Objective:To compare the clinical and imaging characteristics between central nervous system vasculitis(CNSV)and mitochondrial encephalomyopathy(ME),so as to analyze the differential diagnosis of the two disorders.Methods:Clinical data on seven patients with CNSV and five with ME were retrospectively analyzed.The clinical manifestations,laboratory parameters,imaging features and histological characteristics were compared to screen for the evidence of their differential diagnosis.Results:The MRI results of both CNSV patients and ME patients(MELAS type)showed a multi-lesion pattern.The symptoms of CNSV patients included headache,limbs weakness,and erythrocyte sedimentation rate(ESR)increase.The symptoms of MELAS patients included epilepsy and increased serum lactic acid.The electroencephalographic manifestations of both diseases were abnormal:CNSV patients mainly had diffused lesions accompanied with limited alterations;ME patients had evidence of epileptic discharge,which was consistent with the clinical symptoms.Conclusion:Clinical manifestations of CNSV and ME patients are more valuable than imaging findings in the diagnosis of the two diseases.CNSV is characterized by vascular disorders and inflammatory reactions;ME is characterized by abnormal energy metabolism and severe damage of gray matter.The final diagnosis should depend on laboratory and histological examinations.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

BACKGROUND: Clinical experiments indicates that Yufeng capsule (composed of milkvetch root, angelica, szechwan lovage rhizome, senega and salvia miltiorrhiza) is effective for benefiting vital energy, circulating blood flow,dispelling gores and killing inflammation. The mechanism may be associated with the function of platelet aggregation, changes of contents of thromboxane B (TXB) and 6-Ketoprostaglandin F1 alpha (6-keto-PGF1 α) in plasma.OBJECTIVE: To observe the influence of Yufeng capsule on the platelet aggregation and its mechanism.DESIGN: Randomized controlled animal trial.SETTING: Department of Pathology, Daqing Branch of Harbin Medical University.MATERIALS: The experiment was performed at the Laboratory of Pharmacology, Daqing Branch of Harbin Medical University from May 2000 to July 2004. A total of 40 Wistar male gerontic rats with mean age of (8-10) weeks and mean body mass of (550±150) g and 8 Wistar male young rats with mean age of 4-6 weeks and mean body mass of (230±120) g were selected.METHODS: The 8 Wistar male youth rats were selected as youth control group. The 40 Wistar male gerontic rats were selected as the blood stasis model, and according to the numeration table method they were classified into 5 groups: aspirin group, low-dose Yufeng capsule group, the middle-dose Yufeng capsule group, high-dose Yufeng capsule group and gerontic model group, with 8 rats in each group. The Yufeng capsule was constituted by milkvetch root, angelica, szechwan lovage rhizome, senega and salvia miltiorrhiza, and provided by the Preparation Office, Second Affiliated Hospital,Heilongjiang University of Chinese Medicine. Respectively the rats were injected with aspirin solution (5.5 g/kg), Yufeng capsule (0.33 g/kg, 0.66 g/kg and 1.32 g/kg), successively for 22 days by gastric perfusion, twice a day.Those in the gerontic group and youth control group were not treated with any drug One hour after last time administration, function of platelet aggregation(PAG), contents of thromboxane B2 (TXB2) and 6-Ketoprostaglandin F1 alpha (6-keto-PGF1 α) in plasma were examined with platelet aggregation method and radioimmunoassay.MAIN OUTCOME MEASURES: Function of platelet aggregation; contents of TXB2 and 6-keto-PGF1 α as well as ratio of TXB2 to 6-keto-PGF1α.RESULTS: Totally 48 animals were involved in the result analysis. ①The PAG was higher in the gerontic model group than other groups (P ＜ 0.01).②One minute platelet aggregation rate (PAG1), five minutes platelet aggregation rate (PAG5)and the maximal platelet aggregation rate (PAGM) in the high-dose Yufeng capsule group were lower than those in the aspirin group[(7.96±2.17), (6.38±1.66), (14.33±2.87) ng/L and (31.95±3.94),(35.29±6.54), (38.68±7.46) ng/L, respectively(P ＜ 0.01 )]. PAG5 in the middle-dose group was lower than that in the aspirin group [(13.96±1.66),(35.29±6.54) ng/L, (P ＜ 0.01 )]. ③TXB2 content in the low-dose Yufengcapsule group, middle-dose Yufeng capsule group, high-dose Yufeng capsule group, aspirin group and youth control group was lower than that in the gerontic model group (P ＜ 0.01). ④The TXB2 content in the high-dose Yufeng capsule group was lower than that in the low-dose Yufeng capsule group [( 100.13±8.90), (127.00±20.99) ng/L, (P ＜ 0.01 )]. ⑤TXB2/6-ke-to-PGF1 α in the high-dose Yufeng capsule group, middle-dose Yufeng capsule group and youth control group was lower than that in the gerontic model group [0.62±0.17,0.69±0.14,1.75±0.17,1.11±1.12, (P ＜ 0.05 )].CONCLUSION: High-dose and middle-dose Yufeng capsule is able to decrease the content of TXB2 and increase the content of 6-keto-PGF1 α, and improve their ratio. It is important to enhance the balance of TXB2 and 6-keto-PGF1 α. The effect in the low-dose Yufeng capsule group is lower as compared with that in the high-dose and middle-dose Yufeng capsule groups. It is thought that the low-dose Yufeng capsule has preventive effect.

Objective:After construction and identification of HBsAg gene recombinant backbone adenoviral vector,it is to prouduct HBsAg gene recombinant adenoviruses by packing PAd-Easy-1-HBs in 293 cells.Methods:The gene of interest was amplified from plasmid pEcob-6 PCR, the gene of interest which contained HBsAg gene was cloned into on adenoviral shuttle vector pAd-track-cmv. The pAd-track-cmv-HBs was linearized by digesting with restriction endonuclease Pme-1, and subsequently cotransformed into E.coli BJ-5183 cells with an adenoviral backbone vector pAd-Easy-1, Homologous recombinants were performed in bacterial cells. Finally, the linearized backbone adenoviral vector was transfected into adenoviruses packing cells lines,e.g. 293 cell by lipofectamine transfection. Transfections and viral productions can be minotored by green fluorescent protein(GFP). The expression of HBsAg in supermatant was investigated by ELISA. It was a certain HBsAg vaccine to amplify recombinant adenoviruses by repeating the infevtion cell to collect the viral supermatant.Results:GFP expression was visible by fluorescence microscopy after transfection. Adenoviral titer was monitored by GFP expression. GFP expression was visible after repeating the infection cell using the viral supernatant in more than 90 percent of the cells.The HBsAg also expressed in supermatant.Conclusion:HBsAg gene recombinant adenoviral backbone vector has been constructed successfully. HBsAg gene recombinant adenoviruses have been producted by packing in 293 cells. The study provides the possibility of further researches on the development of new anti-HBV vaccines.

Objective To explore the expression of discoidin domain receptor 1 (DDR1) in rats with pulmonary fibrosis induced by paraquat (PQ) poisoning, and its relationship with the expression of transforming growth factor-β1 (TGF-β1). Methods 120 Sprague-Dawley (SD) rats were divided into control group and 20, 40, and 80 mg/kg PQ poisoning groups (each n = 30). Pulmonary fibrosis induced by PQ poisoning model was reproduced by one time administration of 20, 40, 80 mg/kg of 20% PQ, and the rats in control group were given 4 mL normal saline. Fifteen rats in control and different doses of PQ groups were sacrificed at 7 days and 21 days after intragastric administration, and lung tissues were collected. Pulmonary fibrosis was observed after hematoxylin-eosin (HE) staining. The immune-histochemical method was used to determine the expressions of DDR1 and TGF-β1. The relationship between the expression of TGF-β1 and DDR1 was analyzed by Pearson correlation analysis. Results The rats in control group were active, and no pathological changes in lung tissue were found. The rats in PQ groups became shortness of breath, bristles, and slow reaction etc. 0.5 hours after intragastric administration. After 7 days, the lung tissue was dark red, hard texture, appearance of yellow soil fiber nodules and obsolete hemorrhage, destruction of alveolar structure. The extent of lung injury increased gradually with the time of poisoning and the increase of PQ dose. It was shown by immune-histochemical staining that the control group had only a small amount of DDR1 and TGF-β1 positive expressions; in PQ groups, there were a large number of DDR1 and TGF-β1 positive expression particles in the alveolar wall, pulmonary interstitial and alveolar cavity. It was displayed by quantitative analysis that compared with the control group, DDR1 and TGF-β1 expressions were significantly increased in 20, 40, 80 mg/kg PQ groups with time- and dose-dependent [DDR1 (integral A value): 0.221±0.014, 0.249±0.021, 0.364±0.016 vs. 0.121±0.036 at 7 days; 0.247±0.025, 0.321±0.015, 0.432±0.027 vs. 0.139±0.021 at 21 days; TGF-β1 (integral A value): 0.230±0.016, 0.265±0.015, 0.339±0.016 vs. 0.129±0.032 at 7 days; 0.248±0.011, 0.295±0.016, 0.399±0.026 vs. 0.119±0.026 at 21 days; all P < 0.05]. It was shown by Pearson correlation analysis that DDR1 expression was positively correlated with TGF-β1 expression with the increase of PQ dose and poisoning time (DDR1 with TGF-β1: r = 0.996, P < 0.000; DDR1 with PQ dose: r = 0.985, P < 0.000; DDR1 with poisoning time: r = 0.989, P < 0.000; TGF-β1 with PQ dose: r = 0.992, P < 0.000; TGF-β1 with poisoning time: r = 0.972, P < 0.000). Conclusions The expression of DDR1 in the lung tissue in PQ poisoning rats showed a time- and dose-dependent change, and it was positively correlated with TGF-β1 expression. DDR1 may be involved in the process of pulmonary fibrosis induced by PQ poisoning.

Objective To draw for character effective sports therapy for middle‐age patients with type 2 diabetes .Methods Choosing 16 middle‐aged patients with type 2 diabetes suitable for sport ,testing the VO2 max ,fasting plasma glucose and the differ‐ent time points after meals ,different intensity exercise corresponding heart rate to find out effective exercise intensity and blood glu‐cose peak time .To determine patients the best starting time ,carrying out effective intensity and time exercise 15 ,30 ,45 ,60 ,75 min before the peak time .Results (1)The blood glucose significantly reduces that 15 min low intensity and 5 min medium intensity were compared with pre‐movement(P<0 .05) ,and low intensity at least 45 min ,15 min of medium and large strength movement can be dropped to close to fasting blood sugar level .(2 ) Peak glucose after meals mainly concentrated at 60 -90 min after the breakfast ,90-120 min after the lunch ,60 -120 min after dinner ,and there was an obvious individual differences ,but men and women was no statistical significance(P>0 .05) .(3) Glucose‐lowering effect was no difference of the movement at different time point before the peak ,but 15-45 min before the peak time was better .Conclusion The middle‐aged patients with type 2 diabetes should combine their own blood glucose peak time ,proceeding moderate intensity more than 15 min or low intensity more than 45 min ,they can achieve good hypoglycemic effect at 15-45 min before the peak time .

AIM: To establish an animal model for studying the development and metastasis of melanoma. METHODS: C57BL/6 mice were used as host to receive melanoma cell transplantation. Three kinds of melanoma cell lines, B16F0, B16F1 and B16F10, cultured to prepare the cell suspensions, were transplanted into the mouse anterior chamber (AC) of the eye. The time of eyeball diabross, time of survival and metastasis of lymph node and lung were observed. RESULTS: The time of eyeball diabross in F10 group was earlier than that in other groups. The time of eyeball diabross was no difference between F0 and F1 groups. Metastasis was developed 18 days after transplantation in F1 and F10 groups, where the tumor cells was found in ipsilateral cervical lymph nodes. The melanoma cells metastasized to lung in all three groups 28 days after transplantation. The survival time in F0 group was longer than F1 and F10 groups. There was no difference in survival times between F1 and F10 group. CONCLUSION: The differences of three kinds of melanoma cell lines in tumor development and metastasis provided the evidence that was useful for choosing suitable animal model further to study the eye melanima.

Objective To investigate the effect of mild therapeutic hypothermia for different lengths of time on cerebral edema and hypoxia-inducible factor 1 α (HIF-1α),vascular endothelial growth factor (VEGF) expressions following intracerebral hemorrhage (ICH) so as to explore possible mechanism for better application of mild hypothermia.Methods ICH models were made in rats by stereotaxically injecting autologous artery blood into right caudate nucleus.Forty male Sprague-Dawley (SD) rats were randomly (random number) divided into 5 groups (n =8 each):sham-operated (sham),normothermic (NT),hypothermic-1 hour (MH1),hypothermic-2 hours (MH2),hypothermic-4 hours (MH3).Normothermic and sham-operated animals were kept at (37.0-± 0.2) ℃ of body temperature.Animals in the hypothermic groups received immediately and rapid cooling after ICH and kept at (33.0 ± 0.5) ℃ of body temperature for 1,2 and 4 hours respectively.Rats were sacrificed at 48 hours after cerebral hemorrhage.Then brain water content and BBB permeability were determined.Quantitative real-time PCR and Western blot were used to analyze the expression of HIF-1α and VEGF.Results The content of brain water,Evans blue concentration in brain,and the mRNA expression and protein levels of HIF-1α and VEGF were noticeably higher in NT group than those in sham group (P ＜0.01).There were statistically significant difference in the expression of HIF-lα mRNA and protein but little difference in other indicators between MH1 group and NT group.Compared with NT group,MH2 group and MH3 group brought about an improvement in BBB permeability and remarkable down-regulation of protein levels and expression of HIF-1 α and VEGF mRNA,whereas there were no statistically significant difference in expression of indicators between the two groups.Conclusions Mild therapeutic hypothermia induced rapidly and immediately after ICH could limit the development of brain edema in rats by down-regulating expression and protein levels of HIF-1 α mRNA,and in turn suppressing the evaluation of VEGF mRNA and protein expression.The brain edema was effectively reduced in animals treated with hypothermia for 2 hours' or 4 hours ' duration with little difference in magnitude of reduction in brain edema between these two modalities of hypothermia.

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.

Objective To investigate the correlation between dynamic contrast-enhanced CT and MRI image findings of intrahepatic mass-forming cholangiocarcinoma(IMCC) and pathologic differentiation.Methods The CT and (or) MRI features of ninety-five patients with IMCC proved by pathologic examination were retrospectively reviewed.Sixty-five patients underwent multiphasic dynamic contrast-enhanced CT scan, twenty-nine underwent multiphasic dynamic contrast-enhanced MRI scan and ten patients underwent multiphasic dynamic contrast-enhanced CT and MRI examination simultaneously.According to the case history and laboratory examination, patients were divided into groups: with chronic hepatitis and without chronic hepatitis and according to the maximum diameter of the tumor, they were divided into＜3 cm, 3 to 6 cm and＞6 cm groups.The imaging features of tumor enhancement were reviewed among groups.The pathologic results and imaging features were compared and patients were divided into well differentiated, moderately differentiated, and poorly differentiated groups.Analyzed by Chi-square test, the difference of tumor enhancement between groups were analyzed.Results The patterns of multiphasic dynamic contrast-enhanced CT and MRI in IMCC patients had five types: type 1:60 cases, peripheral rim and (or) separating enhancement during artery phase, followed by centripetal enhancement progressively and(or) separating enhancement in the equilibrium phase;type 2:11 cases, peripheral rim enhancement in the artery phase and hypointensity (hypoattenuating) during equilibrium phase with central nodular enhancement;type 3:15 cases, no enhancement in the arterial phase and internal heterogeneous enhancement during equilibrium phase;type 4: 6 cases, heterogeneous enhancement in the early phase and wash-out during equilibrium phase;type 5 : 3 cases, no enhancement throughout dynamic enhancement.The results showed that in hepatitis group type1 to 5 had 31, 7, 12, 5 and 1 cases and without hepatitis group had 29, 4, 3, 1 and 2 cases.There was no statistical significance between groups(x2=3.567,P=0.059).The maximum diameter＜3 cm group(28 cases) had 9, 8, 6, 3 and 2 case which showed enhancement type1 to 5;3 to 6 cm group(40 cases) had 27, 2, 7, 3 and 1 cases and＞6 cm group(27 cases) had 24, 1, 2, 0 and 0 cases.There was significant difference in groups(x2=19.582,P＜0.01).Pathological well differentiated and moderately differentiated groups(40 cases) had 24, 7,6, 2 and 1 cases presented enhancement type 1 to 5 and poorly differentiated group(55 cases) had 36, 4, 9, 3 and 3 cases.There was no statistical difference in three differentiated groups(x2=0.296,P=0.586).Conclusions CT and MRI enhancement patterns of IMCC are presented with diversity.The imaging features are associated with focus size and had no relationship with pathological differentiated degree.