Etiologic classification of ischemic stroke is the basis for epidemiological investigation, risk factor screening developing individualized treatment plan and prognostic measures. The etiologic classifications, such as TOAST, CCS, and ASCO, are more generally accepted methods at present. This article reviews the advantages and disadvantages from the diagnostic criteria and clinical application.

Objective To investigate the differences in the clinical application of the etiological subtypes of ischemic stroke according to the TOAST,ASCO and CISS criteria.Methods A total of 167 consecutive patients with fist-ever ischemic stroke were enrolled in the study.They were classified with the TOAST,ASCO and CISS criteria,respectively.The differences and consistency of subtype diagnosis of each etiology were compared.Results Compared with TOAST,ASCO grade 1 significantly increased the proportion of patients in a large atherosclerosis group (23.4％ vs.19.8％ ;x2 =4.167,P =0.031) and decreased that in a small vessel disease group (32.9％ vs.38.3％ ; x2 =4.923,P =0.022); similarly,CISS also significantly increased the proportion of patients in the large atherosclerosis group (37.1％ vs.19.8％ ;x2 =27.034,P ＜0.001)and decreased that in the small vessel disease group (19.2％ vs.38.3％;x2=25.289,P ＜ 0.001).However,ASCO grade 1 (34.1％ vs.28.1％;x2 =3.682,P=0.052) and CISS (32.9％ vs.28.1％;x2 =0.880,P =0.268) did not decrease the proportion of patients in a cryptogenic group.The consistency of the 3 typing methods was between moderate (other etiology group of TOAST/ASCO-1,κ =0.434) and excellent (cardioembolism group of TOAST/ASCO-1,κ =0.967).Conclusions Both ASCO-1 or CISS typing may not decrease the proportion of the patients with the subtype of cryptogenic stroke,but the consistency among all the subtypes was better.The design and characteristics of the diagnostic criteria in all subtypes with the 3 criteria should be considered in clinical practice.

Objective To study the indoor air pollution characteristic and control countermeasure. Methods 10 office rooms and 100 houses that were newly redecorated for one month were chosen for the determination of formaldehyde, TVOC, ammonia and radon. The distribution characteristic of time, space of pollutants was studied. Results The concentrations of formaldehyde, TVOC, ammonia in the investigated office rooms exceeded the standard limits greatly, the average levels were 0.533, 5.57and 0.396 mg/m3 respectively. In the 100 houses, the rates of exceeding limit of formaldehyde, TVOC, ammonia were 35.0%-78.8%, 56.0%-75.0% and 37.0%-41.7% respectively. In the two kinds of sites, the concentration of radon did not exceed the limit. Along with ventilation, the concentrations of pollutants went down. Conclusion Indoor air pollution caused by redecoration is serious in a certain degree in Lanzhou.

Objectives To observe the effect of inhibition of transforming growth factor (TGF)?1 on the growth and aggression of colon cancer cells by RNA interference. Methods HCT116 colon cancer cells were transfected with small interfering dsRNA (siRNA), the effect of the inhibition of TGF?1 was tested by semi-quantitative RT-PCR, and changes in cell cycle distribution were analyzed by flow cylometry, the ability of aggression was detected by soft agar colony assay. Results The inhibition of the expression of TGF?1 was significantly detected after the transfection of siRNA against TGF?1, which induced the increase of S phase by 59.0%-82. 5% and decrease in G2 phase, colony assay further demonstrated that siRNA against TGF?1 led to a significant reduction in colony formation as compared with the control group. Conclusions The present data suggested that the expression of TGF?1 was conveniently and rapidly blocked by siRNA transfection, and this may lead to the cell cycle arrest and inhibition of the growth and tumorigenesis of colon cells.

BACKGROUND: Recent studies indicate that after indirect co-culture of neonate rat myocardial cells and bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells can differentiate into myocardial cells successfully. OBJECTIVE: To induce human bone marrow mesenchymal stem cells (hBMSCs) to differentiate into endothelial cells using human umbilical vein endothelial cells by indirect co-culture. DESIGN, TIME AND SETTING: In vitro study of cell engineering was done at the Medical Research Center of Guangdong Provincial People’s Hospital between January and July 2007. MATERIALS: Small quantities of bone marrow were obtained from 11 children with congenital heart disease but without hematologic diseases through manubrium of sternum puncture in the congenital heart defect corrective surgery after the permission of family member. Umbilical cord of full-term normal delivery healthy newborn was provided by the Department of Obstetrics, the First Affiliated Hospital of Sun Yat-sen University. Fresh cattle jugular vein was provided by Guangdong Dali Meat Cattle Butchery. METHODS: The hBMSCs were isolated and purified using density gradient centrifugation method and were cultured in vitro. Human umbilical vein endothelial cells were obtained from newborn umbilical cord by enzyme digestion. Cell culture insert with semipermeable membrane combined with 6-well plate was used to do indirect co-culture induction. Human umbilical vein endothelial cells were expanded in the cell culture insert, passage 3 bone marrow mesenchymal stem cells were expanded in the 6-well plate outside the culture insert at the density of 1?105 cells/well, the initial ratio of the two kinds of cells was 1:5, then low-glucose DMEM culture solution containing 10% fetal bovine serum was added, cells were cultured for 14 days. Co-culture of bone marrow mesenchymal stem cells and bone marrow mesenchymal stem cells was used as control. Introduced endothelioid cells were cultured and then seeded on the cell-free cattle jugular vein intravascular stent. MAIN OUTCOME MEASURES: Morphology changes of induced cells; introduced endothelioid cell surface antigen detected through immunocytochemical staining; the growth and adhesion condition of endothelioid cells on the intravascular stent observed under scanning electronic microsope. RESULTS: The morphologies of introduced endothelial cells were uniform, introduced endothelial cells presented a cobblestone-like appearance, they amplified fast and expressed endothelial cell-specific surface marker CD31 and vWF and the positive rate was over 99%. They also could form a continuous unicellular layer on the cell-free cattle jugular vein intravascular stent. CONCLUSION: Human umbilical vein endothelial cells can induce hBMSCs to differentiate into endothelial cells successfully and to adhere and grew on the cell-free cattle jugular vein intravascular stent through indirect co-culture method.

Different from conventional MRI, Diffusion-weighted(DW) magnetic resonance(MR)imaging is dependent on the molecular motion of water, and provides information on the physiologic state of the brain. In the diagnosis of acute cerebral infarction,the sensitivity is 94% and specificity is 100%. On MRDW imaging, the epidermoid tumors and cerebrospinal fluid or arachnoid cysts, subdura effusions and subdural empyemas,abscess cavities or empyemas and necrotic tumors could be differentiated accurately. MRDW imaging also provides adjunctive information for the diagnosis and evaluation of other cerebral diseases including neoplasms, intracranial infections, traumatic brain injury, and demyelinating processes. As a valuable technique, diffusion-weighted MR imaging should be considered an essential sequence on the diagnosis of brain stroke, and its use in most brain MR studies is recommended.

Purpose To investigate the relation of Epstein-Barr virus ( EBV) infections and malignant lymphoma. Methods EBV-co-ded RNA ( EBER) was detected by in situ hybridization in tumor tissue of 81 cases of malignant lymphoma in oral, maxillofacial and neck regions, with analysis of the clinical pathological features. Results The detection frequencies of EBER was 44. 44%. The posi-tive detection of EBER in Hodgkin′s lymphomas was 40% and that in non-Hodgkin lymphomas was 45. 1%, including 75% in T cell lymphomas, 87. 5% in NK/T cell lymphomas and 2. 9% in B-cell lymphoma. The positive rates of EBER in T cell lymphomas and NK/T cell lymphomas were significantly higher than that in B-cell lymphoma (P<0. 05). There was a significant difference in the pos-itive rates of EBER between intra-nodal ( 17. 9%) and extra-nodal ( 58. 5%) lymphomas ( P<0. 05 ) . But there was no significant difference the positive rates of EBER between in lymphoma patients over 50 years of age and under the age of 50 patients (55. 9%) (P>0. 05). Conclusion Oral and maxillofacial and neck lymphoma is closely associated with EBV infection in Guangxi region, espe-cially, in which NK/T cell lymphoma most typically occurs in extra-nodal diffuse lymphoid tissues.

Objective The gastrointestinal tract of neonate becomes colonized with microorganisms from environment and mother immediately after birth. Strong evidences suggested that early composition of the microflora in neonates play an important role for postnatal development of the immune system. This study was designed to investigate the effect of mode of delivery on the development of gut microflora and characteristics of the stool in breast-fed infants by molecular biology methods. Methods Sixty healthy breast-fed term infants were enrolled in the study(including vaginal delivery group and cesarean section delivery group,each group included 30 infants). Anthropometric measurements and stool study were done at 6-week,8-week,10-week,and 12-week. Fecal samples were subjected to quantitative fluorescence real-time polymerse chain reaction assays for the enumeration of lactobacili,bifidobacteria,and subtype of bifidobacteria(bifidobacterium longum and bifidobacterium breve). Results The numbers of lactobacilli and bifidobacterium longum species were less in cesarean delivery group than those in vaginal delivery group(P ＜ 0.05). Stool mean pH was lower in vaginal delivery group than that in cesarean section delivery group(P ＜ 0.05). There were no differences in stool characteristics and growth between two groups. Conclusions Cesarean section is associated with the decrease of bifidobacteria and lactobacilli in breast-fed term infants.

[Objective]To compare the differences of neuromyelitis optica spectrum disorder(NMOSD)and multiple sclerosis (MS) on pregnancy ,and analyze the mutual impact of pregnancy on the diseases.[Methods]Prospectively collected clinical information of 235 NMOSD patients and 125 MS patients ,including the annualized relapse rate (ARR),the Expanded Disability Status Scale(EDSS)and pregnancy outcomes. 70 NMOSD patients and 30 MS patients were screened out as information patients. The ARR and EDSS score in two groups were compared during the year before pregnancy,during pregnancy and after 1 year postpartum, respectively. 50 cases of normal pregnant women for the same period as the control group ,then to compared the difference of three groups on pregnancy outcomes.[Results]Attacks occurring during pregnancy or one year after childbirth/abortion in NMOSD and MS were 53.25%(41/77)and 20.00%(7/35)(P=0.001);The ARR during the first 3 months postpartum periods of NMOSD and MS group(2.65,2.51)was significantly higher than during the year before pregnancy(0.27,0.49,P < 0.001)and during pregnancy (0.32,0.2,P<0.001);The EDSS score of two groups increased after 1 year postpartum(3.06 ± 2.16,2.19 ± 1.28)than that during the year before pregnancy(1.58 ± 0.48,1.92 ± 1.29,P < 0.001)and during pregnancy(1.92 ± 1.35,1.67 ± 0.70,P < 0.001). There was no difference on ARR and EDSS score between NMOSD and MS group. NMOSD ,MS and normal control group had no dif?ference on pregnancy outcomes and neonatal weight.[Conclusions]Compared with MS,the attack of NMOSD had more closer relation?ship with pregnancy;both NMOSD and MS would increase the risk of disease relapsing and disability after pregnancy;the diseases had no effect on pregnancy outcomes.

Objective:To analyze the change rules of quantitative parameters of magnetic resonance-perfusion weighted imaging (MR-PWI) in cynomolgus monkeys with different degrees of liver fibrosis, and to explore the best parameter of MR-PWI in evaluating the severity of liver fibrosis.Methods:Liver fibrosis models of twenty-two cynomolgus monkeys were successfully established by subcutaneous injection of carbon tetrachloride and feeding with high-fat food. Among them, 15 cynomolgus monkeys developed into early liver cirrhosis (stage S4 of liver fibrosis). Compatibility group design was adopted, the comparative study on MR-PWI of exchange double blood supply model of liver was carried out in these 15 cynomolgus monkeys with a complete development process of liver fibrosis. The quantitative parameters of MR-PWI included endothelial transfer constant ( ktrans), reflux rate constant ( kep), extravascular extracellular space fractional volume ( ve), fractional plasma volume ( vp) and hepatic artery perfusion index (HPI). The change rules of the above parameters and their correlation with the severity of hepatic fibrosis were analyzed. The best parameter of MR-PWI was explored. Compatibility group design (randomized block design), analysis of variance, SNK- q test, Spearman rank correlation analysis and receiver operating characteristic (ROC) curve analysis were used for statistical analysis. Results:ktrans and kep of MR-PWI of cynomolgus monkeys decreased along with the progress of hepatic fibrosis, and the differences were statistically significant ( F=685.228, 99.718, both P<0.01). There were statistically significant differences between each stage of hepatic fibrosis (S1 to S4) and normal liver tissue (S0) ((0.527±0.038), (0.479±0.035), (0.432±0.032) and (0.387±0.031) mL/min vs.(0.584±0.044) mL/min, all P<0.01; (2.193±0.307), (1.997±0.301), (1.624±0.174) and (1.532±0.130) mL/min vs. (2.565±0.482) mL/min, all P<0.01). There were statistically significant in ktrans and kep between stage S3, S4 severe liver fibrosis and stage S1 mild liver fibrosis, stage S2 moderate liver fibrosis (all P<0.01), however there were no statistically significant differences between stage S3 and stage S4 liver fibrosis, between stage S1 and stage S2 liver fibrosis (all P>0.05). Along with the development of the severity of liver fibrosis, HPIs increased gradually, and the differences were statistically significant ( F=839.883, P<0.01). The HPIs of stage S0 to S4 were 0.244±0.022, 0.317±0.035, 0.421±0.046, 0.546±0.043 and 0.651±0.058, respectively, and there were statistically significant differences between groups (all P<0.01). Along with the progression of the severity of liver fibrosis, vp decreased while ve increased gradually, but there were no statistically significant differences among groups (all P>0.05). The results of Spearman rank correlation analysis indicated that ktrans and kep were negatively correlated with the severity of liver fibrosis ( rs=-0.875 and -0.797, both P<0.01), however HPI was positively correlated with the severity of liver fibrosis ( rs=0.959, P<0.01). The results of ROC curve analysis showed that area under curves (AUCs) of ktrans, kep and HPI in the diagnosis of early cirrhosis were 0.852 (95% CI 0.767 to 0.937), 0.799 (95% CI 0.700 to 0.897) and 0.967 (95% CI 0.932 to 1.002), respectively. The best cut-off values were 0.395 mL/min, 1.561 mL/min and 0.590, respectively. The sensitivity was 86.7%, 79.6% and 97.4%, respectively and the specificity was 77.4%, 71.9% and 93.1%, respectively. The thresholds of HPI in the diagnosis of liver fibrosis at stage S1, stage S2, stage S3 and stage S4 were 0.291, 0.376, 0.503 and 0.590, respectively; the sensitivity was 95.7%, 93.8% and 94.4% and 97.4%, respectively and the specificity was 89.5%, 84.7%, 91.3% and 92.7%, respectively. Conclusions:The parameters of MR-PWI change regularly with the development of liver fibrosis in the cynomolgus monkey model, among which HPI is the best parameter for quantitative evaluation of the severity of liver fibrosis.