Objective To evaluate the mechanical homogeneity pattern of isolated carotid atherosclerotic plaque intima on longitudinal axis view using ultrasonic velocity vector imaging.Methods Fourty six patients with 48 isolated plaques were undergone the high frequency ultrasound scanning,the real-time two-dimensional longitudinal-axis gray scale view at the maximal thickness of the plaque was obtained in three complete cardiac cycles.A dedicated velocity vector imaging(ⅤⅤⅠ)workstation was used for the off-line dynamic two-dimensional gray-scale image analysis and mechanics parameter(i.e.,the peak strain and the absolute difference of the peak strain)assessment at the sites of the upper,middle and down stream separately.The length and direction distribution of the velocity vectors at the carotid atherosclerotic plaque intima were observed.Wilcoxon test was utilized for the comparison of the peak strain and the absolute difference of the peak strain between two sites.Results The chaos phenomenon of velocity vector distribution at the sites of plaque intima occurred significantly differed from those uniform velocity vectors at the reference sites.According to the two groups of the higher strain value side and the lower strain value side on the upper stream and the down stream of the plaque intima,the peak strain at the higher strain value side was significantly higher than the lower strain value side(P=0.000).There was a significantly difference between the absolute difference of peak strain from the higher strain value side to the middle stream point of the plaque intima and the absolute difference of peak strain from the lower strain value side to the higher strain value side of the plaque intima(P＜0.017).Conclusions The length and direction distribution of velocity vectors of the isolated carotid atherosclerotic plaque intima on longitudinal axis view are uneven,the mechanical heterogeneity pattern exists at the plaque intima and could be visualized and quantitatively evaluated using ultrasonic velocity vector imaging.

ObjectivesTo identify the related abnormalities of gray matter in pediatric patients with Tourette syndrome (TS) by using the optimized voxel-based morphometry (VBM).Methods Three dimensional T1WI was acquired in 31 TS children (28 boys,3 girts,mean age 8 years,range 4-15 years) and 50 age- and sex-matched controls on a 1.5 Tesla Philips scanner. Images were pre-processed and analyzed using a version of VBM 2 in SPM 2.The whole brain gray matter volume was compared between the study and control group by using t-test.Multivariate linear regression analysis was used for analyzing the correlation between the change of grey matter volume within each brain region (mm3 ) and YGTSS score and course of disease of TS patients.Statistical analyses were performed by using SPSS 13.0.ResultsUsing VBM,significant increases in gray matter volumes in left superior parietal lobule, right cerebellar hemisphere and left parahippocampal gyrus were detected in TS patients,and the volume changes were 4059,2126 and 84 mm3 ( t =3.93,3.71,3.58,P ＜ 0.05 ) respectively.Compared to the control group,decreased grey matter volumes were found in medulla and left pons,and the volume changes were 213 and 117 mm3( t =3.53,3.48,P ＜ 0.05 )respectively.Tic severity was not correlated with any volume changes of gray matter in brain (P ＞ 0.05,a small volume correction,KE ≥ 10 voxel).Tic course was negatively correlated with the gray matter volume of left parahippocampal gyrus ( Beta =- 0.391,P =0.039 ).ConclusionsUsing VBM technique,the gray matter abnormalities can be revealed in TS patients without obvious lesions on conventional MR imaging.The increasing volume of temporal and parietal lobes and cerebellar may be an adaptive anatomical change in response to experiential demand. The gray matter volume of the parahippocampal gyrus may be used as one potential objective index for evaluating the prognosis of TS.

Osteoarthritis (Osteoarthritis, OA) is a common clinical degenerative joint disease with increased incidence rate in recent years. Animal experiment is one of the important ways to explore pathogenesis and treatment of OA, while induced animal model is the most important part in animal experiment. Intra-articular injection of drugs is a classical method for establishing animal model of OA. Choose of animal should follows the principle of correlation, appropriateness and practicability, injections should perform in accordance with experimental purposes and subject, detections means and evaluation methods also should corresponding to experimental reality. The gold standard of OA animal model and intra-articular injections has not build, need further study.
Animals ; Cytokines ; analysis ; Disease Models, Animal ; Injections, Intra-Articular ; Mice ; Osteoarthritis ; diagnosis ; etiology ; immunology ; Rabbits ; Rats

Objective To study the characteristics of ambulatory blood pressure in advanced age patients with hypertension during pregnancy and its effect on pregnancy outcome, and to explore the clinical significance of ambulatory blood pressure monitoring in advanced age women with hypertension.Methods A retrospective analysis from January 2016 to August 2017, in patients with pregnancy induced hypertension in the Second Affiliated Hospital of Kunming Medical University of production inspection and delivery in hospital as the research object, according to the age of pregnant women, they were divided into the advanced age group (35 years of age or older, n=100), and age group (age ＜35, n=100). All the pregnant women underwent 24-hour ambulatory blood pressure examination in the middle and third trimester of pregnancy to compare the difference of ambulatory blood pressure parameters between the two groups and the relationship between them and the adverse outcome of pregnancy. Results Systolic pressure index of the advanced age group 24 hours average systolic pressure, day mean systolic pressure, night mean systolic pressure, day systolic pressure load value, night systolic pressure load value were higher than the age group, the differences were statistically significant (P＜0.05); The incidences of cesarean section and premature infant were higher than thase in the age group, and the differences were was statistically significant (P＜0.05). The average diastolic blood pressure andthe day systolic load were correlated with fetal growth restriction in both the aged and age groups, and the24-hour mean diastolic blood pressure was associated with preterm infants. Conclusions Ambulatory blood pressure monitoring has a positive significance in the diagnosis, evaluation and reduction of adverse pregnancy outcomes in the advanced age patients with hypertensive pregnancy, and can be used as prenatal routine examination for the advanced age pregnant women.

Special emphasis about cancer metastasis was concentrated on tumor cells themselves, and we usually considered the ability of migration and invasion was the final decider. Recently, bewaring of tumor microenvironment is a fundamental determinant in metastasis has become the most outstanding breakthrough. Considerable "microbes" in the microenvironment are closely linked with tumor metastatic behaviors, and the major proportion of them is tumor-associated macrophages (TAMs). Actually, TAMs conserve immediate "cross-talk" with cancer cells throughout tumor development. It is generally accepted that TAMs have mostly pro-tumoral functions and play an important role in several stages of tumor progression. This progression involves a series of events that leads from the primary site to the metastatic site, including tumor cell growth, angiogenesis, migration, invasion, intravasation and finally extravasation at distant site where the process begins again (metastasis). Thereby, TAMs has attracted substantial attentions in recent years and could become a promising therapeutic strategy. In this review, we focus on the multi-functions of TAMs in cancer and certain drugs targeting TAMs for cancer treatment those are under experimental research procedures or have even been entered human clinical tests.
Animals ; Gene Expression Regulation, Neoplastic ; Humans ; Macrophages ; metabolism ; Neoplasms ; pathology ; Neovascularization, Pathologic ; metabolism ; pathology

OBJECTIVETo analyze the frequency of thyroid dysfunction and determine its influencing factors in chronic hepatitis C (CHC) patients treated with pegylated-interferon alpha (peg-IFNa)-2a and ribavirin (RBV) combination therapy.

METHODSA total of 194 CHC patients were treated with peg-IFNa-2a and RBV for 48 weeks. Development of thyroid dysfunction was recorded. Clinical and biological factors from pre-treatment (baseline) to post-treatment were statistically analyzed to determine correlation with thyroid dysfunction in this patient population.

RESULTSFifty-two (26.80%) of 194 peg-IFNa-2a/RBV-treated patients developed thyroid dysfunction. Dysfunction severity ranged from hyperthyroidism (n = 1, 0.52%) and hypothyroidism (n = 10, 5.15%) to subclinical hyperthyroidism (n = 4, 2.06%) and subclinical hypothyroidism (n = 37, 19.07%). The dysfunction rate was significantly higher after peg-IFNa-2a/RBV treatment (26.80% vs. 12.37% at baseline, x2 = 12.829, P less than 0.05, odds ratio (OR) = 0.386, 95% confidence interval (CI): 0.226-0.657), in females (33.00% vs. 20.21% in males, P less than 0.05, 95% CI: 1.016-3.040), and in thyroid auto-antibody positive patients (64.29% vs. 23.89% in negative patients, P less than 0.05, 95% CI: 1.681-36.183). Early virological response did not have any significant effect on dysfunction rate (23.00% vs. 30.85% no early virological response, x2 = 1.522, P more than 0.05) nor did end of treatment response (27.19% vs. 26.25% no response at end of treatment, x2 = 0.021, P more than 0.05). Patients who developed thyroid dysfunction had higher interleukin (IL)-6 at baseline (i.e. before peg-IFNa-2a/RBV treatment) (27.08+/-14.90 vs. 11.65+/-5.46 in patients who maintained normal thyroid function, t = 3.127, P less than 0.05, 95% CI: 5.28-25.58). IL-6 levels were not significantly different between the two groups at 24 weeks (6.30+/-2.47 vs. 6.81+/-2.80, t = 0.352, P more than 0.05). IL-6 levels before and after 48 weeks of treatment in normal thyroid function patients were 27.08+/-14.90 and 6.30+/-2.47, t = 3.632, P less than 0.05, and in thyroid dysfunction patients were 11.65+/-5.46 and 6.81+/-2.80, t = 1.997, P more than 0.05.

CONCLUSIONPeg-IFNa-2a/RBV combination therapy may cause thyroid dysfunction, especially hypothyroidism, in CHC patients. Female sex and thyroid auto-antibody positivity may put CHC patients at higher risk of developing thyroid dysfunction during peg-IFNa-2a/RBV therapy. Elevated IL-6 may be a predictive marker of peg-IFNa-2a/RBV-induced thyroid dysfunction.

Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic ; drug therapy ; physiopathology ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; adverse effects ; therapeutic use ; Recombinant Proteins ; adverse effects ; therapeutic use ; Retrospective Studies ; Ribavirin ; adverse effects ; therapeutic use ; Thyroid Diseases ; chemically induced ; physiopathology ; Thyroid Gland ; drug effects ; physiopathology ; Treatment Outcome

Objective To gain an in-depth understanding of the motivations,patterns,and related factors in family decision-making regarding the referral of terminal patients in tertiary hospitals.Methods Using purposive sampling,terminal patients and their family members from three tertiary hospitals in Beijing were se-lected as subjects.Semi-structured interviews were conducted,and the interview data were subjected to thematic analysis.Results Following the saturation principle,a total of 11 patients and 15 family members were includ-ed.The interview data were organized and analyzed,yielding six major themes:decision premises,decision pat-terns,family support,support from the referring hospital's medical team,referral channel conditions,and in-volvement of volunteer teams and social support.Based on these findings,a flowchart illustrating the family deci-sion-making process for the referral of terminal patients was constructed.Conclusions The study provides a com-prehensive analysis of various factors influencing family decision-making in the referral of terminal patients in ter-tiary hospitals.The results underscore the significance of internal and external factors,emphasizing the integrated impact of decision patterns,family support,medical team support,referral channel conditions,and the in-volvement of volunteer teams and social support.The research offers profound insights into improving the referral process for terminal patients and enhancing the quality of family decision-making.It provides valuable recommen-dations for future improvements in medical services and decision support.

To investigate the effect of forced running in motor-driven wheel on neurogenesis in the hippocampal dentate gyrus (DG) of adult rats, 5-bromo-2-deoxyuridine (BrdU), a thymidine analog was applied to mark cell proliferation. Neuroepthelial stem cell protein (nestin) expression was used to identify neural stem/precursor cells. The BrdU- and nestin-positive cells were examined by immunohistochemical technique. The ability of learning was evaluated by Y-maze test to explore the functional role of the newborn cells in the DG after forced running. It was found that the number of BrdU- and nestin-positive cells in the DG in running groups was significantly increased compared to that in the control group (P<0.05). The effect of forced running on neurogenesis was intensity-dependent. In addition, an improvement of learning ability in Y-maze test was observed after forced running. These findings suggest that forced running in motor-driven wheel could enhance neurogenesis in the hippocampal DG of adult rats and improve learning ability.
Animals ; Bromodeoxyuridine ; metabolism ; Cell Survival ; Dentate Gyrus ; cytology ; physiology ; Intermediate Filament Proteins ; analysis ; Learning ; Male ; Maze Learning ; Nerve Tissue Proteins ; analysis ; Nestin ; Neurons ; physiology ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Running

To explore influence of ultrasound‐guided lauromacrogol foam sclerotherapy on peripheral blood levels of counting of endothelial cells (CEC) , endothelin (ET)‐1 and nitric oxide (NO) in patients with sa‐phenous vein varicosis .Methods : A total of 90 patients with saphenous vein varicosis were randomly and equally di‐vided into lauromacrogol group (received ultrasound‐guided lauromacrogol foam sclerotherapy ) and routine treat‐ment group (received routine stripping ).Peripheral blood levels of CEC , ET‐1 and NO were observed and com‐pared between two groups before and after surgery , and therapeutic effect and incidence of complications were eval‐uated.Results : Compared with routine treatment group , there were significant reductions in surgery time [ (81. 79 ± 16.88) min vs .(40.55 ± 10. 19) min] , hospitalization time [(3.94 ± 1.36) d vs.(2. 17 ± 1.31) d] and hospital‐ization fee [ (7640. 15 ± 1025.11) RMB vs.(3998.89 ± 910. 67 ) RMB ] in lauromacrogol group , P＝ 0.001 all. Compared with routine treatment group after surgery , there were significant reductions in incidence rate of total complications (17.78% vs .4. 44%) , percentage of patient＇s condition class IV (17. 78% vs.4.44%) , peripheral blood levels of CEC [ (5562. 48 ± 1194. 73)／L vs.(4655.87 ± 1209. 88)／L] and ET‐1 [ (70. 32 ± 10.30) ng／L vs. (62.95 ± 13.78) ng／L] , and significant rise in percentage of patient’ s condition class I (6.67% vs.25. 00%) and peripheral blood NO level [(1.27 ± 0.42) μmol／L vs.(1. 59 ± 0.51) μmol／L] in lauromacrogol group , P＜0. 05 or＜0. 01. Conclusion : Ultrasound‐ guided lauromacrogol foam sclerotherapy can significantly increase therapeutic effect , improve vascular endothelial function in patients with saphenous vein varicosis .And its complications are few .

OBJECTIVETo demonstrate the abnormal intima rotation pattern of the carotid atherosclerosis plaque using velocity vector imaging, and to develop a new method for the clinical mechanical state assessment of the plaque intima.

METHODSThe rotation movement and rotation angle on the serial dynamic ultrasonic short-axis gray scale views of 48 isolated atherosclerosis plaques (i. e., upstream, midstream, and downstream) and nearby reference segments of carotid artery in 46 patients were derived and analyzed using a dedicated velocity vector imaging workstation. The incidence of intima rotation movement and the rotation angle at different sections of the plaque and nearby reference segments before and after the standard grip stress test during systole and diastole respectively were counted and measured.

RESULTSBefore and after the stress test, the intima rotation movement occurred at the majority of the short-axis sections of the plaque and the nearby reference segments during cardiac cycle. Before the stress test, the incidence of intima rotation movement at the upstream section of the plaque during systole was significantly higher than that of reference segment (P = 0.036) The reversal direction of the intima rotation at those sections and reference segment during systole and diastole was demonstrated. After the stress test, the incidence of intima rotation movement at the midstream section of the plaque during diastole was significantly lower than that of reference segment (P = 0.031). The incidence of the intima rotation movement changed at the sections of upstream, midstream, and downstream of the plaque before and after the stress test also were explored (i. e., increased in systole and decreased in diastole) except the reference segment intima.

CONCLUSIONSThe intima rotation movement occurs at the majority of the isolated plaque and nearby reference segment, and the incidences of the intima rotation movement at the plaque is different from that of the reference segment during systole and diastole respectively. The abnormal pattern of intima rotation movement may be used to indicate the unstable mechanical state of the isolated plaque intima.

Carotid Arteries ; diagnostic imaging ; physiopathology ; Carotid Stenosis ; diagnostic imaging ; physiopathology ; Echocardiography, Stress ; Exercise Test ; Humans ; Rotation ; Tunica Intima ; diagnostic imaging ; physiopathology