Objective To study the clinical features and treatment of the patients with Takayasu's arteritis (TA) with cerebral infarction.Methods Retrospective analysis was done in 14 TA patients with cerebral infarction from 1998 to 2003.Results The patients with TA complicated with cerebral infarction accounted for 10.6%(14/132) of all the hospitalized patients with TA.The time from cerebral infarction to the symptom onset of TA was 1 month to 15 years.In all the cases,there were more than 3 branches stenosis or occlusion of aortic arch and hemiparalysis.Basal ganglion was the most frequently involved infarction area.Corticosteroid and cytotoxic drugs were effective therapy.Conclusion The cases of TA with cerebral infarction have extensive arterial lesions.We must pay attention to it to avoid misdiagnosis.The key point of treatment is to control the primary disease.

Objective:To obtain flavonoids of Cacumen Platycladi with high purity by using the method of ultrasonic emulsification combined with ultrafiltration membrane separation.Methods:Seven compounds including myricetrin as the reference substances,an HPLC method was used for the content determination.Using the single factor experiments,ultrasound,microwave,reflux and ultrasonic emulsification were compared,and using the orthogonal experiments,the ultrasonic emulsification time,ethanol concentration,solid-liquid ratio and times were studied.Biomax-5 membrane was adopted to improve the membrane separation.Results:The single factor experiments showed the homogeneous extraction method with the highest contents.The orthogonal experiments showed the optimal extracting conditions as follows:the ultrasonic emulsification time was 15 min,the ethanol concentration was 50%,the material-liquid ratio was 1∶10,and the extraction times was 3.The conditions of ultrafiltration membrane separation were as follows:the flow rate was 1.5 L·min-1,and the membrane separation pressure was 0.8 kg.Conclusion:The combination of ultrasonic emulsification and ultrafiltration membrane separation is feasible in the extraction and purification of flavonoids in Cacumen Platycladi,and the product is with high purity,suggesting the method has good application prospect.

Objective To investigate the relationship between bone marrow micrometastasis of patients with breast cancer and clinical pathological parameters, some molecular markers as well as prognosis.Methods The expression of hMAM mRNA in BM of patients with breast cancer was detected by RT-PCR.The expressions of ER, PR in cancer tissues were detected by immunohistochemical SP method. Results About 38.2 % positive expression rate of hMAM mRNA in 102 patients with stage Ⅰ -Ⅳ breast cancer was found.The expression of hMAM increased more in patients with T2-3 (＞2 cm) tumors than T1 (≤2 cm) (P =0.001)and with stage Ⅱ ,Ⅲ than stage Ⅰ (P =0.001). The expression of hMAM in the BM of breast cancer with grade I was lower than that of grade Ⅱ or Ⅲ (P =0.014). The expression of hMAM in the BM was related to the pathological type (P =0.032) and the axillary lymph node metastasis (P =0.001). The expressions of hMAM in BM were much higher with ER negative in breast cancer tissues (P ＜0.05). There was a correlation between patients with positive expression of hMAM in BM and distant metastasis (P =0.009). Conclusion The micrometastasis in BM is correlated with some clinical pathological parameters and some tumor markers. The patients with positive expression of hMAM in BM have more chances with distant metastasis and poor prognosis. The detection of micrometastasis may be as one of targets to predict the prognosis of breast cancer.

Objective To study the changes of plasma endothelial microparticles (EMP) in children with Kawasaki disease (KD) and its relation to coronary artery lesions (CAL).Methods The participants in this study were 30 children with KD (24 children with typical KD and 6 cases with incomplete KD).All KD patients met the diagnostic criteria established by the Japanese Kawasaki Disease Research Committee.According to the course of KD,3 phases were divided:the acute phase,the subacute phase and the convalescent phase.We evaluated the presence of CAL using two-dimensional echocardiographic examination,and then the KD children were divided into two groups,including 24 children without CAL and 6 children with CAL.Ten children with fever and rash and 10 healthy children were studied as control.The levels of CD31+/CD42b- EMP were measured by flow cytometry.Results The level of EMP was significantly higher in the acute phase [ (8.18 ± 2.29) ％ ] than those either in the convalescent phase [ (2.77 ± 0.85 ) ％ ] of KD or the healthy children [ ( 1.34 ± 0.38 ) ％ ] (P ＜ 0.01 ).The level of EMP was also significantly higher in the subacute phase [ (5.93 ± 1.05 )％ ] than those either in the convalescent phase of KD or the healthy children (P ＜0.01 ).The level of EMP was higher in the children with fever [ (3.66 ± 1.16) ％ ] than that in the healthy children ( P ＜ 0.05 ).Furthermore,the level of EMP during the acute phase was also higher in KD patients with CAL than in those without CAL(P ＜0.01 ).Conclusion The measurement of EMP may be useful for the early diagnosis of KD and the identification of CAL.

Objective T o determine the normal range of the 33 elements (Li, Be, B, mg, Al, Ca, Ti, V , Cr, mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Rb, Sr, Zr, mo, Ag, Cd, Sb, Cs, Ba, Au, Hg, Tl, Pb, Th and U ) in human whole blood of general population in Hunan province. Methods Blood samples were ana-lyzed by inductively coupled plasma-mass spectrometry (ICP-mS ) to determine the normal range. T he influences of district, gender and age to the element content in blood samples were also observed. Re-sults T he normal range of 33 elements in blood samples fromgeneral population in Hunan province were obtained. Gender was shown to statistically influence the concentrations of B, mg, Ca, Ti, mn, Fe, Co, Cu, Zn, As, Se, Rb, Sr, Ag, Cd, Cs, Hg and Pb (P<0.05), while age was shown to influence the concentrations of Co, Ni, Cs and Hg in women (P<0.05) as well as Cu, Se and Hg in men(P<0.05). Conclusion Although there are variables in different districts, the normal ranges of trace element in blood of the four cities in Hunan province are established.

Objective To analyze the incidence of the disease, clinical features, diagnostic criteria, therapy and prognosis of Penicilliosis marneffei found in Guangdong province. Methods To analyze patients data, clinical features, laboratory findings, response to therapy, and prognosis of 15 cases Penicilliosis marneffei found in Guangdong province of China. Results The male was predominant compared with the female (ratio 2 to 1) and without occupational preference, but the patients with AIDS as underlying disease were mostly drivers and the unemployed. Thirteen patients were immunocompromised such as AIDS, connective tissue disease, and kidney transplant. Clinical features showed different manifestations, such as high fever, loss of weight, skin lesion, and respiratory system symptoms. Biopsy of the skin lesion showed PAS stain positive yeast-like, or sausage-form spores. Four patients were localized infection of the skin, eleven patients were systemic infection. Nine patients died, five recovered, 1 patient refused to be treated. Fifteen isolates from different anatomic sites of the patients were identified to be Penicillium marneffei by morphology and dimorphism in the culture, and eleven isolates among these 15 isolates were also confirmed by DNA sequence analysis. Conclusion The incidence rate of Penicilliosis marneffei become higher in the recent years and many patients were accompanied with AIDS in Guangdong province. Attention should be paid to the disease.

Objective To investigate current status of schistosomiasis control system at the county level and make recommendations to improve the infrastructure adapting to the prevalent condition of the disease. Methods Through pertinently sampling and semi-quantitative questionnaire among the professional workers, experts and administrators in schistosomiasis control, the primary weaknesses involved in the management system and human resources were analyzed. Results 380 questionnaires were distributed, 33 out of 40 were returned from experts/administrators and 285 out of 340 were received from the professionals. In general, the participants acknowledged the effectiveness of the mechanism on anti-schistosomiasis campaign during the past 40 years. It was found that lack of funds for schistosomiasis control and the poor administrative model of anti-schistosomiasis activities were the main barriers to the control. About half of the participants agreed that the policy about merging the county level anti-schistosomiasis facilities into the Center for Disease Prevention and Control (CDPC) system. The study also showed an inbalanced distribution of the manpower for schistosomiasis control across the endemic regions. The dropout rate of human resources was high due to the poor management and welfare. Conclusion Reforms on the management model should be performed and multiform compensation system should be built in accordance with the prevalence and trends of schistosomiasis.

ObjectiveTo assess revascularization and vessel anastomosis in digital replantations with DSA.MethodsTwelve cases of digital replantations underwent digital subtract angiography during 2 to 4 days after fingers reattachment. The vessel anastomosis,hemodynamics,stenosis and discontinuation were investigated.The unobstructed and smooth anastomosis was suggested as early stage survival of the reattached fingers,the spasm and stenosis of the reattached vessels were considered as mild vascular crisis,and the discontinuation of hemodynamics were indicated as severe vascular crisis.ResultsThe total 27 vessels were clearly displayed on DSA.Of these vessels,23 vessels were unobstructed and smooth,all digits were survived.Diagnosis coincidence of early stage survival was 100%(23/23). Two vessels were obstructed,which were testified having thrombus by operation research.The other 2 vessels were spasm,the digits were also survived ultimately by expectant treatment.All 4 abnormal vessel anatomosis were found by DSA.Conclusion DSA is important modality in assessing revascularization and blood circulation for digital replantations,guiding in dealing with the vascular crisis,and in predicting early stage survival of the reattached digits.

Objective: To analyze the clinical characteristics of Kawasaki disease in infants and explore the risk factors of coronary artery abnormities in Kawasaki disease. Methods: The clinical data of 300 children with Kawasaki disease from January 1, 2018 to December 31, 2018 were retrospectively analyzed, including laboratory tests and coronary ultrasound results.The clinical characteristics of infants with Kawasaki disease and elderly children with Kawasaki disease were compared.The risk factors of coronary artery injury in infants with Kawasaki disease were analyzed. Results: The majority of infants with Kawasaki disease were atypical Kawasaki disease, and the typical changes of conjunctival congestion, perianal changes and plaque were significantly higher than those of elderly children (P<0.01). Leukocyte count and platelet count were higher in the infant group, and the number of children with abnormal liver function was significantly higher than that in the older group (P<0.05). Coronary artery dilatation occurred in 11% of infants with Kawasaki disease, and most of them returned to normal within 3 months.Logistic model design was used to analyze the risk factors of coronary artery injury in infants with Kawasaki disease.It was found that boys and CRP increased significantly were the risk factors of coronary artery injury in infants with Kawasaki disease. Conclusion Infant Kawasaki disease has its own characteristics.The incidence of coronary artery injury is high.Timely diagnosis, differential diagnosis and symptomatic treatment may reduce the incidence of coronary artery injury.At the same time, follow-up should be maintained to monitor the changes of coronary artery by echocardiography.

BACKGROUND:Percutaneous injection of bone cement into the vertebral body can enhance the vertebral strength and vertebral stability, and obtain pain relief. But the bone cement may leakage into the paravertebral vessels during injection, and may back to the right ventricle and flow into the pulmonary artery through vena cave and thus causing pulmonary embolism.
OBJECTIVE:To evaluate the relationship between cement paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty.
METHODS:Total y 134 cases of osteoporotic compression fractures treated with vertebroplasty were retrospectively analyzed. Among them, 23 cases of cement paravertebral vascular leakage were considered as the experimental group, and the 43 cases without cement paravertebral vascular leakage and had the complete imaging data were considered as the control group. The spine and chest X-ray films were taken before and after vertebroplasty to detect whether there were cement paravertebral vascular leakage and pulmonary cement embolism in the patients of two groups.
RESULTS AND CONCLUSION:Among the 134 patients, 23 patients had cement paravertebral vascular leakage, and accounted for 17.2%. Among the 23 patients with cement paravertebral vascular leakage, three cases had pulmonary cement embolism without chest symptoms, and accounted for 13%. No pulmonary cement embolism occurred in the 43 patients without paravertebral vascular leakage of the control group, and there was no significant difference between two groups (P=0.039). Although the patients with cement pulmonary embolism remained asymptomatic, pulmonary cement embolism remained possible if cement paravertebral vascular leakage was detected during vertebroplasty.