Objective To explore the relationship between vertebrobasilar insufficiencies caused by subclavian steal syndrome and degree or type of steal phenomena.Methods 80 patients who were diagnosed subclavian steal syndrome by transcranial doppler ultrasound were analyzed retrospectively,24 cases in them were received digital subtraction angiography.The degree of steal phenomena were determined by direction of blood flow in the ipsilateral vertebral artery,and the type of steal phenomena were determined by whether basilar artery involved in steal phenomena.Finally,we made the correlation analysis between vertebrobasilar insufficiency caused by subclavian steal syndrome and degree or type of steal phenomena.Results There was a significant relationship between the severity of subclavian artery stenosis and degree of VA steal in 24 patients performed with both TCD and DSA(t =15.59,P ＜0.05).There was no significant relationship between the vertebrobasilar insufficiency and severity of steal phenomena (P ＞0.05).There were 21cases(77.8％) exist vertebrobasilar insufficiency in the patients whose basilar artery were involved in steal phenomena,and there were 18 cases(33.9％) exist ertebrobasilar insufficiency in the patients whose basilar artery were not involved in steal phenomena.There was a significant differences between the two type of steal phenomena(P ＜ 0.05).Conclusion The vertebrobasilar insufficiency caused by subclavian steal syndrome doesn't associate with the degree of steal phenomena,and associates with the type of steal phenomena.Paying close attention to whether basilar arteries are involved in steal phenomena is useful for analyzing the patient 's condition and guide clinical treatment.

Objective To investigate the perinatal outcomes of twin-twin transfusion syndrome (TTTS)and the management.Methods During Nov 1, 2002 to Sep 30, 2005, 24 cases of TTTS in Beijing Obstetrics and Gynecology Hospital were analyzed.The outcomes of them were compared with the pregnancy without TTTS in all twins and in monozygotic twins.The outcomes of the blood-supplying fetus and the blood-recepter were compared.Results 6.8%cases had TTTS in all twins.The group of TTTS had more maternal,fetal and neonatal complications than twins pregnancy without TTTS :polyhydramnios [37.5%(9/24)vs 2.1%(7/328),P＜0.01],gestational hypertension[20.8%(5/24)vs 7.0%(23/328),P=0.043],premature labor[66.7%(16/24)vs 36.3%(119/328),P=0.003],perinatal dead fetus in uterus[18.8%(6/32)vs 1.1%(7/540),P＜0.01],neonatal asphyxia[73.1%(19/26)vs 3.0%(19/632),P＜0.01],the proportion of NICU[88.5%(23/26)vs 23.4%(148/632),P＜0.01],neonatal death [15.4%(4/26)vs 1.7%(11/632),P=0.002 ]and the rate of perinatal mortality [31.2%(0/32)vs 2.8%(18/632)].Compared with the monozygotic twins without TTTS,in TTTS group there were more complications of the mother,the fetus and the neonates:gestational hypertension[20.8%(5/24)vs 9.9%(14/142),P=0.224],premature labor[66.7%(16/24)vs 49.3%(70/142),P=0.115 ],perinatal dead fetus in uterus [ 18.8%(6/32)vs 0.7%(2/282),P＜0.01 ],neonatal asphyxia [73.1%(19/26)vs3.9%(11/280),P＜0.01 ],the proportion of NICU[88.5%(23/26)vs 29.3%(82/280),P＜0.01],neonatal death[15.4%(4/26) vs 2.1%(6/280),P:0.006]and the rate of perinatal mortality[31.3%(10/32) vs 3.2%(8/282)].The perinatal outcomes were better in those cases that the grades of TTTS were below 3 in the first diagnosis.Conclusions We should try to diagnose and treat TTTS as early as possible because the outcome is poor.

Objective To evaluate the effect of octreotide on the survival of patients with advanced hepatocellular carcinoma(HCC).Methods Electronic databases searches were conducted.Meta-analysis of all randomized controlled trials (RCTs) comparing octreotide versus placebo or no treatment was performed.Results Five RCTs including 579 patients with HCC wers assessed.Meta-analysis of the five studies showed that octreotide had no significant effect on the 6,12 and 24 months survival rates of the patients(6months:OR=1.69,95%CI 0.89-3.21,P=0.11;12 months:OR=2.41,95%CI 0.83-6.93,P=0.10;24months:OR=0.58,95%CI 0.28-1.17,P=0.13).To perform the sensitivity analysis,the blank study,the trial detecting somatostatin receptor expression,the study with short survival or the two trials with short follow-up intervals were excluded,and the results also showed that the octreotide treatment had no significant effect on the 6 and 12 months survival rates.A sensitivity analysis based on two trials indicated that the 24months survival rate of the octreotide group was even lower than that of the control group(OR=0.51,95% CI0.27-0.98,P=0.04).Conclusions This Meta-analysis demonstrates that octreotide could not improve the survival of patients with advanced HCC.The administration of octreotide should not be recommended for the treatment of advaneed HCC.

Dendritic cells (DCs)can capture HIV from the mucosal site and carry it to the draining lymph nodes to promote CD4 + T cell infection.DC-SIGN(CD209)plays a vital role during this process. Heroin,methamphetamine and cocaine are the most abused drugs used by drug abusers,which can increase the opportunities of HIV infection.Drugs acting on the corresponding receptors activate the downstream signaling pathway and regulate the expression of DC-SIGN on the surface of DCs,weakening the inhibited effects of immune cells on HIV and promoting HIV infection in many aspects.Given the multiplex effects of drugs on immune function,this article reviews the relationship between abused drugs,DCs and HIV infection,particularly in the signal pathway on immune modulation.

Objective To investigate the present situation of the combination of antimicrobial drugs and to improve the rationality of antimicrobial medication.Methods Choose 1734 prescription of antimicrobial from February 2015 to May 2016 in our hospital outpatient service and emergency departments, combined with pharmacology, clinical medication instructions and drug instruction,the prescriptions were analyzed statistically,and the name of antimicrobials, combination mode, type, period of treatment, rationality and other aspects of the situation were studied.Results The total prescription of antibiotics was 45.44%, and the combination of antimicrobial drugs was 76.65 %, with the combination form of the dosage form and the injection machine with a maximum of 41.72%.Oral dosage form and oral dosage form combined drug 21.19%.The proportion of combined penicillin was 43.54 percent, followed by the cephalospora 27.81%.The rational compatibility prescription 86.92%, the prescription compatibility is unreasonable 13.08%.In the unreasonable preparation of the prescription, the majority of the formulations for pharmacodynamics were 82.28%.Conclusion The current use of antibiotics in our hospital gradually become standardized, in the process of clinical treatment, to understanded and master the drug combination medication indications, can significantly improve the treatment effect, to avoid the occurrence of adverse reaction phenomenon, the use of drug safety is effectively guaranteed.

Objective To observe the head and neck CTA application value in the diagnosis of ischemic cerebrovascular disease.Methods 430 patients with suspected diagnosis of ischemic cerebrovascular disease were adopted with head and neck CTA examination.The carotid artery stenosis degree,grade and plaque formation were observed,and the sensitivity and specificity of CTA in the diagnosis of ischemic cerebrovascular disease were calculated.Results After CTA examination,a tctal of 293 cases (68.14％) with carotid artery stenosis symptoms,among them 87 cases of mild stenosis,moderate stenosis in 169 cases,35 cases of severe stenosis and occlusion in 2 cases.430 plaques were detected in 430 patients,in extracranial arteries,81 soft plaques were identified,as well as 134 calcified plaque and 107 cases of mixed plaque,totally 322 cases;in intracranial arteries 312 cases of the soft plaque were identified,as well as 115 cases of calcified plaque and 97 cases of mixed plaque,totally 524 cases.The sensitivity of CTA in the diagnosis of ischemic cerebrovascular disease was 97.09％ and the specificity was 83.33％.Conclusion In the diagnosis of ischemic cerebrovascular disease,head and neck CTA examination for head and neck vascular stenosis and plaques has visual assessment,and high sensitivity,specificity.

Reovirus,a kind of oncolytic viruses, is seldom pathogenic, but is selectively able to replicate in cancer cells through activation of Ras signaling. Pre-clinical studies have demonstrated that treatment with reovirus is associated with significant anticancer activity across a range of tumor types. Further clinical evaluation of reovirus therapy has shown that it is well tolerated when administered locally or systemically. Encouraging anticancer efficacy has been observed with single-agent treatment and in combination with chemotherapy and radiotherapy. High safety and promising efficacy of reovirus has raised hopes that it will become a new anticancqt agent.

Objective To investigate the effects of exercises on expressions of retinol binding protein-4 (RBP4)in serum and phosphatidylinositol 3 kinase(PI3K)in skeletal muscles of insulin-resistant(IR)rats induced by diets.Methods A total of 30 Wistar rats were randomly divided into 3 groups:normal control group fed with normal diet,IR and exercises groups with high sugar and high fat diet.After 8 weeks,the Wistar rats in exercises group took swimming training for 6 weeks and all groups kept their assigned diets.At the end of 14-week experiment,the body weight(BW)of rats were measured,the general behaviors of rats were observed and then sacrificed.Rats' blood were sampled for measuring the levels of glucose(FPC)and serum RBP4,insulin(FINS),HDL-C,LDL-C,TG,TC.The indexes of IR(HOMA-IR)were calculated.The levels of RBP4 in serum were measured with ELISA technique.The ratios of visceral fat content to BW were calculated too.Immunohistochemistry method was applied to detect the expression levels of PI3K in skeletal muscle.Results(1)The levels of RBP4,TC,TG,FPG in serum in exercises group were lower than those in IR group significantly;the visceral fat content,ratio of visceral fat content to BW,FINS,RBP4,LDL and HOMA-IR in serum increased significantly in IR group after 6 weeks feeding compared with normal control group and exercises group(P＜0.01);the levels of HDL in serum in IR group were lower than those in the other two groups.(2)The expression levels of PI3K in skeletal muscles in exercises group were significantly higher than that in IR group(P＜0.01).(3)In a multiple stepwise regression analysis,FINS,ratio of visceral fat content to BW,LDL and HOMA-IR were correlated with RBP4 positively;HDL and PI3K were correlated with RBP4 negatively.Conclusion Exercises could downregulate the level of RBP4 in serum and upregulate the level of PI3K in skeletal muscles of IR rats.This effect was important for improving the organism sensibility to insulin.

Objective To investigate the level changes of plasma soluble intercellular adhesion molecule-1(sICAM-1), endothelin(ET) and Nitric oxide(NO) and the effects of perindopril on their levels in elderly patients with essential hypertension. Methods Enzyme linked immunosorbent assay(ELISA), radioimmunoassay and nitrate reductase method were used to respectively measure the plasma levels of sICAM-1, ET and NO in 63 elderly patients with mild to moderate essential hypertension before and after perindopril treatment and 40 normotensive elderly individuals. Results Elderly hypertensive patients exhibited significantly higher plasma levels of sICAM-1 and ET, and lower plasma level of NO than normotensive elderly individuals did(P

Objective To study the cytopathogenic effect of epidemic hemorrhagic fever with renal syndrome virus (HFRSV) on renal tubular cells(RTC). Methods Human fetal renal tubular cells (HFRTC) were cultured in vitro. HFRTC infected or not infected by HFRSV were observed by using trypan-blue stain and transmission electron microscopy(TEM). Viral-mRNA was detected by in situ molecular hybridization. Results (1) HFRSV could directly infected HFRTC: (2)The death rate of HFRTC in the infection group was significantly higher than that in the control grou 1 to 4 weeks after infection; (3) Injuries of cell membrane and cell organs after infection with HFRSV were significantly earlier and more severe as compared to control by means of TEM. Conclusion HFRSV can directly damage renal tubular cells (RTC ), which contributes to the pathogenesis of hemorrhagic fever with renal syndrome (HFRS).