Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Objective To evaluate the effectiveness of arthroscope-assisted surgical technique in treating knee fractures and knee peripheral fractures.Methods From September 2000 to December 2005,there were 46 cases with knee or knee peripheral fractures,in whom artbroseope-assisted surgical technique was performed in 36 cases including 24 males and 12 females,with mean age of 30.5 years (18-52 years).Of 36 cases,26 cases with patella fractures were treated by internal fixation of tension band using cancellous bone screws,four with distal end femoral fractures by retrograde interlocking using intramedullary nail and six with fractures of tibial plateau and tibial condyle crista by internal fixation u- sing cancellous bone screws.Results The mean hospitalization was eight days.A follow up for 3-36 months(average 14 months)in 36 cases showed fracture healing.Of 36 cases,32 cases regained full knee range of motion,four left with terminal flexion,with mean loss of 15?,and had thigh circumference (10 cm above knee)1.1 cm(range 0.6-2.0 cm)shorter than health side and two had slight pain in the knee joint.Lysholm knee joint function score was 86.5+7.6 for patellar fractures,tibial plateau frac- tures and condylar crista fractures.Conclusion As for knee or knee peripheral fractures,arthroscope- assisted surgical technique can provide fine monitoring,decrease trauma and complications,fixate inter- nally and help early ground exercise.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

Objective To evaluate the detection of serum pepsinogen (PG) in screening of gastric cancer. Methods (1) To calculate the detection rate of gastric cancer in PG Positive patients from northeastern, noah-western and northern China. (2) To determine the PG positive rate in patients with chronic superficial and atrophic gastritis. (3) To calculate the detection rate of gastric cancer, H. pylori infection and esophageal cancer in PG positive patients from gastric cancer high risk areas. Results (1) The detection rate of gastric cancer in PC, positive patients from Changchun (northeastern China), Xihing (northwestern China) and Beijing ( northern China) was 22. 58%, 25. 2% and 0, respectively. The sensitivity of PG to seeen gastric cancer in Changchun and Xihing was 50. 9% and 35.6%, and the specificity was 82. 56% and 85.69%, respectively. (2) Only 25% of patients with chronic atrophic gastritis were PG positive. (3) The serum PG level was measured in 2346 cases from gastric cancer high risk areas, and PG positive rate was 27.02% (634/2346), in which 496 patients (76. 65%, 496/634) received endoscopy, and gastric cancer was detected in 10 (2. 02%, 10/496), including 9 cases of early gastric caner. The prevalence of gastric cancer was 0. 43% in common population and 1.58% in PG positive population. The infection rate of H. pylori was 70. 73% in 2346 subjects and 2 cases of esophageal cancer, including 1 case of early cancer was diagnosed. Conclusion Serum PG level cannot be used as a marker for gastric cancer or atrophic gastritis, while it may be of value for gastric cancer screening in high risk areas.

Humans ; Stroke ; epidemiology

AIMTo study the endogenous mechanism for the inhibition of aquaporin-1 expression in rat renal proximal tubule epithelial cells in response to acetazolamide.

METHODSPrimary cultured rat renal proximal tubule epithelia cells were divided into two groups: one was subjected to 1 x 10(-5) mol.L-1 acetazolamide, the other served as normal control. When grown to sub-confluency, the cells were disintegrated to perform isoelectrofocusing electrophoresis in order to find the differential proteins induced by the acetazolamide treatment. The differential proteins were defined by peptide mass fingerprinting technology.

RESULTSTwo differential proteins were found in the cell disintegrant. The pI 3.8 protein was reduced after treatment, which showed 21.4% similarity with the brush border membrane myosin from rat brain and testis, and 27% with glycogen phosphorylase; The pI 5.5 protein was increased on the contrary, with 20% similarity to phosphatidylinositol transfer protein alpha isoform.

CONCLUSIONAcetazolamide inhibited AQP1 expression probably by affecting the expression of pI 3.8 and pI 5.5 proteins.

Acetazolamide ; pharmacology ; Animals ; Aquaporin 1 ; Aquaporins ; antagonists & inhibitors ; metabolism ; Diuretics ; pharmacology ; Epithelial Cells ; metabolism ; Isoelectric Focusing ; Kidney Tubules, Proximal ; cytology ; metabolism ; Male ; Peptide Mapping ; Rats ; Rats, Sprague-Dawley

BACKGROUNDCerebral venous thrombosis (CVT) may lead to serious neurological disorders; however, little is known about the risk factors for recurrent CVT. Our aim was to determine the association between elevated fibrinogen and decreased high-density lipoprotein cholesterol (HDL-C) levels with recurrent CVT.

METHODSThis retrospective cohort study included participants if they had a first episode of objectively defined CVT and were admitted to Xuan Wu Hospital, Capital Medical University from August 2005 to September 2009. Demographic and clinical variables were collected, as well as laboratory parameters, including plasma fibrinogen and HDL-C. Patients with CVT were followed for recurrent symptomatic CVT. Follow-up was through the end of September 2010. Potential predictors of recurrence were analyzed using Cox survival analysis.

RESULTSAt the end of the follow-up, 95 patients were eligible for the study. Twelve of 95 patients (12.6%) had recurred CVT. The median time of recurrence was 7 months (range: 1-39 months). Eight of these 12 (66.7%) experienced recurrence within the first 12 months after their initial CVT. The recurrence rate of CVT was 2.76 per 100 patient-years. Multivariate Cox regression analysis demonstrated that the coexistence of high fibrinogen (>4.00 g/L) and low HDL-C (<1.08 mmol/L) levels at baseline was the only independent predictor for recurrent CVT (hazard ratio: 4.69; 95% confidence interval: 1.10-20.11; P < 0.05). Of the twelve patients with recurrent CVT in our study, 7 (58.3%) had high fibrinogen plus low HDL-C levels. All 7 of these patients took warfarin for 3-12 months, and 6 of 7 had recurrent CVT after the discontinuation of anticoagulant treatment.

CONCLUSIONSConcomitant high fibrinogen and low HDL-C levels may be associated with recurrence of CVT. The effect of potential risk factors related to atherothrombosis on recurrent CVT should be closely monitored.

Adolescent ; Adult ; Aged ; Cholesterol, HDL ; metabolism ; Cohort Studies ; Female ; Fibrinogen ; metabolism ; Humans ; Intracranial Thrombosis ; metabolism ; pathology ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Young Adult

BACKGROUND AND PURPOSE: Atherothrombotic cerebral infarction [atherothrombotic stroke (ATS)] shares common risk factors and pathophysiological mechanisms with coronary artery disease (CAD), and both diseases appear to have common susceptibility loci. The muscle RAS oncogene homolog gene (MRAS) has been identified as a susceptibility locus for CAD and is implicated in atherosclerosis. The aim of this study was to elucidate whether the single-nucleotide polymorphisms (SNPs) and haplotypes of MRAS are associated with increased risk of ATS in a population of Han Chinese. METHODS: A case-controlled association study was conducted in which only patients with ATS (identified as a major subtype in the Korean modification of the Trial of Org 10172 in Acute Stroke Treatment classification) were enrolled. Subgroup analyses were carried out to determine whether the effect of the MRAS polymorphism was specific to age and gender among the subjects. RESULTS: In total, 194 ATS and 186 control subjects were included in the present study. Two tagging SNPs were identified in MRAS (rs40593 and rs3755751). A multivariate regression analysis revealed a positive association between rs40593 and ATS under dominant and additive models after adjustment for covariates. Subgroup analyses revealed that there were no gender differences with respect to allele or genotype frequencies between the groups. The AG genotype for rs40593 (p=0.028), the CT genotype for rs3755751 (p=0.036), and G-allele carriers (AG plus GG) for rs40593 (p=0.015) exhibited a significant protective effect among those aged > or =45 years. For the haplotype analysis, ATS subjects aged > or =45 years had a higher frequency of the ACAC haplotype (76.0%) than the controls (68.1%; p<0.05); that haplotype was associated with an increased risk of ATS. CONCLUSIONS: The obtained data suggest a positive association between MRAS and ATS among the Han Chinese. Further studies should be performed with larger sample and among different ethnic populations, and gene-gene or gene-environment interactions should be considered.
Alleles ; Asian Continental Ancestry Group* ; Atherosclerosis ; Case-Control Studies ; Cerebral Infarction ; Chondroitin Sulfates ; Coronary Artery Disease ; Dermatan Sulfate ; Gene-Environment Interaction ; Genes, ras ; Genetic Variation* ; Genotype ; Haplotypes ; Heparitin Sulfate ; Humans ; Muscles ; Polymorphism, Single Nucleotide ; Risk Factors ; Stroke*

BACKGROUNDStereotactic radiosurgery is an alternative to resection of intracranial cerebral arteriovenous malformations (AVMs), while it will fail in some cases. This study aimed to evaluate the changes after stereotactic radiosurgery for AVMs.

METHODSNineteen cases with cerebral AVMs had failure after stereotactic radiosurgery therapy. The symptoms and angiography were assessed. All patients underwent microsurgery. Pathologic examination was performed for all cases and electron microscopic examination was carried out in 6 patients.

RESULTSSeven cases had hemorrhage from 12 to 98 months after stereotactic radiosurgery, 5 had headache, 4 had refractory encephalon edema, 2 had epilepsy as a new symptom and 1 had a pressure cyst 5 years after radiosurgery. Angiography in 18 cases, 8 - 98 months after radiation therapy, demonstrated no significant changes in 5 cases, slight reduction in 9, near complete obliteration in 1 and complete obliteration in 3. An abnormal vessel was found on pathologic examination in 17 cases, even one case had obliterated in angiography. Electron microscopy examination showed vessel wall weakness, but the vessels remained open and blood circulated. One case died because of a moribund state before surgery. The other 18 cases had no new neurological deficiencies, seizure control and no hemorrhage occurred after microsurgery at an average follow-up of 3 years.

CONCLUSIONStereotactic radiotherapy for AVMs should have a long period follow-up. If serious complications occur, microsurgery can be performed as salvage treatment.

Adult ; Cerebral Angiography ; Cerebral Hemorrhage ; etiology ; Female ; Headache ; etiology ; Humans ; Intracranial Arteriovenous Malformations ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Radiosurgery ; adverse effects ; Treatment Outcome

BACKGROUNDCerebral venous sinus thrombosis (CVST) is a special form of stroke with multiple causes and risk factors. However, there are still a portion of cases with unknown reasons. The aim of this study was to investigate the relationship between internal jugular vein (IJV) abnormalities and the development of CVST.

METHODSA total of 51 CVST patients and 30 healthy controls were enrolled. The diameter, the maximum velocity (Vmax) and the reflux time in bilateral IJVs were measured by color Doppler flow imaging (CDFI). The paired t test was used to compare the numeric values between the bilateral IJVs. The Pearson chi-square test was used to evaluate the relationship between IJV abnormality and CVST, IJV abnormality and IJV reflux, respectively.

RESULTSAmong the 51 CVST patients, 20 (39%) patients were with normal IJV and 31 (61%) patients were with abnormal IJV. The types of IJV abnormality included annulus stenosis 19 cases (61%), hypoplasia 9 cases (29%), thrombosis 2 cases (7%) and anomalous valve 1 case (3%). In patients with unilateral IJV abnormality, the minimum diameter of the IJV on the lesion side was significantly smaller than that of the contralateral side (P < 0.0001). When compared with contralateral side, the Vmax of the lesion side with unilateral annulus stenosis was significant higher, however, it was obvious lower in patients with unilateral hypoplasia (P < 0.05). Furthermore, among 27 cases with unilateral IJV abnormality, all the CVST occurred on the same side as the IJV lesions.

CONCLUSIONIJV abnormality closely correlated with the development of CVST, which is a newly identified risk factor for CVST.

Adolescent ; Adult ; Female ; Humans ; Jugular Veins ; abnormalities ; diagnostic imaging ; Male ; Middle Aged ; Risk Factors ; Sinus Thrombosis, Intracranial ; etiology ; Ultrasonography