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Objective To evaluate the association between hypoxia inducible factor-1α (HIF-1α)gene 1772C/T polymorphism and coronary collateral circulation formation in the patients with coronary heart disease (CHD).Methods The databases of PubMed,Cochrane Library,CBM,CNKI,VIP and Wanfang databases were comprehensively retrieved.The retrieval time was from the database establishment to January 2017.The case control trials on the relationship between HIF-1α gene 1772C/T polymorphism and coronary collateral circulation formation were collected.The included trials were performed the meta analysis.Results A total of 5 articles were included in analysis with a sample amount of 1 355 cases.The meta analysis suggested that HIF-1α gene 1772C/T polymorphism in 5 genetic models had no significant correlation with coronary collateral formation in CHD patients.The odds ratio(OR) values and 95 ％CI in allele,dominant,recessive,homozygote and heterozygote models were 1.70(0.85-3.39),P=0.134;1.46(0.77-2.77),P=-0.251;1.73(0.75-3.99),P=0.197;1.73(0.74-4.03),P=0.204;1.00(0.72-1.37),P=0.988,respectively.Conclusion HIF-1α gene 1772C/T polymorphism might have no association with coronary collateral formation in CHD patients.
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Objective To compare the clinical efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and Quadrant minimally invasive system in treatment of lumbar disc herniation (LDH). Methods 59 single-level LDH patients were randomly divided into PTED group (n = 31) and Quadrant group (n = 28). Then compare the operative time, incision length, blood loss, length of hospital stay, and the return-to-work time between the two groups. In addition, visual analogue scale (VAS), Japanese Orthopedic Association (JOA), Oswestry disability index (ODI), and modified MacNab criteria were used for surgical efficacy evaluation. Results In PTED group, compared with Quadrant group, we observed, shorter incision length, less blood loss, shorter hospital stay, and shorter time of returning to work (P 0.05). According to the improved MacNab criteria, there was no significant difference in excellent or good rate between the two groups (P > 0.05). Conclusion The clinical results of PTED and Quadrant minimally invasive system in treatment of lumbar disc herniation were satisfactory, and PTED were less traumatic method with rapid recovery.
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Objective To investigate the clinical effect of the treatment of osteoporotic vertebral compression fractures in the elderly populationthrough different surgical approaches.Methods 98 cases with a single-level osteoporotic vertebral compression fracture in the elderly population were randomly divided into two groups from February 201 1 to June 2013.48 patients were performed by percutaneous vertebroplasty (PVP)through unipedicular approach and 50 patients through bipedicular approachs.The clinical data of patients were prospectively analyzed and the clinical efficacy were compared between two groups using VAS (visual analogue scale method)and ODI (Oswestry disability index)in preoperative,postoperative 1 day and 1 year postoperatively .The data of age, gender,injury to the patients with operation time,postoperative follow-up time,operation time,bone cement injection,bone cement leakage and other complications were observed.Cobb angle,vertebral compression ration were observed by imaging data.Results All the cases were followed-up.There was no statistical difference in preoperative clinical data between the two groups (P >0.05).In unilateral group (48 cases),the data of operation time,bone cement injection,bone cement leakage,Cobb angle improve,vertebral compression ration improve were (34.87±5.91)min,(6.20±0.66)mL,1 6 cases(33%),(10.1 9±2.12)%,(13.23°±1.58°)and adjacent vertebral fractures was 10 cases (20.9%).VAS score was respectively improved (4.05 ± 0.12 ),(5.42 ± 0.12 ) in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.40 ±0.1 1 )in postoperative 1 year than 1 day.ODI score was respectively improved (35.46 ± 1.89)%,(47.88 ±2.21 )% in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.42±0.24)% in postoperative 1 year than 1 day.In bilateral group (50 cases).The data of operation time,bone cement injection,bone cement leakage,Cobb angle improve, vertebral compression ration improve were (41.66±6.90)min,(4.88±0.52)mL,9 cases(18.0%),(10.48±1.43)%,(13.04°±2.03°)and adjacent vertebral fractures was 6 cases(12.0%).VAS score was respectively improved (4.06±0.1 1),(5.30±0.10)in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.34± 0.08)in postoperative 1 year than 1 day.ODI score was respectively improved (36.08±2.13)%,(47.54±1.97)%in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.26 ± 0.54)% in postoperative 1 year than 1 day.There was no obvious clinical problems after occurred leakage in two groups.there was statistical difference in cement injection,bone cement leakage and postoperative adjacent vertebral fractures after operation between the two groups.there was no statistical difference in Cobb angle improve,vertebral compression ration improve,VAS score and ODI score between the two groups.Conclusion Both approaches are effective in the treatment of osteoporotic vertebral compression fractures in the elderly population ,but there is advantage of decrease the incidence of bone cement leakage and postoperative adjacent vertebral fractures through bilateral approach.
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Objective To investigate the clinical effect of laparoscopic operation and laparotomy in the treat-ment of uterine fibroids.Methods A retrospective analysis of uterine fibroids and requests to retain the clinical data of 380 cases of uterine of patients,according to treatment methods,they were divided into laparoscopic myomectomy group (group A)and cesarean section uterine fibroids removed surgery group (B group),there were 190 cases,two groups of patients,surgery,clinical effect were analyzed.Results In group A,operation time,postoperative exhaust time,postoperative ambulation time,postoperative VAS score,duration of hospitalization,injection of analgesics appli-cation proportion were (96 ±35)min,(24 ±8.5)h,(12 ±4)h,(2.0 ±1.5),(4.0 ±1.2)d,17.8%,patients in the group B respectively (98 ±28)min,(40 ±12)h,(20 ±8)h,(6.0 ±1.3),(8 ±2)d,84.6% there was a significant differences between the two groups (t=-2.558,33.96,45.810,50.571,34.120,χ2 =169.89,all P0.05);group A,the complication rate was 7.34%,lower than the 12.6%in the group B,there was significant difference between the two groups (χ2 =3.923,P<0.05).Conclusion Laparoscopic myo-mectomy in treatment of uterine fibroids,good effect,less trauma,quicker recovery,shorter hospitalization time of patients,should be further popularized in clinic.
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Objective To explore the clinical treatment effects of high risk lying-in women with postpartum hemorrhage by using B-Lynch suture combined misoprostol.Methods 82 high risk lying-in women with postpar-tum hemorrhage underwent cesarean delivery,were randomly divided into the observation group A ( n=42) and the controlled group B(n=40).B-Lynch suture combined misoprostol were used for preventive treatment in group A, and misoprostol were used in group B.Amount of bleeding,the effects and complications of lying-in women in group A and group B were observed and comparerd.Results There were significant differences in amount of bleeding of intraoperative period (t=-27.758,P<0.01),2 hours (t=-22.717,P<0.01) and 24 hours (t=-48.162,P<0.01) after delivery in group A and group B (P<0.01),respectively.The total effective rate of group A was superior to that of group B(χ2 =6.797,P<0.01).The complication incidence in group A was significantly lower than that in group B (χ2 =28.616,P<0.01).Conclusion The treatment effects of B-Lynch suture combined misoprostol for high risk lying-in women are superior.It can reduce significantly the intraoperative and postoporative amount of bleeding,and decrease complication incidence.The method is easy to master and ought to be promoted in the clinic.
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Objective To investigate the result of local injection of growth differentiation factor-5 (GDF-5) and fibrin gel for treatment of lumbar disc injury in rabbits.Methods Lumbar puncture with a 20-gauge needle was performed at L3/4,L4/5,and L5/6 discs of 40 New Zealand white rabbits.After needle puncture,L3/4 discs were injected with GDF-5 and fibrin gel (compound group) ; L4/5 discs fibrin gel (fibrin gel group) ; L5/6 discs nothing (blank control group).Two weeks later,intervertebral disc degeneration in each group was observed via radiography,MRI and nucleus proteoglycan content detection and histological examination.Results At postoperative 2-,4-,8-,and 12-weeks,X-ray films revealed a gradual decrease in disc height index (DHI) among the three groups,but the decreasing velocity was lower in compound group than in other two groups (P ＜ 0.05).On MRI,the signal of intervebral discs among the three groups diminished progressively with time,but a relatively lower decreasing was observed in compound group (P ＜ 0.05).At postoperative 4-week,proteoglycan content of the nucleus pulposus was (6.3-± 0.4) in compound group,higher than (5.9-0.4) in blank control group and (5.8-± 0.3)in fibrin gel group (P ＜0.05).At postoperative 2-week,histological evaluation showed (5.28 ±0.41)points in compound group,lower than (7.54 ± 0.53) points in blank control group and (7.21 ± 0.44)points in fibrin gel group (P ＜ 0.05).Conclusion Local injection of GDF-5 and fibrin gel facilitates the restoration of the injured discs and delays further disc degeneration.
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Objective To explore the clinic value of blood loss during and after cesarean section in women with scarred uterus. Methods From July 2007 to December 2008, thirty-six women with scarred uterus received weighing methods to evaluate the actual blood loss during and after cesarean section in Yuhuangding hospital, while 98 cases without pregnant complications were chosen as control. Results In women with scarred uterus, the blood loss during operation Was (372.4 ± 180.0) ml, and the total amount after 2 hours and 24 hours were (444.7± 228.2) ml and (527.4 ±251.6) ml respectively, which were higher than corresponding values in control group (P < 0. 05). The incidence of postpartum hemorrhage in scarred uterus was 47.2%, higher than that in control group (P < 0. 05). There were no significant differences between two groups in the tests of hemoglobin and coagulation functions (P > 0. 05). Conclusions Scarred uterus may be one of the important reasons which lead to postpartum hemorrhage. The clinical treatment of pregnant women with scarred uterus should focus on the prevention of blood loss during the cesarean section.
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Objective To evaluate the clinical efficacy and safety of injection azithromycin in the treatment of the acute bacteria pneumonia of infant. Methods A randomized controlled open trial was carried out. Erythromycin as a controll drug was compared the clinical efficacy and safety with azithromycin as a test drug. Results In azithro-mycin group,the clinical effective rate was 90.6% ;the fully recovered rate was 75.5%. While those of erythromycin group were 68.0% ,36.0% respectively. The incidence of adverse reaction was 9.3% and 30.4% respectively in two groups. Conclusion Injection azithromycin of new macrofides type is a kind of effective and safe anti-bacterial drug.
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Objective: To compare the accumulative scores of cerebrovascular hemodynamic parameters (CVHP) in different populations and to analyze the relationship between the change of accumulative scores and the risk of stroke. Methods: A total of 10 565 participants aged 40 years and above were selected from a cluster sampling community-based population. Their risk factors were investigated and CVHP was evaluated. The CVHP scores were accumulated by a unified approach, and the incidence of stroke was followed up. The participants were grouped into health adult, single factor exposure, multiple-factor exposure, and newly developed stroke during the follow-up period. The differences of CVHP accumulative scores and the change law among the 4 groups were compared respectively according to age and sex. Results: The accumu-lative scores of the mean (SD) CVHP in the health adult, single factor exposure, multiple-factor exposure, and newly developed stroke groups were 86.44 (20.69), 72.07 (28.10), 60.82(34.64), and4.01 (29.36) in men respectively, and they were 83.95 (22.19), 67.97 (29.73),59.91 (31.34), and 42.64 (28.00) in women respectively, which had a tendency to gradually decrease. The accumulative scores of CVHP and their distributions at the same age stage in all the 4 groups had significant differences (P ＜ 0.01 ). The accumulative scores of CVHP and their distributions for the same factors between all age groups also had significant differences (P ＜0. 01). Conclusions: The accumulative scores of CVHP had a tendency to gradually decrease from the health adults, risk factor exposure to high risk status before stroke. The decrease of the accumulative scores is closely associated with the increase of stroke risk, which can be used as a predictor of stroke.
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BACKGROUND: The understanding about characteristics and variation trends of cerebral vascular hemodynamic indexes in high-risk stroke population,in prior and post-stroke period patients as well as in normal people,particularly the cerebral vascular hemodynamic index(CVHD) prior to stroke can improve diagnosis efficiency of stroke and increase sensitivity and specificity of stroke diagnosis.OBJECTIVE: To study the features of CVHD in acute stoke,in order to provide evidences for early evaluation and rehabilitation intervention.DESIGN: Case analysis and observational study based on patients.SETTING: A neurological department in a general hospital of military area command of Chinese PLA and a prevention and cure institute of cerebrovascular diseases.PARTICIPANTS: Totally 55 (male 38,female 17) inpatients in the Neurological Department of Fuzhou General Hospital of Chinese PLA from June to December 2001 were enrolled in the study.METHODS: CVHD was measured during the first week after onset and the data were analyzed.MAIN OUTCOME MEASURES: The CVHD,blood pressure and cerebral vascular hemodynamic parameters.RESULTS: The CVHD of each patient is below 75,median 32.5. The mean velocity,blood flow,maximum velocity,minimum velocity and difference between diastolic and critical pressures were lower than corresponding ones of healthy men in seventies( P ＜ 0.01 ). And the pulse wave velocity,peripheral resistance,specific impedance and critical pressure increased( P ＜ 0. 01).CONCLUSION: During the first week after stroke,the CVHD decreases and many hemodynamic parameters alters significantly. Examination of CVHD can reveal cerebral circulation insufficiency or predict an attack of cerebral stroke.
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Objective To observe the treatment effect of transplanted autogenous bone marrow stroma cells (BMS-C) absorbed in the type-Ⅰ collagen matrix in bone repair. Methods Thirty-two adult white New Zealand rabbits were randomly divided into Group Ⅰ and Group Ⅱ. The bone marrow was extracted from tubercle and greater trochanter of femur for culture. Then, the cells were amplified, implanted into type-Ⅰ collagen matrix and further cultured for two weeks. Two weeks later, the cells were implanted into the 1.5 cm radius defect. In the Group Ⅰ, management A (BMS-C+type-Ⅰ collagen) was given to the defect of one radius and management B (control) to the defect of the contralateral radius. In the Group Ⅱ, the defect of one radius was given management A and the defect of the contralateral radius management C (type-Ⅰ collagen).The rabbits were killed 8 and 12 weeks after implantation, the effect of three managements was compared. Results Twelve weeks after implantation, in the management A, all specimens had complete bony union; and in the management B, the specimens were filled with fibrous tissues; in the management C, a little scar formed. Conclusions BMS-C absorbed in the type-Ⅰ collagen can effectively repair bone defect.
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<p><b>OBJECTIVE</b>To evaluate efficacy and optimal cut-off-point through cerebral vascular hemodynamic indexes (CVHI) examination to predict stroke.</p><p><b>METHODS</b>A number of 20,333 people at 35 years old and over were checked by CVHI and accumulative score was calculated according to the value of detected indexes. Risk factors of stroke were investigated simultaneously. One hundred and sixty-eight patients with stroke occurred during 4-year following up. Typical syndromes and signs stroke were used as golden standard to evaluate screening efficacy of CVHI.</p><p><b>RESULTS</b>Score of optimal cut-off-point of cerebral vascular hemodynamic indexes was under 75 in ROC curve analyses. Sensitivity, specificity, accuracy, positive and negative predictive values, positive and negative likelihood ratios as well as Youden's index for predicting stroke within 4 years after examination were found to be 87.50%, 67.70%, 67.86%, 2.21%, 99.85%, 2.71, 0.18 and 0.55 respectively. Sensitivity and positive predict values for predicting cerebral vascular thrombosis were superior to predicting cerebral hemorrhage. Positive predicting value in risk exposure population was higher than that of overall population. Coefficiency of variation of cerebral vascular hemodynamic examination was 4.03%. The agreement rate of examination between two physicians was 97.62% and Kappa value was 0.94.</p><p><b>CONCLUSION</b>The score of optimal cut-off-point of cerebral vascular hemodynamic indexes examination was 75. Both Efficacy and reliability for predicting stroke seemed to be good, especially for predicting cerebral vascular thrombosis.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Brain , Hemodynamics , Stroke , DiagnosisABSTRACT
Objective To evaluate the effectiveness of "screen and target population intervention policy" for stroke intervention in Nanhui county of Shanghai city.Methods A cross sectional survey on stroke was carried out in January 1999,and 696558 population in Nanhui county of Shanghai city were investigated in the study. Surveillance data on incidence and mortality rate of stoke from January 1996 to December 1998 in the county were retrospectively checked and reinvestigated.The CVHI of 35 years old and over in this population which have one and more of risk factors were measured,their CVHI total score
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This study is to set up a method for separating,culturing and identifying neural stem cells from cortex in rat embryo,observing their characteristics of multipotentiality and differentiation in vitro. By using serum-free cell culturing and clone technology,the stem cells were isolated,cultured and passaged from cortex in 14-day old rat embryo. The expression of Nestin antigen of brain cells were investigated by immunocytochemistry and H-E staining. It proved that cells separated from cortex in rat embryo possessed the potential to form clones and express nestin special antigen,the differentiated cells could express special antigen of neurons,astrocytes,and oligodendrocytes,they were stem cells of central nervous system.
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This paper reports the efficacy of allosteric snake neurotoxin in the treatment of 114 cases of motor neuron disease. The drug was given intramuscularly once a day with a dose of 2 ml (500 ?g/ml) in 68 cases of amyotrophic lateral sclerosis, 40 cases of progressive muscular atrophy and 6 cases of primary lateral sclerosis. Eighty-three cases were followed up from 3 to 28 months. The recent therapeutic effects observed were as follows : there was some improvement in 20 cases (24.1%), stability of disease in 26 cases (31.3%) and no effect in 37 cases (44.6%).The clinical effectiveness of modified neurotoxin is evaluated and the possible mechanism of its therapeutic action is also discussed.
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Point prevalence rate of complete stroke on December 31, 1986 in China was investigated using a retrospecive section study for 5 814 851 people of 29 provinces and cities (excluding Taiwan province), and 14275 stroke cases were found. Point prevalence rate was 245.49 per 100000 people with 95% CI (confidence interval) 241.57-249.61 per 100000 people. The rate standardized by the constituent ratio of population between city and rural area of China in 1986 was 247.66 per 100000 people. The rate age-standardized by the population of China in 1982 accounted for 191.92 per 100000 and the rate agestandardized by the world standard population was 259.86 per 100000 people.It has also been found that there was a tendency for the prevalence rates to increase gradually from south to north and to decrease progressively from east to west. The linear regression models have been fitted between the point prevalence rates and latitude or longitude respectively. The results were Y= 12.3819?-1107.38 (tb = 4.65 df = 5 P = 0.0056) for longitudes and Y = 12.6279?-146.6266 (tb = 11.7517 df = 4 P = 0.0003) for latitudes. There was a difference statistically among various topographic areas. The prevalence rate was much higher in urban areas than rural areas and much higher in men than in women. The prevalence rate increased with age and their relationships have been fitted well with the logistic curve.
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A large-scale population survey has been made to clarify the degree of harm and feature of distribution of cerebrovascular disease (CVD) in China. The sample investigated was 5814851 from about a billion people in 29 provinces, municipal cities and autonomous regions except Taiwan in China. The incidence, prevalence and mortality rates have been standardized by the direct method using the world standard population. It has been found that the incidence rate of CVD in China was 109.95 per 100 000 people in 1986 and its 95%CI (confidence interval) was 107. 25 ~ 112. 65 per 100000. The age-standardized incidence rate was 115.87/100000. The point prevalence rate of CVD in China was 245.49 per 100000 people on December 31, 1986 and its 95%CI was 241.57-249.61 per 100000, with an age-standardized prevalence rate of 259.86 per 100000. The mortality rate of CVD was 76.78 per 100000 in 1986 and its 95%CI 74.52~79.04 per 100000, with an age-standardized mortality rate of 80.94 per 100000. It has also been found that there was a tendency for the rates to increase gradually from south to north and to decrease progressively from east to west. The models of linear regression have been established between latitude and rates as well as between longitude and rates, respectively. The incidence, prevalence and mortality rates of CVD differ significantly in various topographic areas. They were much higher in cities than in rural areas, and much higher in men than in women. The incidence, prevalence and mortality rates increased with the age, and their relationships were fitted with logistic curve, respectively.