Objective To investigate the diagnostic value of multidirectional diffusion weighted image (DWI) and apparent diffusion coefficient(ADC) image in acute brainstem infarction.Methods 24 cases of brainstem infarction included 2 cases in super acute stage,22 cases in acute stage.All cases were performed multidirectional DWI,ADC and T1 WI、T2 WI examination including of 2 cases of midbrain,21 cases of pons and 1 case of medulla.All of them were accompanied with infarction of other location.Results Among 24 cases there were 13 cases that their lesions displayed clearly and established by transverse T2WI,transverse、coronary or sagittal DWI、ADC and the diagnostic accuracy was 54.2%.In other 9 cases(37.5%) could not display the signal and extent of the lesions,but they could be confirmed by transverse、coronary or sagittal DWI 、ADC.Moreover there were 2 cases(8.3%) who were indicated accurately the diagnosis by coronary、sagittal DWI 、ADC.Conclusion Multidirectional DWI and ADC could show the location of lesions in the lower brainstem so the multidirectional DWI and ADC scan could be an excellent method for the diagnosis of the brainstem infarction.

Adult ; Aged ; Biomarkers, Tumor ; analysis ; Carcinoma, Non-Small-Cell Lung ; blood ; genetics ; pathology ; Cell Differentiation ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Keratin-19 ; genetics ; Leukocytes ; metabolism ; Lung Neoplasms ; blood ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; RNA, Messenger ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Analysis

Aim To investigate the effect on antagonism of benthiactzine and atropine against the function of muscarinic acetylcholine receptors by desensitization of nicotinic acetylcholine receptors. Methods The whole cell recording configuration of patch-clamp technique was used and the cell model was rat SCG neurons. To identify antagonists' antimuscarinic effect, mAchRs mediated IM-inhibition was measured and nicotine and oxotremorine were used. Results After de sensitization of nAChRs,the antimuscarinic effect ofboth benthiactzine and atropine decreased compared to the normal condition. The decreased antimuscarinic effect of benthiactzine was weaker than that of atro-pine. The antimuscarinic effect of both benthiactzine and atropine recovered gradually with the recovery of nAChRs from desensitization. Conclusion Desensiti-zation of nAChRs weakens the antagonists' antimuscarinic effect.

Objective To study the advantage and disadvantage of two types of rat heart trans- plantation models.Methods Twenty Wistar rats served as donors and 20 SD rats as recipients ran- domly in two groups.Abdominal working and nonworking cardiac transplantation models from Wistar to SD rats were established.In the working model,the donors pulmonary artery was anastomosed to the left atrial appendage.The left ventricle ejected volume through an end to side anastomosis of the donor's aorta to the recipient's abdominal aorta.In the nonworking cardiac transplantation model,the donor's pulmonary artery was anastomosed to the recipient's inferior vena cava and the donor aorta was anastomosed to the recipient aorta.Results Working model and nonworking model were successfully established.The survival rate of both models was 90 %.Total operating time of the working model was 10 min shorter than the nonworking model.Postoperative UCG demonstrated the working trans- planted hearts had ejection.Conclusions Rat abdominal working cardiac transplantation model was used perfectly with high rate of survival and shorter total operating time.The working model approached cardiac physiological functions more than the nonworking model.

Objective To investigate the optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine in the patients undergoing caesarean section.Methods One hundred and twenty-eight nulliparous parturients who were at full term with a singleton fetus,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 24-37 yr,weighing 54-78kg,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =32 each) using a random number table:control group (group C),and different concentrations of propofol groups (P1-3 groups).Carboprost tromethamine 250 μg was injected into the body of the uterus,and propofol with the target plasma concentrations of 0.8,1.2 and 1.6 μg/ml was simultaneously given by target-controlled infusion in P1,P2 and P3 groups,respectively,and normal saline was infused at a rate of 0.5 ml · kg-1 · h-1 in group C.The occurrence of cardiovascular events was recorded from the end of carboprost tromethamine administration until the end of surgery.The relatedadverse effects after carboprost tromethamine administration,and Ramsay sedation score at 15 mm after carboprost tromethamine administration were recorded,and satisfactory sedation was defined as Ramsay sedation score of 2.The occurrence of complications associated with combined spinal-epidural anesthesia was recorded during the postoperative follow-up.Results Compared with group C,the incidence of carboprost tromethamine-related adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in P1 and P2 groups,the incidence of hypotension and tachycardia was significantly decreased in group P1 (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adv erse effects in group P1,and in the rate of satisfactory sedation in group P3 (P＞ 0.05).Compared with group P1,the incidence of carboprost tromethaminerelated adverse effects was significantly decreased in P2 and P3 groups,the rate of satisfactory sedation was significantly increased in group P2,and the rate of satisfactory sedation was significantly decreased in group P3 (P＜0.05).Compared with group P2,the rate of satisfactory sedation was significantly decreased (P＜0.05),and no significant change was found in the incidence of carboprost tromethamine-related adverse effects in group P3 (P＞0.05).No cardiovascular events were found in group P2,and the incidence of hypotension was 9％ in group P3.Conclusion The optimum target plasma concentration of propofol in preventing the adverse effects of carboprost tromethamine is 1.2 μg/ml in the patients undergoing caesarean section.

Objective To evaluate the efficacy and safety of transarterial chemoembolization (TACE)combined with sonographically guided percutaneous microwave coagulation therapy(PMCT)for hepatic carcinoma with diameter＞5.0 cm.Methods We retrospectively reviewed 68 cases of hepatic carcinoma with diameter＞5.0 cm under treatment of TACE combined with PMCT.CT,USG and correlated laboratory tests of hepatic carcinoma were carried out.Results Among 68 cases,complete ablation were 5 cases(5/68),tumor ablation area more than 50% or tumor shrinkage less than 30% were 59 cases(59/ 68),tumor ablation area less than 50% or tumor shrinkage more than 30% were 6 cases(6/68).Forty five cases with high AFP descended more than 50% after the procedure in 42 eases(93.33%).Thirty seven cases and 29 cases with increase of CEA and CA19-9 decreased to 28(75.97%)and 23(93.10%)cases with corresponding index decreasing more than 50% respectively.Survival time reached 4-6 months in 3 cases, more than 6 months for 31 cases,more than 12 months of 34 cases.Two cases among them showed no recurrence up to now after stoppage of treatment for 24 months and finally no correlative mortality occurred. Conclusion TACE combined with sonographically guided PMCT for hepatic carcinoma with diameter more than 5 cm is safe and effective.

Background and Objectives: Stroke is the most common neurological disease in China and regulation of lipid levels is important for secondary prevention. This study aimed to investigate the practice of lipid lowering agents immediately after and one month following ischemic stroke in China, and to determine the factors affecting the practice. Methods: A total of 857 patients with acute ischemic stroke were enrolled from 11 hospitals in the Qingdao area, Northern China. Data pertaining to the patients’ demographic, clinical data, and treatment before and after the stroke were recorded. Univariate and multivariate logistic regression analyses were used to determine the factors associated with the treatment at two time points: at the acute stage and at one month follow-up. Results: The frequency of lipid lowering therapy was 50.3% (431/857) at acute stage and 41.5% (306/738) at one month. Lipid lowering therapy at acute stage was independently and positively associated with a history of hyperlipidemia((P=0.002, OR (95%CI): 3.784 (1.610-8.898)) and excess alcohol consumption (P=0.005, OR (95%CI): 1.928 (1.214-3.062)), partial anterior circulation infarct classifi cation (P=0.000, OR (95%CI): 1.974 (1.370-2.767)), and low-density lipoprotein levels ((P=0.000, OR (95%CI): 1.426 (1.170-1.739)). Lipid lowering therapy at one month follow-up was independently and positively associated with lipid lowering therapy at acute stage ((P=0.000, OR (95%CI): 18.275 (11.476- 29.101)), and negatively with the Modifi ed Rankin Scale ≥4 at follow-up ((P=0.030, OR (95%CI): 0.568 (0.341-0.948)). Conclusions: Lipid lowering therapy was found to be used in about half of patients during acute and early secondary prevention of ischemic stroke in the Qingdao area of Northern China. There should be more education efforts to the health care professionals and public to increase its use.

Purpose To investigate the occurrence of echinoderm microtubule-associated protein-like 4 (EML4) gene and the anaplas-tic lymphoma kinase (ALK) gene rearrangements in lung squamous cell carcinomas (SCC), and to provide with a test for targeted therapy of SCC. Methods In this study, we analyzed ALK protein expression with a specific rabbit monoclonal Ig antibody ( D5F3 clone) in 219 cases of lung SCC. The positive cases were confirmed with ALK fluorescence in situ hybridization ( FISH) . Results 4 out of 219 (1. 8%) cases of lung SCC were ALK positive detected by immunohistochemistry (IHC) staining, which were confirmed by ALK FISH. Conclusions There are SCC having EML4-ALK gene rearrangement. The response of SCC patients with ALK expression to targeted therapy of Crizotinib should be explored. Strong positive expression of ALK protein can be interpreted as EML4-ALK gene rearrangement.

AIM:To evaluate the efficacy and safety of "one-stitch anastomosis through the skin" repair of canalicular laceration.METHODS:The data of 32 cases (32 eyes) of canalicular laceration who underwent repair of lacerated canaliculi with one-stitch anastomosis through the skin were retrospectively reviewed, inferior canalicular laceration in 29 patients,superior canalicular laceration in 1 patient, 2 cases involving both the inferior and superior canalicular laceration. All the operations were performed under surgical microscope, 5-0 silk sutures were used and silicone tube of 0.8mm diameter was employed in intubation. The stents were left in place for 3 months postoperatively and then removed. The follow-up period was 1 to 36 months.RESULTS: In 32 patients, 28 (88%)patients were cured entirely, 3 (9%)patients were meliorated, and 1 (3%)patient had no effects. A total of 29 patients complied with scheduled follow up 1-36 months (average 12 months) after stent removal, and 3 patients were lost in follow-up. All the patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus.CONCLUSION: In "one-stitch anastomosis through the skin"repair of canalicular laceration, the cut ends could be anastomosed directly,for there was no suture remained in the wound permanently, so there was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. It was simple, economical ,effective and safe.

AIM: To evaluate cell proliferation, apoptosis and migration of human retinal pigment epithelial cells ( RPE) when co - cultured with human marrow mesenchymal stem cells ( hMSCs ) in condition of hypoxia and hyperglycemia so as to explore possible mechanisms of diabetes aggravating choroidal neovascularization ( CNV) preliminarily.
METHODS:Both hMSCs and RPE cells were co-cultured in a transwell system. The experiment was divided into four groups: 21% O2 with 5. 56mmol/L glucose ( control group, A ), 21% O2 with 30mmol/L glucose ( hyperglycemia and normoxia group, B ) , 5% O2 with 5.56mmol/L glucose ( normoglycemia and hypoxia group, C ) and 5% O2 with 30mmol/L glucose ( hyperglycemia and hypoxia group, D) . Cell Counting Kit-8 (CCK-8) was used to detect the proliferation of RPE cells in each group at 12, 24 and 48h respectively. Flow cytometry was performed to observe apoptosis of RPE cells at 24h. Additionally, we assessed migration
capabilities of RPE via transwell assay under the condition of hyperglycemia and hypoxia by co-culturing of hMSCs.RESULTS:In this co-culturing system, at 12, 24 and 48h, group B (1. 61±0. 41, 1. 80±0. 34;1. 91±0. 35), C (1.34±0. 46, 1. 94±0. 40, 2. 14±0. 41) and D (1. 98±0. 47, 2.26±0.42, 2. 55±0. 40) showed significantly higher proliferation rate than group A (0. 92±0. 45, 1. 27±0. 32, 1.59±0. 41, P<0. 05). The migration capabilities of RPE in group B (149. 5±9. 19), C (140±9. 90) and D (170. 5±7. 78) increased dramatically compared with group A ( 114. 5±7.78, P<0.05) at 24h, whereas there was no significant difference of apoptosis ratio among four groups (P>0. 05).
CONCLUSION:By coexistence with hMSCs, the synergy of hyperglycemia and hypoxia can improve migration and proliferation of RPE cells, and have no effect on apoptosis of RPE cells within short period.