Objective To study the effect and safety of intra-arterial thrombolysis combined with mechanical ad-juvant in the treatment of acute large artery occlusive infarction of anterior circulation and posterior circulation. Methods Fourty-tow patients were divided into anterior circulation group (24 cases) and posterior circulation group(18 cases). The recanalization rate, NIHSS score (National Institute of Health stroke scale), GCS score ( Glasgow coma score,GCS), BI ( Barthel Index) excellent rate, symptomatic intracranial hemorrhage rate and mortality was analyzed after intra-arterial thrombolysis combined with mechanical aids therapy. Results The anterior circulation group was mainly caused by car-diogenic embolism (15/24, 62.5%) and posterior circulation group was mainly caused by atherosclerosis thrombosis (5/18, 72.2%). The NIHSS score was significantly lower after treatment (8.3±4.9 vs. 8.1±5.7) than before treatment(15.1±5.3 vs. 16.8±7.8)(P=0.001 vs. P=0.001), the GCS score was significantly higher after treatment(13.9±4.4 vs. 12.8±4.2)than be-fore treatment(9.5 ± 3.8 vs. 9.6 ± 3.7)(P=0.001 vs. P=0.021). The symptomatic intracranial hemorrhage rate was signifi-cant higher in anterior circulation group (5/24, 20.8%) than in posterior circulation group (0,0%) (P<0.05). Compared with the anterior circulation group, the recanalization rate trended to increase in posterior circulation group (P=0.830).The symptomatic intracranial hemorrhage rate in anterior circulation group (5/24,20.8%) was significant higher than in pos-terior circulation group (0,0%) (P<0.05), the mortality was similar between these two groups. Conclusions Intra-arterial thrombolysis combined with mechanical adjuvant therapy can improve neurological deficit in acute large artery occlusive infarction and increase the recanalization rate,which is more suitable for the treatment of posterior circulation infarction.

Objective To investigate the effects of simvastatin on the abatement of the mRNA,protein expression of RhoA and the improvement of the cardiac remodeling and cardiac disfunction after the myocardiac infarction in rats.Methods Rats were divided into 3 groups: the control group,the myocardiac infarction group and Simvastatin intervened group.After 8 weeks,cardiac weight index and hemodynamics were observed,mRNA and protein expression of RhoA in cardiac muscles was measured. Results Compared with the control group,the cardiac weight index and the mRNA and protein expression were increased in rats with myocardiac infarction and the hemodynamics was worsened(P

Objective To study the molecular mechanism of injection with hepatocyte growth factor (HGF) at different doses on angiogenesis in myocardium of dogs with acute myocardial infarction (MI).Methods Sixteen 1.5-year-old male hybrid dogs,weighing 11-13 kg,were divided into 500 ?g HGF treatment group,1 000 ?g HGF treatment group,sham operation group,and no MI interference group,4 dogs in each group.Expressions of VEGF,HGF,CD31,and platelet factor Ⅷ in myocardium of dogs with MI were detected,the number of micro blood vessels was calculated,and correlation between angiogenesis and expression of HGF and VEGF was analyzed in 28 d after the model was established.Results HGF gene therapy could up-regulate the expression of CD31 and VEGF.The expression of CD31 and VEGF mRNA was 0.82 and 0.39 respectively in 1 000 ?g HGF group,and 0.47 and 0.21 respectively in 500 ?g HGF group.The expression of VEGF mRNA was 0.09 and no expression of CD31 mRNA was found in MI group.HGF could increase the angiogenesis in infracted myocardium.The microvascular density was 126.4?10.6,79.8?6.0,and 21.7?2.5/mm2,respectively,in 1 000 ?g HGF group,500 ?g HGF group,and MI group (P

Objective To investigate the morbidity rate of hyperuricemia and its association with hypertriglyceridemia and hypertension in elderly people in Fujian Quanzhou.Methods A crosssectional population survey for hyperuricemia was performed in Fujian Quanzhou.Questionnaire and physical examination were conducted in 1358 subjects.The levels of serum UA and lipid-profile as well as blood pressure were measured.Results In the same aged group,the level of blood uric acid was significantly higher in male (371.7±83.6) μmol/L than in female (294.8±66.5) μmol/L (t=15.8,P＜0.01).Blood uric acid concentration was gradually increased with aging in the group at age 40-70 years,but was gradually decreased with aging in female group aged over 70 years (F=12.1,P＜0.01).The total morbidity rate of hyperuricemia was 18.6％.The incidence of hypertriglyceridemia or hypertension in female with hyperuricemia was higher than those with normouricemia (22.1％ vs.10.5％,59.1％ vs.26.2％,x2=16.3,65.0,all P＜0.01).The incidence of hypertension in male with hyperuricemia was higher than those with normouricemia (54.6％ vs.42.8％,x2=4.0,P＜0.05).Conclusions The morbidity rate of hyperuricemia in elderly people is higher in south China coast than other region of China.The incidence of hypertriglyceridemia and hypertension in people with hyperuricemia is significantly higher than those with normouricemia.

Objective To explore the differences in clinical features between the latent autoimmune diabetes in adults (LADA) and type 2 diabetes mellitus (T2DM) in the elderly.Methods Clinical features of 41 cases with LADA and 49 cases with T2DM were retrospectively analyzed and compared.Results (1) Body mass index (BMI),fasting and postprandial levels of cpeptide,triglyceride (TG) and serum albumin were lower in LADA patients than in T2DM patients.(2) The levels of fasting and postprandial blood glucose were higher in LADA patients than in T2DM patients.(3) There were no statistically significant differences in the disease course,blood pressure (BP),and the functions of liver and kidney between LADA and T2DM patients.Conclusions As compared with T2DM patients,LADA patients have higher blood glucose level,lower BMI and TG level,and poorer function of islet B cell.But there is no significant difference in the chronic complications between two groups.

Objective To discuss the clinical effect of thumb and fingers reconstruction with vascular anastomosis transplantation from toes.Methods From April 2009 to April 2013,166 cases of thumb and finger defect were treated,including 46 cases Ⅰ °-Ⅲ° thumb defect and 120 cases Ⅰ °-Ⅴ° finger defects.Sixty-two cases were emergency reconstructed by vascular anastomosis transplantation from toes,the other 104 cases were subemergency reconstructed.Early functional rehabilitation was carried out postoperative.Results All 208 thumb and fingers in 166 cases with these procedures were survived.Patients were followed up from 4 to 24 months,averaged of 1 l months.The reconstructed thumb and fingers were all with abundant blood supply,having similar shape to the normal thumb and fingers,good pain and temperature sensation,with two-point discrimination of 6-10 mm,with normal range of joint activity,flexible function of finger to finger and finger to palm.Most patients were satisfied with the thumb and finger shape,regained life and work ability as before.The donor sites had no obvious discomfort,and walking and weight-bearing function remained normal.Conclusion For patients with thumbs Ⅰ °-Ⅲ° and fingers Ⅰ °-Ⅴ ° degree of traumatic defect,emergency and subemergency reconstruction of fhumb and fingers by vascular anastomosis transplantation from toes have good clinical effect and less damage to the donor site.

Total DNA of B. amyloliquefaciens and S. aureus were isolated and cut partially with Hind Ⅲ Separately, The genes for barnase and for staphylococcal nucl ease were obtained by PCR and cloned into pGEM7Z-f(+), The sequencing show that the n ucleotide (nt) sequence of the barnase is 99.3% homologous with the previously determimed sequence and the deduced animo acid (an)sequence found to correspond precisely to the previously determined sequence; the nucleotide (nt) sequence of the staphylococcal nuclease is 99.1% homologous with the previously determined sequence and the deduced amino acid (an) sequence 99.3% homologous with the previously determinded sequence.These have built basis of making use of special expression or activation of nuclease to produce the male sterility plant by plant gene engineering and to explore new antiviral strategy.

ObjectiveTo elucidate the clinical application value of intravascular ultrasound(IVUS) in assessing intermediate lesions and the relationship between serum levels of fractalkine,CD36 and LP-PLA2and severity of coronary artery atherosclerosis.MethodsOne hundred and twenty patients with unstable angina underwent coronary angiography.Then the patients were divided into two groups:severe lesion group (lumen diameter stenosis greater than 70％,including 40 patients),and the intermediate lesion group lumen diameter stenosis(50％～70％,80 patients).IVUS were performed in all patients to analysis the coronary lesions.Concentrations of CD36,fractalkine and LP-PLA2 were measured by means of ELISA.Results IVUS found that 74％ intermediate lesion patients had soft lipid plaques,while 48％ severe lesion patients had lipid plaques ( P＜0.01 ).Patients with severe lesion had larger plaque burden and vascular remodeling index than those of patients with intermediate lesions(P＜0.05～0.01).There were 59 patients(74％) in the intermediate lesion group underwent PCI.IVUS also found the PCI patients had larger plaque burden and vascular remodeling index.Concentration of CD36 was significantly higher in severe lesion group than that of intermediate lesion group (P＜0.05).ConclusionsIVUS could further clarify the characteristics of the intermediate and severe lesions,and provide guidance for PCI treatment.Plasma CD36 level could be used to predict pathological severity of coronary atherosclerosis.

Objective To explore the treatment method for femoral neck fracture in the young adult patients and discuss the corresponding curative efficacy.Methods Closed reduction and internal fixation with hollow screws were carried out in treatment of 58 young adult patients with femoral neck fracture.There were 37 males and 21 females at age range of 19-56 years(average 37.5 years).According to Garden classification,there were seven patients with type Ⅰ fractures,19 with type Ⅱ,23 with type Ⅲ and nine with type Ⅳ.Results Follow-up lasted for 0.5-7.0 years(average 3.8 years),which showed the average one stage healing time of 5.8 months in 50 patients.Nonunion occurred in three patients and avascular necrosis of the femoral head(ANFH)in five patients,of which six patients were treated with two stage sartorius pedicled iliac graft,with fracture healing in three patients.According to Harris evaluation,the result was rated as excellent in 29 patients,good in 22,fair in two and poor in five,with excellence rate of 88％.Conclusions Closed reduction and internal fixation with hollow screw takes advantages of minor wound,few complications,high healing rate and satisfactory function recovery,and is effective in treatment of femoral neck fracture in the young adult patients.Open reduction and internal fixation with sartorius pedicled iliac graft can be used as remedial treatment for fracture nonunion and avascular necrosis.

Objective To evaluated intra-articular injection of TNF-α inhibitors into the sacroiliac joint as an effective and viable alternative. Methods Sixteen patients with documented ankylosing spondylitis (AS), without steroids or disease modifying anti-rheumatic drugs (DMARDs) were performed CT-guided intra-articular injections of etanercept (TNF-α antagonist) at week 0, 4 and 8 (25 mg per dose). Similarly, 20 patients with AS in the control group received systemic etanercept therapy at a dose of 50 mg per week for 8 weeks. All patients were followed up clinically and evaluated periodically. Pathological features of sacroiliitis were observed with light microscopy and immunohistochemistry. Expression of cytokines in joint biopsy samples was estimated by RT-PCR. Image changes of sacroiliitis were observed by SPECT/CT and MRI. Ttest, t'tesr and χ2 Fisher's test were selected. Results All the 16 patients who received intra-articular etanercept, the mean value of radiological nuclide decrease of the SIJ ROI (region of interest) in the SPECT improved significantly after 8 weeks treatment [(1.38±0.16 vs 1.45±0.14) P<0.05] . Bone marrow edema and fat deposition in MRI were relieved significantly after 8 weeks (P<0.05). In 8 patients the expression of TNF-α and TGF-β mRNA in joint tissue decreased significantly after 8 weeks [(0.89±0.06, 0.84±0.05) vs (l.08± 0.19, 1.13±0.33) (P<0.05)]. The occurrence of gynonitis, enthesitis, chondritis, subehondral bony plate destruction, bone marrow inflammation and inflammatory cell index also decreased significantly (P<0.05). Participants given intra-articular injection showed significant clinical improvement after 8 weeks and 12 weeks treatment(P<0.01 ) in BASDAI score [(32±13) mm]. Conclusion This study has shown that intra-articular injection of etanercept in SIJ can improve joint function and quality of life. It has a satisfactory safety profile and is cost effective. This mode of treatment is most beneficial in local arthropathy of recent onset and in those patients who do not tolerate systemic etanercept therapy.