Objective: To examine correlations between MRI and cognitive changes associated with cerebral infarction. Methods: Using HDS-R and Senior Cognitive Scale, we assessed 101 patients with cerebral infarction during acute to rehabilitation phase. The results were compared with their MRI. Results: At 3 weeks after onset, cognitive impairment was found in 70.3% of the patients. At 6 months after onset, 10% recovered to normal, 35.6% improved, 22.8% worsened, and 42.5% met the criteria of dementia. During acute phase, infarction focus and leukoaraiosis (LA) were related to cognitive impairment ( P

Objective: To investigate the achievement of the target for blood glucose control among community patients with type 2 diabetes mellitus (T2DM) and its influencing factors, so as to provide insights into developing blood glucose management strategies and intervention measures. Methods: Basic information, lifestyle, medication use, disease history, and HbA1c test results of T2DM patients aged 18 years and older and living in Jinshan District, Shanghai Municipality for more than 6 months were collected through Jinshan District Chronic Disease Follow up Management System and district-level information platform. The proportion of blood glucose achieving the control target (HbA1c<7%) was analyzed. Factors affecting the achievement of the target for blood glucose control were identified using a multivariable logistic regression model. Results: A total of 16 758 T2DM patients were included, with 7 844 males (46.81%) and 8 914 females (53.19%), and a median age of 69.00 (interquartile range, 12.00) years. There were 8 095 patients achieving the blood glucose control target, accounting for 48.31%. Multivariable logistic regression analysis showed that age (60-69 years, OR=0.749, 95%CI: 0.675-0.832; 70-79 years, OR=0.892, 95%CI: 0.801-0.993; ≥80 years, OR=1.238, 95%CI: 1.086-1.411), body mass index (overweight, OR=0.926, 95%CI: 0.863-0.993; obesity, OR=0.800, 95%CI: 0.718-0.891), disease course (6-10 years, OR=0.728, 95%CI: 0.673-0.787; ≥11 years, OR=0.534, 95%CI: 489-0.583), smoking (daily, OR=0.792, 95%CI: 0.730-0.860), drinking (daily, OR=0.788, 95%CI: 0.642-0.967), medication adherence (intermittent, OR=0.293, 95%CI: 0.271-0.317; self discontinuation, OR=0.074, 95%CI: 0.064-0.087), hypertension (OR=0.643, 95%CI: 0.588-0.703) and cardiovascular and cerebrovascular diseases (OR=0.671, 95%CI: 0.563-0.800) were the influencing factors for the achievement of the target for blood glucose control among T2DM patients. Conclusion The blood glucose control among T2DM patients is mainly affected by age, body mass index, disease course, smoking, drinking, medication adherence and comorbidities.

Objective To discuss hemorheologic changes and hepatic function in patients with chronic hepatitis B(CHB)and its correlation with HBV genotype.Methods Relative index of hemorheologic changes,ALT,HBV-DNA and HBV genotype were examined in 96 CHB patients and 24 healthy control people.The results underwent correlation analysis.Results Low-shear blood viscosity and RBC aggregation index were significantly higher in CHB patients than those in the healthy control people(P＜0.05).Low-shear blood viscosity and RBC aggregation index were significantly higher in CHB patients with abnormal ALT than those CHB patients with normal ALT and the healthy control people(P＜0.05).No statistical difference was seen when CHB patients with normal ALT were compared with the healthy control people and patients with positive HBV-DNA were compared with patients with nesative HBV-DNA(P＞0.05).No statistical difference was seen in hemorheologic changes in CHB patients with different genotype(P＞0.05).Conclusions Microcirculation disorder of CHB patients is correlated with damage degree of hepatic function.Hemorheologic changes are not correlated with HBV-DNA and HBV genotype,so it can be a relatively independent index for clinical evaluation of disease.

Objective To investigate the role of Akt signal pathway on the expression of monocyte chemoattractant protein-1 ( MCP-1 ) and nuclear transcription factor-κB (NF-κB) in renal tubular epithelial cells (HK-2) stimulated by albumin and to explore the mechanisms of action. Method The HK-2 cells were incubated in the presence of albumin (5,15,30 mg/mL) with or without Ly294002 (an inhibitor of Akt). Expression of mRNA was analyzed by reverse transcription-polymerase chain reaction (RT-PCR).Expression of Akt and protein MCP-1 were assessed by Western blot. Electrophoretic mobility shift assay (EMSA) was used to detect the activation of NF-κB. q-test was used to evaluate the differences in means between groups. Results Compared with control group, the expression of MCP-1 mRNA remarkly increased. [Control group: 0.233 ±0.01; BSA(5 mg/mL) group: 0.285 ±0.04; BSA( 15 mg/mL) group:0.387 ± 0.02; BSA ( 30 mg/mL) group: 0.473 ± 0.05; BSA ( 30 mg/mL) + Ly294002 group: 0. 325 ±0.05, P ＜ 0.05 ]. The expression of MCP-1 protein in renal interstitum of operation group were remarkly increased too. [ Control group: 100 ± 15.1; BSA ( 5 mg/mL) group: 148 ± 19.3; BSA ( 15 mg/mL) group: 176±20.7; BSA(30 mg/mL) group: 263 ± 18.1; BSA(30 mg/mL) + Ly294002 group: 175 ± 18.0, P ＜0.05 ]. Albumin stimulated the expression of MCP-1mRNA and protein in a dose-dependent manner. Albumin remarkably increased the activity of NF-κB. Albumin enhanced the expression of Akt. Ly294002 inhibited albumin-induced the expression of NF-κB and partially decreased the level of MCP-1. Apositive correlation was noted between NF-κB activation and MCP-1 expression( r = 0.68 ,P ＜ 0.01 ). Conclusions Albumin-induces MCP-1 and NF-κB production via Akt signal pathway in renal tubular epithelial cells.

Objective　To develop a new method to induce the gene transfection in high efficiency for eukaryotic cells in vitro. Methods　 Four kinds of p14ARF gene primarily deleted human carcinoma cell line including H460,A549,U251,and PC-3 were transfected with the human p14ARF expression vector (pCI-neo-p14ARF) by using the new nonliposomal transfection reagent Fugene 6. The efficiency of gene transfer was determined by screening the cells in G418. Results　 After 21 days' selection, G418-resistant clones were shown in all the transfected plate. PCR product of p14ARF gene was positive in all the G418-resistant clones. Cytotoxicity of Fugene 6 was detected. The cell proliferation activity was not affected when it was cultured in a high dose of Fugene 6. Conclusion　 These results demonstrate that Fugene 6 is a rapid, feasible, reproducible, and noncytotoxic gene transfection approach for eukaryotic expression vector in vitro.

Objective To observe the effects of high sucrose,high saturated fatty acid and high unsaturated fatty acid(diets) on insulin resistance and endothelium-dependent vasodilation function.Methods Adult Wistar rats were divided into normal control(NC) group,high sucrose(HS) group and high saturated fatty acid(HSF) group,high unsaturated fatty acid(HUF) groups.Insulin sensitivity was tested by hyperinsulinemic-euglucemic clamp after 24 weeks.Acetylcholine-induced(or sodium nitroprussideinduced) relaxation of preconstricted isolated renal arteries was measured by Mulvany myograph.Results GIR was obviously lower in experimental groups than that in NC group.GIR was negatively correlated with triglyceride (TG),free fatty acid(FFA).Acetylcholine-induced relaxation was markedly decreased in all experimental groups compared with that in NC group and the maximal response was decreased 37.4% in HSF group,32.7% in HUF group,27.7% in HS group.Acetylcholine-induced relaxation was enhanced by incubation with L-Arg and decreased incubated with L-NNA,MB in all experimental groups.Vasodilation response was negatively correlated with TG,INS and well positively correlated with NO,GIR.There was significantly negative correlation between FFA andNO.Conclusions: The rats fed high sucrose,high saturated fatty acid and high unsaturated fatty acid diets developed insulin resistance with reduced endothelium-dependent vasodilation function.

Objective To improve the understanding and diagnosis of pulmonary lymphangioleiomyomatosis (PLAM) by the comprehensive review of domestic literatures in the past ten years.Methods Three new cases with PLAM were reported and integraed with other 45 cases reported domestically in the past ten years for analysis of their clinical features.Results The newly reported three cases of PLAM were all women at child-bearing age, with initial symptom of dyspnea after activity. Two of them complicated with extra-pulmonary PLAM. All the three cases were free of chylous effusion. Forty-seven of 48 cases with PLAM were pathologically diagnozed, with ages of onset of 5~69 (mean?s of 34?10) years. Their clinical manifestations were mainly respiratory, including dyspnoea (95.8%), haemoptysis (52.1%), pneumothorax (45.8%), chylous effusion (33.3%),cough (31.3%) and chest pain (12.5%). Abnormal manifestations in abdomen, including renal mass, retroperitoneal mass and retroperitoneal lymphadenopathy, were detected in 16 cases. Thirty-nine cases had their high-resolution CT (HRCT) examined and appearance of multiple cysts distributed throughout the bilateral lung fields could be discerned in 38 of them. Obstructive ventilation disturbance could be observed in 23 of 30 cases with the data or conclusions on pulmonary function tests, and mixed ventilation disturbance in seven cases. Respiratory failure was complicated in 17 of 28 cases with the data of arterial blood gas analyses.Conclusions HRCT had confirmative value for diagnosis of PLAM. In practice, HRCT, as well as other routine abdominal and pelvic imaging examinations, should be performed in time for child-bearing-age women with progressive dyspnoea, haemoptysis, or spontaneous pneumothorax, to detect if they complicate with PLAM.

Adult ; Behcet Syndrome ; complications ; Cochlear Implantation ; Cochlear Implants ; Deafness ; etiology ; rehabilitation ; Humans ; Male ; Treatment Outcome

Objective Changes of small intestine villus microcirculation perfusion in sidestream dark-field (SDF) imaging in the rabbits during endotoxic shock after fluid resuscitation with different target mean arterial pressure (MAP), and evaluation of feasibility of monitoring small intestine villus microcirculation by SDF were studied. Methods Sixty standard New Zealand white rabbits were randomly divided into two groups: low target MAP group (group A, n = 30) and high target MAP group (group B,n = 30). Fistula operation of ileum was madein vitro, and lipopolysaccharide (LPS, 2 mg/kg) was injected to establish endotoxic shock model. Group A was administered with the lower dose fluid resuscitation (lactated Ringer solution, 20 mL·kg-1·h-1) for target MAP of 65 mmHg (1 mmHg =0.133 kPa); group B was administered with the higher dose fluid resuscitation (lactated Ringer solution, 30 mL·kg-1·h-1) for MAP of 80 mmHg. Continuous norepinephrine intravenous injection (0.5-1.0μg·kg-1·min-1) was administered only after fluid therapy couldn't reach the target MAP. The changes of small intestine villus microcirculation perfusion indexes such as vessels per villus (VV), proportion of perfused villi (PPV), microvascular flow index (MFI), borders of villus score (BVS), vessels villus score (VVS) were continuously observed and recorded before the shock, during the shock and after fluid resuscitation using SDF imaging. The differences of microcirculation perfusion were compared between two groups using the specific parameter evaluation system to determine severity of villi microcirculation and injury scores at different stages.Results VV and borders of villus were clear and contact before shock in two groups. After shock, VV, PPV were significantly decreased in both two groups, the borders of villus were destroyed, MFI, BVS, VVS and the total score of villi injury microcirculation were obviously and severely decreased. Partial blood flow of villous capillaries after fluid resuscitation was recovered in two groups, but the perfusion of some region was un-balanced with the outworn borders of villus. VV were rose as compared before and after fluid resuscitation in groups A and B (vessels: 1.21±0.22 vs. 0.81±0.12, 1.54±0.28 vs. 0.79±0.13), and PPV [(31±4)% vs. (12±2)%, (38±5)% vs. (13±3)%], MFI (1.55±0.09 vs. 1.09±0.03, 1.97±0.11 vs. 1.05±0.03), VVS (points: 1.22±0.08 vs. 0.89±0.02, 2.06±0.15 vs. 0.90±0.02) and the sum of MFI, BVS, VVS (3.70±0.19 vs. 2.85±0.07, 5.01±0.29 vs. 2.88±0.08) were significant rose (allP< 0.05). The recovery of group B was better than that of group A, and the injury score was reduced. But BVS were not increased in both groups compared with before and after shock (points: 0.93±0.05 vs. 0.87±0.03, 0.98±0.09 vs. 0.93±0.05, bothP > 0.05).Conclusions For the small intestine villus microcirculation perfusion, the higher target MAP (80 mmHg) after fluid resuscitation or/and vasoconstrictor drugs usage were probably better than the relatively lower target MAP (65 mmHg) during endotoxic shock. SDF imaging is a very promising technique for intestinal villi microcirculatory visualization and assessment.

In this study ,we aimed to understand the sequence characteristics ,transmembrane structures ,line B cell epitopes present in the OMP18 from Campylobacter jejuni ,and provide candidate antigens for the antibody detection and vac-cine development .NCBI/Blast ,TMHMM Server V2 and DNA Star softwares were used for the OMP18 sequence analysis . Based on the ELISA ,the whole bacterial antibody IgG of Campylobacter jejuni was used for the identification of the predicted line B cell epitopes .The OMP18 gene was found conserved in different Campylobacter jejuni strains .The OMP18 was predic-ted to be located on the outer surface of the bacteria .And three line B cell epitopes were determined to be present in the OMP18 protein .As a conclusion ,the OMP18 protein was confirmed to be an important outer membrane protein ;three line B cell epitopes were identified in the OMP18 ,which could be further used for Campylobacter jejuni antibody detection and vaccine development .