Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.

BACKGROUNDAppropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.

METHODSA total of 22 029 and 8046 patients, who received medical care from a physician at an Olympic or Paralympic medical station, were included. The patient proportion among different personnel, various disease proportions at different kinds of venues, and the disease spectrum at specified venues at the Olympics and Paralympics were analyzed.

RESULTSAt both games, the patient proportion varied by accreditation status. The staff accounted for the largest number of visits at the Olympics (44.83%) and Paralympics (36.95%), with respiratory diseases the most common. Various disease spectrums were discovered at the different kinds of venues. Surgical diseases were the most frequently listed reason for visits, both at competition and non-competition venues, especially during the Paralympics. The sport-related injuries accounted for a majority of the surgical cases during both games. At training venues, ear nose and throat diseases accounted for the greatest number of visits during both games.

CONCLUSIONSDuring both games, people contracted different diseases at different venues. Adequate surgeons should be designated to offer assistance mostly in trauma situations. Appropriate numbers of physicians in respiratory diseases and otorhinolaryngology is of great importance.

Anniversaries and Special Events ; China ; Emergency Medical Services ; utilization ; Humans ; Population Surveillance ; Public Health ; statistics & numerical data ; Sports

OBJECTIVETo explore the clinical effects of anterior decompression and fusion with a nano-hydroxyapatite/ polyamide 66 (n-HA/PA66) cage in treating lower cervical fracture and dislocation.

METHODSFrom January 2008 to December 2010, the clinical data of 42 patients with lower cervical fracture and dislocation were retrospectively analyzed. There were 29 males and 13 females aged from 20 to 65 years old. The mean age was 46.8 years. Five cases got injuried in C3, 14 cases in C4, 12 cases in C5, 7 cases in C6 and 4 cases in C7. According to Frankel grade, 4 cases were classified in grade A, 11 cases in grade B, 13 cases in grade C, 9 cases in grade D and 5 cases in grade F. Twenty-eight cases were treated with anterior corpectomy and fusion and 14 cases with anterior discectomy and fusion. Frankel grade was used to do neurologic assessment and visual analogue scale (VAS) was used to evaluate the improvement of clinical symptoms. Segmental height and sagittal lordosis were measured by radiographs and cage location. Cage appearance and fusion status were assessed by 3D-CT images.

RESULTSAll patients were followed up for 3 to 5.2 years with an average of 4.1 years. Frankel grade had obviously improved than preoperative (Z = -4.845, P < 0.001). There were 2, 3, 11, 8, 11 cases classified in grade A, grade B, grade C, grade D and grade E respectively. At the third day after operation and latest follow-up,VAS was (2.6 +/- 1.8),(1.3 +/- 1.0) scores respectively. Both had improved than preoperative (P < 0.05). Up to the latest follow-up, there was only one patient (2.4%) with slight cage translocation (less than 2 mm), however, no cage prolapsed, or collapse, or breakage were found. Both segmental height and lordosis improved significantly after surgery (P < 0.001). And there was not significant difference in both parameters between each postoperative time points (P > 0.05). The mean distance of cage subsidence was 1.5 mm and the rate of cage subsidence (> 3 mm) was 4.8%.

CONCLUSIONThe n-HA/PA66 cage can not only restore and maintain the fusion segmental height and radian, but also promote the osseous fusion and profit the radiographic assessment after operation. Thus, it was an ideal material for prop graft.

Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods

OBJECTIVETo discuss the operative effects and evaluate how the waiting time before surgery influence the outcome of complex acetabular fractures.

METHODSFrom January 2006 to December 2008, 33 patients, 28 males and 5 females, with complex acetabular fractures were operated in our hospital. All of them were followed up for an average 24 months (ranged, 14 to 47 months). The average age was 42 years (ranged,27 to 57 years). According to the waiting time before surgery, all patients were divided into two groups, namely preoperative waiting time of more than 14 days group and preoperative waiting time of less than 14 days group. Postoperative reduction quality and long-term radiographic results were evaluated according to the Matta radiological systems. The modified Merle d' Aubigne-postel hip scoring system was used for evaluating the functional outcomes. The Mos SF-36 was used to evaluate the quality of life.

RESULTSAnatomical reduction in 28 cases, good in 4 cases, and poor in 1 case. According to the mean Merle d'Aubigne and Postel Score, 22 patients got excellent result, 4 good, 4 fair and 3 bad. Average score of the Mos SF-36 was (70.63 +/- 17.03). When time was measured as a categorical variable, an anatomical reduction and an excellent or good functional outcome were more likely if surgery was performed within 14 days. Postoperative complications: iatrogenic injuries of sciatic nerve in 2 cases, heterotopic ossification in 6 cases,traumatic osteoarthritis in 3 cases, and femoral head necrosis in 1 case.

CONCLUSIONGood image evaluation,correct approaches, appropriate time before surgery and approach, early functional rehabilitation are essential for better outcomes in the treatment of complex acetabular fractures, of which, time to surgery is a crucial and controllable prognostic factor.

Acetabulum ; injuries ; physiopathology ; surgery ; Adult ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; prevention & control ; Osteoarthritis ; prevention & control ; Postoperative Complications ; prevention & control ; Radiography ; Sciatic Nerve ; injuries ; Time Factors

BACKGROUNDY-27632 is a specific inhibitor of Rho-associated coiled kinase (ROCK) and has been shown to promote the survival and induce the differentiation of a variety of cells types. However, the effects of Y-27632 on adult human adipose tissue-derived stem cells (ADSCs) are unclear. This study aimed to investigate the effects of Y-27632 on the neuronal-like differentiation of ADSCs.

METHODSADSCs were isolated from women undergoing plastic surgery and cultured. ADSCs were treated with different doses of Y-27632 and observed morphological changes under microscope. The expression of nestin, neuron specific enolase (NSE) and microtubule-associated protein-2 (MAP-2) in ADSCs treated with Y-27632 was detected by immunocytochemistry and Western blotting analysis.

RESULTSY-27632 had the potency to induce neuronal-like differentiation in ADSCs in a dose-dependent manner. Moreover, the differentiation induced by Y-27632 was recovered upon drug withdraw. ADSCs treated with Y-27632 expressed neuronal markers such as NSE, MAP-2 and nestin while untreated ADSCs did not express these markers.

CONCLUSIONSelective ROCK inhibitor Y-27632 could potentiate the neuronal-like differentiation of ADSCs, suggesting that Y-27632 could be utilized to induce the differentiation of ADSCs to neurons and facilitate the clinical application of ADSCs in tissue engineering.

Adipose Tissue ; cytology ; Adult ; Amides ; pharmacology ; Cell Differentiation ; drug effects ; Cells, Cultured ; Female ; Humans ; Neurons ; cytology ; Pyridines ; pharmacology ; Stem Cells ; cytology ; drug effects

OBJECTIVETo study the effect of human urotensin II (HU II) on secretion of adrenomedullin (ADM) from human vascular endothelial cells (HVEC) and its mechanism.

METHODSIn cultured HVEC, different concentrations of HUII were used to stimulate the ADM secretion from HVEC, and the inhibitors of different signal transduction pathway were used to investigate their effects on ADM secretion. The contents of ADM in medium were determined by radio immunoassay.

RESULTSHUII stimulated secretion of ADM from HVEC in a time-dependent and concentration-dependent manner. The contents of ADM in the experiment groups were changed compared with that in control group (P < 0.05). The increase of ADM could be inhibited by inhibitor of extracellular signal-regulated protein kinase (PD(98059)), inhibitor of P38 kinase (SB(202190)), inhibitor of calmodulin (W(7)) and inhibitor of Ca(2+) (nicardipine) (P < 0.05). The inhibition ratio in those groups was 68%, 78%, 24% and 25% respectively. But the inhibitor of Calcineurin (CaN) and inhibitor of protein kinase C (H(7)) had no influence on the secretion of ADM from HVEC (P > 0.05).

CONCLUSIONThe stimulated effect of HUII on the ADM secretion from HVEC may be mediated by Ca(2+), ERKs, CaM-PK and P38 signal transduction pathways.

Adrenomedullin ; metabolism ; Calcium ; metabolism ; Calcium Signaling ; Cells, Cultured ; Endothelial Cells ; secretion ; Humans ; Signal Transduction ; drug effects ; Urotensins ; pharmacology

OBJECTIVETo investigate the changes of CD4(+)CD28(-) T cell and CD4(+)CD25(+) regulatory T cell (Treg) subsets in patients with coronary artery disease (CAD).

METHODSTwenty-eight patients with angiographically established CAD were recruited in this study, including 16 with unstable angina (UA group) and 12 with stable angina (SA group). Eleven patients with chest pain syndrome served as the control group. The proportions of peripheral CD4(+)CD28(-) T cells and CD4(+)CD25(+) Treg subsets were determined with fluorescence-activated cell sorting (FACS).

RESULTSThe proportions of CD4(+)CD25(+) Treg were significantly lower in UA group (6.55-/+2.45%) than in SA (14.01-/+4.92%) and control groups (13.55-/+3.87%). The proportions of CD4(+)CD28(-) T cells were significantly higher in UA group (10.55-/+4.76%) than in SA (2.64-/+1.33%) and control (2.75-/+1.55%) groups.

CONCLUSIONAlterations of circulating T-lymphocyte subsets occur in patients with UA. The changes of Treg and CD4(+)CD28(-) T cells may lead to breakdown of peripheral autoimmune tolerance and play an important role in the development and progression of CHD.

Aged ; Angina, Unstable ; immunology ; CD28 Antigens ; CD4-Positive T-Lymphocytes ; immunology ; Case-Control Studies ; Coronary Disease ; immunology ; Female ; Humans ; Interleukin-2 Receptor alpha Subunit ; Male ; Middle Aged ; T-Lymphocyte Subsets ; immunology ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo compare the diagnostic value between digital photography (DR) and multi-slice spiral CT (MSCT) in fracture and dislocation of foot and ankle.

METHODSFrom August 2010 to August 2012, the DR and MSCT data of 52 patients with fracture and dislocation of foot and ankle were compared according to results of surgery or discharge diagnosis. There were 37 males and 15 females, aged from 15 to 49 years old. Wilcoxon signed rank test was used for statistical analysis.

RESULTSThe results of 52 cases of MSCT were matched with the postoperative or discharge diagnosis. A total of 172 fractures were found on MSCT and 98 fractures were found on DR, the results had significant difference in detecting fracture (V=1 081, P<0.05); A total of 24 dislocations were found on MSCT and 16 dislocations were found on DR,the results also had significant difference in detecting dislocation (V=21, P<0.05). Fractures of 6 cases with DR diagnosis were corrected and located by MSCT.

CONCLUSIONMSCT is significantly better than DR in diagnosis of fracture and dislocation of foot and ankle. The examination of two parts should be performed in DR. MSCT and multi-planar reconstruction (MPR) examination should be further performed if DR results are unclear or do not match with clinical symptoms, missed diagnosis and misdiagnosis can be avoided.

Adolescent ; Adult ; Ankle Injuries ; diagnostic imaging ; Female ; Foot Injuries ; diagnostic imaging ; Fractures, Bone ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Joint Dislocations ; diagnostic imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Photography

OBJECTIVEObese children and adolescents are often complicated with the abnormalities of lipid and glucose metabolism, which are often associated with adulthood hypertension, diabetes and cardiovascular disease. In this study, the blood lipids, blood pressure and carotid arterial intima-media thickness (IMT) in obese children and adolescents were measured to investigate the relationship between the dyslipidemia and early vascular lesions.

METHODA total of 580 obese children and adolescents aged from 7 to 17 years of age were enrolled from 3 hospitals from Jan. 2008 to Sept. 2009. They were divided into 2 groups according to their blood lipoid levels. Ortholiposis group included 100 males and 52 females with a mean age of 10.47 years and a mean body mass index (BMI) of 28.28 kg/m(2). Dyslipidemia group included 305 males and 123 females with a mean age of 10.83 years and a mean BMI of 27.60 kg/m(2). Physical examination, and measurement of blood lipid, glucose and liver enzyme were taken. Carotid IMT was measured for 285 subjects.

RESULT(1) Hypertension was found in 12.5% (19/152) and 20.1% (86/428) patients in ortholiposis and dyslipidemia groups, respectively, with a significant difference (χ(2) = 4.362, P = 0.037). The OR was 1.760 with 95% confidence interval of 1.030 - 3.008. Higher prevalence of hypertension was found in patients with dyslipidemia. (2) The left, right and mean common carotid IMTs of dyslipidemia group were higher than those of ortholiposis group without significant difference (all P > 0.05). The left, right and mean internal carotid IMTs in dyslipidemia group were (0.66 ± 0.15) mm, (0.65 ± 0.15) mm and (0.65 ± 0.15) mm, respectively while these in ortholiposis group were (0.62 ± 0.13) mm, (0.60 ± 0.13) mm and (0.61 ± 0.12) mm, respectively (P < 0.05 for all). (3) Bivariate correlation analysis showed that systolic blood pressure was positively correlated with age, BMI, BMI Z score, waist circumference, hip circumference, uric acid, alanine transaminase, triglyceride, fasting insulin and insulin resistance index (P < 0.05 for all). Moreover, mean carotid and internal carotid IMTs were positively correlated with age, BMI, waist circumference, hip circumference, and triglyceride (all P < 0.05). Multiple linear regression analysis showed that hip circumference and insulin resistance index were independent determinants of systolic pressure. Waist circumference was independent determinant of mean common and internal carotid IMT and triglyceride was independent determinants of mean internal carotid IMT.

CONCLUSION(1) Vascular lesions, including hypertension and thicker tunica intima are common in obese children and adolescents. (2) Vascular lesions are closely related with dyslipidemia, and waist circumference and hypertriglyceridemia are the risk factors.

Adolescent ; Blood Glucose ; metabolism ; Body Mass Index ; Cardiovascular Diseases ; etiology ; metabolism ; Child ; Dyslipidemias ; metabolism ; Female ; Humans ; Hypertension ; etiology ; metabolism ; Lipids ; blood ; Male ; Obesity ; metabolism

OBJECTIVETo initially evaluate the application of artificial vertebra of n-HA/PA66 in anterior reconstruction of lower cervical spine fracture and dislocation.

METHODSIn this study, 84 patients with lower cervical spine fracture and dislocation received anterior cervical discectomy, spinal canal decompression or subtotal corpectomy, spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. Neurological function was followed up by improvement rate of Frankel and situations of the supporting body was observed by X ray and 3D-CT in 3, 12, 24 months postoperatively. The intervertebral height, physical arc (reflected by Cobb angle) and the locations and fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements.

RESULTSAll the patients underwent operation successfully and were followed up for 6 to 24 months with an average of 12 months. The preoperative symptoms were improved to varying degrees. Imaging studies showed that in all cases graft fusion were achieved, and cervical alignments, intervertebral height, cervical spine stability and the locations of the artificial vertebral body were well maintained. No displacement and subsidence of the artificial vertebral body occurred. Postoperative immediate intervertebral height (2.4 ± 0.2) cm, preoperative intervertebral height (1.9 ± 0.1) cm, comparisons of the two groups was statistically significant (q = 2.48, P < 0.001). The immediate, 3 month, 1 year, 2 year period follow-up group intervertebral height was not statistically significant (P > 0.05). Preoperative Cobb angle was 9.8° ± 1.2°, postoperative immediate Cobb angle was 16.6° ± 1.2°, comparisons of the two groups was statistically significant (q = 14.25, P < 0.001). The immediate, 3 month, 1 year, 2 year period follow-up group Cobb angle was not statistically significant (P > 0.05).

CONCLUSIONSn-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and effectively maintain the biological alignment and cervical intervertebral height. It has high rate of graft fusion and is convenient to observe by X-ray. Therefore, n-HA/PA66 can be taken as an ideal graft for anterior lower cervical spine fracture and dislocation operation, but further follow-up study is still required to evaluate the long-term effects.

Adolescent ; Adult ; Aged ; Bone Substitutes ; Cervical Vertebrae ; injuries ; surgery ; Decompression, Surgical ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Hydroxyapatites ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Nanostructures ; Nylons ; Spinal Fractures ; complications ; surgery ; Spinal Fusion ; instrumentation ; Young Adult