Objective To explore application of the bolus-triggered technique and optimal match between collimation and pitch of MSCTA in intracranial and cervical arteries.Methods(1)The small-dose tests were performed in 19 healthy volunteers and the theoretical threshold was obtained by the time-density curve.(2)forty healthy volunteers were divided randomly into two groups and the scanning parameters were as follows.Group A:collimation 1.0 mm,pitch 1.750. Group B:collimation 2.5 mm,pitch 0.625. Statistical significance was determined with the X~2 test and t test(?=0.05).Results(1)In 19 volunteers,CT value 4 seconds before the peak was 75 HU,the CT value at the beginning segment of the carotid artery and the C_1 segment of internal carotid artery was in accordance with the standard.(2)Image quality ofⅠ,Ⅱgrades artery structures of group B was superior to that of group A.Image quality ofⅢ,Ⅴ grades artery structures of group A was superior to that of group B.Conclusions(1)MSCTA in intracranial and cervical arteries can display systematically the cerebral and carotid arteries.(2)The bolus-triggered technique can improve the image quality of the target vessels.The image quality of the MSCTA of intracranial and cervical arteries is better with the threshold of 75 HU on the basis of 3.5 ml/s injection rate.(3)On the basis of the same other parameters,the optimal scanning parameters are a collimation of 1.0 mm with a pitch of 1.750.

Objective To compare the effects of fluvastatin and valsartan on the inflammatory cytokines in the early stage of type 2 diabetic nephropathy and their protective effects on to diabetic nephropathy. Methods Ninety patients with early stage of type 2 diabetic nephropathy were divided into three groups, 30 patients receiving routine hypoglycemic agents (DN1) as control,30 patients receiving routine hypoglycemic agents plus valsartan (DN2) and the other 30 receiving routine hypoglycemic agents plus fluvastatin (DN3). Blood glucose, blood lipid,serum creatinine and C reactive protein(CRP),24-hour urine protein,urinary albumin excretion rate (UAER) and several inflammatory cytokine were measured before and after treatment. Results ( 1 ) No significant difference of the levels of serum CRP,TGF-β1,IL-6,TNF-α, IL-18 at the baseline were observedamong these three groups.In the DN2 group,after treatment,IL.6 was([15.99±2.87]ng/L and[17.64±2. 131 ,P <0. 05) ,TGF-β1 was ( [33.54 ±10. 69] μg/L and [40. 11 ± 12. 08] μg/L,t = -2. 921 ,P <0. 01 ),IL-18 was ( [139.65±66. 37] ng/L and [158.74±74. 20]ng/L,t = -2.053,P <0. 05),CRP was ( [5. 12±3. 54] mg/L and [6. 08 ±3. 39] mg/L, t = - 2. 072, P < 0. 05 ) after and before treatment, respectively. All abovemented indices significantly decreased after treatment. In the DN3 group, IL-6 was ( [15. 39 ±2. 77] ng/L ng/L,t = -3. 651 ,P <0. 01 ) ,TGF-β1 was ( [31.19 ±10. 48] μg/L and [37. 11± 11.76] μg/L,t = -2. 963,P<0.01),IL-18 was ([141.54 ±66.65] ng/L and [158.01±73.23] ng/L,t = -2. 182,P <0.05),CRP respectively. All abovemented indices significantly decreased after treatment No significant difference was observed on inflamaory factors after treatment between the DN2 and DN3 group ( P > 0. 05). (2) In the subgroup that there was no difference in blood pressure between before and after treatment in both the DN2 and DN3 group,in the DN3 group,UAER was ([63. 1 ±31.7] μg/min and[82.9±40.0] μg/min,t = -2. 145,P <0. 05) ,24 h total urokinase protein was ( [0. 14 ±0. 11] g/24 h and [0. 18±O. 15] g/24 h, t = - 2. 438, P <0. 05 ), microalbuminuria/urine creatinine was ( [ALb/Cr] [114. 7±68. 1] mg/g and [162.0±83.8] mg/g,t = - 2. 399, P < 0. 05 ) after and before treatment. All abovemention indices significantly decreased after treatment. In the DN3 group, UAER was ( [65.5 ±32. 6]μg/min and [83.5 ±42. 1]μg/min,t = - 2. 131, P <0. 05 ),24 h total urine protein was ( [0. 14 ±0. 11] g/24 h and [0. 18±0. 15] g/24 h, t = - 2. 438, P < 0. 05 ),0. 05 ) after and before treatment. All abovemention indices significantly decreased after treatment. No significant difference was observed after treatment between the DN2 and ON3 group ( P > 0. 05 ). Conclusion Both valsartan and fluvastatin are able to protect the renal function of patients with type 2 diabetic nephropathy by decreasing the levels of urine proteins and correlated serum inflammatory cytokines.

Objective To investigate the effect of chronic infection of Toxoplasma gondii on the spatial learning and memory capability in mice.Methods Toxoplasma tachyzoites(RH strain)were reanimated at 37 ℃ after 15 days' storage at-20 ℃,and injected intraperitoneally to mice of the experimental group each with 7.7?105.Normal saline was given to the control group,0.5 ml per mouse.Two months later,all mice were tested in the Morris Water Maze.Smears of the mice brain homogenate and pathological sections were examined.Results ① The density of cysts in the brain homogenate was 15/HP,and there was no evident pathological change in the hippocampus and adjacent areas of mice in the brain in the experimental mice.② Latency to platform,cumulative distance to the platform,total distance traveled in both experimental and control groups decreased significantly with the increase of training days(P

ObjectiveTo explore the relationship between the negative co-inhibitor programmed death-1 ( PD-1 ) and the pathogenesis of myasthenia gravis ( MG), by detecting the expression of PD-1 and programmed death ligand-1 ( PD-L1 ) on peripheral blood mononuclear cells (PBMCs) and soluble PD-1 (sPD-1) in plasma from myasthenia gravis patients. MethodsPeripheral blood samples were collected from 45 MG patients and 33 healthy persons without prednisone or other immunodepressant treatment during the half year ahead of withdrawal.The expression of PD-1 and PD-L1 on PBMCs were detected using immuno-fluorescence labeling and flow cytometry, and the concentrations of sPD-1 in plasma were measured using an ELISA kit. Results(1) The proportion of CD4+ PD-1 + T cells, as well as CD14+ PD-L1 +monocytes of the MG group was higher than that of the control group. There were no significant differences in the proportion of CD4+ PD-1 + T cells or CD14+ PD-L1 + monocytes in the MG sub-groups between different genders or MG types. While the proportion of CD4+ PD-1 + T cells of the late-onset MG (age ≥40) group was higher than that of the early-onset MG group (age ＜40). And it was higher in the MG patients with thymoma or thymus hyperplasia than that from the MG patients with normal thymus. The proportion of CD14+ PD-L1 +monocytes from the MG patients with thymoma or thymus hyperplasia group decreased obviously compared with that of the patients with normal thymus group; but no difference could be found between the late-onset group and early-onset group. (2)The concentration of sPD-1 in the plasma from the group of MG patients was(6. 92 ±0. 72) ng/ml,which was higher than that of the healthy control group ( (3.28 ±0. 42) ng/ml),even more, it was significantly higher in the early-onset MG group than that of the late-onset MG group,there was a negative correlation( r =-0. 526, P =0. 000) between the age of onset and the concentration of sPD-1. ConclusionsThe increased expressions of PD-1 on CD4+ T cells and PD-L1 on CD14+ monocytes in MG patients suggested the involvement of the couple of molecules in the pathogenesis of MG.Higher concentration of soluble PD-1 in the plasma of patients with MG suggested that it might disturb the ligation of PD-1 and PD-L1 on T cells and antigen presenting cells, which might result in the abnormal transportation of the negative modulating signal, and accelerate the pathological progress of MG.

OBJECTIVETo explore the effect of the level of lipid peroxidation and biomechanical properties after chronic treating with tetrahydrobiopterin (BH4) in thoracic aorta of hyperlipemia (HL) rats.

METHODSHL rats were given BH4 chronically. The opening angle in the zero-stress state and the relationship between pressure and diameter (P-D) of mesenteric artery were measured by computer image 8, 16, and 24 week-old respectively.

RESULTSTreating with BH4 chronically from 8 week-old in HL rats, there was a significant increase in the zero-stress state of opening angle of thoracic aorta. The P-D curve of mesenteric artery moved upward.

CONCLUSIONTreating with BH4 prevented the structure and function of artery from abnormal changing, and attenuated lipid peroxidation in HL rats.

Animals ; Aorta, Thoracic ; metabolism ; physiopathology ; Biomechanical Phenomena ; drug effects ; Biopterin ; analogs & derivatives ; therapeutic use ; Hyperlipidemias ; drug therapy ; Lipid Peroxidation ; drug effects ; Male ; Rats ; Rats, Wistar

Objective To investigate the efficacy of heparin gelatin sponge stickers in the treatment of traumatic perforation of tympanic membrane. Methods Total of 79 cases (83 ears ) of traumatic perforation of tympanic membrane were randomly divided into two groups:the test group had 54 patients ( 58ears),and the control group had 25 cases (25 ears ).The test group received the treatment of heparin gelatin sponge stickers,and the control group received conservative traditional drying method. All the subjects were followed up for 4 weeks,observed and recorded the rate and healing period of traumatic tympanic membrane.Results In 4-week's follow-up,56 ears were cured in the test group,with a rate of 96.55％.Fourteen ears were cured in the control group with a rate of 56.00％.The healing rate of test group was significantly higher than that of the control group( x2 =18.79,P ＜0.01 ).The average of healing period was 17.6 days in the test group,and 32.0 days in the control group. There were significant differences in healing period between two groups( t =6.37,P ＜0.01 ).All the cured tympanic membrane in the test group was morphologically complete.In all followed up patients,there were no allergies and signs of infection,as well as other adverse reaction in the process of healing.Conclusion The heparin gelatin sponge can effectively enhance closure of the traumatic perforation of tympanic membrane and can shorten the healing period of traumatic perforation of tympanic membrane,and the smaller of the perforation,the shorter of healing period.

Objective To summarize the experiences of diagnosis and treatment for blunt tracheobronchial injuries ( BTI) . Methods From January 1993 to December 2013, 15 patients were diagnosed with BTI and underwent surgical treatment at our hospital.Mean age of the 15 patients (11 men and 4 women) was 26.4 ±4.5 years.All the patients had a history of trauma, which included crushing injury in 8 cases, deceleration injury in 4, fall injury in 2, and traction-type injury in 1.BTI loca-tion: right main bronchus in eight cases, left main bronchus in four cases, upper trachea in one case, lower trachea with the right main bronchus in one case, and cervico-thoracic trachea with left main bronchus in one case .Thoracic computerized tomo-graphy was performed in 15 patients, which showed pneumothorax, subcutaneous emphysema, pneumomediastinum or falling lung sign of Kumpe.Preoperative fiberoptic bronchoscopy examination was performed in 15 cases, which included bronchial atresia in 9 cases, bronchial transection in 3 cases, laceration of trachea in 2 cases, and tracheal transection in 1 case.An e-lective surgical procedure after BTI was performed in 10 cases, and emergency surgery was performed in 5 cases.Tracheo-bron-chial laceration repair were performed in 2 cases, tracheal end-to-end reanastomosis in 1 case, and bronchial end-to-end re-anastomosis in 12 cases.Results There was no operative death, and one case was complicated with anastomotic stenosis.The average operation time was 205.7 ±41.3 minutes, and the average blood loss was 268.4 ±109 ml.The postoperative hospi-tal stay was 11.6 ±3.7 days on average.Follow-up was completed in 15 patients (mean, 29.3 months), and 15 patients were all symptomatic improvement .Conclusion The most common site of BTI was the right main bronchus near Carina parts .Al-though the diagnosis and treatment are often delayed , our findings indicate that chest CT and endoscopic findings could be used for the diagnosis of BTI.Surgical resection and reconstruction are effective methods to repair BTI successfully even many months after they occur.Often they do not require the resection of pulmonary parenchyma .

BACKGROUNDDespite technical advances in tools used to facilitate implantation of cardiac resynchronization therapy (CRT) devices, there are many hurdles related mainly to the variation in the anatomy of the coronary veins. One such difficulty is the presence of a very sharply-angulated or tortuous of the lateral or posterolateral cardiac vein.

METHODSTotally 44 patients, 28 males and 16 females, with congestive heart failure and intraventricular conduction delay were studied retrospectively. There were 23 patients who had left ventricular (LV) lead implantation using standard techniques and equipment. For the other 21 patients with LV lead implantation we used the Attain Select II catheter delivery system. The patients were seen every 3 - 6 months for 12 months and the efficacy of the primary procedure, LV lead implantation time, procedure and fluoroscopy time and the complications associated with the two techniques were evaluated.

RESULTSThere were no significant differences in the age, gender, New York Heart Association (NYHA) functional class, ischemic etiology, QRS duration, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and LV dyssynchrony between the two groups. The LV lead implantation time, procedure time and fluoroscopy time were significantly shorter in the group using the Attain Select II catheter delivery system; LV lead implantation time from (51 ± 7) minutes to (40 ± 7) minutes (P < 0.001), procedure time from (143 ± 17) minutes to (124 ± 18) minutes (P = 0.001), and fluoroscopy time from (45 ± 7) minutes to (35 ± 6) minutes (P < 0.001). A successful procedure of LV lead implantation was significantly improved from 17/23 (74%) patients using the standard techniques and equipment, to 20/21 (95.3%) patients using the Attain Select II catheter delivery system (P = 0.06)

CONCLUSIONIt is feasible and safe to implant LV leads through the coronary sinus using the Attain Select II catheter delivery system.

Aged ; Cardiac Resynchronization Therapy ; methods ; Female ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ventricular Dysfunction, Left ; therapy

OBJECTIVETo determine the risk factors in the development of central nervous system (CNS) congenital malformations.

METHODSA hospital-based 1:2 matched case-control study was conducted. Each case was matched with two normal controls on sex and residential area, date of birth, within half a year. By means of simple and multivariable conditional logistic regression, 48 factors were analyzed.

RESULTSMaternal exposure to pesticide or having cold with fever, family history of positive congenital malformations, preference eating pickled vegetables, negative life events, large consumption of meat, eggs, beans and milk during pregnancy and paternal exposure to poisonous chemicals were significantly associated with CNS congenital malformations, with odds ratios 16.471, 12.621, 10.246, 7.274, 3.730, 0.229, 5.616, respectively.

CONCLUSIONSMaternal exposure to pesticides, cold with fever, positive congenital malformations family history, preference of eating pickled vegetables, negative life events during pregnancy, and paternal exposure to poisonous chemicals were the key risk factors contributing to CNS congenital malformations, while maternal exposure to big consumption of meat, eggs, beans and milk during pregnancy was protective factors that reducing CNS congenital malformations.

Adult ; Case-Control Studies ; China ; epidemiology ; Environmental Exposure ; Female ; Humans ; Male ; Maternal Exposure ; Nervous System Malformations ; epidemiology ; etiology ; Neural Tube Defects ; epidemiology ; etiology ; Paternal Exposure ; Pregnancy ; Risk Factors

OBJECTIVESTo explore the effect of c-Myc, Ki-67, MMP-2 and VEGF expression on prognosis of hepatocellular carcinoma (HCC) patients who had tumor resection.

METHODSPrimary HCC patients who underwent tumor resection were retrospectively analyzed. The maximum size of their mononodular tumors was less than 5 cm, and no intrahepatic arterial chemotherapy was performed before the resections. They were followed up after resection and the time of recurrence was recorded. They were divided into 2 groups: group A (15 cases): tumor recurred within 1 year after tumor resection; group B (15 cases): with tumor recurrence after 2 years or without it. Paraffin sections of the tumors were remade from their old blocks. Immunohistochemistry stainings were performed with c-Myc, Ki-67, MMP-2 and VEGF monoclonal antibodies. Staining intensity of the tumor and paracancer tissues was quantitatively analyzed.

RESULTSc-Myc, Ki-67, MMP-2 and VEGF expressing intensities in cancer tissues in group A were higher than those in group B, and their expressed intensities in paracancer tissue in group A and B were not significantly different.

CONCLUSIONThe expressions of c-Myc, Ki-67, MMP-2 and VEGF in cancer tissues of the patients are related to the recurrence of their HCC after tumor resection.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; surgery ; Female ; Humans ; Ki-67 Antigen ; biosynthesis ; genetics ; Liver Neoplasms ; metabolism ; surgery ; Male ; Matrix Metalloproteinase 2 ; biosynthesis ; genetics ; Middle Aged ; Postoperative Period ; Prognosis ; Proto-Oncogene Proteins c-myc ; biosynthesis ; genetics ; Retrospective Studies ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics