Intravenous thrombolysis is the only treatment that has the evidence of evidence-based medicine in acute ischemic stroke. However, the narrow time window has limited the treatment opportunities of many patients. Transcranial ultrasound thrombolysis is a very promising thrombolysis-assisted method, and transcranial ultrasound plus microbubble-assisted thrombolysis is the research hotspot in recent years. At present, more suitable ultrasonic instruments for thrombolysis and a number of ways of ultrasound-assisted thrombolysis are being developed.

This study aims to detect early changes of kidney in patients with primary hypertension by 3.0 T functional magnetic resonance imaging (fMRI). 26 patients with primary hypertension (hypertension group) and 33 healthy volunteers (control group) underwent conventional and functional magnetic resonance scans, which included blood oxygen level-dependent (BOLD) MRI, diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). We measured renal cortical thickness (CT), parenchymal thickness (PT), and functional values of renal cortex and medulla including R2* value, apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value in each group, and then calculated the cortical/parenchymal thickness ratio (CPR). Compared with those in the control group, CT and CPR in hypertension group were larger (P < 0.01), cortical and medullar R2* values increased (P < 0.01) whereas medullar FA values decreased (P < 0.05). It could be well concluded that noninvasive 3.0 T functional MRI would have important clinical significance in identifying early abnormalities of kidney in hypertension patients.
Anisotropy ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Essential Hypertension ; Humans ; Hypertension ; Kidney ; pathology ; Magnetic Resonance Imaging

Objective To understand the status of the life mcaning among medical students.Methods Totally 300 students in our school were measured by the scale of purpose in life test (PIL)to analyze the status and influencing factors of life meaning.The questionnaire data were analyzed by using two independent samples t-test,One-way ANOVA and multiple linear regression.Results The average score of the life meaning survey of medical students was 84,the life goal and life value dimension scores were relatively high and the life attitude and life independent dimension scores were low.Meanwhile,the life mean in scores were higher in senior students than in junior students ( P =0.003 ),higher in undergraduate students than in college students (P =0.021 ),higher in students from urban cities than in students from rural areas ( P =0.004),higher in student leaders than in non student leaders (P =0.001 ),higher in students liking their majors than in students disliking their majors (P =0.003).Conclusions The formation of medical students' life meaning is influenced by a variety of factors.Educators need to seize the important period of students' growth and launch some targeted educational activities.Meanwhile,in order to enhance the medical students' life meaning,it is also necessary to consolidate the professional education,increase students' self-identity and guide them to correctlv view social problems.

Aimed at the current plight of medical students' professionalism education,such as ignoring the top -level design and the overall plan but emphasizing practice,ignoring the permeability of professional spirit but emphasizing the impartation of professional knowledge,ignoring humanities but emphasizing professional issues in curriculum setting,Capital Medical University advocated the all-dimensional education philosophy implenented by all staff through the whole process,made top-level design scientifically for medical students' professionalism education.The university strengthened professionalism through teaching,permeated professionalism through a series of educational activities,consolidated professionalism through clinical practice,and thus to strengthen the cultivation of medical students' professionalism and realize scientific education by all staff and throughout the whole process.

AIM: To observe of cataract phacoemulsification and intraocular lens implantation in patients with postoperative tear film, and to explore its clinical significance.
METHODS: A total of 106 patients ( 140 eyes ) undergone phacoemulsification were randomly chosen. Subjective dry foreign body sensation were observed at six nodes of period 1d, 1, 2, 3wk, and 1mo. Corneal fluorescein ( FSC ) , basal tear secretion ( SIT ) and tear film break-up time ( BUT) were used to detect functional changes of the tear film. And the correlation between tear film stability and corneal sensitivity was analyzed.
RESULTS: Dry eye cumulative score of postoperative 1d, 1, 2wk was higher than preoperative ( t= 8. 53, P=0.000;t=6. 27, P=0. 000; t=9. 02, P=0. 000). There was no significant difference in dry eye cumulative score at postoperative 3wk, 1mo compared with preoperative ( t=1.91, P= 0. 824; t= 1. 27, P= 0. 069). Corneal epithelial fluorescein staining points of postoperative 1d, 1, 2wk were increased compared with preoperative (t=11. 64, P=0. 000;t=9. 61, P=0. 000; t=8. 87, P=0. 001). There was no significant difference in corneal epithelial fluorescein staining points of postoperative 3wk and 1mo compared with preoperative (t=2. 52, P=0. 746; t=1. 16, P=0. 094). Corneal sensitivity detection values of postoperative 1d, 1, 2wk were significantly higher than that of preoperative (t=9.61, P=0.000;t=9.27, P=0.000;t=11.39, P=0.024), and there was no difference postoperative 3wk and 1mo compared with preoperative (t=1. 19, P=0. 562;t=2. 17, P=0. 501).
CONCLUSION: Phacoemulsification with intraocular lens implantation will reduce the tear film stability in the short term, but after a long rest will be improved to a certain extent.

Objective Toinvestigatetheoperativeeffectandsafetyofendovascularstentingfor thetreatmentofsymptomaticvertebralarteryostialstenosis.Methods Fortypatientswithsymptomatic vertebral artery ostial stenosis and stenosis rate ≥70% were admitted to the Department of Neurology, China-Japan Friendship Hospital from November 2010 to January 2013 were enrolled retrospectively. All patients received endovascular stenting therapy,15 of them were implanted bare metal stents,and 25 were implanted drug eluting stents. The technical successful rate of operation,perioperation complications,and symptom remission rate of the patients were analyzed. At the same time,stroke and death incident as well as the related ischemic symptoms of the stent vascular feeding area in the follow-up period (13 to 36 months)wereobservedandtherestenosisratewasdocumented.Results Atotalof42stentswereimplanted in 40 patients,and the technical success rate was 100. 0%. The preoperative stenosis rate of vertebral artery ostial stenosis was 75% to 99%(mean 85 ± 7%);the postoperative stenosis rate was 0% to 20%(mean 6 ± 4%). There was no perioperative complication. The clinical symptoms of 19 patients disappeared completely,16 were improved significantly within the follow-up period,and the symptom remission rate was 87. 5%. No stent vascular feeding area related stroke and death occurred. Four patients had transient ischemic attack in posterior circulation,13 had restenosis after procedure (10 of them with bare mental stents and 3 with drug eluting stents). There was significant difference in restenosis rate between the bare mental stents andthedrugelutingstents(10/15vs3/25,P=0.001).Conclusion Endovascularstentingforthe treatment of the severe symptomatic vertebral artery ostial stenosis is a safe and efficient method. Although its restenosis rate is high,but it can improve the symptom of posterior circulation ischemia effectively.

OBJECTIVE: To detect variants of EXT1 and EXT2 genes among five pedigrees affected with multiple osteochondromas and provide prenatal diagnosis for the families based on the results. METHODS: The EXT1 and EXT2 genes of the probands were analyzed by targeted next generation sequencing (NGS). Suspected pathological variants were validated by Sanger sequencing in the probands, their family members and 200 unrelated healthy controls. Multiple ligation-dependent probe amplification (MLPA) was used to confirm the presence of gross deletions. Prenatal diagnosis was provided for 2 couples carrying pathogenic or likely pathogenic variants. RESULTS: Five variants were detected in the pedigrees, which included EXT1 exon 2-3 deletion, c.1468dupC (p.Leu490ProfsX31), c.2084delC (p.Pro695LeufsX11), and EXT2 c.187delT (p.Phe63SerfsX29) and c.1362T>G (p.Tyr454X). Among these, EXT1 exon 2-3 deletion, c.2084delC (p.Pro695LeufsX11) and EXT2 c.187delT (p.Phe63SerfsX29) were unreported previously. The three novel variants were not found among unaffected members of the pedigree and the 200 healthy controls. Upon prenatal diagnosis, the two fetuses were found to carry the same variants of the the probands. CONCLUSION Pathological variants of the EXT1 and EXT2 genes probably underlie the multiple osteochondromas among the 5 pedigrees. Prenatal diagnosis based on the results can effectively reduce the birth of further offspring affected with the disease.

Adult ; Carotid Artery, Internal ; pathology ; physiopathology ; Headache ; pathology ; physiopathology ; Humans ; Male ; Migraine Disorders ; pathology ; physiopathology

OBJECTIVETo investigate the therapeutic effect of free tissue flap anastomosed with reverse descendant branch of lateral femoral circumflex artery for severe soft tissue defect at leg.

METHODSThe severe soft tissue defect at leg, without any vessels for anastomosis of free tissue flap, was reconstructed with free tissue flap, which was anastomosed with proximal end of descendant branch of lateral femoral circumflex artery and great saphenous vein. From Oct. 2004 to Dec. 2009, 36 cases were treated with 15 cases of latissimus dorsi musculocutaneous flaps, 12 cases of anterolateral femoral flaps, and 9 cases of thoracoumbilicus flaps.

RESULTSAll the 36 free flaps survived completely. The patients were followed up for 6 months to 2.5 years with good cosmetic results.

CONCLUSIONSIt is effective and practical to repair the severe soft tissue defects at legs with the reverse descendant branch of lateral femoral circumflex artery to carry the free flaps.

Adult ; Female ; Femoral Artery ; surgery ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Thigh ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the safety of a 60-minute rituximab rapid infusion protocol in the maintenance therapy for Chinese B-cell lymphoma patients (including the elderly) and to discuss the feasibility of rituximab treatment in outpatient departments or daily wards. Methods This prospective study enrolled 820 patients diagnosed with B cell lymphoma in the Department of Hematology of Peking Union Medical College Hospital from February 2015 to July 2016. From the second chemotherapy cycle,rituximab was infused within 60 minutes (100 mg/h over the first 15 minutes and the remaining dose given over 45 minutes, there was no maximum infusion rate,and 700 mg/h was acceptable),and the adverse reactions were recorded. Comparison was done between patients<65 years and≥65 years. Results The overall adverse reaction rate was 4.20% and no grade 4 or higher adverse reactions were recorded. The adverse reaction rate in the elderly patients was not significantly elevated. Conclusion For Chinese patients (including the elderly) with B cell lymphoma,the 60-minute rapid infusion of rituximab (beyond the first cycle) is a safe treatment option with low adverse reaction rate.