Objective To depict the characteristics of the flow shape and distribution of superficial lymphadenophathy and to clarify the effiency of color Doppler flow imaging and power Doppler sonography in the differential diagnosis.Methods Prospectively,81 cases with 95 lesions were observed and clarified as four vascular patterns by sonography and were correlated with the histopathological or clinical diagnosis.The four vascular patterns were as follows: type Ⅰ shows central hilar vascularity with radial symmetric branches; type Ⅱ shows eccentric hilar vascularity with deformed radial branches; type Ⅲ shows subcapsular vessels(Ⅲa),mixed vessels(Ⅲb),or multifocal hilar vasculature(Ⅲc); type Ⅳ shows spotted or peripheral flow signals.Results The majority ( 85.0% ) of the benign reactive nodes revealed a vascular pattern of type Ⅰ,while a few ( 10.0% ) showed that of type Ⅱ.The most( 97.8% ) of lymphoma showed the patterns of type Ⅱ( 33.3% ) and type Ⅲ( 64.5% , and Ⅲa 28.9% ,Ⅲb 22.2% ,Ⅲb 13.4% ,respectively).The vascular patterns of metastatic lymphadenopathies were of type Ⅳ( 66.7% ) and type Ⅲb(26.7%).The lymphoma which revealed a vascular pattern of type Ⅱ were mostly of high grade differentiation in pathological results.The differrent vascular types of metastatic nodes has no correlation with its histologic source.Conclusions Color Doppler sonography is a valuable method for aid in the differential diagnosis of superficial lymphadenophathy by using findings of intranodal vascularity.

Objective To investigate TORCH infections in neonatal hyperbilirubinemia ,and explore the relationship between them.Methods 644casesofneonatalhyperbilirubinemiainourhospitalfromJanuarytoDecemberin2014werechosenasneonatal hyperbilirubinemia group ,160 cases of healthy newborns in the same period were selected as control group .Chemiluminescence im‐munoassay and Enzyme‐linked immune‐sorbent assay (ELISA )were used to detect the TORCH‐IgM antibody .TORCH infections wereobservedbetweenthetwogroups.Results 58casesofpositiveTORCH‐IgMantibodywerefoundin644casesofneonatalhy‐perbilirubinemia group ,detection rate of TORCH‐IgM antibody was 9 .0% ,0 case of positive TORCH‐IgM antibody was found in 160 cases of the control group ,detection rate of TORCH‐IgM antibody was 0 .0% ,the difference was statistically significant be‐tween the two groups(P<0 .05) .The infection rate of B19 was the highest ,the positive rates of B19 ,CMV were 7 .3% ,1 .7% .Con‐clusion There would be a possible relation between TORCH infections and neonatal hyperbilirubinemia ,TORCH infection is one of the causes of neonatal hyperbilirubinemia ,and the screening of TORCH in neonatal hyperbilirubinemia is necessary .

Objective:To investigate the relationship of CYP2C19 gene polymorphisms and clopidogrel resistance in the patients with coronary atherosclerotic heart disease ( CAHD) accepted percutaneous coronary intervention ( PCI) in Chinese Han population from north Sichuan. Methods:The patients with CAHD undergoing PCI were recruited. The fluorescence in situ hybridization ( FISH) technology was used to detect the CYP2C19 gene polymorphisms in all the patients. According to the different genotypes, the patients were divided into different groups. The platelet maximum aggregation rate ( MAP) induced by ADP was detected before and after the administration of clopidogrel. Results:The 110 patients were divided into three groups:52(47. 3%) patients were divided into the fast metabolism group, 42(38. 1%) patients were in the moderate metabolism group and 16(14. 6%) patients were in the slow metab-olism group. Before the administration, there was no significant difference in the basic values of the platelet aggregation rate among the groups with various metabolism type (P=0. 873). In 24 hours after the administration of 300mg clopidogrel, there was notable differ-ence in the platelet aggregation rate (17. 74% ± 5. 87% vs 21. 44% ± 8. 71% vs 27. 05% ± 8. 83%, P=0. 044) and the decrease de-gree (20. 08% ± 5. 94% vs 18. 87% ± 4. 72% vs 11. 54% ± 2. 94%, P=0. 01) among the three groups. The moderate metabolism group and slow metabolism group had higher MAP with lower decrease degree than the fast metabolism group. Totally 21 patients (19. 1%)were with CR, and among them, 2 patients (3. 8%) were in the fast metabolism group,12 patients (28. 6%) in the moder-ate metabolism group and 7 ones (43. 8%) in the slow metabolism group, and the difference of CR distribution among the three groups was significant (P<0. 001). The moderate metabolism group and slow metabolism group were more likely to have clopidogrel resist-ance, especially the slow metabolism group. Conclusion: There is a certain relationship of CYP2C19 gene polymorphisms and clopi-dogrel resistance in the patients with CAHD accepted PCI in Chinese Han population from north Sichuan, and those with slow metabo-lism genotype are more likely to have clopidogrel resistance with reduced efficacy.

Objective To study the clinical value of VACORA vacuum-assisted rotation system in the treatment of benign breast lesions. Methods Under the screening of dynamic ultrasound,122 beast lesions in 93 patients diagnosed as benign lesions from ultrasound were treated with VACORA vacuum-assisted rotation system,and all the patients were examined for follow-up. Results All the lesions were totally rotated and 119 lesions demonstrated to be benign and 3 lesions were atypical hyperplasia from pathologic examination. In the benign lesions, 72 cases were demonstrated to be fibroadenoma, 39 cases were demonstrated to be fibrosis adenosis,4 cases were intraductal papilloma,2 cases were duct inflammation, 1 case was epithelial hyperplasia of the duct and 1 case was lymphode. In 8 cases,bleeding was seen along the needle tract,which was stopped after compression. Small hematoma was formed in 10 patients in the second day of follow-up, which was disappeared in the 3 to 6 months of the follow-up. And all patients had no remnant lesions in the local area and the incisions were not clear in the skin 3 to 6 months of the follow-up. Hypoechoic focuses were detected out at the original location in the 3 benign cases, which were possibly residual focuses. Conclusions Benign breast lesions could be clearly resected with VACORA rotation system under the screening of ultrasound, which is safe, minimal invasive, prosthetic, and has little complications.

Objective To assess the volume of epicardial adipose tissue(EAT) and intrathoracic adipose tissue(IAT) and the correlation of EAT,IAT and the EAT/IAT ratio with the severity of coronary artery atherosclerosis in patients with metabolic syndrome(MS) and coronary heart disease(CHD).Methods Ninty-seven MS subjects without coronary atherosclerosis and one hundred and eighteen MS subjects with CHD were enrolled in this study.The volumes of EAT,PAT and IAT were measured using axial data from base to apex traced manually with a dedicated semiautomatic software program-volume.Results (1)Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD had significantly increased age[(60.6± 1 1.4)years vs.(57.9 ± 8.7) years,P=0.001],positive family history of cardiovascular disease(29.7％ vs.21.6％,P=0.03),EAT[(98.3±41.4) cm3 vs.(82.2±39.7) cm3,P=0.001],IAT [(171.3±64.1) cm3 vs.(156.2±48.1) cm3,P=0.001] and HbA1c[(7.1 ± 1.8)％ vs.(6.6±2.3)％,P=0.02],but siginificantly reduced total cholesterol[TC,(4.9 ± 1.2)mmol/L vs.(5.4 ± 1.0) mmol/L,P=0.003],low-density lipoprotein cholesterol[LDL-C,(3.0±1.1) mmol/L vs.(3.6±1.0) mmol/L,P=0.03] and high-density lipoprotein cholesterol[HDL-C,(1.0 ± 0.4) mmol/L vs.(1.1 ± 0.3) mmol/L,P=0.04].(2) In MS subjects without coronary atherosclerosis,the volumes of EAT,pericardial adipose tissue(PAT) and IAT were associated with gender,body mass index(BMI),waist circumference(WC),diabetes mellitus and hyperlipidemia(all P＜0.05); however,in MS subjects with CHD,the volumes of EAT,PAT and IAT were associated with BMI and WC (both P＜0.05).(3) The volumes of EAT and IAT were correlated with calcification grades(r values were 0.45 and 0.50,P values were 0.017 and 0.013,respectively) and Gensini score(r values were 0.476 and 0.563,P values were 0.015 and 0.017,respectively) instead of coronary artery calcifacation score(CACS).Moreover,the EAT/IAT ratio was negatively correlated with CACS(r=-0.321,P=0.028).Conclusions Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD have significantly increased EAT and IAT volumes.In our subjects,the volumes of EAT,PAT and IAT were associated with BMI and WC.Only in MS subjects with CHD,the volumes of EAT and IAT were correlated with caleification and Gensini score.

Objective To detect stunned myocardium using low-dose dobutamine stress (DBS)combined with two-dimensional speckle tracking imaging (2D-STI),and to evaluate the difference and characteristics of mechanical parameters in different conditions between stunned myocardium and adjacent normal myocardium.Methods The acute myocardium ischemia/reperfusion (I/R) of anterior wall of left ventricle(LV) was induced with 60 minutes ligation of left anterior descending coronary artery (LAD),and with reperfusion of 120 minutes in 10 open-chest beagle dogs.Dobutamine was administered continuously via vein with two different dose of 5 μg · kg-1 · min-1 and 10 μg · kg-1 · min-1.At baseline,post ischemia/reperfusion,after the first DBS and the second,the gray-scale dynamic images of three cardiac cycle of left ventricular short axis at the levels of mitral annulus,papillary muscle and apex were acquired.The systolic peak of circumferential strain (CS),radial displacement (RD) of eighteen segments of subendocardium and subepicardium were analyzed by Speckle tracking workstation.LV end-systolic dimension(LVIDS),LV end-diastolic dimension (LVIDD),LV eject fraction (LVEF),heart rate (HR),aortic valve forward flow velocity time integral(AV-VTI) were also measured.Results ①There was no statistical significance (P ＞0.05) under the conditions of baseline,post I/R,the first DBS and the second for LVIDD,LVIDS,LVEF,HR and AV-VTI.②Compared with baseline,the peak systolic subendocardium and subepicardium CS,RD decreased significantly at the apex and middle of short-axis anterior wall of LV under the conditions of post I/R;The parameters of the first DBS was significantly increased compared with the I/R (P ＜ 0.05) ; There was no difference between the two DBS and baseline(P ＞0.05).The peak systolic subendocardium and subepicardium CS,RD at the bottom segment of LV were no statistical significance under the four conditions.③There was no difference for anterolateral wall and anterior septum of LV at the level of papillary muscle under the four conditions.Conclusions ①Low-dose DBS combined with two-dimensional speckle tracking imaging can detect stunned myocardium accurately.② After the occurrence stunning myoeardium,the peak systolic subendocardium RD decreased slightly,subepicardium RD was normal,the subendocardium CS of the surrounding myocardium was still normal,and the peak systolic subepicardium CS decreased to some degree.

Objective: To clone cDNA encoding Ⅴ-Ⅶ extra-cellular domains of VEGF receptor KDR and investigate biological activity of the recombinant protein. Methods: Total RNA from the umbelical venous endothelial cells was obteined. From it, KDR cDNA was cloned into the BamH1 and Kpn 1 sites of pQE31 and made expressed with induction of IPTG. The recombinant protein was purified, refolded and determined for its biological activities. Results: The expression system could express the human recombinant extra-cellular protein of KDR with expression level accounting for 5% of the total bacterial protein. After renaturation, the recombinant protein could bind to 125 I-VEGF and suppress endothelial cell proliferation and angiogenesis of chick chorioallantoic membrance induced by VEGF. Conclusion: Human KDR extra-cellular domain can be expressed in E coli and after being refolded, has an action of binding to VEGF.

BACKGROUND: There are a lot of researches on the protective action of calcium channel blocker(CCB) on diabetic peripheral neuropathy, but the dosage and the effect on injured nerve need to investigate further in clinical application.OBJECTIVE: To observe the results of electrophysiologic assessment of the effect of CCB flunarizine at different dosages on Bell' s palsy after 1-month treatment.DESIGN: Randomized grouping, blank control and l-month follow up.SETTING: Department of Neurology, First Affiliated Hospital of Nanjing Medical University.PARTICIPANTS: Totally 35 patients with Bell' s palsy, including 19males and 16 females aged from 16 to 58 and the mean age of 32. 8, were selected from Outpatients of the Department of Neurology, the First Affiliated Hospital to Nanjing Medical University from November 1999 to May 2001. The course of disease was ≤ 3 days. Patients were without any treatment, and all of the facial nerve palsy was complete. According to random samplings, all patients were divided randomly into control group (basic treatment group) with 12 cases and treatment groups with 10 cases in first subgroup and 13 in second subgroup.METHODS: Basic treatment: 1 mg/kg per day prednisone(the maximal dosage ≤ 60 mg/day) was taken once every day and reducing dosage by half every 5 days, with a course of therapy for 15 days. 500 μg methycobal was taken orally three times a day and 25 mg fursulthiamine also orally three times a day. Ultrashort wave physiotherapy was taken once a day for 15 days. On the basis of the basic treatment, patients in the first subgroup accepted 5 mg flunarizine once every night, and 10 mg flunarizine once every night was given to the patients in the second subgroup. The latency and amplitude of Blink response were checked before treatment and after 1-month treatment.MAIN OUTCOME MEASURES: The latency and amplitude of Blink response in every group after 1-month treatment.RESULTS: According to the imagery analysis, 35 patients entered the resulting analysis. Before treatment, the 3 groups of blink responses were all efferential blocking in facioplegic side, and in addition, R1 and R2 all disappeared. After treatment for 1 month, Blink response of R1, R2 appeared. The latency of R1 and R2 in the second treatment group was better than that in control group[ (9. 608 ± 0. 575) ms, (31. 869 ± 2. 934) ms,(11.208±1.490) ms and (37. 583 ±5. 408) ms, P ＜0.01], but there were no differences in this respect between the first treatment group and the control group. The ipsilateral amplitudes of Blind response in the three groups were not different after 1-month treatment.CONCLUSION: After 1-month treatment with flunarizine(10 mg/day),the recovery of facial nerve function can be promoted, but the protective effect of flunarizine(5 mg/day) on peripheral nerve is not superior to that with normal treatment. The mechanism and the proper dosage are not observed further in this study.

Objective To investigate the virus-carrying rate of non-polio enteroviruses ( NPEV) in patients with acute flaccid paralysis ( AFP) in Yunnan province of China in 2015 and to analyze the genetic characteristics of enterovirus 71 (EV71) strains. Methods A total of 213 cases under 15 years old with AFP were reported by Center for Disease Control and Prevention ( CDC) of Yunnan Province of China. Virus isolation was conducted for all samples and the serotypes of isolated NPEV strains were identified by VP1 se-quencing. The isolation rates of NPEV in the past consecutive 5 years were analyzed by SPSS22. 0 software. Phylogenetic trees of NPEV and EV71 strains were constructed by MEGA6. 06 software based on neighbor-joining algorithm and Kimura 2-parameter substitution model and the reliability of the phylogenetic trees was determined by bootstrap analysis with 100 pseudo replicate datasets. Results Altogether, 23 NPEV strains were isolated from 213 AFP cases. Among the 23 strains, 7 strains belonged to EV-A group (2 serotypes, 6 strains of which were EV71 ) , 14 strains belonged to EV-B group ( 8 serotypes ) and the other 2 strains belonged to EV-C group. No NPEV strains of EV-D group were identified. Statistical analysis showed that no significant differences in the isolation rates were observed in the past 5 years ( P=0. 101 ) . Conclusion The isolation rate of NPEV in patients with AFP in Yunnan province in 2015 was similar to that of the previ-ous years. The EV71 strains of C4 subgenotype were the predominant strains circulating in Yunnan province.

Objective To establish the cell model of intractable epilepsy and to observe its neuronal damage and morphologic change of neurites.Methods The model was established by exposing hippocampal neurons to Mg2+ -free media for 3 hours on days 10 of culture.Expression of lactic acid dehydrogenase (LDH) in supernatant was measured as an index of neuronal damage.The morphologic change of neurons and neurites was observed by optical microscope and scanning electron microscope (SEM).Results Compared to the control group, level of LDH (U/L) was significantly increased in the model group at different time points (3 hours: 4.26 ± 1.28, 6 hours: 6.56 ±2.34 and 24 hours: 16.67 ±3.57, P <0.05).With time prolonging, release of LDH in the model group was gradually increased (F = 39.316,P <0.05).Under optical microscope, neurons of model group migrated closely to each other and neurite connections appeared to be gradually "reticulated" after Mg2+ -free media treatment for 24 hours; and the "reticulated" neurites connections become more obvious after 72 hours.Under SEM, neuronal membrane was rough and had several small depressions, neurites were interlaced in cluster.Conclusions Neuronal damage and morphologic change of neurites are verified in the cell model of intractable epilepsy.