Posterior circulation iscbemia refers to the transient iscbemic attack and the cerebral infarction in vertebrobasilar artery system,its prognosis is not as good as anterior circulation ischemia,and its treatment is similar to that of anterior circulation ischemia.However,because of the mortality of basilar artery occlusion is higher,usually more aggressive treatment should be considered,such as thromholytic therapy(especially intra-arterial thromholysis)and endovas- cular therapy,and the therapeutic time window is much longer.This article reviews the treatment of anterior circulation ischemia.

Objective To analyze the curative effect of oxaliplatin combined with S-1 in the treatment of advanced colorectal cancer.Methods Totally 90 cases of patients with advanced colorectal cancer in Shangluo No.2 Provincial People's Hospital from January 2013 to August 2015 were divided into observation group and control group,45 cases in each group.Patients in control group were treated with oxaliplatin combined with fluorouracil,4 weeks for one cycle of treatment,and patients in observation group were treated with oxaliplatin combined with S-l,21 d for one cycle.The curative effects,adverse reactions,life quality,and one year survival rate were compared between two groups.Results After treatment,the total remission rate of observation group was higher than that of control group,and the disease control rate was lower than that of the control group,but there was no significant difference between the two groups.During the treatment,there were no significant differences in Ⅰ degree and Ⅱ degree adverse reactions between two groups;But the adverse reactions of level Ⅲ and level Ⅳ of gastrointestinal reaction,liver function damage,reduce the incidence of white blood cells in observation group were significantly lower than that of control group (P ＜ 0.05).There was no significant difference between the two groups in the SF-36 scale scores.The one year survival rate of observation group was (21/45),and the survival rate of the control group after treatment was 42.22％ (19/45) in the control group,and there was no significant difference between the two groups in the one year survival rate.Conclusion Compared with oxaliplatin combined with fluorouracil,oxaliplatin combined with S-1 has equivalent efficacy and life quality,but the adverse reactions in gastrointestinal tract,liver,and marrow were better.

Objective By analyzing domestic and foreign papers on plague research with bibliometrics and visualized methods, we explored the current situation research trends and cutting-edge dynamics in order to provide information sup-port for plague research as well as strategies for countering bioterrorism.Methods Based on data sources from SCI and CNKI databases, bibliometrics and visualized methods were adopted,including Pajek,VOSviewer, Bibexcel and Citespace, so as to show the major cutting-edge areas of plague research.Results Comprehensive research analysis showed that the USA is leading in plague research, with some strong related institutions.There is still a gap between China and international community for research.Academy of Military Medical Sciences and other institutions are our main plague research efforts. Conclusion We should strengthen plague research, improve our overall level of plague research to provide the necessary support for effective response to natural epidemics and potential bioterrorism incidents.

Animals ; Antioxidants ; pharmacology ; Ascorbic Acid ; pharmacology ; Cumulative Trauma Disorders ; metabolism ; Lipid Peroxidation ; drug effects ; Male ; Muscle, Skeletal ; injuries ; pathology ; Oxidation-Reduction ; Oxidative Stress ; drug effects ; Rats

Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.

Objective To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy. Methods From December, 2013 to June, 2014, seventeen spastic cerebral palsy children with talipes equinus (34 feet) received Achilles ten-don lengthening. Ankle dorsiflexion range of motion (ROM) and surface electromyography from tibialis anterior and medial head of gastroc-nemius were measured before and 8 to 12 months after operation, respectively. ROM of passive and active dorsiflexion, root mean square (RMS) of tibia muscle group and co-contraction ratio (CR) when standing were compared. Results The ROM of ankle passive and active dorsiflexion increased (Z>4.867, P<0.001), while the RMS of gastrocnemius muscle decreased when ankle passively dorsiflex (t=4.31, P<0.001). RMS of tibialis anterior and gastrocnemius muscle changed little when standing (Z<1.291, P>0.05), while CR reduced (t=2.38, P<0.05). Conclusion Achilles tendon lengthening can improve the coordination of tibia muscle group to increase the ROM of ankle for chil-dren with talipes equinus after spastic cerebral palsy.

Objective To evaluate the early outcomes of mini-open lumbar microdiscectomy. Methods There were 38 cases in each group of mini-open lumbar mierodiscectomy and conventional discecto- my.Operating time,blood loss,time of leaving the bed and length of hospital stay were compared in two groups.MacNab criteria were used to evaluate the outcomes.Results To compare the conventional discec- tomy group,microdiscectomy group spent similar operating time,but had less blood loss(P

Objective: To systematically evaluate the effects of different forms of traditional Chinese health-preservation exercises on osteoporosis (OP) using network meta-analysis.Methods: A systematic search on Excerpta Medica Database (EMBASE), Springer Link, Allied and Complementary Medicine Database (AMED), PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP) targeted the randomized controlled trials (RCTs) studying traditional Chinese exercises for OP published up to January 2020. Cochrane handbook was adopted to estimate the publication bias in the included studies, and statistical analysis was performed using Stata 14.0 and GeMTC 0.14.3 when data were extracted. Results: Fifty RCTs were included in the network meta-analysis, comprising a total of 4505 OP patients. The network meta-analysis showed that in terms of visual analog scale (VAS) for pain, Tai Ji Quan (Tai Chi) was the most efficacious, followed by Yi Jin Jing (Sinew-transforming Qigong Exercises), Ba Duan Jin (Eight-sectioned Exercise), Wu Qin Xi (Five-animal Exercises), sports training, drug and blank control; in terms of bone mineral density (BMD) of femoral neck, Yi Jin Jing was the most efficacious, followed by Wu Qin Xi, Ba Duan Jin, Tai Ji Quan, sports training, blank control and drug; regarding the lumbar BMD, it was Yi Jin Jing, Tai Ji Quan, Ba Duan Jin, Wu Qin Xi, sports training, blank control and drug in the descending order of efficacy; in terms of serum alkaline phosphatase, it was Yi Jin Jing, Tai Ji Quan, sports training, Wu Qin Xi, Ba Duan Jin, drug and blank control in the descending order of efficacy. Conclusion: The evidence to date suggests that the first choice for OP amongst the traditional Chinese exercises should be Yi Jin Jing, which can not only reduce the subjective pain, but also promote bone formation and increase BMD, though this conclusion requires more high-quality large-scale RCTs for further proof.

Acute respiratory distress syndrome (ARDS) is a common clinical critical disease, characterized by progressive respiratory distress, intractable hypoxemia, respiratory failure and so on, with high mortality rate and lack of effective prevention and treatment strategies. In recent years, mesenchymal stem cell (MSC) can be used in the treatment of acute lung injury (ALI), which cannot only replace the damaged lung epithelial cells, but also promote tissue repair and alleviate ARDS by secreting anti-inflammatory and anti-fibrosis factors. This review focuses on the related mechanisms and signal pathways of MSC and its paracrine factors in the treatment of ARDS by regulating the balance of macrophage polarization.

Objective To investigate the value and safety of colonoscopy in patients aged 80 years and over.Methods Clinical and endoscopic data of 1 249 patients aged 80 years and over collected from December 2005 to December 2015 at PLA army General Hospital were analyzed retrospectively.Results The average age was 83.03 years.Reasons for receiving colonoscopy included constipation with abdominal distension(19.38 ％)and hematochezia(10.57％).The completion rate of colonoscopy for the entire length was 94.50 ％.There were no abnormal findings in 492 cases (39.39 ％).Colonic polyps (31.62 ％) and colorectal cancer (14.25 ％) were among the major lesions detected with colonoscopy.Colorectal neoplasms were found in 58.33％ of the 132 patients with hematochezia.The total complication rate from colonoscopy and treatment was 0.72％,with the complication rate from treatment at 1.32％.Conclusions Constipation with abdominal distension and hematoehezia are the main reasons for undergoing colonoscopy for very elderly patients.Colon polyps and colorectal cancer are common disorders in elderly patients over 80 years of age and people with hematochezia in this age group are at high risk of having colorectal cancer.Colonoscopy is a safe and effective procedure and an important examination method for very elderly patients with hematochezia.