Microglia is the principal immune effector cell in brain. It plays some important roles in support, nutrition, protection, and repair in the physiological activities of neuron. Microglia can be quickly activated, which may proliferate after cerebral ischemia, and promote phagocytosis of macrophage. It exerts dual effects by producing neurotoxic molecules and neurotrophic factors. Therefore, to study the relationship between microglia and cerebral ischemia, give full play to its protective functions and reduce its damage will help to improve the therapeutic effects of cerebral ischemic injury.

Objective To investigate the CTA, MRA and DSA in the primary liver cancers and the value of the perfor-mance. Methods 29 cases of primary liver cancer patients were diagnosed through comparative analysis of CTA, MRA and DSA in the diagnosis of primary liver cancer between the common and the differences to explore the full and effective ways so as to facilitate the clinical work in a more effective diagnostic tool. Results For 29 cases of liver cancer patients, both the detection rate and accuracy rate of MSCTA were significandy higher than MRA. Conclusion At this stage, the MSCTA has features of shortcut, convenience, high detection rate, which is the preferred method of examination and has higher value in clinical application.

Objective To evaluate the use of keyhole dynamic magnetic resonance (MR) imaging in evaluation of pituitary microadenomas. Methods Fifty three patients with pituitary microadenomas proved by operation or clinical findings such as headache, amenorrhea, lactating, fat or acromegaly were retrospectively studied on dynamic MR, conventional contrast enhanced MR, and unenhanced MR. Then the image data were analyzed by two experienced doctors who didn′t know the details and three degrees were made as follows: grade 0, no evidence of the tumor; gradeⅠ, asymmetry signals in the pituitary; and gradeⅡ, nodulated or sheets signals in the pituitary. The grading data were compared with statistical methods. Results In dynamic MR grading system: grade 0 was revealed in 1 patient, gradeⅠ in 29 patients and gradeⅡ in 23 patients. In conventional enhanced MR: grade 0 in 26 patients, grade Ⅰ in 17 patients and gradeⅡin 10 patients. In conventional unenhanced MR: grade 0 in 39 patients, grade Ⅰin 10 patients and grade Ⅱ in 4 patients. The diagnostic rate of dynamic MR, conventional enhanced MR, and unenhanced MR was 98.1%, 51.9%, and 26.4%, respectively. ( P

Objective To sum up the experiences of successful long-distance transportation of 35 burned casualties as a result of a mass fire catastrophe.Methods Thirty-five burned victims of a mass fire catastrophe were transported by air from a northern part of Heilongjiang province to Beijing,a voyage of 1600km.The successful experiences of organization and medical instructions during the transportation were summed up and analyzed.Results The transportation was launched 20 hrs after the arrival of specialists group.Under a well-knitted organization and meticulous care,all the casualties were transported to the destination safely and smoothly in 4 hrs.Conclusions Before transportation the condition of the patients to be transported and their tolerance to the ordeal of transportation must be evaluated or judged according to the general condition of each patient,and due precaution should be carefully taken.Medical staff,drugs and equipments for circulatory and respiratory care must be provided for immediate care of any life-threatening complications which might occur during the air-lift and road transportation.Before transportation tracheostomy tube and venous line should be secured,especially for those with head and face burns,the airway must be kept free.The patients were tagged with number and with their conditions documented on wound tags to ensure the patients to receive prompt and proper care in accordance to their condition in the accepting hospital.During airlift,the stretchers should be arranged close to the exit of the plane and perpendicular to the longitudinal axis of the cabin.Ample space should be kept between stretchers to allow emergent care.The hospital of destination must check the wound tags carefully and try its best to treat the patients as earlier as possible.All these efforts were contributory to successful transportation of these mass burn casualties.

Objective To study the effects of bone marrow stromal cells derived neural stem cells on apoptosis and the expression of Bcl-2 and Bax after focal cerebral ischemia and reperfusion.Methods The model of middle cerebral artery occlusion (MCAO) and reperfusion was set up by Longa. Thirty-two Sprague-Dawley rats were divided into 4 groups: sham-operated group (A), ischemia control group (B), bone marrow stromal cells transplanted group (C) and bone marrow stromal cells derived neural stem cells transplanted group (D). The rats were killed on the day 7 and 14 after transplantation. The brain sections were used for terminal deoxynucleotidyl transferase dUTP mickend labeling (TUNEL) staining and Bcl-2, Bax immunohistochemical staining.Results The number of apoptotic cells in groups C and D was decreased as compared with that in group B on the day 7 and 14 after transplantation (P

Objective To study the mechanism of miR-548a-3p targeting MMP-2 inhibits the metastasis and invasion of gastric cancer cells.Methods Bioinformatics were used to search those miRNAs targeting MMP-2.The level of miR-548a-3p in gastric cancer tissues were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.The level of miR-548a-3p in three reconstructed gastric cancer cell lines were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.miR-548a-3p targeting the 3'-UTR of MMP-2 were detected by Luciferase reporter assay detected.And the changes of ability of metastasis and invasion were examined by Transwell experiment before and after transfection.Results There were high expression of miR217 and low expression of MMP-2 in human poorly differentiated gastric cancer cell line BGC-823.There were low expression of miR-548a-3p and high expression of MMP-2 in human middle and high differentiated gastric cancer cell line MKN-28 and SGC-7901 (P ＜ 0.05).The result of Luciferase reporter assay showed that miR-548a-3p can targeting the 3’-UTR of MMP-2.There were high expression of miR-548a-3p and low expression of MMP-2 in MKN28-miR-548a-3p mimics.There were low expression of miR-548a-3p and high expression of MMP-2 in others reconstructed three cell lines.There were smaller invaded cells in SGC-7901-miR-217 mimics than in others three cell lines (P ＜ 0.05).Conclusions miR-548a-3p can target the 3'-UTR of MMP-2 and down regulate its expression and inhibit the ability of invasion of gastric cancer cells.

ObjectiveTo investigate value of minimally invasive surgical approach in patients with hypertensive intracerebral hemorrhage in primary hospital.MethodsAccording to the operation procedure,93 cases with basal ganglia hemorrhage were divided into three groups:1.minimally invasive surgery group A (n =37 ),2.ventricular puncture and drainage,lumbar cistern drainage group B(n=10),3.usual operation group C( n =46).Estimated operation effect with computed tomography in 24 hours after operation.Case fatality rate and complication incidence were analyzed after three months of operation according to the Glasgow Outcome Scale (GOS).ResultsMinimally invasive surgery group A had the highest hematoma clearance rate (82.7 ± 8.1 ) ％,group B (78.6±6.5 ％ ),group C (50 ±10％ ).The incidence rate of rebleeding was 8.1％ in group A( n =3 ),10％ in group B ( n =1 ),34.8％ in group C (n =16).The grade Ⅳ of the GOS and the grade Ⅲ of the GOS was respectively 93.8％ and 6.5％,case fatality rate was zero.Conclusion The minimally invasive surgical operation not only lead to less tissue damage and decrease rebleeding,but also improve neurological functional recovery.

Objective To examine the relationship between quetiapine serum concentration,dose,therapeu-tic efficacy and side effects in male patients with schizophrenia.Methods Sixty-three male patients with schizo-phrenia were collected.They were treated openly for 8 weeks with quetiapine,the dose was adjusted according to clini-cal improvement and tolerance.The plasma quetiapine concentrations,therapeutic efficacy and adverse drug reactions were observed after the 4 -week treatment period,and at the end of the 8 weeks of the treatment.Results After 4 weeks,the serum concentration had significant correlation with age,the disease duration and education level.After 8 weeks,there was significant correlation between serum concentration and age.We found a correlation between dose and serum concentration of quetiapine,and no relationship between serum concentration and PANSS scores.Side effects were correlated with 4 weeks′serum concentrations.Conclusion Quetiapine is effective for male patients with schizophrenia.Age,quetiapine dose and side effects have significant correlations with the serum concentration.It appears that plasma quetiapine concentration has no effects on therapeutic efficacy.

Synchronous multiple primary carcinomas refers to 2 or more than 2 kinds of different primary malignant tumors develop synchronously or in 6 months.The incidence of synchronous multiple primary carcinoma is low.A patient with esophageal basaloid squamous cell carcinoma (BSCC) and gastric adenocarcinoma was admitted to the First People's Hospital of Lianyungang in October 2011.The main symptom of this patient was dysphagia,and multiple lesions were found in esophagus,cardia and stomach fundus by gastroscopy respectively.On computed tomography image,eminence lesion in esophageal midpiece and wall thickening from esophagus-cardia to stomach fundus were displayed and were both enhanced slightly by enhancement scanning.The esophageal and cardia tumors were resected via left thoracic approach,and postoperative pathological examination revealed esophageal BSCC and moderately differentiated adenocarcinoma of cardia respectively.Comedo necrosis and red basal membrane material were seen under light microscope.The expressions of cytokeratin 5/6 and P63 were positive,the expression of cytokeratin L was weak positive and the expressions of synaptophysin,chromogranin A and CD117 were negative.The patient suffered from pleural effusion and multiple liver metastases after 4 months follow-up and died of liver metastases in May 2012.Multiple primary carcinomas including esophageal BSCC and gastric adenocarcinoma are rarely seen in clinical practice.Their diagnosis and differential diagnosis mainly depend on histological morphology and immunohistochemical method.Surgical resection combined with postoperative radiotherapy and chemotherapy is selectable,but the prognosis is poor.

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.