0.9 mm(n = 26).Twenty-five healthy individuals served as a control group.Clinical data including age,sex,BMI,ABI,HbA1c,fasting glucose and insulin were collected.Insulin resistance index in Homa model was calculated following the equation:Homa IR = FINS ? FPG) /22.5.Serum adiponectin level was measured by ELISA.Results The serum adiponectin level was significantly lower in atherosclerosis group than in non-atherosclerosis and control groups(P

Objective To study the CT features of small hepatocellular cancer.Methods 37 patients with small hepatocellular cancer proved histopathologically underwent spiral CT examinations including plain scans and contrast-enhanced scans.The arterial phase scan,the portal phase scan and delayed phase scan started at 25th second,70th second and 5th minute respectively after injecting the contrast medium with the high pressure syringe,the velocity was 2.5 ~3 ml/s,and the dose was 1.5 ml/kg.Results 73% (27/37) of tumors showed hyperdensity in arterial phase,65%(24/37) of tumors was hypodensity and 35% (13/37) had hyperdensity during portal phase,of which eight showed hypodensity in equilibrium phase.Conclusion Spiral CT can display the features of blood supply of small hepatocellular carcinoma that is of benefit in early diagnosis.

BACKGROUND: Activation of leucocyte and endothelial cell in ischemic area of brain and the expression of adhesive molecule on the surface can cause aggregation and infiltration of leucocyte which deteriorated cerebral injury due to cytotoxicity. Ligustrazine can inhibit thrombosis and improve microcirculation.OBJECTIVE: To observe the effect of ligustrazine on adhesion of leucocyte and endothelial cell in focal area after cerebral ischemia-reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Second Division of Brain, Department of Neurology, Daping Hospital of the Third Military Medical University of Chinese PLA; Department of Psychiatry, the Second People's Hospital of Yuxi, Yunnan Province.MATERIALS: The experiment was carried out at the Second Cerebral Laboratory of Neurological Department of Daping Hospital Affiliated to the Third Military Medical University of Chinese PLA. A total of 32 male Wistar rats weighing 250-300 g were randomly divided into normal control group (n=8), cerebral ischemia-reperfusion group (n=12) and cerebral ischemia-reperfusion + ligustrazine group (n=12).METHODS: Rats in ligustrazine group were venously injected with 15 g/kg ligustrazine phosphoric acid, and rats in normal control group and cerebral ischemia-reperfusion group were venously injected with the same volume of saline. Cerebral ischemia-reperfusion injury and adhesive changes of leucocyte in focal area after administration of ligustrazine were observed with immunofluorescent labeling technique and micro-ultra-speed imaging system.MAIN OUTCOME MEASURES: ① Adhesive density index of leucocyte of arteriole in focal area after cerebral ischemia-reperfusion injury; ② Adhesive changes of leucocyte in focal area after administration of ligustrazine.RESULTS: All experimental animals were involved in the finalanalysis.① As compared with those in control group, adhesive density index of leucocyte of arteriole in focal area in cerebral ischemia-reperfusion group was increased, broken stress between leucocyte and endothelial cell was decreased remarkably, adhesion was increased obviously, and there was significant difference (P ＜ 0.01). ② As compared with those in cerebral ischemia-reperfusion group, adhesive density index and adhesion of leucocyte in ligustrazine group were decreased and reached the lowest values after 24 hours. Broken stress was increased and maintained at a higher level. There was no significant difference from that in normal control group till 24 hours.CONCLUSION: Ligustrazine can relieve adhesion between endothelial cell and leucocyte after cerebral ischemia-reperfusion injury.

Aim To investigate whether rosuvastatin induced reduction of atherosclerotic plaque was related to the expression of Sialyltransferase ( ST6 Gal-Ⅰ) in ApoE-/ - mice. Methods Six-weeks old ApoE-/ -mice fed with high fat were divided randomly into three groups: baseline group ( n=12 ) , control group ( n=12 ) and rosuvastatin group ( n =12 ) . Sixteen weeks later, control group was sacrificed. Serum and aortic intima were saved. Control group and rosuvastatin group were fed for seven weeks continually. Concentra-tions of serum lipids(TC, TG, LDL and HDL) were analyzed. Sections from the aortic root were examined by Hematoxylin-Eosin( HE) staining. The size of ath-erosclerotic lesion in each section was evaluated. Ex-pression of ST6 Gal-Ⅰ in aortic intima was detected by immunohistochemistry. Results Plasma TG and LDL-C, plaque areas and intimal thickness of control group were significant higher than those of baseline group ( P<0. 05 ) . Those results indicated that the AS model was successfully constructed. After seven weeks, the plaque areas and concentrations of serum lipids of rosu-vastatin group were obviously smaller than those of con-trol group(P<0. 05). The expression of ST6Gal-Ⅰin aortic root was decreased in control group compared to the baseline, and which was increased in control group compared to the rosuvastatin group. Conclusion Ro-suvastatin could inhibit the progression of atherosclero-sis, which might be related to the expression of ST6Gal-Ⅰ in aortic root.

Objective To compare the serum cytokines and high-sensitive C-reactive protein (hs-CRP) in the post-stroke depression(PSD) and depression patients,and further study of the pathogenesis PSD and depression.Methods The levels of serum IL-1β,IL-6 and TNF-α in the PSD group(n=30),the depression group(n=30),the post-stroke non-depression group(n=30)and normal control group(n=30)were measured with enzymatic-linked immunosorbent assay(ELISA),and the levels of serum hs-CRP were measured by scatter rate nephelometryat for these four groups.Results The levels of serum IL-1β,IL-6,TNF-α and hs-CRP in the PSD group,the depression group,the the post-stroke non-depression group and the normal control group were respectively((137.23 ±8.12) pg/ml,(34.12±3.12) pg/ml,(64.62±6.11) pg/ml,(15.36±6.25) mg/L) ; ((133.21 ±7.56) pg/ml,(33.56±2.65) pg/ml,(62.95±5.66) pg/ml,(4.02± 1.21) mg/L) ; ((43.25 ±6.23) pg/ml,(16.12±2.60) pg/ml,(32.23±7.12) pg/ml,(14.88±7.23) mg/L) ; ((42.12±5.78) pg/ml,(15.32±3.23) pg/ml,(31.55±6.70) pg/ml,(3.68± 1.11)mg/L).The levels of serum IL-1β,IL-6 and TNF-αt in the PSD group and the depression group increased significantly than those in the the post-stroke non-depression group and the normal control group(P＜0.01).The levels of serum hs-CRP:PSD group ＞ post-stroke non-depression group ＞ depression group ＞ normal control group(P＜0.05).Conclusion The PSD and depression may have the same immune mechanism.

Objective　To investigate the significance of TGF-β1, TGFRl and TGFR2 in the pathogenesis and prognosis in patients with myelofibrosis. Methods　The expression of TGF-β1 and its receptors (TGFR1 and TGFR2 ) in bone marrow tissues and the level of TGF-β1 in the blood of 23 patients with myelofibrosis were detected by SABC immunocytochemistry and ELISA repectively. Results　Expression of TGF-β1 and TGFR 1 was significantly higher in primary and secondary myelofibrosis patients than that of the control. No significant difference of TGFR2 expression was found between the groups of myelofibrosis and the control (P>0.05). The level of TGF-β1 in the blood of the patients with myelofibrosis was significantly higher than that of the control (P<0.01) and more obvious in secondary cases while TGF-β1 decreased nearly to the normal level when patients were in clinical remission. Conclusion　TGF-β1 and it's receptors may be involved in the pathogenesis of myelofibrosis and might be of importance for the prognosis of the patients with myelofibrosis.

OBJECTIVE:To provide reference for the further improvement of the drug purchasing system in Chongqing city. METHODS:30 primacy medical and health institutions in Chongqing were selected to collect the data about cost changes and busi-ness development in above-mentioned institutions from 2009 to 2013,the purchasing price,use and supply of essential medicines were collected via Chongqing Municipal Health and Family Planning Commission to evaluate and analyze the effects and existing problems of drug purchasing system,and suggestions were put forward. RESULTS:Compared with 2009,the non-essential drugs’ prices fell an average of 28.00%in 2013,prices of 307 varieties in National Essential Medicine System(2009 edition)fell an aver-age of 32.97%,205 varieties in supplementary list of local prices fell an average of 43.78%. The proportion of sales amount(not including Chinese herbal medicine)in primacy medical and health institutions increased from 76.48% in 2010 to 92.07% in 2013, the average rate of essential medicines increased from 6.84% to 28.12%. Compared with 2009,the average drug cots and inpatient drug costs decreased 16.78% and 25.85% in 2013,the proportion of drugs decreased from 56.32% in 2009 to 49.70% in 2013. CONCLUSIONS:Generally speaking,the implementation of drug purchasing system in Chongqing is successful,but also exists some problems,such as imperfect pricing mechanism,difficult supply of low-cost drugs,slow rise of average outpatient costs in primacy medical and health institutions and irrational drug use. It is suggested to improve it from aspects of perfecting drug pricing mechanism,optimizing logistics and distribution,strengthening the role of the medical insurance institutions,regulating medication overuse and improving compensation policy of medical institutions.

Objective To observe the effect of alteplase intra-arterial thrombolysis combined with continuous monitoring of transcranial Doppler (TCD) in patients with acute cerebral infarction. Methods Fifty-four patients with acute cerebral infarction were divided into TCD group and control group by random digits table method. The patients of 2 groups were given alteplase intra-arterial thrombolysis, and the patients of TCD groups were combined with continuous monitoring of TCD. The degree of clinical neurologic impairment was evaluated by National Institutes of Health stroke scale (NIHSS) and Barthel index (BI). The condition of vascular recanalization was evaluated by the change of blood flow signal of TCD. CT was performed within 1 d after thrombolysis to detect intracranial hemorrhage and other adverse reaction. The degree of clinical neurologic impairment, blood vessel recanalization rate after thrombolysis and recanalization time and incidence of intracranial hemorrhage and other adverse reaction were compared between 2 groups. Results There were no statistical difference in NIHSS score before thrombolysis and 1 h after thrombolysis between 2 groups (P>0.05). The NIHSS scores 7 and 30 d after thrombolysis in TCD group were significantly lower than those in control group:(8.1 ± 4.9) scores vs. (12.1 ± 4.2) scores and (6.9 ± 3.1) scores vs. (10.9 ± 3.9) scores, there were statistical differences (P<0.05). The BI scores 7 and 30 d after thrombolysis in TCD group were significantly higher than those in control group: (78.5 ± 13.8) scores vs. (60.8 ± 12.4) scores and (82.6 ± 13.5) scores vs. (63.2 ± 12.9) scores, and there were statistical differences (P<0.05). The blood vessel recanalization rate 24 h after thrombolysis in TCD group was significantly higher than that in control group: 70.4% (19/27) vs. 44.4% (12/27), the recanalization time after thrombolysis was significantly shorter than that in control group: (36.4 ± 9.5) min vs. (58.5 ± 12.4) min, and there were statistical differences (P<0.05). No adverse reaction like intracranial hemorrhage and so on was found by CT detection within 1 d after thrombolysis in the 2 groups. Conclusions Alteplase intra-arterial thrombolysis combined with continuous monitoring of TCD in acute cerebral infarction has good curative effect, and no obvious adverse reaction.

Objective This study was designed to examine the clinical characteristics of bloodstream infections (BSI) caused by Staphylococcus aureus in a teaching hospital and the risk factors for 30-day mortality.Methods A single center retrospective cohort study was conducted for all the patients with BSI caused by S.aureus between 2008 and 2015.The data of clinical features,microbiology,and 30-day mortality were collected from the database of electronic medical records.Results A total of 121 patients with S.aureus BSI were identified.The prevalence of methicillin-resistant S.aureus (MRSA) was 17.4％ (21/121).MRSA BSIs were significantly associated with old age (≥65 years) (P=0.026),hospital acquired infection (P=0.035),respiratory tract infection (P=0.001),polyinfection (P=0.005) and inappropriate initial antibiotic therapy (P=0.001) than methicillin-sensitive S.aureus (MS SA) BSIs.The 30-day mortality was 18.2％ (22/121).Both univariate and multivariate analysis suggested that solid tumor (OR,8.932,P=0.004) and septic shock (OR,56.721,P＜0.001) were independently associated with the 30-day mortality.Conclusions The present study confirms that solid tumor and septic shock are more important risk factors than MRSA in mortality of patients with S.aureus BSI.