BACKGROUND: The structural and functional changes in resistance arteriole of external diameter ＜300 μm is one of the pathological foundations for ischemic cerebrovascular diseases, however there are few quantitative study on the arterioles of various external diameter at different brain area.OBJECTIVE: To probe the difference of arteriolar sclerosis of various external diameter at different brain area after cerebral infarction.DESIGN: Sample investigation.SETTING: Department of Nerve Internal Medicine, General Hospital of Beijing Military Area Command of Chinese PLA.SUBJECTS: Specimen was taken from donated autopsy case in General Hospital of Beijing Military Area Command of Chinese PLA from January 1980 to September 2000. According to the clinical manifestation, brain CT inspection and pathological diagnosis of autopsy, 38 cases were defined as arteriosclerosis cerebral infarction and taken as experimental group, other 15 cases with non-cardiac cerebrovascular disease were taken as controls.METHODS: specimen was obtained in 1-3 days after death from frontal and parietal cerebral cortex and basal gonglion white matters (3 pieces /case) and cut into slices. Five fields of vision were selected from each slice for microscopic observation. Arteriole was divided into ＜ 50 μm group,50-100 μm group and ＞100 μm group according to the arteriole external diameter. (External diameter- internal diameter)/internal diameter was used to assess vascular sclerosis.MAIN OUTCOME MEASURES: [1] Difference of arteriole sclerosis between corresponding external diameter cerebral infarction group and control group. [2] Arteriole sclerosis in various brain region in cerebral infarction group.RESULTS: Totally 38 experimental cases died from arteriosclerosis cerebral infarction and 15 controls died from non-cardiac cerebrovascular disease were enrolled and all data was entered the result analysis. [1] The arteriolar sclerosis index was obviously higher in ＜ 50 μm external diameter cerebral infarction group than in 50-100 μm group and ＞100 μm group[(138.55±76.67)% vs (116.82±58.80)%, (78.07±32.06)%, P ＜ 0.01], while it was approximately the same in the 100 μm external diameter group and control group [(78.07±32.06)% vs (46.38±13.41)%, P=0.174 ]. [2] In ＜ 50 μm external diameter cerebral infarction group, the arteriolar sclerosis index in white matters was significantly higher than that in gray matter [(152.86±87.83)%,(127.97±64.76)%, P ＜ 0.05 ].CONCLUSION: Arteriolar sclerosis degree is correlated with its external diameter and position in patients with cerebral infarction after arteriosclerosis, arteriole of small external diameter or in the white matter has higher arteriolesclerosis liability.

Objective To investigate the salty, efficacy and feasiblify on eholedochotomy with endobiliary drainage and prumary closure of the common bile duct. Methods There were 20 partients without introhepatic or re-tained stones and biliary stricture underwent common bile duet exploration. 20 of them with endobiliary tube drainage and primary CBD closure and the other 20 patients with T tube drainage. Results The average of the time to return routine home was (9. 2 ±1. 3)d, (15. 2 ± 3.6) d(P < 0. 01). The hospital expense of postoperation was (3 252± 312)Yuan,(4 116±388)Yuan(P<0.01). Conclusion Choledochotomy with endobiliary catheter and primary closure of CBD is a safe, effective and feasible procedure for the management of choledochohthiasis.

Objective To observe the clinical effects and safety of radiofrequency thermocoagulation in treating the lumbar intervertebral disc protrusion.Methods Thirty patients with lumbar intervertebral disc protrusion,whose diagnoses were confirmed by clinical manifestations and CT findings,were involved in this study.The needle was punctured to the target point of the diseased intervertebral space under C-arm fluoroscopic guidance.After the testing of sensory nerve,motor nerve and temperature was made,the target needles were heated until the nerve radiofrequency temperature meter reached the point of 92℃.This point of temperature was held for 100 seconds and the procedure was repeated for four cycles.Results Six months after the treatment,all patients showed an obvious improvement in VAS,which decreased from 7.83±0.33before operation to 2.37±0.48 after treatment(P＜0.05).According to the modified Macnab therapeutic evaluation criteria,excellent result was seen in 9,good result in 12,fair result in 5 and poor result in 4cases,with a total effective rate of 86.7%.No serious complications occurred in all patients.Conclusion Radiofrequency thermocoagulation is an effective and safe method for the treatment of lumbar intervertebral disc protrusion.

For recent two decades,radiofrequency ablation technology(RFA)has made great progress in the field of the treatment for diseases for its distinguishing characteristic of microtrauma,targeted,effective and almost having no side-effect.At the very beginning,radiofrequency ablation was adopted in treating solid tumors,and since then it has been gradually practiced in treating benign diseases of solid organs such as hypersplenism,prostatic hyperplasia and widely used in almost every system of the body.Here,we review its therapic principle,types and clinical application.

Objective To evaluate the effectiveness and safety of interventional thermochemotherapy for VX2 transplanted hepatic tumor model in experimental rabbits.Methods The hepatic tumor model was established in 20 New Zealand rabbits by implanting VX2 tumor cells into the right hepatic lobes of the rabbits.The rabbits were randomly and equally divided into two groups with 10 rabbits in each group:group A (study group)and group B(control group).Via the femoral access,the catheter was placed into the tumorfeeding artery,which was confirmed by DSA.The rabbits in group A received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at 60℃ temperature,while the rabbits in group B received an infusion of 100 ml 5% glucose plus 5-Fu(20 mg/kg)at normal room temperature(22-25℃).Before and after the procedure,the tumor size was measured by means of B ultrasonography and the serum ALT was estimated to assess the liver function.The results were statistically compared between two groups.Results After the treatment,the tumor size in group A(study group)became much smaller than that in group B(control group),with P＜0.05.And no significant difference in the serum ALT level existed between group A and group B.Conclusion The interventional thermochemotherapy is superior to interventional chemotherapy in inhibiting VX2 transplanted hepatic tumor in experimental rabbits.

Objective To investigate the efficacy and safety of vinpocetine (Cavinton) in treatment of patients with acute cerebral infarction.Methods Six hundred and ten patients with acute cerebral infarction (within 48 h to 14 d of onset),admitted to 17 hospitals from July 31,2010 to November 27,2012,were recruited and randomly allocated into 2 groups:control group (n=141) and therapy group (n=469).Patients in the control group were treated with citicoline for 14 d,and those in the therapy group were treated with citicoline combined with 30 mg cavinton via intravenous drip once daily for 14 d.The outcomes were evaluated according to Mini-mental State Examination (MMSE),National Institute of Heath Stroke Scale (NIHSS),modified Rankin scale (mRS) and Barthel index before treatment and 7,14 and 90 d after symptom onset,respectively.Results Significant difference in mRS scores was noted between therapy group (1.85±1.28) and control group (1.97±1.23) 14 d after treatment (P＜0.05).There were significant differences in scores of MMSE,NIHSS and Barthel index between therapy group (27.42±5.24,1.37±2.08 and 7.21 ±17.29) and control group (25.59±7.36,2.63±4.98 and 80.60±25.06) 90 d after treatment (P＜0.05).No significant differences in blood biochemical indicators were noted between therapy group and control group (P＞0.05).Conclusion Treatment with vinpoccetine in patients with acute cerebral infarction is effective.

In response to the major national strategic needs of "Healthy China" and "Chengdu-Chongqing Economic Circle", and in strict accordance with the requirements of "New Medicine" construction, Chongqing University builds the medical discipline with a high starting point, develops high-quality medical education, and promotes the exploration and practice of elite education of clinical medical talents in the cross-disciplinary context of medicine and engineering. From the perspective of SWOT, this study analyzed the situations and trends of clinical medical education in "Double First Class" universities which newly established the medical discipline. Combined with the training model of clinical talent class in Chongqing University and the practices of "Four Capacity-Buildings", "Four Integration-Measures", and "Three Optimization-Mechanisms", we discuss the thoughts and strategies of cultivating clinical medical talents in the background of "New Medicine" construction and in the cross-disciplinary context of medicine and engineering.

Objective:To explore the mechanism of circular permuted tumor necrosis factor-related apoptosis-inducing ligand (CPT) reversing the resistance to imatinib in chronic myeloid leukemia (CML) cells.Methods:Five patients with CML in the Affiliated Hospital of Inner Mongolia Medical University from 2016 to 2020 were selected, and heparinized bone marrow blood samples were collected at the first diagnosis and imatinib resistance phase, and mononuclear cells were isolated. The mononuclear cells collected at the first diagnosis were named A1-E1, and the mononuclear cells collected after imatinib resistance were named A2-E2. Human CML wild-type K562 cell line (K562-W) was given gradually increasing small doses of low-concentration imatinib to obtain imatinib-resistant K562 cells (K562-R). K562-R cells were cultured with 20 μg/L CPT and these cells were set as CPT-K562-R group. The CCK-8 method was used to detect the half inhibitory concentration ( IC50) of cells for imatinib. K562-W and K562-R cells were used to establish CML xenografts nude mice models, then the nude mice were divided into K562-W, K562-R and CPT-K562-R xenograft groups. Imatinib was perfused orally in all three groups, and CPT was injected subcutaneously in the CPT-K562-R group at the same time. The tumor volume of the three groups of nude mice before and 4 weeks after treatment with imatinib, and the survival time of the three groups of nude mice were compared. Western blot was used to detect the changes of tyrosine protein kinase receptor B4 (EphB4) and myeloid cell leukemia protein 1 (Mcl-1) protein levels in bone marrow mononuclear cells, K562 cell line and transplanted tumor tissues of CML patients. Results:The expressions of EphB4 protein in A2-E2 cells of 5 patients with CML were higher than those in A1-E1 cells (all P < 0.01). The IC50 of K562-W, K562-R and CPT-K562-R cells for imatinib were (0.160±0.015) mg/L, (5.450±0.460) mg/L, (0.300±0.035) mg/L, and the difference was statistically significant ( F = 390.65, P < 0.01). In cells of K562-W group, EphB4 and Mcl-1 proteins were expressed at low levels (0.54±0.02 and 0.70±0.08); in cells of K562-R group, the expressions of EphB4 and Mcl-1 proteins were enhanced (3.04±0.11 and 2.88±0.04); in cells of CPT-K562-R group, the expressions of EphB4 and Mcl-1 proteins decreased (0.57±0.03 and 0.38±0.04). Before imatinib treatment, there was no statistically significant difference in the tumor volumes of nude mice among the K562-W, K562-R and CPT-K562-R xenograft groups ( F = 0.39, P = 0.68), suggesting the transplanted tumors formed in nude mice were balanced; after imatinib treatment, the difference in the tumor volumes among the three groups were statistically significant ( F = 26.16, P < 0.01). The survival time of nude mice in the K562-W, K562-R and CPT-K562-R xenograft groups was (18.5±3.3) d, (10.0±2.4) d and (17.5±1.6) d, and the difference was statistically significant ( F = 20.45, P < 0.01). In K562-W xenograft group, both EphB4 and Mcl-1 proteins were expressed at low levels (0.55±0.06 and 0.67±0.06); in K562-R xenograft group, the expressions of EphB4 and Mcl-1 proteins were enhanced (1.95±0.08 and 6.21±0.53); the expressions of EphB4 and Mcl-1 in CPT-K562-R xenograft group decreased (0.59±0.04 and 0.37±0.04) and were close to their expressions in K562-W xenograft group. Conclusion:CPT may enhance the sensitivity of CML to imatinib by inhibiting the expressions of EphB4 and Mcl-1, and this may be a targeted pathway for imatinib therapy.

Objective:To explore the effects of dopamine receptor D2(DRD2)on astrocytic dedifferentiation based on SOX2-regulated genes in neural stem cells(NSCs)and astrocytes.Methods:Immunofluorescence staining and SOX2-GFP mice were used to examine the lineage differentiation of SOX2-positive cells during the development of cere-bral cortex.Primary NSCs/astrocytes culture,ChIP-seq and Western Blot were adopted to analyze and verify the expres-sion of candidate genes.Pharmacological manipulation,neurosphere formation,photochemical ischemia,immunofluo-rescence staining and behavior tests were adopted to evaluate the effects of activating DRD2 signaling on astrocytic dedif-ferentiation.Results:Immunofluorescence staining demonstrated the NSC-astrocyte switch of SOX2-expression in the normal development of cerebral cortex.ChIP-seq revealed enrichment of DRD2 signaling by SOX2-bound enhancers in NSCs and SOX2-bound promoters in astrocytes.Western Blot and immunofluorescence staining verified the expression of DRD2 in NSCs and reactive astrocytes.Application of quinagolide hydrocholoride(QH),an agonist of DRD2,signifi-cantly promoted astrocytic dedifferentiation both in vitro and in vivo following ischemia.In addition,quinagolide hydro-choloride treatment improved locomotion recovery.Conclusion:Activating DRD2 signaling facilitates astrocytic dedif-ferentiation and may be used to treat ischemic stroke.

Objective To screen Cuproptosis genes and characteristic genes for differential prognosis in acute mye-loid leukemia(AML)and explore their prognosis in AML as well as their biological roles and correlations in the immune and tumor microenvironment.Methods AML clinical,transcriptome,genomic,and copy number data were downloaded from three major databases,TCGA,GEO,and UCSC,and Cuproptosis genes were collected from published studies.From the perspective of multiomics,the effects of Cuproptosis gene and characteristic gene on survival,immunity,tumor microenvironment,stem cell correlation and drug sensitivity were studied by various bioinformatics methods,meta-analysis and secondary typing.Results One Cuproptosis gene was identified as a differential prognostic gene in AML and five characteristic genes were identified as influencing the prognosis of AML patients by influencing Cuproptosis,and a prognostic model was established.The differential genes were mainly concentrated in mitochondrial activity,REDOX enzyme and energy metabolism.In terms of immunity,macrophage M0,neutrophils,activated memory CD4 T cells and Tregs were positively correlated with risk score,while macro-phage M2,resting mast cells,immature CD4 T cells,helper follicular T cells and memory B cells were negatively correlated with risk score.In terms of tumor microenvironment,the immune cell score of the low-risk group was lower than that of the high-risk group,and in the total score,the tumor microenvironment score of the low-risk group was also lower than that of the high-risk group,indicating that the tumor purity of the high-risk group was lower than that of the low-risk group.However,there was no significant association between stem cells in the high-risk and low-risk groups,and a total of 14 drugs were found to be sensitive to treat AML.Conclusion Cuproptosis gene and characteristic gene are closely related to immune and tumor microenvironment in AML by constructing a prognostic model of AML.