Objective To investigate the correlation between the plasma homocysteine(Hcy) level and the plaque and its degree of the carotid atherosclerosis (CAS) in elderly patients with acute cerebral infarction (ACI).Methods 93 definit ACI patients recieved the colour Doppler ultrasonograph to detect the intima-media thickness (IMT) of bilateral carotid arteries. Then, the patients were divided into group with CAS plaque(60 cases) and group without CAS plaque(33 cases) according to the result of the detection. Also the degree of CAS were divided to 0～4 levels. The concentration of plasma Hcy of all the patients were measured by enzymatic cycling assay. The correlation analysis was made between plasma Hcy levels and the CAS plaque and the degree of CAS.Results The concentration of plasma Hcy in the group with CAS plaque[18.83 (15.20～24.03)?mol/L] was significantly higher than that in group without CAS plaque[12.30 (9.70～15.10) ?mol/L](P

BACKGROUND: Multiple sclerosis(MS) is a chronic autoimmune disease induced by the interaction between genetic and environmental factors. Its pathogen and the mechanism of the relapse and remission m the course of the disease are still unknown. Most of the MS research centers are looking for the pathogenic polypeptide epitope in proteolipid protein(PLP), myelin sheath basic protein (MBP) and oligodendrocyte glycoprotein (MOG) OBJECTIVE: To compare the proliferation of T cell lines(TCL) in MS induced by myelin sheath and delipidated myelin sheath towards 11 components of myelin sheath to mainly search the possible pathogenic polypeptide epitope in PLP, and investigate the possible effects of abnormal dcgrease in myelin sheath.DESIGN: A case-controlled trial.SETTING: Department of neurology in a hospital of a university.PARTICIPANTS: Mononuclear cells(MNC) of 16 MS cases(clinical relapsing-remitting type, patients did not receive any immunosuppresant for at least 3 months when their peripheral blood samples were taken) and 12 HLA-DR15 healthy volunteers were furnished by Dr. Trotter JL of MS Research Center of Washington University from the cell database.INTERVENTIONS: MS-TCL and normal TCL were induced twice by stimulation with myelin sheath and delipidated myelin sheath in vitro by cell culture in vitro. TCL proliferation was tested by 11 antigens including PLP,MBP, M87-106, P30-49, P40-60, P89-106, P95-117, P117-137,P139-151, P178-191, and P185-206.MAIN OUTCOME MEASURES: Difference of scintillation counting in every minute of every well, and the stimulative index of each well were calculated, and the mean wells with positive proliferation of TCL towards each antigen were confirmed as well.RESULTS: The general specific proliferation towards myelin sheath antigens was bigger in MS group than control group 5.49 ±5.31 to 3.10 ± 3. 17, and delipidated myelin sheath-induced TCL was bigger than myelin sheath-induced one 5. 49 ± 5.31 to 3.41 ± 4. 83 . Delipidated myelin sheath significantly changed the immune responses of MS group,especially the changes of responses towards P30-49, P40-60, P89-106,P117-137, P139-161, and P185-206 were significant compared with that the control group only responded to two polypeptides, which indicated that the antigen epitope of MBP, PLP, M87-106, P95-117, P40-60, and P185-206 might have significance in the triggering of MS autoimmune responses.CONCLUSION: TCL induced by MS myelin sheath has different proliferation towards antigen components of myelin sheath from control group. Delipidated myelin sheath significantly increases TCL proliferation in MS group, which suggests that if MS patients developed abnormal degrease in myelin sheath, TCL would produce autoimmune response towards self-myelin sheath, MBP, PLP and its polypeptide segments all can trigger MS or aggravate the state of the illness. Our finding supports the hypothesis of MS autoimmune pathogenic mechanism.

Objective To investigate the value of 18F-FDG SUVmax in gastric cancer diagnosis with coincidence imaging.Methods The coincidence imaging was performed in 92 patients with gastric diseases (60 males,32 females,age 65 (32-85) years; 78 malignant cases,14 benign cases).The malignant cases included 3 remnant gastric cancers and 75 primary gastric cancers (staging: 4 of Tis,13 of T1,9 of T2,33 of T3,11 of T4 and 5 without surgery).The well-,moderately-and poorly-differentiated adenocarcinomas were 22,15 and 28,respectively.Images were analyzed retrospectively with visual method and 18F-FDG SUVmax,and the diagnostic results were compared with the histopathological findings.The ROC curve was used to analyze the SUVmax.The Pearson's correlation analysis was performed to evaluate the relationship between SUVmax and tumor size.The Wilcoxon rank sum test was applied to determine the difference of SUVmax between early and advanced gastric cancers.The Kruskal-Wallis test was used to analyze the difference of SUVmax in various types of differentiated adenocarcinoma.Results No matter visual method or SUVmax was used,the sensitivity,specificity and accuracy of coincidence imaging in diagnosis of gastric cancer were 64.1％(50/78),64.3％(9/14) and 64.1％(59/92),respectively.The AUC of SUVmax was 0.695 and the cut-off value was 0.700.SUVmax Was positively correlated with tumor size significantly(r=0.489,P＜0.001).There was statistically significant difference between SUVmax of Tis-1 and that of T2-4(0.676± 1.288 vs 3.851 ±3.764;Z=-3.754,P＜0.001).However,there was no statistically significant difference among SUVmax of various grades of differentiated adenocarcinoma(2.805±4.008,3.447±2.365,3.413± 3.737 ; x2 =2.459,P＞ 0.05).Conclusions SUVmax provides more information than visual method in assessing gastric cancer with 18F-FDG coincidence imaging.Appropriate cut-off value of SUV is necessary for improvement of the diagnostic efficiency.Relationships between SUV and pathological T stage,histopathological types and differentiation degree need further investigation.

Objective To explore the mechanism underlying the poor prognosis in cerebral infarction (CI) patients with low T3 syndrome by comparing the NIHSS scores in these patients with or without low T3 syndrome.Methods One hundred and sixty-two patients with CI,admitted to our hospital from January 2010 to December 2012,were chosen in our study; the levels of thyroid hormones,including triiodothyronine (T3),four iodine thyronine (T4),thyroid stimulating hormone (TSH),free Triiodothyronine (iT3) and free four iodine thyronine (fT4),were measured by radioimmunoassay.CI lesions and TOAST distribution were determined by cranial MRI,magnetic resonance angiography (MRA) or CT angiography (CTA),and carotid ultrasonography.NIHSS scores at the worst in cerebral infarction inpatients were detected.Results In the 162 patients with CI,29 patients (17.90％) were combined with low T3 symptom and 20 had fT3 level lower than the lowest normal level (2.63 pmol/L); and T4,fT4 and TSH levels were within normal limits.T3,fr3 and TSH levels in patients with low T3 symptom were significantly lower than those of patients without low T3 symptom (P＜0.05).The distribution of TOAST showed no significant difference between patients with low T3 symptom and patients without low T3 symptom (P＞0.05).In patients with large artery atherosclerosis-internal carotid artery,the NIHSS scores at the worst in patients with low T3 level were significantly higher as compared with those in patients with normal T3 levels (P＜0.05).Conclusion The neurologic impairment is more severe in large artery atherosclerosis-intemal carotid artery patients with low T3 level than those without low T3 level,which might be responsible for the poor prognosis of the illness with low T3 syndrome.