Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.

To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.

Objective To explore the causes of postoperative recurrence in patients of nodular goiter,the selection of method for reoperation and the postoperative complications. Methods The clinical data of 278 nodular goiter patients admitted in the first affiliated hospital of Harbin Medical University between 2001 and 2008 were analyzed retrospectively,including the methods and complications for first operation and reoperation. Results In the first operation,79 eases received simple eminectomy and 167 cases received partial lobectomy,accounted for 28.4% and 60.1%,respectively. Unilateral subtotal lobectomy plus contralateral eminectomy was performed in 23 cases and subtotal thyroideetomy was conducted in 9 cases,accounted for 8.3% and 3.2%,respectively. Postoperative complications occurred in one hundred and twenty-three cases,the incidence being 8.2% (23/278). Unilateral subtotal Iobectomy plus contralateral partial iobectomy was reperformed in 37 cases and bilateral subtotal thyroidectomy in 241 cases. Postoperative complications occurred in 12 cases,the incidence being 4.2%(12/278). No postoperative recurrence of nodular goiter was found. Conclusions Recurrence of nodular goiter is closely associated with the scope of previous surgical treatment,and correct operative manipulation may reduce the recurrent rate.

Objective To study the effects of parthenolide on osteoclast differentiation of RAW264. 7 cell induced by receptor activator of nuclear factor κB ligand (RANKL). Methods The mouse macrophage RAW264.7 cells induced by RANKL was used alone as the control group, different concentrations of par-thenolide (0.5, 1, 2 μmol/L) were added to culture the RAW264.7 cells. On the third, fifth and seventh day, the tartrate resistant acid phosphatase (TRAP) staining method was used to detect osteodast-like cells and the cell number was count;the contents of tartrate resistant acid phosphatase (TRAP5b) in the Culture supernatant of each groups were detected by enzyme linked immunosorbent assay (ELISA) and the expression of osteodast marker gene alcitonin receptor (CTR) and matrix metalloproteinase (MMP)-9 in each groups were detected by realtime-polymerase chain reaction (PCR) on the seventh day. We use Chi-square test and t test to test the differences between groups by SPSS 17.0. Results In different culture conditions, RANKL could always induce the RAW264.7 cell differentiate into mature osteoclasts. Compared with the control group at the same time control group, on the third, fifth and seventh day, he number of mature osteoclasts induced were obviously decreased in groups adding different concentration of PAR; the number of induced osteoclasts decreased along with the increase of parthenolide concentration, on the seventh day in 0.5, 1, 2 μmol/L concentration PAR groups, the number of mature osteoclasts compared with the control group were descended 36.3%, 40.8%, 49.3%(t=7.758, 8.742, 10.56;P<0.05);the contents of TRAP5b in the culture supernatant were consistent with the cell counting results on the seventh day (P<0.05). The expression of CTR and MMP-9 by TRAP positive osteoclasts decreased along with the increase of parthenolide concentration, and the 2 μmol/L group was the lowest. Compared with the control group, there were statistically significant differences with the different PAR concentration groups 0.5, 1, 2 μmol/L (P<0.05). Conclusion Parthenolide can inhibit RANKL induced RAW264.7 differentiation into osteoclast cells, and the inhibition is dose dependent.

Objective To explore the effects of chronic disease management in the treatment and quality of life for rheumatoid arthritis (RA).Methods A total of 160 patients with active RA were selected from June 2011 to August 2012 and randomly assigned into experimental and control groups (n =80 each).Based upon oral medication,the experimental group had chronic disease management for 6 months.Before and after therapy,DAS28 score,erythrocyte sedimentation rate (ESR),ACR50 and quality of life score were measured.Results The number of regular medication in experimental group was significantly more than that in the control group (68 vs.37,x2 =26.625,P =0.000).The inter-group difference of DAS28 score reduction was statistically significant (2.46 ± 1.09 vs.3.68 ± 1.65,t =1.655,P =0.002).After intervention,ESR significantly decreased in experimental group (66.09 ± 41.98 vs.21.27 ± 19.61,t =1.655,P =0.029) and the reduction of control group was not statistically significant (t =1.976,P =0.059).The number of ACR50 in experimental group was more than that in control group (60 vs.44,x2 =4.314,P =0.038).The score of life quality of experimental group increased dramatically (56.58 ± 20.24 vs.63.71 ± 18.35,t =1.655,P =0.013) and it was significantly higher than control group (63.71 ± 18.35 vs.48.76 ± 19.88,t =1.906,P =0.020).Conclusion Chronic disease management can improve the life quality and clinical indices of RA patients.Thus it may be widely applied clinically as an adjunct treatment.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

Objective To study the differentiation and proliferation ability of the spinal neural stem cells (NSCs) at different gestational ages in fetal rats. Methods Sprague-Dawley fetal rats were divided into group A (12 days of pregnancy), group B (14 days of pregnancy) and group C (16 days of pregnancy). NSCs were separated with enzyme-assisted microdissection. The diameter and numbers of NSCs balls were measured at different time. The cell growth curve was drawn with CCK8 colorimeter. NSCs were identified with BrdU/Nestin immunohistochemical staining. They were induced with 10% fetal bovine serum for 10 days, and the expression of β-tubulinⅢ and glial fibrillary acidic protein was detected with immunocytochemistry. Results There were cells expressed BrdU, Nestin, β-tubulinⅢ and GFAP in all the group. The most cells (22.74±0.79%) expressed β-tubulinⅢ in the group B, but no significant difference between group B and group C. The cell vitality on the 5th day of third-generation neural stem cells was the most in group B. Conclusion For enzyme-assisted microdissection, it may obtain more neurons to isolate the neural stem cells from 14 days of pregnancy pregnant rats.

Objective To investigate the best injection position and curative effect of ultrasound-guided thrombin injection (UGTI)on femoral pseudoaneurysm (FPA).Methods Review the data of FPA cases in the neurology department of southwest hospital from January 2010 to June 2015.Detailed clinical information of the patients,including the curative effect of local compression therapy,the position,meth-od,dosage and curative effect of ultrasound-guided thrombin injection were collected and analyzed.Results From January 2010 to June 2015,43 cases (1.20%)of FPA were diagnosed in 3573 patients undergoing cerebrovascular interventional operation.Local compression therapy was effective in 11 of 43 FPA patients.The remaining 32 patients who had no response to local compression therapy were treated by UGTI,and the average dosage of thrombin was (30 ±12)IU.All FPA were blocked successfully within 1 minute and without any distal em-bolism events after the first UGTI attempt.No relapse and complications occurred during the follow-up of 5 to 70 months,averagely (38.69 ± 20.79)months.Conclusion UGTI is effective for treatment of FPA who had no response to local compression therapy.Thrombin injection at position far away from the blood flow direction of pseudoaneurysm neck crevasse with ultrasound-guided could bring about highe success rate, less amount of thrombin,and less complications.

Objective:To explore the independent risk factors of death during hospitalization in patients with acute myocardial infarction (AMI) .Methods :Clinical data of 614 cases ,who were diagnosed as AMI during hospitaliza‐tion in our hospital from 2011 to 2013 ,were retrospectively analyzed .According to AMI patients'survival or not during hospitalization ,they were divided into death group (n=62) and survival group (n=552) ,single and multi-variable Logistic regression analysis were used to analyze the relationship among baseline feature factors and thera‐peutic methods of all patients and hospital mortality .Results:The mean age was (66.58 ± 12.87) years and there were 39 males (62.9% ) among the 62 dead patients .Hospital mortality was 10.10% (62/614) .Multi‐variable Lo‐gistic regression analysis screened following factor were independent risk factors related to AMI hospital mortality :age (OR= 3.065 ,95% CI:1.188~ 7.915) ,female (OR= 2.775 ,95% CI :1.200~ 6.419) ,heart rate (OR=2.836 ,95% CI:1.405~ 5.722) ,blood glucose (OR = 1.943 ,95% CI :1.186 ~ 3.184) ,Killip class IV (OR=1.744 ,95% CI:1.211~2.513) and left main or triple -vessel coronary disease (OR= 3.157 ,95% CI :1.244 -8.014) . P < 0.05 ~ < 0.01 .Conclusion : Advanced age ,female ,rapid heart rate ,elevated blood glucose level at hospitalization ,Killip class IV and left main or triple‐vessel coronary disease may be independent risk factors of death during hospitalization in patients with acute myocardial infarction .

Objective:To measure vertical axis length of humerus head in patients with proximal hu-meral fractures and to evaluate the use of structure screws in proximal humerus internal locking osteosyn-thesis system ( PHILOS) .Methods:From January 2007 to February 2014,117 patients with proximal hu-merus fracture were treated by PHILOS plate.Preoperatively, all the patients tookanteroposterior X-ray of shoulder, and the vertical axis length of humerus head were measured, and the use of structure screws in PHILOS plate was observed.Results: There were 40 male and 77 female patients; The vertical axis length of humerus head in male patients was (47.64 ±3.44) mm, and the rate of structure screw use was 52.5%;The vertical axis length of humerus head in female patients was (42.46 ±3.21) mm, and the rate of structure screw use was 32 .5%.The vertical axis length of humerus head and the rate of structure screw use had significant difference in the male and female groups (P<0.05).Conclusion:The rate of structure screw use was low in the treatment of proximal humerus fracture by PHILOS plate, especially for women.We should improve the design of plate according to the anatomical characteristics of Chinese.