Objective To compare the effect of contrast medium by left or right side ulnar vein injection on the quality of enhanced CT images. Methods One hundred and sixty-five consecutive patients underwent thoracic CT contrast enhancement examination with multi-detector CT and scan delay time was 60 seconds. According to group sampling, subjects were divided into three groups: young age group ( < 40 years old) 35 cases, middle age group( 40-60 years old ) 60 cases, elder age group( > 60 years old ) 70 cases, and then patients were divided into two groups by random digits table with left side ulnar vein injection (left vein group, 77 cases ) and right side ulnar vein injection ( right vein group, 88 cases ) . Anteroposterior dimension between posterior border of manubrium sterni and anterior border of aortic arch (or brachiocephalic artery) where left brachiocephalic vein acrossing was measured and analyzed with relation of image quality. Results The anteroposterior dimension showed a statistical significant difference between young age group and elder age group(P< 0.05), but no statistical difference between middle age group and elder age group(P> 0.05). The CT value in left vein group and right vein group was (106 ?24 ), (149 ?29 ) HU respectively, and there was statistical difference between two groups (P<0.05). The good quality CT image in left vein group and right vein group was 61.0% (47/77),79.5% (70/88), and there was statistical difference (P <0.05). Conclusion CT contrast enhancement examination with right ulnar vein injection rather than left side may improve the quality of images by avoiding compression of left brachiocephalic vein in some patients .

Objective To discussed the relationship between multiple sclerosis(MS)and the genepolymorphism of HLA hoping that these results would be useful for further pathogeny studies,diagnoses,therapy and prognosis estimation of MS.Methods HLA-Ⅱ alleles in 32 patients with MS,36 nonimmunological neurological disease controls and 30 healthy controls,were identified by polymerase chain reaction-specific sequence primers(PCR-SSP)methods.Results The gene frequency of HLA-DR16 (7/32,1/36,0/30),DR11(7/32,3/36,1/30)and DQB1*0502(10/32,6/36,4/30)in patients with MS were higher than those in the 2 control groups.The gene frequency of DQB1*0601(8/32,12/36,17/30)in the patients with MS was lower than the controls.However,only the HLA-DR16 had significant difference (χ2=7.398,RR=17.94,P=0.011;χ2=5.52,RR=9.8,P=0.022).Conclusion HLA-DR16 alleles may be associated with the susceptibility to MS in Guizhou Province.

ObjectiveTo study the mechanism of differentiation of mesenchymal stem cells(MSCs) into neuron-like cells in vitro.MethodsMSCs of Wistar rats were separated and cultured, and then induced with DMSO and BHA in vitro. The specific marking proteins of neurons, glia and neural stem cells were detected before preinduction, at 24h after preinduction, at 6h, 24h, and 48h after neuronal induction.ResultsAfter the inducement, many MSCs turned into bipolar,multipolar and taper,and then intersected as network structure. Nestin was strong positive at 6h after neuronal induction, and decreased at 24h, 48h after the induction. NeuN was present at 6 h after neuronal induction, and increased at 24h, 48h after the induction.ConclusionMSCs can be induced into neural stem cells(NSCs) at first, and then differentiate into neuron-like cells in vitro.

Objective To study the changes of ambulatory blood pressure parameters after endovascular treatment.Methods The ambulatory blood pressure of 7 patients with artery stenosis was tested before and after endovascular treatment,and the coefficient of variation(CV)was calculated.Results All patients' blood pressures decreased after endovascular treatment.The CV of blood pressure of patients with internal carotid stent decreased,but the CV of blood pressure in patients with vertebro-basilar artery stent increased.Conclusion The effects of stent on blood pressure is far from clear.

Aim To research the synergistic effect of hyperlipoproteinemia and Aβ in the processing of Alzheimer′s disease.Methods Seventy SD rats were randomly divided into seven groups, and dealt with D-gal(hypodermic injection), hyperlipemia diet, microinjection into both side of CA1 section in hippocampus, independently.Morris water maze(MWM) test was used to evaluate the spatial memory impairments.Tau and tau(pThr181) pathology in the hippocampus were detected using Western blot and immunohistochemistry.Nissl′s staining was used to detect cell apoptosis.Results Aβ25-35-treated rats showed significant impairments of spatial memory in MWM test, especially in the group of D-gal+Aβ25-35+HLD(P<0.01).Furthermore, these rats treated with Aβ25-35, D-gal, and hyperlipemia diet, exhibited significantly increased phosphorylation of tau, particularly in the Thr181 site.Conclusion Hyperlipoproteinemia is the risk factor for older person, which could strengthen the toxic effect of Aβ, and promote phosphorylation of tau.

Objective To study the relationship between the genetic polymorphism of interleukine-6 (IL-6)-174 and the response to benazepril treatment in patients with hypertensive renal damage. Methods Two hundred and eighty-four patients with hypertension were enrolled in this study. The hypertensive renal damage was defined by the measurement of urinary albumin excretion rate (UAER). One hundred and sixty healthy subjects were enrolled simultaneously as control group. Blood samples were obtained from all the subjects, and plasma levels of IL-6 and the genotype of gene IL-6-174 were detected. The patients with hypertensive renal damage were treated with benazepril for 16 weeks. The responses were evaluated by the changes of UAER level to benazepril in different genotypes. Results Genotype CC was the most common of the gene IL-6-174 in patients with hypertension, followed by GG and GC successively, with the G/C allele frequency of 47%and 53%(P<0.05), while in patients with hypertensive renal damage, GG was the most common genotype of the gene IL-6-174, followed by GC and CC successively, with the G/C allele frequency of 68%and 32%(P<0.05). After benazepril treatment, the UAER was decreased most in patients with genotype CC, followed by GC and GG successively ( P<0.05). Conclusion The G allele frequency of the gene IL-6-174 is related with hypertensive renal damage in patients in Ningxia, with GG as the most common genotype. The patients with CC genotype have the best response to benazepril treatment, with most decreased UAER.

Objective　To evaluate the real-life clinical characteristics of benign prostatic hyperplasia (BPH) patients with moderate and severe enlarged prostate.　Methods　From February 2009 to January 2011,a prospective,non-interventional,multi-center study was conducted on 2 758 BPH patients recruited from 32 hospitals in 10 cities nationwide with the following criteria:prostate volume (PV) larger ≥30 ml and international prostate symptom score (IPSS) ≥ 8. Patient age,PV,IPSS,Qmax medical treatment patterns and physician prescription practice were recorded. The demographic information and clinic characteristics were evaluated as well.　Results　The mean patient age,PV,IPSS score and Qmax of 2 786eligible patients were 69.2 ±8.5 years (50 to 97 years),47.8 ±16.6 ml (30 to 165 ml),17.5 ±5.4 (8to 35 ) and 11.6 ± 3.6 ml/s (2 to 36 ml/s),respectively.Age subgroup analysis pointed that the mean PV and Qmax in 50 -55 years group were 42.8 ml and 13.3 ml/s compared to 49.0 ml and 11.1 ml/s in the group beyond 71 years.Both parameters had statistical significances (P ＜ 0.05 ). For 56.1％ of the patients,it was their first time coming to clinic seeking for medical advice. Of whom,22.8％ patients had taken BPH prescription medication regularly beyond two weeks.Only 31.3％ of the patients had a history of BPH shorter than one year.22.9％ and 18.3％ of the patients had a history of BPH for 1 -2 and 3 -4 years.And 27.5％　of the patients had a history of BPH related symptoms longer than five years. Only 52.6％ patients were treated with α adrenoceptor antagonists + 5-α reductase inhibitor by urologists according to the recommendation in Chinese guideline of BPH.　Conclusions　The symptoms and key parameters of moderate and severe benign prostatic hyperplasia (BPH) patients become worse and more with increased age in China.It is quite late for most patients coming to clinic seeking for their first medical advice.Furthermore,there is a huge gap between urologist prescription and the recommendation of the Chinese guideline on BPH.

Objective:To investigate the expression of circhipk3 in microglial cells in heat-induced neurological injury, and to preliminary analyze the effect of circhipk3 on microglial polarization in heat-induced neurological injury.Methods:Mice were randomly (random number) divided into a control group and a heat radiation disease 0.8 h group (HS 0.8), a heat radiation disease 8h group (HS 8), and a heat radiation disease 24 h group (HS 24). By establishing a mouse model of heat shock (HS), heat-damaged brain tissue was obtained, microglia were isolated and RNA was extracted. Quantitative PCR method was used to detect M1 and M2 marker molecules in microglia, and to evaluate the polarization direction and type of microglia. The expression level of circhipk3 was detected in microglial cells in heat-induced neurological injury, and the effect of circhipk3 on microglial polarization was further elucidated by intervening the expression of circhipk3 in microglial cells.Results:The expression of CD45 and CD11-b in the HS 8 group was significantly higher than that in the control group [(4.41±0.18) vs. (1±0.15), P=0.000], [(3.47±0.19) vs (1±0.15), P=0.000] , and the CD45 and CD11-b of the HS 24 group was significantly lower than that of the HS 8 group [(1.34±0.15) vs. (4.41±0.18), P=0.000], [(1.38±0.21) vs. (3.47±0.19), P= 0.001]. At the same time, the expression of CD206, FIZZ and Arg1 in the HS 8 group started to increase compared with the control group [(1.59±0.16) vs. (1±0.12), P=0.014], [(1.62±0.15) vs. (1±0.15), P=0.002 ], [(2.23±0.28) vs. (1±0.19), P=0.004], and CD206, FIZZ, and Arg1 in the HS 24 group were significantly higher than those in the control group [(2.67±0.20) vs. (1±0.12), P=0.002], [(2.19±0.15) vs. (1±0.15), P=0.000], [(3.04±0.18) vs. (1±0.19), P=0.001]; circhipk3 mimicis significantly increased the expression of Arg1 [(7.26± 0.06) vs. (3.86±0.06), P=0.000]; at the same time, circhipk3 inhibitor promoted the expression of CD45 and HO-1 [(2.96±0.03) vs. (1.63±0.09), P=0.000], [(2.52±0.10) vs. ( 1.30±0.02), P=0.000]. Conclusions:Microglial cells are predominantly M1-type in early neurological injury of heat radiation disease. HO-1 may be one of the microglial M1-type markers. The high expression of circhipk3 in microglial cells mainly promotes its transformation to M2 type.

Objective:To screen the common low-frequency mutation sites in primary biliary cholangitis (PBC) by whole exome sequencing (WES), in order to find PBC-related new susceptibility genes.Methods:From January 2000 to December 2017, the clinical data of seven patients with PBC of three PBC families diagnosed at General Hospital of Tianjin Medical University and two healthy controls were collected. The DNA blood samples were extracted and analyzed by WES. SAMtools 1.3 software was used to detect gene single nucleotide polymorphism (SNP) and indel sites, and gene mutation sites were screened from known databases of 1000 Genome, ExAC, ESP6500 and Novo-Zhonghua gene database. Pymol V2.3.2 software was performed to simulate the three-dimensional structure of major histocompatibility complex-Ⅱ (MHC-Ⅱ), and the amino acid position corresponding to the common mutation sites among families were observed.Results:The age of first diagnosis of seven PBC patients was (61.2±10.2) years. The results of serum test of seven patients indicated that alkaline phosphatase (ALP) level was (306.9±242.5) U/L, γ-glutamyltranspeptidase (GGT) level was (121.7±85.9) U/L, alanine aminotransferase (ALT) level was (47.6±33.1) U/L, aspartate aminotransferase (AST) level was (55.7±34.1) U/L and immunoglobulin G level was (14.9±3.1) g/L. The antinuclear antibody were all cytoplasmic granule types and anti-mitochondrial antibody were all positive. Five PBC patients developed intra-abdominal lymphadenopathy; two patients had extrahepatic autoimmune diseases and the pathological results of liver biopsy of two patients both showed interface hepatitis and small bile duct lesions. Eighteen SNPs were common in three PBC families, which were located in the gene of OTOA, OBSCN and human leucocyte antigen- DRB1( HLA- DRB1). rs200988634 located in OTOA gene was a common polymorphic locus among the three families. rs746424683, rs545316651, rs553144914, rs533059830 and rs56087721 located in OBSCN caused the changes of nine amino acids of different location. There were 12 SNP variations located in HLA- DRB1 gene, which leaded to the changes of 12 amino acids of different location, among them rs16822698, rs112796209 and rs11554463 mutation induced G154A, Y152C and Y107X amino acid variation of MHC-Ⅱ beta chain, and Y107X amino acid was located in the groove region of MHC-Ⅱ binding with peptide. Conclusions:WES in PBC families is a good strategy to elucidate the candidate deleterious mutation genes OBSCN and OTOA. HLA- DRB1 which is a susceptible gene of PBC may affect MHC-Ⅱ mediated antigen presentation process by the changing amino acid sequence.

Based on chaos theory,chaological connotations of pulse tracings and sphygmology were expounded and explained.Main contents included embodiments of four characteristics(inner randomness,sensitivity to initial value,chaos order and unpredictability of long-term behavior)of chaos in pulse tracings and sphygmology.