Post stroke depression (PSD) is a common complication after senile cerebrovascular diseases. It influences both physical and mental health of the elderly severely. So, the attention should be paid to not only the medical cares but also the function and mental rehabilitation, in order to improve the qualities of PSD patients' lives and decrease the death rate.

Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.

Objective With the isocentric C-arm (Iso-C) three-dimensional computerized navigation system,cadaveric pelvic specimens were used to imitate double screw fixation of the symphysis pubic.Practicability and safety of the screw trajectory were examined postoperatively by local cadaveric dissections and imaging tests.Methods Pelvic specimens were harvested from 8 male and 7 female adult cadavers.Double screw placement in symphysis pubic was performed using the Iso-C three-dimensional navigation and entry point and safety trajectory was achieved.With the detailed local dissection postoperatively,distances from screw entry and exit points to unilateral structures (spermatic cord,femoral artery and vein,femoral nerve,obturator artery and vein,obtrurator nerve,and so on) were measured respectively.After complete removal of surrounding soft tissues of the specimen with only bony structure kept,the entry angle and length were calculated.Accuracy of double screw fixation of symphysis pubic was further checked using X-ray and CT.Results Entry point of the first screw was at the junction of unilateral pubic tubercle and transitional site of superior pubic ramus.Mean angle of the first screw with the horizontal plane was (7.7 ± 1.9) ° in men and (8.1 ± 1.7) ° in women.Mean angle between the first screw and coronal plane was (7.8 ± 1.8)° in men and (7.7 ±2.0)° in women.Entry point of the second screw was in the same place in the contralateral pubic tubercle.Mean angle between the second screw and horizontal plane was (30.6 ± 4.0) ° in men and (30.8 ± 3.4) ° in women.Mean angle between the second screw and coronal plane was (9.1 ± 3.0)°in men and (9.2 ± 3.3)°in women.Conclusions With the three-dimensional computerized navigation system,the bony channels of double screws implanted in the symphysis pubic are achieved and reliable.Percutaneous double screw fixation is feasible to treat the pubic symphysis diastasis.

Network pharmacology is an emerging discipline based on the Disease-Gene-Drug multilevel network. And it has been used to forecast the drug targets and improve the efficiency of drug discovery. Its research ideas are similar to the overall efficacy of traditional Chinese medicine (TCM), which attracts more and more medical re-searchers to look for the joint point of TCM and network pharmacology. A series of approaches on disease-related genes, predicting the information of target and active ingredients of TCM emerge. In this paper, the network pharma-cology research tools, databases and their applications were summarized and introduced. This paper also proposed scientific strategies to separate active ingredients of TCM using network pharmacology, so as to improve the efficiency and speed of finding active ingredients of TCM.

OBJECTIVE To develop a macroarray method to detect pathogens in cerebrospinal fluid.METHODS According to the bacterial 16S rRNA genes,designed 10 kinds of specific probes and a pair of universal primers that can amplify rRNA gene of all bacteria.The tailed probes were spotted onto a nylon membrane.DNA was isolated from each pathogen,and subjected to UP-PCR to amplify target fragments,which were labeled with bio-16-dUTP at the same time.All those denatured fragments were hybridized to the probes on nylon membrane and visualized by AKP labeled avidin.The sensitivity and specificity of the system were detected.A total of 32 CSF samples,which were verified the bacterial infection by the routine method,were tested by this method.RESULTS It was sensitive to 10 CFU/ml when detecting Escherichia coli.Every kind of pathogens only reacted to its corresponding probes fixed on nylon membranes,which showed high specificity.The result of identifying 32 CSF clinical specimens accorded with that of routine method.CONCLUSIONS The method can screen out common pathogens in CSF sensitively and exactly.

Objective To summarize the safety and efficacy of Sunitinib in the treatment of metastatic renal clear cell carcinoma. Methods Fifteen patients with clear cell metastatic RCC were treated with Sunitinib,with 11 males and 4 females,aged from 26 to 74 years with median age of 55 years.Thirteen cases of 15 were T3 to T4 stage,and 8 cases underwent radical nephrectomy,while 5 other cases underwent renal biopsy with the pathological diagnosis of renal cancer.The other two cases (one man and one woman)with the solitary kidney renal cell carcinoma ( stage T1a) and renal insufficiency,were diagnosed as metastatic renal cell carcinoma by biopsy.Sunitinib monotherapy was administered by the regimen of 6 weeks per cycle with daily oral Sunitinib 4 weeks,followed by 2 weeks off ( from 1 - 10 cycles).Response was evaluated by RECIST.Renal tumor was 9.52 ± 3.3 cm in diameter at baseline,and the assessment of metastases included retroperitoneal lymph nodes (6 cases),mediastinal lymph nodes (3 cases),brain (2 cases),lung (6 cases),bone (2 cases) and liver (2 cases).Karnofsky score,tumor changes,adverse events and the survival of each patient was assessed and recorded. Results The follow-up duration was from 1.5 - 15months,with median follow-up of 6 months,and tumor response was evaluated by RECIST.Seven of 15 patients (46.7％) treated with Sunitinib achieved partial responses (PR),7 patients (46.7％) demonstrated stable disease (SD),and 1 patient (6.7％) developed progressive disease (PD) during the follow-up.Objective Response Rate (ORR) was 46.7％,PR + SD was 93.3％,6 months PFS was 93.3％,and median PFS was 12 months,respectively.Renal tumor was 8.7 ± 4.0 cm in diameter after therapy.Two PR patients with the obvious effectiveness had experienced progressed hypertension,and one cases with hypertension that could be controlled below 140/90 mm Hg ( 1 mm Hg =0.133 kPa) by a single drug before treatment,showed increased blood pressure ( ＞ 160/105 mm Hg) following the second cycles treatment,who were administered increased dosage and combination therapy.The other case without history of hypertension,showed high blood pressure ( ＞ 150/100 mm Hg) in the third cycle,and could be controlled well by antihypertensive drugs.Fortunately,the tumor of these two cases reduced obviously by more than 50％. 1/2 adverse reactions of 12 cases:yellowing of the skin and yellow sweat ( 12 cases,80％ ),fatigue ( 12 cases,80％ ),4 cases of hypothyroidism (26.7％),bilirubin and triglyceride levels elevated in 7case (46.7％); Four cases showed 3/4 degree adverse events with the emergence of gastrointestinal bleeding in one case secondary to platelets reduction (6.7％).Three cases (20％) showed serious fatigue,nausea,vomiting and severe hand-foot skin reaction. Conclusions Sunitinib is recommended for the treatment of metastatic renal clear cell carcinoma with good efficacy and safety.

Objective To establish a medical quality evaluation system for gynecology wards in specialized gynecology hospitals by means of DRGs. Methods DRGs method was used to adjust risks of the information of gynecology inpatients discharged in 2016. On such basis, the medical quality evaluation system was built on the three dimensions of medical ability, medical efficiency and medical safety, while a general scoring was obtained by multiplying the scoring of the dimension with its respective weighting coefficients. Results The general scoring of the 10 wards ranged between 0. 89-1. 08, averaging 0. 99. That of Ward B ranked the highest, and Ward I the lowest of the ten. The medical ability scoring ranged between 0. 87-1. 12, averaging 1. 00;That of Ward B ranked the highest,and Ward I the lowest of the ten. Medical efficiency scoring ranged between 0. 93 -1. 23, averaging 1. 00;That of Ward J ranked the highest,and Ward E the lowest of the ten. Safety scoring ranged between 0. 89-0. 99, averaging 0. 94; That of Ward F ranked the highest, and Ward A the lowest of the ten. Conclusions The medical quality evaluation system based on DRGs can effectively evaluate wards of a gynecology department, supporting their fine management.

Objective To explore the effect of new therapy of high-dose methotrexate (HD-MTX,3 g/m2) combined with rituximab on primary central nervous system lymphoma.Methods Thirty-seven patients with primary central nervous system lymphoma,admitted to our hospital from January 2006 to January 2013,were chosen in our study; targeted therapy group (n=9) accepted chemotherapy scheme (HD-MTX +Rituximab 375 mg/m2) for 2-6 cycles (4 weeks a cycle),and the traditional treatment group adopted whole brain radiotherapy plus HD-MTX for 2-6 cycles.Progressive free survival (PFS) was compared between the two groups.Results Complete response was achieved in 5 patients of targeted therapy group,partial response in 2,stable disease in 1 and progressive disease in 1.Complete response was achieved in 12 patients of traditional treatment group,partial response in 11,stable disease in 4 and progressive disease in 2.The median PFS in the targeted therapy group was 28 months while that in the traditional treatment group was 11 months,with significant difference (R=0.823,P=0.021).Conclusion The scheme of HD-MTX combined with Rituximab for primary central nervous system lymphoma relieves the side-effect of the traditional therapy and gains satisfied results,which can be recommended as an effective therapy for primary central nervous system lymphoma.

Objective To study the effects of heat shock treatment of rat bone marrow mesenehymal stem cells(MSCs),the apoptosis ratio of treated-cells under low serum condition and the treated-cells transplantation on left ventricular function in rats with myocardiaIinfarction.Methods MSC8 were heat-treated under 42℃for 30 min,then the heat shock protein-70(HSP-70)was detected bv Western blot.The apoptosis ratio of heat-treated MSCs under low serum condition was tested by Annexin kit.The treated-MSCs labeled with Dil were transplanted into infarcted myocardium and 8 weeks later,the cardiac function of rats in each group was evaluated by echocardiography and cardiac catheterization.Results The immunophenotype of heat-treated MSCs did not vary,Western blot confirmed a higher level expression of HSP-70 in the treated-MSCs group as compared with that in the control group.The early apoptosis ratio was lower in treated-MSCs measured by flow cytometry with annexin staining than that of MSCs when cultured with low serum medium.After 8 weeks,LVEF,LVSP,+dp/dtmax,and-dp/dtmax were significantly higher,and the LVEDP was significantly lowar in heat-treated MSCs transplantation group than that in the control group.Conclusions Heat shock pretreatment of MSCs enhances the tolerance of MSCs to low serum medium,whereas does not lcad to the change of the cell immunophenotype.Transplantation of heattreated MSCs might improve the cardiac function in a rat myocardialinfarction model.

OBJECTIVETo study the clinical and pathologic features of gliosarcoma of cerebral hemispheres.

METHODSThe clinicopathologic features of 10 cases of gliosarcoma involving cerebral hemispheres were reviewed. Immunohistochemical study was carried out using EnVision method.

RESULTSThe mean age of the patients was 54 years and the male-to-female ratio was 6 to 4. Clinical symptoms included headache (6/10), nausea/vomiting (5/10), and sensory or motor impairment (4/10). Nine of the cases were primary gliosarcoma, with maximum diameter ranging from 2.4 to 5.5 cm (mean = 4.2 cm). The remaining case represented secondary gliosarcoma involving skull base and extracranial tissues. Histologic examination showed a biphasic pattern in all cases. Regarding the glial component, there were 9 cases of pleomorphic glioblastoma and 1 case of giant cell glioblastoma. Reticulin stain was positive in all cases. Immunohistochemical study showed that the tumor cells variably expressed GFAP (10/10), p16 (4/10), EGFR (1/10), CD68 (1/10) and p53 (6/10). The Ki-67 index ranged from 15% to 70% (mean = 34%). Six patients had follow-up data available. One patient was disease-free for 45 months and 5 patients died of the disease at 3 to 17 months after the operation (mean duration of survival = 9 months).

CONCLUSIONSGliosarcoma is a highly aggressive tumor, often locates in the deeper part cerebral hemispheres and has a relatively short duration of symptoms. It carries a poor prognosis. GFAP immunostain and reticulin stain are helpful in confirming the diagnosis. p53 and p16 are also expressed in some cases.

Adult ; Brain Neoplasms ; metabolism ; pathology ; Cerebrum ; pathology ; Female ; Glioblastoma ; metabolism ; pathology ; Gliosarcoma ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Neuroglia ; pathology