It is unanimously accepted that stroke is a highly heterogeneous disorder.Different subtypes of ischemic stroke may have different risk factors,clinical features,and prognoses.The aim of this study was to evaluate the risk factors,clinical characteristics,and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment (TOAST) criteria.We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period.Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria.Patients were followed up till 30 and 90 days after stroke onset.It was found that large-artery atherosclerosis was the most frequent etiology of stroke (37.4％),and showed the highest male preponderance,the highest prevalence of previous transient ischemic attack,and the longest hospital stay among all subtypes.Small artery disease (36.4％) was associated with higher body mass index,higher plasma triglycerides,and lower plasma high-density lipoprotein cholesterol than cardioembolism.Cardioembolism (7.7％),which was particularly common in the elderly (i.e.,individuals aged 65 years and older),showed the highest female preponderance,the highest prevalence of atrial fibrillation,the earliest presentation to hospital after stroke onset,the most severe symptoms on admission,the maximum complications associated with an adverse outcome,and the highest rate of stroke recurrence and mortality.Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder.Studies involving risk factors,clinical features,and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.

OBJECTIVETo introduce our experience in diagnosis and treatment of 33 patients with Tessier craniofacial clefts.

METHODS33 patients with craniofacial clefts were classified by Tessier classification. According to the type and severity of the clefts, various techniques, from simple local flap transfer to complicated osteotomy and bone grafting were used to correct the deformity in 29 patients.

RESULTSAll patients who underwent corrective operation were satisfied with the result, and there were no complications.

CONCLUSIONS(1) Tessier classification is very important for plastic surgeon to find potential craniofacial deformities related to main signs. (2) No. 7 cleft is one of most common Tessier craniofacial clefts. (3) Each Tessier cleft is unique, therefore, the treatment plans cannot be standardized. Specific corrective operation must be performed on each patient according to the type and severity of the cleft, including simple local flap transfer to complicated osteotomy and bone grafting or distraction osteogenesis.

Craniofacial Abnormalities ; classification ; diagnosis ; surgery ; Humans

OBJECTIVETo investigate the role of releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus in the correction of the congenital blepharoptosis.

METHODSTwenty-seven patients with 40 eyes of blepharoptosis were undergoing the treatment. It was performed by releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus to correct the mild and moderate blepharoptosis. A further procedure can also be added to by folding the levator aponeurosis if necessary. In the severe blepharoptosis, the frontalis aponeurose flap may be applied for the suspension as well during the operation.

RESULTSOf the 40 eyes in 27 cases with mild, moderate and severe blepharoptosis were treated by using this method, with 38 eyes corrected satisfactorily and 2 eyes corrected mostly in the following-ups from 3 months to 1 year.

CONCLUSIONThe above mentioned technique may be a good, simple and effect method to corret congenital blepharoptosis.

Adolescent ; Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Eyelids ; surgery ; Facial Muscles ; Humans ; Oculomotor Muscles ; surgery ; Surgical Flaps

OBJECTIVETo study the mechanism and clinical effect of using the manipulatin of move, adduction, rotation method for the treatment of shoulder dislocation.

METHODSfrom January 2010 to March 2012,120 patients with shoulder dislocation admitted were randomly divided into treatment group and control group, 60 cases in each group. In the treatment group, there were 31 males and 29 females; In control group, there were 30 males and 30 females. In treatment group, 60 patients create their own "on the move, adduction, rotation manipulative treatment,the other 60 cases in control group used traditional restoration methods in wearing the traction treatment. The efficacy of two methods of treatment of shoulder dislocation were compared on reset process once successfully rate, the patient's level of pain (VAS).

RESULTSIn treatment group, restoration once successfully were in 59 cases, improvement of the pain (VAS) values was 3.76 +/- 1.05, the results were excellent in 57 cases, good in 2, poor in 1,without concurrent fractures and nerve injury, without re-dislocation after 3 months. In control group, restoration once successfully were in 50 cases, improvement of pain (VAS) values was 5.67 +/- 1.15, the results were excellent in 45 cases, good in 7, poor in 8. The reset once successfully rate,improvement of VAS values and clinical effect in treatment group were better than that of control group.

CONCLUSIONOn the move, adduction, rotation method has advantages of more wearing traction with uniform force, work together to focus, saving time and effort, easy and convenient to avoid iatrogenic injury.

Adult ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Rotation ; Shoulder Dislocation ; therapy

OBJECTIVETo retrospectively analyze the curative effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia patients (CML).

METHODSOf the 35 CML patients, 26 were males and 9 were females, with a median age of 32 (12 - 50) years. 30 patients were in chronic phase of CML, 5 patients were in accelerated phase. Allo-HSCT from HLA identical siblings was performed for 35 patients, of whom 11 received bone marrow transplantation (BMT) and 24 peripheral blood stem cell transplantation (PBSCT). Conditioning regimens was TBI (total-body irradiation) + CY (CTX) protocol in 8 patients and BU/CY protocol in 27 patients. The average follow-up was 48 months (range 7 - 108 months).

RESULTS34 (97.1%) patients were successfully engrafted. Among them, 21 patients (60.0%) had three years disease-free (DFS) survival. The overall 5-year survival (OS) was 57.1%. Two patients (5.7%) relapsed. Transplant-related mortality occurred in 12 patients. Hemorrhagic cystitis (HC) occurred in 5 patients and HVOD was observed in 1 patient. Acute graft-versus-host disease (aGVHD) occurred in 18 patients (51.4%), among them 7 patients (20.0%) were of grade III-IV. Chronic GVHD was in 17 patients (48.5%). There was no significant difference in 3-years DFS between BMT group and PBSCT group (54.5% vs. 62.5%, P > 0.05). The 3-year disease-free survival (DFS) was 42.9% in TBI/CY group and 55.6% in BU/CY group (P > 0.05). In univariate prognostic analysis model, the DFS at 3 years is 75% and 47.4% for < or =30 years patients and >30 years patients, respectively, P < 0.05. The 3-year DFS of patients with first chronic phase is higher than patients with advanced diseases (61.3% vs. 40%, P < 0. 05). The 3-year DFS in patients of grade I - II GVHD was higher than that in patients of grade III-IV GVHD (81.8% vs. 14.3%, P < 0.05).

CONCLUSIONThe patients who had transplantation done within 1 year after diagnosis during their first chronic phase of disease and who had low-grade GVHD have better prognosis. Those patients who had III-IV acute GVHD are prone to incorporate severe infection, which was a worse prognostic factor of allo-HSCT for chronic myelogenous leukemia.

Adolescent ; Adult ; Age Factors ; Child ; Cystitis ; etiology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; mortality ; therapy ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Siblings ; Survival Rate ; Transplantation Conditioning ; Transplantation, Homologous

To investigate the therapeutic effect of Jingfang Granules on carbon tetrachloride(CCl_4)-induced liver fibrosis in mice and its mechanism. Forty-nine 8-week-old male C57 BL/6 J mice were randomly divided into a blank group, a CCl_4 group, a silybin group(positive control, 100 mg·kg~(-1))+CCl_4, a Jingfang high-dose(16 g·kg~(-1)) group, a Jingfang high-dose(16 g·kg~(-1))+CCl_4 group, a Jingfang medium-dose(8 g·kg~(-1))+CCl_4 group, and a Jingfang low-dose(4 g·kg~(-1))+CCl_4 group, with 7 mice in each group. The mice in the blank group and Jingfang high-dose group were intraperitoneally injected olive oil solution, and mice in other groups were intraperitoneally injected with 10% CCl_4 olive oil solution(5 mL·kg~(-1)) to induce liver fibrosis, twice a week with an interval of 3 d, for 8 weeks. At the same time, except for the blank group and CCl_4 group, which were given deionized water, the mice in other groups were given the corresponding dose of drugs by gavage once daily for 8 weeks with the gavage volume of 10 mL·kg~(-1). All mice were fasted and freely drank for 12 h after the last administration, and then the eyeballs were removed for blood collection. The liver and spleen were collected, and the organ index was calculated. The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bile acid(TBA), and triglyceride(TG) in the serum of mice were detected by an automated analyzer. Tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-1β(IL-1β) levels were detected by enzyme-linked immunosorbent assay(ELISA). Kits were used to detect the contents of superoxide dismutase(SOD), malondialdehyde(MDA), and glutathione(GSH) in the liver tissue. Pathological changes in the liver tissue were observed by hematoxylin-eosin(HE), Masson, and Sirius red staining. Western blot was used to detect protein expressions of transforming growth factor-β(TGF-β), α-smooth muscle actin(α-SMA) and Smad4 in the liver tissue. The results indicated that Jingfang Granules significantly reduced the organ index, levels of ALT, AST, TBA,TG, TNF-α, IL-6, and IL-1β in the serum, and the content of MDA in the liver tissue of mice with CCl_4-induced liver fibrosis. Jingfang Granules also significantly increased the content of SOD and GSH in the liver tissue. Meanwhile, Jingfang Granules down-regulated the protein levels of TGF-β, α-SMA, and Smad4. Furthermore, Jingfang Granules had no significant effect on the liver tissue morphology and the above indexes in the normal mice. In conclusion, Jingfang Granules has obvious therapeutic effect on CCl_4-induced liver fibrosis, and its mechanism may be related to reducing the expression of pro-inflammatory factors, anti-oxidation, and regulating TGF-β/Smad4 signaling pathway.
Mice ; Male ; Animals ; Tumor Necrosis Factor-alpha/metabolism* ; Interleukin-6/metabolism* ; Olive Oil/therapeutic use* ; Carbon Tetrachloride/metabolism* ; Liver Cirrhosis/metabolism* ; Liver ; Superoxide Dismutase/metabolism* ; Transforming Growth Factor beta/metabolism*