Studies in recent years have suggested that the basic characteristics of the identified cerebral autosomal dominant arteriopathy with subeortical infarcts and leukoencepha-lopathy (CADASIL) are the onset of the disorder with a form of familial hereditary, middle-age onset with progressive ischemic stroke-like course and multiple diffuse white matter lesions, the identified MRI abnormal white matter signals and pathology. Molecular genetic studies have suggested that the multiple mutations of the Notch3 gene are associated with CADASIL. The combination of gene diagnosis with peripheral tissue biopsy may be the most valuable diagnostic means before death. To study CADASIL from the aspects of pathogenesis and clinical manifestations contributes to improve clinical diagnosis rate.

[Objective]To discuss the methods selection for lumbar compressed fracture.[Method]137 cases were respectively treated with non-operation,AF nail,Z-Plate steel board internal fixation and protruding formation behind centrum.[Result]All were cured in 10~14w,(12?0.6)w in average;the pain VAS score,Frankel score,Cobb’s angle,the height of front and back edge of centrum were all relieved a lot after treatment,without operation sequela or marked loss of injured vertebra.[Conclusion]The methods shall be selected for lumbar compressed fracture under compressing degree,bone occupation degree in lumbar tube,nerve injure degree,stability of spine structure or fracture dislocation,etc.The stable fracture shall rest in bed with cushion under back.

Objective To evaluate the clinical effects in t he treatment of femoral peritrochan teric frac-tures by PFN(proximal femoral nail).Methods A retrospective analysis was done in the treatment of femoral peritrochanteric fractures(72cases).38cases were male and 44cases female.Their age ranged 64～96years old with the average age being 78years old.70cases were intertrochanteric f ractures(EvensⅠtype 16,Ⅱtype 31,ⅢA type 14,ⅢB type 6,Ⅳtype 3),and 2cases subtrochanteric fractu res.Results65patients were followed up for over 6months.All fractures healed and all patients could take care of themselves and were satisfied with t he clinical curative effect except one patient who had the lag screw pulled o ut and coxa vara because of serious os-teoporosis.Conclusion PFNis a better way to cure femoral peritrochanteric fractures because of few complications and simple surgical procedure.Bein g a micro-trauma technique,it is worthy of wide application in clinic.[

Stroke-associated pneumonia (SAP) refers to the stroke patients suffering from infectious lung parenchyma (including the alveolar wall,i.e.the general pulmonary interstitial) inflammation without previous pulmonary infection.It is one of the most common major complications resulting in death and affecting functional recovery in patients with stroke.Dysphagia resulting in aspiration is the main reason of SAP.Therefore,avoiding aspiration and preventing SAP have important significance for patients with stroke through early correct tube feeding.This article reviews the tube feeding methods of preventing SAP.

Adiponectin is one of the cytokines secreted by fat cells.It has a variety of physiological functions,including anti-inflammation,anti-atherosclerosis,anti-diabetes,and anti-obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factors and cerebrovascular disease.

Ischemic stroke is closely associated with carotid atherosclerosis.Detecting carotid plaque components (including fibrous Cap,lipid core,hemorrhage,and calcification) using high-resolution 3.0T magnetic resonance imaging contributes to evaluate the risk of ischemic stroke and guide treatment.This article reviews the research status of magnetic resonance imaging of carotid atherosclerotic plaque components.

According to the traditional point of view,CT and lumabar puncture are the main means in the diagnosis of subarachnoid hemorrhage(SAH).The values of conventional MRI T1-weighted imaging(T1WI)and T2 weighted imaging(T2WI)are very little in the diagnosis of SAH.With the development of MRI technique and the research and application of novel MRI sequences,the value of MRI are gradually recognized and affirmed in the diagnosis of SAH.and has shown its superiority.MRI isn't inferior to CT in the diagnosis of acute SAH.evidently superior to CT in the diagnosis of subacute,chronic and atypical SAHs and superior to CT in the diagnosis of the complications of SAH.MRI is valuable in screening for intraeranial aneurysms and postoperative follow-up.

Objective To observe the clinical efficacy of auricular acupuncture plus acupoint injection at Zusanli (ST 36) in treating shoulder pain due to gynecologic laparoscopy.Method Totally 120 patients with shoulder pain due to gynecologic laparoscopy were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by auricular acupuncture plus acupoint injection at Zusanli (ST 36), while the control group was by ordinary analgesics. The clinical efficacies were compared after 2 treatment courses.Result The Visual Analogue Scale (VAS) scores, Present Pain Intensity (PPI), and the item scores of the Short-Form (36) Health Survey (SF-36) were significantly changed in both groups after treatment (P<0.01,P<0.05). There were no significant differences in comparing the VAS score, PPI, and the item scores of SF-36 between the two groups (P>0.05). The total effective rate was 95.0% in the treatment group versus 75.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular acupuncture plus acupoint injection at Zusanli (ST 36) is effective in treating shoulder pain due to gynecologic laparoscopy, and it can effectively reduce the occurrence of complications.

Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4 + T lymphocyte counts were analyzed and the follow up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4 + T lymphocyte counts of 30 patients was 0 30 (mean, 15?9/?l), and the survival time ranged from 2 weeks to 18 months (mean, 6.4?3.3 months). The vision was improved and CD4 + T lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis.

The combination of high-speed countercurrent chromatography and rapid bioactive assay is a desirable method in the screening of bioactive components from CMM and natural products.This review focused on the application status of high-speed countercurrent chromatography to the rapid screening of bioactive components from CMM and natural products based on our previous studies and the recent progress over it.