Risk factors of stress-induced upper gastrointestinal hemorrhage in acute cerebral infarction / 中国神经精神疾病杂志

Objective To explore risk factors for upper gastrointestinal bleeding in acute cerebral infarction. Method We enrolled continuously a total of 350 patients with acute cerebral infarction. Among them, 33 cases occurred upper gastrointestinal bleeding, accounting for 9.4%, and 317 cases without upper gastrointestinal bleeding, accounting for 90.6%. The incidence of various risk factors was compared between the two groups, and the independent risk factors of stress upper gastrointestinal bleeding were finally determined. Results National Institute of Health stroke scale (NIHSS) was significantly higher in the upper gastrointestinal bleeding group than in the control group [20 (2,32) vs. 5 (0,31)](P<0.001). The incidence of upper gastrointestinal bleeding was significantly increased in patients with posterior circulation infarct (POCI) (36.4% vs. 16.7%) and bilateral infarction (33.3% vs. 8.9%) (P<0.01). Only high NIHSS (OR=1.256, P<0.001) and bilateral infarction (OR=9.452,P<0.001) were independent risk factors for upper gastrointestinal bleeding in acute cerebral infarction. Conclusion More attention should be paid to patients with high NIHSS and bilateral infarction to avoid the occurrence of upper gastrointestinal hemorrhage, thereby reducing the negative influence on the prognosis of patients with cerebral infarction.

The role of gaze-face-arm-speech-time score in evaluating prognosis of intravenous thrombolysis in acute ischemic stroke / 中华神经科杂志

Objective To evaluate the predictive value of gaze-face-arm-speech-time (G-FAST) score,a simple and rapid scoring tool,for the prognosis of intravenous thrombolysis in patients with acute ischemic stroke.Methods The clinical data of 386 patients with acute ischemic stroke who received intravenous thrombolytic therapy in 4.5 hours in the Department of Neurology of Beijing Shijitan Hospital from May 2010 to April 2018 were analyzed retrospectively.Among them,126 cases completed CT angiography or magnetic resonance angiography before intravenous thrombolysis.According to the modified Rankin scale (mRS) score of 90 days after treatment,those with the mRS score ≤ 2 were regarded as good prognosis group (74 cases),and those with the mRS score ≥ 3 as poor prognosis group (52 cases).The baseline clinical data of the two groups were analyzed,including age,sex,previous history,the National Institutes of Health Stroke Scale (NIHSS) score,G-FAST score,Alberta Stroke Early CT Score (ASPECTS),anterior circulating large artery occlusion (LAVO),etc.And further multifactor Logistic regression analysis was used to analyze the influencing factors of poor prognosis.Results The rate of good prognosis of these patients was 58.7％ (74/126).The age ((61.72± 11.98) years vs (69.53 ± 11.58) years,t=-3.317,P=0.001),history of atrial fibrillation (18.9％(14/74) vs 36.5％(19/52),x2=4.905,P=0.027),thrombolytic time window ((145.19±43.44) min vs (164.26±40.07) min,t=-2.19,P=0.031),baseline NIHSS score (9.65±5.33 vs 12.83±6.25,t=-2.760,P=0.007),pre thrombolytic G-FAST score (2.46± 1.00 vs 3.02±0.79,t=-3.068,P=0.003),ASPECTS (8.06±1.29 vs 6.89± 1.91,t=3.613,P=0.000) and LAVO (39.2％(29/74) vs 67.3％(35/52),x2=9.661,P=0.002) showed statistically significant differences between the good and the poor prognosis groups.Multiple factor Logistic regression analysis showed that the age (OR=1.609,95％CI 1.067-2.001,P=0.026),history of atrial fibrillation (OR=1.302,95％CI 1.157-1.658,P=0.002),LAVO (OR=6.416,95％CI 3.302-12.84,P=0.000),longer thrombolytic time window (OR=6.756,95％CI 2.035-9.754,P=0.001),lower ASPECTS (OR=1.452,95％CI 1.035-2.279,P=0.002),higher baseline NIHSS score (OR=1.309,95％CI 1.083-1.542,P=0.033) and G-FAST score (OR=1.583,95％CI 1.432-1.855,P=0.000) were independent risk factors for the poor prognosis of acute ischemic stroke.The age ((67.89± 17.28) years vs (62.24± 12.54) years,t=2.317,P=0.024),history of atrial fibrillation (34.3％(24/70) vs 16.1％(9/56),x2=5.339,P=0.021),baseline NIHSS score (11.68±5.68 vs 9.02±4.36,t=2.150,P=0.034),ASPECTS (7.06±2.08 vs 8.77±1.85,t=-1.613,P=0.042) and LAVO (68.6％(48 / 70) vs 28.6％(16 / 56),x2=19.916,P=0.000) showed statistically significant difference between the G-FAST score ≥ 3 group and the G-FAST score ≤ 2 group by further analysis.And the good prognosis of 90 days was lower in the G-FAST score ≥ 3 group (51.4％ (36/70)) than in the G-FAST score ≤ 2 group (67.9％ (38/56),x2=4.953,P=0.026).Conclusions High G-FAST score is an independent risk factor for thrombolytic therapy for acute ischemic stroke.The high score of G-FAST may suggest the incidence of LAVO,the obvious changes in early cerebral ischemia,and the poor prognosis of 90 days.Patients in this group may consider bridging endovascular treatment as early as possible.

Clinical and pathological differences in common subtypes of Charcot-Marie-Tooth disease / 中华神经科杂志

Objective To analyze the differences of the clinical and neuropathological features among the common Charcot-Marie-Tooth disease (CMT) subtypes.Methods There were 81 CMT patients confirmed by genetic testing from 2005 to 2015 in Department of Neurology,Peking University First Hospital,including 31 cases of CMT1A (38.3％),19 cases of CMTX1 (23.5％),16 cases of CMT2A2 (19.8％) and 15 cases of 9 rare types of CMT (1.2％-4.9％).We compared the onset age,duration,muscles weakness of legs,frequency of pes cavus,and main pathological changes of the sural nerve biopsy in 48 cases of the common CMT subtypes.Results The mean age of the onset was (12.00 ± 6.77) years in CMT1A patients,(11.81 ±4.65) years in CMTX1 patients and (5.00 ±2.68) years in CMT2A2 patients (Brown-Forsythe test,P =0.001).The duration was (12.00 ± 6.75) years in CMT1A patients,(8.50 ± 4.75) years in CMTX1 patients and (5.00 ± 2.73) years in CMT2A2 patients (Brown-Forsythe test,P =0.001).The muscle force of the dorsi flexors was Ⅳ (0,Ⅴ) in CMT1A patients,Ⅲ + (0,Ⅳ) in CMTX1 patients and 0 (0,Ⅳ) in CMT2A2 patients (H =11.359,P =0.020).The pes cavus appeared in 15/23 cases of CMT1A,10/16 cases of CMTX1 and 1/9 cases of CMT2A2 (Fisher test,P=0.017).The leukoencephalopathy appeared only in 3 cases of CMTX1 and the visual loss appeared only in 3 cases of CMT2A2.The onion-bulb formations of myelinated fibers appeared in 23/23 cases of CMT1 A,5/16 cases of CMTX1 and 2/9 cases of CMT2A2(Fisher test,P =0.000).The axonal regeneration appeared in 16/23 cases of CMT1A,16/16 cases of CMTX1 and 9/9 cases of CMT2A2 (x2 =7.666,P =0.016).There were significant differences among the three common CMT subtypes in the above parameters.Conclusions CMT1A,CMT2A2 and CMTX1 are the most common subtypes of CMT in the present study.For the clinical diagnosis,more attention should be paid to the onset of the disease,duration,muscles weakness,pes cavus,cerebral symptoms and visual loss.The present frequency of onion-bulb and the axonal regeneration of myelinated fibers help the different pathological diagnosis among them.

The association of glucocorticoid receptor gene polymorphism with the prognosis of myasthenia gravis / 中华神经科杂志

Objective To investigate the association of glucocorticoid receptor (GR) polymorphisms (BclI)with the prognosis of myasthenia gravis (MG).Methods We totally enrolled 74 patients diagnosed as MG from the Department of Neurology,Beijing Shijitan Hospital between 2002 and 2014.Of them,54 patients started with ocular MG and 20 patients started with general MG.MG patients were divided into recurrence group and non-recurrence group according to the progression at two years after onset.Patients with simple ocular symptom at disease onset were further divided into generalized MG (GMG) group and single ocular MG (OMG) group according to disease progression or not.The GMG group was divided into two groups (≤6 months,7-24 months) according to the progression time of generalization.The GMG group was further divided into three groups (limbs,throat,both limbs and throat) according to the first symptom of generalization.The genotypes of GR were determined by polymerase chain reaction and nucleotide sequence determination.Results The frequencies of three genotypes (GG,CG,CC) in BclI were 57.7％,34.6％,7.7％ in recurrence MG and 64.6％,31.3％,4.1％ in non-recurrence MG respectively.The difference in distribution of the genotypes between the two groups was not statistically significant (x2 =0.570,P =0.750).The frequencies of G and C allele were 75.0％ and 25.0％ in recurrence MG,and 80.2％ and 19.8％ in non-recurrence MG.The difference in distribution of the alleles between the two groups was not statistically significant (x2 =0.540,P =0.462).The frequencies of three genotypes GG,GC and CC were 55.9％,35.3％,8.8％ in GMG and 2/6,4/6,0/6 in OMG respectively.The frequencies of G and C allele were 73.5％ and 26.5 ％ in GMG,and 8/12,4/12 in OMG.The difference in distribution of the genotypes and alleles between the two groups was not statistically significant (x2 =2.278,P =0.320;x2 =0.241,P =0.624).The frequencies of three genotypes GG,GC,CC were respectively 61.9％,28.6％,9.5％ and 3/6,3/6,0/6 in ≤6 months,7-24 months of GMG group.The frequencies of G and C allele were 76.2％,23.8％ and 9/12,3/12 in the two groups.The difference in distribution of the genotypes and alleles between two of the three groups was not statistically significant (x2 =1.326,P =0.515;x2 =0.007,P =0.932).The frequencies of three genotypes GG,GC and CC were respectively 2/8,4/8,2/8;11/13,2/13,0/13 and 3/6,3/6,0/6 in limbs,throat,both limbs and throat of GMG group.The frequencies of G and C alleles were 8/16,8/16;92.3％,7.7％ and 9/12,3/12 in the three groups.The difference in distribution of the genotypes and alleles between two of the three groups was statistically significant (x2 =8.813,P =0.028;x2 =9.706,P =0.008).The genotype frequencies in every group were all in Hardy-Weinberg equilibrium.Conclusions BclI polymorphism may predict the first generalized symptom of OMG.BclI polymorphisms of GR might have no relationship with the recurrence of MG,generalization and generalized time of OMG during the first two years after MG onset.

Role of β2-adrenergic receptor polymorphisms in prognosis of myasthenia gravis with other autoimmune diseases / 中华神经科杂志

Objective To explore the correlation of β2-adrenergic receptor (β2-AR)polymorphisms (Arg16Gly) with the prognosis of myasthenia gravis (MG) complicated with other autoimmune diseases.Methods Among the 75 MG patients in analysis,17 cases were complicated with other autoimmune diseases (AIDMG),58 cases without other autoimmune diseases (NAIDMG).MG patients,AIDMG patients,NAIDMG patients were separately divided into recurrence groups and nonrecurrence groups according to the progression at 2 years after onset.The genotypes of β2-AR in 75 MG patients were determined by gene sequecing.Results The frequencies of three genotypes (Arg/Arg,Arg/Gly and Gly/Gly) in position 16 were 30.8％,50.0％,19.2％ in recurrence MG group and 42.9％,38.8％,18.3％ in non-recurrence MG group respectively.The difference in distribution of the genotypes between recurrence MG group and non-recurrence MG group was not statistically significant (x2 =1.150,P=0.563).The frequencies of Arg and Gly allele were 55.8％ and 44.2％ in recurrence MG group,and 62.2％ and 37.8％ in non-recurrence MG group.The difference in distribution of the alleles between the two groups was not statistically significant.The frequencies of 3 genotypes in position 16 were 27.3％,63.6％ and 9.1％ in recurrence AIDMG group and 100.0％,0,0 in non-recurrence AIDMG group,respectively.The frequencies of Arg and Gly allele were 59.1％,40.9％ in recurrence AIDMG group,and 100.0％,0 in non-recurrence AIDMG group.The difference in distribution of the genotypes between recurrence AIDMG group and non-recurrence AIDMG group was statistically significant (P =0.009).There also was significant difference in distribution of alleles between recurrence and non-recurrence AIDMG groups (x2 =6.676,P =0.010).The frequencies of 3 genotypes in position 16 were 33.3％,40.0％ and 26.7％in recurrence NAIDMG group and 34.9％,44.2％,20.9％ in non-recurrence NAIDMG group,respectively.The frequencies of Arg and Gly allele were 53.3％,46.7％ in recurrence NAIDMG group,and 57.0％,43.0％ in non-recurrence NAIDMG group.There was no significant difference in distribution of genotypes or alleles between recurrence and non-recurrence NAIDMG groups.Conclusion β2-AR gene polymorphism in position 16 may predict the prognosis of AIDMG,and there is no correlation between the polymorphism in position 16 of β2-AR and the prognosis of MG and NAIDMG.

The relationship between β2-adrenergic receptor polymorphisms and early onset Myasthenia Gravis / 中国神经精神疾病杂志

Objective To explore the correlation of β2-adrenergic receptor (β2-AR) polymorphisms (Arg16Gly) with early onset Myasthenia Gravis (MG). Methods Forty-eight with age less than 40 years at disease onset were divided into three groups:normal thymus (13 cases), thymic hyperplasia (22 cases) and thymoma (7 cases) groups according to the thymus histology. These patients were further divided into different subgroups including female (31 cases) and male groups (17 cases) based on the gender, OMG (29 cases) and GMG (19 cases) groups according to the symptom of disease onset and groups associated with (10 cases) or without (33cases) other autoimmune diseases Or with unknown causes (5 cases). The genotypes ofβ2-AR in 48 early onset MG were determined by gene sequencing. Results Arg/Arg was more common in early MG patient with normal thymus ( 53.8%)and thymic hyperplasia(54.6%)whereas Arg/Gly was more common in thymus group(71.4%). The difference in distribution of the genotypes between the three groups was not statis?tically significant (χ2=5.657,P=0.226). Arg/Arg was more common in early female MG patient (58.1%) and Arg/Gly was more common in male MG patients (58.8%). The difference in distribution of the genotypes between the two groups was statistically significant (χ2=6.064,P=0.048). Arg/Arg was more common in early OMG patient (48.3%). Arg/Arg(42.1%) and Arg/Gly(47.4%) were equal common in GMG patients. The difference in distribution of the genotypes between the two groups was statistically significant ( χ2=1.623,P=0.444). Arg/Arg was more common in early MG patient associated with other autoimmune diseases (80.0%). Arg/Gly was more common in MG patients without other autoimmune diseases (39.4%). The difference in distribution of the genotypes between the three groups was statistically significant (χ2=6.394, P=0.041). Conclusionβ2-AR gene polymorphism in position 16 is associated with gender and other autoimmune diseas?es in patients with early onset of MG.

Surgical outcome for occipitocervical intradural extramedullary tumors / 中华骨科杂志

Objective To investigate the surgical strategy and outcome for occipitocervical extramedullary tumors.Methods 15 patients with occipitocervical extramedullary tumors from January 2007 to July 2010 were reviewed retrospectively.There were 7 males and 8 females with an mean age of 44.6 years (range,21-72 years).All cases were intradural tumors,including 7 cases in dorsolateral,5 cases in lateral side,and 3 cases in ventralis of spinal cord.Functional and neurological statuses were assessed using the Frankel grade and Japanese Orthopaedic Association (JOA) scale.According to Frankel grade system,there were 4 patients with Grade C,8 with Grade D,and 3 with Grade E.The mean preoperative JOA score was 10.5±3.6.Based on the tumor site,there were 5 cases in medulla oblongata-C1 and 10 cases in C1,2.Frankel grade and JOA score were used to evaluate neurological status and general health.The improvement of symptoms and characteristics of surgical strategies were analyzed.Results All cases were followed up for 2-4 years (mean 2.8 years).Complete resection of tumor and good fusion of bone graft were found in radiography postoperatively.The pathological diagnoses included 10 cases of schwannoma,3 cases of meningioma and 2 cases of neurofibroma.There was statistical difference between the preoperative and the final follow-up functional and neurological statuses including Frankel grade and JOA score.At the latest follow-up,2 cases improved from Frankel grade C to D,2from C to E,6 from D to E,but none in 2 cases with grade D.The mean JOA score at final follow-up was 15.6±1.6,and the average improvement rate was 80.7％± 17.4％.The mean preoperative C0-2 angle was 27.0°±4.1 °,and C2-7 angle was 16.8°± 12.7°.C0-2 angle was 27.6°±8.8°,and C2-7 angle was 10.2°±6.8° at the latest follow-up.However,these differences did not reach statistical significance.Conclusion Surgical treatment can effectively maintain or improve neurological function and improve quality of life.Extramedullary tumors can be resected completely by posterior approach,and spinal stabilization can be obtained satisfactorily through selecting appropriate surgical strategies.For medulla oblongata-C1 level,occipitocervical fusion is usually chosen after extirpation of tumor.For C 1,2 level,C1,2 fusion after tumor resection is useful in preventing atlantoaxial instability.

Effect of GRK5 on activation of rat astrocytes / 中国病理生理杂志

AIM: To study the effect of G-protein-coupled receptor kinase 5 (GRK5) on the activation of astrocytesin the brain cortex of newborn Wistar rats .METHODS: GRK5 gene was silenced in the model of rat brain cortexastrocytes in vitro for 24 h.N-acetylcysteine (NAC), which is a known inhibitor of NF-κB, was added into the culture mediumaccording to gene silencing for 24 h.The expression levels of GFAP and caspase-3 were detected by the method of immunofluorescence,and the mRNA levels of NF-κB, TNF-α, IL-1βand iNOS were determined by real-time PCR.Moreover,the activity of SOD and concentrations of TNF -αand NO were measured.RESULTS: GRK5 gene silencing increasedthe expression of NF-κB at mRNA and protein levels obviously (P <0.01), and the mRNA levels of IL-1βand iNOS increasedsynchronously (P <0.01).Furthermore, caspase-3-positive cells in GRK5 siRNA group were increased comparedwith control siRNA group (P <0.01).Treatment with NAC obviously reduced the activity of NF -κB and weakened theeffects induced by GRK5 siRNA (P <0.05).CONCLUSION: GRK5 siRNA increases NF-κB activity and induces the activationof astrocytes.

Study on the relationship between single nucleotide polymorphisms of PRKCG gene (rs2547362 and rs3745406) and susceptibility to osteosarcoma in a Chinese Han population / 中华骨科杂志

Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) of PRKCG gene (rs2547362,rs3745406) and osteosarcoma susceptibility in the osteosarcoma patients and the normal population.Methods Sixtyone patients with osteosarcoma who had been admitted in our hospital from January 2011 to December 2012 and 63 healthy adults were enrolled in this study.A 2-ml peripheral blood sample was taken from each participant.The RT-qPCR method was used to detect the genotype and allele frequency distribution of PRKCG gene at rs2547362 and rs3745406 in osteosarcoma patients and normal population.Osteosarcoma patients were divided into several groups according to the clinical parameters such as age,gender,histology,tumor location,Enneking classification,tumor metastasis and therapy,and then we analyzed the relations between the genetic polymorphism and clinical parameters.Results 1) The genotype of PRKCG gene at rs3745406 included CC,CT and TT.The differences of genotypes (CC,CT,TF) and alleles (C,T) frequency distribution at rs3745406 were not statistically significant between osteosarcoma patients and the normal population (P=0.490,P=0.554).2) The genotype of PRKCG gene at rs2547362 included CC,CT and TT.The differences of genotypes (CC,CT,TT) and the alleles(C,T) frequency distribution at rs2547362 were statistically significant between the osteosarcoma patients and the normal population (P=0.006,P=0.007).3) The differences of genotypes (CC,CT,TT) and alleles (C,T) frequency distribution at rs3745406 were statistically significant between patients with metastasis and patients without metastasis (P=0.000,P=0.000).The CT and TT genotypes and the T allele carrier frequency at rs3745406 were higher in patients with metastasis than in patients without metastasis.SNPs at rs2547362 were not associated with clinical parameters.Conclusion The genetic polymorphism of PRKCG gene at rs2547362 is associated with osteosarcoma susceptibility.The TT genotype and T allele at rs3745406 are associated with metastasis of osteosarcoma,which may be a risk factor for metastasis in the osteosarcoma patients.

Tremor, hypermyotonia and gatism / 中华老年医学杂志

Neuropsychiatric systemic lupus erythematosus (NP-SLE) is more common in young woman but not yet in people over 75 years old.We report a case of NP-SLE in an old woman,who complained of tremor,hypermyotonia and gatism.The lab examinations showed strong positive (1∶3200) ANA,decreased levels of CH50,C3,C4,WBC,RBC,PLT,anti-ds-DNA(+),anti-Sm(+),SSA(+),PO(+),RO-52(+),urine blood (+) and protein (+).The proteins,MBPand IgGin CSF were increased.Head MRI scan showed many demyelination in bilateral intra ventricular and multiple patchy irregular long T1 and T2 signal under right parietal subcortical.The patient was immediately given methylprednisolone hormone therapy,combined with gamma globulin and hydroxychloroquine.After 4 days of treatment,most symptoms such as tremor and hypermyotonia disappeared.Laboratory tests showed that all immune markers changed better in three weeks.The patient was discharged in 4 weeks.it must be identified with cerebrovascular disease,Parkinson's disease and other common diseases in elderly people.It can be improved if the diagnosis and treatment of NP-SLE is immediately and the illness is well controlled.

Custom-made Artificial Total Knee Prosthesis Replacement for Pathological Fracture of Distal Femur Caused by Giant Cell Tumor of Bone / 中国肿瘤临床

Objective: TO evaluate the effect of custom-made artificial total knee prosthesis replacement on pathological fracture of distal femur caused by giant cell tumor of bone. Methods." A total of 12 knees of 12 patients with pathological fracture of distal femur caused by giant cell tumor of bone were treated with cus-tom-made artificial total knee prosthesis replacement. There were 5 males and 7 females aged from 23 to 40 years (34.2 years on average). Results: All patients tolerated surgery very well. The surgical duration was 120～ 180 rain and the intraoperative bleeding was 500 ～ 900mL. The drainage tube was taken out in 5 days after surgery. The postoperative drainage volume was 300 ～ 700mL. There were no postoperative complica-tions. The postoperative X-ray examination showed that all of the prosthesises were in the right position. Lo-cal pain disappeared in all patients after surgery. The pathological examination identified all the patients with giant cell tumor of bone. All patients were followed up for 18 ～ 30 months (24 months on average). No recur-rence was observed after surgery. No infection or implant loosening occurred during the follow up. According to the Enneking assessment system of function after limb salvage surgery, the mean Enneking scale was 23.8 points (ranged from 15 to 28 points) at the last follow-up visit. Conclusion: Custom-made artificial total knee prosthesis replacement can achieve a high satisfactory rate in clearance of lesion and restoring function of the knee in patients with pathological fracture of distal femur caused by giant cell tumor of bone, improving patients' quality of life.

Cathepsin B antisense oligodeoxynucleotide suppresses invasive potential of MG-63 cells / 药物分析学报

Objective To study the biological effects of cathepsin B phosporotbioated antisense oligodeoxynucleotide on human osteosarcoma cell line MG-63 after transfection. Methods A 18-mer phosphorothioate antisense oligodeoxynucleotide (ASODN) targeted against the cathepsin B mRNA was transfected into the human osteosarcoma cell line MG-63 by lipofectamine 2000. The sense and nonsense oligodeoxynucleotides to cathepsin B and blank vector were used as controls. The expression of cathepsin B mRNA was examined by RT-PCR and the expression of cathepsin B was examined by Western blot. The invasive capability of MG-63 cells was evaluated by the boydern chamber assay. Results The expression of cathcpsin B was obviously inhibited in antlsense oligodeoxynucleotide treated cells compared with the control cells. The number of invading MG-63 cells was significantly lower in the ASODN-treated groups than that in the control groups. Conclusion The cathepsin B ASODN significantly inhibits the expression of cathepsin B and invasive ability of MG-63 cell in osteosarcoma.

One-stage anterior debridement,allografts and internal fixation for leaping tuberculosis of lumbar vertebrae / 中国矫形外科杂志

[Objective]To assess the efficacy of one-stage allograft fusion and anterior spinal stabilization as an alternative treatment of lumbar leaping tuberculosis.[Methods]Eight patients with lumbar leaping tuberculosis underwent anterior route decompression and fusion.Combined chemotherapy was delivered to each patient at least three weeks before operation.There were 5 men and 3 women ranging in age from 21 to 62 years(average,37.2 years).The involved area included L1 and L3 in 2 patient,L1、2and L4 in 3 patient,L2、3and L5 in 1 patient,L2 and L5 in 2 patients.There were 1 patient with Frankel Grade B,2 with Grade C,1 with Grade D and 4 with Grade E.The kyphosis angle ranged from 5?～40?(average 21.5?).The patients were followed up for 12～24 months.[Results]The patients folerated operation well.The operation time were 120～180 min and the bleeding during operation were 400～900 ml.After surgery,pain reliefed in all patients.One patient in Grade B improved to Grade C,1 patient in Grade C improved to Grade D,1 patient in Grade C improved to Grade E,1 patients in Grade D improved to Grade E.The mean angle of kyphosis correction were 5?～20?(average angle:12.5?).There was no postoperative complication.During the follow-up period,all cases healed without any recurrence.There was no breakage of nails or fall of the internal fixation.Spinal fusion occurred after 4～7 months(average 5.3 months) after operation.[Conclusion]Lumbar leaping tuberculosis treated with this surgical technique can achieve a high satisfactory rate with advantages of restoring the spinal stability,providing early fusion,preventing and correcting progression of the kyphosis.

Change of thrombin antithrombin Ⅲ complex after acute brain infarction / 中国康复理论与实践

@# ObjectiveTo determine the change of coagulation in acute brain infarction.MethodsBlood samples were taken intravenously from 57 patients with acute brain infarctions (within 24hr) and the thrombin time(TT), prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB) levels were detected serially at the time of instant admission, 1st day ,3rd day and 7th day after routine therapy, including 21 patients whose thrombin antithrombin III complex(TAT) levels were detected at the same time.ResultsTAT levels were significant increased in acute brain infarctions, especially in acute progress stroke, but TT, PT, APTT were not significantly different before and after routine treatment. FIB levels were higher at 7th day than pre-treatment. ConclusionTAT levels can be served as a marker of progress stroke.

Effect of Tongxinluo on expression of matrix metalloproteinase-9 in a rat model of transient middle cerebral artery occlusion / 中国康复理论与实践

@#ObjectiveTo investigate the effect of Tongxinluo by the dynamic changes of the expression of matrix metalloproteinase-9(MMP-9) on local cerebral ischemic-reperfusion injury in rats.MethodsMale Wistar rats were randomly divided into sham-operated control group, normal saline control groups (24-hour and 5-day) and Tongxinluo treatment groups(24-hour and 5-day). Animals in the latter four groups were subjected to focal ischemia by filament occlusion of the middle cerebral artery for 90 min. At the different end point, the expression of MMP-9 were assayed using immunohistochemistry staining method. ResultsCompared with the control groups, the expressions of MMP-9 were significantly decreased in both 24-hour and 5-day Tongxinluo treatment groups(P<0.05).ConclusionThe protective effects of Tongxinluo on cerebral ischemia reperfusion injury may be mediated by pharmacological inhibition of MMP-9 activity.The protective effects of Tongxinluo on cerebral ischemia reperfusion injury may be mediated by pharmacological inhibition of MMP-9 activity.

脑卒中就诊时间延迟因素分析 / 中国康复理论与实践

@#目的分析影响急性脑卒中就诊时间的相关因素。方法对326例急性脑卒中患者或家属进行问卷调查,用多变量对数回归分析模型统计不同变量和就诊时间的独立关系。结果发病6小时内就诊的患者占51.5%。就诊延迟主要与病情严重,患者对脑卒中症状的认识缺乏有关。年龄、首诊医院亦与就诊时间有关。结论对公众进行卒中症状及早期就诊重要性的教育是必要的。

Detection of subarachnoid haemorrhage with gradient echo T_2 ~*sequences / 中华神经科杂志

Objective To measure the sensitivity and specificity of gradient echo T*_2(GRE-T*_2) to subarachnoid haemorrhage (SAH). Methods 12 patients with SAH underwent MRI using T_1WI, T_2WI, FLAIR, GRE-T*_2 sequences and CT as well. Results (1)In the acute-stage of the patients, SAH was seen as an area of high signal intensity as compared with the surrounding cerebrospinal fluid in 66.6% of the cases on T_1-weighted images, and in 100% on FLAIR images; low signal intensities were seen in 50.0% of the cases on T_2-weighted images, and in 100% on GRE-T*_2-weighted images; (2) In the subacute of the patients, SAH was detected on T_1-weighted images (25.0% of cases), FLAIR (25.0%), T_2-weighted images (0), GRE-T*_2-weighted images (100.0%); (3) In the patients with atypical SAH, both CT and FLAIR sequence in MRI were negative for SAH, while lumber acupuncture and GRE-T*_2 had positive findings. Conclusion GRE-T*_2 is the most sensitive sequence of MRI for detecting acute and subacute SAH and has significant advantages over CT in the detection of subacute and atypical SAH.