Objective To observe the clinical curative effect of edaravone on treatment of acute lagre area cerebellar irdarction(ALACI). Methods 31 ALACI patients attacked within 72h were randomly assigned to therapygroup( n = 16) and control group( n = 15). Therapy group took the basic treatment as well as edaravone infused at a dose of 30mg,twice a day for 14 days. Control group took similar treatment to therapy group expect for edaravone.At 0th ,7th, 14th ,21th day after treatment, the C.SS and ability of daily living(ADL) were used to evaluate the recovery of neurological functions. Results Significant difference of CSS and ADL grading were detected between therapygoup and control group at 7th, 14th day( P < 0.05 ), with lower grading in therapy group ; there were significant differ-ence of CSS and ADL grading between therapy goup and control group at 21th day( P < 0.01 ), with lower grading in therapy group. No evident side effect was detected in edaravone therapy group. Conclusion Edaravone is a safe a-gent. It can effectively improve the neurological deficits and daily living ability of ALACI patients.

Objective To investigate the clinical features of ulcerative colitis(UC).Methods Based on typical clinical manifestation,enteroscopy and pathological results,138 in-hospital patients were diagnosed UC during 1998 to 2006.Their clinical features were analyzed in this report.ResultsUC was more commonly seen in people aged 20～60(n=108,78.3％).Nearly forty-six percent of the patients (n=63,45.7％)had the disease less than one year.More patients(n=100,72.4％)showed mild or moderate UC.Bloody stool was the most common manifestation.erythrocyte sedimentation rate,hemoglobin,albumin and α1 or α2 globulin levels were closely related with the condition.The mean value of platelet counting was in the upper limit of the normal value.Enteroscopy found more lesion located in the whole colon (n=78,56.5％).Pathological results showed infiltration of inflammatory cells,especially in patients with chronic inflammation.Salieylazosulfapyridine(SASP)and/or 5-Aminosalicyclic(5-ASA)were effective in most UC patients(n=70,50.7％).ConclusionsChinese patients usually had mild to moderate UC,and their courses were often shorter than abroad.The disease was closely related with α1 and α2 globulin levels.Most of the patients had response to SASP and/or 5-ASA.

Objective To study the relationship between coagulation abnormal and inflammatory in the TNBS induced rats colitis model as well as the therapeutic effect of heparin on this model Methods Forty SD-rats were separated into 4 groups randomly, including normal control group, colitis group, heparin group and SASP group. PT, APTT and the activity of antithrombin (AT)were chosen as indexs of coagulation. The level of damage ancl inflammatory state of the colitis rats were assessed by macroscopical score, histological score and the level of TNFα in each group. Results Compared with normal control group, TNBS induced colitis group has a shorter PT [(14.83±0.45)s vs(16.68±1.08 )s, P < 0.05] and APTT[(12.49±1.30)s vs(29.06±1.60) s, P<0.05] and a lower activity level of AT [(111.33± 8.50)% vs(122.13±3.52)%,P<0.05]. In heparin group, PT, APTT were prolonged [PT: (17.83± 0.78)s vs (14.83±0.45)s,P<0.05, APTT:(53.34±9.49)s vs (12.49±1.30)s,P<0.05] and AT activity was higher than colitis group [(131.67±6.92)% vs (111.33±8.50) %, P < 0.05]. SASP group has a similar data in PT, APTT compared with colitis group and no statistical significance(P>0.05). The activity of AT in SASP group is higher than in colitis group [(122. 33±5.82)% vs (111.33±8.50)%,P <0.05]. The heparin therapy group showed lower macroscopical score(2.50±0.55 vs 4.75±1.16, P< 0.05), histological scores(3.83±0.41 vs 7.75±1.04, P<0.05) and the level of TNFα[(84.75± 18.03) ng/L vs (149.93±23.52)ng/L, P < 0.05] compared with the colitis group. Conclusion Coagulation was abnormality in the rat colitis model induced by TNBS; heparin therapy is effective in the colitis model It seemed that the abnormality of coagulation plays an important role in the pathogenesis of the rat colitis model.

Objective To study the relationship between coagulation and inflammatory in 2,4,6- trinitrobenzenesulfonate (TNBS) induced colitis model as well as the therapeutic effect of warfarin.Methods Forty SD-rats were divided into 4 groups, including normal control group (received 0.9% HCI solution), colitis group, warfarin treated group (240 ng/kg daily) and salieylazosulfapyridine (SASP) treated group (100 mg/kg daily). The animal model was induced by injection with 20 mg TNBS. The blood and colon of the rats were removed and the rats was sacrificed at the 14th day. The index of coagulation such as prothrombin time (PT), activated partial thromboplastin time (APTT) and the activity of antithrombins (AT) and the level of tumor necrosis factor-α (TNF-α) were tested.The damage and inflammatory state of the colitis were evaluated by macroscopical score and histological score . The value of disease activity index (DAI) and the platelet counts were alsomeasured. Results The value of DAI was lower in warfarin (1.20±0.45) and SASP (1.78±0.90) treated groups as compared with colitis group (2. 25 ± 0. 89) with no difference (P>0. 05). The macroscopical score was lower in warfarin (1.40 ± 0.55) and SASP (3.14± 1.46) treated grouos as compared with colitis group (4.75 ± 1.66, P<0.01 ). The histological score in warfarin (4. 00± 1.41 ) and SASP (4.28 ± 1.49) treated groups were lower than that in colitis group (7. 75± 1.04, P<0.01). The level of TNF-α was lowest in normal control group (P<0. 01 ), and highest in colitis group. (P<0.01). The PT and APTT were shorter and the aetivity of AT was lower in colitis groupin comparison with warfarin treated group and normal control group (P<0.01). The platelet counts was highest in colitis group. P<0.01). Conclusion The abnormal coagulation in TNBS induced colitis can be effectively treated with warfarin.

Objective To explore the alterations of intestinal mechanical barrier during the nonalcoholic fatty liver disease (NAFLD) progression. Methods To establish NAFLD rats' model,ninety male SD rats were divided into three groups equally: normal-diet group, high-sucrose diet group and high-fat diet group. At the 4th, 8th and 12th week each time point, ten rats were sacrificed in each group. Another twenty SD rats were randomly divided into carbon tetrachloride (CCl4) group and control group. The liver injured model of CCl4 group was induced by CCl4 ; all the rats of these two groups were killed at the 4th week. The degree of liver steatosis was observed through HE staining of liver paraffin sections. The lipopolysaccharide (LPS) level of portal vein blood was measured by limulus test. The occludin expression in intestinal mucosal was detected by immunofluorescent assay,and the fluorescence intensity was scored. The morphology change of intestinal mucosa tight junction was observed through electron microscopy. Results The liver histopathology suggested that NAFLD and liver injured rats' model was successfully established. There was no statistical significance of LPS level between high-sucrose diet group and normal diet group at all the time point (P＞0.05). At the 4th and 12th week, there was no statistical significance of LPS level between high-fat diet group and normal diet group (P＞0.05), while it was significantly higher in high-fat diet group than normal diet group at the 8th week (P＜0. 05). There was no statistical significance of LPS level between CCl4 group and control group (P＞0. 05). At the 8th week, the expression of occludin in normal-diet group, high-sucrose diet group and high-fat diet group was 1.80±0. 42, 1. 50 ± 0. 53 and 1.30±0.67, respectively, the expression was a little bit lower in high-sucrose diet group and high-fat diet group than in normal diet group, the difference was statistical significance (P＜0. 05). At the 12th week, the expression of occludin was significantly lower in high-sucrose diet group and high-fat diet group than normal diet group. The expression of occludin was significantly lower in CCl4 group (0.60±0.16) than in control group (1.80±0. 42) (P＜0. 05). No obvious morphology changes of tight junction was found in high-sucrose diet group, high-fat diet group and CCl4 group at each time point.Conclusion The expression of occludin decreased gradually during the non-alcoholic fatty liver disease progression. So in the NAFLD treatment, besides improving insulin resistance and protecting liver function,the protection of intestinal mucosa barrier as early as possible may slow down the progression of liver injury.

Objective To study the expressions of TLR4, CD14, MD-2 and NF-kB in colonic mucosa in patients with diarrhea-irritable bowel syndrome (IBS-D) , and compared with normal subjects. The purpose of this study is to explore the role of TLR4 and TLR4 signal transduction pathway in the pathogenesis of IBS-D. Methods The expressions of TLR4, CD14, MD-2 and NF-kB in colon mucosa were examined by immunohistochemistry (IHC) in 30 IBS-D patients and 12 healthy volunteers separately. The average absorbance (A value) of TLR4 was analyzed. The positive expression rates of CD14, MD-2 and NF-kB of colonic mucosa were studied. Results Compared with healthy controls, significant upregulation of TLR4 expression relative to controls was found in colon mucosa of IBS-D. A value of TLR4 in IBS-D was significantly higher (0.3971 ±0.0996 vs 0. 3044 ±0.0481). The positive rate and intensity of NF-kB in IBS-D were significantly higher than those in healthy. The number of positive cells of MD-2 showed significant increase in lamina propria of IBS-D against controls. The percent of CD14 positive was upregulated in lamina propria in IBS-D. The expressions of MD-2 and CD14 in intestine epithelial cell were low or negative. Conclusions There is the activation of the signal transduction pathway of TLR4/NF-kB in the colonic mucosa of patients with IBS-D. Up-regulated expression of TLR4 in IBS patients suppose that it might contribute to occurrence of IBS-D.

Two hundred male and 200 female patients with type 2 diabetes mellitus admitted from January 2007 to April 2008 were enrolled in the study. Of them, 267 were diagnosed as non-alcoholic fatty liver disease (NAFLD) by ultrasonography. The measurements included:body mass index (BMI) ,waist-to-hip ratio (WHR) ,fasting blood glucose( FBG), ALT, AST, total bilirubin(TBIL), cholesterol(CHO),triglyceride(TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol ( LDL-C) ,serum creatinine (Cr), supersensitive C-reactive protein (hsCRP) and urine albumin/creatinine. The relationship of above factors with NAFLD was determined. Our data showed that male NAFLD patients were in general younger than female. The BMI ( t = 11. 361, P = 0. 000), waist circumference ( t = 9. 771, P =0. 000), hip circumference (t = 10. 469, P =0. 000) ,TG(t =7. 352, P =0. 000) and hsCRP (t =2. 242,P =0. 026) of NAFLD patients were significantly higher than those without NAFLD. The hsCRP of patients with central obesity was also significantly higher than those without central obesity (t = 0. 266, P = 0. 045 ).BMI and TG were positively correlated with NAFLD. Waist circumference was an independent factor of NAFLD in male patients, same as hip circumference with NAFLD in female patients. In conclusion, gender,central obesity and dyslipidemia may be risk factors for NAFLD in patients with type 2 diabetes mellitus.

OBJECTIVE:To evaluate the pharmacoeconomic effectiveness of three therapeutic schemes for lower respiratory tract infections.METHODS:The cost-effectiveness analysis of three therapeutic schemes for lower respiratory tract infections was carried out.RESULTS:The cost-effectiveness ratio of penicillin-piperacillin schemes(L1)was minimum in respect to the effective rate.However,the cost-effectiveness ratios had no significant difference between cefotaxime scheme(L3)and L1 scheme in regard to cure rate(P>0.05),the cost-effectiveness ratio of ciprofloxacin-clinadmacin scheme(L2) was higher significantly than those of L1 and L3 schemes(P<0.05,both schemes).CONCLUSION： L1 is the best therapeutic scheme.Although L3 scheme had higher cost,it had higher cure rate and lower ADRs occurrence.L3 scheme is benefitial to improvement of patient's life quality.

Objective To analyze the clinical characteristics of ulcerative colitis (UC) in elderly patients.Methods A total of 166 cases with diagnosed UC were recruited.The clinical characteristics were compared between the elderly group (n=35,≥60 years) and the young group (n =131,20 59 years).Results The number of male patients were more than female patients in both groups.The incidence of abdominal pain was significantly lower in the elderly group than in young group (P＜0.05).The number of severe patients were significantly lower in the older group than in young group.Severe UC prevalence was 27.5％ (36 cases) in the young versus 11.4％ (4 cases) in the elderly (x2 =3.89,P＜0.05).The prevalence of total colitis was lower in elderly group than in younggroup [31.4％ (11 cases) v,.51.1％ (61 cases),~ =4.31,P＜0.05],however,the prevalence of proctitis is more common in the elderly than in young group.The extra-intestinal manifestations and the ratio of receiving immune inhibitor and operation showed no significant differences between the two groups.Conclusions Compared with young group,there are a lower incidence of abdominal pain,a higher number of severe patients,a lower incidence of total colitis,and a higher incidence of proctiits in elderly group.

Objective To summarize the clinical features of Budd-Chiari syndrome.Methods A total of 151 Budd-Chiari syndrome admitted in Peking University People's Hospital from 1996 to 2012 were analyzed retrospectively.Results Abdominal distension was the most common complaint,with 62.9％ (95/151)of lower extremity edema,53.0％ (80/151)of typical bottom-up flow of the abdominal wall longitudinal varicose veins and 60.9％ (92/151) with ascites.Laboratory tests results showed median of alanine aminotransferase (ALT) was 21.5 (15.0,30.0) U/L,aspartate aminotransferase (AST) was 30.0 (23.8,42.0) U/L,total bilirubin was 31.1 (23.3,47.8) μmol/L,blood albumin 37.5 was (31.8,41.5) g/L,prothrombin activity was 71％ (61％,84％).WBC was 5.2 (3.5,7.5) × 109/L,hemoglobin concentration was 126.5 (108.8,144.2) g/L,and platelet count was 117.0 (85.5,155.5) × 109/L.Abdominal B-ultrasound examination showed hepatomegaly existed in 68.9％ (104/151) patients.Intraoperative angiography and surgical exploration showed that 41.1％ (62/151) patients were simple inferior vena cava obstruction or stenosis,15.9％ (24/151)were simple hepatic vein obstruction or stenosis and 43.0％ (65/151) suffered from the inferior vena cava combined with hepatic vein stenosis or obstruction.Surgically confirmation of the lesions showed that inferior vena cava membrane-like structure combined with thrombosis was in 59.6％ (90/151) cases.Conclusions Liver congestion,inferior vena cava congestion and portal hypertension are the main clinical manifestations of Budd-Chiari syndrome.With slightly liver function injury,liver dysfunction of Budd-Chiari syndrome isn't parallel with its portal hypertension.