Intracranial atherosclerotic stenosis mostly occurs in Asians,blacks and Hispanicsis,which is the most important reason for the occurrence and recurrence of ischemic stroke.The current studies mainly concentrate on the aspect of the relationship between the intracranial atherosclerotic stenosis and the traditional risk factors.With the development of genetic technology,the relationship between the genetic factors and intracranial atherosclerotic stenosis has also received increasing attention.This article reviews the advances in research on the traditional risk factors for intraeranial atherosclerotic stenosis and genetic research.

Breast Neoplasms ; therapy ; China ; Female ; Humans

Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; chemistry ; therapy ; Carcinoma, Intraductal, Noninfiltrating ; chemistry ; therapy ; Female ; Humans ; Immunohistochemistry ; Medical Oncology ; standards ; Practice Guidelines as Topic ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Societies, Medical ; Tamoxifen ; therapeutic use ; United States

[Summary] Fulminant type 1 diabetes (F1D) which is characterized by the abrupt onset of disease , severediabetic ketoacidosis ,high serum pancreatic enzyme concentrations ,and absence of diabetes‐related antibodies is classified astype 1B diabetes. T1DM that developed during pregnancy were mostly F1D. Once occurred ,it would lead to severe outcomes such as stillbirth and death of gravida. One case of pregnancy combined with F1D is reported in this article. We discussed the incidence ,pathogenesis and diagnosis of the disease ,aiming at strengthening the awareness of the disease and also improving the prognosis.

ObjectiveTo investigate the curative effect of structural bone graft in treatment of high energy injury-induced complicated distal radius fractures combined with articular surface collapse and comminuted epiphyseal bone defect.MethodsThe study involved 38 patients with distal radius fractures (AO classification, type C3) treated from January 2007 to October 2010.The patients were treated with temporary Kirschner wire fixation to recover the wrist articular surface, distal radius length and palmar tilt angle at the greatest possibility.According to the form of the bone defects, the iliac bone taken from three layers of the cortical bone was embedded in the subchondral bone to support the bone graft, and a small amount of cancellous bone graft was collected to fill the articular surface collapse as much as possible for anatomical reduction of the articular surface, and anatomical form of the distal radius was reconstructed.Modified Sarmiento Gartland and Werley evaluation systems were used to evaluate the articular function recovery.ResultsThe follow-up lasted for 1-3.2 years, which showed no complications such as plate rupture or iatrogenic nerve blood vessels injuries.The fracture healing time was 15-22 weeks (mean 18.3 weeks).The wrist articular function in some patients obtained obvious improvement through functional rehabilitation training.According to the modified Gartland and Werley function evaluation systems, the curative effects reached excellence rate of 87％.During follow-up, there were two patients with high progressive loss in the height of the distal radius and two with articular surface collapse and severe carpal joint flexion and extension dysfunction.ConclusionsThe high energy injury-induced distal radius fractures with articular surface collapse and epiphyseal bone defect need recovery of the wrist articular surface, distal radius length and palmar tilt angle.Structural bone graft can effectively support the grafted bone and maintain the flatness of the radiocarpal articular surface, restore the anatomy of the distal radius and facilitate the functional recovery of the wrist.

Objective To investigate the effective methods for the treatment of periprosthetic fracture after hip replacement.Methods The clinical data of 13 cases underwent the artificial total hip replacement (THR) with postoperative periprosthetic femur fractures were analyzed.Results The happening time was 12 days to 2 years after primary THR.According to Vancouver classification,there were 2 cases of type A,two cases of type B1,7 cases of type B3,and 2 cases of type C.The treatment included nonoperative treatment in 2 cases,3 cases received open reduction with memory alloy encircling fixer fixation,one case received wire binding with autologous iliac bone grafting,7 cases received revisions with modular revision implant combined with wire binding and autologous iliac bone grafting.The stem was loosened in one type B1 patient at 3 months after surgery.X-ray examination showed that the fractures were united and no infection occurred after operation in 12 patients.No migration or breaking of the instruments was observed.The average Harris hip score was 81 (70 ～ 86points).Conclusion The effective treatment method of periprosthetic fracture after THR should determined by Vancouver classification,degree of bone defect and economic situation of the patients.

Acute Coronary Syndrome ; etiology ; Aortic Valve Insufficiency ; Female ; Heart Valve Prosthesis ; adverse effects ; Humans ; Middle Aged ; Prosthesis Failure

Objective To explore the expression and significance of hedgehog signal molecules (Ptch, Smo and Gli1 ) in pancreatic cancer. Methods Two hundred SD rats were randomly divided into DMBA group ( group A, n = 90), cyclopamine intervening group ( group B, n = 90) and control group ( group C, n = 20).For group A and B, DMBA was directly implanted into the parenchyma of the pancreas to establish the model of pancreatic cancer. The rats in group B were treated with 6.25 ml/kg cyclopamine and DMSO solution intraperitoneally daily. All rats were sacrificed four months later to observe the pancreatic tissue pathologic changes, and immunohistochemistry SP was used to detect the expression of Ptch, Smo, Gli1 protein in pancreatic cancer and normal pancreatic tissue. Results The prevalence rate of pancreatic cancer in group A was 57.5％ (46/80), the maximum size of the tumor was 0.5 ～ ＞2 cm; the prevalence rate of pancreatic cancer in group B was 17.1％ ( 14/82), the maximum size of the tumor was 0.5 ～ 2.0 cm, and the difference between the two group was statistically significant (P ＜0.05). The positive expression rate of Ptch, Smo and Gli1 protein was 82.6％, 73.9％ and 65.2％ in DMBA group, and was 50.0％, 42.9％ and 28.6％ in cyclopamine group, and the difference between the two group was statistically significant ( P ＜ 0.05 ). Ptch,Smo and Gli1 protein was expressed in normal pancreatic tissue. Conclusions Direct implantation of DMBA in the parenchyma of rat pancreas can induce pancreatic cancer with a high incidence in a short time.Hedgehog signal protein expression is significantly increased, cyclopamine can inhibit the occurrence and progression of pancreatic cancer by inhibiting Hedgehog messenger expression.

Objective To explore the surgical method and effect of arthroscopy assisted minimally invasive therapy in the treatment of tibial plateau fractures .Methods Under arthroscopy surveillance ,32 patients with tibial plateau fracture ( Schatzker Ⅰ-Ⅳ) were taken reduction and fixation .Results All cases were followed up for 4-39 months .All fractures were unitied 3-6 months after operation ,and no joint infection compartment syndrome or ankylo-sis occurred.The results were excellent in 25 patients,good in 7 cases according to the HSS evaluating system 9 months after operation .Conclusion For tibial plateau fractures under arthroscopy assisted reduction and minimally invasive plate osteosynthesis has little injury ,exact reset fixation ,early recovery of the knee joint function ,the curative effect is satisfied .

0.05). Ac-cording to the classification criteria of ARIA in 2001, 26 children suffered from intermittent A(R22 mild cases,4 moderate-severe cases),while 22 suf-fered from persistent AR(10 mild cases,12 mod-erate-severe cases). Forty percent patients with AR also had bronchial asthma. Domestic decora-tion was an important factor in the induction of AR and 27.1% of the children with AR had inher-ent predisposition. CONCLUSION The prevalence rate of AR in children aged from 9 to 10 in Nanjing is 5.1 %. Strategy of prevention and treatment of AR should beworked out according to the epidemic feature of AR.