Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; etiology ; physiopathology ; therapy ; Spondylosis ; complications ; Upper Extremity ; physiopathology

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

Objective To study the genomic molecular organization and genogroup of human metapneumovirus(hMPV) infected infants in Guangzhou of China. Methods Primers were designed on the basis of the genomic sequence of hMPV 00-1 strain(AF371337) in the GenBank, and amplify hMPV genomeby RT-PCR. The PCR-products were cloned to T vector and sequenced, the genomic nucleotide sequences were analyzed with the programs Clustal W/X, DNASTAR and MEGA4. 1. Results The cloned strainhMPVgz01 genome is 13 327 bp in length, the genome contains eight open reading frames in the order 3-N-P-M-F-M2-SH-G-L-5. The genomic sequences of hMPVgz01 strain are compared with those of hMPV in GenBank, revealed that the homology with hMPV group A ranges between 92%-97%, homology with group B is 81%, and with avian metapneumovirus group C is 71%, the highest homology is with BJ1887 strain of genogroup A2b. The N, F, G genes of hMPVgz01 strain are compared with those corresponding genes of hMPV subgroups A1, A2, B1, B2, revealed that the highest homology is also with genogroup A2b. Conclusion The complete nucleotide sequence of hMPVgz01 strain isolated from Guangzhou in China is 13 327 bp in length, GenBank accession No. is GQ153651. Comparison of the genomic sequence and three genes of hMPVgz01 strain with those corresponding sequences of hMPV show the highest homology is with genogroup A2b. Sequence and phylogenetic analysis of the hMPVgz01 strain revegled that this isolate belongs to genogroupA2b.

0.05).There was a positive correlation between the tempo of the engraftment and the progressive increase of the doses of MNC in the range of (3～5.99)?108/kg,but which was not found in the range of 6?108/kg.Conclusion These results indicate that MNC taken as an index for the measurement of the hematopoietic stem cell/progenitor content can reliably predict hematopoietic reconstitution after both HLA-matched and-mismatched sibling donor peripheral blood stem cell transplantation,with the rate and tempo of engraftment comparable with that in CD34+ cell group,and however,the target dose was reached with one apheresis in all 83 donors in MNC group(100%),as compared with 14 donors in CD34+ cell group(37.84%),suggesting that MNC may replace CD34+ cell as an independent index for the assessment of the stem cell/progenitor content in clinical practice.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Objective To evaluate the reproducibility of normal liver ADC measurements by different respiratory motion compensation techniques. Methods A total of 31 young healthy volunteers who are 20 to 40 years old without any hepatic diseases were selected to research. Each volunteer underwent liver DWI twice in 24 hours with the same parameters and location. The imaging was performed with free-breath(FB), breathhold(BH), rspiratory-triggered(RT)and navigator-triggered(NT)techniques, and the ADC values of the left hepatic lobe and right hepatic lobe (upper, middle and lower) was acquired with two scans. Analysis the the ADC values of various anatomic locations of liver with two-way analysis of variance of randomized block design. Reproducibility of ADCs was assessed with the Bland-Altman method. Analysis of variance and paired-sample t test was used to assess ADCs from both right and left liver lobe among the four techniques. Result The ADC values acquired from the four techniques were significant differences (P<0.01),and the ADC values of the right lobe were less than the left lobe's(P<0.01). It showed a trend to decrease moving from superior to inferior levels in both left and right lobes, and the ADC values among The middle and lower were significant differences (P<0.01). The limit of agreement of ADC of twice imaging among the four techniques were as follow: the right lobe was less than the left lobes, and the breathhold was less the others. As the result, reproducibility in the right liver lobe was better to that in the left and the reproducibility with breathhold was better than the other respiratory motion compensation techniques. Conclusions Both anatomic location and DWI technique influence the liver ADC measurements and their reproducibility. The reproducibility of BH is the best.

Objective To explore the clinical value of endoscopic ultrasonography (EUS) examination before esophageal achalasia (EA) patients treated by peroral endoscopic myotomy (POEM).Methods From August 2011 to November 2011,esophageal EUS examination was conducted in 34 EA patients scheduled for POEM treatment (EA group) and 30 cases accepted gastric EUS examination (control group) at endoscopic center,Zhongshan Hospital,Fudan University.The thickness of muscularis propria layer and the circular muscle layer was measured at cardia,5 cm,10 cm and 15 cm above cardia,and the proportion of circular muscle layer was calculated.The differences in groups and between groups were compared.The correlation between muscle thickness and complication after POEM treatment was analyzed.The data were analyzed by t test.Results There was no difference between EA group and control group in the thickness of the muscularis propria layer at same part (at cardia,5 cm,10 cm and 15 cm above cardia,t=1.210,1.116,0 and 0.292respectively; all P＞0.05 respectively).The thickness of the circular muscle layer of EA group at cardia,5 cm,10 cm and 15 cm above cardia was (1.72±0.49) mm,(1.86±0.81) mm,(1.56±0.47) mm and (1.41±0.48) mm respectively,those of control group was (1.06±0.50) mm,(1.40±0.33) mm,(1.05±0.37) mm and (0.78±0.12) mm respectively.At same part,the thickness of the circular muscle layer of EA group was significantly thicker than that of the control group (t =5.326,2.903,4.778 and 6.993 respectively,all P＜0.05).After POEM treatment,complication was high in EA cases with the thickness of muscularis propria layer less than 2 mm.Conclusion Before POEM treatment,EUS examination for EA patients has certain guiding significance.

Objective To study the relationship between the genetic polymorphisms of carboxylesterase 1 gene (CESI) and the susceptibility to antituberculosis drug-induced hepatotoxicity (ATBDIH).Methods Genetic polymorphisms of CES1 in 473 tuberculosis patients with or without hepatotoxicity (200∶ 273) after antituberculosis chemotherapy were analyzed by PCR-MassArray.Results In4 tags of CES1 single nucleotide polymorphism (SNP),the frequency of the rs1968753 allele had statistical difference between the hepatotoxicity group and the no-hepatotoxicity group ( P =0.0236 ).The characteristics of anti-hepatotoxicity had been shown relationship with rs8192950 ( P =0.044,OR =0.649,95％ CI =0.426-0.989,AC/AA ) and rs1968753 ( P =0.048,OR =0.556,95％ CI =0.311-0.995,GG/AA).The diplotypes with ‘ CGC' haplotype exhibited significant protection against hepatotoxicity at one copy (P=0.048,OR=0.654,95％CI=0.430-0.996).Conclusions The genetic polymorphisms of CESI might have significant association with ATBDIH.SNP rs8192950 AC genotype and rs1968753 GG genotype might be the candidates for risk prediction of ATBDIH.

Objective To investigate the clinical outcomes of sternoclavicular hook plate in treatment of the anterior sternoclavicular joint dislocation. Methods A new device named sternoclavicular hook plate was devised by our team. Between May 2002 and Octorber 2009, 66 patients with sternoclavicular joint anterior dislocation were treated with the new device, among whom there were 47 males and 19 females,aged 21-68 years old (average, 32.6 years old). Twenty-one cases were caused by crush injury, 5 cases by falling and 40 cases by traffic accident. Anterior fracture-dislocation was found in 41 cases. According to the Allman system, there were 35 cases of type Ⅱ and 31 cases of type Ⅲ. Patients were evaluated with serial clinical and radiographic examinations. Rockwood score were used after the operation to assess the curative effect. Results The average operative time was 33 min (range, 20-48 min). The mean blood loss was 60 ml (range, 20-90 ml). There were no vascular or peripheral nerve injuries in the patients. All incisions healed smoothly. The X-ray and CT showed that the reduction of sternoclavicular joint and the location of internal fixation were satisfactory. All the 66 patients were followed up for 12-37 months (average, 17 months). There was no internal fixation failure, redislocation or other complications. The sternoclavicular hook plate was removed 12 months after operation. The mean Rockwood's score was 13.2 (8 to 15). There were excellent in 50cases, good in 15 cases, and fair in 1 case. Conclusion The sternoclavicular hook plate is a new, safe and liable technique for sternoclavicular fracture-dislocation. This new technique is helpful for early functional exercises.

Objective To establish a predictive model and to find the preoperative predictors for the nature of lesion in the setting of chronic pancreatitis. Methods The 121 patients from 7 tertiary medical centers in Shanghai from July 1998 to April 2007 with focal mass lesions in the setting of chronic pancreatitis were selected as the study population. The final diagnosis had to be confirmed histologically by surgical specimens (n =97) or by follow-up (n = 24). A case control study was conducted; the patients were divided into pancreatic cancer group and chronic pancreatitis group. The age, sex, past history, initial clinical presentations, lab results and imaging exams were collected by reviewing the medical records of these patients. χ~2 test and t test was used for univariate analysis, then the factors with P≤0. 25 were selected for further multivariate analysis, and multivariate logistic regression model was used to estimate odds ratio and 95% CI. Results Of 121 , 21 patients had a final diagnosis of pancreatic cancer and other 90 patients had a final diagnosis of chronic pancreatitis. Abdominal tenderness, direct bilirubin, CA19-9 and CEA were independent predictors of cancer in patients with focal mass lesions. Their odds ratios (95% CI) were 5. 691 (1.468, 22.070) , 1.011 (1.001 , 1.021) , 1.003 (1.001, 1.005) , 101.9 (0.988, 1.051) , respectively. Their P values were 0. 012, 0. 030, 0.003 and 0. 23 , respectively. Conclusions The logistic regression model may accurately predict the nature of lesion in the setting of chronic pancreatitis and may have certain clinical implication.