The incidence of early neurological deterioration of acute ischemic stroke is higher and the clinical prognosis is poor.There are no effective prevention and treatment measures yet.The prognosis may be improved if early predicts by serum biomarkers and actively manages.This article reviews the serum biomarkers of early neurological deterioration in ischemic stroke.

Current anti-hepatoma agents in clinical aplication have not been proved to be satisfactory. The major obstacles are low efficacy, toxicity, and drug resistance. Identifying new drug targets and discovering new agents accordin gly with high efficacies and low toxicities have become the key part of the solu tion. Recent studies have shown that hyper-methylation of tumor suppressor gene s, interaction between hepatocyte growth factor and its receptor, vascular endothelial growth factor and its receptor, as well as cyclooxygenase-2 might be potential targets for hepatomachemotherapy. Indeed, agents acting on these targets have shown to be effective. In addition, other agents such as As 2O 3 have also shown th eir activities against hepatoma.

OBJECTIVE To compare the BacT/Alert FN with Botai SN anaerobic blood culture bottles for detection of commonly encountered anaerobes.METHODS Using these two types of anaerobic bottles to culture 5 commonly encountered anaerobes in automatic blood culturing system and BacT/Alert system,and then to analyze the results.RESULTS There were all 32 anaerobic bottles reported positive results by BacT/Alert FN bottles,and only 8 positive bottles were reported by Botai SN bottles.CONCLUSIONS The performance of the BacT/Alert FN is much better than Botai SN anaerobic blood culturing bottle when it is used to detect commonly encountered anaerobes.

Objective To investigate the distribution characteristics of cerebral artery stenosis and its risk factors in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke examined with MRI and magnetic resonance angiography (MRA) were divided into either a stenosis group or a non-stenosis group according to whether they had cerebral artery stenosis or not.The patients in the stenosis group were redivided into a simple intracranial stenosis,simple extracranial stenosis,and intracranial + extracranial stenosis subgroups according to their stenotic sites; they were redivided into either a young and middle-aged subgroup (＜60) or an elderly subgroup (≥60) according to their age; they were redivided into either a single-branch lesion subgroup or multibranch lesion subgroup according to the number of vascular stenosis.The distribution characteristics and influencing factors of cerebral artery stenosis were analyzed.Results A total of 232 patients with acute ischemic stroke were enrolled,and 114 of them (62.0％) were simple intracranial stenosis,30 (16.3％) were simple extracranial stenosis,and 40 (21.7％) were intracranial+ extracranial stenosis.The patients with anterior circulation stenosis (76.6％) were more common than those with posterior circulation stenosis (33.7％).They were mainly in the middle cerebral artery (64.4％) and posterior cerebral artery (53.8％) respectively.Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.049,95％ confidence interval [CI] 1.015-1.084; P =0.005),hypertension (OR 10.063,95％ CI 4.402-23.004; P ＜ 0.001),diabetes (OR 3.873,95％ CI 1.141-13.147; P =0.030),smoking (OR 3.311,95 ％ CI 1.112-9.855; P =0.031),and fibrinogen (OR 6.085,95％ CI 1.396-26.533; P=0.016) were the independent risk factors for cerebral artery stenosis in patients with acute ischemic stroke; hypertension (OR 10.779,95％ CI 4.468-26.007; P＜ 0.001),diabetes (OR 3.593,95％ CII.018-12.685; P =0.047),and smoking (OR 4.408,95％ CI 1.403-13.826; P =0.011) were the independent risk factors for simple intracranial artery stenosis; hypertension (OR 6.143,95％ CI 1.838-20.537; P=0.003),diabetes (OR 8.179,95％ CI 1.844-36.287; P=0.006),and fibrinogen (OR 2.410,95％ CI 1.046-5.551; P =0.039) were the independent risk factors for simple extracranlal artery stenosis.C reactive protein (CRP) level of the intracranial + extracranial stenosis group was significantly higher than that of the simple intracranial stenosis (P=0.001) and simple extracranial stenosis (P =0.018) groups.There was no significant difference between the two groups,but the mean level of the 3 groups was higher than that of the normal value.The simple intracranial stenosis and the simple extracranial stenosis were most common in the young and middle-aged group,and the simple intracranial stenosis and the intracranial + extracranial stenosis were more common in the elderly group.The age (P=0.036) and uric acid level (P=0.006) in the subgroup of multiple branches stenosis were significantly higher than those in the subgroup of single branch stenosis,but only age (OR 1.030,95％ CI 1.003-1.057; P =0.028) was significantly independent correlated with the multiple branches stenosis.Conclusions Intracranial artery stenosis is common in cerebral artery stenosis of patients with acute ischemic stroke.The proportion of intracranial + extracranlal stenosis increases sfightly with age.Age,hypertension,diabetes,smoking,and fibrinogen are the independent risk factors for cerebral artery stenosis in patients with acute ischemic stroke.Hypertension and diabetes are the common independent risk factors for simple intracranial and extracranial artery stenosis in patients with acute ischemic stroke.Smoking is an independent risk factor for simple intracranial artery stenosis in patients with acute ischemic stroke.Fibrinogen is a simple independent risk factor for extracranial artery stenosis in patients with acute ischemic stroke.CRP and uric acid may be the inflammatory predictive factors associated with the patients with acute ischemic stroke and cerebral artery stenosis.

Objective To study the influence of postoperative chemotherapeutic regimens on menstruation in pre-menopausal patients with breast cancer. Methods 120 pre-menopausal patients with breast cancer from Jan 2010 to Dec 2012 were followed-up. The occurrence rate and recovery rate of chemotherapy-induced amenorrhea (CIA) were analyzed. The relationship between different chemotherapeutic regimens and CIA of various age groups was analyzed. Results 120 women were followed-up, 94 (78.3 %) patients developed CIA. The frequency of CIA in younger patients (≤ 35 years) was significantly lower than that in patients older than 35 years (P < 0.05). 50 (53.2 %) patients returned to normal menses. The recovery situation of CIA was significantly different among various age groups (P < 0.05). The difference of the occurrence rate of CIA was not statistically significant between the patients who received anthracycline-based chemotherapy and docetaxel-based chemotherapy (P > 0.05). Conclusions Age is an important influence factor of the CIA. Chemotherapy has less influence on the menstruation of younger patients (≤35 years) and most amenorrhea is reversible. The effects of sequential addition of taxanes in chemotherapy and anthracyclines alone on menstruation have no significant difference.

BACKGROUND:Microcapsules is one of the main directions of targeted therapeutic dosing system. With a size of several microns to several hundred microns, it can be used for injection, oral, arterial administration and local treatment of targeted organs and other treatment approaches. OBJECTIVE: To prepare rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules and optimize the preparation conditions. METHODS: The rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules was prepared by ultrasonic emulsification. The effect of the mass concentration (60, 100, 140, 180 g/L), stirring speed (50, 1 000, 2 000, 4 000 r/minutes), colostrum emulsification time (2, 4, 6, 8 minutes), colostrum water oil ratio (1:5, 1:10, 1:15, 1:20) of rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules on gross morphology, particle size distribution width and total flavonoids encapsulation efficiency of microcapsules was univariately analyzed. The rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules with smaler particle size, uniform dispersion and higher encapsulation efficiency was filtered out. RESULTS AND CONCLUSION: The optimum process parameters were as folows: 140 g/L polylactic acid-glycolic acid solution, the stirring speed of 2 000 r/min, the colostrum emulsification time of 6 minutes, and the colostrum water-oil ratio of 1:15. The microcapsules prepared in the optimized process displayed a uniform distribution and its average particle size was (789.8±712.3) nm, which distributed relative narrowly and basicaly less than 5 μm. Microcapsules presented round, with a regular edge under scanning electron microscope. The average encapsulation efficiency was 47.72%.

Objective To retrospectively analyze the clinical and pathological characteristics of breast cancer in women ≤ 40 years of age.Methods One hundred and thirty one young (≤ 40 years) female patients with breast cancer pathologically confirmed in the General Hospital of PLA from January 1 st 2008 to December 31st 2012 (young group) were collected,and 262 elderly (41-69 years) female patients with breast cancer in the same period (old group) were collected as control using the random number table method.The clinicopathological characteristics involved TNM staging,histological grade,the expression levels of estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (Her-2) and clinical stage of the two groups were contrastively analyzed.Results Compared with elderly patients,young female patients with breast cancer had lower positive rate of ER or PR (64.9％ vs.76.7％;x2 =6.171,P =0.013),higher positive rate of Her-2 (26.7％ vs.15.3％;x2 =7.415,P =0.006) and higher histological grade (grade Ⅱ 38.2％ vs.35.1％;grade Ⅲ 55.7％ vs.49.6％;x2 =6.835,P=0.033).There were no significant differences in T stage (x2 =1.764,P =0.623),N stage (x2 =0.129,P =0.988),clinical stage (x2 =4.916,P =0.178),molecular subtype (x2 =7.475,P =0.058) and different surgical procedures (x2 =0.913,P =0.339) between the two groups.Conclusion Young (≤ 40 years) female patients with breast cancer have specific clinical and pathological characteristics including higher histological grade,higher positive rate of Her-2,lower positive rate of ER or PR and higher degree of malignancy,who should be diagnosed and treated as soon as possible.

Objective To introduce and evaluate the characteristics of a GyroKnife Digital Cobalt-60 System for stereotactic radiotherapy and radiosurgery in mechanical aspect.Methods To test the radiation safety,the dose rate required for radiation protection was measured by using an ionization survey meter ( Inovision Model 451 B,Cleveland,OH ).Micrometer was used to verify the accuracy of the table in movement and protractor to verify the rotation movement range.The 160 mm diameter polystyrene spherical phantom and film were used in measurement of the radiation Full Width at Half Maximum.And the difference between radiation isocenter and mechanical isocenter was also verified.Results Clinical requirement in radiation protection was met.The maximum error of table movement accuracy was 0.2 cm at Z axis; the maximum error of gantry movement accuracy was 0.1°.For all the collimators,radiation Full Width at Half Maximum ( FWHM ) was 2.55,5.40,10.50,and 18.55 mm and average penumbra was 5.0,12.4,30.1,and 51.5 mm,respectively.The maximum difference between mechanical center and radiation center was 1.41 mm.Conclusions Stereotactic radiotherapy and radiosurgery has good mechanical characteristics and is suitable clinic applications.

Objective To introduce and evaluate the dosimetric characteristics of a GyroKnife cobalt-60 system for radiosurgery.Methods0.015 cm3 and 0.600 cm3 ionization chamber,EDR2 film and semiconductor dosimeter were used to measure the dose rate of center point for the four collimators.The diameter of the four collimators were 5 mm,12 mm,30 mm and 50 mm,respectively.0.015 cm3 ionization chamber was used to test the dose-time linear relationship and dose stability.0.015 cm3 ionization chamber and semiconductor was used to measure the dose error of phantom between treatment planning system (TPS)calculation and measurement.The film was used to measure the error of TPS calculation isodose lines width.ResultsThe results from the four measurement methods have no significant difference for the collimator 50 mm.But for collimator 5 mm great discrepancy appeared.The error between calculation by TPS and the measurement by semiconductor was biggest and the value was 4.8％.Most of the error was within 3.0％.The error of the 50％ isodose line along x-axis was biggest and the value was 4.9 mm,others are all within 2.0 mm.ConclusionThe dosimetric character of this system is suitable for stereotactic radiotherapy.

Objective To investigate the correlation between the plasma homocysteine (Hcy) level and intra/extracranial artery stenosis in patients with ischemic stroke.Methods The medical history,baseline clinical data,imaging and Hcy and other laboratory test results in patients with ischemic stroke were collected.The patients were divided into either a stenosis group or a non-stenosis group according to magnetic resonance angiography.The artery stenosis group was further redivided into an isolated intracranial stenosis group,an isolated extracranial stenosis group,and combined extracranial and intracranial stenosis group.The relationship between plasma Hcy level and intra/extracranial stenosis was analyzed.Results A total 147 patients with ischemic stroke were enrolled,including 115 patients in the stenosis group and 32 in the non-stenosis group.There were significant differences in age (t =4.577,P ＜ 0.001),the plasma levels of Hcy (t =3.65,P ＜ 0.001),C-reactive protein (t =2.06,P =0.041),low-density lipoprotein cholesterol (LDL-C) (t =1.896,P =0.046),high-density lipoprotein cholesterol (HDL-C) (t =-4.261,P ＜ 0.001),as well as the proportions of diabetes mellitus (x2 =5.772,P =0.016),hypertension (x2 =10.507,P =0.001) and smoking (x2 =12.282,P ＜ 0.001) between the stenosis group and the non-stenosis group.Multivariate logistic regression analysis showed that age ≥60 years (odds ratio [OR] 3.374,95％ confidence interval [CI] 1.351-8.426; P=0.009),Hcy ＞15 mmol/L (OR 2.274,95％ CI 1.147-8.173; P=0.025),hypertension (OR 5.782,95％ CI 2.045-16.345; P =0.001),and smoking (OR 3.514,95％ CI 1.200-10.293; P=0.002) were the independent risk factors,while HDL-C ＞ 1.0 mmol/L was an independent protective factor for intra/extracranial stenosis (OR 0.166,95％ CI 0.054-0.511; P =0.002).The stenosis group was redivided into an isolated extracranial stenosis group (n =24),an isolated intracranial stenosis group (n =61) and a combined extracranial and intracranial stenosis (n =30) according to the sites of stenosis.The comparison of the clinical data and risk factors among the three groups showed that there were significant differences in the proportions of patients with hypertension (x2 =7.024,P=0.003),as well as the plasma levels of LDL-C (F =3.276,P =0.042) and C-reactive protein (F =3.645,P =0.029).Multivariate logistic regression analysis showed that hypertension was the common independent risk factor for isolated intracranial stenosis (OR 3.795,95％ CI 1.261-11.424; P =0.018),isolated extracranial artery stenosis (OR 18.490,95％ CI 3.117-10.966; P=0.001) and combined extracranial and intracranial stenosis (OR 9.178,95％ CI2.211-38.094; P=0.002),and the increased HDL-C level was the common protective factor for isolated intracranial artery stenosis (OR 0.150,95％ CI 0.043-0.523; P =0.003),isolated extracranial artery stenosis (OR 0.078,95％ CI 0.012-0.488; P=0.006) and combined extracranial and intracranial stenosis (OR 0.089,95％ CI 0.021-0.385; P=0.001).Age was an independent risk factor for isolated intracranial stenosis (OR 6.351,95％ CI 2.277-17.717; P ＜ 0.001).The increased LDL-C level was an independent risk factor for isolated extracranial stenosis (OR 6.021,95％ CI 1.212-29.917; P =0.028).The increased Hcy level was an independent risk factor for isolated extracranial stenosis (OR 4.376,95％ CI 1.026-18.671; P-0.046) and combined extracranial and intracranial stenosis (OR 4.951,95％ CI 1.378-17.783; P =0.014).Conclusions The increased plasma Hcy level correlated with extracranial stenosis.