Objective To evaluate the safety,middle or short -term effect and indication of the endovascular treatment for ischemic stroke patients with extracranial carotid stenosis.Methods The clinical datas with percutaneous transluminal angioplasty and stenting for extracranial carotid artery stenosis cases were retrospectively reviewed,from which 106 cases with ischemic stroke in the past were selected for study.And theinformation including operation opportunity,operation experience,serious complications such as cerebral hemorrhage and secondary ischemic stroke were summarized.Their clinical features,methods of treatment and prognosis were analyzed specially.Results The placement of 106 cases with 120 stents was satisfaction.Cerebral hemorrhage occurred in 3 cases while thrombosis fol-lowing stent placement in 2 cases,hypotension and bradycardia in 6 cases,vasospasm in 11 cases,gastrointestinal stress bleeding in 1 case,restenosis occurred in 8 cases and no cerebral infarction occurred after operation.Apart from one case of death cerebral hemorrhage,8 cases of restenosis,the,middle or short -term results of the remaining 97 patients were satisfactory.83 cases were followed up for 3 months to 5years,there were no ischemic attack and cerebral infarction occurred.Conclusion The satisfactory effect and safety are achieved in the therapy of carotid stenosis by percutaneous transluminal angioplasty and stenting.Angioplasty and stenting may improve the cerebral hemodynamics of patients with severe /moderate internal carotid artery stenosis.It is suitable for previous ischemic stroke patients.We must be individualized to more carefully assess these patientsˊsurgical risk,strictly adhere to the indications of surgery,and general measures is the key of preventing the complications during the perioperative period.

0.05)indicating no significant loss of correction.The length of the growth of instrumented spine was 13.3 mm.No sever complications in the series. Conclusion The PRSS which dispenses without bony fusion is a safe and an effective instrumen for management of juvenile scoliosis.It provides and maintains desirable scoliosis correction in one stage procedure,while allowing spinal growth.

In pregnant women,positive rate of thyroid peroxidase antibody(TPOAb) is approximately 3%~10%.It is still controversial whether thyroid antibody positive rate is higher in women undergoing artificial assistant reproductive technologies.TAI might have a negative effect on pregnant outcome,which has been proved in different groups of women.Intravenous immunoglobulin,thyroxin replacement therapy and selenium therapy have been used for TAI intervention.More evidence is needed to demonstrate mechanism and evaluate effect for each therapy.

Objective To study the significance of antikeratin antibodies(AKA) in rheumatoid arthritis(RA). Method Serum samples of 98 patients with RA and 70 rheumatic disease controls were tested by indirect immunofluorescence assay.The diagnostic specificity and sensitivity of AKA were compared with rheumatoid factor(RF). The features of clinical manifestation and lab findings were compared in patients with RA who were positive for AKA with ones who were negative.Results The positive rate of AKA in RA patients was significantly higher than that in rheumatic disease controls.AKA showed a diagnostic specificity of 97.1%, higher than RF.RA patients who were positive for AKA had more active disease as assessed based on clinical, laboratory tests,and radiological variables, as compared with AKA negative patients. Conclusion AKA showes high disease specificity and has prognostic significance in patients with RA.

The incidence of thyroid carcinoma is associated with a variety of factors.Radiation is the clear risk factor,the relationship between iodine intake and thyroid carcinoma remains controversial.Researches show that the genetic and epigenetic changes of many signaling pathways are the key of molecular pathogenetic mechanism of thyroid carcinoma.In addition,thyroid stimulating hormone,body mass index and chronic lymphocytic thyroiditis are also associated with thyroid carcinoma.

Objective To investigate the curative effects of laparocopic treatment for cystiduodenal internal fistula. Methods All procedures were conducted under laparoscope. After the exposure of the cholecystic base, trans-cholecystic cholangiography was performed to detect the relations between the cholecyst and neighboring organs. Once the internal fistula was confirmed, the orifice of fistula was closed laparoscopically. Then abdominal drainage, gastrointestinal decompression, and administration of somatostatin were routinely employed. Results In a series of 327 cases of laparoscopic cholecystectomy (LC) with intraoperative cholangiography, a total of 6 cases of cystiduodenal internal fistula were detected, all of which were anatomized and closed successfully under laparoscope. No postoperative hemorrhage or duodenal bile leakage occurred. Conclusions Routine intraoperative cholangiography during LC is beneficial to the detection of the cystiduodenal internal fistula.Effective and reliable management rests upon skillful laparoscopic techniques of dissection and fistula closure, as well as the supportive treatment.

Objective To investigate the efficacy of dermabrasion combined with aminolevulinic acid-based photodynamic therapy (ALA-PDT) for the treatment of nasal nodular basal cell carcinoma (nBCC).Methods Twentyfive patients who were pathologically diagnosed as nasal nBCC with lesion area ＞ 1 cm2 but no bone or cartilage involvement,were included in this study and treated with dermabrasion combined with ALA-PDT.At first,the part of tumor protruding outside the skin was removed by artherectomy,then dermabrasion was carried out.The wound surface was topically treated with 20％ aminolevulinic acid solution for 3-4 hours away from light immediately after surgery,then irradiated with LED light at a mean dose of 100 J/cm2 for 20 minutes.ALA-PDT was performed once a week for 3 consecutive weeks.The degree of and time required for wound healing were assessed,and tumor recurrence,cicatrization and appearance outcomes were observed during 1 year after surgery.Efficacy was assessed comprehensively.Results No postoperative wound infection occurred in these patients,and the average time for wound healing was (11.2 ± 1.3) days.During 1 year after the treatment,no recurrence was found,while cicatricial contracture developed in 1 case,mild proliferative scar in 3 cases,and depressed scar in 4 cases.All the patients were satisfied with the treatment outcomes,except 1 patient who was basically satisfied.Conclusions Dermabrasion combined with ALA-PDT is easy to operate with rapid wound healing,low postoperative recurrence rate and high degree of patient satisfaction,and is worthy of clinical promotion.

ObjectiveTo observe the dynamic changes of blood perfusion and hypoxic status by CT perfusion imaging and hypoxia imaging in patients with non-small cell lung cancer (NSCLC) after treatment with recombinant human endostatin (RHES). MethodsA total 15 patients with NSCLC were randomly divided into treatment group (n = 10) and control group (n = 5). The patients in treatment group continuouly received the treatment with RHES (7.5 mg/m2) by intravenous infusion for ten days, and CT perfusion imaging and hypoxia imaging were performed at day 1, 5 and 10,respectively. The time window' was observed with the blood perfusion status and hypoxic changes.ResultsIn the treatment group, capillary permeability surface (PS) and tumor to normal tissue (T/N) were firstly decreased, and then increased. Their lowest points occurred at about the fifth day. PS showed statistical significance compared with the first day (q1.5 = 12.05, P＜0.01 ) and no significance compared with the tenth day(q10.5 = 2.79, P=0.69), while T/N showed a significant difference between above time points (q1.5 = 73.81, q10.5 = 20.6, P = 0.00).Blood flow (BF) was firstly increased, and then decreased.Its highest point appeared at about the fifth day with statistical significance compared with the first and tenth day (q1.5 = 12.29, q10.5 = 10.48, P＜0.01 ). All the PS,BF and T/N between the fifth day in treatment group and the control group showed statistically significance (all P ＜ 0.01 ).Conclusions The time window of recombinant human endostatin improving blood perfusion and hypoxic status in non-small cell lung cancer is within about one week after administration.

Objective: To investigate the differential expression of Sox9 in conventional chondrosarcoma,dedifferentiated chondrosarcoma and normal cartilage. Methods: We reported 12 cases of chondrosarcomas,which were initially diagnosed as chondrosarcomas(6 cases of conventional chondrosarcoma and 6 cases of dedifferentiated chondrosarcoma)at Peking University People's Hospital between January 2003 and January 2007.We used genechip method to identify difierentially expressed genes involved in conventional chondrosarcoma,dedifferentiated chondrosarcoma and in normal cartilage(6 cases)and found thousands of differentially expressed genes after extensive statistical analysis.With Sox9 which played crucial roles in the process of both differentiation and maturation of chondrocyte as a candidate,we used Real-time PCR,Westem blot and immunohistochemistry to confirm the results found by gene chip. Results: DNA microarray results showed that Sox9 was up-regulated about 1.6 times in conventional chondrosarcoma compared with that in normal cartilage.But in dedifferentiated chondrosarcoma,the expression level of Sox9 was significantly down-regulated,0.082 times of that in normal cartilage.Real-time PCR results showed that the expression levels of Sox9 mRNA in conventional chondrosarcomas and dedifferentiated chondrosarcomas were 1.68±0.119 and 0.088±0.017,respectively.Sox9 protein level was significantly higher in humen conventional chondrosarcomas than that in normal cartilage.Sox9 protein level in dedifferentiated chondrosarcomas was significantly lower than that in normal cartilage tissue.All of the 6 cases of conventional chondrosarcomas showed diffuse and strong staining of Sox9.However,Only scattered staining was observed in dedifferentiated chondrosarcomas. Conclusion: Compared with that in normal cartilage,Sox9 expression is up-regulated in conventional chondrosarcomas and down-regulated in dedifferentiated chondrosarcomas.Decrease of Sox9 expression in dedifferentiated chondrosarcoma is correlated with poor survival,indicating that Sox9 may serve as a molecular prognostic marker for chondrosarcomas and disease progression.

Objective Brain metastasis(BM) is unusual in colorectal carcinoma(CRC) patients.This study was to evaluate the characteristics and prognosis of brain metastasis of colorectal carcinoma patients.Methods Twenty-eight consecutive CRC patients underwent surgical resection for BM between January 2001 and December 2008.The clinical data were analyzed by univariate (logrank) and Cox regression test.Results The median age at BM diagnosis from CRC was 57 years(41-75 years).Median survival after neurosurgical intervention was 9.4 months.The 1-year and 5-year survival rates were 28.9%and 7.1%,respectively.Seventeen patients(61%)had concurrent systemic metastasis.All patients were symptomatic with neurologic deficits and symptoms.On multivariate analysis,gender,infratentorial location of lesions and characteristics of primary CRC had no significant impact on survival.Two factors were signitlcandy associated with better survival:single brain metastases and absence of extracranial metastases.Perioperative mortality was zero.There were no difference of survival among patients undergoing resection alone and resection combined with whole brain radiotherapy (WBRT) or stereotactic radiosurgery(SRS). Conclusions Brain metastases from colorectal cancer is an evil omen of poor prognosis of CRC patients.Sursical resection of symptomatic brain metastases from colorectal cancer is relatively safe and provides the opportunity for prolonged survival.