AIM: To observe the efficacy, feasibility and safety of endovascular stent-grafts in treating aortic dissection.METHODS: Six patients with aortic dissecting aneurysm (3 males and 3 females, aged 32-67 years, average of 50 years old) were selected from Department of Cardiology, First Affiliated Hospital of Gannan Medical College between March 2005 and March 2006. They were diagnosed by transthoracic magnetic resonance imaging (MRI) and aortic angiography, and as type Ⅲ aortic dissecting aneurysm according to Debakey typing. The tumor diameter was ranged from 3.2 to 4.3 cm. The informed consent was obtained from all patients. Two weeks after the onset, the blood pressure was control between 90-110 and 60-70 mm Hg and heart rate at 60-65 times/min, then the straight circular and bifurcated stents, the product of Yuhengjia Company, composed of single naked membrane, straight circular and bifurcated stents made of nickel-titanium memory alloy, and cover of domestic artificial blood vessel were implanted with the patients generally anesthetized. The aortic dissection and general condition of patients after operation were observed with angiography, and the patient recovery condition was examined by spiral CT at postoperative months 3 and 12.RESULTS: All 6 cases were involved in the result analysis.①The diameters of stents for the patients were appropriate. The angiography showed that the thoracic aortic dissection in 4 cases disappeared, and thrombogenesis was found in false lumen; the thoracic aortic dissections in 2 cases disappeared, however, a little contrast agent was found in false lumen, but the blood flow was very slow. The general condition of all patients was good with stable vital signs, all patients discharged after 7-10 days.②CT results at 3 month after operation suggested that the original false lumen significantly contracted, and the true lumen restored to normal level. In case 3, there was mural thrombus in the distal stent that connected with stent vessel wall, and the thrombus hyperplasia was not obvious during follow up. At 12 months after operation, there was no distinct alteration in the stent location and appearance, and the life quality of patients was significantly improved.CONCLUSION: Endovascular stent-grafts are effective and safe in treating aortic dissection.

Objective To investigate the function of human glia maturation factor gamma to induce the proliferation and differentiation of neural stem cells into astrocytes.Methods The neural stem cells were isolated from cerebral cortex of 11-to 12-day embryoes of SD rats.After three passages,the cells could react with nestin antigen,which demonstrated that the cells were neural stem cells.The neural stem cells were divided into 4 groups,control group,FBS group FBS,GMFG 5 ?g/L group and 5 ?g/L of GMFG,GMFG 10 ?g/L group with medium and 10 ?g/L of GMFG.Results In the control group,the cells had no significant differentiation in two days and slight branches were observed at the fourth day.In FBS group,the cells differentiation into astrocytes within three days,which grew on the surface of the culture flasks.In GMFG group,the cells differentiated into astrocytes in one day,and the differentiation of cells from the 10 ?g/L group was more obvious than that of cells from the 5 ?g/L group.The cells from the 10 ?g/L group reacted weakly with GFAP antigen.Conclusion GMFG can induce proliferation and differentiation of neural stem cells into astrocytes effectively in vitro.

OBJECTIVE:To explore the effect of dexmedetomidine with different doses combined with ropivacaine on the bra-chial plexus block. METHODS:Totally 90 patients with upper extremity surgery of brachial plexus block were randomly divided in-to test group,control group 1 and control group 2. Test group was treated with 0.375%ropivacaine 40 ml+dexmedetomidine 100μg, brachial plexus injection;control group 1 was treated with 0.375% ropivacaine 40 ml+dexmedetomidine 50 μg,brachial plexus in-jection;and control group 2 was treated with 0.375% ropivacaine 40 ml,brachial plexus injection. Onset time of sensory and motor nerve block,block duration,postoperative pain time for the first time and pain score,analgesia duration,quality of analgesia and muscle relaxant,before anesthesia induction(T0),plasma cortisol concentrations in nerve block 10 min (T1),the start of surgery (T2)and incidence of adverse reactions were observed. RESULTS:The onset time of sensory and motor nerve block and postopera-tive pain score for the first time in test group werecontrol group 1>control group 2,plasma cortisol concentrations at T1 and T2 were higher than T0,and T2>T1>T0,test group0.05). CONCLUSIONS:Ropivacaine combined with 100 μg dexmedetomidine can effectively im-prove brachial plexus block and shorten the onset time of sensory and motor nerve block,with good safety.

Objective To explore the effects of microstructure grinded on the labial face of porcelain fused to metal crown (PFM) in esthetic prosthesis for anterior teeth. Methods 193 patients with single maxillary incisor tooth defects were repaired with 2 crowns for each one. After the crowns being blent colour and molded, the crown A was not grinded particularly on the labial face and the crown B was done according to the records of the microstructure.The patients were allowed to choose the most satisfied one when 2 crowns were cemented temporarily. Results 36 patients chose the crown A and 157 chose B.The difference was significant ( P0.05). Conclusion The crown has great vitality and accordes with the esthetic standards of the patients by way of being grinded microstructure on the labial face.

This study was aimed to preliminarily evaluate the acute toxicity and anti-inflammatory effects of coffee residue extract. The test maximum tolerated dose was applied in mice by gavage to observe the acute toxicity of coffee residue extract. Mice acute inflammation model was induced by xylene and glacial acetic acid. The gavage administration of coffee residue extract (1.00, 2.00, 3.00 g?kg-1, in terms of crude drug) was given 7 days con-tinuously. The ear swelling rate and celiac capillary permeability were measured. The results showed that the ex-tract of coffee residue maximum tolerated dose in mice is 8 . 60 g?kg -1 ( in terms of crude drug ) . The coffee residue extract of 3 . 00 g?kg-1 is able to inhibit ear swelling induced by xylene in mice ( P < 0 . 05 ) and the ex-cessive celiac capillary permeability ( P < 0 . 05 ) . It was concluded that the coffee residue extract have certain an-ti-inflammation activities.

Objective To study the diagnosis and treatment of hepatic focal nodular hyperplasia(FNH).Methods The clinical data of 15 FNH patients proved by pathological examination were retrospectively analyzedResults Most cases of FNH were asymptomatic,and some had nonspecific symptom such as dull pain of upper abdomen.Most cases of FNH showed nodular lesion on liver imaging with isodensity or hypodensity on pre-contrast CT scan and strong enhancement during arterial phase.of the 15 FNH patients,5 eases were diagnosed by needle biopsy pathology,10 cases were diagnosed by postoperative pathology.And 10 cases underwent surgical resection(7 cages with irregular hepatectomy,1 case with resection of segment 7,2 cases with left lateral lobeetomy),2 cases underwent percutaneous transhepafic chemical ablation,3 cases underwent clinical observation.All cases were followed up,and no recurence or malignancy were found.Conclusion FNH is a kind of benign tumor of liver without specific clinical manifestation.Accurate diagnosis needs pathological examination.Surgical treatment is recommended in most cages.Close follow-up is recommended in cases without operation.

Objective To evaluate the efficacy of transarterial embolization(TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepato-cellular carcinoma(HCC).Methods 50 cases with ruptured HCC were divided into 4 groups according to the type of their previous treatment:group A,TAE followed by elective hepatectomy 12;Group B,TAE alone 12;Group C,emergency operation 13;Group D,medical conservative management.Results Celiac arterio-graphy done before the present treatment showed extravasation of contrast material in 6(25%) of the 24 patients in group A and B,and hypervascular tumor was observed in the rest.The hemostasis success rate of group A,B and C were 100%,which were much higher than that of group D(40%)(P

BACKGROUND: Magnetic resonance diffusion tensor imaging (MRDTI) may non-wounded detect damage of fiber in white matter and becomes an effectively way to evaluate upper motor neuron(UMN) impairments.OBJECTIVE: To investigate the clinical significance of MRDTI on amyotrophic lateral selerosis(ALS).DESIGN: Case contrast observation.SETTING: Department of Neurology, Renmin Hospital of Wuhan University.PARTICIPANTS: Twenty ALS patients were selected from Department of Neurology, Renmin Hospital of Wuhan University from April to December 2005. There were 11 males and 9 females, and their ages ranged from 33 to 73 years with the mean age of (51±10) years. All subjects met the diagnostic criteria of ALS set by World Neurology League.Other 15 healthy subjects were collected as control group. There were 8 males and 7 females, and their ages ranged from 31 to 73 years with mean age of (50±11) years. All subjects provided the confirm consent.METHODS: Based on level of upper and lower motor neuron impairments, ALS patients were divided into UMN impairment group (n =16) and lower motor neuron group (n =4). Functional scores of ALS, illness developing velocity and pyramidal sign scores were performed, respectively. All subjects were scanned with DTI at axial view. Regions of interest [subcortical white matter of precentral gyrul and postcentral gyrul (Pre-CG/Post-CG), centrum semiovale and frontal white matter (CS/FWM), peripheral lateral cerebral ventricle, posterior limb of internal capsule (PIC), cerebral peduncle (CP), genu corpus callosum and splenium corpus callosum (GCC/SCC) and dorsal thalamus (DT)] were selected to measure fractional anisotropy (FA) and apparent diffusion coefficient(ADC).MAIN OUTCOME MEASURES: Correlations among FA, ADC, functional score of ALS, illness developing velocity and pyramidal sign scores.RESULTS: Twenty patients and 15 subjects in the control group were involved in the final analysis. ① FA was reduced and ADC increased in the posterior limb of the internal capsule in patients with UMN signs compared to healthy volunteers (t =3.452, 2.670; P ＜ 0.01, 0.05). Nonparametric tests revealed that there was a trend toward reduced FA in the posterior limb of the internal capsule in B group compared to controls (U =11, P =0.057). ② In UMN impairment group, FA in the posterior limb of the internal capsule was positively correlated with the ALS rating scale (r =0.577, P ＜0.05) and negatively correlated with pyramidalsign scores (r = -0.789, P ＜ 0.01 ),CONCLUSION : The impairment of pyramidal tracts can be noninvasively evaluated by diffusion tensor MR in vivo, thus providing useful information in diagnosing and further understanding MND.

Objective To discuss the clinical features and treatment of isovaleric academia (IVA) patients,and to gain more comprehensive understanding of isovaleryl-CoA dehydrogenase(IVD) mutation in 2 siblings in order to raise awareness to prevent the occurrence of IVA.Methods The clinical history and laboratory test of 2 cases of children with IVA were carried out.The exons and neighboring introns of IVD gene of the whole family were PCR-amplified for DNA sequencing.The literature review of IVA in China was also conducted.Results Organic acid analysis of urine by GC/MS for both siblings showed extremely elevated concentrations of isovaleric glycine.For the older sibling,an acute episode of IVA caused severe metabolic stress and eventually death in the neonatal period.However,the disease was well-controlled for the younger sibling due to timely treatment and follow-up care for 2 years.The DNA sequencing of the IVD gene in the family revealed a novel c.1016G ＞ A(C339Y) heterozygous mutation in mother and both of the siblings.No IVD mutation was detected in father or in any of the 50 cases of healthy controls.According to literature review,15 cases of IVA were reported in recent 15 years in China,including neonatal onset (11 cases),acute episode (12 cases),odor of sweaty feet (12 cases),pancytopenia (9 cases),hyperammonemia (5 cases),hypocalcemia (6 cases),and 6 cases of death were reported.Additionally,5 cases that received treatment of BCAA-free formula milk showed positive outcome.However,only 2 cases were followed up for more than 2 years.Conclusions Two new IVA patients carrying c.1016G ＞ A(C339Y) mutation were reported in China.The mutation may lead to conformational change and functional deficient of the IVD protein.It is also necessary to point out that using direct DNA sequencing can not identify all patients with IVA due to limitations of this technology,and thus clinicians should be aware of the possibility of genetic misdiagnosis.Moreover,there is a trend of increasing IVA in China in recent years.

Objective To study the effect of core stability training on motor function in patients with hemiplegia after stroke. MethodsSixty-eight patients with hemiplegia after stroke were randomly divided into a treatment group (34 cases) and a control group (34 cases).Both groups were given regular rehabilitation training.The patients in the treatment group also were taught core stability training.The trunk control test (TCT),Berg's balance scale (BBS),the modified Barthel index (MBI),functional ambulation categories (FACs) and the Fugl-Meyer assessment scale (FMA) were used to assess motor function before and after treatment. ResultsThere were significant differences between the two groups in average TCT scores,BBS scores,FACs,M BI scores and FMA scores after treatment.The gains in the treatment group were significantly superior to those in the control group.The patients'trunk control was positively correlated with the BBS,MBI,FAC and FMA results.Conclusion Core stability training can improve the motor function of patients with hemiplegia after stroke.