Cocaine is usually used in clinical local anesthesia. However, because of its excitatory effect, it is also abused by some people, and thus results in the onset of disease. Since the first cocaine-related stroke was reported in 1977, many researchers have gradually realized that cocaine abuse causes many cerebrovascular diseases; its exact pathophysiological mechanism remains unknown and it may be involved in a variety of mechanisms.

Actinomycosis ; pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Mycoses ; pathology ; Staphylococcal Skin Infections ; microbiology ; pathology ; surgery ; Staphylococcus aureus ; isolation & purification ; Young Adult

Objective To evaluate the MRI findings and clinical features of methotrexate-induced acute encephalopathy in children.Methods The clinical data and brain MRI obtained in 13 children with methotrexate-induced acute encephalopathy were retrospectively reviewed.The MRI features were analyzed , including information on the location , the signal intensity and follow-up MRI study was performed.Results Of the 13 patients , 2 patients suffered from seizure.Five patients had dysphasia , of which 4 patients had evidence of hemiparesis , 1 patient had right facial palsy.Five patients had unilateral weakness.And left hemiparesis was observed in 1 patient.DWI revealed well demarcated asymmetrical hyperintensity lesions within the centrum semiovale and/or periventricular white matter in 10 patients, corresponding to areas of hypointensity on ADC maps.One case showed hyperintensity areas in the bilateral supratentorial cortex and subcortical white matter on T 2-weighted images with subtle high-intensity on DWI.In all 10 cases there were resolution of the diffusion abnormality , 8 cases displayed residual FLAIR signal abnormalities involving areas of previously seen diffusion restriction , 5 cases showed decreased range of the lesion , 1 case was progressive, and 2 cases were stable.One case with hyperintensity areas in the supratentorial cortex and subcortical white matter showed small residual hyperintensity on T 2-weighted images and resolution of the diffusion abnormality.Conclusions MTX-induced acute encephalopathy often manifests as stoke-like symptoms.DWI is the imaging modality of choice for the detection of acute MTX neurotoxicity , and asymmetrical restricted diffusion in the deep white matter is the characteristic sign.Cytotoxic edema induced by MTX is transient and reversible .

Objective To explore the clinic effect of arthroscopic in the treatment of Haglund deformity.Methods Sixteen patients with Haglund deformity were treated with arthroscopy from June 2009 to December 2011,including 7 males and 9 females,with an average age of 28.8 years (range,17-39 years).All 16 patients were suffered ankle back pain,exacerbations of pain during active and passive plantar flexion.This group of patients was chosen arthroscopic surgery to treat Haglund deformity as conservative treatment was invalid.With the prone position for surgery,we selected two approaches next to the Achilles tendon.Use the C-arm X-ray fluoroscopy observed calcaneus orthopedic during the operation.From the posteromedial approach to the posterolateral approach to alternately use the shaver and ArthroCare to clean up the front of the inflammation of the Achilles tendon bursa,by which could form arthroscopic operations security zone.All operating equipment was on the back toward the Achilles tendon,which could maximize the protection Achilles tendon.Postoperative plaster or brace short brake was used for two weeks.16 cases of postoperative patients were followed up； the mean follow-up time was 13 months (9-18 months).According pain visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle (AOFAS),the clinic effects were evaluated.Results At the last follow-up,the AOFAS hindfoot score of 91.5±2.8 was significantly higher than the preoperative 71.0±3.7 (t=17.38,P=0.014),postoperative VAS score 1.3±0.6 was significantly lower than the preoperative 5.10±0.44 (t=19.20,P=0.022).Conclusion The treatment of Haglund deformity by means of arthroscopic minimally invasive,with smaller trauma,faster recovery and lower complications,is effective and safe in clinical practice.However,dues to its steep learning curve,this method requires doctors to carry out who had relatively large arthroscopic surgery experience.

Obesity has rapidly become a pandemic and is associated with increased carcinogenesis, especially esophageal adeno-carcinoma (EA). Adipose tissue is considered an endocrine organ because of its capacity to secrete a variety of adipokines, such as leptin, adiponectin, and resistin. Adipokines have recently been found to be associated with different types of chronic esophageal diseas-es, including gastro-esophageal reflux diseases, Barrett esophagus, and carcinogenesis. First-hand evidence supporting the inhibitory and/or active function of adipokines has been collected on human EA. This review aims to provide important insights into the potential mechanisms of adipokines in EA progression.

Objective To investigate the early diagnosis and rational treatment of traumatic retroperitoneal hematoma(TRPH). Methods Retrospective analysis was done on the clinical data of 96 cases of TRPH admitted in our hospital in the past 10 years. Results Eighty two patients received operation, of whom,73 combined with other celiac organ injuries.The other 14 patients were treated by non surgery.Two patients combined brain trauma and 1 with hemorrhagic shock died during operation,and 2 died of multiorgan failure postoperatively. Conclusions Early diagonsis depends on clinical appearance, abdominocentsis, B ultrasonography and CT. Operation should be done immediately,if the patient has the following condition:(1)apparant hemorrhagic shock after blunt trauma;(2) comfirmed celiac viscera trauma or blood vessel trauma;and (3)retroperitoneal hematoma caused by penetric trauma. Kidney surrounding hematoma or hematoma in pelvis area needs no immediate operation.

Objective To observe the therapeutic effects and complication of combined endoscopic trerapy of the acute biliary pancreatitis(ABP). Methods 70 cases of acute biliary pancreatitis were treated in our hospital in recent 7 years.37 cases(group E) admitted undergone emergency endoscope procedure were treated with endoscopi- cretrograde cholongiopancreatography ( ERCP ), endpscopic sphincterotomy ( EST ) and endoscope naso-biliary drainage(ENBD) in 24h after be hospitalized. 33 cases(group C) were treated with conservation treatment or opera-tion treatment. Results Achievement ratio of endoscopic management was 92 %. There was no severe complication or mortality in group E. The duration of symptoms and hospitalization in endoscopy group were significantly shorter than those in group C(P<0.01). The change of serum and urine amylase was not significant between two groups in the first day after treatment(P > 0.05). But the serum and urine amylase of group E were significantly lower than those in group C in the second day(P< 0.05) and more significantly lower in the third day after treatment(P< 0.01 ). Conclusion Early endoscopic therapy is safe and effective in ABP patients. It is a valuable method to treat a- cute biliary pancreatitis.

ABSTRACT:Chlamydiae are obligate intracellular bacteria with a unique biphasic developmental cycle ,and have close rela‐tionships with human .Emerging Chlamydia species such as Chlamydia ibidis ,Chlamydia avium and Chlamydia gallinacea changed the chlamydial taxonomy .The biggest change is the abandon of genus Chlamydophilaand its previous six species were recombined into genus Chlamydia ,which in together with the emerging species ,expands genus Chlamydia to 12 species .This paper briefly reviewed the latest taxonomy of Chlamydiae and their identification methods ,which include the classical biological characteristics and physico‐chemical properties ,modern molecular genetics ,and the newly developed whole genome analysis . Presently ,molecular genetics methods ,including sequence analysis of 16S rRNA ,ompA and other Chlamydia‐specific genes , are commonly used for chlamydial identification .

Objective To study the value of CT and MRI in the diagnosis of hepatocellular adenoma(HCA).Methods The comprehensive imaging features of HCA in 11 patients confirmed by pathology were analyzed retrospectively in our hospital.Results 11 patients presented with a total of 18 lesions, and plain CT showed low or slightly low density in all lesions, with irregular high density area in two lesions.The CT values of the lesions were significantly higher than in adjacent normal liver in the arterial phases(P<0.05).On T1WI, two lesions showed low or slightly low signal intensity, and 16 lesions showed slight hyperintensity.On T2WI, 14 lesions showed hyperintensity, and 4 lesions showed hypointensity.All lesions showed significant enhancement in arterial phase of dynamic enhanced scanning.Pseudocapsule enhancement was revealed in 17 lesions.For 18 lesions, ADC values were measured on DWI, and the ADC values of the lesions were higher than the value of surrounding normal liver parenchyma.Conclusion Dynamic contrast-enhanced CT combined with MRI and ADC value measurement can provide valuable information in diagnosis of HCA.

Objective To explore effect of health management on blood lipid level and carotid artery plaque in patients with carotid artery stenosis.Methods One hundred and eighty patients with carotid artery stenosis were dived divided into health management group (90 cases) and routine treatment group (90 cases).All the patients took routine treatment, and the health management were given for 12 months continuously in health management group.The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were tested, the carotid artery was checked by carotid artery color Doppler flow imaging before and at 6 months, 12 months after treatment.Results The levels of TC, TG, LDL-C in health management group and routine treatment group at 6 and 12 months after treatment were significantly decreased than those before the treatment , and the level of HDL-C were significantly increased (all P<0.05).There was no significant difference in the levels of TC, TG, HDL-C, LDL-C before and at 6 months between the two groups (all P>0.05).The levels of TC, TG and LDL-C at 12 months after treatment in health management group were significantly decreased than those in routine treatment group, and the level of HDL-C was significantly increased (all P<0.05).There was no significant difference in Crouse plaque integral in health management group and routine treatment group between before and at 6 months after treatment (all P>0.05).The Crouse plaque integral at 12 months after treatment in health management group and routine treatment group were significantly decreased than those before the treatment (all P<0.05).There was no significant difference in Crouse plaque integral before and at 6 months after treatment between the two groups (all P>0.05).Crouse plaque integral at 12 months after treatment in health management group was significantly decreased than that in routine treatment group (P<0.05).Conclusion Long-term health management can decreased the level of serum lipid level and inflammation, and improve the situation of carotid artery plaque.