Objective To evaluate the effect of tranexamic acid (TXA ) in medical treatment of chronic subdural hematoma (CSDH) .Methods A total of 19 patients with CT-confirmed CSDH in our department from Mar 2014 to Aug 2015 received an in-travenous dose of 1g TXA in the first week ,and followed by a maintenance oral dose of 250 mg TXA three times a day for 1 - 5 months (2 .73 ± 1 .05) months .These patients received a follow-up period of 6 - 10 months .Hematoma volume and neurological functions were compared before and after treatment .Results The therapeutic outcome was divided into effectiveness and ineffec-tiveness .Thirteen cases (68 .4% ) were effective ;six cases (31 .6% ) were ineffective .Among them ,three patients (15 .8% ) whose neurological functions deteriorated underwent surgery ,one patient (5 .3% ) who did not show any improvement with initial one month of TXA underwent surgery ,one patient (5 .3% ) stopped the treatment due to the side-effect of drug ,one patient (5 .3% ) lost .Conclusion Results of this preliminary study show that the administration of TXA is effective and safe in treating CSDH .

As a member of nuclear receptor superfamily, farnesoid X receptor (FXR) has been shown to regulate numerous metabolic pathways, which include playing an important role in bile acid metabolism, maintaining lipid and glucose homeostasis when FXR is activated. With the prevalence of the glucose and lipids disorder, FXR attracts increasing attention. It may be a potential target for the treatment of type 2 diabetes mellitus and lipid disorders.
Bile Acids and Salts ; Diabetes Mellitus, Type 2 ; Glucose ; metabolism ; Homeostasis ; Humans ; Lipid Metabolism ; Receptors, Cytoplasmic and Nuclear ; metabolism

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

Objective To conduct the statistical analysis on the free carnitine and acylcarnitines levels in 0?6 years old children by detecting the contents of free carnitine and acylcarnitines in dry blood spot to provide the biological reference range for the diagnosis of fatty acid metabolic disorder and organic acidemia.Methods The levels of acylcarnitines of peripheral blood dry blood spot in 263 normal children were detected by using the isotopic dilution non-derived tandem mass spectrometry.All children were divided into male and female groups according to different genders and divided into the groups according to the age,1-28 d(gestational weeks ≥37 weeks),1-12 months old,13 months-3 years old and 4-6 years old.Results The detection results after normality test found that the levels of free carnitine and acylcarnitines in children showed a normality distribution.The free carnitine and various acylcarnitines levels had no statistical difference between male children and female children (t=0.5,P=0.619).The C4,C5,C6,C10,C12 and C18 had equal variance among various age groups(P>0.05) and could conducted the one way variance analysis;C0,C2,C3,C5,OH,C6,C8,C14,C16 and C18 had the variance heterogeneity among different age groups(P<0.05) and could conduct the rank-sum test(P<0.05).The C0,C2,C3,C5,OH,C6,C8,C10,C12,C14,C16 and C18 had statistical differences among different age groups,the reference value ranges were calculated according to different ages.The difference in C4 and C5 had no statistical significance and the reference value range could be calculated by the merged group.Conclusion It is a very important for the diagnosis and treatment of fatty acid metabolic disorder and organic acidemia to establish the reference value ranges of dry blood spot free carnitine and acylcarnitines in children according to different ages.

Objective:To fabricate and to study the surface morphology and biological safety of a novel coating on microarc-oxidized titanium.Methods:The novel functional coating was fabricated by cross-linking the double-layer nanoparticles loading rhBMP-2 and SDF-1 with gelatin on microarc-oxidation coating on titanium implant surface.The surface topography was observed and optimized,and the biological safety of the novel coating was primarily evaluated by cell toxicity test,oral mucosa stimulation test and hemolysis test in vitro.Results:The novel functional coating possesses excellent morphology.The coating showed the cytotoxicity of score 1 and no mucous membrane irritation,the hemolytic rate of the coating was 4.6％.Conclusion:The coating possesses good morphology and biological safety.

Objective To investigate the characteristics of medicine taking,the type and ratio of long-term medication and treatment satisfaction in patients with gastroesophageal reflux disease (GERD),to analyze the effects of GERD combined with functional bowel disease (FBD) on the treatment satisfaction,and to compare the changes of type of medication and treatment satisfaction in patients with GERD in recent years.Methods From April to June in 2011,the questionnaire survey was conducted in gastroenterology clinic of People's Hospital of Peking University.The incidence of typical GERD symptoms was investigated by a validated reflux disease questionnaire (RDQ),the score between one and five was considered there might be reflux symptoms and the score over 12 was diagnosed as GERD.FBD was diagnosed according to Rome Ⅲ criteria.The information of GERD related medication taking within one year before the survey,long-term medication taking (≥ 1 year)and the treatment satisfaction of patients whose RDQ score over zero was recorded and compared with the data collected in the same method in 2004.The chi-square test was performed for data statistical analyses with SPSS 17.0 software.Results Among 1074 patients who completed questionnaire survey in 2011,the percentage of patients with reflux symptoms was 32.7％ (351/1074),the percentage of diagnosed GERD was 10.0％ (107/1074),and GERD combined with FBD was 25.2％ (27/107) of GERD.A total of 304 cases (86.6％) of patients with reflux symptoms had information of medication taking; 78.0％ (237/304) of whom had taken GERD related medication within one year before the survey.The rate of GERD related medication taking especially proton pump inhibitor (PPI) and antiacid medication taking increased along with RDQ score (x2 =24.2,13.1 and 18.2,all P＜0.05).A total of 104 cases of GERD patients had information of medication taking; 88.5 ％ (92/104) GERD patients had taken GERD related medication within one year before the survey,52.9％ (55/104) GERD patients had taken PPI medication,30.8％ (32/104) needed long-term medication and 20.2％ (21/104) needed longterm PPI treatment.There was no significant difference in treatment satisfaction between different RDQ score ranges (x2 =3.3,P＞0.05).Among GERD patients who appraised the effects of treatment,the percentage of satisfied,acceptable and not satified with the treatment was 37.1％(26/70),48.6％ (34/70)and 14.3％(10/70),respectively.There was no significant difference in treatment satisfation between GERD with and without FBD (x2 =3.1,P＞0.05).In 2011,the rates of medication taking (88.5％,92/104) and PPI taking (52.9％,55/104) in GERD patients significantly increased compared with those in 2004 (57.3％,98/171; 7.6％,13/171,x2 =29.4,71.4,both P＜0.05).The percentage of treatment satisfaction in 2011(37.1％,26/70) increased compared with that in 2004(25.7％,18/70,x2 =12.8,P＜0.01).Conclusions Some of patients with GERD symptoms need long-term medication,especially PPI treatment.In recent years,the rate of medication taking in GERD patients increased in outpatients department,PPI taking significantly increased and the treatment satisfaction also increased.Maybe the treatment satisfaction is not affected by GERD combined with FBD.

Objective:To examine the expression and function of thrombonspondin-1 (TSP-1) in oxygen-induced retinopathy in new-born mice, and to investigate its role in retinal neovascularization. Methods:A total of 40 C57BL/6J newborn mice were divided equally into a model group (n=20)andanormalcontrolgroup(n=20).Miceinthemodelgroupwereexposedto75%oxygentoestablish the oxygen-induced retinopathy (OIR) model. On the 7th, 9th, and 11th day after the birth of mice, 5 mice were randomly selected each time from the 2 groups to examine the expression of TSP-1 mRNA with reverse transcription polymerase chain reaction (RT-PCR). After that, 5 mice were selected on the 11th day to observe the retinal neovascularization by fluorescein angiography retinal flatmount. Results:On the 11th day, fluorescein angiography retinal flatmount showed that the retinal blood vessels presented mean network distribution in the normal control group, while in the model group, a lot of dilatated areas in the retinal main vessels surrounded the optic disc. Meanwhile lots of new blood vessels were found surrounding the optic disc with irregular distribution but well distributed peripherial retinal small vessels, which was typical of early stage OIR. There was no signiifcant difference in the retinal TSP-1 mRNA level between the model group and the normal control group in the postnatal 7-day mice (P>0.05). Compared with the normal control group, the expression of TSP-1 mRNA in the model group was signiifcantly lower in postnatal 9-day and 11-day mice (P<0.05, P<0.01) , and the expression of TSP-1 mRNA in postnatal 9-day mice was lower than that in the postnatal 11-day mice(P<0.05).
Conclusion:In the early stage of OIR model (retinal vascular growth and development stage), the expression of TSP-1 mRNA in the retinal tissue is gradually decreased, implying that TSP-1 (as a negative regulatory factor) may be involved in the formation of retinal neovascularization in the early stage.

Objective To study the values of serum CA19-9,CA242,CEA,alone or in combination in the diagnosis and prognosis of combined hepatobiliary calculus and cholangiocarcinoma (HCWC).Method Serum CA19-9,CA242,CEA in 100 patients with HCWC,70 patients with hepatobiliary calculus combined with cholangitis and 30 patients with hepatic hemangioma (normal bile duct group) were preoperatively studied.Results When the serum levels of CA19-9,CA242,CEA were separately used in the diagnosis of HCWC,the sensitivity of CA19 9 was highest,but its specificity was significantly lower than that of CA242 and CEA (P＜0.01).Patients with all the three tumor markers raised had significantly lower survival than those of patients with only one or two raised markers (P＜0.05).Conclusions The diagnostic rate for CA19 9 in HCWC was better than that of CEA and CA242.A joint detection improved the diagnostic specificity.Raised tumor markers were associated with progression of HCWC.Survival was worse in patients with 3 raised markers than those with 2 or 1 raised markers.

Objective: To clone , express and purify of Dermatophagoides farinae ( Der f 11 ) , and then test its immunogenicity.Methods:The gene coding for Der f 11 was synthesized ,and was then linked with the pET-32a vector.The expression plasmid pET32a(+)-Der f 11 was induced by IPTG.After purification of recombinant allergens Der 11 proteins through the Ni +affinity chromatography ,immunological allergic patients serum as the Primary antibody.Results: We obtain high purity recombinant Der f 11 protein.The results of SDS-PAGE show that the expression product is about 118 KD.Recombinant allergen Der f 11 test 15 dust mites allergic patients serum specific IgE , positive rate was 20%.Conclusion: Recombinant allergen Der f 11 obtained has the similar immunologic activity to natural Der f 11 protein.It can lay the foundation for the specific diagnosis ,treatment and further experimental studies of the dust mite allergy disease.

Objective To evaluate the value of 320 row CT upper abdominal computed tomography angiography (CTA) in the follow up of transjugular intrahepatic portosystemic shunt(TIPSS) .Methods 21 cases after TIPSS therapy underwent upper ab-dominal CTA .Post-processing images ,including MPR ,VR ,MIP ,and CPR ,were used to determine the position and patency of the stent .The best images of the portal veins were obtained .Results Among the 21 cases ,CPR image clearly demonstrated endovascu-lar stent thrombosis in 3 cases(14 .29% ) with stent occlusion and 1 case(4 .76% ) with stent stenosis ;there were no stent stenosis or occlusion in 17 cases(80 .95% ) ,their CPR image showed the contrast agent was filled completely in the stent and no low-density thrombosis was found .The best phase of the portal vein was 45 s .Conclusion 320 row CT upper abdominal CTA can clearly dis-play the stent position and patency situation in patients ,therefore ,should be regarded as the first choice for the follow-up of patients after TIPSS therapy .