BACKGROUND: About more than three fourth of patients with stroke have motor dysfunction at different degrees, especially hand motor dysfunction. Functional magnetic resonance imaging (fMRI) provides very reliable visi...BACKGROUND: About more than three fourth of patients with stroke have motor dysfunction at different degrees, especially hand motor dysfunction. Functional magnetic resonance imaging (fMRI) provides very reliable visible evidence for studying central mechanism of motor dysfunction after stroke, and has guiding and applicable value for clinical therapy. OBJECTIVE: To observe the activation of motor-related cortex of patients with acute ischemic stroke with functional magnetic resonance imaging, and analyze the relationship between brain function reconstruction and motor restoration after stroke. DESIGN: A contrast observation. SETTING: Medical Imaging Center, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. PARTICIPANTS: Nine patients with acute ischemic stroke who suffered from motor dysfunction and received the treatment in the Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between August and December 2005 were recruited, serving as experimental group. The involved patients including 5 male and 4 female, aged 16 to 87 years, all met the diagnostic criteria of cerebrovascular disease revised by The Fourth National Conference on Cerebrovascular Disease, mainly presenting paralysis in clinic, and underwent fMRI. Another 9 right handed persons matched in age and gender who simultaneously received healthy body examination were recruited, serving as control group. All the subjects were informed of the detected items. METHODS: ①Muscular strength of patients of the experimental group was evaluated according to Brunnstrom grading muscular strength(Grade Ⅰ-Ⅵ). ② Passive finger to finger motion was used as the mission (alternate style of quiescence, left hand motion and quiescence , right hand motion was repeated 3 times, serving as 1 sequence, 20 s per block and 20 s time interval . The whole process of scanning was 260 s), and subjects of 2 groups were given Bold-fMRI examination with GE1.5T double gradient 16-channel magnetic resonance imaging system. All the data were given off-line management, and fMRI was treated with SPM2 software. The activation of passive finger-to-finger motion-related cortex of subjects in 2 groups was observed. ③ Results of fMRI of subjects in 2 groups were compared. The size of activation region of brain and signal intensity were measured and unilateral index was calculated. The data of activation region of cerebral hemisphere of different sides at finger motion were given statistical analysis of unilateral index. Differences among unilateral indexes at hand motion were compared between intact and affected hands of patients in experimental group. The relationship between unilateral index and muscular strength of affected hands at affected hand motion in patients of the experimental group was performed Spearman correlation analysis. MAIN OUTCOME MEASURES: ① The activation of motion-related cortex passive finger-to-finger motion between handedness and non-handedness was detected with functional magnetic resonance imaging of subjects in 2 groups. ② Relationship between unilateral index and muscular strength of subjects of experimental group at affected hand motion. RESULTS: Nine patients with ischemic stroke and 9 controls all participated in the final result analysis. ① Passive fMRI detection results between handedness and non-handedness of controls: Right-handed finger-to-finger motion of subjects of control group mainly activated contralateral sensorimotor cortex, and left-handed finger-to-finger motion not only activated above-mentioned brain region, but also activated supplementary motor area (SMA) of contralateral brain region; ②In the experimental group, sensorimotor cortex of contralateral hemisphere was activated at affected hand motion, and homolateral posterior parietal cortex (PPC)was also obviously activated. Bilateral sensorimotor cortex was activated at affected hand motion in 2 patients, and homolateral activation area was larger than contralateral one. At intact hand motion, contralateral sensorimotor cortex was activated, but no obvious homolateral activation area was found. ③ Correlation of unilateral index with muscular strength: Passive finger-to-finger fMRI ( between affected and intact hands of subjects of experimental group: Unilateral index at passive single finger motion of affected and intact hand of subjects of experimental group was -0.018±0.01 and 0.319±0.187, respectively, with significant difference (t=4.059, P < 0.01). Unilateral index was significantly positively correlated with the muscular strength of affected hand at affected hand motion(r=0.834, P < 0.05). CONCLUSION: ① fMRI can objectively shows different activation states of motor cortex between patients with ischemic stroke and healthy controls, and brain functional compensation and recombination exist. Both primary sensorimotor cortex and SMA of bilateral hemispheres participant in affected hand motion, at the same time, parietal lobe and cortex of intact side also obviously participant in the affected hand motion. ②Correlation analysis of unilateral index and muscular strength of affected hand performed through fMRI can be used as an effective means to investigate the relationship between motion rehabilitation and brain functional recombination after stroke.展开更多
Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,...Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,2013;Jang et al.,2014).Because the ARAS is composed of several neuronal circuits connecting the brainstem to the cortex.These neuronal connections begin from the reticular formation(RF)of the brainstem and the in-展开更多
BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To o...BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury. DESIGN: A randomized controlled observation. SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University. PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30). METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site. ② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were evaluated with Barthel index, the total score was 100 points, 60 for mild dysfunction, 60-41 for moderate dysfunction, < 40 for severe dysfunction). MAIN OUTCOME MEASURES: Changes of MAS grade, FMA scores and Barthel index before and after BTX-A injection. RESULTS: All the 60 patients with brain injury and stroke were involved in the analysis of results. ① FMA scores of upper limbs: The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment [(14.98±10.14), (13.10±9.28) points, P < 0.05], whereas there was no significant difference at corresponding time point in the control group. The FMA scores at 1 and 3 months in the treatment group [(23.36±10.69), (35.36±11.36) points] were higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. ② MAS grades of upper limbs: There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks after treatment than before treatment in the treatment group (0, 9 cases, P < 0.05), whereas there was no obvious difference in the control group. There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks and 1 month after treatment in the treatment group (0, 0 case) than the control group (5, 2 cases, P < 0.01). ③ Barthel index of upper limbs: The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group [(30.36±22.25), (28.22±26.21) points, P < 0.05], whereas there was no significant difference in the control group. The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. CONCLUSION: BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury, and relieving muscle spasm; Meanwhile, the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.展开更多
Dear Editor,Iam Yoon Jin Kong from the Department of Ophthalmology,Soonchunhyang University Bucheon Hospital,Bucheon,Korea.Herein,we describe a series of three patients with active Graves'ophthalmopathy(GO)who pre...Dear Editor,Iam Yoon Jin Kong from the Department of Ophthalmology,Soonchunhyang University Bucheon Hospital,Bucheon,Korea.Herein,we describe a series of three patients with active Graves'ophthalmopathy(GO)who presented with epiphora caused by swollen caruncles whose symptoms improved after surgical excision of the caruncles.展开更多
BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to ...BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to severe hypoxic-ischemic encephalopathy (HIE).OBJECTIVE: To observe the abnormal results of HIE at different degrees detected with BEAM and TCD in infant patients, and compare the detection results at the same time point between BEAM, TCD and computer tomography (CT) examinations.DESIGN: Contrast observation.SETTING: Departments of Neuro-electrophysiology and Pediatrics, Second Affiliated Hospital of Qiqihar Medical College.PARTICIPANTS: Totally 416 infant patients with HIE who received treatment in the Department of Newborn Infants, Second Affiliated Hospital of Qiqihar Medical College during January 2001 and December 2005. The infant patients, 278 male and 138 female, were at embryonic 37 to 42 weeks and weighing 2.0 to 4.1 kg, and they were diagnosed with CT and met the diagnostic criteria of HIE of newborn infants compiled by Department of Neonatology, Pediatric Academy, Chinese Medical Association. According to diagnostic criteria, 130 patients were mild abnormal, 196 moderate abnormal and 90 severe abnormal. The relatives of all the infant patients were informed of the experiment. METHODS: BEAM and TCD examinations were performed in the involved 416 infant patients with HIE at different degrees with DYD2000 16-channel BEAM instrument and EME-2000 ultrasonograph before preliminary diagnosis treatment (within 1 month after birth) and 1,3,6,12 and 24 months after birth, and detected results were compared between BEAM, TCD and CT examinations. MAIN OUTCOME MEASURES: Comparison of detection results of HIE at different time points in infant patients between BEAM, TCD and CT examinations.RESULTS: All the 416 infant patients with HIE participated in the result analysis. ① Comparison of the detected results in infant patients with mild HIE at different time points after birth between BEAM, TCD and CT examinations: BEAM examination showed that the recovery was delayed, and the abnormal rate of BEAM examination was significantly higher than that of CT examination 1 and 3 months after birth [55.4%(72/130)vs. 17.0%(22/130),χ2=41.66;29.2%(38/130) vs. 6.2%(8/130),χ2=23.77,P < 0.01], exceptional patients had mild abnormality and reached the normal level in about 6 months. TCD examination showed that the disease condition significantly improved and infant patients with HIE basically recovered 1 or 2 months after birth, while CT examination showed that infant patients recovered 3 or 4 months after birth. ② Comparison of detection results of infant patients with moderate HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination 1,3,6 and 12 months after birth [90.8%(178/196),78.6%(154/196),χ2=4.32,P < 0.05;64.3%(126/196),43.9%(86/196),χ2=16.44;44.9%(88/196),22.4%(44/196),χ2=22.11;21.4%(42/196),10.2%(20/196),χ2=9.27,P < 0.01]. BEAM examination showed that there was still one patient who did not completely recovered in the 24th month due to the relatives of infant patients did not combine the treatment,. TCD examination showed that the abnormal rate was 23.1%(30/196)in the 1st month after birth, and all the patients recovered to the normal in the 3rd month after birth, while CT examination showed that mild abnormality still existed in the 24th month after birth(1.0%,2/196). ③ Comparison of detection results of infant patients with severe HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination in the 1st, 3rd, 6th and 12th months after birth[86.7%(78/90),44.4%(40/90),χ2=35.53;62.2%(56/90),31.1%(28/90),χ2=17.51;37.8%(34/90),6.7%(6/90),χ2=27.14,P < 0.01]. BEAM examination showed that mild abnormality still existed in 4 infant patients in the 24th month after birth. TCD examination showed that the abnormal rate was 11.1% (10/90) in the 3rd month after birth, and all the infant patients recovered in the 6th month after birth. CT examination showed that the abnormal rate was 6.7%(6/90) in the 12th month after birth, and all of infant patients recovered to the normal in the 24th month after birth.CONCLUSION: BEAM is the direct index to detect brain function of infant patients with HIE, and positive reaction is still very sensitive in the tracking detection of convalescent period. The positive rate of morphological reaction in CT examination is superior to that in TCD examination, and the positive rate is very high in the acute period of HIE in examination.展开更多
BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after bra...BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE: To comparatively observe the intelligence quotient (IQ), latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase (AChE) in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN: Correlation analysis of contrast observation. SETTING: Department of Endocrinology, Affiliated Hospital of Binzhou Medical College. PARTICIPANTS: Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS: ① Evaluation on IQ: The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian (WAIS-RC). WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ (VIQ), performance IQ (PIQ) and full scale IQ (FIQ). FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave: P300 wave was detected with evoked potential instrument (MYTOPRO, Italian), and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid: Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer. ④Correlation analysis: Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed. t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES: ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS: Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups: The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were (97.4±10.4),(92.6±8.4) and (95.2±9.7) scores, respectively; and those of patients with non-diabetes mellitus were (104.7±9.6),(102.5±8.5)and(102.7±8.9) scores, respectively, and P < 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was (370.8±41.8),(371.5±39.1)and (375.1±43.1) ms, respectively, and that of patients with non-diabetes mellitus was (332.1±28.3),(335.7±29.4)and(339.7±27.3) ms, respectively, and P < 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was (8.6±4.1),(8.6±4.0) and(7.7±4.0) μV, respectively and that of patients with non-diabetes mellitus was (11.9±4.1),(11.5±4.4) and (10.9±5.0) μV, respectively , and P < 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was (235.61±50.34)and (17.89±4.46) μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [(205.03±44.15)and (14.63±0.48) μkat /L, respectively], and P < 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave: The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid (r=-0.588 1, P < 0.01), significantly negatively correlated with the latent period at points Fz, C and Pz of P300 wave (r= -0.700 5, -0.689 4, -0.688 5, P < 0.01), and significantly positively correlated with the amplitude at points Fz , Cz and Pz of P300 wave(r= 0.607 4,0.616 1,0.592 0,P < 0.01). CONCLUSION: ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ② Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.展开更多
BACKGROUND: Functional magnetic resonance imaging (fMRI) studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significa...BACKGROUND: Functional magnetic resonance imaging (fMRI) studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE: To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN: A case-controlled observation.SETTING: Department of Radiology, Second Affiliated Hospital, Shantou University Medical College.PARTICIPANTS: Twenty-three patients (13 males and 10 females) with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of (47±1) years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central lobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma (n =8), metastatic tumours (n =7), meningiomas (n =5) and oligodendroglioma (n =3). The muscle strength was normal in 11 cases (grade 5) and obviously decreased in 12 cases (grade 2-3 in 3 cases and grade 4 in 9 cases); muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees (5 males and 4 females) of 20-56 years old with an average of (34±1) years were taken as controls. All the patients and healthy subjects were right-handed. METHODS: All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex (M1) in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES: ① Brain areas activated by finger-tapping movements in each group; ② Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS: The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. ① In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex (M1), bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex (M1), smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex (M1), bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcus around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit (n =1, P < 0.01), and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit (P < 0.01). ② The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group (P < 0.01). The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group (P < 0.05), but that of SMA had no obvious difference between the two groups (P > 0.05). CONCLUSION: fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.展开更多
Objective: To explore possible consequences of short stays in hospitals, as these short contacts reduce the patients’ time for information and support. Method: A literature survey was carried out to get an insight in...Objective: To explore possible consequences of short stays in hospitals, as these short contacts reduce the patients’ time for information and support. Method: A literature survey was carried out to get an insight in possible consequences by summarizing the state of knowledge on how men with prostate cancer undergoing prostatec-tomy surgery experience their contacts with the healthcare professionals. Results: A consequence is that often men with prostate cancer, treated with prostatectomy surgery, do not receive the individualized support, infor-mation, and dialogue they need, which leads to feelings of uncertainty, insecurity, and loss of control. The men use the Internet in their search for information and support, which makes them able to stay in control and be active, responsible partners in their own course of treatment. Conclusion: For men to feel secure and certain the accessibility of the healthcare professionals and the healthcare professionals’ ability to individualize information and support are important aspects. Practice Implications: It is relevant to provide male cancer patients with tools that can underpin their contact to the healthcare professionals. Utilizing Web 2.0 technologies, Internet based tools can support exchange-ability, towards dialogue-based contacts, between men with prostate cancer and healthcare professionals.展开更多
Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Method...Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Methods Totally 68 HBe Ag negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group展开更多
Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patien...Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patients under inflammatory stress and further to investigate its potential mechanisms modulated by purinergic receptor P2X ligandgated ion channel展开更多
文摘BACKGROUND: About more than three fourth of patients with stroke have motor dysfunction at different degrees, especially hand motor dysfunction. Functional magnetic resonance imaging (fMRI) provides very reliable visible evidence for studying central mechanism of motor dysfunction after stroke, and has guiding and applicable value for clinical therapy. OBJECTIVE: To observe the activation of motor-related cortex of patients with acute ischemic stroke with functional magnetic resonance imaging, and analyze the relationship between brain function reconstruction and motor restoration after stroke. DESIGN: A contrast observation. SETTING: Medical Imaging Center, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. PARTICIPANTS: Nine patients with acute ischemic stroke who suffered from motor dysfunction and received the treatment in the Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between August and December 2005 were recruited, serving as experimental group. The involved patients including 5 male and 4 female, aged 16 to 87 years, all met the diagnostic criteria of cerebrovascular disease revised by The Fourth National Conference on Cerebrovascular Disease, mainly presenting paralysis in clinic, and underwent fMRI. Another 9 right handed persons matched in age and gender who simultaneously received healthy body examination were recruited, serving as control group. All the subjects were informed of the detected items. METHODS: ①Muscular strength of patients of the experimental group was evaluated according to Brunnstrom grading muscular strength(Grade Ⅰ-Ⅵ). ② Passive finger to finger motion was used as the mission (alternate style of quiescence, left hand motion and quiescence , right hand motion was repeated 3 times, serving as 1 sequence, 20 s per block and 20 s time interval . The whole process of scanning was 260 s), and subjects of 2 groups were given Bold-fMRI examination with GE1.5T double gradient 16-channel magnetic resonance imaging system. All the data were given off-line management, and fMRI was treated with SPM2 software. The activation of passive finger-to-finger motion-related cortex of subjects in 2 groups was observed. ③ Results of fMRI of subjects in 2 groups were compared. The size of activation region of brain and signal intensity were measured and unilateral index was calculated. The data of activation region of cerebral hemisphere of different sides at finger motion were given statistical analysis of unilateral index. Differences among unilateral indexes at hand motion were compared between intact and affected hands of patients in experimental group. The relationship between unilateral index and muscular strength of affected hands at affected hand motion in patients of the experimental group was performed Spearman correlation analysis. MAIN OUTCOME MEASURES: ① The activation of motion-related cortex passive finger-to-finger motion between handedness and non-handedness was detected with functional magnetic resonance imaging of subjects in 2 groups. ② Relationship between unilateral index and muscular strength of subjects of experimental group at affected hand motion. RESULTS: Nine patients with ischemic stroke and 9 controls all participated in the final result analysis. ① Passive fMRI detection results between handedness and non-handedness of controls: Right-handed finger-to-finger motion of subjects of control group mainly activated contralateral sensorimotor cortex, and left-handed finger-to-finger motion not only activated above-mentioned brain region, but also activated supplementary motor area (SMA) of contralateral brain region; ②In the experimental group, sensorimotor cortex of contralateral hemisphere was activated at affected hand motion, and homolateral posterior parietal cortex (PPC)was also obviously activated. Bilateral sensorimotor cortex was activated at affected hand motion in 2 patients, and homolateral activation area was larger than contralateral one. At intact hand motion, contralateral sensorimotor cortex was activated, but no obvious homolateral activation area was found. ③ Correlation of unilateral index with muscular strength: Passive finger-to-finger fMRI ( between affected and intact hands of subjects of experimental group: Unilateral index at passive single finger motion of affected and intact hand of subjects of experimental group was -0.018±0.01 and 0.319±0.187, respectively, with significant difference (t=4.059, P < 0.01). Unilateral index was significantly positively correlated with the muscular strength of affected hand at affected hand motion(r=0.834, P < 0.05). CONCLUSION: ① fMRI can objectively shows different activation states of motor cortex between patients with ischemic stroke and healthy controls, and brain functional compensation and recombination exist. Both primary sensorimotor cortex and SMA of bilateral hemispheres participant in affected hand motion, at the same time, parietal lobe and cortex of intact side also obviously participant in the affected hand motion. ②Correlation analysis of unilateral index and muscular strength of affected hand performed through fMRI can be used as an effective means to investigate the relationship between motion rehabilitation and brain functional recombination after stroke.
基金supported by the National Research Foundation (NRF) of Korea Grant funded by the Korean Government (MSIP) No. 2015R1A2A2A01004073
文摘Consciousness is controlled by activation of the ascending reticular activating system(ARAS).The ARAS consists mainly of the lower and upper parts between the thalamus and cerebral cortex(Edlow et al.,2012;Yeo et al.,2013;Jang et al.,2014).Because the ARAS is composed of several neuronal circuits connecting the brainstem to the cortex.These neuronal connections begin from the reticular formation(RF)of the brainstem and the in-
基金a grant from the Tackle Key Problem and Planning Projectin Science and Technology of Hebei Province,No.052761224
文摘BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury. DESIGN: A randomized controlled observation. SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University. PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30). METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site. ② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were evaluated with Barthel index, the total score was 100 points, 60 for mild dysfunction, 60-41 for moderate dysfunction, < 40 for severe dysfunction). MAIN OUTCOME MEASURES: Changes of MAS grade, FMA scores and Barthel index before and after BTX-A injection. RESULTS: All the 60 patients with brain injury and stroke were involved in the analysis of results. ① FMA scores of upper limbs: The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment [(14.98±10.14), (13.10±9.28) points, P < 0.05], whereas there was no significant difference at corresponding time point in the control group. The FMA scores at 1 and 3 months in the treatment group [(23.36±10.69), (35.36±11.36) points] were higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. ② MAS grades of upper limbs: There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks after treatment than before treatment in the treatment group (0, 9 cases, P < 0.05), whereas there was no obvious difference in the control group. There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks and 1 month after treatment in the treatment group (0, 0 case) than the control group (5, 2 cases, P < 0.01). ③ Barthel index of upper limbs: The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group [(30.36±22.25), (28.22±26.21) points, P < 0.05], whereas there was no significant difference in the control group. The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. CONCLUSION: BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury, and relieving muscle spasm; Meanwhile, the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.
基金Supported by the Soonchunhyang University Research Fund(No.20160003)
文摘Dear Editor,Iam Yoon Jin Kong from the Department of Ophthalmology,Soonchunhyang University Bucheon Hospital,Bucheon,Korea.Herein,we describe a series of three patients with active Graves'ophthalmopathy(GO)who presented with epiphora caused by swollen caruncles whose symptoms improved after surgical excision of the caruncles.
文摘BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to severe hypoxic-ischemic encephalopathy (HIE).OBJECTIVE: To observe the abnormal results of HIE at different degrees detected with BEAM and TCD in infant patients, and compare the detection results at the same time point between BEAM, TCD and computer tomography (CT) examinations.DESIGN: Contrast observation.SETTING: Departments of Neuro-electrophysiology and Pediatrics, Second Affiliated Hospital of Qiqihar Medical College.PARTICIPANTS: Totally 416 infant patients with HIE who received treatment in the Department of Newborn Infants, Second Affiliated Hospital of Qiqihar Medical College during January 2001 and December 2005. The infant patients, 278 male and 138 female, were at embryonic 37 to 42 weeks and weighing 2.0 to 4.1 kg, and they were diagnosed with CT and met the diagnostic criteria of HIE of newborn infants compiled by Department of Neonatology, Pediatric Academy, Chinese Medical Association. According to diagnostic criteria, 130 patients were mild abnormal, 196 moderate abnormal and 90 severe abnormal. The relatives of all the infant patients were informed of the experiment. METHODS: BEAM and TCD examinations were performed in the involved 416 infant patients with HIE at different degrees with DYD2000 16-channel BEAM instrument and EME-2000 ultrasonograph before preliminary diagnosis treatment (within 1 month after birth) and 1,3,6,12 and 24 months after birth, and detected results were compared between BEAM, TCD and CT examinations. MAIN OUTCOME MEASURES: Comparison of detection results of HIE at different time points in infant patients between BEAM, TCD and CT examinations.RESULTS: All the 416 infant patients with HIE participated in the result analysis. ① Comparison of the detected results in infant patients with mild HIE at different time points after birth between BEAM, TCD and CT examinations: BEAM examination showed that the recovery was delayed, and the abnormal rate of BEAM examination was significantly higher than that of CT examination 1 and 3 months after birth [55.4%(72/130)vs. 17.0%(22/130),χ2=41.66;29.2%(38/130) vs. 6.2%(8/130),χ2=23.77,P < 0.01], exceptional patients had mild abnormality and reached the normal level in about 6 months. TCD examination showed that the disease condition significantly improved and infant patients with HIE basically recovered 1 or 2 months after birth, while CT examination showed that infant patients recovered 3 or 4 months after birth. ② Comparison of detection results of infant patients with moderate HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination 1,3,6 and 12 months after birth [90.8%(178/196),78.6%(154/196),χ2=4.32,P < 0.05;64.3%(126/196),43.9%(86/196),χ2=16.44;44.9%(88/196),22.4%(44/196),χ2=22.11;21.4%(42/196),10.2%(20/196),χ2=9.27,P < 0.01]. BEAM examination showed that there was still one patient who did not completely recovered in the 24th month due to the relatives of infant patients did not combine the treatment,. TCD examination showed that the abnormal rate was 23.1%(30/196)in the 1st month after birth, and all the patients recovered to the normal in the 3rd month after birth, while CT examination showed that mild abnormality still existed in the 24th month after birth(1.0%,2/196). ③ Comparison of detection results of infant patients with severe HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination in the 1st, 3rd, 6th and 12th months after birth[86.7%(78/90),44.4%(40/90),χ2=35.53;62.2%(56/90),31.1%(28/90),χ2=17.51;37.8%(34/90),6.7%(6/90),χ2=27.14,P < 0.01]. BEAM examination showed that mild abnormality still existed in 4 infant patients in the 24th month after birth. TCD examination showed that the abnormal rate was 11.1% (10/90) in the 3rd month after birth, and all the infant patients recovered in the 6th month after birth. CT examination showed that the abnormal rate was 6.7%(6/90) in the 12th month after birth, and all of infant patients recovered to the normal in the 24th month after birth.CONCLUSION: BEAM is the direct index to detect brain function of infant patients with HIE, and positive reaction is still very sensitive in the tracking detection of convalescent period. The positive rate of morphological reaction in CT examination is superior to that in TCD examination, and the positive rate is very high in the acute period of HIE in examination.
基金the Grants from Department of Education of Shandong Province, No.J02K11
文摘BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE: To comparatively observe the intelligence quotient (IQ), latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase (AChE) in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN: Correlation analysis of contrast observation. SETTING: Department of Endocrinology, Affiliated Hospital of Binzhou Medical College. PARTICIPANTS: Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS: ① Evaluation on IQ: The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian (WAIS-RC). WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ (VIQ), performance IQ (PIQ) and full scale IQ (FIQ). FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave: P300 wave was detected with evoked potential instrument (MYTOPRO, Italian), and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid: Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer. ④Correlation analysis: Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed. t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES: ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS: Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups: The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were (97.4±10.4),(92.6±8.4) and (95.2±9.7) scores, respectively; and those of patients with non-diabetes mellitus were (104.7±9.6),(102.5±8.5)and(102.7±8.9) scores, respectively, and P < 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was (370.8±41.8),(371.5±39.1)and (375.1±43.1) ms, respectively, and that of patients with non-diabetes mellitus was (332.1±28.3),(335.7±29.4)and(339.7±27.3) ms, respectively, and P < 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was (8.6±4.1),(8.6±4.0) and(7.7±4.0) μV, respectively and that of patients with non-diabetes mellitus was (11.9±4.1),(11.5±4.4) and (10.9±5.0) μV, respectively , and P < 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was (235.61±50.34)and (17.89±4.46) μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [(205.03±44.15)and (14.63±0.48) μkat /L, respectively], and P < 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave: The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid (r=-0.588 1, P < 0.01), significantly negatively correlated with the latent period at points Fz, C and Pz of P300 wave (r= -0.700 5, -0.689 4, -0.688 5, P < 0.01), and significantly positively correlated with the amplitude at points Fz , Cz and Pz of P300 wave(r= 0.607 4,0.616 1,0.592 0,P < 0.01). CONCLUSION: ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ② Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.
基金a grant from theMedical Scientific ResearchFoundation of GuangdongProvince, No. A2003526
文摘BACKGROUND: Functional magnetic resonance imaging (fMRI) studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE: To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN: A case-controlled observation.SETTING: Department of Radiology, Second Affiliated Hospital, Shantou University Medical College.PARTICIPANTS: Twenty-three patients (13 males and 10 females) with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of (47±1) years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central lobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma (n =8), metastatic tumours (n =7), meningiomas (n =5) and oligodendroglioma (n =3). The muscle strength was normal in 11 cases (grade 5) and obviously decreased in 12 cases (grade 2-3 in 3 cases and grade 4 in 9 cases); muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees (5 males and 4 females) of 20-56 years old with an average of (34±1) years were taken as controls. All the patients and healthy subjects were right-handed. METHODS: All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex (M1) in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES: ① Brain areas activated by finger-tapping movements in each group; ② Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS: The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. ① In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex (M1), bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex (M1), smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex (M1), bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcus around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit (n =1, P < 0.01), and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit (P < 0.01). ② The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group (P < 0.01). The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group (P < 0.05), but that of SMA had no obvious difference between the two groups (P > 0.05). CONCLUSION: fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.
基金The Novo Nordisk Foundation DOF Det Obelske Familiefond+1 种基金 Danish Nursing Research Society Harboefonden
文摘Objective: To explore possible consequences of short stays in hospitals, as these short contacts reduce the patients’ time for information and support. Method: A literature survey was carried out to get an insight in possible consequences by summarizing the state of knowledge on how men with prostate cancer undergoing prostatec-tomy surgery experience their contacts with the healthcare professionals. Results: A consequence is that often men with prostate cancer, treated with prostatectomy surgery, do not receive the individualized support, infor-mation, and dialogue they need, which leads to feelings of uncertainty, insecurity, and loss of control. The men use the Internet in their search for information and support, which makes them able to stay in control and be active, responsible partners in their own course of treatment. Conclusion: For men to feel secure and certain the accessibility of the healthcare professionals and the healthcare professionals’ ability to individualize information and support are important aspects. Practice Implications: It is relevant to provide male cancer patients with tools that can underpin their contact to the healthcare professionals. Utilizing Web 2.0 technologies, Internet based tools can support exchange-ability, towards dialogue-based contacts, between men with prostate cancer and healthcare professionals.
文摘Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Methods Totally 68 HBe Ag negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group
文摘Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patients under inflammatory stress and further to investigate its potential mechanisms modulated by purinergic receptor P2X ligandgated ion channel
