Objective To investigate the diagnosis and treatment of mesenteric cyst.Methods The clinical data of 5 patients with mesenteric cyst who were admitted to the First Affiliated Hospital of Harbin Medical University were retrospectively analyzed.The experiences in diagnosis,treatment and prognosis were summarized.Results Preoperative diagnosis of the mesenteric cyst mainly depended on imaging examination,such as color Doppler ultrasonography or computed tomography.The cysts of the 5 patients were located at the mesentery of the small intestine.All the patients received surgical resection of the cysts,and postoperative pathological examination confirmed the preoperative diagnosis.The duration of hospital stay was 8-12 days,and time of follow-up was 4-52 months,no recurrence nor canceration of the cysts was detected.Conclusions Color Doppler ultrasonography and computed tomography have high diagnostic value for mesenteric cyst,while its final diagnosis depends on pathological findings.Complete surgical resection is the first choice for the treatment of mesenteric cyst,and it provides a satisfactory prognosis for the patients.

Objective To evaluate the agreement of antinuclear antibody (ANA) titer reported in clinical laboratories and analyze possible problems in clinical laboratories.Methods Experiment survey.The panel consisting of 5 samples was distributed to 533 laboratories.Each panel contains one negative sample and 4 positive samples,which were from individuals of autoimmune disease.ANA titer system was divided into traditional titer system with two-fold dilution and titer system with 3.2 times dilution.Clinical laboratories were required to report the ANA titers and initial screening dilution according to the standard used in routine work.Results were expressed as median titers and range for acceptable performance.As to titer system with two-fold dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± two two-fold dilutions.While as to titer system with 3.2 times dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± 3.2 times dilutions.The laboratories percentages with acceptable performance were calculated to evaluate their agreements.Results 412 laboratories reported ANA titer results,of which 11.9％ (49/412)reported results with two-fold dilution titer system,88.1％ (363/412)reported results with 3.2 times dilution titer system.The median titers of sample 1211,1212,1213 and 1215 reported with two-fold titer system were 1 ∶ 640,1∶ 320,＞ 1 ∶ 1280 and1∶ 160,respectively.The agreement within the median ANA titer reported with two-fold dilution titer system ranged from 24.5％ (12/49) to 57.1％ (28/49) and the lowest percentage of the results within the acceptable limits was 87.8％ (43/49).The median titers of sample 1211,1212,1213 and 1215 reported with 3.2 times dilution titer system were 1 ∶ 1000,1∶ 1000,＞ 1 ∶ 3200 and 1 ∶ 320,respectively.The agreement within the median ANA titer reported with 3.2 times dilution titer system ranged from 63.3％ (31/49)to 83.7％ (41/49).The lowest percentage of the results within the acceptable limits was 98.0％ (48/49).Conclusions The results of ANA titer reported are unsatisfactory.Standardization for reagent,microscopy,procedure and result interpretation is necessary to improve the agreement of ANA titer report in different laboratories.

Objective To investigate the efficacy of erythropoietin (EPO) on cerebral ischemia of patients after intracranial aneurysm surgery.Methods Sixty patients with cerebral ischemia after operation of intracranial aneurysm,admitted to our hospital from May 2006 to August 2010,were randomly divided into control and treatment groups (n=30).Control group received conventional treatment,while the other group,on the basis of conventional therapy,was hypodermically given EPO at a dosage of 3000 IU for a consecutive 3 days.U.S.National Institutes of Health Stroke Scale (NIHSS) was used to score the patients on the admission day,1,2,3,4 and 5 weeks after EPO treatment; and diffusion-weighted imaging (DWI) of MRI was used in determining the changes of cerebral ischemic area on the ischemic day and l,2,3,4 and 5 weeks after ischemic.Results NIHSS scores of the EPO group (9.4±1.9,11.3±2.3,8.7±1.7) at 3,4 and 5 weeks after treatment were significantly higher as compared with those in the control group (10.8±2.2,7.9±1.6,10.1±2.3) (P＜0.05).Similarly,3,4 and 5 weeks after treatment,the reducing percentage of cerebral ischemia area in the EPO group (21.6±4.1,27.5±5.3,32.8±5.5)％ was larger than that in the control group (16.8±3.1,18.9±3.3,19.5±3.4)％ (P＜0.05).Conclusion EPO may play an effective role in cerebral ischemia of patients after intracranial aneurysm operation.

Objective To investigate current status of cognitive behavior on chronic obstructive pulmonary disease (COPD) to provide evidence for targeted intervention.Methods A questionnaire survey on COPD was conducted at 12 settings of 4 prefectures that were sampled from Ningxia Province using multistage stratified cluster random sampling method,and 4268 residents at least 40 years old were interviewed.Multivariate linear regression method was used for data analysis.Results A total of 4056 valid questionnaires were returned from 4200 participants with an effective response rate of 96.57％.Only 6.51％(264/4056) had an idea of COPD,13.88％ (563/4056) regarded cigarette smoking as a risk factor of chronic bronchitis and emphysema,and 6.39％ (259/4056) knew pulmonary function tests.Home income,living area,education level and ethnicity were main factors influencing COPD awareness.The percentage of current cigarette smoking was 28.80％ (1168/4056) with 20.40％ in Hui (Muslim) ethnic group and 34.63％ in Han ethnic group (P ＜ 0.05 ) ; smoking index and severe smokers were not significantly different between the two groups ( P ＞ 0.05 ).Conclusion Our data suggest a considerably poor knowledge and prevention awareness of COPD in Ningxia Province.In spite of relatively lower cigarette smoking rate,the problem that Hui (Muslim) ethnic people are lack of COPD awareness should not to be neglected.

Objective To compare imaging quality and radiation dose on full-field digital mammography (FFDM) system and dual-sided reading CR mammography (DSCRM) system.Methods The TRM of ALVIM statistics phantom was exposed by FFDM system and (DSCRM) with the same radiation dose.The exposure parameters and the entrance surface dose (ESD) were recorded.Then,the phantom was exposed by DSCRM system with different mAs and same kV,and the ESD was recorded.The images obtained above were read by three radiologists on the monitor of diagnosis work station with the same window width and window level.The evaluation of the images were given using a five-level confidence scale.ROC curves were drawn and probability Pdet were calculated.Results The ROC analysis of microcalcifications and masses showed A(z) values of 0.730-0.925 and 0.670-0.945 for FFDM,and 0.632-0.815 and 0.575-0.785 for DSCRM when the radiation dose is 1.36 mGy.The radiation dose with DR system could be reduced compared with dual-sided reading CR system at the same probabilities Pdet,the ESD reduced from 1.63 mGy to 1.36 mGy by 19.8％,the AGD reduced from 0.65 mGy to 0.56 mGy by 16.0％.Conclusions The observable details with FFDM system were proved to be superior to DSCRM system at the same radiation dose.With the similar image quality,the radiation dose of FFDM system was less than the DSCRM system.

Objective To study the prevalence,risk factors of overactive bladder (OAB) in middle-aged and senior residents in Zhengzhou China.Methods A randomized,community-based,crosssectional study was performed on 10 160 residents aged 40 or older in urban area of Zhengzhou by using a stratified system sampling approach.A questionnaire including the subjects' basic information,previous history,present history,the Chinese overactive bladder symptom score (OABSS) was filled on site.The diagnostic criteria for OAB was 'an urgency score for Question 3 of 2 or more,and an OABSS of 3 or more'.Chisquare test was used to determine the differences of prevalence between genders,age groups,BMI and people with and without diabetes mellitus (DM).A pairwise comparison was conducted between different age,BMI group by using Bonferroni method.Results A total of 10 160 residents were investigated and finally 9805 (96.5％) were qualified for final statistical analysis.The mean age was (57.9 ± 9.7) years.The overall prevalence of OAB was 2.1％ (209/9805),of which,with OABdry 1.0％,and OABwet 1.1％.Male subjects were more likely suffered from OAB than female,with 2.7％ (84/3129) versus 1.9％ (125/6676).The prevalence of OAB in both male and female increased with age.There was no significant difference in the prevalence of male and female before the age of 60 years (1.2％ versus 1.4％,P ＞ 0.05) and more common in men than in women after the age of 60 years (4.6％ versus 2.6％,P ＜ 0.05).The prevalence of the subjects with DM was significantly higher than those without DM (P ＜ 0.05).The subjects with BMIs of 30 or more were nore likely to have OAB (3.2％ versus 1.8％,P ＜ 0.05).Conclusions The prevalence of OAB increases with advancing age.The prevalence of male is higher than female after the age of 60 years.The diabetics and obese people are more likely to have OAB.

Objective To assess the clinical application values of the protcin markers associated with Down syndrome (DS) in maternal serum which were screened and identified.Methods Seven maternal serum samples with DS fetus ( DS group) and 7 maternal serum samples with normal fetus ( control group) in the second trimester were separated by two-dimensional gel electrophoresis (2-DE).The differentinal expression profile of proteome in maternal serum from DS group was established.The differentially expressed proteins were screened by mass spectrometry (MS) and some proteins were verified by Western blotting (WB).Results Twenty-nine proteins were discovered to be differentially expressed by more than 1.5 folds in maternal serum from DS group,among which 19 proteins were up-regulated and 10 proteins were downregulated.Eight proteins displayed 2 or more folds changes in maternal serum from DS group were identified by MS and possibly matched with 12 proteins in Ameracan National Center of Biotchnology Information (NCBI) protein sequence database,such as dGTPase and Beta2-Glycoprotein Ⅰ (β2-GPI),etc.The resuhs of WB showed that the mean a values of dGTPase and β2-GPI were 21 567.0 ± 3009.4 and 22 097.0 ±3958.9 in the DS group,3957.7 ± 250.9 and 1799.7 ± 105.5 in the control group respectively,which presented that the expression of dGTPase and β2-GPI significantly increased in DS group (t'dGTPase =- 17.66,t'β2-GPI =- 14.83,P ＜0.0001 ).Conclusions 2-DE and MS are effective methods for preliminary identification of protein markers associated with DS in maternal serum.dGTPase and β2-GPI verified by WB laid a solid fundation for further screening new biologic markers for early diaglosis of DS.

Objective To investigate the effects of transplantation of bone marrow mesenchymal stem cells (BMSCs) transfected with adrenomedullin (ADM) on cardiac function in heart failure rats and the mechanism.Methods BMSCs were isolated from femur and tibia marrow of 10 rats,20 days old,body weight 30-50 g,and in vitro cultured.The third passage of BMSCs were tuansfected with adenovirus containing ADM and labeled with green fluorescent protein(GFP).Before transplantation,BMSCs were labeled with 4',6-diamidino-2-phenylindole (DAPI).Eighty healthy male Wistar rats weighted 180-200 g were randomly divided into 2 groups according to body weight:control group (n =10) was injected with normal saline (NS); diffuse myocardial injury heart failure rat model(n =70) was established by subcutaneous injection of isoproterenol (ISO,170 mg/kg) every day for 4 consecutive days.Four weeks after administration of ISO,heart function was assessed by echocardiography,the 39 rats with left ventricle ejection fraction(LVEF) ＜ 70％ of global heart failure model were randomly divided into three groups in accordance with the level of heart function:untransfected group,transfected group and NS group.DAPI labeled untransfected BMSCs suspension,ADM gene transfected BMSC suspensions (3 × 106/150 μl) and equal volume of NS were injected into the left ventricular anterior wall in 4 places in each goup.Control group received thoracotomy only.Four weeks after transplantation,rats were examined by ultrasound echocardiography,then were sacrificed and left ventricular were dissected.The myocardium was stained with Massons trichrome to analyze myocardial tissue fibrosis.The transplanted cells were observed by fluorescence microscopy and matrix metalloproteinase-2 (MMP-2) expression of myocardial tissue was detected in each group by Western blotting.Results After in vitro culture for three days,the BMSCs began to grow adherently,tended to be fused about 10 days,in the fusiform shape.Four weeks after transplantation,ultrasound echocardiography results showed that rat cardiac left ventricular end systolic diameter (LVDs),LVEF,and left ventricular cardiac fractional shortening (LVFS) were different between groups,and the difference were statistically significant(F =5.838,32.983,51.714,P ＜ 0.05 or P ＜ 0.01).Compared with the control group[(86.50 ± 1.54)％,(50.66 ± 1.87)％],the LVEF and LVFS of NS groups[(56.67 ± 6.86)％,(26.27 ± 4.01)％],the transfected group[(79.40 ± 1.70)％,(43.48 ±2.15)％] and untransfected group[(69.24 ± 7.30)％,(34.59 ± 5.13)％] were significantly lower(all P ＜ 0.05);compared with the NS group,the LVEF and LVFS of the transfected groups and the untransfected group were significantly increased(all P ＜ 0.05) ; compared with the untransfected group,the LVEF and LVFS of the transfected group were increased (all P ＜ 0.05).Compared with the control group [(3.16 ± 0.22)mm],the LVDs of the NS group[(5.35 ± 1.57)mm] was significantly increased (P ＜ 0.01); compared with the NS group,the LVDs of the transfected group and the untransfected group[(3.95 ± 0.55),(4.24 ± 0.92)mm] were significantly decreased (all P ＜ 0.05).There was no statistically significant difference between the control group,the transfected group and the untransfected group in LVDs (P ＞ 0.05).It can clearly be seen that there was GFP and DAPI labeled transplanted cells under a fluorescence microscope in the myocardial tissue transplanted area.There was significant difference in myocardial fibrosis area and the myocardial tissue protein expression of MMP-2 between groups(F =533.75,32.777,all P ＜ 0.01).The area ratio of the NS group[(15.200 ± 0.356)％,0.584 ± 0.013],the transfected group[(8.530 ± 0.573)％,0.386 ± 0.017] and the untransfected group [(10.670 ± 0.369)％,0.438 ± 0.015] and the MMP-2 protein expression were significantly higher than that of the control group[(1.070 ± 0.113)％,0.319 ±0.013,all P ＜ 0.01)]; compared with the NS group,the two index of the transfected group and the untransfected group were decreased (all P ＜ 0.05).Compared with the untransfected group,the two index of the transfected group was decreased (all P ＜ 0.05).Conclusion Transplantation of ADM gene transfected BMSCs can improve heart function of rats with heart failure significantly and reduce myocardial fibrosis.

Objective To study the effect of electrical pre-stimulation of cerebellar fastigial nucleus (FN) on protein expression of telomerase reverse transcriptase (TERT) in rats with focal cerebral ischemia and reperfusion and its mechanism of mitochondrial protection. Methods Adult male Wistar rats (n=150) were randomly divided into a vehicle group (2-hcerebral ischemia,followed by 24,48 and 72 h of reperfusion) and a FN stimulation group (electrical stimulation of the FN for 1-h daily before 2-h cerebral ischemia,followed by 24,48 and 72 h of reperfusion).TTC staining was employed to measure ischemic lesion volumes.Western blotting was used to observe TERT and Bax protein expressions.The apoptotic cells were detected by TUNEL assay. Transmission electron microscopy was employed to detect the changes of mitochondrial ultrastructure. Results The size of the cerebral infarct in the vehicle group was significantly larger than that in the FN stimulation group at all reperfusion time points (P＜0.05).The relative value of TERT protein expression in the FN stimulation group (0.87±0.51,0.91 ±0.40 and 0.80±0.24) was also obviously higher than that in the vehicle group (0.73±0.37,0.80±0.51 and 0.64±0.33) at all reperfusion time points (P＜0.05); however, a significantly reduced number of TUNEL-positive cells in the FN stimulation group (53.60±5.18,64.00±2.37 and 49.83±4.26) was noted as compared with that in the vehicle group (63.57±3.74,75.40±5.55 and 60.00±2.37) at all reperfusion time points (P＜0.05).No significant difference on Bax protein expression was noted between the vehicle group and FN stimulation group (P＞0.05).The degree ofmitochondrial damage in the FN stimulation group (1.50±0.41,1.75±0.52 and 1.33±0.52) was also significantly lower than that in the vehicle group (2.50±0.63,3.08±0.58 and 2.33±0.41) at all reperfusion time points (P＜0.05). Conclusion TERT protein expression is significantly increased following FN stimulation, which can reduce ischcmic neuronal apoptosis by protecting the mitochondrial dysfunction.

Objective To explore the assessment methods of dysphagia.Methods The data of 37patients with dysphagia were retrospectively analyzed.These patients took the Kubota drinking test,Tengdao's evaluation,videofluoroscopic swallowing study(VFSS)and fibroptic endoscopic evaluation of swallowing (FEES).Results Fourteen out of thirty-seventh patients showed abnormal results during Kubota drinking test.Tengdao's evaluation results showed that 29/37 patients were abnormal.There 27/37and 33/37 patients showed abnormalities in positive-aspiration score and swallow dysfunction score of VFSS.The number of abnormal patients in aspiration score of FEES was 19/21.The Kappa values were 0.137,0.416 between Kubota drinking test.Tengdao's evaluation and VFSS.The FEES was measured against the VFSS for sensibility,specificity,positive predictive value,and negative predictive value,the values were 88.9％,66.7％,94.1％ and 50.0％.Conclusions Kubota drinking test and Tengdao's evaluation can be applied for screening purpose and evaluating result after treatment;VFSS and FEES can be used as more accurate assessments,they can study the dysphagia's character,position and severity.The combination of a variety of dysphagia evaluation methods is the most important basis for diagnosis and treatment of deglutition disorders.