Objective To explore the CT perfusion imaging with acetazolamide (ACZ) challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug 2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT perfusion imaging with acetazolamide challenge test,and the cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT) and time to peak (TTP) in anterior cerebral artery (ACA),middle cerebral artery (MCA)cortical branch supply area,MCA deep perforator region,posterior cerebral artery (PCA) and pons part blood supply area were examined in the elderly people of two groups.Results CBV and CBF values in ACA,MCA cortical branch supplyarea,MCA deep perforator region,PCA and pons part blood supply area after ACZ stimulation were significantly lower in case group than the control group (t=3.57,3.39,9.34,11.04,4.21,5.99,9.91,11.10,6.66,9.97,P＜0.01 or 0.001),while MTT and TTP values were significantly higher in case group than in the control group (t =7.21,6.94,16.53,4.82,11.67,6.46,6.11,6.71,6.87,4.82,all P＜ 0.001),CBV and CBF values in the control group were significantly higher after ACZ excitation than before the challenge (t=6.44,6.86,9.72,10.99,7.03,6.33,12.48,14.82,8.98,12.03,all P＜0.001),and the MTT and TTP values in the control group were significantly lower after ACZ excitation than before the challenge (t=7.98,5.77,17.29,8.28,9.74,7.01,7.52,6.32,6.01,5.54,all P＜0.001).Conclusions CT perfusion imaging with acetazolamide challenge test can increase the detection rate of chronic cerebral insufficiency with better clinical significance,and is worthy of promotion.

Objective To investigate the clinical characteristics of gliomas in children,and assess the value of CT and MRI for diagnosing glioma.Methods Fifty-three children under 14 years old who were admitted into department of neurosurgery of Henan Provincial People's Hospital from Jan.2001 to Dec.2006 were diagnosed as glioma.Their age and sex distribution,clinical symptoms and signs,imaging examinations and pathological examinations were retrospectively analyzed.Results 1.There were 35 males and 18 females.2.The common symptoms and signs were headache and dizziness(32 cases,60.4%),nausea and vomiting(32 cases,60.4%),balance function disorder(31cases,58.5%),episodic convulsion(6 cases,11.3%) and fundus changes(33 cases,62.3%).3.There were 24 gliomas located at supratentorial and 29 gliomas located at infertentorial in this group.4.Thirty-three cases had a CT examination(1 case was wrongly diagnosed) and 28 cases had a MRI examination(all cases were positive);The positive rate of CT for displaying these tumors was 97%,MRI was 100%.5.Pathological examination revealed gliomas in 42 cases after operation.The most common histologically confirmed tumor type reported was astrocytoma,which accounted for 40.5%(17 cases),and the second was medulloblastoma,which accounted for 31.0%(13 cases).Conclusions 1.Glioma are more frequently affected in males than females in children.2.It often occurs in cranial posterior fossa and midline,which causes the symptoms of intracranial hypertension including headache,dizziness,nausea,vomiting,fundus changes,and so on.3.It often occurs in infertentorial,which causes the symptoms of balance function disorder,since it can invade cerebellum directly or indirectly.4.CT and MRI play an important role in the diagnosis of glioma in children.MRI is more valuable than CT in glioma diagnosis.5.Histological types of glioma in children are significantly different from adults.The most common histological types are astrocytoma and medulloblastoma.

Objective:To study influence of type 2 diabetes mellitus (T2DM) on coronary artery lesion and plaque sta‐bility using optical coherence tomography (OCT) in patients with coronary artery disease (CAD) manifesting unsta‐ble angina pectoris (UAP) . Methods :A total of 200 patients diagnosed as CAD manifesting UAP were selected.According to complicated with diabetes mellitus or not ,they were divided into normal blood glucose group (n=98) and complicated T2DM group (T2DM group ,n=102). Coronary angiography (CAG) and OCT were used to eval‐uate coronary artery lesion ,assess plaque nature and measure the thickness of plaque fibrous cap in order to confirm plaque stability . Results:Compared with normal blood glucose group ,there were significant rise in percentages of multi-vessel coronary disease (48.98% vs. 78.43% ) ,severe artery stenosis (20.57% vs. 40.21% ) ,lipid plaques (25.00% vs. 39.84% ) and plaques with fibrous cap thickness <65μm (25.93% vs. 45.24% ) in T2DM group , P<0.05 or < 0.01 .Conclusion :Patients with coronary artery disease have more severe coronary artery lesion and high ‐ er incidence rate of multi‐vessel coronary disease and unstable plaque when complicated with type 2 diabetes mellitus .

Objective To study the effect of hospital disposal manners after workplace violence in hos-pital on organizational commitment and turnover intention among the head nurses. Methods Self-made questionnaire about workplace violence in hospital and general condition, organizational commitment question-naire and turnover intention questionnaire were conducted in 122 head nurses who had suffered hospital vio-lence in recent years from all level hospitals of Fujian province. Results The scores of affective commitment and normative commitment of organizational commitment and turnover intention showed significant difference be-tween the groups who suffered positive disposal and who suffered negative interference by the hospital after the violence events (P<0.05), but aggregate score of organizational commitment and the scores of continuance commitment showed no significant difference between the two groups (P>0.05). Hospital disposal manners af-ter the hospital violence and hospital grade were influence factors on turnover intention among the head nurses.Hospital grade was also an influence factor on organizational commitment among the head nurses. Conclu-sions Hospital positive disposal means after the hospital violence on head nurse help to ameliorate organiza-tional commitment and reduce turnover intention among the head nurses.

Objective To explore the risk factors of neonatal necrotizing enterocolitis(NEC)and assess the effect of prophylactic use of probiotics(Bifico)in prevention of NEC and observe changes of weight.Methods Five hundred and twenty-four cases of prematures who were inpatients were divided into 2 groups randomly(prevention group,n=276,no-prevention group,n=248)and the morbidity of NEC and the increase of eight during hospitalization were observed.A case-control study and conditional Logistic regression model multifactorial analysis were made to 20 cases NEC neonates and 80 cases non-NEC neonates.Results The prevention group(276 cases)had 5 cases of NEC and the average weight increase was(8.114?8.137)g/d,the no-prevention group 248 cases had 17 cases of NEC,and the average weight increase was(6.595?5.337)g/d.The occure rate of NEC in prevention group was significantly lower than that of no-prevention group(?2=5.57 P

Objective To discuss the diagnosis of refractory epilepsy (RE) in children, and to study the association of the single nucleotide polymorphisms (SNPs) of muhidrug-resistance gene (MDR1) C3435T with pharmaco- resistant epilepsy. Methods Four hundred children with epilepsy were retrospectively or prospectively identified from multiple sources in our hospital in Shanghai and were followed-up for the occurrence of refractory epilepsy. The clinical features of RE regarding age at onset, gender, seizure type, electroencephalogram, neuroimaging, development of central nervous system, etiology and prognosis etcetera were investigated. DNA samples were obtained from 132 patients with epilepsy (70 RE and 62 responsive epilepsy) and 62 health children by DNA extraction kit. Genotype of the C3435T polymorphism was determined by DNA sequence analysis after traditional polymerase chain reaction. The frequency of genotypes and alleles among the three groups was compared by Chi-square test. Results Eighty-three (20.8%) out of total 400 patients were RE. Among them 65 (78.3%) patients failed at least 2 drugs in six months. Forty-two (50.6%) were administered at least 3 drugs on the last follow-up. Medical treatment showed remarkable effective in 6 (7.2%) RE patients, effective in 40 RE patients (48.2%). No effectiveness was seen in another 37 (44.6%) RE patients, however 25 out of 37 presented symptomatic alleviation. Significant difference in genotype (CC, CT, Tr) frequency was neither found between RE and responsive epilepsy patients nor between RE patients and healthy controls. No association between the C3435T polymorphism in the human MDR1 gene and refractory epilepsy was found by logistic analysis. Conclusions Refractory epilepsy could be diagnosed in 6 months after being treated with anti-epilepsy drugs (AEDs) in children with average attack once per month at least and failed more than 2 AEDs. Multiple AEDs were necessary for treatment. No association between the C3435T polymorphism in the human MDR1 gene and refractory epilepsy was found by logistic analysis in this study.

Aim To evaluate the effect of CYP1A1 on intracellular Ca2+ in human vascular endothelial cells(HVEC304).Methods The expression plasmid of human CYP1A1 was constructed,HVEC304 was transfected,and the intracellular calcium ion level was monitored by microfluorescent technique.Result The expression plasmid of human CYP1A1 was constructed and its expression location was extranuclear.In HVEC304 cells over-expressing CYP1A1(HVEC304-CYP1A1),Ca2+ basal level decreased obviously(P

Objective To explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09?19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94?25.44)mg/L](P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.

Objective:To study the drug distribution in the local tissues and lymph nodes treated with targeting and continuous interstitial chemotherapy for the oral squamous cell carcinoma before operation. Methods:8 patients with oral squamous cell carcinoma were treated by implanting the sustain-released cisplatin around and into the primary lesion. Drug distribution in tissue were studied by the graphite furnace atomic absorption spectrometry. Results:The drug concentration in the center of the tumor,1 cm and 2 cm from the tumor fringe were (34.877 1?15.720 8),(20.690 0 ?15.688 6) and (6.635 7?3.862 3) ?g/g, respectively. The drug concentration within lymph nodes of the sub-mental and submandibular area, deep cervical lymph nodes for the upper,middle and lower were(2.991 4?3.055 7),(4.026 0 ?3.692 0), (7.192 0 ? 8.958 7) and (5.028 5?3.484 3)?g/g, respectively. Conclusion:Targeting and continuous interstitial chemotherapy for the oral squamous cell carcinoma by implanting sustain-released cisplatin can increase drug concentration in the local tissues and the lymph nodes, to attain good efficacy of targeting chemotherapy.

Objective To investigate the prevalence and risk factors of Toxoplasma gondii infection among key populations in Wuxi City,Jiangsu Province,so as to provide evidences for developing preventive and control interventions for T. gondii in-fection. Methods A questionnaire was designed to conduct face-to-face interviews to HIV/AIDS carriers/patients,tumor pa-tients,pregnant women and pet breeders. The blood samples were collected to test anti-Toxoplasma IgM and IgG antibodies by using ELISA method. Results Totally 404 participants were investigated,and 38 were positive in testing T. gondii antibodies (9.4%),and among these,37(97.4%)were IgG positive and 1(2.6%)was IgM positive. The multivariate logistic regression indicated that age,regularly contacting cats/dogs and being HIV positive were associated with the infection of T. gondii(OR=2.1,2.6 and 2.3,all P < 0.05). Breeding pets,being HIV positive and being tumor patients were more likely to infect T. gondii than being pregnant(OR = 1.5,8.1 and 2.8,all P < 0.05). Conclusion The high infection rate of T. gondii is observed among key populations in Wuxi City,so that the effective measurements should be taken to enhance the intervention among key popula-tions including immunocompromised people,pet breeders or people having bad dietary habits of eating raw food.