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.

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.

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

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 assess the accuracy of ultrasonographic measurement of gastric fluid volume in predicting the occurrence of nausea and vomiting during and after emergency cesarean section.Methods Seventyseven ASA Ⅰ-Ⅲ patients aged 18-35 yr weighing 66-87 kg undergoing emergency cesarean section were divided into 3 groups according to the preoperative gastric fluid volume:group A ≤ 0.4 ml/kg (n =21); group B 0.4-0.8ml/kg (n =34) and group C ＞ 0.8 ml/kg (n =22).Gastric fluid volume was calculated by Bouvet regression equation,based on antral area of the stomach measured with M-Turbo ultrasonography system (Somo Site Co.USA).Cesarean section was performed under combined spinal-epidural anesthesia with 0.4％ ropivacaine.BP,HR and SpO2 were measured and recorded after entering the operating room,at skin incision and at the end of operation.The occurrence of nausea and vomiting was recorded during operation and within 1 h after operation.Results There was no significant difference in hemodynamic variables among the 3 groups.The incidence of nausea was comparable among the 3 groups:33％ in group A,35％ in group B and 46％ in group C,while the incidence of vomiting was significantly higher in group C (46％) than in group A (10％) and group B (15％).Conclusion The incidence of vomiting is significantly higher during and within 1 h after emergency cesarean section in patients with preoperative gastric fluid volume ＞ 0.8 ml/kg,but the incidence of nausea is not related to preoperative gastric fluid volume.

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

[Objective]To discuss the failure and countermeasure of Ni-Ti shape memory alloy fixer for treatment of limb fracture.[Method]A retrospective survey was performed in 259 cases with fracture treated by Ni-Ti shape memory alloy fixer.Eight cases of the fixer had been ruptured,risen,loosen after operation.[Result]The failure case of Ni-Ti shape memory alloy fixer for treatment of limb fracture were 8 case in 259 case.There were one case of ulna and two cases of femur fracture had be ruptured after the first operation,healing up after the second operation.The fixer has been risen of shoulder bone and femur fracture in each one and two cases of clavicle,the fracture has be malformation concrescence.One case of patella fracture was loosn after concrescence.[Conclusion]The requisite for Ni-Ti shape memory alloy fixer is needed for treatment of limb fracture,the right operation's condition,the best type and length are selected for different part,the convalescent exercise is regnired after operation to avoid failure of treatment.

[Objective]To compare the reliability and value of clinical signs,MRI imaging and arthroscopy in management of meniscal tears in order to increase the diagnostic rate.[Method]A retrospective study was done on 176 cases undergoing MRI examination and arthroscopic treatment,and being diagnosed as meniscal injuries in knee joint by any one of the three clinical,MRI or arthroscopic examinations.Using arthroscopic diagnosis as the standard,the sensitivity,specificity.and overall accuracy of clinical diagnosis and MRI were then calculated respectively.Significant differences between arthroscopic diagnosis and clinical diagnosis or MRI diagnosis were analyzed using statistical method of Chi-square test.[Result]The sensitivity,specificity and accuracy of clinical diagnosis were 79.3%,26.3% and 73.8% respectively.There was statistically significant difference between arthroscopic diagnosis and clinical diagnosis.The sensitivity,specificity and accuracy of MRI diagnosis were 94.1%,92.9% and 93.4% respectively.The difference between arthroscopic diagnosis and MRI diagnosis had no statistically significance and can be used as an important examination before knee arthroscopy.[Conclusion]MRI is a reliable,noninvasive diagnostic tool for meniscal tears and can be used as an important examination before knee arthros copy with MRI examination combining with the clinical signs,diagnotic rate of meniscal tears can be increased.Unnecessary arthroscopic therapy could be avoided.

[Objective]To discuss the clinical results and treatments of the Monteggia's fracture in children.[Method]Total of 66 patients including 61 fresh and 5 old fractures were reviewed.There were 47 males and 19 females.According to the Bado classification system: 46 of type Ⅰ,4 of type Ⅱ,15 of type Ⅲ,1 of type Ⅳ,all patients received conservative or operatire treatment.The conservatively treated patients received manipulation and plaster immobilization.In the operative group,the patients were fixed with single or/and double Kirschner's wires after reduction of the radiohumeral joints or/and fractured ulna.Neither reparation nor reconstruction was needed.[Result]All patients were available at the final follow up with 0.5～5 years.According to the Li Hanmin's scoring system for the motion function in children: excellent and good rate was 95.7% in conservative group and 84.2% in operative group.There was no complication such as myositis ossificans,synostosis of radius and ulna,ulna nonunion,radial head dislocation and profundus radial nerve injury.The cases of nerve injury were complete recovered after operation two or four months later.[Conclusion]The clinical results of the Monteggia's fracture in children was very good with immediate reduction and internal fixation in proper cases,a good overall therapeutic outcome can be expected in children with Monteggia's fracture.It is very important to prevent missed diagnosis.