ObjectiveTo explore the clinical characteristics of reversible posterior leukoencephalopathy syndrome ( RPLS ),in order to deepen the awareness of the disease.MethodsThe clinical data of 11 patients with RPLS in our hospital were retrospectively analyzed.ResultsIn the 11 cases with RPLS,there were two cases of pregnancy induced hypertension,preeclampsia(38 weeks pregnant),four eases of chronic renal insufficiency,four cases of malignant hypertension,and one case of lung cancer after chemotherapy.The main clinical presentations were headache,abnormality of visual perception,mental and behavioral abnormalities,ataxia,epileptic seizure and so on.The neuroimaging performances were extensive white matter abnormalities of the rear of the bilateral cerebral hemispheres,such as the parietal-occipital temporal lobe lesions,also involving the brain stem,cerebellum,thalamus and other parts.ConclusionThe clinical characteristics and neuroimaging performances of RPLS has certain characteristics,the majority of lesions were reversible,if the early diagnosis and treatment,the prognosis is usually good.

Gastric stump carcinoma (GSC) generally refers to the primary cancer in the remnant stomach,which occurs 5 years or latter after subtotal gastrectomy for gastric or duodenal ulcer,or 10 years or latter after gastric cancer resection.Laparoscopic radical gastrectomy for GSC is difficult with low resection rate.Although laparoscopic gastrectomy is technically mature in recent years,there is still few reports about laparoscopic resection for GSC.From January 2009 to June 2012,18 patients with GSC received laparoscopic radical gastrectomy at the General Hospital of Lanzhou Military Area of PLA.Laparoscopic gastrectomy for GSC is technically feasible and safe with satisfactory short-term outcome.Surgeons who have mastered laparoscopic D2 dissection could perform this procedure.

Microthrombosis may be involved in the pathogenesis of cardiac microangiopathy due to diabetes. Recent studies have shown that fibrinogen-like protein 2 (fgl2) plays a pivotal role in microthrombosis in viral hepatitis, acute vascular xenograft rejection and cytokine-induced fetal loss syndrome. The current study was designed to examine the expression of fgl2 in microvascular endothelial cells and investigate the effects of microthrombi due to fgl2 on cardiac function and structure in rats with type 2 diabetes. Following induction of type 2 diabetes, 24 rats were observed dynamically. Fgl2 expression and related cardiac microthrombosis were examined. Local or circulating TNF-α was measured. Coronary flow (CF) per min was calculated as an index of cardiac microcirculation. Cardiac function and morphology were evaluated. It was found that Fgl2 was highly expressed in cardiac microvascular endothelial cells of rats with type 2 diabetes, which was promoted by local or circulating TNF-α. The Fgl2 expression was associated with cardiac hyaline microthrombosis. In parallel with the fgl2 expression, CF per min, cardiac diastolic or systolic function and cardiac morphology were aggravated to some extent. It was concluded that in rats with type 2 diabetes, microthrombosis due to fgl2 contributes to the impairment of cardiac diastolic or systolic function and morphological changes.

Autoimmune is involved in the pathogenesis of ventricular remodeling in acute myocardial infarction (AMI). In the present study, we investigated the effect of anti-cardiac myosin heavy chain antibodies (AMHCA) from patients with AMI on rat cardiomyocyte apoptosis. Cardiomyocyte apoptosis was observed and measured by DNA end labeling and Annexin-V/PI double-staining assay. The expression of apoptosis related p53 and Bcl-2 protein and the second messenger calcium were detected respectively by Western blotting, patch clamp and confocal calcium imaging. The results showed that AMHCA was able to induce cardiomyocyte apoptosis in a dose dependent manner. Apoptosis-accelerating nucleoprotein p53 was up-regulated, while apoptosis-inhibiting cytoplasmic protein Bcl-2 was down-regulated. In parallel, cytoplasmic calcium concentration was elevated. There was no effect on L-type calcium currents. It is concluded that AMHCA in patients with AMI as a novel triggering factor can induce cardiomyocyte apoptosis, which contributes to ventricular remodeling.

Objective To evaluate the curative effectiveness and safety of human chorionic gonadotropin(HCG) treatment on children with microphallic hypospadias.Methods A total of 48 consecutive children with microphalic hypospadias were enrolled in the study,and the children were randomized into the experiment group(HCG treatment) and the control group with the research randomizer.The patients in experiment group were treated with HCG prior to surgery,and the control group did not received any hormone therapy preoperatively.All children in the experiment group and the control group underwent hypospadias repair by using transverse preputial island flap (Duckett technique) urethroplasty.Penile length,diameter of glans penis,bone age,serum testosterone level,and secondary effects were recorded before and after therapy in the experiment group.Postoperative complications were assessed with respect to fistulas,urethral strictures,diverticula,meatal stenosis,and glanular dehiscence in both groups.Results (1)Mean penile length and diameter of the experiment group increased significantly by (1.08±0.47) cm (t=-5.196,P<0.05) and (0.31±0.06) cm and there was a significant difference between before and after treatment (t=-5.080,P<0.05).(2)Urethrocutaneous fistulas were observed in 8 patients in the control group compared to 2 patients in the experiment group with a statistically significant difference (χ2=4.547,P<0.05).There was a significant difference between the overall reoperation rates of control group (9 patients) and the experiment group (3 patients,χ2=4.000,P<0.05).The penile tissue of the patients in the experiment group was soft and able to be easily separated and released during the operation and the flap had more blood supply.Conclusions Pretreatment with HCG therapy prior to hypospadias repair is beneficial to children with microphallic hypospadias.Significant penile growth was seen in the children treated with HCG and there was no obvious side effect.Moreover,pretreatment with HCG is beneficial to decrease the complications and reoperation rates of hypospadias repair which proves to be effective and safe.

Objective To explore the effects of nerve growth factor (NGF) and low frequency electricity stimulus on the configurations of skeletal muscle cells and the change of muscle fibre types in the denervated skeletal muscle separately.Methods The denervated rat model was established and model animals were injected with the NGF and given the stimulus (frequency=2 Hz) about 30 days. The configurations and the change of muscle fibre types were observed by immunohistochemistry and image analysis.Results The muscle fibre was in chaos and the boundary was not obvious among cells in the denervated rats; the muscle fibre of the denervated rats with NGF injection and low frequency electricity stimulus was more regular and the boundary of cells was clearer, the cells number was more than those of the denervated rats. Compared to normal rats, the proportion of Ⅰ muscle fibre in the denervated rats increased ( P<0.05), whereas the proportion of Ⅱ muscle fibre decreased ( P<0.05); it had no significant differences of the two types of muscle fibre between the denervated rats with NGF injection, low frequency electricity stimulus and the denervated rats ( P<0.05).Conclusion NGF injection and low frequency electricity stimulus can make the configurations of denervated muscle to better.

OBJECTIVETo explore clinical effect of treatment of fractures of the talar neck with hollow compression screw via inner malleolus tomy approach.

METHODSTwelve patients with fractures of the talar neck included 7 males and 5 females with a mean age of 38 years (reaging from 20 to 56 years). According to the Hawkins classification, 8 cases were type II and 4 cases were type II. Twelve patients were treated with hollow compression screw via inner malleolustomy approach.

RESULTSAll the patients were followed up for 1 year to 6 years and 8 months (average 4 years and 5 months), all the fractures were bony union. The mean Hawkins score was excellent in 5 cases, good in 5 cases, fair in 1 case and poor in 1 case.

CONCLUSIONIt is a good method to treat the fractures of the talar neck with hollow compression screw via inner malleolus tomy approach.

Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Neck Injuries ; surgery ; therapy ; Pressure ; Treatment Outcome ; Young Adult

OBJECTIVETo understand the incidence of post-stroke depression (PSD) and the therapeutic effect of acupuncture-moxibustion.

METHODSFive hundred and sixty cases were rating with Hamilton depression scale, and lesion parts, gender, age and property of stroke between the PSD and non-PSD were compared by analysis of variance, chi2 test, and then the patients of PSD were randomly divided into two groups and treated respectively with Prozac-20 and acup-moxibustion at Sishencong (EX-HN 1), Anmian, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Taichong (LR 3), Zhaohai (KI 6), Shenmai (BL 62).

RESULTSThe total incidence rate of PSD was 43.9%, with no relation to the lesion parts, gender, age and property of stroke (P > 0.05), and there were very significant differences in HAMD scores before and after treatment in the two groups (P < 0.0001), with no significant difference in the effective rate between the two groups (P > 0.05).

CONCLUSIONPSD has a high incidence and influences the recovery of nervous function, and it should be treated at early stage. Acup-moxibustion and Prozac-20 have similar therapeutic effect.

Acupuncture Therapy ; Aged ; Depression ; epidemiology ; therapy ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Moxibustion ; Stroke ; complications

OBJECTIVETo evaluate the survival rate and complications of endodontically treated residual crowns and roots restored directly or by glass fiber post and core or cast metal post and core.

METHODSIn this study, 96 patients with a total of 142 teeth were selected. All the teeth were undergone root canal therapy. And then, according to different situations, some of them were restored with glass fiber post and core, another with cast metal post and core, the rest were restored directly in the strict controlled indications.

RESULTSThe teeth (135) in 89 patients were divided into three groups. The first group contained 73 (54.1%) teeth restored with glass fiber post and composite resin core. The survival rate reached 97.3% in the average observation period of (5.7 +/- 1.9) years. The second group contained 40 teeth, restored with pure titanium casting post and core. The survival rate reached 87.5% in the average observation period of (6.2 +/- 2.2) years. The last group contained 22 teeth received no treatment. The survival rate reached 90.9% in the average observation period of (5.4 +/- 1.8) years. The success rate had no significant difference among the three groups. The most common complications after restored included root fracture (6.7%), retention loss (2.2%), secondary caries (1.5%) and periapical periodontitis (0.7%).

CONCLUSIONUnder the premise of high quality root canal treatment and standard restoration treatment, the abutment teeth, whether are restored by glass fiber post and core, cast metal post and core or without post, have a higher survival rate over 5 years of observation period and complications especially root fracture still should attract the necessary attention.

Composite Resins ; Crowns ; Dental Abutments ; Dental Stress Analysis ; Glass ; Humans ; Metals ; Post and Core Technique ; Root Canal Therapy ; Tooth Root ; Tooth, Nonvital

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.