Silent cerebral infarction is widely exist in the elderly population.It is considered to be the early clinical stage of symptomatic stroke and cognitive impairment.The incidences of silent cerebral infarction are higher in patients with atrial fibrillation and after atrial fibrillation ablation.It is not clear whether anticoagulant therapy can prevent silent cerebral infarction and improve cognitive function in patients with atrial fibrillation.This article reviews the hot issues related to silent cerebral infarction and atrial fibrillation.

Adenoma, Villous ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Lymphoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Myosins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma, Alveolar ; metabolism ; pathology ; surgery ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

The sex difference in stroke is increasingly receiving attention. The incidence and prevalence of stroke in males are higher than in females. There are greater differences both among the age groups and populations. The incidences of cerebral infarction and intracerebral hemorrhage in males are higher than females, while the incidence of subarachnoidal hemorrhage is even higher in females. Studies have shown that mortality of stroke in males is higher; however,because the females are older and have more serious symptoms at the onset of stroke, therefore their prognosis is poorer. Poststroke depression is common in females and their quality of life is lower. Stroke in females is mostly involved in cerebral cortex; their atypical symptoms are more common. Both males and females can benefit from thrombolytic and stroke unit therapies. Females with cardioembolic stroke may benefit more from anticoagulant therapy.

Leptospirosis is an important zoonosis with worldwide distribution. As the first procedure in immunity system, the role and significance of innate immunity in controlling infection at the early stage of the disease have gradually been emphasized. Macrophages can phagocytize and kill leptospira, while the pathogenic leptospira can evade the killing by macrophages. In addition, neutrophils, complement system and cytokines also contribute to the defence of leptospira infection.

Ojective To evaluate the therapeutic effect of conformal radiotherapy on metastatic hepatic cancer. Methods 10 cases of metastatic hepatic cancer (1 to 5 metastatic focus respectively) were treated with stereotactic radiotherapy from Septermber 1997 to April 2000. The clinical target volume(CTV) of tumor ranged from 0.6cm 3 to 232cm 3 (the mean 41.9cm 3), peripheral irradiation doses of planning target volume (PTV) ranged from 3.96Gy to 7.00Gy(the mean 5.26Gy)each time, cential irradiation doses of PTV were 6.3Gy～10.88Gy (the mean 7.89Gy) each time, once a day for 5～8 times totally. Results No patient died during therapy. KPS of patients normal condition were 20～90(54?25.90) before treatment and 30～100 (74?23.90) after treatment. Effect of entity tumor were as follows completely relaxed (CR) in two cases, partly relaxed (PR) in four cases, no change (NC) in three cases, progressed (PD) in one case. During follow-up period tasting 2 to 28 months 90% of the tumors were controlled (no progressive disease). 60% fo the tumors decreased in size or disappeared. Conclusions Stereotactic radiotherapy has better therapeutic effects on cases of metastatic hepatic cancer.

0.05),but the duration of the peaking period, the time for improving one grade, the time for reaching 2 grade, and the hospitalization was significantly shorter in patients treated with steroid than without steroid(P0.05). (3) The major side effects included Cushing's reaction and the infection of the upper respiratory tract.Conclusion Steroids can quicken the recovery of GBS, and shortened average hospitalization in patients with GBS, but steroid doesn't alter the incidence rate of the sequel and the severity of the disability at 1 year in the course.It has no side reaction to use steroid reasonably.

Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.

Objective To ascertain serum inflammatory markers could be modified following treatment of periodontal disease in elderly patients. Methods The probing depth (PD), clinical attachment level (AL), C-reactive protein (CRP), interleukin-6 (IL-6) were determined. And then fifty-two elderly periodontitis patients underwent a standard phase of non-surgical periodontitis treatment (consisting of oral hygiene instructions and subgingival scaling and root planning). After three and six months, PD, AL, CRP and IL-6 were determined again and compared to the baseline. Results Six months after treatment, significant reductions in PD [(5.9±1.1) mm vs. (6.8±1.0) mm, P＜0.05], AL [(1.3±0.9) mm vs.(8.4±1.1) mm, P＜0.05], CRP [(1.5±0.2) mg/L vs. (2.0±0.3) mg/L, P＜0.01] and IL-6 [(1.6±0.5) ng/L vs. (1.9±0.4) ng/L, P＜0.05] were observed. Conclusions Treatment of chronic periodontitis can decrease the levels of serum inflammatory markers in elderly patients.

Objective To compare the clinical outcomes of open reduction and internal fixation (ORIF) with total elbow arthroplasty (TEA) for type C inter-condylar fractures of the distal humerus in the elderly. Methods Twenty-two patients who were treated with ORIF or TEA from April 2003 to September 2009 were included in the study. All fractures were OTA classification 13C. Among them, 10 patients who were treated with ORIF were follow up for 8-56 months, while 12 patients who were treated with TEA were followed up for 15-54 months. The Mayo elbow performance score (MEPS) and the complications were compared. Results Using the MEPS, there were 2 in excellent, 4 in good, 4 in fair in the patients treated with ORIF. Complications included heterotopic ossifications (2 cases) and ulnar nerve dysfunction (2 cases).There were 6 in excellent, 4 in good, 2 in fair in the patients treated with TEA. Complications included 1heterotopic ossification (1 case), ulnar nerve dysfunction (1 case), the weakness of musculus triceps brachii (1 case). The patients treated with TEA had significantly better range of motion (107.5° vs 84.5°, P=0.007),also had better MEPS (87.9 vs 75.5, P=0.047) than those with ORIF had ones. Conclusion TEA is a liable option for type C inter-condylar fractures of the distal humerus in the elderly.