Objective To investigate the effects of surgical method on the falx paraneoplastic parasagittal meningiomas.Methods 30 cases of surgical treatment in sagittal sinus and falx meningioma patients with imaging data,surgical approach,microsurgical resection of the tumor method and efficacy were analyzed.Results 30 patients resected by Simpson standard,Ⅰ grade resection 23 cases,Ⅱ grade resection in 7 cases,no operative mortality.1-5 years of follow-up,2 patients relapsed,all secondary surgical cure.Conclusion To be familiar with microscopic neuroanatomical relationship,using microsurgical resection of the superior sagittal sinus,falx meningioma,tumor removal rate can be increased to reduce the important functional areas of damage,reduce complications and improve quality of life of patients.

Angiotensin II (Ang II ) is an effector of rein-angiotensin system. Ang II receptors mediate its biological effects. An analysis of radioactive ligand demostrated that mammalian exists AT1 receptor and AT2 receptor subtype. AT1 receptor exists three isoforms, AT1A, AT1B and AT1c receptor subtype in rat and mouse. The AT3 and the AT4 subtype receptors had been cloned, but their structure and function were unknown. The AT1 receptor belongs to the superfamily of seven trans-membrane domain, G-protein-coupled receptors and was 20%~ 30% homologous to other G-protein-coupled receptors. The AT1 receptor mainly exists in vessel, heart and adrenal glands in adult animals. The AT2 receptor only has 32% amino acid sequences homologous to AT1 receptor and mainly exists in embronic tissue and intersti-tium. Recent studies have shown that the AT1 receptor may mediate most of the biological functionof Ang I . The AT1 receptor mediates promoting the expression of growth-related inducible transcription factors such as c-fos, c-jun and c-myc, and inducing myocardial cell hypertrophy, cardiac fibroblasts proliferation and interstitial collagen deposition. The AT1 receptor antagonist can reverse myocardial hypertrophy and collagen accumulation induced by hypertension, but the AT2 receptor antagonist can't. The biological function of the AT2 receptor is little known. The AT2 receptor may mediate inhibit on of growth factor-induced cell proliferation, oposite AT1 receptor-induced mi-togenic effect and induce apoptosis. The AT1 receptor and AT2 receptor subtype in myocardial tissue may regulate the genesis and development of myocardial remodeling in hypertension togather.

OBJECTIVE: To investigate the effects of Wenyang Huoxue Recipe (WRHXR), a compound traditional Chinese herbal medicine for warming yang and promoting blood flow, on the expression of angiopoietin mRNA in rats with chronic aristolochic acid nephropathy induced by Caulis Aristolochia Manshuriensis (CAM) decoction, and to explore the protection mechanism of WYHXR against kidney damage. METHODS: Twenty-eight male SD rats were randomly divided into normal control group, CAM group and WYHXR-treated group. Rats in the normal control group (n=8) and CAM group (n=10) were intragastrically administered with normal saline 10 ml/(kg.d) or CAM decoction 10 ml/(kg.d) respectively. Rats in the WYHXR-treated group (n=10) were intragastrically administered with WYHXR 30 g/(kg.d) and CAM decoction 10 ml/(kg.d). The expressions of Ang-l and Ang-2 mRNAs were detected by real-time reverse transcription polymerase chain reaction (RT-PCR) after 20-week treatment. RESULTS: Compared with the normal control group, the expression of Ang-l mRNA was significantly decreased, and the expression of Ang-2 mRNA was significantly increased in the CAM group (P<0.01). Compared with the CAM group, the expression of Ang-l mRNA was increased in the WYHXR-treated group (P<0.01). The expression of Ang-2 mRNA had no significant difference between the CAM group and the WYHXR-treated group (P>0.05). Renal pathology showed that renal damage in WYHXR-treated group was significantly reduced as compared with the CAM group. CONCLUSION: WYHXR can up-regulate the expression of Ang-l mRNA, which may be its action mechanism in protecting the kidneys.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

Proteomic technology has been widely used in the research of differently-expressed proteins under different physiology and pathologic conditions.In the aspect of the human spermatozoa proteomics,many reports have demonstrated the differently expressed proteins and the roles of sperm under different physiology and pathologic state from proteome level,and these results provided reliable theoretic base for well understanding of sperm molecule mechanism in physiology and pathologic conditions.

Objective To compare the clinical value of 18F-FDG PET imaging and 99Tcm-MDP whole body bone imaging in detection of bone metastases. Methods 43 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. 28 of them were with confirmed bone metastases by other examinations or follow-up and the remaining 15 were confirmed without bone metastases. The results of the 2 different modalities were analyzed. Results Among 28 patients with confirmed bone metastases, PET and MDP accurately diagnosed 26 and 27, respectively. The sensitivity of them were 92.9 %(26/28), 96.4 %(27/28), Among the remaining 19 cases without bone metastases, PET and MDP correctly gave 14 and 8 negative results, respectively. The specificity of them were 93.3 %(14/15), 53.3 %(8/15), and accuracy of them were 93.0 %(40/43), 81.4 %(35/43). The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion For the detection of bone metastases in patients with malignant tumors, 18F-FDG PET showed a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan. For patients with suspected bone metastases, negative finding or single hot spot in 99Tcm-MDP imaging, 18F-FDG PET imaging was recommend as a further and complementary assessment of bone metastases.

Objective To evaluate the value of positive 99Tcm-MIBI tumor imaging for thyroid cancer diagnosis. Methods Fifty four suspected thyroid cancer patients underwent 99Tcm-O4 and 99Tcm-MIBI combined imaging procedure. The imaging data were confirmed by pathological findings. Results All the 54 cases had single throid nodules, and 25 of which were pathologically malignant. Fifty two cases of nodules were detected by the 99Tcm O4 thyroid static imaging, including 2 hot nodules,4 warm nodules, 10 cool nodules and 36 cold nodules;2 cases were negative by the imaging. Of the 25 malignant thyroid nodules, 16 nodules were visible by 99Tcm-MIBI uptake and were cold nodules;29 exhibited benign thyroid nodules,of which 15 could be seen by 99Tcm-MIBI uptake,including 1 warm nodules,2 cool nodules and 12 cold nodules. The sensitivity, specificity of the combined imaging of 99Tcm O4 and 99Tcm-MIBI were 64. 00% ( 16/25 ) and 48. 28% (14/29). No significant difference was found for the positivity between benign nodules and malignancy nodules by 99Tcm-MIBI tumor imaging ( χ2 = 0. 83, P ＞ 0. 05 ). Conclusion 99Tcm-MIBI tumor imaging is not specific for the diagnosis of thyroid malignancy.

Objective To investigate the clinical curative effect of Prepenem for pathogen from cranial neu-rosurgieal patients with lower respiratory tract infection after traeheotomy and to provide basis for treatment of such pa-tients. Methods Thirty-two cranial neurosurgical patients with lower respiratory tract infection after tracheotomy were enrolled in the study with original empiric therapy with Prepenem. And the pathogenic bacteria in sputum from patients with lower respiratory tract infection after traeheotomy were stricdy identified and analyzed by automatic mi-croorganism analyzers. The clinical efficacy of Prepenem was identified after treatment. Results The straim of bacte-rial species(48) and funni(5) from 32 specimens were isolated. 15 strains were infected by one kind of bacteria and 38 strains were infected by two kinds of bacteria. Among the pathogen, gram-negative bacilli were about 64. 1% and Klebsiela pneumoniae (18. 8%)was the most predominant, gram-positive coccobacteria were about 26. 4% and Staph-ylococcus aureus(13.2%)was the most predominant,funni were about 9.4% and C. albicans (5.7%)was the most predominant. The drug sensitivity test showed that the ratio of drug resistance of bacteria isolated from sputum was high,but gram-negative bacilli were highly sensitive to imipenem. Staphylococcus aurens was sensitive to Nitrofuran-toin and Rifampicin. Satisfied clinical curative effect was shown by the de-escalation therapy for all patients. Conclu-sions Gram-negative bacili in cranial neurosurgical patients with lower respiratory tract infection after tracheotomy are the main pathogenic bacteria from lower respiratory tract infection, and Staphylococcus aureus are the main gram-positive cocci. So the drug sensitivity test of sputum should be done more often and antibiotics must be selected ac-cording to the drug sensitivity test. In general, this kind of infection can be controlled by prepenem effectively.

Objective To observe the clinical efficacy and safety of ticagrelor,a new antiplatelet agent,in patients with ST-Segment elevation myocardial infarction (STEMI) underwent emergency PCI.Methods Selected 174 patients with STEMI receiving emergency PCI treatment from January 2013 to July 2014 in Nanjing General Hospital of Nanjing Military Area Command,and randomly divided into clopidogrel group (preoperative taking 600 mg of clopidogrel,n =88) and ticagrelor group (preoperative taking 180 mg of ticagrelor,n =86).Compared platelet inhibition rate,renal function before and after treatment,major clinical cardiovascular events and bleeding events 30 d after treatment,adverse drug reactions of two groups.Results (1) Arachidonic acid pathway inhibition rate of the two groups were compared,the difference was not statistically significant (P ＞0.05).Compared two groups of patients with adenosine phosphate pathway inhibition rate,ticagrelor group was higher,the difference was statistically significant ((71.82 ± 19.97) ％ vs.(38.96 ± 27.55) ％;t =-7.569,P ＜0.001).(2) Compared major cardiovascular events of ticagrelor group(5 cases) and clopidogrel group (15 cases),ticagrelor group was decreased.There was significant differences (P =0.02) between the two groups.Bleeding events compared to between ticagrelor group (15 cases) and clopidogrel group (11 cases),no statistically significant difference was found(P =0.617).Conclusion Clinical efficacy of ticagrelor in acute ST-segment elevation myocardial infarction treated with primary PCI is superior to clopidogrel in which can reduce the risk of cardiovascular events in patients and without an increase in severe bleeding.

Objective The control rate of blood pressure in hypertension patients is very low in our country , while follow-up intervention can significantly improve the situation .This study aimed to evaluate the clinical effects of anti-hypertension under follow-up intervention . Methods From October 2013 to October 2014 , 125 patients with hypertension were chose as the study objectives after first clinical anti-hypertension and were divided into intervention group (follow-up,n=65) and control group(no follow-up,n=60). Comparative analysis was made in blood pressure control , compliance with therapy and cardiovascular event incidence between the two groups after 12 weeks'intervention. Results After 12 weeks, diastolic and systolic blood pressure in intervention group was signifi-cantly lower than that in control group (P<0.05).Significant difference was also found in the compliance with drug-taking between in-tervention group and control group (73.8%vs 43.3%, P<0.01).During the follow-up period, 1 case in the control group suffered stroke and unstable angina pectoris hospitalized for treatment . Conclusion Follow-up intervention after clinical service can improve the efficacy of blood pressure control and encourage the patients to live healthy lifestyle .