The causes of transient ischemic attack (TIA) are diverse and complex.It often attacks repeatedly and its early risk of stroke is high.Identifying etiology and pathogenesis and start the correct treatment in time are the important measures for the prevention of cerebral infarction.However,the conventional CT and MRI reveal no abnormalities in patients with TIA,and it brings difficulties to the clinical diagnosis and treatment.CT perfusion imaging can reflect abnormal cerebral blood flow perfusion in patients with TIA.CT perfusion imaging in combination with CT angiography may visually display its corresponding abnormal changes in the feeding artery and provide the valuable diagnostic information for the location of vascular stenosis,severity,plaque characteristics and collateral circulation.It has very an important significance for guiding clinicians to choose the best treatment options,improve clinic efficiency and observe efficacy.

Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Endosonography ; Humans ; Lymph Node Excision ; Neoplasm Staging ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; pathology ; surgery ; Tomography, X-Ray Computed ; methods

Diarrhoea is one of the main causes of morbidity and mortality in the developing countries,it accounts for a large part of global disease burden every year.Water and sanitation are closely associated with the morbidity of diarrhea.The recent researches were reviewed in this paper,and the effect of drinking water,sanitation and hygienic knowledge on diarrhea was discussed.The incidence rate of diarrhea was likely to decrease as water supply and sanitation were improved.

Objective Disorder of intestinal barrier function is associated with the non-alcohol fatty liver disease ( NAFLD) . The present paper aimed to explore the intestinal barrier function in the rat model of NAFLD . Methods Sixteen SD rats were ran-domly divided into an NAFLD and a normal control group of equal number .The NAFLD models were constructed by high-fat feeding . HE staining was used for pathologic examination of the liver , the levels of TNF-α, IL-1, and endotoxin (ET ) were measured by ELISA and the limulus reagent method , and the expressions of intestinal ZO-1 and Occluding were determined by real time PCR . Resu lts Compared with the normal controls , the NAFLD rats showed typical hepatic lipid deposition , with significantly increased levels of serum TNF-αand IL-1 and plasma ET and decreased expressions of intestinal ZO-1 and Occluding (P<0.05). Conclusion Intestinal barrier function is decreased in NAFLD rats .

Postoperative ileus( POI)is a temporary impairment of coordinated gastrointestinal motility that develops as a consequence of abdominal or non-abdominal surgery and is a major factor contributing to the prolonged hospitalization of patient. In recent years,because of the widespread use of opioid analgesics,morphine induced POI is common. This article reviewed the progress in study on mechanism and management of POI caused by morphine.

Objective The purpose of this study is to investigate the expression of human epidermal growth factor receptor-2(HER-2)in gastric carcinoma tissue and normal gastric tissue of these patients,and its relationship with the clinical pathological characteristic,the microvessel density( MVD) and early post-operative recurrence,and to analyze the clinical significance of expression of HER-2 in gastric carcinoma,in order to lay the theoretical foundation of effective therapy for gastric carcinoma.Methods The clinical data of 398 cases of gastric cancer and 363 cases of their adjacent non tumorous gastric tissue of Liaoning Cancer Hospital from March 2012 to July 2013 were analyzed retrospectively.The expression of HER-2 gene was detected by IHC method and Fish method.The expressive rate of HER-2 in gastric carcinoma tissue and normal gastric tissue of these pa-tients were compared,and its relationship with the clinical pathological characteristic,MVD and early post opera-tive recurrence were also analyzed.Results (1)Expressive rate of HER-2 in 398 cases of gastric cancer tissue was 14.07%(56/398),which was higher than that in all the adjacent non tumorous gastric tissue presented none expression 0(0/363)(P<0.05);(2)In gastric cancer tissue of 398,the expression of HER-2 was related with Lauren type,tumor site,vessel invasion status,TNM stage,lymph node metastases(P<0.05),and it had no cor-relation with age,sex,tumor size,histological differentiation degree,growth patterns of cancer(P>0.05).Expres-sive rate of HER-2 in T4 stage was higher than( T1 +T2 +T3 ) stage,but the difference was not statistically sig-nificant( P>0.05).(3)The value of MVD in HER-2 expressive group(58.63 ±19.97)was significantly higher than those in HER-2 non expressive group(49.04 ±19.25).A positive significant correlation was found be-tween HER-2 and MVD expression using the rank correlation matrix(P<0.001,r=4.33).(4)1 year and 1.5 year of early post operative recurrence rate in HER-2 expressive group were 16.00%、38.00%,in HER-2 non expressive group were 8.81%,25.53%,the difference was not statistically significant(P>0.05).Conclusion There is excessive expression of HER -2 in gastric cancer tissue,excessive expression of HER -2 patients withgastric cancer is correlated with Lauren type,tumor location,vessel invasion status,TNM stage,lymph node metastases;it displays no correlation with age,sex,tumor size,histological differentiation degree,growth patterns ofcancer.HER -2 expression is positively associated with MVD value.Excessive expression of HER -2 is possibleto be correlative with early post operative recurrence,and it must have further follow up to confirm.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with central venous catheter related infections were set as infection group,patients without infection as the control group,and the group logistic regression analysis was used to analyze the collected data.Results 21 patients in infection group had CVC-RI,and the incidence was 14.00％ (21/150),while 129 patients in control group had CVC-RI.Univariate analysis showed there was significant difference between infection group and control group in age,anamnesis,catheter indwelling time and infusion rate of nutrient solution (x2=17.126,5.447,12.795,7.973,P＜0.05),however there was no significant difference in sex,health insurance,the success rate of catheterization and whether glutamine was in nutrient solution (P＞0.05);the group logistic regression analysis showed that age (OR=15.927,95％CI 3.305-76.756,P＜0.05)and catheter indwelling time (OR=3.511,95％CI 1.028-11.992,P＜0.05) were independent risk factors for CVC-RI,however infusion rate of nutrient solution (OR=0.140,95％CI 0.033-0.597,P＜0.05) was a protective factor.Conclusions For the postoperative patients with gastric carcinoma treated with parenteral nutrition,CVC-RI is closely related to age,catheter indwelling time and infusion rate of nutrient solution.So reducing catheter indwelling time,restoring the enteral nutrition under condition permission as so on as possible can reduce infection of elderly patients.

Objective To investigate the cerebral regularity of dynamic charge and the correlation with intracranial pressure(ICP),clinical seriousness and prognosis on acute stage of intracerebral hemorrhage(ICH) patients by transcranial Doppler(TCD).Methods 54 patients with first acute supratentorial ICH 24h after onset were studied.All patients were dynamic evaluated by beside TCD on 1st,7th,21st day.The correlation of TCD with ICP,MESSS were studied.Results On the 1st day the TCD abnormity of the acute phase of the ICH occurred mainly in the anterior circulation of cerebrum,in which the cardinal manifestation was high-resistance,low-flow velocity blood waveforms,especially on the bleeding side.Continuous TCD monitoring revealed the low velocity of the cerebral blood flow increased;meanwhile the high value of PI decreased gradually and the TCD monitoring was within the normal range three weeks after the attack.The ICP had negative correlation with the VmMCA,positive correlation with the PI value.MESSS scale had negative correlation with the VmMCA,positive correlation with the PI value.Conclusions The TCD examination can be used to monitor the cerebral hemodynamics of the patients suffering from intracerebral hemorrhage.The combination of fVEP and TCD facilitate the evaluation of the dynamic changes of ICP so as to instruct lowering the ICP.

Objective To study the effects of repetitive transcranial magnetic stimulation(rTMS) of the supplementary motor area(SMA)on the cortical excitability in patients with Parkinson's disease(PD).Methods Sixteen patients with PD were included in this study.The motor evoked potentials(MEP)and the N30 component of somatosensory evoked potentials(SEP) were assessed for each patient before and after 1200 pulses of rTMS of the SMA at 5 Hz and an intensity of 100% of relaxed motor threshold (RMT) for the abductor pollicis brevis.Results Ten minutes after the rTMS intervention,the peak-to-peak amplitude of the SEP component P20-N30 increased significantly(P<0.05),with the P/F index decreased simultaneously(P<0.05).The MEP amplitude increased significantly,and reached the highest value at 10min after the rTMS intervention. Conclusion 5 Hz rTMS of the SMA can improve the excitability of the SMA itself temporarily.Meanwhile,it can induce a short-lasting facilitation of the excitability of M1 connected with SMA.