Objeetive To investigate the relationship between 24-hour blood pressure rhythm and carotid scleratheroma in elderly patients with hypertension.Methods 193 elderly patients with hypertension were enrolled in the study and divided into study group (91 cases with carotid atherosclerosis) and control group (102 cases).All the patients were given 24h blood pressure rhythm examination.The characteristics of 24hour blood pressure rhythm was compared between the two groups.Results The 24h average systolic blood pressure(24h-SBP),24h average diastolic blood pressure (24h-DBP),24h average pulse pressure (24h-MBP) between the study group and the control group had no significant differences(P ＞ 0.05).The daytime average systolic blood pressure(d-SBP),diurnal mean diastolic blood pressure (d-DBP),diurnal average pulse pressure (d-MBP),nocturnal mean systolic blood pressure (n-SBP),nocturnal mean diastolic blood pressure(n-DBP),nocturnal mean pulse pressure(n-MBP) of the study group were significantly higher than those of the control group (t =16.92,24.68,6.16,12.87,11.59,6.35,all P ＜0.05).In study group,d-SBP,d-DBP,d-MBP were higher than n-SBP,n-DBP,n-MBP,the differences were statistically significant(F =73.61,P ＜ 0.01).The circadian blood pressure variability of the study group was more than 10％,the 24h ambulatory blood pressure curve graph of the study group was non-dipper curve.The circadian blood pressure variability of the control group was less than 5％,the 24h ambulatory blood pressure curve was dipper type curve.Conclusion The MBPS is strongly associated with carotid scleratheroma,and clinical treatment and study could derive from ABPM data analysis.

Microglia(MG)is recognized as the main immune effector in central nervous system injury and disease.MG can regulate the tumorigenesis and development of brain metastases tumor(BMT)by different ways.Studing the roles and mechanisms of MG in BMT will provide new insights into the prevention and treatment of BMT.

Objective To determine the expressions of transcription factor activator protein-2α (AP-2α), estrogen receptor-β (ER-β) and matrixmetalloproteinase-9 (MMP-9) in lichen planus (LP) lesions and their significance. Methods Tissue samples were resected from the lesions of 30 patients with LP and normal skin of 30 human controls. An immunohistochemical method using streptavidin-peroxidase (SP) was performed to detect the expression of ER-β and MMP-9, reverse transcription-PCR and Western blot to measure the mRNA and protein expressions of AP-2α, ER-β and MMP-9 in these specimens. Results There was a significant decrease in the mRNA expressions of AP-2α (0.488 ± 0.039 vs. 1.008 ± 0.023, P < 0.01 ) and ER-β (0.365 ± 0.032 vs. 0.998 ± 0.036, P < 0.01), together with an increase in the expression of MMP-9 (1.237 ± 0.027 vs. 0.567 ± 0.015, P< 0.01) in the LP lesions compared with the control specimens; similar results were observed for the protein expressions of AP-2α, ER-β and MMP-9. In LP lesions, the expression of AP-2α was positively correlated with that of ER-β (R = 0.89, P < 0.01), but negatively correlated with that of MMP-9 (r = -0.91, P < 0.01). Conclusions The down-regulation of ER-β expression and up-regulation of MMP-9 expression may be ascribed to the abnormal regulation of upstream target genes mediated by the decreased expression of AP-2α, which may be involved in the pathogenesis of LP.

The centrosome plays a crucial role in the maintaining of cell conformation,mitosis and chromosome seg-regation.It responds to the DNA damage and keeps the genome stability via cross-talking with the intranuclear DNA damage repair system.The apoptosis of tumor cells can be induced through inhibition of the duplication of centro-some.So the inhibitors of centrosomal proteins will be a potential anti-tumor therapy.

Objective To investigate the effect of intranasal instillation of insulin with different doses on cognitive function in patients with Alzheimer disease (AD).Methods Sixty-three AD patients were collectcd.According to the order of doctor's office visiting,they were divided into insulin 1 group (21 cases,intranasal instillation of insulin 20 U,2 times per day),insulin 2 group (21 cases,intranasal instillation of insulin 40 U,2 times per day) and placebo group (21 cases,intranasal instillation of physiological saline,2 times per day).Mini-mental state examination scale (MMSE) and Rivermead behavioural memory test second edition (RBMT Ⅱ) were used to evaluate the improvement of cognitive function after 3 months and 6 months.Results Before treatment,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (20.2 ± 2.3) and (17.2 ± 1.9) scores,in insulin 2 group were (20.7 ± 2.8) and (16.5 ± 1.9) scores.After treatment for 3 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (21.8 ± 3.2) and (19.2 ± 2.0) scores,in insulin 2 group were (21.6 ± 3.5) and (18.1 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group significantly improved compared with those before treatment (P ＜ 0.05 or ＜ 0.01).But the scores of MMSE and RBMT Ⅱ in placebo group were significantly aggravated,(18.9 ± 3.8) scores vs.(20.9 ± 2.5) scores,(15.2 ± 2.1) scores vs.(16.1 ± 2.0) scores,P ＜ 0.05.After treatment for 6 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (22.5 ± 3.3) and (20.5 ± 2.0) scores,in insulin 2 group were (22.7 ± 3.1) and(19.8 ± 1.9) scores,and in placebo group were (17.9 ± 4.5) and(14.7 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group were significantly better than those in placebo group (P ＜ 0.01).Conclusion Intranasal instillation of insulin can improve cognitive disorders in patients with AD.

Objective To study the clinical effect of minimally invasive treatment of 24 patients with hemor-rhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,ther-apeutic results of minimally invasive treatment were studied retrospectively.Results 24 patients with hemorrhagic moyamoya disease spontaneous intracerebral hematoma who need to acutely remove the hematoma were examined by CT angiography ( CTA) .Emergency minimal invasive puncture was performed according to the result of CTA,and the role of CTA in operation was analyzed.In all 24 patients,most of them were cerebral hemorrhage breaking into ventri-cles,5 cases with intracranial aneurysm.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AchA and P-CoM were observed in 9 patients,superficial temporal artery.Conclusion Minimally invasive treat-ment of hemorrhagic moyamoya disease scheme is simple,practical and effective,the maneuverability is strong.

Objective To evaluate the efficacy of CHOP (cyclophosphamide,doxorubicin,vincristine,and prednisone)chemotherapy on peripheral T cell lymphomas-unspecified (PTCL-U)in patients aged 80 years and over,and investigate the chemotherapy adverse effects and its prognostic factors.Methods Clinical data of 57 patients with PTCL-U confirmed by pathology and immunohistochemistry in Guangzhou First People's Hospital from January 2008 to January 2015 were retrospectively analyzed.The efficacy and adverse effects of CHOP chemotherapy,and its prognostic factors were evaluated.Results Of 57 patients,11 (19.3％) achieved complete remission,23(40.4％)had partial remission,14(24.6％)had stable disease,and 9(15.8％)had progressive disease after CHOP chemotherapy,with a total effective rate of 59.6％ (34 cases).The expected 1-year,2-year and 3-year overall survival(OS)rate was 70.2％ (40 cases),36.8％ (21 cases) and 17.5％ (10 cases),respectively.The median survival time was 18.2 months.Among the 57 patients,40(70.2％) had hypoplasia of bone marrow at degree Ⅰ-Ⅱ,17 (29.8％) at degree Ⅲ-Ⅳ,49 (86.0％) had mild nausea and vomiting(degree Ⅰ-Ⅱ),8(14.0％)had severe nausea and vomiting(degree Ⅲ-Ⅳ),7 had liver dysfunction,2 had cardiac toxicity and 7 had disturbance of blood coagulation.Univariate analysis showed that the alkaline phosphatase,Ki-67 percentage,lymphoma international prognostic index(IPI)score,extranodal involved sites(＞1),as well as the efficacy and course of chemotherapy were the prognostic factors for survival time in very elderly patients.Multivariate analysis indicated that IPI score＞2(95％CI:1.12～6.35,x2 ＝5.45,P＜0.01),extranodal involved sites(＞1)(95％ CI:2.58-15.32,x2 ＝ 16.42,P＜0.01),disease progression(95％CI:1.82～12.15,x2 ＝ 10.23,P＜0.01),chemotherapy courses(＞4) (5％CI:0.18～0.79,x2 ＝7.28,P＜0.01)were the independent prognostic factors for the median survival time in very elderly patients.Conclusions PTCL U patients aged 80 years and over have poor prognosis.CHOP chemotherapy has a certain effect on PTCL-U in very elderly patients,and chemotherapy side effects can be tolerated.IPI score＞2 and extranodal involved sites(＞ 1)are the important prognostic factors in very elderly PTCL-U patients.The completion of full course of chemotherapy with remission occurrence is important to prolong survival time in very elderly PTCL-U patients.

Cancer-related fatigue survivors have been found to have lower morning serum cortisol levels, flattened diurnal cortisol cy-cles, and decreased cortisol responses to psychological stress. The mechanism may be related to the inflammation caused by disorder of hy-pothalamus-pituitary-adrenal axis, and there are also some evidences to support that cortisol can be used to reduce cancer-related fatigue. This study introduced the research progress of the relationship between cancer-related fatigue and hypothalamus-pituitary-adrenal axis.