Objective To explore the independent risk factors and distribution of intracranial arterial stenosis in young pa‐tients with acute lacunar infarction .Methods We retrospectively reviewed the clinical data of 30-45 year‐old young patients with lacunar infarction who were admitted to the Third Affiliated Hospital of Xinxiang Medical University .The patients were divided in‐to two groups according to their skull blood vessel examination :intracranial arterial stenosis group and intracranial arterial stenosis group .Results There were 28 cases of intracranial large artery stenosis and 17 cases without stenosis in 45 young patients ,it was found that the levels of triglyceride ,low density lipoprotein cholesterol and carotid artery plaque in the intracranial arterial stenosis were significantly less than those of the intracranial artery stenosis (P<0 .05) .In the intracranial artery stenosis group ,15 cases were single vessel stenosis ,13 cases were multiple stenosis ,the difference was not statistically significance (P>0 .05) .Simple ante‐rior circulation stenosis in 12 cases ,simple posterior circulation stenosis in 8 cases ,only the anterior and posterior circulation in‐tracranial artery stenosis ,vascular risk factors were not statistically significant ( P> 0 .05 ) .Binary Logistic regression analysis showed that LDL cholesterol was an independent risk factor of intracranial arterial stenosis .Conclusion With intracranial artery stenosis in young patients with lacunar cerebral infarction prone to progressive stroke ,young patients with cerebrovascular infarc‐tion should be examined .

Objective To discuss the application effect of fansclub informatization on the self-management of breast cancer patients. Methods A total of 240 breast cancer patients were equally divided into the experimental group and the control group by the random number table with 120 patients in each group. The control group was provided with routine health education, based on this, patients of the experimental group participated in the fans club. The compliance, tempering effect, readmission rate and the satisfaction degree were evaluated between the two groups one year later. Results A significant difference was observed between the two groups′ compliance (t=11.08, P<0.01), with the experimental group graded 69.27 ± 8.02 and the control group graded 48.76 ± 7.51. Moreover, in the experimental group, the angel of abduction, anteflexion, rear protraction, medial rotation, lateral rotation were respectively (170.13 ± 3.16)° , (172.45 ± 1.94)° , (46.71 ± 1.86)° , (81.30 ± 2.47)° and (85.18 ± 1.55)° ,which were significantly higher than the control group (125.16±1.93)°, (136.28±4.67)°, (34.63±2.68)°,(61.59±1.71)° and(85.18 ± 1.55)° (t=22.74-73.76,P<0.01). Further more, there were also remarkable differences (χ2=32.97, 54.21, 15.34, P<0.05) between the two groups on the consultative, readmission and the satisfaction degree, which in the experimental group were 91.67% (110/120), 81.67% (98/120), 96.67%(116/120), and in the control group were 55.83% (67/120), 47.50% (57/120), 84.17% (101/120). Conclusions The establishment of the fans club informatization remarkably improves the self-management of the breast cancer patients, which are worth popularizing.

Objective To study whether stilnox intervention could prove the prognosis for subjective tinnitus patients combined with sleep disorders.Methods By random and double-blind method,68 tinnitus patients with sleep disorders were randomly divided into the treatment group and control group,with 34 cases in each group.The patients in the control group received ginaton and methycobal oral administration.On the basis of this,the patients in the treatment group received Stilnox oral administration before sleep.All objects of study were evaluated using Tinnitus handicap inventory (THI)and Pittsburgh sleep quality index (PSQI)two weeks before and weeks after treatment.Results The tinnitus disability in the treatment group showed statistical differences before and after treatment (t=8.810,<0.05).The levels of sleep disorders in the treatment group showed statistical differences after treatment (t=20.446,<0.05).The tinnitus disability in the control group showed statistical differences after treatment(t=6.900,<0.05).The sleep disorders in the control group showed statistical differences before and af-ter treatment(t=4.631,<0.05).The tinnitus disability (t=2.313,<0.05)and sleep disorders(t=7.906,<0. 05)after treatment showed statistical differences between the treatment group and control group.Conclusion Stil-nox intervention therapy could improve the prognosis of subjective tinnitus patients with sleep disorders.

OBJECTIVE:To optimize the extraction technology of astilbin from medicinal herbs in Puling penyankang cap-sules. METHODS:The extraction technology of astilbin from ingredients(Smilacis glabrae rhizoma,chuanxiong rhizoma,Eucom-miae cortex,notoginseng radix et rhizoma,Plantaginis semen)of Puling penyankang capsules was optimized with concentration of ethanol,immersion time and percolation speed as factors,and using the yield of extractum and the extraction amount of astilbin as index. RESULTS:The optimized extraction technology was as follows as 2-fold 70% ethanol,immersed for 24 h,percolated with 70% ethanol with percolation speed of 3 ml/min,10-fold percolate volume was colleted. In verification test,the yield of extractum were 6.79%,6.92% and 6.84%,respectively,with average value of (6.85 ± 0.96)%(n=3);the extraction amounts of astilbin were 39.23,39.67 and 39.69 mg,with average value of (39.53 ± 0.66) mg (n=3). CONCLUSIONS:The optimized extraction technology of astilbin in Puling penyankang capsules is stable and practical.

[ABSTRACT]OBJECTIVETo assess the efficacy of postauricular injection of shuxuening combined with lidocaine in treating intermediate and high-frequency sudden hearing loss.METHODS48 patients with intermediate and high-frequency sudden hearing loss were randomly divided into postaurical injection group (n=24) and control group (n=24). The control group was given hormone, microcirculation improvement, nutrition of nerve and other conventional treatment. The postauricular injection group received 3 doses of postauricular inject of 0.5ml shuxuening and 0.3ml lidocaine tertian injection in addition to conventional treatments.RESULTSTwo weeks after administration, the total effective rates of postauricular injection group 87.5%were significantly higher than that of the control group 62.5%. Pure tone average improved (20.74±15.19)dB on average in the postauricular group, and (12.44±9.12)dB in the control group. The difference was statistically significant (P<0.05). CONCLUSIONPostauricular injection of shuxuening combined with lidocaine treatment for intermediate and high-frequency sudden hearing loss has better curative effect than that of the conventional treatment.

Objective To investigate the combination of multiple CT signs in diagnosis and differential diagnosis of nodular goiters (NGs).Methods The CT images of 242 pathologically confirmed lesions (＞ 10 mm in diameter) from 188 patients with nodular goiters were retrospectively reviewed.The CT signs,including regular shape,cystic degeneration,clearer enhancement margin,strong enhancement of nodular goiters were compared with those of 236 pathologically confirmed lesions (＞ 10 mm in diameter)from 225 patients with papillary thyroid carcinomas (PTCs).The sensitivity,specificity and accuracy of different CT signs or their combination in diagnosis and differential diagnosis of NGs were analyzed.Results Regular shape was present in 208 of 242 NGs (86.0％) and in 35 of 236 PTCs (14.8％) (x2 =241.804,P =0.000).Cystic degeneration was present in 143 of 242 NGs (59.1％) and 7 of 236 PTCs (3.0％)(x2 =174.783,P =0.000).Clearer enhancement margin was present in 192 of 242 NGs (79.3 ％) and in 51 of 236 PTCs (21.6％) (x2 =159.318,P =0.000).Strong enhancement was present in 41 of 242 NGs(16.9％) and in 3 of 236 PTCs (1.3％) (x2 =35.108,P =0.000).Regular shape showed the highest sensitivity and accuracy for diagnosis of NGs (86.0％ and 85.6％),while strong enhancement showed the highest specificity (98.7％).The combination of regular shape and clearer enhancement margin showed the highest sensitivity and accuracy of 67.4％ and 80.5％,respectively.The combination of strong enhancement with any of other signs showed the highest specificity of 100.0％.The combination of regular shape,cystic degeneration and clearer enhancement margin showed the highest sensitivity,specificity and accuracy of 45.5％,99.6％ and 72.2％ respectively.The combing of 4 signs showed a sensitivity,specificity,and accuracy of 2.9％,100.0％ and 50.8％.Conclusion CT scan is effective for diagnosis of NGs,and the combination of different CT signs can significantly improve the specificity and reduce the incidence of misdiagnosis to avoid unnecessary surgery.

Objective: To observe the effect of LQC on relieving fever in rabbits and the effect on secretion of TNF-?, probe into the correlated mechanism of LQC on pharmacological action and its substance basic of “treating different diseases with the same therapeutic principle”. Method: Rabbit pyrexia model was made by injecting lipopolysacchatide (LPS) into auris edge vein, and alveolar epithelial cell II damnification model was made by adding LPS to culture medium. The change of temperature and TNF-?lever in cell culture supernate were observed before or after using LQC. Result: LQC can resist the temperature rising by LPS, relieve pyrexia reaction, restrain the augment of TNF-?content. Conclusion: The results suggested that LQC possess distinct function of relieving fever, which is likely related to restraining the abnomal augment of TNF-?.

OBJECTIVE: To retrospectively analyze the long-term curative effects and prognostic factors of 137 cases of NPC patients treated with intensity modulated radiation therapy. METHOD: The three-dimensional conformal intensity modulated radiation therapy adopted for the design plan of 137 cases of newly diagnosed and no distant metastatic NPC patients. Evaluation of short-term clinical efficacy was made according to the efficacy evaluation criteria of WHO solid tumor one month after radiotherapy. During the 2 years after radiotherapy, re-examinations were made every 3 months. Two years later, re-examinations were made every 6 to 12 months, and the routine examinations included clinical body check, nasopharyngoscope, CT, B Chao, MRI, chest X-ray, bone scan, so as to understand the condition of cavum nasopharyngeum, cervical lymph nodes and cranial nerves. Life table method was adopted to calculate the overall survival rate, Kaplan-Meier method was used to calculate relapse-free survival rate, distant metasis-free survival rate and disease-free survival rate. Log-rank test was used for univariate analysis of 14 clinical factors which may exert influences on prognosis. Multivariate analysis was performed with the Cox regression model, P < 0.05 is of statistical significance. RESULT: (1) Of the 137 cases, the overall survival rates of 1-year, 3-year and 5-year were 98.5%, 90.3%, 74.6% respectively, relapse-free survival rates were 97.0%, 81.9%, 66.7% respectively; distant metasis-free survival rates were 96.3%, 80.5%, 56.0% respectively; disease free survival rates were 95.6%, 76.9%, 43.8% respectively. (2) Univariate analysis revealed that the influences of T-staging,N-staging, 92 Fuzhou clinical staging, combined chemotherapy, skull base bone destruction, injury of cranial nerve, retropharyngeal lymph node metastasis, residual disease, total time of IMRT on prognosis were of no statistical significance(with all the P values lower than 0.05) The influences of gender, nationality, age, pathological type and anemia or on prognosis were of no statistical significance(with all the P values higher than 0.05). (3) T-staging, skull base bone destruction, injury of cranial nerve, retropharyngeal lymph node metastasis, N-staging, combined chemotherapy, residual disease, total time of IMRT, and anemia were drawn into Cox model, and the results showed that N-staging, combined chemotherapy, injury of cranial nerve, residual disease, and total time of IMRT were independent factors that affect prognosis (with all P values lower than 0.05). CONCLUSION IMRT obviously has advantages than conventional radiotheraphy in treating NPC patients. N-staging, injury of cranial nerve, combined chemotherapy, residual disease, and total time of IMRT are the main factors that affect prognosis.
Adult ; Aged ; Carcinoma ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; mortality ; radiotherapy ; Neoplasm Recurrence, Local ; Prognosis ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Skull Base ; pathology ; Survival Rate

Objective To analyze CT characteristics of patients with primary parathyroid hyperplasia ( PPH) , parathyroid adenoma ( PA) , atypical parathyroid adenoma ( APA) , and parathyroid carcinoma ( PC) and to evaluate the value of CT in the diagnosis and differential diagnosis of primary hyperparathyroidism ( PHPT ) . Methods CT scan of 134 pathologically proved PHPT patients with complete clinical and laboratory data were retrorespectively analyzed .The similarities and differences of CT features in patients with PPH , PA, APA and PC were studied.Results Among 140 lesions in the 134 patients, 130 cases had solitary parathyroid mass and 4 cases had 10 parathyroid masses , including 22 lesions in 17 patients with PPH, with the diameter ranging from 0.6 cm to 2.8 cm(1.2 ±0.6)cm, 106 lesions in 105 patients with PA, with the diameter ranging from 0.3 cm to 3.2 cm (1.1 ±0.6)cm, 10 lesions in 10 patients with APA, with the diameter ranging from 0.9 cm to 3.3 cm(2.6 ± 0.6)cm, and 2 lesions in 2 patients with PC, with the diameter ranging from 2.1 cm to 3.0 cm(2.6 ±0.6)cm. 124 lesions were located in tracheo-esophageal groove or at the side of trachea on CT .The boundaries between the parathyroid and thyroid gland were low density .3 lesions did not appear .9 lesions were located at the area over the manubrium sterni among 13 lesions which were ectopic.CT images showed round (29.9%,41/137), oval (38.0%,52/137), triangular(19.7%, 27/137), and cylindrical(12.4%,17/137) tumors in 137 lesions.The density of lesions were 30-66 Hu(45.0 ±12.3)Hu on non-enhanced CT scan, and 59-209 Hu(121.8 ±32.7)Hu on enhanced scan .Different pathological lesions had no statistical difference on location ( left upper , left lower , right upper, right lower, ectopic)(χ2 =15.839), linear low density sign(χ2 =1.896), shape(χ2 =10.945), non-enhanced CT(χ2 =0.915) or enhancement CT(χ2 =6.165)(P>0.05).Different pathological lesions had statistical significance on sizes(χ2 =18.395, P<0.05).The diameter of APA-PC was bigger than that in PH-PA.99 lesions exhibited homogeneous enhancement , and 38 lesions exhibited heterogeneous enhancement .The necrosis rate of APA-PC was more than that of PH-PA(χ2 =7.929, P<0.05).Conclusions The lesions origi-nate from parathyroid if they are located in tracheo-esophageal groove or at the side of trachea with hyperparathy-roidism.Multiple lesions help in PH diagnosis .Large size and necrosis in lesions imply APA or PC .The location (left upper, left lower, right upper, right lower, ectopic), shape, density and the degree of enhancement of the lesions have not specificity for diagnosis of PHPT .

BACKGROUND: Transcutaneous electrical acupoint stimulation (TEAS) exerts good analgesic effect, but its effectiveness and safety in analgesia after total knee arthroplasty have not been reported.OBJECTIVE: To evaluate the analgesic effect of TEAS at the auricular Shenmen (H 7) point in patients undergoing total knee arthroplasty.METHODS: Forty ASA Ⅰ-Ⅲ patients scheduled for total knee arthroplasty under general anesthesia combined with femoral nerve block were enrolled and randomly divided into experimental and control groups (n=20 per group). The patients in the experimental group received TEAS at auricular Shenmen (H 7) point before anesthesia, 8, 16, 36, and 56 hours postoperatively for 30 minutes. The patients in the control group received same method with the experimental group, but without electrical stimulation. Ultrasound-guided continuous femoral nerve blockade was performed before induction, followed by tracheal tube was inserted and the patients were mechanically ventilated. The patients received patient-controlled continuous femoral nerve analgesia after surgery for 72 hours. The Visual Analogue Scale scores and the quadriceps maximum voluntary isometric contraction were recorded at postoperative 6, 12, 24, 48 and 72 hours. The consumption of ropivacaine and tramadol hydrochloride was recorded. Additionally, the incidence of adverse reactions was recorded.RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores in the experimental group were significantly lower than those in the control group at postoperative 48 and 72 hours (P < 0.05). (2) The quadriceps maximum voluntary isometric contraction in the control group was significantly lower than that in the experimental group at each time point (P < 0.05). (3) The consumption of ropivacaine in the control group ((495.7±39.4) mL) was significantly more than that in the experimental group ((394.5±27.1) mL) (P < 0.05). Seven cases in the control group and one case in the experimental group received the injection of tramadol hydrochloride (P < 0.05). (4) Nausea and vomiting occurred in six cases in the control group and one case in the experimental group, and dizziness only occurred in four cases in the control group (P < 0.05). (5) To conclude, TEAS at the auricular Shenmen (H 7) point can improve the pain after total knee arthroplasty, reduce the consumption of ropivacaine and tramadol hydrochloride, and maintain quadriceps strength.