[Objective]To observe the surgical treatment for the huge disc herniation of C3、4.[Method]Sixteen patients with huge disc herniation of C3、4 were operated upon with combined posterior decompression of expansive open-door laminoplasty with anterior decompression,bone graft and plate fixation.After operation,neurological findings,height of the interbody space and fusion rate of the space were observed.[Result]All the patients were followed up for an average of more than six months,all of them did not get secondary nerve injuries in operation,neurological function were improved obviously and all the affected interbody space got solid fusion.Based on the standard of Odom,50% of the patients were very good,25 % good,25 % general,and the effective rate was about 100%,excellent rate was about 75%.[Conclusion]The combined posterior with anterior decopression and interbody fusion for treatment of huge disc herniation of C3、4 has advantage of more security in removing the prolapsed disc,improvement of the interbody fusion rate,keeping the height ofinterbody space.This procedure is one of the effective operative methods in the treatment of huge disc herniation of C3、4.

PurposeTo evaluate the value of dual-source CT angiography (DSCTA) in the diagnosis of carotid atherosclerosis, and to explore the relationship between carotid atherosclerosis and diabetes mellitus (DM).Materials and Methods 145 patients with ischemic stroke were divided into DM group (n=80) and non-DM group (n=65). All patients underwent DSCTA. The location and characteristic of carotid atherosclerosis were analyzed using curve planE reconstruction (CPR), maximum intensity projection (MIP), multi-plane reformation (MPR) and volume rendering (VR). The differences between two groups were analyzed.Results Compared with non-DM group, the body mass index and high blood cholesterol were higher in DM group (t=6.197,P<0.05;χ2=8.372,P<0.01). The incidence of carotid atherosclerosis and vulnerable plaques were also higher in DM group than non-DM group (χ2=11.617 and 9.388,P<0.01). There was no significant difference between DM group and non-DM group in the location of carotid atherosclerosis (χ2=0.160, 0.509, 0.419 and 0.016,P>0.05). Carotid atherosclerosis was more common in carotid bifurcation and carotid artery siphon.Conclusion DSCTA can demonstrate the location and characteristics of carotid atherosclerosis in ischemic stroke patients with diabetes mellitus. Diabetes is a risk factor for the formation of carotid atherosclerosis, especially vulnerable plaques.

Objective To investigate the diagnostic value of dual-source CT angiography (DSCTA) for vertebrobasilar atherosclerosis in patients with transient ischemia attack (TIA).Methods 80 TIA patients underwent DSCTA.Common data were collected.Vertebrobasilar plaques and stenosis degree were analyzed by using CT reconstruction.Results 152 plaques were found in 69 patients(86.2％,69/80),59 plaques(38.9％,59/152)in unilateral vertebral artery in 31 patients,83 plaques (54.6％,83/152) inbilateral vertebral artery in 28 cases,10 plaques (6.6％,10/152) in basilar artery in 10 patients,among which 51(33.6％,51/152)plaques were hard,69(45.3％,69/ 152)plaques were soft,32(21.1％,32/152)plaques were mixed.There were 31 cases (44.9％,31/ 69) with mild stenosis,27 cases (39.1％,27/69) with moderate stenosis,7 cases (10.1％,7/69) with severe stenosis,and 4 cases (5.8％,4/69) had vascular occlusion.Conclusions Vertebrobasilar atherosclerosis is a common cause of TIA.DSCTA can be used to analyze the vertebrobasilar plaques and stenosis degree.Soft plaques and severe stenosis promote TIA.

Objective: To observe the clinical characteristics and current treatment status in patients with chronic heart failure (CHF) at different grade hospitals in Xinjiang Area.
Methods: A total of 5357 patients with CHF diagnosis discharged from 20 different grade hospitals in Xinjiang area from 2011-01 to 2012-02 were enrolled. The age, gender, nationality, etiology of CHF, cardiac function, complications and current medication status in all patients were systemically studied.
Results:①There were 2295/5357 (42.8%) patients with Han nationality, 2255 (42.1%) with Uyghur nationality and 8.07 (15.1%) with other nationalities. The average age of patients was at (64.60 ± 12.77) years.②The etiology of CHF were, in turn, as: coronary artery disease (CAD) 50.8%, hypertension (31.8%), dilated cardiomyopathy (7.2%).③ The ratios of patients with NYHA III-IV in county hospital 440/682 (64.5%), in regional hospital 1180/1557 (75.8%) were higher than that that in grade A class 3 hospital 967/3118 (31.0%), ( =1390.362,P=0.000).④The patients in county hospital, regional hospital showed increased left atrial diameter (44.7 ± 8.8) mm, (39.5 ± 8.1) mm and left ventricular end-diastolic diameter (60.6 ± 11.1) mm, (56.9 ± 11.1) mm than those in grade A class 3 hospital (37.3 ± 7.1) mm and (53.8 ± 9.7) mm; while decreased LVEF (41.9 ± 10.5) %, (42.3 ± 13.0) % than that in grade A class 3 hospital (46.5 ± 12.8), allP<0.001.⑤The medication status in different grade hospitals as ACEI/ARB, β-blocker, aldosterone antagonist, diuretics, digitalis were at 72.8%, 66.8%, 46.6% , 45.5% and 26.8% respectively. The application of ACEI/ARB and β-blocker in county hospital (61.4% and 51.5%) and in regional hospital (72.3% and 58.3%) were lower than those in grade A class 3 hospital (75.6% and 74.3%); while the application of aldosterone antagonist in county hospitals (57.9%) and in regional hospital (73.8%) were higher than that in grade A class 3 hospital (30.6%), allP<0.001.
Conclusion: The etiology of CHF were mainly as CAD and hypertension in Xinjiang area, the patients in county and regional hospitals had more severe conditions than that in grade A class 3 hospital, which implying the distance between the guideline standard and real practice especially in basic level hospitals.

Objective To investigate the clinical features and current therapy of atrial fibrillation (AF) of inpatients in Urumqi,China.Methods The clinical data of inpatients diagnosed with AF from January,2008 to December,2012,in 12 hospitals in Urumqi were retrospectively analyzed.Results Totally 1 310 AF inpatients were enrolled in this study with the age of (64.8 ±3.3) years old and a men to women ratio of 1.39.Most patients were in age groups of 61-70 years (26.5％) and 71-80 years (27.6％).More patients with paroxysmal AF were at cardiac function class Ⅰ-Ⅱ (75.2％),while more patients with persistent AF were at cardiac function class Ⅲ-Ⅳ (31.0％) (both P values ＜ 0.05).The most common co-morbidities of AF were hypertension (49.2％),coronary heart disease (38.5％),diabetes mellitus (20.1％).Compared with patients of chronic AF,the patients of paroxysmal AF had higher success rates in amiodarone conversation and sinus rhythm maintenance after ablation (44.8％ vs 29.9％,87.5％ vs 68.9％,P values ＜ 0.05).Among the 1 310 inpatients,992 patients (75.7％) received antithrombotic therapy.There were statistically significant differences in CHA2DS2 score and incidence rate of cerebral infarction among patients receiving aspirin,warfarin or rivaroxaban/other anticoagulation drugs [2 (1,3) vs 3 (2,4) vs 3 (2,5) and 6.3％ vs 23.8％ vs 30.2％,both P values ＜0.05].Conclusion Our results of AF inpatients' age,gender,related disease distribution,AF types,incidence of stoke,therapeutic and epidemiological features are in accordance with the domestic and abroad reports.

Objective: To study the relationship between dilated cardiomyopathy and nuclear lamina protein (LMNA) gene mutation in Kazak ethnics at Xinjiang area.
Methods: A Kazak familial dilated cardiomyopathy (FDCM) with 31 members was studied. In addition, 160 patients with idiopathic dilated cardiomyopathy (IDCM) with 160 healthy controls were enrolled in our study, and they were divided into 4 groups: IDCM-Kazak, IDCM-Han and Control-Kazak, Control-Han.n=80 in each group. Peripheral blood DNA were extracted, 12 exons with nearby introns of LMNA gene were detected by PCR and the ampliifed products were sequenced and compared with the standard template of CHROMAS and BLAST software to identify mutation sites. LMNA mutation in both Kazak and Han IDCM patients were investigated.
Results: A novel LMNA mutation (insC, CGG→CCG) at exon 7 was identiifed in a FDCM proband, it caused an amino acid substitution as Arg to Pro, and a known LMNA polymorphism loci rs4641 (c.1362C>T His454His) was fund at exon 10. In addition, LMNA polymorphism loci rs4641 genotype distribution (χ2=5.16,P=0.036) and allele frequency (χ2=4.50,P=0.034) were statistically different between IDCM-Kazak group and Control-Kazak group; while such differences were no statistic meaning between IDCM-Han group and Control-Han group. Logistic regression analysis indicated that LMNA polymorphism loci rs4641 was related to IDCM occurrence in Kazak ethnics (P=0.025, OR=0.412, 95% CI 0.189-0.896).
Conclusion: LMNA polymorphism loci rs4641 was related to IDCM in Kazak ethnics at Xinjiang area, which might be susceptible loci for IDCM occurrence.

Objective: To comparatively study the atrial ifbrillation (AF) in patients with Han, Uygur, Kazak and Hui ethnic groups in Urumqi city.
Methods: A total of 1510 AF patients treated in 12 hospitals in Urumqi city from 2008-01 to 2012-12 were retrospectively studied. There were 1310 patients enrolled in our research including the 4 ethnic groups of Han, n=995 (75.95%), Uygur, n=168 (12.82%), Kazak, n=55 (4.20%) and Hui, n=92 (7.02%).
Results: ①The gender ratios were similar in 4 ethnic groups, P>0.05, while the AF type, cardiac function and risk factors were different, all P<0.05.②The blood pressure was similar in 4 ethnic groups, P>0.05, while the blood routine test, biochemistry and cardiac ultrasound examination were different, all P<0.05.③The treatments were different among 4 ethnic groups, all P<0.05.
Conclusion: The AF patients were different in AF type, biochemistry, cardiac ultrasound and function, anti-coagulation treatment among 4 ethnic groups of Han, Uygur, Kazak and Hui in Urumqi city.

AIM:To investigate the effects of microRNA-29a and 133a expression in the atrium on atrial fibril-lation (AF) and fibrosis.METHODS:Chronic rapid atrial pacing was used to establish the persistent AF dog model , and the sham group was also set up .The cardiac ultrasound measurement was used for determining the cardiac structure size . The Masson 3 color staining were used to evaluate the stage of fibrosis .The expression of microRNA-29a and 133a in the left atrium ( LA) was detected by real-time transcriptase polymerase chain reaction .RESULTS: Compared with before modeling , no statistical difference of atrial dilatation and decreased ejection fraction in the model dogs with persistent AF was observed (P>0.05).Compared with sham group, the degree of fibrosis and collagen volume fraction (CVF) in per-sistent AF model group were increased obviously (P<0.05).The expression of microRNA-29a and 133a were decreased obviously (P<0.01, P<0.05).CONCLUSION:Structural remodeling of the atrium and atrial fibrosis are the essential for development and maintenance of atrial fibrillation .Down-regulation of microRNA-29a and 133a expression may be very important molecular mechanism for atrial structural remodeling in the persistent AF model dogs .

Objective Retrospectively analyze of urate crystal deposition using dual-source CT in asymptomatic hyperuricaemia and symptomatic gout patients.Methods Sixty patients with asymptomatic hyperuricemia (uric acid ≥540 μmol/L) and 48 patients with gout (without any change in the appearance of the limbs and obvious gout nodules) were selected.All patients underwent dual-energy CT imaging.The location number and size were analyzed using CT gout software.Results Eighteen patients with asymptomatic hyperuricemia with urate crystal deposition in limb joints (13 in foot and ankle, 7 in the hand and wrist, 2 in knee), the average size of crystal was (0.12±0.04) cm3.Forty-eight gout patients (28 cases of early gout and 20 cases of late gout and 20 gout cases) had urate crystal deposition (48 in foot and ankle, 39 in hand and wrist, 27 in knee), the average size of crystal was (1.7±0.7) cm3.The number and size of urate crystals deposited in the joints, tendons and ligaments was higher in patients with gout than asymptomatic hyperuricemia (x2=52.076, P＜0.001;t=44.834, P＜0.001).There was no difference between the early gout and late gout in the size of urate crystals (t=0.163, P＞0.05).Conclusion Urate crystals can deposite in asymptomatic hyperuricemia.However, more and larger urate crystals appear in gout patients, there is no difference in size and number of urate crystals between the course duration of gout.