ObjectiveTo investigate the relationship of blood glucose,blood lipids,serum uric acid,fibrinogen level and prognosis of patients with acute lacunar cerebral infarction.MethodsClirical data of 127 cases with acute lacunar cerebral infarction were retrospectively analyed.Patients with normal blood glucose,blood lipid,uric acid and fibrinogen level were enrolled into A group of 64 cases,63 cases with abnormal levels were selected as group B,an average of 2 years of follow-up,observing the two groups of neurologic,re-infarction incidence and prevalence of vascular dementia were obsenved in two groups.ResultsAfter 4 weeks of treatment,A group of neural function defect score(9.6 ±7.3) was significantly lower than group B( 14.3 ±7.4) (t =3.8696,P ＜0.05) ;95.4％ total effective rate in A group was significantly higher than B group of 82.0％ ( x2 =5.8623,P ＜ 0.05 ).After an average follow-up of 2 years,A group of recurrent cerebral infarction rate( 18.8％ ),vascular dementia rates(7.8％ ),were significantly lower than group B(28.6％),17.5％(11/63)(x2 =6.5421,5.9623,P＜0.05).ConclusionA number of abnormal serum biochemical indexes had a significant impact on short and long-term prognosis of acute lacunar cerebral infarction.

Objective To explore the levels of water channel protein 4 (aquaporin-4,AQP-4) in the serum and the cerebrospinal fluid of patients with severe hand-foot-mouth disease (HFMD) and its clinical significance.Methods Children with the critical HFMD (clinical stage 3) admitted to Xuzhou Children's Hospital from February 2017 to November 2017 were recruited(critical group).In the same period,another 25 cases of common HFMD (central nervous system infection excluded in cerebrospinal fluid examination,common group),the other 25 cases of severe HFMD (clinical stage 2,severe group) were taken as the controls.The levels of AQP-4 in the serum and and cerebrospinal fluid were measured in all children and the levels of AQP-4 in cerebrospinal fluid were checked again in the critical and severe cases after treatment.The levels of interleukin-6 (IL-6),norepinephrine (NE) and neuron-specific enolase (NSE) in the serum were examined simultaneously and the correlation between them was analyzed.Results Before treatment,the levels of AQP-4 in the serum of critical group were (54.42 ± 19.86) μg/L,which were significantly higher than common group[(8.02 ± 1.59) μg/L] and severe group[(22.04 ± 8.14) μg/L] (F =36.684,P ＜0.01).Compared with before treatment,the levels of AQP-4 in the serum of critical and severe group were significantly lower after treatment (P ＜ 0.05).Before treatment,the levels of AQP-4 in the cerebrospinal fluid of critical and severe cases were respectively (9.81 ±2.27) μg/L and (8.58 ± 1.92) μg/L,which were significantly higher than common group (6.56 ± 1.79) μg/L (F =6.713,P ＜ 0.05).After treatment,the levels of AQP-4 in the cerebrospinal fluid of critical and severe cases were (8.41 ± 1.63) μg/L and (7.14 ± 1.69) μg/ L separately,which were significantly lower than before treatment (t =6.340,5.073,all P ＜ 0.01).The levels of IL-6,NE and NSE in serum were significantly different among the three groups (P ＜ 0.01).The above indicators were positively correlated with the levels of AQP-4 in the serum(r =0.734,0.810,0.729,all P ＜ 0.01)and were also positively correlated with AQP-4 in the cerebrospinal fluid (r =0.299,0.431,0.363,all P ＜ 0.05).Conclusion AQP-4 may participate in pathophysiological processes of HFMD.The levels of AQP-4 in serum can be used as an indicator for judging the severity and monitor prognosis of HFMD.

Objective:To investigate the effect of vector sum concept in fine-tuning posterior column screw channel via ilioinguinal approach for the treatment of bi-column acetabular fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 patients with acetabular double column fracture admitted to Weifang People′s Hospital from July 2015 to May 2021, including 22 males and 20 females, aged 23-77 years [(49.3±16.3)years]. The ilioinguinal approach was used in all patients with the anterior column fixed with a plate and posterior column fixed with a lag screw. The vector sum concept was used intraoperatively to fine-tune the posterior column screw channel in 19 patients (channel fine-tuning group): namely, a 2.5 mm Kirschner wire was inserted into the bony channel of the posterior column screw under fluoroscopy of iliac oblique and obturator oblique positions; when the Kirschner wire was not located in the middle of the ischial ramus under single fluoroscopy, the vector only needed to be adjusted in one direction, with zero in the other direction; when the Kirschner wire was not located in the middle of the ischial ramus under fluoroscopy of both the iliac oblique and obturator obturator oblique positions, the sum of the deviation vectors in the two directions was calculated before fine-tuning. The vector sum concept was not used to fine-tune the posterior column channel screw in 23 patients (channel non-fine-tuning group). The time of posterior column screw placement, intraoperative blood loss, frequency of guide wire adjustment and fracture healing time were recorded and compared between the two groups. At 6 months after operation, the quality of fracture reduction and hip function were assessed by Matta score and Merle D′Aubigne-Postel score, respectively. The complications were observed.Results:All patients were followed up for 7-71 months [(35.7±8.5)months]. In channel fine-tuning group, the time of posterior column screw placement was (5.1±1.5)minutes, with intraoperative blood loss of (798.8±83.9)ml, frequency of guide wire adjustment of (1.8±0.5)times and fracture healing time of (12.4±3.2)weeks; while these parameters [(39.8±12.0)minutes, (1 119.3±172.0)ml, (5.6±1.6)times and (15.6±4.2)weeks] were significantly shorter or less in channel non-fine-tuning group ( P<0.05 or 0.01). There were no significant difference in the quality of fracture reduction and hip function between the two groups at 6 months postoperatively (all P>0.05). After operation, symptoms of lateral femoral cutaneous nerve was found in seven patients, superficial incision infection in two who was healed after debridement and dressing change, deep venous thrombosis of lower limbs in three. There was no significant difference in the incidence of postoperative complications between the two groups [channel fine-tuning group: 26%(5/19), channel non-fine-tuning group: 30%(7/23)] ( P>0.05). Conclusion:For bi-column acetabular fractures via ilioinguinal approach, application of vector and concept to fine-tune the posterior column screw channel is beneficial for rapid screw placement into the osseous channel, significant reduction of intraoperative blood loss and early fracture healing.

Humans ; Spondylitis, Ankylosing/diagnosis* ; Delayed Diagnosis ; East Asian People ; Asian People