Objective To investigate the correlation between the serum thyroid-stimulating hormone levels and the outcomes in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke were enrolled prospectively.The general clinical data,vascular risk factors,and biochemical indexes including thyroid hormones were collected.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of baseline neurologic deficit.The modified Rankin Scale (mRS) was used to evaluate the neurological outcomes at day 90 after onset.The mRS 0-2 was defined as good outcome.Multivariate logistic regression analysis was used to identify the independent influencing factors of the poor outcomes in patients with acute ischemic stroke.Results A total of 140 patients with acute ischemic stroke were enrolled,including 95 men (67.86％) and 45 women (32.14％),aged 35-94 years old.Thirteen patients (9.29％)had subclinical hyperthyroidism and 17 (12.14％) had subclinical hypothyroidism.Ninety-eight patients (70.00％) had good outcome and 42 (30.00％) had poor outcome.The proportions of male (x2 =4.717,P =0.047) and small arterial occlusive stroke (x2 =5.564,P =0.018),as well as uric acid (t =2.602,P =0.010),FT3 (t =2.406,P=0.017),and TSH (t =2.302,P =0.023) in the good outcome group were significantly higher than those in the poor group (P =0.001);age (t =-3.489,P=0.001),fasting blood glucose (Z =-2.178,P =0.031),and baseline NIHSS score (t =-8.009,P ＜ 0.001) were significantly lower than those of poor outcome group.The proportion of patients with TSH in the first quartile (＜0.805 mU/L) in the good outcome group was significantly lower than that in the poor outcome group (17.35％ vs.42.86％;x2 =10.204,P =0.003,and that in the fourth quartile (＞ 2.476 mU/L) was significantly higher than the poor outcome group (30.61％ vs.11.90％;x2=5.488,P=0.002).Multivariate logistic regression analysis showed that after adjusting various confounding factors,the higher baseline NIHSS score was an independent risk factor for poor outcome at day 90 after onset (odds ratio,1.690,95％ confilence interval 1.317-2.168;P＜ 0.001),while the higher baseline TSH level was associated with good outcome (odds ratio,0.520,95％ confidence interval 0.408-0.867;P=0.007).Conclusions The higher serum TSH level was independently associated with good neurological outcome at day 90 after onset in patients with acute ischemic stroke.

Subclinical thyroid dysfunction including subclinical hypothyroidism and subclinical hyperthyroidism, subclinical hypothyroidism is more common in the general population. Subclinical thyroid dysfunction may increase the incidence of risk factors of stroke, like hypertension, diabetes melitus, dyslipidemia, atherosclerosis, atrial fibrilation, homocysteinemia and so on. Subclinical thyroid dysfunction may be associated w ith the outcomes in patients after acute ischemic stroke.

Objective To determine the normal value and clinical significance of the lengths and angles of both mandible and hyoid, and their relationship with cervical vertebra as well as the transverse area of the airway at the hyoid level using CT. Methods Several lines and angles on the CT images were measured in 68 normal subjects. Line A was the length between both free ends of the mandible; line B was the distance from the body of the mandible to line A; Line C was the distance from line A to the anterior aspect of the cervical vertebra. ?1 was the angle between the middle of mandible body and its two free ends. Line a was the distance between two free ends of greater horn of hyoid bone. Line b was the distance from hyoid to line a. line c was the distance from line a to the cervical vertebra ?2 was the angle between the middle of hyoid body and its two free ends. S stood for the area of the airway at the hyoid level. SPSS 11.5 statistical analysis package was used to analyze the results. Results The average and median distance/angle of various measurements were as follows: bne A was (89. 28?5. 90) mm and 88. 70 mm, line B was (62. 61?5. 78) mm and 62. 50 mm, line C was (9. 29?3. 29) mm and 4. 20 mm, ?1 was (71. 25? 6. 77)? and 71. 05? , line a was (38. 69?6. 07) mm and 39. 90 mm, line b was (28. 79?4. 37) mm and 28.50mm, line c was (1.91?3.03) mm and 1.75 mm, ?2 was (68.47?15.71)? and 66.95?.The average S was (436. 14?160. 37) mm and median was 431. 75mm2. Conclusion It's easy to measure the three lines and the two angles of mandible and hyoid. The measurement is of vital importance in the diagnosis and treatment for obstructive sleep apnea syndrome.

Objective In order to identify cytotoxicity and specificity of the suicide gene systems which vascular endothelial growth factor receptor 2(KDR) and CMV were used as promoters respectively. Methods Two cell lines, HUVEC and CNE-2, one expresses KDR highly,another doesn't, were used as target cells for identifying the cytotoxicity and specificity of recombinant adenoviral vectors with herpes simplex virus thymidine kinase (HSV-tk) gene expression driven by KDR promoter and CMV promoter respectively (pAdKDR-tk and pAdCMV-tk) in Vitro by adding GCV. Results HUVEC and CNE-2 showed similarly sensitivity to GCV when they were transfected by pAdCMV-tk. However, They shown different sensitivity to GCV when they were transfected by pAdKDR-tk. When HUVEC was transfected in high MOI (MOI=100) and concentration of GCV was 50 ?g/ml, The cell growth rate decreased to (23.12?4.90)% .On the contrary, CNE-2 cells growth rate remained as high as (70.46 ?3.27)%. Conclusion Two kinds of cell line CNE-2 and HUVEC can be killed by pAdCMV-tk suicide gene system, but pAdKDR-tk suicide gene system only can kill HUVEC cell line. The result implied that pAdKDR-tk could kill the cells that express KDR specifitly.

OBJECTIVE: To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. METHOD: Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". RESULT: Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". CONCLUSION Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
Dysphonia ; diagnosis ; physiopathology ; Female ; Humans ; Language ; Male ; Phonation ; Spasm ; diagnosis ; physiopathology ; Voice

OBJECTIVE: To assess the feasibility, risks and advantages of endoscope-assisted second branchial cleft cyst (SBCC) resection via the retroauricular hairline approach (RHA) by comparing with conventional trans cervical approach. METHOD: Using prospective clinical controlled study, in twenty five patients with SBCC, 13 cases underwent endoscope-assisted resection via the RHA, 12 cases underwent conventional transcervical approach resection. Preoperatively, the sizes, locations and adjacency of all lesions were evaluated by ultrasonography, CT or MRI. Pathologic diagnoses of all cases were identified as SBCC using fine needle aspiration biopsy. Two groups were compared at length of incision, operation time, bleeding, incision cosmetic result, complication etc. RESULT: All 25 operations were successfully performed. Length of incision and operation time in endoscopic group were significantly longer than that of the transcervical group (P < 0.05). After three months, the mean subjective satisfaction score of incision scar in the endoscopic group was significantly higher than that of transcervical group (P < 0.01). In endoscopic group, 1 cases (7.7%) with temporary numbness of earlobe and 1 case (7.7%) with a darkened color change of the flap margin at the incision angle were found postoperatively. However, they were recovered within 1 month. All the 25 patients were disease free with a follow-up from 18 to 36 months (median follow-up: 26 months). CONCLUSION Endoscope-assisted SBCC resection via RHA is feasible and safe for the treatment of SBCC. In comparison with the transcervical approach, this method can provide an invisible incision and better cosmetic re suits without significant complications.
Adolescent ; Adult ; Branchioma ; surgery ; Endoscopy ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To evaluate the modified rhytidectomy incision in superficial parotidectomy. METHOD: Thirty-five patients with superficial parotid tumor were included in this study. A modified rhytidectomy incision often used in facial plastic surgery was used for superficial parotidectomy and subtotal superficial parotidectomy with preservation of facial nerve and great auricular nerve. The follow-up study included the exposed region, the cosmetic effect of this approach and the rate of complication. RESULT: All patients healed without salivary fistula, and were satisfied with this modified approach. Temporary paralysis of the marginal mandibular branch of facial nerve were found in five patients, and six patients felt insensible around earlobe after operation. They all recovered in 1 to 3 months after surgery, no recurrence was happened during follow-up in 36 to 60 months (median follow-up period was 48 months). CONCLUSION The modified rhytidectomy incision provided good exposure, had less complication and better cosmetic outcome.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; surgery ; Rhytidoplasty ; methods ; Young Adult

Objective To investigate the expression of the mRNA of muscle fibre types in the denervated post cricoarytenoid(PCA)muscle of rat.Methods Unilateral recurrent laryngeal nerve of eight rats were removed.Eight rats were used as controls.The mRNA expression of heavy chain myosin of PCA muscle fibre subtypes was measured with real-time quantitative RT-PCR in control rats and denervated rats 40 days after denervation.Results Compared to the control group,there were no significantly differences in mRNA expression of each muscle subtype between two groups.The ratio of MyHC type I to IIB was increased significantly(P=0.018).Conclusion The increased ratio of MyHC subtype I to IIB suggests the decreased contraction power of denervated PCA muscle.

Human tissue kallikrein-binding protein (Kallistatin, KAL), a secretory protein that participates in the regulation of multiple signaling pathways by binding to the extracellular receptor, however, at present has not been reported about the intracellular activity, and whether it has the similar biological activity with extracellular activity. Here we constructed no signal peptide KAL (NSK) into the adeno-associated virus vector to explore the intracellular activity of KAL. Both the endothelial cell and lung cancer cells could express KAL, but not secreted after rAAV2-NSK transfection. The proliferation and migration of human umbilical vein endothelial cells (HUVECs) were inhibited, but the apoptosis rate was not affected. The proliferation rates, mobility and tubule formation of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited to different extents. This cellular study not only confirmed the intracellular activity, but also suggested it may serve as a kind of "balance factor" in multi-targeted controlling, which may provide a new train of thoughts to explain the regulatory contradiction in PI3K-Akt signaling pathways by KAL.

Objective To discuss the clinical significance of serum neutrophil gelatinase associated lipocalin(NGAL)detection in the diagnosis of contrast induced nephropathy .Methods A total of 299 inpatients with contrast medium in department of inten‐sive care unit(ICU) ,department of cardiovascular disease ,department of urology from Guangdong Province Hospital of Traditional Chinese Medicine were enrolled ,and the fasting blood glucose and lipids were detected .Sera were collected before examination of contrast medium and 1 ,2 and 6 d after examination of contrast medium respectively .Serum creatinine(SCr)and cystatin C(CysC) were detected ,the concentration of NGAL was determined .CIN was defined as of increased by 44 μmol/L or 25% from baseline in SCr within 24-48 h .The NGAL detection variation tendency was analyzed in different time point .Results In 299 cases ,CIN oc‐curred in 28 patients ,the incidence rate was 9 .36% .The diabetes patients in the incidence of CIN was 16 .21% (12/74) ,no inci‐dence of diabetic patients was 7 .11% (16/225) .When compared with that of before contrast ,CIN in serum of patients with Cr and CysC coronary angiography in 2 d significantly increased after contrast medium ,returned to the level before angiography on 6 d .But the serum NGAL in angiography 1 d after it was significantly increased (P<0 .05) ,statistically significant differences compared with pre contrast ,and was still at a high level on sixth day .Conclusion Prediction of CIN level of serum NGAL in contrast after 1 d could be a good predictor for CIN ,and the prediction time is earlier than the serum levels of Cr and CysC .The level of serum NGAL can be used for early diagnosis of CIN .