Molecular imaging develops faster in the field of neuroimaging of ischemic stroke.Many studies have shown that its values in the aspects of cerebral blood flow monitoring during ischemic stroke and brain tissue metabolism.Ischemic penumbra is the basis of reperfusion therapy for acute ischemic stroke.The imaging methods,including magnetic resonance perfusion-weighted imaging/diffusion-weighted imaging mismatch,have been widely used to reveal ischemic penumbra because of their fast and strong availability.However,they can only reveal the blood flow of penumbra tissue.By contrast,molecular imaging technology can describe and measure the in vivo biological processes on the cellular and molecular levels,thus it can more accurately reveal the penumbral tissue.

Objective To assess the influence of atrial fibrillation on post-thrombolytic hemorrhagic transformation and functional prognosis in acute ischemic stroke patients within different time window.Methods We retrospectively reviewed the clinical and imaging data of patients of acute ischemic stroke with intravenous thrombolysis admitted from June 2009 to October 2013.According to onset-to-needle time,we divided patients into 3 groups and then assessed the effect of the comorbidity with atrial fibrillation on the occurrence of hemorrhagic transformation and favorable outcome (defined as modified Rankin Scale score≤2 at 90 days) after thrombolysis within different time window.Results A total of 345 patients were included in this study,among whom 101 (29.3％) were treated by intravenous thrombolysis within 3.0 h (≤3.0 h),157(45.5％) ＞3.0 h and≤4.5 h,87(25.2％) over 4.5 h(＞4.5 h).Atrial fibrillation was observed in 50.5％ (51/101) patients in ≤3.0 h group,37.6％ (59/157) in ＞3.0 h and≤4.5 h group and 40.2％ (35/87) in ＞ 4.5 h group (x2 =4.362,P =0.113).There were no statistically significant differences among these three groups about the rate of hemorrhagic transformation (hemorrhagic infarction:16.8％ (17/101),22.3％ (35/157),20.7％ (18/87),and parenchymal hematoma:5.0％ (5/101),10.2％ (16/157),10.3％ (9/87),x2 =4.278,P =0.370) and favorable outcome (51.5％ (52/101),53.5％ (84/ 157),47.1％ (41/87),x2 =0.913,P =0.633).Multivariate analysis demonstrated that atrial fibrillation was associated with hemorrhagic infarction for patients in ＞ 4.5 h group (OR =3.637,95％ CI 1.101-12.013,P =0.034),and the presence of atrial fibrillation independently predicted parenchymal hematoma for patients in ＞ 3.0 h and ≤4.5 h group (OR =3.757,95％ CI 1.133-12.457,P =0.030).There was no significant association between atrial fibrillation and favorable outcome at 90 days.Conclusions The presence of atrial fibrillation is not associated with the prognosis in thrombolytic patients.However,it enhanced the risk of parenchymal hematoma if patients were treated within the time window ＞ 3.0 h and ≤4.5h.

Objective To investigate the relationship between plasma concentration of osteopontin (OPN) and disease activity in systemic lupus erythematosus (SLE).Methods The plasma concentration of OPN in 28 healthy controls and 38 SLE patients was measured by enzyme-linked immunosorbent assay. Results The plasma concentration of OPN was significantly higher in SLE patients compared to that in the healthy controls (420?203 ng/mL vs 73?14 ng/mL,P＜0.001),in the patients with proteinuria com- pared to that in the patients without proteinuria (623?88 ng/mL vs 288?135 ng/mL,P＜0.001),in the patients with active disease compared to that in those with inactive disease (529?143 ng/mL vs 185?66ng/mL,P＜0.001),in the patients before treatment compared to that in the patients after treatment (556?130 ng/mL vs 142?22 ng/mL,P＜0.001).The plasma concentration of OPN in patients with arthritis was not different from those without arthritis (489?153 ng/mL vs 375?222 ng/mL,P＞0.05).Plasma concentration of OPN showed a significant positive correlation with systemic lupus erythematosus disease ac- tivity index (SLEDAI) (r=0.93,P＜0.001),but a significant negative correlation with serum C3 level (r=-0.49,P＜0.05).There was no correlation between plasma concentration of OPN and antinuclear an- tibody titre,erythrocyte sedimentation rate,or serum level of C4.Conclusions These data show that plas- ma OPN level has some correlation with the SLE activity,renal damage and progression or amelioration of SLE.OPN could be involved in the pathogenesis of SLE.

Objective To compare the postoperative recovery of vaginal and abdominal hysterectomies of non-prolapsed uterus ,in order to offer the advantages, surgical indications and contraindieations ,surgical characteristic and diflieuhy of transvaginal hysterectomies of non-prolapsed uterus. Methods To retrospectively analyze 480 cases transvaginal hysterectomies (TVH) and 440 cases transabdominal hysterectomies (TAH) with similar indications in the corresponding period, and compare the operation duration ,blood lost during the procedure, postoperative analgesic, morbidity, recovery time of the function of intestine, activity time of getting up and hospitalization between those surgi-ca] techniques. Results There were no intraoperation and postoperative complications in group TVH. In group TAH: more blood was lost(P <0.01) ,the function of intestine recovered more slowly(P <0.01) ,more analgesic needed, more morbidity noted (P < 0.01), activity time of getting up is much longer(P < 0.01). The hospital stay after opera-tion was much shorter in group TVH(P <0.01). No statistical difference was found between the two groups in terms of the duration(P 0.05). Conclusion TVH is minimal invasive surgery that include small trauma,reduced pain, no abdomen scar and quick recovery. So the patients are happy to accept it.

TNF gene was transfected into murine LAK cells by retrovirus. Our results showed that TNF gene-transfected LAK cells secreted TNF more than normal LAK cells and control gehe-transfected LAK cells. The in vitro growth ability and cytotoxicity of TNF gene-transfected LAK cells were augmented significantly.The cytotoxicity of ,TNF gene-transfected LAK cells was markedly inhibited by anti - TNF monoclonal antibody, indicating that the, above augmentation was mediated by TNF secreted by transfected LAK cells. Significant therapeutic effect on the ascitic liver carcinoma.-bearing mice was achieved by i.p. injection of low dosage TNF gene transfected LAK cells and IL - 2.

Objective To study the clinical characteristics of Guillain-Barr? syndrome(GBS) and the misdiagnosis and mismanagement in emergency department.Methods According to the diagnosis criteria of Chinese Journal of Neurology and Psychology,145 GBS in-hospital patients in our hospital from January 1,1994 to December 312004 were studied to find characteristics of GBS and auxiliary examinations.The reasons for GBS misdiagnosis and mismanagement were analysis.Results Most of the patients were young,the ratio of male to female was 2.5 to 1.Among them,mild-type was 34.5%,medium-type was 25.5%,severe-type was 13.9%,very severe-type was 7.6%,relapse-type was 4.1%,chronic-type was 12.4% and variation-type was 2.1%.The initial symptoms were multiplie.Bilateral limbs weakness and/or numbess were the most common symptom,and non-specificity asymmetrical weakness and/or numbess,headache,ophthalmalgia,distortion of angle of mouth or weak mastication were uncommon symptoms.Twenty-three patients(15.9%)were misdiagnosed in emergency department.71.3% patients developed albuminocytolgoic dissociation in cerebrospinal fluid.The content of protein in cerebrospinal fluid was correlated to the course of disease and uncorrelated to the patitent's condition.Conclusion GBS was a common cause of clinical acute flaccid paralysis,the mild-type has good prognosis and the mortality of very serere-type is high.GBS should be paid attention to in emergency department.

Objective To evaluate the relationship between the serum free IGF-1 level and the severity and prognosis in patients with chronic severe hepatitis. Methods Serum free IGF-1 was assessed by ELISA in 44 patients with chronic severe hepatitis, 43 chronic viral hepatitis, 46 liver cirrhosis. At the same time the liver function, prothrombin activity and cholinesterase were also determined. Results Serum free IGF-1 in patients with chronic severe hepatitis, liver cirrhosis and chronic viral hepatitis was 0.24?0.15,0.33?0.17 and 1.06?0.70 (ng/ml), respectively. IGF-1 was significantly decreased in patients with chronic severe hepatitis and liver cirrhosis. IGF-1 level in patients with chronic severe hepatitis at early, middle and advanced stages was 0.28?0.07, 0.27?0.19 and 0.16?0.06 (ng/ml), respectively. The reduction in the value showed a positive correlation with different stages of chronic severe hepatitis. Patients with chronic severe hepatitis having a serum free IGF-1 below 0.2ng/ml had a higher mortality, and those with the value above 0.35ng/ml had a better chance to survive during the follow-up period. There was a significant positive correlation between serum free IGF-1 and prothrombin activity. Conclusion Serum free IGF-1 was decreased in the patients with chronic severe hepatitis. The clinical observation suggested that the serum free IGF-1 might be an important prognostic indicator in patients with chronic severs hepatitis.

Objective To explore the prognostic effect of fluid-attenuated inversion recovery imaging vascular hyperintensity (FVH)on intravenous thrombolysis of acute ischemic stroke.Methods We retrospectively reviewed the clinical and imaging data of intravenous thrombolytic patients with acute anterior circulation infarction admitted from May 2009 to December 2013.The presence of FVH was evaluated,and its associations with reperfusion and clinical outcome after thrombolysis were assessed.Results Ninety-three patients were analyzed.FVH was detectable in 55 (59.1％) cases.Patients with FVH had higher NIHSS scores (11.8 ± 6.0 vs 7.2 ± 4.5,P ＜ 0.01),larger initial DWI lesions (5.5 ml vs 2.0 ml,Z =-3.030,P=0.002) and perfusion lesions (42.0 ml vs 3.0 ml,Z=-6.104,P =0.005),compared with those without FVH.The history of hyperlipidemia (OR =0.264,95％ CI 0.07-0.90,P =0.048) and proximal large vessel occlusion(OR =48.874,95％ CI 11.6-205.924,P ＜ 0.01) were independently associated with the presence of FVH.The presence of FVH independently predicted the poor neurological outcome at 3 months (OR =4.143,95 ％ CI 1.440-11.919,P =0.008).However,early reperfusion was associated with favorable outcome in patients with FVH after intravenous thrombolysis (OR =8.500,95％ CI 1.964-36.790,P =0.004).Conclusions The presence of FVH is associated with proximal large vessel occlusion,which predicts poor outcome in patients with intravenous thrombolysis.However,early reperfusion among patients with FVH can improve the outcome.

BACKGROUND:Neural stem cel transplantation provides an important way to treat sequela of traumatic brain injury, but the timing for treatment is inconclusive.
OBJECTIVE:To explore the clinical effect of neural stem cel transplantation in the treatment of sequela of traumatic brain injury and the choice of the best treatment time.
METHODS: Totaly 178 patients with sequela of traumatic brain injury who underwent neural stem cel transplantation were divided into three groups as per the timing for neural stem cel transplantation: group A (with 6 months after injury,n=60), group B (6-12 months after injury,n=59), and group C (over 12 months after injury,n=59). Improvement in clinical symptoms and scores on function independent measure (FIM) were recorded and compared in the three groups.
RESULTS AND CONCLUSION:The total effective rate of group A was significantly higher than that in groups B and C (P < 0.05). FIM scores were significantly improved in the three groups after cel transplantation (P < 0.05). At 3 months after the fourth transplantation, the FIM score in the group A was significantly higher than that in the other two groups, and the incidence of adverse reactions in the group A was significantly lower than that in the other two groups (P < 0.05). These findings indicate that neural stem cel transplantation at different timing can al harvest certain clinical effects, but the best timing for neural stem cel transplantation is within 6 months after injury.

Objective To establish a practical and effective predictive model for predicting carotid plaque/thickened intima,and to provide a novel perspective for stroke screening.Methods A retrospective analysis of the community screening data collected from September 2012 to March 2013 was performed.The data of blood pressure,serum lipid profile and fasting blood glucose and ultrasonographic checks of carotid artery were documented.One thousand subjects were randomly sampled from totally 14 226 individuals and divided into 2 groups according to the presence of carotid plaque/thickened intima.Analysis of relevant data of subjects with Logistic regression were performed.Predictive model was established according to the odds ratio for each risk factor and evaluated by C statistics.Results In the randomly sampled 1000 subjects,164 ones were found to be with carotid plaque/thickened intima.The mean age was (60.23 ± 10.09) years old,110 (67.1％) were male.Smoker,hypertension,angina pectoris,diabetes and hyperlipidemia were seen more often in the subjects with carotid plaque/thickened intima.Logistic regression analysis showed the independent risk factors for carotid plaque/thickened intima included advanced age (OR =1.15,95％ CI:1.12-1.84,P＜0.01),male (OR=3.97,95％CI:2.49-6.33,P＜0.01),smoking (OR=1.80,95％CI:1.24-2.56,P =0.002),diabetes (OR =1.80,95％ CI:1.15-2.98,P =0.012),hypertension (OR =2.82,95％ CI:1.15-2.98,P ＜ 0.01),high total cholesterol level (OR =1.63,95％ CI:1.31-2.02,P ＜ 0.01) and high LDL-C (low density lipoprotein-cholesterol) level (OR =1.70,95 ％ CI:1.35-2.14,P ＜ 0.01).The advanced age was found to be the strongest predictive factor in this model.The C statistics of this model is 0.804,which overweighs other models previously reported.The optimal cutoff point for prediction was 3.5,with a sensitivity of 0.713 and a specificity of 0.757.Conclusion An practical and effective model for predicting carotid plaque/thickened intima established from sampling data of community residents is favorable for both stroke screening and primary stroke prevention.