Objective To analyze the causes and possible mechanisms of vertigo for emergency,and to discuss the diagnosis and therapy methods.Furthermore, the possible effective preventions were suggested.Methods 86 elderly patients with vertigo for emergency were enrolled to analyze the causes through symptoms,signs and accessory examinations.Results The majority of the patients fell within the age range between 60～69 ,it occurred more frequently in female patients than in male.The main causes were cervical vertebra disease,hypertension atherosclerosis,acute cerebrovascular disease,hyperlipidemia,diabetes mellitus and autonomous nerve function disorder.Conclusion The mechanisms which induce vertigo in elderly patients are concerned with disturbance of vertebra-basal and blood supply system.It is not only resulted from single disease,but also from several factors.Moreover,it often co-exist with multi-diseases, which shows that symptomatic treatment is still the essential method for curing vertigo in elderly patients for emergency.

Nerve injury as a kind of tissue damage, inevitably stimulates nerve tissue inflammatory reaction, mediates neural tissue repair and regeneration, and participates in the occurrence of chronic pain. The high mobility group protein B1 (HMGB1) and Toll-like receptor 4 (TLR4) in neurological pain plays an important role, HMGB1-TLR4 pathway is involved in the initiation and progression of neuropathy pain. If the mechanism of HMGB1-TLR4 pathway in the neurological pain is identified, it can provide an effective pain-relieving methods and new target for drugs.

Objective Early clinical symptoms of esophageal cancer are often not obvious , so a deeper insight into tumor markers is very important for the early diagnosis of esophageal cancer .This study was to investigate the expressions of Rock 2 and Wnt11 in the specific esophageal cancer cell lines Eca-109 and HEEC and the relationship of the signal transduction pathway of proteins with the development of esophageal cancer . Methods Esophageal cancer cell lines Eca-109 and HEEC were cultured and the expression levels of Rock2 and Wnt11 in the cell lines were determined by real-time quantitative PCR and Western blot . Results The mRNA expressions of Rock2 and Wnt11 were significantly increased in the Eca-109 as compared with those in the HEEC cell line (4.955± 0.539 vs 1.000±0.000, P<0.01;2.925±0.230 vs 1.000±0.000, P<0.01), and so were the protein expressions of Rock 2 and Wnt11 (955.000±21.628 vs 778.844±102.193, P<0.05;2175.316±145.623 vs 1312.233±50.734, P<0.05). Conclusion The up-regula-ted expressions of Rock 2 and Wint11 may be the markers of the metastasis of esophageal squamous cancer .

Objective To study the chemical constituents of the acid hydrolytic products from the stems and leaves of Panax quinquefolium. Methods The stems and leaves of P. quinquefolium were hydrolyzed with acid;Isolation and purification were carried out by various chromatographic techniques,such as silica gel and so on. Compounds were identified and elucidated by spectral and chemical methods. Results Eight compounds were obtained from the acid hydrolytic products in the stems and leaves of P. quinquefolium and identified as 20 (S)-panaxadiol (Ⅰ),20 (S)-protopanaxadiol (Ⅱ),20 (R)-protopanaxadiol (Ⅲ),20 (S)-panaxatriol (Ⅳ),24 (R)-ocotillol (Ⅴ),20 (R)-protopanaxatriol (Ⅵ),20 (R)-dammarane-3?,12?,20,25-tetrol (Ⅶ),and 20 (R)-dammarane-3?,6?,12?,20,25-pentol (Ⅷ). Conclusion Compounds Ⅰ-Ⅷ are the derivates of the aglycones of ginsenosides,isolated from the acid hydrolytic products from the stems and leaves of P. quinquefolium for the first time. Among these compounds,Ⅳ,Ⅶ,and Ⅷ are discoverd from the roots,stems,leaves,fruits,and buds of P. quinquefolium for the first time. Compound Ⅶ is discovered and reported that it is the derivate of the aglycone of protopanoxadiol ginsenoside,with the conspicuous anticancer activity from the fruits of P. ginseng for the first time.

Objective To investigate the microvessel density of stomach tumor and the relationship between the microvessel density and CT findings.Methods Conventional contrast-enhanced CT scans were performed in 64 patients with stomach tumor(OMNIPAQUE 100 ml,3.0 ml/s),the images at 45 s were gained.After operation,the specimens with partial normal stomach tissue were dealed with injecting the contrast medium through its feeding arteries(10 ml/100 g,within 30 min),then,the specimens underwent CT scan(delayed time 10 s and 20 s),the nets of blood vessel of the masses were reconstructed by post-processed.The density of masses was evaluated in comparison with the enhanced effect of masses before operation.The pathological examinations of specimens were done and the microvessel density of tumors were measured through immunohistochemical technique.The hemodynamic characteristics of tumors were analysed.Results In tumors,the highest density(D)increased with the tumor rank(beside dead band).The visive vessels of specimen were more than that on conventional contrast-enhanced CT,but the D/d(the highest density in the masses/the density in normal stomach tissue)was basically consistent.Conclusion For gastric carcinoma,the D/d ratio can reflect the microvessel density of the tumors on certainly and the hemodynamic characteristics of tumors.

31 patients from Anhui province maternal and child health care with cesarean scar pregnancy ( CSP ) treated with UAE ( before or after uterine curettage) were analyzed retrospectively. 12 subjects with a definite diag-nosis of CSP were offered preventive UAE. 1 case of an emergency rupture of the CSP patient was offered emergen-cy interventional therapy. The other eight patients,who were misdiagnosed as having an intrauterine pregnancy,with the symptoms of active vaginal bleeding were treated with emergency UAE after uterine curettage. The results showed all the 31 patients with CSP were resolved successfully without hysterectomy and had a significant decrease on the data ofβ-HCG. 24 patients received preventive UAE combined with methotrexate followed by uterine curet-tage. 3 patients received a excision of the scar in the uterus after UAE. 4 patients had a UAE combined with conser-vative medication. Results showed that UAE might be an effective means of treating CSP, including treatment in an emergency setting. It decreases the incidence rate of hysterectomy.

Objective To evaluate the effect of dexmedetomidine on lipid peroxidation during lung ischemia-reperfusion (I/R) in rats.Methods Fifty-four pathogen-free healthy male Wistar rats,weighing 250-350 g,were randomly divided into 3 groups (n=18 each) using a random number table:sham operation group (S group),I/R group,and dexmedetomidine group (Dex group).In group Dex,dexmedetomidine 5 μg/kg was injected via the caudal vein once a day for 2 consecutive days.The equal volume of normal saline was given in S and I/R groups.At 30 min after administration on 2nd day,lung I/R was produced by clamping the left hilum of lung for 45 min followed by 120 min of reperfusion in I/R and Dex groups.At 45 min of ischemia,and 60 and 120 min of reperfusion,6 rats selected from each group were sacrificed,and the left lungs were removed for examination of the pathological changes and for determination of wet/dry lung weight ratio (W/D ratio),malondialdehyde (MDA) content and superoxide dismutase (SOD) activity.Results Compared with S group,the SOD activity was significantly decreased,and the MDA content and W/D ratio were significantly increased at 60 and 120 min of reperfusion in I/R and Dex groups (P＜0.05).Compared with I/R group,the SOD activity was significantly increased,and the MDA content and W/D ratio were significantly decreased at 60 and 120 min of reperfusion in Dex group (P＜0.05).The pathological changes of lungs were significantly attenuated in Dex group as compared with I/R group.Conclusion Dexmedetomidine mitigates lung I/R injury through inhibiting lipid peroxidation in rats.

Objective To investigate the expression of histone acetylated H3 and H4, methylated H3K4 and H3K9 in diffuse large B-cell lymphoma (DLBCL). Methods The expression of histone acetylated H3 and H4, methylated H3K4 and H3K9 were examined by SP immunohistochemistry technique in lymphoid tissue of 40 cases with DLBCL and 16 cases with proliferative lymphadenitis. Results The expression of histone acetylation of H3 and H4 were lower than that in proliferative lymphadenitis. Histone methylated H3K4 was lower in expression and H3K9 was in higher expression. There was a positive correlative expression between the global histone acetylation of H3 and H4, the global histone acetylation of H3, H4 and histone methylation of H3K4. Conclusion Improper modification of histone acetylations and methylations may play an important role in pathogenesis in DLBCL.

Objective The clinical value of ifrst-trimester standard ultrasound views in screening for fetal structural abnormalities. Methods From September 2008 to March 2011, transabdominal sonographic screening by standard ultrasound views was performed in 3 134 viable singleton pregnancies during the ifrst trimester at Beijing Obstetrics and Gynecology Hospital. Used the following views:(1) Fetal proifle;(2) Neck sagittal;(3) Skull and brain;(4) Thorax;(5) Abdomen;(6) Bladder;(7) Upper limbs, and (8) Lower limbs. The women underwent 20-to 24-week and 28-to 32-week ultrasound examination if the anatomical survey was normal during the ifrst trimester. Follow-up was obtained by reviewing of the birth records from hospital charts. Results Sixteen prenatal abnormalities were detected at 11-to 13-week scan (including one case of encephalocele and meningoceles, one case of endothelial cushion defect and single umbilical artery, one case of ectopia cordis, gastroschisis, and spinal abnormalities, two cases of exencephaly, one case of anencephaly, one case of gastroschisis and lower limb malformation, two cases of omphalocele, one case of encephalocele, ectopia cordis, and gastroschisis, one case of single ventricle, one case of endothelial cushion defect, four cases of hyhrop). All of the 13 women decided on termination of pregnancy. Three suspected structural abnormalities (hydrops) detected at the ifrst-trimester scan were found as normal after birth. Seven cases were diagnosed at 20-to 24-week scan (including one case of dextrocardiac and double outlet right ventricle;two cases of endothelial cushion defects;one case of trisomy 21 with VSD;one case of omphalocele, one case of short ulna and radial with wrist distortion, and one case of club foot). One case of diaphragmatic hernia was detected at 32-week scan. Two cases (one case of cardiac defects and one case of ear deformity) were identified after birth. Of all the 3 134 fetuses, follow-up was obtained in 2 822 cases, 312 cases were excluded from the analysis because the outcome of their pregnancy could not be traced. Twenty-three fetuses with at least one major structural defect detected by prenatal ultrasonography were confirmed by follow-up. The sensitivity of the standard first-trimester ultrasound views was 56.5%(13/23), speciifcity was 99.9%(2 796/2 799), CR was 99.6%(2 812/2 822), and the false negative rate was 43.5%(10/23). Conclusions The standard views of the ifrst trimester are feasible and effective in screening the major fetal abnormalities including exencephaly, anencephaly, gastroschisis, omphalocele, ectopia cordis and single ventricle. However, ultrasound screening in early pregnancy still has some limitations, continuous scanning in different stages of pregnancy is necessary.