Objective To analyze the occurrence of traumatic carotid cavemons fistula (TCCF) resulted from the fracture of basilaris cranii, in order to find out the related factors to outcomes and to discuss the approaches to improving prognosis.Method Data of 312 patients with the fracture of skull base complicatcd with TCCF con-firmed angiography from 1999 to 2005 were analyzed. These patients were classified into patients with disable and patients without disabed. The factors potentially impacting on outcomes were analyzed. Results The overall inci-dence of TCCF in 312 patients with fracture of basilaris cranii was 3.8% .The incideucs of TCCF occurred in pa-tients with the fracture of anterior fossa, middle fossa and posterior fossa accounted for 2.4%, 8.3 % and 1.7 %, respectively. Between two cohorts of patients, there were no difference in age, gender, number of embelization proce-dares performed and the time from injury to appearence of the first symptom except the differencc in time from ap-pearence of the first symptom to the intravascular embohzation performed (P>0.05). Conclusions A relatively high incidence of TCCF occurs in patients with middle fossa fractures, especially those with transverse or oblique fractures. Prompt diagnosis and intervention can not be emphasized in case of patients with TCCF, and non inva-sive techniques for the early detection of TCCF under certain circumstance after brain or facial trauma should be considered so as to avoid a miss in the early diagnosis of middle fossa fracture to ensure favourable outcomes.

Objective To discuss the technical points, safety and clinical effectiveness of DSA-guided percutaneous acetabuloplasty (PA) for the treatment of acetabular metastases. Methods Fifteen patients, including 6 males and 9 females, with acetabular malignant metastases were enrolled in this study.A total of 19 lesions were detected. The lesions were 13 - 25 mm in size (mean 19 ± 4 mm), the dose of PMMA used for per lesion was 5 - 13 ml (mean 8.2 ± 2.3 ml). All patients complained of greater or less degree of pain in their hips, 8 patients had to use walking stick, 4 patients showed limping although they could walk independently and three patients could not walk alone. DSA-guided percutaneous acetabuloplasty was performed in all patients and follow-up after the procedure was conducted for 1 - 12 months. Visual analogue score (VAS), walking state score and analgesic dosage taken by the patients were used for the evaluation of the clinical effectiveness. The complications were analyzed. All the data obtained were statistically analyzed with paired samples t test and analysis of variance by using SPSS12.0 statistical software.Results The procedure was technically successful in all patients. Pain rating evaluated by the VAS decreased from a mean of 7.8 before surgery to a mean of 4.2 in 24 hours after surgery (P < 0.01 ), which further decreased to 2.5 in one month (P < 0.01 ), while walking state score increased from a mean of 1.5before surgery to a mean of 2.5 in 24 hours after surgery (P < 0.01 ). The analgesic dosage taken by the patient was reduced in 14 patients and remained the same in one patient. The bone cement leakage into paraacetabular soft tissues occurred in three cases and peripheral vascular exudation of acetabulum was observed in three cases with no obvious clinical symptoms. Conclusion As a safe, reliable and minimally-invasive technique, DSA-guided percutaneous acetabuloplasty has excellent anti-pain effect in treating acetabular metastases. This therapy can markedlyimprove the patient's walking ability and the quality of life.

Objective To investigate the effects of exercising on a cycle ergometer on lower limb motor function and the walking ability of hemiplegic stroke patients.MethodsSixty hemiplegic stroke patients were randomly divided into a treatment group and a control group with 30 in each. Both groups were treated with routine rehabilitation, but the treatment group also undertook cycle ergometer training. The training lasted for 10-20 min/d, 6 d/week for 6 weeks. All patients were assessed with the Fugl-Meyer lower limb assessment ( FMA), functional ambulation category (FAC) classification and the modified Barthel index (MBI) pretreatment and 6 weeks post treatment.ResultsBefore intervention there was no significant difference between the two groups in any of the assessments. Six weeks post treatment, the average FMA, FCA classification and MBI results in the treatment group were significantly better than those pretreatment and better than those in the control group.ConclusionsCycling exercise combined with routine rehabilitation training can distinctly improve the motor function of the lower limbs and the walking ability of hemiplegic stroke patients.

Objective To summary and explore the indications,safety and effectiveness of no touch ostial cardioplegia delivery method during aortic valve replacement(AVR) for severe aortic insufficiency(AI),in order to provide guidance for clinical application.Methods Between September 2012 and February 2015,63 cases were randomly divided into two groups,in study group we used this technique in 31 patients with a mean age of(58.0 ± 15.0) years and a range of 31 to 74 years old.The degree of AI averaged (3.5 ± 0.5) according to a semiquantitative 5-grade scale[1].32 patients were enrolled in control group with a mean age of(60.4 ± 9.4) years and a range of 22 to 73 years old.The degree of AI averaged (3.6 ± 0.5).The abnormal aortic cusps were sutured though the aortic incision,which would be closed temporarily.Blood cardioplegia was infused repeatedly into the coronary osita through the closed aortic incision during the remainder of the procedure except AVR,when the closed aortic incision was reopened.Results In the study group,spontaneous resumption of nodal and normal sinus rhythm shortly after the removal of aortic cross-clamp was achieved in all patients,no hearts had to be electrically defibrillated and electrocardiogram showed no obvious S-T segment elevation.The time from cross-clamp removal to sinus rhythm was(12.3 ± 7.7) minutes in the study group,versus (18.6 ± 8.2) minutes in the control group(P =0.037).No operative mortality occurred in both groups.There was a significant increase in left ventricular ejection fraction[from(0.54 ± 0.09) preoperatively to(0.62 ± 0.06) postoperatively] (P =0.005) in patients of the study group,which was not seen in patients of the control group.Conclusion Preliminary results have shown that the no touch ostial cardioplegia delivery method is a feasible method for cardioplegia infusion during aortic valve replacement in patients with severe AI.

Off-label drug use to some extent meets the clinical medication,achieves the most needed treat-ment of patients and promotes the development of medicine,but there exists certain risks at the same time.Through the analysis of the phenomenon of off-label drug use,from the perspective of medical ethics,this paper proposed that it should adhere to the principles of beneficence and respect,specifically,correcting the motives of off-label drug use,strict review of supporting evidence,ensuring patient's informed consent,strengthening ethical review andintroducing the insurance sharing mechanism,so as to achieve both the guarantee of patient's medication safety and the aversion of medical personnel's practice risks.

Objective To observe the effect of Compoud Qingqin Liquids on renal function of rat model of uric acid nephropathy, and to discuss its protection of renal function. Methods The rat model was induced by gavaging adenine and feeding yeast. SD rats were randomly divided into control group, model group, positive group, and high-, medium-, low-dose groups of Chinese medicine. Blank control group and model group were daily gavaged with distilled water, positive control group was daily gavaged with allopurinol by 9.33 mg/kg, and high-, medium-, low-dose group of Chinese medicine was daily gavaged with Compound Qinggin Liguids by 3.77, 1.89, 0.09 g/(kg·d) respectively for 6 weeks. General condition of rats were observed, renal pathological changes were observed with light and electron microscope. Urine protein concentration, blood uric acid, blood urea nitrogen, creatinine and kidney weight index were respectively tested before and after treatment. Results There were no significant differences in eating, drinking and body weight between before and after modeling. Compoud Qingqin Liquids can obviously decrease the concentration of urine protein, blood uric acid, serum creatinine, blood urea nitrogen, and kidney weight index (P<0.05) of rats with uric acid nephropathy. Renal tubular epithelial cells atrophy and renal interstitial fibrosis of high-dose group of Chinese medicine were not evident. Conclusion Compoud Qingqin Liquids can protect the rats renal function against uric acid renal injury.

OBJECTIVETo explore the relationship between the major allergens of 6 common allergic foods and IgA nephropathy.

METHODSA sensitive sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of food-specific IgA1, IgG and IgE in 31 patients with IgA nephropathy and 80 healthy volunteers. All the patients were examined for a history of food allergy using a questionnaire.

RESULTSSerum levels of IgA1 and IgG against the major allergens of the 6 common allergic foods were significantly higher in patients with IgA nephropathy than in healthy volunteers (P<0.05). There was no detectable food-specific IgE antibodies in the two groups. No patients had a clear history of food allergy. All the patients with increased IgG levels specific to 4 or more foods simultaneously had proteinuria.

CONCLUSIONSSome foods especially the highly allergic ones may participate in the pathogenesis and progression of IgA nephropathy.

Adult ; Antibody Specificity ; Case-Control Studies ; Female ; Food Hypersensitivity ; classification ; immunology ; Glomerulonephritis, IGA ; blood ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Male ; Young Adult

In order to afford new antiplatelet agents with higher potency, a series of paeonol oxime derivatives (4a-4y) were designed and synthesized from paeonol.Their structures were confirmed by HRMS, 1H NMR spectra.The anti-platelet aggregation activity of the target compounds was evaluated.The results revealed that most of them had moderate to good anti-platelet aggregation activity.Among them, compound 4h and 4j were the most potent on adenosine diphosphate (ADP)-induced platelet aggregation and collagen-induced platelet aggregation. Furthermore, the target compound 4h not only showed strong antiplatelet aggregation activity, but also exhibited good water-solubility and drug-like properties, which can be used as a new antiplatelet active compound for further research.