BACKGROUND: The number of dementia patients ceaselessly increases with the extension of the life expectancy and the ageing of the population; hence the survival rate of patients with post-stroke dementia(PSD) has become an important issue of public health. Although it is generally believed that dementia could shorten human life expectancy, there is rare report regarding the impact of PSD on the survival rate of the patients in developing countries.OBJECTIVE: To investigate the impacts of ischemic dementia on the survival rate of the patients to explore the risk factors that would affect the survival rate of patients after cerebral infarction(CI).DESIGN: A prospective randomized controlled study based on patients.SETTING: The second department of neurology of a field surgery institute in a military university hospital of Chinese PLA.PARTICIPANTS: Totally 619 cases of acute CI including 313 males and 306 females aged between 55 and 85 years old[mean of (70. 3 ±9.5) years old] were selected form the Department of Neurology of the Daping Hospital of the Third Military Medical University of Chinese PLA between 1st May 1998 and 28th December 1999.INTERVENTIONS: Data including human factor, vascular factor and CI characters of 619 cases of ischemic cerebral stroke were collected and they also received neuropsychological test. Dementia was diagnosed in CI patients at admission and 3 months after CI according to DSM-Ⅳ criteria. Two-year follow up was conducted for the analysis of survival rate in PSD patients and survival-correlated predicting factors.and survival rate in CI patientsRESULTS: Totally 146 total patients(23.6% ) were diagnosed as PSD at 3 month after CI, of which 39 cases were pre-stroke dementia and 107 cases were CI-correlated dementia. The survival rate of PSD patients was 49.3%after(19.4 ±8.3) months of follow-up. The survival rate of patients with CI-correlated dementia was 53.7% while the non-dementia patients was 92.0% after(21.3 ± 9.1 ) months of follow-up. There was significant correlation between PSD and survival rate as indicated by multifactor analysis ( RR = 4. 91, 95% CI = 3.85 - 13.49) . The rest predicting factors included age(RR=1. 12, 95% CI=1.06-1.18), BarthelIndex(BI, RR=1.63,95% CI=1.15-2.31), auricular fibrillation(AF, RR=1.47, 95%CI = 1.17 - 1.85) and CI history( RR = 2. 81, 95% CI = 1.53 - 5.16).CONCLUSION: Dementia could reduce the survival rate of CI patients and it could be set as a predicting factor for post-infarction survival rate.

BACKGROUND:Recently, the number of elder patients with femoral neck fracture increased. It is controversial if patients aged over 75 years should receive total hip replacement or hemiarthroplasty. To select a reasonable surgical manner is of great significance for increasing surgical safety, improving hip joint function, elevating quality of life, decreasing postoperative complications, and reducing revision rate.
OBJECTIVE:To retrospectively analyze data of patients aged over 75 years after hip replacement, to compare the advantages and disadvantages, and to find a precise indication.
METHODS:Case data of 171 patients undergoing total hip replacement (observation group) (n=51) or hemiarthroplasty (control group) (n=120) were included. Their differences were compared using basic diseases, operation time, bleeding amount, postoperative complications, postoperative hospitalization day, Harris score at 1 week and 3 months after operation.
RESULTS AND CONCLUSION:Patients in both groups were fol owed up for 3 to 39 months (averagely 23 months). No significant difference in basic diseases, average age, postoperative complications, postoperative hospitalization day, and Harris score at 1 week was detected between the two groups (P>0.05). Harris score and excellent and good rate at 3 months were better in the total hip replacement group than that in the hemiarthroplasty group (P<0.05). Results indicated that strict choice of indication achieved good short-period efficiency in two groups. Thus, hip function of elder patients was early recovered. Quality of life was obviously elevated. The recovery of hip function was relatively better at 3 months in observation group. The incidence of postoperative complications did not increase obviously. These results suggested that besides sufficient preparation, total hip replacement should be the first choice for elder patients.

Science and technology innovation is an important quality of young talents in the new period requirements and training objectives,as well as hospital's driving force and source of the future sustainable development.Under the innovation-driven strategy,characterized by cultivating young talents of science and technology innovation,with the efforts to develop and improve young talents cultivation way,our hospital aim to accelerate the development of young talent as soon as possible.By setting up a hospital's fund,we gradually formed a stable funding system including the four directions of clinical,nursing,management,education.With the development purposes of young researchers as the main body,adhere to improve the quality of hospital funds is the key,we aim at forming a reasonable fund scale.Through the top level design,strict process management,implementation of opening argument and a series of strong measures to ensure project quality,we promote youth science and technology innovation talents effectively.

Aim To study the expression of β-NGF gene in the mammlian cells and the biological activity of its expression products. Methods The β-nerve growth factor (β-NGF) cDNA which obtained from the plasmid pGEM-β-NGF by enzyme digestion analysis was cloned into the expression vector pcDNA3 to construct the recombinant plasmid pcDNA3-β-NGF. COS-7-cell line grown to log phase was transfected using lipofectamine reagent. The expression level of β-NGF mRNA and the biological activity were analyzed by Northern blot and observation of neurite outgrowth of PC12 cell line stimulated by supernatant, respectively. Results The β-NGF gene was expressed successfully in COS-7 cell lines. The culture supernatant of the positive COS-7 cells transfected with pcDNA3-β-NGF could stimulate the neurite outgrowth of PC12 cell line. Conclusion The target gene expressed successfully in the transfected COS-7 cell line and had good biological activity.

Objective To evaluate the effect of vertebral artery kinking on cerebral hemodynamics. Methods The patients with vertebral artery kinking on digital subtraction angiograph (DSA) were selected from 223 patients with vertebral-basilar artery transient ischemic attack, then the changes of vertebral artery hemodynamics were evaluated using transcranial color Doppler (TCD). Results There were 84 patients with vertebral artery kinking among 223 patients with vertebral-basilar artery transient ischemic attack. Patients with vertebral artery kinking were older and had more vascular risk factors than patients without vertebral artery kinking. Compared with the control group, patients showed decreased blood flow rate such as peak velocity (Vp) and mean velocity (Vm), increased pulsatility index (PI) and resistant index (RI) in vertebral artery kinking group. Conclusions Vertebral artery kinking is common abnormal artery among patients with vertebral-basilar artery transient ischemic attack, it leads to hemodynamic changes. Age and vascular risk factors are potential causes of vertebral artery kinking.

Objective To analyze the data from Online Mendelian Inheritance in Man (OMIM) to understand more about it, and provide reference to researchers using this database.Methods 19414 mutations which have definite relevant phenotypes from OMIM were obtained, then these mutations with three databases (1000 Genome Project,GO-ESP,ExAC) which record the mutation frequency in different population were compared.Results Most of the phenotype-related mutations from OMIM are rare mutations whose mutation frequency is less than 1%:18866 in 1000 Genome Project, 18981 in GO-ESP, 18979 in ExAC.The number of mutation whose frequency is more than 1% is 548433435 in 1000 Genome Project, GO-ESP, ExAC, respectively.And there are 320 mutations whose frequency is more than 1% in all databases.In all phenotypes, there are 127 polymorphism phenotypes, 584 susceptibility phenotypes, while in 320 ( 1.6%) phenotypes with common mutations, there are 62 polymorphism phenotypes, 88 susceptibility phenotypes and occupies 48.8%, 15.1%, respectively.Conclusion Approximately 97.5% mutations in OMIM are rare mutations.Polymorphism and susceptibility enrich in common mutations, especially in the mutation whose frequency is more than 10%.

OBJECTIVE: to explore the relationship between the maxillary sinus volume and the amount of alveolar bone, and the effect of molar loss upon the maxillary sinus was further analyzed,by measuring adult maxillary sinus volume, sinus ridge distance, and calculating the gasification coefficient of maxillary sinus. METHOD: One hundred and ninety cases (361 maxillary sinus) with CT examinations were collected, they were divided into group A and group B, 121 cases (242 maxillary sinus) of normal subjects served as group A, 42 cases (65 maxillary sinus) with molar part off were B group, in which 31 maxillary sinus with a molar loss were group B1,22 maxillary sinus with two molar loss were B2 group,12 maxillary sinus with three molar loss (one molar remains) were B3 group, 27 cases (54 maxillary sinus) with upper teeth off were C group. Bymeasureing the maxillary sinus volume, sinus ridge distance and the size of the maxillary sinus, calculating the gasification coefficient, we analyzed the relationship between maxillary volume and sinus ridge distance, and comparatively analyzed the differences among the three groups in the size, gasification coefficient, volume of maxillary sinus and sinus ridge distance. RESULT: In the normal group,the volume of maxillary sinus and sinus ridge distance had a correlation coefficient of -0. 63,(P< 0.05); Sinus ridge distance in group A was larger than the other two groups (P<0.05), and larger in B group than in C group (P<0. 05), anteroposterior maxillary sinus diameter and reft-right diameter in C group was greater than in A group and B group(P<0.05), group C gasification coeffiecent was less than A group and B group (P<0. 05). CONCLUSION The volume of maxillary sinus is negatively correlated with the amont of alveolar bone; Upper teeth's shedding promotes maxillary sinus deformation; Maxiuary sinus volume has a tendency to decrease.
Adult ; Humans ; Maxilla ; Maxillary Sinus ; anatomy & histology ; diagnostic imaging ; Molar ; Radiography ; Tooth Loss

BACKGROUND: The presence of cognitive impairment following stroke onset strongly indicates poor prognosis of the patients surviving the crisis.Understanding of the incidence of cognitive impairment after ischemic stroke and its confidence interval has practical significance in preventing is occurrence in stroke patients and its differentiation from age-related cognitive impairment.OBJECTIVE: To study the incidence of cognitive impairment in patients with the first onset of ischemic stroke.DESIGN: Single-factor analyses of the cases followed up for 3 months SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA.PARTICTPANTS: Totally 434 inpatients with acute cerebral infarction [218 male and 216 female, aged 55 to 85 with a mean of (70.3±9.5) years]admitted within 48 hours after the onset in Department of Neurology, Daping Hospital of Third Military Medical University from May 8, 1999 to December 31, 2000. All patients participated in this study voluntarily.METHODS: The general background and clinical data of the patients were collected at the time of admission. A simplified intelligence test was performed both 7 to 10 days of the onset and 3 months after discharge. The scale employed for the test included 20 questions with a total of 30 items divided to test 5 aspects of the patients' cognition, namely orientation ability, memory, calculation ability, memory recall and linguistic ability (1 point was given for a correct answer, and 0 for an wrong one or an answer of "I don't know", with the total score of 30 for all items). A score of the simplified intelligence test less than the score of demarcation (specifically,below 17 for illiterate patients, below 20 for those receiving an education no more than 6 years, and below 24 for those having an education for no less than 7 years) for 3 months after cerebral stroke was regarded as the diagnostic criteria for cognitive impairment.MAIN OUTCOME MEASURES: The incidence of cognitive impairment was recorded 3 months after hospital discharge and single-factor analysis of the scores of simple intelligence test.RESULTS: All the 434 patients were included in result analysis. Totally 161 (37.1%) patients were diagnosed as having cognitive impairment, and 273 (62.9%) had normal cognitive function 3 months after hospital discharge. The mean age of the patients with cognitive impairment was significantly higher than that of the patients with normal cognitive function [(73.0±7.0) years vs (64.5±6.6) years, t=2.626, P ＜ 0.01]. The proportion of patients with cognitive impairment receiving education for no more than 6 years was significantly higher than that among patients with normal cognition (45.3% vs 22.7%, OR=2.823, with 95% confidence interval of 1.855 -4.297), and the score of simple intelligence test was significantly lower in the former patient group (16.3±8.7 vs 23.4±4.2, t=3.352, P ＜ 0.001).CONCLUSION: The incidence of cognitive impairment in this cohort is relatively high. The patients with cognitive impairment following cerebral infarction have obviously older age and poorer education, suggesting significant synergetic effect of age and education with cognitive impairment following cerebral infarction.

Objective To investigate whether blocking NR2B receptor can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig by applying ifenprodil (a NR2B antagonist) at the round window niche .Methods Sixty healthy guinea pigs provided by the experimental animal center of Guangxi medical university were randomly and evenly divided into a control group (Group I ,no treatment) ,an APL group (Group II ,60μl APL directly applied to the round window ) ,a sodium salicylate group (Group III ,60 μl APL di-rectly applied to the round window and then be given intraperitoneal sodium salicylate injection ) ,and an ifenprodil group (Group IV ,60μl of 10μmol/l ifenprodil in APL directly applied to the round window and then be given intra-peritoneal sodium salicylate injection ) .Sodium salicylate was given at 400 mg · kg -1 · d-1 for 7 days .Auditory brainstem responses (ABRs) were recorded before animal sacrifice by decapitation .The left cochlea was removed and prepared for detection of caspase -3 expression in spiral ganglion neurons via immunohistochemistry .From each group ,6 cochleae were used to test apoptosis index in spiral ganglion neurons using the TUNEL technique .Results Before salicylate administration ,the ABR threshold was less than 40 dB SPL in all animals .After salicylate ad-ministration ,the ABR threshold was 33 .33 ± 5 .17 dB SPL in Group II ,64 .17 ± 7 .36 dB SPL in Group III and 49 .17 ± 5 .85 dB SPL in Group IV ,in contrast to 31 .67 ± 5 .16 dB SPL in Group I (controls) .The caspase -3 ex-pression was not changed obviously in Group I and Group II ,but was significantly changed in Group III and Group IV (P<0 .01) .The caspase-3 expression appeared to be decreased in Group IV compared to those in Groups III (P<0 .05) ,but still increased compared to those of in Group I and II (P<0 .05) .The apoptosis index among spiral ganglion neurons in Groups III and IV increased significantly compared to those of in Group I and II (P<0 .001) .It was however ,lower in Group IV than in Group III (P<0 .01) .Conclusion Blocking NR2B receptor with specificity can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig .

Objective To screen the mutations of MYOC gene in a Chinese primary open angle glaucoma (POAG) family from Cbengqing and investigate the relationship between the mutations in MYOC/TIGR gene and POAG.Methods In a large 4-generation glaucoma family, myocilin gene (MYOC) was screened in 39 family members, 8 of which were confirmed patients. Normal controls included 100 normal Chinese subjects.The known mutations of MYOC gene ( including G34C, C136T, G144T, G227A, C624G,G736A, C1009G, A1036G, C1081T, G1099A, G1138A, A1139C, T1430A, C1441A and C1442T) were detected by single strand conformation polymorphism(SSCP) , po]ymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis and DNA sequencing.Results G227A mutation was detected in 2 POAG patients and 1 asymptomatic patient, but not in the controls.Cl009del mutation was identified in all patients of the pedigree and an offspring member but not in the controls. No other mutations were detected.Since the C1009del mutation was revealed for the first time, a new GenBank number FJ237047 correponding to ACI62293 was applied.Conclusions The G227A mutation is a known site and there is no relationship between G227A mutation and glaucoma. But C1009del may be related to glaucoma which suggests that morbidity could be higher in the relatives of POAG than the controls.