Objective To investigate the long-term outcome of intra-arterial thrombolysis in patients with acute ischemic stroke and its influencing factors.Methods Patients with acute ischemic stroke received intra-arterial thrombolysis were included in the study.The neurological outcome at day 90 was assessed using the modified Rankin Scale (mRS).They were divided into the good outcome group (mRS scores,0 to 2) and the poor outcome group (mRS scores,3 to 6)according to the evaluation results; the degree of recanalization after thrombolysis was assessed by the grading criteria of the Thrombolysis in Myocardial Infarction (TIMI) trial; the incidence of intracerebral hemorrhage within 7 days after thrombolytic therapy and the mortality at 3months were recorded.Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors of long-term outcome of arterial thrombolysis.Results A total of 42 patients were included,of them,19 (45.2％) with good outcome and 23 (54.8％) with poor outcome after intra-arterial thrombolysis; 27 patients (64.5％ ) with good recanalization (TIMI grade,2 to 3); 13 patients (31.0％) occurred intracranial hemorrhage within 7 days,and 8 of them (19.0％ ) had symptomatic intracranial hemorrhage; 11 (26.2％ ) died within 90 days.Univariate analysis showed that the baseline blood glucose levels (P=0.019),the baseline National Institutes of Health Stroke Scale (NIHSS) scores (P =0.014),symptomatic intracranial hemorrhage (P =0.005),and the degree of recanalization (P =0.002) could influence the longterm outcome of patients with intra-arterial thrombolysis.Multivariate logistic regression analysis indicated that the lower level of basdine glucose and good recanalization were the independent predictive factors of the good long-term outcome after intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusion After the exclusion of contraindications,the intra-arterial thrombolysis was safe and effective for patients with acute ischemic stroke.The lower blood glucose levels on admission and the good recanalization after thrombolysis were associated with the good long-term outcome of intm-arterial thrombolysis.

Objective:To evaluate the effects of smokeless tobacco extract(ST) on number,morphology,ultrastructure and proliferation of human gingival fibroblasts(HGFs) on titanium in vitro.Methods:HGFs on titanium were cultured in the presence of ST at various concentrations.The cell changes in the morphology and ultrastructure were examined by scanning electrical microscope(SEM).The growth and attachment of the cells were measured by MTT method.Results:The size of the cells became smaller gradually and their shapes changed from spindle type to oval or round when the concentrations of ST increased.Ultrastructure showed that pseudopod decreased in number,the growth and attachment were dose-dependently inhibited.Conclusion:ST can change number,morphology and ultrastructure of HGFs on titanium,they can inhibit the cells growth,suggesting ST may play a pathological role on implant-gingiva interface.

The purpose of applying antibiotics prophylaxis in perioperative orthopedic surgery is to prevent or decrease the risk of infection.The opportune administration is the key point for prevention of infection.The application principle,classification and current situation are reviewed in this paper,its perspective and prospects are also investigated.

Objective:To investigate the effects of sodium phenylbutyrate(NaPB) on the matrix metalloproteinase-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) expression and invasive ability of human thyroid follicular carcinoma cell line CGTHW-1.Methods: CGTHW-1 cells were treated with different concentrations of NaPB,then the invasive ability of CGTHW-1 cells was assessed using Transwell assay.The expression of MMP-9 and TIMP-1 was examined by immunocytochemistry staining and RT-PCR in CGTHW-1 cells.Results: After treatment with NaPB(4 mmol/L) for 72 h,CGTHW-1 cells passing the Transwell were significantly reduced[(29.8?1.77) vs(11.00?2.59),P

In the past, panretinal photocoagulation (PRP) and vitrectomy (PPV) were the main treatments for proliferative diabetic retinopathy (PDR). In recent years, anti-vascular endothelial growth factor (VEGF) drugs have been used more and more widely in PDR due to their advantages in rapidly subtracting new blood vessels, reducing leakage, and promoting the absorption of blood. The combination of anti-VEGF drugs and PRP in the treatment of PDR, especially high-risk PDR, can increase the rate of neovascularization and prevent some patients with mild to moderate vitreous hemorrhage from PPV. The application of anti-VEGF drugs during the perioperative period of PPV can also reduce bleeding during the operation, shorten the operation time, and reduce surgical complications. Although clinical studies have confirmed that anti-VEGF drugs can be used as an alternative treatment for PRP, most patients require multiple and long-term treatments, which increase the psychological and economic burden of patients. It is expected that the cost of anti-VEGF drugs and the development of long-acting dosage forms can be reduced and bring better efficacy and benefits to PDR patients in the future.

Carcinosarcoma ; Female ; Humans ; Maxillary Sinus Neoplasms ; Middle Aged

Objective To evaluate the efficacy of dexmedetomidine injected into axillary sheath in alleviating the tourniquet pain during brachial plexus block with ropivacaine.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 18-60 yr,weighing 52-85 kg,scheduled for the replantation of amputated finger,were randomly divided into 2 equal groups (n =30 each):ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).All patients underwent axillary brachial plexus block guided by a nerve stimulator.When the intensity of electric stimulation ≤ 0.4 mA,flexion of fingers or wrist still existed,and the local anesthetic was injected into the axillary sheath.0.5％ ropivacaine 40ml was injected in group R.0.5％ ropivacaine mixed with 100μg dexmedetomidine 40ml was injected in group DR.The pressure of inflation was set at 200-250mmHg,and the stress duration was 120 min.Tourniquet pain and the level that the patients could tolerate was evaluated using visual analog scale (VAS) at 120 min of stress status.The patient' s satisfaction with anesthesia was rated and the development of adverse cadiovascular events and local and systemic adverse reactions were recorded.Excessive sedation was measured with Ramsay score in group DR.Results Compared with group R,the tourniquet pain that the patients could tolerate was significantly increased,the severity of tourniquet pain was reduced and the incidence of adverse cadiovascular events was decreased in group DR (P ＜ 0.01).No serious tourniquet-related complications were observed in both groups.No patients developed excessive sedation in group DR.Conclusion Dexmedetomidine 100μg injected into the axillary sheath can safely and effectively alleviate the tourniquet pain when used during brachial plexus block with ropivacaine.

Objective To investigate the pathophysiology mechanism in belching by using high resolution manometry combined with impedance monitoring.Methods Ten belching patients (four male and six female,ages ranged from 28 to 50 years) received high resolution manometry combined with impedance monitoring.The characters of esophageal motility at rest,swallowing and belching and the possible mechanism of belching were analyzed.Results Nine of 10 patients had esophageal peristaltic dysfunction,displaying as non-peristaltic contraction such as non-conduction contraction,interrupt contraction and dropping contraction.The pressure of the lower esophageal sphincter (LES) of three patients decreased.LES of one patient had incomplete relaxation.Nine of 10 patients were supragastic belching,in which air moved rapidly into esophagus and reversed exited from the mouth in one second.Among nine supragastic belching patients,the pleural pressure of seven patients increased during inspiration,upper esophageal sphincter relaxed and air was mistaken into the esophagus.The pharyngeal muscle contracted in two patients and the air was forced into esophagus.Of all the patients,intragastric and esophageal pressure increased through abdominal muscles and diaphragm contraction and air exited from the mouth.Conclusions The results of this study indicated that there was esophageal peristaltic dysfunction in belching patients.There was no frequently air swallowing in excessive belching patients,the typical belching model was supragastic belching.

Objective To evaluate the relationship between the optimum preoperative fasting time and in tervals between eating and trauma in pediatric patients undergoing emergency orthopedic surgery by measuring the gastric antral cross-sectional area (CSA) using ultrasound.Methods Fifty ASA physical status Ⅰ or Ⅱ pediatric patients,aged 2-7 yr,weighing 10-25 kg,undergoing elective orthopedic surgery,were randomly divided into 2 groups (n =25 each) using a random number table:6-h fast group (group CA) and 8-h fast group (group CB).Seventy-five ASA physical status Ⅰ or Ⅱ pediatric patients,aged 2-7 yr,weighing 10-25 kg,undergoing the emergency orthopedic surgery,were randomly divided into 3 groups according to the interval between eating and trauma:interval ≤ 1 h group (TA group,n =22),1 h ＜ interval ≤ 4 h group (TB group,n =26) and interval ＞ 4 h group (TC group,n =27).CSA was measured at 6 h after the last eating (T1) in group CA,8 h after the last eating (T2) in group CB and T1 and T2 in TA,TB and TC groups.Results There was no significant difference in CSA between group CA and group CB (P ＞ 0.05).Compared with group CA,CSA was significantly enlarged in TA and TB groups (P ＜ 0.05) and no significant change was found in group TC (P ＞ 0.05).Compared with group CB,CSA was significantly enlarged in TA group (P ＜ 0.05),and no significant change was found in TB and TC groups (P ＞ 0.05).Compared with group TA,CSA was significantly decreased at T1 in TC group and T2 in TB and TC groups (P ＜ 0.05),and no significant change was found at T1 in TB group (P ＞ 0.05).Compared with group TB,CSA was significantly decreased at T1 (P ＜ 0.05),and no significant change was found at T2 in TC group (P ＞ 0.05).Compared with the CSA measured at T1,CSA was significantly decreased at T2 in TB group (P ＜ 0.05),and no significant change was found at T2 in TA and TC groups (P ＞0.05).Conclusion For the pediatric patients undergoing emergency orthopedic surgery,when the interval between eating and trauma is within the period of 1-4 h,an 8-h preoperative fast is recommended; when the interval ＜ 1 h,an 8-h preoperative fast is still not able to achieve the aim of fasting and measures should be taken to avoid regurgitation of gastric contents; when the interval ＞ 4 h,the preoperative fasting time can be properly shortened to 6h.

Objective To investigate the relationship between the levels of serum glial fibrillary acidic protein (GFAP) ,ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) ,CT findings and outcome in patients with severe traumatic brain injury .Methods En-zyme linked immunosorbent assay (ELISA) was conducted to detect the serum level of GFAP and UCH-L1 in 62 patients with se-vere traumatic brain injury at the time of 12 h and 36 h after the trauma .CT scans of the brain were obtained within 12 h of injury . Outcome was assessed by glasgow outcome scale (GOS) at 6th month .The relationship between GFAP ,UCH-1 ,CT findings and outcome were analyzed .56 healthy persons were selected as control group .Results The concentrations of serum GFAP and UCH-L1 of patients were significantly higher than those of the control group (P< 0 .05) ;GFAP levels were higher in patients with mass lesions than in those with diffuse injury while UCH-L1 levels were higher in patients with diffuse injury (P< 0 .05) ;the levels of GFAP and UCH-L1 of patients with unfavourable outcome(GOS 1 - 3 scores) were significantly higher than those of patients with favourable outcome(GOS 4 - 5 scores) ,and the concentrations of biomarkers were significantly negatively correlated with outcome . Conclusion Serum levels of GFAP and UCH-L1 are good predictors for severity and outcome in severe traumatic brain injury (TBI) .The levels of GFAP and UCH-L1 could reflect different injury pathways which were different in patients with mass lesions and diffuse injury remarkbly .GFAP and UCH-L1 could provide better characterization of subjects for specific types of cellular dam -age than that obtained with CT alone .