At present, the roles of neural plasticity and motor functional recovery in stroke have increasingly been paid attention to. The remodeling of cerebral cortex after stroke can complement the function of injured tissues, which has been confirmed by animal experiments. Functional neuroimaging technique has been gradually used in the evaluation of neural plasticity.

Objective To investigate the effect of glycated albumin on recurrent cerebral infarction in elderly patients with diabetes mellitus. Methods All of 252 elderly acute cerebral infarction patients with diabetes mellitus were chosen from clinics. They were divided into 2 groups: A group ( glycated albumin <19.0% , 117 patients) and B group ( glycated albumin ≥ 19.0%, 135 patients). The clinical characteristics and the recurrent rate of cerebral infarction were compared between two groups. Results The levels of glycated albumin, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol and triglycerides in B group were significantly higher than those in A group:(21.00 ± 4.93)%vs. (16.75±1.72)%, (9.84 ± 2.89) mmol/L vs. (5.36 ± 1.00) mmol/L, (5.44 ± 1.30) mmol/L vs. (4.57 ± 1.00) mmol/L, (3.13±0.81) mmol/L vs. (2.58 ± 0.74) mmol/L, (2.34 ± 1.61) mmol/L vs. (1.74 ± 1.47) mmol/L, P<0.01 or<0.05. The recurrent rate of cerebral infarction in B group was significantly higher than that in A group: 53.3%(72/135) vs.36.7%(43/117), χ2 = 6.946, P = 0.008. Logistic regression analysis showed that the increase of glycated albumin was the independent risk factor of recurrent cerebral infarction in elderly patients with diabetes mellitus (P=0.048). Conclusions The recurrent rate of cerebral infarction is increased in elderly diabetes patients with high glycated albumin. The increase of glycated albumin is the independent risk factor of recurrent cerebral infarction.

Objective To evaluate the efficacy and clinical value of percutaneous transluminal angioplasty(PTA)with stenting for the treatment of superior vana cava syndrome(SVCS)with malignant causes.Methods A total of 13 patients with SVCS with malignant causes were enrolled in this study.Among the patients,2 had mediastinal cancer,and 11 had metastatic mediastinal tumor.The malignancy of the primary tumors of the 11 patients,including pulmonary cancer in 8,esophageal cancer in 2,and breast cancer in 1,were all confirmed by pathological examination.Via the right femoral vein,a pigtail catheter was introduced percutaneously into the proximate or remote end of the stenotic segment for the visualization of the SVC.After the location,length,and gravity of the stenosis were determined,Wallstent(Boston Scientific,USA)was placed into the SCV,if the patients had no local thrombosis in the stenotic segment.In one patient,a Z-shape stent(COOK,USA)was inserted simultaneously.For the cases complicated with thrombosis,the Wallstent was inserted after local thrombolysis.Results The procedure was completed in all the 13 patients with a success rate of 100%.The average length of the stenotic segment was 4.3 cm(3-6 cm).In one patient,two stents were used,while in the others only one stent was inserted.Thrombolysis was carried out before stenting in 6 patients.The intravenous pressure at the proximate end of the stenotic segment was determined with the patients supine before and after stenting.The pressure decreased from(26.2?1.6)cm H2O to(4.3?0.8)cm H2O after the operation.Postoperative angiography showed no collateral vein in the patients.The SCVS disappeared 0 to 3 days after the surgery.The patients were followed up for 8-26 months with a median of 13.During this period,8 patients died of multiple organ failure caused by multiple metastasis of the primary tumor in 4 to 10 months;the other 5 patients survived(3 of them received further therapies)without recurrence of SCVS.Conclusion PTA with stenting combined with local thrombosis is an effective and invasive treatment for patients with SCVS with malignant causes.

Objective To evaluate the effectiveness of pulmonary embolectomy by cathether for the treatment of acute pulmonary embolism. Methods 38 cases were diagnosed pulmonary embolism by pulmonary angiography, treated by thrombus fragmentation and suction by cathethers, and local fibrinolysis. The symptoms, PaO 2, PAPM and pulmonary arteries were observed after the procedure. Results 36 patients survived and showed clinical improvement with significant decrease in PaPm and increase in PaO 2( P

Objective To evaluate the effectiveness and method of intraarterial embolization in treatment of hepatic cavernous hemangioma. Methods 17 patients,8males and 9 females, were treated by super selective hepatic artery embolization with iodized oil, gelfoam pieces, and embolization coils. Results All patients had been embolized successfully. The rate of success was 100%. 11 cases were followed up by CT/USG for 1～12 months. The size of tumor was decreased more than 50% in 8 cases, more than 30% in 2 cases, and the effect was uncertain in 1 case. Symptoms of 11 patients were disappeared and relief was obvious in 5 cases.Total effective rate was 94% with no significant complications. Conclusions HAE is a safe and effective method. It may be considered as the first method of choice in treatment of hepatic cavernous hemangioma.

Objective To evaluate the effect of simpler and chemotherapeutic renal artery embolizations in the treatment of renal carcinoma preoperatively Methods 19 patients including simpler renal artery embolizaiton group( n =8) and chemotherapeutic renal artery embolization group( n =11) were retrospectively studied. The surgical procedures were recorded and pathology sections were observed for all the patients. Results All the preoperative embolization were achieved successfully. We found vessels obliteration of the renal carcinoma in the operation. In pathology, the tumor had clear border with the necrosis. Conclusions Preoperative renal artery embolization could decrease the risk in operation, and had positive effects on the prognosis of these patients.

Objective To study the effect of purslane decoction on oxidative stress products and soluble protein of senile cataract patients tears.Methods 120 cases of cataract patients (160 eyes) were selected, according to different drugs were randomly assigned to two groups.The control group were treated with Imidacloprid sinnock sodium drops eye drops, 1 drop each time, 4 times per day,the patients in the experimental group on the basis of the control group with Portulaca oleracea decoction 100 mL, for three consecutive months.SOD, MDA, soluble protein level and visual improvement were compared after the end of treatment.Results Compared with control group, the visual acuity of the experimental group was higher(P<0.05), MDA was lower, SOD was higher(P<0.05), soluble protein content was higher(P<0.05).Conclusion Portulaca oleracea decoction can apparently improve the cataract patients with tear of SOD, MDA, soluble protein level and improve visual acuity.

Objective:To evaluate the new scoring system for gastric cancer screening and risk assessment of gastric precancerous lesions.Methods:A total of 442 patients who underwent endoscopy due to stomach discomfort at the First Hospital of Jiaxing from March 2018 to September 2019 were enrolled. The patients were divided into three groups based on the new scoring system for gastric cancer screening before endoscopy: low-risk group (0-11 points), median-risk group (12-16 points) and high-risk group (17-23 points). The detection rates of gastric cancer and atrophic gastritis in three groups were analyzed. According to the range or degree of atrophy or intestinal metaplasia, patients were divided into five groups of stage 0 to Ⅳ based on the operative link for gastritis assessment (OLGA) or operative link for gastritis intestinal metaplasia (OLGIM). The correlation between the new gastric cancer screening scoring system and OLGA or OLGIM staging system were evaluated.Results:Among 442 patients, 211 were assigned to low-risk group, 207 median-risk group and 24 high-risk group according to the new scoring system. For OLGA staging system, there were 241 cases of stage-0, 105 of stage-Ⅰ, 58 stage-Ⅱ, 27 stage-Ⅲ and 11 stage-Ⅳ. For OLGIM staging system, there were 224 cases of stage-0, 113 stage-Ⅰ, 61 stage-Ⅱ, 31 stage-Ⅲ and 13 stage-Ⅳ. The pepsinogen (PG) Ⅰ and pepsinogen ratio (PGR) levels had differences among different OLGA stages ( F=2.844, P=0.027; F=5.435, P=0.001), and these two variables at Stage-Ⅲ and Ⅳ were significantly lower than three other OLGA stages (all P<0.001). The PGR level had differences among different OLGIM stages ( F=3.887, P=0.008), which was significantly lower at Stage-Ⅳ than at other OLGIM stages (all P<0.001). Gamma coefficient analysis and Kendall′s tau-b analysis showed significant correlations between OLGA/OLGIM staging system and new gastric cancer screening scoring system ( P<0.001). Conclusion:The new scoring system is reliable for gastric cancer screening, and is closely linked with OLGA/OLGIM staging system in the risk assessment of gastric precancerous lesions.

Adult ; Female ; Hearing Loss, Sensorineural ; Humans ; Male ; Molecular Motor Proteins ; genetics ; Mutation ; Myosin Heavy Chains ; genetics ; Pedigree ; Thrombocytopenia ; genetics

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.