A study on 48 middle-aged and elderly joggers through exercise echocardio-graphy and measurements during systolic time intervals (STI) showed that whencompared with a control group of 26 sedentary persons, their stroke volume was44.2% and cardiac output 25.1% greater at rest, 34.3% and 15.8% greater duringequivalent load exercise, and 35.1% and 33.1% grater during equivalent heart rateexercise. In addition, their left ventricular end-diastolic diameter (LVEDd) andleft auricule diameter were also longer and the closing velocity of the mitral valveduring the early diastolic stage was greater, although their ejection fraction, AD%and STI showed no significant difference. This proves that jogging can improvecardiac pumping function by enlarging LVEDd and increasing pre-load of heart.

Objective To investigate the effect of pathoglycemia on the tumor biomarker expression in pancreatic tumor and assess its influence on the diagnostic value of these biomarkers.Methods We recruited 59 patients with malignant pancreatic tumor in total into this study,including 46 cases with pancreatic carcinoma and 13 cases with other pancreatic malignancies.Twenty-seven patients with benign pancreatic diseases were selected as control.All subjects were extracted venous blood and serum samples were separated by centrifugation.Serum levels of CA199,CA125 and CEA were measured by chemiluminescent microparticle immunoassay(CMIA).The positive expression criteria were designated as ＞37 kU/L for CA199;＞35 kU/L for CA125;＞10 μg/L for CEA.Results (1) CA199 showed the highest diagnostic accuracy when the tumor biomarker was used alone.CA199 plus CEA showed the highest diagnostic accuracy when the biomarkers were used pairwisely,even better than three biomarkers used in combination(x2=26.131,P＜0.05).(2)The average rank of all tumor biomarkers were higher in all malignant pancreatic tumor than benign pancreatic diseases,and some of the differences reached statistically significance(CA199,Z=4.682,P=0.000;CA125,Z=1.866,P=0.062;CEA,Z=2.573,P=0.010).(3)When the malignant pancreatic tumor group were further divided into two groups according to their blood sugar level,we found that CA199 were significantly higher in pathoglycemia group than euglycemia group(Z=2.265,P=0.024),while no significant differences were observed in patients with benign pancreatic diseases when compared between patients with different blood sugar levels(Z=4.214,3.224,3.154,Ps＞0.05).Conclusion The combination use of three tumor biomarkers showed no improvements in the diagnosis of pancreatic neoplasm,but with disadvantage of elevated medical expense.CA199 showed the highest diagnostic accuracy when used alone.CA199 plus CEA showed the highest diagnostic accuracy when the biomarkers were used pairwisely.The blood sugar level should be considered when using CA199 in the differential diagnosis of pancreatic neoplasm from benign pancreatic lesions;a new set-point of CA199 should be set by studying the ROC curve and other statistic index to improve the overall accuracy.

Objective To explore the locating, parameter measurement and 3D display of nucleus accumbens in human brain in terms of digital anatomy .Methods The raw data of the head specimen of a 45-year-old male adult with 0.5mm as the section spacing was collected by using digital milling machine .Three hundreds images of continual cross sections containing brain were chosen and the segmentation of the caudate nucleus , putamen and nucleus accumbens was accomplished with Photoshop CS .The nucleus accumbens on the images of continual coronal section reconstruction were distinguished according to Harvard Medical School ’ s segment method to calculate the volume of nucleus accumbens and collect the correlative location information .The caudate nucleus , putamen and nucleus accumbens were 3D visualize with the software of Amira 3.1.1.Results The nucleus accumbens , the adjoining structure and the lesion target of nucleus accumbens were all clearly visible .The left nucleus accumbens volume was 972.5mm3 , and the right was 830.6mm3 .The 3D coordinate value was the left ( -11.0, 24.4, 1.3) and the right (9.3, 23.9, 1.7).Conclusion The digital anatomy of nucleus accumbens can distinctly display the nucleus accumbens , form and confirm it ’ s volume, location and adjoining area , which is useful to clinician .

Objective To observe whether appropriate intermittent exercise at the ischemic threshold can safely promote collateral circulation in an ischemic area of the myocardium through the increased expression of vascular endothelial growth factor(VEGF)and its receptor fetal liver kinase-1(Fik-1). Methods A balloon constrictor was surgically implanted in the first obtuse marginal coronary artery(OM1)of miniature pigs.The subjects were divided into 3 groups:a sham-operation group,a pure ischemia group,and an exercise training group.Subjects in the exercise training group performed individualized treadmill programs 30 min daily,5 d per week,for 8 weeks,including 2 two-minute episodes of exercise-induced ischemia.Two pre-exercise episodes of pure ischemia induced by brief OM1 occlusion were also conducted.Only pure ischemia was induced in the pure ischemia group,and the sham-operation group remained sedentary for the experimental period.Relative myocardial blood flow(RMBF)was measured using microspheres.VEGF and Flk-1 expression levels were measured by Western blotting and real time RT-PCR analyses.Cardiac troponin I(ctnI)levels were determined using an enzyme-linked immunosorbent assay(ELISA). Light and electron microscopy were employed to examine myocardia damage in the ischemic area.Results RMBFs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups. RMBFs in the pure ischemia group were significantly higher than those in the sham-operation group.The expression of VEGF and Flk-1 proteins and mRNAs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups,and the levels in the pure ischemia group were also significantly higher than those in the sham-operation group.After training,no myocardial damage and no ctnI increase was observed in the pure ischemia group.Microscopy revealed no obvious structural changes. Conclusion Intermittent exercise at the isehemia threshold intension can safely promote coronary collateral formation through upregulation of VEGF and Flk-1 expression in the ischemic myocardial area of a porcine model.

Objective To investigate the expression of CYP2W1 in gastric cancer and its effect on proliferation and invasion.Methods CYP2W1 protein expression in 326 gastric cancertissues and in the corresponding normal gastric mucosa was measured by immunohistochemstry.The expression of CYP2W1 mRNA in 10 randomly chosen gastric cancer tissues and its corresponding normal gastric mucosa was tested by semi-quantitative RT-PCR.4 groups pairs of gastric cancer and normal gastric mucosa cell lines were constructed.CYP2W1 expression in each of the cell line was tested.The effect of CYP2W1 expression on the proliferation and invasion capacity of the gastric cancer cells was studied by MTT experiment and transwell cell experiment.Results Expression of CYP2W1 protein in the gastric cancer tissues is higher than that in normal gastric mucosa (26.7％ vs.0,x2 =100.396,P ＜ 0.05).CYP2W1 mRNA in the gastric cancer tissues is higher than that in normal gastric mucosa [(0.413 ± 0.026) vs.(0.074 ± 0.005),t =28.115,P ＜ 0.05].CYP2W1 protein expression in the gastric cancer cell lines is higher than that in normal gastric mucosa cell lines [(0.481 ± 0.024) vs.0,t =49.097,P ＜ 0.05].The growth capacity of CYP2W1 positive gastric cancer cell is stronger than that of CYP2W1 negative cells (P ＜ 0.05),and CYP2W1 positive gastric cancer cells are also more of invasiveness,[(63 ±8) vs.(18 ±3),t =24.134,P ＜0.05].Conclusions CYP2W1 is only expressed in the gastric cancer tissues,hence it is closely related to the growth multiplication,and invasiveness of gastric cancer cells.

Objective To preliminarily discuss the efficacy and safety of balloon protection technique in venous sinus in the embolization of lateral sinus dural arteriovenous fistula.Methods FromDecember 2012 to August 2016,7 consecutive patients with lateral sinus dural arteriovenous fistula embolized with Onyx under the protection of venous sinus balloon were enrolled retrospectively. Their clinical data,imaging data,and follow-up results were analyzed.Results In 7 patients,the fistulas of 3 cases were located in the sigmoid sinus and the fistulas of 4 cases were located in the transverse sinus. Immediately after operation, 5 patients were embolized completely and 2 were embolized mostly. All balloon protected venous sinuses maintained patency. Seven patients were followed up clinically and the follow-up time was 6-43 months. No new neurological deficits were observed. All 7 patients received whole DSA reexamination and the follow-up time was 6-11 months. It is suggested that 5 patients were completely cured,among them,the venous sinuses were patent in 4 cases,the venous sinus was occluded in 1 case;the fistula was stable and venous sinus patency in 1 case;and 1 had newly complicated venous sinus occlusion.Conclusion At the same time of embolization of the fistulas,the dural arteriovenous fistulas were embolized under the protection of venous sinus balloon. It could maintain long-term patency of venous sinus and be conductive to maintaining the stability of the embolization effect.

Objective:To investigate the synergistic killer effect of natural killer cells(NK cells) combined with tamoxifen(TAM) on breast cancer cells(BCC)through the experiment in vitro,and to explore its mechanism.Methods:Three kinds of BCC with different receptor expression levels were selected for the experiment.Blank control group, different concentrations of TAM groups and different time groups were set up.MTT assay was used to detect the inhibitory rates of proliferation of cells,and the final experiment concentration of 5 μmol·L-1 was determined.The cells were divided into natural-release group,largest-release group,TAM group,NK cells group, and combined-experimental group(BCC+NK cells+TAM),and the synergistic killer effect of NK cells combined with TAM in different effector-target ratios were detected with Calcein-AM release assay.In ELISA assay the cells were divided into blank control group (NK cells),NK cells+TAM group, NK cells+BCC group and combined-experimental group,and the levels of IFN-γ and TNF-α in the NK cells in various groups were measured.In flow cytometry detection the cells were divided into blank control group (NK cells),NK cells+TAM group,NK cells+ BCC group, and combined-experimental group,and the expression levels of NKp46,CD158a,CD158b,CD158b2,and CD158e were determined;while the cells were divided into blank control group (BCC),BCC+TAM group,BCC + NK cells group, and combined-experimental group,and the expression levels of the MICA,ULBP1 and ULBP2 were detected.Results: The MTT assay results showed that the inhibitory rates of proliferation of 3 kinds of BCC had obvious time-and concentration-dependence (P<0.05).The Calcein-AM release assay results showed that the killing-rates of BCC in TAM groups were increased with the increase effector-target ratios of compared with NK cells group;and the killing-rate in combined experimental group was obviously higher than those in NK cells and TAM groups(P<0.05).The ELISA assay results showed that the levels of TNF-α and IFN-γ of NK cells in various experimental groups with BCC or not were increased compared with blank control group(P<0.05 or P<0.01);the levels were significantly increased when combined with TAM (P<0.05).The flow cytometry results showed that the NKp46 expression levels in various experimental groups were elevated compared with blank control group(P<0.05);the expression levels of CD158a, CD158b,CD158b2, and CD158e were significantly decreased(P<0.05);the expression levels MICA,ULBP1, and ULBP2 in BCC were significantly increased (P<0.05).Conclusion:The NK cells combined with TAM has the synergistic killer effect on the BCC in vitro.The synergetic mechanism may be as follows: TAM could increase the secretion of TNF-α and IFN-γ of NK cells to enhance their cytotoxicity;TAM also could up-regulate the expression levels of activating receptors and activating ligands,and down-regulate the expression levels of inhibitory receptors to increase the killing ability of NK cells.

Objective To make a comparison between the plain radiograph, CT, and MR findings of gouty arthritis and to analyse the relationship between clinical data and imaging findings. Methods Fifty-four joints of 33 patients with a confirmed diagnosis of gouty arthritis were included in this study. In the morning, the blood uric acid level of patients was tested before meal. In the afternoon, their clinical data were recorded and joints were examinated by plain radiography, CT, and MRI. The imaging findings were evaluated by tophi, bone erosion, soft tissue swelling, hydrarthrosis, synovial thickness, and bone oedema. The data was analyzed by Chi-square test, indepentdent-samples t test, and logistic regression. Results The Chi-square test was utilized to evaluate number of joints with tophi(CT>plain radiography, MR>plain radiography, P<0. 01), soft tissue swelling (MR>CT>plain radiography, P<0. 01), hydrarthrosis(MR>CT, P<0. 01). In addition, 35 joints had bone oedema and 50 joints had synovial thickness. The course of disease(tophi positive group vs tophi negative group, P<0. 01) was analyzed by indepentdent-samples t test. The tophi's causative agents including bone erosion and course of disease were analysed by logistic regression(P<0. 01). Conclusions MRI is superior to CT and plain radiography on the early diagnosis of gout. Tophi and bone erosion may not affect the blood uric acid level. With the progression of disease, the probability of tophi formation increases. The relationship between the formation of tophi and bone erosion may be interpromotied.

Objective To develop a rotatable scalp acupuncture to enhance success rate of arteriovenous puncture during hospital treatment, field firstaid and evacuation.Methods The acupuncture was composed of a pinhead, a neilsbed, wings and a soft tube. The wings connected with each other to form a hole to hold the intermediate section of the neilsbed rotating in it. There was an index point in the middle of the head of the neilsbed, whose direction corresponded linearly with that of the inclined plane of the pinhead in the vessel.Results Clinical trials proved that the acupuncture could eliminate the failure of puncture due to tremble hands, incoordination of the patient and etc.Conclusion The acupuncture structured well is easy to operate for all conditions, and thus is worth popularizing practically.

Objective To establish a comprehensive,simple,and effective scoring model for predicting the recurrence risk after endovascular embolization of intracranial aneurysms in order to assess the possibility of recurrence and to provide guidance for the selection of surgical protocols and postoperative management.Methods From May 2012 to May 2014,434 patients (441 aneurysms) with intracranial aneurysm treated with endovascular embolization at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively,and they were used as a modeling group.After modeling,109 patients (109 aneurysms) were used as a validation group.In the modeling cohort,a predictive scoring model of recurrence risk was established according to the results of multivariate logistic regression analysis;the model was validated in the validation cohort.According to the scoring model of the modeling group,the scoring table of best cut-off value of the receiver operating characteristic (ROC) curves was divided into a low-risk and a high-risk of recurrence.The recurrence risk score model was compared with the North America aneurysm recanalization stratification scale (ARSS) model,and Raymond grade.Results Multivariate logistic regression analysis showed that the 3 factors included in the scores and finally,a established scoring model of recurrence risk prediction were non-stent assisted embolization (1 point),Raymond grade ≥Ⅱ (1 point),and the size of aneurysm (aneurysm >25 mm[3 points)],aneurysm 10-25 mm[1 point],and aneurysm <10 mm[0 point]).The validation indicated that the scoring system had higher predictive value (AUC=0.738,95%CI 0.641-0.834,P<0.05) and goodness of fit (Hosmer-Lemeshow χ2=2.109,P=0.146).The scoring table was further divided into the low-risk recurrence (0-1 point) and high-risk recurrence (2-5 points),its sensitivity was 72.73% (48/66) and specificity was 68.80% (258/375).The predictive ability of the aneurysm recurrence risk score model was similar to that of the ARSS score (χ2=0.54,P=0.462),and it was better than the Raymond grade (χ2=15.10,P<0.01).Conclusion The established simple aneurysm recurrence risk predicting score model in this study may accurately predict the recurrence of aneurysms,however,a multicenter,large sample prospective study is needed for further validation.