Recent studies have demonstrated that hyperhomocysteinemia is an independent risk factor for stroke,which may cause vascular endothelial injury by multiple mechanisms,destroy blood coagulation and fibrinolytic systems,and influence on lipid metabolism.Methylenetetra hydrofolate reductase(MTHFR)is a key enzyme of homocysteine metabolic pathway in the human body.If it is insufficient or its activity decreases,it will directly result in the accumula tion of homocysteine in the human body,and callse hyperhomocysteinemia.Although a number of studies have found that MTHFR gene mutation is the main cause of MTHFR insufficient and its activity decrease,the correlation between MTHFR gene mutation and ischemic cerebral vascular disease is quite controversial now.This article reviews the relationship between MTHFR gene polymorphisms and ischemic stroke.

Objective To evaluate the difference of myocardium strain between myocadial infarction and ventricular aneurysm (VA) by two-dimensional speckle-tracking imaging in rabbits.Methods 26 healthy New Zealand white rabbits were enrolled in this study,6 were put into the control group and 20 in the experimental group.models of myocardial infarction concomitant with VA were prepared by the ligation of the middle segment of left anterior descending artery and left circumflex artery.At 4 weeks after the procedure,according to the pathological inspect and echocardiography for whether VA formed,the experimental animals were divided into the VA group and the myocadial infarction group.Echocardiography was performed to measure the LV cavity size and cardiac function.Radial strain rate (SrR) and circumferential strain rate(SrC) indexes were measured by 2D-STI software for each animal at the level of apex in left ventricular short-axis view,and then calculated the strain rate decrease percentage in each segment.Results 1)Compared with the control group,SrR-S,SrR-E,SrR A,SrC-S,SrC-E,SrC-A in all segments were reduced significantly in the VA group and the myocadial infarction group (P ＜ 0.05),the VA group was the most significant.2)Compared with the myocadial infarction group,the strain rate decrease percentage of SrR-S,SrR-E,SrR-A,SrC-S,SrC-E,SrC-A in all segment had significant in the VA group.Comparison between the each section,the strain rate decrease percentage of SrR-Santerior wall,SrR-Sateral wall,SrC-Santerior wall,SrC-Slateral wall were the most significant.3)There were the tighter relationship between the strain rate decrease percentage of SrR-Santerior wall,SrC-Santerior wall,SrR-Slateral wall,SrC-Slateral wall and left ventricular ejection fraction (r =0.82,0.72,0.75,0.71,repectively,all P ＜ 0.05).4) The ROC curve analysis showed that when the strain rate decrease percentage was 60％ as the critical point,the strain rate decrease percentage of SrC-Santerior wall,SrC-Slateral wall,SrR-Santerior wall,SrR-Slateral wall had a sensitivity of 83.30 ％,84.40％,83.30％,67.70％％ and a specificity was 73.60％,78.20％％,69.70％,83.30％ for prognosis ventricular aneurysm,repectively.Conclusions After ventricular aneurysm formation,anterior and lateral wall myocardial strain were give priority to the myocardial mechanics reconstruction,thus systolic myocardial strain rate decrease percentage can be important indicator of infarction myocardial developing into ventricular aneurysm.

Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal microsurgery group, 24 cases were cured , 5 cases were effective and 3 cases were invalid , contrasting in the traditional group with 11 cases of cured , 7 cases of effective and 6 cases of invalid respectively, with a significant difference (Z=-2.239, P=0.025).No significant difference in effective rate between the two groups [90.6%(29/32) vs.75.0%(18/24),χ2 =1.459, P=0.227]. Conclusion The clinical efficacy of self-retaining laryngoscope microsurgery in the treatment of Reinke ’ s edema of vocal cords is faster and better comparing traditional operation , with a more significant pronunciation quality improvement .

OBJECTIVE: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
Adenoma, Pleomorphic ; complications ; Carcinoma, Adenoid Cystic ; complications ; Diagnosis, Differential ; Facial Paralysis ; complications ; Horner Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; therapy ; Pharynx ; pathology ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Salivary Gland Neoplasms ; complications ; Tomography, X-Ray Computed

To investigate the correlation of apolipoprotein E (ApoE) gene polymorphism and atherosclerotic cerebral infarction (ACI).Methods Polymerase chain reaction-restricted fragments length polymorphism (PCR- RFLP) was used to determine ApoE genotype on 92 cases with ACI (42 cases

OBJECTIVETo explore the feasibility and safety on lung resection surgery with the combined method of microinjection acupuncture (MIA) and intravenous anesthesia instead of compound traditional acupuncture and drug anesthesia (ADA).

METHODSNinety cases of lung resection surgery were randomized into a general anesthesia group, a MIA group and a ADA group, 30 cases in each one. In the general anesthesia group, before surgery, the intramuscular injection of atropine 0. 5 mg was used; during surgery, the anesthesia induction was followed with intravenous injection of fentanyl citrate, propofol and rocuronium bromide and the dosage was increased accordingly; after surgery, the analgesia pump was applied. In the MIA group, on the basis of general anesthesia, before anesthesia induction, the acupoint catgut embedding was applied to Jiaji (EX-B 2) of T4 , T6 and T, , Feishui (BL 13), Xinshu (BL 15) and Geshu (BL 17) on the affected side and bilateral Quchi (LI 11) and Zusanli (ST 36); after surgery, the analgesia pump was applied. In the ADA group, on the basis of general anesthesia, before! anesthesia induction, electroacupuncture (EA) was applied to Hegu (LI 4), Neiguan (PC 6) , Houxi (SI 3) and Zhigou (TE 6) for 30 min; during surgery, EA and intravenous medication were combined at the same acupoints as those before surgery; after surgery, moxibustion and the analgesia pump were applied in combination for analgesia. In each group, the biological indices were monitored during surgery at 11 time points named T. (before anesthesia I induction), T1 (intubation in general anesthesia induction), T2 (skin incision), T3 (rib exposure in muscular incision) T. (chest open), T, (lung removal), T6 (drainage tube implantation), T7 (chest closure), T (muscular stitching), T, (skin stitching) and T0 (extubation). The actual dosage of anesthetics during surgery and the, dosage of fentanyl citrate in analgesia pump were quantified after surgery. Results (1) In the MIA group and ADA group, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(1. 23±0. 28) µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1, (1. 1±0. 38µg . kg-1 . h-1 vs (2. 4±0. 54µg. kg-1 . h-1 , both P<0. 05]. The increased dosage of propofol and rocuronium bromide was not different during surgery among the groups (all P>0. 05). (2) In the MIA group and ADA group, after surgery, the increased dosage of fentanyl citrate was less than that in the general anesthesia group [(11. 0±1. 04)µg/kg vs (15. 4±1. 52µg/kg, (11. 5±1. 38µg/kg vs (15. 4±1. 52µg/kg, both P<0. 05], reducing by 25% in comparison. (3) The differences in heart rate and blood pressure at 11 time points during surgery were not significant among the three groups (all P>0. 05).

CONCLUSIONn The combined method of MIA and intravenous anesthesia significantly reduces the dosage of intravenous anesthetics during and after lung resection surgery as compared with ADA, presenting the similar analgesic effect as simple intravenous medication and the good safety. The combined method of MIA and intravenous anesthesia is much

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Anesthetics, Intravenous ; administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Lung ; surgery ; Lung Diseases ; physiopathology ; surgery ; Male ; Microinjections ; Middle Aged ; Propofol ; administration & dosage ; Young Adult

Objective To explore more reasonable way of early post-operative effect of enteral nutrition fluids support for colon cancer.Methods A total of 86 case of colon cancer were selected and assigned to enteral nutrition group(EN n=45)and parenteral nutrition group(PN n=41)randomly.Parameters inclu ding the body wetght,IsA,IgM,lymphocyte,human serum prealbumin and albumen were monitored on three days before operation,the fifth,and eighth days after operation.Results The IgA,IgM,lympho cyte,human serum prealbumin and albumen levels of patients in EN group were much higher than that in PN group on the fifth and eighth days after operation(P＜0.05).Also IgA,lgM levels of EN group patients were almost higher than that in PN group on eighth day after operation(P＜0.01).Concusions It showed that to perform enteral nutrient supports for patients of colon cancer during early post-operative could increase their gut immunity after operation and reduce the complications and raise human serum prealbumin and albu men of them for their body recovery.

The therapy based upon individuality is becoming a trend Oil general surgery field which has been highlighted by lots of specialists,scholars and clinic doctors,and so as the therapy of inguinal hernia.Along with the rushing appearoace of new idea and technique,the problem up to the minite which is confusing clinic doctors is how to select proper method of inguinal hernia therapy.This article is focused on the therapy of inguinal hernia based upon individuality.

ObjectiveTo evaluate the influence on left ventricular(LV) twist,and the relationship between LV twist and function in the rabbits with ventricular aneurysm formed after myocardial infarction by two-dimensional ultrasound speckle tracking imaging.MethodsTwenty-six healthy rabbits were divided into two groups,six as control group,twenty as experimental group.The model of myocardial infarction and ventricular aneurysm were established by ligaturing left anterior descending coronary artery and left circumflex artery.After four weeks,according to the pathological examination of whether ventricular aneurysm formed or not,the experimental group was divided into myocardial infarct group and ventricular aneurysm group.Echocardiography was performed to measure rotations (at the levels of mitral annulus and apex in LV short-axis view),LV twist,left ventricular cavity size and function.ResultsCompared with the myocardial infarct group,LV end-diastolic diameter(LVEDD) and LV end-diastolic volume(LVEDV) were larger in the ventricular aneurysm group,but LV ejection fraction (LVEF),LV fractional shortening (LVFS),apical rotation and LV twist were lower in the ventricular aneurysm group than the myocardial infarct group.Both apical rotation and LV twist had shown a great correlation with LVEF.The conclusion was also shown in the ROC curve that sensitivity and specificity of diagnosis cardiac dysfunction were 76.9％ and 80.0％ respectively when the apical rotation was 1.21°.Conclusions There was a closely relationship between the change of apical rotation and the LV systolic function.When the apical rotation dropped to 1.21°,an apparent decline of LV systolic function was implied.

Objective To study the effect of cream of bedsore on the treatment of severe bedsore.Method One hundred and twenty patients were randomly divided into treatment group and control groups Ⅰ and Ⅱ,respecially 40 patients,given systemic treatment.Results The decubitus wound healing of treatment group was significantly better than the other two groups,the total effective rate being 85%,P ＜ 0.01.In the treatment group,pathogenic bacteria culture positive rate on decubitus wound was significantly lower than the two control groups,inhibition rate being 78%,P ＜ 0.05.Staphylococcus aureus,Pseudomonas aeruginosa,Escherichia coli and so on were inhibited.Conclusions In the treatment group,bedsore healing ointment was significantly better than Western medicine used in the control groups.It can improve the microcirculation of the blood perfusion,promote the establishment of collateral circulation,increase the affected area nutrition,improve the local tissue ischemia,hypoxia-induced metabolic disorders,and remove the necrotic tissue,and promote tissue repair and regeneration,the granulation growing,and the effect of epithelial healing.