Objective To investigate the influence of vertebral artery (VA) dominance in basilar artery (BA) curvature and pontine or cerebellar infarction occurring around the vertebrobasilar junction.Methods Radiological data (infarction laterality,VA dominance,BA curvature and their directional relationships)were analyzed in 86 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarction.Multiple Logistic regression analysis was performed to predict the moderate to severe BA curvature.Results The dominant VA frequently happened on the left side (69.8％,60/86).The BA curvature frequently happened to be right lateral flexion (74.4％,64/86).In 86 patients,71 patients had negative direction relationship between VA dominance and BA curvature.The diameter grade of VA had significant relationship with hypertension,moderate and severe BA curvature and right diameter of VA (P ＜ 0.05 or ＜ 0.01).The diameter of VA was the only independent predictor for moderate and severe BA curvature (OR =2.81,95％ CI:1.33-6.09).Conclusions VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of VA dominance.VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarction.

Objective To observe the effects of propofol or thiopental on the changes of blood brain barrier (BBB) permeability in focal cerebral ischemia Methods Focal cerebral ischemia model was induced with occluding the middle cerebral artery (MCA) Sixty adult male SD rats were divided randomly into 5 groups: control group(group MC): without any anesthetics; propofol pretreated group (group MP1) or thiopental pretreated group (group MT1): intravenous bolus of propofol 20mg/kg or thiopental 40mg/kg, followed by intravenous infusion of propofol or thiopental at rate of 50 60 mg?kg 1 ?h 1 or 100 120 mg?kg 1 ?h 1 ,respectively ,to achieve and maintain the EEG burst suppression 30 min before MCA occlusion until the beginning of reperfusion; propofol therapy group (group MP2) or thiopental therapy group (group MT2): from the beginning to the end of the reperfusion , propofol or thiopental was administered at the same dose as group MP1 or group MT1; Blood pressure, P ET CO 2, ECG and EEG were monitored throughout the experiment Rectal temperature was maintained between 37 5℃ and 38 5℃ At the end of the experiment, after intravenous bolus of 2% evans blue dye(EB) 3ml/kg, the brain was taken out to check out the extends and areas of EB staining on the surface and standardized serial coronal sections of the brain ,under the optical microscope and electromicroscope Results 1 Both propofol groups did not alleviate BBB permeability changes and cerebral damage 2 Cerebral injury was most slightly in group MT1 3 BBB permeability and brain injury in group MT2 were slighter than those in group MC and MP1, MP2 Conclusions Thiopental at the dose maintaining EEG burst suppressioncan can reduce the brain injury induced with ischemia and reperfusion, with the better protective effects following the prophylactic administration Propofol at that dose can not improve the cerebral ischemic reperfusion injury

To observe the influence of different concentrations of sevoflurane on blood brain barrier permeability in rats, thirty adult male SD rats were randomly divided into three groups: control group (without general anesthetics), 1 MAC sevoflurane and 1.5 MAC sevoflurane groups (maintaining end expiratory concentration to 2.2% and 3.3% respectively for 1 hour). Before the end of the experiment, 2% Evans′ blue dye (EB, 3ml/kg) was intravenously injected. The range and areas of EB staining on the surface and standardized serial coronal section of the brain were assessed. The brain was also observed under the light microscope and electron microscope. The results indicated that sevoflurane at both concentrations did not increase the permeability of BBB to EB and lanthanum, and there were no significant changes in morphological features of central nervous system after inhalation of sevoflurane.

Objective To compare the clinical effects of 3i nternal fixation devices,130?comp res-sion-plate,Richards screw-plate system and Gamma locking nail,in tre atment of intertrochanteric fractu res of femur in order to provide evidence fo r clinical choice.Methods The 3different internal fixation devices were statistically compared in terms of t heir surgery time,volume of operative bleeding,hospitalization time,postop-erative complications,as well as excellent and good rate of function in t reatment of intertrochanteric frac tures of femur.Results Compared with the other two treatmen t groups,the Gamma locking nail grou p presented the best therapeutic effects.Its posto perative complications were significantly lower and its excellent and f ine rate of function was significantly higher t han those of the other two groups.Conclusion Gamma locking nails are a kind of effective internal fixation device for the treatment of intertro chanteric fractures in elderly patients,because it has better biomechanical properties which facilitate fracture healing and recovery of hip joint function.[

Objective To study the role of total flavonoids of hippophae rhamnoides in improving contactile function of stretched cardiac myocyte.Method Flavonoids were given to stretched myocytes which were proved their contractile function decline and then myocyte contractile mechanics characteristics and calcium transfer were measured.Result Flavonoids increased myocyte contractility,as indicated by myocyte shortening,velocity of shortening,peak+dL/dt and peak-dL/dt during shortening,in a concentration-dependent manner (r>0.9,P<0.001),and with no relation to the intracellular calcium transfer in the myocytes.Conclusion Flavonoids of the traditional Chinese drug hippophae rhamnoids is effective in improving the contractile function of stretched cardiac myocyte in low dosage.

Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.

Objective To evaluate the role of 11C-methionine positron emission tomographv(MET PET-CT)in differentiating tumor recurrence from radiation necrosis in brain slioma patients.Methods From June 2008 to September 2009,30 brain glioma patients with suspected tumor recurvence or radiation necrosis after radiotherapy were evaluated by MET PET-CT.The median time between initial radiotherapy and PET examination was 13.5 months.Tumor recurrence were confirmed by histological analysis while necrosis was based on histological analysis or the subsequent clinical follow-up.Results Eighteen out of 19 patients were histologically confirmed tumor recurrence among those tumor recurrence shown by MET PET-CT after surgery or stereotactic biopsy.11 patients were considered to have radiation necrosis because of stable neurological sympotoms and without massive enlargement of the lesion during the after follow-up.The sensitivity,specificity and accuracy of MET PET-CT for detecting tumor recurrence were 100%,91.7%and 96.7%respectively.Conclusion MET PET-CT is a powerful tool in differentiating brain tumor recurrence from radiation necrosis after radiotherapy.

Objective To analyze the ultrasonic and clinical features of fetal gastric duplication. Methods Ultrasonographic apperance of 12 fetal stomach duplication cases were reviewed and followed up. Results The age of 12 fetal gestational duplication cases ranged from 19 weeks to 36 weeks. All cases were cystic-type,and 11 cases of gastric duplication were diagnosed by antenatal ultrasonography. Eleven cases were normal labored,2 patients were cured after surgical management. One case was misdiagnosed to be bile duct cyst, and was induced in 1 week after diagnosis because of simultaneous combination of hydrocephalus in bilateral ventricle. Stomach duplication prenatal sonographic findings were cysts near the stomach with thickened wall in local enlarged images. The cystic wall included 3 layers of strong-weak-strong hierarchical structure as normal stomach wall. Conclusions Fetal stomach duplication has characteristic ultrasound features,and can be definitively diagnosed prenatally. Early diagnosis is of great importance for prenatal consultation and timely treatment after birth.

Objective To construct a multi-gene recombinant pcDNA3-HBsAg-p30-ROP2 expression vector and identify it preliminarily. Methods According to recombinant pcDNA3-p30-ROP2 restriction sites,HBV HBsAg gene sequences of primers were designed and synthesized to amplify target fragment,and then cloned into pcDNA3-HbsAg-p30-ROP2 expression vector. Af-ter sequencing,it was identified finally by restriction enzyme digestion and other molecular biology techniques. Results HBV HBsAg gene segment was amplified by PCR and the multi-gene recombinant pcDNA3-HBsAg-p30-ROP2 expression vector was constructed and identified to be correct as theoretical values. The PCR and restriction enzyme digestion results showed that HBsAg and p30-ROP2 gene in recombinant plasmid were confirmed by DNA sequencing. Conclusion The multi-gene recombinant pcD-NA3-HBsAg-p30-ROP2 expression vector is successfully constructed.

Objective: To determine the correlation of IgM deposition with clinic-pathological features and outcomes of IgA nephropathy patients. Methods: A total of 1060 patients, who were diagnosed as IgA nephropathy by renal biopsies between 2001 and 2007 in Guangxing Hospital were enrolled. According to immunofluorescent test, patients were divided into patients with mesangial IgM deposition and patients without IgM deposition. Renal survival curves were assessed by Kaplan-Meier method. The effect of IgM deposition on outcomes of IgA nephropathy patients was examined by univariate and multivariable Cox proportional-hazards regression. Results: Among 1060 IgA nephropathy patients, there were 750 patients with IgM deposition and 310 patients without IgM deposition. (1) Urinary protein and uric acid in patients with IgM deposition were significantly higher than those in patients without IgM deposition (all P<0.05). Other clinical indicators shown no statistical difference (all P>0.05). Moreover, IgM deposition patients had higher serum IgA, serum IgG and serum IgM (all P<0.05). (2) In pathological indicators, IgM deposition patients had more segmented sclerosis or adhesions (S1 of Oxford classification), activity lesions as inflammatory cell infiltration and mesangial proliferation, and chronic pathological changes as tubular atrophy, segmented glomerular damage than patients without IgM deposition (all P<0.05). (3) All patients were followed-up for a median of 89.7(61.8, 113.4) months, Kaplan-Meier analysis revealed that kidney survival rate was significantly lower in IgM deposition patients compared with patients without IgM deposition (Log-rank χ²=4.95, P=0.026). In a univariate Cox hazards regression mode, IgM deposition was a risk factor for poor prognosis of IgA nephropathy patients (HR=1.597, 95% CI 1.053-2.422, P=0.027). However, in a multivariable Cox analysis, IgM deposition shown no influence on outcomes of IgA nephropathy patients (HR=1.409, 95% CI 0.921-2.156, P=0.114). Conclusions IgA nephropathy patients with IgM deposition have higher urinary protein, and more serious pathological damage and immune fluorescence deposition. IgM deposition affects renal survival of IgA nephropathy, while IgM deposition is not an independent risk factor for prognosis of IgA nephropathy.