Objective To discuss effective methods for treating hypertensive intracerebral hemorrhage at the different sites. Methods Different operative methods were adopted in 85 cases of hypertensive intracerebral hemorrhage at the different sites from January 2001 to August 2003 in this hospital. Small fenestration and hematoma clearance under local intensify anesthesia was conducted in 40 cases of hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia; small incision trepanation with suction and drainage of hemorrhage under local intensify anesthesia was used in 26 cases of hemorrhage in the medial area of the basal ganglia without brain hernia; craniotomy and hematoma clearance under general anesthesia was adopted in 11 cases of preoperative brain hernia and 6 cases of cerebellar hemispheric hemorrhage; lateral ventricle external drainage was adopted in 2 cases of brain stem hemorrhage involving into the fourth ventricle and also in these cases with ventricle involved. Results The overall mortality rate was 12 9% (11/85). There were no deaths in cases of hemorrhage without brain hernia,under the cortex, in the cerebellum, in the brain stem or in the lateral area of the basal ganglia.The mortality was 29 0% (9/31) in cases of hemorrhage in the medial area of the basal ganglia and 45 5% (5/11) in cases of preoperative brain hernia, respectively. Conclusions Small fenestration and hematoma clearance under local anesthesia is effective for hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia. Provided surgical treatment is early and adequate, the prognosis of cerebellar hemorrhage is excellent. Small incision trepanation with suction and drainage under local anesthesia exerts no appreciable effect on hemorrhage in the medial area of the basal ganglia.

OBJECTIVETo explore the clinical effects of anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation in treatting multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 48 patients with multilevel cervical spondylotic myelopathy underwent surgical operation were retrospectively analyzed from October 2010 to January 2013. There were 37 males and 11 females, aged from 37 to 76 years old with an average of 54.6 years. Thirty-five cases were two-segment lesion, 7 cases were three-segment lesion, 6 cases were four-segment lesion. All the patients were treated by anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation. ROM, JOA, VAS and SF-36 scores were recorded before and after operation(including 3, 6, 12 months after operation and final follow-up). Fusion degree and spinal canal decompression condition were observed by radiographic data.

RESULTSAll patients were followed up from 14 to 48 months, with an average of 27.3 months. At 12 months after surgery, radiographic data showed that all patients obtained bony fusion, spinal canal decompression were sufficient. Preoperative vertebral canal sagittal diameter of the most serious segment were (5.13 +/- 1.32) mm, 12 months after surgery were (9.94 +/- 1.22) mm, there was statistically significance (t=2.463, P=0.014); the degree of vertebral canal decompression were (92.15 +/- 2.35)%. Postoperative ROM, JOA, VAS and SF-36 scores were obviously improved than that of preoperative (P<0.05); there was no statistically significance of ROM, JOA, VAS and SF-36 scores in each time after operation (P>0.05).

CONCLUSIONAnterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation can obtain higher fusion rate, complete thoroughly decompression, improvement of clinical symptoms and well safety in treating multilevel cervical spondylotic myelopathy.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostheses and Implants ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spondylosis ; diagnostic imaging ; surgery ; Treatment Outcome

Objective To evaluate the effect and safety of ultrasound-guided percutaneous thrombin injection for the treatment of postcatheterization femoral arterial pseudoaneurysm.Methods Seventy-eight patients with femoral anterial pseudoaneurysm were included in this study.Pseudoaneurysms were treated by bedside compression in 50 of these 78 patients(group A),and by thrombin injection in 28 patients(group B).All patients were diagnosed by GE LOGIQ 9 Color Doppler Ultrasound.Ultrasound guided thrombin injection for femoral arterial pseudoaneurysme were carried out in patients in group B.Results Closure of the pseudoaneurysm was successfully in 82 percent(41/50) of the patients in group A.Six patients had vagus reflex,4 patients could not tolerate repeating compression and 5 patients were not effectively cured by compression and needed to receive remedial ultrasound-guided percutaneous thrombin injection.Closure of the pssudoareurysm by percutaneous thrombin injection was successful in all patients in group B.Successful immediate closure were noted in 25 patients and 2 patients needed second thrombin injection.One patient had vasovagal syncope and 12 patients had mild fever.No distal embolization,infection,hemorrhage or allergic reaction occurred.Conclusion Compared to compression therapy for treatment of femoral arterial pseudoaneurysme,ultrasound-guided percutaneous thrombin injection is a simple,safe and effective treatment alternative.

Objective: To investigate the effects of miR-200a on the proliferation of lung cancer cells and to identify its direct target genes. Methods:Real-time PCR was performed to analyze the miR-200a expression in 15 paired clinical specimens of non-small cell lung cancer and adjacent noncancerous tissues, human lung cancer cell lines (A549, NCI-H520, and SK-MES-1), and one human normal lung bronchial epithelial cell line (16HBE). The effects of miR-200a on the proliferation of A549 lung cancer cells were detected through CCK-8 method. The candidate target genes of miR-200a were identified by bioinformatics screening and then verified by dual luciferase reporter gene assay, real-time PCR, and Western blot. The effects of YAP1 downregulation on the proliferation of A549 lung cancer cell line were also observed through CCK-8 method. Results:The miR-200a expression in non-small cell lung cancer tissues and lung cancer cell lines was significantly decreased (P<0.01). The upregulation of miR-200a expression could significantly inhibit the pro-liferation of A549 lung cancer cells (P<0.01). Dual luciferase reporter gene indicated that miR-200a could directly affect the 3′-untrans-lated region of the YAP1 gene to inhibit luciferase activity (P<0.01). Real-time PCR and Western blot revealed that the upregulation of miR-200a expression could significantly reduce the mRNA and protein expression levels of YAP1 in A549 lung cancer cells (P<0.01). CCK-8 method indicated that the downregulation of YAP1 could significantly prevent the proliferation of A549 lung cancer cells (P<0.01). Conclusion:MiR-200a inhibits the proliferation of lung cancer cells by targeting YAP1. Thus, miR-200a elicits tumor suppression effects.

Objective To study the relationship between cardioembolic stroke and plasma BNP by analyzing the plasma BNP level in cardioembolic stroke patients.Methods The clinical data of 81 patients with acute stroke were collected.According to the TOAST classification,all the patients were diagnosed as non-cardioembolic stroke,including atherothrombotic,lacunar,others etiology and undetermined etiology cardioembolic stroke.Blood samples were drawn on emergency department arrival( within 24 hours) to test BNP( assayed by ELISA).The plasma BNP level between non-cardioembolic stroke and cardioembolic stroke was compared.Results Cardiogenic stroke patients with plasma BNP level( 147.5 ±7.8 ) ng/L,atherosclerotic stroke patients level(51.2 ± 5.8) ng/L,lacunar stroke( 39.5 ±10.0)ng/L.Higher levels of BNP were observed in patients with cardioembolic stroke than other stroke subtypes(t =67.8,23.6,17.6,all P ＜ 0.01 ).Conclusion The plasma BNP could be used for distinguishing cardioembolic stroke from other stroke subtypes and has great clinical significance in etiologic diagnosis of ischemic stroke subtypes.

BACKGROUND: As the second anti-Alzheimer disease drug approved by Food and Drug Administration(FDA), donepezil (Aricept) has been applied in European and American market. According to the regulation of Health Ministry of China, it needs conducting clinical trial of multiple center nationwide in order to come into Chinese market.OBJECTIVE: To evaluate the efficiency and safety of donepezil on treating mild and moderate Alzheimer disease (AD).DESIGN: Randomized, single blind and placebo control prospective study based on patients.SETTING: Neurological Department of Peking Hospital and Neurological Department of the 301 Hospital of Chinese PLA, and ect.PARTICIPANTS: Totally 188 patients with mild and moderate AD[with mini-mental state examination(MMSE) score of 10 to 24 points] from 15 big hospitals of Beijng, Shanghai and Guangzhou were conducted 12 weeks'clinical trial, among which 89 cases were of single blind and placebo control study while 99 cases were of self-controlled study. All the cases met the AD diagnostic standard of clinical neurology, linguistic dysfunction and stroke(NINCDS-ADRDA) and the 4th edition of Statistic Manual (DSM-IVR).INTERVENTIONS: Donepezil (5 rmg/tablet, ip, 5 rmg/time) or placebo with same color, shape, flavor and size with donepezil ( ip, 1 tablet/time)was taken orally for 12 consecutive weeks.MAIN OUTCOME MEASURES: MMSE, clinical dementia rating scale(CDR), activities of daily life scale(ADL), biochemical parameters, electrocardiograph(ECG) and chest x-ray were conducted once every 4 weeks before and after treatment.RESULTS: The random, single blind and placebo control study showed that the score of MMSE, CDR and ADL was greatly improved in donepezil group after 12 weeks' treatment when comparing with placebo group(P ＜ 0. 01,0.05, 0.01 ). Self-controlled study showed that the score of MMSE, CRD and ADL in donepezil group after 12 weeks' treatment increased 3.5, 0.6 and 7.1 points respectively compared with those before treatment(P ＜ 0.01,0.05, 0.01 ) . The score of MMSE was already improved in the 4th week of treatment. Among the 145 patients who took donepezil, 7 cases(4.8% )experienced side effect of mild cholinergic excitability. In the placebo group,2 of the 43 cases appeared dizziness and nausea. There was no difference between two groups( P ＞ 0.05).CONCLUSION: Donepezil can effectively treat mild and moderate AD patients and improve their cognitive functions, dementia level and daily living abilities with good tolerance and high safety.

Animals ; Cell Differentiation ; physiology ; Cell Hypoxia ; Cell Line ; Mice ; Myoblasts ; cytology ; Transcription Factors ; metabolism

Objective To investigate the feasibility of high resolution melting(HRM)curve analysis technique for detecting β-thalassemia gene mutations.Methods The HRM method was used to detect five kinds of common β-thalassemia mutations (-28, CD17,CD41-42,CD71-72 and IVS-2-654)in Guangdong province.Sixty specimens of the patients with suspectedβ-thalassemia were performed the HRM analysis.The results of HRM analysis were confirmed by the direct DNA sequencing.Results Among 60 specimens of the patients with suspectedβ-thalassemia,12 cases of heterozygosis mutant gene were detected,including 3 cases of-28,2 cases of CD17,5 cases of CD41-42,2 cases of CD71-72 and 2 cases of IVS-2-654 gene mutation;2 cases of homozygosis mu-tant gene were detected,including 1 case of-28 and 1 case of CD41-42 homozygous mutation (both were amniotic fluid specimens). The results of HRM analysis were consistent with the DNA sequencing results.Conclusion The HRM method can accurately de-tect five kinds of common β-thalassemia mutations in Guangdong province,has the advantages of simpleness,rapidness and high sensitivity and is expected to be a new method for screening β-thalassemia mutation in clinic.

1.5 cm in diameter) are significant risk factors for the failure of stone clearance. Prophylactic cholecystectomy of an acalculous gallbladder is unnecessary.

Objective To investigate the effect of triamcinolone acetonide(TA) with different dosage and place of production on retina.Methods Twenty-four rabbits were divided into 6 groups(A:untreated as a blank control;B: normal sodium;C:10mg imported TA;D:10 mg domestic-made TA;E:25 mg imported TA;F:25 mg domestic-made TA).Excepting group A every right eyeball underwent vitrectomy before intravitreal injection triamcinolone acetonide.All the eyeballs were extirpated on the 21st day after the intravitreal injection,and then pathological examinations were performed.Results Ganglion cell's light edemata had been seen in group B,C,D,E,F.Cell hyperplasia and vacuolar degeneration had been seen in the internal granular layer or external granular layer in some animals of group E,F.Two samples(1 in group E,1 in group F)observed there were a great amount of fibrinoid materials in cavum vitreum and cavum between amphiblestroid membrane and choroid membrane.Pathological changes in group E,F were severer than in group C,D.Conclusions Intravitreous injection TA at 25 mg can cause photoreceptor cells hyperplasia in rabbits,while there are no toxic effects at 10 mg.No obvious difference is observed between the groups of imported TA and domestic-made TA.