BACKGROUND: It is manifested in epidemiology and clinical observation that lipoprotein (a) is a new risk factor of cerebrovascular disease and is closely related to cerebral ischemic stroke.OBJECTIVE: To discuss the relationship between levels of high serum lipoprotein (a) and stroke.DESIGN: Case controlled analysis.SETTING: Neurological Institute of Xiangya Hospital of Central South University.METHODS: Totally 294 patients with stroke were selected from Neurological Department of Xiangya Hospital of Central So, uth University between September 1999 and March 2002. Of them, 159 cases were regarded as cerebral infarction group and other 135 cases as acute hypertensive cerebral hemorrhage group. In cerebral infarction group, 109 patients had atherosclerotic cerebral infarction and 50 patients had lacunar cerebral infarction, and 94patients with contimuous health examination were regarded as health examination group. Serum lipoprotein (a) in each group was assayed with "sandwich enzyme-linked immuno-sorbent assay". According to whether the value of lipid was normal or not, patients with atherosclerotic cerebral infarction and acute hypertensive cerebral hemorrhage were divided into two groups. Comparisons between the two groups were assayed with single sample t test, and multiple liner regression was used to assay whether sex, hypertension and value of lipid were related to the level of serum lipoprotein (a).MAIN OUTCOME MEASURES: ① Comparisons of serum lipoprotein (a)among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group. ② Correlated analysis between serum lipoprotein (a) and lipid.RESULTS: Among 294 patients, 94 cases in control group entered the final analysis. ① Comparisons of serum lipoprotein (a) among atherosclerotic cerebral infarction group, lacunar cerebral infarction group, acute hypertensive cerebral hemorrhage group and health examination group: Levels of serum lipoprotein (a) in atherosclerotic cerebral infarction group and cerebral hemorrhage group were higher than those in health control group (P ＜ 0.05), and concentration of lipoprotein (a) in atheroosclerotic cerebral infarction group was increased as compared with that in acute hypertensive cerebral hemorrhage group (P ＜ 0.05). Also, level of lipoprotein (a) in lacunar cerebral infarction group was a little higher than that in control group,but the difference was not significant (P ＞ 0.05). ② Correlated analysis between serum lipoprotein (a) and lipid: Levels of lipoprotein (a) in both normal lipid group and abnormal lipid group were assayed with single sample t test, and the results showed that levels in the two groups were similar (P ＞ 0.05). Multiple liner regression was used to assay whether sex,hypertension and value of lipid were related to level of serum lipoprotein (a).CONCLUSION: Levels of lipoprotein (a) may be an independent risk factor for cerebral hemorrhage and atherosclerotic cerebral infarction.

We used 4 methods,such as ultrasonic crush(UC),ultrasonic rinse(UR),whorl surge(WS)and rubbing(RU),to isolate epiphytic bacteria from red alga Gracilaria lemaneiformis.Then,we counted bacteria numbers,detected bacterial species,observed bacterial configuration and characteristic of cell wall.Compared with these methods and with different treatments in one method,the results were drawn:the UR and RU were inferior in all methods to isolate bacterial numbers and species,the UC and WS were better,especially,the treatment 30W 30s of UC was the best in experiment,which isolated 12 of 16 bacterial species,and got 1.75 10~6 cells per gram wet weight G.lemaneiformis.

Background: The etiology of Kienb?ck's disease is controversial, and the blood supply is a possible pathogenic factor. The red lead (Pb3O4) angiography with micro?computed tomography (micro?CT) of lunate to investigate intralunate arteries has rarely been reported. This study aimed to investigate a new, reasonable, and simplified technique to study the intraosseous arterial pattern of normal lunates. Methods: This study investigated the intraosseous arterial pattern of six normal cadaveric lunates through Pb3O4 injection and three?dimensional reconstruction with micro?CT. The intraosseous arteries of all specimens were clearly enhanced. The data of enhanced arteries and nutrient foramina were shown as median (Q1, Q3) and analyzed with Wilcoxon signed?rank test. Results: The mean number of total nutrient foramina was 2.00 (1.75, 2.00) on the palmar side and 3.50 (2.50, 4.25) on the dorsal side. The number with enhanced arteries on the palmar side was 1.00 (0.75, 2.00) and on the dorsal side was 3.50 (1.75, 4.00). There were no significant differences between the number of nutrient foramina on the palmar and dorsal sides of the lunates, no matter the total number or enhanced arteries. The intraosseous arterial pattern in normal lunates can be classified into three types: the dominate stems from the palmar side, from the dorsal side, and from both sides with anastomosis. Conclusions: The Pb3O4 angiography with micro?CT is a simplified, quicker, and reliable method to study intraosseous arteries.

In order to study the microstructure characteristics of normal lunate bones,eight fresh cadaver normal lunates were scanned with micro-computed tomography.High-resolution images of the micro-structure of normal lunates were obtained and we analyzed the nutrient foramina.Then nine regions of interest (ROI) were chosen in the central sagittal plane so that we could obtain the parameters of trabecular bones of ROIs.The distal lamellar-like compact structure had statistically significant differences when it was compared with the ROIs in the volar and dorsal ends of the distal cortex.The difference of diameter between the volar and dorsal foramina was significant (P＜0.05).However,there was no significant difference regarding the number.The trabecular bones of the volar and dorsal distal ends had lower intensity than those of the distal central subchondral bone plate.The diameters of the nutrient foramina on the volar cortex were larger than those on the dorsal.This research provided more detailed information about microstructure of normal lunate and the nutrient foramina on cortex,and a reference for further study about diseased lunate.

OBJECTIVETo analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method.

METHODSThe clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function.

RESULTSAfter 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P < 0.05): the external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (P< 0.05).

CONCLUSIONTreatment of external fixation with limited internal fixation in the treatment of Pilon fracture of Rüedi-Allgower type III is effective and safe.

Adult ; Aged ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective To investigate the antibacterial activity of quinu-prisitin/dalfopristin on the clinical isolates of Enterococcus faecium in vitro.Methods A total of 2217 Enterococcus faecium isolates were isola-ted from the various specimens of patients at the first affiliated hospital of Wenzhou medical university from January , 2011 to December , 2015.The susceptibility of 2217 Enterococcus faecium isolates to quinuprisitin/dalfopristin and the susceptibility of quinuprisitin/dalfopristin -non -susceptible isolates to clinically often used antimicrobials were determined by full automated Microbiology Analyzer.Results Among 2217 Entero-coccus faecium isolates, 115 (5.2%) were non -susceptible to quinu-prisitin/dalfopristin, among which 25 with quinuprisitin/dalfopristin re-sistance and 90 with quinuprisitin/dalfopristin intermediate.The rates of quinuprisitin/dalfopristin non -susceptibility among tested clinical iso-lates from 2011 to 2015 were 4.3%(25/588), 3.1%(18/581), 6.2%(22/353), 6.3%( 25/394 ) and 8.3%( 25/301 ), respectively.All non-susceptible isolates were susceptible to vancomycin , linezolid , teicoplanin and tigecycline.However , more than 80% of theses isolates were resistant to ampicllin, penicillin, levofloxacin, ciprofloxacin, moxifloxacin and erythromycin.Conclusion Quinuprisitin/dalfopristin has good antimicrobial activity in vitro against Enterococcus faecium clinical isolates.The prevalence of quinuprisitin/dalfopristin resistance remained relatively stable and low , but non-susceptible rate showed an upward trend.

BACKGROUNDTo repair late median nerve injury, many methods have been used in the past years. The aim of this study was to review a thirteen-year experience in restoration of thumb opposition by transposing flexor pollicis brevis muscle.

METHODSFrom July 1992 to August 2005, 63 patients without thumb opposition because of late median never injury were treated by transposing the flexor pollicis brevis muscle. All the patients had received primary nerve repair after the jnjury. The interval between the injury and the second operation was (1.87 +/- 2.31) years (6 months to 4.2 years). The patients were followed up for 3 to 48 [months mean (22.93 +/- 2.31) months]. A functional evaluation system designed in 1992 were used to estimate the outcomes of the patients.

RESULTSAll the patients gained excellent functional results without complications and disabilities during follow-up.

CONCLUSIONSRestoration of thumb opposition by transposing flexsor pollicis brevis muscle has the following advantages: 1. Operative trauma is minimal; 2. It is not necessary to transpose other tendons; 3. Except for the thumb in opposition, movements of other fingers and the wrist are not restricted postoperatively.

Adolescent ; Adult ; Biomechanical Phenomena ; Female ; Forearm Injuries ; physiopathology ; surgery ; Humans ; Male ; Median Nerve ; injuries ; Middle Aged ; Muscle, Skeletal ; surgery ; Tendon Transfer ; Thumb ; physiopathology ; surgery ; Wrist Injuries ; physiopathology ; surgery

OBJECTIVETo summarize the clinical characteristic and outcome of digital gigantism of the foot.

METHODSRetrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis.

RESULTSSeven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair.

CONCLUSIONSDigital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Foot Deformities, Congenital ; surgery ; Forefoot, Human ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Toes ; abnormalities ; Treatment Outcome

OBJECTIVETo explore the diffusion-tensor imaging (DTI) characteristics of normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM) on conventional magnetic resonance imaging (MRI) in patients with subcortical ischemic vascular disease (SIVD) and examine the relation of such features with the general cognitive function of the patients.

METHODSDTI was performed in 46 SIVD patients and 34 age-matched control subjects with normal MRI findings. The apprarent diffusion coeeficient (ADC) and fractional anisotropy (FA) were measured within the regions of white matter lesions (WMLs), NAWM and NAGM. All the subjects were examined by neurologists with MMSE and clinical neurologic examination.

RESULTSCompared with normal controls, SIVD subjects showed increased ADC values in the subcortical NAGM and NAWM in anterior periventricular and centrum semiovale, with decreased FA values in the caudate nucleus, thalamus and centrum semiovale. An increased severity of the WMLs was associated with increased ADC and decreased FA in the NAWM of SIVD patients. After controlling for age, the ADC in the NAWM of the posterior periventricular, NAWM and WMLs in the centrum semiovale, caudate nucleus and thalamus showed significant inverse correlations to MMSE; FA values in NAWM of the anterior periventricular and WMLs of the centrum semiovale were positively correlated to MMSE.

CONCLUSIONIn SIVD patients, the NAWM and NAGM regions shown by MRI contain diffusion abnormalities, and these abnormalities shown by DTI are significantly correlated to the general cognitive function of the patients.

Aged ; Anisotropy ; Brain Ischemia ; physiopathology ; psychology ; Case-Control Studies ; Cerebral Cortex ; pathology ; Cognition ; physiology ; Cognition Disorders ; pathology ; physiopathology ; Dementia, Vascular ; pathology ; physiopathology ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Male ; Middle Aged

Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; CA-19-9 Antigen ; blood ; Carcinoma, Hepatocellular ; diagnosis ; Cholangiocarcinoma ; diagnosis ; Humans ; Liver Neoplasms ; diagnosis