Objective To study the clinical, imaging and pathological features of primary angiitis of central nervous system (PACNS). Methods The clinical data of 8 patients with PACNS (4 suspected and 4 definite) were retrospectively analysed.Results There were 5 males and 3 females in 8 patients with PACNS. Average age was 32 years old and average disease course was 11 months. The initial symptoms were headache in 5, extremital weakness in 2, and speech disorder in 1 patients. The major clinical manifestations were headache in all patients, extremital weakness and numbness in 5, speech disorder in 1, and seizure disorder in 2 patients. 7 patients were with slow-progressive disease courses, and 1 patients with a relapsing-remitting one. MRI showed abnormality in all patients. 6 cases had unilateral lesions and 2 had bilateral lesions. MRI showed ill-defined, irregular or atypical wedge-shaped foci in cortical and subcortical areas in 7 patients and strip-shaped foci with surrounding finger-like cerebral edema in the left frontal and parietal lobe and gyrus cinguli in 1 patient. All lesions enhanced with different degree on contrast-enhanced scan. Enhanced lesions along sulcus and gyrus were seen in 7 patients and mass-like irregular linear enhancement lesion in 1 patient. Diffusion-weighted imaging(DWI) showed hyper-signal and apparent diffusion coefficient(ADC) showed hypo-signal in 5 patients. MRA showed stiffness and lack of smooth in one or more cerebral arteries with multiple segmental narrowing and expanding, and rarity of arterial distal branches in 8 patients. Digital subtraction angiography (DSA) also showed multiple segmental narrowing and expanding in cerebral arteries, and rarity of arterial distal branches in 4 patients. Brain biopsy in 4 cases revealed angiitis with lymphocytic infiltration. 5 patients received treatment with single corticoid, and 3 with cyclophosphamide. All cases had good outcome. Conclusions The clinical manifestations of PACNS are various. The changes of imaging are obvious, MRI, MRA and DSA are helpful in the diagnosis of PACNS. The definite diagnosis relies on brain biopsy.

Objective:To establish a method for the simultaneous determination of fluoxertine and olanzapine in capsules by re-versed-phase high performance liquid chromatography ( RP-HPLC) . Methods:The successful separation of fluoxertine and olanzapine was achieved on a Phenomenex C18 column (250 mm × 4. 6 mm, 5 μm) with 10 mmol·L-1 potassium dihydrogen phosphate buffer (pH 4. 0)-acetonitrile-methanol (55 ∶40 ∶5, v/v/v) as the mobile phase. The flow rate was 1. 0 ml·min-1, the detection wave-length was 227 nm, the column temperature was 30℃, and the injection volume was 20 μl. Results:Fluoxertine could be well separa-ted from olanzapine under the chromatographic conditions. The linearity between the peak areas and the concentrations was observed within the range of 5. 0-80. 0 mg·L-1(r=0. 999 9) for fluoxertine and 1. 2-19. 2 mg·L-1(r=0. 999 9) for olanzapine. The mean recovery of fluoxertine and olanzapine was 99. 9%(RSD=0. 94%, n=9) and 100. 2%(RSD=2. 08%, n=9), respectively. Con-clusion:The method is simple, sensitive and accurate, and it can be applied in the content determination of fluoxertine and olanzapine in capsules.

Objective:To compare the similarity of dissolution curves of domestic ibuprofen suspension and the imported prepara-tion to provide the basis for the comprehensive quality evaluation of ibuprofen suspension. Methods: The in vitro dissolution of the products from four different manufacturers was investigated in pH 7. 2 phosphate buffer solution. The similarity of dissolution behavior was compared with that of the imported preparation in pH 1. 2 hydrochloric acid solution, pH 4. 5 acetate buffer solution, pH 6. 8 phos-phate buffer solution, pH 7. 2 phosphate buffer solution and water, respectively. Results:The dissolution rate of ibuprofen suspension from the four different manufacturers reached above 80% in 60 min. The dissolution profiles of ibuprofen suspension from two different manufacturers were similar with that of the imported preparation. Conclusion: The dissolution behavior of ibuprofen suspension from different manufacturers is significantly different.

Objective To quantify the effect of gradual respiratory functional training on the lung function and quality of life (QOL) of patients convalescing from Guillain-Barré syndrome (GBS). Methods Thirty-two GBS patients were randomly divided into two groups a control group which received routine nursing and a respiratory function training group.The training was in three stages:thoracic or/and abdominal respiration,deep breathing and respiratory exercise.After 2 and 4 months of treatment,the 16 min walk test and the SF-36 health questionnaire were used to evaluate the subjects' lung function,motor capacity and QOL. Results After 2 and 4 months of treatment,vital capacity (VC),forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and maximal ventilatory volume (MVV) had all improved significantly in the training group.Their 6 min walk distances and QOL ( in all 8 domains) had also improved significantly.The average VC.FVC.FEV1 and MVV in the control group all decreased slightly but the decreases were not significant.Their 6 min walk distances had improved significantly,however,as had the physical function,mental health.psychological role,physical pain and integrated health domains of their QOL. Conclusion Training the respiratory functional of GBS patients during convalescence can prevent the lung function decay due to muscle weakness,and can also improve motor ability and QOL.

Objective To investigate epigenetic inactivation of SPOCK2 gene in the malignant transformation of ovarian endometriosis ( EM ) by comparing the methylation status and protein expression of SPOCK2 gene in the malignant tissues,ectopic endometria and the eutopic endometria of endometriosis.Methods From Jan.2005 to Jan.2011,22 paraffin-embedded specimens diagnosed as malignant transformation of ovarian endometriosis ( EAOC ) including 11 cases with ovarian endometrioid carcinoma,8 cases with clear cell carcinoma,2 cases with serous cystadenocarcinoma and 1 case with mucous cystoadenocarcinoma matched with 22 cases with ovarian endometriosis and 16 cases with normal endometrium form cervical intraepithelial neoplasia(CIN) patients as controls in Department of Obstetrics and Gynecology of Shengjing Hospital.Twenty-two malignant tissues,15 ectopic endometria and 10 eutopic endometria were captured by microdissection in EAOC group; 22 eetopic endometria and 17 eutopic endometria were captured in EM group; 22 endometrium were captured in the NE group.The methylation statue of SPOCK2 was determined by combined bisulfite restriction analysis,and the protein expression of SPOCK2 was evaluated by immunohistochemistry.Results ( 1 ) Methylation of SPOCK2:in the EAOC group,the frequency of SPOCK2 hypermethylation in malignant tissue was 45％ (10/22),which was significantly higher than 1/15 in the ectopic endometrium (P＜0.05).There was no statistical difference of the frequency of SPOCK2 hypermethylation in ectopic endometrium in the EAOC group(1/15) and EM group (5％,1/22) (P＞0.05).(2) SPOCK2 protein:the loss rate of SPOCK2 was 44％ (11/22) in malignant tissue in EAOC group,which were significantly higher than 2/15 of in ectopic endometrium of EAOC (P ＜ 0.05).However,there was no remarkable difference in loss rate of SPOCK2 protein between ectopic endeometrium of EAOC and endometrium of EM [ 2/15 vs.5％ ( 1/22 ),P ＞ 0.05 ].No significantly difference in loss rate of SPOCK2 in eutopic endometrium was observed among three groups ( P ＞ 0.05 ).(3) The abnormal methylation of SPOCK2 could lead to loss expression of protein ( P ＜ 0.05 ).Conclusion Epigenetic inactivation of SPOCK2 gene is involved in the malignant transformation of ovarian endometriosis.

Objective To investigate the effect of propofol on hypoxic pulmonary vasoconstriction(HPV)and assess the underlying mechanism in rats.Methods Twenty male SD rats weighing 300-400 g were.anesthetizedwith intraperitoneal phenobarbital.Heart and lungs were removed after thoracotomy.Pulmonary.arterial rings 4 mmin length and 1.0-1.4 mm in diameter were prepared and suspended in Earl solution maintained at 37℃ with a pHof 7.40 and aerated with 20% O_2-5% CO_2-25% N_2.The rings were stimulated with phenylephrine(PE)10~(-6)mol?L~(-1) with different preloads(300,500,700,900,1 100 mg).The isometric tension of the arterial rings wasmeasured.The optimal preload was determined to be 900 mg which allowed best contractility.Hypoxia was inducedby aerating the solution with 95% N_2-5% CO_2 and the flow rate was adjusted to maintain PO_2 of the solution at40-20 mm Hg and pH at 7.40.HPV of the rings were recorded.Then propofol was added to achieve a finalconcentration of 1,3,10,30,100 ?mol?L~(-1) and HPV was again induced and the changes in HPV wererecorded.In addition the effects of propofol(10,30 ?mol?L~(-1))on vasoconstriction produced by KCI and PE werealso measured.Results The lower doses of propofol(10 ?mol?L~(-1))significantly inhibited HPV(P

Objective To study the effects of methylene blue(MB), a soluble guanylate cyclase inhibitor , on intestinal perfusion and oxygenation in dogs with septic shock.Methods A septic shock model was established by lipopolysaccharide infusion.After resuscitation with normal saline infusion,2mg/kg MB was infused within 15min in seven dogs.Blood flow of the superior mesenteric artery (SMA) was measured respectively at baseline,post shock for 1h, after resuscitation and 30min after MB injection.Blood gas analysis was done , and oxygenation was calculated.Results Blood flow of the SMA was significantly decreased by 61 8%(P0 0 5 ) ,butO2 extrincreasedby 14 8% .Conclusions Septicshockindogsresultsinadecreaseinintestinalperfusionandanincreasein oxygenextraction ,whichcanbeimprovedbyMBinjection .Theintestinalperfusionispartlyincreasedbyvolumetherapy .

Objective To evaluate the prognostic value of 18 F?FDG PET/CT in untreated small cell lung cancer ( SCLC) . Methods A total of 49 SCLC patients( 35 males, 14 females, median age 61 years) with pathologically confirmed SCLC had underwent 18 F?FDG PET/CT scan before treatment from January 2008 to December 2013 and were retrospectively analyzed in this study. Clinical staging were mainly deter?mined by 18 F?FDG PET/CT scan. Performance status ( PS) was acquired according to the clinical symptoms before PET examination. Patients were followed up for at least 6 months and the survival interval was recor?ded. Two?sample t test, Kaplan?Merier, log?rank and Cox regression analysis were used for statistical analy?sis. Results (1)Among 49 patients, 20 died during the follow?up, 1 patient was lost to follow?up, and 45 patients(91.84%) had metastasis. Patients with limited disease (LD) and extensive disease (ED) were 27 and 22 respectively according to 18F?FDG PET/CT imaging. (2)The median OS was 23.68 months and me?dian PFS was 19.93 months. LD patients had significantly longer OS and PFS than ED patients (35.30 months vs 12.57 months, 28.87 months vs 11.30 months;χ2=18.810, 13.647, both P<0.05). (3)SUVmax of primary tumor ranged from 1.97 to 21.50. The SUVmax of primary foci had no difference between LD(8.27± 3.14) and ED(9.68±5.36)patients(P>0.05). SUVmax of primary tumor showed no significant correlation with OS and PFS (both P>0.05).There were no significant differences in OS and PFS between low SUVmax group and high SUVmax group in both LD and ED patients (χ2=0.001-0.565, all P>0.05). (4) Staging based on 18 F?FDG PET/CT results and PS score were independent prognostic factors ( hazard ratios:3.93, 5?00, both P<0.05) , while SUVmax showed no significant prognostic value. Conclusions PS score before PET scan and imaging staging based on 18 F?FDG PET/CT results are independent prognostic factors. The predictive value of primary foci SUVmax needs further investigation.

Group A β-hemolytic streptococcus (GAS),namely Streptococcus pyogenes,is one of the most im-portant human pathogen.GAS can cause skin and mucous membrane superficial infectious diseases,life -threatening invasive disease,toxin -mediated diseases and immune -related diseases.Antibiotic is an effective mean to control GAS infection.The β-lactam antibiotics remain the first -choice treatment for GAS infection and the macrolides are often recommended as a replacement therapy for β-lactam antibiotics allergic patients or a means to blocking GAS exotoxin product.But with the widespread use of macrolides autibiotics,macrolide -resistant GAS spread in the world. This paper will elaborate the situation of macrolide -resistant clones.

Objective To explore the treatment principle of distal crevasses in aortic dissection.Methods According to the different treatment principles of distal crevasses in aortic dissection to divide the patients into two groups:following the treatment principle group:take the principle of from near to far,endovascular repair of distal crevasses,if not deal with the crevasses involving visceral arteries,do not handle the distal crevasses; unfollowing the treatment principle group:do not deal with the crevasses involving visceral arteries,endovascular repair of it's distal crevasses).Analyze the postoperative discomfort (chest and back pain,lower back pain) incidence,postoperative distal crevasses happening again and false lumen changes respectively.Results Fifty-three patients were included in the standard,in which follow the treatment principle group has 37 cases,and do not follow the treatment principle group has 16 patients.There were no significance statistically in complained of postoperative discomfort and postoperative distal crevasses happening again(P ＞ 0.05).And there was statistically significant in the false lumen (P ＜ 0.05).Conclusions The prognosis of patients in the following the principle treatment is better than that of unfollowing the principle group.To treat the distal crevasses in aortic dissection should be took the principle of from near to far,if not deal with the crevasses involving visceral arteries,don't handle the distal crevasses also.