Objective:To investigate the effects of thalidomide on vascular endothelial growth factor(VEGF) and quality of life in patients with primary hepatocellular carcinoma after transcatheter arterial chemoembotization.Methods:A total of 60 patients with HCC,who were treated with transcatheter arterial chemoembolization (TACE) in Affiliated Hospital of Chengde Medical University from January 2014 to January 2016,were randomly divided into group A (n=30)and group B (n=30).Group A was treated with Thalidomide in combination with TACE,oral 200 mg every night for 1 month;group B was treated with TACE alone.The levels of VEGF in the two groups were detected before treatment and 3 weeks after treatment;the quality of life of patients before treatment and 1 month after treatment was evaluated by quality of life scale (QOL);the weight of two groups before and after treatment and adverse reactions during treatment were compared.Results:There was no significant difference in VEGF levels between the two groups before treatment (P＞0.05).After treatment,the levels of VEGF in the two groups were higher than those before treatment,and the VEGF levels in the group A was significantly lower than that in the group B,the difference was statistically significant (P＜0.01).There was no significant difference in QOL score and body weight between the two groups before treatment (P＞0.05).The QOL scores of the two groups after treatment were lower than those before treatment,but the QOL scores of patients in group A were significantly higher than those in group B (P＜0.05).There was no significant difference in weight between the two groups before and after treatment (P＞0.05).In group A,1 patients (3.33％) had severe somnolence,2 (6.67％) patients stopped taking thalidomide due to severe dry mouth,and the remaining 27 patients were able to tolerate.Conclusion:Thalidomide combined with TACE in the treatment of patients with HCC can reduce the levels of VEGF and improve the quality of life of cancer patients,which is worthy to be popularized in clinic.

Objective To describe the echocardiographic and clinical findings of patients with accessory mitral valve(AMV).Methods Four adult patients were diagnosed to have AMV by Doppler echocardiography.Results All the four patients had cardiac murmur but 2 were asymptomatic.Echocardiogram showed that two cases had isolated AMV with significant left ventricular outflow tract (LVOT)obstruction.Another patient was complicated by idiopathic hypertrophic subaortic stenosis and his systolic pressure gradient across the LVOT reduced to normal after taking negative inotropic drugs.The fourth patient was associated with complex congenital cardiac anomalies but without LVOT obstruction.Conclusions AMV may not be very rare as previously reported.An echocardiographic examination Can detect AMV and difierentiate it from other causes of LVOT obstruction.

Aged ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Humans ; Male

Objective To investigate optimal extraction process of Piper puberulum ( Benth.) Maxim.and qualitative analyze the chemical component of the extracts.Methods Method of solvent heating reflux was used for extraction.On the basis of single factor experiment, L9 (34 ) orthogonal experiment was designed with the variants of extraction frequency, time, material-liquid ratio, and immersion time.Extraction rate as index, extraction processes were optimized to achieve best extraction.The extracts, including total extract, water elution, and ethanol elution, were physiochemically analysed to achieve an initial qualitative result.Results The optimal extraction process was: extractions 3 times for 2 hours, with an 1︰30 material -liquid ratio and 2 hours of immersion, Initial qualitative analyzed the total extracts containing amino acids, polypeptides, proteins, alkaloids, steroids or triterpenes, flavones, saponins, polysaccharides, reducing sugars or glucosides, cumarins, terpene lactones, phenols, and tannins.The water elution containing: amino acids, polypeptides, proteins, saponins, polysaccharides, reducing sugars or glucosides, cumarins, and terpene lactones.The ethanol elution containing: amino acids, polypeptides, proteins, alkaloids, steroids or triterpenes, flavones, polysaccharides, reducing sugars or glucosides, phenols, and tanins.Conclusion The experiments show that optimal extraction process can achieve high extraction yield, stable and practical.

Objective To investigate the value of bone marrow imprints in the cytomorphology diagnosis.Methods A total of 354 cases of bone marrow smears,imprints,and sections were analyzed from January 2011 to December 2013 to detect morphological diagnosis difference.Results Bone marrow imprints in groups of extremely reduced,significantly reduced,normal,slightly increased,increased significantly,and extreme increase were better than that of smear which nucleated cells quantity assessment(P ＜ 0.01).Smears and imprints were similar (P ＞0.05).Imprints nucleated cell number decreased mostly were the same as smear,but smear reduced imprints mostly normal or increased.The bone marrow sections nucleated cells quantity as the standard,smears and imprints had high coincidence rate in the group of nucleated cells reduced (87.5％ and 96.9％),and imprints were higher than smear in the group of nucleated cells quantity in normal and increased(87.8％ and 95.7％ vs 68.3％ and 55.8％),and the difference was statistically significant.Imprints were better than smear in specificity,Youden index,and sensitivity.Patients with plasma cell myeloma (PCM) imprint plasma cell volume and immature plasma cells were higher than that of smear (42.73 ± 10.47 and 13.60 ± 4.83 vs 24.67 ± 11.18 and 11.07 ± 5.82) with a statistically significant difference (P ＜ 0.05).Conclusions Imprints have characteristics both smear and sections,and imprints are superior to smears in assessment of nucleated cells and tumor cell invasion degree.Smear combined with imprints can improve the diagnosis level of bone marrow cell cytomorphology.

Objective To investigate the effects of ciprofloxacin on dermal collagen synthesis and profibrotic gene expressions in an experimental mouse model of scleroderma induced by bleomycin. Methods Experimental mouse models of scleroderma were established by subcutaneous injection of bleomycin into the dorsal skin of 15 BALB/c mice for 4 consecutive weeks. Then, the mouse models were randomly and equally divided into 3 groups to be topically treated with 1% ciprofloxacin cream (ciprofloxacin group), 2.5% asiaticoside cream (asiaticoside group)and cream vehicle (model group)respectively for 5 consecutive weeks. Five mice firstly injected with sterile phosphate buffered saline (PBS)for 4 weeks then topically treated with cream vehicle for 5 weeks served as the blank control group. After the 5-week topical treatment, all the mice were sacrificed, skin specimens were resected from the dorsal skin of them, and subjected to HE staining and Masson staining. Further more, an immunohistochemical assay was performed to measure the expressions of type I collagen (COL-1), matrix metalloproteinase-1 (MMP1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP1), semi-quantitative reverse transcription PCR to quantify the expressions of connective tissue growth factor (CTGF), transforming growth factor-β1 (TGFβ1)and Smad3 genes, and alkaline hydrolysis-spectrophotometry to determine the level of hydroxyproline in skin. Statistical analysis was carried out by one-way analysis of variance and the least significant difference(LSD)test with the SPSS 17.0 software. Results Compared with the blank control group, the model group showed increased dermal thickness at injection sites (432.76 ± 93.74 μm vs. 301.69 ± 79.47 μm, P < 0.01). Masson staining revealed thick and dense collagen bundles in an irregular arrangement in the dermis in the model group, which was consistent with dermal fibrosis in scleroderma. The total content of collagen and staining intensity of COL-1, MMP1 and TIMP1 were all significantly decreased in the ciprofloxacin group and asiaticoside group compared with the model group (F = 1628.54, 33.29, 84.82, 224.81, respectively, all P < 0.01), while no significant changes were observed in dermal thickness (both P > 0.05). Moreover, compared with cream vehicle, asiaticoside down-regulated the expressions of the three profibrotic genes(CTGF, TGFβ1 and Smad3)to different extents (all P < 0.05), while ciprofloxacin only inhibited the expressions of TGFβ1 and Smad3 genes (both P < 0.05)with no significant effect on CTGF gene expression (P > 0.05). Conclusion Ciprofloxacin may counteract dermal fibrosis by inhibiting the TGFβ1/Smad3 pathway and modulating the unbalanced expressions of MMP1 and TIMP1.

Objective:To determine the effects of TPS on peripheral blood Tregs in sepsis mouse induced by burn plus P.aeruginosa infection.Methods: The experimental mice were separated into five groups randomly ,including sham burn group ,burn plus P.aeruginosa infection group ,burn plus P.aeruginosa infection with TPS (50,100,200 mg/kg) treatment group.Peripheral blood Tregs were isolated with Magnetic Microbeads and cultured in vitro from the day after burn (PBD0) to 4 days after burn(PBD4).IL-10, IFN-γ,IL-4 levels in Tregs culture supernatants were determined by sandwich enzyme-linked immunosorbent assays ( ELISA ) . Purification of CD4+CD25high Tregs and CD4+T cells in C57BL/6 mice were administrated by magnetic beads sorting .Tregs and CD4+T cells were cultured in vitro after joining TPS to without TPS cells as a control .The phenotypes of Tregs were analyzed by flow cytometry , and cytokines were measured by ELISA .Results:Vis-a-vis the results of the untreated group ,TPS could markedly decrease IL-4 and IL-10 secretion level and significantly increase the secretion of IFN-γ,and the secretion of IL-10 level and concentration of TPS dose effect.Vis-a-vis the results of the untreated group ,in vitro experiment ,without stimulation of TPS ,CD4+T cell proliferation and IFN-γwere significantly reduced ( P<0.05 ) and IL-4 levels increased significantly;CD4+T cell proliferation and IFN-γwere significantly increased and IL-4 levels were significantly reduced in the group of TPS with antibody-1;there was no significant difference in CD 4+T cell proliferation and the levels of IFN-γand IL-4 in the group of TPS with antibody-2.Conclusion:TPS could inhibit the abnormal ac-tivities of CD4+CD25highTregs in burn with P.aeruginosa infection mice,at least in part via inhibiting IL-10 secretion,and trigger a shift of Th2 to Th1 with activation of CD4+T cells in burn with P.aeruginosa infection mice.

Objective To summarize imaging appearances of brain in AIDS patients,as to supply the evidences of imaging diagnosis for this disease . Methods CT or/and MRI appearances of brain in 19 patients with AIDS of nervous system type were reviewed . Results 3 cases showed the symmetry signal abnormal in bilateral whiter matter and 2 cases showed brain atrophy in 5 patients with HIV encephalitis.2 cases of toxoplasma encephalitis appeared multiple abnormal density or/and signal intensity in the brain and multiple ring enhancement . 3 patients with lymphoma displayed single or multiple nodule in the brain and nodular-enhancement or inhomogenous enhancement.3 patients with brain infarction displayed lower density in the basal ganglia on CT.2 patients with progressive multifocal leukoencephalopathy displaied multiple patch abnormal signal intensity of the white matter in frontal and parietal lobus.1 patient with cryptococcal infection showed abnormal signal and ring enhancement of the pons.1 patient with cryptococcal meningitis and 2 patients with intracranial hypertension had not abnormal imaging appearances.Conclusion Most lesions of the brain in AIDS patient may be detected by CT and MRI,but the definite diagnosis is still in need of combining with clinical appearances and other relative examination.

AIM: To observe the effect of Jiawei sinisan (JWSNS) on some amino acids in hippocampus of rats with chronic stress. METHODS: Wistar rats were randomly divided into 3 groups: control, model and JWSNS group. OPA (HPLC) was adopted to detect the contents of amino acids in hippocampus. RESULTS: The contents of Glu and Asp in hippocampus of model group increased significantly ( P

Objective To investigate the correhtion between cognitive impairment and cerebral atherosclerosis in patients with acute ischemic stroke.Methods Acute ischemic stroke patients without cognitive impairment were recruited before symptom onset.The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function.Magnetic resonance imaging (MRI) was used to identify the infarct locations and sides.Magnetic resonance angiography,CT angiography and digital subtraction angiography were used to identify atherosclerotic arteries.Resul~ A total of 101 patients with acute ischemic stroke were enrolled,including 75 (74.3％) with cognitive impairment.The proportions of age (54.54 ± 12.59 years vs.64.43 ± 10.37 years;t =-3.960,P ＜0.001),years of education ≤6 years (50.7％ vs.11.5％;x2 =12.257,P ＜ 0.001),and cerebral atherosclerosis (89.3％ vs.50.0％;x2 =18.137,P ＜0.001) of the cognitive impairment group were significantly higher than those of the normal cognitive function group.Multivariate logistic regression analysis showed that cerebral atherosclerosis was an independent risk factor for cognitive impairment in patients with acute ischemic stroke (odds ratio 1.720,95％ confidence interval 1.005-2.942;P=0.048).MoCA score was negatively correlated with the offending vessels (r=-0.365,P＜ 0.001) and the most severe vessels of atherosclerotic degree (r=-0.243,P =0.014).Conclusions Most patients with acute ischemic stroke had cognitive impairment in the early stage after onset,and the MoCA scores was negatively correlated with the degree of cerebral atherosclerosis.Cerebral atherosclerosis was an independent risk factor for cognitive impairment in patientswith acute ischemic stroke.