Objective:To investigate the correlation between ankle-brachial index(ABI)and intracranial atherosclerosis in patients with ischemic stroke.MetlaTds:qhe ABI of 73 patients with ischemic stroke were detected using vascular Doppler ultrasound;head magnetic resonance angiography(MkA)was performed using a 1.5 T magnetic resonance imahing system,and the extent of intracranial artery stenosis was graded.The correlation between ABI and the grade of intracranial artery stenosis in patieras with ischemic stroke was analyzed.Results:The ABI in patients without intracranial artery stenosis(n=38)was significantly higher than those with intracranial artery stenosis(n=35)(0.975±0.114 vs 0.837±0.096,P<0.001).The ABI was significantly negatively correlated with the extent of intracranial artery stenosis(r=-0.736,P=0.001).Conclusions:The ABI was negatively correlated with the extent of intracranial artery stcnosis.It can he used as a preliminary screening means of intracranial atherosclerosis.

The high mortality of paraquat (PQ) poisonings is mainly due to the lack of effective treatments. Most toxicologists recommend rapid initiation of charcoal haemoperfusion (CHP) to lower plasma PQ levels and to limit pulmonary and other organs uptake of PQ. Although there are considerable evidences of CHP efficacy in the reversion of the fatal outcome resulting from PQ poisonings, the usefulness of this therapy has been the subject of significant controversy with several evidences published in the literature showing a lack of clinical benefit in numerous cases. Considering that the blood concentration at a given time is directly related to clinical outcome, the rebound in plasma paraquat concentration after haemoperfusion may be partly relate to the poor clinical benefit, but may indicate the necessity for prolonged haemoperfusion. Continuous rather than intermittent haemoperfusion has been advocated for treatment of paraquat poisoning. However, 24h daily conventional pump driven haemoperfusion is usually impossible to carry out due to bleeding complications. Plasmapheresis is also a blood purification process. Unselective therapeutic plasma exchange is the first technology used for therapeutic apheresis (TA). However, limited efficacy by restricted plasma volume that can be exchanged in a single session is one of the severe limitations. To further increase the clearance of target molecules, plasma perfusion (PP) techniques was developed. modification of the conventional plasma perfusion in patients with paraquat poisoning has been reported and plasma levels of paraquat were reduced effectively.

Objective To measure the difference of radiosensitivity between small and large intestines toward high dose of radiation and investigate the role of stem cells in this difference.Methods C57BL/6 male mice,6-8 weeks old,were randomly divided as control group and radiation group received 19 Gy whole body γ-ray irridiation.Large and small intestines of the mice were collected 6,12,24,48,72 and 96 h after radiation.The proliferation and apoptosis of the large and small intestines and their stem cells were then detected by immunochemistry,and the change of stem cell number in the large and small intestines were detected by in-situ hybridization.Results HE staining showed that 19 Gy γ-ray irradiation caused more severe injury in the small intestine,and all the crypt in the small intestine were extinct at 48 h post-radiation.However,the proliferation index of crypt in the large intestine was as high as 0.23 (t =4.67,P ＜0.05).Compared with the small intestine,the apoptotic index of epithelial cells in the crypt of large intestine was much lower at 12 and 24 h after irradiation (t =-1.92,-2.42,P＜0.05).The apoptotic population of stem cells in the small intestine at 12 and 24 h post irradiation were significantly lower than that in the large intestine (t =-1.98,-2.33,P ＜ 0.05),and the number of stem cell in the large intestine was significantly higher than that in the small intestine 24,48 h after radiation (t =1.98,3.31,P ＜0.05).Conclusions The radiosensitivity of small intestine toward high dose of irradiation is significantly higher than that of the large intestine,where the difference in radiosensitivity of stem cells between large intestine and small intestine may be involved.

Objective To study the effect of expansion ex vivo on the hematopoietic reconstitution of umbilical cord blood (UCB) hematopoietic cells, and to find a probable way of UCB transplantation (UCBT) to be used on adults. Method Three groups of UCB hematopoietic cells were transplanted to lethally irradiated BALB/C mice: fresh cells, a half part of fresh cells and a half part of cells expanded for a week, cells expanded for a week. Results All the three groups of cells could reconstitute hematopoiesis. The cells in the latter two groups could more rapidly accelerate the recovery of early-period hematopoiesis. The death rate of the mice in second group was the lowest among three groups. Conclusion The way transplanted with a half part of fresh UCB hematopoietic cells and a half part of UCB hematopoietic cells ex vivo expanded for a week may be a probable one for adult UBCT.

[Objective]To evaluate the efficacy of nerve transfer for reconstructing the sensory function of the sole.[Method](1)Select saphenous nerve as donor nerve for the patients with the sensory loss beneath ankle level:dissect and cut off the saphenous nerve at the medialposterior aspect at upper-middle 1/3 of the leg and divide the gastrocnemius to expose the tibial nerve at the medialposterior aspect of the tibia, cut off partly nerve fibre of the tibial nerve and then end-to-end anastomose to the proximal end of the saphenous nerve. (2) Select sural nerve as donor nerve for the patients with sensory loss of sole only:dissect and cut off the sural nerve at the posterior aspect of the lateral malleolus, expose the tibial nerve at the posterior aspect of the medial malleolus and then cut off partly nerve fibre of the tibial nerve. The sural nerve was comdicted from the subcutaneous tunel at the anterior aspect of the Achilles's tendon to the posterior aspect of the medial malleolus and end-to-end anastomose to the partial nerve fibre of the tibial nerve. [Result]All the 9 cases were followed up from 1.5 to 2 years(mean 2 l months). The SCV(sensory conduction velocity) of the tibial nerve was ranged from 36.1 to 41.2 m/s, mean 38.3 m/s and the amplitude of wave (peak-to-peak amplitude) was a range from 7 to 15.3?V, mean 11.2 ?V by orthodromic electrophysiologic techniques. All 9 cases regained the sense of pain and touch of the sole.Three cases restored their sense of two point discrimination. All the patients expressed their satisfaction with their ability of walk and no muscles atrophy of the foot. The sensory loss in donor region was oberserved only lateral part of the foot beneath the lateral malleolus (sural nerve as donor nerve) and a small part of the anterior aspect of the ankle(saphenous nerve as donor nerve).[Conclusion]Nerve transfer can reconstruct the sensory function of the sole effectively.

Objective To analyze the clinical and pathological features of collecting duct carcinoma (CDC) of the kidney. Methods 11 patients with CDC were analyzed,among which 6 were males and 5 were females.Their age ranged from 22 to 67 years old with a mean age of 55.4 cases were found by routine health examination,4 cases were presented with gross hematuria and 3 cases had flank or abdomen pain.The CT scan showed an unclear boundary mass in kidney,with tumor sizes from 2.1 to 8.5 cm ( mean 5.6 cm).Only medullary involvement was present on CT in 3 cases,Medullary and cortical involvement in 5 cases,Medullary and pelvic involvement in 2 cases,and all involvement in 1 case.Infiltrative lesion has expanded kidney but maintains reniform contour.Contrast-enhanced CT scan showed lesion mild to moderate enhancement compared with surrounding parenchyma. Results Radical nephrectomy was performed in 8 cases and palliative nephrectomy in 3 cases.All patients were finally diagnosed by pathology.Grossly,the tumor is often appears gray or white.In HE staining,tumor showed prominent tubular or tubulaopapillary structures with desmoplasia and inflammatory reaction.Occasionally,some tumor cells take on a hobnail appearance.Immunohistochemical examination showed UEA-1 positive in all cases,EMA positive in 9 cases,PNA positive in 8 cases,and HMW-CK positive in 7 cases.Only 2 patients showed positive CD10.7 patients died within 6 to 47 months (mean 12.5 months),2 survived with tumor free for 9 months and 8 years respectively,one lost of follow-up,and one patient with distant metastasis is receiving postoperative chemotherapy. Conclusions Collecting duct carcinoma of the kidney is a rare histological type of renal cell carcinoma,whose final diagnosis depends on histopathological examination.Rapid progression,highly malignant,poor prognosis are the characteristics of this disease.

Objective To investigate the significance of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system in evaluating elderly patients with hyperglycemic hyperosmolar state. Methods Elderly patients with hyperglycemic hyperosmolar state were enrolled in the study from January 2003 to May 2008. The patients were divided into two groups according to the outcome: death group and survival group. APACHE Ⅱ scoring system was used on the day of admission and the scores were compared in the two groups. The risk factors for death were evaluated by logistic regression analysis. Results Forty patients were registered including 10 cases in death group and 30 cases in survival group. The mortality rate was 25%. There were no differences in blood glucose, serum sodium, blood osmotic pressure, serum creatinine and hemoglobin between two groups before the treatment (t=-1.50～1.53, all P>0.05). The APACHE Ⅱ scores were significantly higher in death group than in survival group on the day of admission(30.1±5.4 vs. 22.9±3.9,Z=-4.08, P<0.01). Multiple logistic regression analysis showed that APACHE Ⅱ scores on the day of admission were the independent risk factor for death. Age, sex, blood glucose, effective blood osmotic pressure, serum creatinine and hemoglobin were not related to mortality rate. Conclusions APACHE Ⅱ scoring system is a helpful method for evaluating the severity and outcome of patients with hyperglycemic hyperosmolar state.

Objective To enhance the understanding of cystitis, obstructive uropathy (OU) and chronic intestinal pseudo-obstruction (CIPO) in systemic lupus erythematosus (SLE). Methods We presented a case of SLE complicated with cystitis, OU and CIPO, and reviewed relevant English and Chinese literature. Results The case was a 37 year-old female with a history of SLE for 4 years. She developed urinary irritant symptoms for 1 year and abdominal distention for 1 month before admission. Ultrasound and cystoscopic studies revealed a thickening of bladder wall and reduced bladder volume; cystoscopic study revealed inflammatory and edematours mucosa; Ultrasound study and X-ray image confirmed the existence of OU and CIPO. Symptoms of urinary irritant and CIPO were relieved after initiation of prednisone and cyclophosphamide (CTX), but reducing the dosage of prednisone and CTX had caused a relapse. Conclusion Cystitis is a rare clinical manifestation of SLE, it is likely to be misdiagnosed. The pathological change of cystitis complicated with SLE is interstitial cystitis and is the most common cause of OU in SLE. OU is closely related to CIPO and it is suggested that patients with these complications may be classified as a unique subgroup of SLE. Intestinal obstruction is a severe complication of SLE with high mortality rate, clinicians should be aware of this unique subgroup of SLE and treat it properly.

OBJECTIVE To investigate the value of screening hospital urinary tract infection with UF-100 automated urine analyzer. METHODS It was to count the bacteria and white blood cells in 422 urine specimens with UF-100 as well as to culture the specimens quantitatively.Then the sensitivity and specificity of UF-100 counts and the correspondence of the two methods were evaluated with Yerushalmy mode. RESULTS Compared with the culture results,UF-100 showed a sensitivity of 81.5%,specificity of 63.9%,positive predictive value of 29.1%,negative predictive value of 95.0%,false positive rate of 30.5%,false negative rate of 2.8% and an accuracy of 67.2%. CONCLUSIONS The UF-100 is excellent in analyzing urine specimens,and its bacteria counts can be a valuable indicator in screening hospital urinary tract infection.

BACKGROUND:Monofocal intraocular lens can restore distant vision of cataract patients, butit is not suitable fornear vision recovery, so most ofpatientsstil need to wear glasses. In contrast, multifocal intraocular lens can make up for the shortcomings of the single lenstoim provenear vision and increase the rate oftaking off the spectacles.
OBJECTIVE:To compare the visual function of senile cataract patients after aspheric multifocal and monofocal intraocular lens implantation.
METHODS:Totaly 30 senile cataract patients with 50 affected eyes were randomly divided into two groups: the eyes were implanted with aspheric multifocal and monofocal intraocular lens as experimental group and control group, respectively. At 3 months after implantation, distance visual acuity at a distance of 5 m, the best corrected distance visual acuity,as wel asnear and intermediate visual acuity at a distance of 30, 60 and 100 cm were detected, respectively. Besides, contrast sensitivity at a spatial frequency of 0.8, 1.5, 6 and 18 cpd under light and dark environment was measured.
RESULTS AND CONCLUSION:At 3 months after implantation, the distance visual acuity at a distance of 5 m in the two groups was significantly better than that before surgery (P< 0.05); no significant differences were found in near and intermediate visual acuitiesat a distance of 5 m and 100 cm between two groups, but the near visual acuitiesat a distance of 30 and 60 cm in the experimental group were significantly higher than those in the control group (P< 0.05). In addition, the contrast sensitivity at different spatial frequencies under light environment had no significant differences between two groups; and compared with the control group, contrast sensitivity at the frequency of 6 cpd under dark environment was significantly decreased in the experimental group (P< 0.05), but no significant differences were found in the other spatial frequencies. These results show that aspheric multifocal intraocular lens can significantly improve the near and intermediate visual acuity of senile cataract patients compared with the monofocal lens.