Objective To study on diagnosis and treatment of brain type fat embolism syndrome complicated with fracture. Method The diagnosis and treatment of 7 cases of brain type fat embolism syndrome complicated with fracture were reviewed. All of 7 cases did not have any brain injury, 3 cases were complicated with femural fracture, 3 cases with fractures of tibia and fibula, and 1 cases with limbs multi fracture. They presented somnolence or coma complicated with rise in temperature (37.7℃～39℃) ,increase in breath and heart rate,anemia,small bleeding spots at chest. It was discussed how to distinguish brain type fat embolism syndrome from brain injury. Synthetical measure was adopted mainly using dexamethasone (20～80mg/d). Results 7 cases of brain type fat embolism syndrome complicated with fracture were cured in 1～7 days. Conclusions Sudden somnolence or coma that does not result from brain injure after limb fracturees in early stage can be diagnosed as brain type fat embolism syndrome. A synthetical measure should be adopted by mainly using dexamethasone (40～80mg/d) .

Objective To explore the roles and related mechanisms of Protein Phosphatase 2A(PP2A) in cognitive dysfunction after the chronic cerebral ischemia.Methods 70 male Sprague Dawley rats in clean degree were divided into sham group,chronic cerebral ischemia group (Bilateral carotid arteries occlusion,2VO),and chronic cerebral ischemia group with PP2A activation group(2VO+aPP2A).The rats were injected intraperitoneally with 1.88 μmol/ml sodium selenate(15 μmol · kg-1 · d-1) or equal volume of saline for 4 weeks.After one month,the chronic cerebral ischemia models were reproduced by the occlusion of bilateral common caroid artery.Then the abilities of learning and memory were tested by Morris water maze,electrophysiological indices were recorded to analyze the LTP changes,and destribution of synaptic vesicles was observed by electron microscope.Results Morris water maze test showed that the 2VO group had significantly longer latent time than sham group in searching platform(P＜0.05),and the 2VO+aPP2A group had dramatically shorter latent time (P＜0.01) than that of 2VO group.Then removing platform to test the rats memory,the data showed that 2VO group spent markedly longer time than sham group to reach the location of the former platform (sham group:(14.50±1.98)s ; 2VO group:(17.30±2.11) s) (P＜0.01),and the 2VO+aPP2A group((15.09± 1.45) s) spent dramatically shorter latent time(P＜0.05) than that of 2VO group.The electrophysiological data showed that 2VO group had the noticeably smaller field excitable postsynaptic potential slope (fEPSP) slope ratio between pre and post of the high frequency stimulations (Long-term potential,LTP) than sham group(sham group:1.69±0.27; 2VO group:2.02±0.137) (P＜0.01),and the 2VO+aPP2A group(1.86±0.19) had strikingly higher ratio than that of 2VO group(P＜0.01).The electromicroscope observation showed that presynaptic vesicles density of 2VO was remarkably lower than that of sham group (sham group:(4.51±0.29) /μm2 ; 2VO group:(2.02±0.14) /μm2) (P＜0.01),and presynaptic vesicles density of 2VO+aPP2A group((3.58±0.50) /μm2) was noticeably higher than that of 2VO group(P＜0.01).Conclusion Activating PP2A can prevent the cognitive dysfunction after chronic cerebral ischemia through regulating LTP and synaptic vesicle density.And PP2A is probably a potential target for preventing and treating the cognitive dysfunction after chronic cerebral ischemia.

Objective To explore the effects of 4-phenylbutyric acid(PBA) on cognitive dysfunction after chronic cerebral hypoperfusion and underlying mechanisms.Methods 62 male Sprague Dawley rats in clean degree were divided into sham group(n=14),chronic cerebral ischemia group(bilateral carotid arteries occlusion,2VO group,n=24),and chronic cerebral ischemia with PBA treatment(2VO+PBA group,n=24).The chronic cerebral ischemia models were produced by the occlusion of bilateral common caroid artery for 1 month.During the hypoperfusion,the rats were injected intraperitoneally with 11.25 mg · ml-1 PBA(90 mg · kg-1 · d-1) or equal volume of saline once a day for 3 days followed by every other day for 27 days.Learning and memory abilities were tested by Morris water maze and novel object recognition test.The expression and distribution of NR2A in hippocampus were examined by Western blot and immunohistochemistry.Results Morris water maze test showed that the 2VO group had significantly longer latent time than sham group in searching platform (P＜0.01) (from 2nd day to 7th day latency time),and the 2VO+PBA group had dramatically shorter latent time than 2VO group (2nd,5th,6th,7th (P＜0.01),3rd(P＜0.05)).Then the rats' memory test showed that 2VO group spent markedly longer time than sham group to reach the location of the former platform(P＜0.01),but the 2VO+PBA group spent dramatically shorter latent time than 2VO group (P＜0.01).The novel object recognition test showed the exploration ratio and discrimination index of novel object in 2VO group were noticeably smaller than that in sham group (P＜0.01),but the exploration ratio and discrimination index of novel object in 2VO+PBA group were noticeably higher than that in 2VO group (P＜0.01).The Western blot data showed that the level of NR2A in 2VO group was significantly lower than that in sham group (P＜0.01),but the level of NR2A in 2VO+PBA group was significantly higher than that in 2VO group (P＜0.05).The level of NR2B in hippocampus of 2VO group had no significant difference with sham group and 2VO+PBA group (P＞0.05).Immunohistochemistry data was consistent with the data of Western blot for NR2A level and distribution.The ratio of p-CREB/total CREB in 2VO group(0.62±0.04) was remarkably lower than that in sham group(1.00±0.07),but the ratio of p-CREB/total CREB in 2VO+PBA group(0.97±0.07) was remarkably higher than that in 2VO group(P＜0.01).Conclusion NR2A reduction is associated with chronic cerebral hypoperfusion-induced cognitive impairment,which is rescued by the PBA treatment.It suggests that PBA may have a therapeutic effect on preventing chronic cerebral hypoperfusion-induced cognitive impairment.

AIM:To investigate the effect of short-chain acyl-CoA dehydrogenase ( SCAD) on collagen expres-sion and proliferation of rat cardiac fibroblasts and to explore the relationship between SCAD and cardiac fibrosis . METHODS:The model of proliferation and collagen expression of rat cardiac fibroblasts induced by angiotensin II was es -tablished.After treatment with siRNA-1186, the expression of SCAD at mRNA and protein levels , fatty acids beta oxida-tion rate, ATP, the enzyme activity of SCAD and free fatty acids in the rat cardiac fibroblasts were determined . RESULTS:The mRNA and protein expression of SCAD was decreased in the rat cardiac fibroblasts induced by angiotensin II compared with the control cells , and the expression of collagen I and collagen III was significantly upregulated .Com-pared with negative control group , SCAD expression and activity , fatty acid beta-oxidation rate and ATP significantly de-creased in siRNA-1186 group, but the content of free fatty acids were obviously increased in the rat cardiac fibroblasts , and the expression of collagen I and collagen III was significantly up-regulated.CONCLUSION:The expression and synthesis disorder of collagen may be triggered by down-regulation of SCAD .SCAD may be a promising therapeutic target for myocar-dial fibrosis .

Weifang Community Hearth Service Center started a pilot program of contracted family doctor service in 2011,and the program included 3 stages:1st stage was the establishment of the health archives of the residents;2nd stage was the service signed with key groups in the community;3rd stage was extension of contracted service to whole community.The working mode of responsible family doctor team was formed,and the health service for contracted residents was managed by the family doctor teams.The individualized service was provided to residents according to their different needs.As a trial,the "Pediatrics Studio" was designed to provide special service for focused group among signed residents.Through a series of measures,the signing rate and the extended prescriptions in Weifang community both ranked the first in Pudong New Area,and the visiting rate by the signed patients increased from 30％ to 41％.The preliminary impact of the contracted family doctor service has appeared in Weifang community.

OBJECTIVETo establish red-green dual-color fluorescence glioma model in nude mice and to explore its practical values.

METHODSCM-DiI-stained rat glioma C6 cells (C6-CM- DiI cells) expressing red fluorescence were inoculated into the brain of athymic nude mice expressing green fluorescence protein (NC-C57BL/6J-EGFP). Then the whole-body dual-color fluorescence imaging was detected dynamically. Finally whole brains of the tumor-bearing mice were removed and 5 µm thick serial frozen slices were made. Light microscopy, fluorescence microscopy and confocal laser scanning microscopy were performed to observe the transplanted tumor tissue structure and fluorescent cells.

RESULTSTumor mass with red fluorescence increased gradually under continuous in-vivo fluorescence imaging monitoring. Under the fluorescence microscope, cells with red, green and yellow fluorescence were observed in the frozen sections of transplanted tumor tissue and the mutual structural relationship among them could be defined. The tumor cells migration, implantation and cell fusion between transplanted tumor cells and host cells could be observed. It could be distinguished according to the fluorescence, that blood vessels of tumor-origin displayed red fluorescence, blood vessels of host-origin displayed green fluorescence and mosaic blood vessels appeared yellow fluorescence. It was depicted that host innate astrocytes and oligodendrocytes in the microenvironment at the tumor periphery could be activated and dedifferentiated into nestin-positive cells.

CONCLUSIONSIn contrast to traditional animal model, the dual-color fluorescence imaging of nude mouse models of glioma possesses enormous advantages in investigating tumor mass in-vivo fluorescence imaging, tumor cells migration and metastasis, tumor angiogenesis and reactive activation of host innate cells in the microenvironment at tumor periphery, thus, has highly practical application value.

Animals ; Astrocytes ; metabolism ; Brain Neoplasms ; blood supply ; metabolism ; pathology ; ultrastructure ; Carbocyanines ; metabolism ; Cell Fusion ; Cell Line, Tumor ; Cell Movement ; Disease Models, Animal ; Fluorescent Dyes ; metabolism ; Glioma ; blood supply ; metabolism ; pathology ; ultrastructure ; Green Fluorescent Proteins ; metabolism ; Luminescent Proteins ; metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Nude ; Microscopy, Confocal ; Microscopy, Fluorescence ; Neoplasm Transplantation ; Neovascularization, Pathologic ; Nestin ; metabolism ; Oligodendroglia ; metabolism ; Rats

Objective To evaluate the diagnostic value of quantitative rest and stress 13N-NH3 PET myocardial perfusion imaging (MPI) on coronary microvascular disease (CMVD),and provide basis for accurate classification.Methods From July 2016 to September 2017,a total of 23 patients (16 males,7 females;27-70 years) who were suspected of CMVD were prospectively enrolled in this study.Rest and ATPstress MPI were acquired using 13N-NH3 PET and analyzed using Heartsee software.Rest and stress relative uptake,absolute myocardial blood flow (MBF) and coronary flow reserve (CFR) were obtained and present on sectional images and cup maps.Based on the information,CMVD was diagnosed or excluded.Combined with myocardial enzymes,echocardiography,cardiac MRI,coronary angiography,CT angiography (CTA),CMVD was further divided into CMVD without (type 1) or with obstructive coronary disease (type 2),and other CMVD (type 3).Two-sample t test and one-way analysis of variance were used to analyze the data.Results In 23 patients,17 cases were diagnosed as CMVD (including 10 cases with type 1,3 cases with type 2 and 4 cases with type 3),and 6 cases were excluded.There were no significant differences in the age,gender and risk factors between CMVD group and exclusion group (all P＞0.05).The relative uptake results,including average uptake of whole left ventricle in rest and stress states,rest minimum quadrant,and area of stress uptake less than 60％ of maximum were significantly different between the two groups (t values:from -3.249 to 2.469,all P＜0.05).All the absolute blood flow parameters,including rest and stress whole MBF and CFR,rest and stress minimum quadrant MBF and CFR,were significantly different between CMVD group and exclusion group (t values:from-8.278 to-3.258,all P＜0.05).There was no statistically significant difference for relative uptake data among three types of CMVD (F values:from 0.002 to 1.440,all P＞0.05).For absolute quantitative values of whole MBF and minimum quadrant MBF in both rest and stress states,difference was statistically significant among groups (F values:from 3.885 to 8.452,all P＜0.05).Conclusion Quantitative PET MPI could provide a noninvasive,safe and accurate method for the diagnosis and classification of CMVD.

Tuberous sclerosis complex(TSC)is a rare genetic disease that can lead to benign dysplasia in multiple organs such as the skin, brain, eyes, oral cavity, heart, lungs, kidneys, liver, and bones. Its main symptoms include epilepsy, intellectual disabilities, skin depigmentation, and facial angiofibromas, whilst incidence is approximately 1 in 10 000 to 1 in 6000 newborns. This case presents a middle-aged woman who initially manifested with epilepsy and nodular depigmentation. Later, she developed a lower abdominal mass, elevated creatinine, and severe anemia. Based on clinical features and whole exome sequencing, the primary diagnosis was confirmed as TSC. Laboratory and imaging examinations revealed that the lower abdominal mass originated from the uterus. CT-guided biopsy pathology and surgical pathology suggested a combination of leiomyoma and abscess. With the involvement of multiple organs and various complications beyond the main diagnosis, the diagnostic and therapeutic process for this patient highlights the importance of rigorous clinical thinking and multidisciplinary collaboration in the diagnosis and treatment of rare and challenging diseases.