Cryptogenic stroke refers to ischemic stroke that can not be defined by routine examination at present. Studies have show n that patent foramen ovale may be a common cause of cryptogenic stroke, and its possible mechanism is the paradoxical embolism. With the development of imaging technology , more and more studies have show n that patent foramen ovale is closely associated w ith cryptogenic stroke. This article review s cryptogenic stroke in patients w ith patent foramen ovale.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; pharmacology ; Humans ; Research Design

Objective:To explore the feasibility and validity of tubo-tymanoaerodynamic graphy(TTAG)determinating the Eustachian tube function of health adult group.Mthod:The ventilation function of Eustachian tube was measured by the TTAG method in health adlut group(132 ears),the results and the graphs were also analyzed.Reslut:The positive rate in health adult group using Valsalva method was 93.93%(124/132).The positive ears were divided into typeⅠand typeⅡ, the mean value of nasopharynx press of type Ⅰand Ⅱ has no significant differences(P>0.05),but the mean value of external auditory canal press had significant differences(P<0.01).Conclusion:TTAG meathod has the clinical value in determinating the states of Eustachian tube function of health group.

Objective To investigate the relationship between insulin level and mild cognitive impairment(MCI) of type 2 diabetes and analyze the risk factors for MCI. Methods We collected 101 type 2 diabetes subjects who were divided into two groups:MCI and normal cognition(NC).All subjects were evaluated with cognition scores of MMSE,GDS,CMS,ADL.Insulin,glycosylated hemoglobin,blood routine test,blood pressure,ECG,brain CT were detected.Independent t-test,correlation and multiple regression analysis were performed. Results 1. The diabetic patients with MCI showed the higher levels of insulin at fasting, 2hr and 3hr after meal than did NC(P

Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy in the treatment of ureter stones.Methods A total of 186 cases ureteroscopic pneumatic lithotripsy were performed in our hospital.The outcomes of the surgery were analyzed.Results The success rate of the operation was 80.6%(29/36) for the upper ureteral calculi,92.7%(51/55) for the middle,and 100%(95/95) for the lower ones,respectively.Four weeks after the surgery,re-examination showed that the rate of stone removal was 94.1%(175/186).Injuries to the ureter occurred in 5(2.7%) of the cases.Conclusion Ureteroscopic pneumatic lithotripsy is an effective and safe method for ureteral calculi.

Objective To investigate the effect of Botulinum toxin type A(BTXA)and rehabilitation intervention on upper limb Brunnstrom stages and ADL performance of stroke patients. Methods In a randomized controlled trial, 30 patients were allocated to either an experimental group (n=15) that received BTXA injection into muscles of the affected arm or to a controlled group (n=15). All patients' Brunnstrom stage and MAS stage were ≥gradeⅡ. All the patients were treated with rehabilitative techniques. The intervention was applied for 3 months. All were evaluated for the severity of spasticity (Modified Ashworth Scale,MAS),the level of impairment (Brunnstrom assessment and Fugl-Meyer upper limb test) and disability(Functional Independence Measure,FIM) before and after 1 week, 1,2,3 months of treatment. Results Patients who received BTXA had significant reduction of muscle tone (P

OBJECTIVE:To investigate advantages and disadvantages of preexisting metal post,casting metal post,ceramic post,and fiber post for clinical application,and to evaluate mechanical function,esthetical performance,and biocompatibility of fiber post.METHODS:Articles were retrieved with the key words of "fiber post,post-core restoration,dental materials,cement material,binder" in both English and Chinese between January 1990 and October 2008.Inclusion criteria:Articles addressing clinical application of fiber post for repairing residual root and crown were included.Exclusion criteria:Duplicated studies or Meta analysis was excluded.A total of 24 articles were included to investigate mechanical function,biocompatibility,and stickiness and retention of fiber post.RESULTS:Traditionally,metal post was easily folded and corrosive; in addition,esthetical performance and biocompatibility were still dissolved.Intension,hardness,esthetical performance,corrosion proof,fatigue resistance,and biocompatibility of fiber post were superior to those of traditional metal post.Furthermore,fiber post was able to highly adhere to root canal dentin via resin splicing agent,which could prolong useful life of dental prosthetic restoration,reduce root folded onset,and benefit for dental storage and repairing.Light mass of fiber post was another advantage compared with metal post.If the repair was failure,fiber post was easily taken out and reused.The combination of fiber post and resin nucleus was beneficial for dental prosthetic restoration which was highly closed to original structure of natural teeth.CONCLUSION:Fiber post was characterized by suitable elastic modulus,great esthetical repairing effect,reliable stickiness,easy identification and removal,high achievement ratio of repairing,and convenient operation; therefore,fiber post was a new and ideal material for clinical application.

Objective To compare the effects of labor epidural analgesia initiated in latent phase and active phase on parturients and neonates. Methods One hundred twenty nulliparous women at full term (single, head presentation, ASA Ⅰ or Ⅱ ) were randomly divided into 3 groups (n=40 each):control group(group C) ; PCEA initiated in latent phase group (cervical dilatation 0.5-3.0 cm) (group L) and PCEA initiated in active phase group (cervical dilatation＞3.0 cm) (group A). Epidural catheter was placed through L2,3 interspace. 0.1% ropivacaine with fentanyl 2 μg/ml was used for PCEA. A test dose of 5 ml was followed by a loading dose of 10 ml. PCEA device was programmed to allow a bolus of 6 ml with a 30 min lockout interval. The intensity of pain was measured with VAS (0=no pain, 10=worst pain) before analgesia, at 5, 10, 15 and 30 min after beginning of PCEA and cervical dilatation of 7-8 cm and 10 cm. Degree of motor block was assessed by lower extremity muscle strength (modified Bromage scale,0=no motor block, 3=inability to flex ankle joints).Plasma cortisol in maternal venous blood obtained before analgesia and at delivery of fetus and in umbilical cord blood and plasma ropivacaine concentrations in umbilical core blood were determined.The length of every stage, duration of analgesia,delivery mode, the amount of oxytocin used, maternal satisfaction, Apgar scores of the neonates and adverse effects were recorded. Results PCEA initiated in latent phase or active phase significantly reduced VAS score, the plasma cortisol level at delivery, the duration of 1st stage of labor, and the rate of cesarean section and increased the use of oxytocin in L and A groups as compared with group C, but there was no significant difference in the above variables between L and A groups. The duration of analgesia was shorter in group A than in group L. Conclusions Labor epidural analgesia initiated in latent phase or active phase can decrease the rate of cesarean section but does not prolong the duration of labor and is safe for the newborn.

Objective To assess the leading causes of death and disability adjusted life year (DALY) due to non-communicable disease (NCD) in China.Methods World Health Report 2004 published by the World Health Organization (WHO) was reviewed,including total deaths,deaths per 100 000,agestandardized death rate per 100 000,total DALYs,DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state.Diseases or injuries were assigned to three levels:communicable diseases,NCD and injuries (the first level); categories of disease or injure (the second level); specific diseases (the third level).R2.15 was used for data analysis.Results NCD causes 737.6 million deaths,141million total DALY years,627 age standardized mortality per 100 000,and 10 829 age-standardized DALYs per 100 000.NCD account for 79.4％ and 70.3％ total death or all-cause DALYs.Conclusions Cardiovascular disease,malignant neoplasm and respiratory disease were the leading causes of death,while neuropsychiatric disorder,cardiovascular disease and sense organ disease were the most important causes of DALYs.Among China,the United Kingdom,the United States,Canada,Japan,Korea and India,China ranked second in age-standardized mortality rate of chronic disease.DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level.Besides,the increasing trend in the prevalence of diabetes mellitus remains impressive.

The metabolic characteristics of ligustrazin (TMPz) in liver microsomes were investigated in the present study. The reaction phenotyping of TMPz metabolism was also identified by in vitro assessment using recombinant human cytochrome P450 enzymes (CYP) and UDP glucuronosyltransferases (UGT). TMPz was incubated at 37 degrees C with human (HLM) and rat liver microsomes (RLM) in the presence of different co-factors. The metabolic stability and enzyme kinetics of TMPz were studied by determining its remaining concentrations with a LC-MS/MS method. TMPz was only metabolically eliminated in the microsomes with NADPH or NADPH+UDPGA. In the HLM and RLM with NADPH+UDPGA, t1/2, K(m) and V(max) of TMPz were 94.24 +/- 4.53 and 105.07 +/- 9.44 min, 22.74 +/- 1.89 and 33.09 +/- 2.74 micromol x L(-1), 253.50 +/- 10.06 and 190.40 +/- 8.35 nmol x min(-1) x mg(-1) (protein), respectively. TMPz showed a slightly higher metabolic rate in HLM than that in RLM. Its primary oxidative metabolites, 2-hydroxymethyl-3, 5, 6-trimethylpyrazine (HTMP), could undergo glucuronide conjugation. The CYP reaction phenotyping of TMPz metabolism was identified using a panel of recombinant CYP isoforms (rCYP) and specific CYP inhibitors in HLM. CYP1A2, 2C9 and 3A4 were found to be the major CYP isoforms involved in TMPz metabolism. Their individual contributions were assessed b) using the method of the total normalized rate to be 19.32%, 27.79% and 52.90%, respectively. It was observed that these CYP isoforms mediated the formation of HTMP in rCYP incubation. The UGT reaction phenotyping of HTMP glucuronidation was also investigated preliminarily by using a panel of 6 UGT isoforms (rUGT). UGT1A1, 1A4 and 1A6 were the predominant isoforms mediated the HTMP glucuronidation. The results above indicate that the metabolism of TMPz involves multiple enzymes mediated phase I and phase II reactions.