Objective To observe the vertebrobasilar artery and its branch courses,diameters and the included angles in the starting part,offering morphological basis for clinic intervention and vascular image.Methods Layer by layer dissecting head,neck and chest of nine adult specimens affused with red latex,and after affused carotid artery with red latex,the origin,course,branches,distribution,anastomosis,and accompanying of the vertebrobasilar artery were observed in three normal adult corroded specimens.Results The degree of the left included angle between subclavian artery and vertebral was (91.70 ± 0.90) ° and that of the right one was (115.80 ± 1.60) ° (P ＜ 0.05).A percentage (14.1％) of them contacted with vagus and glosssopharyngeal nerve.The degree of the left included angle between posterior cerebal lower artery and vertebral artery was (118.60 ± 3.70) ° and that of the right one (77.60 ± 7.90) °.A percentage (27.6 ％) of itself contacted or pressed by root of facial nerve.The degree of the included angle on the left side between anterior cerebellar lower artery and brobasilar artery was (91.60 ± 2.40) ° and that of the right one was (27.10 ±2.70)°(P ＜0.05).The degree of the left included angle between posterior cerebral artery and basilar artery was (93.90 ± 3.40) ° and that of its right one was (130.80 ± 3.20) ° (p ＜ 0.05).Conclusions Both vertebral artery in every part out of skull and the data of the each branch pipe diameter,the starting included angle of vertebrobasilar artery had statistical significance,which should select personalized catheter or operation method in endovascular intervention or craniocervical surgery.

Objective: To investigate the treatment efficacy of radiofrequency ablation (RFA) of hepatic tumors and the relevant complications. Methods: A total of 343 patients with 778 hepatic tumors underwent ultrasound-guided RFA (582 procedures). There were 212 cases of hepatic cellular carcinoma (HCC) with 448 tumors, and the average largest diameter was 4.0 cm.Of all the patients, 63 (29.7%) were in the stage of Ⅰ-Ⅱ(UICC Systems) and 149 (70.3%) in stage of Ⅲ-Ⅳ(including 43 patients with tumor recurrence after surgical resection). There were 131 cases of metastatic liver carcinoma (MLC), with 330 metastases in the liver, the average diameter was 3.9 cm, and the liver metastases of 91 patients (69.5%) came from gastrointestinal tract. The patients were treated using the relatively standard protocol. Crucial attention must be paid to monitoring the abnormal changes in ultrasound images as well as the vital signs of the patients to find the possible hemorrhage and peripheral structure injury in time. The tumors were considered ablated successfully if no viability was found on enhanced CT within 24 hours or 1 month after RFA. The patients were followed up for 2 -62 months.Results: The ablation success rate for HCC was 95.5% (428/448 tumors), and the rate for MLC was 96.4% (318/330 tumors). The local tumor recurrence rates for HCC and MLC were 8.5 % (38/448 tumors) and 11.8 % (39/330 tumors), respectively. A total of 138 patients (40.2%) underwent repeated ablations for 2-11 times because of tumor recurrence or metastasis. The first,second and third years survival rates were 87.7% , 67.4% and 56.8% for HCC patients, 81.6%, 50.8% and 27.2% for MLC patients,respectively. The survival rate from 63 early-stage HCC patients were 92.9%,82.8% and 74.5%, respectively. The major complication rate in this study was 2.4 % (14 of 582 procedures).The complications which consisted of mechanical and thermal injuries usually occurred during or shortly after the RFA treatment. There were 5 hemorrhages, 1 colon perforation, 5 injuries of adjacent structures, 2 bile leakages and 1 skin burn. Conclusion: RFA, as a minimally invasive local treatment, has become an effective and relatively safety alternative for the patients of hepatic tumors, even of advanced live tumor, tumor recurrence, liver metastases which are unresectable or difficult to treat with traditional therapies. Knowledge about possible complications and their control may increase the treatment efficacy and help to promote the use of RFA technique.

Objective:To comparison of three different beta blockers on murine hemangioma (EOMA cells) cells in vitro and in vivo effects.Preliminary study on the therapeutic effect of propranolol on vascular tumor in mice and possible mechanisms , provide a reference for beta blockers in the treatment of infantile hemangioma .Methods: Comparative study on the effects of three kinds of different β-receptor blockers---metoprolol, propranolol and butoxamine , on the proliferation and apoptosis of Mouse Hemangioendothelioma Endothelial cell (EOMA cells) was conducted in vitro.EOMA cells were cultured in vitro,randomly divided into different groups,propranolol and timolol were added into the medium respectively ,after 24 h intervention.MTT assay and acridine orange staining assay were conducted respectively to detect cell viability and apoptosis level .EOMA cells were transplanted into nude mice in vivo.Tumor volume growth to 100 mm3 ,animals were randomly divided into 4 groups respectively ,the control group ,metoprolol group,Bhutto Samin group and propranolol group ,drug group according to 2 mg/( kg? d) oral gavage ,control group were given an equal volume of saline ( NS ) , every two days measurement tumor volume size .Serum levels of tumor necrosis factor alpha ( TNF-α) and vascular endothelial growth factor ( VEGF ) were detected by enzyme linked immunosorbent assay ( ELISA ) in the end of the experiment.Results:For propranolol,after 24 h treatment,significant differences of cell viability and apoptosis were noted (P<0.05) at the concentration of 50 μmol/L,while continuing to increase to 800 μmol/L,the cell survival rate decreased sharply to close to 10%. Acridine orange staining at the 50 μmol/L group after 24 h revealed many apoptotic cells .For metoprolol and butoxa mine ,significant differences of cell viability and apoptosis were noted ( P<0.05 ) at the concentration of 100 μmol/L,while continuing to increase to 800μmol/L,the cell survival rate decreased sharply to close to 20%.It was significantly higher than propranolol group at the same concentration ( P<0.05 ) .It showed a similar trend in acridine orange staining .In vivo experiments showed that the end of the experiment of metoprolol , butoxamine group and propranolol drugs in mice tumor volume , respectively ( 1 642.8 ±89.3 ) , ( 1 529.3 ± 119.1) and (752.7±46.5)mm3,significantly lower than the control group of mice tumor volume of (2 023.3±123.0) mm3(P<0.001).Metoprolol,butoxamine mice and propranolol drugs group ,serum VEGF levels for (606.5±105.8 ) pg/ml,(534.3±243.2 ) pg/ml and (420.1±123.7) pg/ml, significantly lower than the PBS control group [(825.8±145.7) pg/ml,(P<0.05)],the TNF alpha result was followed by(301.3±62.3) pg/ml,(305.1±53.8) pg/ml and (288.8±59.5) pg/ml,significantly lower than the normal control group [(444±100.4) pg/ml,P<0.05].Conclusion:Three kinds of beta-blockers can effectively inhibit EOMA cells proliferation and induce apoptosis in vitro, the role of propranolol more significantly than butoxamine and metoprolol .Three kinds of beta blockers restrain the growth of the hemangioma in vivo ,in which the inhibitory effect of propranolol is stronger than the metoprolol and butoxa mine.Three kinds of beta blockers can lower the levels of VEGF and TNF-αin vivo.Indicating that propranolol on vascular tumor in mice may be one of the mechanisms of β1 and β2 receptor synergy effect and its mechanism in the treatment of hemangioma may be associated with VEGF and TNF-α.

Objective To determine the incidence and prevalence of transient ischemic attack (TIA) and to evaluate its epidemiological situation in Hunan province.Methods Seven monitoring points were randomly selected from the province,a total of 8 311 subjects aged≥50 years were then chosen by stratified sampling.The cases counted in prevalence was defined as patients diagnosed before 24:00 o'clock August 31st,2013,and the new diagnosis for incident counting was defined as those diagnosed between 00:00 September 1st,2012 and 24:00 August 31st,2013.Results Among all 8 311 screened subjects,the number of TIA patients was 24 (288.8 per 100 000 people),the incidence of TIA was 7 (85.2 per 100 000 people).Standardized prevalence and incidence were 283.2 and 82.4 per 100 000 respectively using 2010 China census population.Among them,the standardized incidence rate of female was higher than that of male (114.8 per 100 000 person-years vs.48.8 per 100 000 person-years),and the prevalence rate of males was higher than that of female (288.2 per 100 000 people vs.273.2 per 100 000 people).Hypertension is the most important risk factor for TIA (55.2％).Conclusion The incidence and prevalence of TIA in Hunan province are higher than the national average.Hypertension is the main risk factor.

Objective Vulnerable plaque of carotid artery is one of the risk factors of atherosclerotic cerebral infarction.Detection and treatment of vulnerable atherosclerotic plaque of carotid artery before symptoms of cerebral infarction is an effective way to prevent atherosclerotic cerebral infarction.Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis,a common risk factor for both myocardial and cerebral infarctions.Studies have indicated that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction and SNP rs3861950 in TNFSF4 is associated with higher risk of atherosclerosis cerebral infarction (ACI),but little is known about the association between TNFSF4 variations and vulnerable plaque of carotid artery.Methods A case-control study involving 510 patients with asymptomatic vulnerable plaque of carotid artery and 485 age and sex matched healthy subjects without vulnerable plaque of carotid artery was conducted in Hunan province.Asymptomatic vulnerable plaque of carotid artery means vulnerable plaque of carotid artery without cerebral infarction.Two SNPs of TNFSF4,rs3850641 and rs3861950,were genotyped by the TaqMan SNP genotyping method,and verified partly by Genomic DNA Sequencing.Results The results revealed a significant allelic association between rs3861950 and asymptomatic vulnerable plaque of carotid artery in case group (x2=9.13,P=0.003;OR=1.41,95％ CI:1.12-1.76).Compared with control subjects,the difference in genotype was significant in case group (x2=25.28,P＜ 0.000 1).However,there was no significant association between rs3850641 and asymptomatic vulnerable plaque of carotid artery(OR=1.16,95％CI:0.92-1.46;x2＝ 1.47,P=0.225).Conclusion TNFSF4 gene polymorphism rs3861950 was associated with the risk of vulnerable plaques of carotid artery in a Chinese population,which might be middle phenotype indicating higher risk of cerebral infarction.

Objective: To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China. Methods: Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015. Results: The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%. Conclusions The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.