Cryptogenic stroke refers to ischemic stroke that can not be defined by routine examination at present. Studies have show n that patent foramen ovale may be a common cause of cryptogenic stroke, and its possible mechanism is the paradoxical embolism. With the development of imaging technology , more and more studies have show n that patent foramen ovale is closely associated w ith cryptogenic stroke. This article review s cryptogenic stroke in patients w ith patent foramen ovale.

Objective To investigate the relationship between insulin level and mild cognitive impairment(MCI) of type 2 diabetes and analyze the risk factors for MCI. Methods We collected 101 type 2 diabetes subjects who were divided into two groups:MCI and normal cognition(NC).All subjects were evaluated with cognition scores of MMSE,GDS,CMS,ADL.Insulin,glycosylated hemoglobin,blood routine test,blood pressure,ECG,brain CT were detected.Independent t-test,correlation and multiple regression analysis were performed. Results 1. The diabetic patients with MCI showed the higher levels of insulin at fasting, 2hr and 3hr after meal than did NC(P

Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy in the treatment of ureter stones.Methods A total of 186 cases ureteroscopic pneumatic lithotripsy were performed in our hospital.The outcomes of the surgery were analyzed.Results The success rate of the operation was 80.6%(29/36) for the upper ureteral calculi,92.7%(51/55) for the middle,and 100%(95/95) for the lower ones,respectively.Four weeks after the surgery,re-examination showed that the rate of stone removal was 94.1%(175/186).Injuries to the ureter occurred in 5(2.7%) of the cases.Conclusion Ureteroscopic pneumatic lithotripsy is an effective and safe method for ureteral calculi.

Objective:To explore the feasibility and validity of tubo-tymanoaerodynamic graphy(TTAG)determinating the Eustachian tube function of health adult group.Mthod:The ventilation function of Eustachian tube was measured by the TTAG method in health adlut group(132 ears),the results and the graphs were also analyzed.Reslut:The positive rate in health adult group using Valsalva method was 93.93%(124/132).The positive ears were divided into typeⅠand typeⅡ, the mean value of nasopharynx press of type Ⅰand Ⅱ has no significant differences(P>0.05),but the mean value of external auditory canal press had significant differences(P<0.01).Conclusion:TTAG meathod has the clinical value in determinating the states of Eustachian tube function of health group.

Objective To investigate the effect of Botulinum toxin type A(BTXA)and rehabilitation intervention on upper limb Brunnstrom stages and ADL performance of stroke patients. Methods In a randomized controlled trial, 30 patients were allocated to either an experimental group (n=15) that received BTXA injection into muscles of the affected arm or to a controlled group (n=15). All patients' Brunnstrom stage and MAS stage were ≥gradeⅡ. All the patients were treated with rehabilitative techniques. The intervention was applied for 3 months. All were evaluated for the severity of spasticity (Modified Ashworth Scale,MAS),the level of impairment (Brunnstrom assessment and Fugl-Meyer upper limb test) and disability(Functional Independence Measure,FIM) before and after 1 week, 1,2,3 months of treatment. Results Patients who received BTXA had significant reduction of muscle tone (P

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; pharmacology ; Humans ; Research Design

Twenty nine moderately halophilic bacteria isolated from salt lakes in Xinjiang Region were compared with nine reference strains of relative species by performing a numerical analysis of 112 phenotypic characteristics. All the new isolates are Gram negative and can grow on the media containing 0～25% NaCl. The results showed that all tested strains were clustered into 2 phena at 76 % similarity level. Phenon I was composed by 25 new isolates strains,and phenon II included 9 reference strains and 4 new lsolated strains. Most of the new isolated strains were clusted into 3 subphena at 86 % similarity level. There were 10 new isolated strains in subphenon 1, 8 new isolated strains in subphenon 2, and 1 new isolated strain and 5 reference strains were included in subphenon 3. The results indicated that there were great differences between the new isolates and the reference strains.

The metabolic characteristics of ligustrazin (TMPz) in liver microsomes were investigated in the present study. The reaction phenotyping of TMPz metabolism was also identified by in vitro assessment using recombinant human cytochrome P450 enzymes (CYP) and UDP glucuronosyltransferases (UGT). TMPz was incubated at 37 degrees C with human (HLM) and rat liver microsomes (RLM) in the presence of different co-factors. The metabolic stability and enzyme kinetics of TMPz were studied by determining its remaining concentrations with a LC-MS/MS method. TMPz was only metabolically eliminated in the microsomes with NADPH or NADPH+UDPGA. In the HLM and RLM with NADPH+UDPGA, t1/2, K(m) and V(max) of TMPz were 94.24 +/- 4.53 and 105.07 +/- 9.44 min, 22.74 +/- 1.89 and 33.09 +/- 2.74 micromol x L(-1), 253.50 +/- 10.06 and 190.40 +/- 8.35 nmol x min(-1) x mg(-1) (protein), respectively. TMPz showed a slightly higher metabolic rate in HLM than that in RLM. Its primary oxidative metabolites, 2-hydroxymethyl-3, 5, 6-trimethylpyrazine (HTMP), could undergo glucuronide conjugation. The CYP reaction phenotyping of TMPz metabolism was identified using a panel of recombinant CYP isoforms (rCYP) and specific CYP inhibitors in HLM. CYP1A2, 2C9 and 3A4 were found to be the major CYP isoforms involved in TMPz metabolism. Their individual contributions were assessed b) using the method of the total normalized rate to be 19.32%, 27.79% and 52.90%, respectively. It was observed that these CYP isoforms mediated the formation of HTMP in rCYP incubation. The UGT reaction phenotyping of HTMP glucuronidation was also investigated preliminarily by using a panel of 6 UGT isoforms (rUGT). UGT1A1, 1A4 and 1A6 were the predominant isoforms mediated the HTMP glucuronidation. The results above indicate that the metabolism of TMPz involves multiple enzymes mediated phase I and phase II reactions.

Objective To investigate the clinical effect of posterior pedicle screw fixation combined with anterior decompression and fusion for the treatment of thoracolumbar burst fractures.Methods The clinical data of 53 patients underwent posterior pedicle screw fixation and anterior decompression and fusion were retrospectively analyzed.The vertebral height,Cobb angle,vertebral tube volume,the Frankel gradient and Fugl -Meyer score were recorded and compared before and after treatment.Results 49 patients were followed up.At the last time of follow -up,the vertebral height,Cobb angle,vertebral tube volume all significantly improved (t =24.047,P <0.001;t =21.815,P <0.001;t =31.699,P <0.001).The Frankel gradient before treatment was:A 6 cases,B 18 cases,C 15 cases,D 10 cases,E 4 cases.After treatment,it came to 3 cases,8 cases,11 cases,17 cases,10 cases,respectively.There was significant difference before and after treatment (Z =2.997,P =0.003).There was significant difference in Fugl -Meyer score before and after treatment[(74.65 ±8.42)points,(90.26 ±9.17)points,respectively,P <0.001 ].Conclusion There is excellent effect on posterior pedicle screw fixation followed by anterior decompression and fusion for the treatment of thoracolumbar burst fractures.It is good for the recovery of motion and spinal function.

Objective To compare the effects of labor epidural analgesia initiated in latent phase and active phase on parturients and neonates. Methods One hundred twenty nulliparous women at full term (single, head presentation, ASA Ⅰ or Ⅱ ) were randomly divided into 3 groups (n=40 each):control group(group C) ; PCEA initiated in latent phase group (cervical dilatation 0.5-3.0 cm) (group L) and PCEA initiated in active phase group (cervical dilatation＞3.0 cm) (group A). Epidural catheter was placed through L2,3 interspace. 0.1% ropivacaine with fentanyl 2 μg/ml was used for PCEA. A test dose of 5 ml was followed by a loading dose of 10 ml. PCEA device was programmed to allow a bolus of 6 ml with a 30 min lockout interval. The intensity of pain was measured with VAS (0=no pain, 10=worst pain) before analgesia, at 5, 10, 15 and 30 min after beginning of PCEA and cervical dilatation of 7-8 cm and 10 cm. Degree of motor block was assessed by lower extremity muscle strength (modified Bromage scale,0=no motor block, 3=inability to flex ankle joints).Plasma cortisol in maternal venous blood obtained before analgesia and at delivery of fetus and in umbilical cord blood and plasma ropivacaine concentrations in umbilical core blood were determined.The length of every stage, duration of analgesia,delivery mode, the amount of oxytocin used, maternal satisfaction, Apgar scores of the neonates and adverse effects were recorded. Results PCEA initiated in latent phase or active phase significantly reduced VAS score, the plasma cortisol level at delivery, the duration of 1st stage of labor, and the rate of cesarean section and increased the use of oxytocin in L and A groups as compared with group C, but there was no significant difference in the above variables between L and A groups. The duration of analgesia was shorter in group A than in group L. Conclusions Labor epidural analgesia initiated in latent phase or active phase can decrease the rate of cesarean section but does not prolong the duration of labor and is safe for the newborn.