Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.

Aim To investigate the immunoregulative action of polysacchrides of Spirulina platensis ( PSP ) on peripheral blood mononuclear cells ( PBMCs) in pa-tients with chronic hepatitis B virus infection. Meth-ods Proliferation and cycle of PBMCs from patients with chronic hepatitis B virus infection were measured by MTT colorimetry and flow cytometry respectively. The concentration of IFN-γ, IL-2 , IL-4 in supernatants of PBMCs were examined by ELISA. The mRNA ex-pression of IFN-γin PBMCs from patients with chronic hepatitis B virus infection was detected by RT-PCR. Results PSP could induce proliferation of PBMCs in patients with chronic hepatitis B virus infection. In ad-dition, PSP could increase the protein expression of IFN-γ and IL-2 in supernatants of PBMCs in patients with chronic hepatitis B virus infection, and PSP could also enhance the mRNA expression of IFN-γof PBMCs in patients with chronic hepatitis B virus infection. However, PSP inhibited the protein expression of IL-4 of PBMCs in patients with chronic hepatitis B virus in-fection. Conclusion PSP can promote the immune function and plays an important immunoregulation function on patients with chronic hepatitis B virus in-fection.

Objective To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE),which is helpful to the differential diagnosis.Methods Outpatients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study.Clinical data were comprehensively collected.Incidence of disease,severity,frequency of esophageal and extraesophageal symptoms,and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.Results Totally 446 subjects were recruited,including 225 patients with NERD and 221patients with RE.The occurrence rates of esophageal symptoms including heartburn [76.0％ (171/225) vs 52.0％ (115/221),P ＜ 0.01] and acid regurgitation [74.7％ (168/225) vs 54.3％ (120/221),P ＜0.05] in NERD group were significantly higher than those in RE patients,with more severe and frequent (P ＜ 0.05).Despite the rates of food regurgitation were similar,NERD patients behaved more severely and frequently (P ＜ 0.05).Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9％ (92/225) vs 27.6％ (61/221),42.2％ (95/225) vs 31.7％ (70/221),all P ＜0.05] were also higher than those in RE group,the degree of which was more severe too (P ＜ 0.05).RE patients claimed a higher proportion of chronic cough.The incidences of overlapping with IBS in two groups were similar.But there were more patients with FD in NERD group [72.0％ (162/225) vs 62.9％ (139/221),P ＜ 0.05] than in RE group.Conclusions The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different,as well as comorbidities such as FD and IBS.These results suggest that NERD and RE are independent diseases.

Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle factors were collected.First,single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed.Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group (all P >0.05).The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group.According to decision tree model analysis,body mass index (BMI),water intake per day and constipation family history were finally enrolled.The incidence of FC was higher in patients with BMI < 23.56 kg/m2 (except 18.74 to < 19.83 kg/m2 )(79.75 %).The incidence of FC was higher in patients with BMI from 18.74 to <19.83 kg/m2 and water intake <1 L
(66.67%).The incidence of FC was highest in patients with BMI≥23.56 kg/m2 and family history of constipation (70.00%).The total prediction accuracy of this model was 64.6% (42/65 )and area under curve (AUC)value was 0.688.Conclusions FC and IBS-C are related with many lifestyle factors.Low BMI and less water intake per day are influence factors of FC,while higher BMI and family history of constipation are influence factors of IBS-C.

Objective To analyze the overall deployment of Class-A large medical equipments in China.Methods Data of Class A large medical equipments deployed from 2007 to 2015 were collected and classified regionally,for the purpose of measuring the overall deployment,growth level and plan performance.Results There were 403 large medical equipments in China,a rapid rise of deployment,yet still far below developed countries in terms of per capita deployment.Regional differences were significant.With PET-CT as an example,the plan performance in the east(92.19%)was much higher than the west of China(68.57%);plan performance of Class-A equipments was better,conducive to regulating the increase and distribution.Conclusions The deployment level of Class-A equipments in China is low in general,and calls for better regulation regardless of the planning and management progress.

Objective To investigate the correlation between AS160 hyperphosphorylation and 18Ffluorodeoxyglucose (18F-FDG) uptaking in invasive breast cancer.Methods Thirty-nine primary breast caner patients received PET/CT scan before operation and their maximum standard uptake values (SUVmax) were recorded.The levels of p-AS160 (Thr642) were detected using immunohistochemical method in breast cancer tissues.The association between p-AS160 (Thr642) levels and SUVmax was assessed using the Spearman nonparametric test.Results The 18F-FDG uptake of tumors of the 39 patients with primary breast caner was 6.1 ± 2.7 (SUVmax).There was one false negative case in PET/CT scan imaging,compared with postoperative pathologic result.The positive rate of p-AS160 (Thr642) was 76.9％,and it was positively correlated with SUVmax (r =0.672,P ＜ 0.001).Conclusion AS160 plays a significant role in the glucose metablism of breast cancer tissues and its hyperphosphorylation may contribute to the increased uptaking of glucose in patients with breast cancer.

Objective To evaluate the accuracy of thyromental height (TMH) in predicting difficult airway.Methods Three hundred and thirty patients of both sexes requiring endotracheal intubation,aged ＞18 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were selected.The modified Mallampati test (MMT) score,thyromental distance (THD),sternomental distance (SMD) and TMH were measured following admission to the operating room.Direct laryngoscope was placed after induction of anesthesia to expose the glottis,and the Cormack-Lehane grade was recorded.Difficult airway was defined as Cormack-Lehane grade Ⅲ or Ⅳ.The receiver-operating characteristics curve was used to evaluate the accuracy of MMT,THD,SMD and TMH in predicting difficult airway.Results The diagnostic threshold of TMH in predicting difficult airway was 39.04 mm,the sensitivity 88.24％,the specificity 90.42％,the area under the curve (95％ confidence interval) 0.897 (0.859-0.928),and the odds ratio 70.750.Compared with MMT,THD and SMD,the area under the curve of TMH in predicting difficult airway was significantly increased (P＜0.05).Conclusion TMH can accurately predict difficult airway,and the diagnostic threshold is 39.04 mm in patients.

Objective To observe the effects of Eldepryl on expressions of tyrosine hydroxylase (TH) and glial cell line-derived neurotrophic factor (GDNF) in substantia nigra and striatum in Parkinson’s disease (PD) and to explore the protective mechanism of Eldepryl on dopaminergic neuron . Methods Healthy male Sprague-Dawley (SD) rats (n=72) were randomly divided into control group, model group and Eldepryl group (n=24 in each group). Each group was divided random?ly into 2 subgroups as 4 day treatment group and 8 day treatment group (n=12 in each subgrop). Pakinson’s disease model was established by injecting rotenone subcutaneously back the neck, rats in the control group were injected with an equal vol?ume of sunflower oil subcutaneously at the same location. Rats in the Eldepryl group were then given Eldepryl 0.5 mg·kg-1 in?tragastrically every day for 4 or 8 consecutive days and rats in model group and control group were given an equal volume of saline instead. The expression of TH and GDNF in substantia nigra and striatum were detected by immunohistochemistry and Western blotting. Results Immunohistochemistry and Western blotting showed that strong expression of TH positive cells with little expression of GDNF positive cells were seen in substantia nigra and striatum in rats of control group, and there was no significant difference between subgroup of 8 day treatment and 4 day treatment within control group. The expression of TH cells and GDNF were both significantly reduced in model group compared with those in control group (both P<0.05), and there was no significant difference between subgroup of 8 day treatment and 4 day treatment within each group. The ex?pression of TH positive cells were significantly reduced in Eldepryl group compared with those in control group, and were sig?nificantly increased compared with those in model group. The expression of GDNF positive cells were significantly increased in Eldepryl group compared with those in control group and model group (all P<0.05). And there were significantly more ex?pression of TH positive cells and GDNF positive cells at subgroup of 8 day treatment compared with those at subgroup of 4 day treatment within Eldepryl group with (all P<0.05). Conclusion These data suggest that Eldepryl can protect the dam?age of dopaminergic neurons in substantia nigra and striatum of PD rats. And its therapeutic mechanism may be associated with increased expression of GDNF.

Aim To investigate the effect of indirubin derivative PHⅡ-7 and TRAIL on proliferation in breast cancer cell MCF-7 and its MDR counterpart MCF-7/ADR and the mechanism.Methods Growth inhibition rate was examined respectively by MTT assay under treatment with TRAIL or PHⅡ-7 or in combination. Cell apoptosis and ROS production were examined by flow cytometry.The change of TRAIL receptors(DR4/DR5 )in mRNA was analysed by realtime PCR.Re-sults IC50 of PHⅡ-7 on MCF-7 and MCF-7/ADR was (4.49 ±1.55 ),(3.44 ±0.90 )μmol · L-1 respec-tively;MDA-MB-231 was TRAIL sensitive cell line, and apparently TRAIL induced apoptosis in MDA-MB-23 1 .Low concentration of PHⅡ-7 in combination with TRAIL could augment TRAIL-induced cytotoxic effect including apoptosis while TRAIL or PHⅡ-7 treatment alone had limited cytotoxity to those cells.Besides, PHⅡ-7 at this concentration had little toxicity to hu-man peripheral blood mononuclear cells even if in com-bination with TRAIL.PHⅡ-7 generated ROS produc-tion inside MCF-7 and MCF-7/ADR cells and up-regu-lated DR4/DR5 expression concentration dependently. Once upon ROS scavenger NAC involved,the effect of TRAIL receptors up-regualtion by expression was abro-gated.Conclusions PHⅡ-7 at low concentration could improve the sensitivities of breast cancer cell MCF-7 and MCF-7/ADR to TRAIL,the mechanism of which may be the ability of ROS production by PHⅡ-7 help up-regulated TRAIL receptor DR4,DR5 .Our re-search set a solid foundation for PHⅡ-7 in combination with TRAIL in future clinical application.

Objective To analyze the normal reference values of left ventricular longitudinal peak systolic strain (LS) and strain rate (LSr) by two-dimensional speckle tracking imaging (2D-STI) in healthy children at different ages.Methods Clinical ultrasound data of 330 healthy children who taking physical examination in our hospital from September 2015 to November 2016 were collected and retrospectively.They were divided into 7 groups according to their ages,that is,neonate group (0 to 28 days old),infant group (28 days to 1 year old),toddle group (1 to 3 years old),pre-school group (3 to 6 years old),school age group (6 to 9 years old),pre-adolescence group (9 to 13 years old) and adolescence group (13 to 18 years old).2D-STI was performed in the 3 apical projections of left ventricle (LV).The regional peak systolic longitudinal strain and strain rate of LV were measured.Results ① Significant differences were found in the LS and LSr values from 6 segments of the same wall (P ＜ 0.05),and the LS and LSr values were gradually increased from basal segment to apical segment.②There were no significant differences in the LS,LSr and global LS (GLS) values of 18 segments between sexes (P ＞ 0.05).③ Except the basal segments of posterior wall,inferior wall and posterior septum,LS value was gradually elevated with the increase of age (LS ＜LSinfant ＜ LStoddler,pre-shool and school age ＜ LSpre-adolescence and adolescence),So was GLS value.④LS in 18 segments had a positive correlation with age,and the value of apical segment in lateral wall was most remarkably correlated (r =0.551,P ＜0.01);Regional LS had a negative correlation with heart rate,and that of middle segment in lateral wall was the most apparent (r =-0.625,P ＜ 0.01);GLS was positively influenced by age (r =0.665,P ＜ 0.01) and negatively affected by heart rate (r =-0.625,P ＜ 0.01).⑤The heterogeneities were found in the correlations of regional LSr with age and heart rate in segments and in the LSr among different age groups.Conclusion Normal reference values of LV peak LS and LSr are established for healthy children at different ages,and they possess their own characteristics.