Objective To compare microsurgery through small skull window hematoma puncture and external drainage in the treatment and clinical effect of basal ganglia hemorrhage.Methods 92 cases of hypertensive basal ganglia hemorrhage were randomly divided into the two groups,46 cases in each group,A group was used microsurgery through small skull window hematoma,group B by puncture drainage.Operation time,complications and serum S100 protein of two groups were compared.Results Two groups were successfully completed operation,operation time, amount of bleeding,the time of hospitalization in A group were (125.3 ±29.1)min,(84.3 ±11.4)mL,(14.2 ± 2.7)d,B group were (70.5 ±5.4)min,(39.6 ±9.6)mL,(8.1 ±1.9)d,A group were significantly higher than that of group B (t =3.724,8.162.2.996,P <0.05,P <0.01 ).A,B two groups had respectively 11 cases,3 cases of respiratory tract infection,A group was significantly higher than that of group B (χ2 =9.12,P <0.05 ).0 case, 3 cases occurred in rebleeding in group A and B,respectively,0 cases,2 cases occurred cerebral hernia in group A and B,respectively,rebleeding,cerebral hernia in group B was significantly higher than that in group A (χ2 =4.76, 4.18,all P <0.05).1 patient because of recurrent cerebral hemorrhage was dead after operation in group B,group A after operation in patients with good treatment in three months according to ADL classification rate was 93.5%,B group after operation in patients with good treatment in three months according to ADL classification rate was 82.6%, the difference was statistically significant (χ2 =5.06,P <0.05).After 1D,7d,14d in serum of S100 beta protein in group A were (3.17 ±0.62)μg/L,(1.52 ±0.41)μg/L,(1.26 ±0.33)μg/L;group B beta protein of serum S100 were (2.38 ±0.52)μg/L,(2.09 ±0.53)μg/L,(1.31 ±0.34)μg/L.1d beta protein of serum S100 in group A was significantly higher than group B (t =2.812,P <0.05);postoperative serum 7d S100 beta protein in group A was lower than that in group B (t =2.620,P <0.05);there was no significant difference between two groups of 14d serum S100 beta protein differences between postoperative (t =1.082,P >0.05).Conclusion Small window craniotomy and puncture drainage micro hematoma surgery treatment of cerebral hemorrhage in basal ganglia and each has advan-tages and disadvantages,we should adopt different treatments according to the patient's condition.

Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome.Methods Data of 417 women with abnormal active phase identified from 1744 term-birth,singleton,cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1,2009 to December 31,2009 were retrospectively studied.Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi square test.Results The incidence of protracted active phase was 23.9％ (417/1744); and the incidence of prolonged active phase was 2.9％ (50/1744).There were 205 cases of cesarean section and 212 cases of vaginal deliveries.The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase ＜6 h [20.6％ (26/126) vs 8.1％ (7/86),x2 =6.07,P＜0.05].The incidence of intrauterine infection in cesarean section group with active phase ＜6 h were higher than that of those with active phase ≥6 h [22.7％ (30/132) vs 6.8％(5/73),x2 =8.37,P＜0.01].In vaginal group with protracted active phase before 6 cm of cervical dilation,the incidences of postpartum hemorrhage (4.8％,9/186),maternal complications (3.8％,7/186) and neonates hospitalization (15.6％,29/186) were similar with those after 6 cm of cervical dilation [6.2％ (1/16),x2=0.12; 0.0％ (0/16),x2=0.01 and 12.5％ (2/16),x2=0.00; all P＞0.05] respectively.In cesarean delivery group with cervical dilation ≥6 cm,the incidence of neonates hospitalization was higher than that of those with cervical dilation ＜6 cm [60.0％ (6/10) vs 19.9％ (34/171),x2 =8.83,P＜0.05].There were no difference in maternal age,gestational age,body mass index at delivery,volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase ≥4 h or ＜4 h when cervical dilation at 3 cm (P＞ 0.05 respectively).The incidence of neonates hospitalization was low in women whose indication of cesarean section was protracted active phase (11.2％,9/80),while it was high when protracted active phase complicated with intrauterine infection (42.1％,16/38).Conclusions Protracted active phase with cervical dilation less than 6 cm might not need active management if neither the mother nor the fetus is compromised.The infants born vaginally should be closely monitored if the active phase is over 6 h.

Objective To investigate the indications for interventional therapy of Budd-Chiari syndrome((B-CS)) and surgical treatment after stent failure. Methods A retrospective analysis of the clinical data of 21 patients with mistakes in treatment of B-CS by stent placement in inferior vena cava(IVC).Results (Among) the 21 cases with mistakes, the indications were inappropriately selected in 6 cases, the main hepatic vein was obstructed by the stent in 1 case, dilated accessory veins were occluded in 10 cases, the stent was (displaced) in 3 cases, and the stent failed to unfold in 1 case. Nineteen cases were converted to operation; of these patients, a shunt was performed in 18 cases, and radical excision of diaphragmatic web of IVC was done in 1 case. Operation was successful in all 19 cases. After shunt procedure in the 18 cases, the free portal pressure significantly decreased(P

Objective To study the complications and the outcome of different type of twin pregnancy. Methods Three hundred and thirty two cases of twins from 1981 to 2000 were analyzed retrospectively. Results The incidence of twins is 8.63%.The common complications were pregnancy induced hypertension, premature rupture of fetal membranes, anaemia, premature labor and postpartum hemorrhage. There were no differences between the monozygotic twins and dizygotic twins in the incidences of these complications. The incidence of one fetal death in monozygotic twins was higher than that of the dizygotic twins (P

Copper is an essential metal element for human metabolism. Copper homeostasis can lead to inherited disorders of copper metabolism and also play an important role in tumor proliferation. In recent years, great progress has been made in the research and development of radioactive metal nuclide tracers, and molecular imaging quickly becomes a new inspection technology for detecting copper metabolism. 64CuCl 2 carries out PET imaging diagnosis of diseases with abnormal copper metabolism and tumors with high copper metabolism through real-time tracking of changes of copper ions in the body. At the same time, β - decay and electron capture of 64CuCl 2 have a therapeutic effect, and can be directly used for tumor nuclide therapy. Therefore, 64CuCl 2, as an integrated radiopharmaceutical for diagnosis and treatment, is the current research focus of molecular imaging. This article reviews 64CuCl 2 preparation, biological metabolism and its application in the diagnosis and treatment of abnormal copper metabolism diseases and tumors.

Objective To develop an effective process for isolating and purifying haptoglobin ( Hp) from Cohn fractionⅣby a new ion exchange chromatography and to preliminarily identify and analyze the product of each purification step . Methods The fraction was first diluted and impurities were adsorbed with Rivanol .Then, the supernatant was treated with 50%ammonium sulfate.Finally, the precipitate was redissolved , and Hp was purified further with Q Sepharose Fast Flow chromatography .Native-PAGE was used to measure the activity of the haptoglobin-bound hemoglobin , while SDS-PAGE analysis and immunoblot were used for identification of the target protein .Results After pretreatment , some of the impuri-ties were removed from the Cohn fraction Ⅳ, and the target protein was enriched .In our case, the target protein was Hp and Hp2-2 was the main phenotype in the human plasma fraction Ⅳ.Target protein band and high purity were identified by SDS-PAGE.Immunoblot analysis further proved that this method could successfully isolate the target protein Hp , and the activity of 2.8 U/ml was measured by Native-PAGE method.Conclusion Haptoglobin is successfully isolated from human Cohn fractionⅣwith this method.The purification process is simple and suitable for scale-up production with a good prospect.

Objective To detect the expressions of circulating microRNAs (miRNAs) of peripheral whole blood in Alzheimer's disease (AD) and investigate the potential roles of the miRNAs as diagnostic bi omarkers for Alzheimer's disease.Methods Peripheral blood samples were obtained from 110 AD patients and 150 age-and gender-matched normal controls.The concentrations of seven candidate miRNAs,including miR-9,miR-29a,miR-29b,miR-101,miR-181c,miR-137and miR-126,were measured with a real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) method.The data of two groups were collected and analyzed by SPSS 19.0 software.Results It was found that miR-29a (P=1.12×10-5) and miR-101 (P=6.24× 10-7) were markedly down-regulated in peripheral blood of AD patients compared with normal controls.In addition,logistic regression analysis revealed peripheral whole blood miR-29a/101 combination could be a potential biomarker of AD with better specificity (82％) and sensitivity (75％).Conclusions miR-29a/101 combination in peripheral whole blood may serve as a useful noninvasive diagnostic biomarker for AD.

Objective Reninoma is a rare benign tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin,while it is extremely rare that reninoma induced hypertensive crisis with reversible posterior encephalopathy syndrome (RPES).To improve the clinical understanding for this disease,we conducted a case-analysis.Methods To analyze the clinical and pathological data of a case of reninoma-induced hypertensive crisis with reversible posterior encephalopathy syndrome,who was admitted to Peking University First Hospital in November,2007 and follow-up.Results This was a 16-year old female patient,onset with suddenly spasm with loss of consciousness,while blood pressure stepped up to 210/140 mm Hg( 1 mm Hg =0.133 kPa),and the head magnetic resonance imaging (MRI) revealed “multiple long-T2 signal”,and hypopotassaemia(2.8-3.2 mmol/L),urine protein positive,ultrasoundcardiogram revealed left ventricular hypertrophy,laboratory study revealed hyperreninism (38.23ng · ml-1 · h-1,normal range 0.07-1.15 ng· ml-1 · h-1 ) and hyperaldosteronism(660.9 ng/L,normal range 60-174 ng/L),abdominal CT-Scan revealed a mass at right kidney,blood pressure achieved safety range and the head MRI was rechecked and revealed “the abnormal long-T2 signal disappeared”.The clinical diagnosis was reninoma induced hypertensive crisis with RPES.The tumor was resected and the pathologic diagnosis was reninoma.The patient remained normotensive in the postoperative period without any medication.Conclusions Reninoma represents a rare but surgically curable cause of hypertension,thus the clinical suspicion of it is very important in young patients.If the diagnosis is confirmed,positive treatment must be done immediately to improve the prognosis.The most common cause of RPES is hypertension,and the diagnosis depends on the distinctive head MRI.There is always a good prognosis with the decline of blood pressure rapidly.

Objective: To explore the sensitivity of Kit or PDGFRA mutants related to gastrointestinal stromal tumor (GIST) to Gleevec.Methods: The recombinant plasmids of KIT Del559-560, KIT Ins IPYD579, PDGFRA D842V and PDG-FRA L839P gene mutants were transiently transformed into the CHO cells by liposome methods.Western blot was used to detect the expression of the related protein and their phosphorylated forms after the cells were incubated with Gleevec for 90 min.At 72 hours after incubation with Gleevec, MTT was used to detect cell proliferation.Results: Western blot results showed that Gleevec at 0.1 μM can notably reduce phosphorylation of KIT Del559-560.Gleevec at 1μM completely blocked phosphorylation of KIT Ins IPYD579 and PDGFRA L839P, but did not affect PDGFRA D842V phosphorylation.MTT analy-sis indicated that growth of CHOPDGFRA L839P was inhibited by Gleevec at 1μM, however, CHOPDGFRA D842V was re-sistant to Gleevec at 5 μM.Conclusion: Gleevec can decrease the expression of phosphorylated protein CHOPDGFRA L839P and CHOKIT Ins IPYD579, and can remarkably inhibit the proliferation of cells containing PDGFRA L839P mutant.

Objective To study the effect of small diameter graft (0.8 cm) splenocaval or mesocaval shunts combined with pericardial devascularization in the treatment of portal hypertensive variceal bleeding. Methods Splenocaval shunts were performed in 14 patients and mesocaval shunts were done in 24 patients, in combination with pericardial devascularization. Results The average decrease of free portal pressure was 6.6±1.2 cm. There was no significant changes in liver function postoperatively (P>0.05). Platelet counts and leukocyte counts were back to normal in splenocaval shunt patients postoperatively (P< 0.05). Operative mortality was 3%. Pyrexia developed in 4 patients, intractable ascites in 1 patient, chylons ascites in 1 patient, hepatic encephalopathy in 1 patient, intraabdominal infection in 1 patient and stress ulceration in 1 patient. All patients recovered after expectant treatment except one who died from severe intraabdominal infection. 35 patients received follow-up between 6 months and 3 years, total effective rate was 89%, 2 patients died from recurrent variceal bleeding, the shunt potency rate was 80% in 1 year and 75% in 3 years. Esophagogastric varices disappeared or alleviated as shown by endoscopy in 25 patients on 6 months postoperatively. Conclusions Small diameter portosystemic graft shunts combined with poricardial devascularization is an effective therapy for bleeding esophagogastric varices with a low rate of hepatic encephalopathy. Splenocaval shunt alleviates hypersplenism concurrently.