Objective To study the effectiveness and safety of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis therapy for acute ischemic stroke in patients with atrial fibrillation (AF).Methods A total of 94 patients treated with intravenous rt-PA thrombolysis within 4.5 hours after cerebral stroke onset were analyzed and divided into two groups:a non-AF group (n =64) and an AF group (n =30).Another 30 acute ischemic stroke patients with AF without thrombolytic therapy were selected as a control group.The prognosis of the three groups was compared.The National Institute of Health Stroke Scale (NIHSS) was used for comparison among the three groups before therapy and 7 days after therapy.The incidences of intracerebral hemorrhage (ICH) and symptomatic ICH (SICH) were recorded.The patients were followed up for 90 days and their clinical outcomes were assessed by using the modified Rankin scale (mRS).Results There were no significant differences in the NIHSS scores among three groups before treatment (P ＞ 0.05).The NIHSS scores were significantly lower in the AF and non-AF groups 7 days after thrombolysis therapy than those before thrombolysis therapy (P ＜0.05 and P ＜0.01),and no significant difference in the NIHSS scores was found in the control group before and after therapy (P ＞ 0.05).The incidence of ICH was significantly higher in the AF group than in the non-AF group (26.7％ vs.9.4％,P ＜ 0.05).No significant difference in the incidence of SICH was found between the AF and non-AF groups (13.3％ vs.6.3％,P ＞ 0.05).The favorable prognosis rate was higher in the AF and nonAFgroups than in control group (40.0％ vs.16.7％,P＜0.05; 45.3％ vs.16.7％,P＜0.01).No significant difference in very unfavorable prognosis rate was found between the AF and non-AF groups (20.0％ vs.18.8％,P ＞0.05).Conclusions It is effective and safe of rt-PA thrombolysis therapy for acute ischemic stroke patients with AF.

It has been demonstrated that astrocyte elevated gene 1 ( AEG-1 ) can promote tumor initia-tion and progression .Over expression of AEG -1 is correlated with tumor angiogenesis ,metastasis and chemother-apy resistance of tumor cells of different origins .The present article is a review on the mechanism of AEG -1 me-diated drug resistance .Studies have shown that AEG -1 participates in carcinogenesis through Ha -ras,myc,NF-κB and PI3K/Akt signalling pathways .AEG-1 can also promote autophagy through activating AMP Kinase . Other researchers demonstrate that AEG -1 promotes MDR1 protein translation by up-regulating MDR1 mRNA expression ,and thus increases polyribosome .It is testified that AEG-1 can influence drug susceptibility and ex-pression of MDR gene as a RNA binding protein .Multiple functions of AEG -1 in drug resistance in multiple cancers demonstrate that AEG -1 can be used as a novel target for antitumor drugs .

Objective To analyze the causes,neuroimaging and clinical manifestations of isolated unilateral pontine infarction and to discuss its relationship to progressive motor deficit(PMD).Methods All 58 patients with isolated acute unilateral pontine infarction confirmed by magnetic resonance imaging (MRI) were recruited in this study for retrospective review.Thirty-one patients of them had brain and neck multi-slice spiral CT angiography(CTA) within 1 week after admission.PMD severity was accessed using the dynamic National Institutes of Health Stroke Scale (NIHSS) within 5 days after onset.All 58 patients were divided into two groups:patients with PMD (23 cases) in group 1 and patients without PMD (35 cases) in group 2.Two groups were compared for the risk factors,initial NIHSS scores,modified Rankin Scale (mRS) scores at 1 month after onset,clinical manifestations,infarction distribution,size and morphology of infarctions and basilar artery lesions.Results The major cause was pathologic changes in basilar artery branch in both groups(6/12 in group 1 and 10/19 in group 2).The proportion of patients with infarction extending to the pontine surface in group 1 was higher than that in group 2 (21/23,91.3％ vs 20/35,57.1％,x2 =7.817,P =0.005).Initial NIHSS score in group 1 was higher than that in group 2(6.7 ±2.9 vs 4.5 ± 2.4,t =3.121,P =0.003).mRS score at 1 month after onset in group 1 was higher than that in group 2(2.2 ± 1.1 vs 1.5 ± 0.8,t =2.909,P =0.004).The Logistic regression analysis showed that isolated unilateral pontine infarction extending to the pontine surface was positively related to PMD (odds ratio 9.670,95％ confidence interval 1.171-79.856,P =0.035).Conclusions Progressive isolated unilateral pontine infarction is mostly caused by pathologic changes in basilar artery branch.Patients with PMD have a more severe initial clinical manifest and they have a worse short-term prognosis than patients without PMD.Isolated unilateral pontine infarction extending to the pontine surface may be a risk predictor in stroke evolution.

Objective To analyze the pathogenesis,initially diagnosed symptoms and clinical manifestations of children with chronic kidney disease (CKD) at stage 2 to 5.Methods The data of 108 children who were hospitalized in Children's Hospital Affiliated to Capital Institute of Pediatrics from September 2007 to April 2016 with CKD stage 2 to 5 were retrospectively analyzed.The etiologies,clinical manifestations and examinations were summarized,and the clinical manifestations were compared between the congenital hereditary urinary diseases group and the acquired urinary diseases group.Results (1) In the 108 cases collected,66 cases were male,42 cases were female,aged from 3 months to 15 years and 1 month old.Twenty-four cases were diagnosed at stage 2,26 cases at stage 3,35 cases at stage 4,and 23 cases at stage 5.(2) Twenty-eight kinds of illness were involved in the cause of CKD.Among them,57 cases (52.8％) had congenital anomalies of the kidney and urinary tract,5 cases(4.6％) had hereditary kidney diseases,41 cases (38.0％) had other primary or secondary kidney diseases,and in 5 cases (4.6％) the causes of disease were unknown.(3) For the initially diagnosed symptoms,29 cases(26.9％) were due to complaints associated with kidney disease,36 cases (33.3％) were of other outside kidney symptoms,and 43 cases (39.8 ％) were of negative symptoms.The results of urinary ultrasound were abnormal in 79 cases(73.1％) and 87 cases(80.6％) showed abnormality in urinary analysis.There were 105 cases (97.2％) with abnormal manifestations either in urinary tract ultrasound or in urinary analysis.(4)The ages on diagnosis as CKD in children with congenital hereditary urinary diseases(5.89 years old) were younger than that of children with acquired urinary diseases (9.20 years old),and the difference was significant(Z =-3.434,P =0.001).The frequency of cases with short stature or lower-weight in group of congenital hereditary urinary diseases[66.1％ (41/622 cases),64.5％ (40/62 cases)] were significantly higher than those of the acquired urinary diseases group[43.9％ (18/41cases),43.9％ (18/41 cases)],and the differences were statistically significant(x2 =4.983,4.263,P =0.026,0.039).Conclusions The causes of CKD are complicated,and the congenital anomalies of kidney and urinary tract are the major causes of CKD at stage 2 to 5 in the cases.The initially diagnosed symptoms of CKD are insidious and atypical.The children with congenital hereditary urinary diseases tend to have more serious growth retardation.Urinary analysis and ultrasound may have an important significance for early diagnosis of CKD in children.

ObjectiveTo study the effect of heat stress on the cytoskeleton and cell cycle of human umbilical vein endothelial cell (HUVEC) in vitro.Methods HUVEC was cultured in vitro in 5%CO2 medium at 37℃ (control group) or 43℃ (heat stress group) for 1 hour. Coomassie brilliant blue R-250 staining was used to determine the effect of heat stress on the cytoskeleton. The cells in heat stress group were subsequently cultured at 37℃in 5%CO2 medium after heat stress for 1 hour, and cell cycle of HUVEC was determined at 0, 6, 12, 18 and 24 hours with flow cytometry.Results Under light microscopy normal cytoskeleton was observed in control group, but thicker and shorter cytoskeleton was found after a rise of temperature, and stress fibers were found in heat stress group. The DNA content of HUVEC at all time points in G0/G1 stage was 38.07%-55.19% after heat stress. The DNA content in control group was 48.57%, and it was 54.06%, 55.19%, 48.23%, 38.07%, and 41.03% at 0, 6, 12, 18, 24 hours in G0/G1 stage in heat stress group. DNA content in S phase was 35.33%-48.18%. The DNA content in control group was 44.62%, and it was 35.33%, 39.50%, 42.50%, 48.18%, and 47.99% at 0, 6, 12, 18, 24 hours in S stage in heat stress group. DNA content in G2/M phase was 5.31%-13.75%. The DNA content in control group was 6.81, and it was 10.61%, 5.31%, 9.27%,13.75%, and 10.98% at 0, 6, 12, 18, 24 hours in G2/M stage in heat stress group. It was demonstrated that compared with control group, the DNA content in G0/G1 stage was significantly increased when the HUVEC were separated from heat stress within 6 hours, and it recovered at a similar level as control group at 12 hours.Conclusion Heat stress can change the cytoskeleton of HUVEC, and cause stagnation at G0/G1 stage in cell cycle.

Objective To compare the effects of intramuscular or subcutaneous forearm parathyroid autotransplantation after total parathyroidectomy on patients with renal hyperparathyroidism.Methods From Jan.2012 to Dec.2013,total parathyroidectomy was carried out in 90 patients with renal hyperparathyroidism.According to the location of their parathyroid autograft,patients were divided into intramuscular group (n =39)and subcutaneous group(n =51).One patient in the intramuscular group and two in the subcutaneous group were excluded for the high levels of intact parathyroid hormone (iPTH) the day after operation.iPHT was analyzed 2 weeks,1 month,3 and 6 months after surgery.Results The time of autotransplantation was significantly shorter in subcutaneous group than in intramuscular group (11.46 (2.63) min vs 22.12 (3.78) min;t =0.632,P ＜ 0.05).iPTH levels were significantly lower in subcutaneous group than in intramuscular group 2 weeks after operation (P ＜ 0.05).There was no significant difference between the 2 groups regarding iPTH levels at 1 month,3 or 6 months after surgery.In the follow-up one patient in intramuscular group and one in subcutaneous group had graft-dependent hyperparathyroidism.Conclusion As compared to intramuscular parathyroid autotransplantation,subcutaneous parathyroid autotransplantation has advantages of simpler to operate,shorter autoimplantation time and easier to autograftectomy.

Background and purpose:Gastric cancer impacts human health seriously. Accurate preoperative assessment of T staging and metastatic lymph nodes of gastric cancer was beneifcial to patients’ treatment options and their prognosis. The purpose of this study was to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging for preoperative assessment of T staging and metastatic lymph nodes in patients with gastric cancer. Methods:This study selected 35 gastric cancer patients met the criteria for this prospective study. They all underwent gastric 3.0 T MRI+DWI imaging scan. These patients’ T stage and metastatic lymph nodes were evaluated before the surgery, with the reference of post-operative histopathological ifndings. Kappa consistency test was used to assess the consistency of T staging between the two methods. This study analyzed short axis diameter, long axis diameter and apparent diffusion coeffcient (ADC) values of lymph nodes, relative of muscle’s ADC (rADCm) values (rADCm=ADC values of lymph nodes/ADC values of right erector spinae), and relative of primary tumor’s ADC (rADCp) values (rADCp=ADC values of lymph nodes/ADC values of primary tumor) on MRI image. Independent samples test was used to assess the difference between metastatic lymph nodes and benign lymph nodes. The receiver operating characteristic(ROC) curve was generated to evaluate the accuracy of diffusion-weighted magnetic resonance imaging (MRI) for preoperative assessment of metastatic lymph nodes of gastric cancer.Results:The accuracy of diffusion-weighted MRI for T stages was 77.14%, 75% for T1, 100% for T2, 76.47% for T3 and 75.00% for T4 and respectively. There were statistically signiifcant differences in the long axis diameter, the short axis diameter, ADC value, rADCm and rADCp between metastatic lymph nodes and benign lymph nodes (P<0.05). The area under the ROC curve of rADCm was greater than thats of other criteria, so rADCm was the most signiifcant parameter. The best discriminative cut-off value of long axis, short axis, ADC value, rADCm value and rADCp value were 9.55 mm, 6.05 mm, 0.934×10-3mm2/s, 0.60 and 1.083, respectively. The sensitivity and speciifcity were 59.00% and 73.10%, 59.00% and 69.80%, 82.60% and 88.50%, 83.70% and 84.60%, 78.20% and 80.80%, respectively.Conclusion:Diffusion-weighted MRI has great signiifcance for preoperative assessment of T staging and metastatic lymph nodes of gastric cancer.

Objective To explore the dynamic change of serum leptin interleukin-6(IL-6),and interleukin-8(IL-8)during cerebral infarction,and to analyze the possible relationship between these factors and the severity of the disease.Method The levels of serum leptin,IL-6 and IL-8 were measured by radioimmunoassay in 60 patients with acute cerebral infarction,who were admitted to the hospital within 24 hours after stroke.Patients' neurologic impairment were evaluated by European Stroke Scale(ESS)at 1,3 and 7 days respectively after hospitalization.At the same time,another 30 normal adults were enrolled set as control group. Results The levels of serum Leptin,IL-8 in patients group after at 1 days,3 and 7 days were higher than those in the controls(P0.05).The ESS of these patients were 76.77?26.42,70.02?29.17,74.65?28.42 respectively,after 1,3 and 7 days.It shown that ESS simply correlated to the level of IL-8(P0.05).Statistic analysis was carried,but by using t test and linear correlation.(SPSS11.5 statistical package).Conclusion Leptin,IL-6 and IL-8 probably play a role in the inflammatory,reaction during acute cerebral infarction.The IL-8 may reflect the severity of the disease.

Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.