Transcranial Doppler can detect the presence of microembolic signal in patients at high risk of stroke as well as in invasive cardiovascular examinations and surgical procedure.A growing number of evidence has suggested that cerebral microemboli may cause cognitive impairment.This article reviews the effects of cerebral microemboli on cognitive function.

OBJECTIVE:To observe the effectiveness of using Ti-alloy mesh and morcellized cancellous allograft in treatment of acetabular deficiency in revision total hip arthroplasty. METHODS:A total of 31 patients with acetabular defects underwent impaction morsellized cancellous allografting combined with Ti-alloy mesh for the reconstruction of the defected acetabula at the Second Department of Orthopaedics,First Hospital,Jilin University from January 2003 to July 2008. There were 13 males and 18 females,aged from 56-77 years,averagely 65 years. The time from previous surgery to this revision surgery was 2.5-11.0 years,averagely 8.3 years. The defects were classified into various types according to AAOS:type Ⅱ in 14 hips,type Ⅲ in 17 hips. The average pre-operation Harris score were 37 points. Bone cement was used to fix the prosthesis in 31 patients,and clinical evaluation and X-ray assessment were conducted following surgery. RESULTS:Following-up was done in 31 patients for 3 months to 5 years. 24 hours following surgery,passive functional exercises were conducted in the lower limb of patients. At 3 weeks,20 patients could get out of bed,with incompletely loading. Eleven patients got out of bed at 5 weeks following surgery,and did normal activities at 3 months. Harris score elevated averagely 45 points half years following surgery compared with preoperation,including 20 excellent cases,9 good cases,and 2 average cases,resulting in the excellent and good rate of 94%. At 3 months following surgery,no infection,fracture around the prosthesis,dislocation,nerve vessel and pelvic cavity organ damages or embolism were detected. The wound was delayed union,with discontinuous effusion in 3 patients till 3 weeks following surgery. None of these patients needed to be revised again and 2 cases had radiolucent line in radiograph plain film,which indicated that the bone graft might be absorbed. CONCLUSION:The treatment of acetabular defects by Ti-alloy mesh and impaction allograft in hip revision operation is easy and effective method.

OBJECTIVE To investigate the urogenital tract Ureaplasma urealyticum infection and drug resistance profile from 2001 to 2003.METHODS The results of U.urealyticum culture and drug sensitivity tests were explored from 2001 to 2003.RESULTS From the 1 386 cases in 2001,1 003 were infected with U.urealyticum;of the 1 015 cases in 2002,801 were infected with U.urealyticum;of the 908 cases in 2003, 691 were infected with U.urealyticum.Among the three years,the drug resistance to doxycycline and minomycine kept lower as 4%,the drug resistance to josamycin increased greatly in 2003,the drug resistance and intermediate sensitivity to roxithromycin and azithromycin were high;and the drug resistance to ofloxacin,ciprofloxacin and spectinomycin kept higher.CONCLUSIONS The drug resistance of U.urealyticum evolves with the time.Monitoring drug resistance of U.urealyticum is of great importance.Treatment for U.urealyticum infection should be based on the results of drug sensitivity tests and the pharmacokinetics of the drugs.

Objective To explore the effect of mosapride combined with polyethylene glycol electrolyte powder on cleaning intestinal tract before colonoscopy in patients with chronic constipation.Methods A total of 127 patients with chronic constipation for colonoscopy were randomly divided into observation group of 64 cases,oral administration of mosapride 10 mg and polyethylene glycol electrolyte powder; control group of 63 cases,oral polyethylene glycol electrolyte powder for bowel preparation for colonoscopy.The intestinal cleanness,first defecation time and adverse reaction was compared between two groups.Results The Boston bowel preparation score was (8.32 ± 0.86) scores in observation group,and (7.69 ± 0.95) scores in control group,and there was significant difference between two groups (t =3.918,P＜ 0.05).The first defecation time after taking the medicine was (45.69 ± 13.57) min in observation group and (54.63 ± 11.78) min in control group,and there was significant difference between two groups (t =3.966,P ＜ 0.05).After taking the medicine,5 cases of nausea and vomiting and 11 cases of abdominal distension in observation group,13 patients of nausea and vomiting and 23 cases of abdominal distension in control group,and there was significant difference between two groups (x 2 =4.29,6.04,P ＜0.05).Conclusion Mosapride combined with polyethylene glycol electrolyte powder can improve the intestinal tract cleaning quality,shorten the time of first defecation time,and reduce adverse reaction.

AIM:Toinvestigatetheassociationbetweenmethylationstatusofapoptosis-relatedgenesandche-mosensitivity in the lung adenocarcinoma cell line P 15.METHODS: Methylation-specific PCR was applied to detect the methylation status of p73, p14ARF, p16INK4a and bax genes of P15 cells in untreated control group and decitabine (DAC) treatment group.RT-PCR was used to detect the expression of p 73, bcl-xL, bad, bax, p14ARF and p16INK4a at mRNA level. Colony formation assay and cell growth inhibition assay were used to detect the sensitivity of P 15 cells to cis-diaminedichlo-roplatinum ( C-DDP) before and after DAC treatment .DAPI staining was used to determine the apoptosis of P 15 cells ex-posed to C-DDP before and after DAC treatment .RESULTS:p73, p16INK4a and bax were expressed in the methylation sta-tus.After DAC treatment, p16INK4a expression was decreased , and the expression of p73 and bax disappeared .The expres-sion of p73, p16INK4a and bax in the unmethylated status was weak , but the enhanced expression was observed following DAC treatment.After P15 cells were treated with DAC and C-DDP, the colony formation rate of the P15 cells was signifi-cantly decreased as compared with untreated control group .The apoptotic P15 cells in DAC+C-DDP treatment group were significantly higher than those in untreated control group (P<0.05).CONCLUSION:After treated with DAC, the sensi-tivity of P15 cells to C-DDP is increased due to the activation of silenced pro-apoptotic genes .DAC and C-DDP synergisti-cally promote tumor cell apoptosis .They have significant anti-tumor effect .

Objective To assess the clinical outcomes of posterior decompression and lumbar interbody fusion with internal fixation treatment for degenerative lumbar scoliosis (DLS). Methods Ninety-eight patients underwent surgery for DLS were retrospectively reviewed in this study. The mean age of the patients(male 35 and femail 63) was (56±9) years. The mean Cobb angle of curves was (26±9)° and the mean scoliosis Cobb angle of lumbar was (19±11)° in patients before surgery. A posterior medial incision was made for spinal exposure. According to the preoperative plan, patients were operated with posterior de-compression and lumbar interbody fusion with internal fixation. The clinical outcomes were assessed by the JOA scores.The preoperative and postoperative Cobb angle was recorded. Results The mean follow-up time was (3.7±2.4) years. The mean JOA scores were improved from (10±2) points preoperatively to (26±3) points at the last follow-up. The excellent or good outcome rates were 89.7%for patients with surgery. The average interbody fusion time was (5.7±1.4) months. The mean postoperative Cobb angle was (6±2)° at the last follow-up, and the mean Cobb angle correction was (17±4)°, with the correction rate of 59.2%. The mean lumbar lordosis angle was (12±3)°. There was no failure in internal fixation. Conclusion The posterior decompression and lumbar interbody fusion with internal fixation appears to be a reasonable option for degenerative lumbar scoliosis.

ObjectiveTo observe the efficacy of a Levofloxacin-containing 10-day sequential therapy for Helicobacter pylori eradication.Methods Totally 86 Helicobacter pylori-infected patients with chronic gastritis or peptic ulcer diagnosed by gastroscopy were randomized into two groups: the trial group and the control group (n =43 in each group).The trial group was treated with Esomeprazole 20 mg bid plus Amoxicillin 1000 mg bid at the first 5 days,and followed by Esomeprazole 20 mg bid,Levofloxacin 500 mg qd and Furazolidone 100 mg bid,at the last 5 days;The control group was treated with standard triple regimen: Esomeprazole 20 mg,Amoxicillin 1000 mg and Clarithromycin 500 mg,all bid for 7 days.The eradication rates of Helicobacter pylori in the two groups were compared after completion of treatment.ResultsAfter treatment,the eradication rates of Helicobacter pylori were significantly different between the trial and control group(93.0％ vs 74.4％,P ＜0.05)Conclusion The 10-day sequential therapy with.Levofloxacin-containing regime can achieve a higher eradication rate of Helicobacter pylori infection.

BACKGROUND: Although angiography is the gold standard for the diagnosis of cerebrovascular disease, it cannot be used widely because of its traumatotaxis. Transcranial Doppler ultrasound (TCD) and MRA are both non-invasive examinations, which can be used to evaluate intracranial large artery vascular trunks and hemodynamics.OBJECTIVE: To investigate the reliability of diagnosis with TCD on hemodynamic changes of ischemic cerebrovascular disease (ICVD) and the relativity between TCD and MRA.DESIGN: Case analysis based on patients.SETTING: Neurological Department of the First Affiliated Clinical Hos-pital, Harbin Medical University.PARTICIPANTS: From April 2001 to February 2002,totally 45 patients with stroke,selected from outpatients and inpatients of Neurological Department of First Affiliated Clinical Hospital of Harbin Medical University,examined by CT, to be told the fact and accepted, were taken part in the study.METHODS: Patients were examined with TC-2021 TCD instrument produced by German EME Corporation and VISART1.5T superconduct MR instrument produced by Toshiba. Totally 45 patients had TCD and MRI examinations, and the alternation between two examinations was 1 to 15 days. The hemodynamics and morphological changes were observed including middle cerebral artery (MCA), end of internal carotid artery (ICA),anterior cerebral artery (ACA), posterior cerebral artery (PCA), basal artery (BA), and vertebral artery (VA).large artery vascular trunks and hemodynamic results with TCD and MRA;ty, false positive and false negative with TCD with those of MRA.TCD and MRA: Theory data was Tmin=9.91; χ2=107.92, P ＜ 0.005, it was considered that the results with the rate of TCD were related with that of MRA. The detection rate of TCD was 19.06%, and that of MRA was 15.25%. There were significant differences between the detection rate of standard, the sensibility of diagnosing abnormal vessels by TCD was 78.10%, specificity 94.22%, false positive 7.46%, false negative 23.31%,and the coincidence rate 89.36%.CONCLUSION: TCD can assess exactly the functional status of the vessels. It can also reflect early and sensitively the change of hemodynamics of cerebral blood flow. While MRA can display the change of vascular appearance directly so that the combination of TCD and MRA will be improve sensibility and specificity of diagnosis.

Objective:To study the role of adhesion molecules in the pathogenesis of polymyositis. Methods:The abnormal expression of adhesion molecules on T cells in peripheral blood and muscle fibers from patients with myositis was analyzed by two colour immunofluoresence and RT PCR methods respectively. Results:The expression of adhesion molecules including lymphocyte function associated antigen 1(LFA 1 ),very late antigen 4(VLA 4) on T cells in peripheral blood and intercellular adhesion molecule l(ICAM 1) on muscle fibers from patients with myositis was markedly higher than that in the healthy control group. Conclusion: These findings suggested that adhesion molecules may be responsible for the migration of T cells and destraction of muscle fibers.

Objective To investigate the protective effect of acetylated epigallocatechin gallate (AcEGCG) against H2O2-induced oxidative damage to human epidermal melanocytes,and to explore its possible mechanism.Methods Human epidermal melanocytes were isolated and cultured in vitro.Some melanocytes were classified into a H2O2 group induced by H2O2 only,EGCG groups and AcEGCG groups induced by H2O2 after pretreatment with different concentrations of EGCG and AcEGCG,respectively.Three concentrations (10,20 and 40 μmol/L) of EGCG or AcEGCG were used to treat melanocytes for 1 hour in MTS assay and lactate dehydrogenase (LDH) leakage assay and for 2 hours in Western blot assay,while only one concentration (40 μmol/L) was used to treat melanocytes for 0.5,1,2 and 4 hours respectively in flow cytometry assay.Some melanocytes treated with only culture medium and 0.1％ dimethyl sulphoxide (DMSO) served as the control group.After additional culture,MTS assay was performed to determine cell survival rate,flow cytometry to detect the level of reactive oxygen species (ROS) in melanocytes,Western blot to measure the expressions of caspase-9 and caspase-3 proteins.Lactate dehydrogenase (LDH) kit was used to detect the leakage of LDH to culture medium.Statistical analysis was carried out by using one-way analysis of variance for comparisons of multiple group means followed by Student-Newman-Keuls-q (SNK-q) test for multiple comparisons.Results Compared with the control group,the H2O2 group showed significantly decreased cell survival rate (22.99％ ± 0.53％,P ＜ 0.01),but increased LDH leakage level (36.58％ ± 0.73％,P ＜ 0.01),intracellular ROS level (19.08 ± 0.57,P ＜ 0.01),as well as caspase-9 (2.65 ± 0.079,P ＜ 0.01) and caspase-3 (2.36 ± 0.057,P ＜ 0.01) expressions.In comparison with the H2O2 group,the cell survival rate was significantly higher in the 10-,20-and 40-μmol/L AcEGCG groups (79.50％ ± 3.62％,86.52％ ± 5.13％,97.81％ ± 5.21％,respectively,all P＜ 0.01) and EGCG groups (43.19％ ± 1.68％,63.34％ ± 3.60％,70.82％ ± 2.1％,respectively,all P ＜ 0.01).However,the 10-,20-and 40-μ mol/L AcEGCG groups and EGCG groups all showed a significant decrease in the expression levels of caspase-9 (AcEGCG groups:1.44 ± 0.067,1.26 ± 0.059 and 1.10 ± 0.072 respectively;EGCG groups:2.31 ± 0.085,2.13 ± 0.091 and 1.35 ± 0.064 respectively,all P ＜ 0.05) and caspase-3 (AcEGCG groups:1.70 ± 0.053,1.57 ± 0.057 and 1.24 t 0.068 respectively,all P＜ 0.05;EGCG groups:2.09 ± 0.076,1.98 ± 0.093 and 1.79 ± 0.056 respectively,all P ＜ 0.05) compared with the H2O2 group.Similarly,a significant reduction was observed in the leakage level of LDH in these AcEGCG and EGCG groups (all P ＜ 0.01) and in ROS levels in the 40-μmol/L AcEGCG and EGCG groups when compared with the H2O2 group.Conclusions AcEGCG has a stronger protective effect against H2O2-induced oxidative damage to human epidermal melanocytes compared with EGCG,which may be realized through clearance of free radicals,antioxidant effects,and decrease of caspase-9 and caspase-3 expressions.