Objective To examine the white matter microstructure alternations in the patients with generalized anxiety disorder (GAD) with diffusion weighted imaging.Methods 19 patients with GAD and 20 matched healthy controls were assessed using apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in the regions of interests (ROIs) approach.The ROIs were the white matter of bilateral cingulate and bilateral hippocampus.Results Significantly increased ADC values were found in GAD patients (0.78±0.02,0.79±0.03) with respect to normal controls in the right and left anterior cingulate white matter.Significantly decreased eADC values were found in GAD patients (0.46±0.01,0.45±0.01) in the right and left anterior cingulate white matter.Conclusion Diffuse cingulate white matter alterations on DWI in GAD denote the disruption of white matter integrity.

OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.

Objective To explore the effect of prevention of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) with hyperhydration, forced diuresis and alkalinizing plus infusion mesna. Methods 32 cases of patients receiving HSCT were included in this study. 2 cases of severe aplastic anemia (SAA) received total body irradiation (TBI)+cyclophosphamide(CTX)(TBI-CTX) regimen,and the remaining 30 patients were using the classic busulfan+CTX (BU+CTX) regimen. All patients were treated with mesna combined with hydration, forced diuresis and alkalization to prevent HC. Ganciclovir and acyclovir were used to prevent cytomegalovirus (CMV) and other viral infections and monitor CMV-IgM levels of the blood. Encourage patients to urinate every hour, testing urine pH value and the calculation of urine output, every 6 h review and testing of urine routine,central venous pressure (CVP), each of 8 h of serum electrolytes. Results Only 1 patient at 6 months after transplantation appeared delayed grade Ⅱ HC after hydration, alkalization, diuretic, hemostatic, anti-graft-versus-host disease (GVHD), and ganciclovir antiviral therapy. The HC patients cured at 35 d. The remaining patients did not suffer HC. Adverse effects such as acid-base balance disturbance did not appear clear. Conclusion Mesna joint hydration, forced diuresis and alkalization was effective and safe to prevent HC.

AIM:To investigate the effects of Zhouluotong (Radix Astragali, Ramulus Cinnamomi, Radix Angelicae Sinensis, Radix Rchmannia, Herba Asari, etc.) on nerve function and polyol pathway in streptozotocin diabetic rats. METHODS: Streptozotocin diabetic rats were administrated with Zhouluotong for 8 weeks. Effects of drugs on sciatic never morphological alterations, sciatic never conduction velocity, aldose reductase activity, Na +,K + ATPase activity and sciatic nerve polyol contents were determined. RESULTS: Compared with diabetic group, sciatic never morphological alterations was improved, sciatic never conduction velocity was increased, aldose reductase activity was depressed and Na +,K + ATPase activity was increased in each administrated group. Sorbitol and gloucose contents were decreased in Zhouluotong groups. CONCLUSION: Zhouluotong could improve metabolism and function of peripheral nerve issue in streptozotocin diabetic rats. As a result of that, it could prevent diabetic peripheral neuropathy in streptozotocin diabetic rats.

Objective To characterize the spinal motion of 6 degrees of freedom (6DOF) under the fulcrum bending in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients using 3D image volume fusion technique.Methods Ten volunteers with Lenke type 1 AIS were examined by the Gemstone Spectral Imaging to obtain their T1-S1 vertebral morphological data in the supine position and fulcrum bending position.With the computer software,images of 2 different positions were fused with the 3D image to obtain in vivo kinematics data of each vertebral body in the target area.Results In the apical vertebrae (AV) region,the main range of motion in the fulcrum bending position ranged from-2.57°± 0.95° to-1.37°± 0.65°,showing significant differences between segments (P ＜ 0.05);along the vertical axis the coupling rotation ranged from-2.71° ± 0.48° to-1.27° ± 0.49°;along the coronal axis,the coupling flexion and extension ranged from 0.19° ± 0.85° to 1.51° ± 0.42°.In the upper end vertebrae (UEV) area,the main ROM ranged from-2.20° ± 1.13° to-1.91° ± 0.76°,showing no significant differences between the 3 segments (P ＞ 0.05);along the vertical axis,coupling rotation ranged from 0.18°±0.47° to 1.35°±0.52°;along the coronal axis,coupling flexion and extension ranged from 1.62° ± 0.41° to 2.07° ± 0.37°.In the lower end vertebrae (LEV) region,the main movement ranged from-0.79°± 0.63° to 0.73°± 1.09°,showing significant differences between the 3 segments (P ＜ 0.05);along the vertical axis,the coupling rotation ranged from-1.62°± 1.05° to-0.60°± 0.60°;along the coronal axis,the coupling flexion extension ranged from -1.41° ± 0.87° to-0.75° ± 0.66°.Conclusionts In the fulcrum bending position,Lenke type 1 AIS shows a unique motion and coupling mechanism in the spine.The coupling rotational movement in the UEV region is at the same side as the lateral flexion movement.The coupling rotational motion in the AV and LEV regions is opposite the lateral flexion movement.

We have investigated the situation about recent interdisciplinary construction for medical subject from several 985-project universities in China as well as the well-known overseas universities via internet. We also have analyzed the results and in mean time, put forward some related suggestions in order to probe an available strategy of interdisciplinary construction for medical subject in the universities of China.

Objective Ascending aortic dissection(AAD),for which the pathogenesis remains unknown,is life-threatening.Matrix metalloproteinase-9(MMP-9)and the pathological changes of vascular smooth muscle cells(VSMCs)have been reported to have roles the pathogenesis.The study examined the expression of matrix metalloproteinase-9(MMP-9)and the pathological changes of,VSMCs in patients with AAD.Methods AAD samples were taken from 35 patients(disease group)in acute phase during aortic replacement operation for AAD and control samples were corresponding part of ascending aorta(control group,n=21)collected from the donor hearts for transplantation.Transmission electron microscepe,hematoxylin-eosin(H-E)staining.Mallory staining were used for observing the pathological changes of VSMCs and matrix in the affected aortic wall.The immunohistochemicai staining of MMP-9 was carried out in both groups and semi-quantified by staining intensity analysis.The affected patients were further grouped according to the diameter of dissected aorta as with a AAD of <55 mm or with a AAD of≥55 mm.The associations of clinical factors,such as smoking status,hypertensive disease and aneurysm diameter,with the expression of MMP-9 were analyzed.Results Increased synthetic function of VSMCs with decreased density,disrupted elastic fibers and fibrosis in the dissected aortic wall were observed in the disease group,but not in the control group.MMP-9 was scarcely expressed in the aortic wall of the patients in the control group,though it was notably expressed in the VSMCs of disease group.Both subgroups presented more MMP-9 than the control group(both P<0.001).In the disease group,sub-group with a AAD diameter of ≥55 mm presented more MMP-9 than that with a diameter of <55 mm(P<0.05).MMP-9 expression was positively correlated with a history of hypertension(P<0.01)or a great aneurysm diameter(P<0.05).MMP-9 expression was not associated with age,smoking status or other clinical factors.Conclusion Increased secretion of VSMCs and the expression of MMP-9 induced by elevated blood pressure may lead to the destruction of matrix proteins.The resulting fibrosis of the aortic wall would decrease the tensile strength of the wall.When the fibrotic aortic wall dilated further,the increased expression of MMP-9 would aggravate the damage to the wall.It can be speculated that acute AAD would occur as a result of partial tearing of the aortic intima.

Objective To explore the changes of cardiac structure and function in streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM)rats so as to detect the level of angiotensinⅡ (AngⅡ)in blood and the myocardium and illuminate the role of AngⅡ in DCM.Methods We randomly divided 30 SD rats into control group and DCM group (which received a single injection of streptozotocin,65 mg/kg).The changes of cardiac structure and function were observed by ultrasonic cardiogram at the end of 16 weeks after injection.Then the changes in the myocardium were also analyzed by using hemotoxylin and eosin staining and Sirius red staining.The level of AngⅡ in blood was tested by radioimmunoassay.The expression of AngⅡ in the myocardium was detected by immunofluorescence. Results Compared with those of the controls,the hearts were dilated in DCM rats accompanied with cardiac dysfunction.There were significant increases in LVEDd,LVESd,LVEDv,and LVESv but decrease in LVEF (P <0.05).There were arrangement disorder and hypertrophic cardiomyocytes in DCM.Then the fibrosis area of DCM was significantly increased compared with that of the controls.The level of AngⅡ in blood and myocardium was significantly higher in DCM than in controls.At the same time,Pearson analysis revealed that the level of AngⅡ in blood was positively related to the collagen content of myocardium (r =0.907,P <0.05).Conclusion Our study provides experimental evidence that AngⅡ plays an important role in myocardial fibrosis of DCM.

[ ABSTRACT] AIM:To observe the effect of high glucose on the protein expression of calreticulin ( CRT) and its association with cell apoptosis and mitochondrial dysfunction in the cardiomyocytes.METHODS: AC-16 cardiomyocytes were randomly divided into normal glucose group, high glucose group, high glucose+CRT siRNA group and isotonic con-trol group.The cell apoptotic rate, reactive oxygen species (ROS), mitochondrial membrane potential level, respiratory enzyme activity, and protein expression of CRT were observed.RESULTS: Compared with the cardiomyocytes in normal glucose group, the apoptotic rate and ROS production of cardiomyocytes increased in high glucose group, accompanying with the decreases in the mitochondrial membrane potential level and enzyme activitiy of the respiratory chain.The protein expression of CRT was significantly increased in high glucose group.However, compared with high glucose group, high glucose+CRT siRNA decreased the expression of CRT and attenuated the damage of mitochondria, but CRT siRNA did not reduce the ROS level in cardiomyocytes.CONCLUSION:High glucose brings about CRT over-expression to induce mito-chondrial injury, thus increasing myocardial apoptosis.

Objective To evaluate the feasibility and its clinical application of 3.0 T MRI in the assessment of the late gadolinium enhancement in patients with cardiac arrhythmias with phase-sensitive inversion recovery (PSIR) single-shot true fast imaging with steady-state precession (True FISP) sequence.Methods Fifty-six patients with arrhythmia confirmed by electrocardiogram underwent MRI in this prospective study.Late gadolinium enhancement were performed with both PSIR single-shot True FISP (sequence 1) and conventional segmented PSIR Turbo FLASH sequences (sequence 2).The overall image quality (4 scales) was assessed and recorded independently by two experienced radiologists.Statistical analysis was performed with Chi-square test and weighted Kappa test.Results Late gadolinium enhancement of all the 56 patients were successfully examined with the sequence 1 and 2.All the image qualities of sequence 1 reached 3 scales or more and met the requirements of clinical diagnosis,and late gadolinium enhancement lesions were detection in 19 patients.All the sequence 2 images were improperly used for clinical diagnosis of the different degrees of artifacts,especially in patients with severe arrhythmia and those who breath-hold with difficulty.Sequence 1 images were classified as scale 4 in 50 cases and scale 3 in 6 cases by Doctor 1,while scale 4 in 48 cases and scale 3 in 8 cases by Doctor 2,respectively.However,sequence 2 images were classified as scale 2 in 15 cases and scale 1 in 41 cases by Doctor 1,as well as scale 2 in 13 cases and scale 1 in 43 cases by Doctor 2,respectively.Sequence 1 image qualities were significantly higher than those of the segmented sequence 2 (x2 values were 141.329 and 141.177,P＜0.01).Excellent agreements between two observers of the 2 sequences (Kappa values were 0.837 and 0.905,P＜ 0.01) were found.Conclusion PSIR single-shot True FISP sequence provides higher reliability for image quality of late gadolinium enhancement in patients with cardiac arrhythmia,which may be useful for clinical application.