Transcranial Doppler can be used for diagnosing,monitoring,identifying the site of arterial occlusion,selecting appropriate cases for thrombolysis,and monitoring arterial recanalization during intravenous thrombolysis,and intra-arterial and intravenous thrombolysis with recombinant tissue plasminogen activator,The continuous monitoring of low frequency transcranial ultrasound has the effect of assisted thrombolysis;however,there are still controversies on the frequencies used in clinical practice.Transcranial Doppler assisted with microbubble contrast agent may further enhance the effect of thrombolysis.

Thanks to the three decades of reform and opening up,hospitals in China have made tremendous achievements in their development,yet facing new ehallenges as well.to address these challenges,there is an urgent need for these hospitals to further their reform under the guideline of the scientific concept of development.This will help them strengthen their hospital culture,quality control,technology,human resources development,and their leadership,in order to achieve a better and faster growth,better serving the role to build a harmonious socialist society.

Objective To study the correlation between the main parameters and the effect of repression in MR fluid attenuated inversion recovery(FLAIR).Methods 0.5 unit was used in this experiment.The protein aqua of different material appearance and concentration was prepared.FLAIR was performed using the tube imitative experimented method and with different paramters.The best scan parameters were selected by comparison each other and their relativity was analysed.Results The best technical parameters:TR=4000~5000 ms,TE=90~100 ms,TI=1800~2000 ms.Conclusion TI is the key parameter in determining the repression effect,TR and TE only determine the scans time and layer number.FLAIR's repress result is stable,and it can estimate the protein content in the protein aqua.

Objective To study CT and MRI findings of the spongiform myelinopathy in poisoning by heroin.Methods CT and MRI findings in 6 patients with spongiform myelinopathy in poisoning by heroin were retrospectively analyzed with review of literature.Results The lesions were located in white matter,they were multiform and symmetrically distributed.On plain CT scans,the lesions were low density.On MRI,the lesions were low signal on T1WI and high signal on T2WI.The border of lesions was clear or not and no enhancement appeared.MRI is precedent of CT in the diagnosis of this disease,totally 55 focal lesions in the brain ,4 in midbrain and 8 in cerebellum were displayed by MRI.Conclusion CT and MRI findings of the spongiform myelinopathy in poisoning by heroin are more characteristic,according to the drug taking history and central nervous system symptom of patients,differentiating this disease from the other demyelinating disease is not difficult.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Adult ; Femur Head Necrosis ; chemically induced ; drug therapy ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Paraquat ; poisoning

Aim To observe the changes of endothelin receptors and their subtypes of left ventricules in normal SD rats and dilated cardiomyopathy rats. Methods To establish the best conditions of the binding experiment, different protein concentrations, incubation temperature ?and?incubating?time?were?tested? with 125 I-ET-1 ligand respectively. With the selected conditions, saturation binding experiments were performed to determine the amount of endothelin receptor and its subtypes in normal SD rats and in dilated cardiomyopathy ones. Results (1) The optimal incubating temperature was 37 ℃. Under this condition, the binding amount of 125 I-ET-1 increased rapidly in 0～30 minutes, and reached to saturation point at 60 minutes, and there was a linear correlation between 125 I-ET-1 binding amount and cell membrane protein concentration. (2) Endothelin-1, bosentan,BQ123,BQ788 etc. could competitively suppress the bound of 125 I-ET-1 to endothelin receptors. (3) The amount of endothelin receptor in left ventricle of dilated cardiomyopathy rats was ( 92.21? 34.34) nmol?kg -1 protein, which was significantly low than that in normal SD ones. There was no change on the ratio of endothelin receptor subtypes A and B. Conclusion 125I-ET-1 can be used to determine the amount of endothelin receptor and its subtypes in varied tissues specifically. The amount of endothelin receptor in left ventricle of dilated cardiomyopathy rats is down regulated, but the ratio of endothelin receptor subtype A vs B remains to be 21.

Aza Compounds ; analysis ; Heterocyclic Compounds ; analysis ; Sensitivity and Specificity ; Spectrophotometry, Ultraviolet ; methods ; Workplace

Objective To analyze the correlation between neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR) in peripheral blood and the therapeutic effect and prognosis of patients with advanced lung adenocarcinoma treated with tyrosine-kinase inhibitors.Methods Retrospective analysis was utilized to measure the clinical pathological characteristics and follow-up data of 40 cases with advanced lung adenocarcinoma definitely diagnosed by pathology.Correlation analysis was performed by Spearman test,and comparison of the sample rate was measured by the chi square test.Survival analysis was performed by Kaplan-Meier method,Log-rank test was used to compare patients survival difference among different groups.COX regression model was utilized to analyze the prognostic factors of patients with lung cancer.Results Through the ROC curve,the optimal cut-off points of NLR and PLR were calculated to be 3.74 and 205.1 respectively.In NLR<3.74 group,objective response rate(ORR),the median progression-free survival(PFS) and the median overall survival(OS) were 86.9%(20/23),9.02 months and 12.37 months respectively.In NLR ≥3.74 group,ORR,the median PFS and the median OS was ORR were 35.2%(6/17),3.15 months and 5.12 months respectively.Compared with NLR ≥ 3.74 group,NLR<3.74 group had a higher ORR(P=0.036),PFS(P=0.011) and OS(P=0.021),the difference was statistically significant.In PLR<205.1 group,ORR,the median PFS and the median OS was ORR were 85.7%(18/21),9.67 months and 14.35 months respectively.In PLR ≥ 205.1 group,ORR,the median PFS and the median OS was ORR were 42.1%(8/19),3.21 months and 9.25 months respectively.Compared with group PLR ≥ 205.1,PLR<205.1 group had a higher ORR(P=0.045) and PFS(P=0.018),the difference was statistically significant.COX multivariate analysis showed that NLR was an independent prognostic factor for PFS(RR=1.091,95%CI:1.004-1.185,P=0.039) and OS(RR=0.986,95%CI:0.932-1.148,P=0.021).PLR was an independent prognostic indicator of PFS(RR=1.100,95%CI:0.996-1.005,P=0.024).Conclusion NLR and PLR may be independent prognostic factors in patients with advanced lung adenocarcinoma.

OBJECTIVE To investigate the effect of phosphotyrosine interaction domain containing 1 (PID1, NYGGF4) onpromotion of IR and HCC, and explore its underlying mechanisms. METHODS Lentivirus were used to mediate the knockdown of PID1 in HFD induced IR mouse model as well as ob/ob mice. Intraperitoneal glucose and insulin tolerance were performed 4 weeks after lentivirus injection. Hydrodynamics-based transfection was applied to induce the liver specific overexpression of PID1. Flow cytometry was exerted to detect the proportion and function of immune cells.qRT-PCR and Western blot were used to detect the expression of downstream pathways of PID1. Liquid chromatography-mass spectrometry (LC-MS) and co-immunoprecipitation (Co-IP) were conducted to identify proteins interacting with PID1.Chromatin immunoprecipitation(ChIP)was operated to measure the modification of H3K4me3 of PID1 promoter.RESULTS PID1 restriction improved insulin resistance,hyperglycemia and fatty liver. Conversely, hepatic knockdown of PID1 attenuated liver xenografted tumor growth. Moreover,PID1 liver-specific protooncogenes via hydrodynamics-based transfection established a primary hepatocellular carcinoma mouse model,induced an immunosuppressive environment,with the reduction of CD3+,CD4+,CD8+T cells,retarded maturation of dendritic cells(DCs),pronounced differentiation of regulatory T cells(Tregs),and recruitment of MDSC.In addition,PID1 overexpression activated prolifer-ation related genes, promoted anti-inflammatory genes, suppressed pro-inflammatory genes, induced glycolysis and lipid metabolism genes to facilitate tumorigenesis in liver. Importantly, PID1 exerted its tumor-promoting function through binding to epidermal growth factor receptor(EGFR)and activation of downstream KRAS/ERK pathway.As such,PID1 exist trimethylation of histone H3 at lysine 4(H3K4me3) modification and IR up-regulated the expression of PID1 by activation the H3K4me3 modification. CONCLUSION PID1 is a new gene that exerts both liver cancer-promoting and insulin resistance inducing function.IR accelerates liver cancer development and progression partially dependent on the activation of PID1.