Objective To investigate the major clinical manifestations and their effect on prognosis in patients with posterior circulation stroke (PCS).Methods The clinical data of 129 consecutive hospitalized patients with acute PCS confirmed by clinical and imaging were registered prospectively,and they were followed up for 3 months.The patients were divided into a good prognosis group (modified Rankin scale [ mRS] score ≤ 2) and a poor prognosis group (mRS score ≥ 3) according to their mRS scores.Results 90.7％ patients had 4 to 12 symptoms and signs,only 1 presented an isolated symptom.The most common symptoms and signs were unilateral.Crossed paralysis (1.6％) or quadriplegia (0.8％ ) was rare.Univariate analysis showed that the symptoms of unilateral limb weakness (relative risk [RR] 1.262,95％ confidence interval [ CI] 1.030-1.546; P =0.030),slurred speech (RR 1.434,95％CI 1.133 - 1.816; P=0.004),dysphagia (RR 2.216,95％ CI 1.131 -4.341; P =0.017),and the signs of decreased unilateral muscle strength (RR 1.288,95％ CI1.047-1.583; P=0.021),central facial/tongue paralysis (RR 1.467,95％CI 1.164- 1.850; P=0.002),dysarthria (RR 1.468,95％CI 1.154- 1.867; P=0.002),ocular motor dysfunction (RR 3.073,95％CI1.346 - 7.017; P =0.005),and conscious disturbance (RR 5.736,95％ CI 1.268 - 25.946; P =0.023) were the risk factors for poor prognosis,while ataxia (RR O.478,95％ CI 0.284 -0.804; P =0.002) was associated with good prognosis.Multivariate logistic regression analysis demonstrated that after adjusted for all risk factors,the baseline National Institutes of Health Stroke Scale (NIHSS) (odds ratio [ OR] 1.513,95％ CI1.107-2.066; P=0.009),dysarthria (OR,7.11,95％ CI 1.207-41.877; P=0.030),ocular motor dysfunction (OR 8.653,95％ CI 1.230- 60.887; P=0.030),and large-artery atherosclerotic stroke (OR5.482,95％ CI 1.008 -29.803; P =0.049) were the independent risk factors for poor prognosis in patients with PCS,while ataxia (OR 0.251,95％ CI 0.067- 0.941; P=0.040) was independently associated with good prognosis of the patients.Conclusions The clinical manifestations in patients with PCS are complex,the majority of their symptoms and signs are unilateral.Most of the patients showed a variety of symptoms,and the isolated symptoms axe rare.Some symptoms and signs may indicate the prognosis of patients.

Objective To study the clinicopathologic classification,and methods of individualized treatment of Budd-Chiari syndrome (B-CS).Methods Analysed the clinical data of 42 cases of B-CS in our hospital from March 2006 to August 2010.Results The 42 patients were divided into three types,including 5 subtypes,which of them underwent operation or the interventional therapy,All kinds of bypass,a total of 20 cases.After operation,1 case appeared hepatic encephalopathy and die from it,the others all recovered well.Radical lesion resection and thrombosis was taken out in 7 cases; a balloon catheter in 5 cases and postoperative recovered well.The spleen-lung fixation in 6 cases were cured after operation.The three cavity two capsule tube was used oppression hemostasis for 4 patients with emergency bleeding,three cases was cured of joint spleen cut + cutoff,1 case with conservative treatment is invalid,died.The 41 cases received follow-up,during the follow up period of 3 months to 3 years,2 patients had recurrence (4.9％),and the other patients recovered satisfactorily.Conclutions According to different the clinicopathologic classification of B-CS,Taking individualized treatment may further improve the clinical curative effect.

To study the role of a novel MDR-related gene MGr1-Ag in the multidrug resistant (MDR) gastric cancer. The whole length MGr1-Ag gene was cloned, and eukaryotic vectors carrying the full length of MGr1-Ag cDNA and its antisense expression vector were constructed. The sense vector and anti-sense were then transfected into MGC803 cells and SGC7901/VCR cells respectively by lipofectamine. The result showed that a 1.0kb fragment was successfully amplified by RT-PCR and cloned into pUCm-T vector. DNA sequencing suggested that the fragment was the properly encoded MGr1-Ag gene. Recombinant eukaryotic plasmids harboring MGr1-Ag and its antisense expression vector were also obtained by subcloning the gene into pCDNA3.1/V5-His, which was confirmed by endonuclease digestion. As confirmed by Western blot, stable cell strains with up and down-regulated MGr1-Ag expression were constructed. Those cell strains provided the basis for further study on the MGr1-Ag in MDR of gastric cancer.

Objective To establish a method for the determination of content in Sinomenine Hydrochloride external applied powder. Methods Diamonsil ODS C_(18) (250 mm ? 4.6 mm, 5 ?m) column was used in HPLC with mobile phase of phosphate buffer (0.01 mol/L K_2HPO_4 solution, and 1%0 triethylamine, pH was adjusted to 3.0)-MeOH (80 : 20). The flow rate was 1.0 mL/min and the detection wavelength was 265 rim. Results The linear range of Sinomenine Hydrochloride was 0.446～4.46 ?g and the regression equation was Y=9.01 ? 10~6X+102803 (r=0.9999). The average recovery was 99.2%, RSD=0.68% (n =9). Conclusion This method is rapid and accurate with good reproducibility. It can be applied to control the quality of Sinomenine Hydrochloride external applied powder.

Objective To investigate a method that perfect imaging could be obtained and minimal contrast media was used. Methods The 5 cases with enhanced CT images were measured at each slice, then the Hu of aim-position was obtained and the Hu-time curve was got. At last, the valid enhanced period would be found. Results According to the experience, the enhancement threshold of aorta, portal vein and hepar were set at 70 HU. The onset and ending time of enhancement threshold were found. Conclusion The dose of contrast media should be extenuatory when new type spiral CT was operated, and the correlative parameters, such as flow rate, delay time etc. should be adjusted according to the objective condition.

ObjectiveTo observe the clinical effects of Jianwei yuyang capsule combined with triad-therapy of western medicine on helicobacter pylori-related peptic ulcer in elderly.MethodsEighty patients above 60 years with peptic ulcer infected with helicobacter pylori were divided into two groups by random,and were treated with Jianweiyuyang capsule combined with triad-therapy of western medicine or triad-therapy of western medicine for 4weeks.The endoscopy and biopsy staining were used to analyze the cure rate and the helicobacter pylori eradication rate at the 6th week after the end of the treatment,and the main symptom improvement were observed.ResultsIn the treatment group,the cure rate,the helicobacter pylori eradication rate and total effective rate were significantly higher than control group.The two groups were significantly different ( P ＜ 0.05).ConclusionJianweiyuyang capsule combined with triad-therapy of western medicine was a more ideal treatment program for helicobacter pylori-related peptic ulcer in elderly.

Objective To explore the indication, to describe the key of operative technique in detail and to summarize the early results in mini-incision and minimally invasive surgery (MIS) total hip arthroplasty (THA) for hip disorders. Methods From Mar. 2003 to Mar. 2005, 43 patients (49 hips) were performed with MIS THA. The mean age of patients was 53.2 years ranging from 22 to 79 years. There were 22 males and 21 females. The average body mass index (BMI) was 23.4 ranging from 17.1 to 30.2. Using the modified postero-lateral approach, MIS THA was performed with cementless prostheses. For comparison, 35 patients (43 hips) were performed with standard THA at the same period. The age and BMI of patients in both groups were similar, but the pattern of disorders was different. The comparative items included preoperative bleeding, operative time, incisional length, postoperative functional recovery, and prosthetic position. Results 31 patients (MIS THA) and 25 patients (standard THA) were followed from 6 to 24 months (mean 13.1 months). No complications occurred in MIS THA. Dislocation appeared in one patient with standard THA at the two days after operation. The length of incision was 9.3 cm (range, 8.7 to 10.5 cm) in MIS group and 16.8 cm (range, 14 to 20 cm) in standard THA group. The difference was significant statistically (P

Objective:To observe the effect of chest pain center management model and emergency green channel on pre-hospital rescue rate of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:Patients with STEMI admitted in Yunnan Provincial Emergency Center between January 2017 and June 2019 were selected as the study subjects. 522 patients with STEMI sent by emergency center were included in the observation group (chest pain center management model of first-aid), while 326 patients with STEMI who came to the hospital by themselves were included in the control group (emergency green channel for first-aid). The pre-hospital and nosocomial first-aid related indexes, cardiac function (assessed by Killip grade), rescue rate, hospital stay and incidence of complications were compared between the two groups.Results:The response time of visit, time of initial electrocardiogram (ECG) completion and total time of first-aid in observation group [(1.04±0.11)min, (1.56±0.25)min, (10.63±2.26)min] were significantly shorter than those in control group [(2.82±0.26)min, (5.99±1.06)min, (18.65±2.98)min, P<0.05]. The grade of cardiac function in observation group was significantly better than that in control group ( P<0.05). Compared with the control group, the observation group had higher successful rescue rate, shorter hospital stay , lower total incidence of complications [94.25% vs 42.02%, (6.09±1.02)d vs (8.92±1.65)d, 13.01% vs 32.12%, P<0.05]. Conclusions:Compared with emergency green channel, chest pain center management model can not only shorten first-aid related time of STEMI patients, but also improve their successful rescue rate, reduce incidence of complications and improve prognosis.

Objective To investigate the effects of the zinc finger protein A20 on LPS-TLR4 signaling pathways in severe acute pancreatitis(SAP) rats.Methods 24 SD rats were randomly divided into 3 groups:group A(the sham operation group),group B (the SAP group),group C (the SAP group treated with LPS).SAP model was induced by retro-injection of intraductal 5％ sodium taurocholate into the biliary-pancreatic duct as previously described.The protein expression of A20,TLR4,NF-κBp65 and p38MAPK in pancreatic tissues was evaluated by immunohistochemistry.Results The positive area of A20 in pancreatic tissues was decreased in group B and group C compared with that in group A (t =17.234,19.698,all P ＜ 0.05).On the contrary,the expression of TLR4,NF-κBp65 and p38MAPK in pancreatic tissues were up-regulated(t =15.909,20.432,16.543,18.629,22.105,19.006,all P ＜ 0.05).A20 was decreased in group C than that in group B (t =14.894,P ＜ 0.05),while TLR4、NF-κBp65 and p38MAPK were increased in group C than those in group B (t =14.047,15.582,17.070,all P ＜0.05).Conclusion The expression of A20 reduced and TLR4,NF-κBp65 and p38MAPK enhanced in the pancreas of rats with SAP,which indicated that A20 inhibited LPS-TLR4 signaling pathways which play important roles in the pathogenesis of SAP.