Objective To observe the specific immune responses and the protection against P815 mastocytoma cells stably expressing HBV surface antigen in H-2 d mice after DNA immunization of HBV surface antigen gene (pCR3.1-S). Methods The immunization was performed by intramuscular injection of DNA vaccine (pCR3.1-S). P815-HBV-S was inoculated subcutaneously into mice three weeks after DNA immunization. The tumor growth was measured every five days. HBsAg specific cytotoxic T lymphocyte (CTL) activity was measured by 51 Chromiunm release assay. Results HBV DNA vaccine can evidently inhibit the tumor growth, prolong the survival period and improve the survival rate in mice. Meanwhile, HBsAg specific CTL activity was obviously increased after DNA immunization. Conclusions The results show that the DNA vaccine, pCR3.1-S, has strong antigenecity in cellular immunity and has marked killing effect on HBV infected cells in vivo. DNA vaccine against HBV may be useful for both prophylactic and therapeutic purposes.

OBJECTIVETo observe differences of immediate effect of twirling reinforcing-reducing manipulation at head acupoints on muscle force in patients with acute ischemic stroke.

METHODSA total of 126 patients who met the inclusive criteria were randomly divided into a twirling reinforcing group, a mild reinforcing-reducing group and a twirling reducing group, 42 cases in each one. The lines between Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected and treated with successive insertion of three needles. The twirling reinforcing method was used in the twirling reinforcing group, and mild reinforcing-reducing method was used in the mild reinforcing- reducing group, and twirling reducing method was used in the twirling reducing group. Each needle was manipulated for 1 min, which was repeated once every 10 min. The needles were retained for 30 min. Muscle force was evaluated immediately after treatment.

RESULTS(1) Muscle force of upper limb: after acupuncture, the muscle force of proximal and remote ends were all improved significantly in three groups (all P < 0.05), which was more obvious in proximal end (all P < 0.05). The improvement of the muscle force of proximal end in the twirling reinforcing group was superior to those in the mild reinforcing-reducing group and twirling reducing group (both P < 0.05); the differences of the muscle force of remote end were not significant among three groups (all P > 0.05). (2) Muscle force of lower limb: after acupuncture, the muscle force of proximal and remote ends was all improved significantly in the three groups (all P < 0.05). The improvement of the muscle force of proximal end was superior to that of remote end in the twirling reinforcing group and mild reinforcing-reducing group (both P < 0.05).

CONCLUSIONThe twirling reinforcing manipulation at head acupoints is superior to mild reinforcing-reducing and twirling reducing manipulation for muscle force in patients with acute ischemic stroke, which is more significant in proximal end of limbs.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Ischemia ; therapy ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Stroke ; physiopathology ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology

Objective To explore the relationship between collateral circulation and clinical manifestation after se-vere stenosis or occlusion of internal carotid artery. Methods According to the clinical manifestation, 78 cases of ICA ste-nosis or occlusion confirmed by digital subtraction angiography (DSA) were divided into two groups:asymptomatic group (n=31) and symptomatic group (n=47). Collateral circulation pathway in circle of Willis and the mean flow velocity of the middle cerebral arteries (MVMCA) were measured by Transcranial Doppler Ultrasonography (TCD). The correlation of the types of intracranial collateral circulation and clinical manifestation was analyzed. Results ① The collateral circulation opening rate of severe stenosis or occlusion of internal carotid artery in 78 cases of patients was 70.5%(55/78). The collat-eral patency rate (27/31, 87.1% of patients) was higher in asymptomatic group than in the symptomatic group (28/47, 59.6%of patients)(P<0.01).②Collateral patency of anterior communicating artery (ACoA)in asymptomatic group (24/31, 77.4%of patients) was higher than that in symptomatic group (20/47, 42.6%of patients) (P<0.01). Collateral patency of ophthalmic artery (OA) in symptomatic group (21/47, 44.7%of patients) was higher than that in asymptomatic group(6/31, 19.4%of patients)(P<0.05). The opening rate of ACoA was significantly higher than that of either the posterior commu-nicating artery (PCoA) or OA collateral circulation in asymptomatic group (P<0.05).③The mean flow velocity of the af- fected side middle cerebral arteries (MVMCA) in asymptomatic group (51.58±12.36cm/s) was significantly higher than that in symptomatic group (32.23±10.31cm/s) (P<0.01). Conclusion The clinical manifestation is closely related to arterial circle of Willis collateral circulation opening after severe stenosis or occlusion of internal carotid artery and collateral patency of anterior communicating artery is the major collateral supply vessel.

Objective To investigate the immediate effect of twirling reinforcing manipulation, twirling reducing manipulation and mild reinforcing-reducing manipulation on motor functions for patients with acute ischemic stroke. Methods Totally 116 patients with ischemic stroke were randomly divided into twirling reinforcing manipulation group (TRFM, n=39), mild reinforcing-reducing manipulation group (TRRM, n=37), and twirling reducing manipulation group (TRDM, n=40) by stratified blocked randomization. Each group was treated in Baihui-Taiyang acupoint area accordingly with twirling reinforcing manipulation, mild reinforcing-reducing manipulation and twirling reducing manipulation once. The operation time for each needle was 1 minute. Interval time between every 2 needles was 10 minutes, and each needle was retained for 30 minutes. Neurological deficit score (NDS) and simplified Fugl-Meyer assessment (FMA) were evaluated before and immediate time, 1 h, 2 h and 3 h after treatment. Results FMA in TRFM was higher than that of TRDM and TRRM at immediate time, 1 h and 2 h after treatment (P<0.05), but there was no difference at 3 h after treatment (P>0.05). DNS in TRFM decreased sharply at immediate time, 1 h, 2 h and 3 h compared with TRDM and TRRM (P<0.05). The statistical analysis showed no significant difference between TRDM and TRRM at all time points (P>0.05). Conclusion TRFM has an advantage over TRDM and TRRM in immediate effect of motor functions for patients with acute ischemic stroke.

Objectives：To observe the effect of eukaryotic expression vectors coding IL-2 and IL-12 on immune responses induced by DNA immunization of HBV surface antigen（pCR3.1-S）in BABL/c(H-2d) and the protection against P815 mastocytoma cells stable expressing HBV surface antigen in mice after immunized with HBV gene vaccine.Methods：The immunization was performed by intramuscular injection,three weeks later,we directly inoculated P815-HBV-S into mice by subcutaneous injection .Tumor growth was measured every five days.Anti-HBs in serum was detected by ELISA and HBsAg specific cytotoxic T lymphocytes (CTLs) activity was measured by 51 Chromium release assay.Results：Eight weeks after immunization,the A value of mice serum in 450 nm and CTLs activity of mice codiog IL-2 and IL-12 eukaryotic expression vectors were significant higher(P<0.05) than that of mice intramuscular injected HBV-S DNA vaccine,these values are significant higher than that of mice injected pCR3.1(P<0.05).The spleen cells CTLs activity have decreased obviously after treated with anti-CD8+ monoclonal antibody and have no significant change after treated with anti-CD4+ monoclonal antibody.The HBV-S gene vaccine could evidently inhibit the tumor growth,prolong the survival period (>38.2 days) and improve the survival rate in mice.Conclusions：The DNA vaccine of HBV ( pCR3.1-S) had strong antigenicity in cellular and humoral immunity and had marked killing effect on HBV infected cells in vivo，which could be promoted by vector coding murine IL-2 or IL-12.CTLs activity was performed by CD8+ cells.

Objective To investigate the inhibiting effect of interleukin-10 on the expressions of intercellular adhesion molecule-1(1CAM-1)and P-selectin in cerebral ischemia and reperfusion foci(I/R)in rats. Methods Sixty adult male Sprague-Dawley rats were assigned to 4 groups randomly:Sham operated group(n=6),cerebral I/R group(6,24,48 hours post I/R,each had 6 rats),vehicle group(6,24,48 hours post I/R,each had 6 rats)and IL-10 treatment group(6,24,48 hours post I/R,each had 6 rats).I/R rat model was established by middle cerebral artery occlusion(MCAO)with Longa's thread method. Immunohistochemical staining and retro-transcriptase polymerase chain reaction were used to detect the expressions of ICAM-1 and P-selectin. Results ICAM-1(31.60±1.85,54.11±2.32,48.61±2.30)and P-selectin(29.39±5.16,50.44±4.38,37.89±4.74)expressions on endothelial cells 6,24 and 48 hours post I/R were significantly upregulated as compared with sham group(7.61±1.14,0,respectively)(alI P＜0.01),and the expressions of ICAM-1 (24.06±2.42,42.00±3.26,45.28±2.91)and P-selectin(27.28±1.84,42.78±2.51,36.00±3.22)on endothelial cells of IL-10 treatment group 6h,24h,48 h post I/R were significantly suppressed at any timepoint in comparison with vehicle group(P＜0.05). Conclusions IL-10 could inhibit the expressions of ICAM-1 and P-selectin on endothelial cells of cerebral I/R foci in rats.

Objective To compare the detection rate of esophageal and cardiac mucosal lesions be?tween screening endoscopy and conventional routine endoscopy. Methods Using iodine staining,a total of 8 918 patients aged 40?69 were screened for esophageal and cardiac early cancer in Xianju and Tiantai county of Zhejiang Province from January 2010 to July 2013.Matched with age, data of 43 834(the conven?tional group) patients who underwent routine endoscopy during the same time period were also retrieved. The detection rates of esophageal and cardia mucosa lesions in both groups were compared and analyzed. Results The detection rate of esophageal mucosal lesions in screening group was significantly higher than that in the conventional group[7?? 48%(667/ 8 918)VS 2?? 17%(953/ 43 834),P<0?? 001].The total detection rate was the lowest in 2010 among 4 years, while that in 2011?2013 were higher and similiar. The detection rate of cardiac mucosal lesions in screening group was higher than that in the conventional group [ 0?? 78%(70/ 8 918)VS 0?? 70%(309/ 43 834)] without significant difference(P>0?? 05). The detection rates of low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and mucosa cancer and total detection rates between 2 groups were similar(P>0?? 05). Conclusion Through training, endoscopists can grasp the skills of finding esophageal mucosal lesions. Iodine staining should be used as addition to conventional endos?copy in areas with high incidence of esophageal cancer. Conventional white light endoscopy plays a limited role in detection of cardia mucosal lesion, depending on joint inspection of other related methods.

Objective To investigate the differences in clinical efficacy and safety between thrombolysis followed PCI (percutaneous coronary intervention) and primary PCI in patients with acute STEMI (ST elevation myocardial infarction). Methods A total of 215 STEMI patients who visit our clinic within 12 h since onset of their symptoms from May 2013 to January 2015 were enrolled. All eligible patients were divided into Early PCI group(n=68) and pPCI group (n=147) based on whether or not they received injection of recombinant human prourokinase thrombolytic therapy before their visit. Immediate TIMI (Thrombolysis In Myocardial Infarction) flow grade of infarct-related artery (IRA) before and after PCI treatment, post?operative CTFC (Corrected TIMI Frame Count) and TMPG (TIMI myocardial perfusion grade) were compared between these two groups. The incidence of bleeding during hospital stay , left ventricular function at 6 month after intervention and major adverse cardiac events (MACE) were all observed. Rusults There is no obvious difference between the baseline of two groups. Before PCI, the proportion of TIMI grade 2-3 was higher in Early PCI group (77.9%vs 20.4%,P<0.05)than that in pPCI group;but there was no significant difference in the proportion of TIMI grade 2-3 between these two groups after PCI (P>0.05). CTFC and peak value of serum CK-MB were lower [(27.7 ± 5.0) vs (32.6 ± 7.1), P<0.05;(225.8 ± 108.3) U/L vs (283.4 ± 110.6) U/L, P<0.05] and rate of TMPG 3 is higher (82.4%vs 68.7%, P<0.05)in Early PCI group than those in pPCI group. No significant difference was found in the incidence of bleeding and MACE during hospital stay and Left ventric?ular function at 6 months after operation between these two groups. By contrast, LVEFs were higher while LVEDds (LVED diameter) were lower after 3 and 6 months of the intervention compared to those before intervention in both groups (P <0.05). Conclusion It is a safe and effective reperfusion strategy for STEMI patients to receive rhPro-UK thrombolytic thera?py followed early PCI as an alternative way to those who failed to receive pPCI on time. It didn′t increase the occurrence of bleeding complications and MACE, and at the same time it presented the same benefit in improving recent cardiac function as pPCI did.

Objective To evaluate the clinic efficacy and adverse effects of four-weekly pirarubicin combined with COP (CTOP-28) regimen in aggressive non-Hodgkin lymphoma patients with bone marrow involvement. Methods 65 aggressive non-Hodgkin lymphoma cases with bone marrow involvement (BMI)from January 2002 to January 2007 were chosen, who were newly diagnosed according to 2001 World Health Organisition (WHO) classification. The response rate and adverse effects of CTOP-28 regimen were retrospectively compared with standard CHOP-21 regimen in these patients. CHOP-21 regimen:eyclophosphamide 750 mg/m2(day 1), vincristine 1.4 mg/m2 (maximum 2 rag, day 1), adrimycin 50 mg/m2 (day1), prednisene 100 nag (day 1 to 5). CTOP-28 regimen: cyclopbosphamide 750 mg/m2 (day 1, 15), vincristine 1.4 mg/m2 (maximum 2 rag, day 1,8,15,22), pirarubicin 25 mg/m2 (day 1,2 and 15,16), prednisone 40 mg/m2(day 1 to 28). Results The complete remission rate (CRR) in CHOP-21 group was less than in CTOP-28group (40 % vs 80 %, P＜0.05). The incidence of 3 and 4 degree blood toxicity in CTOP-28 was more than in CHOP-21 (100.0 % vs 50.0 %, P ＜0.05), but incidence of 1 and 2 degree cardic toxicity was similar as CHOP-21 (8.57 % vs 10.0 %, P＞0.05) and 3 and 4 degree cardic toxicity did not occurred in both groups.The gastrointestinal, hepatobiliary and renal toxicities at only 1 and 2 degree took place and no difference wasfound between two groups. No therapy-related mortality occurred in these patients. Conclusion CTOP-28regimen is more effective, safer for aggressive non-Hodgkin lymphoma patients with BMI as induction treatment.

Objective To investigate the risk assessment,guiding role,and clinical value of Vaso CT image features for recanalization of vertebrobasilar junction occlusion. Methods From January 2016 to May 2017,14 patients with vertebrobasilar junction occlusion admitted to the Department of Neurology, Chinese PLA General Hospital were analyzed retrospectively. Preoperative cerebral angiography confirmed vertebrobasilar junction occlusion. Vaso CT was used to measure the length of the occluded vessels and vascular direction at both ends. According to these results, the operative risks were evaluated and the recanalization of vertebrobasilar junction occlusion were guided. Results The length of vertebrobasilar junction occlusion was 2. 56-19. 09 mm (mean 4. 5 ± 2. 1 mm) in 14 patients,and 13 of them were treated with the recanalization of vertebrobasilar artery occlusion,the blood vessels of 12 cases were successfully recanalized and stent placement was performed after the recanalization,among them,8 Solitaire stents and 4 Wingspan stents were implanted;One patient did not perform recanalization because of longer length of occlusion (19. 09 mm). All patients operated did not have any perioperative complications, and the neurological symptoms were significantly improved after procedure. Conclusion Vaso CT can accurately determine the surgical risk of the recanalization of vertebrobasilar junction occlusion,and can guide the surgical pathways,reduce the incidence of perioperative complications,and improve the success rate of the operation.