Objective To investigate the intracranial vascular lesions in patients with subcortical infarction-induced vascular cognitive impairment(VCI), and to investigate the etiology and mechanisms of VCI. Methods Inpatients with subcortical infarction in our hospital were enrolled in this study from Nov. 2012 to Feb. 2014, with those unable to complete the cognitive evaluation eliminated. According to the diagnostic criteria of VCI the patients were divided into two groups: 49 with cognitive impairment (VCI group) and 42 without cognitive impairment (NVCI group). The clinical data, physical examinations, laboratory tests, and the Montreal Cognitive Assessment (MoCA) scale scores were collected. Cerebral blood vessels were assessed by CT angiography or magnetic resonance angiography (MRA). Results The results showed that, according to TOAST classification, VCI group had 24 (48.98%) patients with large artery atherosclerosis (LAA) and NVCI group had 22 (52.38%), showing no significant difference between the two groups. CTA or MRA indicated that 37 (75.51%) patients in VCI group had vascular stenosis, with 75.25% of the 37 patients having intracranial vascular stenosis and 28.71% with middle cerebral artery stenosis. Patients with single cerebral artery stenosis accounted for 18.37% and those with the multiple artery stenosis accounted for 57.14%. CTA or MRA indicated that 34 (80.95%) patients in NVCI group had vascular stenosis, with 60% having intracranial vascular stenosis, including 32% with middle cerebral artery stenosis, 26.19% with single cerebral artery stenosis, and 54.76% with the multiple artery stenosis, with the latter two data being significantly different from the VCI group (P <0.05). In VCI group, the number of intracranial vascular stenosis branches ranged 0-6, with a mean of (1.51±1.67), and a negative relation was found between numbers of stenosis arteries and MoCA scores in patients of VCI group (rs=-0.283, P <0.05). Conclusion Different from the common causes of small blood vessels, LAA is the most common etiology of subcortical VCI, which implied that exploring the LAA causes of small lesions is crucial for the prevention of VCI in Chinese patients.

Objective To investigate the effects of Huoxue Yiqi Decoction(composed of Carthami Flos,Crataegi Fructus,Salviae Miltiorrhizae Radix et Rhizoma,and Astragali Radix)combined with Pinggan Qianyang Muzu Powder(composed of Uncariae Ramulus cum Uncis,Prunellae Spica,Chrysanthemi Flos,Lonicerae Japonicae Flos and Cassiae Semen)on blood lipid metabolism and cardiac function in female patients with essential hypertension.Methods A total of 220 female patients with essential hypertension of qi deficiency and blood stasis type were randomly divided into observation group and control group,with 110 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Huoxue Yiqi Decoction orally combined with Pinggan Qianyang Muzu Powder for foot bath on the basis of treatment for the control group.The course of treatment for the two groups covered one month.Before and after treatment,the two groups were observed in the changes of blood pressure,blood lipid,traditional Chinese medicine(TCM)syndrome scores and cardiac function indicators of left ventricular ejection fraction(LVEF)and stroke volume(SV).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After one month of treatment,the total effective rate of the observation group was 95.45%(105/110),and that of the control group was 84.55%(93/110).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the TCM syndrome scores of primary symptoms and secondary symptoms in the two groups were decreased when compared with those before treatment(P＜0.05),and the decrease in the observation group was superior to that in the control group(P＜0.01).(3)After treatment,the levels of systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the two groups were lower than those before treatment(P＜0.05),and the decrease of SBP and DBP levels in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the levels of blood lipid indicators of total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the two groups were lower than those before treatment(P＜0.05),and the levels of high density lipoprotein cholesterol(HDL-C)were higher than those before treatment(P＜0.05).The decrease of TC,TG and LDL-C levels and the increase of HDL-C level in the observation group were significantly superior to those in the control group(P＜0.01).(5)After treatment,the levels of cardiac function indicators of LVEF and SV in the two groups were higher than those before treatment(P＜0.05),and the increase of LVEF and SV levels in the observation group was significantly superior to that in the control group(P＜0.01).Conclusion The combination of Huoxue Yiqi Decoction and Pinggan Qianyang Muzu Powder exerts certain effect in the treatment of female patients with essential hypertension of qi deficiency and blood stasis type.The combined therapy is effective on controlling blood pressure,improving blood lipid metabolism and cardiac function indicators.

OBJECTIVETo investigate the effect of (AT)n repeat polymorphism of the 3'untranslated region in cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) gene on CTLA-4 mRNA stability and full length (flCTLA-4) and soluble CTLA4 (sCTLA-4) expression in ulcerative colitis (UC).

METHODSflCTLA-4 mRNA in colonic biopsies and sCTLA-4 mRNA stability in peripheral blood mononuclear cells of UC patients were measured by quantitative PCR and half-life, respectively. The protein expression of flCTLA-4 in colonic biopsies and sCTLA-4 in sera of UC patients were determined by immunohistochemistry and enzyme-linked immunosorbent assay, respectively. The polymorphism of CTLA-4 (AT)n repeats in 300 UC and 700 age and sex matched healthy controls was genotyped by fluorescent PCR.

RESULTSAmong the UC patients, sCTLA-4 mRNA expression levels were decreased in active disease compared to non-active disease (P= 0.004). Carriers of the longer alleles of the (AT)n repeats expressed lower levels of flCTLA-4 and sCTLA-4 mRNA and sCTLA-4 protein than those of the shorter alleles in UC (all P< 0.01), and mRNA with long (AT)n repeat alleles has shorter half-life than mRNA with short alleles and, hence, are unstable. The frequency of long allele carriers of CTLA-4 (AT)n repeats was significantly higher in UC patients than in the healthy controls (22.0% vs. 6.3%, P< 0.01, OR= 4.21, 95% CI: 2.79-6.33), and associated with extensive colitis (P= 0.008).

CONCLUSIONCTLA-4 gene expression levels were associated with (AT)n repeat polymorphisms in UC patients. The expression of CTLA-4 mRNA and protein were decreased in carriers of the longer alleles of the (AT)n repeats of CTLA-4 gene. This study suggests that CTLA-4 plays an important role in genetic risk and pathophysiology for UC in central China.

Adult ; Antigens, CD ; chemistry ; genetics ; metabolism ; CTLA-4 Antigen ; Case-Control Studies ; Colitis, Ulcerative ; genetics ; metabolism ; Female ; Gene Expression Regulation ; Genotype ; Humans ; Male ; Phenotype ; Polymorphism, Genetic ; RNA Stability ; genetics ; RNA, Messenger ; chemistry ; genetics ; metabolism ; Solubility

Objective:Using an area in east of China as a case,the paper exploit the methodology to define and visualize the scope of the medical insurance pharmacy service through using ArcGIS and its function modules to analy-zing the basic data including this area's population distribution,address of drugstores,administrative districts,road network and soon.Plan A based on the 15-minute walk distance norm for defining the scopes, shows that this area need to increase 548 medical insurances designated drugstore,the effect of which was service area can be increased by 12.36%,service population can be increased by 10.82%, designated drugstore healthy competition rate can be increased by 8.36%;Plan B based on the 10-minute walk distance norm for defining the scopes, displays that this area need to increase 1197 medical insurance designated drugstore, the effect of which was service area can be in-creased by 15.23%,service population can be increased by 20.49%,designated drugstore healthy competition rate can be increased by 19%.

Purpose To investigate the clinical features,pathological type and composition of nasal cavity and nasopharyngeal lymphoma.Methods The clinical data,histopathologic features and immunotypes of 319 consulted cases of nasal cavity and nasopharyngeal lymphoma from department of pathology,Beijing Friendship Hospital,Capital Medical University were retrospectively analyzed.According to the new WHO (2008) classification,all data of these cases were reappraised.Results Among these 319 cases,3 cases (0.9％) were diagnosed as classical Hodgkins lymphoma (CHL).Other 316 cases (99.1％) were diagnosed as non-Hodgkins lymphoma (NHL),56.0％ (177 cases) of them were T and NK-cell lymphoma and 44.0％ (139 cases) were B-cell lymphoma.The commonest subtypes were extra-nodal NK/T-cell lymphoma (NK/TCL) in 160 cases (50.6％),diffuse large B-cell lymphoma in 64 cases (DLBCL 20.3％).Among these 319 cases,106 cases (33.2％) over 60 years old were diagnosed as NHL.The most common subtypes were DLBCL in 40 cases (37.7％),NK/TCL in 36 cases (34.0％).There was no statistic difference in the incidence rate between the two types.Other 210 cases of NHL 0.9％ below 60 age including NK/TCL 124 cases (59.0％)and DLBCL 24 cases (11.4％).The diference is statistically significant.Conclusion Among those 319 nasopharyngeal lymphoma cases,3 cases are considered as CHL.NK/TCL is the commonest subtype of other 316 cases.DLBCL and NK/TCL are the most common subtypes in 106 cases over 60 years old.There was no statistic difference in the incidence rate between the two types.

Adult ; Aged ; Bevacizumab ; therapeutic use ; Brain Neoplasms ; drug therapy ; therapy ; Edema ; drug therapy ; etiology ; Female ; Humans ; Male ; Middle Aged ; Re-Irradiation ; adverse effects

OBJECTIVETo observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis.

METHODSA multi-center, self-controlled open clinical trial was conducted. A total of 280 subjects with chronic prostatitis were enrolled and treated by Qianlieantong Tablets, 3 times a day, 5 tablets each time. Before and after 2 and 4 weeks after the administration, NIH-CPSI scores and white blood cell counts in the prostate secretion were recorded.

RESULTSOf the 273 subjects evaluated, the rates of excellence, effectiveness and ineffectiveness were 35.2% (n = 96), 47.6% (n = 130) and 17.2% (n = 47), respectively, with a total effectiveness rate of 82.8%. After 4 weeks'medication, the scores of the subjects on NIH-CPSI pain, voiding and quality of life and white blood cell counts in prostate secretion were significantly decreased compared with pre-treatment (P < 0.01). No adverse events or laboratory abnormality related to the medication were observed.

CONCLUSIONQianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.

Adult ; Chronic Disease ; Drug Administration Schedule ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prostatitis ; drug therapy ; Quality of Life ; Tablets ; Treatment Outcome

AIM To study the chemical constituents from the branches and leaves of Toona ciliata Roem.var.pubescens(Franch.)Hand-Mazz.and their antitumor activities.METHODS The compounds were isolated and purified by silica gel,RP-18 reverse phase silica gel and semi-preparative HPLC,the structures of compounds were identified by physicochemical properties and spectral data.The antitumor activities were determined by MTT method.RESULTS Fifteen compounds were isolated and identified as toonaolide D(1),toonaciliatin E(2),bourjotinolone A(3),(21R,23R)-epoxy-21α-ethoxy-24S,25-dihydroxyapotirucalla-7-en-3-one(4),(Z)-toonasterone C(5),(E)-toonasterone(6),3-epi-dyscusin C(7),(Z)-aglawone(8),(E)-volkendousin(9),8(14),15-isopimaradiene-2α,3α,19-triol(10),(-)-loliolide(11),cyclohexenone(12),pubinernoid A(13),quercetin-3-O-(4″-methoxy)-α-L-rahmnopyranosyl(14),5-hydroxymethyl-2-furancarboxaldehyde(15).The IC50 values of compounds 3 and 4 on K562 cells were 54.2 and 47.3 μmol/L,respectively,and the IC50 values on HEL cells were 47.3 and 61.1 μmol/L,respectively.CONCLUTION Compounds 4,7,10 and 11 are isolated from Toona genus for the first time,and compounds 2,15 are first isolated from this plant.Compounds 3 and 4 show weak antitumor activities.

BACKGROUNDThis study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China.

METHODSThis study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP.

RESULTSThe outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that.

CONCLUSIONSStaff training and SRP can significantly improve the efficiency of severe trauma treatments in China.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Emergency Medical Services ; standards ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Wounds and Injuries ; Young Adult

OBJECTIVETo evaluate the feasibility of three-dimensional pseudo-continuous arterial spin label (3D pCASL) non-contrast enhanced perfusion imaging applied to head and neck tumors in high-field MR and detect the effects of different postlabeling delay (PLD) time on image quality and the reliability of repeated measurements of tumor blood flow (BF) in different 3D pCASL groups.

METHODSIn this prospective study,all the 25 patients received neck 3D pCASL non-contrast enhanced perfusion examinations in a 3.0 T MR system by using an 8-channel head and neck joint coil. Conventional T1-weighted (TIWI) and T2-weighted imaging (T2WI) were performed firstly. Finally,three 3D pCASL with different PLD time [ASL1(PLD1=1525 ms),ASL2 (PLD2=2025 ms), ASL3(PLD3=2525 ms)] were acquired. Patients' perfusion-weighted images acquired from different 3D pCASL sequences underwent the analysis of signal to noise ratio (SNR) and contrast noise ratio (CNR) for tumors. Two observers performed the qualitative assessments on spiral artifacts and vascular artifacts of perfusion-weighted images from different 3D pCASL sequences. Blood flow (BF) of tumors from different 3D pCASL sequences were measured by the two observers respectively for the first time and by observer 2 for the second time.

RESULTSSeventeen enrolled patients (age:50.1 ± 12.7 years,M/F=10:7) with histopathologic.

RESULTSunderwent the evaluation of image quality and measurements of BF values. The SNRs and CNRs of ASL1,ASL2, and ASL3 showed a descending trendency. SNRs (P=0.011) and CNRs (P=0.009) of ASL1 were significant higher than those of ASL3. There was no significant difference of scores of spiral artifacts among the three ASL groups (P=0.932). The scores of vascular artifacts of ASL1,ASL2,and ASL3 showed a descending trendency,also. And scores of ASL1 was significant higher than that of ASL3(P=0.000). The intraclass correlation coefficient (ICC) of intre-and intraobserver were high (ICC>0.9). Although the BF values of ASL1,ASL2, and ASL3 showed an ascending trendency,there was no significant difference among the three groups (P=0.977).

CONCLUSIONSThe 3D pCASL no-contrast enhanced perfusion MR imaging can be used for head and neck tumor. The image quality of perfusion weighted images and reliability of BF measurements were satisfied. The 3D pCASL series with PLD of 1525 ms and 2025 ms have better image quality than PLD of 2525 ms. And BF values do not show significant statistic difference among the three groups. Therefore, 3D pCASL series with PLD of 1525 ms and 2025 ms are more suitable for the perfusion imaging of head and neck tumors

Artifacts ; Female ; Head and Neck Neoplasms ; Humans ; Image Enhancement ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Signal-To-Noise Ratio ; Spin Labels