Objective To assess the value of susceptibility weighted imaging (SWI)in the diagnosis of different cerebral diseases complicated with cerebral microbleeds (CVBs)and cerebral vascular malformations (CVMs).Methods The MRI data of 76 cases with CMBs and 25 cases with CVMs were retrospectively analyzed and the data were translated as follows:(1 )To compare the counts and detecting sensitivity of CMBs on routine MRI sequences (T1 WI,T2 WI,T2 FLAIR,DWI)with SWI.(2)To assess the difference of SWI,MIP and Phase in detecting the size,counts,intensity and edge features of CMBs.(3)To assess the advantages of SWI in the diagnosis of different CVMs.Results (1)In all 1 524 CMBs detected on SWI,294,87,361,391 CMBs were detected on T1 WI,T2 WI,T2 FLAIR and DWI respectively.The sensitivities were 19.3%,5.7%,23.7% and 5.7% on T1 WI,T2 WI,T2 FLAIR and DWI respectively.It was of statistical significance (P <0.05)in the counts and detecting sensitivity on different MRI sequences.(2) 1 524 and 1 539 CMBs were detected on SWI and MIP respectively.CMBs showed oval,dotted hypointensity or hypointensity domi-nated mixed intensity lesions which were ≤10 mm in size on SWI and MIP.1 521 CMBs were detected on Phase,which appeared as hyperintensity or hyperintensity dominated mixed intensity lesions.MIP and SWI were similar in detecting the size,counts and edge features of CMBs.And Phase was inferior compared with MIP and SWI .(3)12 cases of cerebral venous malformation were detec-ted,which all appeared as the classic Medusa head sign on SWI.6 cases of intracerebral capillary telangiectasia were detected , which were characterized as multiple small rounded even hypointense lesions ortarget signon SWI .2 cases of arteriovenous malformation (AVM)were detected on SWI,in which one case only showed multiple small vessels and gross drainage vein,and the other showed clear nidus and gross drainage veins into the sigmoid sinus.4 cases of cerebral cavernous angioma were detected.Mulberry sign, which was characterized as dotted mixed intensity lesion with hypointense ring,was noted in all the cases on SWI.One case of Sturge-Weber syndrome was detected,which showed gyriform low signal lesion on MIP imaging.And many broadened,tortuous veins in the cerebral hemispheres and near the tentorium were also noted.Conclusion SWI can be used as an important sequence for detecting CMBs.Different CVMs show their specific signs in SWI sequence.Combined with conventional MRI sequences an accurate diagnosis can be achieved most of the time.

Objective To study characters of pathology associated with functional alteration of primary brainstem injury (PBI) at different injury severities in rabbits .Methods Animal model of graded PBI was produced using rabbits .Animals were di‐vided into five groups ,group Ⅰ to Ⅳ with an increase of impact power ,10 cases in each group ,and the control group with 5 cases . The pathology characters of PBI were investigated combining dissection observation with unaided eye ,tissue HE histochemical stai‐ning and electron microscope .Results Slight brainstem injury were observed in group Ⅰ ,and pathological results showed regional subarachnoid hemorrhage (SAH) ,stripping of regional cerebral pia mater ,a few petechial hemorrhage in surface ,nerve cell edema , normal medulla sheath and axon roughly .The brainstem injuries were apparent in group Ⅱ ,and the pathological changes indicated SAH in sheet ,petechial and sheeted hemorrhage in surface ,and slight swelling and vacuoles in nerve cells .The brainstem injuries were observed obviously in group Ⅲ ,exhibiting thick SAH ,petechial and sheeted hemorrhage in surface and inside ,degeneration of nerve cells ,abruption of axon ,and atrophy of axoplasm .Eight of ten animals died of respiratory depression induced by brainstem in‐jury in group Ⅳ ,presenting thick hemorrhage in subarachnoid surrounding brainstem ,the whole brainstem injured ,microscopically with multiple small hemorrhage ,nerve cells only residual nuclei ,myelin lamellar severe stratification and fracture ,and axonal tran‐section ,disintegration .No abnormal pathological changes were shown in control group .Conclusion The impacts to brainstem with higher powers lead to more manifest functional and more severe pathological changes ,with an alternation of injury location from surface to deep .

Objective To explore the correlation between hepatitis B virus large surface protein(HBV-LP)and hepatitis B virus deoxyribonucleic acid(HBV-DNA),analyze the clinical significance of detecting the two index dynamically for diagnosis and treatment of hepatitis B.Methods Enzyme linked immunosorbent assay(ELISA)and fluorescent quantitation polymerase chain reaction(FQ-PCR)were used to detect the levels of HBV-LP and HBV-DNA in serum specimen of 230 hepatitis B patients.Results There was a positive correlation between the content of HBV-LP and copy numbers of HBV-DNA in serum of hepatitis B positive cases(r=0.84,P＜0.01).The positive rate was 84.78％ in HBV-LP and 84.35％ in HBV-DNA of 230 HBV positive cases.As a result there was no significant difference(P＞0.05)in this study.Therefore,the positive rate was 63.63 ％(35/55)in HBV-LP and 58.18％(32/55)in HBV-DNA of 55 HBV negative cases.There was also no significant difference(P＞0.05)in this study.However,the positive rate of HBV-LP(82.47％)was higher than HBE(52.06％)in the 194 HBV-DNA positive cases.There was significantly different(P＜0.01).Conclusion HBV-LP and HBV-DNA are the significant index of the degree of hepatitis B virus replication in hepatitis B positive cases,especially in determining the virus replication and prognosis of treatment in HBe Ag negative,providing the reliable laboratory data for the clinical diagnosis and treatment.

Bronchitis ; diagnosis ; Diagnostic Errors ; Humans ; Infant ; Male

Data is the basis and soul of clinical trials. To obtain accurate data, strict and standard data management is essential, which can be effectively supported by quality control in statistical analysis. In this paper, we briefly introduce the concept of the quality control in clinical trials, and describe its contents and methods. We hope that this work will be helpful to the application of statistical quality control in data management of clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Quality Control ; Statistics as Topic

In order to compensate for the deficiencies of current medical education, improve the comprehensive quality of medical students, the First Clinical College, Tongji Medical College of Huazhong University of Science and Technology took the lead in carrying out the health management practice of rela-tives and friends, and made a beneficial exploration of humanistic education for medical students. Relatives and friends were regarded as the specific practice objects, and by telephone and network at school, face-to-face communication during the vacation, medical students established, managed and track the health records of relatives and friends. The students could practice while learning, which made medical students, in im-proving the knowledge structure, enhance their emotional communication with friends and relatives, improve their doctor-patient communication ability, establish the concept of humanistic care, and cultivate their occupation moral respect for life and their dedication to medicine and the sense of responsibility and mission to the society. It provides a new strategy for medical humanities education.

Objective To study the effects of amniotic epithelial cells conditioned medium on the differentiation of bone marrow stromal cells into neural cells. Methods Bone marrow stromal cells and amniotic epithelial cells were isolated and cultured in vitro,then the cell surface antigen was detected by flow cytometry and the expressions of nestin and ki67 were detected by immunofluorescence staining method.When the cells were co-cultured with amniotic epithelial cells conditioned medium,the morphological character of cells was observed by inverse phase-contrast microscope,and the expressions of NSE(neurone specific enolase),TH(tyrosine hydroxylase) and DAT(dopamine transporter) were detected by immunofluorescence staining method. Results Amniotic epithelial cells conditioned medium had obvious inductive effect on bone marrow stromal cell's neural differentiation.Conclusion The amniotic epithelial cells conditioned medium may have inductive effect neuron-like cell's differentiation and dopaminergic neuron-like cell's differentiation of bone marrow stromal cells in vitro.

BACKGROUND: Induced pluripotent stem cells (iPSCs) are a special type of cells with self-renewal and multi-differentiation potential, which can differentiate into intestinal organoids under certain conditions. OBJECTIVE: To explore whether iPSCs can differentiate into intestinal organoids under specific conditions in vitro.METHODS: iPSCs from B6J mice were recovered and cultured for 3 days until clone units covered about 80％ of the culture dish, and then the cells were cultured in the medium containing Activin A for 3 days until the deterministic endoderm formed. Further, the culture medium was replaced by the medium with fibroblast growth factor 4 and Wnt3A for 4 days to differentiate into the spheroids with CDX2+. After that, spheroids were collected and mixed with Matrigel,and then the mixture was dropped into the 4-well plate and cultured with Rspondin1, Noggin, epidermal growth factor, B27 and other growth factors to differentiate into intestinal organoids. Cell morphology was observed, FoxA2 and Sox17 expresson in the deterministic endoderm was detected, and CDX2, Sox9, CGA, MMP7 were measured.RESULTS AND CONCLUSION: iPSCs were cultured with Activin A for 3 days with higher cell fusion, initial differentiation and FoxA2/Sox17 expression (P < 0.05) than those of non-induced iPSCs. Spheroids began to appear at the 3rd day after culture with fibroblast growth factor 4 and WNT3A, and formed a lot at the 4th day. And CDX2 expression in spheroids was significantly increased compared with that in the deterministic endoderm (P < 0.05). Organoids gradually formed after 3 days culture, which contained all cell types of intestinal organoids, and expressions of specific markers, Sox9, CGA, MMP7, were significantly higher than those in spheroids (P < 0.05). To conclude, iPSCs can be induced to differentiate into intestinal organoids in three-dimensional niche in vitro.

Objective To investigate the function of amnion endothelial cell in the differentiation of human umbilical cord blood stem cells into dopaminergic neurons.Methods Primary human amnion endothelial cells were separated and cultured in vitro;the conditioned medium(CM) was prepared through high speed centrifugation.The cord blood mesenchymal stem cells of P_1 passage were induced by the conditioned medium,and the mophology of cells was observed under the inverted phase contrast microscope.The expression of tyrosine hydroxylase(TH)and dopamine transportor(DAT) of the induced cord blood mesenchymal stem cells were detected by immunocytochemistry staining method and immunoblotting(Western blotting).Results The masculine rate of TH and DAT of the cord blood mesenchymal stem cells of P_1 passage which were induced by amnion endothelial cells conditioned medium was higher than that of the control group,with a significant difference(P

Objective To analyze the ophthalmologic characteristics and examinations which caused by vertebral-basilar insuffi- ciency.Design Retrospective case series.Participants 469 eases of vertebral-basilar insufficiency.Methods Retrospective analysis of 469 cases of vertebral-basilar insufficiency patients with ophthalmologic signs' features,incidence,the main cause,color Doppler flow imaging and(or)digital subtraction angiography clearly stenosis location,the degree of stenosis from July 1st 2005 to July ist 2007 in PLA General Hospital.Main Outcome Measures Ophthalmologic signs' related reasons and supplementary examination.Results 96 cases were with the corresponding eye symptoms(20.4%).Vision decreased in 83 cases,diplopia was in 56 cases,ipsilateral hemiopia quadrant blind in 12 cases and depending on deformation in 10 cases,fundus arteriosclerosis in 72 cases,nystagmus in 39 cases,the eye movement disorder in 16 cases.Among 96 patients with associated ocular symptoms,75 patients with color Doppler flow imaging (CDFI)showed unilateral vertebral artery abnormal in 66 cases(88%),among those blood flow velocity decreased in 26 cases,17 cases with vascular plaque stenosis,thinning in 20 cases,3 cases with complete occlusion;different bilateral vertebral artery abnormal in 9 cases(12%),among those velocity dropped in 4 cases,two cases with vascular plaque stenosis and thinning in 3 cases.Forty-five cases with the digital subtraction angiography(DSA),left vertebral artery was abnormal in 24 cases,18 cases with stenosis,occlusion in 5 cas- es,abnormal bending in 1 case.Right vertebral artery was abnormal in 16 cases,13 cases with stenosis,occlusion in 3 cases.Bilateral vertebral artery stenosis was found in 2 cases;vertebral artery stenosis was in 3 patients.Conclusion Vertebral-basilar insufficiency may cause eye-related symptoms,therefore,vision acuity decrease,fundus 'arteriosclerosis,diplopia and nystagmus symptoms are more likely for patients with vertebral-patients with basilar artery insufficiency performance of the eye.(Ophthalmol CHN,2002,16:406-410)