Transient ischemic attack(TIA)is a common ischemic cerebrovascular disease,and the incidence of secondary ischemic stroke and cardiovascular events is very high.It needs to be assessed and managed urgently.The article presents the contents of emergency assessment of TIA,and emphasizes the importance of overall assessment.

Objective To evaluate the indications and clinical efficacy of the different surgical methods for lumbosacral tuberculosis.Methods 112 patients suffering from lumbosacral tuberculosis from January 1998 to October 2011 were reviewed retrospectively.Based on American Spinal Injury Association (ASIA) grading system,31 case was classified as grade C,32 as grade D and 49 as grade E.The affected locations were L5,S1 in 66 cases,L4-S1 in 32,and L5-S2in 14 cases.41 cases (posterior group) underwent posterior pedicle screw instrumentation,debridement and allograft; and 38 cases (anterior group) underwent one-stage anterolateral debridement plus allograft and internal fixation.33 (posterior-anterior group) cases experienced posterior pedicle screw instrumentation and anterior debridement and allograft.All cases underwent routine support and anti-tuberculosis treatment before and after operation.The change of erythrocyte sedimentation rate (ESR),signs of tuberculosis activity,graft fusion,neurological recovery and correction of deformity were evaluated in follow-up and compared among three groups.Results The average operating time in posterior,anterior and posterior-anterior group was (150±22) m in,(140± 18) min,(180± 1 8) min respectively.ESR and C-reactive protein (CRP) were recovered to normal 3 months post surgery.The quality of life total score of lumbosacral tuberculosis patients was very low (55.54 ± 9.23).After surgery and drug treatment,the total score and each dimension scores of the SF-36 were significantly improved.Postoperative ASIA classification and 1umbosacral angle were significantly improved.Tuberculosis recurrence occurred in three cases,fixation loosening in two cases,fixation fracture in one case,and all above cases were cured after revision surgery.The others all were cured and bone graft fusion was determined.Conclusion The quality of life of lumbosacral tuberculosis patients were impacted seriously,and which could be significantly improved with surgical intervention.According to the patient MRI,CT characteristics,surgical approach selection was based on lesion location.Effective internal fixation was based on the extent of damage in bone structure and anatomical characteristics.Following above principles,satisfactory clinical results could be achieved.

Objective To investigate the relationship of serum levels of macrophage migration inhibitory factor (MIF), matrix metallo-proteinase-9 (MMP-9), hypersensitive C-reactive protein (hs-CRP) with the severity of acute cerebral infarction (ACI). Methods 101 pa-tients with ACI were envolved and divided into 3 groups according to the scores of National Institute of Health Stroke Scale (NIHSS):mild group (group A, n=38, NIHSS score<4), moderate group (group B, n=36, NIHSS score 4-15) and severe group (group C, n=27, NIHSS score>15). Meanwhile, 44 non-ACI inpatients with atherosclerosis were included as control group (group D). Their serum MIF and MMP-9 were detected with ELISA, and hs-CRP with immunoturbidimety. Results The levels of serum MIF, MMP-9 and hs-CRP ranged from more to less as groups C, B, A and D (P<0.05). There was positive correlation of MIF with MMP-9 (r=0.301, P<0.01) and hs-CRP (r=0.309, P<0.001). Conclusion Serum MIF, MMP-9 and hs-CRP levels increased with the severity in ACI patients, which may be prediction of athero-sclerotic plaque instability.

Objective:To observe the color change of tooth i nduced by hydrogen peroxide gel. Method:12 extracted teeth were randomly assigned to two groups (n=6) and treated with 350 g/L and 75 g/L hy drogen peroxide gel respectively. One of the 6 samples in each group was used as the control. The bleaching gel was placed onto the enamel surface of the sample s. In 350 g/L gel group digital photographs were taken just before,10 and 30 min after the process, in 75 g/L gel group digital photographs were taken before an d 1.5?N(N=0,1,2,3,4,5,6,7) hours after the process respectively. All photograph s were taken at the same illuminating conditions and photographic parameters wer e analyzed with Photoshop7.0 software. Results:10.5 h after trea tment in the 75 g/L gel group L *, a * and b * values on the teeth surface were in creased(+) or decreased(-) by +4.5,-1.4 and -0.5,those on the inner sections 2.7 ,-1.0 and -0.8,respectively. 30 min after treatment in the 350 g/L gel group L *, a * and b * values on the teeth surfaces were increased(+) or decreased (-) by +1.9,-0.6 and 0,those on the inner sections +0.4,-0.4 and -0.6,respectively. Conclusion:Effective bleaching effect may be obtained in 10~30 min b y 75 g/L or 350 g/L hydrogen peroxide gel on teeth surface and in inner dentin. 75 g/L hydrogen peroxide bleaching gel may produce more reliable and save effect than 350 g/L.

Objective To study normal imaging features of choroid fissure and to improve the ability of diagnosis of choroid fissureneuroepithelial cyst.Methods The MR manifestations of choroid fissure were studied by comparing general brain specimen with MR images of normal brains.The analysis of CT and MRI findings of choroid fissure neuroepithelial cysts in 14 cases were also conducted.Results The whole choroid fissure was clearly displayed as fissures full of cerebrospinal fluid on MRI.Cysts were shown round or ellapse foci with sharpmargins and homogeneous low density on CT or cerebrospinal fluid-like signal intensity on MRI.There was no enhanced contrast or nodramatic changes in follow-up studies.Conclusion The recognization of MR anatomy of choroid fissure and imaging manifestations ofchoroid fissure neuroepithelial cysts can improve the ability of diagnosis and differential diagnosis of cysts.

Objective To raise the etiological diagnostic rate of renal colic in remission period with intravenous urography.Methods High-dense intravenous urography with TV monitoring (HIVP-TV) was employed to detect the 48 cases,including 37 cases in remission and 11 cases in attack periods.Results There were signfiicantly differences in imaging time of obstractive sites of injured kidney and ureter between both remission and attack periods(P

Objective To study the effect of tranexamic acid of reducing the bleeding and transfusion on total hip arthroplasty and the recovery of joint function.Methods The clinical data of 62 patients who underwent total hip arthroplasty from February 2013 to February 2015 were randomly divided into the control group(31 cases)and the observation group(31 cases).Patients treated with tranexamic acid for hemostasis were the observation group and patients without tranexamic acid for the control group.The Hct,Hb and Harris scores were compared before and after operation.The total blood loss,intraoperative blood loss,postoperative drainage,occult blood loss and blood transfusion were compared between the two groups.Results The preoperative Hct,Hb and Harris scores in observation group were 0.43±0.06,(131.13±18.52)g/L and(23.45±10.24)points,respectively,0.42±0.05,(130.42±14.36)g/L and(24.36±9.34)points,respectively in control group.Postoperative 1st,3th d Hct in observation group were 0.35±0.05,0.28±0.05,in control group were 0.30±0.06,0.25±0.03,postoperative Hb in observation group were(111.58±20.32)g/L,(121.26±18.28)g/L in control group.Postoperative 2nd,6th,12th weeks Harris scores in observation group were(54.88±6.14)points,(67.79±12.05)points,(83.55±12.12)points,in control group were(50.21±5.01)points,(58.17±13.24)points,(74.38±12.67)points,compared with before treatment were improved,and three indexes in the observation group were significantly higher than those in control group(F between grouP=3.213,P=0.023,F across grouP=3.213,P=0.036,F inner grouP=3.327,P=0.032;F between grouP=3.277,P=0.002,F across grouP=2.865,P=0.006,F inner grouP=3.564,P=0.001;F between grouP=3.327,P=0.016,F across grouP=32.912,P=0.005,F inner grouP=3.614,P=0.001).The patients total blood loss,the amount of hemorrhage,postoperative drainage volume,the hidden blood loss and blood transfusion in the observation group were(1 820.9±367.6)ml,(685.5±363.62)ml,(561.3±366.1)ml,(530.8±410.7)ml and(210.1±25.9)ml,respectively,less than the control group((2 229±564.6)ml,(1 010.3±415.11)ml,(725.9±257.8)ml,(798.4±279.5)ml,(701.2±51.2)ml,with significant differences between the two groups(t=3.373,3.281,2.047,2.999,47.655,P＜0.05).Conclusion Intraoperative hemostasis of tranexamic acid in total hip arthroplasty can effectively reduce the amount of blood loss and blood transfusion,and to promote patients recovery of joint function,clinical promotion,with great value of clinical promotion.

Objective To analyze the related factors of local recurrence in patients with rectal cancer after Dixon operation. Methods A retrospective analysis of clinical data of 100 patients from September 2005 to September 2007 in our hospital by TME standard surgicai treatment of low rectal cancer was carried out. Results Of 100 patients, the pre-sacral recurrence rate was 10. 0%, with gender, age, tumor size, tunor invasion lumen circumference,depth of invasion,lymph node metastasis and Duke's stage has nothing to do with the gross type,histological type and lumen,peritoneal tumor cell shedding,and as an independent prognostic factor. Of 90 patients without local recurrence,the 5-year survival rate was 76. 0% ,haff of the survival of 62 months;10 cases of local recurrence,5-year survival rate was 5. 0%, half of the survival of 24 months, suggested that local recurrence in patients influenced the prognosis. Conclusion The low local recurrence of rectal cancer related factors were gross type,histological type and the intestine, peritoneal tumor cells shed, seriously affect the prognosis of patients with local recurrence.

Objective To evaluate the efficacy and safety of phacoemulsification combined with trabeculectomy and phacoemulsification after trabeculectomy in patients with angle-closure glaucoma and cataract with high intraocular pressure.Methods We divided 32 eyes of 32 patients with angle-closure glaucoma and cataract with high intraocular pressure into 2 groups.Phacoemulsification combined with trabeculectomy were performed in group 1,and phacoemulsification after trabeculectomy were performed in group 2.The intraocular pressure,visual acuity,and complications were determined.Results In these 2 groups,the intraocular pressure decreased and the visual acuity increased 1 week after the surgery,without statistical significance.No serious complication was found in these 2 groups.Conclusion It is effective and safe to perform phacoemulsification combined with trabeculectomy in patients with angle-closure glaucoma and cataract with high intraocular pressure.

Objective To compare the effect of different urethrovesical anastomosis methods on postoperative anastomotic complication in laparoscopic radical prostatectomy (LRP). Methods The clinical method of 121 patients with localized prostate cancer who underwent LRP from June 2012 to June 2015 was retrospectively analyzed. The patients were divided into two groups according to different urethrovesical anastomosis methods: interrupted suture group with 36 patients and continuous suture group with 85 patients. The operation time, postoperative anastomosis leakage, anastomosis stenosis and urinary control status 1, 3 and 6 month after operation were compared between two groups. Results All the operations were completed successfully without converting to open approach. The operating time of continuous suture group and interrupted suture group was (20.35 ± 3.10)min and (34.02 ± 3.94) min, the rate of postoperative anastomosis leakage was 3.53%(3/85) and 16.67%(6/36), the rate of anastomosis stenosis was 2.35%(2/85) and 13.89%(5/36), the rate of urinary incontinence after operation for 1 month was 15.29%(13/85) and 33.33%(12/36), for 3 months was 7.06%(6/85) and 25.00%(9/36), for 6 months was 2.35% (2/85) and 13.89% (5/36), there were significant differences (P<0.05). Conclusions Continuous suture can shorten operation time, decrease the risk of anastomotic leakage, anastomosis stenosis and urinary incontinence.