Objective To investigate the relationship between the stenosis of clinically relevant artery or the characteristics of carotid plaques and frequent transient ischemic attacks(TIA).Methods Seventy-nine consecutive patients sufiered TIA attribute to carotid territory in the acute phase(within 7 days )who had been admitted to neurology department of Xuanwu Hospital from August 2005 to January 2007 were retrospectively analyzed.Patients with nonatherosclerotic vasculal disease were excluded.According to the times of TIA from the first attack to the day of hospitaliztion(within 7 days)patients were divided into two groups:those who had sparse TIA(onsets＜3 times),and those who had multiple TIA(onsets≥3 times).All patients underwent the examination of DSA.carotid ultrasound and transcranial doppler.The degree of stenosis of clinically relevant artery and the characteristics of carotid plaques were compared between the two groups.According to degree of stenosis of relevant artery,we defined as normal or＜50%stenosis.50%-69%stenosis.70%-99%stenosis or occlusion.According to the characteristics of carotid plaques we divided into stable or unstable plaques.Resuits Patients with TIA in carotid territory had more intracranial artery diseases.The middle cerebral artery was the most commonly involved artery(5 1.2%).the extracranial internal carotid artery was the next(37.2%).Multiple TIA were more likely to have a short duration of symptoms≤10 min than sparse TIA(x2=5.343,P=0.021).A significant stenosis of clinically relevant artery(≥50%)was demonstrated more frequently in the multiple TIA group(66.7%)than in the sparse TIA group(35.3%,x2=7.655,P=0.006).No significant correlation was observed between the multiple TIA and characteristics of carotid plaques in the focus side(x2=0.939,P=0.332).Conclusions Frequent TIA is significantly associated with a short duration of symptoms and≥50% stenosis of clinically relevant artery.Transient flow reduction by hemodynamic compromise may he an important mechanism of frequent TIA.

Geometrically virtual models of three-dimensional blood flow field and eight types of mesh stent (different porosity and different stent shape) were constructed using SoildWorks software, and simulation of stented models were performed respectively using finite element software ANSYS11.0 according to computation fluid dynamics method. The flow resistance of the semi-circular section stent model of blood flow from the semi-circular planar surface was greater than the reverse in a certain range of permeability. However, the result was the opposite when the porosity increased to a specific value. For both grid-stent model and sine-stent model, flow resistance of blood that flowed from the stent in both directions increased with the porosity reduction. Under the same porosity and the direction of blood flow from the same stent, the flow resistance of the grid stent model was 1.5 times greater than the sine-stent model. Results showed that there are different effects on the flow resistance in blood flow in different directions from the semi-circular section stent model.

Objective: Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue. Method:Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A. Result:The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls(P<0.05), and there was no remarkable difference in the expression of SP-A between allergic rhinitis and polyp(P>0.05). The result demonstrated that SP-A was positivly correlated with eosinophils within the basement membrane of epitheli-um(R=0.81,0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group(P<0.05). Conclusion:SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

BACKGROUND: Pergolide and madopar are the effective medicines to treat Parkinson disease, but the effects on the prognosis of patients with Parkinson disease are still under discussion. The progress of neuroimaging makes it possible to evaluate quantitatively the effect of the drug treatment on the prognosis of Parkinson disease.OBJBCTIVE: To observe the influence of pergolide or madopar as initial treatment on the prognosis and the striatal dopaminergic neuron in patients with early Parkinson disease by means of 99Tcm-TRODAT-1 dopamine transporter imaging single-photon emission computed tomtheography (SPECT) in combination with Parkinson disease scale.DESIGN: A randomized grouping, parallel control and placebo control trial.SETTING: Department of Neurology, the 81 Hospital of Chinese PLA;Department of Neurology and Department of Nuclear Medicine, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty-six patients with early Parkinson disease who were recruited at the Specific Clinic of Parkinson Disease in the Shanghai Changhai Hospital affiliated to the Second Military Medical University of Chinese PLA and did not receive any drug treatment before, were enrolled between February and July 2002. They were randomly divided into artane control group (n=12), pergolide-treated group (n=12) and madopar-treated group. The diagnosis accorded with the clinical diagnostic standard set by United Kingdom Society of Parkinson Disease. This protocol was approved by the Medical Ethics Committee of Changhai Hospital, and all the subjects were enrolled in this study with informed consent.INTERVENTIONS: After test with unified Parkinson disease rating scale (UPDRS) and 99Tcm-TRODAT-1 SPECT, patients in the artane control group, pergolide-treated group and madopar-treated group were treated with corresponding drugs respectively, and each capsule of artane, pergolide and madopar contained drug of 0.05, 0.05 and 125 mg respectively. In the 1st week, the dosage was 1 capsule for each time, once a day, and then the daily dosage was increased by 1 capsule per week later, and the daily dosage reached 0.2, 0.2 and 500 mg respectively after 1 month, and then the dosages were kept constant. The curative effects were evaluated with UPDRS at 6 and 10 months after treatment. At 10 months after treatment,the 99Tcm-TRODAT-1 specific intakes of ipsilateral or contralateral striatum of the affected limb were tested with striatum dopamine transporter SPECT and semi-quantitative analysis.MAIN OUTCOME MEASURES: ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment were compared among the three groups;② Changes of UPDRS scores before and after treatment were compared among the three groups.RESULTS: Totally 36 patients were involved in the study, and 1 case lost in each of the 3 groups respectively at 10 months after treatment, finally 33 cases entered the analysis of results. ① Changes of percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb at 10 months after treatment: At 10 months after treatment, the percentage of 99Tcm-TRODAT-1 decrease of ipsilateral or contralateral striatum of the affected limb were obviously higher in the madopar-treated group than in the artane control group and pergolide-treated group [(46.3±19.4)%, (28.9±13.0)%, (34.4±18,1)%; (47.5±20.8)%, (31.8±15.6)%, (33.8±17.2)%; P all ＜ 0.05]. ② Changes of UPDRS scores before and after treatment: As compared with the UPDRS scores before treatment, there was no obvious change in the artane control group at 10 months after treatment,but those in the madopar-treated group and pergolide-treated group were obviously decreased [(15.5±8.68), (6.4±9.05); (15.8±6.75), (10.36±8.30); Pall ＜ 0.05].CONCLUSION: Both madopar and pergolide can ameliorate the symptoms of early Parkinson disease, but they had different influences on the prognosis of patients with Parkinson disease. Madopar may accelerate the apoptosis of dopaminergic neuron and then aggravate the severity, but pergolide does not affect the prognosis of Parkinson disease, so it is a more suitable selective drug for the treatment of early Parkinson disease.

With the further development of education informatization,the popularity of computer simulation technology and multimedia network technology were increasing.The teaching center of school of stomatology in the fourth military medical university combined stomatology teaching with information technology and gradually applied diversified teaching mode in the dental clinical experiment teaching,which not only saved the input of faculty and consumables items,but also improved the stomatology experimental teaching quality and achieve the teaching modernization.

Objective To investigate the drug resistance,source and molecular epidemiology of methicillin-resistant Staphyloccus aureus(MRSA)causing nosocomial infection. Methods Fifty-seven pathogenic MRSA strains were isolated from Beijing Tongren Hospital during 2007 and 2008.K-B method,MIC assay,multiple PCR,automatic repetitive element sequence-based PCR(REP-PCR)typing platform and DL MRSA Library were used to identify the resistant phenotypes,Panton-Valentine leukocidin gene (pvl)and REP-PCR types of the MRSA.Results All strains were classified as 6 antibiotic resistant phenotypes(a-f)based on the resistance to rifampin,clindamycin,levofloxacin and cotrimoxazole.The MRSAs with Staphylococcal cassette chromosome mec(SCCmec)Ⅲ and SCCmec Ⅱ accounted for 91.23% (52/57)and 5.26%(3/57)of all strains,respectively.Only one strain was pvl positive.All strains were typed as REP-A-F(6 types)and three single clones by automatic REP-PCR typing platform,in which REP-C was predominant(30/57,52.63%).Three out of 6 REP-D strains were from laryngology wards.The REP-C-SCCmec Ⅲ were genetically most close to the Brazilian clone-SCCmec Ⅲ in DL MRSA Library.Conclusion s REP-C-SCCmec Ⅲ-a type are the major epidemic hospital-associated MRSA and the REP-D-SCCmec Ⅲ-d is usually isolated from patients received laryngeal surgery. Automatic REP-PCR typingplatform combined with DL MRSA Library database is an effective approach to study the nosocomial infection.

BACKGROUND: Selegiline can effectively alleviate motor disorder symptoms during the earlier stage of Parkinson disease(PD),but the influence on prognosis is still warmly discussed. With the development of neuroiconologicai study,the objective predictor for dopaminergic neuronal degeneration in PD would became possible.OBJECTIVE: To observe the influence of selegiline on dopaminergic neurons in earlier stage of PD with the aid of iconology.DESIGN: Randomized controlled study based on patients.SETTING: Neurological department in a military hospital of Chinese PLA,the nuclear medicine and neurological department in a military medical hospital of Chinese PLA.PARTICIPANTS: Between April and December 2001,25 patients were selected from PD specific clinic of Changhai Hospital,the Second Military Medical University of Chinese PLA. They were confirmed of earlier stage of PD without given any related drugs.INTERVENTIONS: Totally 25 patients were randomly divided into placebo group of 13 cases and selegiline group of 12 cases. After assessed with unified PD rating scale(UPDRS),they were given placebo and selegiline respectively with the dosage gradually increased from 0.05 mg at the beginning and added with 0.05 mg every week for four weeks until reaching the sustaining dosage of 0.2 mg. Dopamine transporting protein (99Tcm-TRODAT-1) examination and single photon emission-computerized tomography (SPECT) were performed at entering the experiment and after the treatment for 13 months,and semi-quantitative analysis was used for counting striatal emission of the ipsilateral and contralateral side. Scores for UPDRS were obtained at entering the experiment,after the treatment for 6months and 13 months.MAIN OUTCOME MEASURES:①Main outcomes:The differences ofstriatal 99Tcm-TRODAT-1 specific intake decreasing percentage on ipsilateral and contralateral side were compared between the two groups after the treatment for 13 months.②Subordinate outcome:Scores for UPDRS of the two groups was also compared.RESULTS: After the treatment for 13 months,striatal 99Tcm-TRODAT-1 specific intake decreasing percentages were (28.9 ± 13.0)% and(31.8 ± 15.6) % on ipsilateral and contralateral side of placebo group compared with the corresponding (30.39 ± 14. 7)% and(32.6 ± 16. 6)% of the selegiline group,the difference was of no statistical significance( P ＞ 0.05). Scores for UPDR was(23.7 ±4.3) in placebo group and(13.1 ± 5.5) in selegiline group after the treatment for 6 months,and(27.0 ±4.3) and(9. 8 ±4. 8) after the treatment for 13 months,indicating that slegiline group was obviously better than placebo group( P ＜ 0. 05).CONCLUSION: Selegiline showed better therapeutic effect in the treatment of earlier-stage PD without increasing the apoptosis of striatal dopaminergic neurons.

OBJECTIVE: The purpose of the study was to investigate the balance function of the patients with benign paroxysmal positional vertigo (BPPV) during standing. METHOD: In this study 41 patients with posterior semicircular canal BPPV (PC BPPV) and 11 patients with horizontal semicircular canal BPPV (HC BPPV) were recruited. Dynamic balance during standing was measured in Sensory Organization Test (SOT). Static balance during standing was measured in modified Clinical Test of Sensory Interaction and Balance (mCTSIB). Data of BPPV patients were compared to that from 44 normal controls. RESULT: Scores of the patients with PC BPPV were lower than that of the normal controls in the last three test conditions of SOT. Patients with PC BPPV demonstrated greater sway velocity in stance on foam with eyes open and eyes closed in mCTSIB. No postural deficit was observed in neither SOT nor mCTSIB when the patients with HC BPPV were compared to the normal controls. CONCLUSION Disorders of the horizontal semicircular canal do not influence postural control. Both dynamic and static posturography can detect the postural imbalance caused by posterior semicircular canal dysfunction.
Benign Paroxysmal Positional Vertigo ; physiopathology ; Case-Control Studies ; Humans ; Postural Balance ; Semicircular Canals ; physiopathology

Objective To identify the mutation of trafficking protein particle complex 2 (TRAPPC2) gene in a large Chinese pedigree with X-linked spondyloepiphyseal dysplasia tarda by the PCR-based capillary electrophoresis methods.Methods The blood samples were collected from a large Chinese pedigree of three generations with six affected persons with X-SEDT.Four exons comprising the TRAPPC2 gene open reading frame as well as their exor/intron boundaries were analyzed by argrose electrophoresis and bidirectional direct sequencing of PCR products.Fluorescence labeled fragment analysis was performed by capillary electrophoresis.Results A 5-bp deletion mutation of TRAPPC2 gene in exon 5,c.262_266delGACAT (D88del; I89fX12),was identified in the proband and his unaffected mother(a heterozygote) in the Chinese family with X-SEDT,but no other sequence change occurring in exons 3,4 and 6 was detected.The old sister of proband was determined being carriers because she carries the deletion fragment allele of exon 5 PCR product and the young sister being normal individuals because she carries the wild allele of TRAPPC2 gene.Conclusions The mutation c.262_266delGACAT (D88del; I89fX12) of TRAPPC2 gene was firstly reported in Chinese people.The mutation of c.262_266delGACAT (D88del; I89fX12) in TRAPPC2 gene may be the pathologic cause of the patients in the X-SEDT pedigree.Fragment analysis combined with DNA sequencing by capillary electrophoresis method is effective laboratory test in the small deletion mutation analysis and carriers screening in X-SEDT family.

Objective Tocomparetheefficacybetweenstentingandmedicationinpatientswith vertebralarteryoriginstenosis.Methods Theclinicaldataof82patientswithmoderatetoseverevertebral artery origin stenosis (stenosis rate >50%)from January 2011 to January 2013 were analyzed retrospectively. They were divided into either a stent+medication group (n=40)or a medication group (n=42)according to the different treatment methods. The degree of vascular stenosis,restenosis rate,incidence of cerebral ischemic events,and National Institutes of Health Stroke Scale (NIHSS)of the patients for DSA reexamination at one year were documented,and comprehensive analysis were conducted. Results (1 )44 stents were implanted in 40 patients,1 of the patients still had residual stenosis of 60% because of the stenosis plaque was harder despite twice balloon dilations. No serious perioperative complications occurred. The success rate of the operation was 97. 5%. The vascular stenosis rate of vertebral artery origins in patients of the stent+medication group was improved significantly,and decreased from 73 ± 13% to median 11%(8%,50%)at one year after stenting. (2)After 1 year,11 patients (27. 5%)had in-stent restenosis in the stent +medication group,including 2 patients (5%)had stent fracture at the same time. Four patients (9. 5%)in the medication group had complete occlusion of vertebral artery,but only 2 had corresponding clinical symptoms. (3)There was no significant difference in the NIHSS scores after the treatment between the stent+medication group and the medication group (Z=1. 678,P=0. 093). The total ischemic events in patients of the stent+medication group was 7 (17. 5%),compared with the incidence of ischemic events in 16 patients (38. 1%)in the medication group,there was significant difference (χ2 =4. 306, P=0.038).Conclusion Stentingissafeandeffectiveforpatientswithvertebralarteryoriginstenosis.It may significantly improve vertebral stenosis,and it is better than medication alone for preventing the occurrence alone of the posterior circulation ischemic events,however,the high in-stent restenosis rate for vertebral artery origin stenosis is still an important problem to be solved.