Patients w ith acute ischemic stroke often have increased blood pressure and cause sharp fluctuations in blood pressure. Analysis of blood pressure variability can quantize the degree of blood pressure fluctuations w ithin a certain period of time and provide reliable predictive information for the outcomes of ischemic stroke. While reducing the average value of blood pressure, decreasing the blood pressure variability can make the patients obtain greater benefits. This article review s the possibility of blood pressure variability in patients w ith acute ischemic stroke for its predictive value and the blood pressure variability as an intervention target.

Objective:To explore the genotype and allele distribution feature of cytochrome P450 2C19 (CYP2C19) in Uighur and Han nationality patients With coronary heart disease (CHD).Methods:A total of 355 CHD patients Without kinship,including 194 Uighur cases and 161 Han cases,Were selected. CYP2C19 genetic polymorphism Was analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),it’ s compared betWeen different age groups (<60 years and≥60 years)of the tWo nationalities.Results:Compared With Han na-tionality patients,there Were significant increase in allele*1 frequency [(64.9% vs.75.2%),P<0.01],signifi-cant decrease in allele*2 (29.5% vs.22.2%),and allele*3 (5.6% vs.2.6%) frequencies (P<0.05 all);geno-type*1/*1 significant increase [(38.5% vs. 57.7%),P<0.01],*1/*2 significant decrease [(44.7% vs. 31.5%),P<0.05],and other four genotype betWeen tWo nationalities Were no significant difference (P>0.05);fast metabolic patter frequency (38.5% vs. 57.7%)significant increase,moderate metabolic patter frequency (52.8% vs. 31.5%)significant decrease (P<0.01 all)in Uighur nationality patients ;In a same nationality,age had no significant impact on its genotype and allele distribution (P>0.05 all).Conclusion:There are significant differences in cytochrome P450 2C19 genotype and allele distribution betWeen Uighur nationality and Han nationali-ty CHD patients,Understanding those is of important significance to guide clinical medication and improve patients' prognosis.

Objective To study the influence of anxiety on left cardiac function in elderly patients with chronic heart failure. Methods 111 cases of chronic heart failure patients with anxiety (anxiety group) and 95 cases of chronic heart failure patients without anxiety (non anxiety group) were selected. General data were collected from patients during hospitalization and the Zung Self-rating Anxiety Scale (SAS)was filled out. Statistical analysis and evaluation of the influence of anxiety on left cardiac function in elderly patients with chronic heart failure was made. Results There was not significant difference (P>0.05) in the gender, age and uric acid between 2 groups, but was (P<0.05) in left ventricular ejection fraction, left ventricular end diastolic dimension, left ventricular end systolic dimension, and cardiac functional grading.Conclusion Anxiety has a strong influence on left cardiac function in elderly patients with chronic heart failure.

ObjectiveTo evaluate the radial rotation osteotomy and ulnadouble rotation osteotomy obstetric brachial plexus injury (obstetric brachial plexus palsy) forearm pronation deformity sequelae value.MethodsFrom August 2007 to August 2011, twenty cases of obstetric brachial plexus palsy sequelae in children with forearm pronation deformity, the implementation of a simple radial rotating radial osteotomy (5cases),double-rotation radius and ulna osteotomy (15 cases) and two surgical type,and by 6 to 54 months after surgery (mean 25 months) follow-up.The groupfunctions to forearm pronation angle and conscious function improvement as the evaluation criteria. ResultsThe 15 cases of radius and ulna osteotomy in children with dual function and appearance in 14 cases significandy improved,one case of supination deformity;five underwent simple radial pronation osteotomy,three patients had improved function and appearance,followed up for 6 months, eight months after the merger which radial head dislocation in 2 cases due to poor efficacy of dual-line radius and ulna osteotomy, twenty patients in this group did not appear nonunion.ConclusionSimple radial rotation osteotomy surgery in obstetric brachial plexus palsy forearm pronation deformity complications without radial head dislocation has some value, radius and ulna double osteotomy in forearm pronation deformity with radial head dislocation aftermath of the effect is more excellent.

Objective: To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C₇) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. Methods: A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C₇ transfer from September, 2004 to December, 2014. Among them, contralateral C₇ were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. Results: All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C₇ transferred to the median nerve group, 10 cases had muscle strength recovered≥M₃, and 26 cases had sensory recovered≥S₃; In the group of C₇ transferred to the radial nerve, 6 cases had muscle strength recovered≥M₃, and 9 cases had sensory recovered ≥S₃; In the group of C₇ transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M₃, and 17 cases had sensory recovered≥S₃. In the group of C₇ simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M₃, 5 cases had elbow flexion recovered≥M₃, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S₃, respectively. Conclusion Contralateral C₇ transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes.

BACKGROUND:The most advanced and representative diagnosis techniques for perforating branch of blood vessels include digital subtraction angiography, CT, MRI and other imaging techniques. These methods can visualize blood vessels clearly and have a high precision, but there are some trauma and less popular.
OBJECTIVE:To apply high-frequency ultrasound for detection of thoracic dorsal artery and perforating branch, and provide a reference for preoperative design of thoracic dorsal artery perforating flap.
METHODFifteen patients candidate for thoracic dorsal artery perforating flap were included in this study. Before surgery, we used high-frequency ultrasound to detect the perforating branch, including vascular contorts, diameter, the location of the perforators and surface markers. The thick, superficial, paral el perforating branch was selected as the main blood vessels, to design and cur the skin flap.
RESULTS AND CONCLUSION:In the involved 15 cases, thoracic dorsal artery were derived from the subscapular artery, thoracic dorsal artery and its main branches, as wel as more than 1 mm main perforating branch in 13 cases were clearly visible. It was consistent with intraoperative measurement results. The perforating branch less than 1 mm only showed strip-like blood flow signal or no blood flow and spectrum signal, and there was an unclear boundary to surrounding tissue. One case appeared distortion and variation of blood vessels before surgery, thus changed to other surgery. Two cases had no perforating branch by preoperative detection, which was then confirmed by intraoperative anatomy. High-frequency ultrasound has a significant effect on preoperative position of perforating branch, and the combination with computer tomography angiography and magnetic resonance angiography can support a more comprehensive and reliable reference.

Objective To investigate the brachial plexus injury patients regional and national characteristics,epidemiological characteristics.Methods Reference to foreign brachial plexus injury epidemiology survey methodology,retrospective analysis of five representative hospitalsthe trauma center in Urumqi,Xinjiang during January 2010 and May 2013 were treated 166 cases of patients with brachial plexus injury medical records.Results The incidence rate of brachial plexus injury was 1.17％ in this 5 trauma center.From 20 to 49 age group accounted for 69.87％,the ratio of male to female was 4.53:1.Workers and farmers accounted for 51.8％,Uygur,Han accounted for respectively 62.04％,24.69％.Kashi,Aksu,Urumqi accounted for respectively 22.89％,12.04％,8.43％.Motor vehicle accidents,high-altitude fall injury and injuries caused by birth trauma accounted for respectively 33.73％,31.92％ and 9.67％.Injury type:root,trunk,bundle/bundle branch injury cases accounted for respectively 28.91％,27.10％,40.36％.Conclusion Brachial plexus injury occurs mainly in young men with low income,motor vehicle accidents,and high-altitude fall injury are dangerous injury factors,different nationalities,different areas occurs constitutes obvious difference,neonatal birth trauma caused by brachial plexus injury constitute relatively high.

Objective To evaluate the iodine nutritional condition among populations in Aksu after implementing free iodized salt in population of Xinjiang.Methods According to the National Iodine Deficiency Monitoring Programme (Revised),totally 45 villages (towns) of subordinated 8 counties and Aksu City,Xinjiang were selected for collecting salt samples.Meanwhile,in 27 villages (towns) primary schools,school-aged children (8-10 years old) were selected for collecting disposable urine samples,B ultrasound was used to check thyroid volume and intelligence (IQ) was evaluated by China Combined Raven Test (CRT).Pregnant women were sampled for collecting their disposable urine near the primary schools.Both the children and pregnant women were evaluated the iodine deficiency disorders (IDD) knowledge awareness by questionnaire.The urine iodine concentration was measured by the ammonium persulfate digestion-As-Ce catalytic spectrophotometer method.The salt iodine concentration was measured by the direct titrimetric method,and other kinds of iodine in salt were measured by referee method (GB/T 13025.7-2012).Results A total of 2 700 household salt samples were collected,the average of iodine concentration in household salt was (26.95 ± 5.10) mg/kg.The coverage of household iodized salt was 98.56％ (2 661/2 700).The coverage of edible iodized salt was 98.00％ (2 646/2 700).A total of 2 159 urine samples were collected,the median of urine iodine concentration (UIC) among school-aged children (8-10 years old) was 235.50 μg/L.The total goiter rate was 1.51％ (33/2 179) among children aged 8-10 years old.A total of 2 098 people were conducted IQ test,the average IQ was 88.03 ± 17.14.A total of 1 047 urine samples were collected,the median of UIC among pregnant women was 213.50 μg/L.The IDD knowledge awareness rate of children and women were 98.82％ (751/760) and 99.23％ (258/260),respectively.Conclusions The iodine nutrition is in an adequate range,awareness of IDD prevention is obviously improved among children which is representative of common people and pregnant women after implementing the free iodized salt in population of Xinjiang in Aksu.The policy of preventing IDD based on this policy has showed enormous effect.

BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.

Celiac disease is a common immune-mediated disorder that may present with various heterogeneous symptoms following gluten ingestion.It accounts for 0.7%-1.4%of the global population.The prevalence of celiac disease in China was once considered extremely low.However,in recent years,several cases of celiac disease have been reported one after another,which has gradually attracted people's attention.A gluten-free diet is the only effective treatment for celiac disease,but it has limitations in certain patient groups and is difficult to maintain over time.This is why studying alternative treatment options for celiac disease is of great clinical importance.In recent years,the treatment of celiac disease has seen the emergence of several novel therapies that provide ideas and directions for clinical treatment in terms of removing or reducing the factors that cause abnormalities in immune tolerance,suppressing one's immune response to gluten,and re-establishing immune tolerance to gluten.This review focuses on the research progress of new therapies for celiac disease.