Objective To investigate the variations of multi-segments of the Willis' circle in cases with ACA-A1 variation.Methods Retrospective comparative analysis was applied to images of 2 246 healthy cases which were excluded from abnomalities of physical and biochemistry examination and angiostenosis caused by angiosclerosis.We divided variant group and contrast group according to variation of ACA-A1 segment.Several aspects were carried to comparison:the variation between bilateral ACA-A1 segment within the variant group was studied by x2 test; the proportion of FTP and developing of PCA-P1 were put into test.Finally we use trend x2 test to compare the variation degree of ACA-A1,ipsilateral FTP formation and PCA-P1 variation.Results Variants of ACA-A1 contains 634 cases whereas normal cases were 1 612.A prominence in variation revealed in right side of ACA-A1 (x2=26.19,P＜0.01) which revealed by 429 cases in right side versus 205 cases in lefi side respectively.Parallelled with contrast group,the variant group showed immensely advantages in high proportion of FTP (x2=14.165,P＜0.01) which indicated by variant group 22.56％ (143/634)and contrast group 18.30％ (295/1 612); but crippled in PCA-P1 formation (x2=4.32,P＜0.05)which illustrated by proportions of by dysplasia and deficiency compared by variant group and contrast group was 17.35 ％ (110/634),14.21％ (229/1 612).AC A-A 1 normal,slight variation,dysplasia and deficiency together with FTP dyformation was 9.15％ (58/634),15.62％ (52/333),16.50％ (34/206),23.16％ (22/95) respectively.Within the variation group,a pattern between ACA-A1 and FTP which fluctuated simultaneously with significant statistical discrepancies (x2=51.117,P＜0.01; linear by linear x2=13.340,P＜0.01)which demonstrated by ACA-A1 normal,slight variation,dysplasia,deficiency together with FTP formation was 4.57％ (29/634),12.91％ (43/333),16.02％ (33/206),20.00％ (19/95) respectively,as far as ACA-A1 variation was concerned,The variant group were more prone to develop PCA-P1 dysplasia or deficiency (x2=45.87,P＜0.01; linear-by-linear x2=43.474,P＜0.01).Conclusions There were more multi-variation of Willis' circle in the cases with ACA-A1 variation,MRA can value the anatomy and variation of the Willis' circle.MRA can also guide the clinic diagnosis,treatment and prognosis of the cerebrovascular diseases.

OBJECTIVETo discuss the TCM pattern classification and measurable diagnosis criterion of the protracted symptoms of heroin-addiction abstinence (PSHAA).

METHODSThrough literature review and clinical study, the concept of TCM patterns and diagnostic standard were established, and a TCM pattern scale for quantitatively analysis of PSHAA was formulated. The scale were used on the clinical investigation on the abuser for 5 times on day 15, 30, 60, 90 and 120 after abstinence. Then the TCM patterns of PSHAA was classified using methods of DME and quantitative diagnosis, to create a corresponding scale of diagnostic indexes referring maximum likelihood method.

RESULTS(1) The TCM patterns of PSHAA commonly seen were Toxin-stasis accumulation (TSA) with Qi-blood insufficiency, TSA with Qi-yin deficiency, TSA with Yin-deficiency and Fire-excess and TSA with Yin-Yang deficiency. (2) The retrospective and prospective verification of the scale of diagnostic indexes showed it has high sensitivity and speciality, with low rates of misdiagnosis and of missed diagnosis.

CONCLUSIONIt is feasible to develop measurable diagnosis on the TCM patterns of PASAA using DME method and measurable diagnostic methods. The scale of diagnostic indexes formulated with the maximum likelihood method of quantified diagnosis has a certain clinical practicability.

Adult ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heroin Dependence ; diagnosis ; drug therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Reference Standards

Objective To study the clinicopathologic features and explore the potential prognostic factors of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).Methods 86 patients diagnosed with MALT lymphoma were retrieved and divided into 2 subgroups according to the location of tumor,namely gastric (32 cases) and non-gastric (54 cases) subgroup.Histological characteristics were reassessed on hematoxylin-eosin staining slides,and immunophenotypic features were determined by immunohistochemical staining.Interphase fluorescence in-situ hybridization (FISH) was carried out to detect the cytogenetic abnormalities.Results There were no significant difference of clinical behavior,histology,and immunophenotype between gastric and non-gastric subgroups.In addition,FISH detected t(14;18) in 9 ％ (4/45) and t(11;18) in 12 ％ cases (6/50) respectively.Among the 20 cases treated with H pylori (HP) eradication,a significantly lower remission rate was observed in cases with bcl-10 (20 ％) nuclear expression or those harboring t(11;18) (33 ％) compared with those in the negative group (73 ％,91％)(x2 =3.842 and 4.639,P =0.035 and 0.031,respectively).For the 35 non-gastric patients with follow-up data,males (35 ％) and patients older than 60 yrs (25 ％) tended to have a lower remission rate as compared to females (60 ％) and those younger than 60 yrs (63 ％) (x2 =3.905 and 7.373,P =0.048 and 0.007,respectively).Moreover,progression-free survival rate was significantly lower in patients with higher stage (ⅢⅣ) (25 ％) and without t(14;18) (50 ％) than that in patients with stage Ⅰ-Ⅱ (52 ％) and with t(14;18)(75 ％).The differences had statistical significance (x2 =4.207 and 4.363,P =0.040 and 0.037,respectively).Conclusion MALT lymphoma in general is an indolent B-cell non-Hodgkin’ s lymphoma which more frequently occurs in the elderly people.Differences in the response to treatment or the prognosis are observed between gastric and non-gastric MALT lymphoma patients.

ObjectiveTo investigate the diagnostic significance of different pathology techniques (Immunohistochemistry and ISH)to detect EBV on bone marrow biopsy tissues of hemophagocytic syndrome. Methods Histological,immunohistochemicalandinsituhybridizationwereusedtostudythe hemophagocytic features and expression of LMP-1,EBER and other markers.Results25 out of 51 cases (49.0 ％)showed an active proliferation growth pattern while other 12 cases(23.5 ％)demonstrated a deterioration morphological character compared with their same age group. The left 14 cases (27.5 ％) showed a normal myeloproliferative pattern. 91.4 ％ (32/35) expressed CD68/KP-1 and 89.5 ％ (17/19) cases expressed CD68/PG-M1, which showed an abnormal increase of monocytes. 26 out of 51 cases (51.0 ％) were positive for EBER,while EBER and immunohistochemistry on LMP-1 were detected simultaneously in 41 cases.The EBER were positive in 19 cases(46.3 ％)but none for LMP-1(P =0.000).ConclusionHypoplasia or hemophagocytic features could be detected on bone marrow biopsy tissues of hemophagocytic syndrome, which might be slightly difficult to diagnose. So immunohistochemistry would be essential. Meanwhile, the detection of EBER is more helpful than LMP-1 for diagnosis.

Objective To investigate the EB virus (EBV) infection and its clinical significance in angioimmunoblastic T-cell lymphoma(AITCL).Methods 62 patients diagnosed as AITCL between 2008 Jan and 2011 Dec were retrospective analyzed.All cases were re-confirmed and classified with the histology and immunology according to 2008 WHO Classification.In situ hybridization of EBV encoded RNA (EBV-EBER) was performed.Clinical characteristics and follow-up data of patients were collected.Results 42 ％ (26/62) AITCL cases were EBER-positive.EBV infection was found to be significant correlation with age over 60 years and poor response to therapy (P =0.025,P =0.049,respectively).However,EBV infection had no relationship with the overall survival,the presence of B symptom and the Ann Arbor stage.Conclusion In AITCL,EBV infection seems not to be associated with the overall survival,B symptom and Ann Arbor stage,but it may have impacts on theraputic response.

Aim To establish a LC-MS/MS method to measure the concentration of ginsenoside Rg1 in intrac-erebral dialysate and compare the probe recovery in vitro and in vivo. Methods The assay was conducted with a ACQUITY UPLC BEH C18(2. 1 mm × 50 mm, 1. 7 μm) . The mobile phase consisted of methanol and ultrapure water and it was detected by gradient elution. The flow rate was 0. 4 mL·min-1 . Specificity, linear range, precision and accuracy, stability were evaluated to investigate the reliability of the method. The recov-ery of ginsenoside Rg1 in probe in vitro and in vivo was compared. Results The retention time of ginsenoside Rg1 was 1. 91 min, the linear range was 0. 1 ~50 μg · L-1 , intra-day and inter-day precisions were less than 15%. The recovery of ginsenoside Rg1 was (4. 05 ± 0. 28)% in vitro and(26. 96 ± 4. 45)% in vi-vo. Conclusion The LC-MS/MS method is accurate, sensitive, and reproducible for quantitative determina-tion of ginsenoside Rg1 in microdialysate. The probe recovery of ginsenoside Rg1 in vivo is higher than in vitro, and both are stable in different concentrations.

BACKGROUND: The most frequently encountered problem that an orthopedic doctor encounters in treating humerus fracture is how to choose the exact direction and amount of load applied on humerus.OBJECTIVE: To explore the clinical significance of establishing a three-dimensional model and finite element analysis in treating humerus fracture and to provide theoretical basis for applying appropriate axial stress.DESIGN: The three dimensional model of humerus was reconstructed, on which compression from different directions was applied.SETTING: Orthopedic department of an affiliated hospital and life science laboratory of a university.MATERIALS: A humerus specimen received CT scanning and the trial was conducted in Shanghai Changhai Hospital and Life Science Laboratory of Tongji University from April 2002 to April 2004.METHODS: The three dimensional model of humerus was established and relevant calculation was completed with ANSYS 5.6 software. The humerus model was divided into 2 729 nodes and 49 041 units based on a three-dimensional ten-node tetrahedron as one unit. The distribution and intensity of axial compression on the fracture gap section were calculated and analyzed in the following conditions, i. e. when the humerus was fixed in X, Y and Z directions and the fracture gap section was 30°, 45°, 90° to Z axis.MAIN OUTCOME MEASURES: The axial pressure on the fracture gap section in different conditions to provide evidence for clinical treatment.RESULTS: The stress applied on the fracture gap was relatively concentrated and was 2 -3 times stronger than that in other areas, and it was generally symmetrically distributed within 10 mm around the fracture gap.CONCLUSION: The required load on humerus fracture should be calculated before a suitable implant is applied to accommodate the movement of humerus without compromising healing of the fracture.

Objective To investigate the effects of sepia on stem cells,granulocyte and monocyte progentior cells and peripheral WBC in mice.Methods Different dosages of sepia were given to normal and model mice with hematopoietic system impairment respectively.The numbers of CFU-S,CFU-GM and peripheral WBC in normal and model mice were measured respectively with the method of hematopoietic progenitor cells cultured in vitro and the technique of experimental hematology.Results Sepia could enhance the number of CFU-S,CFU-GM and peripheral WBC in normal mice significantly,resist the decrease of CFU-S,CFU-GM,and peripheral WBC in model mice of hemapoiecsis impaired effectively and promote the restoration of those indices mentioned above in model mice significantly.Conclusion Sepia has significant effects on stimulating granulopoiesis in bone marrow in mice.The mechanism may be related to regulating immunological function and inducement GM-CSF and other sorts of cellular factors,which in turn promote the multiplication differentiation of CFU-S and CFU-GM.

Objective To analyze the clinical pathological characteristics and prognosis of elderly patients with EB virus-positive diffuse large B-cell lymphoma (EBV+ DLBCL).Methods 24 elderly patients with EBV + DLBCL were collected to evaluate their clinical pathological characteristics and prognosis by comparison with the EBV-DLBCL,NOS during the same period.Results 24 EBV + DLBCL cases demonstrated two morphologic subtypes:polymorphic and monomorphic.And polymorphic subtype showed geographic necrosis more frequently than that in monomorphic subtype.According to Hans and Choi models,the majority of EBV+ DLBCL of the elderly were classified as non-GCB subtype (91.3 ％ and 100.0 ％,respectively).55.0 ％ cases showed CD30 positive,which was significantly higher than that in EBV-DLBCL group (P ＜ 0.001).Under the treatment of R-CHOP regimen,the overall survival (OS) of the elderly EBV+ DLBCL patients showed no significant difference with the ＞50-year old EBV-DLBCL patients (the median OS were 44.2 months and 29.2 months,P =0.587).Conclusions The elderly EBV + DLBCL patients are normally presented with polymorphic and monomorphic patterns.And geographic necrosis are often seen in polymorphic cases.CD30 expression and non-GCB subtypes are high.With the R-CHOP regimen,the OS of the elderly EBV+ DLBCL patients is similar with that of ＞50-year old EBV-DLBCL patients.

Traditional Chinese Medicine(TCM) makes great contributions to the prosperous growth and people's health.But understanding deviation and imperfect evaluation system of TCM affect the healthy development of TCM.Clinic practice is the motive power of TCM,and curative effect is the key of TCM researches,and the scientific evaluation system is the safeguard for a healthy development of TCM.So we should focus on clinical researches of stubborn diseases and emergency cases to satisfy social demand and upgrade the position of TCM in the medical system.At the same time,functional disease must be explored to show the advantage of TCM.Our mission is to establish a scientific objective evaluation system to accurately understand TCM and take it as the turning point to give an impetus to theoretical breakthrough of the basic studies to promote an overall and healthy development of TCM.