Objective To evaluate the role of multi-slice computed tomography (MSCT) in the diagnosis of pulmonary sequestration.Methods MSCT scans of 18 cases of pulmonary sequestration proved by surgery and pathology were reviewed.All cases underwent plain and contrast enhanced CT scanning,and retrospective reconstruction was made.Various reconstruction techniques in displaying the pulmonary sequestration and associated malformation were evaluated.Results Anomalous systemic arterial supply was discovered by transverse CT images in 12 cases.The reconstructed images using multiple methods showed the aberrant artery more clearly in all cases,including 6 cases in which the abnormalities were not confirmed by transverse CT.Drainage vein was revealed in 13 cases and lung heteroplasia with other malformation was demonstrated in 14 cases.Volume rendering (VR) reconstruction is the optimal choice for displaying the abnormal vessels and airway.Conclusion Enhanced MSCT with image post-processing can show the abnormal artery and vein of the pulmonary sequestration and the associated malformation,so it is the first choice in diagnosing pulmonary sequestration in pediatric population.

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 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 improve understanding of infectious mononucleosis by reporting the clinical data of 21 adults diagnosed as infectious mononucleosis.Methods We investigated retrospectively the clinical and laboratory data of 21 patients diagnosed as infectious mononucleosis.Results Among those 21 cases,the manifestations were fever(19 cases,90%),angina(14 cases,67%),lymphadenopathy(15cases,71%),hepatosplenomegaly (9 cases, 43%).Laboratory results showed that increased leucocyte count (10 cases,48%),high percentage of abnormal lymphocytes between 10% to 29%(14 cases,67%),abnormal liver function(18 cases,86%),positive Epstein -Barr virus capsid antigen IgM(18 cases,86%).All 21 patients were get better.Conclusion It showed that the clinical manifestations of infectious mononucleosis in adults were complex and diverse.The diagnosis should be combined with clinical manifestations and relevant examination.The outcome of this disease is good.

Objective To analyze the clinical features, laboratory findings, electroencephalography (EEG) and neuroimaging of the neurosyphilis presented with parkinsonism as the principal manifestation to improve the diagnosis of neurosyphilis. Methods Eight eurosyphilis patients were from department of neurology of Hainan provincial people’s hospital from early July 2010 to December 2014. We retrospectively analyzed the clinical manifestation, laboratory exami?nations, neuroimaging examinations, diagnosis and treatment outcomes of 8 cases neurosyphilis who presented with par?kinsonism as principal manifestation. Results Myotonia and bradykinesia were principal symptoms in these 8 cases. Limb tremor, posture disorder, abnormal mental behavior and cognitive impairment occurred in some patients. Serum treponema pallidum particle agglutination (TPPA) and toluidine red untreated serum test (TRUST)were positive in 8 cas?es. Cerebrospinal fluid (CSF) protein and cell counts were elevated in all the patients. CSF-TPPA and TRUST were posi?tive in all the patients. The MRI showed that cerebral infarction in basal ganglia, cerebral atrophy in temporal lobe and hippocampus and ventricular enlargement in all the patients. EEG showed abnormal activity in all the patients. After treatment with a large dose of penicillin, clinical symptoms were obviously improved;the titer of serum and CSF TRUST decreased;and scores of UPDRS decreased in all the patients. Conclusions There is a wide variation in the clinical man?ifestation of the neurosyphilis. When patients present with Parkinsonism, we should comprehensively analyze the laborato?ry examinations, EEG and neuroimaging to rule out the possibility of neurosyphilis.

An efficient modified route based on the targeting mechanism of antibacterial fluoroquinolones for the shift from the antibacterial activity to the antitumor one was further developed. Using a fused heterocyclic ring, s-triazolothiadiazine as a carboxyl bioisostere of ciprofloxacin, the title compounds, 1-cyclopropyl-6-fluoro-7-piperazin-1-yl-3-(6-substituted-phenyl-7H-[1, 2, 4]triazolo[3, 4-b][1, 3, 4]thiadiazin-3-yl)-quinolin-4(1H)-ones (5a-5e) and their corresponding N-acetyl products (6a-6e), were designed and synthesized, separately. Meaningfully, a ring-contraction of fused six-membered thiadiazine occurred by a sulfur extrusion reaction gave new tri-acetylated fused heterocycles related to pyrazolo[5, 1-c][1, 2, 4] triazoles (7a-7e). The in vitro antitumor activity against L1210, CHO and HL60 cell lines was also evaluated for the synthesized fifteen heterocycles compared to parent ciprofloxacin by methylthiazole trazolium (MTT) assay. Interestingly, the results displayed that fifteen fused heterocyclic compounds showed more significant growth inhibitory activity (IC50 < 25.0 micromo x L(-1)) than that of parent ciprofloxacin (IC50 > 150.0 micromol x L(-1)), and the active order decreased from 7a-7e to 5a-5e to 6a-6e, respective.

Objective To investigate the alterations of connexin 43 (Cx43) expression and its distribution at different stages of myocardial infarction (MI) in rats after transplantation of allogenic mesenchymal stem cells (MSCs).Methods Wistar rats were ligated on the left anterior descending coronary artery to make MI models.They were injected with allogenic MSCs,which were induced by 5-aza and labelled by DAPI,during the second operation after 7 days of MI.In subgroups,MSCs were detected by fluorescence microscope.Cx43 expression and GJ distribu-tion were examined by immunohistochemistry after 4,8 or 12 weeks respectively.Results MSCs differentiated into cardiac muscle cell-like cells which were capable of pulsing spontaneously,expressing cTnT and forming myofilament in vitro.Transplanted MSCs can survive in MI host and upregulate Cx43 expression and normalize Cx43 distribution at ischemic zones after 4,8 and 12w.No change of Cx43 was seen at infarcted zones.Conclusion MSCs have the plasticity of differentiating into cardiac muscle cell-like cells which can continuously upregulate Cx43 expression and normalize Cx43 distribution at ischemic zones after 4,8 and 12w.

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 explore the clinical prognostic significance of arterial blood lactate level and early lactate clearance rate in elderly septic patients. Methods Totally 82 elderly septic patients who were admitted into emergency department were enrolled.Their arterial blood lactate levels were tested at admission and 6 hours later. Early lactate clearance rate was calculated as following:(lactate level of admission minus lactate level of 6 hours later) /lactate level of admission ×100 ％. Heart rate and blood pressure were recorded at admission,and the acute physiology and chronic health evaluationⅡ (APACHE Ⅱ ) score was evaluated in the first 24 hours.28 days after admission was the end of research.Patients were divided into survival group (n=59) and death group (n=23).Taking 10％ as cut-off,patients were divided into high lactate clearance (≥ 10％) group (n=59) and low lactate clearance (＜10％) group (n=23).Values of arterial blood lactate level,APACHE Ⅱ score and early lactate clearance to predict the prognosis of elderly septic patients were determined by ROC curves. Results Arterial blood lactate level was lower in survival group than death group[(2.4± 1.7)mmol/L vs.(3.9±3.2)mmol/L,P＜0.01].Early lactate clearance was higher in survival group than death group [(339.0 ± 28.0) ％ and (300.0 ± 81.0) ％,P ＜ 0.01].Mortality of high lactate clearance group was decreased as compared with low lactate clearance group [18.6％ (11/59) and 52.2％ (12/23),P＜0.01].The thresholds of early lactate clearance to predict mortality of elderly septic patients were 24.0％ (sensitivity 72.9％,specificity 65.2％) which was more valuable than APACHE Ⅱ score ( sensitivity 65.2 ％,specificity 57.6 ％). Conclusions Arterial blood lactate level and early lactate clearance were meaningful predictors for prognosis of elderly septic patients.

Objective To explore the prognostic value of B-type natriuretic peptide (BNP) for 28-day mortality of elderly patients with non-cardiac critical ill in emergency intensive care unit (EICU). Methods A total of 70 elderly non-cardiac critically ill patients (age≥60 years) in EICU were enrolled, and the blood samples were collected to detect BNP level after the patients' admission to EICU. After 28 days, the mortality was assessed. Results Twenty-two patients (31.4 %) died during 28 days observation, whose BNP levels were significantly higher than that of the survivors [ln BNP: (6.4 ± 1.2) ng/L vs. ( 5. 1 ± 1.5 ) ng/L, P＜ 0. 05] ; BNP level had an area under the receiver operating characteristic curve of 0. 759 (95% CI: 0. 636-0. 882, P＜0.05) for predicting mortality,and the optimal cut point of BNP was 342 ng/L (sensitivity 77.3%, specificity 68.7%).Conclusions BNP level could be a predictor for 28-days mortality for elderly non-cardiac critically ill patients.