BACKGROUND: The posterior circulation artery is characterized by small caliber, long traveling, many curves and branches, so a stronger resistance will be encountered when a stent is delivered.OBJECTIVE: To investigate the effects of coaxial double catheter technique on intracranial posterior circulation stenting.DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College between December 2004 and February 2008.PARTICIPANTS: A total of 21 patients, 11 males and 10 females, aged 50-76 years old, were se/ected from the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College.METHODS: All patients were confirmed as posterior circulation intracranial stenosis (stenosis > 70%) by digital subtraction angiography (DSA), magnetic resonance angiography (MRA), or CT angiography (CTA). They underwent cerebrovascular stent implantation, during which, single catheter technique was first applied, if failed, a coaxial double catheter technique was followed. A conventional group (single catheter technique successfully applied) and a double catheter group (coaxial double catheter technique successfully employed) were set. A written informed consent was obtained from each patient.MAIN OUTCOME MEASURES: Therapeutic results and biocompatibility of implanted stents.RESULTS: The single catheter technique was applied in 21 patients and 6 of them (28.57%) had successful stent deployment, The remaining 15 patients were managed by a coaxial double catheter technique, and the stent was successfully released in these patients. There was only 1 patient presenting with subarachnoid hemorrhage, and the success rate of stent deployment was 93.33%. Chi-square tests results showed that the coaxial double catheter technique produced significantly higher success rate of stent implantation than the single catheter technique (P < 0.05). Except this, no other adverse reactions were found. All stents covered the stenosis lesions completely, and fitted well with the blood vessel wall without rejection, showing the good biocompatibility of selected stents with the host.CONCLUSION: The coaxial double catheter technique can increase the longitudinal supporting strength and enhance the success rate of the intracranial posterior circulation stenting. Meanwhile, the risks of this procedure are low. Therefore, the technique deserves to be popularized.

Adult ; Drug Resistance, Viral ; genetics ; Female ; Genotype ; Guanine ; analogs & derivatives ; pharmacology ; therapeutic use ; Hepatitis B virus ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans

Objective To investigate the myocardial protective effects ,mechanism and safety of recombinant human erythropoie-tin(rHuEPO) pretreatment in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) .Methods Thirty pa-tients with rheumatic heart disease undergoing valve replacement surgery were randomly divided into the observation group and the control group ,15 cases in each group .The observation group was given rHuEPO 300IU/kg by hypodermic injection on preoperative 2 d ,once daily for twice .The control group was given the same dose of normal saline .The blood routine was performed before sur-geryandonpostoperative7d.Thelevelsofcreatinekinaseisoenzyme(CK-MB)andtroponinT(cTnT)weredetectedbeforeopera-tion ,at 6 ,24 ,72 h after the aorta opening (T0 ,T6 ,T24 ,T72 ) .At the end of CPB ,myocardial biopsy was conducted for detecting the myocardial apoptosis index (AI) .The CPB time ,aortic cross clamp(ACC) time ,postoperative ICU stay ,blood transfusion and post-operative complications were recorded .Results The level of postoperative CK-MB and cTnT in the two groups were significantly increased after the aorta opening ,which at T6 was highest ,followed by a downward trend .The levels of CK-MB and cTnT at vari-ous time points in the observation group were significantly lower than those in the control group .The main effect of rHuEPO pre-treatment had statistical difference between the two groups (P= 0 .01) .Myocardial AI in the observation group was significantly lower than that in the control group ,the difference showing statistical significance (P<0 .01) .The observation group had no risk leading to obviously increase postoperative Hb ,Hct values and thromboembolism ,but the postoperative blood transfusion amount was reduced .Conclusion rHuEPO pretreatment has the protective effect on myocardium in the patients undergoing cardiac surgery under CPB ,which can reduce myocardial apoptosis and has safe reliability .

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Objective To explore the effect of home-based rehabilitation on cerebral palsy.Methods 60 children with cerebral palsy were assigned to hospital-based rehabilitation group and hospital-home-based rehabilitation group and treated for 1 year.Every child was evaluated before and after the treatment with Bayley Scales of Infant Development(BSID).The Mental Development Index(MDI) and Physical Development Index(PDI) were compared between these two groups.Results After one year,the MDI and PDI improved in both groups(P<0.05),while those of the hospital-home-based rehabilitation group was better than of the hospital-based rehabilitation group(P<0.05).Conclusion Home-based rehabilitation plays an important role in the rehabilitation of cerebral palsy children.

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Aged ; Anesthesia, General ; Dentures ; Esophagoscopes ; Esophagus ; surgery ; Foreign Bodies ; Humans ; Male

Objective To investigate the weight,length and scale of normal children′ stools and discuss clinical signification.Met-(hods) The fresh stools of 60 normal children (male 34,female 26)were measured,classify the stools according to Bristol′s scale.Results 1.The average weight of stools in 60 cases was (109.53?52.00) g,of male was (123.79?55.87) g,of female was (90.12?(39.66)) g,there was significant difference between them (t=0.013 P0.05);3.The stools was classified into 7 group according to Bristol′s scale.From 1 grade to 6 grade were 3.30%,(5.10%),5.10%,64.40%,15.30% and 6.80%,respectively,but there was no 7 grade stools.Conclusion The weight,length and scales of normal children′s stools can be used as a sign to evaluate the clonic movement of children,especially in diagnosis and treatment of constipation and stools dryness

Objective To investigate the protein and gene expression of bcl-2, bcl-6 in diffuse large B-cell lymphoma (DLBCL). Methods 73 cases of DLBCL were selected for study using the Envision immunohistochemistry method with a panel of antibodies CD3, CD10, CD20, bcl-6, bcl-2, MUM-1. The bcl-2gene expression in 57 of 73 cases with chromosome translocation t (14; 18), breakage and amplification of 3q27 chromosome in 54 of 73 cases were detected by fluorescence in situ hybridization (FISH) method. Results The percentages of tumor cells expressing CD10, bcl-6, MUM-1, bcl-2 were separately 15.1%, 38.4 %, 71.2 %, 79.2 %. t (14;18) chromosomes were detected in 16 of 57 cases (28.1%). The expression of bcl-2 protein have significantly correlated with immunophenotype subtype (P=0.035), and t (14;18) was significantly correlated with the prognosis (P=0.045). There were no association between the expression of bcl-2 protein and t (14;18)(P=0.710). 11 of 54 cases were presented with 3q27 chromosomal breakage (20.4 %), and 14 cases were chromosomal amplification (25.9 %). The prognosis of cases with positive bcl-6 protein was better than that with negative protein obviously. There was no relationship between bcl-6 and 3q27 chromosomal breakage or amplification (P=1.000). Conclusion The expression of bcl-2, bcl-6 protein and gene were different events and had the different significance on DLBCL. The expression of bcl-2 protein was a prognostic marker correlated with immunophenotype subtype, and GCB type with the positive expression of bcl-2 protein had the poor prognosis. Conversely, t(14;18) was an independent event for the prognosis, and the positive expression have the poor prognosis. Patients who require the target therapy should be detected for the t(14;18). The expression of bcl-6 protein was beneficial to the judgment of DLBCL prognosis, it could be an independent factor of the prognosis. 3q27 chromosomal breakage may be a hint to the poor prognosis.

Adolescent ; Angiography ; Child, Preschool ; Female ; Hemoptysis ; diagnostic imaging ; drug therapy ; Humans ; Male