Association Between Intracranial Pulsatility and White Matter Hyperintensities in Asymptomatic Intracranial Arterial Stenosis: A Population-Based Study in Shandong, China.

OBJECTIVES: The effects of increased intracranial pulsatility on the severity of white matter hyperintensities (WMH) in participants with asymptomatic intracranial arterial stenosis (aICAS) remain uncertain. We aimed to investigate whether an increased pulsatility index (PI) is associated with WMH volume (WMHV) in individuals with aICAS. MATERIALS AND METHODS: All participants were recruited from the Kongcun Town aICAS Study, including a total of 103 participants with aICAS and 98 healthy controls (age- and sex-matched). PI was assessed using transcranial Doppler ultrasound. The WMHV was calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between PI and lnWMHV was analyzed by linear regression models adjusting for demographics, lifestyle, and vascular risk factors. RESULTS: The lnWMHV and PI between the aICAS and control groups showed no significant differences (P = 0.171 and 0.287, respectively). In a multivariable model, age ≥ 60 years and male sex (P = 0.000 and 0.006, respectively) were significant predictors of lnWMHV in the aICAS group. In sex-stratified analyses, there was a significant association between PI and lnWMHV in males with aICAS (P = 0.038). CONCLUSIONS: This study suggest there might be a likely association between increased intracranial pulsatility and WMH burden in males with aICAS.

Relationship between non-headache symptoms and right to left shunt in episodic migraine. A single-center cross-sectional study.

The relationship between right to left shunt (RLS) and non-headache symptoms (NHS) in episodic migraine is unknown. This study aimed to investigate the incidence and classification of RLS in episodic migraineurs, calculate the occurrence rate of NHS, and analyze the associations between RLS and NHS. We consecutively recruited 204 episodic migraine patients. Contrast-enhanced transcranial doppler was adopted to screen RLS. Structured questionnaire via face-to-face survey was conducted to collect clinical data. A total of 172 episodic migraineurs were included in the final analysis, of which 20 cases were migraine with aura. The positive rate of RLS was 47.1%, of which 50 cases (29.0%) had small shunt (Grade 1) and 31 cases (18.1%) had mid-large shunt (Grade 2-4). The most common NHS was nausea (115 (66.9%)), followed by headache aggravation with physical activity (96 (55.8%)), dizziness (93 (54.1%)), vomiting (77 (44.8%)) and phonophobia (74 (43.0%)). Yawning was more common in Grade 2-4 group than Grade 0 group (p = 0.012), while no statistical differences among other groups. Grade 2-4 group had a higher rate of headache aggravation with physical activity than grade 0 group (p = 0.008). Binary logistic regression analysis showed that yawning at premonitory phase, headache aggravation with physical activity and cranial autonomic symptoms during attack are independent predictors of RLS. In conclusion, yawning and headache aggravation with physical activity are more common in migraine patients with RLS. Besides aura, particular NHS may also serve as indicators for screening RLS in episodic migraineurs.

NHC-Ni catalyzed enantioselective synthesis of 1,4-dienes by cross-hydroalkenylation of cyclic 1,3-dienes and heterosubstituted terminal olefins.

Enantioenriched 1,4-dienes are versatile building blocks in asymmetric synthesis, therefore their efficient synthesis directly from chemical feedstock is highly sought after. Here, we show an enantioselective cross-hydroalkenylation of cyclic 1,3-diene and hetero-substituted terminal olefin by using a chiral [NHC-Ni(allyl)]BArF catalyst. Using a structurally flexible chiral C2 NHC-Ni design is key to access a broad scope of chiral 1,4-diene 3 or 3' with high enantioselectivity. This study also offers insights on how to regulate chiral C2 NHC-Ni(II) 1,3-allylic shift on cyclic diene 1 and to build sterically more hindered endocyclic chiral allylic structures on demand.

Design and experimental study of new type of external fixation device for bone fracture / 医疗卫生装备

Objective To design a new type of external fixator for bone fracture and verify its rationality and feasibility. Methods The frame and screw of stainless steel achieved fracture fixation in vitro with a threaded locking structure.At the same time the increasing thickness of body frame, the inclined nail holes and the raised bottoms were designed to greatly enhance the strength and overall stability of body frame.FEM (finite element method),measuring the relative displacement and stress distribution after axial load,was used to verify the rationality of the design.An animal experiment with sheep was used to verify the feasibility of fracture treatment. Results Simulated result of FEM indicated that the biggest relative displacement between the separated bones was 0.04 mm,which was much less than the minimum value 1 mm required for fracture healing.The maximum stresses applied on the frame of the fixator,fixator screw,and bone were 35,26,and 6 MPa, respectively, which was much less than the allowable stress. In the animal experiment, fracture site was fixed firmly after operation and was well cured 3 months later.Conclusion The design of this new device is feasible and it can be used as a new method of fracture treatment.

Research progress on treatment of tibial fracture with internal fixation plates as external fixators / 医疗卫生装备

The advantages and disadvantages of different treatment methods of traditional tibial fracture were summarized. The research progress on the treatment of tibial fracture with internal fixation plates as external fixators was introduced from two aspects of biomechanics and clinical application. It was proved that internal fixation plates as external fixators could reduce the structural stability, but this technique was still controversial to meet the mechanical requirements of fracture healing on biomechanics.Internal fixation plates as external fixators,it had the advantages of minimal invasion,high healing rate, less complications and favorable activities. It's pointed out clinical trials on its feasibility and availability as well as simulating body mechanics environment should be carried out to provide basis for relevant biomechanics researches.

(NHC)NiH-Catalyzed Intermolecular Regio- and Diastereoselective Cross-Hydroalkenylation of Endocyclic Dienes with α-Olefins.

Highly selective cross-hydroalkenylations of endocyclic 1,3-dienes at the least substituted site with α-olefins were achieved with a set of neutral (NHC)NiII H(OTf) catalysts and cationic NiII catalysts with a novel NHC ligand. Under heteroatom assistance, skipped dienes were obtained in good yields, often from equal amounts of the two substrates and at a catalyst loading of 2-5 mol %. Rare 4,3-product selectivity (i.e., with the H atom at C4 and the alkenyl group at C3 of the diene) was observed, which is different from the selectivity of known dimerizations of α-olefins with both acyclic Co and Fe systems. The influence of the various substituents on the NHC, 1,3-diene, and α-olefin on the chemo-, regio-, and diastereoselectivity was studied. High levels of chirality transfer were observed with chiral cyclohexadiene derivatives.

Research progress of haemostatic dressing for traumatic injury prehospital firstaid / 医疗卫生装备

The main species and research status were introduced for the haemostatic dressing of the prehospital first aid in foreign countries and China.The advantages and disadvantages,problems and futural development were analyzed for kinds of haemostatic dressing.It's pointed out that the haemostatic dressing tended to be multi-functional and complicated in the future.Dressing and haemostatic system had to be designed based on traumatic conditions in case multi function could not be realized.

The SUMO E3 Ligase-Like Proteins PIAL1 and PIAL2 Interact with MOM1 and Form a Novel Complex Required for Transcriptional Silencing.

The mechanism by which MORPHEUS' MOLECULE1 (MOM1) contributes to transcriptional gene silencing has remained elusive since the gene was first identified and characterized. Here, we report that two Arabidopsis thaliana PIAS (PROTEIN INHIBITOR OF ACTIVATED STAT)-type SUMO E3 ligase-like proteins, PIAL1 and PIAL2, function redundantly to mediate transcriptional silencing at MOM1 target loci. PIAL1 and PIAL2 physically interact with each other and with MOM1 to form a high molecular mass complex. In the absence of either PIAL2 or MOM1, the formation of the high molecular mass complex is disrupted. We identified a previously uncharacterized IND (interacting domain) in PIAL1 and PIAL2 and demonstrated that IND directly interacts with MOM1. The CMM2 (conserved MOM1 motif 2) domain of MOM1 was previously shown to be required for the dimerization of MOM1. We demonstrated that the CMM2 domain is also required for the interaction of MOM1 with PIAL1 and PIAL2. We found that although PIAL2 has SUMO E3 ligase activity, the activity is dispensable for PIAL2's function in transcriptional silencing. This study suggests that PIAL1 and PIAl2 act as components of the MOM1-containing complex to mediate transcriptional silencing at heterochromatin regions.

GmPGIP3 enhanced resistance to both take-all and common root rot diseases in transgenic wheat.

Take-all (caused by the fungal pathogen Gaeumannomyces graminis var. tritici, Ggt) and common root rot (caused by Bipolaris sorokiniana) are devastating root diseases of wheat (Triticum aestivum L.). Development of resistant wheat cultivars has been a challenge since no resistant wheat accession is available. GmPGIP3, one member of polygalacturonase-inhibiting protein (PGIP) family in soybean (Glycine max), exhibited inhibition activity against fungal endopolygalacturonases (PGs) in vitro. In this study, the GmPGIP3 transgenic wheat plants were generated and used to assess the effectiveness of GmPGIP3 in protecting wheat from the infection of Ggt and B. sorokiniana. Four independent transgenic lines were identified by genomic PCR, Southern blot, and reverse transcription PCR (RT-PCR). The introduced GmPGIP3 was integrated into the genomes of these transgenic lines and could be expressed. The expressing GmPGIP3 protein in these transgenic wheat lines could inhibit the PGs produced by Ggt and B. sorokiniana. The disease response assessments postinoculation showed that the GmPGIP3-expressing transgenic wheat lines displayed significantly enhanced resistance to both take-all and common root rot diseases caused by the infection of Ggt and B. sorokiniana. These data suggested that GmPGIP3 is an attractive gene resource in improving resistance to both take-all and common root rot diseases in wheat.

Synthesis, structures, and norbornene polymerization behavior of C(sp³), N-chelated palladacycles bearing o-aryloxide-N-heterocyclic carbene ligands.

Treatment of the o-hydroxyaryl imidazolium pro-ligands (2-OH-3,5-tBu2C6H2)(R)(C3H3N2)(+)Br(-) [R = Mes (1a), Ph (1b), iPr (1c), Me (1d)] with Ag2O afforded the corresponding silver complexes 2a-d. Subsequent metal-exchange reactions of 2a-d with [Pd(OAc)(8-Me-quin-H)]2 (3) yielded the desired C(sp(3)), N-chelated and o-aryloxide-NHC-ligated palladacycle complexes 4a-d in 60-80% yields. When the N-tert-butyl substituted o-hydroxyaryl imidazolium pro-ligand 1e reacted with 3 in the presence of K2CO3 in dioxane, the palladacycle complex 4e, in which the NHC adopted an abnormal binding (C4-bonding), was obtained in 20% yield. All these complexes were fully characterized using (1)H and (13)C NMR spectra, high-resolution mass spectrometry (HRMS), and elemental analysis. Single-crystal X-ray diffraction analysis results further confirmed the molecular structures of 4a-c and the abnormal binding of NHC in 4e. With methylaluminoxane (MAO) as the cocatalyst these palladacycles showed excellent catalytic activities of up to 10(7) g of PNB (mol of Pd)(-1) h(-1) in the addition polymerization of norbornene.

Comparative study of perpendicular versus parallel double plating methods for type C distal humeral fractures / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.</p><p><b>METHODS</b>Between March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.</p><p><b>RESULTS</b>All patients were followed up. The mean duration of follow-up was 16 months (range 12 - 25 months) in group I and 15.5 months in group II (range 12 - 25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.</p><p><b>CONCLUSIONS</b>Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.</p>

The significance of intraoperative computed tomograph scan for complex acetabular fractures / 中华骨科杂志

ObjectiveTo investigate the application of intraoperative Computed Tomograph (CT) using in surgery for complex acetabular fractures.MethodsFrom June 2008 to December 2010,14 patients (9 males,5 females; with the mean age of 45.1 years; range,28-62 years) with complex acetabular fractures were operated using intraoperative CT.Preoperative radiotherapy and CT scan were adopted to evaluate the fractures.Three dimensional reconstruction based on CT scan was used to mimic surgery.The surgery approach and the type of internal fixators were noted.Intraoperative C-arm and CT scan were used to evaluate the fractures reduction respectively.Decision of additional reduction was made by surgeons according to above mentioned methods respectively and the results were noted.Comparing to preoperative design,the change of surgery plan were noted.Overall time,frequency and radiation dose of intraoperative CT scan were also noted.ResultsAll patients in this study received average 2.7 times of intraoperative CT scan.Mean time of CT scan was 40.4 min and the overall dose of radiation was 47.2 mGy.Decision of additional reduction was made in 3 cases according to C-arm radiography and 4 cases according to CT scan (above mentioned 3 cases were included).The change of surgery plan was made in one case.In postoperative radiography evaluation according to Matta's score system,anatomical reduction were achieved in 8 cases,imperfect reduction in 3 cases and poor reduction in 3 cases.ConclusionIntraoperative CT scan increases the radiation time and dose of patients dramatically.When used to evaluate fracture reduction intraoperatively,it can't take the advantage of traditional C-arm radiography.When delicate preoperative plan is made with radiography and three dimensional reconstruction based on CT data,the efficiency of intraoperative CT scan for complex acetabular fractures are to be discussed.

Surgical treatment of compound fracture of the ankle / 中华外科杂志

<p><b>OBJECTIVE</b>To report the clinical outcome of the treatment of compound ankle fractures by vacuum sealing drainage and spanning external fixator.</p><p><b>METHODS</b>From April 2005 to April 2009, 19 cases of Gustilo type III compound ankle fractures were treated, with type IIIA in 10 cases, Type IIIB in 7 and Type IIIC in 2. All cases underwent emergency debridement, and had the fractures fixed with spanning external fixator following indirect reduction, the wound closed with vacuum sealing drainage and repaired through direct suture, split-thickness skin graft or flap transposition.</p><p><b>RESULTS</b>In this series, following VSD of 5.0 to 18.0 d (mean 10.3 d), 2 cases had their wounds closed by direct suture, 12 by skin graft and 3 by flap transposition. The other 2 cases had repeated wound debridement and multiple use of VSD, and had their wounds repaired by flap transposition. All the 19 cases were followed up for 8 to 36 months with an average of 26 months. All the fractures united 3.0 to 10.0 (mean 3.8) months. At the final follow-up functional evaluation of the affected ankle joints was performed only to find excellent in 9 cases, good in 5, fair in 4 and poor in 1.</p><p><b>CONCLUSION</b>Gustilo type III compound ankle fracture can effectively be treated with VSD and spanning external fixator.</p>

A comparisive study between intramedullary interlocking nail and plate-screw fixation in the treatment of tibial shaft fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effects of tibial shaft fractures treatment with plate-screw or intramedullary interlocking nail.</p><p><b>METHODS</b>Thirty-five fractures were treated with intramedullary interlocking nail. Tape A, B and C were 11, 18 and 6 cases respectively according to AO classification. Forty-five fractures were treated with plate-screw system. Type A,B and C were 10,22 and 13 cases respectively. The mean time between injury and operation was 3 days and 3.5 days respectively. The patients were evaluated with operation time,range of motion,time of bone union,and complications after a mean followup of 13 months(range 8 to 26 months).</p><p><b>RESULTS</b>The mean operation time and the mean range of motion of the ankle and knee were found similar in both groups. The average dorsiflexion angle of ankle was 13 Degrees (0 degrees to 20 degrees) in locked intramedullary nailing group and 11 degrees (0 degree to 20 degrees) in plate group. The average plantar flextion angle of ankle was 41 degrees (30 degrees to 50 degrees) in locked intramedullary nailing group and 47 degrees (30 degrees to 50 degrees) in plate-screw group. The mean time of bone union was 3.3 months with intramedullary nailing and 3.5 months with plate-screw fixation. Length discrepancy occurred in only two patients (2 and 2.5 cm) with intramedullary interlocking nail. One patient treated by intramedullary interlocking nail for a type III open fracture occured osteomyelitis. Plain radiographs showed rotation in two patients with intramedullary interlocking nail and angulation in 3 patients with plate-screw fixation, which were distal-third tibial fractures.</p><p><b>CONCLUSION</b>Plate-screw osteosynthesis could attain satisfactory results in uncomminuted tibia shaft fractures, and locked intramedullary nailing is more appropriate in comminuted fractures.</p>

Experimental study on preparation of decellularized artery vascular graft matrix and explantation of carotid artery allografts / 中华外科杂志

<p><b>OBJECTIVE</b>To set up a new process to access the preparation of decellularized artery grafts. And to evaluate the feasibility of decellularized artery allografts was evaluated.</p><p><b>METHODS</b>This study compared the effects of four extraction chemicals [1% t-octyl-phenoxypolyethoxyethanol (Triton X-100), 1% tri (n-butyl) phosphate (TnBP), and 1% sodium dodecyl sulfate (SDS) and trypsin (0.125, 0.25%) on thoracic artery vascular for 24 h (except trypsin for 2 h). At the base of it, a four-step process, including hypotonic, hypertonic solutions and combining with 1% Triton X-100 and 1% SDS detergents, were performed in rabbit thoracic artery vascular. Histological examination, tensile tests and expanding-burst tests were done on the samples. The decellularized carotid artery allografts were transplanted in other rabbits.</p><p><b>RESULTS</b>Treatment with 1% SDS or 1% Triton X-100 for 24 h could remove most cells with retention of near normal structure. A four-step process could remove all cells with the extracellular matrix well conserved. The pulling mechanical properties and burst pressure of decellularized carotid artery were similar to the control. The decellularized carotid artery allografts (diameter of 2 mm) were patent at explanting up to 2 months.</p><p><b>CONCLUSIONS</b>The acellular artery vascular graft matrix is well prepared with four-step process including detergents, such as TritonX-100, SDS without compromising the graft structure or mechanical properties significantly. The carotid artery allografts (diameter of 2 mm) decellularized by the process are patent at explanting up to 2 months.</p>