Inflammation is associated with the occurrence and recurrence of ischemic stroke, and patients with coronary artery disease who receive colchicine treatment have a lower incidence of vascular events. However, the efficacy and safety of anti-inflammatory therapy with colchicine in preventing recurrent stroke is unclear. This article reviews the relevant mechanisms of action of colchicine and its role in the prevention of ischemic stroke, aiming to provide reference for the secondary prevention of ischemic stroke.

Objective: To evaluate the clinical effect and safety of retroperitoneal laparoscopic surgery combined with mini-flank incision hybrid surgery for partial nephrectomy of complex renal tumors.Methods: Between April 2015 and December 2016, the clinical data from 16 patients with complex renal tumors who underwent the hybrid surgery, including 10 males and 6 females, were retrospectively reviewed.The average age was (50.2±10.7) years, 9 cases were located in the left side and 7 cases in the right side, the mean tumor size was (6.1±1.0) cm, and the mean R.E.N.A.L.nephrometry score was 9.3±1.3.All the patients received the hybrid surgery, the first step was to adequately mobilize the kidney and tumor, prepared the renal artery by retroperitoneal laparoscopy, and then the incision about 10-12 cm was done under the twelve rib to convert to open surgery.After the renal artery was clamped, the tumor was removed and the wound was closed under direct vision.The operative time, ischemia time, estimated blood loss, intraoperative and postoperative complications and short-term renal function were recorded.Results: All the 16 patients'' hybrid surgeries were successfully performed.The mean operative time was (164.9±23.6) min, mean ischemia time was (32.4±6.2) min, and mean estimated blood loss was (204.0±125.1) mL.The mean drainage tube removal time was (4.1±1.0) d, and the mean postoperatively hospital stay was (6.9±1.5) d.There were 2 patients with Clavien Ⅲ grade complications.One patient was injured with collecting system, and 1 patient received a second emergency surgery for acute postoperative bleeding.The mean 1 day postoperative serum creatinine level was (126.3±26.4) μmol/L, which was statistically significant (P<0.05) compared with the preoperative serum creatinine level(74.3±16.9)μmol/L.There were no significant differences (P>0.05) in comparing the 1 month postoperative serum creatinine level(92.6±18.2) μmol/L, 3 months postoperative serum creatinine level (80.8±18.4) μmol/L with the preoperative serum creatinine level.During 3 to 20 months follow-up periods, no local recurrence or distant metastasis occurred.Conclusion: This hybrid surgery combined retroperitoneal laparoscopic surgery with mini-flank incision for partial nephrectomy is safe and effective.It could decrease the operative difficulty and be worthy of further application for some selected complex renal tumor patients.

We analyze the epidemiology,clinical features,and outcome of the patients with Creutzfeldt-Jakob diseases (CJD) in Guizhou Province from 2010 to 2015.The epidemiology,clinical characteristics and follow-up data of CJD suspected patients obtained from Guizhou CJD surveillance network were analyzed.The testing results of cerebrospinal fluid (CFS) and blood from the patients were also collected and analyzed.Results showed that a total of 11 CJD cases was found from 23 reported CJD suspected patients in Guizhou from 2010 to 2015,including 8 probable sporadic CJD(sCJD) cases,2 possible sCJD cases and 1 genetic CJD(gCJD) case.In 11 cases,rapidly progressive dementia was the major initial symptom,following by mental symptoms,extrapyramidal symptoms,signs and cerebellum cortical blindness.Clinical symptoms of progressive dementia were the main symptoms,following by visual or cerebellar dysfunction,myoclonus,cone system/extrapyramidal dysfunction,and akinetic mutism.Most of cases were abnormal in MRI (45.45％) and 14-3-3 protein detection in CSF(70％).The 14-3-3 blood samples of prion gene 129 amino acids (PRNP)polymorphisms were M/M type,excepting for 1 case gCJD confirmed diagnosis cases with D178N mutation in PRNP gene.Eleven CJD cases did not show season and regional clusterings and vocational tendency.The majority of the cases were male,the median age was 65,and mainly were the Han nationality.For all cases of CJD reported during that year for follow-up,the lost-tofollow-up rate was 27％,and the majority of cases died within one year.The sCJD cases were the majority in CJD cases of Guizhou Province,2010-2015.The epidemiological characteristics were similar to the national monitoring cases in the same period.

Objective:To compare various data of open pyeloplasty,laparoscopic pyeloplasty and en-dopyelotomy as a treatment of ureteropelvic junction obstruction(UPJO),and to investigate and discuss the feasibility and effect of the three methods.Methods:In the study,109 cases of UPJO treated by dif-ferent surgical approaches in Peking University People’s Hospital from January 2004 to December 2014 were retrospectively investigated.The patients were divided into three groups according to the treatment they received:open peyloplasty group (32 cases),laparoscopic peyloplasty group (31 cases)and en-dopyelotomy group (46 cases).We compared the data of the operative time,intraoperative blood loss, perioperative complications and post-operative hospital stay among the three groups.The mean follow-up time was(51.9 ±40.1 )months (6 -132 months).Results:None of the laparoscopic peyloplties was converted to open peyloplasty.All endpyelotomies were successfully completed.The operative time was as follows:laparoscopic peyloplasty group (195.97 ±55.22)min,open peyloplasty group (121.19 ± 33.95)min and endopyelotomy group (74.04 ±33.95 )min,and there were significant differences among the three groups respectively(P <0.001 ).There was no significant difference on the operative blood loss between open peyloplasty group and laparoscopic peyloplasty group (P =0.163).The opera-tive blood loss of endopyelotomy group was 5(0,310)mL,which was lower than the other two groups,and this result had significant differences with the other two groups respectively(P <0.001).There were sig-nificant differences on the post-operative hospital stay (days)among open peyloplasty group,laparoscopic peyloplasty group and endopeylotomy group (P <0.05,respectively).The success rate was comparable between open peyloplasty group and laparoscopic peyloplasty group(93.8% vs.90.3%,P =0.672), while the endopeylotomy group had a lower success rate compared with both open surgery group and laparo-scopic group(69.6% vs.93.8%,P =0.01;69.6% vs.90.3%,P =0.048,respectively).The complica-tion rates of open peyloplasty group,laparoscopic peyloplasty group and endopeylotomy group were compa-rable(15.6%,16.1% and 13.0%,respectively,P >0.05).Conclusion:The laparoscopic peyloplasty group had a longer operative time than open peyloplasty group,while its post-operative stay was shorter. There was no significant difference on the operative blood loss between open peyloplasty group and laparo-scopic peyloplasty group.Although the success rate of endopyelotomy was lower than those of the other two groups,it had advantages over the aspect of operative time,operative blood loss and post operative stay.

Objective To detect radiation-induced changes of temporal lobe normal-appearing white matter on conventional MRI following radiation therapy (RT) for nasopharyngeal carcinoma (NPC).Methods The clinical and imaging features of 75 patients with nasopharyngeal carcinoma were retrospectively analyzed,all patients were confirmed by biopsy.All patients performed conventional MRI and Diffusion-tensor imaging (DTI) examinations,and there was no abnormal finding on conventional MRI.Eighteen patients without radiotherapy were selected as the control group and fifty-seven patients with radiotherapy were as the experimental group.We divided the experimental group into five subgroups based on completion time of RT:group 1 (less than 3 months,n =16),group 2 (3 to 6 months,n =12),group 3 (6 to 9 months; n =10),group 4 (9 to12 months,n =8),and group 5 ( more than 12 months,n =11 ).The mean diffusivity ( MD),apparent diffusion coefficient ( ADC ),fractional anisotropy ( FA),radial diffusivity ( λ⊥ ) and axial diffusivity ( k ‖ ) were calculated in bilateral temporal lobe.One-way analysis of variance (one-way ANOVA) test was used for comparison among groups.Results The mean λ⊥ values of the control group and experimental groups ( group1-5 ) after radiotherapy were ( 6.075 ± 0.341 ) × 10 -4 (6.700±0.379) × 10-4,(6.976 ±0.527) ×10-4,(6.621 ±0.388) ×10-4,(6.751 ±0.460) ×10-4,(6.222 ±0.256) × 10-4 mm2/s,respectively.The mean λ ‖ values of the control group and experimental groups were (12.524±0.713) ×10-4,(11.764 ±0.574) ×l0-4,(11.842±0.471) ×10-4,(11.569 ± 0.552) × 10-4,( 12.050 ±0.614) × 10-4,( 12.100 ±0.529) × 10-4 mm2/s,respectively.The mean FA values of the control group and experimental groups were 0.452 ± 0.030,0.379 ± 0.028,0.382 ± 0.028,0.389 ± 0.032,0.388 ± 0.022,0.423 ± 0.232,respectively.The three indicators were significantly different among groups ( F =10.485,4.625,16.539,respectively,P ＜ 0.05 ). Multiple comparisons showed that λ⊥ increased significantly in group 1-4 compared with that in the control group.In group 5,λ ⊥ was not significantly different from that in the control group,λ ‖ decreased in group 1-3 compared with that in the control group,but was not significantly different in the control group and group 4-5. In all experimental groups,FA decreased significantly. MD and ADC values in experimental groups were not significantly different from those in the control group. Conclusion Diffusion tensor imaging is a noninvasive and quantitative method to detect the structural changes in WM after RT and can provide scientific evidence for the early diagnosis and intervention treatment of radiation-induced changes.