Objective To investigate the correlation between cerebral microbleed (CMB) and hemorrhage transformation (HT) after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Methods The patients with acute cerebral infarction treated with intra-arterial urokinase were enrolled.They were divided into either an HT group or a non-HT goup according to whether they had HT or not.Conventional MRI sequences,susceptibility-weighted imaging (SWI),and CT scan were performed before procedure.CT or MRI was reexamined within 48 hours after procedure.The patients' demographic data,vascular risk factors,and the SWI sequences showed the numbers of CMB were documented in detail and they were compared and analyzed.Results A total of 62 patients were included,22 in HT group and 40 in non-HT group.Univariate analysis showed that the proportions of hypertension (81.8％ vs.57.5％ ; x2 =3.125,P =0.048),diabetes (63.6％ vs.40.0％ ; x2 =4.019,P =0.042),smoking (72.7％ vs.37.5％ ; x2 =4.971,P =0.030),and presence of CMB (x2 =5.297,P =0.018) of patients in the HT group were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that hypertension (odds ratio [OR]1.51,95％ confidence interval [CI]1.102-2.954; P =0.028),diabetes (OR 1.48,95％ CI 1.09-2.825; P =0.039),and CMB (OR 1.867,95％ CI 1.103-3.158; P =0.020) were the independent risk factors for HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusions CMB was one of the independent risk factors for occurring HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.

Two p-phenylenediamine (p-PD)-imprinted polymers, P (MAA) and P (AA), were synthesized using methacrylic acid (MAA) and acrylamide(AA) as functional monomer, respectively, in order to prepare molecular recognition material with high selectivity for p-PD and explore the feasibility of methods such as molecular spectrometry and computational approach of quantum chemistry for the selection of functional mono mer with high imprinting efficiency.The molecular recognition properties of the imprinted polymers were evaluated by high performance liquid chromatography.The results indicated that P(AA) exhibited no imprint ing effect for p-PD, while P(MAA) can bind p-PD selectively(k' =3.57), which showed remarkable imprint ing effect (IF=2.95), and p-PD and its analogues o-phenylenediamine and p-aminobenzoic acid can almost realize baseline separation on P (MAA) column in the mobile phase of methanol.Furthermore, we made a comparative study on the interaction of p-PD with MAA and AA by spectroscopic techniques such as UV and fluorometry as well as HF/6-31G~* computational approach.The results demonstrated that the complex of p-PD-MAA was more stable than that of p-PD-AA, which can give a good explanation for the molecular recog nition properties of P (MAA) and P (AA).The study indicated that both molecular spectrometry (UV and fluorometry)and computational approach of quantum chemistry can be employed as efficient means for the selection of efficient functional monomer.The results showed that fluorometry is sensitive and convenient for the choice of functional monomer if the template molecule is fluorescent.

Objective To observe the therapeutic effect between less invasive stabilization system (LISS) plate and anatomical plate internal fixation for the treatment of tibial plateau fractures. Methods The clinical data of 58 patients with tibial plateau fractures were retrospectively analyzed. The patients were divided into LISS plate group and anatomical plate group according to the internal fixation method with 29 cases each. The operative time, blood loss, incision length, fracture healing time, postoperative weight-bearing time, postoperative complications and therapeutic effect (according to Rasmussen knee joint function score scale) were compared between 2 groups. Results The operative time, incision length, blood loss and incidence of postoperative complications in LISS plate group were significantly lower than those in anatomical plate group:(68.5 ± 7.1) min vs. (92.3 ± 9.4) min, (5.8 ± 1.4) cm vs. (8.6 ± 2.1) cm, (208.5 ± 27.8) ml vs. (329.7 ± 25.2) ml and 17.2%(5/29) vs. 41.4%(12/29), and the excellent rate was significantly higher than that in anatomical plate group: 86.2% 25/29) vs. 62.1%(18/29), and there were statistical differences (P<0.05);there were no statistical differences in fracture healing time and postoperative weight-bearing time between 2 groups (P>0.05). Conclusions Both of LISS plate and anatomical plate internal fixation for the treatment of tibial plateau fractures have good clinical efficacy, but the LISS plate has advantages of shorter operation time, less tissue trauma, less blood loss, quicker fracture healing and less postoperative adverse reaction.

Objective To evaluate the safety and effectiveness of treating the endovascular stents placement for spontaneous isolated dissection of splanchnic artery ( SIDSA).Methods Sixteen consecutive patients with diagnosis of SIDSA through CTA and DSA were retrospectively analyzed .All patients had acute persistent abdominal pain and treated by endovascular stents placement.The serious complications and symptoms improvement were reviewed after the operation.The symptoms recurrence and repeated color doppler ultrasonography and CTA were also reviewed in the follow up.Results Twelve superior mesenteric artery ( SMA) dissection and four celiac artery ( CA) dissection were diagnosed among sixteen patients.The dissection length was 1.07 to 11.87 cm and the median length was 3.93 cm.The distance from the original dissection to the orifice of superior mesenteric artery or celiac artery was 0.50 to 6.44 cm and the median was 1.98 cm.Eight stent-grafts and 3 bare stents were successfully implanted in 11 patients.One case with celiac dissection was failed to treat because of the severe compression of true lumen and the guide wire cann′t cannulate to the distal true lumen.Four patients with superior mesenteric artery dissection gave up interventional therapy , Among these 4 patients , 2 patients had small tear site and small false lumen , 1 patient had extremely long dissection , and one case had blood supply of target organs from both true and false lumen.No severe complications such as hemorrhage , intestinal necrosis , hepatic failure and splenic necrosis occurred during the eleven successful endovascular interventions.The abdominal pain in 10 cases was disappeared or significantly relieved , 1 case with superior mesenteric vein thrombosis and severe intestinal ischemia before intervention underwent intestinal resection for necrosis.The follow up period was 1 to 74 months in eleven successful cases , and the median follow-up period was 16 months.One patient with SMA dissection after endovascular treatment was died of sudden stroke three months later .Others had satisfactory outcome and the repeated color doppler ultrasonography and CTA were normal .Conclusions Endovascular stents placement is a safe and effective therapy for symptomatic spontaneous isolated dissection of splanchnic artery.

Objective To summarize the experience in the diagnosis and treatment of symptomatic splanchnic artery dissection. Methods A total of 21 patients with symptomatic splanchnic artery dissection, who were admitted to the Affiliated First Hospital of China Medical University during the period from June 2006 to March 2014, were included in this study. Combined with the literature, the clinical data, including the diagnosis and treatment, were analyzed. Results Contrast-enhanced abdominal CT and CT angiography revealed superior mesenteric artery dissection in 15 cases, celiac artery dissection in 5 cases and splenic artery dissection in one case. Conservative therapy was employed in 5 patients; among them one was complicated with hepatic artery thrombosis. Of the 16 patients who received endovascular stent placement, additional intestinal resection was performed in 2 and transcatheter thrombolysis treatment in other 2. No procedure-related severe complications occurred in perioperative period. All the patients were followed up for 2-74 months (mean of 19.1 months). In patients who received endovascular stent placement, the abdominal pain and the bloody stool were relieved or disappeared, and no abdominal pain recurred. CT angiography showed that in-stent blood flow was fluent, the stent was in good position, and neither stenosis nor thrombosis was observed. One patient with superior mesenteric artery dissection died of stroke three months after the treatment. Conclusion It is very important to make early diagnosis and to adopt early treatment for symptomatic splanchnic artery dissection. CT angiography can confirm the diagnosis in most cases, but attention should be paid to some atypical manifestations. For the treatment of splanchnic artery dissection, endovascular stent placement is mini-invasive, safe and reliable.

Objective To evaluate effect of Xugu-Huoxue decoction on the treatment of patients with femoral neck fracture after internal fixation with hollow screw fixation. Methods A total of 120 patients with femoral neck fracture were randomly divided into the treatment group and the control group according to the inclusion criteria, 60 patients in each group. The control group was treated with cannulated screw internal fixation; the observation group was treated with Xugu-Huoxue decoction at the second day after the operation. Both groups were assessed with the Harris hip function score at the end of 12 months after operation. The SF-36 scale was used to evaluate the quality of life of the patients. Results The total effect rate of the observation group was 88.3% (53/60) and the control group was 71.7% (43/60). The difference between the 2 groups was statistically significant (χ2=5.208, P=0.022). At 12 months after surgery, the pain (41.4 ± 7.3 vs. 32.2 ± 5.7, t=7.738), the joint function (45.7 ± 6.2 vs. 36.3 ± 7.2, t=7.701), joint mobility (5.0 ± 0.8 vs. 3.1 ± 0.8, t=13.115), and the total score of Harris (87.7 ± 4.6 vs. 65.4 ± 5.4, t=24.461) in the observation group were significantly higher than those in the control group (P<0.001). The physical function (83.1 ± 7.2 vs. 78.8 ±14.2, t=2.095), body pain (82.1 ± 9.9 vs. 67.7 ± 11.1, t=7.524), the overall health (76.6 ± 10.3 vs. 68.8 ± 14.4, t=3.401) and activity (81.1 ± 7.9 vs. 76.6 ± 11.2, t=2.549) in the observation group were higher than those in the control group (P<0.05 or P<0.01). Conclusions The Xugu-Huoxue decoction could improve the prognosis of patients with femoral neck fractures after cannulated screw fixation, promote the recovery of hip function and improve the quality of life.

Objective To evluate the efficacy of ureteroscope and holmium laser in the treatment of ureteral stones. Methods 48 cases of ureteral stones were ureteroscopicaly treated by the use of the above mentioned lithotripter from February 2001 to August 2001. Results 98%(47/48)of the stones being expelled within 5 days after the double J tube were pulled out.No complicaticons occurred. Conclusions Treatment of the ureteral stones by the use of ureteroscope and holmium laser is safe and effective.

Objective To investigate the imaging features of alar ligament and its extent, and provide the basis forclinical treatment.Methods 3.0 T superconducting MRI was used to scan the alar ligament with high resolution PDWI sequence (Proton density weighted imaging, PDWI)in 109 patients of emergency admissions due to head and neck trauma. Based on imaging features, ligamentous injury was classified into three degrees(Ⅰ to Ⅲ degrees).Patients with Ⅰ degree ligamentous injury were treated conservatively, andⅡtoⅢdegree injury patients were treated with surgery, then follow-up was performed with MRI for the recovery of ligaments and clinical evaluation for symptoms (6 months follow-up period). Results High-resolution PDWI showed 78 patients with no ligament injury.On follow-up, patients recovered well (atlantoaxial joint motor function and clinical symptoms). Thirty one patients had alar ligament injury in varying degrees, of which 18 patients had grade Ⅰ injury, nine patients had degree Ⅱinjury, and four patients had degreeⅢinjury .All gradeⅠinjury patients received conservative treatment. Follow-up of patients showed good recovery, MR revealed the lesions shrank in varying degrees or disappear.
Six gradeⅡinjury patients had surgical treatment, and three received conservative treatment. On follow-up, seven patients had a good recovery, two patients underwent surgical treatment within 3 months after injury and recovered well.Three gradeⅢpatients treated by surgery, and all with good recovery postoperative, and a patient died of respiratory failure. Conclusions High resolution PDWI is an effective tool to evaluate the extent of the alar ligament injury. Grade Ⅰ ligamentous injury patients treated conservatively can achieve good results, GradeⅡandⅢligamentous injury patients should receive surgical treatment early.

Objective To investigate the inhibition rate of cell proliferation, cell apoptosis rate and their effects on the cell cycle proceeding of the SSMC7721 cell line when 5-FU combined with thermotherapy is induced into the cells, and then provide theoretical bases to the combined therapy of hepatocellular carcinoma. Methods The inhibition rate of cell proliferation was detected by the MTT under different conditions, the cell cycle proceeding and the cell apoptosis rate was detected by flow cytometry and the subcellular structure was detected by the electronmicroscope. Results The cell inhibition rate of the thermotherapy group, 5-FU group and the combinedgroup were 18.4% ,28. 3% and 52. 7% ,respectively. The inhibition rates in the latter two groups were significantly different to the thermotherapy group. The results of flow cytometry showed that the cell numbers increased in G1 stage decreased in S stage,and increased in G2/M stage;the cell apoptosis rate increased. There was significant difference between different groups(P ＜ 0.01 or P ＜0.05). The results of the electronmicroscop showed that the nuclear chromatins agglutinated in the borderline and the mitochondriums became swelled. Conclusions The 5-FU combined with thermotherapy could significantly improve the inhibition rate of cell proliferation, inhibit the cell cycle proceeding from G1 stage to S stage, and induce cells apoptosis and change the subcellular structures in the SSMC7721 cell line.

Objective To evaluate the clinical value of the kissing stenting in bilateral brachiocephalic-superior vena cava obstruction syndrome.Methods Analysis the clinic effect in 17 patients who received interventional treatment retrospectively.All patients with bilateral brachiocephalic vein-superior vena cava obstruction were caused by malignant tumor.Each patient was implanted two stents by kissing stenting style.Among them,1 patient accompanied thrombosis in brachiocephalic vein was conducted with catheter-directed thrombolysis before stenting.The symptoms,pathological signs and complications were observed after the treatment,patients were underwent follow-up to see whether symptom recurred.Results All 17 patients received successful kissing stenting in bilateral brachiocephalic vein-superior vena cava.The symptoms and pathological signs eliminated after the operation.No serious complications occurred.Seventeen patients were underwent follow-up (1 to 16 months) with no obstructive symptom recurred including 5 patients died of the end-stage of malignant tumor.Conclusion Kissing stenting is a safe and effective methods for the treatment of bilateral brachiocephalic-superior vena cava obstruction.