Objective:To study the relationship between serum level matrix metalloproteinase-9 (MMP-9) and atrial fibrillation (AF) and to assess its predictive value of AF recurrence in persistent AF patients after cardio-version.
Methods: Our research included in 4 groups: Control group, n=30 healthy subjects, Paroxysmal AF group, n=30, Persistent AF group, n=60 and Permanent AF group, n=30. Serum levels of MMP-9 were examined and compared among different groups. The patients in Persistent AF group received drug therapy or drug+electric cardio-version;with successful cardio-version, antiarrhythmia medication was used to maintain sinus rhythm and the patients were followed-up for prognosis, MMP-9 levels were further compared between the patients with or without AF recurrence to assess the predictive value of MMP-9 for AF recurrence.
Results: Serum levels of MMP-9 were as follows: Control group (151.43±88.14) ng/ml, Paroxysmal AF group (182.66±96.39) ng/ml, Persistent AF group (278.93±89.22) ng/ml and Permanent AF group (336.82±112.35) ng/ml respectively, which indicated that MMP-9 level in Persistent AF group was higher than Paroxysmal AF group and Control group;MMP-9 in Persistent AF group was higher than the other 3 groups, P<0.01. The patients in Permanent AF group were followed-up for (15.4±4.3) months after cardio-version, retrospective analysis found that the patients with AF recurrence had the higher MMP-9 level than those without AF recurrence (315.63±94.52) ng/ml vs (261.92±87.86) ng/ml, P=0.036. Multivariate regression analysis was conducted on age, gender, AF history, left atrial diameter and MMP-9, the consequence showed that serum MMP-9 level was the independent predictor for AF recurrence in persistent AF patients after cardio-version (P=0.035, OR=1.135, 95%CI 1.018-1.321).
Conclusion: Serum MMP-9 level was elevated in persistent and permanent AF patients;MMP-9 was the independent predictor for AF recurrence in persistent AF patients after cardio-version.

Objective To observe the therapeutic effect of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets for chronic functional constipation. Methods Sixty patients with chronic functional constipation were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was treated with Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets orally, and the control group was treated with oral administration of Prucalopride Succinate Tablets alone. The therapeutic effects on traditional Chinese medicine (TCM) symptoms and constipation, and the follow-up therapeutic effect of the two groups were evaluated after treatment. During the three months after the completion of treatment course, the recurrence of constipation was monitored. Results (1) The cure rate of the treatment group was 90.0％ and that of the control group was 60.0％, indicating that the therapeutic effect on TCM symptoms in the treatment group was stronger than that of the control group(P < 0.05).(2) In respect of the relief of constipation, the markedly effective rate was 93.3％ in the treatment group and was 50.0％ in the control group, and the overall effective rate was 100.0％ in the treatment group and was 73.3％ in the control group, the difference being significant between the two groups(P<0.05 or P<0.01).(3) During the treatment, the percentage of patients with weekly completely spontaneous defecation frequency ≥3 was 86.7％ in the treatment group, and was 53.3％ in the control group, the difference being significant (P < 0.05). (4) The results of 3-month follow-up after the completion of treatment course showed that one case from the treatment group had the recurrence of constipation, and the recurred cases from the control group were 6, the difference being significant (P < 0.05). Conclusion Oral use of Baizhu Shengjiang Decoction combined with Prucalopride Succinate Tablets exerts certain therapeutic effect for chronic functional constipation, which is effective both on relieving constipation symptoms and on reducing recurrence rate.

Objective:To study the influencing factors in the preparation of salicylic acid dropping pills , and determine the opti-mum preparation process .Methods: The environmental factors , heating temperature , matrix ratio and preparation steps of salicylic acid drop pills were observed .With pill weight difference , dissolution time and appearance quality as the indices , an orthogonal test was adopted to optimize the preparation process .Results:Salicylic acid and the matrix should be separately heated to prevent red ox-ide.The optimized preparation process of drop pills was as follows:the ratio of PEG 400 and PEG 6000 was 1∶5, the temperature of drug solution was 50℃, the dropping distance was 8 cm and the dropping rate was 70 drops per minute .Conclusion:The preparation process is simple and practicable .The pill weight difference , dissolution time and appearance quality all meet the quality require-ments.

Objective To investigate the application significance of 3.0T MR three dimensional double-echo steady state(3D-DESS) and three dimensional-true fast imaging with steady-state procession(3D-True FISP) sequences in diagnosis of wrist cartilage of rheumatoid arthritis (RA).Methods 26 patients who were clinically diagnosed with RA underwent wrist MR scans with 3D-DESS and 3D-True FISP sequences, while both sequences' scanning were achieved on 20 of them.340 articular-surface morphological conditions' were observed,which were divided into level 0, level 1 and level 2 damages according to morphological performance,and recorded on 3D-DESS and 3D-True FISP sequence respectively.The diagnostic differences in the number of lesions were compared for two sequences.Results The numbers were 79 and 50 for level 1 damage and 23 and 33 for level 2 damage on 3D-DESS and 3D-True FISP sequence respectively (P<0.05).The artifacts were showed in 14 patients on 3D-True FISP,and only two patients on 3D-DESS.Conclusion 3D-DESS sequence does better than 3D-True FISP in displaying RA wrist cartilage,which is able to provide certain help for treatment and prognosis evaluation of RA.

Objective To explore the value of manganese-enhanced MRI in locating the rat visual nuclei.Methods The visual nuclei of thirty-six rats were located by 3 different ways including individual MEMRI locating (group A,n= 1 6),anatomical atlas locating (group B,n=1 6)and direct puncture by using the data obtained in MEMRI (group C,n=4).After unilateral intra-vitreal injection of MnCL2 (30 mmol/L×3 μL)in group A,the brain MRI was performed 24 h later.The location coordinate of lateral geniculate nucleus (LGN) and superior colliculus (SC)were recorded individually.The nuclei injections (3% fluorogold solution,1 μL)were performed by using different location coordinate in groups A and B.The rat’s retinas were examined under fluorescence microscope 5 days later,and the results were compared between the two groups.After brain nucleus puncture injection (30 mmol/L MnCL2 solution,0.5 μL),MRI was performed 1 h later in group C.Results The success rate was 93.8% (1 5/1 6)in group A,and 65.5% (10/1 6)in group B.The difference between groups was statistically significant (P<0.05).All the injection locations of C group were agreed with atlas.Conclusion MEMRI in the visual nucleus stereotactic can improve the accuracy of location.

Objective To investigate the optimal concentration of manganese-enhanced MRI (MEMRI)in the visual pathway of experimental rats.Methods Sprague-Dawley rats were intravitreally injected with 3 μL of 10 - 100 mmol/L MnCl2 ,respectively. The contrast-to-noise ratio (CNR)of MEMRI for optic nerve(ON)and midbrain superior colliculus (SC)enhancement were measured at differ-ent concentrations of MnCl2 .Results The ON and SC were all clearly detected by MEMRI 24 h after unilateral intravitreal injected 10-100 mmol/L MnCl2 ,respectively.The CNR increased with the increasing concentration of MnCl2 from 10 to 50 mmol/L;But the CNR decreased from 50 to 100 mmol/L.The enhancement of superior colliculus were higher than optic nerve.Conclusion The optimal concentration of MnCl2 is 30 mmol/L(3 μL)through intravitreal injection for the rat visual pathway on 1.5T MEMRI.

Objective To discuss the CT manifestations of multi-parasite infection in liver to improve the diagnostic accuracy. Methods A total of 11 patients with ELISA-proved multi-parasite infection in liver were enrolled in this study.The plain and dynamic enhanced CT scans were performed.The imaging findings including the number,distribution,size,shape,density,enhancement and degree intratumaral features,cholangiectasis and abdominal lymphadenopathy were retrospectively analyzed.Results A single lesion of multi-parasite infection in liver was detected in 6 patients and multiple lesions were in other 5.The lesions in 8 patients were located in a single lobe of the liver,and involved in several hepatic lobes in other 3.The maximum diameter of the lesion ranged from 1.7 cm to 6.3 cm with an average diameter of 4.4 cm.Irregular lesions were found in 7 patients and round ones in shape were in other 4.Plain CT showed the lesions with low-intensity.All lesions were mild to moderate inhomogeneous enhancement on portal vein phase,presented honeycomb-like or separated enhancement with cholangiectasis (n=2)and abdominal lymphadenopathy (n=2).Conclusion The CT manifestations on portal vein phase in combination with clinical data are useful for the diagnosis of multi-parasite infection in liver.

Objective To investigate the imaging features of perivascular epithelioid cell tumor of liver (PEComa),and to improve the diagnostic level of the disease. Methods A retrospective analysis of imaging manifestations was performed on 11 cases of hepatic hemangioma confirmed by surgery and pathology. All patients underwent CT and MRI examination before PET/CT examination ,then received operation. Results Eleven cases were solitary hepatic lesions ,10 of which were located in the right lobe of the liver ,and 1 in the left. The lesions were round or quasi-circular and the diameter ranged from about 13.5cm to about 1.8 cm,with an average of 5.7 cm. CT plain scanning showed that the liver was slightly lower density ,with clear boundary. The smaller lesions were homogeneous density,while the larger ones were not,and the lower density area was visible. Enhancement of peripheral lesions in the arterial phase was enhanced. The lesions in the portal vein were not uniformly enhanced , and visible separation was found in large lesions. In the delay phase ,the lesions were significantly decreased or slightly lower. MRI plain scan showed the lesion T1WI showed moderate signal or slightly low signal ,and large lesion signal was not uniform,and T2WI lesions showed slightly high signal while DWI lesions high signal and the enhanced features were similar to those of CT. PET/CT examination showed that visible radioactive uptake of abnormal concentration or uneven concentration were found in lesions with diameter larger than 3.0 cm,and the maximum SUV value ranged from 12.2 to 3.6,with an average value of 5.7. Lesions with diameter less than 3.0 cm showed a slight concentration of radioactive uptake and the highest SUV value was 4.7,with an average value of 2.9. The only 11.8 cm lesion showed no significant radioactivity ,which was as the same as that of normal liver tissue. Delayed PET/CT imaging(1 hour)showed that SUV values of all lesions were decreased in varying degrees. Conclusion PET/CT imaging of perivascular epithelioid cell tumor of liver has its characteristics. The combina-tion of PET/CT imaging and routine imaging examination will benefit the improvement of diagnosis level obviously.

Objective To identify disease-causing mutations in a large panel of Chinese Han patients with hereditary spastic paraplegia(HSP).Methods The coding sequence of the SPG11 gene in the probands of 28 families with ARHSP and 14 sporadic HSP patients was analyzed,and the identified changes in the sequence were tested to exclude being a benign polymorphism by sequencing 200 chromosomes from normal controls.Results Identified 13 causative mutations in SPG11 gene in 7 ARHSP and 3 sporadic HSP The mutations were:c.5977C>T/p.Q1993X、c.4668T>A/p.Y1556X、c.6898_6899delCT/p.L2300AfsX23.38、c.3719_3720delTA/p.11240VfsX263、c.733_734delAT/p.M245VfsX246、c.7088_7089insATTA/p.Y2363X、c.2163_2164insT/p.1722Yfsx731、c.7101-7102insT/p.K2368X、c.6790_6791insC/p.12264PfsX2339、c.654_655delinsG/p.S218RfsX219、c.7151+4_7151+7delAGTA/p.K2384fsX2386、c.6355-21_6355-18delTCT、c.3004C>T/p.G1002X.Among them,12 were novel mutations.The rate of mutation in the SPG11 gene was 25.0%(7/28)in ARHSP,6/6 in ARHSP-TCC and 3/14 in sporadic cases.Conclusions In Chinese Han population,patients with ARHSP-TCC and sporadic HSP-TCC should be screened for SPG11.Sequencing of the SPG11 gene in these patients with is valuable for clinical diagnostic testing.

Objective To study the imaging apperances and the diagnostic value of conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in differentiating histopathological types of small hepatocellular carcinoma (sHCC).Methods 40 sHCC confirmed by histopathology were classified into 4 groups according to their degree of differentiation:well (n=6),well-moderate (n=5),moderate (n=27) and moderate-poor (n =2).All patients received conventional MRI and DWI (1.5T,b =0 and 600 s/mm2) before the operation.The ADC values of the sHCC were measured and compared.Results On T1WI,32 lesions showed hypointensity,4 hyperintensity (well) and 4 isointensity (well-moderate =2,moderate =2).On T2WI,hyperintensity was observed in 39 lesions and isointensity in 1 lesion (well).Steatosis in the sHCC was seen in 17 of 40lesions (17/40,42.5 ％,well=4,well-moderate=1 and moderate=12).A pseudocapsule was seen in 67.5 ％ sHCC (27/40,well=4,well-moderate=3,moderate=18 and moderate-poor=2).32 lesions showed hypervascularity on arterial phase,and 8 lesions showed hypovascularity (well=3,moderate =4,moderate-poor=1).On DWI,37 lesions showed hyperintensity,except for 3 lesions with welldifferentiated sHCC which showed isointensity (50％,3/6).The mean ADC values±S.D.of sHCC in the well,well-moderate,moderate and moderate-poor groups were (1.757 ± 0.337) × 10-3,(1.917±0.574)×103,(1.816±0.545)×103 and (1.723±0.217)×10-3,respectively.There were no significant differences among the 4 groups.Conclusion The imaging appearances of wellmoderate,moderate and moderate-poor sHCC on conventional MRI were classical which make diagnosis easy.Hyperintensity on DWI contributed to diagnosis.However,the imaging appearances of some well-differentiated sHCC were atypical.The lesions could be isointensity or hyperintensity on DWI.The combination of conventional MRI and DWI contributed to better diagnosis of sHCC,especial for atypical sHCC.