Objective:To explore the correlation between homocysteine (Hcy) level and left ventricular diastolic func‐tion in patients with hypertension .Methods :A total of 121 enrolled patients with essential hypertension received plasma Hcy ,routine biochemical measurement and echocardiography examination .With Hcy=10 mmol/L as the di‐viding line ,patients were divided into H hypertension group (high Hcy group ,n=65) and hypertension with normal level group (normal Hcy group ,n=56) .Correlation between plasma Hcy level and left ventricular diastolic function was analyzed .Results:(1) H hypertension accounted for 53.7% ,male proportion in H hypertension group was sig‐nificantly higher than that of normal Hcy group (67.7% vs .37.5% , P<0.01);(2) Compared with normal Hcy group ,there were significant rise in left atrial diameter [LAD ,(34.4 ± 3.3) mm vs .(37.6 ± 5.4) mm] ,left ven‐tricular mass [LVM ,(183.5 ± 37.0) g vs .(205.6 ± 53.1) g] ,left ventricular mass index [LVMI ,(111.1 ± 19.2) g/m2 vs .(121.2 ± 31.8) g/m2 ] and transmitral early diastolic peak flow velocity/peak velocity of early diastolic mi‐tral annular motion [E/Em ,(8.4 ± 2.6) vs .(15.3 ± 7.4)] in H hypertension group ,P<0.05 or <0.01 ;(3) Pear‐son correlation analysis indicated that Hcy was positively correlated with LAD ,left ventricular end‐diastolic dimen‐sion (LVEDd) ,E/Em ,LVM and LVMI (r=0.247~0.620 , P<0.05 or <0.01);multi‐factor linear gradual re‐gression analysis found that plasma Hcy level ,was influencing factors for E/Em (P=0.529 ,t=7.599 ,P<0.05) . Conclusion:There is a significant positive correlation between plasma homocysteine level and left ventricular diastolic function insufficiency in patients with hypertension .More attention is required for detection of plasma homocysteine level in clinic .

Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with various genomic alterations.In most patients,HCC is associated with cirrhosis which contributes to treatment morbidity and mortality.Cirrhosis adds difficulties to clinical management of HCC.Over the past decade,several molecular targets which are involved in the etiology of HCC have been identified.Among them,treatment with sorafenib,an antiangiogenic and Raf kinase inhibitor,has shown survival benefit.This represents a breakthrough in treatment of this complex disease,and proves that molecular therapies can be effective in HCC.It is becoming apparent that to overcome the complexity of genomic aberrations in HCC,combination therapies are essential.Several ongoing clinical trials show encouraging results.Future researches are necessary to identify new compounds to block important undruggable pathways,and to identify new oncogenes as targets for therapies through novel high throughout technologies.Ultimately,a molecular classification of HCC based on genome investigations and identification of patient subclasses using drug responsiveness will lead to a more personalized treatment.Although molecular therapy is a promising treatment for HCC with cirrhosis,surgery,if applicable,remains the first choice of treatment.

Objective To investigate the relationship between post-cerebral infarction depression and negative life events and the therapeutic effect on depression. Methods 162 patients with cerebral infarction were assigned to negative life event affecting group (A group,85) and non- negative life event affecting group (B group,77), and then assessed condition of depression by self-rating depression scale( SDS )and Hamilton rating scale (HRSD). The curative effect before and after therapy of fluoxetine(20 mg/d?4 w) was compared. Results The incidence of depression are 56.5% in group A and 36.4% in group B respectively. The difference is significantly( P

The proposal of the view of scientific development is a new opportunity for the development of the hygiene industry,and plays an important part in the prevention and cure of AIDS.Therefore,during the prevention and cure of AIDS,we should make people the center,coordinate comprehensively,and promote social harmony,to strengthen the ba?sis of the prevention and cure of AIDS.

Objective To study the clinical, imaging and pathological features of primary angiitis of central nervous system (PACNS). Methods The clinical data of 8 patients with PACNS (4 suspected and 4 definite) were retrospectively analysed.Results There were 5 males and 3 females in 8 patients with PACNS. Average age was 32 years old and average disease course was 11 months. The initial symptoms were headache in 5, extremital weakness in 2, and speech disorder in 1 patients. The major clinical manifestations were headache in all patients, extremital weakness and numbness in 5, speech disorder in 1, and seizure disorder in 2 patients. 7 patients were with slow-progressive disease courses, and 1 patients with a relapsing-remitting one. MRI showed abnormality in all patients. 6 cases had unilateral lesions and 2 had bilateral lesions. MRI showed ill-defined, irregular or atypical wedge-shaped foci in cortical and subcortical areas in 7 patients and strip-shaped foci with surrounding finger-like cerebral edema in the left frontal and parietal lobe and gyrus cinguli in 1 patient. All lesions enhanced with different degree on contrast-enhanced scan. Enhanced lesions along sulcus and gyrus were seen in 7 patients and mass-like irregular linear enhancement lesion in 1 patient. Diffusion-weighted imaging(DWI) showed hyper-signal and apparent diffusion coefficient(ADC) showed hypo-signal in 5 patients. MRA showed stiffness and lack of smooth in one or more cerebral arteries with multiple segmental narrowing and expanding, and rarity of arterial distal branches in 8 patients. Digital subtraction angiography (DSA) also showed multiple segmental narrowing and expanding in cerebral arteries, and rarity of arterial distal branches in 4 patients. Brain biopsy in 4 cases revealed angiitis with lymphocytic infiltration. 5 patients received treatment with single corticoid, and 3 with cyclophosphamide. All cases had good outcome. Conclusions The clinical manifestations of PACNS are various. The changes of imaging are obvious, MRI, MRA and DSA are helpful in the diagnosis of PACNS. The definite diagnosis relies on brain biopsy.

Pancreatic head carcinoma could easily invade the neighboring vessels due to its own biological features and anatomical location,which increases the technique difficulty and risk,leading to low resection rate.Recently,with the progress on the surgical techniques and perioperative management,and the emergence of neoadjuvant chemoradiation,vascular invasion is no longer the surgical contraindications and pancreaticoduodenectomy combined with vascular resection has saved many patients ' lives.However,the preoperative assessment,the timing of surgery,the vessel management during the surgery,and the prevention and treatment of the postoperative complications remain controversial.In order to achieve a clear understanding on the application of pancreaticoduodenostomy combined with vascular resection,here we review the recent publications and share the experiences on pancreaticoduodenectomy with portal and/or superior mesenteric vein resection from our center,which may help improve the safety and resection rate of pancreatic carcinoma and enhance the overall therapeutic efficacy of treating pancreatic cancer.

The long-term use of immunosuppressive agents after organ transplantation is associated with many undesirable side effects which may limit the survival of patients and transplanted organs.To patients and transplant surgeons,organ transplantation tolerance is the ultimate goal to improve patient's quality of life.The clinical state of allograft acceptance termed operational tolerance has remained infrequent in clinical transplantation because of the lack of validated assays or biomarkers predictive of tolerance and the concerns about the safety and ethics of complete withdrawal of immunosuppression.Despite these barriers,a number of investigators have continued to conduct well-designed studies with the long-term goal of inducing clinical transplantation tolerance.This review provides an overviewof the currently successful approaches to achieve clinical operational tolerance,including using immunosuppression slow withdrawal in organ transplantation,transplantation tolerance through mixed chimerism and clinical application of T regulatory cells in tolerance.

ObjectiveTo explore the anatomy and clinical significance of fixation combined with limited outside cut restoration gram needle internal fixation for distal radial fractures. MethodsBased on the anatomical observation and measurement of the forearm and hand. Found out the distal radial fractures fixed bracket screws and gram needle safety area and the needle into the body, and made reasonable angle respectively, to formulate standardized orientation, and applied to clinical procedures, and the clinical cases were followed up. The clinical curative effect was observed. ResultsThe place for the fixed bracket screws of the second metacarpal was the nail parts of radial dorsal partial ends. The proximal fracture for external fixation stents bolt into the nail near abductor muscle and manipulation long in the thumb short extensormuscles. Its feet side for stabbing abductor muscle and refers to a long stretch of radial side for tendon, radial side wrist short stretch muscles. The farthest distance between the lister nodule was (63.69 ±3.00) mm,nearest distance between the lister nodule was(123.64 ±5.00)mm. Gram needle do limited internal fixation security clearance for thumb long stretch tendon and refers to stretch tendons,radial side wrist length stretch tendons, thumb short extensor tendons, stretch retinaculum and this gap proximal distance lister nodule for ( 33. 52 ± 4.20) mm, remote distance lister nodule for( 8.81 ± 0. 88) mm. In clinical applications, wrist imaging recovery, function of ratings had no significant difference ( P ＞ 0.05). But the postoperative complications of the two sets of patients had statistically significant difference ( P ＜ 0. 05 ). ConclusionAccording to the anatomy of distal radial fractures,from the results of our research applied in fixation distal radial fractures in the operation,it had the advantages of simple operation,reset good,fixed firmly,and small trauma. It was worth of used widely in clinical.

On the basis of studying the necessity of cultivating the medical students' occupation personality, we should have a further research on the content of their occupation personality. And it's useful for the medical college to renew the concept,strengthen the revolution, pay highly attention to the education of the medical students' occupation personality and promote the development of the medical students'occupation personality.

Traditionally,antigen presenting cells were shown to express MHC Ⅱ antigens.However,some researchers have demonstrated that a subset of T lymphocytes could express MHCⅡ antigens in some situation.Its regulatory mechanism and biological effects remains challenging to researchers.This review provides an overview of the results of these MHC Ⅱ + T lymphocytes regarding to the generation,mechanisms,and the role in immune tolerance induction,aim to provide some insights in clinical immune tolerance induction.