Objective To investigate the changes of serum C-reactive protein(CRP)and neu-ron-specific enolase(NSE)levels in patients with acute cerebral infarction(ACI)and their relations with in farct size,severity of neurological impairment.Methods The levels of serum CRP,NSE were measured in 60 patients(ACI group)within 72 hours after infarction and 40 normal controls(control group).The severity of neurological impairment of patients with ACl was assessed by National Institutes of Health Stroke Scale (NIHSS)at admission.Results The mean levels of serum CRP and NSE in ACI group were higher than those in control group, (6.95±2.34)mg/L vs(2.21±1.05)mg/L,P＜0.01, (22.39±4.72)μg/L vs(7.16±2.63)μg/L,P＜0.01,respectively.Higher levels of CRP and NSE were obviously associated with larger infarct size and more severe neurological impairment.The changes of CRP and NSE levels correlated with scores of NIHSS(r=0.51,r=0.44,all P＜0.01)significantly.CRP levels were positively correlated with those of NSE(r=0.57,P＜0.01).Conclusion The levels of serum CRP and NSE can be used as an important biological marker to estimate the size of infarct and the severity of neurological impairment in ACI.

Antiplatelet therapy is a major strategy with a growing body of evidence in management of ischemic cerebrovascular diseases.This article introduces the mechanism of currently available antiplatelet drugs as well as their practice guidelines and evidence from clinical trials.There is currently no robust evidence to support the use of venous antiplatelet agents.Aspirin is the sole evidence-based antiplatelet drug for treatment of acute ischemic stroke.Aspirin,dipyridamole and clopidogrel are effective in secondary stroke prevention.Combination therapy using aspirin plus extended-release dipyridamole is the only combination approach to demonstrate additive benefit.

Objectives:To observe the therapeutic effect of Cuochuang Misture on acne vulgaris and study the mechanism by external bacteria repressing experiment.Methods:34 cases of acne of syndrome of dampness and heat in lung and stomach were treated with Cuochuang Misture and 28 cases with Dangguikushen Pill as controls,and their curative effect were compared;Different concentration of Cuochuang Misture were used to inhibit Propionibacterium acnes(P.ance)and Malassezia furfur(M.furfur).Results:The clinical total effective rates were 94.12%in the treatment group,and 89.29%in the control group.The scores of skin lesions and syndromes reduced obviously between two groups in the end of the treatment(P

BACKGROUND: For the orthopedic surgeon, the postoperative functional recovery after total knee arthroplasty, in which the reconstruction of posterior femoral condylar offset plays an important role, is an important goal.OBJECTIVE: To understand the anatomic characteristics of the femoral condylar offset and the mechanism how posterior condylar offset influences the functional recovery of knee joint after total knee arthroplasty.METHODS: The author searched PubMed database and Wanfang database for articles about posterior femoral offset and knee range of motion. The key words were arthroplasty; replacement; knee; femur; posterior condylar offset; range of motion. A total of 96 articles were retrieved, and 38 articles met the inclusion criteria.RESULTS AND CONCLUSION: Posterior condylar offset had differences in gender, ethnics and medial and lateral condyles. To restore the biomechanics of the knee joint, the design of knee prosthesis should consider the difference in genders, ethnics, medial and lateral condyles. The influence mechanism is the femur-tibia impingementand gap balance. However, further clinical research is needed, for contradictory results regarding whether posterior condylar offset has an effect on knee flexion after total knee arthroplasty.

Objective:To compare the clinical application effect of polyetheretherketone (PEEK) and titanium in cranioplasty.Methods:Sixty patients with skull loss in Shengjing Hospital of China Medical University from January 2015 to December 2019 were retrospectively analyzed. Among them, 25 patients were repaired with PEEK material (PEEK group) and 35 patients were repaired with titanium mesh (titanium mesh group). The postoperative complications within 6 months, plastic surgery satisfaction, hospital stay and hospitalization cost were compared between 2 groups.Results:There were no significant differences in bleeding, infection, epilepsy, implant displacement, implant exposure, incidence of secondary operations and the length of hospital stay between 2 groups ( P>0.05). The incidence of subcutaneous fluid, good plastic surgery satisfaction and hospitalization costs in the PEEK group were significantly higher than those in titanium mesh group: 28.0% (7/25) vs. 5.7% (2/35), 88.0% (22/25) vs. 62.9% (22/35) and (12.4 ± 1.5) × 10 4 yuan vs. (7.0 ± 2.4) × 10 4 yuan, and there were statistical differences ( P<0.05 or<0.01). Conclusions:PEEK material is safe and effective in cranioplasty, and the treatment satisfaction is better, but the cost is higher. PEEK can be used as an ideal skull repair material for patients with economic basis.

Objective: To analyze the characteristics of multislice spiral computed tomography (CT) for acute myocardial infarction. Methods: The anterior descending coronary arteries of 6 pigs were ligated at the 1/3 distal end to establish acute myocardial infarction model without reperfusion. Dual multislice spiral CT scanning was performed in all animals and the CT characteristics were analyzed. Results: Acute myocardial infarction model was successfully established in all 6 animals. Myocardial perfusion deficits were detected during early phase scanning; the area of deficits were significantly decreased during late phase scanning (13.52 ± 5.22% vs 9.07 ± 3.47% P = 0.004), with a mean decrease of 32.14%. CT value of different myocardial varied at different scanning times: the values of LV cavity decreased from (586 ± 111) HU to (294±53) HU (P = 0.001), that of the normal myocardial area decreased from (247±54) HU to (132±25) HU (P = 0.001); the values of the perfusion deficit regions were not significantly changed ([42 ± 14] HU vs [29 ± 23] HU, P = 0.289). During late phase scanning, CT value around residual perfusion deficit was higher than that of normal myocardium ([156±21] HU vs [132±25] HU, P = 0.004). Conclusion: The dual-phase MSCT characteristics of AMI include early perfusion deficits, late enhancement and residual perfusion deficits. Early phase scanning may overestimate the infarction area.

Objective To investigate MVD, TSP-1, TGF-?1 expression in GH-Secreting Pituitary Adenomas by immunohistochemistry, and to correlate data with clinical characteristics.Methods The protein expression of TSP-1, TGF-?1 in 48 surgical specimens (21 invasive cases; 27 non-invasive cases) of pituitary adenomas was measured using immunohistochemical method. The relationship between the expression and clinical properties was examined. MVD was measured by detecting CD34.Results Compared with the noninvasive group, no difference of expression of CD34(t=2.257; P=0.083) was observed. The expression of TSP-1 in invasive group was low. The expression of TGF-?1 was higher in invasive cases than that in noninvasive ones. The expression of TGF-?1 had positive correlations with MVD; but there was no correlation between the expression of CD34 and the invasion of pituitary adenomas. In addition, MVD count was not associated with the expression of TSP-1. Size, sex or rate of recurrence did not influence MVD and TSP-1 expression. Conclusion MVD values do not necessarily represent angiogenesis in pituitary adenomas. TGF-?1 may increase MVD, and TSP-1 does not affect MVD in pituitary adenomas and angiogenesis may be regulated by other pathway.

WTBZ]Survivin belongs to the member of IAP family (inhibitor of apoptosis, IAP) proteins and is a bifunctional protein that suppresses apoptosis and regulates cell division. Survivin is a tumor specific antiapoptosis factor that is expressed selectively in all the most common human carcinomas but not in normal adult tissues. Studies indicated that Survivin played a crucial role in the genesis and progression of malignancy and was an important predictive/prognostic parameter in tumors. Survivin also participates in angiogenesis. Recently, Survivin has been used as a novel diagnostic/therapeutic target in cancer.

Objective To retrieval the ways of prevent complications of video-assisted thoracoscopic surgery. Methods The operation included bullectomy in 462 patients, resection of mediastinal tumor or cyst in 86; esophageal diseases in 94, lobectomy or wedge resection of lung in 140, VATS hemostasis in 22, partial pericardial or pleural excision in 54 and biopsy for undetermined chest diseases in 54. Combined anesthesia with intubations of double lumen tracheal tube was performed in 866 patients and single-lumen tracheal tube in 46. Results 886 operations were completed by VATS, and 26cases were converted into thoracotomy for various reasons. Complications occurred in 36 patients (3.95%), including 10 cases occurred during the operation (esophageous mucous rupture in 4, nerve injury in 2 and insufficient hemostasis leading to postoperative bleeding in 4). 26 cases (2.85%) developed complications postoperatively, including persistent air leak (≥7 days) in 19, pleural effusion making a second water-sealed drainage necessary in 3, atrial fibrillation in 2 and infection in 1. One died for respiratory failure on the fifth postoperative day. Conclusion VATS experience should be gained systematically. In order to reduce the complications, more attentions must be paid to training of the thoracic surgeons in order to master the skill and the correlated knowledge of VATS.

Objective To discuss the necessity of mediastinal lymph node dissection in the resection of lung cancer. Method 740 patients with lung cancer underwent lobectomy or pneumonectomy during Jan. 1987 to Dec. 2002 in our hospital were retrospectively analyzed. Totally 3492 lymph nodes were removed and checked up pathologically. Result Lymph nodes with metastasic were confirmed in 362 out of the 740 cases, and the metastasis ratio was 48.9%, and among them in 276 patients suffered N_2 lesion, with the ratio of 37.3%. The statistic result showed that lymph node metastasis was correlated to the location, cell type, the size, T stage and differentiation of lung cancer. Conclusion Lymph node metastasis in lung cancer is common and related to multiple factors. In order to obtain radical cure, both mediastinal and hilar lymph nodes should be removed.