ObjectiveToinvestigatethecorrelationbetweentheetiologicsubtypeandoutcomein patients w ith non-disabling ischemic cerebrovascular events (NICE). Methods The consecutive patients w ith NICE admitted to hospital within 7 days after onset were enroled prospectively and folowed for 90 days. Etiologic subtypes w ere classified according to the Chinese Ischemic Stroke Subclassification (CISS). Good outcome w as defined as modified Rankin Scale score 0-2. Multivariate logistic regression analysis w as used to identify the independent risk factors for stroke recurrence and poor outcomes. Results A total of 162 patients with NICE were enroled. According to CISS, 76 (46.9%) were classified into large artery atherosclerosis (LAA), 54 (33.3%) into penetrating artery disease (PAD), 15 (9.3%) into cardiogenic stroke (CS), 11 (6.8%) into undetermined etiology (UE), and 6 (3.7%) into other etiology (OE). A total of 30 patients (18.5%) had recurrent stroke w ithin 90 days and 42 (25.9%) had poor outcomes. The proportions of patients w ith diabetes (46.7%vs.20.5%;χ2 =8.885, P=0.003), previous stroke or transient ischemic attack (46.7%vs.25.0%;χ2 =5.572, P=0.018), CS (20.0%vs.6.8%;Fisher exact test:P=0.036) in the stroke recurrence group w ere significantly higher than those in the non-stroke recurrence group, and the proportion of PAD patients in the stroke recurrence group w as significantly low er than that in the non -stroke recurrence group ( 16.7%vs.37.1%; χ2 =4.602, P=0.032 ). Multivariate logistic regression analysis show ed that diabetes (odds ratio [OR] 2.137, 95%confidence interval [CI] 1.359-4.187;P=0.004) and CS (OR 5.236, 95%CI 2.326-10.256; P<0.001) w ere the independent risk factors for recurrent stroke of NICE. The proportions of patients w ith hypertension ( 83.3%vs.61.7%; χ2 =6.635, P=0.010 ), diabetes (40.5%vs.20.0%;χ2 =6.900, P=0.009), atrial fibrilation (35.7%vs.14.2%;χ2 =9.113, P=0.003) and CS ( 19.0%vs.5.8%; Fisher exact test: P= 0.017 ) in the poor outcome group w ere significantly higher than those in the good outcome group, and the proportion of PAD patients ( 16.7%vs. 39.2%;χ2 =7.088, P=0.008) in the poor outcome group w as significantly low er than that in the good outcome group. Multivariate logistic regression analysis show ed that diabetes ( OR 2.257, 95%CI 1.209-3.687; P=0.010), atrial fibrilation (OR 3.137, 95%CI 1.359-6.107, P=0.002), and CS (OR 6.123, 95%CI 2.026-12.256, P<0.001) w ere the independent risk factors for poor outcomes in patient w ith NICE. Conclusions The etiologic subtype is associated w ith the poor outcomes and recurrent stroke, and can provide reference for recurrence and clinical outcome assessment in patients w ith NICE.

Background Orbital blow-out fracture often results in the abnormalities of appearance and function of eye.Because of the special and complex anatomical structure of orbital cavity,it is difficult to design and manufacture the corresponding orbital implants.The computer-aided designing and manufacturing (CADM) technology provides a new approach to orbital implants.However,the clinical value of this method is still under evaluation.Objective This study was to investigate the application and the therapeutic effect of CADM for orbital blow-out fracture.Methods The clinical data of 74 eyes of 74 patients who received surgery for orbital blow-out fracture from July 2006 to July 2012 in Henan Eye Institute,Henan Eye Hospital were retrospectively analyzed.Fiftyeight patients underwent CADM implanted surgery and 16 patients received non-CADM surgery in the same period with matched age,gender and lateral eyes in both groups.The individualized 3D orbital implants were designed and manufactured by the technology of CADM and then were implanted in the bone defects in the CADM group,while the traditional hydroxyapatite artificial bone or high density porous polyethylene material (Medpor) was utilized in the non-CADM group with a fellow-up duration for 22 to 69 months.The best corrected visual acuity (BCVA),eyeball exophthalmos,ocular position,eye movement,diplopia and postoperative complications were evaluated.Results The preoperative BCVA were 0.71±0.37 and 0.69±0.41,and the postoperative BCVA were 0.74±0.38 and 0.72±0.41 in the CADM group and the non-CADM group,respectively,showing an insignificant intergroup difference (Fgroup =0.043,P=0.837),but a significant variation was found over time (Ftime =13.576,P ＜ 0.01).The BCVA was significantly improved after surgery compared with before surgery in both groups (both at P＜0.05).No significantdifferences were found in the number of eyes with curative and improved diplopia and eye movement disorders between the two groups during the fellow-up duration (Z =-0.298,P =0.766;Z =-0.548,P =0.584).The preoperative eyeball exophthalmos values were (3.93±0.99)mm and (3.88±0.97)mm and the postoperative ones were (0.91 ±0.67)mmand (1.84±0.80) mm in the CADM group and the non-CADM group,respectively,without significant differencebetween the two groups (Fgroup =3.558,P =0.063).However,the eyeball exophthalmos values after operation wereremarkably lower than those before operation in both groups (both at P＜0.05).CT imaging displayed implants fitting well with fracture defect and attached to bone tissue accurately in all of the eyes in the CADM group,but in the nonCADM group,the bulge of implants damaging extraocular muscles or optical nerve was found in 2 eyes.No postoperative complication was seen throughout the fellow-up duration in the CADM group.Conclusions CADM technology for orbital blow-out fracture can reconstruct a 3D bony orbit and effectively repair ocular position and appearance,and furthermore restore eye movement and visual functions.The therapeutic outcome of CADM technology for orbital blow-out fracture is superior to conventional implants.

Two cases of adenocarcinoma of the urinary bladder with clinical and pathological features, and brief review of the literatureare presented. Case 1: The patient, a 52 year-old man, was admitted to this hospital because of intermittent painless total gross hematuria for 15 years. Cystoscopy was done, and showing a cauliflower mass with broad based diffuse infiltrating lesion at the right anten or portion of bladder. TUR-B was performed. Microscopically, the lesion consisted of colonic metaplastic epithelium with atypical glands and cystic dilatation and adenocarcinoma. Case 2: The patient, a 52-year-old woman, was admitted to this hospital because of total painless gorss hematuria for 1 year. Cystoscopy was done showing a sessile diffuse mass with ulceration on the dome area. Total cystectomy was performed. Grossly, the tumor showed an ulcerative tumor mass with elevated nodular margin at the dome of the bladder. Microscopically, the lesion consisted of anaplastic glands with back to back arrangement and branching glands through the entire thickness of the bladder wall.
Female ; Humans ; Adenocarcinoma

Two unusual and rare forms of Brenner tumor are reported and the literatures are reviewed. The one, "proliferating" Brenner tumor, morphologically resembling low grade papillary transitional cell carcinoma of urinary bladder and regarded as a third variant intermediate between the benign and malignant forms; the other, malignant Brenner tumor of right ovary, corresponding to grade III transitional cell carcinoma of urinarybladder with areas of invasive squamous cell carcinoma and benign Brenner tumor of left ovary, combined with bilateral cystic teratomas. These tumors give additional support to the concept that Brenner tumors are composted of epithelium of urinary tract(urothelial) type.

Total 481 cases of gallstones from Korean patients operated at Keimyung University Dongsan Hospital during the last 6 years were classified by macroscopic view according to the classification of Sato, et al and reviewed with a special reference to age, sex, and kinds and sites of gallstones. Gallstrones were present predominatly in the age of 50-60 years, the average 52. Sex ratio (M:F) was nearly equal, being 1:1.05. Gallbladder was the most frequent site, comprising 53.2%, followed by common bile duct, 23.3% and intrahepatic location, 3.7%. Macroscopic classification revealed pigment gallstones in 53.0% (calcium bilirubinate, 41.8%; black, 11.2%); cholesterol gallstones in 36.2%, of which mixed stone being 33.1%. Cholesterol gallstones occurred predominantly in 50-60 years of age with a prediletion to females. On the contrary, elderly persons more than 60 years of age had calciu bilirubinate stones. No sex difference was found in the calcium bilirubinate stones. Eightly-six percent of cholesterol gallstones were present in the gallbladder only. Common bile duct stones were mostly composed of pigment gallstones in 80.4%.
Female ; Humans

OBJECTIVE To compare the bacterial resistance of wounds and clinical features in burned patients in intensive care unit (ICU) with those in general wards (GW) in the same period so as to provide basis for clinical prevention and treatment. METHODS Nineteen cases with wound infection admitted to the burn unit during June and July in 2005 were included in the retrospective study, 4 cases with 114 bacterial strains were from ICU and 15 cases with 47 bacterial strains were from GW respectively. The clinical features, bacterial culture and sensitivity test to antibiotics were analyzed. RESULTS Susceptibility to bacterial infection in ICU patients was significant than those in GW. The prevalent bacterial strains in ICU were Pseudomonas aeruginosa (PAE), Staphylococcus aureus (SAU) and Acinetobacter baumannii (ABA). In contrast, SAU, ABA, Klebsiella pneumoniae (KPN) and PAE prevailed in GW. Drug resistance of PAE, ABA and KPN to some kinds of antibiotics in ICU was severer than those in GW. CONCLUSIONS There is relatively great difference in bacterial constitution and drug resistance ratio between ICU and GW. To take certain disinfection and isolation measures could effectively prevent bacterial strains from transmitting among the wards.

OBJECTIVE To analyze the antimicrobial activity of recombinant human ?-defensin 3(rhBD-3) on clinically isolated multidrug-resistant bacterial strains.METHODS The antimicrobial activity of rhBD-3 on clinically isolated multidrug-resistant Staphylococcus aureus,Enterococcus faecium,Acinetobacter baumannii and Pseudomonas aeruginosa from the wards of burns department was measured by turbidity method.RESULTS rhBD-3 Demonstrated antimicrobial activity against all the strains in a dose-dependent manner.The minimal inhibitory concentration(MIC) to Gram-positive strains and Gram-negative strains was 4 ?g/ml and 8 ?g/ml,respectively.CONCLUSIONS rhBD-3 Has significant antimicrobial activity against clinically isolated multidrug-resistant strains and thus implies therapeutic potential as an effective substitute for the present drug-resistant bacteria.

Objective To explore the effects of angled abutments on the anterior maxilla implant restoration. Methods We analyzed the biomechanical properties of implants of different sizes (Φ3.5 mm,4.0 mm and 4.5 mm in diameter;L11.5 mm and L13 mm in length)after connecting different angled abutments (0°,10°,20°,and 30°) using finite element method.Results The stresses and strains of loading parts of restorations increased and their distribution became more concentrated as the angle of abutment increased.Cortical bone of Φ3 .5 implants with smaller angle (10°or less)andΦ4.0 implants with abutments had the risk of overpassing the bone elastic threshold when the angle approached 30°.However,the cortical bone elastic deformation was within a safe range at all angles inΦ4.5 group.Conclusion We should consider the diameter of the implant when selecting angled abutments.The angled abutments are not suitable for small diameter implants.The bite force should be under control when needed. The larger angled abutments can be applied in the standard and major diameter implants and it is necessary to avoid occlusal overloading.

The objective of this study was to elucidate the association of various risk factors with dengue cases reported in Lundu district, Sarawak, by analyzing the interaction between environmental, entomological, socio-demographic factors. Besides conventional entomological, serological and house surveys, this study also used GIS technology to generate geographic and environmental data on Aedes albopictus and dengue transmission. Seven villages were chosen based on the high number of dengue cases reported. A total of 551 households were surveyed. An overall description of the socio-demographic background and basic facilities was presented together with entomological and geographical profiles. For serological and ovitrap studies, systematic random sampling was used. Serological tests indicated that 23.7% of the 215 samples had a history of dengue, either recent or previous infections. Two samples (0.9%) were confirmed by IgM ELISA and 49 samples (22.8%) had IgG responses. A total of 32,838 Aedes albopictus eggs were collected in 56 days of trapping. Cluster sampling was also done to determine whether any of the risk factors (entomological or geographical) were influenced by geographical location. These clusters were defined as border villages with East Kalimantan and roadside villages along Lundu/Biawas trunk road. The data collected were analyzed using SPSS version 10.01. Descriptive analysis using frequency, means, and median were used. To determine the association between variables and dengue cases reported, and to describe the differences between the two clusters of villages, two-sample t-test, and Pearson's Chi-Square were used. Accurate maps were produced with overlay and density function, which facilitates the map visualization and report generating phases. This study also highlights the use of differential Global Positioning System in mapping sites of 1m accuracy. Analysis of the data revealed there are significant differences in clusters of villages attributable to container density, house density, distance of the house from the main road, and number of Ae. albopictus eggs from ovitraps set indoor, outdoor and in dumping sites (Person's Chi-Square = 6.111, df = 1, p < 0.01). Further analysis using t-test showed that house density, container density, indoor mosquitoes egg count, outdoor mosquitoes egg count, and dumping sites mosquitoes egg count were higher at the roadside villages compared to border villages. A number of potential risk factors including those generated from GIS were investigated. None of the factors investigated in this study were associated with the dengue cases reported.
Dengue ; seconds ; physical density ; Risk Factors ; Analysis of substances

Objective: To compare JGW with autogenous bone when used as grafting material in maxillary sinus floor augmentation.Methods: A study was conducted by performing a bilateral maxillary sinus floor augmentation with autogenous bone and JGW(Jin Gu Wei,Golden Bone,bone substitute,Shanghai Xiaobo Tec.) on rabbits.The process of bone formation was evaluated during different periods by imageology and histomorphology methods.Results: At 2nd week the gray scale of JGW was very lower than that of autogenous bone,but no significant difference was found at 12th week.The number of osteoblasts decreased with the time,no significant difference was found at 12th week.The degradation of JGW was relatively faster.Conclusion: JGW is feasible in maxillary sinus floor augmentation.