BACKGROUND: Transcranial Doppler(TCD) spectrum analysis techniques cannot measure the diameters of blood vessels and therefore and not be used to calculate the changes of brain blood flow. A formula was designed for regional cerebral blood flow loss index(rCBFLI) following arteriostenosis when arteriostenosis index formula was deduced; the former may provide a reference to assess cerebral function.OBJECTIVE: To introduce the formula of cerebral blood flow loss ratio obtained basing on TCD results.DESIGN: Retrospective controlled study based on patients with cerebral middle arteriostenosis diagnosed with TCD and healthy people.SETTING: At the departments of neurology in a university hospital and in a military medical university affiliated hospital of Chinese PLA.PARTICIPANTS: Between October 1994 and December 2000,43 patients who were confirmed of arteriostenosis with TCD at outpatient or neurological ward of the First Affiliated Hospital of Fujian Medical University were enrolled into this study,and their TCD results were compared with 908 normal controls between March 1992 and September 2000.METHODS: Stenosis index (STI) formula was deduced from TCD results of 31unilateral and 12 bilateral stenoses at middle cerebral artery(MCA) . STI = 1- [ normal average blood velocity (Vm0) ÷ average blood velocity at stenosisSince(PI1 ÷PI0) may be equal to [post-stenosis blood flow(Q1) ÷ normal blood flow(Q0)],regional cerebral blood flow loss index is concluded as:MAIN OUTCOME MEASURES: rCBFLI,relationship between STI and Vm,as well as between rCBFLI and STI.RESULTS: rCBFLI formula was used to calculate the rCBFLI of 31 patients following unilateral MCA stenosis. rCBFLI of these 31 patients was obtained by Pearson statistical analysis. STI was found to be related to the average blood velocity at stenosis with relative coefficient(Vm) of(r) =0.76( P ＜ 0. 001 )and r = 0. 83 ( P ＜ 0. 001 ) . rCBFLI was proved to be correlated with Vm and STI with r = 0. 76( P ＜ 0. 01 ) and r = 0. 81 in 55 side MCA stenoses,and the difference was of statistical significance( P ＜ 0. 001 ).CONCLUSION: rCBFLI can be used to assess the decrement of regional brain blood flow due to the stenosis of supplying artery; also,it can be used to observe the changes of brain hemodynamics if combined with STI.

Objective To evaluate the efficacy and safety of oral prednisone in patients with relapsing neuromyeli?tis optica. Methods Seventeen patients with relapsing neuromyelitis optica receiving long-term oral prednisone had been followed. The Expanded Disability Status Scale (EDSS) and annualized relapse rates were used to evaluate curative effect. Results During long-term oral prednisone treatment, patients had a significant reduction in the EDSS [(3.09 ± 0.85) vs. (4.06 ± 0.80), P<0.05] and the median annualized relapse rate was significant reduced [(0.34 ± 0.31) vs. (1.51 ± 0.57), P<0.005]. But the effect of different dosage of prednisone on annualized relapse rates was not different. No severe adverse re?actions were observed. Conclusions Treatment with long-term oral prednisone in patients with NMO significantly reduces relapse rates, improves neurological function and the treatment was well-tolerated.

Objective To investigate the clinical characteristics and mechanism of cavernous sinus dural arteriovenous fistula (CSDAVF). Methods The clinical data of 17 CSDAVF patients, including clinical manifestations, characteristics of cerebrospinal fluid (CSF)and neuroimaging,were analyzed.The interventional catheter embolization of CSDAVF and postoperative follow-up were performed. Results Of the 17 subjects with CSDAVF, 5 (29.4%) were men and 12 (70.6%)were women (sex ratio=1:2.4).The average age of onset was (58.12±14.61)years old. Older CSDAVF patients were prone to be complicated with hypertension than general population at the same age. Onset symptoms included headache in 6 cases,eye symptoms in 5 cases,intracranial murmur in 2 cases,diplopia in 2 cases, dizziness in 1 case and slurred speech in 1 case. Digital subtraction angiography (DSA) was performed in all 17 patients. Further embolization was applied in 14 patients and had satisfactory outcome. In CSDAVF patients with headache, 2 patients showed orthostatic headache as initial symptom. One of them with intracranial hypotension reported exophthalmos 3 months after the onset. Those two patients remained asymptomatic during 3-year and 2-year follow-up after receiving interventional catheter embolization for CSDAVF. Conclusions CSDAVF usually occurs in middle-aged and older women, especially in those with hypertension. CSDAVF varies in clinical manifestations. A special attention should be given to orthostatic headache which can be presented as the initial symptom in few patients with CSDAVF. CTA or DSA should be considered in patients with clinically suspected CSDAVF to rule out the possibility of CSDAVF. The interventional catheter embolization is the primary treatment of CSDAVF.

Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer. Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale. Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05). Conclusion The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.

Objective: To evaluate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy (PCNL) accessed by SVOF-principle and two-step puncture techniques. Methods: A total of 838 cases with upper urinary stones underwent percutaneous nephrolithotomy successfully accessed by ultrasound-guided between June 2007 and December 2015 at Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Of all cases were divided in two groups: hydronephrosis calyces puncture group include 425 cases and SVOF-principle puncture group include 413 cases. The access establishment time, operation time, stone free rate (SFR), postoperative complications, and postoperative hospitalization time between the two groups we compared by t test or χ² test. Results: Statistically significant differences were observed between hydronephrosis calyces puncture group and SVOF-principle puncturegroup in the first access establishment time ((16.5±8.4) minutes vs. (11.2±5.9) minutes, t=3.931, P=0.013), one-stage SFR (74.3% vs. 85.7%, χ²=16.868, P=0.000), postoperative hospitalization time ((6.4±2.1) days vs. (4.8±1.8)days, t=4.574, P=0.000), transfusion rate (7.1% vs. 2.9%, χ²=8.027, P=0.006), and embolization rate (3.3% vs. 1.0%, χ²=5.390, P=0.020). There were no statistically significant differences in operation time, total SFR, postoperative fever and sever infection between these two groups (all P>0.05). In both two groups, no serious complications such as peripheral organ injury and death occurred. Conclusions PCNL accessed guided by ultrasound with SVOF-principle and two-step puncture techniques has advantages of quick puncture location, high stone free rate, fewer complications and fast recovery. This technique is an effective and safe treatment option for upper urinary stones and deserved promotion and application in clinic.

OBJECTIVE To study the effects of isoliquiritigenin （ISL） regulating gut microbiota and repairing gut barrier function in model mice with non-alcoholic fatty liver disease （NAFLD）， and to clarify its mechanism for improving NAFLD. METHODS Thirty male C57BL/6J mice were randomly divided into the normal （ultrapure water）， model group （ultrapure water）， ISL group （100 mg/kg）， with 10 mice in each group. Model group and ISL group were fed with high-fat diet for 19 weeks to establish NAFLD model； at the same time， the mice were given relevant medicine/ultrapure water intragastrically. The changes of body weight in mice were recorded， and liver index， white fat index and brown fat index were calculated. The pathological changes of liver tissue and colon tissue as well as lipid accumulation were observed in mice. The levels of total cholesterol （TC）， triglyceride （TG）， aspartate aminotransferase （AST） and alanine aminotransferase （ALT） E-mail：xiangshj3@mail.sysu.edu.cn in serum or liver were measured； the serum levels of interleukin-6 （IL-6）， IL-1β and tumor necrosis factor-α （TNF-α） and the levels of IL-6， IL-1β and TNF-α mRNA expression in liver tissue were detected. Fecal samples underwent 16S rDNA sequencing analysis， and the effects of ISL on gut microbiota structure of mice were investigated. The expressions of gut mucosal barrier-related proteins （Claudin-4， Occludin and ZO-1） were determined in the colon tissue of mice. RESULTS Compared with model group， the body weight， liver index， the levels of TC in liver tissue and serum， the levels of AST and ALT in serum， the levels of IL-6， IL-1β and TNF-α in serum， and the mRNA expression of TNF-α in liver tissue were all decreased significantly in ISL group， while brown fat index was increased significantly. The inflammation and damage of liver tissue were significantly improved， and the NAFLD activity score and the proportion of lipid staining area were significantly reduced （P＜0.05）. ISL could significantly up-regulate the relative abundance of beneficial microbiota （norank_f_Muribaculaceae， Odoribacter， Ruminiclostridium， etc.） and the expressions of intestinal barrier function- related proteins， but could significantly down-regulate the relative abundance of harmful bacteria （Desulfovibrio， norank_f_Lachnospiraceae， unclassified_p_Firmicutes）， and could repair intestinal barrier. CONCLUSIONS ISL could significantly delay the progress of NAFLD， the mechanism of which may be associated with regulating gut microbiota and improving gut barrier function.

OBJECTIVE To study the effects of bergapten in the treatment of liver fibrosis and its mechanism based on serum metabolomics. METHODS Forty mice were divided into normal control group （0.5% carboxymethyl cellulose sodium solution）， model group （0.5% carboxymethyl cellulose sodium solution）， and BP low-dose and high-dose groups （50， 100 mg/kg）， with 10 mice in each group. Except for the normal control group， the other three groups were all treated with carbon tetrachloride to induce liver fibrosis model； they were given relevant medicine/solution intragastrically， once a day， for consecutive 8 weeks. After the last medication， the levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in serum were detected， and liver pathological changes were observed； the expressions of α-smooth muscle actin （α-SMA） and Collagen Ⅰ were detected in liver tissue； the serum of the mice was collected for metabolomics analysis. RESULTS Compared with the model group， serum levels of ALT and AST and protein expressions of α-SMA and Collagen Ⅰ in liver tissue were decreased significantly in BP high-dose and low-dose groups （P＜0.05）， while liver fibrosis was improved significantly. Meanwhile， metabolomics analyses showed that there were a total of 175 serum differential metabolites in the BP high-dose group and model group， of which 18 substances were upregulated and 157 substances were downregulated； the main metabolic pathways involved in bergapten intervention were pyrimidine metabolism， butanoate metabolism， fatty acid synthesis， tyrosine metabolism， β-alanine metabolism， nicotinic acid and nicotinamide metabolism， glutathione metabolism， etc. CONCLUSIONS BP is effective in the treatment of liver fibrosis by regulating pyrimidine metabolism， butanoate metabolism， glutathione metabolism and so on in rats with liver fibrosis.