Objective To apply early comprehensive rescue including embolism and microsurgery for trea- ting acute ruptured intracranial aneurysm in order to lower mortality and disability.Methods 120 patients with rup- tured intracranial aneurysm were treated by early comprehensive rescue.An cases were given support treatment,e- mergency rescue and DSA after hospitalization.Embolism and microsurgery were done within 72 hours and releasing bleeding CSF were done after surgery to prevent complications.Results Good recovery was over 80%(excellent in 95 ases,light disability in 18 cases,heavy disability in 4cases,and death in 3 cases).2 cases relapsed during hospi- talization.5 cases were coma induced by serious cerebral vesospasm.Conclusion Early comprehensive treatment including embolism and microsurgery complication prevention may reduce rebleeding,serious vasospasm and hydro- cephalus,1ower mortality and improve prognosis.

The present study was designed to investigate the effects of mifepristone on apoptosis of the decidual tissue cells and apoptotic correlated gene Fas/FasL expression in human early gestational period. The extent of DNA fragmentation of apoptotic cells were assessed by using an in situ terminal transferase reaction to label free 3′ ends of the DNA.The expression of Fas, FasL in the deciduas was examined by in situ hybridization with cDNA probe and immunohistochemical staining with polyclonal antibodies, respectively. The results showed that there were evident apoptosis in decidual tissues at about 40 days of gestation. Fas and FasL were strongly expressed in these decidual tissues. At about 50 days of gestation, there were a few apoptotic cells in the decidual tissues. Expression of Fas, FasL decreased at the same time. More apoptotic cells were observed in decidual tissues after adiministration of Mifepristone (RU486) in about 50 days of gestation. Fas, FasL mRNA and protein were up regulated after administration of Mifepristone. The results suggested that the induction of apoptosis by Mifepristone in decidual tissues might be one of the major mechanisms with regards to contraceptive and antigestational effects of mifepristone. Fas pathway might participate in the process of decidua apoptosis induced by RU486.

Objective To explore the imaging characteristics of neurologic complications associated with the enterovirus 71 ( EV71 ) epidemic by analyzing 25 cases and reviewing the literature. Methods Twenty-five cases of hand-foot-mouth disease with neurologic complications during the recent EV71 outbreaks of Hainan province were studied for the clinical features and imaging findings, and literature were reviewed.Results In 5 cases, acute flaccid paralysis associated with EV71-infected hand-foot-mouth disease was related to the linear high signal in the spinal cord on sagittal images. Two cases showed symmetrical, welldefined hyperintense lesions in the spinal cord on T2WI transverse. Strong enhancement of the ventral horns and root was seen on the contrast-enhanced axial T1WI. In brainstem encephalitis, all lesions presented with significant hyperintensity on T2WI and hypointense on T1WI in the posterior portions of the medulla oblongata, midbrain, and pons. The manifestations of aseptic meningitis (AM) on MRI have no characteristics, but subdural effusion, meningeal enhancement and hydrocephalus can be the indirect signs of AM. Conclusions MRI is an effective method to investigate neurologic complications associated with the EV71 epidemic. Posterior portions of the medulla oblongata and pons, bilateral ventral horns of spinal involvement are characteristic findings of enteroviral encephalomyelitis.

Objective To investigate the synthesis, in vivo biodistribution of 99Tcm-HYNIC-PEG4-E[PEG4-c (RGDfk)] 2 (99 Tcm-Galacto-RGD2), and its potential usage for targeted imaging of mice orthotopic glioma.Methods 99Tcm-Galacto-RGD2 was synthesized straightforward and its radiochemical purity and stability and distribution in mice were analyzed.MicroSPECT-CT imaging was done in a mice orthotopic glioma model, which had been set up with U87MG cells, after administration of 99Tcm-Galacto-RGD2.Region of interest (ROI) of glioma was drawn on SPECT-CT section images to quantify tumor uptake (％ ID/cm3).Glioma was harvested for pathological examination.Linear-regression was used to analyze the relationship between integrin αvβ3 and tumor uptake (％ID/cm3).Results The radiochemical purity of 99Tcm-Galacto-RGD2 was (97.7 ±0.8)％ and stable in vitro.Hynic-Galacto-RGD2 could specifically bind to integrin αv β3 of tumor cells with a IC50 of (18 ± 3) nmol/L.After tail vein injection, 99Tcm-Galacto-RGD2 was rapidly discharged from the blood, liver, kidneys and had a relative low concentration in normal brain tissue.MicroSPECT-CT imaging demonstrated that, after 60 min of injection, this drug was well uptaken by glioma tumor than that after 30 min (t =7.13 ,P ＜0.05), and the tumor to normal brain tissue (T/B) uptake ratio of 99Tcm-Galacto-RGD2 was 13.92± 3.43.Injection of HYNICGalacto-RGD2 2 min prior to 99Tcm-Galacto-RGD2 injection extensively reduced the uptake of radioactive drug in tumor tissue (t =11.36, P ＜ 0.05).Bland-Altman analysis showed that tumor volume based on SPECT-CT imaging measurement had almost same value with the tumor reference volume (95％ CI =-11.94％-11.92％).In addition, the tumor uptake of 99Tcm-Galacto-RGD2 and cellular integrin αvβ3 expression level had a linear relationship (R2 =0.896).Conclusions Stable 99Tcm-Galacto-RGD2 can be synthesized easily and is applicable for microSPECT-CT imaging analysis of orthotopic glioma in mice together with the evaluation of integrin αvβ3 level in tumor.

Objective To observe the effect of consciousness-restoring obstruction-clearing needing technique combined with swallowing function training on pseudobulbar paralysis after stroke.Methods 80 stroke patients with pseudobulbar paralysis were randomly divided into the trial group and control group with 40 cases in each group.The patients of the trial group were treated with consciousness-restoring obstruction-clearing needing technique combined with swallowing function training and routine medicine,those of the control group were treated only with routine medicine.Results After treatment,the whole effective rate of the trial group was 92.5%,that of the control group was 60.0%,there was a significant difference between two groups(P<0.05).Conclusion The therapeutic effect of consciousness-restoring obstruction-clearing needing technique combined with swallowing function training and routine medicine on pscudobulbar paralysis after stroke is superior to simply routine medicine.

Objective To study the effect of Punica granatum( pomegranate) see d oil( PSO) on proliferation and apop-tosis behaviors of breast cancer cells.Methods Fatty acid composition was detected by gas chromatography,breast cancer cells, MCF-7 and MDA-MB-231 were treated with PSO, cell proliferation was observed by MMT, cell apoptosis was analyzed by flow cytometry,and expression levels of proliferation and apoptosis-related proteins were detected by Western blot.Results Punicic acid (PA) was the major fatty acid in PSO(74.41%).PSO could inhibit the proliferation while in-ducing apoptosis in both cell lines in a dose-and time-dependent manner, significantly decrease the expression level of Cox-2 and Bcl-2, increase the expression level of Bax and caspase-3 (cleaved),remarkably upregulate the expression of P53 in MCF-7, and downregulate p53 expression in MDA-MB-231.Conclusion PA may be one of the functional ingredients of PSO which can inhibit proliferation and induce apoptosis in breast cancer cells.These effects are probably mediated by regu-lating the expression of Cox-2, Bcl-2, Bax, caspase-3 (cleaved) and p53.

objective To investigate preoperative donor and recipient assessment,choice of surgical options in living donor liver transplantation(LDLT).Methods The clinical data of 95 patients who underwent LDLT from January 1995 to October 2007 in our center were retrospectively analyzed.Of all,92 recipients were benign end-stage liver disease patients (including 45 patients with Wilson disease),and 3 were malignant hepatic carcinbma patients.Results Thirty-one fight lobes without middle hepatic vein(MHV),3 right lobes with MHV,51 left lobes with MHV.and 10 left lobes or left lateral lobes without MHV were obtained.All the donors recovered after operation. Recipients with benign end-stage liver disease were followed up for 1 to 86 months,and the 1-,3-,5-year accumulative survival rates were 89%(82 cases),78%(71 cases)and 73%(67 cases),respectively. The 1-,3-,5-year survival rates of patients with Wilson disease were 92%(42 cases),89%(40 cases)and 76%(34 cases),respectively. For the 3 patients with malignant hepatic carcinoma,2 died and 1 was alive and well. The copper metabolism was back to normal in both donors and recipients. Conclusions Establishment of a system for the safety of donors is basic for LDLT. The key to raise the recipients' survival rates is to choose the optimal surgical approach. LDLT is effective in treating Wilson disease.

Objective To explore the relationship between uric acid (UA) level and cognitive function in elderly patients with Parkinson,s disease (PD) and analyze the cognition related factors.Methods The clinical data of 60 elderly PD cases in our hospital from 2001 to 2009 were retrospectively analyzed. The 60 healthy people receiving medical examination in our hospital and matched by gender and age, were as control group. The information including gender, age, illness duration, Hoehn & Yahr stage (H-Y stage), serum UA level and Mini-Mental State Examination (MMSE) scale were recorded. Results The serum UA level was significantly lower in PD group than in control group [(262±53) μmol/L vs. (332±45) μmol/L, t=-6.724, P＜0.001]. In PD group, the serum UA level was slightly higher in males than in females [(271 ±48) μmol/L vs.(254±39) μmol/L, t=3. 282, P=0. 058]. The serum UA level was significantly lower in male PD patients than in male controls [(353± 62) μmol/L, t=- 5. 625, P＜0. 001], and was lower in female PD patients than in female controls [( 294 ± 59) μmol/L, t = - 4. 721, P = 0. 012]. There were no significant differences in serum UA level among different H-Y stage subgroups (P＞0. 05), but the serum UA level was lower in different H-Y stage subgroups than in control group (F=22. 039, P＜0. 01 ). There was no correlation between the UA level and the illness duration (r=0. 961, P＞0.05).The MMSE score had significant difference between elderly PD group and control group (t= -3. 168,P＜0. 001). In PD patients, the MMSE score was positively correlated with serum UA level (r=0. 789, P= 0. 000), and was negatively correlated with H-Y stage (r= - 0. 577, P = 0. 019 ), age (r= -0. 333, P=0. 034), but was not correlated with illness duration (r= -0. 333, P=0. 207) and BMI (t=- 0. 410, P= 0. 115). Conclusions The level of serum UA is lower in elderly patients with PD than in normal controls. There is correlation between the serum UA level and cognitive impairment. Lower serum UA level predicts worse cognitive scores.

Objective To investigate the value of integrin αvβ3 targeted microSPECT/CT imaging with 99 Tcm-3P4-RGD2 as a radiotracer in tumor anti-angiogenesis therapy .Methods Animal models bearing glioma and prostate cancer xenografts were established by subcutaneously injecting tumor cells U87MG and PC-3 in nude mice.Anti-angiogensis therapy with Avastin was administered via intraperitoneal injection when the tumor diameter reached 6 to 7 mm while saline was served as control group . MicroSPECT/CT imaging was performed with 99 Tcm-3P4-RGD2 as radiotracer one day before and 3, 5, 10, 15 days after Avastin administration .Tumor volume and tumor uptake of 99 Tcm-3P4-RGD2 , expressed as percentage of injected dose (%ID) or %ID per gram (%ID/g) were measured and calculated based on microSPECT/CT.Mice basic condition was monitored and tumor xenograft was harvested in one tumor bearing nude mouse after its sacrifice at each imaging time point .Results Tumor volume of U87MG glioma in the administration group was significantly smaller than that of non-administration control group at 10 d after Avastin adminstration ( t=5.81, P<0.05), while no significance was observed between the administration group and its control group of PC-3 tumor (P >0.05).The uptake of 99Tcm-3P4-RGD2 (%ID/g) in U87MG group was higher than that in PC-3 group before Avastin administration ( t=10.48, P<0.05), and it decreased to a value less than control ( t =3.26, P <0.05) at 3 d after Avastin administration and continually reduced at longer time after administration .PC-3 tumor had less uptake of 99 Tcm-3P4-RGD2 in both Avastin administration group and its control group .The pathologic results revealed on that the decrease of tumor integrin β3 expression in U87MG treatment group was mainly on the endothelial cells of the neovessel .Linear relationship was verified between tumor uptake (%ID/g ) and integrin β3 expression (y=0.499 1x-0.243 8, R2 =0.811 7).Conclusions Complete inhibition of integrin is demonstrated early after Avastin administration .99 Tcm-3P4-RGD2 microSPECT/CT imaging, assessing the expression level of integrin αvβ3 level by quantification of tumor uptake of 99 Tcm-3P4-RGD2 , is probably an important method to reflect the early therapeutic effect of tumor anti -angiogensis .

Objective To study the clinical application of laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOEST) with the antegrade guidewire technique in the treatment of cholecystocholedocholithiasis.Methods This is a prospective controlled study comparing LC combined with preoperative endoscopic sphincterotomy (POEST) versus LC combined with IOEST in the treatment of cholecystocholedocholithiasis.Patients who were diagnosed to have cholecystocholedocholithiasis from June 2012 to February 2013 in our hospital were divided into the POEST group and the IOEST group.There were 50 patients in each group.The operation time,successful stone-extraction rate,residual stones rate,complication rate,postoperative stay and hospitalization cost between the groups were compared.Results The sex,age,stone size,number of stones and diameter of the common bile duct showed no significant difference between the two groups (P ＞ 0.05).There were no differences between the two groups in surgical time of EST,surgical time of LC combined with EST,successful stone-extraction rate and hospitalization cost (P ＞ 0.05).There were significant differences between the two groups in the residual stones rate,postoperative hyperamylasemia rate,postoperative acute pancreatitis rate and postoperative stay (P ＜0.05).LC combined with IOEST using the antegrade insertion of guidewire technique significantly reduced the residual stones rate (0 vs 8％),postoperative hyperamylasemia rate (4％ vs 18％),postoperative acute pancreatitis rate (0 vs 8％) and postoperative stay.Conclusions LC combined with IOEST using the antegrade guidewire technique could be performed safely when compared with the traditional sequential technique,LC combined with IOEST using the antegrade guidewire technique significantly reduced the postoperative acute pancreatitis rate and the residual stones rate.LC combined with IOEST using the antegrade guidewire technique should be the recommended technique to treat patients with cholecystocholedocholithiasis.