Tirofiban,a platelet glycoprotein (GP) Ⅱ b/Ⅲ a receptor antagonist has been widely used in the treatment of acute coronary syndrome (ACS) and percutaneous transluminal coronary intervention.This article introduces the mechanism of action of tirofiban and its application in intravenous thrombolysis,intraarterial thrombolysis,and endovascular therapy in ischemic stroke,emphasizing the safety and effectiveness of tirofiban in the application of the emergency cerebral angioplasty.

Objective To study the clinical significance of routine MRI and 3 dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) for the pathogenesis of Trigeminal neuralgia (TN) Methods 32 patients with TN and 32 controls were observed by MRI and 3D-TOF-MRA by the enhancement of DTPA Diagnosis of the presence of compressions in the root exit zone (REZ) of the Trigeminal nerves were carried out by two radiologist on an independent console Results (1) In patients studied, compressions of the REZ of the nerves were detected with 29 on symptomatic sides (90 63%), neurovascular on 25 sides and tumor on 4 sides, and 2 on the asymptomatic sides(6 25%, all neurovascular) In the controls, 3 sides (4 26%, all neurovascular) were involved in the compressions of the REZ of the Trigeminal nerves (2) In 25 cases with TN of neurovascular etiology, the offending vessels were the superior cerebellar arteries in 17 cases (68%), anterior inferior cerebellar arteries in 2 cases, vertebral artery (VA) in 1 cases, difficultly identified vessels in 2 cases, vein in 2 cases, vascular malformation in 1 case (3) The RR of microvascular and tumor compressions which cause TN were 36 74 (4) The real microvascular compression and entrapping were only detected on the symptomatic sides of TN in 13 patients (52%) Conclusion MRI and 3D-TOF-MRA appeared to be the best imaging test for the pathogenesis of TN now The major causes of TN might be different neurovascular and tumor compressions in the REZ of the fifth cranial nerve, with real compression, entrapping or tight contact

Objective To investigate the pathological and electro-physiological process of terminal sprouting after muscle injection of Botulinum toxin type A(BTXA) in rats. Methods Sprague-Dawley rats were randomly divided into a BTXA group and a control group. Five unit of BTXA was injected into the right gastrocnemius of the rats in BTXA group, instead of 0.9% saline in the control group. The morphologic axon analysis and SFEMG (mean consecutive difference and fiber density) were measured at 1,4,8,12 week after injection. Results The mean consecutive difference was prolonged in 1-4 week, and got better at 8 week, recovered at 12 week. It was revealed of the recovery of neuromuscular junction at 12 week after BTXA injection. The results of fiber density and morphologic axon analysis demonstrated terminal sprouting after injection of BTXA. Conclusion Motor nerve terminal sprouting could appear after BTXA injection and the function of neuromuscular junction could become recovered at 12 week.

Objective:To study the immune stimulation effect of Portulaca oleracea L.polysaccharide ( POL-P3b) on cervical tumor-bearing mice.Methods:Using graft U14 cervical cancer mouse model ,and all the mice were randomly divided into tumor-bearing control group,cyclophosphamide (CTX) group and purslane polysaccharide low (L) (POL-P3b(L)) group and high dose of POL-P3b (POL-P3b(H)) group.After continuous treating 13 d,the thymus index and spleen index were determined; cellular immune function in mice was evaluated by ConA inducing mice spleen lymphocyte transformation test.The cytokines content of IL-2,IFN-γ,IL-10 and IL-4 secreted by spleen cells was detected using ELISA method.Indoleamine 2,3-2 oxidase ( IDO) expression in tumor tissue was detected by immunohistochemistry and Western blot method.Results:POL-P3b could obviously improve immune organ weight of tumor-bearing mice and enhance the cellular immunity function.POL-P3b could reduce the level of IL-4 and IL-10 secreted by spleen cells , and could promote the secretion of IL-2 and IFN-γ.POL-P3b also could inhibit the expression of IDO in tumor tissues ,and the effect of high dose group was more obvious.Conclusion:The antitumor mechanism of POL-P3b might be related to increase the body′s immune function and reduce the immune escape.

BACKGROUND: Cranial base angle is related to the formation of sagittal dentoskeletal type, and the effect of occlusal plane or posterior occlusal plane on the formation of sagittal dentoskeletal type remains controversial. OBJECTIVE: To compare the importance of occlusal plane inclination and posterior occlusal plane inclination in determining the formation of sagittal dentoskeletal type, and to explore the combined influence of the cranial base angle and posterior occlusal plane inclination on the formation of sagittal dentoskeletal type, and its correlation. METHODS: The study was implemented in accordance with the ethical requirements of Hospital of Stomatology, Southwest Medical University. Patients and their guardians signed the informed consents. Totally 207 lateral cephalograms from patients (100 males and 107 females, aged 12-20 years) were selected. Dentoskeletal landmarks and subsequent measurements were performed and analyzed using Uceph software and SPSS 17.0 software, respectively. The samples were classified as three sagittal dentoskeletal types according to the anteroposterior dysplasia indicator (APDI) value: Class I, class II, and class III. The SNK and LSD methods were used for comparison among the three groups. The Pearson correlation coefficient analysis was used to analyze the correlation between skull base angle (NSBa angle), occlusion plane (FH-OP), posterior occlusion plane (FH-POP) and other related measurement indexes. Descriptive statistical methods were used to group occlusal plane inclination, posterior occlusal plane inclination and skull base angle, and the two-sample f-test was used to compare relevant bone and tooth indexes. Four dentoskeletal groups were established according to the posterior occlusion plane inclination and skull base angle: Small skull base angle-flat posterior occlusion plane group (S-F), small skull base angle-steep posterior occlusion plane group (S-S), large skull base angle-flat posterior occlusion plane group (L-F), large skull base angle-steep posterior occlusion plane group (L-S). Intergroup comparison was completed using crossover one-way analysis of variance. RESULTS AND CONCLUSION: The skull base angle was significantly smaller in the class III group than the class I and II group. Significantly higher posterior occlusion plane inclination was observed in the class II group than the class I and III groups. No differences were found in the APDI and ANB between occlusal plane groups. Significant differences in the ANB angle and APDI value were shown on the small skull base angle-flat posterior occlusal plane group and the large skull base angle-steep posterior occlusal plane group. These results indicate that among the factors affecting the formation of sagittal dentoskeletal type, the posterior occlusal plane is more representative than the occlusal plane. The curvature of the skull base and the inclination of the posterior occlusal plane affect the formation of sagittal dentoskeletal type. During the formation of sagittal dentoskeletal type, there may be some compensatory mechanisms between the curvature of the skull base and the posterior occlusal plane.

Objective To assess intraplaque hemorrhage before carotid artery stenting (CAS)by use of 3D-MPRAGE and DWI sequence.Methods Thirty-two symptomatic patients who had carotid artery plaque suspected by color Doppler ultrasonography and prepared for CAS underwent 3.0T carotid high-resolution MR scans,including regular sequence,T1-weighted gradient echo three-di-mensional magnetization prepared (3D-MPRAGE ) sequence,diffusion-weighted imaging (DWI ) sequences.According to 3D-MPRAGE sequence hemorrhage and non-hemorrhage groups were divided,and measured the mean ADC values of the two groups, hemorrhage and non-hemorrhage part in the hemorrhage group.Meanwhile preoperative cerebral hemorrhage group underwent brain DWI scans.Independent samples t-test analysis was utilized by SPSS V20.0 statistical software.Results High-resolution MRI dis-played 40 plaques,fourteen hemorrhagic plaques showed by 3D-MPRAGE sequence.The mean ADC values of hemorrhage and no-hemorrhage group were(1 233.5±283.5)× 10 -6 mm2/s,(1 688.9 ± 449.6)× 10 -6 mm2/s respectively,the difference of both was significant (t=3.43,P <0.05).The mean ADC values of hemorrhage and non-hemorrhage parts in the hemorrhage group mean ADC values were (934.0 ± 387.9)× 10-6 mm2/s,(1 313.9 ± 295.0)× 10-6 mm2/s respectively;the difference of both was statistically significant (t=2.92,P < 0.05 ).The difference of mean ADC values between non-hemorrhage part in the hemorrhage group and hemorrhage group was statistically significant (t=2.80,P <0.05).Conclusion 3D-MPRAGE and DWI sequences can be evaluated intraplaque hemorrhage before CAS,and provided a reliable basis for timely clinical interventions to prevent stroke.

Objective To evaluate the effect of non-linear blending function for dual-energy CT on image of pulmonary angiogra-phy.Methods 27 patients underwent dual energy CT pulmonary angiography(CTPA).Data obtained with 100 kVp,140kVp,and non-linear blending were divided into group A,B,and C respectively.CT value of emboli were measured.Corresponding signal to noise ratio(SNR )and contrast to noise ratio(CNR)were calculated.One-way Anova analysis and Friedman test were used to ana-lyze statistical significance among these values.Results On quantitative analysis of 27 patients,there was no statistical difference for CT value of CTPA among the three groups(P >0.05).For the noise,CNR and SNR,there were statistically significant among the three groups(P <0.05).Conclusion The non-linear blending function has certain advantages in improved image signal-to-noise ratio and it can be used in CT pulmonary angiography examination for patients suspected pulmonary embolism clinically .

Objective To evaluate the application of CT myelography (CTM) in detecting the site of spontaneous cerebrospinal fluid (CSF) leaks and analyze it's imaging features.Methods Six patients (3 women and 3 men) with spontaneous intracranial hypotension (SIH) were included, who met the criteria of the International Headache Classification (2nd edition, 2004). Five patients subsequently underwent whole spine MRI and all 6 patients underwent CTM. Autologous blood mixed with omnipaque (300 mg/ml) was injected followed by selective puncture at the leak site indicated by CTM. Results MRI was failed to find leak site in the 5 patients, whereas CTM successfully found leak sites in all 6 patients. There were 1 to 7 leak sites respectively with an average of 4.2 sites (totally 25 points). Leak sites at cervical (12 sites) and thoracic (12 sites) were more frequent than at lumbar (1 site). CTM was featured by linear leakage of the contrast medium along the spinal nerve roots, paraspinal collections of hyper-density contrast medium and beak-like enlargement of the nerve sleeves. All patients responded well to the treatment, with complete resolution of symptoms. Conclusion CTM has been shown to be a study of choice to accurately define the location and extent of a CSF leak.

Objective To evaluate the value of united nerve electrophysiological tests in the diagnosis of diabetic peripheral neuropathy (DNP).Methods The quantitative temperature threshold (QTT), including the cold sensation threshold (CST) , thermal sensation threshold (WST), cold pain threshold (CPT) and thermal pain threshold (HPT), sympathetic skin response (SSR) and nerve conduction velocity (NCV) were measured for 85 diabetic patients.Results The abnormal rate of QTT was 84.71％ , significantly higher than that of SSR and NCV (56.47％ and 31.76％ respectively).However, no significant difference was found in the abnormal rate of QTT between the DPN asymptomatic group and DPN symptomatic group (78.85％ and 93.94％ respectively).There was significant difference in the abnormal rate of SSR (48.08％ and 69.70％ respectively) and the abnormal rate of NCV (19.23％ and 51.52％ respectively) between the above two groups(P ＜ 0.05).There was no difference in the abnormal rate of QTT for patients with short or long course of disease (77.77％ and 89.80％ respectively), but significant difference in the abnormal rate of SSR (44.44％ and 65.31％ respectively) and the abnormal rate of NCV (19.44％ and 40.82％ respectively) Conclusion The abnormal rate of QTT was highest in detecting the diabetic patients, and it is not related to clinical symptoms or disease course.However, the abnormal rates of SSR and NCV were related to clinical symptoms and course.It is more sensitive to diagnose DPN using united electrophysiological tests of QTT, SSR and NCV.

Objective To preliminarily select safe parameters for different forms of teeth by irradiating 532 nm picosecond Nd∶YAG laser on human isolated teeth with different irradiation time length and power.Methods Isolated human teeth including anterior teeth,premolars,molars were irradiated with 532 nm picosecond laser.Repeated measurements were made for each tooth by thermometer to measure the temperature of pulp chamber on different time point and power,and the temperature change (△T) was calculated.Results △T of the anterior irradiation group at 0.6 W,30 s;0.8 W,20 s and 30 s;1.0 W,10 s,20s and 30s were more than 5.6 ℃,which was the same with that of premolar group at 1.0 W,30s.△T of the molar group at 1.0 W,30 s was less than 5.6 ℃.Under certain power,the temperature of pulp chamber increased with the prolonging of irradiation time (P＜0.05).At a certain time,temperature increased with the power (P＜0.05).Conclusions It is safe to carry out operation on the parameters setting of 0.8 W,10 s and 0.6 W,20 s irradiation for anteriors teeth;0.4 W,30 s,0.8W,30 s and 1.0 W,20 s for premolar teeth,and 1 W,30 s for molar teeth.In the application of 532 nm picosecond laser,attention is required to be paid on parameter setting to control input power and irradiation time.