Objective:To investigate the correlation between ankle-brachial index(ABI)and intracranial atherosclerosis in patients with ischemic stroke.MetlaTds:qhe ABI of 73 patients with ischemic stroke were detected using vascular Doppler ultrasound;head magnetic resonance angiography(MkA)was performed using a 1.5 T magnetic resonance imahing system,and the extent of intracranial artery stenosis was graded.The correlation between ABI and the grade of intracranial artery stenosis in patieras with ischemic stroke was analyzed.Results:The ABI in patients without intracranial artery stenosis(n=38)was significantly higher than those with intracranial artery stenosis(n=35)(0.975±0.114 vs 0.837±0.096,P<0.001).The ABI was significantly negatively correlated with the extent of intracranial artery stenosis(r=-0.736,P=0.001).Conclusions:The ABI was negatively correlated with the extent of intracranial artery stcnosis.It can he used as a preliminary screening means of intracranial atherosclerosis.

The high mortality of paraquat (PQ) poisonings is mainly due to the lack of effective treatments. Most toxicologists recommend rapid initiation of charcoal haemoperfusion (CHP) to lower plasma PQ levels and to limit pulmonary and other organs uptake of PQ. Although there are considerable evidences of CHP efficacy in the reversion of the fatal outcome resulting from PQ poisonings, the usefulness of this therapy has been the subject of significant controversy with several evidences published in the literature showing a lack of clinical benefit in numerous cases. Considering that the blood concentration at a given time is directly related to clinical outcome, the rebound in plasma paraquat concentration after haemoperfusion may be partly relate to the poor clinical benefit, but may indicate the necessity for prolonged haemoperfusion. Continuous rather than intermittent haemoperfusion has been advocated for treatment of paraquat poisoning. However, 24h daily conventional pump driven haemoperfusion is usually impossible to carry out due to bleeding complications. Plasmapheresis is also a blood purification process. Unselective therapeutic plasma exchange is the first technology used for therapeutic apheresis (TA). However, limited efficacy by restricted plasma volume that can be exchanged in a single session is one of the severe limitations. To further increase the clearance of target molecules, plasma perfusion (PP) techniques was developed. modification of the conventional plasma perfusion in patients with paraquat poisoning has been reported and plasma levels of paraquat were reduced effectively.

[Objective]To evaluate the efficacy of nerve transfer for reconstructing the sensory function of the sole.[Method](1)Select saphenous nerve as donor nerve for the patients with the sensory loss beneath ankle level:dissect and cut off the saphenous nerve at the medialposterior aspect at upper-middle 1/3 of the leg and divide the gastrocnemius to expose the tibial nerve at the medialposterior aspect of the tibia, cut off partly nerve fibre of the tibial nerve and then end-to-end anastomose to the proximal end of the saphenous nerve. (2) Select sural nerve as donor nerve for the patients with sensory loss of sole only:dissect and cut off the sural nerve at the posterior aspect of the lateral malleolus, expose the tibial nerve at the posterior aspect of the medial malleolus and then cut off partly nerve fibre of the tibial nerve. The sural nerve was comdicted from the subcutaneous tunel at the anterior aspect of the Achilles's tendon to the posterior aspect of the medial malleolus and end-to-end anastomose to the partial nerve fibre of the tibial nerve. [Result]All the 9 cases were followed up from 1.5 to 2 years(mean 2 l months). The SCV(sensory conduction velocity) of the tibial nerve was ranged from 36.1 to 41.2 m/s, mean 38.3 m/s and the amplitude of wave (peak-to-peak amplitude) was a range from 7 to 15.3?V, mean 11.2 ?V by orthodromic electrophysiologic techniques. All 9 cases regained the sense of pain and touch of the sole.Three cases restored their sense of two point discrimination. All the patients expressed their satisfaction with their ability of walk and no muscles atrophy of the foot. The sensory loss in donor region was oberserved only lateral part of the foot beneath the lateral malleolus (sural nerve as donor nerve) and a small part of the anterior aspect of the ankle(saphenous nerve as donor nerve).[Conclusion]Nerve transfer can reconstruct the sensory function of the sole effectively.

Objective To study the effect of expansion ex vivo on the hematopoietic reconstitution of umbilical cord blood (UCB) hematopoietic cells, and to find a probable way of UCB transplantation (UCBT) to be used on adults. Method Three groups of UCB hematopoietic cells were transplanted to lethally irradiated BALB/C mice: fresh cells, a half part of fresh cells and a half part of cells expanded for a week, cells expanded for a week. Results All the three groups of cells could reconstitute hematopoiesis. The cells in the latter two groups could more rapidly accelerate the recovery of early-period hematopoiesis. The death rate of the mice in second group was the lowest among three groups. Conclusion The way transplanted with a half part of fresh UCB hematopoietic cells and a half part of UCB hematopoietic cells ex vivo expanded for a week may be a probable one for adult UBCT.

Objective To measure the difference of radiosensitivity between small and large intestines toward high dose of radiation and investigate the role of stem cells in this difference.Methods C57BL/6 male mice,6-8 weeks old,were randomly divided as control group and radiation group received 19 Gy whole body γ-ray irridiation.Large and small intestines of the mice were collected 6,12,24,48,72 and 96 h after radiation.The proliferation and apoptosis of the large and small intestines and their stem cells were then detected by immunochemistry,and the change of stem cell number in the large and small intestines were detected by in-situ hybridization.Results HE staining showed that 19 Gy γ-ray irradiation caused more severe injury in the small intestine,and all the crypt in the small intestine were extinct at 48 h post-radiation.However,the proliferation index of crypt in the large intestine was as high as 0.23 (t =4.67,P ＜0.05).Compared with the small intestine,the apoptotic index of epithelial cells in the crypt of large intestine was much lower at 12 and 24 h after irradiation (t =-1.92,-2.42,P＜0.05).The apoptotic population of stem cells in the small intestine at 12 and 24 h post irradiation were significantly lower than that in the large intestine (t =-1.98,-2.33,P ＜ 0.05),and the number of stem cell in the large intestine was significantly higher than that in the small intestine 24,48 h after radiation (t =1.98,3.31,P ＜0.05).Conclusions The radiosensitivity of small intestine toward high dose of irradiation is significantly higher than that of the large intestine,where the difference in radiosensitivity of stem cells between large intestine and small intestine may be involved.

Objective To investigate the significance of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system in evaluating elderly patients with hyperglycemic hyperosmolar state. Methods Elderly patients with hyperglycemic hyperosmolar state were enrolled in the study from January 2003 to May 2008. The patients were divided into two groups according to the outcome: death group and survival group. APACHE Ⅱ scoring system was used on the day of admission and the scores were compared in the two groups. The risk factors for death were evaluated by logistic regression analysis. Results Forty patients were registered including 10 cases in death group and 30 cases in survival group. The mortality rate was 25%. There were no differences in blood glucose, serum sodium, blood osmotic pressure, serum creatinine and hemoglobin between two groups before the treatment (t=-1.50～1.53, all P>0.05). The APACHE Ⅱ scores were significantly higher in death group than in survival group on the day of admission(30.1±5.4 vs. 22.9±3.9,Z=-4.08, P<0.01). Multiple logistic regression analysis showed that APACHE Ⅱ scores on the day of admission were the independent risk factor for death. Age, sex, blood glucose, effective blood osmotic pressure, serum creatinine and hemoglobin were not related to mortality rate. Conclusions APACHE Ⅱ scoring system is a helpful method for evaluating the severity and outcome of patients with hyperglycemic hyperosmolar state.

Objective To observe the effect and adverse reactions of iron sucrose injection in treating old patients with iron deficiency anemia(IDA). Methods Thirty-two old patients with IDA were divided into injection group(17 patients)and oral group(15 patients)by random digits table. The effects of improvement on IDA and their adverse reactions were observed. Results After treatment, hemoglobin(Hb)in the injection group and oral group was(100.18±8.71)g/L and(85.80 ± 6.92)g/L(P＜0.01), and serum iron was(23.84±5.34)μmol/L and(14.63±3.29)μmol/L(P＜0.01).There were no obvious adverse reactions in injection group, whereas there were 6 cases(40%)with gastric and colon adverse reaction in oral group. Conclusions The treatment of intravenous injection of iron sucrose can be effectively used to cure old patients with IDA. It has better effect and has lower rate of adverse reaction.

Objective To analyze the clinical and pathological features of collecting duct carcinoma (CDC) of the kidney. Methods 11 patients with CDC were analyzed,among which 6 were males and 5 were females.Their age ranged from 22 to 67 years old with a mean age of 55.4 cases were found by routine health examination,4 cases were presented with gross hematuria and 3 cases had flank or abdomen pain.The CT scan showed an unclear boundary mass in kidney,with tumor sizes from 2.1 to 8.5 cm ( mean 5.6 cm).Only medullary involvement was present on CT in 3 cases,Medullary and cortical involvement in 5 cases,Medullary and pelvic involvement in 2 cases,and all involvement in 1 case.Infiltrative lesion has expanded kidney but maintains reniform contour.Contrast-enhanced CT scan showed lesion mild to moderate enhancement compared with surrounding parenchyma. Results Radical nephrectomy was performed in 8 cases and palliative nephrectomy in 3 cases.All patients were finally diagnosed by pathology.Grossly,the tumor is often appears gray or white.In HE staining,tumor showed prominent tubular or tubulaopapillary structures with desmoplasia and inflammatory reaction.Occasionally,some tumor cells take on a hobnail appearance.Immunohistochemical examination showed UEA-1 positive in all cases,EMA positive in 9 cases,PNA positive in 8 cases,and HMW-CK positive in 7 cases.Only 2 patients showed positive CD10.7 patients died within 6 to 47 months (mean 12.5 months),2 survived with tumor free for 9 months and 8 years respectively,one lost of follow-up,and one patient with distant metastasis is receiving postoperative chemotherapy. Conclusions Collecting duct carcinoma of the kidney is a rare histological type of renal cell carcinoma,whose final diagnosis depends on histopathological examination.Rapid progression,highly malignant,poor prognosis are the characteristics of this disease.

Objective To investigate the clinical efficacy of new-type patent endotracheal tube in difficult endotrachea intubation patients.Methods Seventy-three patients with the abnormal airways were selected as our subjects.Patients were given the traditional endotracheal tube by mouth after anesthesia.The successes patients in terms of endotracheal intubation were as group Ⅰ (n =73).The failed patients were asgroup Ⅱ (n =63),who performed the secondary endotracheal intubation with new type patent endotracheal tube.Analyze the success rate of intubation of the two groups when on use the tube core.Results The first time intubation success rate and intubation success rate was (2.7％ (2/73),13.7％ (10/73) respectively) in Ⅰ group,and 73.02％ (46/63) and 98.41％ (62/63) respectively in the group Ⅱ,and there was the significant difference between two groups (x2 =36.01,31.08 respectively,P ＜ 0.01).Conclusion The new type endotracheal tube was proved with three advamage of good plasticity,without need of auxiliary core intubation with trachealtube and give full play to lead the soft cannula guide tubes leading role.Therefore,the new type patent endotracheal tube has more efficacy over traditional tube.

Objective To compare the differences of atria and atrial myocyte structure in patients with atrial fibrillation (AF) and sinus rhythm(SR) .To evaluate the influence of AF on cardiac function .Methods 79 patients without heart failure undergoing car-diopulmonary bypass surgery were divided into the AF group (n=39) and the SR group(n=40) .Echocardiography was performed for analysis of left ventricular end diastolic dimension(LVDd) ,left ventricular end-systolic dimension(LVDs) ,left ventricular poste-rior wall(LVPW) ,interventricular septum(IVS) and left atrial diameter(LAD) .Part of left atrial appendages was taken freshly for HE staining in order to observe atrial tissue structure .Results LVDd ,LVDs ,LVPW and IVS of the AF group were lower than that of the SR group .But LAD of the AF group was higher than the SR group .There was statistical significance in IVS and LAD between the two groups(P<0 .05) ,and there were no significant differences in other aspects (P>0 .05) .Compared with the SR group ,the AF group had thinner myocardial atrophy ,more obvious fibrosis ,smaller nucleus and darker HE staining .Conclusion The incidence of AF was mainly in rheumatic heart disease .The development of AF was mostly accompanied with the enlargement of LAD and the change of atrial tissue structure which showed that AF can reduce cardiac function .