ObjectiveTo investigate the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP) level on the capacity load of patients with maintenance hemodialysis (MHD).MethodsOne hundred and twenty patients undergoing MHD were divided into two groups according to blood pressure levels:bad blood pressure control group with 72 patients and good blood pressure control group with 48 patients.NT-proBNP levels were detected before and after dialysis,and cardiothoracic ratio,left ventricular mass index ( LVMI ),swelling index,number of occurrences of low blood volume and ultrafiltration volume were measured and compared between two groups.The correlation between NT-proBNP and the above indicators was analyzed.ResultsThe systolic blood pressure,diastolic blood pressure,NT-proBNP before dialysis,cardiothoracic ratio,LVMI,swelling index and number of occurrences of low blood volume in bad blood pressure control group respectively were (159.7±18.2) mm Hg (1 mm Hg =0.133 kPa),(95.3±14.8) mm Hg,(11 837.13±1374.26) ng/L,0.61±0.12,(174.36±21.35) g/m2,2.93±1.72,12cases/week,while the indicators in good blood pressure control group were ( 131.6±17.3) mm Hg,(86.5±13.2) mm Hg,(7649.54±1106.18) ng/L,0.52±0.11,( 151.83±18.94) g/m2,1.02±1.48,26 cases/sweek.There were significant differences between two groups (P ＜ 0.01 ).It was showed that NT-proBNP difference between before and after dialysis had significant positive correlation with ultrafiltration volume(P＜ 0.05).NT-proBNP before dialysis had a significant positive correlation with systolic blood pressure,diastolic blood pressure,cardiothoracic ratio,LVMI and swelling index (P ＜ 0.05 or ＜ 0.01 ),while had obvious negative correlation with the number of occurrences of low blood volume(P ＜ 0.01 ).ConclusionsNT-proBNP level of MHD patients has close correlation with blood pressure,cardiothoracic ratio,swelling index,number of occurrences of low blood volume and ultrafiltration volume.Detecting the level of NT-proBNP can better evaluate the changes of blood volume in dialysis patients,adjust dialysis prescription in time,and ensure the adequacy of dialysis.It has important significance to improve the quality of life of MHD patients.

0.05). Conclusion CCM is a proper scaffold,on which KC and FB of tympanum maintain satisfactory proliferation and collagen secretion activity.

[Objective]To assess whether the canal compromise and the location of conus medullaris determine neurological deficit in burst fracture of the first lumbar vertebra(L1).[Method]Twenty-seven consecutive patients with L1 burst fracture were collected in the study.The compressive ratios of anterior and posterior heights of fractured vertebral bodies,the remains to the estimated ones of the original vertebral bodies were measured on the radiogram,the extent of spinal canal compromise was assessed by computed tomography,and the location of conus medullaris was determined by the MRI examination.The neurological status was evaluated according to the standard neurological classification of spinal cord injury(ASIA).[Result]The compressive ratio of the anterior height was 0.63,the posterior height was 0.91,the stenotic ratio of the canal mid-sagital diameter was 0.69,the stenotic ratio of the distance between pedicles was 1.14,and the stenotic ratio of canal area was 0.83.The group having the stenotic ratio of canal area below 0.5 was at significant risk of neurologic involvement than the control [above(or equal to) 0.5(P=0.049)],and the group with lower conus medullaris had more serious neurological deficit than the upper ones(P=0.046).[Conclusion]There is a significant difference of neurological deficit between the groups with the spinal canal stenosis level of more than 50% and less 50%,and the group with lower conus medullaris had more serious neurological deficit than the upper one.

Objective To explore the effect of elbow release and debridment with arthroscopy for elbow malfunction. Methods The study was carried out on 15 patients (male 11, female 4; age 21-63 years old, average 40.1 years old) with the use of arthroscopy to brisement accretion and articular capsule from August 2001 to December 2003. The mean course was 55.2 months (range, 8-24 months). The flexion angle of joint preopration was 15?-60?, average 30.4?, the extension angle was -80?--20?, average -51.2?. The diagnosis was osteophyma and liberum in 4. The old fracture of radius capitulum was in 2; the old fracture of ulnar olecranon in 2; the old fracture of condyle of humerus in 3; degeneration in 4. The brachial plexus anesthesia,the elbow hung to traction, interna and extra-pathway, to cut synovium and accretion fibers with shver, removal liberum and milling osteophyma, meanwhile brisement articular capsule. Pathology manifestation in arthroscopy: there were a lot hyperemia synovium and fiber accretion. There was cartilage exfoliation in 8, hyperplasy and liberum in 5, ossification of cicatricle in 2. The motion range of elbow was reexamined, if the extension function was restricted, release was performed on anterior soft tissue and capsule. If the flexion function was restricted, release was carried out on posterior capsule via posterior straight approach(3 cm supra point of olecranon). Results All patients recovered daily life and occupation postoperative 7 to 14 days. Transient ulnar nerve paralysis occurred postoperatively in one case, which recovered three months later. There were no blood vessel and nerve injury. The mean follow-up period was 14.1 months (range, 7-20 months). At the final follow-up, the flexion of joint post operation was 70?-120?, to improve average 60.5?; the extension of joint post operation was -20?--5?, to improve average 37.6?. In accordance with HSS scoring system, excellent 7, good 5, fail 3. Conclusion Using of arthroscopy to release elbow joint have many advantages such as less trauma, quick recovery and less sequela. The application in release with arthroscopy is a good way for elbow malfunction.

The endothelial cells activated by tumor cells are genetically stable and regress easily. Moreover, at the surface there are specific markers, which are easily accessible by system administration. This report review the studies of tumor treatment targeting at the activated endothelial cells.

Pain is a common complication after spinal cord injury. Clinical studies involve pain mechanisms, classifications and treatments,etc. Pain after spinal cord injury needs comprehensive treatment. However, each of these interventions may produce only small curative effect, so this article aims to emphasize the best evidences and provide clear, wise and prudent evidences for clinical decision by reviewing clinical researches about pain after spinal cord injury.

Objective To observe the changes of hippocampal NogoA-NgR1 signaling on postoperative cognitive function (POCD) in aged mice, and explore the potential underling mechanism.Methods Isoflurane anesthesia and laparotomy were applied to establish the POCD model.Forty aged male C57BL/6 mice were randomly divided into the following four groups (n=10): group O2+saline (group OS), group O2+NEP1-40 (group ON), group isoflurane anesthesia+laparotomy surgery+saline (group SS), and group isoflurane anesthesia+laparotomy surgery+NEP1-40 (group SN).Cannula placement was performed into lateral ventricle 7 days before the surgery.Animals were subjected to an administration of NEP1-40 (20 μg/2 μl) or isochoric saline via intracerebroventricular injection once daily for 8 consecutive days, injection was given from 2 h before isoflurane anesthesia to the last behavioral test.Open field test was performed at 5th d after operation.Contextual and cued fear conditioning training and testing were exhibited at 6th and 7th d after operation, respectively.The hippocampus was harvested 2 h after the behavioral test.Western blot was used to detect the expressions of NogoA, NgR1, RhoA, ROCK2 and GAP43.Golgi staining was applied to measure the changes of dendritic spines in hippocampal CA1 area.Results Compared with the groups OS and ON, the freezing time in the contextual fear conditioning test was significantly decreased, the contents of NogoA, NgR1, RhoA and ROCK2 were significantly increased, the content of GAP43 and the number of dendritic spine were significantly decreased in group SS (P<0.05).Compared with the group SS, the freezing time in the contextual fear conditioning test was significantly increased, the contents of RhoA and ROCK2 were significantly decreased, the content of GAP43 and the number of dendritic spine were significantly increased in group SN (P<0.05).Conclusion Over-activated of hippocampal NogoA-NgR1 signaling participated in the pathogenesis of POCD in aged mice.

Objective To observe the clinical efficacy of electroacupuncture in treating deglutition disorders after radiotherapy of nasopharyngeal carcinoma. Method Forty nasopharyngeal carcinoma patients with deglutition disorders after radiotherapy were randomized into a treatment group and a control group, 20 in each group. The control group was intervened by nourishing nerve, improving microcirculation, promoting nerve growth factor, and physical rehabilitation. Based on the treatment given to the control group, the treatment group was additionally intervened by electroacupuncture. Water drinking test was adopted to evaluate the deglutition function before and after intervention, and the clinical efficacy was compared. Result After intervention, there was no significant difference in comparing the deglutition function between the two groups (P>0.05). The total effective rate was 80.0%in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Electroacupuncture is an effective method in treating deglutition disorder after radiotherapy of nasopharyngeal carcinoma.

Objective:To discuss the variation of parameters in ambulatory blood pressure for neurally mediated syncope(NMS) in children,and to analyze the diagnostic value of ambulatory blood pressure pattern in children with NMS.Methods: Forty-seven children with NMS [20 males and 27 females,mean age(11.7?2.8) years] who came from Peking University First Hospital from July,2007 to March,2008 were included in the study.Twenty-three healthy children [12 males and 11 females,mean age(11.0?3.2) years] were recruited as control group.And the hemodynamic patterns of NMS were detected.Based on the hemodynamic patterns,they were divided into vasovagal syncope(VVS) group [16 children in total,7 males and 9 females,mean age(11.5?2.8) years] and postural tachycardia syndrome(POTS) group [31 children in total,13 males and 18 females,mean age(11.7?2.9) years].Parameters of children with different hemodynamic patterns in ambulatory blood pressure and diagnostic value of ambulatory blood pressure pattern were analyzed.SPSS 10.0 software was used for the statistical analysis of these data.Results: Mean diastolic pressure of the whole day,mean diastolic pressure in the day-time and mean systolic pressure at night in POTS group were higher than those of the control group,reapectively(P0.05).The systolic pressure differences in the day-time and at night in VVS group and POTS group were lower than those of the control group,respectively(P0.05).The non-spoon pattern rate of fluctuation curve of ambulatory blood pressure in VVS group and POTS group was higher than that of the control group(68.8% vs 17.4%,64.5% vs 17.4%,P0.05).The sensitivity,specificity and diagnostic coincidence of ambulatory blood pressure pattern to NMS was 66.0%,82.6% and 71.4%,respectively.Conclusion: There was autonomic nerve adjustment imbalance in children with NMS.And the diagnostic value of ambulatory blood pressure pattern to children with NMS was high.

Objective To evaluate the benefit of three dimensional (3D) reconstruction images with rotational digital subtraction technique for the clinical applications Methods Conventional two dimensional digital substraction angiography ( 2D DSA ) was obtained on A P and lateral view. Three dimensional digital subtraction angiography ( 3D DSA ) images were obtained by reconstruction of a rotational acquisition on a C arm (LCV+, GE Medical Systems) spinning at 40 degrees per second 53 cases of cerebral angiographies were performed (32 men and 21 women; the age ranged from 19 to 72 years, mean 46 3 years) Results In this series of 53 cases of cerebral angiographies, 5 cases of arteriovenous malformation were all correctly diagnosed by 3D DSA and 2D DSA . Seven cases were misdiagnosed as intracranial aneurysms at conventional 2D DSA but confirmed to be kinking of the vessel by 3D DSA . 41 cases were confirmed to be intracranial aneurysms Of the 41 cases, 5 cases were diagnosed as normal at 2D DSA but confirmed to be intracranial aneurysms at 3D DSA . The total consistency rate of 3D DSA and 2D DSA for the diagnosis of intracranial aneurysm is 77 4% (41/53) The consistent test shows that there was consistency between the two modalities (chi square test, ? 2=5 267, P