Objective To discuss the opportunity of hemilateral craniotomy in treatment of a large area combined middle cerebral artery (MCA) infarction.Methods Thirty-two patients with a large area combined MCA infarction were performed by hemilateral craniotomy.Initial clinical presentation was evaluated by the Glasgow coma scale(GCS).All survivors were assessed three months after surgical decompression according to Barthel index(BI).The effects of pre-hemia decompressive surgery(before any signs of cerebral hernia,based on clinical status and CT or DWI findings)versus post-hernia surgery (after signs of hernia) on mortality,functional outcome.Results In 18 patients with pre-hernia decompressive surgery,3 patients (16.7%)were dead and average BI was (66.94±7.75)scores.The mortality was 57.1%(8/14)and average BI was (38.43±9.82)scores of post-hernia surgery with 3 cases severe aphasia.Conclusion Hemilateral craniotamy is performed before occurrence of cerebral hernia may decrease the mortality and improve outcome in these patients.

To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p＞0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NTBNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460. 1±92.7pg/mL, p＜0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities.The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction.

Objective To explore the association between the infection rate of Helicobacter pylori (Hp) and intake frequency of capsicum in dietary pattern. Methods A total of 914 health check-up participants were recruited from Tianjin Medical University General Hospital (male: 510,female:404). All participants were asked about the intake frequency of capsicum. Diagnostic criteria of the Hp infection included positive C13 breath test. Results The intake frequency of capsicum was ≥2 times/week, 1 time/week and <1 time/week. The infection rate of Hp was 56.08%, 49.04% and 48.29%. After adjusting for covariates, compared with the≥2 times/week, the odds ratios(95%confidence interval)of intake frequency of capsicum 1 time/week and <1 time/week: the frequency of capsicum intake ≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 0.57(0.33-0.97) and the frequency of capsicum intake<1 time/week was 0.69(0.42-1.14) in men;the frequency of capsicum intake≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 1.01(0.54-1.88), and the frequency of capsicum intake<1 time/week was 0.71(0.41-1.23) in women. Conclusions This study found that food intake frequency of capsicum≥2 times/week was associated with the infection rate of Hp in men. But similar relationship was not observed in women.

Background Acanthamoeba keratitis is a sort of serious infectious eye disease with high causing-blindness rate.Acanthamoeba keratitis often is misdiagnosed as fungal keratitis or viral keratitis in the early stage.Because conventional clinical diagnosis methods show a low specificity and take a long time,timely treatment often is delayed.Conventional PCR does not apply well because the lesion sample is not enough to extract DNA.However,direct PCR can amplify 18S rRNA conserved sequence of acanthamoeba keratitis without the extraction of DNA.Objective This study was to discuss the feasibility for rapid diagnosis of acanthamoeba keratitis using direct PCR to amplify the gene 18S rRNA fragment.Methods Ten acanthamoeba strains were isolated from 10 eyes with acanthamoeba keratitis in Qingdao Eye Hospital.The sensitivity of the direct PCR assay was tested using different numbers of amoebas.The specificity of the assay was tested using DNA extracted from acanthamoeba,candida albicans,pseudomonas aeruginosa,herpes simplex virus-1 (HSV-1) and normal human corneal epithelial cell.Acanthamoeba keratitis models were established using infected method in clean 6-week-old female BALB/c mice.Corneal lesion samples were obtained 1 day,3,5,7,10,15 days after modeled.The effectivity and feasibility of the direct PCR assay for rapid diagnosis of acanthamoeba keratitis were evaluated and compared with culture method,corneal smear examination and real-time PCR.Results Direct PCR primers could only amplify DNA of acanthamoeba rather than other pathogens,and 10 stains of acanthamoeba were detected at least in each sample.During the development of acanthamoeba keratitis in the mice,the diagnosis positive rate of direct PCR was 80.0％,90.0％,80.0％,70.0％,70.0％ and 50.0％ in 1 day,3,5,7,10,15 days after modeled with the total positive rate 73.3％,which was higher than 31.7％ of culture method,56.7％ of corneal smear examination and 61.7％ of realtime PCR,with a significant difference between the direct PCR and culture method (P =0.005),but no significant difference was seen in the total positive rate between the direct PCR and real-time PC R (P =0.172) or corneal smear examination (P =0.056).Conclusions The direct PCR assay is a simple,rapid,highly specific and sensitive method for the rapid diagnosis of acanthamoeba keratitis,especially for the limited lesion sample.

AIM: To investigate the comparison of different types of catheter treatment of anastomotic ring canalicular effect.
METHODS:Retrospective analysis. A total of 114 cases 114 eyes were randomly selected between May 2013 to May 2015 jointly admitted to Huizhou Huizhou City People's Hospital and the Central People's Hospital of canalicular patients in accordance with the agreement of the annular catheterization divided into three groups, group A of annular nasal lacrimal duct catheterization in 36 eyes, group B for the whole nasal lacrimal annular catheterization in 33 eyes, group C between the upper annular tears point catheterization 45 eyes. Through the A, B, C three groups after 1, 3wk, 1, 3mo and 1y follow-up were analyzed to compare.
RESULTS:Group A of 31 eyes were cured, improved in 2 eyes, 3 eyes, the effective rate was 91. 7%;group B, 27 cases were cured, improved in 3 eyes, 3 eyes, the effective rate was 90. 9%;group C, 40 cases were cured, improved in 2 eyes, 3 eyes, the effective rate was 93. 3%. A, B, C three groups efficiency pointless difference (P=0. 124). Eye Effect: A, B, C meaningful difference among the three groups(F=36. 578; P=0.002), Group A scored the highest score of a minimum group C, respectively( 3. 5±0. 8 ) and ( 2. 3±0. 7 ); comparison meaningless difference between group a and group B( t=0. 086, P>0. 05 ); Group A and C and comparison of differences between group C and group B have the significance ( t = 15. 241, t = 17. 472; P<0. 05 ). Nasal influence: A, B, C meaningful difference among the three groups(F=778. 581;P=0. 001), the highest score in group B, group C minimum scores were(6. 6±0.8) and ( 0. 9 ± 0. 7 ); A, B, C three groups comparison of differences twenty-two have significance(t=17. 262; t=18.247; t = 16. 647; P<0. 05). Shape Effect: A, B, C difference among the three groups of meaningful ( F=481. 113;P=0. 002), Group A scored the highest score of a minimum group C, respectively(5. 8±0. 9) and(1. 2±0.6);Compare the difference between Groups B and C meaningless ( t = 0. 087, P > 0. 05 ); comparing the differences between the Groups A and B and between Group A and C were significance(t=26. 362, t=27. 532; P<0. 05 ). Unplug risk: A, B, C meaningful difference among the three groups(F=751. 121;P=0. 003), Group A scored the highest score of a minimum group C, respectively(6. 5±0. 7 ) and ( 1. 5±0. 7 ); A, B, C three groups comparison of differences twenty - two have significance(t=19. 642; t=20. 153; t=18. 345; P<0. 05). Group A had 8 patients had lower eyelid eversion, 5 cases of inferior lacrimal point expansion, 13 cases of sneezing, itchy nose, runny nose syndrome. Group B had 20 cases of varying degrees of now sneezing, itchy nose, runny nose syndrome. Group C had no serious complications.
CONCLUSION: Similar to A, B, C three groups of treatment efficacy, patient lacrimal functional recovery is safe and effective, which the group C treatment, during treatment and less material and fewer postoperative complications in patients, it is worth promotion.

Objective To investigate the prevalence of perimenopausal syndrome and relative risk factors in perimenopausal and postmenopausal women in Chongqing city .Methods Totally 1 680 questionnaires from women with perimenopausal syndrome , all the objects were patients who visited gynecology clinic from January 2013 to June 2014 in Chongqing .Results The average men‐arche age was (14 .71 ± 1 .95) years old ;average menopause age was (47 .22 ± 3 .13) years old in 1 680 perimenopausal women . 93 .51% (1 571/1 680) objects were diagnosed perimenopausal syndrome ,mainly presented to be forgetfulness ,sleep disorder ,irrita‐bility ,palpitation ,headache ,hot flashes ,sweating ,loss of libido ,orgasmic dysfunction ,dyspareunia ,colpoxerosis ,bone ,joint and muscle pain ,paraesthesia of skin ,depression .The risk factors were analyzed ,forgetfulness(P < 0 .01) ,sleep disorder(P < 0 .01) , menopause(P< 0 .01) ,normal sex or not(P< 0 .05) ,the attitude of sex(P< 0 .05) ,and the attitude of menopause(P< 0 .05) .Con‐clusion Most women in the period of perimenopausal have the problem with perimenopausal syndrome .The special service should be provided to perimenopausal women ,such as knowledge about perimenopausal and rational hormone replacement therapy .

Objective To investigate the diagnostic value of twinkling artifact in urinary calcium stones.Methods Calcium oxalate monohydrate,hydroxyapatite and whitlockite stone phantoms were prepared and embedded in porcine kidneys for ultrasound scanning.The length and width of twinkling artifact were measured.The intensity of twinkling artifact and the contrast-to-noise ratio (C/N ratio) of acoustic shadowing were recorded and all the data was analyzed statistically.Results All the stone phantoms generated twinkling artifact and acoustic shadowing.The difference of the intensity,length and width of twinkling artifact and the C/N ratio of acoustic shadowing had statistically significant each composition (P ＜0.01).There was no overlap between 95％ confidence interval of the intensity of twinkling artifact for any two compositions,and any two compositions of stones could be differentiated by the intensity of twinkling artifact (P ＜0.05).The C/N ratio of acoustic shadowing of calcium oxalate monohydrate and whitlockite stone phantoms were higher than those of hydroxyapatite ones (P ＜0.05).The receiver operating characteristic (ROC) curve displayed that the cutoff value of 1 127 of the intensity of twinkling artifact could be used to diagnose hydroxyapatite stones.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and area under the curve (AUC) were 74 ％,68 ％,69.8％,72.3％ and 0.743 respectively.Conclusions Twinkling artifact could be used to differentiate the calcium stones,which will be helpful for clinical treatment.

Objective Neutrophil/lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker but few studies have assessed the relationship between NLR and type 2 diabetes. In order to evaluate how NLR is related to type 2 diabetes, we designed a large scale cross?sectional study in an adult population. Method A cross?sectional study (including 49 861 men and 40 376 women) was conducted on participants recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin, China. Measurements of neutrophil and lymphocyte counts, fasting blood glucose and other potential confounding factors were performed. Type 2 diabetes was defined according to the criteria of American Diabetes Association. Adjusted logistic regression models were used to assess relationships between NLR quintiles and type 2 diabetes. Result In the final multivariate models, the odds ratios (95% confidence interval) for T2D across NLR quintiles were 1.00 (Reference), 1.19 (1.05, 1.35), 1.33 (1.17, 1.50), 1.28 (1.13, 1.44) and 1.34 (1.19, 1.51) (P for trend<0.000 1), in men. Similar relationships were also observed in women. Conclusion This study demonstrated that NLR was related to the prevalence of type 2 diabetes in men and women, and suggesting that NLR may be an efficient and accurate prognostic biomarker for type 2 diabetes.

Objective To assess the impact of a single hemodialysis on the left ventricular systolic function of uremia patients with 3-dimensional ultrasound speckle tracking imaging (3D-STI).Methods Thirty-seven clinically stable outpatients with uremia undergoing hemodialysis were studied.The echocardiographic examinations were obtained in 30 minutes before and after homodialysis.Twenty nine normal subjects with age and sex matched were selected as control groups.Conventional ultrasound was recorded and then left ventricular mass index(LVMI) was calculated.The peak systolic mitral annular velocity S' was recorded by tissue Doppler imaging.3D-STI imaging were recorded from standard left ventricular apical 4-chamber views before and after a single hemodialysis.Left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LVEF),and left ventricular global longitudinal peak systolic strain (LVGLS),left ventricular global radial peak systolic strain (LVGRS),left ventricular global circumferential peak systolic strain (LVGCS),left ventricular global area peak systolic strain (LVGAS) were measured.The indicators of conventional ultrasound and 3D-STI were compared between the pre-hemodialysis group and the normal control group,and also between pre-and post-hemodialysis groups.Results ①Compared with the control group,the left ventricular end-diastolic diameter (LVDD),interventrieular septal thickness at diastole (IVSD),left ventricular posterior wall thickness at diastole(LVWPD),left atrial diameter(LAD) in the group before a single hemodialysis were significantly higher (P ＜0.05 for all).Meanwhile,the S' was significantly lower (P ＞0.05) and LVMI was significantly higher in the pre-hemodialysis group than the control group(P ＜ 0.05).The LVDD,LAD,left atrial volume index(LAVI) were significantly lower in the post-hemodialysis group than that in the pre-hemodialysis group(P ＜0.05 for all).②Results of 3D-STI showed that the LVEF,LVGLS,LVGCS,LVGRS,LVGAS was significantly lower,however LVEDV,LVESV were higher in the pre-hemodialysis group compared with the control group (P ＜ 0.05 for all).After a single hemodialysis,LVEDV,LVESV,LVGLS were significantly lower than before(P ＜0.05 for all),but LVEF,LVGRS,LVGCS,LVGAS were not significantly changed (P ＞ 0.05 for all).Conclusions After a single hemodialysis,the whole systolic function of the left ventricular was not changed.but the left ventricular global longitudinal peak systolic strain was significantly lower.The parameter of LVGLS was sensitive to the change of preload and was volume-load dependent.The preload of the patients should be sufficiently considered when the LVGLS are measured in the patients with uremia undergoing hemodialysis.

Objective To investigate the tissue remodeling and cell alignment of TDBM scaffolds seeded with rabbit tenocytes under the cycle dynamic tensile force or static tension-free culture in vitro. Methods TDBM were made by ourselves, and uniaxial cyclic tendon stretching device was designed and manufactured on our own. Primary tenocytes were isolated from the Achilles tendon of three-day-old New Zealand white rabbits and seeded into scaffolds, and were cultured collectively in DMEM in vitro. Samples were divided into two groups:dynamic tension-loaded group, and static tension-free group. Fresh natural tendons were used to be positive control. The experiment's time was six weeks. The scaffold-cell complexes were harvested at 3 and 7 days of culture for Inverted microscope and scanning electron micrograph (SEM) analysis. The morphological characters of the samples, including the general view, HE and Masson's dyeing, were observed at 2, 4 and 6 weeks. In addition, the gene expression of the I-type collagen and III-type collagen of the samples was detected by using Real time PCR at every week. Set fresh natural tendon as control. Results The inverted microscope and SEM showed that it was nice compatible condition between the tendon cells and TD-BM scaffold. In addition, the tendon of tension-loaded group revealed a structure of longitudinally aligned collagen fi bers and dense structure of collagen fibers arranged in orderly form a unique corrugated structure. Tenocytes layer located between the col-lagen fibers and aligned longitudinally along the force axis, with increased matrix deposition after the 3th week showed by RT-PCR. The cell/matrix ratio decreases. When cultured to 6 weeks, the tissue structure was very similar to that of fresh natural ten-don pattern. By contrast, HE and Masson's staining revealed the collagen fibro-tissue structure in tension-free groups with disorga-nized matrix structure and randomly distributed cells. Collagen fibers were gradually degraded with time. In tension-loaded group, Real-time PCR showed that gene expression of I-type collagen and III-type collagen gradually increase, but in tension-free group, the relative gene expression of I-type collagen and III-type collagen was highest at 3rd week, and from that time the relative expres-sion gradually decrease. Conclusion Under the dynamic stress, the TDBM scaffolds seeded with rabbit tenocytes can promote extra-cellular matrix biosynthesis and tendon structure remodeling, which is a promising method for tendon tissue engineering.