Objective To investigate the clinical features,recanalization after medical treatment and clinical outcome of cerebral artery dissection.Methods We reviewed the clinical records of ischemic stroke patients with cerebral artery dissection who visited the First Affiliated Hospital of Zhejiang University between October 2010 and December 2013.We recorded patients' general information,neurological deficit,imaging and clinical treatment.We followed up the patients and statistically analyzed demographic data,recanalization and clinical outcome.Results Among 28 cases of cerebral artery dissection,carotid dissection was the most common (n =19,67.9％),followed by vertebral artery dissection (n =7,25.0％),while the combination of carotid and vertebral artery dissection was rare (n =2,7.1％).In the imaging of cerebral artery dissection,wire beads and occlusion were the most common signs (n =15,53.6％),followed by rat tail sign (n =7,25.0％),aneurysmal dilatation (n =4,14.3％) and dualchamber levy (n =2,7.1％).There were 18 cases of acute cerebral infarction in the 28 studied cases,but there was no significant difference between the degree of stenosis and cerebral infarction caused by cerebral artery dissection.All patients received standard antithrombotic therapy.The difference of the recanalization rate between using anti-platelet aggregation and anticoagulant therapy was not statistically significant (5/6 vs 9/13,P =0.37).Conclusions Although cerebral artery dissection is relatively rare clinically,the typical clinical manifestations of the disease and the characteristic imaging are helpful for the diagnosis.Standardization of antithrombotic treatment is still the first-line treatment of cerebral artery dissection.

Objective To study antibiotic resistance phenotypes and genotypes of extended spectrum ?-lactamases (ESBLs) and AmpC ?-lactamase-producing Klebsiella oxytoca isolated from specimens of respiratory tract in children.Methods Bacterial isolates were identified by API or VITEK32. Agar dilution was used for antibiotic susceptibility test,and ESBLs and AmpC were detected by confirmatory test recommended by CLSI/NCCLS and by 3-aminophenylboronic acid (APB) disk potentiation test, respectively.Microarray was used to determine the genotypes of ESBLs and AmpC ?-lactamases.Genotypes of Klebsiella oxytoca were determined by enterobacterial repetitive intergenic consensus (ERIC)- PCR.Results ESBLs were positive in 129 out of 165 isolates (78.2%).Both ESBLs and AmpC ?- lactamases were positive in 16 out of 165 isolates (9.7%).AmpC ?-lactamase alone producer was not detected in term of phenotype and genotype.CTX-M was the most common type of ESBLs and DHA was the only type of AmpC ?-lactamase in these isolates.Most antibiotic resistant strains of Klebsiella oxytoca possessed the same genotype by ERIC-PCR.Although all strains were susceptible to carbpenem,Klebsiella oxytoca with ?-lactamases were more resistant to other antibiotic agents than those without ?- lactamases.Conclusions There is high prevalence of ESBLs production among Klebsiella oxytoca isolated from children in Urumqi.The main genotypes of ESBLs and AmpC ?-lactamases are CTX-M and DHA.

Humans ; Leiomyoma ; pathology ; Microtomy ; methods ; Microwaves ; Paraffin Embedding ; methods ; Specimen Handling ; methods ; Thyroid Neoplasms ; pathology

OBJECTIVE:To optimize the formulation optimization of Nicorandil sustained-release matrix tablet,and evaluate its drug release properties in vitro. METHODS:Based on single factor test,powder direct compression method was used,using nicorandil cumulative release rate (Q) in 1,4,8,12 h as evaluation indexes,central composite design-response surface method was adopted to optimize the amount of hydroxypropyl methylcellulose(HPMC)and ethyl cellulose(EC);Q values within 12 h in different pH (1.0,5.0,6.8,7.4) media were compared. RESULTS:The optimized formulation (every tablet) was nicorandil 10 mg,HPMC 150 mg,EC 90 mg,microcrystalline cellulose 80 mg,lactose 60 mg,magnesium stearate 2%. Q1 h,Q4 h,Q8 h and Q12 h of the obtained formulation were 23.6%,51.3%,83.7% and 96.9%,respectively;deviation from the predicted values were 2.1%,1.6%,1.0%,0.2%. Q values were similar in pH 1.0-7.4 at different time points. CONCLUSIONS:The obtained Nicor-andil sustained-release matrix tablet by optimal formulation shows sustained-release effect,and the change of pH 1.0-7.4 has no in-terference in the release characteristics of main drug.

IgG4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition of autoimmune etiology in recent twenty years, mainly manifesting as mass-forming lesions in single or multiple organs. In the past, it was often missed or misdiagnosed as inflammation or tumor. Patients may die from multiple organ failure due to end-stage fibrosis if they are not treated promptly. However, the number of clinically confirmed cases has gradually increased with the improvement of diagnostic level in recent years, and these patients have benefited greatly after receiving early treatment. Although patients generally respond well to traditional immunosuppressors including glucocorticoids and disease-modifying anti-rheumatic drugs, refractory and recurrent cases, even patients with glucocorticoid contraindication are common. Important mechanistic insights have been derived from studies of B-cell depletion therapy, but greater awareness of the pathophysiology of IgG4-RD is still badly needed to identify novel therapeutic targets. In this article, we reviewed the pathogenesis progress and promising therapy of IgG4-RD to seek better clinical management of IgG4-RD.

Objecfive To investigate antibiotic resistance,carbapenemase genotype and the molecular epidemiology of multidrug-resistant Acinetobacter baumannii (Aba) collected from 3 military hospitals in China.Methotis The minimum inhibitory concentrations (MIC) were examined by ager dilution method.Genotypes of carbapenemases were amplified by multiplex PCR and its products were sequenced.PCR was used to detect per gene,Homology of the resistant isolates was analyzed by pulse-field gel electrophoresis(PFGE).Results Among the 64 MDRA strains,78.1%(50)strains possessed blaOXA-23 gene,89.1%(57) carried Class 1 integrase gene,39.1% (25) with blaPER-1 gene,and 1 strain with blaOXA-58-like gene.PFGE showed that 13(A,B,C,D,E genotype) different clones were identified in these strains.A,B,and U clones were the predominant clones in three hospitals,respectitively.Conclusion OutbreaEs of muitidrug-rcsistant Aba occurred at 3 military hospitals with the most prevalent carbapenemase as OXA-23 enzyme.OXA-58 type of carbapenemase and per-1 in Aba were also isolated.

50%.The patients were categorized into as:one-,two-, and three-vessels coronary artery disease group.Central aortic SBP and DBP was measured by cathetarization dur- ing angiography of coronary artery and brachial blood pressure was measured using cuff method.Results Periph- eral SBP,PP and ascending aortic SBP,PP,fractional systolic pressure(FSP=SBP/MAP)were increased and as cending aortic fractional diastolic pressure(FDP=DBP/MAP)was reduced when the diseased coronary vessels were increased(P

OBJECTIVETo explore the feasibility of using an intracavitary convex array probe for detecting the distal extracranial internal carotid artery (ICA) by transoral carotid ultrasonography (TOCU).

METHODSForty patients underwent examinations with bilateral ICA inspected with an intracavitary convex array probe by TOCU to observe the internal diameter, visible length, peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI).

RESULTSEight of the 40 patients were excluded from the observation for the presence of carotid plaques. The examination was terminated in two patients due to sensitive throat and severe pharyngeal reflex. The rest of the patients completed the examination of the internal diameter, visible length, PSV, EDV and RI, which showed no statistically significant differences among them (P>0.05).

CONCLUSIONUsing intracavitary convex array probe, the distal extracranial ICA disease can be diagnosed with higher accuracy.

Adult ; Aged ; Carotid Artery, Internal ; diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Male ; Middle Aged ; Mouth ; diagnostic imaging ; Ultrasonography, Doppler, Duplex ; methods

Objective To evaluate the effect of PTH gene polymorphisms on bone mineral density (BMD) at multiple skeletal sites in normal females.Methods PTH gene phenotype was determined by PCR-RFLP of restriction enzyme Bst BⅠin 596 females aged (46.3?13.7) years (20-80 years),and PCR products with or without enzymolytic site were considered as genotype B or genotype b respectively.BMDs of the anteropesterior spine (AP) and supine lateral spine (Lat) of lumbar vertebrae (L_1-L_4),femoral neck (FN),total hip (T-hip), Ward's triangle (Ward),Trochanter (Troch),forearm [radius+ulna ultradistal (RUUD) and total area of radius + ulna (RUT) ] were measured by DEXA (QDR4500A).Results (1) Hardy-Weinberg equilibrium was evident for PTH polymorphisms.The frequencies of genotype were BB 0.784,Bb 0.208,bb 0.008 and frequencies of alleles B,b were 0.888 and 0.112 respectively in 596 normal females.Frequencies of BB,Bb,bb genotypes were 0.781,0.210,and 0.009 respectively in 347 postmenopausal women and their frequencies of alleles B,b were 0.886,0.114.No significant difference was found between post- and premenopausal women in genotype frequen- cy.(2) Comparing their BMDs of AP,Lat,FN,T-hip,Ward,Troch,RUUD and RUT,there was no significant difference between BB and Bb genotypes of pre- and postmenopansal women groups.(3) Logistic regression analysis failed to show any statistical difference between normal and osteoporosis women with regard to PTH phenotype.Conclusion PTH gene polymorphism has little effect on BMD in normal females.

Objective　To observe some biological features of bone marrow mesenchymal stem cells and explore the best conditions for isolatin g and culturing in vitro. Methods　Common cell culture techn ique, light and electron microscopy were used to study the effects of the growth , proliferation, morphology of the bone marrow mesenchymal stem cells in differe nt adherent time, concentration of serum and cell density. Results　The best culture condition in vitro for growth was 4-24 hours adherent time, 5%-10% fetal bovine serum, (4-8)×104/ml cell density. The cells were sp indle in shape and had a strong ability of proliferation. The time for cell duplication was 3 to 4 days. The cells showed the characteristics of stem cell s in electron microscope. Conclusion　The best condition for iso lation and culture of bone marrow mesemchymal stem cells was successfully establ ished and some biological features were obserred. It found a base for further in vestigation and using of mesenchymal stem cells.