Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.

Objective To analyze the different doses of mifepristone in treatment of menopause induced by perimenopausal uterine leiomyoma , and to explore the clinical application of the effective dose of mifepristone.Methods 141 cases with perimenopausal uterine leiomyoma were divided into group A, group B and group C randomly, 47 cases in each group.Three group of patients were given mifepristone.Group A were treated with dose of 12.5 mg/d, group B was treated with 10.0 mg/d, group C was given with 5.0 mg/d.Three groups of patients continued treatment for three months. Uterine volume and leiomyoma volume were observed after treatment, and recorded status of induced menopausal after six months.Results Three groups with uterine volume and leiomyoma volume post-treatment were significantly less than pre-treatment (P<0.05);induction of menopause success rate of group A was 89.4%, menstruation incidence was 6.4%, vaginal bleeding was 2.1%, which was significantly better than the other two groups ( P<0.05) .Conclusion Different doses of mifepristone orally in treatment of perimenopausal uterine leiomyoma has a significant effect, but with 12.5mg/d induced menopause can effectively enhance the success rate , it could be used as the optimal dose of clinical treatment.

To investigate the effect of Chinese herbs (Astragalus-As,Angelica-An,AG-a composition of Astragalus) on muscle protein metabolism in nephrotic rats. Methods The method of incorporation of [3 H-phenylalanine ] ([3 H-phe]) into the muscle was used. Results (l)The incorporation of [3 H-phe] into the muscle of untreated nephrotic rats (1.12 ? 0.37) was significantly lower than ihe normal control rats (2.25?0.47) ( P

Objective To investigate the diffusion tensor imaging(DTI)and magnetic resonance spectroscopy(MRS)changes in amyotrophic lateral sclerosis(ALS)and to study on the physiopathology of ALS.Methods Thirty-eight AIS patients,8 patients with pure lower motor neuron involvement and 5 patients with mixed-type cervical spondylosis and 34 healthy controls were enrolled and examined with the conventional brain MRI,DTI and 1H-MRS.Results T2-weighted and T2 FLAIR images revealed abnormal high signals in bilateral pyramidal tract positions in 21%(8/38)of ALS patients,which was higher than that in the coaex When compared with the control group,the values of FA in the precentral gyms(0.492±0.059 vs 0.552±0.045,F=17.150,P<0.01),the posterior limb of the internal capsule(0.679±0.048 vs 0.727 4-0.031.F=19.481.P<0.01)and the cerebral peduncle(1eft:0.740 4-0.038 vs 0.761 4±0.024.F=4.290;right:0.720 ±0.044 vs 0.746 ±0.034,F=3.264,both P<0.01)of the ALS group were decreased significantly.so were the values of NAA/Cr.And the FA reduction rate was 10.9%,6.6% and 2.8%-3.5% respectively.There was also a significant decrease in FA in the anterior limb of the internal capsule and the occipital lobe in the ALS group.Conclusion Not only does the application of DTI and MRS help to demonstrate upper motor neuron involvement in the brain and facilitate the diagnosis and differential diagnosis of ALS,but also increases the understanding of the lesion distribution and physiopathology in ALS.

Objective To evaluate the diagnostic accuracy of diffusion tensor imaging (DTI) of corticospinal tract in amyotrophic lateral sclerosis (ALS) and find optimal testing strategies and optimal cutoff values of DTI indices for individual patient discrimination.Methods Thirty-three ALS patients and 34 healthy controls,collected at Peking Union Medical College Hospital from June 2004 through July 2005,undergoing brain DTI studies and fractional anisotropy (FA) examinations along the corticospinal tract,were analyzed by receiver operating characteristic (ROC) curves.Results Compared with the controls,ALS group had significantly decreased FA values in subcortical white matter of the precentral gyrus,the posterior limb of the internal capsule and the cerebral peduncle.In ROC analysis,the average FA value of the former two positions showed the best performance with an area under the curve of 0.917,an optimal cut-off value of 0.604,a sensitivity of 0.759 and a specificity of 0.912.The corresponding data for the average FA of all the three positions and each single position were listed as follows:average of three 0.914,0.648,0.759,0.912; precentral gyrus 0.875,0.509,0.733,0.824; internal capsule 0.845,0.692,0.656,0.941 ; and cerebral peduncle 0.752,0.742,0.656,0.735.Conclusions FA values of the corticospinal tract have a good accuracy in detecting upper motor neuron involvement in ALS.Precentral gyrus and posterior limb of the internal capsule and the average FA values of these two positions were suggested as the preferred testing places and DTI indices for clinical use.

AIM: To observe the effects and location of autologous bone marrow stem cells(BMSCs) transplanted through renal artery into ischemic-reperfusion(I/R) injured kidney.METHODS: BMSCs were collected from rabbits after isolated and then labeled with 5-bromo-2-deoxyuridine(BrdU).Twenty-eight rabbits were subjected to clamping renal pedicles for 105 min and divided into the transplantation group and control group randomly.BrdU labeled BMSCs or saline were injected into the kidney by renal artery,respectively.Before and after I/R at the 1st,3rd, 5th,7th,14th,21th and 28th d,the venous blood was collected to measure serum Cr and BUN.In the same time,renal tissue was collected for pathological and immunohistochemical study.RESULTS: After I/R,serum Cr and BUN levels in the rabbits in two groups became higher,and on the 1st and 3rd d after I/R,reached the highest level.On the 7th d the serum Cr and BUN levels in transplantation group were lower than those in control group.On the 28th d the levels of serum Cr(90.1?11.1) ?mol/L and BUN(8.0?1.5) mmol/L in transplantation group were significantly lower than those in control group(135.6?32.5) ?mol/L and(10.9?2.5) mmol/L,respectively(P

OBJECTIVE: To prepare Polylactic-co-glycolic acid)(PLGA) microspheres loaded with Chinese herbal extract cucurbitacin B.METHODS: Cucurbitacin B loaded by PLGA microspheres were prepared by modified emulsification-solvent evaporation method.Central composite design-response surface method was applied to optimize the formulation with PVA concentration and ratio of drug to polymer as independent variables,and with yield of microspheres(Y1),drug loading amount(Y2),encapsulation efficiency(Y3),mean particle diameter(Y4),and the cumulative percentage of the drug release in 24 hr(Y5) as indexes to conduct multiple linear regression and second-order polynomial equation fitting.In vitro release test was performed by modified immediate release method.RESULTS: The results showed that all response variables were greatly fitted by a second-order polynomial equation.The optimal formulation was proved to be as follows: PVA concentration was 0.014 and ratio of drug to polymer was 0.066 5.The microspheres prepared in the optimal formulation were spherical and had smooth surface.Y1,Y2,Y3,Y4,and Y5 were 79.9%,7.83%,80.5%,56.18 ?m and 6.98%,respectively.The cumulative release from microspheres within 35 days reached 86.73%.CONCLUSION: Cucurbitacin B-PLGA microspheres are characterized by prolonged action and sustained-release.Furthermore,the established model has satisfactory predictability.

Objective To discuss the MRI features and pathogenic mechanisms of lung cancer intramedullary spinal cord metastasis (ISCM). Methods Four cases with clinically and 3 cases pathologically proved lung cancer ISCM were analyzed retrospectively. Turbo spin-echo sequence T 1 and T 2 weighted images were acquired in all patients. T 1 weighted images were obtained after intravenous administration of Gd-DTPA in all patients. Results A total of 7 ISCM were displayed by MR studies. The tumor occurred in thoracic cord (3/7) and in medullary cone (4/7). The tumor involved the central aspect of the cord. The lung cancer ISCM showed hypointensity (n=1) or isointensity (n=6) on T 1WI and hyperintensity on T 2WI. The extensive cord enlargement with cyst formation or syringomyelia was common. On contrast study, all tumors showed marked homogenous enhancement with clear borders. Conclusion The lung cancer ISCM usually presented as solitary lesions with marked contrast enhancement. The extensive cord enlargement was common in all patients. Because of the limitation in the evaluation of lung cancer ISCM on MRI, definite diagnosis of lung cancer ISCM depended on combination of clinical and MRI data.

Objective To investigate the experience of treating Budd-Chiari syndrome through orthotopic liver transplantation.Methods The clinical data of LTx performed on 9 patients with Budd-Chiari syndrome from December 2003 to April 2010 were retrospectively analyzed. We summarize the preoperative image and surgical experience,and observe the occurrence of postoperative complications and survival. Results Budd-Chiari syndrome was diagnosed in 9 patients by the preoperative abdominal CT enhancement and vascular reconstruction,and cavity venography was done to observe obstruction and sub-type of CAVA vein.All 9 patients were subjected to cadaveric liver transplantation.Eight cases accepted classic non bypass type,and one accepted living related right lobe liver transplantation. Postoperative triple immunosuppressive regimen included tacrolimus,mycophenolate mofetil,and hormone.The average follow-up periods for all these 9 patients were 32.8 months (13 to 61 months). One patient died from the tumor recurrence at 35th month after the operation.Two patients received re-transplantation for the lost of the graft.One recipient received the donor liver with medium steatosis,and the re-transplantation was performed on the12th day after the first transplantation due to the primary non function of the graft.The other one received the secondary liver transplantation at 6th month after the first transplantation due to the biliary complication and died from the liver tumor recurrence. Among all the 9 cases,seizure disorder (1 case),dysfunction of duodenal papillary muscle (1 case) and small-for-size syndrome (one case) occurred after the operation.Pulmonary infection occurred in 4 cases:3 cases due to the bacterial infection and 1 due to the fungal infection. Neither outflow obstruction nor the recurrence of the Budd-Chiari syndrome occurred in this study.The 1- and 2-year survival rate after the operation was both 100％,and 3-year survival rate post-transplantation was 88.9％ (8/9).Conclusion Liver transplantation can be the ideal treatment to the Budd-Chiari syndrome based on the definite clinical diagnosis,accurate imaging evaluation and eligible modus operandi.

Objective To analyze the factors that influence the family training compliance of THR,to provide a theoretical basis for the early rehabilitation of the patients' limbs function.Methods A questionnaire survey was used in this study,52 patients who received THR six months ago were given family visit.The survey including the scores of the patients' basic information,compliance of rehabilitation training and the rehabilitation of hip function,and statistical analysis was given to acquired data.Results The score of the postoperation family rehabilitation training compliance was (30.76±5.28).The order of the four dimensions was ranked as:the self-care capacity,the good habits,rehabilitation training skills and the relevant knowledge of the disease.The major related factors of the compliance were the education level,psychological condition,family and social support condition and economic condition.Conclusions Factors such as knowledge of rehabilitation,rehabilitation training skills,education level,psychological condition,family and social support and the economic condition are related to the compliance of family rehabilitation training.An effective rehabilitation training plan,postoperation visiting,recovery instruction and stable social support can play a positive influence on the compliance of family rehabilitation training and the recovery of limbs'function as well as the patients' quality of life.