Objective: To analyze the risk factors and the predictive value of LDL/HDL ratio in acute ischemic stroke recurrence.
Methods: A total of 143 patients with acute ischemic stroke treated in our hospital were studied. The patients were followed-up for 2 years, the risk factors and the predictive value of LDL/HDL ratio for stroke recurrence were analyzed.
Results: Single factor analysis indicated that lacunar infarction, hypertension, blood pressure, the levels of LDL, HDL, ratio of LDL/HDL, stroke scale score, life ability score were the risk factors of ischemic stroke recurrence. Multivariate analysis presented that hypertension, ratio of LDL/HDL, TG level were the independent risk factors for ischemic stroke recurrence. LDL and ratio of LDL/HDL were positively related to ischemic stroke recurrence, HDL was negatively related to ischemic stroke recurrence, P<0.05. The speciifcity and sensitivity of LDL/HDL for predicting ischemic stroke recurrence were at 81.16%and 95.65%respectively.
Conclusion: The predictive value of LDL/HDL ratio could help us to identify the patients with high risk of ischemic stroke recurrence which is important for the early clinical intervention.

Several signaling pathways are involved in clonal proliferation of lymphoma cells and disease progression. It has been shown that cyclic adenosine monophosphate (cAMP) signaling pathway, as an important intra-cellular messenger delivery system, is related to modulation of multiple physiological processes including cell prolifer-ation, secretion, metabolism and apoptosis. Manipulating the cAMP signaling pathway can induce cell cycle arrest and apoptosis of various malignant lymphoid cells, which involves mitochondria-dependent apoptosis and cAMP-modulated protein kinases as well as changes of intracellular mediators. In-depth research and analysis of cAMP-induced apoptosis in lymphoma cells would provide potential targets and possible therapeutic means for the treatment of lymphoma.

Mesenchymal stem cells(MSCs) have became the hot spot in cell tissue engineering,cell replacement therapy,gene therapy and transplant research fields. Recent studies have shown that changes in oxygen concentrations affect many biological characteristics of MSCs. Under different oxygen concentrations,MSCs have different proliferation,differentiation,migration and chemotoxis abilities. Hypoxia is a kind of common pathophysiological status,which can promote the proliferation,apoptosis,migration and chemotoxis abilities of MSCs,while hypoxia impacts the differentiation ability depending on different cell types. The mechanism of these response might be involved in hypoxia-inducible factor-1(HIF-1) ,chemokines and their receptors,and matrix metalproteinases. Hypoxia can activate HIF-1 signaling pathway,which upgrades the expression of stromal-derived factor-1(SDF-1) ,and forms microenvironments which stem cells are adapted to and grow in. SDF-1 increases the adhesion,migration and homing of circulating CXCR4-positive progenitor cells to ischemic tissue,and promotes degradation of extracellular matrix,then enhances the migration ability of MSCs by modulating the expression of matrix metalloproteinase and its protein as well.

Objective To identify the risk factors for postoperative reintubation in patients undergoing general anesthesia.Methods Forty-six thousand five hundred and seven patients,aged 18-83 yr,requiring reintubation after planned extubation in the postanesthesia care unit (PACU) of our hospital from January 2010 to December 2012,served as reintubation group.Patients in a 1∶5 ratio,aged 18-83 yr,admitted to the PACU of our hospital from January 2010 to December 2012,with successful extubation,served as control group.The general data of patients and operation-related factors including type of operation (emergency operation/elective operation),operative sites (head and neck,airway,within the chest,upper abdomen,lower abdomen,other sites) and operation time and anesthesia-related factors including requirement for opioids and muscle relaxants within 30 min before operation,and for neostigmine at the end of operation were recorded.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify reintubation-related risk factors.Results Thirty-two patients were reintubated after operation and the incidence was 0.069％.There was significant difference in age,gender,body mass index,ASA physical status,preoperative SpO2,complication with upper respiratory infections within 2 weeks before operation,chronic obstructive pulmonary disease (COPD),or systemic inflammatory response syndrome (SIRS) and hypoproteinemia,operative sites and operation time between the two groups (P ＜ 0.05 or 0.01).The logistic regression analysis showed that ASA physical status ≥ Ⅲ,complication with COPD or SIRS,and thoracic surgery were closely correlated with postoperative reintubation in patients undergoing general anesthesia.Conclusion ASA physical status ≥ Ⅲ,complication with COPD or SIRS,and thoracic surgery are risk factors for postoperative reintubation in patients undergoing general anesthesia.

Cerebellar Neoplasms ; genetics ; Chromosome Aberrations ; Genes, myc ; Genes, p16 ; Genes, p53 ; Humans ; Medulloblastoma ; genetics ; Mutation ; Neuroectodermal Tumors, Primitive ; genetics ; Supratentorial Neoplasms ; genetics

Epidemic diseases often occur following natural disasters, such as earthquakes. The most commonly seen epidemics after an earthquake include: enteric diseases (dysentery, typoid and paratypoid fever, cholera, hand foot-mouth disease, hepatitis A, hepatitis E, etc), arthropod-borne infectious diseases (malaria, Kala-Azar, Japanese encephalitis, etc), zoonosis (plague, hemorrhagic fever with renal syndrome, anthrax, etc), soil and epidemic water transmitted diseases (tetanus, gas gangrene, leptospirosis, etc), respiratory diseases (measles, rubella, influenza, etc), food-borne diseases (food poisoning caused by bacteria or bacterial toxin). This article reviews the controlling principles and measures for major infectious pathogens and epidemic diseases after earthquake.

Tropical medicine is defined by an association with geographic location, and it is a branch of medicine integrating preclinical medicine, clinical medicine and preventive medicine and investigating the diagnosis, treatment and prevention of diseases of tropical and subtropical zones. Military tropical medicine is a new interdiscipline based on tropical medicine and military medicine. With the improvement of health condition and the development of global economy, some tropical infectious diseases have been gradually controlled. However, factors such as increasingly frequent international communication and extreme changes in global climate induced by overproduction activity of human are leading to a redistribution of infectious diseases, which inevitably has impact on military strategies and tactics. This article reviews the past and prospect of military tropical medicine.

BACKGROUND:Intertrochanteric fracture is one of the common complications in patients with senile osteoporosis.Internal fixation is a common method in clinical therapy.Different internal fixators are selected in different studies.However,there are few studies on influential factors for outcomes of internal fixation at present.OBJECTIVE:To investigate related influential factors for outcomes of internal fixation in elderly patients with osteoporotic intertrochanteric fracture.METHODS:A total of 86 elderly patients with osteoporotic intertrochanteric fracture,who were treated in the Guanghua Hospital from May 2011 to May 2014,were enroled in this study.They were divided into three groups according to different manners of fixation.There were dynamic hip screw group (n=34),proximal intramedulary nail group (n=41) and proximal femoral compression plate group (n=11).Rate of fixation failure was compared among the three groups.The relevant factors affecting fixation effects were analyzed using univariate and multivariate analysis.RESULTS AND CONCLUSION:Internal fixation failure was detected in 5 patients (15％) in the dynamic hip screw group,11 patients (26％) in the proximal intramedulary nail group,and 4 patients (36％) in the proximal femoral compression plate group.Results of univariate analysis revealed that Evanse genotyping of patients,whether fractures were found on outer arm side,degree of osteoporosis,quality of reduction,steeple distance,whether combined with internal medicine diseases and selection of fixator were associated with internal fixation effects (P＜ 0.05).However,the internal fixation effects were not correlated with gender,age,hospital stay and ambulation time (P＞ 0.05).Multivariate analysis results demonstrated that unstable fractures,severe osteoporosis,fractures of the lateral arm,medical ilness,steeple distance ＞ 25 mm,and different internal fixators are independent factors affecting internal fixation effects in patients.

[Objective]To evaluate the surgical effect of posterior correction and instrumentation on the treatment of congenital kyphoscolosis deformity. [Methods]From july 2002 to august 2007,there were 15 congenital kyphoscoliotic patients,which included 8 males and 7 females with an average age of 11.6 years.The average Cobb’s angle of scoliosis was 78?(35?~156?),the average Cobb’s angle of kyphosis was 25?(15?~38?).For the 9 kyphoscolsis patients with hemivertebra,hemivertebra resection and intervertebral fusion and fixation with pedicle screw instrument system were used,Luque’s systems was used in 2 cases,for the 3 cases accompanied with Chiari malformation and/or syringomyelia and 1 case with neurofibroma,posterior correction and long segmental pedicle screw fixation were performed and the compensative curve was included in the instrumentation level.[Results]The operation time was 3.5~7.5 h (average,5.5 h ),the blood loss was 300~2 100 ml (mean,850 ml);the average follow-up was 43 months (10~82 months),and the radiographs taken from standing posteroanterior position and lateral side showed that the mean Cobb’s angle of scoliosis was corrected from preoperative 78? to postoperative 28?(11?~38?),with a correction rate of 64%.Postoperatively ,the angle of kyphosis was improved from the preoperative 25? to 16?( 7?~33?),with a correction rate of 36%.Solid fusion was achieved in all 15 cases of patients. But significant blood loss occurred in the operative procedure of neurofibroma. And long term follow-up showed 3 cases of rod fracture,1 case of crankshaft phenomenon.[Conclusion]The congenital kyphoscolosis deformity is a kind of complex syndrome concerning skeleton-muscle-nerve system,aim to different cause,strategy of treatment should be individualized.The posterior hemivertebral resection and correction is a safe and effective method for the prepubertal children with the congenital hemivertebrae deformity.

AIM:The different effect of bivalent immunoglobulin Yolk(IgY) was evaluated against snake venom between intragastric administration and intraperitoneal injection in mice with cobra or viper envenomation.METHODS:The venom of naja and viper was injected alternately into the leghorn hen.Bivalent anti-snake venom IgY was extracted by water dilution.The concentration of bivalent IgY in plasma was observed in indirect ELISA assay after bivalent anti-snake venom IgY taken orally.The gastric emptying function test was used for determining optimization time after gastric administration of IgY.The protective effect of bivalent anti-snake venom IgY was compared between intragastric administration and intraperitoneal injection in mice with cobra or viper envenomation.RESULTS:Bivalent anti-snake venom IgY was extracted from eggs laid in 28-42 d after the first immunization.The titers of Bivalent IgY against cobra and viper venom were 1:12 800 and 1:6 400.At the time of 2.5-3.5 h after bivalent anti-snake venom IgY was taken orally in three concentrations(75 mg,150 mg,300 mg?0.5 mL-1?20 g-1 BW),the gastric evacuation rate of mice was above 68.9%,with the plasma concentration of bivalent IgY in peak.The survival time of mice envenomation with snake venom was extremely prolonged(P