Aim To investigate the effects of bradykinin preconditioning on the damage produced by focal cerebral ischemia-reperfusion in rats.Methods Rats were scheduled to undergo middle cerebral artery ischemia-reperfusion by intraluminal suture.Prior to ischemia,bradykinin was pumped into the brain via extra carotid artery and control group was given the same amount of normal saline.The infarct volume、brain water content、permeability of blood brain barrier and histological neuronal changes were evaluated after 2 h ischemia and 24 h reperfusion.Results Compared with other groups, bradykinin preconditioning 15min before ischemia reduced infarct volume、brain edema、permeability of blood brain barrier and histological neuronal damage.Conclusion Bradykinin preconditioning may provide protective effects against cerebral ischemic injury.This protection may be due to the protection of cerebral vasculature and the decrease of infarct volume.

Objective To investigate lymphovascular invasion (LVI) in mid-low rectal cancer following neoadjuvant therapy. Methods A total of 297 consecutive patients with mid-low rectal cancer received radical surgery from August 2002 to August 2005 at Beijing Cancer Hospital. All patients were divided into the neoadjuvant therapy group and a control group according to whether they underwent preoperative radiotherapy or radiochemotherapy. Histological assessment of tumor specimens was made, and correlation of LVI and prognosis was analysed using the chi-square test. The disease-free survival rate and overall survival rate were analysed by the Kaplan-Meier survival curve. Results The overall positive rate of LVI was 23.9% (71/297). The positive rates of LVI in neoadjuvant therapy group and control group were 21.5% (31/144) and 26. 1% (40/153), respectively,with no significant difference between the groups ( x2 = 0.872, P ＞ 0.05). In the neoadjuvant therapy and control groups, LVI was significantly associated with pathologic T and N stages as well as the degree of histological differentiation (x2 =13.490, 27.401,7.323;16. 188, 21.623, 16.534, P＜0.05). In the control group, LVI was closely associated with local recurrence (x2 =4. 010, P ＜0.05 ), whereas this was not the case in the neoadjuvant therapy group (x2 =0.000, P＞0.05). LVI was significantly associated with distal metastasis in both the neoadjuvant therapy and control groups (x2 = 4.950, 14. 332, P ＜ 0.05 ). The disease-free and overall survival rates of patients with LVI were 46.4% (26/56) and 56.7% (34/60), which were significantly lower than 75.1%(148/197) and 79.4% ( 166/209 ) of those with no LVI, respectively ( x2 = 16. 720, 12.660, P ＜ 0.05 ).Conclusions Neoadjuvant therapy does not significantly reduce LVI;however, the biological behaviour of LVI has changed. Patients with LVI may benefit from neoadjuvant radiotherapy.

Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .

Objective:To investigate the clinical significance of changes of platelet count after splenectomy in patients with cirrhosis and portal hypertension.Methods:In this study,from January 2002 to January 2006,the platelet count and liver function in 153 splenomegaly and hypersplenism due to cirrhosis patients who had been carried out splenectomy were selected.The change tendency of platelet count was observed,the relationship of changes of platelet count and liver function was analysed,and compared with patients of spleen trauma.Results:Postoperative platelet count was higher than preoperatively in most patients with cirrhosis,the portion did not elevate,even decreased.The change tendency of platelet count was correlated with the liver function.The change in cirrhosis patients is not more than patients of spleen trauma.Conclusions:The reason of thrombocytopenia in patients with cirrhosis may be correlated with the change of liver function besides the splenomegaly.

Objective To observe the effect of somatostatin on liver function in patients after splenectomy combined with de-vascularization.Methods The clinical data of 48 patients with liver cirrhosis,portal hypertension and esophageal varices were retro-spectively analyzed,26 cases (somatostatin group)were used somatostatin after splenectomy combined with devascularization,and the other 22 cases (control group)were not used.The changes of serum albumin (Alb),alanine aminotransferase (ALT),aspartate transaminase (AST),prothrombin activity (PTA)and total bilirubin (TBIL)was observed.Results All patients recovered well af-ter surgery,and no deaths occurred.However,ALT,AST and TBIL of using somatostatin group were significantly reduced than those of control group(P <0.05),Alb and PTA were also improved significantly (P <0.05).Conclusion The combination of som-atostatin can not only reduce postoperative portal pressure,control of bleeding,but also to be significantly promote recovery of liver function.

Objective To assess the diagnostic value of determining infarct core and penumbra using CT perfusion source images (CTP-SI) mismatch model in hemispheric stroke less than 9 hours.Methods "one-stop shop" CT examination including non-contrast enhanced CT (NCCT), CTP, CT angiography (CTA) were performed in 24 patients with symptoms of stroke less than 9 hours.The Alberta Stroke Program Early CT Score (ASPECTS) were analyzed on arterial phase CTP-SI and venous phase CTP SI using Wilcoxon rank-sum test, then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median (min-max) scores of ASPECTS on arterial phase CTP-SI, venous phase CTP-SI and follow-up imaging were 9.0 ( 2.0-10.0 ), 9.3 ( 6.5-10.0 ) and 9.0 ( 7.0-10.0 ),respectively. ASPECTS measured on arterial phase CTP-SI significantly differed from the ASPECTS on venous phase CTP-SI ( Z =-2.812, P = 0.005 ).Moreover, the linear regression analysis showed significant correlation between the ASPECTS on venous phase CTP-SI and follow up imaging ASPECTS ( Beta =0.715,P = 0.003 ).Conclusion CTP-SI mismatch model provides a method of choice in predicting penumbra and infarct core in hemispheric stroke.

Objective To detect the prevalence of human cytomegalovirus (HCMV) in peripheral blood of patients with systemic lupus erthematosus (SLE) and explore its role in the pathogenesis of SLE.Methods HCMV DNA was isolated from the peripheral blood leucocytes (PBLs) of 60 patients with SLE and 111 healthy controls.Nested polymerase chain reaction (nPCR) technology was used to investigate the gene of HCMV glycoprotein gB (UL55) in these specimens.HCMV infections in the PBLs of SLE patients were confirmed by HCMV-UL55 detection.Two-sample t test,nonparametric test,Chi-square test and Fisher probabilities were used to analyze.Results Agarose gel electrophoresis and sequencing analysis showed that established nPCR could specifically detect HCMV-UL55 gene,the HCMV infection rate was significantly higher in patients with SLE than in the healthy controls (P＜0.01).Positive rates of HCMV infection in SLE group and controls were 41.7％ (25/60) and 1.8％ (2/111),respectively.Compared to the SLE patients with HCMV-negative PBLs,the positive rate of Rib-P [26％(9/35) vs 56％(14/25),x2=5.659,P=0.017],the positive rate of direct Coomb's test [37％(13/35) vs 72％(18/25),x2=7.096,P=0.008] and the level of antiβ2GP1 [21.3 (9.9,51.8) U/ml vs 13.6 (5.9,23.1) U/ml,U=2.017,P=0.044] were significantly higher than those in the SLE patients with HCMV-positive PBLs.Compared to the SLE patients with HCMV-negative PBLs,the number of red blood cells [(3.65±0.10)×1012/L vs (3.17±0.17)×1012/L,t=2.574,P=0.013] and lymphocytes [(1.37±0.14)×1012/L vs (0.90±0.13)×1012/L,t=2.456,P=0.017] in peripheral blood and the hemoglobin levels [(110±19) g/L vs (98±5)g/L,t=2.034,P=0.048] of the SLE patients with HCMV-positive decreased significantly.At the same time,the positive rate of hematuria [40％(14/35) vs 72％(18/25),x2=6.000,P=0.014] and 24 h proteinuria [0.80 (0.53,2.37)g vs 0.48 (0.13,1.21)g,U=2.140,P=0.032],which indicated kidney damage were also significantly increased in SLE patients with HCMV-positive PBLs.Conclusion The infection of HCMV in peripheral blood cells may take part in the development of SLE.

Objective To clarify the role of syk kinase in inflammasome activation in mouse peritoneal macrophages during Listeria monocytogenes (LM) infection. Methods Murine peritoneal macrophages were randomly divided into BAY treatment group, SB treatment group, WO treatment group, no treatment group and negative control group (NI). There were three wells in each group. The syk inhibitor BAY 117082, P38MAPK inhibitor SB203580 and PI3K inhibitor wotamine were used to treat murine peritoneal macrophages for 1h in BAY treatment group, SB treatment group and WO treatment group. Murine peritoneal macrophages were infected with LM for 24 h except NI group. The protein level of interleukin (IL)-18 in the supernatant was detected by ELISA kit. The activation condition of key molecule ASC in the infected-macrophages cyto-plasm was observed under fluorescence microscope. The phosphorylation levels of syk protein kinase at different time points during LM infection were determined by Western blot assay. Results There was no significant difference in IL-18 protein level before and after BAY treatment in NI group (P>0.05). The IL-18 protein level was significantly lower after LM infec-tion in BAY treatment group compared with that in no treatment group (P<0.05). In contrast, there was no significant differ-ence in IL-18 production between SB treatment group, WO treatment and no treatment group (P>0.05). Meanwhile, the per-centage of ASC-speck positive cells was obviously diminished in BAY treatment group compared with that in no treatment group (P<0.01). The phosphorylation levels of syk were significantly increased in 5 min, 15 min and 30 min post-infection. Conclusion Syk kinase signaling is involved in the inflammasomes activation upon Listeria monocytogenes infection in mu-rine macrophages.

Objective To investigate the effect of before and after combination therapy of thalidomide and methotrexate (T+M) on regulatory T cells and IL-6 expression profile,and to reveal the mechanism of therapeutic effect of T+M on rheumatoid arthritis.Methods A total of 58 patients with rheumatoid arthritis from August 2014 to August 2016 in the Third Affiliated Hospital of Wenzhou Medical University.The flow cytometry assay and enzyme-linked immunosorbent assay (ELISA) were used to estimate the ratio of peripheral blood regulatory T cells and expression profile of IL-6 in peripheral blood lymphocyte before and after combination therapy of thalidomide and methotrexate .Results After combination therapy of T+M,the ratio of peripheral blood CD25 +Foxp3/CD4 +T cells had a marked increase compared with before combination of therapy of T +M;but the expression of IL-6 had a significant decrease in the group of after combination therapy of T +M compared with before combination therapy.Conclusion The effect of combination therapy of T+M on rheumatoid arthritis is associated with increasing the ratio of regulatory T cells and decreasing the secretion of IL-6 that could regulate T cells to homeostasis.

Objective To investigate the diagnostic value of CTP-SI in acute stroke less than 9 hours.Methods In present study."one-stop shop"CT examination were performed in 34 patients with symptoms of acute stroke in le88 than 9 hours.We divided patients into two groups according to with and without delayed perfusion on CTP-SI.and compared ASPECTS (Alberta Stroke Program Early CT Score Study)scores on non-contrast CT(NCCT),arterial phase CTP-SI,venous phase CTP-SI with follow-up imaging.The ASPECTS were analyzed on arterial phase CTP-SI and veIlous phase CTP-SI using Wilcoxon rank-sum test.then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median(min-max)scores of ASPECTS on NCCT,arterial phase CTP-SI,venous phase CTP-SI and follow-up imaging were 9.0(6.0-10.0),6.5(1.0-8.0),8.0(3.0-10.0)and 7.0(0-10.0)in group with delayed perfusion,respectively,and 9.0(1.0-10.0),8.5(1.0-10.0),8.5(1.0-10.0)and 8.0 (0～10.0)in group without delayed perfusion respectively.ASPECTs scores measured on arterial phase CTP-SI did not differ from venous phase CTP-SI in group without delayed perfusion ( Z = - 1.00, P =0.317), while there was significant difference in group with delayed perfusion (Z = -3.08, P = 0.002 ).There were significant correlation with ASPECTS scores measured on NCCT, arterial phase CTP-SI and venous phase CTP-SI to follow-up imaging ASPECTS (r =0.899,0.926,0.928,P ＜0.01 ) in group without delayed perfusion; ASPECTS measured in venous phase CTP-SI showed the best correlation to follow-up imaging ASPECTS (r = 0.762, P = 0.004) in group with delayed perfusion.Multiple linear regression showed that the correlation in only venous phase CTP-SI with foUow-up imaging ASPECTS was statistically significant:in group without delayed perfusion, Beta = 0.966, P ＜ 0.001 ; in group with delayed perfusion,Beta = 0.765, P = 0.004. Conclusion Presence of delayed porfusion in CTP-SI is quite important in identifying ischemic penumbra, which plays a critical role in imaging-guided thrombolytie therapy.