ObjectiveTo investigate preliminary applic ation values of intravascular ultrasound(IVUS)in the carotid artery narrowing of transient ischemia attack (TIA) patients. MethodsIVUS has been used to 4 TIA patients with carotid artery narrowing identified by carotid artery echo, following carotid stenting and completion angiogram to detect evidence of inappropriate stent deployment. ResultsIVUS revealed the vessel wall structure, plaque morphology, measured accurately the narrowing degree of carotid artery. The narrowing percent identified by IVUS was larger than angiogram, and IVUS was more sensitive in detecting plaque than digital subtraction angiography(DSA). Four patients accepted stent deployment successfully.ConclusionsDSA underestimated the severity of the lesion. IVUS more accurately evaluates the extent and characteristics of the lesions than DSA, it is an important and useful component of carotid artery stent procedures.

Objective To investigate the role of p21-activated kinase 1 (PAK1) in colorectal mucosal carcinogenesis and the relationship between PAK1 expression and biological behavior of colorectal carcinoma. Method PAK1 was detected with immunohistochemical method in 10 normal colorectal mucosas,40 colorectal villous or tubular adenomas and 60 colorectal carcinomas. Results The positive rate for PAK1 was 10.0% in normal colorectal mucesas,and 25.0%, 33.3% and 33.3% in slight, moderate and severe dys-plastic adenomas, respectively, 65.0% was found in colorectul carcinomas. The positive rate for PAK1 in col-orectal carcinomas was higher than that in normal colorectal mucosas(P<0.01), colorectal villous or tubular adenomas(P<0.01), slight dysplastic adenomas(P<0.01) and moderate dysplastic adenomas (P<0.05).The positive rate for PAK1 of poor differentiated colorectal carcinomas was higher than that of high differentiated ones (P<0.05), and the positive rate for PAK1 of patients with lymph node metastasis was higher than that of patients without lymph node metastasis (P<0.05). In clinical stages, the positive rate for PAK1 in Dukes C and D stages patients was higher than that in Dukes A stage patients, respectively (P<0.05). Conclusion PAK1 maybe play some role in the process of carcinogenesis of colorectal mucesa, and be used as an useful marker for assessment of the biological behavior and prognosis of colorectal carcinoma.

Objective To investigate the mRNA and protein expressions of Nav 1.1 and Nav 1.2 in hippocampus following traumatic brain injury ( TBI) in rats.Methods After the lateral fluid percussion model was established in adult male Sprague Dawley rats,the rats were sacrificed at 2,12,24 and 72 hours after percussion and collected ipsilateral hippocampus for detecting mRNA and protein expressions of Nav 1.1 and Nav 1.2 by means of fluorescent quantitation RT-PCR,Western blot and immunofluo rescence staining.Results The mRNA expressions of Nav 1.1 and Nav 1.2 were significantly down-regulated (P<0.01) in hippocampus and reached the lowest level at 2 hours following TBI.The protein expression of Nav 1.1 was significantly down-regulated (P<0.01) but recovered near to level of control group at 72 hours after TBI.While there was no statistical difference on protein expression of Nav 1.2 in hippocampus after TBI compared with control group (P>0.05).Conclusion TBI induces significant down-regulated mRNA and protein expressions of Nav 1.1 in the hippocampus,which may be one of molecular mechanisms for functional alternation of sodium channels and excitotoxic action following TBI.

Objective To analyze causes for postoperative coxa vara and anti-rotation nail cutting-out after treatment of brittle femoral intertrochanteric fractures with proximal femoral nails ( PFN ).Methods An retrospective study was done on 227 patients with intertrochanteric fracture treated with PFN from June 2006 to February 2009. The causes for postoperative coxa vara and anti-rotation nail cutting-out were analyzed. Harris score was used to evaluate the functional recovery of the hip joint. Results Of all, 221 patients were followed up for 12-48 months (mean 23 months) and six patients were died from serious internal disease within one year. According to Harris evaluation system, the results were excellent and good in 183 patients, fair in 30 and poor in 14. Postoperative coxa vara and anti-rotation nail cuttingout occurred in 16 patients, eight of whom received reoperation to remove internal fixation and skeletal traction at abducent position and the other eight received prosthetic replacement. Conclusions Treatment of proximal femoral fracture with PFN requires a high precision of reduction and operation. Many factors including lateral cortical bone conditions of tuberosity, postoperative patient's cognitive condition,use of improved Jensen-Evans classification and Singh's classification may affect operation outcome.

Objective To investigate the diagnosis value of aortic aneurysm with MRI.Methods Two radiologist analysed 312 cases MRI of clinically suspected aortic aneurysm retrospectively,and screening 198 cases of aortic aneurysm,analysed by double blind method.Among these patients,there were 112 male and 87 female,aged 9 to 82 years(mean age of 50.4 years).86 cases underwent X-ray angiography(XRA) examination,and 79 cases with operation.Results The MRI showed 22 cases of ture aneurysm,19 of false aneurysm,127 of dissecting aneurysm,26 of Marfan′s syndrome and 4 of compound aneurysm.Contrast analysed the XRA,CT and operation,the sensitivity and accuracy of MRI is 99% and 94%.Conclusion The MRI is an accurate and safe method for detecting aortic aneurysm.

Objective To assess the value of coronal MPR of 64-slice spiral CT in investigation of the cause of bowel obstruction. Methods Thirty-eight patients with different kinds of bowel obstruction underwent 64-slice spiral CT examination, and the data of axial and coronal image were reconstructed. Then the images were analyzed respectively by 4 readers in group A and B. Doctors in one group viewed the axial images first, then the coronal images, while in the other group viewed the coronal images first and then the axial images. The CT findings were compared with the surgical and pathologic results. Results The accuracy of coronal MPR of 64-slice spiral CT for investigating the cause of bowel obstruction was similar to that of axial MPR (86.84% vs 89.47%), and both had high accuracy. Diagnostic accuracy and confidence of doctors were improved obviously with the combination of axial images and coronal images (both 94.73%). Conclusion Coronal MPR of 64-slice spiral CT has very high clinical application value for diagnosing bowel obstruction. Diagnostic accuracy and doctors' confidence are improved with the help of axial images.

The 34 cases in the treatment group were treated with allicin injection through Murphy drip for a course of 10 days with nitroglycerin group as control. Results demonstrated that the total effective rate for symptoms and ECG were 82% and 62% respectively for the treatment group. It also markedly lowered the level of plasmal endothelin, and that of blood sugar in diabetics'. Adverst effects included local pain at the injection site and headache, the incidence of which were 18% and 6% respectively. This therapy is a satisfactory one for stubborn angina pectors.

Glioblastoma multiforme (GBM) is the most common primary brain tumor and the most malignant astrocytoma in adults, with rare extra-cranial metastases, especially for subcutaneous metastases. It could be easily misdiagnosed as primary subcutaneous tumor. In this report, we describe a patient with pontine GBM who developed a subcutaneous swelling at the ipsilateral posterior cervical region 8 months after operation, and the pathological and immunocytochemical examination carry the same characteristics as the primary intracranial GBM cells, which defined it as subcutaneous metastasis. GBM with subcutaneous metastasis is extremely rare, and knowledge of a prior intracranial GBM, pathological examinations and immunocytochemical tests with markers typically expressed by GBM are of vital importance for the diagnosis of GBM metastasis. Surgical resection of subcutaneous swelling, followed by chemotherapy and radiotherapy, could be the best strategy of treatment for the patients with GBM subcutaneous metastasis.
Adult ; Astrocytoma ; Brain Neoplasms ; Glioblastoma ; Humans ; Neoplasm Metastasis

Objective To study the clinical curative effect of syndrome differentiation-based treatment with traditional Chinese medicine on patient with Chronic Kidney Disease (CKD3-4). Method According to prospective multicenter randomized controlled study which was applied to the patients with CKD3-4 , the total of 339 patients were divided into two groups. To one group as standard including 167 patients ,the other including 172 patients. Chinese Traditional Patent Medicine single or combined-prescription oral treatment according to syndrome differentiation-based treatment was employed. To the other group as reference , Chinese Traditional Patent Medicine oral treatment according to experienced rule was applied. The clinical curative effect results were obtained after a 24 weeks-treatment. Result The Scr ,eGFR and UTP with CKD3 in standard group illustrate statistics significance (P<0.05). On the opposite, those of the reference group remain insignificance (P > 0.05). The clinical curative effect result of patient in standard group was better than that of reference group. About the clinical curative effect of CKD4, no statistics significance difference (P > 0.05) could be found between groups or between patients in one group. The TCM score of patient with CKD3-4 in standard group have improved (P < 0.05) according to baseline. However, that of reference group did not show any statistics significance (P > 0.05). Conclusion Syndrome differentiation-based treatment with traditional Chinese medicine illustrated a better result in protection of renal function, reduction in urinary protein and decline in TCM score than the treatment according to experienced rule.

Obstructive sleep apnea hypopnea syndrome(OSAHS)is one of the most common sleep disorders in both adults and the elderly.A large number of studies in recent years have shown that OSAHS may increase the risk of cognitive impairment.This article summarizes the latest research findings on cerebrospinal fluid and plasma biomarkers associated with Alzheimer disease(AD)in patients with OSAHS,as well as how various treatment methods for OSAHS can relief the symptoms of OSAHS and alter the levels of AD biomarkers simultaneously,so as to emphasize the importance of treating OSAHS symptoms to prevent and delay the development and progression of AD.