Humans ; Hypertension, Pulmonary ; etiology ; Male ; Middle Aged ; POEMS Syndrome ; complications

Objective To evaluate the relationship between recurrence of cryptogenic ischemic cerebrovascular disease (CICVD) and patent foramen ovale (PFO),as well as to access the clinical significance of PFO in ischemic cerebrovascular disease.Methods Consecutive patients with CICVD aged 15 to 70 years who were hospitalized in Department of Neurology,Xuanwu Hospital Capital Medical University from January 2008 to March 2011 were prospectively investigated.Identified by transesophageal echocardiography,patients were divided into two groups with respect to outcome:PFO group and non-PFO group.The recurrence of cerebral ischemic events was compared between the two groups after neurological follow-up.Results A total of 91 patients were recruited,including 57 patients with PFO and 34 patients without PFO.The follow-up period of two groups was 695 (506,1142) d.The recurrence rate at 15 months in patients with PFO (24.5％ (12/49)) was higher than those without PFO (6.9％ (2/29),x2 =4.391,P =0.036).Cum hazard curve indicated that recurrence risk of cerebral ischemic events in patients with CICVD in PFO group was higher than that of patients in non-PFO group during the follow-up period (P =0.044).Cox model used for multivariate survival analysis indicated that PFO was a risk factor for cerebral ischemic event recurrence among patients with CICVD (OR =4.159,95％ CI 1.178-14.689,P =0.027).Conclusions PFO is associated with increased recurrence risk of cerebral ischemia in CICVD patients.In addition,PFO may be a significant factor for ischemic cerebrovascular disease.

Child ; Evidence-Based Medicine ; Humans ; Nephritis ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Purpura ; complications ; diagnosis ; therapy

Objective To analyze the risk factors for patients with cryptogenic ischemic cerebrovascular disease (CICVD) and patent foramen ovale (PFO), as well as to evaluate the relationship between common risk factors and PFO in cerebral ischemia. Methods Consecutive patients with CICVD aged 15 to 70 years who referred to Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2008 to July 2011 were investigated. Identified by transesophageal echocardiography, they were divided into PFO group and non-PFO group with respect to outcome. The common risk factors of cerebral ischemic between 2 groups were compared. The relationship between these risk factors and PFO was analyzed. Results A total of 102 patients were investigated, including 61 patients (59.80%) with PFO and 41 patients (40.20%) without PFO. Positive family history of ischemic cerebrovascular disease proportion in PFO group (31.1%)was higher than that in non-PFO group (9.8%) (P=0.011). There was no significant difference in other observed indicators (P>0.05). Positive family history of ischemic cerebrovascular disease correlated with PFO among CICVD patients (r=0.251, P=0.011). Conclusion PFO was not only more common in CICVD patients, but also correlated with positive family history of ischemic cerebrovascular disease.

In order to find an easy and rapid quantitative analytical method to detect rhamnolipid produced by Pseudomonas aeruginosa, three methods, H_ 2 SO_ 4 -anthrone analysis method, L-cysteine-H_ 2 SO_ 4 method and phenol-H_ 2 SO_ 4 method, were compared in the present paper, and the influence factors were also considered.The results showed that H_ 2 SO_ 4 -Anthrone analysis method was better than the others and its optimal reaction condition was obtained.The influence to the quantitative analysis of rhamnolipid from the residual glucose and the top clean liquid layer in the ferment solution could be ignored.But the influence from the bacterial body and the middle layer of the ferment solution reached a certain degree.Thus, the bacterial body should be removed before measuring.However, the influence from the middle layer of the ferment solution could be avoided by making a standard curve which was made by using a rhamnose mixed with the middle layer ferment solution.

OBJECTIVE: To explore the clinical evaluation system reflecting the superiority and characteristics of comprehensive traditional Chinese medicine (TCM) therapy for acute stroke. METHODS: A randomized controlled trial with single blind in various therapeutic centers was applied on the patients with the acute stage of hemorrhagic stroke due to hypertension, who were allocated to the trial group and the control group. The trial group accepted the general Western medicine therapy and differential treatment of traditional Chinese medicine based on stage classification. Patients in the control group were treated with the general Western medicine and the placebo of traditional Chinese herbal medicine. The treatment effect was assessed at the 7th day, 14th day, 21st day, and 28th day of post-treatment and after 3-month follow-up. The clinical evaluation system included the syndromes of TCM (ZH), Glasgow coma standard (GCS), nerve functional failure (NF), activity of daily living (ADL), Barther index (BI), quality of life index (QLI) and functional activities questionnaire (FAQ). RESULTS: Four hundred and four patients with acute stroke were included. There were 178 cases with yang-syndrome and 21 cases with yin-syndrome in the trial group (n=199), and there were 165 cases with yang-syndrome and 40 cases with yin-syndrome in the control group (n=205). The rates of recovery and obvious improvement after 3-month treatment in the trial group and the control group were 86.5% and 73.6% respectively. There was significant difference between the two groups (P<0.01). The response sensitivity of the effect items indicated that the sensitivity of GCS began to increase from the 7th day and was high at the 14th day and the 21st day for all patients. The response sensitivity of the NF scale was high for all patients at the 14th day, the 21st day and the 28th day. The BI scale and the QLI scale were sensitive to the patients with light and middle stage of stroke at the 21st day, and were sensitive to the patients with light stage of stroke after 3-month follow-up. The FAQ scale was sensitive to the light stroke at the 21st day and after 3-month follow-up. The ADL scale was sensitive to all patients at the 28th day and the patients with light stage of stroke after 3-month follow-up. The ZH scale was sensitive to all patients from 0 to 7d, the 14th day, and the 28th day. The principle components analysis indicated these 7 items could reflect the condition of stroke from 0-7d, the 21st day and after 3-month follow-up, and could be used to evaluate the therapeutic effect of hemorrhagic stroke. ZH scale and FAQ scale were more sensitive than other effect items at the 28th day. CONCLUSION: The seven items (GCSbNFbBIbQLIbFAQbADLbZH) have high sensibility to all patients in the acute stage of hemorrhage stroke especially at the 21st day. The ZH score will change in accord with the condition of stroke, and is appropriate to reflect the condition of stroke. It is believed that the seven items can form the system of effect evaluation in different stages of stroke, and the ZH scale is a very important item.

Objective To explore the relationship between IL-1?-511C/T and IL-1?+3953C/T site polymorphisms and the susceptibility of pediatric epilepsy.Methods Under the case-control study,IL-1?-511C/T and IL-1?+3953C/T site polymorphisms in 117 patients with pediatric epilepsy and 95 healthy individuals controls(healthy control group) were analyzed with polymerase chain reaction restriction and fragment length polymorphism(PCR-RFLP),the relationship between IL-1?-511C/T,IL-1?+3953 C/T site polymorphisms and the risk of pediatric epilepsy were analyzed.SAS 8.0 software was used to analyze the data.Results Multiple variate logistic regression analysis revealed that compared with healthy control group,there was no relationship between the IL-1?-511C/T site polymorphisms and the susceptibility of pediatric epilepsy individuals,carrying at least one +3953T variant allele(CT and TT genotypes) had a significantly increased risk for pediatric epilepsy(adjusted OR=2.46,95%CI 1.03-5.87),compared with the wild-type genotype(+3953CC).Furthermore,individuals with epilepsy or febrile seizures family history had a significantly higher risk(adjusted OR=4.12,95%CI 1.28-29.34),compared with those with both CC genotypes.Conclusions These findings support the hypothesis that IL-1?-511C/T site polymorphisms have no relationship with epilepsy,but the IL-1?+3953C/T polymorphism may contribute to the risk of developing pediatric epilepsy.

OBJECTIVETo investigate the efficacy of Ilizarov fixator on cicatricial foot drop after burn.

METHODSSix patients with cicatricial foot drop after burn were treated with Ilizarov fixator during June 2004 approximately October 2007, the fixator was set on the leg and foot by fixed bone needles. Nuts on the threaded rod were turned from 3 post operation day, 2 approximately 4 rounds per time and 4 times per day in the first week, then 1 approximately 2 rounds per time and 4 times a day, which corrected the deformity of talipes equinus by shortening or lengthening the thread rod in the front and at the back. Ankle joint was maintained in neutral position for 2 approximately 3 months after effective correction. Weight carrying for patients was increased gradually after removal of fixator. Ankle joint was maintained in neutral position with fixator at least three months. Patients were followed up 5 approximately 10 months.

RESULTSAnkle joints from all patients were restored to neutral position after application with fixator for 4 approximately 6 weeks. All patients achieved 0 degrees dorsiflexion in weight carrying for whole planta pedis after use of fixator for 12 approximately 15 weeks with good locomotion function.

CONCLUSIONIlizarov fixator is safe and mini-injury, which is an effective method for treatment of cicatricial foot drop.

Adolescent ; Adult ; Burns ; complications ; surgery ; Child ; Cicatrix ; etiology ; surgery ; Clubfoot ; etiology ; surgery ; Contracture ; etiology ; surgery ; External Fixators ; Female ; Foot Deformities, Acquired ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.

Objective To understand the status and difference of breastfeeding behavior in urban and rural areas of Southwest China.Methods From March to July in 2011,3659 infants aged 6-24 months were selected by stratified cluster randomized sampling method in urban and rural areas of three provinces of Southwest China (Sichuan,Yunnan and Guizhou),including 1801 (49.2％)infants from urban areas and 1858(50.8％) from rural areas.Basic information of these infants,their families and breastfeeding was obtained by a questionnaire for the mothers or baby-carers.Descriptive analysis and survival analysis (Kaplan-Meier method) were used to describe breastfeeding behavior.Chi-square test and Log-Rank test were used to identify the differences of breastfeeding behavior between urban and rural areas.Results Early breastfeeding initiation rate within one hour after birth was 10.7％(355/3315),and the numbers of urban and rural areas were 12.3％(198/1604) and 9.2％ (157/1711),respectively,x2 =8.691,P＜0.05.Totally,20.3％(725/3575) of all infants were initially fed by breast milk after delivery,and 25.1％ (440/1754) in urban areas and 15.7 ％ (285/1821) in rural areas,x2 =49.192,P＜0.05.The exclusive breastfeeding rate and breastfeeding rate within four months after birth were 35.5％ (27.4％ in urban and 43.6％ in rural areas,x2=88.678,P＜0.05)and 76.2％ (68.5％ in urban and 84.3％ in rural areas,x2 =124.702,P＜0.05),respectively.However,the exclusive breastfeeding rate and breastfeeding rate within six months after birth reduced to 11.3％ (7.9％ in urban and 14.4％ in rural areas,x22 =18.001,P＜0.05) and 65.0％ (54.0％ in urban and 76.3％ in rural areas,x2 =199.662,P＜0.05),respectively.The median breastfeeding duration was 8.0 months (7.0 months in urban and 9.0 months in rural areas,x2 =96.780,P＜ 0.05).The most common reason of weaning was insufficient breast milk which accounting for 48.7 ％ of families [56.9％ (1161/2385) in urban and 39.9％(462/1157) in rural areas,x2=68.840,P＜0.05].Conclusions In Southwest China,intervention program should be implemented to improve the breastfeeding status.Breastfeeding behaviors are different between urban and rural areas in Southwest China.The initiation of breastfeeding in urban area is better,but the sustainability of breastfeeding is better in rural area.