Objective To evaluate the relationship between the degree of corticospinal tract (CST) injury and motor function prognosis in patients with cerebral infarction using magnetic resonance diffusion tensor imaging (DTI)and diffusion tensor teactography (DTT)imaging. Methods Sixty-eight patients with cerebral infarction were selected prospectively. They underwent conventional MRI,DWI,and DTI examinations,and the DTT technique was used to perform CST 3D reconstruction. The white matter fractional anisotropy (FA)of the infarct zones and contralateral corresponding regions was measured within 7 days and at 3 months after onset. The Fugl-Meyer scale was used to perform motor function defect score. The CST involvement degrees were divided into four grades. The patients were divided into Group 1 (96-99,roughly return to normal;n=16),Group 2 (51-95,partial recovery;n=34),and Group 3 (<50,poor recovery;n=18)according to the Fugl-Meyer scale scores after treatment. The analysis of variance,Pearson,and Spearman correlation analysis were used to analyze the relationship between FA values,CST involvement degrees and motor function recovery. Results There were significant differences in the amplitude of variation of FA within 7 d (0. 05 ± 0. 06,0. 08 ± 0. 07,and 0. 18 ± 0. 02)and at 3 months after onset (0. 11 ± 0. 02,0. 21 ± 0. 06,and 0. 39 ± 0. 03)(within 7 d F=32. 821,at 3 months F=192. 372,all P<0. 05). DTT showed that the lesion sides of CST were presented as compression,deformation,displacement,and interruption. The CST grades were negatively correlated with the neurological functional rehabilitation of the patients within 7 d after onset (r= -0. 682,P <0. 01). The CST grades were negatively correlated with the neurological functional rehabilitation of the patients at 3 months (r= -0. 728,P<0. 01). Conclusion The decreased FA values in infarct areas and the degrees of CST involvement were associated with the motor function prognosis. MR DTT can directly display the degrees of CST involvement of cerebral infarction. It can provide an important basis for early identifying the prognosis of cerebral infarction.

Objective To design a data management solution based on geographic information system for health service units to deal with health resources of subordinate medical institutions.Methods The whole solution was developed with layer logic function of data service, application and presentation. Storage, transformation and relationship of both spatial data and health service data were totally managed by relational database.Results The system was able to import, export, maintain, sum, query and analyze geography spatial information and health service information.Conclusion A new method is provided to improve capability of health support and health service management efficiency.

Objective To evaluate the predictive value of ABCD3-I score for early stroke risk after transient ischemic attack (TIA). Methods A total of 136 consecutive patients with TIA admitted to the Department of Neurology,the First Hospital of Shangqiu from January 2010 to December 2012 were enrolled. The clinical data,medical history and image findings of the patients were collected. The incidence of stroke was observed within 90 days. The occurrence of stroke risk after TIA were scored with the ABCD2 and ABCD3-I. Logistic regression analysis was used to analyze the impact of risk factors for early stroke after TIA. The area under the curve (AUC)of receiver operating characteristic was used to compare the predictive values of the two kinds of scores. Results Of the 136 eligible patients with TIA,19 cases (14. 0%)had cerebral infarction within 90 days after TIA. There were no death and hemorrhagic stroke. The results of multivariate regression analysis showed that the duration of TIA≥60 min (OR,1. 060,95%CI 1. 012-1. 112)was an independent risk factor for early progressing stroke after TIA (P<0. 05). In the ABCD2 scoring model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 5. 6%(4/72),18. 5%(10/54),and 50. 0%(5/10),respectively. In the ABCD3-I score model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 0,7. 1%(6/84),and 52. 0%(13/25),respectively. In the low-,moderate-,high-risk groups,there were significant differences in the incidences of stroke in 90 days between the ABCD3-I and ABCD2 scoring models (P<0.01). The AUC of ABCD3-I score (0. 839,95%CI 0. 766-0. 896)was higher than that of ABCD2 score (0.783,95%CI 0. 704-0. 849;P<0. 01). Conclusion The ABCD3-I score may effectively predict the risk of early stroke after TIA,and its accuracy is better than ABCD2 score.

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

According to the physiological characteristics of lumbar vertebrae in Chinese, we designed and made a lumbar vertebral fusion cage of titanium and then engaged in its biomechanical test. T12-S1 of lumbar vertebrae from 18 fresh dead bodies were used. We measured the stress relaxation and the creep effects of the normal group (T12-S1 of intact lumbar vertebrae), the control group 1(simulating operation of excising intervertebral disc and planting bone on the back route) and the control group 2(simulating operation of excising intervertebral disc and inserting fusion cage). The data and stress, strain-time curves under the condition of constant stress and strain were obtained. Regression analysis yielded the reduced stress relaxation and creep functions. Finally, we analyzed and discussed the effects of the operation of excising intervertebral disc and planting bone on the back route and the operation of excising intervertebral disc and inserting fusion cage on the stability of spine.
Elasticity ; Humans ; Intervertebral Disc ; physiology ; surgery ; Lumbar Vertebrae ; physiology ; Spinal Fusion ; Spine ; Titanium

Objective To evaluate the effect of irbesartan treatment on progression of nephropathy in patients with concurrent diabet-ic nephropathy (DN) and high blood pressure (HBP).Methods This study enrolled 180 patients with DN and HBP in a single-center,randomized,parallel group clinical trial.All patients were randomized in a 1 ∶ 1 ratio to irbesartan and amlodipine groups,using a software-generated block randomization method.Results After 12 months of treatment,the estimated glomerular filtration rate (eGFR) in the irbesartan group was markedly lower than in the amlodipine group (P =0.026).When grouped according to the Chronic Kidney Disease (CKD) Epidemiology Collaboration equation,results showed that in stage 1-2 CKD and stage 3 CKD patients,reductions in eGFR in the irbesartan group were notably less than in the amlodipine group (P =0.009 and P =0.028,respectively).At 12 months,the decrease in urinary protein excretion (g/24 h) in the irbesartan group was obviously greater than in the amlodipine group (P ＜ 0.001);however,no difference in reduction of systolic and diastolic BP was found between groups (P =0.534 and P =0.386,respectively).Conclusion Irbesartan can ameliorate the progression of nephropathy in patients with concurrent DN and HBP to some extent.

Objective To assess the correlation of serum uric acid (SUA) and microalbuminuria (MAU) with chronic vascular disease in type 2 diabetes mellitus (T2DM). Methods The study enrolled 892 T2DM patients. The association of different SUA and MAU levels with the incidence of chronic vascular disease was evaluated. Chronic vascular disease included coronary artery disease (CAD),cerebrovascular disease (CVD),diabetic nephropathy (DN),diabetic retinopathy (DR),and diabetic peripheral neuropathy (DPN). Results With increasing levels of SUA and MAU,the incidence of chronic vascular disease increased. In addition,the level of SUA was positively correlated with the incidence of CAD,CVD,DN,DR,DPN,and total chronic vascular disease,while the MAU level was positively associated with the incidence of CAD,CVD,DR,DPN,and total chronic vascular disease. Multivariate logistic regression analysis revealed that SUA level was an independent predictive risk factor for patients with concurrent CAD,CVD,DN,DR,DPN,and total chronic vascular disease,and MAU level independently predicted the risk of CAD and CVD. Conclusion The levels of SUA and MAU may be reliable biomarkers for prediction of the risk of chronic vascular disease in T2DM patients.

Objective To explore the relationship between traditional Chinese medicine (TCM) syndromes of state of evil domination and clinical and laboratory indicators of IgA nephropathy. Methods A prospective study was used to collect data on clinical and laboratory examination of IgA nephropathy in multi clinical centers. Patients’ TCM syndrome types were determined according to the national diagnostic criteria at the same time. Totally 266 patients with IgA nephropathy were included in the study to establish a database for analyzing the relationship between TCM syndrome of state of evil domination and clinical and laboratory indicators. Results In the relationship between syndromes of state of evil domination distribution and clinical subtypes, patients of wind-heat syndrome had more macroscopic hematuria;patients of phlegm-damp syndrome had more nephrotic syndrome;patients of damp-heat syndrome had more chronic nephritis type Ⅰ;patients of blood stasis syndrome had more chronic nephritis type Ⅱ. In the relationship between syndrome of state of evil domination distribution and clinical manifestation, the incidence of hypertension was higher in patients of blood stasis syndrome than in other three types. It was more serious for hematuresis in the patients of wind-heat syndrome. For patients of phlegm-damp syndrome, the incidence of heave proteinuria was highest. In the relationship between syndrome of state of evil domination distribution and laboratory examination, 24-hour urinary protein quantification was higher than in patients of wind-heat and damp-heat syndrome, but the level of blood albumin was lowest. For patients of blood stasis syndrome, serum creatinine level was significantly higher than in other three types;the level of eGFR was just the opposite. The levels of blood cholesterol and triglyceride in patients of phlegm-damp syndrome were higher than in other three types. The activated partial thromboplastin time (APTT) levels in patients of blood stasis and phlegm-damp syndrome were lower than in other patients, but the FIB level was the exact opposite of APTT. In the relationship between syndrome of state of evil domination distribution and the stages of chronic kidney disease (CKD), patients of wind-heat syndrome were more in the first stage of CKD;patients of blood stasis syndrome were more in the third stage of CKD. Conclusion There is relative correlation between TCM syndromes of state of evil domination and clinical and laboratory indicators in IgA nephropathy, which would provide some reference to narrow the gap in the information of the four methods of TCM with clinical and laboratory indicators to enhance accurate diagnosis of TCM syndrome.

Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.

Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.