Objective To evaluate the relationship between cranial CT characteristics and prognosis after first-ever primary supratentorial intracerebral hemorrhage (PSICH). Methods The data of clinic and CT in patients with first-ever PSICH were registered prospectively and followed up for 6 months. The relationship between the prognosis and the clinic data was analyzed using univariate and multivariate Logistical regression analysis.Results (1) The volume of hematoma was an independent CT predictor of death at 1st, 3rd and 6th month. (2) Both the volume of hematoma and secondary ventricular hemorrhage were independent CT predictors of death/disability at 6th month.Conclusions (1)The volume of hematoma can be used to predict death in patients with PSICH.(2)The volume of hematoma and secondary ventricular hemorrhage can be used to predict the death/disability rate of PSICH.

Objective To evaluate the efficacy of superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage. Methods The clinical data of 31 iatrogenic renal hemorrhage patients who had underwent superselective renal artery embolization were retrospectively analyzed. Results All patients were found to have bleeding site by contrast examination, including pseudoaneurysm in 21 cases, renal arteriovenous fistula in 3 cases, extravasation of contrast media in 4 cases, and pseudoaneurysm and renal arteriovenous fistula in 3 cases. Microcoil embolization was used in 20 patients, and microcoil embolization combined with gelatin sponge was used in 12 patients. Thirty patients got successful embolization once, and success rate was 96.8%(30/31). One patient got successful embolization in the second time. There were no serious complications and no recurrence of renal hemorrhage. Conclusions Superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage has the advantages of exact hemostasis, less trauma and fewer complication, and can retain the normal renal tissue maximumly.

Objective To observe the effect of alpha lipoic acid on quality of life in patients with type 2 diabetic peripheral neuropathy.Methods 76 cases diagnosed with type 2 diabetic peripheral neuropathy,in accordance with the random number table,were divided into the control group (37cases)and treatment group (39cases).All the patients received diabetic diet,exercise guidance and blood glucose control.The control group was treated with methy-cobal 500μg muscle injection once a day for 2 weeks.The treatment group was treated besides above treatment with intravenous drip alpha lipoic acid 600mg once a day was added for 2 weeks.Then,the changes of motor nerve conduc-tion velocity,sensory nerve conduction velocity and quality of life (QoL)score (somatic symptoms,cognitive func-tion,health happy feeling,social participation,emotional state,work performance,life satisfaction and total score)of the two groups after treatment were observed.Results After treatment,the motor nerve conduction velocity of the control group were as follows:median nerve (40.7 ±4.5)cm/s,common peroneal nerves (41.3 ±4.9)cm/s,The sensory nerve conduction velocity of the control group were as follows:median nerve (38.6 ±4.3)cm/s,common per-oneal nerves (38.3 ±4.5)cm/s.After treatment,the motor nerve conduction velocity of the treatment group were as follows:Median nerve (45.4 ±5.7)cm/s,common peroneal nerves (44.9 ±6.4)cm/s,The sensory nerve conduction velocity of the treatment group were as follows:Median nerve (45.0 ±2.0)cm/s,common peroneal nerves (43.6 ± 3.2)cm/s.Both the two groups′motor nerve conduction velocity and sensory nerve conduction velocity were significantly increased after treatment (P <0.05).Compared with control group,the motor nerve conduction velocity and sensory nerve conduction velocity in the treatment group were significantly improved after treatment,which had statistically significance,(t =2.63,2.51,2.85,2.79,all P <0.05).After treatment,the somatic symptoms,cognitive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and the total score of control group were (52.4 ±9.6)points,(27.0 ±7.8)points,(35.7 ±10.3)points,(19.6 ±7.3)points,(17.4 ± 3.1)points,(16.5 ±3.9)points,(185.4 ±40.7)points,respectively.After treatment,the somatic symptoms,cogni-tive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and total score of treatment group were (41.9 ±7.4)points,(24.1 ±8.6)points,(28.3 ±9.2)points,(14.5 ±5.5)points, (12.6 ±5.6)points,(11.9 ±4.7)points,(135.0 ±38.7)points,respectively.The quality of life score of the treat-ment group was obviously lower than the control group,which had statistically significance,(t =5.14,2.54,2.96, 2.87,2.69,3.05,6.25,all P <0.05).Conclusion Alpha lipoic acid can improve the nerve conduction function of patients with type 2 diabetes peripheral neuropathy,and improve the quality of life.

Objective: To observe the effect of the combination of acupuncture and medication on orthostatic hypotension after incomplete cervical spinal cord injury. Methods: Ninety-two patients with orthostatic hypotension after incomplete cervical spinal cord injury were divided into two groups according to the random number table method, with 46 cases in each group. The control group was treated with oral midodrine hydrochloride on the basis of conventional treatment, and the observation group was treated with acupuncture in addition to the intervention used in the control group. Both groups were treated for 4 weeks. The changes in supine and orthostatic blood pressures, motor and sensory scores, quadriplegic function index score, clinical efficacy, and safety evaluation were observed. Results: During the treatment, 2 cases dropped out in the observation group, and 3 cases dropped out in the control group. After 4 weeks of treatment, the clinical efficacy of the observation group was better than that of the control group (P<0.05). After treatment, the supine systolic blood pressure and diastolic blood pressure in the two groups had no significant changes (P>0.05), while the orthostatic systolic blood pressure and diastolic blood pressure, the motor and sensory scores, and the quadriplegic function index score were significantly higher than those before treatment (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05). Adverse reactions were mild in both groups. Conclusion: The combination of acupuncture and medication can significantly improve the orthostatic blood pressure, motor and sensory function and daily living ability of patients with orthostatic hypotension after incomplete cervical spinal cord injury, and it is safe and reliable.

Objective To systematically assess the diagnostic performance of CTA for lower extremity peripheral arterial disease (PAD) using a Meta analysis method. Methods Studies were located through electronic searching of the PubMed, EBSCO, Springer, Ovid, CNKI, Cochrane library (from the date of establishment of the databases to October 2009 ). Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of PAD using CTA had been searched and reviewed, and the studies with the DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC ( summary receiver operating characteristics)analyzing using the Meta Disc 1.4 software. Results Totally 24 studies met the inclusion criteria with a total of 1096 patients. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.95 ( 95% CI:0.94-0.95 ), 0.96 ( 95% CI:0.95-0.96), and 471.13 (95% CI:242. 92-913.71 ), respectively. The area under of SROC curve was 0.9888 and the Q index was 0.9555. Subgroup analysis demonstrated significant difference on diagnostic performance for various CT slices (P ＜ 0.05 ). Conclusion CTA can be regarded as an effective and feasible method for PAD diagnosis and screening, based on the results of this systematic review. However,more rigorous evaluations of CTA in patients with critical limb ischemia are needed.

Objective To investigate the expressions and correlations of Kiss-1 and matrix metalloproteinases-9 (MMP9) proteins in the colorectal cancer (CRC) tissues of patients with synchronous colorectal liver metastasis (SCRLM),and the association with the clinicopathologic factors and prognosis of patients.Methods The retrospective case-control study was adopted.The clinicopathological data of 96 patients with SCRLM and 69 patients with CRC and no metastasis who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2000 to May 2013 were collected.The 96 CRC tissues and 50 adjacent normal tissues (distance from resection margin ≥ 5 cm) were collected from 96 patients with SCRLM,and 69 CRC tissues were collected from 69 patients with CRC and no metastasis.Expressions of Kiss-1 and MMP9 protein were detected by immunohistochemistry (IHC).The follow-up of outpatient examination and telephone interview was performed to detect survival of patients till August 2014.Comparison of count data and correlation between expressions of Kiss-1 or MMP9 protein and clinicopathological factors were analyzed by the chi-square test and Fisher exact probability.Survival curve was drawn using the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Correlation analysis was done by the Pearson correlation.Results Expression of Kiss-1 protein was located in the cytoplasm of tissue cells.The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 24.0％ (23/96),43.5％ (30/69) and 52.0％ (26/50),respectively,with a significant difference among the 3 tissues (x2 =14.307,P ＜ 0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2 =0.845,P ＞ 0.05).The positive expression rate of Kiss-1 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =0.702,11.594,P ＜ 0.05).Expression of MMP9 protein was located in the cytoplasm of tissue cells.The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 67.7 ％ (65/96),62.3 ％ (43/69) and 36.0％ (18/50),respectively,with a significant difference among the 3 tissues (x2=14.203,P ＜0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2=8.038,P ＞ 0.05).The positive expression rate of MMP9 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =13.475,13.475,P ＜ 0.05).The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM were 66.7％,21.9％ and 17.6％ in the high-,mederate-and low-differentiated tumor,50.0％,28.6％ and 17.5％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 16.9％ in patients with and without lymph node metastasis,respectively,showing significant differences among the tumor differentiation degree,depth of tumor invasion and lymph node metastasis (x2=6.546,6.172,7.453,P ＜0.05).The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM were 25.0％,66.7％ and 76.2％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 76.1％ in patients with and without lymph node metastasis,respectively,showing significant differences between the depth of tumor invasion and lymph node metastasis (x2 =12.094,8.690,P ＜ 0.05).All the 96 patients with SCRLM were followed up for a median time of 68 months (range,12-176 months).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,26 months,69.6％ and 26.1％ in patients with SCRLM and positive expression of Kiss-1 protein and 26 months,19 months,24.7％ and 12.3％ in patients with SCRLM and negative expression of Kiss-1 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=16.578,14.436,P ＜ 0.05).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,19 months,24.6％ and 12.3％ in patients with SCRLM and positive expression of MMP9 protein and 28 months,16 months,58.1％ and 22.6％ in patients with SCRLM and negative expression of MMP9 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=14.073,8.532,P ＜0.05).Of 96 patients with SCRLM,there were 23 patients with positive expression of Kiss-1 protein (10 with positive expression of MMP9 protein and 13 with negative expression of MMP9 protein) and 73 with negative expression of Kiss-1 protein (55 with positive expression of MMP9 protein and 18 with negative expression of MMP9 protein),with a negative correlation between expressions of Kiss-1 protein and MMP9 protein (r =-0.291,P ＜ 0.05).Conclusions The reduced expression of Kiss-1 protein and elevated expression of MMP9 protein are closely associated with invasion and metastasis of CRC and prognosis of patients.A combination detection of Kiss-1 and MMP9 proteins is expected to become a marker for predicting the prognosis of patients with SCRLM based on the negative correlation between them.

Objective To understand the clinical characteristics of Acinetobacter baumannii infections in elderly patients in intensive care unit (ICU)and investigate its drug susceptibility. Methods Bacterial identification was carried out by VITEK?32 automatic micro?analyzer(Bio?Merieux Company of French). Data processing was performed with WHONET5.6 software. Results Totally 259 strains of Acinetobacter baumannii were isolated from 220 infected elderly patients. The detection rate of Acinetobacter baumannii was 71.43%(185 strains),13.13%(34 strains), 6.18%(16 strains )and 9.26%(24 strains)from sputum,drainage fluid,blood and other specimens,respectively . Drug resistance of Acinetobacter baumanniito antibiotics was relatively high. Resistance to tigecycline of Acinetobacterbaumanniistrains was the lowest(0%?23.38%)while the sus?ceptibility was the highest(70.13%?80.85%)in all kinds of antibiotics in this study. Conclusion Acinetobacter baumannii varied in drug resis?tance to different antibiotics. It is necessary to choose susceptible antibiotics for clinical anti?infection treatment on the basis of in?vitro antibiotics sus?ceptibility testing for isolated strains from local regions.

Purpose To analyze the differences of CT manifestations, and to explore the disparity of drainage volume in early drainage between Klebsiella pneumoniae induced liver abscess and non-Klebsiella pneumoniae induced liver abscess. Materials and Methods 337 cases of patients whose blood culture or drainage fluid culture results were positive were divided into Klebsiella pneumoniae group (219 cases) and non-Klebsiella pneumoniae group (118 cases). CT characteristics of the two groups were analyzed, including lesion distribution, quantity, structure, texture, abscess wall thickness, enhancement character around the lesion, whether or not concurrent with thrombophlebitis or migratory infection and so on. Early drainage volume in interventional puncture drainage was observed in both groups. Results Chest CT showed that solitary, multi-room, solid, thin-walled abscesses with concurrent thrombophlebitis, migratory infection and no enhancement around tend to occur in Klebsiella pneumoniae group (χ2=4.065, 3.834, 4.682, 5.689, 5.215, 8.362, 8.407, P<0.01). Early drainage volume of Klebsiella pneumoniae group was significantly lower than that of non-Klebsiella pneumoniae group (χ2=5.863, P<0.01). Conclusion CT manifestations of Klebsiella pneumoniae induced liver abscess are solitary, multi-room, solid, thin-walled abscesses without enhancement around them, thrombophlebitis and migratory infection are common seen and drainage volume is less in early stage after interventional operation.

Objective To synthesize podo-and epipodo-podophyllotoxin labeled with 11C and investigate their biodistribution in mice bearing EMT6 tumor by microPET.Methods 11 C-podo-or epipodopodophyllotoxin was synthesized by 11 C-CH3-Triflate mixed with 4'-methyl-demethmyl-podophyllotoxin (podo-and epipodo-) and purified using HPLC.The radiochemical purity (RCP) was analyzed by HPLC.Thirty mice bearing EMT6 tumor were divided into 2 groups and injected with 3.7 MBq 11C-podo-or epipodo-podophyllotoxin.The biodistribution of 11C-podo-or epipodo-podophyllotoxin was evaluated with microPET.The ID％/g was calculated.Paired t test was used to analyze the data.Results The yields of 11C-podo-and epipodo-podophyllotoxin were both ＞90％.The RCP was ＞99％.The biodistribution of 11C-podo-and epipodo-podophyllotoxin was similar with slow blood clearance and high uptake in abdomen.The tumor uptake of 11C-epipodophyllotoxin and 11C-podophyllotoxin at 30 min was (3.63±0.98) ％ID/g and (3.16±0.27) ％ID/g,respectively.The uptake ratio of tumor to blood and to muscle was 0.68 vs 0.62 and 1.52 vs 1.22,respectively.There was no significant difference between the tumor uptake of the two agents (t=0.47,P＞0.05).The result of microPET imaging was consistent with that of mice experiment.Conclusion 11C-podophyllotoxin has limited clinical value for tumor imaging.

Objective To explore the clinical metabolic characteristics and the blood glucose variability in the insulin resistance polycystic ovary syndrome (PCOS) patients.Methods Totally 69 cases of PCOS patients were divided into two groups:PCOS with insulin resistance (PCOS-IR) group and PCOS without insulin-resistance (PCOS-NIR) group.Their clinical and metabolic characteristics were analyzed,and continuous glucose monitoring system (CGMS) was used to monitor the glucose concentration of subcutaneous interstitial fluid to reflect the blood glucose level.Mean blood glucose level (MBG) and its standard deviation (SDBG),mean amplitude of glycemic excursion (MAGE),peak level of postprandial plasma glucose as well as its peaking time during a 48-hour period CGMS were calculated.Results MBG,SDBG,large amplitude of glycemic excursions (LAGE),MAGE level in PCOS-IR group,were significantly higher than those in PCOS-NIR (P ＜ 0.05).Body mass index (BMI),triglycerides,glycated hemoglobin Alc (HbAlc),fasting blood glucose (FBG),2 hours glucose,free androgen index (FAI) level in PCOS-IR group were higher than in PCOS-NIR group (P ＜ 0.01).The difference of total cholesterol,low-density lipoprotein,mean of daily difference (MODD) level were not statistically significant (P ＞ 0.05).Conclusions PCOS-IR patients suffer from more serious metabolic disorder and blood glucose variability.