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.

ObjectiveTo study the relationship between DNA aneuploidy and proliferative activity and the clinical and pathologic features.MethodsDNA ploidy and cell cycle analysis were analyzed in 119 colorectal fresh cancer apecimens using flow Cytometry and prospectively compared with the CEA in serum,tumor size,tumor morphology,lymph node metastases,Dukes' Classfication,histologic type and grade in colorectal cancer.ResultsThere was no relation between serum CEA and DNA aneuploidy and proliferative activity. Aneuploidy was detected at 56.5% in ulcerating carcinoma, which was significantly higher than 14.7% in bulge carcinoma (P<0.01). Aneuploidy was detected at 64.7% in middle and lower grade carcinoma, which was significantly higher than 36.5% of high grade carcinoma (P<0.01). No significant differences in aneuploidy were observed with respect to tumor size, lymph node metastases, Dukes' classfication,tumor histologic type.ConclusionsDNA aneuploidy of cancer cell can express the degree of malignancy of colorectal cancer. But proliferative activity does not relate to all the clinical and pathologic features. CEA in serum does not relate to DNA aneuploidy and proliferative activity.

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 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 investigate the genotype of HPV and L1 gene polymorphism of HPV subtype 6b in patients with condyloma acuminatum (CA) from Wenzhou region. Methods Gene chips were used to profile the genotype of HPV in tissue samples from 73 patients with CA. PCR was performed to amplify the L1 gene in 11 samples positive for HPV type 6 followed by sequencing. Results Of the 73 patients, 61 (83.56%) were positive for HPV DNA. Among the 61 HPV-positive patients, 93.44% were infected with single type of HPV, and 6.56% with mixed type of HPV. In patients infected with single type of HPV, type 11 predominated with a prevalence of 29.51% followed by HPV 6 (18.03%); in those infected with mixed type of HPV, 6and 11 were the most common genotypes. Besides, sequencing analysis revealed single nucleotide polymorphism at 6 sites of HPV 6b type L1 gene, and an A/T polymorphism at position -810 was present in all samples, which was considered to be a local mutation of HPV from Wenzhou region. Conclusions In Wenzhou region, HPV types 11 and 6 prevail in patients with CA, and multiple mutations are present in L1 gene of HPV 6b type.

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 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.

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.