Objective To compare the safety and efficacy of intravenous thrombolysis for patients with acute cerebral infarction in a second-grand class-A hospital and a third-grand class-A hospital. Methods Twenty-one consecutive patients with cerebral infarction treated with alteplase for intravenous thrombolysis were enrolled in a second-grand class-A hospital (Fengtai Hospital,Beijing)prospectively from January 2012 to December 2013 as the study group,and 65 patients in a third-grand class-A teaching hospital (Xuanwu Hospital,Capital Medical University,Beijing)admitted at the same period for intravenous thrombolysis were used as a control group. The differences of efficacy and safety of intravenous thrombolysis in patients of both groups were compared. The primary outcome measures were Barthel Index (BI)at day14 after onset and the modified Rankin Scale (mRS)scores at discharge. The main safety indicator was the incidence of serious adverse events (SAEs)after thrombolysis (symptomatic intracranial hemorrhage and death). Results (1 )In the primary outcome measures,the proportions of mRS≤2 at discharge in the study group and the control group were 71. 4%(n=15)and 58. 5%(n=38)respectively. At day 14 after thrombolysis,the proportions of BI ≥60 were 61. 9%(n=13)and 64. 6%(n=42)respectively. There were no significant differences between the two groups (P>0. 05). (2)The incidences of the primary serious adverse events were 4. 8%(n=1)and 6. 2%(n=4). There was no significant difference (P>0. 05). Other secondary outcome measures,such as the early reperfusion rate,recanalization rate,and the proportion of neurological improvement at day 14 after thrombolysis and the overall incidence of cerebral hemorrhage had no significant differences. The case referral proportion (9. 5%,n=2)of the study group had a trend of lowering than the control group (27. 7%,n=18)P=0. 09. (3)The out-hospital time delay, in-hospital time delay,and overall time delay of the study group were less than those of the control group, and the mean time was 75 ± 33 vs. 102 ± 50 min,and 72 ± 41 vs. 111 ± 38 min,147 ± 41 vs. 212 ± 47 min. There were significant differences (P<0. 01). Conclusion The second-grand hospital selected by our study can relatively safely and effectively perform intravenous thrombolysis for acute cerebral infarction with alteplase. Moreover,the intravenous thrombolysis of the second-grand hospitals may reduce the case referral ratio and visiting time.

Objective To study the clinic effects and safety of budesonide suspension combined with tubertaline solution for nebulization therapy on infantile asthma.Methods Seventy-five cases with asthma were divided into 3 groups randomly,double-blinded and controlled,each group having 25 cases.Group A inhaling tubertaline solution(bricanyl),while group B inhaling pulmicort respules combined with bricanyl,group C inhaling budesonide suspension(pulmicort respules)only.Results In group A,16 cases was cure,3 cases was markedly improved,6 cases was failure,the total efficacy rate was 76 percent.In group B,22 cases was cure,2 cases was markedly improved,1 case failed,the total efficacy rate was 96 percent.While in group C,14 cases was cure,4 cases was markedly improved,7 cases failed,the total efficacy rate was 72 percent.The difference of efficacy rate between group A and group B was significant(P0.05).Conclusion Pulmicort respules combined with bricanyl for nebulising inhalation is effective and safety on infantile asthma and its effect is better than inhaling bude-sonide or tubertaline only.

Objective Objective To explore the reasons of lung hypervolemia after liver transplantation and the corresponding treatment strategies.Method 291 patients received liver transplantation,in which 35 cases underwent pulmonary edema at early stage (pulmonary hypervolemia group),and the rest without pulmonary hypervolemia served as control group.Average central venous pressure (CVP) was recorded pre-,intra-and post-operatively.Total intake,total discharge and fluid balance were also recorded intraoperatively and 3 days post-operatively.Result In pulmonary hypervolemia group,CVP was (12.33 ± 5.08),(14.33 ± 3.03) and (16.50 ± 4.57) mmHg pre-,intra-and post-operatively,significantly higher than that in control group (P＜0.05 for all).Total intake,total discharge and fluid balance in pulmonary hypervolemia group were significantly higher than those in control group intraoperatively and 3 days post-operatively (P＜0.05 for all).After diuretic therapy and hemodialysis,30 cases in pulmonary hypervolemia group recurred,and 5 cases died of infection.Conclusion Pulmonary hypervolemia at early stage after liver transplantation is related to fluid balance.The reasonable control of total intake,total discharge and fluid balance is necessary.

To study the molecular genetic basis of ABO alleles in para-Bombay type individuals, samples from five para-Bombay type individuals identified by serologic tests including absorption-elution tests, saliva neutralizing or inhibitor substances tests, were genotyped by using PCR-SSP based ABO genotyping. Exon 6 and exon 7 at the ABO locus for all 5 samples were sequenced. The results showed that the ABO genotypes of five para-Bombay samples were A102B1, A102B1, A102O1, A102B1, B1O1 respectively, the direct DNA sequencing results were in accordance with the results genotyped by PCR-SSP method, No novel nucleotide mutation was found at the exon 6 and exon 7 of ABO gene. In conclusion, the ABO genotyping assay by PCR-SSP provide a simple, rapid and accurate method for determining the ABO type of para-Bombay cases.
ABO Blood-Group System ; genetics ; Alleles ; Chromosome Mapping ; Female ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo introduce an arthroscopic technique in managing recurrent dislocation of the patella and its clinical results.

METHODSSixteen patients with recurrent patellar dislocation were reviewed, including 3 males and 13 females. The average age was 17.6 years old (ranged from 14 to 32 years). The patients suffering from patellar sub-luxation averaged 18.5 months (ranged from 6 to 23 months)before operation. These patients were treated with lateral patellar retinacular release outside the synovial bursa of knee joint and medial patellofemoral ligament reconstruction using the semitendinosus tendon free autograft. The Lyshohm scores before and after operation were used to evaluate outcomes at the final follow-up.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 48 months, with an average of 12 months. There was no recurrence. The Q angle decreased from (16.4 ± 3.7)° to (10.1 ± 1.4)°; insall index decreased from 1.37 ± 0.25 to 1.28 ± 0.23; congruence angle decreased from (21.3 ± 2.6)° to (5.86 ± 2.23)°; Lysholm score improved from 76.1 ± 5.2 to 89.8 ± 4.1 at 6 months after operation.

CONCLUSIONCompared with conventional procedure, arthroscopic surgery for recurrent dislocation of the patella achieves excellent outcomes with minimum invasion.

Adolescent ; Adult ; Arthroscopy ; Bursa, Synovial ; surgery ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

AIM: To investigate the safety and effect of EX-PRESS glaucoma drainage device on open-angle glaucoma.
METHODS: A retrospective review of 40 patients ( 47 eyes ) whose eyes were diagnosed as open angle glaucoma through the best - corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , gonioscope, examination of the ocular fundus, and visual fields et al. Fourty patients 6-73y old ( mean 39. 90±16. 50y old) with the BCVA from 0. 01 to 0. 6 and the IOP from 18mmHg to 65mmHg were treated with EX-PRESS glaucoma drainage device after achieving not well IOP over three drugs. Follow - up of these patients 1d, 3d and 1wk after treatment, IOP, slit lamp examination were retrospectively observed. The changes of the BCVA, IOP were used to evaluate the safety and effect before and after treatmeat.
RESULTS: The mean BCVA was 0. 26 ± 0. 29 pre -operatively, while it was 0. 24±0. 22 after treatment one week. The mean BCVA decreased slightly, but there was no statistic difference between pre-treatment and post-treatment (t=1. 56,P=0. 13). The mean IOP was (36. 62 ±14.01)mmHg pre-operatively, (10.04±5.77)mmHg after treatment one day , ( 9. 59±4. 93 ) mmHg after treatment three days, (9. 47±3. 06)mmHg after treatment one week. The IOP was decreased significantly in post-treatment after one day, three days, one week compared with pre-treatment (F=157. 20, P<0. 05). Except for 5 eyes of the IOP below 5mmHg, there was no ocular or systemic adverse events observed in all patients.
CONCLUSION:EX-PRESS glaucoma drainage device is an effective and safe treatment for the patients with open-angle glaucoma. The risk and complication are low intraoperatively and postoperatively.

Objective To detect the changes of CD4 + CD25 + CD127low/-regulatory T (Treg) cells in peripheral blood in patients with portal hypertension and hepatitis B virus infection before and after splenectomy,and to study the effects of splenectomy on the immune function of patients with portal hypertension.Methods The clinical data of 20 patients with portal hypertension,hepatitis B virus infection and hypersplenism who were admitted to the Third Hospital of Hebei Medical University from May 2012 to May 2013 were retrospectively analyzed.The dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of the 20 patients (portal hypertension group) at 1 day before splenectomy and at postoperative week 1,month 1 and month 3 were detected by flow cytometry,and the dynamic levels of CD4 + CD25 + CD127low/ Treg cells in the peripheral blood of 10healthy individuals (control group) from the same hospital were also detected by flow cytometry.The effects of changes of Treg cells on the immune function were analyzed.All data were analyzed using the t test or repeated measures analysis of variance.Results The proportions of CD4 + CD25 + CD127low/-Treg cells before operation were 5.1％ ± 3.5％ in the portal hypertension group and 1.4％ ± 0.2％ in the control group,with significant difference between the 2 groups (t =2.573,P ＜ 0.05).The proportions of CD4 + CD25 + CD127low/ Treg cells in the portal hypertension group at postoperative week 1,month 1 and month 3 were 9.2％ ±2.7％,5.6％ ± 1.7％and 2.5％± 2.1％,respectively.There was significant difference in the proportion of CD4+ CD25 + CD127low/-Treg cells between postoperative week 1 and that before operation (F =9.814,P ＜ 0.05),while there was no significant difference in the proportion of CD4 + CD25 + CD127low/-Treg cells between postoperative month 3 and that before operation (F =2.364,P ＞ 0.05).Conclusion The proportion of Treg cells increases in a short period after splenectomy,and then it decreases as time passed by,which indicates that splenectomy has slight influence on the immune system from the perspective of Treg cells.

Background There is no effective method to regenerate the optic nerve after injury. It has been recently reported that α-crystallin could promote the survive rate and axon regeneration of retinal ganglion cells (RGCs) effectively. However,the molecular mechanism is not clear. Objective This study was to identify the site of RGCs where the exogenous α-crystallin bind to. Methods RGCs was isolated from retinas of two 2-day-old Long Evans rats and primarily cultured. The positive rate of the RGCs was assessed by counting the number of positive cells for fluorescently-labeled thy1. 1 and cy3 under the fluorescence microscope. The biotinylated exogenous α-crystallin was evaluated by direct coloration and the activity of molecular chaperones was measured by insulin test.After identifying the success of biotinylation along with the activity of molecular chaperones,biotinylated α-crystallin was co-incubated with RGCs and the cells then were reacted to fluorescently labeled avidin for the observation of binding site of exogenous α-crystallin under the laser confocal microscope. Results RGCs of 94% were survived through primary culture. The coloration of biotinylated α-crystallin labeled by the direct coloration method was more intensive, and the value of A450 descended as the decrease of biotinylated α-crystallin concentration,indicating that the α-crystallin was biotinylated successfully. The activity of molecular chaperones of biotinylated α-crystallin was significantly strong but no significant change after being biotinylated after co-incubation of RGCs with biotinylated α-crystallin. Laser confocal microscope examination revealed that co-incubated RGCs with biotinylated α-crystallin showed the red fluorescence on membrane and axon of RGCs rather than cytoplasm and nucleus. The absent response was seen in the control group. Conclusion Exogenous α-crystallin can specifically combine with the membrane of RGCs to play the biological function,but its binding mode and mechanism need further study.

Objective To explore the value of mast cell tryptase and brain natriuretic peptide(BNP)in the differential diagnostic of sudden death due to hypersensitivity and coronary atherosclerotic heart dis-ease.Methods Totally 30 myocardial samples were collected from the autopsy cases in the Department of Forensic Pathology, Shanxi Medical University during 2010—2015. All samples were divided into three groups:death of craniocerebral injury group, sudden death of hypersensitivity group and sudden death of coronary atherosclerotic heart disease group, 10 cases in each group. Mast cell tryptase and BNP in myocardium were detected by immunofluorescence staining and Western Blotting.Results Immunofluo-rescence staining showed that the positive staining mast cell tryptase appeared in myocardium of sudden death of hypersensitivity group and coronary atherosclerotic heart disease group. Among the three groups, the expression of mast cell tryptase showed significantly differences through pairwise comparison(P<0.05); The expression level of BNP in sudden death of coronary atherosclerotic heart disease group were significantly higher than the sudden death of hypersensitivity group and death of craniocerebral injury group(P<0.05). The difference of the expression level of BNP between the sudden death of hypersensitivity group and the death of craniocerebral injury group had no statistical significance(P>0.05).Conclusion The combined detection of the mast cell tryptase and BNP in myocardium is expected to provide help for the forensic differential diagnosis of sudden death due to hypersensitivity and coronary atherosclerotic heart disease.

OBJECTIVETo study the therapeutic effect of one-staged repair of unilateral cleft lip an nasal deformity with modified Mohler.

METHODSThe unilateral cleft lip and nasal deformity were repaired in one stage with modified Mohler. The nasal retainers were kept for at least 6 months. The patients were followed up at 3 months and 12 months after operation.

RESULTSFrom Sept. 1998 to Aug. 2008, 103 cases, aged from 2.5 m to 12 m, were treated. 3 months after operation, 97 of 103 patients had good appearance of both lips and noses, which included unobvious scars, symmetric Cupid's bows and nostrils, intermedial nasal columellae and eminentia nasal tips. 6 of them had good appearance of noses only with a little malposition of Cupid' s bows. 89 patients were followed up for 12 months with no deterioration of nasal deformity and delayed growth of greater alar cartilages. 3 patients who had malposition of Cupid's bows also got better.

CONCLUSIONSThe one-staged repair of unilateral cleft lip and nasal deformity with modified Mohler is very practical.

Cleft Lip ; surgery ; Female ; Humans ; Infant ; Male ; Nose ; abnormalities ; Reconstructive Surgical Procedures ; classification ; methods