Objective:To investigate the high resolution vessel wall imaging (HR-VWI) features of basilar artery (BA) in patients with acute isolated pontine infarction (AIPI) of different infarct types, and explore the pathogenesis of AIPI.Methods:A retrospective analysis of clinical and imaging data of 52 patients with AIPI admitted to our hospital from June 2016 to November 2019 was performed. According to the morphology and location distribution of pontine high-signal lesions in diffusion-weighted imaging (DWI), these patients were divided into paramedian pontine infarction (PPI) group and small deep pontine infarction (SDPI) group. The general clinical data, modified National Institute of Health stroke scale (mNIHSS) scores at admission and discharge, modified Rankin scale (mRS) scores, and incidence of basilar artery plaques and plaque characteristics of basal artery in HR-VWI of patients from the two groups were compared.Results:Among the 52 AIPI patients, there were 28 patients with PPI (54%) and 24 with SDPI (46%). The mNIHSS scores at admission and discharge in the PPI group were significantly higher than those in the SDPI group ( P<0.05). The incidence of basilar artery plaques in PPI group was significantly higher than that in SDPI group (92.9% vs. 62.5%, P<0.05). As compared with SDPI group, PPI group had a significantly higher incidence of right lateral wall plaques, a statistically lower incidence of ventral wall plaques, and a significantly higher incidence of centripetal plaques, and significantly increased maximum thickness of vessel wall ( P<0.05). Conclusion:The AIPI mechanism is generally related to the branch atheromatous disease of basilar artery; PPI patients have more severe clinical symptoms, more serious clogged perforation opening of the basilar artery plaque, more unstable basilar artery plaque than the SDPI group.

With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.

Objective:To explore the value of enhancement rate of aneurysm wall by high-resolution magnetic resonance vessel wall imaging (HR-VWI) in assessing the risk of intracranial aneurysm rupture.Methods:Seventy patients with 80 intracranial aneurysms, admitted to our hospital from January 2016 to December 2019, were chosen in our study; morphological parameters (shape, neck width, height, diameter) of the intracranial aneurysms, and signal intensity and enhancement rate of aneurysm wall were collected from HR-VWI. These patients were divided into a high-risk rupture group (PHASES scores>3) and a low-risk rupture group (PHASES scores≤3) according to PHASES scores. Univariate analysis was used to compare the differences of clinical data (age, gender, blood pressure, blood lipids, and smoking history) and aneurysm imaging data between the two groups of patients. Multivariable Logistic regression was used to determine the independent influencing factors for aneurysm rupture, and receiver-operating characteristic (ROC) curve of enhancement rate of aneurysm wall in predicting aneurysm rupture was drew to determine the best diagnostic value.Results:Univariate analysis showed that the percentages of patients with hypertension, multiple aneurysms and irregular aneurysm morphology, aneurysm height, aneurysm diameter and aneurysm wall enhancement rate were significantly different between the high-risk rupture group and low-risk rupture group ( P<0.05). Multivariate Logistic regression analysis showed that aneurysm diameter ( OR=1.647, 95%CI: 1.177-2.306, P=0.004) and aneurysm wall enhancement rate ( OR=5.317, 95%CI: 1.527-18.512, P=0.009) were independent influencing factors for rupture of intracranial aneurysms. The area of ROC curve was 0.735, the optimal cut-off value was 0.583; the sensitivity of predicting rupture of intracranial aneurysms was 72.7% and the specificity was 70.2%. Conclusion:The aneurysm wall enhancement rate is significantly correlated with risk of aneurysm rupture; when the PHASES scores>3 and aneurysm wall enhancement rate>58.3%, clinical intervention should be vigilant.

Objective　To investigate the characteristics of high resolution vessel wall imaging (HR-VWI) imaging of unstable plaques in acute pontine infarction.Methods　Data from thirty-nine patients with symptomatic acute pontine infarction and 45 patients with asymptomatic pontine infarction in the Peopl’s Hospital of Baoan District,Shenzhen from June 2016 to November 2019 was retrospectively analyzed.The distribution of BA plaques and plaque involvement were counted on HR-VWI Quadrant.Plaque surface continuity,plaque length,vascular volume (Vouter),vascular wall volume (V wall),lumen diameter in the narrowest layer of the lumen (LD MLN),maximum diameter of the outer lumen (OD MLN ),vascular area (OA MLN),vascular wall area (WA MLN),the thickest thickness (WTmax),the plaque load (PB),and lumen stenosis rate were measured.Measurement indicators were compared between the two groups.Results　The plaque distribution,plaque discontinuity,WTmax,WA MLN,PB,and BA lumen stenosis rates between the two groups were statistically different (P<0.05).Conclusions　BA plaques with symptomatic pontine infarction are more likely to be distributed on the side wall,the surface is more discontinuous,thicker plaque thickness,larger blood vessel area and plaque load,higher luminal stenosis rate,suggesting that it has instability Plaque characteristics.

OBJECTIVE: To investigate the effect of 1,2-dichloroethane(1,2-DCE) acute inhalation exposure on the differential gene expression of phase Ⅰ metabolic enzymes. METHODS: The specific pathogen free SD rats were randomly divided into control group(16 rats), low-and high-dose groups(24 rats in each group, half males and half females). Low-and high-dose group were given daily 600, 1 800 mg/m~(3 ) of 1,2-DCE, and the control group given the fresh air by dynamic inhalation for 8 hours per day for consecutive 7 days. After the end of exposure, the relative mRNA expression of cytochrome P450 2 E1(CYP2 E1), alcohol dehydrogenase(ADH1) and acetaldehyde dehydrogenase 3 alpha 1(ALDH3α1) in the liver tissue was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS: The relative expression of CYP2 E1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ADH1 in male low-and high-dose groups was higher than that in male control group(P<0.05). The relative expression of ADH1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ALDH3α1 in high-dose group was higher than that in control group and low-dose group(P<0.05). CONCLUSION: High dose 1,2-DCE could increase the gene expression of phase Ⅰ metabolic enzymes in rat liver. The 1,2-DCE has more obvious effect in male rats than in female rats.

Atherosclerotic plaque is an important cause of ischemic stroke. High-resolution vessel wall magnetic resonance imaging (VW-MRI) has been widely used in the study of intracranial atherosclerotic plaques, which is of great value for the display of plaque distribution. This article reviews the distribution of intracranial atherosclerotic plaques based on VW-MRI.

The geometric morphology of intracranial arteries has unique characteristics and laws. Congenital variation is also often seen in clinical work. Both have certain clinical significance in the occurrence and development of cerebrovascular diseases, as well as in anatomy and function. This article summarizes some of the findings on the morphology and variation of intracranial arteries in cerebrovascular disease research in recent years, and reviews the imaging techniques of intracranial arteries as well as the clinical significance of geometric morphology and congenital variation.

Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.

Objective To establish a sensitive method for the determination of rhodamine 123 (Rh123) in rat plasma by high performance liquid chromatography (HPLC).Methods The plasma samples were extracted by acetonitrile,and then separated on a Hypersil BDS C18 colunm (4.6 mm×100 mm,5 μm) equipped with a guard column kept at 25 ℃.The mobile phase consisted of acetonitrile and phosphate buffer (0.02 mol·L-1,pH4.0) (60:40) and was pumped at a constant rate of 1.0 mL·min-1.The peak was detected using a fluorescence detector set at FLD1A:Ex=485 nm,Em=546 nm.Results In this study,the method was validated for the Rh123 range of 0.1 to 32.0 μg·L-1,and the lower limit of quantitation (LLO Q) was 0.1 μg·L-1.The intra-and inter-day precisions for Rh123 were less than 7%,and the mean recoveries of Rh123 were 87.93%,89.03%,86.11% at low,mid,and high concentrations,respectively.Conclusion A simple,rapid and reproducible HPLC method was developed for the determination of Rh123 in rat plasma,which was an applicable method in modeling and description of the possible pharmacological interactions between the medicines and P-glycolprotein transporter.

A 69-year-old female patient suffered from cholestasis caused by acute viral hepatitis A was treated with ursodeoxycholic acid capsules 250 mg thrice daily. The patient developed facial flushing after a week. The symptoms relieved after the drug discontinuation. Three days later, the patient continued to take the medicine at the same dose, the symptom of facial flush recurred accompanied by facial swelling and systemic red rash. The medicine was discontinued immediately. The patient was under the treatment with IV infusions of vitamin C, calcium gluconate and methylprednisolone, intramuscular injection of diphenhydramine hydrochloride, oral loratadine and cetirizine hydrochloride, externally used calamine lotion, fluticasone propionate cream and fusidic acid cream. However, scattered bulla with clear liquid and cankered part appeared on the patient′s trunk skin, the diagnosis of drug eruption was made. She was given IV infusion of cefoperazone sodium and tazobactam sodium and oral mizolastine. One day later, the patient developed pain at lower limb skin, large red patches occurred on her thigh and trunk, double outer thighs with bulla of clear fluid, multiple target red patches on both legs with blisters of clear fluid. She was considered as having epidermolysis bullosa. She received an IV infusion of human immunoglobulin 20 g once daily. The target red patches were fused and formed diffuse erythema. After 3 days, the pain relived with the diffuse erythema faded away and the wizened bulla. After another two days, the blisters formed skin erosion in the thighs. After 3 days, the erosion was clean and dry, the dose of methylprednisolone was reduced. One week later, her liver function returned to normal. After 5 days, the erythema on the thigh and trunk appeared flake desquamation. Methylprednisolone was stopped and the patient received oral prednisone and externally used compound lactic acid ointment.