ±26,F =7.302,P ＜0.05).After 24 hours,the differences remained statistically significant (179 ± 32 vs.95 ± 33 vs.95 ± 28,F =10.960,P ＜ 0.05).Conclusions Transgelin-2 enhances migration and invasion ability of colon cancer cells.

Objective To explore the risk factors for patients with massive hemoptysis in tuberculosis and to provide a strategy for clinical treatment for tuberculosis massive hemoptysis (TMH). Methods Chi-square test and multivariate logistics analysis were applied to analyze the medical data of 241 cases of TMH. Results Chi-squared test showed that eleven factors were found to be significantly correlated with TMH. Longer disease course (≥3 months), lung lesions range ≥ 3 lung fields, pulmonary tuberculosis cavity, a higher smoking index (≥400 cigarettes per year) and clinical treatment were risk factors for TMH. Patients aged 45 years or older accompanied with bronchiectasia, pulmonary fungal infection, diabetes or hepatopathy had higher probabilities of developing massive hemoptysis. Multivariate analysis showed lung lesions range over 3 lung fields (OR = 2.447,P = 0.015), pulmonary tuberculosis cavity (OR = 2.486, P = 0.004), bronchial asthma (OR =3.192,P = 0.002), pulmonary fungal infection (OR = 3.896, P = 0.005) and hepatopathy (OR = 3.101, P =0.006) were final risk factors for TMH. Conclusion Multiple factors contributed to patients with massive hemoptysis in tuberculosis. Lung lesions range over 3 lung fields, pulmonary tuberculous cavities, bronchial asthma, lung fungal infection and hepatopathy might be the independent risk factors for TMH.