Objective To explore the different changes of the adult cerebral blood flow with ages,different weight and gender,to summarize the changing characteristics of cerebral blood flow.Methods 360 cases of examination were divided into two groups according to gender,and were divided into five groups at different ages,and were divided into four groups according to body mass index,using TCD detector blood flow velocity.Results 196 cases of male physical examination,the mean cerebral blood flow was (969.37 ± 117.54)ml/min;the 164 females physical examination,the average cerebral blood flow was (987.76 ± 114.34)ml/min,there was no statistically significant difference (P ＞ 0.05).Different ages cerebral blood flow velocity were different,20 to 29-year-old group and the 30 to 39-year-old group had no significant difference (P ＞ 0.05) ;40 to 49-year-old group,50 to 59 years,60 to 69 years old ＞ 70 age group significantly declined compoued with the first two groups,there was significant difference (P ＜ 0.05) ;there were significant difference between the four groups (P ＜ 0.05).Overweight and obese group were significantly lower than the light and the normal group,there was a statistically significant difference (P ＜ 0.05).Conclusion TCDcan be a sensitive and accurate hemodynamic changes in the human brain,and is very important in the early diagnosis,prevention,treatment,and follow-up of cerebrovascular disease.

Objective To investigate the role of the ERG11 gene in the drug resistance of Trichosporon asahii (T.asahii), and to explore the relationship between the gene expression and drug concentrations. Methods Stable fluconazole-resistant strains of T.asahii were induced in vitro following exposure to a series of concentrations of fluconazole. Fluconazole-sensitive and-resistant strains of T.asahii were separately cultured in the medium containing fluconazole at concentrations of 0, 0.25, 0.5, 1, 2, 4, 8, 16, 32 and 64 μg/ml. Real-time quantitative PCR was performed to determine the mRNA expression of ERG11 gene. Results In fluconazole-free medium, the fluconazole-resistant strain of T.asahii showed significantly increased mRNA expression of the ERG11 gene compared with the fluconazole-sensitive strain (7.542 ± 5.311 vs. 1.014 ± 0.012, t=3.002, P=0.03). Additionally, the mRNA expression of ERG11 gene was also significantly higher in the fluconazole-resistant strains than the fluconazole-sensitive strains in the culture medium containing fluconazole at different concentrations of 0.25 (9.183 ± 3.226 vs. 3.281 ± 2.068), 0.5(13.657 ± 5.428 vs. 3.459 ± 1.923), 1(15.292 ± 7.007 vs. 3.242 ± 2.530), 2(13.720 ± 8.550 vs. 3.651 ± 0.728), 4(13.949 ± 2.960 vs. 3.969 ± 1.924)and 8(13.123 ± 6.429 vs. 3.824 ± 1.875)μg/ml(all P<0.05). However, no significant correlation was observed between the mRNA expression of ERG11 gene and fluconazole concentrations(fluconazole-resistant strains: rs = 0.229, P = 0.096; fluconazole-sensitive strains:rs=0.166, P=0.357). Conclusion Overexpression of ERG11 gene is associated with fluconazole resistance in T.asahii, but there is no correlation between the mRNA expression of ERG11 gene and fluconazole concentrations.

To analyze and compare the protective effects of active components in different ethyl acetate extracts (EAEEPs) from Eclipta prostrate, in order to study the comparison of materials bases protecting normal human bronchial epithelial (NHBE) cells. The MTT assay was taken to compare the protective effect of different EAEEPs on cigarette smoke extracts (CSE) -induced NHBE cells. The ultra-performance liquid chromatography (UPLC) was applied to analyze the content of phenolic acid, coumaric grass ether and flavonoid in EAEEPs. According to the results, all of the eight EAEEPs (0-200 mg x L(-1)) showed certain protective effect on NHBE cells, with statistical difference. Specifically, the total mass of EAEEP VII (89.15 mg x L(-1)) and EAEEP VIII (57.44 mg x L(-1)), which showed the strongest activity, was not the highest, while EAEEP III (132.25 mg x L(-1)) displayed the highest total mass. In the combination with the "component structure" theory, the analysis showed a significant difference in the mass structure among phenolic acid, coumaric grass ether and flavonoid in EAEEP VIII and EAEEP VIII, which were 1.0: 1. 0: 0.5 and 1.0: 1.9: 0.8, respectively. The results suggested a specific optimal "component structure" relationship may exist in EAEEP, which could provide reference for the material base study and quality control.
Bronchi ; cytology ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Eclipta ; chemistry ; Epithelial Cells ; cytology ; drug effects ; Humans ; Protective Agents ; chemistry ; isolation & purification ; pharmacology ; Tobacco Smoke Pollution ; adverse effects

Objective To discuss the outcomes of the clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy. Methods 75 patients (11％) with CIRF among 655 who underwent initial MPCNL from January 2008 to December 2010 were diagnosed by CT scan.Clinical data of 68 patients (39 male and 29 female) were analyzed retrospectively.Previous open surgery hadbeen performed in 13 and ESWL in 20 cases.The median residual fragment size was 1.8 mm.The anatomical distribution of CIRF was 9 at upper pole,14 at middle,34 at lower,9 at renal ureteropelvic junction and 2 at upper and lower pole.Stone analysis showed 40 cases of calcium oxalate calculi,15 of calcium oxalate calculi mixed with carbonate calculi,2 calcium oxalate calculi mixed with uric acid,3 calcium oxalate calculi mixed with struuvite stone,3 struuvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Mean follow up was 23 months (12-36).Follow-up consisted of physical examination,serum routine,urine routine and CT imaging. Results 14(21％) patients (3 upper pole,1 middle pole,4 lower pole and 6 ureteropelvic junction) had symptomatic episodes,including 9 hematuria,2 renal colic pain,5 lower urinary tract symptoms,12 with size of CIRF ＞ 4 rmm.8 patients required surgical procedures.5 patients (1 middle,2 upper pole and 2 renal pelvis) underwent ESWL.3 patients with ureteral CIRF were performed ureteroscopic lithotripsy.The CIRF were clear after surgeries.4 paticnts with CIRF ＞ 4 mm did not have symptoms.These patients were recommended to conservational treatments.2 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.27％ (3/11)CIRF located in upper pole had symptom,compared with 4％ (1/14) in middle pole,11％ (4/36) in lower pole and 67％ (6/9) in ureteropelvic junction. Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or SWL are more likely to get CIRF.Medium-term follow-up of CIRF revealed that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Objective To evaluate the efficacy,safety and impact of recombinant human cytotoxic T lymphocyte-associated antigen (CTLA)-4 fusion proteins (rhCTLA-4Ig) on serum human tumor necrosis factor (TNF)-α and CX3CL1 in active rheumatoid arthritis (RA) patients.Methods Forty-four RA patients were treated with rhCTLA-4Ig and placebo.Clinical response was assessed by American College of Rheumatology (ACR) criteria and disease activity score in 28 joints (DAS28).The levels of serum TNF-α and CX3CL1 were determined in 44 RA patients and 20 healthy controls by enzyme-linked immunosorbent assay (ELISA).Comparisons between groups were performed by t-test or x2 test.Results At week 12,ACR20,ACR50and ACR70 responses in RA patients with rhCTLA-4Ig were achieved by 95％(20/21 ),76％( 16/21 )and 19％(4/21) respectively,but no patient with placebo achieved ACR20,ACRS0 and ACR70 responses.There were significantly statistical differences in ACR20 and ACR50 responses (x2=39.17,26.69,P＜0.01 ).At week 12,the mean DAS28 in the rhCTLA4Ig group was 3.1±1.3 versus 6.2±1.1 at baseline (P＜0.01).Similarly,health assessment questionnaire (HAQ) improved significantly,declining from 1.4±0.5 at baseline to 0.4±0.5 at week 12 (P＜0.01).However,the mean DAS28 in the placebo group was 5.8±1.2 versus 6.0±0.7 at baseline (P＞0.05),HAQ declined from 1.6±0.4 to 1.6±0.6 (P＞0.05).In addition,there were higher levels of TNF-α and CX3CL1 in the active RA patients than those of the healthy controls (P＜0.01).After 12 weeks therapy,Serum TNF-α and CX3CL1 levels in the rhCTLA-4Ig group decreased significantly (P＜0.01).There weren't decline in the placebo group (P＞0.05).Conclusion This study has shown that rhCTLA-4Ig is very effective in reducing disease activity,improving function during the 12 weeks treatment.rhCTLA-4Ig therapy for 12 weeks can lead to significant decrease of serum TNF-α and CX3CL1.

ObjectiveTo study the metastructure volumes of medial temporal lobe in diagnosis the patients with Alzheimer's disease (AD) using 3 dimensional MRI.Methods23 AD patients according to DSM-Ⅳ criteria and 23 normal controls (NC) were examined with 3D-MRI.Hippocampus formation,amygdala,entorhinal cortex ( EC ),perirhinal cortex ( PC),and comu temporale were measured with 3D-MRI.ResultsSensitivity and specificity of diagnosis AD were 73.9％,97％ ( Hippocampus formation) ;39.1％,95.7％ (amygdala) ;73.9％,95.7％ (EC) ;95.7％,87.0％ (PC) and 34.8％,39.1％ ( cornu temporale).Overall discriminate function =cornu temporal × 3.887 + PC × 5.960 - EC × 0.074 + amygdale × 3.489 + hippocampus formation × 6.656- 22.449.Over-all-accuracy was 91.3％.ConclusionThe total volume of PC can better diagnosis the mild to moderate AD than other structure of medial temporal lobe.The changes of the medial temporal lobe volume could be used in diagnosis the patients with Alzheimer's disease.

Background Normal adult optic disc rim width follows inferior ≥ superior ≥ nasal ≥ temporal (ISNT) rule.Analysis of the optic disc structural parameters with Heidelberg retina tomograph (HRT) can understand whether ISNT principle is suitable to other optic disc structure parameters.Objective This study was to investigate the characteristics of optic nerve head structure parameters in normal Chinese adults.Methods The parents of twins who participated Guangzhou Twin Eye Study were enrolled in Zhongshan Ophthalmic Center from 2006 June to 2011 August.All subjects received the routine eye examinations,including visual acuity,slit lamp microscope,direct ophthalmoscope examination,auto-refraction examination and HRT Ⅲ examination.All data from the right eyes were collected and analyzed.HRT values from different quadrants of optical nerve head were compared with one-way analysis of variance,and the multiple comparison between quadrants was carried out by Bonferroni test.The differences of optical nerve head parameters in different gender were analyzed using independent sample t test and Bland-Altman test.Results In this study,1672 eyes of 1672 subjects were included,with the 759 male and 913 female persons and average age of (41.8±5.3)years.No significant differences were seen in the disc area (DA)between the superior and inferior,as well as the nasal and temporal quadrants among the subjects (P＞0.05).In addition,there were not significantly different in the rim area (RA) between the superior and nasal disc as well as the rim volume (RV) among the inferior,superior and nasal disc (P＞O.05).However,significant differences were found in the cup area (CA),cup/disk area ratio (C/DAR),cup volume (CV),mean cupdepth (MCD),maximum cup depth (MxCD),height variation contour (HVC),cup shape measure (CSM),mean retinal nerve fiber layer thickness (mRNFLT) and retinal nerve fiber layer cross section area (RNFLcsa) among the different quadrants (P＜0.001).The local differences from only DA and RA complied with an ordination of the ISNT rule.The values of DA,CA,C/DAR,CV,MCD,MxCD from male individuals were higher,but those of the RV,HVC,mRNFLT RNFLcsa were lower in comparison with female individuals.Nevertheless,all the differences were ＜ 0.1 with a maximal mean difference in DA and CA (both 0.07 mm2).Conclusions The optical nerve head configurations measured by HRT have different distributing characteristics in four quadrants in normal adults.Most parameters show the higher values in the inferior and superior than those in nasal and temporal of disc,but DA and RA meet ISNT rule.The differences of most parameters between male and female subjects can be ignored.

Background Heidelberg Retinal Tomograph (HRT) has been widely used in clinical diagnosis of glaucomatous optic neuropathy,importantly,the measurement results of HRT may be affected by myopia.Therefore,studying the effect of different refractive status and axial length on structural parameters of the optic disc is important.Objective This study was to evaluate the influence of refractive error and axial length to optic nerve head parameter measured by HRT.Methods The parents who participate in Guangzhou Twin Study were enrolled in this investigation from July 2006 to August 2011.The regular eye examinations,including visual acuity,slit lamp,fundus,auto-refraction,HRT-Ⅲ and intraocular lens (IOL) Master,were performed on all the subjects.Thc data from right eyes of subjects were collected and analyzed.The linear correlation analysis and multiple linear regression analysis were applied to analyze the correlation between HRT optic papilla configuration parameter and equivalent sphere and ocular axis length.Results A pilot prospective series cases observational study was designed.1748subjects were enrolled in this study.The disc area (DA) (P=0.021),rim area (RA) (P＜0.001),rim volume (RV) (P＜0.001),mean retinal nerve fiber layer thickness (mRNFLt) (P＜0.001) and retinal nerve fiber layer cross section area (RNFLcsa) in the high myopia were greater than those of the emmetropic group,with significant difference between the two groups (P＜0.001).However,the cup area (CA),cup/disk area ratio (C/DAR) and cup volume (CV) were less in the high myopic group than those of the emmetropic group (P=0.004,P＜0.001 and P＜O.001),respectively.In the mild-moderatc myopic group,the RV,mRNFLt and RNFLcsa were greater than those of the emmetropic group (all of the P value less than 0.001),but the numbers of DA,CA,C/DAR,and CV were less than those of the emmetropic group,the differences were significant and their P valuables were 0.038,＜ 0.001,＜0.001 and 0.001 respectively.The differences of structure parameters between the hyperopia group and the emmetropic group were not statistically significant (P＞0.05).The DA,CA,RA,C/DAR,CV,RV,mean cup depth (MCD),maximum cup depth (MxCD),cup shape measure (CSM),mRNFLt and RNTLcsa were (2.04±0.43) mm2,(0.49±0.34) mm2,(1.55 ± 0.34) mm2,0.23-0.13,(0.11 ± 0.12) mm3,(0.45 ± 0.19) mm3,(0.21 ± 0.09) mm,(0.60±0.21) mm,-0.21 ± 0.07,(0.29 ± 0.07) mm and (1.46 ± 0.36)mm2,respectively,in the 1748 eyes of 1748 subjects.No significant correlation was found between the DA value with SE (r=-0.032,P =0.186).However,weaker positive correlations were seen between the CA,C/DAR,CV,MCD,MxCD with SE (r=0.139,0.163,0.130,0.004,0.054,P＜ 0.05) and negative correlation between RA,RV,mRNFLt and RNFLcsa with SE (r =-0.178,-0.331,0.241,-0.239,P＜0.001).With the increase of the ocular axial length,the DA,RA,RV,mRNFLt and RNFLcsa values were enlarged,and the CV value was smaller.With the increase of CA,the RA,C/DAR,CV,RV,MCD,MxCD,CSM and RNFLcsa values elevated,but mRNFLt value was decreased.Conclusions Refractive error is not associated with DA,but the measuring results are different among various refractive groups.Refractive error,ocular axial length and DA affect the measuring result of HRT.

Objective To assess the safety and efficacy of a novel technology referred to as percutaneous ureteroscopic laser deroofing in the management of renal cysts.Methods From November 2014 to August 2016,59 patients having surgical indications with renal cysts were enrolled and evaluated by ultrasound and CT scan.Of all the 59 patients,36 were males and 23 were females.Their mean age was 46 years (ranging 35-64 years).41 patients complained about the reported flank and abdominal pain.18 patients were found by imaging examination.Their mean diameter of cyst was 6.3cm(ranging 4.9-9.1cm).In regards to the 59 patients,include 6 patients suffered with parapelvic cysts and 4 patients suffered with renal cyst complicated with ipsilateral renal calculi.Their mean stone surface area was 5.7 cm2 (ranging 3.4-9.8 cm2).All of the patients received combined spinal and epidural analgesia or paravertebral nerve block anesthesia.Patients were placed in the prone position for percutaneous puncture and tract dilation.Under ultrasound guidance,an eighteen gauge needle was placed inside the cyst cavity percutaneously,a metal guidewire was introduced followed by sequential dilation up to F26-28.9.8F rigid ureteroscope was inserted through the Amplazt access sheath and advanced into the cyst cavity.Then sheath and ureteroscope both returned to the exterior cyst together.Cyst wall was dissociated from perirenal adipose tissue by used ureteroscope.A majority of the collapsed cyst wall was grasped and gently pulled towards the Amplazt sheath interior using grasping forceps and incised using either Thulium (Power 40 ～50W) or Holmium laser(Power 60 ～70W) and was taken for pathological examination.Nephrostomy tube was left in place for 2-3 days and removed before discharge.For parapelvic cysts patients,ureter stent was inserted into the renal pelvis i n the dorsal lithotomy position firstly.Patients were then placed in the prone position for percutaneous puncture and tract dilation.Laser was used to incise cyst wall towards identified pelvis to create a permanent communication between the cyst and adjacent renal collecting system.F6 double-J stent was inserted into the cyst cavity at the end to prevent auto-closure for at most two months.F22 nephrostomy tube was left in renal pelvis for two weeks.For renal cyst complicated with ipsilateral renal calculi patients,a puncture was created targeting the stone through the cyst,after fragmenting and extracting the stone,the same laser was used to deroof the cyst.More than 50％ reduction in cyst volume was considered a success.The perioperative complications,hospitalization days and the effective rate of surgery were evaluated.Results All operations were conducted without intraoperative complications such as bleeding,urinary leakage or injury of the renal parenchyma and the adjacent organs.The hospital stay after the surgery was 2-4 days (mean 2.5 days).After 3-12 months follow-up (mean 8.1 months),patients underwent imaging examinations.42 out of 59 cases were completely resolved,15 were reduced to less than 50％,the total effective rate for the operation is 96.6％ (57/59).4 patients with ipsilateral renal calculi were completely clear.However,two cases failed probably due to incomplete resection and follow treated with laparoscopic renal cyst deroofing.Conclusions Percutaneous ureteroscopy renal cyst laser deroofing is a safe,effective,less invasive,which can be performed in any endourological center without the need of special instruments and training.

Objective To assess and compare the effectiveness of gadolinium diethylenetriamine pentacetic acid(Gd-DTPA) solution and barium sulfate(BaSO4) suspension with different concentrations in improving the imaging quality of magnetic resonance cholangiopancreatography(MRCP). Methods The phantom study was carried out to determine the optimal concentration of Gd-DTPA and BaSO4 suspension used as an oral negative contrast agent in MRCP.The patients were grouped randomly and performed MRCP before and after using oral contrast agents in combination with intravenous injection of contrast agents.A comparison of the influence of BaSO4 suspension and Gd-DTPA with different concentrations on the signal intensity of the fluid in gastrointestinal tract on MRCP images was made.Results The phantom study showed that the dilution ratio 1∶10 of Gd-DTPA solution and 100%(W/V)BaSO4 suspension were the optimal concentrations in decreasing the signal intensity.In all patients the high signal intensity of the gastrointestinal fluid was completely suppressed after oral administration of Gd-DTPA diluted solution(P