Objective To investigate the correlation between the distribution of lesions on MRI and the findings of computerized tomography angiography (CTA) in patients with posterior circulation infarction.Methods Patients with acute posterior circulation infarction were enrolled in the study.The sites of the infarcts were divided into proximal,middle and distal infarctions according to the results of MRI.All the patients received head and neck CTA.The correlation between the distribution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed.Results A total of 203 patients with acute posterior circulation infarction were enrolled.Their primary clinical symptoms and signs were unilateral limb weakness (n =77,37.93％),dizziness (n =129,63.55％),dysarthria (n =31,15.27％),nausea and vomiting (n =61,30.05％),headache (n =79,38.92％),gait abnormal (n =50,24.63％),nystagmus (n=34,16.75％),and ataxia (n=21,10.34％).Proximal infarction (n=35,17.24％):medullary infarction (n =28,13.79％),posterior inferior cerebellar artery infarction (n =7,3.45％); middle infarction (n =95,46.79％):pontine infarction (n =80,39.4％),anterior inferior cerebellar infarction (n =15,7.39％); distal infarction (n=73,35.96％):middle cerebral infarction (n=6,2.96％),superior cerebellar infarction (n =16,7.88％),thalamic infarction (n =34,(16.75％),occipital lobe infarction (n =10,4.93％),temporal lobe infarction (n =7,3.44％).Extracranial vertebral artery lesions were most common in the distal infarction group.It reached 53.42％,and was significantly higher than 22.86％ in the proximal infarction group (P =0.003) and 33.68％ in the middle infarction group (P =0.010).Intracranlal vertebral artery lesions were most common in the proximal infarction group.It reached 57.14％,and then followed by the middle infarction (41.05％).They were all significantly higher than 15.07％ in the distal infarction group (all P =0.000).Basilar artery lesions were most common in the middle infarction group.It reached 20.00％ and was significantly higher than 4.11％ in the distal infarction group (P=0.002).Posterior cerebral artery lesions were most common in the distal infarction group.It reached 27.40％ and was significantly higher than 5.71％ in the proximal infarction group (P =0.009) and 5.26％ in the middle infarction group (P=0.000).Conclusions The range of vascular lesions of the distribution of lesions shown on MRI and the findings of CTA on vertebrobasilar artery system in patients with posterior circulation infarction had some connection.During the proximal and middle infarctions,the possibility of having intracranial vertebral artery lesions was greater; during the distal infarction,the possibility of having extracranial vertebral artery and posterior cerebral artery lesions was greater.

Objective:To explore the role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma (HNSCC).Methods:The expression of CXCR2 in HNSCC tissues of 105 cases was detected by immunohistochemical staining,the correlation between CXCR2 expression and cervical lymph node metastases of HNSCC was analysed.Then,3 stable HNSCC cell lines with CXCR2 interference were established,the effects of CXCR2 silencing on cell migration and invasion were observed by in vitro tests.Results:CXCR2 was positively expressed in 51.43% of HNSCC specimens and was statistically associated with the cervical lymph node metastases of HNSCC.CXCR2 silencing markedly inhibited the migration and invasion of HNSCC cells in vitro.Conclu-sion:CXCR2 may play a key role in the invasion and metastases of HNSCC.

Objective To investigate whether black cohosh could be improve patients with breast cancer treated chemotherapy like-menopausal symptoms through a non-estrogen pathway.Methods We selected 120 patients with breast cancer dianosised and treated chemotherapy from January 2012 to June 2013 in four Affiliated Hospital of Harbin Medical,which were female patients,20-51 years,preoperative menopause,menstrual regularly,postoperative chemotherapy timely and regularly,and Kupperman score ≥ 15 points.All patients were randomized,double-blind divided into two groups,the experimental group was treated with medication Li Fumin Black Cohosh Extract,40 mg once daily,the other one was treated with placebo,40mg once a day.After 12 weeks,all patients were checked by estrogen hormones,gynecological ultrasound,the ultrasound of the other breast,Kupperman score,Then we make an assessment with those.Results During the experimental group and the control group,estrogen and endometrial thickness were within normal range,and there are not statistically significant difference between before and after medicine(P ＞ 0.05).What's more,before and after medication,the experimental group and the control group were not found new breast lumps.After taking medicine,the Kupperman score of experimental group was significantly lower than before treatment,the difference was statistically significant (P ＜0.05); however,there was not statistically significant difference between before and after medicine for the Kupperman score in control group(P ＞ 0.05).In experimental group,there are 5 cases of patients,which Kupperman is more 15 points,but lower than the score before taking medicine.Conclusions Black cohosh could improve like-menopausal symptoms of patients with breast cancer treated chemotherapy through a non-estrogen pathway,regardless of estrogen-receptor positive or negative,which has a good effection.

Objective:To analyze the frequencies of HLA-A*0201 restricted CEA-specific CD8+T cells, HLA-A*0201/FLUmp tetramer and HLA-A*0201/CAP-1 tetramer were applied in patients with colorectal cancer.Methods: Lymphocytes from peripheral blood and lymph node,1×106 cells/ml,were incubated with 1μg HLA-A*0201/peptide tetramers and anti-CD8 for 1 h at 25 coseperately.The cells were then washed in PBS.Next,the cells were illuminated by detecting frequencies of FLUmp-specific CD8+T cells and CAP-1-specific CD8+T cells with flow cytometry.Results: HLA-A*0201/peptide were used to detect CAP-1 or FLUmp-specific CD8+T cells,which were analyzed either healthy individuals or patients with colorectal cancer.We did not find differences in average frequencies of FLUmp-specific CD8+T cells between 11 HLA-A*0201+patients with colorectal cancer and 14 HLA-A*0201+healthy individuals [ ( 0.671 ±0.421 )%, ( 0.564 ±0.408 )%].But the frequencies of CAP-1-specific CD8+T cells of HLA-A*0201+patients with colorectal cancer showed higher than HLA-A*0201+healthy individuals [ ( 2.409 ± 2.385 )%, ( 0.020 ± 0.021)%respectively],which was statistically significant(P=0.008).Conclusion:The frequencies of CAP-1-specific CD8+T cells in PBMC from peripheral blood and lymph node of HLA-A*0201+patients were increased,showed CEA-specific CTs has a vital role in colorectal cancer.

Objective:To explore the feasibility and precautions of laparoscopic pyeloplasty for children with hydronephrosis combined with renal trauma.Methods:The clinical data of 6 cases with hydronephrosis and renal trauma admitted to the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from August 2016 to August 2019, aged from 5 to 11 years old (average age 7 years old) were reviewed.These patients had suffered renal trauma for 1 to 4 days.All patients had the symptoms of pain in the affected kidney, and 4 patients had hematuria.The renal pelvis diameter of all patients was more than 25 mm.The patients underwent laparoscopic pyeloplasty and renal rupture repairment, with the ureteral stent, perirenal drainage tube and catheter placed inside the body during the operation.Results:All operations were completed successfully without any blood transfusion and open surgery.Intrao-perative time was from 2.5 to 3.5 hours.Two cases had renal parenchymal contusion in the front lower pole of kidneys and 4 cases in the lateral lower pole.Five cases had renal cortex and pelvis rupture, and 1 case had renal cortical fracture and subcapsular hematoncus.After the operation, the perinephric drainage tube was pulled out in 3 to 5 days, the catheter was pulled out in 7 to 10 days, and the ureteral stent was removed in 6 to 8 weeks.All children recovered well and hydronephrosis was ameliorated.The glomerular filtration rates and fractional renal function were all improved.Conclusions:One stage laparoscopic pyeloplasty is safe and effective for the treatment of hydronephrosis with renal trauma in children.Renal trauma in children usually occurs at the lower pole of the kidney.Early operation is needed if hydronephrosis is aggravated and symptoms are not relieved after the trauma.Intraoperative impairment of renal parenchymal rupture can be conducted.For intraoperative bleeding in grade 3 renal injury, renal parenchyma suturation and removal of necrotic renal tissue should be adopted to arrest bleeding.

ObjectiveTo understand the relationship between mycoplasm load in bronchoalveolar lavage lfuid (BALF) with the status of Th1/Th2 immune response in children withMycoplasma pneumoniae pneumonia (MPP).MethodsThe levels of IL-4, IFN, IL-8 , TNF-α in BLAF and total IgE, ECP in serum from 90 children with MPP were measured by ELISA.MP DNA in BALF was detected quantitatively by lfuorescent real-time PCR. Children with MPP (n=90) were divided into two groups of low MP-DNA load (n=24) and high MP-DNA load (n=26) according to the copies of MP DNA in BALF. The cytokines in BALF, and total IgE and ECP in serum were compared between the two groups. The relationship between the levels of cytokines in BLAF and the copies was evaluated.ResultsThe levels of IL-4 and the IL-4/IFN ratio in BALF from the high DNA-load group were signiifcantly higher than that of the low group (t=4.280, 2.076, allP<0.05). The level of IL-4 was signiifcantly correlated with the copies of MP-DNA in BALF from children with MPP (r=0.509,P<0.05). The percentage of total IgE and ECP positive result in serum from the high DNA-load group is higher than that of the low group. (χ2=24.638, 6.392,allP<0.05).Conclusion Infection with high-load MP in children may cause the imbalance of Th1/Th2. And the Th2 cytokines response seems predomi-nant.

Objective To analyze the clinical characteristics,pathological classification and therapy strategy of rectal carcinoid and its prognostic factors.Methods Forty four patients with rectal carcinoid were diagnosed and treated in Ruijin Hospital Shanghai Jiaotong University from January 2006 to November 2013,among whom 21 patients (19 males and 2 females) were followed-up for 1-7.5 years.The clinical data of these cases were retrospectively analyzed.Results The patients underwent colonoscopy because of changed bowel habits and/or abnormal digital rectal examination,none of them had carcinoid syndrome.Colonoscopy showed that most lesions presented yellowish in color and smooth in surface; the diameter of the tumor was ≤ 1.0 cm in 12 cases (57％) ; the tumors were located at the rectum within 8 cm from anal rim in 17cases (76％); most of them were well differentiated.Immunohistochemistry demonstrated that NSE expression was highly positive.The 1 year-and 3year-survival rate were both 100％.Among 8 cases who were followed up for over 5 year,2 relapsed.Conclusions The digital rectal examination plays a key role in detecting rectal carcinoid.Though prognosis is relatively good,we should keep close following-up to detect the recurrence.The main risk factors influencing the prognosis are tumor size,depth of invasion and clinical stage.The combination measurement of CEA,TSGF,CA19-9 and NSE will either increase the sensitivity or the specificity of early detection.

Objective To assess the curative effect and security of bisoprolol in the elderly chronic obstructive pulmonary disease (COPD) patients combined with chronic heart failure (CHF) .Methods 61 cases of elderly COPD patients combined with CHF in our hospital were selected .on the basis of conventional treatment ,the patients were applicated bisoprolol 2 .5 mg ,1 time each day , the NT-proBNP ,LVEF% ,LEVDD and FEV1% were respectively observed before treatment ,4 weeks after treatment ,8 weeks af-ter treatment ,6 months after treatment .Results 4 weeks after treatment ,NT-proBNP ,LVEF% ,LEVDD showed no significant changes .8 weeks after treatment ,NT-proBNP and LEVDD decreased(P<0 .05) ,LVEF% showed no significant changes .6 months after treatment ,NT-proBNP and LEVDD decreased significantly ,meanwhile LVEF% increased (P< 0 .05) .before treatment ,4 weeks after treatment ,8 weeks after treatment ,6 months after treatment ,FEV1% were 47 .33 ± 5 .57 ,47 .08 ± 5 .50 ,48 .30 ± 6 .31 , 49 .64 ± 6 .24 ,All groups showed no changes in the pulmonary function(P>0 .05) .NT-proBNP of all groups were negatively corre-lation with the FEV1% (r= -0 .708 ,-0 .702 ,-0 .833 ,-0 .778) .Conclusion Small doses of bisoprolol is safe and effective in the treament of the elderly COPD patients with chronic heart failure .

Objective To explore the expression of Ras-related protein 11(Rab11)in hypoxia, the effect of Rab11 on the invasion and migration of cervical cancer cell line SiHa and its possible mechanism. Methods SiHa cells were divided into 4 groups, the normoxic blank group (normal culture in normoxia), the hypoxic blank group (normal culture in hypoxia), the negative control group [transfection of negative control small interfering RNA(siRNA)in hypoxia], the Rab11-siRNA group (transfection of Rab11 siRNA in hypoxia). Western blot was used to examine the expression of Rab11, integrin α5, integrin β3, phosphorylated focal adhesion kinase(p-FAK), phosphorylated phosphatidylinositol 3 kinase(p-PI3K) protein, together with the expression of Ras correlative C3 creotoxin substrate 1(Rac1), which was critical in regulating cell invasion. The mRNA expression of Rab11 in the 4 groups was detected by realtime-qPCR. The cell invasion was detected by matrigel assay, while the cell migration was detected by transwell assay. Immunofluorescence was used to identify intracellular location of Rac1 in SiHa cell. Results (1) The expression of Rab11, intergrin α5, intergrin β3, p-FAK, p-PI3K and Rac1 in the normoxic blank group were 0.56±0.04, 0.33±0.03, 0.32±0.03, 0.36±0.03, 0.35±0.03 and 0.47±0.03, respectively. In the hypoxic blank group, they were 0.73±0.03, 0.74±0.03, 0.61±0.03, 0.62±0.03, 0.60±0.03 and 0.73±0.03, respectively. In the negative control group, their expressions were 0.72±0.03, 0.73±0.03, 0.59±0.03, 0.61±0.03, 0.59±0.03 and 0.72±0.03, respectively. While in the Rab11-siRNA group, they were 0.44±0.03, 0.30±0.03, 0.29±0.03, 0.30±0.03, 0.30±0.03 and 0.34±0.04, respectively. The expressions of Rab11, α5, β3, p-FAK, p-PI3K and Rac1 were significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and were significantly lower in the Rab11-siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (2) The expressions of Rab11-mRNA were 1.000±0.000, 1.454±0.114, 1.442±0.101, 0.570± 0.046 in the normoxic blank group, the hypoxic blank group, the negative control group and the Rab11- siRNA group, respectively. It was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11-siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (3) By Matrigel, the invasion cell number in the normoxic blank group, the hypoxic blank group,the negative control group and the Rab11-siRNA group were 65±12, 106±16, 104± 17 and 50±11, respectively. The invasion capacity was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11- siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (4) By transwell assay, the migration cells in the normoxic blank group, the hypoxic blank group, the negative control group and the Rab11-siRNA group were 127±12, 169±15, 161±13 and 77±13, respectively. The capacity of invasion was significantly higher in the hypoxic blank group than in the normoxic blank group(P<0.05), and was significantly lower in the Rab11- siRNA group than in the hypoxic blank group and the negative control group(P<0.05). (5) The immunofluorescence showed that the red fluorescence intensity around nucleus was significantly increased in the normoxic blank group, the hypoxic blank group and the negative control group than in the Rab11- siRNA group. Conclusions Hypoxia could promote the invasion and migration of SiHa cells. In hypoxia, the down regulation of Rab11 expression could inhibit the invasion and migration of SiHa cells. This might be due to the decreased expression of the intergrin α5, intergrin β3, p-FAK, p-PI3K and Rac1 protein.

Objective To analyze the discrepancy and similarities of clinical characteristics in elderly patients with ulcerative colitis (UC) and ischemic colitis (IC).Methods A total of 43 elderly patients (age≥60 yrs) with UC and 36 elderly patients with IC were enrolled from 2004 to 2015 at Peking Union Medical College Hospital.The clinical characteristics were retrospectively analyzed and compared between the two groups.Results Compared with IC group,the disease course was longer with lower incidence of cardiovascular comorbidities in UC patients (P ＜ 0.05).In UC group,more patients presented with diarrhea,mucopurulent bloody stool [39 (90.7％) vs 16 (44.4％) and 34 (79.1％) vs 2 (5.6％)respectively,both P ＜ 0.01].Yet bloody stool as the only symptom was seen in more IC patients than UC patients [61.1％ (22/36) vs 7.0％ (3/43),P ＜ 0.01].The ratio of extra-intestinal manifestations was higher [18.6％ (8/43) vs 0 (0/36)] in UC patients,while complications were lower [11.6％ (5/43) vs 30.6％ (11/36),P ＜ 0.05].As to the laboratory parameters,median platelet count [(294.38 ± 104.83) × 109/L vs (235.47±94.82) × 109/L,P ＜0.05] was higher in UC group.In addition,more patients with UC had positive perinuclear antineutrophil cytoplasmic antibody (p-ANCA) [50.0％ (15/30) vs 10.0％ (2/20),P ＜ 0.05].The most commonly involved regions of IC were descending colon and sigmoid colon,in which the lesions were clearly demarcated with the normal mucosa.Lesions in patients with UC mainly originated from rectum and might spread to the whole colon.Vascular occlusion and micro thrombosis were characteristic pathological findings of IC.The crypt abscesses were frequently seen in the UC group.Conclusion Even though UC and IC have some similar manifestations in the elderly patients,clinical and pathological discrepancy is still helpful to differentiate each other.