Objective To investigate the long-term outcome of intra-arterial thrombolysis in patients with acute ischemic stroke and its influencing factors.Methods Patients with acute ischemic stroke received intra-arterial thrombolysis were included in the study.The neurological outcome at day 90 was assessed using the modified Rankin Scale (mRS).They were divided into the good outcome group (mRS scores,0 to 2) and the poor outcome group (mRS scores,3 to 6)according to the evaluation results; the degree of recanalization after thrombolysis was assessed by the grading criteria of the Thrombolysis in Myocardial Infarction (TIMI) trial; the incidence of intracerebral hemorrhage within 7 days after thrombolytic therapy and the mortality at 3months were recorded.Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors of long-term outcome of arterial thrombolysis.Results A total of 42 patients were included,of them,19 (45.2％) with good outcome and 23 (54.8％) with poor outcome after intra-arterial thrombolysis; 27 patients (64.5％ ) with good recanalization (TIMI grade,2 to 3); 13 patients (31.0％) occurred intracranial hemorrhage within 7 days,and 8 of them (19.0％ ) had symptomatic intracranial hemorrhage; 11 (26.2％ ) died within 90 days.Univariate analysis showed that the baseline blood glucose levels (P=0.019),the baseline National Institutes of Health Stroke Scale (NIHSS) scores (P =0.014),symptomatic intracranial hemorrhage (P =0.005),and the degree of recanalization (P =0.002) could influence the longterm outcome of patients with intra-arterial thrombolysis.Multivariate logistic regression analysis indicated that the lower level of basdine glucose and good recanalization were the independent predictive factors of the good long-term outcome after intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusion After the exclusion of contraindications,the intra-arterial thrombolysis was safe and effective for patients with acute ischemic stroke.The lower blood glucose levels on admission and the good recanalization after thrombolysis were associated with the good long-term outcome of intm-arterial thrombolysis.

In the past, panretinal photocoagulation (PRP) and vitrectomy (PPV) were the main treatments for proliferative diabetic retinopathy (PDR). In recent years, anti-vascular endothelial growth factor (VEGF) drugs have been used more and more widely in PDR due to their advantages in rapidly subtracting new blood vessels, reducing leakage, and promoting the absorption of blood. The combination of anti-VEGF drugs and PRP in the treatment of PDR, especially high-risk PDR, can increase the rate of neovascularization and prevent some patients with mild to moderate vitreous hemorrhage from PPV. The application of anti-VEGF drugs during the perioperative period of PPV can also reduce bleeding during the operation, shorten the operation time, and reduce surgical complications. Although clinical studies have confirmed that anti-VEGF drugs can be used as an alternative treatment for PRP, most patients require multiple and long-term treatments, which increase the psychological and economic burden of patients. It is expected that the cost of anti-VEGF drugs and the development of long-acting dosage forms can be reduced and bring better efficacy and benefits to PDR patients in the future.

Objective:To evaluate the effects of smokeless tobacco extract(ST) on number,morphology,ultrastructure and proliferation of human gingival fibroblasts(HGFs) on titanium in vitro.Methods:HGFs on titanium were cultured in the presence of ST at various concentrations.The cell changes in the morphology and ultrastructure were examined by scanning electrical microscope(SEM).The growth and attachment of the cells were measured by MTT method.Results:The size of the cells became smaller gradually and their shapes changed from spindle type to oval or round when the concentrations of ST increased.Ultrastructure showed that pseudopod decreased in number,the growth and attachment were dose-dependently inhibited.Conclusion:ST can change number,morphology and ultrastructure of HGFs on titanium,they can inhibit the cells growth,suggesting ST may play a pathological role on implant-gingiva interface.

The purpose of applying antibiotics prophylaxis in perioperative orthopedic surgery is to prevent or decrease the risk of infection.The opportune administration is the key point for prevention of infection.The application principle,classification and current situation are reviewed in this paper,its perspective and prospects are also investigated.

Objective:To investigate the effects of sodium phenylbutyrate(NaPB) on the matrix metalloproteinase-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) expression and invasive ability of human thyroid follicular carcinoma cell line CGTHW-1.Methods: CGTHW-1 cells were treated with different concentrations of NaPB,then the invasive ability of CGTHW-1 cells was assessed using Transwell assay.The expression of MMP-9 and TIMP-1 was examined by immunocytochemistry staining and RT-PCR in CGTHW-1 cells.Results: After treatment with NaPB(4 mmol/L) for 72 h,CGTHW-1 cells passing the Transwell were significantly reduced[(29.8?1.77) vs(11.00?2.59),P

Objective To investigate the pathophysiology mechanism in belching by using high resolution manometry combined with impedance monitoring.Methods Ten belching patients (four male and six female,ages ranged from 28 to 50 years) received high resolution manometry combined with impedance monitoring.The characters of esophageal motility at rest,swallowing and belching and the possible mechanism of belching were analyzed.Results Nine of 10 patients had esophageal peristaltic dysfunction,displaying as non-peristaltic contraction such as non-conduction contraction,interrupt contraction and dropping contraction.The pressure of the lower esophageal sphincter (LES) of three patients decreased.LES of one patient had incomplete relaxation.Nine of 10 patients were supragastic belching,in which air moved rapidly into esophagus and reversed exited from the mouth in one second.Among nine supragastic belching patients,the pleural pressure of seven patients increased during inspiration,upper esophageal sphincter relaxed and air was mistaken into the esophagus.The pharyngeal muscle contracted in two patients and the air was forced into esophagus.Of all the patients,intragastric and esophageal pressure increased through abdominal muscles and diaphragm contraction and air exited from the mouth.Conclusions The results of this study indicated that there was esophageal peristaltic dysfunction in belching patients.There was no frequently air swallowing in excessive belching patients,the typical belching model was supragastic belching.

Purpose To study the clinicopathological features and immunohistochemical characteristics of IgG4-related disease. Meth-ods The microscopic characteristics and immunohistochemical staining (EnVision) of IgG, IgG4, CD138 and CD34 have been per-formed on 12 cases of IgG4-related disease. Results IgG4-related disease were characterized by diffuse fibrosis, accompanied with in-filtrating of dense lymphocytes and plasma cells surrounding neurovascular and occlusive phlebitis. Immunohistochemical staining re-sults showed the ratio of IgG4+/IgG+ cells were over 40%. Conclusions IgG4-related disease is absent of characteristic clinical and radiographic features and is easily misdiagnosed as tumor. Preoperative serum IgG4 detection could be used as the prior examina-tion for the suspected cases.

Point Zusanli( ST 36) injection plus acupuncture of point Futu(LI 18) was used to treat 48 cases of refractory hiccup due to various kinds of cancers.The cure rate was 100%.

Objective:Entrepreneurial failure refers to the process of entrepreneurial performance continuous decline until the business is bankrupt. The aim of this research is to analyze implicit stigma effect against entrepre-neurial failure in college students. Methods:Sixty-four college students in a natural class participated in this survey, 4 D values of the total tool of entrepreneurial failure implicit stigma and its three dimensions (including cognitive appraisal,emotional reaction,and behavior tendency)were assessed with the traditional implicit association test (IAT). Through independent sample t test,the differences between zero and 4 D values were analyzed. The differ-ences of four D values at gender and entrepreneurial experienceon were explored,the difference between reaction time of the compatibility task and incompatibility task was analyzed,and the reliability of the tool of implicit stigma effect against entrepreneurial failure was evaluated. Results:The 4 D values were all greater than zero. In 3 inde-pendent dimensions and total IATs,the automatic association between entrepreneurial failure and negative words was closer relative to positive words (P<0. 001 ),it showed that their implicit negative attitude against entrepre-neurial failure was significant. Split-halfreliability and internal consistency coefficient of the total tool of entrepre-neurial failure implicit stigma were respectively 0. 87 and 0. 82. Conclusion:In this study,the entrepreneurial failure implicit stigma effect may be significant in college students. These college studeuts have implicit negative cognition and emotion,and discrimination behavior tendency against entrepreneurial failure.

Objective To evaluate the efficacy of dexmedetomidine injected into axillary sheath in alleviating the tourniquet pain during brachial plexus block with ropivacaine.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 18-60 yr,weighing 52-85 kg,scheduled for the replantation of amputated finger,were randomly divided into 2 equal groups (n =30 each):ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).All patients underwent axillary brachial plexus block guided by a nerve stimulator.When the intensity of electric stimulation ≤ 0.4 mA,flexion of fingers or wrist still existed,and the local anesthetic was injected into the axillary sheath.0.5％ ropivacaine 40ml was injected in group R.0.5％ ropivacaine mixed with 100μg dexmedetomidine 40ml was injected in group DR.The pressure of inflation was set at 200-250mmHg,and the stress duration was 120 min.Tourniquet pain and the level that the patients could tolerate was evaluated using visual analog scale (VAS) at 120 min of stress status.The patient' s satisfaction with anesthesia was rated and the development of adverse cadiovascular events and local and systemic adverse reactions were recorded.Excessive sedation was measured with Ramsay score in group DR.Results Compared with group R,the tourniquet pain that the patients could tolerate was significantly increased,the severity of tourniquet pain was reduced and the incidence of adverse cadiovascular events was decreased in group DR (P ＜ 0.01).No serious tourniquet-related complications were observed in both groups.No patients developed excessive sedation in group DR.Conclusion Dexmedetomidine 100μg injected into the axillary sheath can safely and effectively alleviate the tourniquet pain when used during brachial plexus block with ropivacaine.