Objective　To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods　The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results　①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion　Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.

Objective To investigate clinicopathological features、diagnosis and surgical treatment of duodenal stromal tumors. Methods A retrospective clinical analysis was made in 23 cases of duodenal stromal tumors admitted from 1995 to 2004. Results Melena and abdominal pain was the most common presenting symptom. Complete resection was achieved in all cases, including pancreatoduodenectomy in 13 cases, by pylorus-preserving pancreatoduodenectomy in 3 cases, and tumor enucleation in 7 cases. The mean size of the tumor was 6. 6 cm (2 - 21 cm) , among them 10 cm in 6. Pathologically tumors less than 5 cm were all of potential malignancy, whereas those larger than 5 cm were malignant. Follow-up of 2 months to 9 years found all cases alive and healthy except for one who died of liver metastasis one year postoperatively. Conclusion Duodenal stromal tumors were low malignancy tumors. Aggressive surgery is the choice of treatment. Favorable prognosis is expected after complete surgical excision.

Objective To type Streptococcus pneumoniae(S.pneumoniae) isolated from children, and provide scientific basis for the correct selection of S.pneumoniae vaccine.Methods 182 strains of S.pneumoniae were collected from Children's Hospital of Hebei Province in 2014, species of strains were identified by polymerase chain reaction (PCR), types of strains were analyzed with multiplex PCR.Results PCR detection showed that cpsA gene amplification of 182 strains were all positive;multiplex PCR detection revealed that except 8 strains were not typed, the main types of the remaining 174 strains were 19 F (n=68, 37.36%), 19A(n=33, 18.13%), and 6A/6B (n=26,14.28%), the other types were 35B, 14, 6C/6D, 23F, 15B/15C, and so on.Conclusion The main types of 182 strains of S.pneumoniae are 19 F, 19A, and 6A/6B, which provide scientific basis for the correct selection of S.pneumoniae vaccine for this province.

Objective To analyze the brucellosis epidemic and genotyping characteristics of Brucella strains isolated from Hebei Province,and to provide scientific basis for brucellosis control and prevention.Methods Descriptive epidemiological analysis (including region,population,and time distribution characteristics) was performed using individual data of human brucellosis in Hebei Province from the National Notifiable Infectious Disease Reporting Information System of China Information System for Disease Control and Prevention in 2016,Brucella strains were isolated by phase culture bottles in Brucellosis Lab from Hebei Provincial Center for Disease Control and Prevention.Multiple-locus variable-number tandem-repeat analysis (MLVA) was used to identify the genotyping characteristics of the isolates.Results There were 3 774 reported cases in 2016,and 11 cities in the province had reported the cases.The cases were found mainly in Zhangjiakou,Chengde and Tangshan.And 95.98％ (167/174) of all counties were reported brucellosis cases.Vocational high risk population was farmers and herdsmen engaged in livestock and processing of animal products,accounting for 90.22％ (3 405/3 774).Male had the highest incidence,accounting for 74.38％ (2 807/3 774).The onset time was concentrated in January-August,accounting for 83.67％ (3 161/3 774).Twenty-one strains of Brucella were isolated,twenty isolates were Brucella melitensis biovar 3,and one isolate was Brucella abortus biovar 3.Panel 1 (MLVA-8) identified three genotypes 42,43,and 114,with genotype 42 representing 85.00％ (17/20);Panel 1 + Panel 2A (MLVA-11) identified three genotypes 116,122,291,with genotype 116 representing 85.00％ (17/20),which were identified as belonging to the East Mediterranean group.Panel 1 (MLVA-8) identified the genotype 36,Panel 1 + Panel 2A (MLVA-11) identified the genotype 72 of one Brucella abortus strain.It was identified as belonging to abortus C.Conclusions The brucellosis epidemic in Hebei is relatively severe,the pathogenic bacteria is mainly Brucella melitensis.The MLVA assay is a very practical and important molecular genotyping tool,it provides a basis for tracing the source of brucellosis infection.

OBJECTIVETo explore the efficacy and safety of deferasirox in aplastic anemia (AA)patients with iron overload.

METHODSA single arm, multi- center, prospective, open- label study was conducted to evaluate absolute change in serum ferritin (SF)from baseline to 12 months of deferasirox administration, initially at a dose of 20 mg·kg(-1)·d(-1), and the safety in 64 AA patients with iron overload.

RESULTSAll patients started their deferasirox treatment with a daily dose of 20 mg · kg(-1) ·d(-1). The mean actual dose was (18.6±3.60) mg · kg(-1)·d(-1). The median SF decreased from 4 924 (2 718- 6 765)μg/L at baseline (n=64) to 3 036 (1 474- 5 551)μg/L at 12 months (n=23) with the percentage change from baseline as 38%. A median SF decrease of 651 (126-2 125)μg/L was observed at the end of study in 23 patients who completed 12 months' treatment, the median SF level decreased by 1 167(580-4 806)μg/L [5 271(3 420-8 278)μg/L at baseline; 3 036(1 474-5 551)μg/L after 12 months' treatment; the percentage change from baseline as 42% ] after 12 months of deferasirox treatment. The most common adverse events (AEs) were increased serum creatinine levels (40.98%), gastrointestinal discomfort (40.98%), elevated liver transaminase (ALT: 21.31%; AST: 13.11%)and proteinuria (24.59%). The increased serum creatinine levels were reversible and non-progressive. Of 38 patients with concomitant cyclosporine use, 12(31.8%)patients had two consecutive values >ULN, 10(26.3%)patients had two consecutive values >1.33 baseline values, but only 1(2.6%)patient's serum creatinine increased more than 1.33 baseline values and exceeded ULN. For both AST and ALT, no patients experienced two post- baseline values >5 ×ULN or >10 × ULN during the whole study. In AA patients with low baseline PLT count (less than 50 × 10(9)/L), there was no decrease for median PLT level during 12 months' treatment period.

CONCLUSIONSAA patients with iron overload could achieve satisfactory efficacy of iron chelation by deferasirox treatment. The drug was well tolerated with a clinically manageable safety profile and no major adverse events.

Anemia, Aplastic ; drug therapy ; Benzoates ; therapeutic use ; Blood Transfusion ; China ; Ferritins ; blood ; Humans ; Iron ; blood ; Iron Chelating Agents ; therapeutic use ; Iron Overload ; drug therapy ; Liver ; Prospective Studies ; Triazoles ; therapeutic use

Acute cerebral infarction （ACI）， also known as ischemic stroke， is a disease with a high disability rate， which brings heavy burdens to society and families. Its pathogenesis is related to many factors， of which the inflammatory theory is one of the important mechanisms. In the early stage of ACI， microglia are activated， and the inflammatory mediators， such as interleukins and tumor necrosis factor-α （TNF-α）， released by them induce vascular endothelial cells to express adhesion molecules. The circulating leukocytes （neutrophils， monocyte-macrophages， etc.） are promoted to roll and adhere to the injured vascular endothelium， migrate and cross the blood-brain barrier， penetrate and infiltrate the brain parenchyma， and further expand the local inflammatory response by releasing a variety of proinflammatory mediators， thus exacerbating the tissue injury at the injury site and ischemic penumbra. Traditional Chinese medicine （TCM） has advantages in treating the disease. TCM believes that the occurrence of stroke is related to blood stasis caused by various reasons， which block the brain vessel. This article reviewed the research progress on the effect of activating blood therapy on inflammatory factors in patients with ACI in recent years and discussed its regulation of inflammatory factors in ACI such as interleukin-1 （IL-1）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， interleukin-10 （IL-10）， TNF-α， C reactive protein （CRP）， and monocyte chemotactic protein-1 （MCP-1）， hoping to elucidate the scientific connotation of TCM treatment of ACI and lay the foundation for further research.

Activation of inflammatory responses regulates the transmission of pain pathways through an integrated network in the peripheral and central nervous systems. The immunopotentiator thymosin alpha-1 (Tα1) has recently been reported to have anti-inflammatory and neuroprotective functions in rodents. However, how Tα1 affects inflammatory pain remains unclear. In the present study, intraperitoneal injection of Tα1 attenuated complete Freund's adjuvant (CFA)-induced pain hypersensitivity, and decreased the up-regulation of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) in inflamed skin and the spinal cord. We found that CFA-induced peripheral inflammation evoked strong microglial activation, but the effect was reversed by Tα1. Notably, Tα1 reversed the CFA-induced up-regulation of vesicular glutamate transporter (VGLUT) and down-regulated the vesicular γ-aminobutyric acid transporter (VGAT) in the spinal cord. Taken together, these results suggest that Tα1 plays a therapeutic role in inflammatory pain and in the modulation of microglia-induced pro-inflammatory cytokine production in addition to mediation of VGLUT and VGAT expression in the spinal cord.