Objective To observe the predictive value of Alberta stroke program early CT score (ASPECTS) and hemorrhage after thrombolysis score (HAT score) for the hemorrhagic transformation (HT) of acute cerebral infarction (ACI) patients after thrombolysis with Alteplase.Methods One hundred and twenty-one patients with ACI admitted to the Department of Neurology of Tianjin Jinghai District Hospital from January 2015to March 2017 were enrolled, they were all treated by using Alteplase 0.6 mg/kg for thrombolysis, maximum dose being 90 mg, and 1/10 of the total dose was intravenously injected in 1 minute, and then the residual part dissolved in 100 mL normal saline was intravenously dripped continuously for 1 hour. The ASPECTS and HAT score were carried out before the start of thrombolysis, and then the HT incidence situations in patients with different ASPECTSs and HAT scores were compared, and logistic regression analysis was used to analyze the risk factors of HT after thrombolysis in patients with ACI; then the receiver operating characteristic (ROC) curve was drawn, and the clinical value of HAT score and ASPECTS in diagnosing HT occurrence was analyzed.Results In cases with ACI, it was discovered that the higher the ASPECTS, the lower the incidence of HT, indicating that the incidences of HT in patients with ASPECTSs 0-4, 5-7, 8-10 were 57.1% (4/7), 26.7% (8/30), 14.3% (12/84) respectively; Similarly, in such cases, the higher the HAT scores, the higher the incidence of HT, showing that the incidences of HT of patients with HAT scores 0, 1, 2, ≥ 3 were 7.1% (4/56), 21.0% (8/38), 33.3% (7/21), 83.3% (5/6) respectively. The single factor analysis showed that the risk factors influencing the HT incidence included the systolic blood pressure on admission, anti-platelet medicine taken in the past history, the sign of high density of middle cerebral artery shown in head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT store and ASPECTS [odds ratio (OR) values were 0.972, 0.279, 0.992, 0.311, 2.628, 2.625, respectively, 95% confidence intervals (95%CI) were 0.9352-1.012, 0.093-0.836, 0.983-1.000, 0.105-0.916, 1.362-5.071, 1.522-4.525,P values were 0.034, 0.023, 0.042, 0.034, 0.003, 0.045 respectively]; the multifactorial logistic regression analysis showed that the independent risk factors influencing HT incidence were as follows: the systolic blood pressure on admission, anti-platelet medicines taken in the past history, the sign of high density of the middle cerebral artery shown in the head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT score and ASPECTS (OR values were 1.766, 1.012, 1.574, 1.030, 2.155, 2.431, 95%CI were 1.233-2.103, 1.009-1.204, 1.186-2.091, 1.009-1.053, 1.237-4.907, 1.213-5.815,P values were 0.023, 0.004, 0.002, 0.005, 0.007, 0.047); HAT score and ASPECTS could predict the risk of HT incidence after venous thrombolytic therapy, sensitivity, specificity, area under ROC curve (AUC), 95%CI in ASPECTS were higher than thoes of HAT score (94.4% vs. 94.0%, 61.4 vs. 41.0%, 0.77 vs. 0.70, 0.710-0.830 vs. 0.650-0.800).Conclusions It is shown in this study that the higher the ASPECTS, the lower the incidence of HT, and the higher the HAT score, the higher the incidence of HT; both HAT score and ASPECTS can predict the risk of HT incidence after venous thrombolytic therapy, and the predictive value of ASPECTS system is higher than that of HAT score.

ObjectiveTo observe the therapeutic effect of standing bed on orthostatic hypotension with cervical spinal cord injury. Methods36 patients with cervical spinal cord injury were divided randomly into the standing bed group and routine treatment group. The blood pressure of all patients were measured every day during rehabilitation treatment. The function of spinal cord was assessed before and after treatment.ResultsThe function of sensory and motor in the two groups were all improved, but there was no statistical difference between the two groups in the grades of spinal cord function. There were 27 patients who had orthostatic hypotension in the study. All the patients with complete spinal cord injury suffered the orthostatic hypotension. There was no improvement in blood pressure of complete spinal cord injury after treatment. In incomplete spinal cord injury patients, there was a significant improvement and the difference of blood presure between lying and standing was decreased in standing bed group after treatment (P<0.05). Compared with routine treatment group, the blood pressure in standing bed group was improved (P<0.05). Conclusions Cervical spinal cord injury could have orthostatic hypotension. Complete spinal cord injury would suffer orthostatic hypotension in different degree. The standing bed treatment could improve the orthostatic hypotension in incomplete spinal cord injury.

Objective To present and evaluate the diagnosis and treatment of congenital giant megaureter. Methods From 1992 to 1999, 6 cases of congenital giant megaureter were diagnosis and treated, the pathogenesis, diagnosis and treatment of congenital giant megaureter were discussed. Results Resection of the kidney and ureter were carried out in all the 6 with satisfaction. Conclusions The diagnosis may be confirmed on B ultrasonography, CT, or intravenous urography. Nephroureterectomy is the principal method of treatment for congenital giant megaureter.

Objective To investigate the feasibility and effects of minimally invasive video-assisted parathyroidectomy(MIVAP)for parathyroid adenoma or cyst.Methods A 2 cm skin transverse incision was made above the suprasternal notch.Without gas insufflation,a cavity was built with retractors.Under endoscopic assistance,parathyroidectomy was performed by using a harmonic scalpel(3 cases of nonfunctioning parathyroid cyst and 7 cases of parathyroid adenoma accompanying hyperparathyroidism).Results The operation was successfully accomplished in all the 10 cases,without conversions to open surgery.The operative time was 20～70 min(mean,40 min).No hoarseness,choking cough,or hemorrhage occurred.A transient hypocalcemia developed in 3 cases.All the patients were followed for 2～18 months(mean,9 months),with satisfactory curative and cosmetic results.Conclusions Minimally invasive video-assisted parathyroidectomy appears to be a safe and effective treatment with good cosmetic results and postoperative outcomes.

Objective To observe the effect of acupuncture on patients with vertebral-artery-type cervical spondylosis by means of transcranial Doppler sonography ~TCD) and brainstem auditory evoked potentials ~BAEP), and to explore the mechanism of acupuncture in treatment of cervical spondylosis by means of blood velocity and neuroelectrophysiology measurements. Methods Forty patients with vertebral-artery-type cervical spondylosis were divided into acupuncture treatment group ~20 cases) and routine treatment group ~20 cases). The TCD and BAEP were examined before the rehabilitation treatment and 2 week later. Comparing with the control group, the effect of acupuncture on the blood velocity and cerebral electrophysiology was analyzed. Results ~1)The total efficiency rates in the two treatment groups were 90% and 85%, respectively. The clinical heal rate was 45% in acupuncture group and 35% in routine group. There was no statistic difference with regard to the therapeutic effect and the length of treatment between the two groups. ~2)The blood velocity of vertebrobasilar artery ~VBA) in the patient group was decreased. The abnormal rate of TCD was 77.5% ~31/40 cases), characterized with the decrease of VBA. The abnormal rate of BAEP was 75% ~30/40 cases), characterized with brainstem abnormality type. ~3)The blood velocity in both groups was increased after treatment. Compared with the routine therapy group, the velocity of blood flow in vertebral artery in acupuncture treatment group was increased markedly ~P

Objective To evaluate the surgical technique and clinical application of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy with no suture of the incision. Methods Twenty-five patients who had upper urinary tract calculi with the course from 10 months to 6 years were enrolled.The size of the calculi was 1.2 to 3.1 cm in diameter.ESWL was ineffecative in 14 of the patients and ureteroscopic lithotomy failed in 2 of them.Then the 25 patients underwent retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy.Details of the procedure were presented. Results All the operations were successful in the 25 patients. The operations took 60 to 190 min with a mean time of 105 min.All the patients fully recovered with no complication observed during the 9～12 months' follow-up. Conclusions Retroperitoneal laparoscopy surgery with no suture of the incision has advantages of minimal invasive,safe,effective and rapid postoperative rehabilitation.The surgical procedure has a good prospect in the urologic clinical practice.

ObjectiveTo explore the effect of patients with acute cerebral infarction (ACI) at different ages receiving intravenous injection of alteplase for thrombolysis on their prognosis.Methods Ninety-eight ACI patients admitted to Jinghai Hospital of Tianjin from January 2014 to December 2015 were conducted in this study, and they were divided into elderly group (over 75 years old) and younger age group (under 50 years old). The patients in two groups of were given intravenous thrombolytic therapy with alteplase (0.9 mg/kg), 10% of the dose was intravenously injected, and continuously the remaining dose was pumped into the vein for 1 hour. Before the thrombolysis and 1 day and 21 days after thrombolysis, the score of United States National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological deficits, the incidence of bleeding adverse event and mortality were recorded.Results Compared to the before thrombolysis, the NIHSS scores after thrombolysis on the 1st day and 21st day were significantly decreased in the two groups (the younger age group 1 day: 6±4 vs. 10±5, 21 days 2±2 vs. 10±5, the elderly group 1 day: 7±5 vs. 10±7, 21 days: 6±4 vs. 10±7, allP < 0.05), and NIHSS score in the younger age group was significantly lower than that in the elderly group on the 21st day after thrombolysis (2±2 vs. 6±4,P < 0.05). After thrombolysis, the incidence of minor mucocutaneous bleeding in elderly group was obviously higher than that in younger age group, the difference being statistically significant [7.69% (4/52) vs. 2.17% (1/46),P < 0.05]; the elderly group had higher symptomatic intracerebral hemorrhage and death events than those in younger age group [1 (1.92%) vs. 0].Conclusion Different ages of patients with ACI can benefit from intravenous thrombolysis with alteplase, showing the younger the age of the patients, the better the benefit they can get and have relatively better prognosis.

Objective:To test the effects of roxithromycin(RM) on TNF? and IL-6 release from periodontal ligment fibroblasts(PDLCs) stimulated with lipopolysaccharide(LPS).Methods:PDLCs of passage 4~8 were cultured with RM at 2,20 and 200 ?g/ml respectively with 10 ?g/ml of LPS.The control cells were cultured with culture medium only.The cultures were continued for 3,6,12 and 24 hours respectively.ELISA method was used to measure TNF-? and IL-6 released into the culture medium from PDLCs in the different groups.Results:LPS increased both TNF-? and IL-6 release from PDLCs at all the time points(P

ObjectiveTo explore the therapeutic effect of floating acupuncture on the the processus transverses of vertebrae lumbales Ⅲ syndrome.Methods40 patients with the processus transverses of vertebrae lumbales Ⅲ syndrome were divided into the floating acupuncture group (20 cases) and the traditional group (20 cases). The pain was evaluated with visual analogue scale (VAS) before and after treatment.ResultsCompared with traditional treatment, the floating acupuncture can relieve pain rapidly after 15 min and 1 d of treatment. ConclusionThe floating acupuncture shows preferable clinical curative effect to patients with the processus transverses of vertebrae lumbales Ⅲ syndrome.

With the development of clinical education,Urology Department in Xiangya Hospital has identified teaching object and scheme,and improved the condition and modality of teaching and the level and development of clinical teaching.