BACKGROUND: Nowadays, it is reported that vessel structural abnormity is the main morphological basis of vertigo due to vertebrobasilar arterial insufficiency abroad, but the report of vascular structural abnormality in vertebrobasilar arterial insufficiency is rare at home.OBJECTIVE: To observe the manifestation and clinical significance of vessel structural abnormity tested by digital substraction angiography (DSA)in patients with vertigo induced by vertebrobasilar arterial insufficiency.DESIGN: Case analysis.SETTING: Department of Neurology, Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University and Department of Neurology, Huaihua Hospital Affiliated to Nanhua University.PARTICIPANTS: A total of 57 patients, who were diagnosed as having episodic vertigo with or without nausea or vomiting, and hospitalized in the Department of Neurology, Huaihua Hospital Affiliated to Nanhua University from August 2003 to May 2004 and Wuxi Second Hospital (Wuxi Municipal Second People's Hospital) Affiliated to Nanjing Medical University between October 2004 and May 2005, were enrolled.METHODS: Fifty-seven patients with vertigo induced by vertebrobasilar arterial insufficiency hospitalized in the recent two years were treated with digital subtraction radiography in aortic arch and aortocranial angiography:Applying retrograde angiography of femoral artery puncture, Optiray nonionic contrast agent with syringe pattern to perform aortic arch angiography. Digital subtraction machine displayed bilateral carotid artery, vertebral artery, ranged from carotid artery to siphon of carotid artery from multiple angles. Measurement and evaluation were conducted by 2 doctors from department of neurology.MAIN OUTCOME MEASURES: Type, distribution and proportion of vesselstructural abnormity of aortic arch, carotid artery and vertebrobasilar system.RESULTS: Of the 57 patients, 1 patient was dropped out, because the left vertebral artery (LVA) could not be entered. A large area cerebral infarction was occurred in another patients during aortic arch angiography was performed, and the operation was stopped. Totally 55 patients were involved in the result analysis. It was found that 71%(39/55) of patients had vessel structural abnormity in cervical part and intracalvarium, 11%(6/55)of patients with simple anterior circulation lesion, 60% (33/55) of patients with posterior circulation lesion, of which 9 cases (16%) with compound lesion of anterior circulation abnormity. Two or above vessels in 24 cases (24/55,44%) were involved. Vertebral artery complicated with other angiostegnosis was the most common, and there was no vessel structural abnormity in other 16 cases (16/55,29%).CONCLUSION: Various types of vessel structural abnormity are the main etiological factors of vertigo induced by vertebrobasilar arterial insufficiency. Gold standard of diagnosing vertigo due to vertebrobasilar arterial insufficiency is DSA.

Antihypertensive Agents ; administration & dosage ; therapeutic use ; Humans ; Hypertension ; drug therapy ; genetics ; Molecular Biology

Objective To investigate the current status of medication compliance of patients with anky-losing spondylifis and analyze its related factors. Methods Seventy-four patients with ankylosing spondylitis were investigated about their general conditions,medication compliance and its related factors.The results were analyzed. Results Thirty-nine patients(52.7%) had good medication compliance while the rest 35 cases has poor medication compliance among which 24 patients with drug withdrawal exceeded 1 month.The medication compliance for patients with disease process of lower than 0.5 year,0.5 to 1.0 year,1 to 2 years and above 2 years was 82.0%,60.0%,25.0%and 31.0%.The logistic regression analysis showed that the disease process,dis-ease knowledge and media advertisement were the main influencing factor for medication compliance,while the age,sex,marital status,education background,adverse reaction,satisfaction degree with medication effect, economic conditions and depression were not major influencing factors. Conclusions About half of patients with anky-losing spondylitis had poor medication compliance,especialy with disease process of above 1 year.The main in-fluencing factors include disease process,disease knowledge and media advertisement.

Objective To define the MRI features of biliary postoperative disoders,so as to find its exact causes.Methods MRI informations of 41 patients with biliary postoperative disoders were retrospectively evaluated to find whether there were such disorders as biliary dilatation,stricture,cholangeitis,remnant stones,remnant gallbladder,etc.Results The biliary abnormality was found in thirty-eight of the 41 patients,including ductal dilatation in 20,intraductal stones in 16,cholangietis in 13,ductal stricture in 7,tumors in hepatic hila in 3.The biliary dilatation commonly presented within 3 months after operation while the biliary stricture and cholangeitis presented commonly 6 months after operation.Conclusion The biliary postoperative disoders is mainly caused by biliary dilatation,stricture and remnant stone,MRI is the sensitive and effective method for diagnosis of biliary abnormalities.

Geographic tongue, also called benign migratory glossitis, is a common and superficial benign inflammatory disorder that affects the tongue epithelium. The majority of geographic tongue lesions typically manifest as irregular central erythematous patches. These lesions, which are caused by the loss of filiform papillae, are defined by an elevated whitish band-like border that can change location, size, and pattern over a period of time. Histological observations of the oral mucosa affected by geographic tongue revealed nonspecific inflammation. Some reports described cases of migratory stomatitis, wherein lesions simultaneously manifested on the extra lingual oral mucosa. This condition is also called ectopic geographic tongue, which is clinically and histologically similar to the type normally confined to the tongue. In most cases, patients are asymptomatic and do not require treatment. The condition may spontaneously exhibit periods of remission and exacerbation with good prognosis. The specific etiology of geographic tongue remains unknown. Geographic tongue is age-related and is prevalent among young individuals. Various etiological factors that have been suggested in literature include immunological factors, genetic factors, atopic or allergic tendency, emotional stress, tobacco consumption, hormonal disturbances, and zinc deficiency. Geographic tongue may coexist with other disorders, such as fissured tongue, psoriasis, diabetes mellitus, gastroin- testinal diseases, burning mouth syndrome, and Down syndrome. Experts currently disagree on whether geographic tongue is an oral manifestation of psoriasis. Moreover, some scholars suggest that geographic tongue is a prestage of fissured tongue. The objective of this review is to summarize current research on risk factors of geographic tongue.
Epithelium ; Female ; Glossitis, Benign Migratory ; Humans ; Mouth Mucosa ; Risk Factors ; Tongue ; Tongue, Fissured

Objective To detect the selective inhibitory effects of irradiation plus adenovirusmediated horseradish peroxidase ( HRP)/indole-3-acetic acid (IAA) suicide gene system using tumorspecific and radio-inducible chimeric promoter on human hepatocellular carcinoma subcutaneously xenografted in nude mouse.MethodsRecombinant replicated-deficient adenovirus vector containing HRP gene and chimeric human telomerase reverse transcriptase (hTERT) promoter carrying 6 radioinducible CArG elements was constructed.A human subcutaneous transplanting hepatocellular carcinoma (MHCC97 cell line) model was treated with -γ-ray irradiation plus intra-tumor injections of adenoviral vector and intra-peritoneal injections of prodrug IAA.The change of tumor volume and tumor growth inhibiting rate,the survival time of nude mice,as well as histopathology of xenograft tumor and normal tissues were evaluated.Results Thirty one days after the treatment,the relative tumor volumes in the negative,adenovirus therapy,irradiation,and combination groups were 49.23 ± 4.55,27.71 :± 7.74,28.53 + 10.48 and 11.58 ± 3.23,respectively.There was a significantly statistical difference among them (F = 16.288,P ＜0.01 ).The inhibition effect in the combination group was strongest as compared with that in other groups,and its inhibition ratio was 76.5%.The survival period extended to 43 d in the combination group,which showed a significantly difference with that in the control group(x2 = 18.307 ,P ＜0.01 ).The area of tumors necrosis in the combination group was larger than that in the other groups,and the normal tissues showed no treatment-related toxic effect in all groups.However,multiple hepatocellular carcinoma metastases were observed in the liver in the control group,there were a few metastases in the monotherapy groups and no metastasis in the combination group.Conclusions Adenovirus-mediated suicide gene therapy plus radiotherapy dramatically could inhibit tumor growth and prolong median survival time.It might provide a promising therapeutic modality for hepatocellular carcinoma therapy.

Objective To evaluate the value of transvaginal ultrasound in diagnosing intrauterine adhesions.Methods Transvaginal ultrasound was performed in 136 patients with suspicious intrauterine adhesions and compared with hysteroscopy correspondingly .The ultrasonographic features of intrauterine adhesions on transvaginal ultrasound were summarized .Results One hundred and twenty one cases (89.0%, 121/136 ) of intrauterine adhesions were verified by hysteroscopy .The hysteroscopic findings included:(1) Forty seven cases(38.9%,47/121) were minimal intrauterine adhesions , 46 cases(38.0%, 46/121) were moderate intrauterine adhesions , and 28 cases (23.1%,28/121) were severe intrauterine adhesions.(2) Sixty one cases(50.4%,61/121) were central intrauterine adhesions , 24 cases(19.8%, 24/121) were marginal intrauterine adhesions , and 36 cases (29.8%, 36/121) were mixed type of intrauterine adhesions.The transvaginal ultrasound findings included:(1)Nineteen cases(40.4%,19/47) were minimal intrauterine adhesions ,33 cases(71.7%,33/46)were moderate intrauterine adhesions ,and 23 cases(82.1%,23/28) were severe intrauterine adhesions .(2) Thirty nine cases (63.9%,39/61) were central intrauterine adhesions ,9 cases(37.5%,9/24) were marginal intrauterine adhesions ,and 27 cases (75.0%, 27/36 ) were mixed type of intrauterine adhesions .By transvaginal ultrasound, seventy-five (62.0%,75/121) cases of intrauterine adhesions were correctly diagnosed , whereas 46 cases (38.0%, 46/121) were missed.And 3 cases ( 3.8%, 3/78 ) were misdiagnosed as intrauterine adhesions on transvaginal ultrasound,including one endometrial polyp ,one thin endometrium and one septate uterus .The sensitivity, specificity and accuracy of transvaginal ultrasound in diagnosing intrauterine adhesions were 62.0%(75/121), 80.0%(12/15) and 64.0%(87/136) respectively.There were significant statistical differences in diagnosing different degrees of intrauterine adhesions ( χ2 =15.956,P=0.000) and different parts of intrauterine adhesions( χ2 =8.792,P=0.012) by transvaginal ultrasound.Conclusions Transvaginal ultrasound is an effective, easy to perform and noninvasive technique in screening and diagnosing intrauterine adhesions.Transvaginal ultrasound is an effective way in diagnosing intrauterine adhesions showing a noninvasive and simpler way than hysteroscopy .Transvaginal ultrasound is of great value in screening and diagnosing intrauterine adhesions .

OBJECTIVE To investigates the effects of imperatorin on the oxidative stress in the cerebral cortex and hippocampus after focal cerebral ischemia/reperfusion injury. METHODS Transient focal cerebral ischemia/reperfusion model in male Sprague-Dawley rats was induced by 2 h middle cerebral artery occlusion followed by 24 h reperfusion. Imperatorin (1.25 and 2.5 mg·kg- 1) or vehicle were administered intraperitoneally at 1, 5 and 9 h after the onset of ischemia. At 24 h after reperfusion, the biomarkers of oxidative stress such as the levels of reactive oxygen species (ROS), lipid peroxidation products malondialdehyde (MDA), nitric oxide (NO) and total antioxidant capacity (T-AOC), the activities of inducible nitric oxide synthase (iNOS), superoxide dismutase (SOD) and catalase (CAT) in the cerebral cortex and hippocampus were observed. We also assessed the nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and the NAD(P)H-quinone oxidoreductase 1 (NQO-1) protein expression by Western blot. RESULTS As compared to vehicle-treated animals, imperatorin treatment significantly reduced the ROS, MDA, NO levels and iNOS activity, increased T-AOC and the activities of SOD and CAT. Furthermore, imperatorin treatment also significantly induced the nuclear translocation of Nrf2, enhanced the protein expression of HO-1 and NQO-1 in the cerebral cortex and hippocampus. CONCLUSION Our findings indicate that imperatorin can protect the brain against the excessive oxidative stress induced by cerebral ischemia/reperfusion through activation of Nrf2 signaling pathway.

Objective To explore the protective effect of folic acid supplementation in different ways on lipopolysaccharide-induced external malformations and skeletal malformations in mice.Methods The pregnant mice were divided into six groups randomly,including saline control group,FA control group,LPS group,LPS+FAig group,LPS+FAip group,and LPS+FAdw group.All dams were medicated on gestational day 8～12,and then sacrificed on gestational day 18,for each litter,the number of live fetuses,dead fetuses,resorption fetuses and external malformations of live fetuses were all counted.All fetuses were subsequently evaluated the skeletal malformations.Results A low dose of LPS injection during the second trimester resulted in external and skeletal malformations.Exencephaly and encephalomeningocele were two of the most common external malformations,skeletal malformations consisted mainly of the incompletion of supraoccipital ossification,sternal malformation and rib malformation.FA supplementation by three ways all attenuated the external and skeletal malformations.And the best protective effect was by oral administration.The incidence of external,sternal and rib malformation was all decreased.Conclusions Three ways can prevent the mice during the second trimester from the external and skeletal malformations caused by LPS injection,and the best protective effect was by intragastric administration.

Objective To investigate the surgical techniques and clinical efficacy of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery in the treatment of talus neck fractures.Methods From March 2008 to June 2011,12 cases with talus neck fractures were treated with cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery.External fixation in functional position for 12-14 weeks,and the load time was determined by X-ray fracture healing.Functional results were assessed according to AOFAS (American Orthopaedic Foot and Ankle Society) score at last follow-up.Results Twelve cases were followed up for an average of 24 months (12 to 48 months).One case of skin flap necrosis healed by dressing.All the fractures healed,and the mean healing time was 20 weeks (16 to 24 weeks).AOFAS ankle and hindfoot mean postoperative score was 82.5 (ranging from 55 to 96) points.Among them 4 cases were excellent,good in 5 cases,fair in 3 cases.Two cases presented with mild posttraumatic subtalar arthritis and pain relief after oral anti-inflammatory analgesic.One case with avascular necrosis of talus body,and X-ray displayed sclerosis of talus body,but no collapse,and the patient was told to reduce weight and regularly followed up.Conclusion The application of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery for the treatment of talus neck fractures is an effective treatment,which can improves the blood supply of the talus body and reduces the occurrence of avascular necrosis of the talus.