Objective To investigate the prognostic value of plasma brain natriuretic peptide (BNP) in patients with acute cerebral infarction. Methods Sixty-five patients with first-ever acute cerebral infarction and 32 healthy controls were recruited. The neurological deficits in patients with cerebral infarction were evaluated by using Chinese Stroke Scale (CSS).Plasma BNP levels were detected by immunofluorescence technique. Death and recurrent stroke events were followed up. Plasma BNP levels were compared between an event group and a non-event group, and the relationship between plasma BNP levels and poor prognosis was analyzed.Results Plasma BNP levels in patients with acute cerebral infarction was significantly higher than those in healthy controls (238.7 ± 131.6 pg/ml vs 38.7±23.8 pg/ml, P <0.01). Nine patients (13.8%) died, and 8 (12.3%) had nonfatal recurrent stroke during the follow-up period. Compared to the non-event group, the baseline plasma BNP levels in the death/recurrent stroke event group were significantly higher (304.0 ± 134.9 pg/ml vs 214.4 ± 120.9 pg/ml,P < 0.01). There was significant correlation between plasma BNP levels and CSS scores (r = -0.359, P <0.05). After performing multivariate analysis of various risk factors, it found that BNP levels (OR = 3.5, 95 % CI 2.1 to 5.8, P < 0.01), advanced age (OR = 4.1,95% CI 1.7 to 9.2, P <0.01) and CSS scores (OR =2.6, 95% CI 1.6 to 4.3, P <0.01)were the independent predictors of poor outcome. Conclusions The increased BNP levels are the recent death and recurrent independent predictors in patients with acute cerebral infarction.

Objective To characterize the foot pressure distribution during walking of the male college students with a normal left foot and toes-out right foot gait.Methods Forty-two male college students age 20 to 25 with a toes-out gait on the right side and a normal gait on the left side were recruited.The FOOTSCAN system was used to measure their foot pressure distribution while walking.Results There were significant differences between the normal and the toes-out foot with regard to the peak pressure on the third metatarsal bone [(45.05 ±13.91)N/cm2 vs (26.83 ± 10.82) N/cm2] and pressure under the arch [(4.48 ± 1.94) N/cm2 vs (2.90 ±1.57) N/cm2],as well as the time for the appearance of peak pressure under the 1st and 4th metatarsal bones.The foot regional impulse was significantly lower on the normal side than on the toes-out side for toes 2 to 5 and for metatarsal bone 2.Conclusion In contrast to the normal foot,the pressure center of the toe-out foot deflects to the inner side.This results in slanted power application instead of straight ahead,so the strength in the direction of travel is small.And it will produce torsion between the tibia and fibula,which makes the tibia appear introverted and causes excessive friction in the knee joint.This will lead to injury of the knee joint.

Objective To analyze the related factors of local recurrence in patients with rectal cancer after Dixon operation. Methods A retrospective analysis of clinical data of 100 patients from September 2005 to September 2007 in our hospital by TME standard surgicai treatment of low rectal cancer was carried out. Results Of 100 patients, the pre-sacral recurrence rate was 10. 0%, with gender, age, tumor size, tunor invasion lumen circumference,depth of invasion,lymph node metastasis and Duke's stage has nothing to do with the gross type,histological type and lumen,peritoneal tumor cell shedding,and as an independent prognostic factor. Of 90 patients without local recurrence,the 5-year survival rate was 76. 0% ,haff of the survival of 62 months;10 cases of local recurrence,5-year survival rate was 5. 0%, half of the survival of 24 months, suggested that local recurrence in patients influenced the prognosis. Conclusion The low local recurrence of rectal cancer related factors were gross type,histological type and the intestine, peritoneal tumor cells shed, seriously affect the prognosis of patients with local recurrence.

Objective To investigate the inhibition mechanism of sodium selenite on HCT116 cells.Methods In the present study,we explored the cytotoxicity induced by sodium selenite and the underlying mechanism by MTS assay,WesternBlot,and small RNA interference technique.Results It was found that the sodium selenite at 5uM concentration could indeed reduce the viability of colon cancer cell line HCT116 by a large margin through increasing the generation of reactive oxygen species (ROS),and that the increased levels of ROS could activate c-Jun Nh2-terninal kinase 1 (JNK1).Additionally,knockdown expression of JNK1 or p53 by using RNAi attenuated the cytotoxicity induced by sodium selenite,indicating that both of JNK1 and p53 are required in the process of cell death induced by sodium selenite.Conclusion The sodium selenite could induces cell death in HCT116 through oxidative stress by involvement of JNK1 and p53,both of which play a critical role in toxicity of sodium selenite.

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the periopera?tive blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture dis?placement, the patients were divided into two groups:GardenⅠ-Ⅱgroup and Garden Ⅲ-Ⅳgroup, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of opera?tion, the patients were divided into four groups:Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ;Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ;Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden gradeⅢ-Ⅳfemoral neck frac?ture group, the preoperative hidden blood loss was significantly higher than that of the Garden gradeⅠ-Ⅱfemoral neck fracture group (t=2.267, P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss vol?ume and total blood loss volume of hemiarthroplasty groups (402.1 ± 36.8 ml, 641.3 ± 53.2 ml, 880.7 ± 61.7 ml, 1 246.1 ± 76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the de?gree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly.

Objective To analyze the MRI features of chordoid meningioma (CM),and to compare with other meningiomas. Methods Clinical and MRI features of 7 patients with CM confirmed by pathology were analyzed retrospectively.Featrues of every MRI sequence were investigated qualitatively.Meanwhile normalized signal ratios of each sequence were analyzed furtherly,including normalized T1 weighted image intensity ratios (NT1 ),normalized T2 weighted image intensity ratios(NT2 ),normalized ADC ratios (NADC)and normalized T1 WI contast enhancement intensity ratios (NCE).Fisher ’s exact test and Dunnett T 3 test were employed to analyze the difference of CM and nonchordoid meningiomas (34 cases of WHO grade Ⅰ meningioma,1 6 cases of nonchordoid WHO grade Ⅱ meningioma,and 5 case of WHO grade Ⅲ meningioma).Results The CM showed hyperintensity on T2 WI and meanwhile other nonchordoid meningiomas demonstrated isointensity,hypointensity or slight hyperintensity on T2 WI.Evaluations of DWI revealed variable signal intensities of CM.But all 7 cases had no obvious restricted diffusion,and increased signal was seen on the ADC map in each patient.The solid parts of CM enhanced markedly after contrast agent injection.Quantitative indicators NT2 , NADC and NCE of CM were higher than other meningiomas(P <0.01),but NT1 showed no statistic difference between CM and other meningiomas (P =0.889).Whether there was cyst,necrosis,orflow void sign on T2 WI,and no matter with or without perifocal edema,dural tail sign and a broader base among meningiomas had no significance in differentiating CM and other meningiomas.Conclusion CM has typical MRI features.The tumors show hyperintensity on T2 WI,especially have no obvious restricted diffusion and enhance markedly after contrast.The measurement of NT2 ,NADC and NCE enables reliable preoperative prediction of the atypical histopathologic diagnosis.

Objective To investigate the diagnosis and operation treatment of primary intrahepatic cholangiocelhlar carcinoma (PICC), for improving the level of diagnosis and treament of PICC. Methods The clinical data of 18 cases with PICC confirmed by operation were analyzed retrospectively. Results In the early stage, no specific symptoms was found in all the 18 cases, the positive cases of AFP, CEA, CA199 and live cirrhosis were 2, 4, 3 and 4. The diagnostic rates of ultrasound examination, CT and MRI were 11.1%(2/18), 42.9%(6/14) and 45.5% (5/11 ). Seven cases were diagnosed as suffering from PICC and the others were misdiagnosed. Of all the 18 patients, 8 cases underwent radical resection and 10 cases received palliative excision. Conclusions PICC patients lack clinical features and serum tumor marker,the rato of misdiagnosis is high, but that of radical resection is low. Knowing its clinicopathological features well. Radicalresection is the best way for treatment of PICC.

Objective To evaluate the feasibility of Selective Portal Vein Embolization(SPVE)in rabbits with the mixture of ZT glue and Lipiodol.Methods Sixteen white New Zealand rabbits were randomly divided into 2 groups:Group A,ZT glue:Lipiodol(1:2)mixture and Group B Lipiodol group.SPVE of left branch was performed in each group under digital subtraction angiography.The distribution feature of the embolic agents and the histopathology of liver in each group were observed.The weight ratio of the right lobe to the whole liver at the 30th day after SPVE were recorded and analyzed.Results Permanent embolization were occurred in group A.Recanalization was appeared in group B.Atrophy of the embolized lobes and compensatory hypertrophy of none-embolized lohes was,observed..The weight ratio of the right lobe to the whole liver Was 69.41±5.10% in group A.There was statistical difference between these two groups(P＜0.05).Conclusion There were permanent embolization after SPVE with the mixture of ZT glue and lipiodol.SPVE induced atrophy of the embolized lobes of liver and compensatory hypertrophy of none-embolized lobes.

Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.
Humans ; Maxillofacial Abnormalities ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Thigh ; surgery

BACKGROUND:After internal fixation, limb fracture nonunion is the most common complication. Many factors affect fracture healing, but in recent years researchers have found that serum leptin may be involved in the process of fracture healing to regulate a variety of metabolisms. OBJECTIVE:To analyze the relationship between the changes of serum leptin and fracture healing in patients with long tubular fracture of the limbs after internal fixation. METHODS:Sixty patients with long tubular bone fracture who underwent internal fixation treatment were selected, and divided into two groups, union group (n=30) and nonunion group (n=30), according to the degree of fracture healing at 8 months after operation. Another 30 healthy volunteers served as normal control group. Peripheral blood samples were extracted before and after internal fixation to detect the changes in serum leptin levels using ELISA. RESULTS AND CONCLUSION:Preoperative serum leptin level was higher in the union group and nonunion group than the normal control group as wel as higher in the union group than the nonunion group (P < 0.05). There was no difference in the serum leptin levels in the union group before and after operation, but the nonunion group had a higher preoperative serum leptin level than the postoperative level. These findings indicate that the serum leptin may have an influence on fracture healing.