Transient ischemic attack (TIA) traditionally refers to temporary brain dysfunction lasting no longer than 24 hours due to a shortage of blood and oxygen, without any residual neurological deficit. In recent years, the development of imaging technology enables us to have a new awareness about TIA. This article reviews the effects of MRI, especially diffusion-weighted imaging, in the diagnosis and prognostic prediction of TIA.

Objective To compare the ventilatory effects between three-way laryngeal mask airway (TLMA)and tracheal catheter (TC) on hemodynamics, respiratory function and stress responses on patients during bronchoalveolar lavage (BAL). Method Forty patients scheduled for BAL under general anesthesia were divided (stratified sampling) into either TLMA group (group T,n = 20) or TC group (group C, n = 20) according to the stratified sampling principle. SpO2, SBP, DBP and HR were measured in 5 min after entering the operating theater (To), just before inserting TLMA or TC(T1), immediately after inserting TLMA or TC(T2) ,3 min(T3), 5 min(T4), 10 min(T5)after mechanical ventilation, 10 min(T6),20 min(T7), 30 min(T8)during the course of BAL,immediately after extubating TLMA or TC (T9)and 3 min after extubating TLMA or TC (T10). The tidal volume (VT), peak inspiratory airway pressure (Ppeak) and end expiratory CO2 pressure(PETCO2)were recorded at T2,T4,T6,T7, T8, T10. The venous blood samples were taken at T0, T2, T3, T4, T6, T9, T10 for the measurements of epinephrine(AE), norepinephrine(NE)and dopamine (DA) levels with high performance liquid chromatography.Data were dealt with SPSS version 10.0 statistic software. The variables of hemodynamics and stress responses were analyzed with ANOVA of repeating test data. P ＜ 0.05 means the difference in statistical significance. Results In group C, SBP, DBP and HR were significantly higher than those in group T at T2 ,T3 ,T9 (P ＜ 0.05). In group C, the levels of Ppeak were significantly higher than those in group T at T6 ,T7 ,T8 (P ＜ 0.05), and the concentrations of AE, NE and DA were also significantly higher in group C than those in group T at T2, T3 and T9 (P ＜0.05). Conclusions Ventilation with TLMA in patients during BAL is better than TC in respects of keeping stable ventilation, stable hemodynamics and producing less stress responses.

Objective To evaluate the analytical performance of a novel HBV DNA assay based on automated DNA extraction and real-time fluorescence quantitative PCR .Methods Analytic verification studies.Accuracy and lower limit of detection were assessed by determining a panel of HBV standard plasma of WHO.HBV standard plasma (genotype A, B, C and D) at 6 different concentrations were measured 18 times to evaluate precision and reproducibility .Pseudo-viral particles at high HBV DNA concentration were serially diluted to assess linear range .One hundred and forty-four clinical specimens were quantified for HBV DNA so as to evaluate the correlation between the new test and COBAS ? system. Results Quantification of HBV standard plasma showed acceptable accuracy , with each deviation between observed and expected values within ±0.35 lg IU/ml (-0.17-0.32 lg IU/ml).Intra-assay coefficients of variation ( CV) for genotype A , B, C and D were 3.87% -6.32%, 0.45% -14.68%, 0.16% -8.36% and 0.64%-13.01%respectively, and the inter-assay CV were 5.67%-9.69%, 1.28%-15.68%, 0.36%-9.05%and 1.69%-13.65%, separately.Linearity assessment exhibited an excellent dynamic range of linear quantification from 20 to 1.0 ×1010 IU/ml ( r =0.998, P <0.001 ) .And the satisfactory results obtained at 3 levels of HBV DNA concentration (10, 20, 50 IU/ml, respectively) confirmed the claimed lower limit of detection with 5/5 detectable rate at 20 IU/ml.Furthermore, good correspondence was observed between the new HBV DNA assay and the COBAS ? system with 100% ( 144/144 ) qualitative coincidence and significant correlation based on 104 positive data ( r=0.984, P<0.000 1).Conclusions The novel fully-automated real-time PCR assay displayed good analytical and clinical performance for highly sensitive detection of HBV DNA.It was well suited for monitoring antiviral responses as well as drug resistance according to current clinical practice guidelines for the management of chronic HBV infection .

Objective To observe the influence of chemotherapy on the changes of tumor markers levels in patients with advanced lung cancer.Methods A total of 75 patients with advanced lung cancer were selected amd treated with the combination of two drugs based on platinum.The therapeutic effect was judged by the changes of solid tumor according to medical image.The levels of tumor markers before and after the treatment were tested by chemiluminescence immunoassay,and tumor markers including cancer embryonic antigen(CEA),neuron specific enolase(NSE),carbohydrate antigen 125(CA125),cytokeratin(CYFRA211),squamous cell cancer antigen(SCC).Results The levels of tumor markers were significantly lower after the treatment than those before the treatment(P<0.05).The decreased level of patients with CR and PR were significantly lower than those with SD and PD(P<0.05).There was significant difference in the changes of tumor markers levels before and after treatment between the patients with different tumor types.Conclusion Effective chemotherapy can significantly decrease the levels of tumor markers in patients with advanced lung cancer.

Objective To establish in vivo and in vitro the characteristic chromatograms of Mongolian medicine compound formula-Shudage-4,and affiliate and identify in vitro chemical compositions of Shudage-4 and its compositions in vivo absorbed into blood.Methods Wistar rats were intragastrically given Shudage-4 and its different single medicinal,and then serum samples were prepared and determined by using high performance liquid chromatography (HPLC).The HPLC characteristic chromatograms of in vitro samples of Shudage-4 and its different single medicinal and Shudage-4 medicated serum were established and analyzed.The chemical compositions in vitro of Shudage-4 and its compositions in vivo absorbed into blood after taken by rats were compared,affiliated and identified.Results There were totally 64 peaks found after analyzing in vitro HPLC characteristic chromatograms of Shudage-4.There were 23 chemical compositions absorbed into blood,and 17 in vitro ones absorbed directly into blood and 6 speculated as new metabolites.These 23 chemical compositions were all derived from different were derived from Gaoliangjiang (Rhizoma Alpiniae Officinarum,Galangal Rhizome),peak 14,from Muxiang (Radix Aucklandiae,Common Aucklandia Root) and peak 13,from Shichangpu (Rhizoma Acori Tatarinowii,Grassleaf Sweetflag Rhizome).The peaks 15,20,21 and 22 were derived from Gaoliangjiang,Muxiang and Shichangpu,peaks 6,10,17,18 and 19,from Gaoliangjiang and Shichangpu,peaks 7 and 16,from Gaoliangjiang and Muxiang,peak 11,from Muxiang and Shichangpu,and peaks 4,5,8 and 12,from the whole formula of Shudage-4,from which 7 chemical compositions were identified.Conclusion The chemical compositions and metabolites in blood may be the active principles of Shudage-4 with direct effects in vitro,which are derived respectively from different single medicinal in Shudage-4.

Objective To observe the influence of chemotherapy on the changes of tumor markers levels in patients with advanced lung cancer.Methods A total of 75 patients with advanced lung cancer were selected amd treated with the combination of two drugs based on platinum.The therapeutic effect was judged by the changes of solid tumor according to medical image.The levels of tumor markers before and after the treatment were tested by chemiluminescence immunoassay,and tumor markers including cancer embryonic antigen(CEA),neuron specific enolase(NSE),carbohydrate antigen 125(CA125),cytokeratin(CYFRA211),squamous cell cancer antigen(SCC).Results The levels of tumor markers were significantly lower after the treatment than those before the treatment(P<0.05).The decreased level of patients with CR and PR were significantly lower than those with SD and PD(P<0.05).There was significant difference in the changes of tumor markers levels before and after treatment between the patients with different tumor types.Conclusion Effective chemotherapy can significantly decrease the levels of tumor markers in patients with advanced lung cancer.

Objective To investigate the clinical value of eynovial membrane volume measurement by MRI in patients with hemophilic arthropathy receiving radionuclide synoviectomy. Methods Forty two patients,total 63 diseased joint,who hospitalized in the hemophilia diagnosis and treatment center of Henan Province People's Hospital were enrolled in the study after receiving both enhanced an non enhanded MRI, from May 2011 to January 2015.Sixteen patients(21 joints)were treated with 32P radionuclide synoviectomy (PRS)and followed up.The synovial membrane volume were evaluated by enhanced and non enhanded MRI before and after PRS. All data were analyzed by t test. Results The synovial membrane volume had no statistical difference by using the non enhanced(3 104.38±60.19)mm3and enhanced(2 995.19±59.14)mm3 MRI scans (t=-1.369, P=0.191). The synovial membrane volume post PRS (2 479.45 ± 46.48)mm3much lower than that before PRS (2 983.30 ± 42.87) mm3(t=7.831,P=0.000). The magnetic resonance enhanced range after PRS (0.92 ± 0.06) was significantly lower than that before treatment (1.17 ± 0.07) (t=2.108, P=0.048). Conclusion Synovial membrane volume and magnetic resonance enhanced range are important index to predict clinical efficacy of PRS.

OBJECTIVE: To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11C-methionine positron emission tomography (11C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. MATERIALS AND METHODS: Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. RESULTS: The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. CONCLUSION: The combination of MRS and 11C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11C-MET PET approach in clinical applications.
Diagnosis ; Electrons ; Glioma ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Methionine ; Positron-Emission Tomography ; Sensitivity and Specificity

Tripterygium glycosides tablet(TGT),the classical commercial drug of Tripterygium wilfordii Hook.F.has been effectively used in the treatment of rheumatoid arthritis,nephrotic syndrome,leprosy,Behcet's syndrome,leprosy reaction and autoimmune hepatitis.However,due to its narrow and limited treatment window,TGT-induced organ toxicity(among which liver injury accounts for about 40％of clinical reports)has gained increasing attention.The present study aimed to clarify the cellular and molecular events underlying TGT-induced acute liver injury using single-cell RNA sequencing(scRNA-seq)technology.The TGT-induced acute liver injury mouse model was constructed through short-term TGT exposure and further verified by hematoxylin-eosin staining and liver function-related serum indicators,including alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin.Using the mouse model,we identified 15 specific subtypes of cells in the liver tissue,including endothelial cells,hepatocytes,cholangiocytes,and hepatic stellate cells.Further analysis indicated that TGT caused a significant inflammatory response in liver endothelial cells at different spatial locations;led to marked inflammatory response,apoptosis and fatty acid metabolism dysfunction in hepatocytes;activated he-patic stellate cells;brought about the activation,inflammation,and phagocytosis of liver capsular macrophages cells;resulted in immune dysfunction of liver lymphocytes;disturbed the intercellular crosstalk in liver microenvironment by regulating various signaling pathways.Thus,these findings elaborate the mechanism underlying TGT-induced acute liver injury,provide new insights into the safe and rational applications in the clinic,and complement the identification of new biomarkers and ther-apeutic targets for liver protection.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.