Therapeutic hypothermia has been shown to improve neurological outcomes after global ischaemia/hypoxia in patients who have had cardiac arrest. Therapeutic hypothermia is one of the most extensively studied and influential therapeutic strategies of acute ischemic stroke. Previous studies of therapeutic hypothermia mainly focused on whole-body cooling. However, delayed induction and systemic complications have limited the clinical application of whole-body cooling. As a selective cerebral hypothermia, the selective intra-arterial brain hypothermia treatment has the characteristics of rapid and even induction of hypothermia, and less affecting the core body temperature. Therefore, it has become a promising treatment modality. This article reviews the application of selective intra-arterial brain hypothermia in acute ischemic stroke and its advantages and limitations in order to provide reference for further experimental studies and future clinical trials.

ObjectiveTo investigate the neural mechanism of prospective memory(PM) using functional magnetic resonance imaging (fMRI).MethodsFifteen healthy volunteers were enrolled,and all subjects were scanned with fMRI while performing the event-based PM tasks (double-task paradigm,including the ongoing task and PM task).And the image data were preprocessed and analyzed by using SPM8 software.Results ( 1 ) Compared to the control task,bilateral rostral prefrontal cortex ( x,y,z =6/- 2,54/42,- 8/- 12,t =3.71 ),right somatosensory association area ( x,y,z =14,- 62,64,t =4.64 ),superior temporal gyrus ( x,y,z =42,- 46,16,t =3.95 ) and right paracentral lobule (x,y,z =10,-22,76,t =4.01 ) were activated significantly by the ongoing task (P ＜ 0.001 ).(2) Bilateral rostral prefrontal cortex ( x,y,z =- 2/6,42/54,- 12/- 12,t =3.28) and paracentral lobule (x,y,z =- 30/10,- 22/- 22,72/76,t =4.25 ),left postcentral gyrus ( x,y,z =- 38,- 46,64,t=3.13) and middle occipital gyrus ( x,y,z =- 30,- 70,0,t =3.97 ) were activated significantly by the PM task (P ＜ 0.001 ).ConclusionRostral prefrontal cortex (BA 10 area) is the major area of prospective memory,and medial BA10 area may be involved in the monitoring of external cues.The present study supports the gateway hypotheses of prospective memory.

OBJECTIVETo analyze the literature on power frequency electric field testing data and to propose views and suggestions for current testing.

METHODSThe literature on power frequency electric field testing data published in the previous years was searched to identify 306 articles involving 193 valid testing data. Mann-Whitney test and Wilcoxon W test were used for analyzing the testing data.

RESULTSThe classification of data was carried out according to one quarter of occupational exposure limit (1.25 kV/m), one half of the exposure limit (2.5 kV/m), and the exposure limit (5 kV/m). The structure of testing data showed a significant difference between the non-power facility group and the power facility group (P<0.05).

CONCLUSIONAs occupational hazard factors, the radiation exposure from power frequency electric field is extensive. However, the power frequency electric field testing data in actual workplaces except high-voltage power facilities are far less than the occupational exposure limit with little harmfulness. There is a phenomenon of excessive testing at present.

Adolescent ; Adult ; Female ; Humans ; Male ; Occupational Diseases ; etiology ; prevention & control ; Occupational Exposure ; analysis ; prevention & control ; Trichloroethylene ; poisoning ; Young Adult

Objective To investigate the relationship between the C-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) prevalence.Methods In this study,63,486 workers who had participated in the Kailuan health examination from July 2012 to October 2013 and without history of drinking,myocardial infarction,stroke and cancer and without data incomplete were recruited.The observation population was divided into three groups according to the levels of CRP at baseline:group 1 (＜ 1 mg/L),group 2 (1-3 mg/ L) and group 3 (＞3 mg/L).The prevalence of NAFLD among three groups was observed.Multiple logistic regression was used to calculated relationship between the CRP and NAFLD prevalence.Results The prevalence of NAFLD in group 1,group 2 and group 3 were 26.9％,42.1％ and 49.3％,respectively,and the differences were significant (x2=2 192.31,P ＜ 0.01).Logistic model showed that after adjustment for age,gender,waist circumference and other confounders,the association between CRP and NAFLD was strong and the OR value (95％ CI) among the group 1,group 2 and group 3 were 1.00,1.49 (1.42-1.56),1.54 (1.45 -1.64),respectively.Conclusion CRP is independently associated with the nonalcoholic fatty liver disease.

Objective To investigate the effect of FK506 on the expression of TNF -? mRNA in isolated liver with reperfusion. Methods After the model of isolated liver with reperfusion was set upp,the expression of TNF-? mRNA was detected with RT-PCR in different preservation time of the isolated liver. Results In FK506-treated group, expression level of TNF-? mRNA was obviously lower(P

Objective To explore the HLA-A2 restriction and immunogenicity of 5 previously identified HCV-speeific CTL epitopes. Methods Based on T2 cell, to explore the HLA-A2 restriction of previously identified HCV-specific CTL epitopes by MHC-peptide complex stabilization assay;To detect pep-tide-specific CTL in HLA-A2~+ PBMC stimulated by HLA-A2-restricted peptides by intracellular cytokine staining(ICS) and ELISPOT; To explore the cytotoxicity of peptide-specific CTL to same peptide-loaded T2 cells (target cells) by CTL cytotoxicity test. Results Among 5 previously identified CTL epitopes NS4b_78 (SMMAFSAAL) and NS5a_367 (TVSSALAEL) have high-affinity for HLA-A2 molecules(FI 1) ;ELISPOT results shown that NS4b_78(SMMAFSAAL) and NSSa_367(TVSSALAEL) induced high levels of IFN-γ-se-creting cells [(60±6) SFC/10~4 PBMC vs (4±1 ) SFC/10~4 PBMC, P < 0.01 ; (10 ± 3 ) SFC/10~4 PBMC vs (2±1 ) SFC/10~4 PBMC, P <0.01, respectively] ;ICS results indicated that there were high percentages of CD8~+ IFN-γ~+ T cells in total CD8~+T cells stimulated by these peptides [(2.33 ±0.22 ) % vs (0.05±0.01)%, P <0.001 ; (0.36±0.06)% vs (0.03±0.01)%, P <0.001, respectively]. Furthermore,peptide-specific CTL could effectively kill same peptide-loadcd T2 cells. Conclusion NS4b_78 (SMMAF-SAAL) and NSSa_367 (TVSSALAEL) were identified as HLA-A2-restricted CTL epitopes which could in-duce immune response in vitro.

Objective To establish a scoring system for evaluating the severity of hepatitis B patients with acute-on-chronic liver failure and to compare the validity of this system with model for end-stage liver disease (MELD). Methods MELD score was used in hepatitis B patients with acuteon-chronic liver failure who were divided into survival group (203 cases) and death group (196 cases).Seven clinical relative indices, including prothrombin activity, serum creatinine, hepatic encephalopathy, accompanying infections, serum total bilirubin, the dimension of liver, the amount of ascites, were selected for evaluating the severity. Each index was graded with 1 to 4 points based on the severity. Then the total score was counted by adding up scores of each index. T test and area under receiver operating characteristic (ROC) were used to evaluate the difference and similarity of the two systems. Results According to the new scoring system, the total score was 8. 07±3. 14 in the survival group and 16. 91 ±3. 54 in the death group. There was a statistically significant difference between these two groups (t = 26.125. P<0.01). In 81.32% of survival patients, their scores ranged from 3.91 to 12.23, while in 81.32% of dead patients, their scores ranged from 12.23 to 21.60. The two ranges overlapped at 12.23. According to the MELD system, the total score was 26. 43 ±5. 58 in the survival group and 40. 16 ±10. 22 in the death group. The difference between the two groups was statistically different (t = 16. 566, P<0. 01). In 61.02% of survival patients, the MELD scores ranged from 21. 49 to 31. 19, while in 61. 02% of the dead patients, the MELD scores ranged from 31. 19 to 48. 94. The two ranges overlapped at 31.19. The areas under ROC of the new scoring system and MELD system were 0.960 (95% CI: 0. 944-0. 977) and 0.886 (95% C/;0. 852 - 0. 920). No overlap was found in these two 95%CJ and there was a statistically significant difference. Conclusions The new scoring system is applicable for evaluating the severity and prognosis of acute-on-chronic liver failure in hepatitis B patients. The sensitivity of this new scoring system is approximate to the MELD system.

Objective To investigate the risk factors of hepatitis B virus(HBV) re-infection after orthotopic liver transplantation(OLT)and to evaluate the therapeutic efficacy of hepatitis B immunoglobulin(HBIG)combined with nucleos(t)ide analogues. Methods The study included 160 patients with HBVrelated liver diseases who underwent OLT in the Third Affiliated Hospital of Sun Yat-sen University from October 2003 to Augest 2007, 117 of whom were treated with nucleos(t)ide analogues before OLT;and all patients were received HBIG i. m and nucleos(t)ide analogues treatment after OLT. Preoperative data of the patients were retrospectively reviewed, and HBV re-infection was assessed prospectively. Independent t test was used to compare normally distributed data and Fisher's exact test was used for the comparison of rates among groups. Results HBV re-infection Was observed in 19 patients after OLT with a rate of 11. 88%(19/160), which was not correlated with HBV DNA loads, HBeAg and the duration of antiviral therapy before OLT(r=0.108, 0.127 and 0.033, P>0.05). Of 19 patients with HBV re-infection, 17 were treated with lamivudine after OLT, and HBV YMDD mutants were detected in 8. The YMDD positive group had a higher HBV DNA level than YMDD negative group(7.0 ± 2.0 log copies/mL vs 3.2 ± 2.5 log copies/mL, t = 3.531, P=0.003). Among above 17 patients, 12 received adefovir add-on treatment, and3 received entecavir instead of lamivadine; all achieved satisfactory responses. Conclusions Low dose of HBIG combined with long-term use of nucleos(t)ide analogues can effectively prevent HBV re-infection after OLT. HBV YMDD mutation may be the primary reason for HBV re-infection in the patients treated with lamivudine after OLT.

Objective To evaluate the long-term prognosis of patients with HBV-related decompensated cirrhosis after treatment with nucleos (t) ide analogues. Methods Totally 94 patients with HBV-related decompensated cirrhosis were enrolled, 53 in nucleos(t) ide group, 41 in control group, and both received routine treatments. Patients in nucleos (t)ide analogue group also received lamivudine ( 100 mg/d), or adefovir ( 10 mg/d), or entecavir (0.5 rag/d). The follow-up was terminated for those who developed hepatocellular carcinoma, received liver transplantation, died or refused the treatment. Serum biochemical markers, Child-Pugh grades and clinical outcomes were compared between two groups at the end of following up. Results After nucleos (t) ide analogues therapy, ALT, AST, globulin ( Glb), and TBil decreased, while Alb and cholinesterase (CHE) increased in the nucleos(t)ide group, and Chiid-Pugh scores decreased in 43 (81.1%) patients. While in the control group, ALT, AST, Glb and TBil did not show significant changes, but the CHE was significantly lower than before ( t = 5. 225, P < 0. 01 ). More patients in nucleos (t)ide group showed improvements in Child-Pugh grades, and there was significant difference between the two groups (X2 = 52.16, P <0.01). The incidence of HCC is lower in nucleos(t) ide group (0%) than that in the control group ( 19.5% ) ( X2 = 23.07, P < 0.01 ). The incidence of death and liver transplantation between two groups did not show siguificant difference. Conclusions Nucleos(t) ide analogues therapy can significantly improve biochemical status of liver functions in patients with HBV-related decompensated cirrhosis. The incidence of hepatocellular carcinoma may decline and the long-term prognosis can be improved.