Objective: To analyze the risk factors for fatal brain edema in patients with large area infarction of middle cerebral artery (malignant middle cerebral artery territory infarction, MMCI). Methods: The clinical data of 137 patients with MMCI from August 2002 to January 2011 were analyzed retrospectively. They were divided into brain hernia group (n = 48) and non-hernia group (n = 89) according to whether they had brain hernia or not in the course of disease. The possible risk factors for brain edema were analyzed. Results: Forty-six patients were died, 36 patients in the hernia group and 10 patients in the non-hernia group; 91 patients survived, but all left limb paralysis. Circled digit oneThe univariate analysis showed that the percentage of atrial fibrillation, staring, smoking, high systolic blood pressure, National Institutes of Health Stroke Scale (NIHSS) score and barthel index (BI) index in the hernia group were all higher than those in the non-hernia group. The differences were statistically significant (all P < 0.05); the Glasgow Coma Scale (GCS) score in the hernia group was lower than that in the non-hernia group (P < 0.01). Circled digit twoMultivariate logistic regression analysis showed that smoking (OR, 3.391; 95% CI, 1.339 to 30.505), GCS score (OR, 0.684, 95% CI, 0.554 to 0.844) and systolic blood pressure level (OR, 1.027, 95% CI, 1.006 to 1.049) were significantly correlated with the occurrence of brain edema. Conclusion: The patients with MMCI combined with atrial fibrillation are more susceptible to acute cerebral edema caused brain hernia. Smoking, GCS score and high systolic blood pressure level may be the risk factors for cerebral hernia.

Stroke is a major cause of death and disability in China.Some strategies to reduce the burden of stroke is to attach importance to thrombolytic therapy within 6 hours,to strengthen public education,to implement systems-level improvements in the prehospital and stroke unit,and to use statins and antiplatelet drugs to prevent and treate stroke.

Objective To investigate the effects of hawthorn powder, refined konjac flour and their compound on the levels of lipid and NO in plasma of rats being induced to hyperlipidemia by high-fat and high-cholesterol diet. Methods Fifty adult Wistar rats were randomly divided into five groups which were fed with normal diet, high-fat and high-cholesterol diet (HFD), HFD plus hawthorn powder, HFD plus refined konjac flour, HFD plus hawthorn and konjac compound, respectively. At week 4 and 8, 20 and 30 rats respectively were sacrificed for detecting the levels of lipid and NO in the blood. Results Hawthorn powder, refined konjac flour and their compound could significantly inhibit the increase of blood total cholesterol, triglycerol, VLDL-C, LDL-C induced by HFD and can significantly increase HDL-C and NO in plasma. Conclusion Hawthorn powder, refined konjac flour and their compound have the lipid-lowering effect. The hawthorn and konjac compound has better effects on increasing HDL-D and reducing VLDL-C. So they are beneficial to the prevention of atherosclerosis.

Objective:To study the mechanism of effect of miR-21 via Wnt/β-catenin signaling pathway in human A549 lung cancer cells and Lewis lung carcinoma in mice. Methods:The effect of miR-21 on A549 cells were detected by MTT method. MiR-21 expression levels were overexpressed or inhibited in A549 cells by transfecting with miR-21 mimics or inhibitors. Correlation among key molecules (Wnt1,β-catenin, CyclinD1 and miR-21) of mRNA and protein levels in Wnt/β-catenin signaling pathway were studied by Real-time PCR and Western blot hybridization assay. Invasive ability of A549 cells was determined via Transwell chamber cell invasion assay;the role of miR-21 in A549 cells was explored via the Wnt/β-catenin signaling pathway. A Lewis lung carcinoma animal model was established to detect miR-21 expressions in tumor animals and controlled animal tissues, and verify expression changes of the above moleculesin the Wnt/ β-catenin signaling pathway was determined in the animal level. Results:MTT assay results showed that miR-21 overexpression could markedly enhance cell absorbance value;that is, miR-21 could increase the ability proliferation of A549 cells.β-catenin and CyclinD1 expression levels were significantly higher in miR-21 mimic transfected cells (P<0.05), and Wnt1 gene had no significant change. Wnt1,β-catenin and CyclinD1 gene expression showed no significant change when miR-21 expression was suppressed, compared with controls. After cells were transfected with miR-21 mimics, cell invasion assay revealed that the perforated cells was significantly higher than the perforated cells in the control group (P<0.01). Lewis lung assay revealed that miR-21 expression levels in the Lewis lung carcinoma were significantly higher;and at the same time, Wnt1,β-catenin and CyclinD1 gene expression levels were significantly increased, compared to controls. Conclusions: In A549 human lung cancer cells and Lewis lung carcinoma in mice, key moleculesβ-catenin and CyclinD1of miR-21 expressions and the Wnt/β-catenin signaling pathway are positively correlated.

Objective To compare the effectiveness and safety of continuous and intermittent ice compression therapy following total knee arthroplasty surgery. Methods Eighty patients were divided into two groups receiving continuous or intermittent 30 minutes every 2 two hours within 48 hours after the operation. The subjective pain (VAS score), additional pain-killer use, swelling of extremity, drainage, range of motion were observed and compared. Results Patients in the observation group had less pain than those in the control group (Z values in the first 3 postoperative day was-2.722,-3.359,-2.039, respectively, P<0.05). Less pain-killers were required in the experimental group (Z=-2.559, P<0.05). The postoperative swelling by the thigh circumferences in the first day in the observation group was (1.84 ± 1.11) cm, which was milder than the (3.30 ± 1.69) cm of the control group (t=4.565, P<0.01). So was it in the calf circumferences, (0.94 ± 0.89 ) cm vs. (1.46 ± 0.91) cm (t=2.627, P=0.01). Within the first 3 days after the operation, this mildness still existed in aspect of thigh circumferences, which was (3.09±1.39) cm in the observation group vs the (4.09 ± 1.71) cm in the control group, t=2.869, P < 0.01. Conclusions Continuous ice compression therapy has better effects than intermittent 48 hours after total knee replacement, with functional training and exercise not disturbed. It is considered safe and assured, and is therefore recommended.

Objective To explore the relationship between cerebrovascular steno-occlusive disease and neuropsychological performance by cognitive function assessment.Methods Using a case-control study,45 patients with cerebrovascular steno-occlusive lesions (patient group) and 59 control subjects without cerebrovascular steno-occlusive disease were included,36 simple hypertension (hypertension group)and 34 simple diabetes mellitus subjects (diabetes mellitus group) without cerebrovascular steno-occlusive disease were also included.A battery of neuropsychological was performed in all subjects.The test battery included tests of memory,executive functions,mental speed,visuospatial ability and visuoconstructive skill,anxietas and depression.Results Patient group showed impairments in multiple cognitive domains compared with other three groups.The immediate recall of auditory verbal learning test (controls 56.8 ± 6.5 ;patient group 48.5 ± 10.1 ;hypertension group 53.5 ±9.0 ;diabetes mellitus group 55.9 ± 7.9;t =-3.57-4.822,P =0.000-0.021) were impaired seriously.Moreover,visual memory Modified Rey-Osterrieth Complex Figure Test immediate recall,long time delayed recall and executive function California cards sorting test were also impaired.Patient group was divided into two subgroups,and neuropsychological tests of these subgroups were compared.Multiple stenosis subgroup had significantly worse performance in tests of verbal memory and some executive functions than the single artery stenosis subgroup.Conclusions Cerebrovascular steno-occlusive disease was associated with poorer neuropsychological performance,which could not be explained by vascular risk factors.Multiple stenosis subgroup had lower performance levels in neuropsychological tests than simple stenosis subgroup.Ischemia or hypoperfusion caused by steno-occlusive disease might be responsible for these cognitive impairments.

Chinese medicinal decoction pieces were the mainly form for traditional Chinese medicine (TCM) treatment,which means TCM prescription drugs.Any processed (heated or unheated) pieces are known as prepared pieces,which include both raw and cooked pieces.Based on differences of the clinical application of processed pieces,this paper summarized three traditional processing theories,such as the raw and prepared effect difference theory,processing accessories action theory,and pharmaceutical theory.The key points were focused on how different processing methods affect the properties of Chinese herbs,such as four natures and five flavors,floating and sinking,attributive channel,tonifying or purging action,and the toxicity.Based on changes of pharmacodynamic substance base and pharmacological action before and after processing,the action mechanism of processing in changes of Chinese medicinal properties was explained.

Objective:To observe the effect of exogenous estrogen on the gene expression of genioglossus myosin heavy chain(MHC) gene expression in ovariectomized rats. Methods: 30 female Sprague-Dawley rats were assigned to three groups randomly: ovariectomized group (OVX), estrogen group(E_2)and sham-operated group (SO). All the rats were sacrificed at 30 days after injection, and the genioglossus was removed for analysis. The gene expression of MHCⅡa,MHCⅡx, MHCⅡb and ?-actin was examined by real-time quantitative RT-PCR (FQ-PCR). Results: Compared to the SO group, genioglossus MHCⅡb increased significantly in OVX group (P

The incidence of oncocytic papilloma of nasal ethmoid sinus is very low. In order to improve the understanding of the disease for clinicians,we report one case of oncocytic papilloma in nasal ethmoid sinus. The case performs mainly congestion of the left nasal cavity, running pus nose and hyposmia. Nasal endoscopy found new creature in the meatus,and CT indicates soft tissue shadow in the left superior nasal passages,ethmoid sinus involved. Tumor is resected completely. There is no recurrence after five years follow-up.
Aged ; Humans ; Male ; Nasal Cavity ; Nose Neoplasms ; Papilloma ; Paranasal Sinus Neoplasms

Objective To investigate the change of erythrocyte immune function and T lymphocyte subsets in patients with uremia and the effect of hemodialysis on them. Methods Flow cytometry and immune adherence rosette method were used to measure the activity of RBC-CR1and the changes of T lymphocyte subsets in 23 uremic patients without hemodialysis, 22 uremic patients before and after sigle hemodialysis and 21 healthy subjects as the control group. Results The activity of RBC-CR1, the number of T lymphocyte subsets significantly changed in patients with uremia, and hemodialysis could partially improve this condition. There was obvious correlation between erythrocyte immune function and T lymphocyte subsets. Serum creatinine was positively relative to the value of RBC-C 3b RR(P