objective To investigate the recurrence of stroke,clinical prognosis and vascular changes in patients with ischemic stroke due to middle cerebral artery stenosis. Methods The ischemic stroke patients with symptomatic middle cerebral artery stenosis were enrolled continuously and followed up prospectively for six months. The recurrence of ipsilateral stroke,clinical prognosis and dynamic changes of vessels were analyzed. Results Eighty patients were included,and 20.0% of the patients(16 cases)presented with recurrence of ipsilateral ischemic stroke and 56 cases (70.0%)with a good outcome(modified Rankin scale[mRS]≤1)during the 6 months follow-up;38.6% patients (27 cases) presented with significant vascular changes with progression in 12 cases (17.1%)and regression in 15 cases (21.4%). Conclusion The patients with simple symptomatic middle cerebral artery stenosis have an high rate recurrence of ipsilateral stroke but have good prognosis;Lesioned artery of the majority of patients in the short period after stroke was stable,but vascular stenosis in some patients could appear progression or remission.

Anemia is a common and severe complication in inflammatory bowel disease. Anemia can induce impaired cardiovascular and renal functions, and lead to a significantly decreased quality of life. This review is dedicated to explain the underlying mechanism, diagnosis and management of anemia in inflammatory bowel disease.
Anemia ; diagnosis ; etiology ; therapy ; Humans ; Inflammatory Bowel Diseases ; complications

Hyperuricemia and metabolic syndrome were studied in 17 762 subjects of Tianjin Municipality from July 2007 to July 2009. The overall prevalence rate of hyperuricemia was 12. 16% (2160cases) , the rate in males was significantly higher than that in females (15. 71% vs. 6. 51% , P <0. 01).The overall prevalence rate of metabolic syndrome was 25. 56% (4540 cases) , the rate in males was also higher than that in females (28. 17% vs. 21. 40% , P <0. 01). Binary logistic regression analysis disclosed that females with high uric acid were twice likely to suffer from metabolic syndrome than males; and female ≤ 44 years with hyperuricemia had the highest odd ratio for metabolic syndrome.

Objective To investigate the renal angiographic manifestations of severe hemorrhage following minimally invasive pereutaneous nephrostolithotomy (MPCNL), and to evaluate the technique of super-selective renal arterial embolization in treating the condition. Methods Forty-eight cases of severe hemorrhage following MPCNL treated with super selective renal arterial embolization in our department were retrospectively reviewed. The angiographic findings, results and complications of embolization procedures were analyzed. Results Two cases were of acute hemorrhage immediately after MPCNL, and the other 46 cases were of delayed hemorrhage 2 to 7 days after MPCNL. Of these 48 cases, 25 (52.1%) showed simple pseudo-aneurysms, 6 (12.5%) pseudo-aneurysms accompanied with arterial-venous shunts, 1 (2.1%) pseudo-aneurysm with extravasated contrast medium, 11 (22.9%) arterial-venous fistulas, 2 (4.2%) extravasated contrast medium from arterial branches, 1 (2.1%) renal capsular branches varix, 2 (4.2%) no lesion detected. Successful super-selective embolization was achieved in all 46 positive cases, and renal hemorrhage was stanched consequently. Polyvinyl alcohol foam embolization particles (PVA), gelfoam and coils were used in the procedures (PVA in 18 procedures, PVA +coil in 5, gelfoam in 10, geffoam + coil in 11, PVA + gelfoam + coil in 2). Post-embolization syndrome of various degrees were seen in all treated patients. A slight rise in blood creatinine levels was observed in 12 cases. Conclusion Super selective renal arterial angiography and embolization is the treatment of choice in patients who suffered severe hemorrhage due to MPCNL.

ObjectiveTo explore the clinical features and factors inlfuencing the prognosis of childhood non-Hodgkin's lymphoma (NHL).MethodsPathologically diagnosed 78 pediatric patients with NHL and treated in the Afifliated Hospital of Qingdao University from January 2004 to August 2013 were collected and analyzed. Patients were grouped according to age, sex, tumor size, immunologic classiifcation, B-symptoms, LDH, hemoglobin and clinical staging. The 5-years event-free survival rate (EFS) were calculated and analyzed by Kaplan-Meier method, and the difference of the survival rate between groups were com-pared. Using Cox proportional hazards model, we analyzed the possible factors that might inlfuence 5-years event-free survival rate EFS , such as age and clinical staging. TheOR value and the 95%CI were calculated.ResultsAmong the 78 cases, median age of onset is 7 years old, male to female ratio is 2.90:1, there are 25 cases of T-cell type and 53 cases of B-cell type. According to pathological types,Burkitt lymphoma is the most common (34.6%), followed by T-lymphoblastic lymphoma (20.5%), diffuse large B-cell lymphoma (11.5%). According to the St. Jude malignant lymphoma staging system, there are 2 cases in stage I, 9 in stageⅡ, 35 in stageⅢ and 32 in stageⅣ. Swelling of periphery lymph node (80.7%) was observed as initial symptom in 26 cases of lymphoblastic lymphoma. Among 45 cases of mature B-cell tumor, the main clinical feature including abdominal cavity and gingival were observed in 27 cases of Burkitt lymphoma. Among the 73 cases received treatments, 66 cases (90.5%) attained CR (complete remission) and 4 cases (5.5%) attained PR (partial remission) by cytology and radiographic assessment after two course of combined chemotherapy, 2 cases (2.7%) rapidly relapsed after the remisson of one course treatment, 1 case (1.3%) appeared the central nervous system inifltration in the chemotherapy. With median follow-up time of 42 months, the 5-year EFS of the 73 cases was (67.0+5.5)%. Single factor analysis showed that B-symptom, LDH, and clinical staging were signiifcantly correlated with prognosis (P<0.05), while age, sex, tumor size, hemoglobin and immune classiifcation was independent of prog-nosis (P>0.05). Multiple factor analysis showed that LDH and clinical staging inlfuenced the prognosis (OR=3.34,95%CI 2.275?10.683,P<0.01;OR=4.354,95%CI 1.519?12.475,P<0.01) .Conclusionclinical features of childhood NHL are variable. LDH and clinical staging at primary diagnosis are important factors affecting the prognosis.

Objective To investigate the executive function of children with different sports training. Methods Forty children with Ping-Pong training (Ping-Pong group) and 41 children with swimming training (swimming group), aged 6-9 years, completed GO/NOGO task. Behavioral data (reaction time and accuracy) and event related potential component N2 were collected and analyzed. Results The reaction time was significantly faster and accuracy significantly lower of GO task and NOGO task in swimming group than in Ping-Pong group (P<0.05 and P<0.01). There were significant differences in the amplitude of NOGO-N2 on site CPz between swimming group and Ping-Pong group[(-11.36±9.4) μV vs (-7.55±7.99) μV, P<0.05]. Conclusion The inhibitory function of children with Ping-Pong training is stronger than those with swimming training.

Objective To investigate the effects of different clipping time of first time using permanent aneurysm clips on common carotid artery wall in rabbitsMethods Sixty healthy male Japanese white rabbits were selected.The first time permanent aneurysm clips were used to clip common carotid artery for 30 min or 60 min respectively according to the random number method (n=30 in each group).Thirty segments of common carotid artery specimens clipped by aneurysm clips were collected respectively.Mean-Whitney U test was used to conduct the comparison of histopathological damage grade of vascular wall.Results The aneurysm clips were use to clip 30 min and 60 min caused vascular wall injury could observe the middle elastic plastic plate deformation and endothelial denudation.The vascular walls in the clipping 60 min group had local necrosis with inflammatory response,and even rupture of vascular wall.There were significant differences in overall damage degree of vascular wall (U=324.00,P=0.045) and severe injury rate (0%[0/30] vs.20.0%[6/30],P=0.031) between the clipping 30 min group and the clipping 60 min group (all P<0.05).Conclusion The vascular wall injury of using disposable permanent aneurysm clips for clipping 60 min was more severe than 30 min.Attention should be paid to shortening the time of carotid artery occlusion in operation.

Objective To summarize the experience in open surgery for huge adrenal tumors in order to improve its safety and efficiency of this complicated surgical procedure. Methods Fortyfour consecutive patients with huge adrenal tumors underwent open surgery with mean long tumor diameter of 13 cm (9-34 cm), and autologous blood transfusion was prepared in routine. It was analyzed retrospectively for clinical data, perioperative complications and the effective and safety results of this procedure. Results The incision was oblique in lumbar region in 5 cases, subcostal unilaterally in 32 cases and abdomino-thoracic joint in 7 cases. There were 27 malignant tumors (61.4%) in 44 cases, 3 with hepatic invasion, 6 with thrombi extending into inferior vena cava, among which 2 needed translocation of artificial blood vessels and 3 needed cardio-pulmonary bypass. The mean blood loss was 1309 ml (100-3000 ml) in 41 cases(93.2%)and the autologous blood transfusion was used in 20 case (45.5%). There were 1 diaphragmatic injury, 1 pleura injury, 3 hemorrhage in large amount more than 15 000 ml and 2 peritoneal cavity infection.There were no perioperative deaths and 42 tumors (95.5%) were curatively resected. Conclusions Open surgery for huge adrenal tumors is a complicated surgical technique with high risk and large amount of blood loss. The key points to success are proper selection of incision, routine autologous blood transfusion, perfect surgical skills and good cooperation between different specialties.

OBJECTIVETo explore the association of Helicobacter pylori infection with gastric cardia cancer.

METHODSAn unmatched prospective nested case-control study was conducted. In 1985, 29 584 subjects in age of 40-69 were recruited from Linxian, Henan Province. 10 mL blood samples were collected from all participants. By March 2001, 1089 cases of gastric cardia cancer were diagnosed. 196 cases were randomly sampled from them and formed the case group. 185 subjects were randomly sampled from the subcohort, which was built up in a previous case-cohort study and was able to represent the baseline population, forming the control group. Serum samples were assayed for H. pylori IgG antibodies by enzyme-linked immunosorbent assay. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) were calculated for cardia cancer, and also calculated by time from blood collection, time to diagnosis, gender and age, when blood was taken.

RESULTSThe positive rate of H. pylori IgG antibodies in control and case groups was 71.4% and 82.1%, respectively. The adjusted OR (95% CI) were 2.00 (1.21-3.31) for all cardia cancer cases, 1.36 (0.71-2.60) for male subjects, and 4.19 (1.73-10.17) for female subjects. By age group when blood samples were collected, the adjusted OR (95% CI) were 3.45 (1.41-8.45), 1.56 (0.69-3.54) and 1.11 (0.37-3.33) for < or = 50, 51-60 and > 60-years-old groups, respectively. The adjusted OR (95% CI) were 1.78 (0.88-3.60), 1.66 (0.80-3.44) and 2.23 (1.05-4.74) for cases diagnosed < or = 5, 6-10 and > 10 years after blood collection, respectively.

CONCLUSIONH. pylori infection is associated with gastric cardia cancer, especially for female subjects, the ones who were younger than 50 years old and who were infected with H. pylori more than 10 years.

Adult ; Aged ; Antibodies, Bacterial ; blood ; Cardia ; Case-Control Studies ; China ; epidemiology ; Confidence Intervals ; Female ; Helicobacter Infections ; epidemiology ; immunology ; Helicobacter pylori ; immunology ; Humans ; Immunoglobulin G ; blood ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Random Allocation ; Stomach Neoplasms ; epidemiology ; immunology ; microbiology

Objective To explore the clinical and pathological features, treatment, and prognosis of capillary proliferative purpura nephritis (DEP-HSPN) in children.MethodsThe clinical data of 19 children diagnosed with DEP-HSPN were retrospectively analysis. Fifty-five children diagnosed with HSPN by renal biopsy were randomly selected as control group. ResultsThe average age was 10.6±2.6 years old, and the average course of disease were 19.4±7.4 days before renal biopsy in 19 children with DEP-HSPN (14 males and 5 females) who make up 3.92% of anaphylactic purpura nephritis children conifrmed by renal biopsy in the same period. In these 19 children, there were 10 cases having nephrotic syndrome and 9 case having hematuria and proteinuria type, all of whom were received immunosuppressive therapy. Finally, 14 cases achieved completely remission and 5 cases had partly remission. All of their classiifcations of renal pathology wereⅢb levels, accompanied with 6.38% to 36.36% of crescents. Compared with 55 age and sex matched children with renal pathology classiifcation ofⅢb, the DEP-HSPN children had shorter disease course, higher level of proteinuria, and lower pathological score of chronic renal injury (P all?