Objective To investigate the risk factors for malignant middle cerebral artery infarction (MMI) in different age groups.Methods Patients with middle cerebral artery infarction were analyzed retrospectively.They were divided into a young and middle-aged group (＜ 60 years) and an elderly group (≥60 years).The demography and vascular risk factors,stroke etiologies,baseline blood pressure,drug use before onset and common blood test results in patients with MMI and non-MMI were compared in general cases and each age group.Multivariate logistic regression analysis was used to determine the independent risk factors for MMI.ResultsA total of 912 patients with middle cerebral artery infarction were enrolled,including 299 females (32.79％) and 613 males (67.21％);401 young and middle-aged patients (43.97％) and 511 elderly patients (56.03％);159 patients in the MMI group (17.43％),and 753 (82.57％) in the non-MMI group.Multivariable logistic regression analysis showed that hypertension (odds ratio [OR]6.962,95％ confidence interval [CI] 1.349-35.934;P=0.021) and NIHSS score (OR 1.551,95％ CI 1.384-1.737;P ＜0.001) were the independent risk factors for MMI.Subgroup analysis showed that NIHSS score (OR 1.402,95％ CI 1.239-1.588;P＜0.001) was an independent risk factor for MMI in young and middle-aged patients;hypertension (OR 10.752,95％ CI 1.213-95.295;P =0.033),diastolic blood pressure (OR 1.080,95％ CI 1.002-1.164;P=0.044),and NIHSS score (OR 1.504,95％ CI 1.281-1.765;P＜ 0.001) were the independent risk factor for MMI in the elderly patients,while systolic blood pressure (OR 0.938,95％ CI 0.893-0.986;P =0.011) was an independent protective factor.Conclusions The baseline NIHSS score was an independent risk factor for MMI in each age group.Hypertension and diastolic blood pressure were the independent risk factors for MMI in the elderly patients,while systolic pressure was an independent protective factor.Therefore,timely NIHSS assessment and appropriate hypertension management had important significance for the prevention and treatment of MMI.

Objective To observe tree shrews gastrointestinal glucagon like peptide 1 ( glp-1 ) immune response positive cells ( EG cells) distribution and the difference of the digestive tract of rats.Methods Immunohisto chemical SABC method to detect tree shrews diges-tive tract (except for oral cavity, pharynx) glp-1 cells positive content.Results EG cells distributed in tree shrews duodenum,ileum and colon,glandular epithelial cells of jejunum,positive material is distributed in the cytoplasm.Tree shrews stomach,rectum did not see EG cell distribution.Ileal immune dyeing results show positive,EG cells of the digestive tract,only the ileum and colon distribution glp-1 more posi-tive, tree shrews compared with the rats in the digestive tract glp-1 significant difference (P<0.01).Conclusion Gastrointestinal tree shrew in duodenum,ileum and colon,jejunum have glucagon positive cells.The rat only have positive cells in the ileum and colon.According to the mechanism of the glp-1 and the distribution of tree shrews gastrointestinal glp-1,tree shrews atherosclerosis ( atherosclerosis,AS) AS the model is not easy to make may be associated with the role of glp-1.

OBJECTIVETo study the significance of P504s in differential diagnosis between solid pseudopapillary tumor of the pancreas (SPTP) and pancreatic neuroendocrine tumors (PanNET).

METHODSForty-three patients with SPTP and 41 patients with PanNET encountered during the period from 2007 to 2014 were recruited. Immunohistochemical study for vimentin, CD10, chromogranin A, synaptophysin, beta-catenin, CD99 and P504s in SPTP and PanNET was performed. The diagnostic value of P504s in differentiating SPTP from PanNET was analyzed.

RESULTSImmunohistochemical study showed that vimentin, CD10, chromogranin A, synaptophysin and CD99 were expressed both in SPTP and PanNET. All cases of SPTP showed granular cytoplasmic expression of P504s, whereas those of PanNET were negative.

CONCLUSIONP504s is a sensitive and useful marker for SPTP and can be used in the distinction between SPTP and PanNET.

Objective To investigate the clinical efficacy of Jin’s Three Needles plus twelve Jing-Well points in treating post-stroke shoulder-hand syndrome. Methods Sixty patients meeting the inclusion criteria of post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture with Jin’s Three Needles plus twelve Jing-Well points and the control group, conventional acupuncture. The Clinical Neurological Disfunction Scale (CNDS) score, the Fugl-Meyer Assessment (FMA) score, the Visual Analogue Scale (VAS) score and the Functiional Comprehensive Assessment (FCA) score were observed in the two groups before and after two weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the CNDS, FMA, VAS and FCA scores in the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 96.7%and 55.7%in the combination group, respectively, in the treatment group and 83.3%and 26.7%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Acupuncture with Jin’s Three Needles plus twelve Jing-Well points is an effective way to treat post-stroke shoulder-hand syndrome.

Objective To study the significance of P504s in differential diagnosis between solid pseudopapillary tumor of the pancreas(SPTP) and pancreatic neuroendocrine tumors(PanNET).Methods Forty-three patients with SPTP and 41 patients with PanNET encountered during the period from 2007 to 2014 were recruited.Immunohistochemical study for vimentin, CD10, chromogranin A, synaptophysin, beta-catenin, CD99 and P504s in SPTP and PanNET was performed.The diagnostic value of P504s in differentiating SPTP from PanNET was analyzed. Results Immunohistochemical study showed that vimentin, CD10, chromogranin A, synaptophysin and CD99 were expressed both in SPTP and PanNET.All cases of SPTP showed granular cytoplasmic expression of P504s, whereas those of PanNET were negative. Conclusion P504s is a sensitive and useful marker for SPTP and can be used in the distinction between SPTP and PanNET.

Objective To establish the model of distraction osteogenesis for rabbit femur bone defect, and to observe the effect of icariin on regenerate ossification after distraction osteogenesis, thus to find a method for promoting regenerate ossification after distraction osteogenesis. Methods After the rabbit model of bone defect had been established successfully, the rabbits were equipped with distraction device. And then the 24 modeled rab bits were randomly divided into 2 groups. The experimental group was injected with icariin extract of Herba Epimedii into the interspace of bone distraction, and the control group was given local injection of recombinant human bone morphogenetic protein-2 (rhBMP-2, 100μg/kg) . On week 0, 1, 4 and 6 after the resting period, X-ray photography was carried out in both groups. On week 6 after distraction osteogenesis, the bone specimens of distraction osteogenesis region in both groups were observed by micro-computerized tomography ( CT) for the comparison of bone mass, and bone mineral content and mineral density of the newly-formed bone. Results The results of the features of imageology, and the statistical data of the bone mineral content and density showed that osteogenesis speed and osteogenic quality of the experimental group were superior to those of the control group. Conclusion The rabbit model of distraction osteogenesis for femur bone defect has been established preliminarily, and icariin can promote the speed and quality of regenerate ossification after distraction osteogenesis.

Objective To study the psychological status of patients having undergone eyeball enucleation,and put forward the corresponding strategy for psychological nursing.Method The symptom checklist-90(SCL-90)was used to investigate their psychological status after eyeball enucleation.Result The scores on interpersonal relationship sensitivity factor,depression factor, anxiety factor and terror factor(28?78±0?61),(40?76±0?65),(33?86±0?62)and(23?88±0?46),respectively.Conclusions Pertinent psychological nursing may help patients to eliminate the adverse emotional and psychological pressures,promoting them to develop a good state of mind,and return to the society better?

Objective To investigate the relationship between the clinical manifestations,prognosis and histopathological findings of mucormycosis.Methods The clinical data on and pathological findings from 7 cases of mucormycosis confirmed by fungal culture in the institute from 1989 to 2006 were analyzed retrospectively.Results There was 1 case of hinocerebral mucormycosis and 6 cases of cutaneous mucormycosis,among them,2 were mucormycotic necrotizing fasciitis (MNF).The condition of patients with rhinocerebral mucormycosis or MNF aggravated rapidly and all the 3 patients died from mucormycosis. Histopathological examination showed mixed infiltrates of inflammatory cells as well as necrosis and angioin vasion.On the contrary,the condition of the remaining 4 patients with cutanesus mucormycosis,who presented mainly with indurated erythematous patch,progressed slowly,and 2 patients were cured.Histologically,the lesions were characterized by granulbmatous infiltration with a few hyphae;no typical angioinva sion phenomenon was noted.There was no evidence of perineural invasion with hyphae in any of the 7 cases.ConclusionIn patients with mucormycosis,histopathological findings characterized by mixed infiltrates of inflammatory cells,numerous hyphae and typical angioinvasion phenomenon may herald a poor prognosis.

Objective To summarize the clinical features and the experience in treating of severe craniocerebral injury complicated by shock.Methods The clinical datas of 76 patients with severe craniocerebral injury complicated by shock were analysed retrospectively.Results Among 76 patients with severe craniocerebral injury complicated by shock,there were 25 cases with good recovery,7 cases with moderate disability,5 cases with severe deficts or vegetable,and 39 dead after therapy.The mortality was 51.3%.Conclusion It is very important to give prompt diagnosis and treatment and to find early the causes of shock.The importance of on site rescue and immediate surgical treatment should be emphasized.

Objective To study the clinical features and treatment of traumatic cerebral intraventricular hemorrhage(TIVH).Methods A retrospective analysis was conducted on the clinical manifestations,the changes of CT scan and the respective therapies in the 28 TIVH cases.Results All the cases were evaluated with GOS at discharge:8 cases were good recovery(29%),5 moderate disabled(18%),4 severely disabiled or vegetable(14%) and 11 died(39%).Conclusion Surgical approaches to treat TIVH rely on changes of CT scan.Injection of urokinase into ventricles,if necessary,can produce a good curative effect.