Objective To investigate the correlation of large artery stenosis and early neurological deterioration (END) of middle cerebral artery infarction.Methods The patients with middle cerebral artery infarction were enrolled retrospectively.END was defined as that the National Institutes of Health Stroke Scale (NIHSS) scores increased ≥2 within 72 hours of admission compared with the baseline value.Middle cerebral artery and internal carotid artery were evaluated by using cerebral angiography.The degree of stenosis was divided into 4 grades:non-or mild (＜ 50％),moderate (50-70％),severe (71-99％) stenosis,and occlusion (100％).The clinical risk factors,degree of neurological deficits,size of lesion,and major arterial lesions were compared between the END group and the non-END group.Results A total of 256 patients with middle cerebral artery infarction were enrolled,and END occurred in 70 of them (27.34％).The age (P =0.045),infarct volume (P =0.045),baseline NIHSS score (P=0.007),and major arterial stenosis (P =0.038) of the END positive group were significantly higher or lager than those of the END negative group.Multivariate logistic regression analysis showed that the higher baseline NIHSS score (odds ratio [OR] 1.071,95％ confidence interval [CI] 1.004-1.142; P =0.037),infarction diameter ＞ 20 mm (OR 2.077,95％ CI 1.077-3.736; P =0.028),and severe stenosis of the major artery (OR 2.521,95％ CI 1.079-5.886; P=0.033) or occlusion (OR 3.074,95％ CI1.262-7.489; P=0.013) were the independent predictor of END.Conclusions Severe stenosis or occlusion of the major artery may be an independent predictor of END in patients with middle cerebral artery infarction.

Objective Toinvestigatetherelatedriskfactorsofneurologicaldeterioration(ND)in patientswithacutecerebralinfarction.Methods Atotalof446patientswithacutecerebral infarction admitted to the Department of Neurology,Zhongda Hospital,Southeast University from January 2012 to December 2013 were analyzed retrospectively. ND was defined as the reevaluation of the National Institutes of Health Stroke Scale (NIHSS)scores at any time for the increased admission baseline score 2 (ND2)or 4 (ND4)within the first 72 hours. All subjects were divided into a ND2 group (n=107)and a non-ND2 group (n=339)or a ND4 group (n=62)and a non-ND4 group (n=384 ). The differences of general demography,vascular risk factors,imaging,and hematological dataamongthedifferentgroupswerecompared.Results Ofthe446patients,107cases(24.0%) were diagnosed as ND2 and 62 cases (13. 9%)were diagnosed as ND4. The result of univariate analysis showed that there were significant differences in the length of hospital stay,age,baseline NIHSS score,baseline systolic blood pressure on admission,guilty artery occlusion,and the levels of leukocyte,fasting glucose,and C-reactive protein between the ND2 patients and the non-ND2 patients (all P<0. 05). There were significant differences in sex,age,atrial fibrillation,baseline NIHSS score, baseline systolic blood pressure on admission,guilty artery occlusion,and the level of C-reactive protein between the ND4 patients and the non-ND4 patients (all P<0. 05). After adjustment for the confounding factors,the results of Logistic regression analysis showed that the baseline NIHSS score (OR,1.114, 95%CI 1. 0481-1.185,P=0. 001),C-reactive protein (OR,1. 014,95%CI 1. 004-1. 024,P=0. 004), and guilty artery occlusion (OR,2. 303,95%CI 1. 152-4. 606,P=0. 018)were independently correlated with ND2;while the age (OR,1. 040,95%CI 1. 011-1. 070,P=0. 006),systolic blood pressure (OR, 1.015,95%CI 1. 003-1. 027,P=0. 018),C-reactive protein (OR,1. 016,95%CI 1. 005-1. 026,P=0.003),and guilty artery occlusion (OR,2. 845,95%CI 1. 291-2. 269,P =0. 009)were independently correlatedwithND4.Conclusion TheearlyonsetofNDinpatientswithacutecerebralinfarctionare closely associated with age,stroke severity,baseline systolic blood pressure,C-reactive protein,and occlusion of guilty artery. In the clinical diagnosis and treatment,detecting the above indicators timely may contribute to identify the patients with acute cerebral infarction and early progressive deterioration.

By means of global budget,the disease-specific scoring method was put in place for both settlement and payment in Huaian,Jiangsu province,for the purpose of cost control by the hospitals.This reform consists of total cost accounting,rational performance-based distribution system,multi-approached regulation of medical behaviors,and individual disease management to regulate medical behavior.These efforts aim at aligning with medical insurance payment reform,so as to improve hospital management,operation quality and socio-economic outcomes.Problems found in practice were also reviewed.

OBJECTIVETo understand the trend of gastric cancer mortality based on the exploration of the death data from 1970 to 2004 in Zhaoyuan County.

METHODSThe death data of 1970-1974 were collected from the first malignant tumor death survey of China, and the data of 1985-2004 were derived from the cancer registration network of Zhaoyuan. The appreciation indexes were crude mortality rate and standardized mortality rates by the percentages of Chinese population in 1982 and the percentages of world population in 1966.

RESULTSThe crude mortality rates in the five periods of 1970-1974, 1985-1989, 1990-994, 1995-1999, and 2000-2004 were 34.94, 44.34, 40.05, 48.73, and 40.18 per 100,000, respectively; the standardized mortality rates by Chinese population were 30.82, 30.35, 27.78, 31.63, and 20.10 per 100,000, respectively. The gastric cancer mortality remained stability from 1970 to 1999, however, the standardized mortality rate of gastric cancer in 2000-2004 declined by 34.8% compared with that in 1970-1974. The study also observed that the highest age-specific gastric cancer mortality, in the past 35 years, has been postponed by 10 years. And, the gastric cancer mortality ranked from top first to top three.

CONCLUSIONThere is a decreasing trend for the incidence of stomach cancer and this might be associated with the changes of dietary consumption and pattern.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Mortality ; trends ; Registries ; Retrospective Studies ; Stomach Neoplasms ; mortality

OBJECTIVETo study operative effects for the treatment of multiple ligament injuries of knee joints.

METHODSFrom 2008 to 2013, 26 patients (17 males and 9 females) with multiple ligament injuries of knee joints were treated surgically. The average age was 40.7 years old, ranging from 29 to 55 years old. All the patients were treated with arthroscopic reconstruction of cruiate ligament with autogenous or allogeneic hamstrings and tendon, and at the same time received repair of medial collateral ligament and lateral collateral ligament, as well as the treatment of exterior and interior complex injuries. Nine patients received second stage operation after the initial operation for mistake or missed diagnosis, and other patients were treated at the first stage. The Lysholm scoring system was used to evaluate function and stability of knee joints before and after operation.

RESULTSAll the patients were followed up for an average duration of 1.6 years (ranged, 0.8 to 3.2 years). The mean awaiting time for operation was 1.2 months. The Lysholm score was improved from preoperative 42.5 +/- 4.5 (ranged, 33 to 48) to the latest follow-up 78.1 +/- 3.9 (ranged, 57 to 95). The function of knee joint was improved obviously in the arthroscopic reconstruction patients, with joint range of motion exceeding 900 and with Varus & Valgus tests near to normal. All the patients had negative findings in the Lachman test at 70 degrees of flexion.

CONCLUSIONArthroscopic reconstruction should be the first choice in treating multiple ligament injuries of knee joints. If the anterior and posterior cruciate ligament injuries can't be treated simultaneously, the posterior cruciate ligament injuries should be treated preferentially at the first stage and the anterior cruciate ligament injuries should be treated at the second stage. The diagnosis of posterior cruciate ligament is easy to be missed.

Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Ligaments ; physiopathology ; surgery ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo explore surgical therapeutic strategies and clinical effects for floating shoulder injury.

METHODSFrom March 2010 to December 2013, 12 patients with floating shoulder injury were treated by open reduction and plate screw fixation,including 10 males and 2 females aged from 22 to 45 years old with an average of 31.7 years old. Preoperative X-ray and CT showed 11 cases were ipsilateral clavicle fracture with scapular neck fractures, 1 case was scapular neck fracture with ipsilateral acromioclavicular dislocation. Postoperative complications were observed and Herscvici functional scoring were used to evaluate clinical effects.

RESULTSTwelve patients were followed up from 8 to 26 months (averaged 15 months). All patients obtained bone union, and no inflammation, loosening and breakage of plate and screw were found. According to Herscvici scoring, 9 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONReconstruction of anatomical structure and stability of floating shoulder joint injury could shorten time of shoulder joint brake and fixation, then got excellent clinical outcomes.

Adult ; Clavicle ; injuries ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Scapula ; injuries

Objective To design a test phantom for clinical routine quality control of magnetic resonance imaging (MRI).Methods The commonly used phantom such as Magphan SMR170 and Victoreen 76-903 were used for experiments with the same parameters,and the test data of all the modules were compared.The advantages and disadvantages of all the modules were analyzed,and an optimization scheme was proposed accordingly.Results The phantom could be applied to the detection of high-image-quality MRI machine,and solved the problems in positioning,size matching and etc.Conclusion The new phantom meets the demand of magnetic resonance imaging clinical routine testing,and provides a certain reference for phantom optimization design.

OBJECTIVETo study the necessity, feasibility, security of carotid angioplasty and stenting (CAS) for symptomatic carotid stenosis combined with kinking.

METHODSTwelve patients with symptomatic carotid stenosis and kinking demonstrated by digital subtraction angiography (DSA) received CAS from December 2003 to December 2009. There were 9 male and 3 female patients, age ranged from 59 to 77 years (mean 69.3 years). All the patients' clinical, imaging, intervention and follow up data were collected and analyzed.

RESULTSAll CAS procedures were successfully performed with 14 self-expandable stents placed. The mean degree of stenosis was reduced from 85.6% before stenting to 11.2% after stenting, the angle of kinking, according to Metz' category, were improved from less than 90° to more than 120° in each case. No perioperative procedure related stroke and transient ischemic attack (TIA) occurred. The clinical symptoms and signs of cerebral ischemia were improved or disappeared for all patients. During follow-up of these 12 patients for 6 to 72 months, one patient experienced ipsilateral carotid territory TIA and another patient experienced contralateral carotid territory TIA. DSA follow up of 5 patients demonstrated 1 case with in-stent restenosis and arterial kinking remote to the stent of internal carotid artery. CAS were performed again and CT angiography follow up demonstrated no kinking and restenosis 2 years after the intervention. Duplex scan of the other 7 patients demonstrated neither kinking nor restenosis.

CONCLUSIONSCAS seems to be feasible and safe for the patients with symptomatic kinking and stenosis, and maybe helpful to lower the risk of cerebral ischemia, but further study is needed.

Aged ; Angioplasty, Balloon ; methods ; Carotid Stenosis ; surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

Objective To develop a novel stress fracture animal model system based on dynamic cyclic mechanical loading.Methods Ulnae and tibiae of rats were respectively fixed using differently shaped fixtures (including a fixed holder and a movable holder).The axial mechanical loading was applied via a linear actuator based on LabVIEW control program.During the loading process,a load cell and a laser displacement transducer were used to detect the force and displacement changes in the limbs,respectively.The two signals were sampled at real time by PC-based LabVIEW data acquisition program.A compressive loading test (peak force of 50 N) was conducted to examine the consistency and reliability of cyclic loads after completing the loading system.The loading system and an ElectroForce 3220 mechanical testing machine were respectively used to measure and compare the Young's modulus of a standard ultra-high molecular weight polyethylene (UHMWPE)cylinder to calibrate the loading system.Results The compressive loading test (peak force of 50 N) demonstrated that the mechanical loading system was able to apply consistent loads with controllable intensity and time.The calibration experiment indicated the accuracy of the loading system.Conclusion The novel mechanical loading device has characteristics of precision,scientificity and reliability,and it is approaching the real development situation of stress fracture,which may provide a reliable experimental base for exploring the precautionary measures of stress fracture.

Objective To statistically analyze the allergen-specific IgE test results for allergic patients and observe the distribution of allergens and their prevalence trends.Methods Allergen-specific IgE test results were collected from 12 486 patients with suspected allergic diseases who attended the outpatient clinic of the Department of Dermatology of the Second Affiliated Hospital of Air Force Medical University from January 2018 to December 2023,and the distribution of the positivity rate of various allergens and their differences among different age,gender and seasonal subgroups were statistically analyzed.Results Allergen-specific IgE positive results were found in 5 109 cases out of 12 486 patients with suspected allergic diseases,with a positive rate of 40.92%.Between different gender groups,the allergen positivity rate were 45.41%(2 371/5 221)in males and 37.69%(2 738/7 265)in females,respectively,and the difference in positivity rate between males and females was statistically significant(x2=74.99,P<0.001).The allergen positivity rate among different age groups was highest in the 3～<6 years group(60.00%),followed by the 6～<18 years group(54.92%),and lowest in the≥60 years group(29.18%),with statistically significant differences in allergen positivity rates among different age groups(x2=344.97,P<0.001).The top three overall allergen positivity rates were milk(11.73%),dwarf ragweed/artemisia/rudolfia/quinoa(11.43%)and house dust mite(10.82%),and the positivity rates of milk and house dust mite had a tendency to increase year by year.The highest allergen positivity rate among groups in different seasons was in summer(42.28%),followed by fall(41.32%)and lowest in winter(38.31%),and the difference in allergen positivity rates among the four seasons was statistically significant(x2=9.09,P=0.028).Dwarf ragweed/artemisia/rutabaga/quinoa had the highest positivity rate in the fall(15.75%),while milk(14.59%)and egg white(2.58%)had the highest positivity rates in the summer,and the differences in the positivity rates of dwarf ragweed/artemisia/rutabaga/quinoa,milk and egg white between the four seasons were statistically significant(x2=92.50,70.45,8.10,all P<0.05).Multiple positives were present for allergen-specific IgE,with 22.18%single positives and 18.92%double and more than double positives.Positive test results for ingestion were mainly distributed in the lower levels,while positive test results for inhalation were more distributed in the higher levels,especially for dwarf ragweed/artemisia/rutabaga/quinoa,which were most distributed in level 6.Conclusion Different types of allergens have different distribution characteristics among different genders,ages and seasons,the distribution levels of positive results are different,and there are multiple positive results.Based on the distribution characteristics of allergens in the region,rational arrangement of the dietary and living shoule be mode to avoid the risks and to reduce the probability of the occurrence of allergic diseases.