Objective To detect the atherosclerotic plaque by 64-slice CT angiography and study the correlation between vulnerable plaque and progressive stroke.Methods One hundred and one patients with cerebral ischemic stroke were divided into progressive stroke group (32 cases) and non-progressive stroke group (69 cases) according to the pathogenetic condition.The stenosis degree and vulnerability of artherosclerotic plaques was recorded and analyzed.Results The percentage of severe or occlusion carotid artery stenosis in progressive stroke group was 28.1％(9/32),which was significantly increased compared with that in non-progressive stroke group [8.7％(6/69)],and there was significant difference (P =0.011).The percentage of vulnerable plaque in progressive stroke group was 75.0％ (24/32),which was significantly increased compared with that in non-progressive stroke group [42.0％ (29/69)],and there was significant difference (P =0.002).There was significant difference in the ulcer plaque between two groups among the different type of vulnerable plaques (lipid core,surface irregularities,ulcers plaque) (P =0.016).Multivariate analysis showed that diabetes mellitus (OR =3.327,95％ CI:1.211-9.145) and vulnerable plaque (OR =3.699,95％ CI:1.292-10.589) was related with progressive stroke.Conclusions Vulnerable plaque and diabetes mellitus are the independent risk factors of progressive stroke.64-slice CT angiography can clear display carotid vulnerable plaque,which is important for clinical treatment.

Objective: To optimize the formula and the preparation technique of orally disintegrating tablets of scopolamine hydrobromide(SH). Methods: The wet granule compressing method and the direct compressing method were compared to choose the suitable preparation method. The orthogonal design was used to optimize the formula of SH tablets while taking the hardness, disintegrating time and dissolution rate of the tablets as indices, and the optimization was verified. Results: The wet granule compressing method was chosen for preparation. The optimized formula was composed of mannitol 40%, MCC 35%, lactose 0, and CMS-Na 10%. And the hardness, disintegrating time and T50 of the optimized tablets were 3.8 kg, 54 s, and 2.47 min, respectively. Conclusion: The obtained formula and preparation technique for orally disintegrating tablets of SH is satisfactory; the quality of the prepared tablets can be well controlled.

Objective To evaluate the causes of postoperative complications in severe liver rupture and explore the prevention experienees.Methods The clinical data of 66 liver rupture patients who underwent surgical treatment in our hospital from January 2005 to July 2012 were retrospectively analyzed.The commou complications after surgery and the treatment measures of the complications were sludied.Results There were 9 deaths of severe liver rupture after surgery and related complications were found in 22 cases,including bile leakage (5 cases),intrahepatic abscess (3 eases),subphrenic infection (3 cases),pleural effusion (8 cases),intra-abdominal hemorrhage (2 cases),stress ulcer bleeding (2 cases).Conclusions Using damage control theory could improve the cure rate.Precise liver transection and postoperative excellent management was able to reduce the incidence of postoperative complications in severe liver rupture.

Hyperthermia therapy employs artificial heat to treat malignant tumors. Hyperthermia uses a variety of physical energy to produce thermal effects in the body tissue. Hyperthermia elevates the temperature of tumor tissues to a certain degree and makes it maintained for a certain period of time to kill cancer cells and prevent normal cells from damage. Compared with other conventional therapy, hyperthermia has its special advantages and has become one of the novel comprehensive medical treatments for cancer therapy. This paper briefly reviews the action mechanism on hyperthermia against tumors and its clinical application in the treatment of gastrointestinal cancer.

Objective To evaluate the value of suprasternal long axis view in echocardiography for right pulmonary artery (RPA) lesions.Methods Echocardiography was performed in 31 patients with clinical suspicion of pulmonary vascular disease.Through suprasternal long axis view,RPA,right superior pulmonary artery and right inferior pulmonary artery were identified,and the vessel wall,intraluminal echoes,and location of the lesion were obtained.Blood flow in pulmonary artery was detected with color Doppler flow imaging.The results of echocardiography were compared with those of computer tomography of pulmonary angiography (CTPA) and clinical diagnosis.Results With suprasternal notch echocardiography,RPA lesions were identified in 27 patients.H owever,RPA could not be clearly identified in four patients.There were 22 patients with moderate or low echo mass in RPA,and five patients with intimal thickening and artery stenosis/obliteration.In the 27 patients with detected lesions,20 lesions were located in RPA,seven lesions were located in distal RPA or its branches.Among the results obtained with echocardiography,25 were in accordance with CT results,6 were not in accordance with CT results.Conclusions The suprasternal long axis view of RPA can be an important alternative imaging modality in identification of pulmonary vascular diseases.

Objective To investigate the levels of transformation growth factor-β1 (TGF-β1),vascular endothelial growth factor (VEGF) and insulin growth factor-Ⅰ (IGF-Ⅰ) role in the pathogenesis of serum of patients with combined pulmonary fibrosis and emphysema (CPFE).Methods Recruited 20 patients with CPFE,40 cases with idiopathic pulmonary interstitial fibrosis (IPF) and 40 cases with emphysema who were admitted to our hospital during July 2011 to February 2012.Serum levels of TGF-β1,VEGF and IGF-Ⅰ were detected by ABC-ELISA.Results Serum levels of TGF-β1 and IGF-Ⅰ were significantly higher in patients with CPFE and IPF than these in patients with emphysema (TGF-β1:(160.73 ± 40.62) ng/L vs.(167.35 ± 42.82) ng/L vs.(128.75 ±35.77) ng/L; IGF-Ⅰ:(179.65 ±60.73) ng/L vs.(192.32 ±58.75) ng/L vs.(148.73 ±49.67) ng/L,P ＜ 0.05 or P ＜ 0.01).The IPF group had significantly higher serum level of VEGF than the emphysema group ((506.12 ±82.37) ng/L vs.(437.31 ±62.58) ng/L,P ＜0.01).Serum levels of TGF-β1 and IGF-Ⅰ in CPFE and emphysema groups were positively correlated (r =0.885,0.918 respectively,P ＜ 0.01).Smokers in the CPFE group had significandy lower level of serum VEGF than those who did no smoke ((406.19 ± 66.94) ng/L vs.(482.88 ± 79.91) ng/L,t =-2.287,P =0.035).Conclusion Serum level of VEGF increased significantly in the IPF group,suggesting the participation of VEGF in pulmonary interstitial fibrosis.IGF-Ⅰ involved in the pathogenesis of pulmonary interstitial fibrosis.TGF-β1 and IGF-Ⅰ have a positive linear regressive relationship,which indicates that they may work synergistically in the process of the fibrosis.

Objective To prospectively study the minimally invasive hematoma stereotactic aspiration and the recovery of neurological deficits after conservative medical treatment alone, as well as the incidence of post-stroke depression (PSD) in patients with intracerebral hemorrhage, so as to investigate the effect of minimally invasive hernatorna stereotactic aspiration on the recovery of neurological deficits and the incidence of PSD. Methods Fifty-five patients with intracerebral hemorrhage received minimally invasive hematoma stereotactic aspiration (n =25) and conservative medical treatment (n = 30), respectively. The neurological deficits of the patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) at admission, day 14 and 90. The decreased values (all compared to baseline score) of the NIHSS scores were calculated at day 14 and 90, respectively; the modified Rankin Scale (mRS) was used to assess the disabled degree at day 90; the 17-item Hamilton Depression Rating Scale (HAMD) was used to assess the PDS status at day 14 and 90. The correlation between PSD and the degrees of neurological deficit and disability in patients was analyzed. Results The decreased value of the NIHSS score in the stereotactic group at day 14 and 90 was significantly higher than that in the conservative treatment group (all P ＜0. 05), and the value of the mRS score was significantly lover than that in the conservative treatment group at day90 (P＜0. 05). The incidence and the total incidence of PSD in the stereotactic group at day 90 were significantly lover than those in the conservative treatment group (all P ＜0.05). There were significant positive correlation between HAMD and NIHSS scores and HAMD and mRS scores. Conclusions The recovery of neurological deficits was faster after the minimally invasive hematoma stereotactic aspiration. The degree of disability in patients was lower, and the incidence of PSD was also lower than that in the conservative treatment group. PSD was closely correlated with the degrees of neurological deficits and disability.

Objective To analysis the β-globin gene mutation in β-thalassemia in the population of Wenzhou natives,and identify the major mutation in Wenzhou and further provide valuable information for genetic counseling,prenatal diagnosis and prevention programs in this region.Methods Patients with β-thalassemia were diagnosed and the genomics DNA were extracted from whole blood cells and amplified with PCR,sequenced and compared to the standard sequence.Some mutations were further identified by subcloned.Results 44 of 66 patients were diagnosed β-Thalassemia,9 mutations were found in the 44 sporadic patients with the sequence analysis,2 of which were known polymorphisms(exonl 59,IVS-2-665),3 belonged to the common mutations in Chinese(IVS-2-654,CD_(41/42)-TTCT and TATA box nt-28),2 were scarce abnormalities(CD_(47),CD_(66))and 2 novel variants(-24T→C,CD_(26A)→G,same sense mutation,unreported).Conclusion The mutations of β-globin gene in Han Chinese in Wenzhou are complex (9 mutations found in all),the rare and novel mutations are identified,which provide the valuable information for genetic counseling in Wenzhou.

Objective To investigate the correlation between the variations of mitochondrial gene ATP6 and type 2 diabetes mellitus ( T2DM ) and chronic complications. Methods Genomic DNA were extracted from 254 T2DM patients and 165 age-matched controls. After amplification of ATP6 by PCR and direct sequencing, all sequences were compared with the reference sequence (rCRS) to find out the variations. Bioinformatics and statistic method were used to analyze these variations. Results Many variations were detected respectively in T2DM patients and controls, a part of them only appeared in T2DM patients in low frequency, which has not been reported previously. Most of these variations are located in thethird and forth transmembrane helix of ATP synthase subunit 6 (ATPase6). Interestingly, these variationsalmost were detected in the non-obese T2DM patients with hypotension, including G8557A, A8563G,T8594C, C8609T, A8689G, G8998A and G9139A. Conclusions There were many variations in geneATP6 and must of them are mitochondrial SNP, while variations A8689G, T8825C, G8920A, G8998A andG9139A may be mild mutations which my increase the susceptibility of T2DM. G8557A, A8563G,T8594C, C8609T, A8689G, G8998A and G9139A may be associated with the biogenetics diseases suchdiabetes and hypertension.

Objective To study the clinical features of a heterogeneous immunodeficiency disease,common vailable immunodeficiency(CVID),and to enhance the understanding of it.Methods 12 cases of CVID treated in Peking Union Medical College Hospital from January 1990 to March 2007 were analyzed retrospectively,including the clinical characteristics,laboratory results,treatment and prognosis.Results Among the 12 patients,the ratio of male to female Was 2:1,the average onset age(26±9)years old and the median time from onset to diagnosis 18 months.The main symptoms were fever(with a percentage of 67.0%),recurrent Cough and expectoration(58.3%)and diarrhea(41.6%).Anemia and leukocytopenia were the common laboratory changes.All the cases were diagnosed due to the presence of hypo- immunoglobulinemia.The tests available for subtypes of lymphocytes in 9 patients showed that B cells and CD4+ T cells decreased obviously,with an inverse ratio of CD4/CD8,indicating T cell dysfunction.Clinical improvement was demonstrated after treatment with intravenously administered immunoglobulin(IVIG)in 10 cases.Conclusions CVID is a heterogeneous group of immunologic disorders of unknown etiology,characterized by impaired antibody responses and recurrent airway and/or gastrointestinal infection and accompanied with autoimmune diseases or cancer.Hypo-immunoglobulinemia is the main evidence of its diagnosis.IVIG as a replacement therapy is an effective way of management.