OBJECTIVE To summarize the characteristics of central vertigo and subclavian steal syndrome(SSS)and analyze the relationship between them.METHODS A retrospective review of 87 cases of patients diagnosed with SSS based on the evidence of clinical symptoms and results of transcranial doppler(TCD),cervical doppler ultrasound(CDUS),head and cervical magnetic resonance angiography(MRA),or cerebral digital subtract angiography(DSA)was present for analyzing the clinical presentation between the central vertigo and the subclavian steal syndrome.RESULTS There were more male than female in the 87 cases;8.05% of patients were under the age of 50,37.93% from 50 to 65,and 54.02% over 65,showing the incidence of SSS increases with the age.In 64.37% of patients,vertigo was the only symptom;in 29.89% of patients,vertigo presented as an accompanying symptom;and in 5.75% of patients,there was no significant vertigo.Of all these patients,65.52% had left SSS,32.18% had right SSS,2.30% had bilateral SSS;there were more left side lesions than right side.CONCLUSION SSS is no longer a rare disease as investigation tools keep developing.Its incidence increases with age.As vertigo may be its only clinical presentation,SSS could be misdiagnosed very easyly.To avoid misdiagnosising,it is very important to screen for SSS in patients with vertigo for the diagnosis early.

There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.
Cervical Vertebrae ; surgery ; Decompression, Surgical ; Humans ; Spondylosis ; diagnosis ; surgery ; Treatment Outcome

Objective To investigate the nasal endoscope Television Co-line self-retaining laryngoscope vo-cal polyps surgery treatment. Methods 121 cases diagnosed of vocal cord polyp (of which 54 cases of bilateral, u-nilateral 67 cases), in the serf-retaining laryngoscope and surveillance camera system of vocal cord polyp removed and opened Lacunar Reinke and will preoperative laryngoscopy and laryngoscopy after surgery and review the results of the video and retain. Results 4 weeks to review 70° nasal endoscope, and 116 cases of vocal sounds close to nor-mal, the cure rate reached 95.9 percent, and the remaining five cases because of vocal hypertrophy or incomplete closure of the vocal cords, sounds worse than normal shoots. Follow-up 3～18 months without recurrence, no serious complications. Conclusion The nasal endoscope and television surveillance camera system of amplification, in par-ticular, Reinke Lacunar throat image more clearly, so that lesions can be completely removed, and the vocal cords can be a very good organization had to protect, and by retaining the video can be pre-operative, during and after vo-cal dynamic comparative situation.

Objective To observe the protection of Caspase inhibitor(zVAD-fmk,benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone) on neonatal rat with hypoxic-ischemic brain damage(HIBD).Methods Thirty-six neonatal rats,7 days old,were randomly divided into hypoxic-ischemic(HI) control group(A),zVAD-fmk treated group(B) and sham group(C).Before HI insult,a pan-Caspase inhibitor,zVAD-fmk or normal buffer solution was injected into the cerebral ventricle.The water content of cerebral hemisphere was measured and the percentage of apoptofic cells in hippocampal neurons was measured by Flow cytometer(Annexin V/PI) at 24 hours after HI insult.The effect on body weights(percentage of increased weight,WIP) and macroscopical changes(percentage of cortox and hippocampal dead neurons) were assessed at 14 days.Results Compared with group A,the water content of ischemic hemisphere and apoptosis percentage of hippocampal neurons in group B reduced significantly.The difference of percentage of increased weight at 14 days in group B was not significantly.Microscopic examination showed that cortox and hippocampus neural death rate in group B was proved significantly reduced compared with that in group A.Conclusion Intracerebral administration of zVAD-fmk has protective effects on hypoxic-ischemic brain damage in neonatal rat.

Affective Symptoms ; drug therapy ; etiology ; Female ; Fluoxetine ; therapeutic use ; Humans ; MELAS Syndrome ; complications ; psychology ; Middle Aged ; Serotonin Uptake Inhibitors ; therapeutic use ; Stroke ; complications ; psychology

Objective To evaluate the efficacy of acting κ opioid receptor for prevention of high altitude pulmonary edema (HAPE) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),hypobaric hypoxia group (group H),normal saline + hypobaric hypoxia group (group NH),U50488H (a selective kappa-opioid receptor agonist) + hypobaric hypoxia group (group UH),and nor-binaltorphimine (norBNI,a selective kappa-opioid receptor antagonist) + U50488H + hypobaric hypoxia group (group NUH).The rats were put into the hyperbaric chamber and exposed to hypobaric hypoxia (atmospheric pressure 355 mmHg,partial pressure of oxygen 74 mmHg) for 2 days to induce HAPE.At 3 days before HAPE,normal saline 0.5 ml,U50488H 1.25 mg/kg,and nor-BNI 2.0 mg/kg were injected intraperitoneally once a day in NH,UH,and NUH groups,respectively,and in addition U50488H 1.25 mg/kg was injected intraperitoneally 10 min later in NUH group.After 2 h exposure to hypobaric hypoxia,mean pulmonary artery pressure (mPAP) was detected,and arterial blood samples were collected for determination of serum malondialdehyde (MDA) and erythropoietin (EPO) levels.The rats were then sacrificed and lungs were removed for microscopic examination and for determination of the levels of nitric oxide (NO),inducible nitric oxide synthase (iNOS),MDA,superoxide dismutase (SOD),endothelin-1 (ET-1),thromboxane B2 (TXB2),and 6-keto-prostaglandin F1α (6-keto-PGF1α) in lung tissues.Lung water content and TXB2/6-keto-PGF1α ratio was calculated.Results Compared with group C,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio,and serum MDA and EPO levels were significantly increased,and iNOS,NO and SOD levels were decreased in the other four groups (P ＜ 0.05).Compared with group H,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio and serum MDA and EPO levels were significantly decreased,and iNOS,NO and SOD levels were increased in UH group (P ＜ 0.05),and no significant changes were found in the indexes mentioned above in NH and NUH groups (P ＞ 0.05).The pathological changes of lung tissues were significantly attenuated in group UH as compared with H group.Conclusion Acting κ opioid receptor can produce prevention for HAPE in rats,and inhibition of lipid peroxidation and correction of the imbalance between vasoconstrictive factors and vasodilative factors may be involved in the mechanism.

Objective To explore the two-dimensional images features and color flow characteristics of scrofula, as well as their application in the localization of scrofula. Methods A total of 110 cases of the scrofula confirmed by operation were retrospectively analyzed. Two-dimensional images and color flow characteristics, the relationship with vascular traveling and the invasion site were recorded. Results Lymph nodes of the lateral neck region along with large vessels were most commonly involved, then followed the submaxillary lymph nodes and the lymph nodes anterior neck longitudinally. There might be multiple lesions behaving differently on two-dimensional images and with different color flow characteristics. Conclusion Most of scrofula can be diagnosed clearly according to the two-dimensional images and color flow characteristics. The description of relationship between involved lymph nodes with vascular, the depth and position of scrofula make the operation safety.

Objective To study the effect of intercostal bronchial artery embolization(BAE) with gelatinum sponge(GS) or polyvinyl alcohol(PVA) in treating acute massive hemoptysis.Methods Fifty-two patients with acute massive hemoptysis underwent selective bronchial arteries angiogaphy first,then superselective bronchial arteries embolization using 3F SP catheter with GS in group A(n=24) and with PVA in group B(n=28).Results In group A,immediate control of hemoptysis was achieved in 16 patients(66.67%),marked reduce in bleeding was seen in 7 patients(29.17%),the effective rate was 95.83%.In group B,immediate control of hemoptysis was achieved in 24 patients(85.71%),marked reduce in bleeding was seen in one patients(14.29%),the effective rate was 100%(P﹥0.05).All patients were followed-up for one year.The recurrent rate was 25%(6 cases) in group A and 3.57%(1 case) in group B(P﹤0.05).Conclusion BAE with PVA is effective and safe method in treating serious hemoptysis.

Objective:To ascertain the optimized ultrasonic condition for extraction of flavone from Radix Astragali by orthogonal design. Methods: The contents of calycosin-7-O-?-D -glucoside and formononetin were taken as the indices and were determined. The ultrasonic time (10 min, 20 min, and 30 min), concentrations of methanol (50%, 75% and 100%) and times of extraction (1, 2, and 3) were analyzed by orthogonal design; the best ultrasonic condition was ascertained and compared with those of soak extraction and Soxhlet extraction. Results: Ultrasonic with 100% methanol twice (20 minutes each time) was the optimized condition for extraction of flavone from Radix Astragali. The efficiency of ultrasonic extraction was better than those of soak extraction and Soxhlet extraction. Conclusion: Compared with other methods, the ultrasonic extraction of flavone from Radix Astragali is efficient, quick and simple.

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.