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.

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.

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.

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.

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 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.

Objective To observe the response of the guiding vane to axial flow pump by testing two types of miniature axial flow pump,which have been developed by our group in recent years.Methods Two types of axial flow pump were tested in a mock circulation apparatus.Results The outputs of the two types of miniature axial flow pump all attain 5L/min against the pressure of 13.332kPa,which is enough for left ventricular assistance.The outputs are similarly related to their pre-load and after-load pressure.In this study,the guiding vane does not produce a significant affection on the hydrodynamic characteristic of the axial follow pump.Conclusion The guiding vane may be neglected in the design to improve the blood compatibility of a axial flow pump heart assist device.

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 To investigate the prognostic factors of gastrointestinal stromal tumors.Methods From Nov.1999 to Dec.2006,a total of 85 patients were diagnosed by postoperative pathology as gastrointestinal stromal tumors.The relationship between the prognosis of GIST and demographic factors、tumor location、operation style、preoperative metastasis、lymphadenectomy、grading of Fletcher were analyzed retrospectively.Results The 1 year、3 year and 5 year survival rate of these 85 patients were 94%,60%,57%respectively,Univariate analysis indicated that tumor location、operation style、grading of Fletcher and preoperative metastasis were significant predictors of survival(P<0.05),while demographics and lymphadenectomy were not statistically related with prognosis.Multivariate analysis showed that preoperative metastasis was the independent factor predicting the prognosis(P=0.020,β=4.226).Conclusion Radical surgical excision is still the therapy of choice for primary gastrointestinal stromal tumors.Preoperative metastasis is the independent factor predicting poor prognosis,therefore early diagnosis and treatment are very important for GIST.Fletcher grading is also a simple recalls to predict the prognosis of GIST.