Objective To compare the effects of pressure bandage with ultrasound-guided compression repair (UGCR) for femoral artery pseudoaneurysms (FAPs) after percutaneous coronary intervention. Methods One hundred and five patients with FAPs were enrolled in the study. Patients were classified into 2 groups (UGCR vs pressure bandage) according to different treatment modalities,and clinical status and therapeutic effects were compared. Results There were no differences between the two groups in gender,age,body mass index,type of intervention,sheath size,anti-platelet agents,low molecular weight heparin,systolic blood pressure and diastolic blood pressure during the procedure. The successful repair rate was higher in the UGCR group than that of the pressure bandage group (85% vs 63%,P =0.03). No complications occurred in both groups. Conclusion UGCR is simple and safe with low cost and complications,which can be used preferably for FAPs repair.

OBJECTIVE To evaluate mortality prediction by analyzing clinical features and pathogens of patients with candidemia in intensive care unit(ICU).METHODS The clinical data of candidemia cases admitted to ICU of the First Affiliated Hospital of Zhejiang University in recent five years were analyzed retrospectively,including risk factors,accompanied diseases,Candida species,drug sensitivity,mortality and prognosis.RESULTS Seventy five cases with candidemia were diagnosed in recent five years.Single factor Logistic regression analysis combined with multiple conditional Logistic regression model analysis was conducted.Compared to other risk factors,indwelling central venous catheter(97.2% vs 74.3%,P=0.043,OR=6.4,95%CI 1.06-38.72),hypoproteinemia(91.7% vs 56.4%,P=0.020,OR=6.01,95%CI 1.33-27.0)and APACHEⅡ score(19.6?3.7 vs 15.0?3.8,P=0.00,OR=1.36,95%CI 1.15-1.62) were markedly different.CONCLUSIONS Candidemia cases in ICU increase gradually and lead to higher mortality.Indwelling central venous catheter,hypoproteinemia and APACHEⅡ score are related to mortality of candidemia cases.

Objective To explore the clinical effect of the percutaneous vertebroplasty(PVP) and filling auto-solidification calcium phosphate cement(CPC) in treatment of osteoporotic thoracolumbar vertebral fractures. Methods From January, 2004, 26 patients with osteoporotic thoracolumbar vertebral compression fracture (29 vertebral bodies) were treated with intraoperative manipulative reduction, PVP and filling auto-solidification CPC. Results PVP were successfully performed with unilateral or bilateral vertebral pedicles for the 29 vertebrae. The average injection dose of CPC was 4.6 mL. CPC leakage occurred during the procedure in 5 vertebrae of 5 cases. All the patients were followed up for 3 to 8 months (averaging 4.6 months) and experienced complete pain relief. There was no severe complication related to the treatment. Except in 3 patients who lost 15%of the vertebral body height, the anterior height of the injured vertebral body in the other 23 patients recovered averagely to 80%of the normal one. Conclusion PVP with filling auto-solidification CPC is safe and effective in the treatment of osteoporotic thoracolumbar vertebral compression fractures.

The present study on 24 cases disclosed that the erythrocyte deformability(ED) of patients with acute myocardial infarction (AMI) was significantly lower than normal control. After incubate the patients' erythrocyte with Prop-lene Glycol Mannituse Sulfate(PGMS) and Pro-plene Glycol Alginate Sudium Sulfate (PSS ) , The ED was significantly higher than that of in-cubated without drug. PGMS was more effi-cious. The result indicated that PGMS and PSS may have high value in improving the microcir-culation of patient with AMI, increasing the blood flow of capilliaries in ischemic myocardium and reducing the area of infarction.

BACKGROUND: Some researches suggest that improvement of motor function is closely related to cognitive function. The better the cognitive status is, the better the recovery of motor function is. Early evaluation of cognitive function can predict prognosis of motor function and improve generalized ability, social communication abilities and quality of life (QOL).OBJECTIVE: To observe the correlation of cognitive function in hemiplegia and aphasia and analyze the prognostic factor of early cognitive dysfunction in patients with acute stroke.DESIGN: Contrast study.SETTING: Department of Neurology, Taian Central Hospital; Department of Neurology, Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Fifty patients with acute stroke were enrolled from Neurological Department of Taian Central Hospital and Neurological Department of the Affiliated Hospital of Medical College of Qingdao University from January 2002 to May 2005. They were 32 males and 18 females aged 34-78 years. All patients were coincidence with the Diagnostic Criteria of Acute Stroke established by the Fourth National Cerebrovascular Diseases Meeting and diagnosed with CT or MRI. Patients were told about the evaluation in details. Among them, 44 patients had hemiplegia, including 30 males and 14 females aged 34-78 years; 30 had aphasia, including 17 males and 13 females aged 34-78 years; 20 had non-aphasia, including 14 males and 6 females aged 38-70 years.METHODS: ① Aphasia was tested with Western Aphasia Battery (WAB).Aphasic quotient of ＜ 93.8 was regarded as aphasia; otherwise, it was regarded as non-aphasia. ② Motor function was evaluated with Fugl-Meyer (FMA).Motor function of upper and lower limbs was scored as 100 in total. The higher the points were, the better the motor function was. ③ Cognitive function was evaluated with Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), which contained 4 items (orientation, perceptibility, visual-motor organization and thinking ability) and 22 subtests in total. The higher the points were, the better the cognitive function was. Functional evaluation started at half-month treatment onset. Intergroup comparison of their mean value was tested using Student's test and one-way analysis of variance.MAIN OUTCOME MEASURES: ① Correlation between cognitive function and hemiplegia; ② correlation between cognitive function and aphasia.RESULTS: Fifty patients with acute stroke were all involved in the final analysis. ① Correlation between cognitive function and hemiplegia: Scores of orientation, perception, visual-motor organization and cognitive function of 44 patients with hemiplegia were positive positively correlated with FMA scores of motor function (r=0.534, 0.598, 0.500, 0.548, P ＜ 0.01); however,scores of thinking ability was not correlated with FMA scores of motor function (r=0.310, P ＞ 0.05). ② Correlation between cognitive function and aphasia: Scores of orientation, perception, visual-motor organization, thinking operation and cognitive function of patients with aphasia were (4.60±2.37), (15.10±6.02), (14.00±6.93), (12.33±6.77), (1.83±1.09) points,which were lower than those of patients with non-aphasia (7.30±1.08),(23.20±1.11), (24.25±4.08), (24.20±5.43), (3.50±0.76) points (t=5.44 to7.197, P ＜ 0.05).CONCLUSION: The more severe the cognitive dysfunction is, the more severe the hemiplegia is. Cognitive function in stroke patients with aphasia is significantly reduced.

Objective To investigate the expression and location of Matrix metalloproteinase-9 (MMP-9) in human salivary gland tumors and the effect of MMP-9 in soft and neural invasion,and to find whether there will be a rational option to treat saliary gland tumors by inducing MMP-9,especially saliary malignant tumors.Methods A total of 140 cases of human salivary gland tumors,including 32 cases of plemorphic adenoma tissues,28 cases of basal cell,adenoma tissues,40 case of mucoepidermoid carcinoma tissues,16 case of carcinomatous metastasis,24 case of no metastasis,18 cases of neurotropism,22 of case non-neurotropism,adenoid cystic carcinoma tissues of 40 cases and normal human salivary tissues of 10 cases were detected the expression and location of MMP-9 by PV-9000 polymer detection system for immunohistoch emical staining mcthod.The relationship between the expression and clinical pathological behaviors was analyzed.Results The positive rate of MMP-9 expression in salivary gland malignant tumors,salivary gland benign tumors and normal salivary glands was 72.5％,30.0％ and 10.0％ ( x2 =32.12,P ＜ 0.01 ).The positive rate of MMP-9 was 93.75％ (15/16) in the mucoepidermoid carcinoma tissue,which was signicantly different from that of 66.67％ (16/24) in the carcinomatous metastasis group ( x2=4.038,P ＜ 0.05 ).The positive rate of MMP-9 in the normal human salivary tissues,adenoid cystic carcinoma tissues and mucoepidermoid carcinoma tissues was 10.0％ (1/10),67.5％ (27/40) and 77.5(31/40) (x2=16.263,P＜0.005).Significant difference was found between groups of neurotropism and non-neurotropism on the positive rate of MMP-9 expression in adenoid cystic carcinoma(94.44％ vs 63.63％,x2=5.389,P ＜ 0.05 ).Conclusion MMP-9 is correlated with the invasion and metastasis of malignant salivary gland tumors,and can be used as an indicator of potential metastasis.The finding suggests that MMPs suppressor combined with antiangiogenic agents might be a new option to treat saliary gland tumors.

OBJECTIVETo explore effects of Tongxinluo Capsule (TC) on platelet activating factor (PAF), vascular endothelial function, thrombolysis in myocardial infarction (TIMI) blood flow, and heart function in acute myocardial infarction (AMI) patients after delayed percutaneous coronary intervention (PCI).

METHODSTotally 80 AMI inpatients were recruited at Department of Cardiology, People's Hospital of Jiangxi Province, from Jan. 2008 to Sep.2013. Those in line with inclusion criteria were randomly assigned to TC treatment group and the conventional treatment group by random digit table, 40 in each group. Besides, another 40 healthy subjects from examinees at Outpatient Department were recruited as a healthy control group. PCI was performed after 1-week treatment. Then blood samples were collected, and then blood contents of CD62P, CD63, GP II b/III a, ET-1, NO, and plasma von Willebrand factor (vWF) levels were detected. Coronary TIMI blood flow and corrected TIMI frame count (CTFC) were determined during PCI. Meanwhile, noninvasive blood pressure (BP) and heart rate (HR) were recorded before and after PCI, and cardiac function measured. They were compared with the healty control group.

RESULTSCompared with the healthy control group, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 significantly increased, but NO significantly decreased in AMI patients (all P < 0.05). After 1-week intervention of TC, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, NO, and ET-1 significantly decreased (P < 0.05, P < 0.01). Compared with the conventional treatment group at the same time point, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 decreased more significantly in the TC group (P < 0.05, P < 0.01), increased NO levels were also more obviously seen (P < 0.01). The aforesaid parameters changed more obviously at day 30, as compared with those changes at week 1 (P < 0.05, P < 0.01). The TIMI blood flow grade and CTFC were more obviously improved after PCI in the two treatment groups. Better TIMI blood flow was seen in the TC group. TIMI level 3 blood flow rate was higher in the TC group than in the conventional treatment group with statistical difference (P < 0.05). The left ventricular ejective factor (LVEF) after PCI was obviously elevated in the TC group and the conventional treatment group (P < 0.01), and the improvement was more obviously seen in the TC group (P < 0.05). There were 6 cases of recurrent angina, 3 cases of ventricular tachycardial (VT)/ventricular fibrillation (VF), 6 cases of heart failure (HF), 1 case of cardiac sudden death in the conventional treatment group, with the total incidence of cardiovascular events being 40% (16/40). There were 2 cases of recurrent angina, 2 cases of VT/VF, 2 cases of HF, no cardiac sudden death in the TC treatment group, with the total incidence of cardiovascular events being 15% (6/40). There was statistical difference in the recurrent rate of cardiovascular events between the two groups (χ² = 2.27, P < 0.05).

CONCLUSIONTC not only could prevent coronary embolism of AMI patients after delayed PCI, attenuate vascular endothelial injury, but also could improve TIMI blood flow, and strengthen cardiac systolic function.

Angioplasty, Balloon, Coronary ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; Fibrinolytic Agents ; therapeutic use ; Heart ; drug effects ; Heart Rate ; Humans ; Myocardial Infarction ; drug therapy ; surgery ; Percutaneous Coronary Intervention ; Platelet Activating Factor ; metabolism ; Regional Blood Flow ; von Willebrand Factor ; metabolism

Objective To investigate the impact of movement frequency on gross tumor volume (GTV) of moving tumors and coordinate position of the central point based on three-and four-dimensional CT scans.Methods The respiratory motion platform from Modus and 8 phantoms with different shapes and volumes were used to simulate the movement of lung tumors.Three-and four-dimensional CT scans were performed at movement frequencies of 10,15,and 20 times/min.GTV (GTV10,GTV15,and GTV20) and IGTV (IGTV10,IGTV15,and IGTV20) were delineated,and the coordinate position of the central point was obtained.The Friedman test was performed for GTV10,GTV15,GTV20,IGTV10,IGTV15,IGTV20,and the coordinate position of the central point.Results GTV10,GTV15,and GTV20 at the three movement frequencies were 12.41±14.26 cm3,10.38±11.18 cm3,and 12.50±15.23 cm3,respectively (P=0.687),and the positional values were-8.2±96.2 mm,-8.6±96.1 mm,and-8.6±95.7 mm in x-axis (P=0.968),108.2±25.0 mm,110.4±22.5 mm,and 109.0±24.2 mm in y-axis (P=0.028),and 65.2±13.7 mm,65.4± 13.4 mm,and 65.4± 13.2 mm in z-axis (P =0.902).IGTV10,IGTV15,and IGTV20 at the three movement frequencies were 17.78± 19.42 cm3,17.43± 19.56 cm3,and 17.44± 18.80 cm3,respectively (P=0.417),and the positional values were-7.7±95.9 mm,-7.9±95.6 mm,and-7.9±95.1 mm in x-axis (P=0.325),109.4±24.5 mm,109.6±24.1 mm,and 109.2±24.3 mm in y-axis (P=0.525),and 65.5±13.3 mm,65.6±13.4 mm,and 65.5±13.3 mm in z-axis (P=0.093).Conclusions During simulated positioning of thoracic tumors,respiratory movement frequency has no significant impact on target volume established by four-dimensional CT scan.There are no significant differences in three-dimensional target volume established at different respiratory frequencies,but respiratory frequency has a significant impact on the position of the central point of the target volume in y-axis.

Objective To comparative analysze of the applications value of breast-conserving surgery and improved surgical in breast cancer patients.Methods One hundred and sixty-eight female breast cancer patients from February 2005 to October 2010 in the People's Hospital of Rizhaoour hospital were selected.The patients were divided into breast-conserving surgery group (n =80) and improved surgical group (n =88).The patients in two groups were followed-up and investigated for three years.Operative time,blood loss,postoperative drainage,postoperative drainage time and hospital stay,incidence of complications,local recurrence,distant metastasis and survival after 3 year,satisfaction ratio of breast cosmetology,psychological anxiety scores and quality of life scores after 3 years of the patients in two groups were compared and analyzed.Results The complication rate of breast-conserving surgery group was 12.50％ (10/80),lower than the improved surgical group,and the difference was significant statistically (29.55％ (26/88),x2 =7.23,P＜0.05).The operative time ((72.68±5.28) min),blood loss ((39.21 ± 8.59) ml),postoperative drainage ((162.25 ± 28.56) ml),postoperative drainage time((8.16±2.58) d) and the length of hospital stay((11.43±1.98) d) of the patients in breast-conserving surgery group were lower than those of the improved surgical group,and the differences of two groups were significant statistically ((92.48 ± 6.01) min,(68.26 ± 10.23) ml,(343.29 ± 62.18) ml,(16.59±4.96) d,(18.47±2.94) d;t =22.72,19.99,24.61,13.99,18.35;P＜0.05).The satisfaction rate after 3 years of breast-conserving surgery group was 92.50％(74/80),higher than that of the improved surgical group,and the difference was significant statistically (81.82％ (72/88),x2 =4.20,P＜ 0.05).The psychological anxiety scores after 2 and 3 years of breast-conserving surgery group were (40.02 ± 2.63) points and (34.26 ± 3.59) points,lower than those of improved surgical group((42.58±2.37) points and (39.85±2.10) points),the quality of life scores after 3 years of breast-conserving surgery group was (67.58± 11.26)points,higher than that of improved surgical group ((50.85 ± 10.42) points),and the differences were significant statistically (t =6.60,12.16,9.96;P ＜ 0.05).Conclusion Breast-conserving surgery could reduce the incidence of complications and psychological anxiety situations,improve clinically relevant indicators and satisfaction ratio of breast cosmetology and quality of life for the breast cancer patients.

Objective:To investigate the impact of osteoporosis on clinical outcomes in elderly patients treated with short segment transforaminal lumbar interbody fusion.Methods:From May 2016 to May 2018, elderly patients who had undergone transforaminal lumbar interbody fusion(TLIF)in our hospital were retrospectively analyzed.Based on bone mineral density(BMD), patients were divided into the osteoporosis group(the OP group, n=75, T≤-2.5 in BMD)and the control group(the CO group, n=103, T>-1.0 in BMD). General patient information, clinical data and postoperative follow-up clinical results were compared between the two groups.Results:Eventually 178 cases were enrolled, including 68 with lumbar disc herniation and 110 with lumbar spinal stenosis.Preoperative Visual Analogue Scale(VAS)scores were 7.35±1.30 in the lower back and 7.32±1.30 in the leg for the OP group and 7.35±1.33 and 7.22±1.40, respectively, for the CO group, and there was no significant difference between the two groups( t=0.140 and 0.468, P=0.989 and 0.640). The proportions of cage collapse and internal fixation loosening were 70.7%(53/75)and 37.3%(28/75)in the OP group, which were higher than 22.3%(23/103)and 14.6%(15/103)in the CO group( χ2=41.440 and 12.280, both P=0.000). However, there was no significant difference between the OP group and the CO group in 1-and 2-year postoperative interbody fusion rates(postoperative 1-year rate: 89.3% or 67/75 vs.91.3% or 94/103, χ2=0.187, P=0.666; postoperative 2 year rate: 94.6% or 71/75 vs.95.1% or 98/103), χ2=0.021, P=0.885). There was no significant difference in VAS score and Oswestry disability index(ODI) between the OP group and the CO group at 6 months, 1 year and 2 years after surgery(all P>0.05). Conclusions:Although there are some osteoporosis-related complications such as cage subsidence and screw loosening, short-segment TLIF can still achieve good clinical results in elderly patients with osteoporosis.