Objective To explore the diagnositic value of dual-phase contrast enhancement CT combined with virtual non-enhanced images by dual-energy CT in clear cell renal cell carcinoma.Methods Sixty patients who were suspected of clear cell renal cell carcinoma underwent non-enhanced CT and contrast enhancement CT of early interface-phase between cortex -medulla and parenchymal phase on a dual-energy CT.The true non-enhanced kidney CT(TNCT) was performed in a single-energy acquisition mode,but the dual-phase contrast enhancement CT were performed in a dual-energy mode of 80 kV and 140 kV respectively.The virtual non-enhanced CT ( VNCT ) images were derived from the data of early interfacephase using liver virtual non-contrast software.The diagnosises according to VNCT combined dual-phase contrast enhancement CT and dual-phase contrast enhancement CT only were made respeetively and compared with x2 test.Between the true non-contrast CT and the virtual non-contrast CT,the image quality was compared with Wilcoxon test ; The radiation dose of volume CT dose index ( CTDlvol ) and dose length product(DLP) in a single-phase and total examination,the mean CT HU values of the tumours werecompared with t test.Results The accuracy of VNCT combined dual-phase contrast enhancement CT was higher than that of dual-phase contrast enhancement CT only [93.3％ ( 56/60 ) vs.78.3％ ( 47/60 ) ; x2 =5.6,P ＜0.05].The detective ability (score) of VNCT was near to that of TNCT and the difference was not obvious( Z =0.00,P ＞ 0.05 ). The radiation dose of volume CT dose index ( CTDIvol ) and dose length product(DLP) in a single phase and total examination of VNCT[(8.85 ± 1.28) mGy,(196.45 ±21.12) mGy·cm,(17.69±2.35) mGy,(392.90±42.25) mGy · cm] were lower than that of TNCT [( 10.20 ± 1.44 ) mGy,( 218.29 ± 29.60 ) mGy · cm,( 30.61 ± 3.27 ) mGy and ( 654.86 ± 88.81 ) mGy ·cm],t =4.21,3.58,23.63,16.12 respectively,P ＜0.05.The mean CT HU values of tumours on VNCT images was higher than that on TNCT images and the difference was significant [(39.37 ± 6.35 ) vs.(34.94 ± 7.00 )HU,t =- 14.39,P ＜ 0.05].Conclusions The diagnositic value of dual-phase contrast enhancement CT combined virtual non-enhanced CT by dual-energy CT for clear cell renal cell carcinoma was obvious,most tumours can be diagnosed correctly,and the radiate dose can be decreased obviously,the normal single-energy non-enhanced and contrast enhancement CT might be replaced in the future.

Objective To investigate the correlation between ankle-brachial index (ABI) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset from January 2014 to December 2014 were enroled. Bidirectional Doppler flow detector was used to detect ABI. END was defined as the increased National Institutes of Health Stroke Scale score ≥2 or the increased motor score ≥1. The demographic characteristics, vascular risk factors, laboratory parameters, and the incidence of END were identified and analyzed. Results A total of 210 patients with acute ischemic stroke were enroled, including 51 had END and 159 did not have END. Univariate analysis showed that the proportion of patient with ABI ≤0. 9 of the END group was significantly higher than that of the non-END group (43. 1% vs. 22. 0% ; χ2 = 8. 714, P =0. 003). Multivariable logistic regression analysis showed that ABI ≤0. 9 (odds ratio 2. 688, 95% confidence interval 1. 265 - 5. 052; P = 0. 009) was independently associated with END in patients with ischemic stroke after adjusting for the confounding factors, such as age, sex, baseline systolic blood pressure, and ischemic heart disease. Conclusion The low ABI was associated with the occurrence of END in patients with acute ischemic stroke.

BACKGROUND: Transplantation of bone marrow mesenchymal stem cells (MSCs) has been used in the field of repair of nerve injury. Brain stereotactic transplantation and transvascular transplantation are two transplantation methods. OBJECTIVE: We infused MSCs into rat peripheral cerebral infarct focus, in order to investigate the improvement of rat neurological dysfunction by forelimb use asymmetry test and postural reflex test.DESIGN: A randomized controlled animal experiment. SETTING: Department of Neurology, First Hospital of Jilin University.MATERIALS: This study was performed at the Key Laboratory of Zoonosis, Ministry of Education, Institute of Zoonosis, Jilin University between October 2006 and April 2007. Healthy male Wistar rats of clean grade, weighing 250-280 g, were provided by the Laboratory Animal Center of Jilin University. The protocol was performed in accordance with ethical guidelines for the use and care of animals.METHODS: MSCs from healthy adult volunteers were in vitro cultured and proliferated by density gradient separation and adherence screening method. Their immunophenotypes were identified by a flow cytometer. The Wistar rats were randomized into 5 groups with 10 rats in each: normal control group, sham-operated group, model group, serum-free DMEM-treated group (DMEM group) and MSCs -treated group (MSCs group). Rat models of cerebral ischemia/reperfusion were developed by occluding rat right middle cerebral artery following suture occlusion method modified by Longa et al. Rats in the normal control group were untouched. In the sham-operated group, operation was not ended till cervical interior and exterior arteries were exposed and sutured, and the other disposals were the same as those in the model group. At ischemia 90 minutes reperfusion 1 hour, a stereotaxic apparatus was used to take rat right peripheral cerebral ischemic region as transplantation site: 3 mm lateral to, 1mm caudal to and 4 mm posterior to Bregma. Rats in the MSCs group were slowly injected 5 μL BrdU-labeled MSCs (4×1011 L-1) serum-free medium. Rats in the DMEM group were injected 5 μL serum-free medium. After perfusion, inserted needle was retained for 5 minutes and then slowly withdrawn in order to avoid the back flow of liquid from needle pole. The survival of MSCs in rats was detected by immunohistochemical technique, and rat behavioral changes of observed on days1, 3, 7 and 28 after transplantation by forelimb use asymmetry test and postural reflex test.MAIN OUTCOME MEASURES: ① The immunophenotype of MSCs were identified by a flow cytometer. ② The survival of transplanted MSCs in the rat brain. ③ Rat behavioral changes. RESULTS: All the 50 rats were included in the final analysis. ① High purity of MSCs were harvested in the experiment. Flow cytometer detection showed that both CD44 and CD29 were positive, while CD34, CD45 and CD31 were negative. ② MSCs transplanted into the brains of rats in the MSCs group gathered in the peripheral cerebral ischemic region and survived. ③ Behavioral scores of rats in the MSCs group were significantly lower than those in the other groups (P < 0.05). They were gradually decreased with time after transplantation, and reached the valley value on day 7 after transplantation (P < 0.01). CONCLUSION: Neurological function of rats recovers in all the groups except normal control group. But the recovery differs in different groups, and neurological function of rats in the MSCs group recovers better than that in other groups.

BACKGROUND: Vascular endothelial growth factor (VEGF) can accelerate neovascularization and, as a multifunctional cytokine, performs critical functions via its receptors in angiogenesis.OBJECTIVE: To investigate the expression of VEGF and its receptor FLT-1 and FLK-1 mRNA during the early stage of acute focal cerebral brain ischemia, and examine the relationship between the timing and location of their expressions.DESIGN: Randomized controlled study.SETTING: Department of Neurology of the First Hospital Affiliated to Jilin University and Teaching and Research Section of Pathology, Bethune Medical College of Jilin University.MATERIALS: This study was carried out between June 2001 and April 2002. Totally 130 adult SD rats were selected, with male and female in half, and randomly divided into normal control group (n=10), sham operation group (n=10), and cerebral ischemia group (n=110). The rats in cerebral ischemia group were further divided equally into 11 subgroups and examined at 0, 1, 2, 3, 6, 24, 48 hours and 1, 2, 3, 4 weeks after cerebral ischemia model establishment, respectively.METHODS: Permanent middle cerebral artery occlusion (MCAO) model was established in rats in cerebral ischemia group by ligation of the left common carotid artery, while the rats in the sham operation group received no artery ligation but with identical other treatments. The rats in the control group did not have any treatment. Reverse transcriptional (RT) PCR was used to detect the expression of VEGF and its receptor mRNA at different time points after ischemic model establishment, and neovascularization in the rats'brain was observed.MAIN OUTCOME MEASURES: ① Expression of VEGF and its receptor mRNA and ② neovascularization in the brain tissue at different time points of cerebral ischemia.RESULTS: Data of the 130 mice were statistically analyzed without losses.At 3, 6, 24, and 48 hours of ischemia, the number of cells positive for VEGF expression was 31.13±2.21, 43.11±2.43, 85.41±2.75 and 98.66±1.76 in each vision filed in the surrounding ischemic region, greater than the numbers in the central ischemic region at the corresponding time points (13.32±1.31, 19.40±3.22, 47.63±2.45, 57.32±3.35 in each vision field, respectively, P ＜ 0.05). VEGF mRNA expression gradually decreased since 48 hours after model establishment till recovering the control level by 2weeks. The expression of VEGF receptor FLT-1 mRNA, determined by the number of positive cells in each vision field at 3, 6, 24, and 48 hour after the ischemia in each vision field for FLK-1 mRNA at these time points in the peripheral ischemic regions, higher than those in the central ischemic regions (P ＜ 0.05), which recovered the control level 3 weeks after the ischemia (P ＜ 0.05). At 48 hours and 1 week after the ischemia, the number of microvessels in each vision field was 47.2±2.11 and 199.2±3.45 in the peripheral ischemic region, significantly higher than the number in the central ischemic region (29.4±2.37 and 76.6±4.62, P ＜ 0.05).CONCLUSION: VEGF and its receptors FLT-1 and FLK-1 mRNA are expressed in the neurons, glial cells and endothelial cells during the early stage of acute focal cerebral ischemia, and the expressions are significantly enhanced in response to ischemia, exhibiting temporal and spatial expression patterns.

BACKGROUND:Bone marrow mesenchyme stem cells are important non-hematopoietic stem cells in the bone marrow, which can stimulate angiogenesis. While, Slit can also stimulate angiogenesis, as many studies have proved. OBJECTIVE:To review the biological functions, clinical application and effects of bone marrow mesenchymal stem cells and Slit2 on promoting angiogenesis. METHODS:A computer-based online research of CNKI and PubMed databases was performed to col ect articles published between 1980 and 2014 with the keywords“MSCs”and“Slit2”in Chinese and English. There were 436 articles after the initial survey. Final y, 65 articles were included according inclusion and exclusion criteria. RESULTS AND CONCLUSION:Both bone marrow mesenchymal stem cells and Slit2 play an important role in promoting angiogenesis, but the relevance of bone marrow mesenchymal stem cells and Slit2 is stil controversial. If assuming that bone marrow mesenchymal stem cells secrete Slit2, more researches should be done to reveal whether bone marrow mesenchymal stem cells promoting angiogenesis is relevant to Slit2 and through which signaling pathway Slit2/Robo functions to adjust bone marrow mesenchymal stem cells thus to promote angiogenesis. If relevant, the transplantation of the Slit2 and bone marrow mesenchymal stem cells wil be a promising treatment of cerebral infarction and other central nervous injuries.

Objective To explore the effect of mesenchymal stem cells(MSCs) on nervous function in rats with focal cerebral ischemia.Methods The MSCs were cultivated,purified,and proliferated in vitro by density gradient and adherence to plastic dishes method.The models of Wistar rats were prepared after middle cerebral artery occlusion(MCAO) of right lasted 90 min and reperfusion 1 h.Wistar rats were randomly divided into normal control group(A,n=10),sham operation group(B,n=10),no-handle group after cerebral ischemia/reperfusion (C,n=10),free-serm DMEM transplantation group after cerebral ischemia/reperfusion(D,n=10),MSCs transplantation group after cerebral ischemia/reperfusion(E,n=10).After identified by flow cytometry,5 ?L 5-bromo-2-deoxyuridine(BrdU) labeled MSCs(4?105? ?L-1) and 5 ?L serum-free DMEM were respectively injected intracerebraly into ischemic boundary zone of right in D and E groups.Immunohistochemical method was used to detect the expression and survival of BrdU-labeled MSCs in vivo.Nervous function behavioral tests were performed on 1st,3th,7th and 28th day after transplantation by forelimb use asymmetry test and postural reflex test.Results MSCs were successfully purified and proliferated in vitro.The MSCs expressed CD29,CD44,but didn't expressed CD34,CD45,CD31 identified by flow cytometry.transplanted MSCs survived and were localized to the ischemic boundary zone.Behavioral tests of every group were improved with time prolonged.However,MSCs transplantation group was significantly better than any other groups(P

Background and purpose:Senescent cancer-associated ifbroblasts (CAFs) in tumor microenvi-ronment are known to mediate the invasion and radio- or chemo-resistance of epithelial cancers. The inflammatory cytokine IL-6 derived from CAFs may promote the invasion and radio-resistance of epithelial cervical cancer. However, the detailed mechanism is not clear. This study aimed to investigate the effects of IL-6 on CAFs senescence, cervical cancer cell invasiveness and radio-resistance.Methods:CAFs from cervical cancer, normal ifbroblasts (NFs) from nor-mal cervical tissues, and cervical cancer cell lines including HeLa, Siha and ME180 were used in this study. Different treatments of cells with IL-6 and inhibitors of STAT3 and Notch were conducted to investigate the alterations of cellular senescence, STAT3/Notch signaling, cell invasiveness, and radiotherapy-induced apoptosis by using cell staining, immunolfuorescence, Western blot, and lfow cytometery.Results:This study found that the conditioned medium (CM) of CAFs or IL-6 could activate the STAT3 and Notch signaling to promote cellular senescence and cervical cancer cell invasiveness. Co-culture of cervical cancer cells HeLa or Siha along with CAFs also increased the invasiveness of can-cer cells, but further treatments of cells by addition of an IL-6 antibody or the inhibitors of STAT3 (S31-201) or Notch (DAPT) blocked the cancer cell invasion. Meanwhile, this study also found that STAT3 functions at the upstream of the Notch signaling to up-regulate Jagged-1, one of the key ligands of Notch in ifbroblasts or epithelial cancer cells through IL-6-mediated autocrine or paracrine pathways, which eventually confers the radio-resistance of cervical cancer cells/tissues.Conclusion:CAFs in tumor microenvironment could induce cervical cancer cell invasiveness and radio-re-sistance through IL-6/STAT3-mediated Notch activation, and that targeting of the STAT3/Notch signaling-associated molecules may improve the effcacy of radiotherapy for cervical cancer.

Obesity is one of the metabolic diseases that affect psychosomatic health of people and is a risk factor of many chronic diseases. In recent years, the incidence of obesity continues to rise, thus effective weight control and healthy weight loss have become the focus and difficulty of medical research today. Studies have shown that internal microecological changes are related to the occurrence of obesity. Comprehensive health education and nursing play an important role in weight management by adjusting intestinal microecological environment. This paper comprehensively describes the effect of intestinal microecological environment on obesity. The intestinal microecology induces obesity by regulating the nervous system, participating in energy metabolism, regulating immunity and other mechanisms. Interventions such as diet, emotion, exercise and traditional Chinese medicine nursing techniques can regulate the intestinal microecological environment and effectively manage body weight.

As a symbiotic organism, microorganism forms a microecosystem with host body and plays an important role in life activities. With the in-depth study of human microecology, more related basic researches that have been transformed into applied research in clinical practice in recent years. Based on the theory of microecology, this paper explores the establishment and evolution of microecological environment, its relationship with aging and disease and intervention content and effects from the perspective of the whole life cycle of human body. From the perspective of research, this paper explores the internal relationship between microecology and nursing discipline so as to provide theoretical basis and practical basis for the application of microecology in nursing field.

Objective:To construct an integrated Chinese and Western medicine health management plan for patients with acute mastitis so as to promote the recovery of patients and reduce the occurrence of adverse reactions.Methods:A research team was set up to search the fifth edition of Chinese Medical Dictionary database, domestic and foreign databases to obtain relevant evidence of health management of acute mastitis. The Evaluation Form of Evidence Quality recorded by ancient books, Appraisal of Guidelines for Research and Evaluation, A Measurement Tool to Assess Systematic Reviews 2, the Risk of Bias Tool in the Cochrane manual, Joanna Briggs Institute (JBI) quality level of evidence (2010 edition) and JBI grade of recommendation (2010 edition) were used to evaluate, grade and recommend the evidence. An integrated Chinese and Western medicine health management plan for acute mastitis was initially drafted, and the plan was further improved in conjunction with the expert consultation.Results:Totals of 326 ancient literatures, 44 randomized controlled trials, 1 clinical practice guideline, and 6 systematic reviews were included. In expert consultation, the expert judgment coefficient was 0.95, and the expert familiarity coefficient was 0.88, and the expert authority coefficient was 0.92. The constructed integrated Chinese and Western medicine health management plan for acute mastitis included two parts: background knowledge and specific implementation methods a total of 5 dimensions, and 82 implementation strategies.Conclusions:The integrated Chinese and Western medicine health management plan for acute mastitis is constructed based on evidence-based research methods and expert consultation methods, and its content has certain scientificity and clinical applicability, and can be used for the health management of patients with acute mastitis.