Expression profiles of exosomal microRNA in the different phases of natural history in chronic hepatitis B patients / 中华传染病杂志

Objective To explore the expression profiles and their clinical significance of serum exosomal microRNA (miRNA ) in the different phases of natural history in chronic hepatitis B (CHB ) patients .Methods A total of 92 treatment-naive CHB patients in Shanghai Public Health Clinical Center between January 2014 and January 2017 were retrospectively studied .The cases in immune tolerant (IT) phase ,immune reactive (IR) phase ,inactive carrier (IC) phase and HBeAg-negative CHB (ENH) phase were 24 ,24 ,24 ,and 20 ,respectively .Exosomes were isolated by ExoQuick solution from 250μL serum . The expressions of the surface protein markers LAMP2 and TSG101 in serum exosomes were determined by Western blotting . The expressions of miRNA-122 , miRNA-125a , miRNA-29c , miRNA-200c in exosomes were detected by real-time fluorescent quantitative PCR .The Kruskal-Wallis H test and Mann-Whitney U test were used to determine intergroup differences . The correlation coeffcients ( r) were calculated using Spearman′s correlation .Receiver operating characteristic (ROC) and the area under the curve (AUC ) were used to calculate the diagnostic values . Results Western blotting showed that exosome-specific markers LAMP2 and TSG101 were positive .The levels of serum exosomal miRNA-122 , miRNA-125a ,miRNA-29c and miRNA-220c were significantly different in CHB patients in different phases (H=41 .06 ,29 .31 ,49 .14 and 31 .73 ,respectively ,all P<0 .05) .Based on the results of liver function test and liver biopsy , serum exosomal miRNA-122 , miRNA-29c and miRNA-200c in inflammation group were down-regulated (U = 804 ,317 and 574 ,respectively ,all P< 0 .05) ,while miRNA-125a was up-regulated (U=279 ,P<0 .01) compared with non-inflammation group .The level of exosomal miRNA-200c was negatively correlated with ALT (r= -0 .3932 ,P<0 .01) ,while the level of miRNA-125a was positively correlated with ALT (r=0 .5981 , P<0 .01) .AUC of the above exosomal miRNA were 0 .6193 ,0 .8396 ,0 .8243 and 0 .6883 ,respectively .The highest AUC was miRNA-125a with the sensitivity of 84 .62％ and the specificity of 74 .47％ .AUC of ALT discrimination for liver inflammation was 0 .7953 ,with the sensitivity of 81 .08％ and the specificity of 70 .97％ .Conclusions The serum exosomal miRNA levels are significantly different among the different phases of natural history in CHB patients .Inflammation-associated exosomal miRNA is expected to be the non-invasive diagnostic biomarkers of liver inflammation and is of great benefit for determining the best time for clinical medication of CHB patients .

Clinical applications of breast imaging reporting and data system / 中国医学影像技术

Breast imaging reporting and data system (BI-RADS) is a standardized system for reporting breast pathology covered mammography,ultrasound and MRI.BI-RADS improves the standardization in interpretation of medical imaging and reduces the confusion of breast imaging interpretation.It is a widely accepted risk assessment and quality assurance tool in mammography,ultrasound and MRI.The development history,clinical applications,limitations of BI-RADS,as well as the clinical applications combined with other imaging techniques were reviewed in this article.

Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study

<p><b>INTRODUCTION</b>Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require total hip replacement (THR) or total knee replacement (TKR). The present study aimed to compare the demographic characteristics and medical costs of RA and OA patients from Taiwan who underwent either THR or TKR.</p><p><b>METHODS</b>The medical records of patients who had undergone THR or TKR from 1 January 1996 to 31 December 2010 were obtained from the Taiwan National Health Insurance Research Database (NHIRD). In all, we found 49 and 146 RA patients who received THR and TKR, respectively, and 1,191 and 6,574 OA patients who received THR and TKR, respectively. The gender, age, Charlson comorbidity index (CCI), hospital grade, age at registration in the catastrophic illness dataset, and medical utilisation costs of the different groups were compared.</p><p><b>RESULTS</b>There were statistically significant differences in age, CCI score, drug costs and surgery costs between RA and OA patients. Joint replacement incidence was lower in RA patients than in OA patients, and among patients who underwent THR, total medical costs incurred were higher for RA patients than OA patients. RA patients who underwent THR incurred a significantly greater total medical utilisation cost in the outpatient department (3 months before surgery and 12 months after surgery) than OA patients who underwent THR.</p><p><b>CONCLUSION</b>Analysis of Taiwan NHIRD with regard to patients who had undergone either THR or TKR indicated that RA patients were younger than OA patients, and that significantly more medical resources were used for RA patients before, during and after hospitalisation for these procedures.</p>

Clinical survey and analysis of allergic rhinitis patients' allergens in Guangdong developed and developing regions / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To survey and analyze the allergic rhinitis patients' allergens in developed region of Pearl River Delta and developing region out of Pearl River Delta in Guangdong.@*METHOD@#Sixteen standard allergens were adopted for skin prick test and correlation factors were studied on 858 cases suspected allergic rhinitis from developed region of Pearl River Delta and developing region out of Pearl River Delta. Two regions patients sorts of allergen and their detection rate were compared, and the relationship between allergen positive rate and age, gender, body weight, family history was analyzed.@*RESULT@#The 6 kinds allergen with higher positivity in developed region of Pearl River Delta are dermatophagoides pteronyssinus (55.4%), dermatophagoides culinae (53.9%), tropical mite (38.3%), dog hair (11.8%), blattella germanica (11.5%) and cat hair (8.1%); that from developing region out of Pearl River Delta are dermatophagoides culinae (50.4%), tropical mite(48.0%), dermatophagoides pteronyssinus (47.2%), blattella germanica (13.4%), cat hair (8.7%) and dog hair (7.1%). There is no significant difference of allergen positivity between the patients from the two regions except tropical mite. The positive rate in 15-18 years old patients was also different in the two groups. The positive rate was highest in the age from 19 to 30 years old,with a decreasing trend in younger and elder patients. There is no significant difference of the allergen positive rate between the both groups with body weight, family history and gender (P > 0.05). A higher allergen positivity was found in the patients with family history (P < 0.05).@*CONCLUSION@#Dermatophagoides pteronyssinus, dermatophagoides culinae, Tropical mite, dog hair, blattella germanica and cat hair are the major allergens in developed region of Pearl River Delta and developing region out of Pearl River Delta in Guangdong, but their ranking has some difference in the two regions. Patients with family history had a higher allergen positive rate.

Risk factors and clinical characteristics of hyponatremia in postoperative patients with aneurysm / 中国医师进修杂志

Objective To explore the risk factors of hyponatremia in postoperative patients with aneurysm and analyze the clinical characterstics in order to provide reference for clinic.Methods Participants included 120 patients who treated by aneurysm occlusion.Detailed recorded the patient's history and basic information.The patients with hyponatremia were in case group,and other patients were in control group.The risk factors of hyponatremia were analyzed.Results Forty-five patients (37.5％) occurred hyponatremia after operation.The level of natrium was (125.2 ± 10.1) mmol/L,the average time of appear hyponatremia was (8.2 ± 0.8) d,15 patients were in the first peak(postoperative 1-3 d),25 patients were in the second peak (postoperative 8-9 d),5 patients occurred hyponatremia at other time.Thirty-nine patients were internal carotid artery aneurysms,6 patients were vertebrobasilar artery aneurysms.Single factor analysis showed that the age,preoperative GCS scores,history of hypertension and diabetes,emergency operation,the size of arterial aneurysms,medium-sized aneurysm of artery between two groups had significant difference [(48.7 ± 8.4) years vs.(54.7 ± 8.4) years,(14.4 ± 3.1) scores vs.(10.3 ± 3.4)scores,26.7％ (20/75) vs.60.0％ (27/45),33.3％ (25/75) vs.62.2％ (28/45),32.0％ (24/75) vs.62.2％(28/45),(0.9 ±0.3) cm vs.(1.4 ±0.4) cm,24.0％(18/75) vs.42.2％(19/45),P ＜ 0.01 or ＜ 0.05].Multifactors regression analysis showed that preoperative GCS scores,emergency operation were the independent risk factors of hyponatremia (P＜ 0.05).Conclusions Postoperative 1-3 d and 8-9 d are the peak stage of hyponatremia.Different treatment should be adopted according the peak stage.Lower scores of preoperative GCS and emergency operation are the independent risk factors of hyponatremia.Clinical work need to pay more attention to the risk factors,appropriate treatment and prevention.

Abnormal expression of miR-let-7b in primary biliary cirrhosis and its clinical significance / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the expression of microRNA (miR)-let-7b in peripheral blood cells of patients with primary biliary cirrhosis (PBC) and investigate its relationship to clinical disease parameters.</p><p><b>METHODS</b>Peripheral blood and serum samples were obtained for study from 60 PBC patients and 60 healthy controls. Peripheral blood cells were extracted and subjected to real-time PCR to measure miR-let-7b expression. Serum levels of interleukin (IL)-18, total bilirubin (TBIL), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) were measured by standard biochemical assays. The relationship between miR-let-7b expression and disease parameters was assessed by Spearman's rank correlation test.</p><p><b>RESULTS</b>PBC patients showed significantly lower expression of miR-let-7b in peripheral blood cells than healthy controls (P less than 0.001); moreover, the miR-let-7b expression level decreased in parallel to increases in disease severity (stage I > II / III > IV). In PBC patients, the miR-let-7b expression was significantly correlated with Mayo risk scores (r = -0.4930, P less than 0.001), IL-18 (r = -0.4643, P less than 0.001) and ALP (r = -4119, P less than 0.001), but not with TBIL or GGT.</p><p><b>CONCLUSION</b>Decreased expression of miR-let-7b may be associated with development and progression of PBC, and this miRNA may represent a novel target of improved diagnostic and preventive strategies for PBC.</p>

Role of TGF-beta, IL-10 and IL-17 in allergic rhinitis patients with specific immunotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the level of TGF-beta, IL-10 and IL-17 in the allergic rhinitis(AR) patients pre- and post-specific immunotherapy (SIT).@*METHOD@#The level of TGF-beta, IL-10 and IL-17 in serum of 48 AR patients were detected by enzyme-linked immunosorbent assay before SIT. and the nasal symptom score (NSS) was evaluated in the first and second year after SIT. At the same time. 35 healthy persons were made as normal.@*RESULT@#(1) The level of TGF-beta and IL-10 in serum of AR patients were lower than that of normal group (P 0.05) when SIT was taken for one year.@*CONCLUSION@#IL-10 and TGF-beta were fluctuated in AR patients taking SIT, which raised first and then dropped. but the level of IL-10 and TGF-beta was higher than that of pre- immunotherapy. However, the level of IL-17 continuously declined in the whole process. It showed that the level change of IL-10, TGF-beta and IL-17 correlate with patients' symptom only two years after SIT,so the level change of IL-10, TGF-beta and IL-17 can be used as an index for evaluating the treatment effectiveness of SIT at that time.

Fluctuation of symptomatic VAS score during immunotherapy on allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To understand the fluctuation of symptomatic visual analogue scale(VAS)score and its reasons during the allergic rhinitis patients treated with single-mite antigen immunotherapy.@*METHOD@#Three hundred and seventy six patients with allergic rhinitis were treated with single-mite antigen immunotherapy and their symptoms were evaluated by VAS score and chart, the relative factors which could affect the symptom were followed up.@*RESULT@#During the allergic rhinitis patients treated with single-mite antigen immunotherapy, the symptomatic VAS score appeared fluctuation from the 8th to 34th time of therapy. The VAS score increased at the 8 th, 18 th, 22 th, 25 th, 29 th, and 34 th time. Afterwards, it generally decreased to a lowest level of the whole treatment process in the last. The comprehensive analysis implied that the factors resulting in VAS score fluctuation were patients expectation, emotion, socio-economic conditions, living environment, re-contact of allergen and children's unclear complain.@*CONCLUSION@#Patients' expectation, emotion, socio-economic conditions, living environment, re-contact of allergen and children's unclear complain can result in symptomatic VAS score fluctuation. It prompts that health education be necessary before the treatment of allergic rhinitis with single-mite antigen immunotherapy.

The preliminary study on hemodynamics change of brain before and after vertebrobasilar angioplasty and stenting in the patients with intracal stenosis / 中国医师杂志

Objective To evaluate the hemodynamics change of brain before and after vertebrobasilar angioplasty and stenting in the patients with intracal stenosis.Methods All the indexes were compared among thirty-eight patients with intracal arterial stenosis,including mean peak flow velocity,systolic peak flow velocity,and resistance index of hemodynamics ; Cerebral blood volume ( CBV),cerebral blood flow (CBF)and middle time to peak(MTT) before and after the operation.Results After vertebro-basilar angioplasty and stenting in the 38 patients,the Vs of PCA were significantly lower in the affected side [ (226 ±27)cm/s vs (135 ± 18)cm/s; t =21.74,P ＜0.01 ].Significant difference was found between pro-and post stenting of rMTT and rCBF in the blood territories of stenotic cerebrovascular ( t =3.987,P =0.001 )and( t =-2.027,P =0.029),There was no significant difference between pro-and post stenting of rCBV in the blood territories of stenotic cerebrovascular ( t =-0.901,P =0.329).Conclusions Transcranial Doppler and CT perfusion can be used to evaluate hemodynamic changes before and after pereutaneous transluminal angioplasty and stenting.

The role of electroencephalogram examination in the prognosis evaluation of patients with severe craniocerebral injury / 中国医师进修杂志

ObjectiveTo investigate the role of electroencephalogram (EEG) examination in the prognosis evaluation of patients with severe craniocerebral injury.MethodsFifty-seven patients with severe craniocerebral injury were selected as study subjects and their clinical data were analyzed retrospectively.All the patients got EEG examination,and the relationships between EEG grading and Glasgow coma scale (GCS) score,the prognosis of outcome were analyzed.ResultsThe EEG of 57 patients within 24 h after hospitalization were all abnormal.There was significantly negative correlation between EEG grading and GCS score (r =-0.742,P ＜0.05).EEG grading was significantly positively correlated with the prognosis of outcome (r =0.730,P＜ 0.05).ConclusionsEEG examination and EEG grading can evaluate the prognosis of patients with severe craniocerebral injury.It provides reference for clinical treatments.

Clinical study of minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage / 中国医师进修杂志

ObjectiveTo study the clinical effect of YL-1 type hematoma puncture needle in the treatment of basal ganglion region cerebral hemorrhage.MethodsSixty-two patients with hypertensive basal ganglion region cerebral hemorrhage were treated by YL-1 type hematoma puncture needle from January 2007 to May 2011 (minimally invasive punctural evacuation group),of which,60 patients were treated by conservative treatment(conservative treatment group) as control,compared two groups of neural function defect score,hematoma clearance rate on admission,after 3 weeks treatment,and quality of life after 6 months.ResultsNeural function defect score on admission of minimally invasive punctural evacuation group was (23.6 ± 18.4) scores,while (23.4 ± 17.8) scores in conservative treatment group,the difference was not statistically significant(P ＞ 0.05).After 3 weeks' treatment,neural function defect score and hematoma clearance rate of minimally invasive punctural evacuation group was superior to conservative treatment group [ (14.6 ± 12.4) scores vs.(20.1 ± 18.4) scores,(92.3 ± 5.4)％ vs.(79.5 ± 13.8)％ ] (P ＜0.05 ).After 6 months' treatment,the good rate of quality of life in minimally invasive punctural evacuation group was 81.7％(49/60),which was significantly increased compared with that of conservative treatment group [67.2％ (39/58)] (P ＜ 0.05).ConclusionsThe minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage has small invasion,better prognosis,effective and fast decompression of intracranial hematoma,reducing disability rates,improvement of the quality of life,which could be a beneficial complement for traditional therapies.

Comparison of Angioseal closure device with manual compression / 中国医师进修杂志

Objective To assess the safety and efficiency of Angioseal device in patients undergoing percutaneous femoral artery puncture in brain angiograph or interventional therapy. Methods A prospective trial was carried out in 128 patients undergoing brain angiograph and interventional therapy,in which 93undergoing brain angiography and 35 interventionsl therapy. All patients were divided into pure compression group by manual compression (83 cases) and vascular blocking group by Angioseal device (45 cases)according to different hemostatic measures. Results In angiography, hemostasis time of vascular blocking group and pure compression group was (1.8 ±0.8) min and(20.2 ±9.4) min (P＜0.01 ),ambulation time was (3.8 ± 0.8) h and (19.4 ± 2.2) h (P ＜ 0.01). In interventional therapy,hemostasis time of vascular blocking group and pure compression group was (2.0 ± 1.1) min and (24.5 ± 10.3) min (P ＜ 0.01), ambulation time was (4.3 ± 1.5) h and (24.3 ± 3.2) h (P＜ 0.01). Pure compression group had higher complication rate (such as bleeding,hematoma,skin ulceration and blister) than vascular blocking group (P＜0.01).Conclusion Angioseal closure device is safe, efficient and easy to use.

Expression of GATA 4 and alpha fetoprotein in fetal mouse liver and hepatocarcinoma cells and their relationship / 第二军医大学学报

Objective: To explore the expression of GATA4 and alpha fetoprotein (AFP) in fetal liver and hepatocarcinoma cells and their correlation. Methods: Semi-quantitive RT-PCR was used to detect the expression of GATA4 and AFP in liver tissues from mouse of E 10.5 d to P 0.5 d, normal liver cells, and hepatocarcinoma cells. Eukaryotic expression vector of mouse GATA4 was used to transfect normal liver cell line and the product was identified. Doxorubicine was used to treat hepatocarcinoma cells; then semi-quantitive RT-PCR was used to determine the mRNA of GATA4, FTF and AFP; Western blot was used to examine the expression of GATA4 and AFP; and ELISA was used to determine AFP in supernatants. Results: The expression of GATA4 and AFP decreased with the maturation of fetal liver cells and reached adult level 0.5 d after birth. GATA4, FTF and AFP were not detected in normal liver cells but were overexpressed in hepatocarcinoma cells. The expression of FTF and AFP was increased in normal liver cells after transfection of GATA4, and the level of AFP was also increased in the supernatant. GATA4 was sharply decreased in hepatocarcinoma cells within 6 h after doxorubicine treatment; the expression of FTF and AFP was also decreased in supernatants 12 h after doxorubicine treatment (P<0.05). Conclusion: GATA4 is highly expressed in fetal liver and hepatocarcinoma cells,which may contribute to the elevation of AFP expression.

Diagnostic value of serum Cys-C, hs-CRP, and urine mALB for early renal injury in gonty patients / 第二军医大学学报

Objective To explore the diagnostic value of serum Cys-C, hs-CRP, and urine mALB for early renal injury in gonty patients. Methods A total of 100 gonty patients and 50 healthy volunteers were divided into 3 groups, acute phase group (n = 50), intermittent group (n= 50), and healthy control group (n = 50) . The serum Cys C,hs-CRP,and urine creatinine were determined by automatic chemistry analyzer and urine mALB by immunofluorometer equipment, and the results were analyzed in each group. Results The results of mALB/Cr(mg/[g • Cr]), hs-CRP(mg/L), and Cys-C(mg/L)in acute phase group were 11.45±3.55, 5.15±1.98, and 2.62±0.83, in intermittent group were 8.96±1.78, 3.28±1.23, and 0.93±0.26, and in healthy volunteer group were 3.89± 0.76, 1.91±0.57, and 0.78±0.22, respectively. The values of the above three parameters in the acute phase and intermittent groups were significantly higher than those in the healthy control group (P< 0.05) ; and the values in the acute phase group were significantly higher than those in the intermittent group (P<0.05). The abnormal rate of hs-CRP+ Cys-C+ mALB/Cr was 87% in gonty patients. Conclusion Simultaneous determination of mALB/ Cr, hs-CRP, and Cys-C can help to assess the early renal injury in gonty patients.

Influence of different interventional treatment timing on the prognosis of intracranial aneurysms / 中国医师进修杂志

Objective To investigate the influence of different interventional treatment timing on the prognosis of patients with intracranial aneurysms. Methods One hundred and thirty-eight patients with ruptured intracranial aneurysms were divided into group A (Ⅰ- Ⅲ grade) with 109 cases and group B ( Ⅳ- Ⅴ grade) with 29 cases according to Hunt-Hess grade when admitted. All patients received interventional treatment, the operation period was divided into early, middle and late stage according to the different time from disease time to operation, then compared the good rate, cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period. Results The good rate at different period in group A were respectively 69.7% (23/33),58.8% (10/17) and 61.0% (36/59),which and the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group A had no significant difference(P > 0.05). The good rate of patients received surgical treatment at early stage in group B was 46.2%(6/13), which was significantly superior to late stage (0), the difference was statistically significant (P < 0.05), while the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group B had no significant difference(P> 0.05). Conclusion The prognosis of patients with Hunt-Hess grade Ⅰ - Ⅲ grade undergoing interventional treatment at early, middle and late stage can be satisfactory, while grade Ⅳ - Ⅴ grade patients should receive interventional treatment at early stage.

Development and validation of a liquid chromatography-isotope dilution tandem mass spectrometry for determination of olanzapine in human plasma and its application to bioavailability study / 药学学报

A simple, reliable and sensitive liquid chromatography-isotope dilution mass spectrometry (LC-ID/MS) was developed and validated for quantification of olanzapine in human plasma. Plasma samples (50 microL) were extracted with tert-butyl methyl ether and isotope-labeled internal standard (olanzapine-D3) was used. The chromatographic separation was performed on XBridge Shield RP 18 (100 mm x 2.1 mm, 3.5 microm, Waters). An isocratic program was used at a flow rate of 0.4 m x min(-1) with mobile phase consisting of acetonitrile and ammonium buffer (pH 8). The protonated ions of analytes were detected in positive ionization by multiple reactions monitoring (MRM) mode. The plasma method, with a lower limit of quantification (LLOQ) of 0.1 ng x mL(-1), demonstrated good linearity over a range of 0.1 - 30 ng x mL(-1) of olanzapine. Specificity, linearity, accuracy, precision, recovery, matrix effect and stability were evaluated during method validation. The validated method was successfully applied to analyzing human plasma samples in bioavailability study.

Development and validation of a liquid chromatography-isotope dilution tandem mass spectrometry for determination of olanzapine in human plasma and its application to bioavailability study / 药学学报

A simple, reliable and sensitive liquid chromatography-isotope dilution mass spectrometry (LC-ID/MS) was developed and validated for quantification of olanzapine in human plasma. Plasma samples (50 microL) were extracted with tert-butyl methyl ether and isotope-labeled internal standard (olanzapine-D3) was used. The chromatographic separation was performed on XBridge Shield RP 18 (100 mm x 2.1 mm, 3.5 microm, Waters). An isocratic program was used at a flow rate of 0.4 m x min(-1) with mobile phase consisting of acetonitrile and ammonium buffer (pH 8). The protonated ions of analytes were detected in positive ionization by multiple reactions monitoring (MRM) mode. The plasma method, with a lower limit of quantification (LLOQ) of 0.1 ng x mL(-1), demonstrated good linearity over a range of 0.1 - 30 ng x mL(-1) of olanzapine. Specificity, linearity, accuracy, precision, recovery, matrix effect and stability were evaluated during method validation. The validated method was successfully applied to analyzing human plasma samples in bioavailability study.

Reconstruction of distal segment defect of thumb with reverse dorsal radial flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the application of reverse dorsal radial flap in reconstruction of distal segment defect of thumb.</p><p><b>METHODS</b>From January 2004 to June 2007, 24 cases of soft tissue defect with exposed bone or tendon at the distal segment of thumb were involved. The flap size ranged from 2 cm x 2 cm to 3 cm x 4 cm.</p><p><b>RESULTS</b>Venous congestion happened in 3 cases with one case of partial necrosis at the distal end of the flap. All the other flaps survived completely. The follow-up period was 6 - 24 months. The appearance and function of the thumbs were satisfactory. The 2-point discrimination was 7 - 11 mm (mean 9.3 mm).</p><p><b>CONCLUSIONS</b>Reverse dorsal radial flap is a good option for reconstruction of distal segment defect of thumb.</p>

Modulatory effect of Rho kinase on the cerebral vasospasm following subarachnoid hemorrhage / 中国医师杂志

Objective To investigate the dynamical changes of Rho kinase in the cerebrospinal fluid (CSF) and its relationship with cerebral vascular spasm CVS. Methods CSF were collected on the ist, 3rd, 7th, 10th and 14th day after subarachnoid hemorrhage. The expression of Rho-kinase mRNA in CSF was determined by RT-PCR. The expression of endothelin-1 in CSF was determined by radioimmuno-assay. TCD was used to measure the velocity of the cerebral artery. Results The levels of ET-1 and Rho-kinase mRNA in CSF were re-markably increased on the 3rd day, and reached at the peak on the 7th day after subarachnoid hemorrhage, which were significantly higher than those without CVS. Conclusion There is a positive correlation between the level of Rho-kinase mRNA and ET-1 in CSF. Rho-kinase may participate in the development of CVS.

The application of C-arm CT scanning in performing transcatheter arterial chemoembolization for hepatic cancer / 介入放射学杂志

Objective To discuss the application of C-arm CT scanning technology in performing transcatheter arterial chemoembolization for hepatic cancer.Methods Seventy-seven patients of hepatic cancer were treated with selective transcatheter arterial chemoembolization(TACE),which was followed by C-arm CT scanning to observe the embolization effect.C-arm CT scanning was also performed before TACE in 13 cases.Three-dimension reconstruction of the images was carried out on Integris 3D-RA workstation.The therapeutic results were evaluated.Results The embolization state of both the peripheral margin and the body of the tumor could be clearly displayed on CT scans in all 77 patients.Some tiny liver lesions were also detected in 3cases.Conclusion C-arm CT scanning technology is a newly-developed high-tech examination.This examination is very helpful for making the proper operation scheme and for evaluating the curative effect of intravascular intervention.Compared to the traditional CT scanning,C-arm CT scanning can provide more accurate information and stereoscopic image of the lesions,therefore,the whole course of the interventional procedure can be entirely under the operator's control and the curative effect can be evaluated at any time during the operation.C-arm CT scanning can be effectively employed in interventional therapy for multisystemic disorders.