Overweight or obesity is a risk factor for many chronic diseases, such as cardiovascular and cerebrovascular disease. Overweighed people have higher risk of stroke occurrence. However the relationship between stroke patient prognosis and body weight is controversial. Based on many studies, there are currently two opposite opinions. One believes that the body weight higher than normal is associated with more adverse effects with regard to stroke patient prognosis, including stroke recurrence, functional recovery and risk of death. The opposite opinion believes that the body weight higher than normal is protective in stroke patients. The present article reviews the relationship between body weight and stroke occurrence and prognosis, in order to provide guidance and reference for weight management of stroke patients during their rehabilitation.

Objective To study the efficacy of interferon Alfa-lb( IFN?-lb) combined with lamivudine in the treatment of chronic hepatitis B. Methods 103 patients with chronic hepatitis B were divided into three groups which were comparable.30 patients were treated with IFN?-lb for about 6 months;38 patients were treated with lamivudine for about 12 months; And the last 36 patients were treated with IFN?-lb and lamivudine. The serum ALT,HBV-DNA,HBV-Marks were studied using electrochemiluminescence technique,fluorescent quantitation poly-merase chain reaction(PCR) and so on. Results The serum level of ALT,HBV-DNA and HbsAg in patients which were treated with IFN?-lb and lamivudjne showed significantly lower than the other groups(P

Objective To evaluate the value of real-time enhanced-ultrasonography (EUS) in the diagnosis of hepatic tumor. Methods Twenty-nine patients with 34 hepatic solid lesions were examined by real-time EUS,including 16 primary liver malignant tumors,4 metastatic liver tumors,5 focal nodular hyperplasias (FNH),and 9 hemangiomas. All the cases were confirmed by histopathology. The ultrasound unit (Esaote Megas) with real-time EUS technique was used. The contrast agent used was SonoVue (Bracco,Italy). Results After injection of SonoVue,all the lesions were variously enhanced on real-time ultrasonogram. A holistic inhomogeneous enhanced pattern with quick disappearing was mostly detected by real-time EUS in hepatic malignant tumors,a peripheral and centripetal enhanced pattern was mostly shown in hamangiomas,and a radial centrifugal enhanced pattern with homogeneity and quickly was observed in FNHs. If the lesions with enhancement in arterial phase and disappearing in portal phase after injection of SonoVue were regarded as a sign for malignant liver tumor,the sensitivity,specificity and accuracy in the diagnosis of liver cancer with real-time EUS were respectively 95%(19/20),100%(14/14) and 97% (33/34). Conclusions The dynamic enhanced fashions and various enhanced features in various hepatic tumors will be reflected by real time EUS,which improves the accuracy of ultrasonography in the diagnosis of liver tumors.

Objective To investigate the diagnosis of hepatic tumors by contrast-enhanced color Doppler ultrasonography. Methods Thirty-two patients with known focal liver lesions(diameter 11-112 mm,mean 43 mm) were studied with color Doppler flow imaging(CDFI) before and after injection of 2.4 ml SonoVue at the concentration of 5 mg/ml. The pathological diagnosis included 13 benign lesions and 19 malignant ones. Analysis was performed on signal intensity of intratumoral vascularity,time of enhancement duration,resistant index and maximum velocity of intratumoral arterial blood flow. The data were compared between benign and malignant lesions. Results Before injection of SonoVue,intratumoral blood flow could be detected among 53.8 %(7/13) benign lesions and 78.9 %(15/19) malignant tumors. However these detection rates went up to 76.9 %(10/13) and 100%(19/19) respectively after administration of SonoVue. Significant difference between benign and malignant tumors was observed in time of enhancement duration. Furthermore RI showed significant difference between benign and malignant lesions.Diagnostic accuracy of hepatic tumors increased from 75.0 %( 24/32 ) to 90.6 %(29/32) after enhancement. Conclusions The clinical results showed the ability of contrast-enhanced CDFI in reflecting the blood supply of the hepatic tumors,demonstrating the high sensitivity and specificity of the technique,which could be of great value to the diagnosis of hepatic tumors.

Objective To evaluate the efficacy and toxicity of anthracycline and taxane combination regimen in the treatment of advanced breast cancer in patients who were previously treated with anthracycline and taxane.Methods Twenty-six patients who previously failed to respond to anthracycline and taxane based chemotherapy received pemetrexed and tegafur combination regimen (pemetrexed:500 mg/m2,ivgtt on the first day; tegafur:80 mg/(m2 · d),twice daily during day 1-14).The regimen was repeated at least two cycles of three weeks each and the clinical response was recorded at two weeks after treatment.Results Of the 26 patients,he tumor control rate was 65.3％ (17/26),and the overall response rate was 46.2％ (12/26),including 3 patients with complete remission and 9 patients with partial remission.The symptoms were stable in 5 patients and improved in 9 patients.There was no severe complications or death observed.The most frequent treatment-related adverse events were myelosuppression,nausea,vomitting,rash and hepatic function impairment.Conclusion Pemetrexed combined with tegafur in the treatment of patients with advanced metastatic breast cancer who did not respond to anthracycline and taxane treatment is effective with minimal adverse reactions and can be tolerated by patients.

BACKGROUND:Pedicle screw fixation has been used in children with thoracic injury. Conventional method is screw implantation by hand. This method can meet the needs of surgery, but its accuracy was low, and incidence of complications was high. The application of digital image navigation aid module is possible. OBJECTIVE:To study accuracy and safety of digital image navigation aid module in thoracic pedicle screw placement. METHODS:Eight thoracic vertebral bodies were equal y and randomly assigned to the manual insertion group and the digital image navigation aid module group. Manual insertion group received manual screw insertion. In the digital image navigation aid module group, navigation aid module was made according to CT scan results combined with principle of reverse engineering and rapid prototyping. Pedicle screw was placed using the digital image navigation aid module. RESULTS AND CONCLUSION:(1) Success rate of once screw set was significantly higher in the digital imaging navigation aid module group than in the manual insertion group (P<0.05). (2) Twenty-eight screws were implanted in the digital image navigation aid module group and manual insertion group separately. The excellent and good rate of screw placement was 96%in the digital image navigation aid module group and 75%in the manual insertion group (P<0.05). (3) These findings suggested that digital image navigation aid module can effectively improve the success rate of pedicle screw insertion. Moreover, this method is simple, easy to operate, and can make a personalized nail placement program for each child.

Objective To explore the effect of latissimus dorsi musculocutaneous flap for repairing severe soft tissue defect of the elbow.Methods Seventeen patients with severe soft tissue defect of the elbow were repaired by latissimus dorsi musculocutaneous flap.Ten patients were performed transfer of skin flap for functional reconstruction,9 patients reconstructed elbow flexion,and 1 patient reconstructed elbow extension.Seven patients' tissue defect were repaired by cover type musculocutaneous flap,and the areas of these flaps ranged from 6 cm × 10 cm-12 cm × 27 cm.Results All the musculocutaneous flaps kept alive.After an average postoperative follow-up for 12-40(22.0 ± 9.6) months,the color and luster of the flaps were satisfying.There were no scar contracture of the flap and no bulkiness of the elbow.Ten patients performed transfer of skin flap for functional reconstruction,and the range of motion was 100°-140° of flexion and-20°-0° of extension.Muscle power was M3-M5.Hand function was near normal.Conclusion Latissimus dorsi musculocutaneous flap is an ideal surgical method to repair the severe soft tissue defect of the elbow.

BACKGROUND:The blood loss and the need of blood transfusion after bilateral total knee arthroplasty are very high. Therefore, the use of medicine such as tranexamic acid in total knee arthroplasty is overheated in recent years. Tranexamic acid has been proved to be able to decrease the blood loss after total knee arthroplasty, while the study of its use in bilateral total knee arthroplasty is seldom. OBJECTIVE:To observe the effect and safety of tranexamic acid on perioperative blood loss and the change of hemoglobin in patients undergoing bilateral total knee arthroplasty. METHODS: We selected 69 patients who received bilateral total knee arthroplasty and divided them into two different groups randomly. The patients in the experimental group were given 1 g of tranexamie acid dissolved in 100 mL of 5% glucose solution through intravenous infusion. Those in control group were only given 5% glucose solution 100 mL. Total blood loss, intraoperative blood loss, the hidden blood loss, amount of postoperative drainage, the ratio of blood transfusion, hemoglobin, D-dimer, prothrombin time and activated partial thromboplastin time were studied and compared between the two groups. We also observed the incidence of thrombotic events between the two groups. RESULTS AND CONCLUSION:The blood loss of the experimental group was significantly lower compared to the control group (t=2.194-2.908,P < 0.05). The blood transfusion rate of experimental group was significantly lower compared to the control group (χ2=5.219,P=0.022). The hemoglobin of the experimental group was significantly higher than that of the control group at 3 and 5 days after replacement (t=-3.481, 2.319,P < 0.05). No significant difference in prothrombin time and activated partial thromboplastin time was detectable between the two groups before and after replacement (P > 0.05). Thrombotic events were not visible in both groups. Venous ultrasonography in the lower extremity did not reveal deep venous thrombosis. Above results suggest that tranexamic acid can significantly reduce intraoperative blood loss in patients undergoing bilateral total knee arthroplasty, decreases the requirement of blood transfusion and the dynamic change of hemoglobin, and does not increase the risk of thrombosis.

Objective To study the relation between function of sperm membrane and seminal parameters.Methods Five hundred and three semen samples were collected from 149 normal men and 354 infertile men.Sperm concentration,motility,viability,semen WBC concentration,morphology and sperm tail hypo-osmotic swelling(HOS) were analyzed according to WHO criteria. Results Sperm HOS score in infertile group was lower than that in control group(P