Using Eu3+as a tracer,a sandwich?type assay was established. HE4 in serum specimens from 225 patients were detected by TRFIA. Serum levels of HE4 in pelvic tumors were quantitatively analyzed. From receiver operating characteristic (ROC) curves,the reference values was calculated for endometrial cancer,cervical cancer and ovarian cancer,respectively. Results The working range of serum HE4 for TRFIA was 10~10000 pmol/L with a sensitivity of 7.5 pmol/L. The method offered less interaction with CA125 and CA199,and also provided a better correlation with ECLA,while the CV of intra?assay was below 10%. HE4 levels were significantly higher in endometrial cancer,cervical cancer and ovarian cancer groups than in healthy volunteer group,while did not differ significantly between uterine fibroid group and healthy women group. As aging,the risk for developing pelvic tumors increased. The area of ROC for malignant tumors was all above 0.5 and the accurate interpretation of HE4 was 60 pmol/L. Conclusion A stable,precise HE4 TRFIA is well established,which is helpful in diagnosis of gynecologic cancers.

OBJECTIVETo investigate the clinical features of Alzheimer's disease (AD) and vascular dementia (VaD), and to find effective methods for differential diagnosis between the two entities.

METHODSTotally 112 AD patients and 92 VaD patients were enrolled in this study, consisted of patients from the memory clinics and patients from the community population visited during the epidemiological survey from 1996 to 2000. Diagnosis of dementia, probable AD and probable VaD were made according to international criteria. Results of specific neuroimaging examination were referred to verify the diagnosis and the final diagnosis of each patient was determined from the discussion between clinical experts and radiological professionals. Analysis on clinical and neuroimaging data was performed, aiming at finding differential points between the two dementia-subtypes. A logistic binary multiple regression analysis was performed to pick out those statistically significant clinical features for differential diagnosis at last.

RESULTSAD and VaD patients have different clinical features in various demented stages, therefore the indexes that differentiate the two dementia subtypes change accordingly. The predominant features of mild AD appear to be deficits of prolonged memory and learning ability, while the major impairment of mild VaD patients is decline of calculating ability. With the progress of dementia, learning ability and attention turn to be the effective indexes for differential diagnosis. In the mild and moderate demented stage, AD patients are inferior to VaD patients in handling finacial affairs and making phone calls, while VaD patients often degenerate in daily activities concerning with both physical ability and intellectual level. Severe VaD patients appears more global degeneration of living ability compared to AD patients. The difference of ADL scores between the two subtypes is significant in moderate to severe demented patients (P < 0.05). Psychological behavior symptoms, such as repeatedly collecting useless things, are the characteristic manifestation to differentiate AD from VaD in all clinical stages.

CONCLUSIONSThe results of our study indicate that substantial differences exist between AD and VaD patients. Such differences can be attributed to the differences of lesion nature and distribution, as well as the underlying pathophysiological procedures of each disease.

Activities of Daily Living ; Aged ; Aged, 80 and over ; Alzheimer Disease ; diagnosis ; Cognition ; Dementia, Vascular ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Memory ; Middle Aged ; Neuropsychological Tests

OBJECTIVETo evaluate the effect of a phospholipid-coated microbubble contrast agent for myocardium opacification in comparison with a albumin-coated microbubble contrast agent (Quanfuxian).

METHODSIn 10 dogs with single coronary artery stenosis involving the anterior descending branch or circumflex branch randomly received infusion of the two contrast agents through the femoral vein. The myocardial blood flow, heart rate and blood pressure were analyzed qualitatively and quantitatively. The concentration and the particle diameter of the two contrast agents were determined.

RESULTSThe concentration of the phospholipid-coated microbubbles was (1.06-/+0.22) x10(9)/ml, with a diameter of 3.04-/+0.34 microm, similar to the concentration and diameter of Quanfuxian ((1.31-/+0.33)x10(9)/ml and 2.88-/+0.58 microm, respectively, P>0.05). Both of the agents achieved grade three myocardium opacification, and produced no obvious effect on the heart rate and blood pressure. Quantitative analysis of myocardial opacification in terms of myocardial blood volume (A), blood velocity (beta), and blood flow (A x beta) revealed no significant difference between the two agents (P>0.05), and the parameters derived from the two agents showed good correlations (P<0.05, rA=0.809, r beta=0.932, rA.beta=0.925).

CONCLUSIONThe phospholipid-coated microbubble contrast agent shows good effect for myocardial opacification without significant difference from Quanfuxian. Both of the agents are good ultrasound contrast agents for quantitative analysis of myocardium blood flow.

Albumins ; chemistry ; Animals ; Contrast Media ; administration & dosage ; chemistry ; Coronary Stenosis ; diagnostic imaging ; Dogs ; Echocardiography ; methods ; Female ; Male ; Microbubbles ; Phospholipids ; chemistry

OBJECTIVETo formulate the classification criteria of disability weight for Alzheimer's disease (AD) and Parkinson's disease (PD) in China and to evaluate the disability weight of AD and PD in population over 60 years old in Beijing.

METHODSBased on the criteria of Global Burden of Disease (GBD), a seven-grade disability classification was used to develop a new disability classification criteria for AD and PD in terms of Delphi method in China. Using the data from epidemiological survey for AD and PD in Beijing in 1997 and new criteria, mean disability weights of AD and PD in population over 60 years old in Beijing were obtained.

RESULTSThe mean disability weights of Alzheimer's disease was 0.40 in population over 60 years old who received treatment in Beijing and 0.52 in those without treatment while the mean disability weights of Parkinson's disease were 0.30 in the patient receiving treatment and 0.23 in those without treatment.

CONCLUSIONDifference between the result of this study and the data of GBD study in the mean disability weight for AD and PD was noticed.

Activities of Daily Living ; Aged ; Alzheimer Disease ; epidemiology ; China ; epidemiology ; Cognition Disorders ; diagnosis ; etiology ; Cost of Illness ; Disability Evaluation ; Disabled Persons ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; epidemiology ; Recognition (Psychology)

Objective To explore the functional connectivity (FC) of the fronto-striatal circuitry in patients with bulimia nervosa (BN) based on the resting-state fMRI and its correlation with the inhibitory function.Methods 27 medication-naive female patients with BN and 27 age-and education-matched female healthy control subjects were included in the study.All the subjects performed a stop signal task (SST) and underwent the resting-state fMRI scan,separately.The FC between striatal subregions and the frontal cortex was analyzed.Results Compared with healthy controls,FC between the right ventral rostral putamen (VRP) and the right supplementary motor areas (SMA) decreased (MNI coordinate:x =3,y =-15,z =51,K =27) in patients with BN.And the FC was also decreased between the right VRP and premotor area(PM) (MNI coordinate:x =27,y =0,z =57,K =44).FC between bilateral dorsal caudal putamen (DCP) (MNI coordinate:x=21,y=-6,z=48,K=43) and the right PM(MNI coordinate:x=21,y=-12,z=57,K=24) was decreased in patients with BN (P＜0.05,Alphasim corrected,voxel P＜0.005,clusters ≥ 20 voxels).FC between the right VRP and right SMA was negatively correlated with the stop signal reaction time (SSRT) in patients with BN (r=-0.595,P=0.004).The FC between right DCP and right PM was positively correlated with the impulsivity regulation subscale scores of the Eating Disorder Inventory-Ⅱ in patients with BN(r=0.483,P=0.023).Conclusion There is disrupted FC between the striatum and motor cortex in medication-naive female patients with BN based on resting-state fMRI,which may be related to impaired inhibitory control in patients with BN.

Objective In order to further improve China 's neurology residency training system , we investigated the differences of standardized residency training system between China and the United States .Methods The differences of the training goal ,plan,program operation and performance evaluation between China and the United States'residency training program were analyzed .Results The neurology residency training system in the United States has been well established and standardized .Standardized residency training in China has been implemented and systematized in recent years .Although tremendous improvement has been made to China 's postgraduate educa-tion, many aspects of the training system still need to be optimized .Conclusions In line with experiences of USA and suitable for China 's national conditions , reform of neurology residency training system will further improve the medical care of neurology in China .

BACKGROUNDRandomized clinical trials have demonstrated equivalent safety to bare-metal stents after drug-eluting stents (DES) implantation. However, the DES thrombosis in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. This study sought to assess the incidence of DES thrombosis after implantation of DES in patients with real world coronary artery disease (CAD) in China.

METHODSFrom December 2001 to April 2007, 8190 consecutive patients received the treatment with DES, 5412 patients completed one year follow-up: 2210 with sirolimus-eluting stent Cypher, 1238 with paclitaxel-eluting stent Taxus and 1964 with Chinese sirolimus-eluting stent Firebird. After two years of follow-up, there were 2176 patients (1245 Cypher, 558 Taxus and 373 Firebird). All patients were treated with aspirin and clopidogrel over at least 9 months.

RESULTSAmong 8190 patients, 17 patients had acute stent thrombosis (0.24%): 7 in the Cypher group, 4 Taxus and 6 Firebird; 23 patients had subacute stent thrombosis: 8 Cypher, 6 Taxus and 9 Firebird. The incidence of acute and subacute thrombosis was 0.49%: 0.50% Cypher, 0.63% Taxus and 0.41% Firebird. The incidence of late thrombosis at one year followup was 0.63%: 0.63% Cypher, 0.88% Taxus and 0.46% Firebird; at two year follow-up the incidence was 0.74%: 0.72% Cypher, 0.90% Taxus and 0.54% Firebird. There was no significant difference among three groups at 1 year and 2 years follow-up.

CONCLUSIONThe first generation DES in the treatment of complex lesions are safe and effective if patients are aggressively treated with dual antiplatelet agents.

Acute Disease ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Angiography ; Coronary Artery Disease ; therapy ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Incidence ; Male ; Thrombosis ; etiology

Objective To develop a time-resolved fluorescent microspheres immunochromatographic assay (TRFMIA) for detection of alphafetoprotein (AFP) and carcinoembryonic antigen (CEA) in human serum and to evaluate its performance.Methods The Eu-time-resolved fluorescent polystyrene particles conjugated with monoclonal antibody AC18# for AFP and AE03# for CEA were used as fluorescent labels.The monoclonal antibody AC17# for AFP,AE05# for CEA and goat anti-rabbit antibody were immobilized on the nitrocellulose membrane as the test lines and control line.Several performances indicators were measured,including linear range,detection limit,and specificity.AFP and CEA were measured by the new method and the results were compared with those obtained by time-resolved fluoroimmunoassay (TRFIA) and electro-chemiluminescence immunoassay (ECLIA) using linear correlation analysis.Results The measurement ranges of AFP were 0.07-1 000.00 kU/L with the intra-and inter-assay CV of 5.93％ and 11.07％,and those of CEA were 0.12-500.O0 μg/L with the intra-and inter-assay CV of 7.53％ and 12.13％ respectively.The average recovery rate of AFP and CEA was 92.77％ and 94.73％,respectively.Measurements obtained by TRFMIA had strong correlation coefficients ranging from 0.93 to 0.97 when compared with those obtained by TRFIA and ECLIA.Conclusion TRFMIA,which can simultaneously detect AFP and CEA,has been successfully established.

Objective To set up a time-resolved fluoroimmunoassay (TRFIA) method for human epidermal growth factor receptor 2 (HER2) detection and to evaluate its performance.Methods Each well of the 96-microwell plate was coated with monoclonal antibody of HER2(H7) and another monoclonal antibody of HER2(E5) was labeled by Eu3+.The sensitivity,stability,specificity,measurement range and reference value of this method were tested.The correlation between chemiluminescence (CLIA) method and TRFIA method was analyzed.Results The sensitivity of HER2-TRFIA method was 0.214 ng/ml.The measurement range was 0.214-1 000 ng/ml.The mean within-run CV and mean between-run CV were 3.48％ and 4.13％,respectively.HER2-TRFIA method had no cross-reaction with HER1 and its reference range was 0-13.20 ng/ml.The correlation coefficient between TRFIA and CLIA was 0.997.The same batch of reagents were found to be stable for more than 6 months at 4 ℃.Conclusions HER2-TRFIA method has high sensitivity,specificity,stability and wide detecting range.It might be suitable for clinical use.

Objective:To evaluate the safety and efficacy of a Zenith fenestrated aortic stent-graft (ZFEN) system in the treatment of short-necked aneurysms.Methods:The clinical data of 5 patients receiving F-EVAR in Zhongshan Hospital, Fudan University from Mar 2018 to Sep 2019 according to the standards of short-necked abdominal aortic aneurysm and COOK ZFEN custom stent were retrospectively analyzed.Results:Patients' average age was (69±11) years old. The time of stent customization was 4-6 weeks. The average maximum diameter of AAA was (60.8±14.0) mm. The average proximal neck diameter was (26.0±2.6) mm and the average length anchoring zone was (6.4±2.2) mm. The rate of technical success was 100%. There was no intraoperative loss of visceral vessels and stent displacement. The meane follow-up time was 6.8 months. The perioperative mortality was 0, and there were no other major complications. There were 3 patients with simple type Ⅱ endoleak and 1 patient with type Ⅲ endoleak. The endoleaks disappeared in 4 patients during follow-up of 3-12 months. 1 patient suffered with type Ⅱ and type Ⅲ endoleak, and the visceral vessels and branching stents were patent in all patients.Conclusion:The short term result of COOK ZFEN stent-graft system was safe and feasible for the treatment of short-necked AAA.