Objective To compare the clinical value of fluid attenuated inversion recovery imaging (FLAIR),magnetic resonance diffusion-weighted imaging(DWI) and magnetic resonance angiography(MRA) in diagnosis of early cerebral infarction.Methods 70 cerebral infarction patients were chosen.They underwent FLAIR,DWI and MRA examination.Results 70 patients with early cerebral infarction mostly were multiple lessions accouting for 60％.Supper actue period had 22 cases and acute period had 48 cases.DWI had the highest detection rate of cerebral infarction,particularly in the hyperacute period the detection rate reached 100％,which was significantly higher than the FLAIR and MRA(x2 =12.4,P ＜ 0.05).Conclusion Especially in the early diagnosis of hyperacute cerebral infarction,DWI is superior to FLAIR and MRA.FLAIR showed better on the cortex and periventricular lesions,MRA can check out the blood vessel lesions in the infarction area.

Animals ; Breast Neoplasms ; metabolism ; Humans ; NF-kappa B ; metabolism ; Neoplasms ; metabolism ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Notch ; metabolism ; physiology ; Signal Transduction

Foreign Bodies ; complications ; diagnosis ; Glottis ; Hoarseness ; diagnosis ; etiology ; Humans ; Male ; Middle Aged

Objective To construct the expression plasmid of porcine leukemia inhibitory factor(LIF) in the prokaryotic system,and purify the expressed recombinant porcine LIF protein as antigen to immune rabbit for preparation of rabbit anti-pig LIF polyclonal antibody,and immunolocalize of LIF in pigs.Methods The cDNA fragment encoding mature porcine LIF protein was amplified by PCR,then cloned into the prokaryotic expression vector PET-31b at restriction sites NdeⅠand XhoⅠ.After transformed into E.coli BL21 for expression,the recombinant porcine LIF protein was purifed for preparation of anti-pig LIF polyclonal antibody as immunogen.Western blotting and ELISA were used to test the specificity and titer of the purifed IgG.Immunostaining was used to assay the expression of LIF in pigs.Results The constructed expression plasmid was identified by DNA sequencing and restriction enzyme digestion.The expression of the recombinant porcine LIF protein was performed exactly in E.coli BL21.By immuning the rabbit,the polyclonal antibody was successfully prepared.The results of ELISA and Western blotting showed that the antibody had high titer(1∶10000) and specificity.By immunostaining,LIF protein was faintly expressed in porcine myocardial cell,splenic cord and monolayer covering epithelium cell and pulmonary fibroblast.Conclusion The prepared polyclonal antibody has high titer and specificity;LIF has faint positive immunoreactivity in the normal porcine,myocardial cell,splenic cord and monolayer covering epithelium cell and pulmonary fibroblast.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective To evaluate the regional long-axis systolic function of left ventricular in patients with coronary artery disease and healthy subjects by two-dimensional strain rate imaging (2D-SRI). Methods During October 2011 to August 2012 , 53 inpatients with coronary artery disease in the department cardiology from the Afifliated Hospital of Medical College, Qingdao University were enrolled. Twenty-nine patients with anterior wall infarction induced by left front-descending coronary artery disease (group LCA) and twenty-four with interior wall infarction induced by right coronary artery disease (group RCA) proved by coronary angiography and echocardiography were enrolled into the study and thirty healthy volunteers in the control group. High frame rate two-dimensional dynamic images were recorded in apical four-chamber view and two-chamber view of the left ventricle. Using two-dimensional strain software, peak systolic longitudinal strain rate (PSRs) of interventricular septum, anterior wall, lateral wall and interior wall of left ventricle were measured. All data of 3 groups were analyzed using One-Way analysis of variance, and LSD-q test used to compare the 2 groups. Results The PSRs were (4.61±0.60) s-1, (5.18±0.87) s-1, (5.60±0.70) s-1, (6.05±0.74) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the control group. There were signiifcant differences among the groups (F=20.95, P=0.00), and there were signiifcant gradient changes from intervetrivular septum, anterior wall, lateral wall to interior wall in the control group. The PSRs were (4.31±0.85) s-1, (1.96±0.93) s-1, (5.54±0.83) s-1, (5.93±0.80) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in the LCA group respectively. There were signiifcant differences among the different walls (F=127.25, P=0.00), which was signiifcant lower in ischemic anterior wall than interventricular septum, lateral wall and interior wall, and the significant differences were identified in anterior wall with lateral wall and interior wall (q=22.62, 25.04, both P<0.01). The PSRs were (4.51±0.62) s-1, (4.99±1.13) s-1, (5.31±0.81) s-1, (2.84±0.85) s-1 from interventricular septum, anterior wall, lateral wall to interior wall in RCA group respectively. There were signiifcant differences among the different walls (F=38.12, P=0.00), which were signiifcant lower in ischemic interior wall than interventricular septum, anterior wall, and lateral wall, and the signiifcant differences were identiifed in interior wall with lateral wall and interior wall (q=13.88, 12.08, both P<0.01). Comparing the same part among 3 groups, signiifcant differences were identiifed as following:the PSRs of anterior wall in group LCA vs control group (q=20.17, P<0.01), the PSRs of interior wall in group RCA vs control group (q=19.98, P<0.01). Conclusions Longitudinal systolic function changes of left ventricular regional myocardium in patients with coronary artery disease and healthy subjects could be accurately analyzed by 2D-SRI. The early changes in ischemic myocardium would be assessed quickly in patients with coronary artery disease using 2D-SRI.

Objective To evaluate the therapeutic efficacy of intratympanic dexamethasone injections combined with prednisone in patients with idiopathic sudden sensorineural hearing loss. Methods A total of 71 patients diagnosed with sudden hearing loss were treated with intratympanic dexamethasone injections plus prednisone (B group) or prednisone alone (A group). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. Results The total recovery rate after the treatment was 81.8% in the B group and 55.3% in the A group. The diflference between two groups was statistically significant (P < 0.05). Conclusion The present study suggests that sudden sensorineural hearing loss patients treated with intratympanic dexamethasone combined with prednisone have a higher likelihood of hearing recovery than those treated with prednisone alone.

Objective To study the difference of body weight gain in the first and second trimesters between pregnant women with abnormal gestational glucose metabolism and those with normal gestational glucose metabolism.Methods We retrospectively analyzed the data of pregnant women visited the obstetric clinic of Peking Union Medical College Hospital from January 2010 to May 2011,with or without abnormal glucose metabolism.The data of body weight gain in the first and second trimesters,body mass index (BMI) before pregnancy,BMI in the end of second trimester,age,obesity history,diabetes family history,insulin level in the oral glucose tolerance test (OGTT),and lipid profile of these women were collected.Results Altogether 216 pregnant women with abnormal glucose metabolism (case group) and 230 pregnant women with normal glucose metabolism (control group) were included in this study.In the case group,the increment of body weight in the first and second trimesters was 10.0 (8.1,12.5) kg,and the increment of BMI was (4.01 ± 1.43) kg/m2,BMI in the end of the second trimester was (25.84 ± 3.14) kg/m2;in comparison,the increments of body weight and BMI in the first and second trimesters were 9.5 (7.0,11.5) kg and (3.60 ± 1.43) kg/m2,respectively,BMI in the end of the second trimester was (25.1 ± 3.00) kg/m2 in the control group,all significantly lower than in the case group (all P ＜ 0.05).The BMI before pregnancy was higher in the case group than in the control group [(21.84 ±2.99) kg/m2 vs.(21.50 ±2.82) kg/m2],but with no statistical significance (P＞0.05).Compare with the control group,the case group had older age [(33.17 ±3.65) years vs.(31.68±3.36) years],higher fasting insulin level [11.2 (7.1,16.3) mU/Lvs.8.9 (6.5,13.7) mU/L],higher peak insulin level in OGTT [135.3 (99.7,208.0) mU/L vs.104.9 (75.6,144.4) mU/L],higher homeostasis model assessment for insulin resistance (HOMA-IR) [2.40 (1.49,3.47) vs.1.82 (1.28,2.71)],and triglyceride [2.62 (2.04,3.31) mmol/L vs.2.18 (1.81,2.81) mmol/L],all with significant differences (all P ＜ 0.05).There were no significant differences in obesity history,family history of diabetes and history of menstrual disorder between the two groups (all P ＞ 0.05).Conclusions The body weight gain is higher in the pregnant women with abnormal glucose metabolism than in those with normal glucose metabolism in the first and second trimesters.Large increment of body weight is likely to be a risk factor for abnormal gestational glucose metabolism.

Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4％ for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1％; the scope and goal field scored an average of 83.8％; participants field scored an average of 71.7％; editorial independence field scored an average of 64.1％ ; rigor of development field scored the lowest average of 62.9％.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines evaluation system should be established.

Objective To investigate the effect of xenon intervention on delayed neuropsychologic sequelae (DNS)in acute carbon monoxide(CO)poisoning.Method Adult Wistar rats were randomly divided into sustained group,early intervention group,and control group.CO(150 ml/kg)was infused by intraperitoneal injection to produce DNS model.In sustained intervention group(S-group),xenon(150 ml/kg/d)was infilsed by intraperitoneal injection for 2 weeks;in control group(C-group),xenon was replaced by equal volume air;and in early intervention group(E-tvoup),xenon(150 ml/kg/d)was,employed in the first 3 days and air(150 ml/kg/d)was substituted for xenon in the following days until 2 weeks after CO poisoning.Morris maze test was used to evaluate the intelligence of rats.The long-term potentiation(LTP)of hippocampus Was detected by neuroelectricity recording.The apoptosis rates in brain was detected by TUNEL staining.The data were expressed as(x±s)and analyzed with student's test and analysis of variance.A P value less than 0.05 indicated statisfical significance.Results After exposure to CO,poisoned rats showed intelligence decline,demyeliation ofwater matler and cell apoptosis increased,which were consistent with DNS.In S-group and E-group,the rates of DNS and apoptosis were significantly lower than those in C-group,whereas the rote of LTP in S-group and E-group Was significantly higher than those in C-group.Conclusions Early xenon intervention can effectively decrease the rates of DNS occurred after acute CO poisoning.