Objective To evaluate the clinical effects of intra arterial thrombolytic therapy for acute ischemic cerebral infarction and analize the factors influencing the clinical prognosis. Methods 32 patients were treated with intra arterial thrombolysis using urokinase(median dose, 65?10 4 U) within 2～20 hours, after the onset. The patient's condition was assessed by neurologists using National Institutes of Health Stroke Scale(NIHSS) score right at the admission. Clinical outcome was assessed after 3 months and graded as good for Modified Rankin Scale(MRS) scores of 0 to 3 and poor for MRS scores of 4 or 5 and death. Results Follow up cerebral angiography of 14 cases treated within 6 hours after onset showed complete/partial recanalization in 13 cases. Other 18 patients whose treatment started beyond 6 hours after onset outcame with complete/partial in 7. 20(62.5%) of the 32 patients had good outcome, 12(37.5%) had poor outcome and two patients(9.4%) died. Cerebral hemorrhage occurred in 2 of the 32 patients. Good outcome was associated with an initial NIHSS score of

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.

Objective To study the multi-slice spiral CT (MSCT) manifestations of septic pulmonary embolism(SPE) in order to get a better understanding of the disease,Methods The MSCT manifestations of 12 patients with septic pulmonary embolism were retrospectively analyzed and compared with chest radiograph.Results Of the 12 patients,Chest radiograph and CT scanning showed multiple peripheral pulmonary nodules in 8 and 12 cases,a feeding vessel sigu(0,9 cases),cavitations(6,10 cases) and wedge-shaped opacities(4,7 cases),focal infiltrates(2,4 cases),air cyst(2,5 cases),pleural lesions (3,6 cases),hilar or mediastinal lymphadenopathy(0,3 cases).Peripheral or subpleural zones were most commonly affected (8,12 cases).CT was more useful in revealing nodules and a feeding vessel sign.Multiplanar reconstructions (MPR),maximum intensity projection (MIP) showed that most of these vessels passed around nodules and wedge-shaped lesions.MPR showed regular nodular margin.Conclusion SPE presents with variable and often nonspecific clinical and radiographic features.MPR and MIP showed the features of nodules and feeding vessels better.The diagnosis is usually suggested by the presence of a predisposing factor,febrile illness,and CT findings of multiple,periphery pulmonary nodules,with orwithout cavitation and a feeding vessel sign.

Objective To construct an animal model of vascularized iliac bone transplantation which could establish the immune chimerism.Methods The experiment was divided into three groups.In experiment group we slected the male SD rats as donors and the female SD rats as recipients.Then the experiment group was performed the improved vascularized ilium transplantation operation.The positive group was male SD rats without handling.The negative group was female SD rats without handling.On the twenty-eighth day after surgery, the rat SRY gene was detected by PCR.Dynamically monitoring the changes of the ratio of CD4+/CD8+ T cells by flow cytometry after operation.Dynamically monitoring the changes of the levels of serum IL-2 by enzyme linked immunosorbent assay after operation.Imaging and pathology were used to detect the transplanted iliac bone.Results Ten transplantations were performed in the experiment group and 7 flaps survived with a successful rate of 73 ％.SRY gene was detected in female rats that receive the male rats'iliac bone transplantation by PCR in the experiment group.After Micro-CT scanning and three-dimensional reconstruction, it showed that the transplanted iliac bone mineral density was decreased.Comparing rats that establish the chimerism with normal rats, the ratio of CD4 +/CD8 + T cells and the levels of serum IL-2 had no difference.Pathological results showed that the transplanted iliac bone of rats with chimerism were normal and the rats without chimerism were necrotic.Conclusions From the improved vascularized ilium transplantation operation, we successfully detected the SRY gene in female rats which received the male rats' iliac bone transplantation.It proved that the improved vascularized ilium transplantation operation could establish the chimerism.Through the immunosuppressant, the immune status of the rat after operation was well.

Objective To further investigate the effect of sinomenine (SIN) on TNF-α-induced VCAM-1 expression in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were isolated from freshly collected umbilical cords. Positive control samples were stimulated with TNF-α, but free of SIN. Negative control samples were treated in the same way, but without TNF-α and SIN. Experimental samples were co-cultured with TNF-α and SIN at various concentrations (0.25, 0.5, and 1.0 mol/L), or TNF-α and dexamethasone (Dex) at concentration of 1.0×10-6 mol/L, or TNF-α with Dex (at concentration of 1.0×10-6mol/L) and SIN at different concentrations (0,25, 0.5, and 1.0 mmol/L) (co-treated groups). VCAM-1 expression was detected by flow cytometry (FCM). Results SIN inhibited expression of VCAM-1 in TNF-α-induced HUVECs, the best effect was shown in the 1.0 mmol/L SIN treated group. VCAM-1 decreased more markedly in the co-treated groups. Conclusion SIN inhibits TNF-α-induced VCAM-1 expression on HUVECs in vitro, and SIN maybe synergistic with Dex in inhibiting TNF-α-induced VCAM-1 expression on HUVECs in vitro.

Objective To compare the efficacy between arthroscopic assisted reduction and traditional opera-tion approach for the treatment of tibial plateau fractures.Methods 75 patients with tibial plateau fracture(SchatzkerⅠ -Ⅳ type)were recruited,which were randomly divided into the arthroscopic and traditional operation group according to different treatment methods.The clinical efficacy and value of arthroscopically assisted reduction was ana-lyzed and compared according to the incidence of postoperative complications,the operative time,incision length,blood loss,hospital stay,and clinical efficacy between the two groups.Results Compared with the data in the traditional operation group,the incidence of postoperative complications (2.70% vs.21.3%)was significantly lower(χ2 =5.980,P =0.014).The operative time[(88.1 ±15.2)min vs.(103.8 ±22.1)min]was significantly shorter(t =3.575,P =0.001).And the incision length[(6.7 ±2.3)cm vs.(10.8 ±2.7)cm)]declined greatly(t =5.745,P =0.000).The hospital stay time and blood loss were significantly lower than that of the traditional operation group[(4.5 ± 2.3)d vs.(6.5 ±3.1)d;(145.2 ±43.0)mL vs.(294.4 ±90.2)mL,respectively],and the differences were statisti-cally significant(t =3.166,P =0.003;t =7.829,P =0.000,respectively).The excellent rate of clinical features in arthroscopic group(86.49%)was higher than that of traditional operation group(71.05%),and the difference was statistically significant(χ2 =3.723,P =0.039).Conclusion Arthroscopic -assisted reduction has many features for the tibial plateau fractures (SchatzkerⅠ -Ⅳ type),such as lower incidence of postoperative complications,less trau-ma,shorter operative time,and better postoperative knee function and so on,so it is worthy of clinical application.

Objective To observe the effect of infliximab combination therapy on the expression of CD147 on the peripheral CD14+ monocytes of active rheumatoid arthritis (RA) patients. Methods Thirty active RA patients who were refractory to MTX treatment were randomized into three groups (group A, B, C) with the proportion of 3:1:1. Group A and B received four or three infusions of infliximab (3 mg/kg), group C received four infusions of placebo. All three groups were added to a stable background of MTX. The mean fluorescence intensity (MFI) of CD147 expression on the peripheral CD14+ monocytes of RA patients and normal healthy controls were detected by flow cytometry analysis. Clinical and laboratory parameters were assessed before each infusion. One-way ANOVA, Kruskal-Wallis the MFI of CD147 expression at week 18 (P<0.05). Marked differences were observed between the infliximab + MTX group and the placebo + MTX group on the change of the MFI of CD147 expression from baseline to week 18 (P<0.05).Conclusion CD147 expression on the peripheral CD14+ monocytes of active RA patients is increased, and combination therapy of infliximab and MTX can inhibit the expression.

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

Objective:To investigate the effect of HLA-DRB1*07,13 allelic genes on the immune response to hepatitis B vaccination.Methods:896 healthy college students of Han nationality from Guangxi province,who had received standard courses of vaccination with recombinant hepatitis B virus vaccine,were tested the level of anti-HBs with ELISA method at the sixth month after their last vaccination.The non- or hypo-responders were selected to receive another 20 μg doses of recombinant vaccine and were examined anti-HBs once more four weeks later.99 non- or hypo-responders and 136 medium or hyper-responders were selected for the study subjects.HLA-DRB1*07,13 allelic genes of the subjects were detected by polymerase chain reaction using sequence specific primer (PCR-SSP) method.Results:The frequencies of HLA-DRB1*07 gene in the non- or hypo-responders group were significantly higher than that in the medium or hyper-responder group (16.16% vs 4.41%,P＜0.05). No significant difference of HLA-DRB1*13 gene between the two groups (1.01% vs 3.68%,P=0.389).Conclusion:There is a close relationship between the expression of HLA-DRB1*07 gene and the non- or hypo-response to HB vaccine;No relationship between HLA-DRB1*13 gene expression and the response to HB vaccine is found.

Objective To explore the diagnostic value of 18F-FDG PET/CT in biliary obstruction.Methods Totally,28 biliary obstruction patients were divided into benign obstruction group (n =11) and malignant obstruction group (n =17)according to the cause of obstruction.Imaging characteristics of 18F-FDG PET/CT and maximal standard uptake value (SUVmax) were compared between the two groups.Efficacy of PET/CT and MRI in the diagnosis of obstructive jaundice were compared.Results In 28 cases,no or mild dilatation of biliary tract accounted for 53.57％ (15/28),moderate to severe dilatation of biliary tract accounted for 46.42％ (13/28).Among the malignant obstruction group,2 cases of hilar cholangiocarcinoma,5 cases of bile duct carcinoma,6 cases of carcinoma of the head of pancreas,and 4 cases of ampullary carcinoma were included,18F-FDG PET/CT showed proximal high metabolic nodules of the obstruction site in 14 cases.Among the benign obstruction group,7 cases were bile duct inflammatory stricture,of which 4 cases with bile duct stones.18F-FDG PET/CT showed a slight increase with patchy or nodular mild metabolism in 6 cases.There were 4 cases of autoimmune pancreatitis.The imaging 18 F-FDG PET/CT demonstrated multi-segmental or multiple nodular enlargement of the pancreas,with generally increased metabolism.SUVmax of malignant obstruction group (6.88± 2.81) was significantly higher than that of benign obstruction group (4.20± 1.70;t=3.143,P＜0.05).The sensitivity,specificity and accuracy of 18F-FDG PET/CT and MRI in the diagnosis of malignant obstructive jaundice were 94.12％ (16/17) and 58.82％ (10/17;x2=4.086 5,P=0.043),81.82％ (9/11) and 63.64％ (7/11;x2=0.229 2,P=0.632),89.29％ (25/28) and 60.71％ (17/28;x2 =4.666 7,P=0.031),respectively.Conclusion 18F-FDG PET / CT has a great value in the diagnosis of obstructive jaundice,which is of great significance for clinical decision-making.