ObjectiveTo investigate the associations of the Oxfordshire Community Stroke Project (OCSP) subtypes with severity and outcomes of acute ischemic stroke.MethodsThe inpatients with acute ischemic stroke were enrolled prospectively and divided into total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI), and lacunar infarction (LACI) according to the OCSP classification.Demographic and baseline clinical data of the patients were recorded.The National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity, ≤8 was mild stroke and >8 was moderate to severe stroke.The clinical outcome was assessed at 90 d after onset with the modified Rankin Scale (mRS), and the favorable outcome was defined as mRS score 0-2, and the unfavorable one was defined as mRS score 3-5, death or cardiovascular event.Multivariate logistic regression analysis was used to determine the independent associations of the OCSP subtypes and stroke severity and outcomes.ResultsA total of 765 patients with acute ischemic stroke were enrolled, including 46 (6.0%) with TACI, 281 with PACI (36.7%), 229 (29.9%) with POCI, and 209 (27.3%) with LACI.There were 580 patients (75.8%) with mild stroke, and 185 (24.2%) with moderate to severe stroke;17 were lost to follow-up, 513 (68.6%) had favorable outcomes, and 235 (31.4%) had unfavorable outcomes.There were significant differences between the baseline NIHSS scores and outcomes in each OCSP subtypes (all P<0.05), in which the baseline NIHSS score in TACI was the highest, the outcome was worst, and the proportion of patients with unfavorable outcome was 89.1%;there was significant difference in the baseline NIHSS scores between the PACI and the POCI (P<0.05), however, the proportion of patients with unfavorable outcome was not the case.Multivariate logistic regression analysis showed that TACI was an independent risk factor for moderate to severe stroke (odds ratio 84.881, 95% confidence interval 20.307-354.792;P<0.001) and unfavorable outcome (odds ratio 21.472, 95% confidence interval 8.362-55.136;P<0.001).Conclusion The OCSP subtypes were independently associated with the severity and outcomes of acute ischemic stroke.

ObjectiveTo explore relations between self-control and aggressive behavior in college students.Methods 310 students were surveyed with Buss-Perry aggression questionnaire and self-control questionnaire(SCQ).Results①High score group in SCQ was higher with physical aggression,verbal aggression,anger,hostility and aggression scores ( respectively ( 25.86 ± 5.04 ),( 15.27 ± 2.76 ),( 20.12 ± 4.26 ),( 23.87 ±4.45 ),( 85.11 ± 11.75 ) ) than the low group ( respectively (20.26 ± 5.04 ),( 14.04 ± 3.35 ),( 13.76 ± 4.68 ),( 19.37 ±5.31 ),(67.43 ± 13.56) ),the difference was statistically significant (P＜ 0.01 ).②Self-control scores had significant positive correlations with aggressive behavior scores( r=0.60,P＜ 0.01 ).③Self-control dimension (self-emotional,simplistic tendency,impulsive risk-taking) were significant predictors of aggressive behavior(P ＜0.01 ).ConclusionSelf-control is closely related with aggressive behavior,and it is a significant predictor of aggressive behavior.

Objective To investigate the clinical application of magnetic resonance hydrography(MRH) in diagnosing cystic echinococcosis(CE).Methods 47 cases with CE were proved by surgery and pathology.All cases were examed by MRI and MRH.Results Among the 151 lesions in 47 cases,the sensitivity and specificity in diagnosis of CE were 61.59% and 93.33% for MR imaging,92.05% and 86.67% for MRH,respectively.Conclusion The detecting rate of MRH was significant high than that of MRI,MRH combined with MRI has more advantages in diagnosis of CE.

OBJECTIVETo investigate the clinical applicability and outcomes of the combined radical operation without breaking the lower lip and mandible with one-stage reconstruction using free anterolateral thigh flap for tongue and lingual root carcinoma.

METHODSThe operation with or without breaking lower lip and mandible was performed respectively in 245 patients (experimental group) and 120 patients (control group).

RESULTSRemoval of tumor and neck dissection were conducted successfully in all patients of two groups with no serious postoperative complication. With the follows-up of 6 to 36 months, in the patients of experimental group there was no recurrence for primary sites but 3 cases with neck lymphnode recurrence, the functions of chewing, swallowing and speaking were good, there was no damage to appearance, and no osteoradionecrosis occurred in the lymphnode positive cases after radiotherapy; in the patients of experimental group there was no recurrence for primary sites but 4 cases with neck lymphnode recurrence, the functions of chewing, swallowing and speaking were good, but there was apparent scar in neck and face, and osteoradionecrosis occurred in 11 of lymphnode positive cases.

CONCLUSIONSThe combined radical operation without breaking the lower lip and mandible with one-stage reconstruction using free anterolateral thigh flap is feasible for tongue and lingual root carcinoma (T2-T3), which reduces the risk for osteoradionecrosis in lymphnode positive cases after radiotherapy and keeps good appearance for patients.

Carcinoma ; surgery ; Free Tissue Flaps ; Humans ; Lingual Nerve ; pathology ; surgery ; Lip ; surgery ; Mandible ; surgery ; Neck Dissection ; Osteoradionecrosis ; Postoperative Complications ; Thigh ; Tongue ; surgery ; Tongue Neoplasms ; pathology ; surgery

Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.

Calcinosis ; Fibula ; Free Tissue Flaps ; pathology ; Humans ; Reconstructive Surgical Procedures

Objective To investigate the clinical application of MR hydrography (MRH) in diagnosing alveolar echinococcosis (AE). Methods Thirty-four patients with suspected alveolar echinococcosis were examined using MRH in addition to conventional magnetic resonance imaging(cMRI).Thirty-two of the 34 patinets had surgery and the pathological diagnoses were alveolar echinococcosis.Results Among 128 lesions in these 32 patients found at surgery,cMRI examination found 68 lesions and MRH found 108 lesions.The sensitivity of cMRI examination was (53.13 ±0.04) %,the specificity was (92.59 ± 0.05) %,concordance rate was (60.00 ± 0.03) %.The sensitivity of MRH examination was (84.38 ± 0.03) %,the specificity was (81.48 ± 0.08) %,concordance rate was (83.87 ± 0.03) %.Comparing concordance rate of cMRI examination and MRH,significant difference was found (U = 5.44,P < 0.01).Conclusion MRH technique can raise the sensitivity and concordance rote for diagnosing AE. This technique should be employed in the evaluation of patients suspected of AE.

Objective To evaluate the application of microvascular coupler device (MVCD) in the free-tissue flap transfer for head-and-neck defects reconstruction.Methods Its a retrospective study of the clinical data of 743 patients who received 763 free-tissue flap transfer for head and neck defects reconstruction in Hunan Cancer Hospital from January,2014 to January,2016.For microvascular anastomoses,413 were done manually (the manual group) and 350 done with MVCD (the MVCD group),of which the latter included end-to-end venous anastomosis in 159,endto-side venous anastomosis in 190 and end-to-end arterial anastomosis in 1.The time for anastomosis,rate of blood leakage from the anastomosis and venous thrombosis,and the survival rate of flaps were compared between the manual group and the MVCD group.The impacts of types of anastomosis of end-to-end vs end-to-side (both with MVCD),on the formation of venous thrombosis and survival of flaps were also recorded.The analysis was performed under t-test and chi-square test using SPSS software 19.0 with P ＜ 0.05 for differences with a statistical significance.Results Time for anastomosis was significantly shorter in the MVCD group (4.43±0.51min) than in the manual group (14.75± 2.43min,P＜0.05).The rates of anastomosis leakage were 0 in the MVCD group and 9.7％ in the manual group(P＜0.01),flap necrosis were 0.57％ and 1.69％ (P=0.15),the rate of venous thrombosis were 1.15％ and 3.63％(P=0.02),respectively.There was no significant difference in the time for anastomosis,the rate of venous thrombosis and the survival rate of flaps with end-to-end anastomosis and end-to-side anastomosis with MVCD.Conclusion The application of microvascular coupler device is valuable in the reconstruction of head-and-neck defects with free-tissue flaps because it can significantly shorten the time for anastomosis,decrease the ocurrence of anastomosis leakage and venous thrombosis,reduce the risk of flap failure.

Objective: To investigate the status of hair loss and analyze the influencing factors among university students in Hangzhou City, so as to provide insights into the management of hair loss among university students. Methods: University students were recruited using a convenient sampling method from 4 universities in Hangzhou City in June 2021. The basic characteristics and life styles were collected using online questionnaire surveys. Self-reported hair loss was evaluated using the grading scales for loss of hair (Hamilton-Norwood scale for males and modified Ludwig scale for females), and factors affecting self-reported hair loss were identified among university students using the multivariable logistic regression model. Results: A total of 1 060 questionnaires were allocated, and 1 038 valid questionnaires were recovered, with an effective recovery rate of 97.92%. The respondents included 391 males ( 37.67% ) and 647 females ( 62.33% ), and 463 respondents ( 44.61% ) reported hair loss, including 431 students with mild hair loss ( 93.09% ). Multivariable logistic regression analysis showed that university students in their fourth or fifth years ( OR=1.721, 95%CI: 1.126-2.630 ), art specialty ( OR=0.411, 95%CI: 0.207-0.816 ), overweight or obesity (OR=1.685, 95%CI: 1.050-2.704), diet taste ( sweet: OR=2.131, 95%CI: 1.370-3.316; spicy: OR=1.510, 95%CI: 1.028-2.218; greasy: OR=3.023, 95%CI: 2.015-4.537 ), feeling nervous/anxious (occasionally: OR=1.891, 95%CI: 1.087-3.289; frequently: OR=2.487, 95%CI: 1.337-4.626 ), smoking ( occasionally: OR=1.906, 95%CI: 1.067-3.405; frequently: OR=1.983, 95%CI: 1.050-3.746), family history of hair loss ( OR=1.506, 95%CI: 1.075-2.110 ), perming/dyeing hair ( occasionally: OR=1.795, 95%CI: 1.280-2.517; frequently: OR=3.282, 95%CI: 1.736-6.204), self-perceived oily hair/scalp in the past three months (slightly increased: OR=1.980, 95%CI: 1.477-2.653; significantly increased: OR=5.347, 95%CI: 2.956-9.670) were factors affecting self-reported hair loss among university students. Conclusion The proportion of self-reported hair loss was 44.61% among university students in Hangzhou City, and hair loss was predominantly mild. A family history of hair loss, nervousness/anxiety, diet habits, smoking and frequency of perm/dyeing hair may affect hair loss among university students.

Objective:To summarize the 10 year clinical experience of treating tibiafibular fractures with rectangle shaped intramedullary nails(RIN). Methods:From January 1987 to December 1996, 4 682 cases (3 278 male and 1 404 female) of tibiafibular fractures from 9 hospitals were treated with RIN . Three kinds of reduction methods including open reduction, semi open reduction and closed reduction were used during operation. Results:Results showed 2 173 cases (62.89%) got excellent result, 947 got good (27.40%), 214 got moderate (6.19%), 121 got poor (3.50%). The total healing rate was 90.29%. Conclusion:RIN has excellent biological characteristics which can provide a flexible interfixation when treating tibiafibular fractures, and the operation is simple, it also can be used for severe open fractures. RIN is one of the good techniques in treating tibiafibular fractures.