Objective To investigate the feature of CT perfusion of the lower limb skeletal muscle in patients with diabetic peripheral arterial disease (PAD).Methods It was a prospective study that collected out-patients and in-patients of interventional vascular surgery from January 2008 to January 2013.The patients were divided into three groups,including 27 patients (54 limbs) in diabetic PAD group,27 patients (54 limbs) in common PAD group and 9 patients (18 limbs) in control group.Patients in diabetic PAD group were selected when PAD were diagnosed through CTA and patient had the exact history of diabetes.There were 54 limbs in diabetic PAD group,including 10 limbs in Fontaine Ⅰ class,21 limbs in Fontaine Ⅱ class,14 limbs in Fontaine Ⅲ class and 9 limbs in Fontaine Ⅳ class.Patients in common PAD group were selected when PAD were diagnosed through CTA,patients those had the exact history of diabetes or coronary heart disease were exclusion.Patients in control group were collected with negative CTA results.CT perfusion scans of lower extremities were performed in all patients.Time density curve (TDC),Blood flow (BF),blood volume (BV),mean transit time (MMT) and permeability surface (PS) of skeletal muscle in different pathologic stage were obtained with perfusion software.The differences of perfusion parameters among diabetic PAD group,common PAD group and control group were compared by analysis of variance; and the differences of perfusion parameters among control group and all Fontaine classes in diabetic PAD group were also compared.Results TDC of normal skeletal muscle in control group continued to rise,and raise rapidly at an early stage; TDC of diabetic PAD group and common PAD group continued to rise,but raise slowly; the TDC of ischemia skeletal muscle has smaller slope and lower peak value than that of control group.The values of BF were (10.41±0.92) ml · 100 ml-1 · min-1 in control group,(13.37± 1.15) ml · 100 ml-1 · min-1 in diabetic PAD group and (17.12 ±0.81)ml· 100 ml-1· min-1in common PAD group.The values of BV were (1.04± 0.13)ml/L in control group,(1.23 ±0.16)ml/L in diabetic PAD group and (1.84 ±0.23) ml/L in common PAD group.The values of MTT were (11.63 ± 1.45) s in control group,(7.92±0.35) s in diabetic PAD group and (7.82±0.38) s in common PAD group.The values of PS were (3.46±0.84) ml· 100 ml 1· min-1 in control group,(9.84±0.87) ml· 100 ml-1· min-1 in diabetic PAD group and (12.11 ±0.70)ml· 100 ml-1· min-1in common PAD group.The differences of the values of BF,BV,MTT and PS among the three groups were statistically significant (F values were 10.892,4.492,27.543 and 20.506,P all＜0.05).The differences of the values of BF,BV among control group and all Fontaine classes in diabetic PAD group were not statistically significant(P all＞0.05),the differences of the values of MTT,PS were statistically significant.And the differences of the values of MTT,PS between control group and each Fontaine class in diabetic PAD were statistically significant (P all＜0.05).Conclusions CT perfusion imaging of Lower extremity skeletal muscle can prompt the existence of early skeletal muscle ischemia for diabetic PAD.The method can be valuable for clinical early diagnosis.

Objective To pool the data of studies and evaluate the efficacy and safety of TNFα blocking agents in the treatment of ulcerative colitis(UC).Methods The randomized clinical trials(RCT)that compared the efficacy or safety of TNFα in the treatment of UC were researched from Pubmed. OVID. EMBASE. Cochrane library, CNKI, Wanfang data and VIP Chinese Scientific and Technologic Periodical Database. Statistical heterogeneity between trials was evaluated by Revman 5.0 and was considered to exist when P＜0.1.Heterogeneity of the included articles was tested. which was used to select proper effect model to calculate. Publication bias was investigated through visual inspection of funnel plots. Results Nine RCT including 1226 cases were analyzed. Eight hundred and six cases had received TNFα treatment and 420cases had received placebo or glucocorticoid treatment. Compared with placebo or glucocorticoid groups, TNFα group achieved significantly higher rates of short-term clinical response, short-term clinical remission, long-term clinical response.10ng-term clinical remission and the total OR were 2.36(95%C,1.34-4.15),2.42(95%CI 1.22-4.81).3.22(95%CI2.28-4.55)and 2.82(95%CI1.91-4.16)respectively. TNFα group was less likely to undergo colectomy than placebo group and the total OR was 0.31(95%CI0.20-0.48).TNFα could not improve the mucosal healing and quality of lire. No significant difference was found in adverse effect between TNFα group and placebo or glueoeortieoid group(OR=1.07(95%CI0.55-2.09,P=0.84)).The rate of serious adverse effect in TNFα group was less than placebo or glueoeorticoid groups (OR=0.65,95%CI0.48-0.89,P=0.007).Inspection of the funnel plots for all dichotomous data measures had not revealed evidence of publication bias. Conclusions Patients with moderately to severely active UC treated with TNFαhave effective clinical response and clinical remission and are less likely to undergo colectomy than those receiving placebo or glucocorticoid. TNFα treatment is safe for UC but can not improve the mucosal healing and quality of life. Large-scale, high-quality RCTs ale needed to confirm or refuse the available evidence.

Objective To compare the effectiveness and safety of radiofrenquency ablation(RFA) with other therapeutic methods for patients with early hepatocelluar carcinoma(HCC). Methods Randomized clinical trials(RCTs)which compared the efficacy or safety of RFA with other therapeutic methods for primary hepatocellular carcinoma in Cochrane library,EMBASE,PubMed,OVID and CBM were searched.Trials were considered of high quality if methodological quality score was 3 or more according to Jadad standard.Statistical heterogeneity between trials was evaluated bv STATA 9.0 and considered to exist when P＜0.1.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Sensitivity analysis was performed and publication bias was investigated through visual inspection of funnel plots and Egger regression model.Results Six RCTs including 862 cases were analyzed.As compared with other therapeutic approaches,RFA significandy increased 3-year overall survival rate and reduced local recurrence rate of early hepatocelluar carcinoma:the total OR were 2.06(95%CI being 1.54-2.77,P=0.000)and 0.40(95%CI being 0.28-0.57,P=0.000)respectively.As compared with other therapeutic approaches,the total OR of new HCC recurrence rates,extrahepatic metastasis rate and major complications in patients with HCC treated with RFA were 0.92 (95%CI being 0.68-1.24),0.98(95%CI being 0.30-3.22),1.35(95%CI being 0.49-3.77)respectively,showing no significant differences(P＞0.05).Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias(P=0.670,0.160,0.884,0.087,0.317,respectively,by Egger regression model).Conclusions RFA is superior to other treatment methods with respect to local recurrence and 3 year overall survival in early HCC and is the preferred tberapeutic method for small HCC because it is minimally invasive,simple and convenient.

Objective To explore the effects of upper limb robot-assisted therapy on motor recovery in acute stroke patients. Methods From August, 2013 to September, 2014, 46 acute stroke patients at their first-ever stroke were enrolled and randomized into experimental group and control group with 23 cases in each group. Both groups received routine therapy. Additional robot-assisted therapy was provided to the experimental group, and additional repetitive movement training was provided to the control group, 30 minutes a day, 5 days a week for 12 weeks. Fugl-Meyer Assessment-Upper Limb (FM-UL), modified Ashworth Scale (MAS) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and hands, the muscular tension of elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FM-UA, MAS and MBI improved in both groups (t>3.856, Z>1.889, P<0.05), and the scores of FM-UA and MAS were better in the experiment group than in the control group (t=-2.386, Z=-2.625, P<0.05), however, there was no significant difference in the score of MBI between two groups (t=-1.326, P=0.098). Conclusion Upper limb robot-assisted therapy can facilitate the recovery of the motor function of upper limbs in acute stroke patient.

Objective:To explore the directed forgetting ability of elder people to disease/death-related words under the conditions of the neutral and negative emotion.Methods:Thirty-six elder people and thirty-seven young people were included in this study.The directed forgetting effects to disease/death-related words were compared by using item-method directed forgetting paradigm under the neutral and negative emotional conditions.Results:Under the neutral and negative emotion conditions,higher recognition of to-be-remembered (TBR) than to-be-forgotten (TBF) words in elder group and younger group (Ps ＜ 0.05).The elder group showed the weaker effect of directed forgetting than younger group[neutral emotion:(0.4 ± 0.1) vs.(0.6 ± 0.1);negative emotion:(0.3 ± 0.1) vs.(0.7 ± 0.04),Ps ＜ 0.05].Under the negative emotion condition,elder people showed stronger effect of directed forgetting for sensitive words compared with control words[(0.4 ± 0.1) vs.(0.1 ± 0.1),P ＜ 0.001].Conclusion:The results suggest that the directed forgetting ability of elderly is weaker than that of young individuals,the ability of non-sensitive words than that with sensitive words,and the directed forgetting effect of elder people tonon-sensitive words in negative emotion is weaker than that in neutral emotion.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; pathology ; Nephrectomy ; methods

Objective: To explore the effect of early enteral nutrition on post-operation recovery of patients undergone liver transplantation.Methods:86 patients undergone liver transplantation were enrolled,among which 37 cases undertook early enteral feeding and 49 cases were mainly giren parenteral nutrition.The infection rate,metabolism condition and immunol function of post-operation were compared.Results:Patients in EN group had a high lever of blood globulin and a lower infection rate,and their liver function recovery,rise of pre-albumin and decrease of CRP were much quick than those of PN group.Conclusion:Early enteral nutrition in post-operation patients can reduce stress reaction,promote synthesis metabolism,improve the recovery of liver cell and decrease the chances of infection.

AIM To study the anti-inflammatory effects and mechanisms of pristimerin. METHODS Several inflammatory models were established, such as ear edema induced by croton oil, hind paw swelling by carrageenan, elevation of capillary permeability by acetic acid in mice and a-cute peritonitis induced by carrageenan in rats. Protein content was measured by Coomassie brilliant blue method, nitric oxide (NO) content by Griess reaction assay, N-acetyl-?-D-glucosamini-dase (NAG) activity by colorimetry, superoxide dismutase (SOD) activity by hydroxylamine method, catalase (CAT) activity by ultraviolet spectro-photometry, and malondialdehyde (MDA) content by fluorescence method in peritoneal exudate in rats. RESULTS Pristimerin ip 0. 156 - 0. 625 mg ? kg-1 or im 1-4 mg - kg-1 inhibited ear edema, hind paw swelling, and elevation of capillary permeability in mice. In the rat peritonitis induced by carrageenan, pristimerin im 1 - 2 mg ?kg-1 reduced neutrophil counts, lessened protein and NO content, inhibited the production of MDA and decreased NAG activity, while augmented the SOD and CAT activity in exudate. CONCLUSION Pristimerin has a significant anti-inflammatory effect which may be related to the inhibition of NO production, scavenging oxygen free radicals, anti-lipoperoxidation and stabilizing lysosome membrane.

Objective To observe the alteration of astrocyte and apoptosis in neonatal hypoxic-ischemic encephalopathy(HIE).Me-thods The pathological brain specimens of 25 newborns who died of HIE were observed macroscopically and microscopically,included male 14 cases and female 11 cases.The immunochemistry staining with glial fibrillary acidic protein(GFAP)and in situ end terminal dexynucleotidy 1 transferase mediated deoxyuridine triphosphate-biotion nick and labeling(TUNEL)methods were used to observe the changes of astrocyte and the neurons apoptosis in HIE.The relationship between the change of astrocyte and the neurons apoptosis and the occurrence of HIE and course of disease were further synthetically analyzed.Results The brain specimens of 25 newborn HIE had apoptosis cells at the different level.The degree of apoptosis of cerebral neurons was severe in the cases of 24 h-6 d survival(P

Objective To primarily explore the efficacy and adverse effects of the combination of fiudarabine,cytarabine and granulocyte colony-stimulating factor(G-CSF)(FLAG regime)therapy for relapsed and refractory acute leukemia in children.Methods Ten children were treated with the FLAG regime for relapsed and refractory acute myeloid leukemia (AML)and acute lymphoblastic leukemia(ALL)from Feb.2007 to Mar.2010.There were 8 male and 2 female,with mean age 8 years(ranging from 4 to 12 years).AML was diagnosed in 8 children,AML-M2 in 5 cases,AML-M4 in 3 cases.ALL was diagnosed in 2 children,both were B-ALL.Six children had refractory disease,and 4 cases were in relapse.FLAG regime included:fludarabine 25 mg?m-2?d-1,days 1-5;cytarabine 2 g?m-2?d-1,days 1-5;G-CSF 150-300 ?g?d-1,from day 0 to neutrophils ≥0.5?109 L-1.Results Complete remission was obtained in 6 children(60%),partial remission was obtained in 1 child(10%),and 3 children were considered non-response(30%).The total effective rate was 70%.For 8 children with AML,6 children had achieved complete remission(75%),2 children had non-response(25%).While in children with ALL,1 child got partial remission,and the other one had non-response.Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity were not observed in these children.And there were no chemotherapy-related death.Conclusions The FLAG regime is effective in treatment of children with relapsed and refractory acute leukemia,especially for the children with the relapsed and refractory AML.The adverse effects from this regime were well tolerated.FLAG regime can give children with relapsed and refractory acute leukemia another chance.