Objective:To study the expression of livin and its correlation with cyclin B1 in breast cancer.Methods:The expressions of livin and cyclin B1 in breast cancer paraffin embedded specimens were detected by immunohistochemical technique.The relationship between livin and cyclin B1 and clinicopathological characteristics was analyzed.Results:The rates of positive expression of livin and cyclin B1 protein in breast cancer were 77.2%and 68.4%,respectively,and the correlation was psitive(?=0.701,P

Nowadays,statin has been one of the key medications for the prevention and treatment of cardiovascular and cerebrovascular diseases.Over the past years,lost of studies related to statins in preventing and treat ischemic cerebrovascular disease have been carried out.For clinical practice,this paper reviewed the clinical evidences of statins on primary prevention and secondary prevention for ischemic stroke as well as the safety of statins.

Intravenous thrombolysis has been proved as an effective therapy for acute ischemic stroke.However,symptomatic intracranial hemorrhage (sICH) occurred after thrombolysis will affect the recovery of patients,even endangers life when it is serious.Therefore,determining the risk factors for sICH after thrombolysis is helpful to select appropriate patients for thrombolytic therapy.The risk factors for slCH after thrombolysis include advanced age,male gender,obesity,higher National Institutes of Health Stroke Scale scores,hypertension,diabetes or higher blood glucose,atrial fibrillation,delayed thrombolysis time,antiplatelet therapy,anticoagulation therapy,and leukoaraiosis.However,some of the risk factors still have conflicting reports.Further large sample clinical studies are needed to confirm them.

Spinal disease is the injury caused by congenital malformation, degeneration, inflammation and trauma. These injuries lead to structural lesion of spinal itself, intervertebral discs, spinal cord, nerve root and the attachment, and can cause spinal and associated diseases. Spinal diseases include some frequently encountered diseases, as well as some stubborn and serious diseases. These diseases may cause pain of head and neck, shoulder and arm, waist and leg when they are mild, and partial or thorough paralysis when they are serious. In this article, the history, development, foundations and research progress of non-surgical operation of spinal diseases and the developing tendency of modern spinology are introduced.

The techniques for endoscopic diagnosis and treatment of biliary and pancreatic diseases mainly include endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography,which have achieved great progress in recent years.Meanwhile,new techniques including combined therapy with endoscopy and laparoscopy and natural orifice transluminal endoscopic surgery have gradually been applied in clinical practice.In the future,it is necessary to cultivate interdisciplinary experts in the field of endoscopy who master various endoscopic techniques and integrated talents with experience in both transluminal operation and gastrointestinal surgery outside lumens.At present,there are still controversies over the application of new techniques in the treatment of biliary and pancreatic diseases.The diagnosis and treatment of biliary and pancreatic diseases can be further improved by promoting the application of biliary and pancreatic endoscopy and standardization,accumulating experience and improving devices,evaluating clinical research,and promoting the bench-to-bedside translation of new techniques.

OBJECTIVE To summarize the characteristics of central vertigo and subclavian steal syndrome(SSS)and analyze the relationship between them.METHODS A retrospective review of 87 cases of patients diagnosed with SSS based on the evidence of clinical symptoms and results of transcranial doppler(TCD),cervical doppler ultrasound(CDUS),head and cervical magnetic resonance angiography(MRA),or cerebral digital subtract angiography(DSA)was present for analyzing the clinical presentation between the central vertigo and the subclavian steal syndrome.RESULTS There were more male than female in the 87 cases;8.05% of patients were under the age of 50,37.93% from 50 to 65,and 54.02% over 65,showing the incidence of SSS increases with the age.In 64.37% of patients,vertigo was the only symptom;in 29.89% of patients,vertigo presented as an accompanying symptom;and in 5.75% of patients,there was no significant vertigo.Of all these patients,65.52% had left SSS,32.18% had right SSS,2.30% had bilateral SSS;there were more left side lesions than right side.CONCLUSION SSS is no longer a rare disease as investigation tools keep developing.Its incidence increases with age.As vertigo may be its only clinical presentation,SSS could be misdiagnosed very easyly.To avoid misdiagnosising,it is very important to screen for SSS in patients with vertigo for the diagnosis early.

Objective Videofluoroscopy could identify the pathophysiologic changes of swallowing and be help to make management plan. The study was to identify image manifestation and characteristics of dysphagia in stroke under X-ray. Methods Videofluoroscopy were performed in 56 stroke inpatients and 30 healthy volunteers who drunk 1, 3 and 5 ml barium with viscosity of 60%w/v, 180%w/v and ate half piece of cake smeared with barium. Abnormal swallowing and quantitative measurements in antero-posterior and lateral position were recorded. Chi square test and Logistic regression analysis were used to identify abnormal swallowing associated with accidental aspiration. Rank test and t test were used to analysis the difference of quantitative measurements between control and accidental aspiration group. Results All the swallowing apparatus could be injured after stroke which led to a variety of abnormal oral and pharyngeal swallowing including decreased tongue and palate motility, insufficient glottis closure, delayed swallowing, accidental aspiration etc. All patients presented abnormality in pharyngeal phase and 46 in oral phase. Compared with that of volunteers, height and velocity of larynx elevation decreased, opening width of cricopharyngeal muscle reduced and swallowing latency prolonged in dysphagia patients. Accidental aspiration was seen in 34 patients, of whom 14 patients presented silent aspiration. Statistic analysis showed that decreased tongue movement(P=0.021), poor tongue-hard palate contact (P=0.021), insufficient glottis closure(P=0.011), decreased height and velocity of larynx elevation(P=0.003), delayed swallowing (P=0.001) and penetration (P=0.000) were associated with accidental aspiration. Conclusions Stroke may injure all the swallowing apparatus, more frequently in pharyngeal phase. Tongue weakness, insufficient glottis closure, poor larynx elevation, delayed swallowing and penetration are associated with accidental aspiration.

Objective To identify whether abnormal clinical manifestations of dysphagia in stroke patients could predict associated imaging abnormalities. Methods Clinical evaluations and videofluoroscopy were performed on 56 consecutive cases of stroke. The clinical and image manifestations of dysphagia were observed and analyzed u-sing logistic regression analysis. Results A bolus leaking from the mouth was found (P =0.037) to predict abnormal lip closure. Raising the head when swallowing (P =0.010) and dysarthria (P =0.025) were found to predict reduced tongue movement. Exertion in swallowing (P = 0.016) could predict poor laryngeal elevation. Abnormal la-ryngeal elevation (P =0.024) and reduced or absent gag reflex (P =0.005) were found to predict insufficient epiglottis tilt down. Coughing caused by swallowing could predict incomplete vocal fold closure (P =0.011) and aspiration (P = 0.042). Conclusion Videofluoroscopic manifestations could be predicted to some extend by some clinical swallowing abnormalities, which could increase the accuracy of clinical evaluation and help in the management of dysphagia in those who could not endure videofluoroscopy.

Articular cartilage as a load-bearing connective tissues may often be caused defects by trauma,sports, degenerative or age-related diseases. As articular cartilage has a limited inherent repair capacity, a large variety of treatment approaches including autologous chondrocyte transplantation, microfracture and mosaicplasty methods have been developed. However, there are limitations in these strategies especially when using autologous chondrcytes. Mesenchymal stem cells are considered the most promising seed cells in the study of tissue engineered cartilage. This review focuses on the induction of mesenchymal stem cells into chondrocytes in vitro and their application in cartilage repair.

OBJECTIVE: Functional deterioration of the nerves following cerebral hemorrhage is associated with cerebral hemorrhage-induced brain edema and involves multiple pathways of nerve injuries, now recognized as a complex pathophysiological process involving the interactions between multiple factors. Elucidation of the mechanisms of nervous system injury after cerebral hemorrhage may provide theoretical basis for implementing effective rehabilitative interventions for cerebral hemorrhage.DATA SOURCES: A computer-based search in the Medline database for related articles published between January 1991 and December 2003 was conducted using the combinations of the searching words of "emorrhagic stroke, cerebral hemorrhage, brain edema, and nervous system injury", with the language of the articles limited to English. A search in Wanfang database was also conducted using the key words of "cerebral hemorrhage, brain edema, nervous system injury" (in Chinese) for related Chinese articles published between January 2004 and January 2005.STUDY SELECTION: Total 85 original articles were selected after elimination of the irrelevant ones. Inclusion criteria: reports of animal experiments and clinical trials on cerebral hemorrhage following brain edema and mechanisms of nervous system injury were selected, particularly those focusing on brain edema after cerebral hemorrhage.DATA EXTRACTION: Of the 85 articles, 22 were found closely related to the subject concerned and 18 were indirectly relevant. Nine were excluded for duplicated reports, so that 31 articles were finally selected for analysis.DATA SYNTHESIS: Analysis of the literature suggested that secondary edema around the hematoma and nervous system injury were important indicators for poor prognosis of patients with cerebral hemorrhage. Multiple factors participated in the process of secondary brain edema and nerve injuries,such as the hydrostatic pressure during formation of the hematoma and clot retraction, activation of blood coagulation cascade, generation of thrombin,erythrocytolysis and the toxicity of hemoglobin, the activation of the complement system, space-occupying effects, rupture of the blood-brain barrier,secondary ischemia around the hematoma, inflammatory reaction of the neurons around hematoma and cell apoptosis.CONCLUSION: Effective protective interventions for brain edema after cerebral hemorrhage and complex pathophysiological changes may attenuate nervous system injuries following cerebral hemorrhage and improve the prognosis of functional recovery.