Objective To analyze the imaging manifestation and feature of congenial pulmonary arteriovenous fistulas (CPAVF) and observe the effect of endovascular treatment. Methods The plain films, CT and DSA of CPAVF retrospective- ly were analyzed. The effect of transcatheter embolization with coil was observed by follow-up. Results Feeding artery was pulmonary artery branches in five cases and was branchial artery in one case. The images of all cases were divided into three types: simple type-3 cases, complex type-2 cases and diffuse type-1 case. Both CT and DSA could give the correct diagnosis, however 3 cases were diagnosed wrongly by X-ray. Three cases were underwent transcatheter endovascular em- bolism with coils, and one case were done three times. Systemic arterial oxygen saturation improved strikingly in two pa- tients after treatment, and the symptoms of hemoptsis disappeared immediately after branchial arterial embolism in other case. Conclusion DSA was the best means in the diagnosis of PAVF. CT and three-dimensional reconstruction can be giv- en correct and direct diagnosis for big PAVF, but can not replace DSA in the diagnosis of small PAVF. Percutaneous tran- scatheter endovascular embolism with coils is an effective and safe treatment for PAVF, but it is only a palliative therapy for diffuse PAVF.

Many genetic events have been described to be involved in the development of tumor,but a lot of recent researches proved that epigenic events also played an important role in it.DNA methylation is one of the common modification of epigenic events,the binding of methyl-CpG binding domain proteins has been shown to lead to transcriptional repression of many tumor repressor genes.

Objective To explore the cause and effective management and prevention of septic shock after minimally invasive percutaneous nephrolithotomy (MPCNL) in the elderly.Methods Clinical data of 13 patients with septic shock after MPCNL in our hospital were retrospectively analyzed,and the cause,prevention and treatment of septic shock were investigated.Results The incidence of septic shock in patients undergoing MPCNL was 3.54％ in this study.Single-factor analysis and logistic regression analysis showed that the risk factors for post-MPCNL septic shock were female and the history of diabetes (both P＜0.05).Conclusions Septic shock is a serious complication after MPCNL.Intensive perioperative prevention measures can reduce the incidence of septic shock.Early diagnosis and proper treatment are the keys to successful treatment of septic shock.

Objective To investigate the effect of inhibition of endoplasmic reticulum stress (ERS) in ischemic preconditioning-induced cerebral ischemia tolerance.Methods A total of 120 adult male SpragueDawley rats were randomly allocated into three groups:sham operation,global cerebral ischemic and ischemic preconditioning groups (ischemic preconditioning for 3 minutes,and global cerebral ischemia for 15 minutes after 2 days).Three time points (day 1,day 3 and day 7) were set.Sugawara method was used to observe the changes of neurological behavior in rats.TUNEL staining was used to observe the conditions of cortical neuronal apoptosis.Immunofluorescence staining and Western blot analysis were used to detect the expression levels of ERS-related protein CHOP,GRP78,and caspase-12.Results The neurological behavior score showed that the sham operation group did not have neurological deficits.Both the global cerebral ischemic group and the ischemic preconditioning group had obvious neurological deficits,and they improved gradually with the passage of time,but after modeling,the neurological scores at each time point in the global cerebral ischemic were significantly lower than those in the ischemic preconditioning group:at day 1∶11.00 ±0.63 vs.14.33 ±0.33 (t =21.74,P＝0.001); at day 3∶ 12.17±0.31vs.15.17±0.48 (t=27.93,P =0.000); at day 7:14.67±0.49 vs.16.33 ±0.33 (t =7.81,P=0.020).TUNEL staining showed that at day 7 after ischemia,the positive cell count per mm2 in the sham operation,global cerebral ischemic and ischemic preconditioning groups were 4.83 ±1.85vs.395.67± 43.43 and 146.17± 27.38 respectively (F=23.62,P=0.001).The ischemic preconditioning group was significantly lower than that in the global cerebral ischemic group (P =0.001).Immunofluorescence staining showed that at day 7 after ischemia,the numbers of positive cells of CHOP (26.50±3.89vs.82.33±4.25; P=0.000),GRP78 (15.00±2.02vs.35.67±2.99; t=0.000),and caspase-12 (22.33 ± 2.76 vs.66.50± 7.25; P=0.000) in the ischemic preconditioning group were significantly less than those in the global cerebral ischemic group.Western blotting showed that at day 7 after ischemia,the expression levels of CHOP (1.22 ± 0.38 vs.3.22 ± 0.51; t =24.50,P =0.001),GRP78 (1.78 ± 0.45 vs.3.16 ± 0.76; t =14.29,P =0.005),and caspase-12 (2.89 ± 0.53 vs.5.96 ± 0.67; t =77.73; P =0.000) in the ischemic preconditioning group were significantly lower than those in the global cerebral ischemic group.Conclusions Ischemic preconditioning demonstrated a neuroprotective effect for the second lethal ischemia,its mechanism may be associated with the relief of ERS and downregulation of ERS-related protein.

Objective To investigate the effects of direct hemoperfusion with polymixin B-immobilized fiber (DHP-PMX) in patients with sepsis. Methods We searched Pubmed, Embase, Web of Science databases and identified relevant randomized controlled trials (RCT) from January 1995 to May 2010. Meta-analysis of DHP-PMX on mortality and levels of endotoxin in patients with sepsis were conducted using the methods recommended by the Cochrane Collaboration. Results Eleven RCTs were included.Eight of them included the mortality of patients (sample size: 211 DHP-PMX and 178 conventional medical therapy). In total, the mortalities of patients with sepsis in DHP-PMX group and conventional group were 37.4% (79/211) and 68.5% (122/178) respectively. Compared with the conventional medical therapy,DHP-PMX appeared to significantly reduce mortality ( OR =0.24,95% CI 0.16-0.38 ,P ＜0.000 01 ). The results were similar when two RCTs enrolling patients with methicillin resistant staphylococcus aureus (MRSA) infections were excluded( OR =0. 27,95% CI 0. 17-0. 45, P ＜0. 000 01 ). When the analysis was limited to the nine studies that reported 28- to 30-day mortality, results were unchanged( OR =0. 29,95% CI 0.17-0.48 ,P ＜0.000 01 ). Six RCTs had the available data of endotoxin. The level of endotoxin decreased 31 ng/L(95% CI 22.46-39.55 ) after DHP-PMX therapy, and the decreasing was statistically significant (P＜0. 000 01 ) ,while the level of endotoxin in patients of conventional group did not change (P =0.94).Conclusions This study suggests a favorable effects of DHP-PMX on mortality and endotoxin decreasing in patients with sepsis. However, lack of enough cases and blinding need to be considered. Further investigation with large sample of high quality RCTs is needed.

Objective To compare the effects of combined aerobic and resistance training(RT)versus aerobic training (AT) alone on glucose control and risk factors for complications in type 2 diabetic patients.Methods The database was retrieved from PubMed,EMBASE,the Cochrane Library and SportDicus.The randomized controlled trials (RCTs) of CT versus AT on type 2 diabetic patients were included.The data were analyzed with RevMan5.1.Results Six RCTs were included.The meta-analysis showed that compared with AT,CT improved glucose control,blood lipids,and decreased abdoninal fat.The difference of CT versus AT on blood pressure was not found.Conclusions The impact of CT on type 2 diabetic patients is better than AT.

Objective To observe the effect of sedative drugs applied on uncooperative children in CT examination. Methods 204 samples were divided into groups of baby, infant and preschool children. 20 minutes before CT scan, chloral hydrate and diazepam were taken by those uncooperative children seperately. Drug dosage was calculated according to body weight (kg). Results The effective rate of chloral hydrate were 96.8%(30 cases) in baby group,54.2%(13 cases) in infant group and 53.9%(21eases) in preschool children group, while that of diazepam were 100%(9 cases), 82.6%(19 cases) and 87.2%(68 cases) respectively.Conclusion When approriate sedative drugs were taken by uncooperative children, satisfactory scanning images can be obtained in CT examination

Objective To explore the therapeutic effects an d the appropriate treating time of the artificial liver support system through obs ervation and analysis of the changes of the liver function indexes before and af ter the treatment of the artificial liver support system. Methods The changes of BIL-T, BIL-D, ALT, AST, ALP, TBA, ALB, GLB, A/G of the liver fu nction indexes in a total of 38 cases with serious hepatitis treated by artifici al liver support system were observed. Besides, the dynamic changes of the BIL- T, ALT of one case of middle stage and late stage serious type hepatitis respect ively before and after the artificial liver treatment several times were observe d. Results The BIL-T, BIL-D, ALT, AST, ALP of the liver func tion indexes after the artificial liver support system treatment showed remarkab le decline, significant differences existed before and after the treatment (P

Objective To explore the association of expression of apoptosis-associated gene BAK and cFLIP with the biological behaviors in endometriosis. Methods The expression of BAK and cFLIP protein gene in eutopic and ectopic tissue samples from 40 cases with pathologically confirmed ovarian endometriosis and 40 cases with pathologically confirmed normal endometrium was detected by immunohistochemical method. Results ①The expression of BAK and cFLIP protein gene was found in three groups of different endometrial tissue. ②The expression of BAK protein gene was increased gradually in ectopic endometrial , eutopic endometrium and normal tissue and there was significantly difference between every two groups ,while cFLIP was contrary expressed (P <0.05); ③In normal endometrium, The expression of BAK protein gene in secretory phase was higher than that in proliferative phase (P < 0.05), while cFLIP was contrary expressed, in eutopic endometrium and ectopic endometrial tissue , The expression of BAK and cFLIP protein gene in secretive phase showed no statistically significant difierence with that in proliferative phase (P > 0.05). ④The expression of BAK protein gene in severe group (Ⅲ-Ⅳ period) is lower than mild group both in eutopic or ectopic endometrial tissues,while cFLIP was contrary expressed (P < 0.05). ⑤The expression of BAK and cFLIP was negatively correlated with each other in ectopic endometrium (r=-0.389,P< 0.05). Conclusion BAK and cFLIP was negatively expressed in EMS, which may take a part in the endometrial apoptosis and disorderly proliferation. BAK and cFLIP may play an important role in the the diagnosis and treatment of endometriosis.

BACKGROUND: Chinese medicine Gukang prescription has a clear effect on clinical treatment of osteoporosis, but the therapeutic pathway is stil unclear.
OBJECTIVE:To investigate the effects of Chinese medicine Gukang on the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin by regulating core binding factor alpha 1 expression to control the growth and development of osteoblasts.
METHODS:Sprague-Dawley neonatal rats within 24 hours after delivery were used for the separation and culture of osteoblasts. Adult Sprague-Dawley rats were used to prepare drug-containing serum, and then divided into two groups randomly:normal control group and Gukang group. Rats in the normal control and Gukang groups were intragastrical y administrated with extract of Gukang prescription and normal saline based on rat’s body surface area, for 1 consecutive week. Two hours after the last administration, blood samples were taken from the heart. Then the serum was col ected. Osteoblasts at passage 3 were confirmed with alkaline phosphatase assay and digested. After counting and planting, al osteoblasts were divided into two groups and treated with col ected
serum for 72 hours. Proliferative rate of osteoblasts was detected by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test. Secretion of alkaline phosphatase was detected by using enzyme linked immunosorbent assay and corrected with the corresponding absorbance value. mRNA expression of core binding factor alpha 1, receptor activator of nuclear factor kappa B ligand and osteoprotegerin were detected by using reverse
transcription-PCR in al groups.
RESULTS AND CONCLUSION:mRNA expression of osteoprotegerin and core binding factor alpha 1 in the Gukang group was significantly higher than that in the normal control group, but protein and mRNA expression of receptor
activator of nuclear factor kappa B ligand were dramatical y lower in the Gukang group compared with the normal control group (P<0.01). These findings indicate that Chinese medicine Gukang prescription can modulate the expression of
core binding factor alpha 1, thereby adjusting the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin, which may be one of the mechanisms underlying Gukang treatment for osteoporosis.