Application of CBL combined with 3D printing teaching in clinical teaching of sacral tumors / 中华医学教育探索杂志

Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.

Influence of online and offline Satir family therapy on emotions of adolescents with depressive disorder and their parents / 中华行为医学与脑科学杂志

Objective:To explore the influence of online and offline family therapy based on the Satir model on emotions of adolescents with depressive disorder and their parents in remote areas.Methods:A total of 98 cases adolescents with depressive disorder treated in the psychosomatic medicine of the Second Affiliated Hospital of Nanchang University from January 2021 to June 2021 and their parents were selected as the objects. The adolescents with depressive disorder and their parents were randomly divided into the control group (49 parents and 49 adolescents) and the observation group (49 parents and 49 adolescents). The control group received the medical treatment (sertraline 100 mg/d) and the routine health education, while the observation group received the online and offline Satir family therapy on the basis of the intervention of the control group. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to investigate the negative emotions of the parents of the two groups before and 12 weeks after the intervention. The screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for childhood (DSRS) were used to investigate the negative emotions of the adolescents before and 12 weeks after the intervention.The SPSS 20.0 software was used for statistical analysis. t test was used to compare the SCARED scale score and DSRS score changes of the adolescents in the two groups, and χ 2 test was used to compare the proportional changes of parents' anxiety and depression. Results:The scores of SCARED (51.55±12.69 vs 36.82±7.69, t=15.839) and DSRS (25.08±4.81 vs 16.88±2.16, t=13.047) of adolescents in the control group were significantly different before and after the intervention (both P<0.05). The scores of SCARED (51.16±15.84 vs 31.31±7.72, t=14.385) and DSRS (24.12±4.81 vs 14.08±2.03, t=14.723) of adolescents in the observation group were significantly different before and after the intervention (both P<0.05). After the intervention, the scores of SCARED and DSRS in the observation group were lower than those in the control group ( t=3.540, 6.609, both P<0.05). Before intervention, there was no significant difference in the proportion of anxiety and depression between the parents of the two groups (χ 2=1.837, 3.547, both P>0.05). After 12 weeks of intervention, there was a statistically significant difference in the proportion of anxiety and depression between the two groups, which were lower in the observation group than those in the control group (χ 2=5.995, 4.009, both P<0.05). Conclusion:Online + offline family therapy based on the Satir model can not only effectively reduce anxiety and depression of adolescents, but also effectively reduce anxiety and depression of their parents.It is especially suitable for outpatient management of children with depressive disorder in remote areas.

Survey on cognition of general practice residency training and willingness of teaching among specialists / 中华全科医师杂志

Objective:To survey the cognition of general practice residency training and the willingness of teaching among specialists.Methods:A questionnaire survey was conducted among 221 specialists from 24 departments in Nantong First People's Hospital from May 2021 to June 2021 to investigate the their cognition of general practice residency training program and the teaching willingness.Results:Total 221 questionnaires were distributed and 185 valid ones were retrieved with a response rate of 83.70%. The results showed that 49 specialists (26.49%) well knew the national general practice training policy, 70 (37.84%) knew the most, 52 (28.11%) knew basically, 11 (5.95%) knew little, and 3 (1.62%) did not know at all. Meanwhile, 44 specialists (23.78%) well knew the hospital incentive policies about general practice education, 62 (33.51%) knew the most, 57 (30.81%) knew basically, 18 (9.73%) knew little, and 4 (2.16%) did not know at all. Whether they holding the teaching certificate of general practice was significantly associated with the cognition of national general practice training policy (χ2=14.28, P=0.003) and with their knowledge of residency training program (χ2=16.79, P=0.001), but not associated with knowing the hospital-level incentive policy (χ2=8.18, P=0.075). A total of 170 (91.89%) participants were willing to be clinical teachers of general practice. The reasons for the willingness of teaching were as following: learning more from the teaching in 161 participants (94.71%), expanding sources of patients from rural areas in 102 (60.00%), facilitating promotion in 77 (45.29%), and others in 30 (17.60%). Among 62 specialists holding teaching certificate, 60 (96.77%) were willing to teach general practice residents; while among 123 specialists without teaching certificate, 110 (89.43%) were willing to teach (χ2=4.92, P=0.027). In all hospital incentive policies, promotion of professional titles was most attractive one (82, 44.32%), followed by performance appraisal (63, 34.05%), priority for in-service training (25, 13.51%), and appraisal for excellence award (15, 8.11%). Conclusions:Strengthening trainings for general practice the faculty is helpful to improve their cognition of the general practice residency training programs. And rational hospital incentive policies can enhance the willingness of specialists to teach general practice residency.

Effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells / 中华烧伤杂志

Objective@#To observe the effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells cultured in vitro.@*Methods@#The dividing method and treatment of cells for the detection of all indexes in this study were as follows. Human dermal microvascular endothelial cells of the 4th passage were divided into 3 groups according to the random number table, with 12 wells in each group. Cells in control group (C) were cultured with complete culture solution containing 5 mmol/L D-glucose for 7 d. Cells in transient high glucose group (THG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 2 d and complete culture solution containing 5 mmol/L D-glucose for 5 d. Cells in prolonged high glucose group (PHG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 7 d. (1) The cell morphology in groups C and PHG on culture day 7 and that in group THG on culture day 2 and 7 was observed by inverted optical microscope. (2) On culture day 0, 2, 4, and 7, cell proliferation rate was determined by cell viability analyzing counter. (3) After culture day 2, the scratch experiment was performed, and the cells were further cultured. At post scratch hour (PSH) 0, 24, 48, 72, 96, and 120, the scratch area was measured, and the cell migration rates of the latter 5 time points were calculated. (4) On culture day 0, 2, 4, and 7, the cell apoptosis rate was determined by cell analyzer. (5) Cells were seeded into Matrigel to culture for 24 h after culture day 7. The formation of vessel-like structure was observed by inverted optical microscope. The length and number of branch point of vessel-like structure were calculated. (6) On culture day 2, 4, and 7, mRNA expression of vascularization-related gene tissue inhibitor of matrix metalloproteinase-3 (TIMP-3) was determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, analysis of variance for repeated measurement, one-way analysis of variance, and LSD test.@*Results@#(1) Cells in group C exhibited ovary shape in cobble stone order on culture day 7. Cells in group THG exhibited long ovary shape and lost cobble stone order on culture day 2 and kept the same changes on culture day 7. Cells in group PHG exhibited long ovary shape and lost cobble stone order on culture day 7. (2) On culture day 0, there was no significant difference in cell proliferation rate among the 3 groups (F=0.23, P>0.05). On culture day 2, cell proliferation rates in groups THG and PHG were similar (P>0.05), which were significantly lower than the cell proliferation rate in group C (with P values below 0.01). On culture day 4 and 7, the cell proliferation rates in groups THG and C were similar (with P values above 0.05), which were significantly higher than those in group PHG (with P values below 0.01). (3) At PSH 24-120, the cell migration rates in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.01). (4) On culture day 0, there was no statistically significant difference in cell apoptosis rate among the 3 groups (F=0.78, P>0.05). On culture day 2, cell apoptosis rates in groups THG and PHG were similar (P>0.05), which were significantly higher than the cell apoptosis rate in group C (with P values below 0.01). On culture day 4 and 7, the cell apoptosis rates in groups THG and C were similar (with P values above 0.05), which were significantly lower than those in group PHG (with P values below 0.01). (5) The length of vessel-like structure of cells in group THG was (1.84±0.10)×105 μm, close to (1.82±0.11)×105 μm in group PHG (P>0.05), both significantly shorter than (2.75±0.23)×105 μm in group C (with P values below 0.01). The numbers of branch point of vessel-like structure of cells in groups THG and PHG were 43±5 and 46±8 respectively, which were close to each other (P>0.05) and both significantly less than 103±21 in group C (with P values below 0.01). (6) On culture day 2, 4, and 7, mRNA expressions of TIMP-3 of cells in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.05).@*Conclusions@#Transient exposure to high glucose can cause metabolic memory of morphology, migration, and angiogenesis in human dermal microvascular endothelial cells cultured in vitro, resulting in sustained changes in biological behaviors. The mechanism may be related to the changes of vascularization-related genes.

Effect of Tourniquet Modified Strapping on Venipuncture in Tumor Patients / 现代医院

Objective To investigate the effect of tourniquet modified strapping on venipuncture in tumor patients.Methods 120 tumor patients whose veins were exposed hard in radiotherapy department from October 2016 to March 2017, randomly divided into the control group and the observation group equally.The control group was treated with the traditional single strapping tourniquet to have venipuncture and the observation group with tourniquet modified strapping.Results The venous filling degree, the success rate of first puncture, and the satisfaction of the patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion The use of tourniquet modified strapping in tumor patients whose veins were exposed hard can significantly improve the venous filling degree, the success rate of puncture, the satisfaction of patients and the quality of nursing service, and thus it is worthy of clinical promotion.

Analysis of clinical phenotype and genotype of unstable Hemoglobin Rush / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the hematological and genetic characteristics of unstable hemoglobin Rush (Hb Rush) and compound heterozygote of Hb Rush and thalassemia.</p><p><b>METHODS</b>Peripheral blood samples and genomic DNA from three patients (including two ethnic Dai and one Han Chinese) with anemia of undetermined origin were collected. Hematological phenotypes of these patients were determined through red blood cell analysis and hemoglobin electrophoresis. Genotypes of alpha- and beta-globin genes, -158 XmnⅠ polymorphic site ofγ promoter region, and haplotypes of 7 polymorphic restriction sites in the beta-globin gene cluster were determined using PCR-based methods and DNA sequencing.</p><p><b>RESULTS</b>All patients have presented hypochromic microcytic anemia and hemoglobin fraction with significant increased measurement (30.5%-59.2%) in the region of fetal hemoglobin during alkaline medium electrophoresis. DNA analysis suggested that all patients have carried mutations leading to the unstable hemoglobin Rush (HBB codon 101, GAG>CAG, Glu>Gln). Two of them were compound heterozygotes of Hb Rush and thalassemia mutations of -α,CD17 and Hb E, respectively. Hb Rush mutation was associated with various haplotypes of the β-globin gene cluster. No significant association was found between increased abnormal hemoglobin fraction in the region of Hb F and the polymorphism ofγ promoter or large deletion of the beta-globin gene cluster.</p><p><b>CONCLUSION</b>This study has confirmed the distribution of Hb Rush among various Chinese populations and is the third report of its kind. Hb Rush can result in increased measurement of hemoglobin fraction in the region of fetal hemoglobin (Hb F) during routine hemoglobin electrophoresis under alkaline condition. Hb Rush heterozygote alone can lead to hypochromic microcytic anemia and thalassemia-like phenotype. Prenatal diagnosis of Hb Rush is necessary for carriers.</p>

Observation of curative effect of Wenxinkeli combined with buspironeon patients with cardiac neurosis associated with ST-T changes / 安徽医科大学学报

Objective To observe the effects of Wenxinkeli combination use with buspirone on the treatment of cardiac neurosis with ST-T changes.Methods Ninety patients with cardiac neuropathy were randomly divided into placebo group, Wenxin Granule group and combination use group (Wenxinkeli combination use with buspirone),30 cases in each group.The scores of HAMA-14 and HAMD-24 of the three groups were observed at the end of 4 and 8 weeks after treatment when the score of SF-36 and the improvement of ST-T of combination use group were evaluated followed 12 weeks treatment.Results After 4 weeks of treatment, the two scale scores of combination use group and the Wenxinkeli group, including HAMD-24 and HAMA-14, were significantly lower than the placebo group (P<0.05).In comparison with placebo group, the scores of HAMD-24 and the HAMA-14 were significantly lower after 8 weeks treatment.After 12 months of follow-up treatment, the SF-36 scores of combination use group were significantly higher than the other two groups'(P<0.05).Meanwhile, our results showed that the ST-T changes of the combination use group was significantly improved than the other two groups'(P<0.05).Conclusion The treatment of Wenxinkeli combination use with buspirone can significantly decrease anxiety and improve depression in patients with cardiac neurosis, moreover, long-term combination use treatment can distinctly improve patients' quality of life and relieve their physical symptoms of ST-T changes.

Clinical characteristic and prognostic analysis of severe anti-N-methyl-D-aspartate receptor encephalitis / 临床神经病学杂志

Objective To observe the clinical characteristic and prognostic analysis of severe anti-N-methyl-D-aspartate receptor ( anti-NMDAR) encephalitis.Methods The clinical data of 9 patients with severe anti-NMDAR encephalitis were retrospective analyzed.Results Nine patients ( two male and seven females ) were taken care at ICU.They were 27.7 years old at average.The median course was 22.4 d and median length of stay in ICU was 50. 9 d.The mainly clinical characteristics were fever(7 cases), psychiatric behavioral symptoms(9 cases), seizures(9 cases) , decreased consciousness ( 8 cases ) , abnormal movement ( 7 cases ) , automatic instability ( 9 cases ) and hypoventilation(6 cases) .Three cases had ovarian teratoma.Anti-NMDAR antibodies in CSF of all patients were testing positive, while in serum were 6 cases.CSF-IgA in 7 cases were increased.The brain MRI indicated abnormal signals in temporal lobe, hippocampus in 3 patients.The EEG showed slowing wave abnormal in 5 patients.All patients were treated with combined first-line immunomodulatory therapies with steroids, intravenous immunoglobulin, or plasma exchange. Five patients were fullly recoveried, 4 patients were improved with residual symptoms. Conclusions Severe anti-NMDAR encephalitis may present progress quickly mental behavior change, epilepsy, and disturbance of consciousness, movement disorders, autonomic nerve dysfunction.Which accompanied with tumor is rare.Most patients with active immunotherapy can get good prognosis.

Analysis of influencing factors of renal insufficiency in acute cerebral infarction patients with non-valvular atrial fibrillation / 中国脑血管病杂志

Objective To observe the incidence and the influencing factors of kidney insufficiency in acute cerebral infarction patients with non-valvular atrial fibrillation. Methods From January 2013 to January 2015,266 consecutive acute cerebral infarction patients with non-valvular atrial fibrillation admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. Renal function was assessed by the estimated glomerular filtration rate (eGFR),eGFR 0. 05). (2)Multiple Logistic regression analysis showed that the age (≥65 years)was an independent risk factor for the occurrence of renal insufficiency in acute cerebral infarction patients with atrial fibrillation (OR,1. 147,95% CI 1. 087 -1. 209;P < 0. 01),and the histories of hypertension (OR,0. 870,95% CI 0. 362-2. 089;P = 0. 755),diabetes mellitus (OR,1. 078,95% CI 0. 403 -2. 883;P = 0. 882 ), and hyperlipidemia (OR,1. 666,95% CI 0. 645 - 4. 302;P = 0. 292 )were not associated with renal insufficiency in cerebral infarction patients with atrial fibrillation. Conclusions The incidence of renal insufficiency in cerebral infarction patients with atrial fibrillation is higher. Age (≥65 years)is an independent risk factor for renal insufficiency in this type of patients.

The characteristics of clinical manifestations in patients with anti-γ-aminobutyric acid B receptor encephalitis / 中华神经科杂志

Objective To analyze the clinical features and prognosis in adult Chinese patients with anti-γ-aminobutyric acid B receptor (GABA-BR) encephalitis.Methods We reviewed the clinical manifestations,cerebrospinal fluid (CSF) examinations,brain magnetic resonance imaging and prognosis of 12 patients who were diagnosed as anti-GABA-BR encephalitis in Capital Medical University Xuanwu Hospital from March 2013 to December 2015.Results The major clinical features of anti-GABA-BR encephalitis patients included seizures (12/12),cognitive disorder (10/12),psychiatric symptoms (10/12),sleep disorders (3/12),visual hallucination (2/12),involuntary movements (2/12),decreased consciousness (3/12),cerebellar signs (2/12),fever (2/12).GABA-BR-antibody was positive in CSF and serum of all the patients.Electroencephalogram revealed epileptic discharges in 4/12 patients.Brain MRI showed abnormal signal in up to 9/12 patients,located in the hippocampus,temporal lobes,thalamus and periventricular area.PET or SPECT indicated hypometabolism in 5/6 patients.After the average of fourteen months follow-up,9/12 patients had good prognosis,3 patients did not.Of 3 patients with poor outcome,2 had small cell lung cancer.Conclusions The predominant clinical features of the anti-GABA-BR encephalitis are seizures,cognitive disorder and psychiatric symptoms.The lesions are not only located in limbic system.Early diagnosis and immune modulation may provide a good outcome.

Application value of carotid artery ultrasonography,CT angiography and DSA in the diagnosis of carotid artery dissection / 中国脑血管病杂志

Objective To investigate the diagnostic value of carotid artery ultrasonography,CT angiography (CTA)and digital subtraction angiography (DSA)for carotid artery dissection. Methods The image data of carotid artery ultrasonography,CTA,and DSA of 24 patients with carotid artery dissection were analyzed retrospectively. Results Twenty-four,16,and 21 patients were examined with DSA,CTA,and carotid artery ultrasonography respectively. The detection rates of carotid artery dissection with DSA,CTA, and carotid artery ultrasonography were 95. 8%,75.0%,and 71. 4% respectively. The DSA mostly showed the line-like sign (n=12,50 %). CTA and carotid artery ultrasonography mostly showed the double lumen sign;they were 37. 5%(n=6)and 52. 4%(n=11)respectively. Compared with DSA,the concordance rates of carotid artery ultrasonography and CTA were 66. 7% and 81. 3% respectively. There was no significant difference (Kappa=0. 39,P=0. 08 and Kappa=0. 43,P =0. 22 respectively). The concordance rate of ultrasonography in combination with CTA and DSA reached 87. 5%(n=15,Kappa=0. 67,P =0.047). There was significant difference. Conclusion DSA is a gold standard for the diagnosis of carotid artery dissection,and it is irreplaceable. Carotid artery ultrasonography in combination with CTA can improve the diagnostic rate. Carotid artery ultrasonography can be used as a screening method for carotid artery dissection.

Efficacy of integrated swallowing function rehabilitation training in patients with nasal feeding during acute ischemic stroke / 中国脑血管病杂志

Objective To investigate the effect of integrated swallowing function rehabilitation training on nasal feeding patients with pseudobulbar palsy or bulbar palsy after acute ischemic stroke. Methods A total of 54 patients met the diagnosis criteria were enrolled prospectively. They were divided into either an integrated group (n=31)or a control group (n=23)using a random number table method. The patients of the control group received routine treatment of stroke,including brain protection therapy,improvement of cerebral circulation,dehydration,regulating blood pressure,and symptomatic treatment,etc;in addition to conventional treatment,those of the integrated group also received integrated swallowing function rehabilitation training,including neuromuscular electrical stimulation plus swallowing reflex facilitation technique,and oral facial glossopharyngeal function training,etc. The oral intake function in patients of the integration and pseudobulbar palsy or bulbar palsy (according to MRI and signs)was compared between the two groups. The evaluation index was the Functional Oral Intake Scale (FOIS)score. Results (1)The FOIS score (median 4)of the integrated group was higher than that of the control group (median 2). There was significant difference between the two groups (P<0. 01). There was also significant difference before and after comparison between the two groups. (2)The FOIS score of pseudobulbar palsy in the integrated group was higher than that of the control group (median scores 4 and 2 ). There was significant difference (P<0.01);There was no significant difference in the FOIS scores of bulbar palsy between the two groups,but the FOIS score of the integrated group was higher than that of the control group (median scores 4 and 3). (3)The median differences between the integrated group and the control group were 2 and 1 respectively. The increased amplitude of FOIS of the integrated group was higher than that of the control group. There was significant difference (P<0. 01). Conclusion The integrated swallowing function rehabilitation training can improve the oral intake function,significantly reduce irritating cough,increase the capacity of oral intake,and increase the types of food. The effect of the improvement of pseudobulbar palsy is more significant in the integrated group.

Association of three polymorphisms in the 3' untranslated region of the HLA-G gene with systemic lupus erythematosus in a population from Yunnan / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of three polymorphisms (14-bpINS/DEL, +3035C/T and +3142C/G) in the 3' untranslated region (3'UTR) of HLA-G gene and systemic lupus erythematosus (SLE) in Yunnan.</p><p><b>METHODS</b>A case-control study has been carried out on 206 SLE patients and 212 healthy controls. Genotypes of 14-bpINS/DEL (rs1704), +3035C/T (rs17179108) and +3142C/G (rs1063320) loci of 3'UTR of the HLA-G gene were determined with DNA sequencing.</p><p><b>RESULTS</b>Allelic and genotypic frequencies of 14-bpINS/DEL and +3142C/G did not differ significantly between the two groups (P > 0.05). The frequencies of +3035T allele was significantly higher in the SLE group compared with the control group (P < 0.01, OR=1.604, 95% CI: 1.186-2.169). With a dominant inheritance model, the odd ratio of dominant genotype (CT+TT) was 2.004 (95% CI: 1.345-2.987, P=0.0006) in the SLE group.</p><p><b>CONCLUSION</b>The 14-bpINS/DEL and +3142C/G polymorphisms in the 3'UTR of the HLA-G gene are not associated with susceptibility to SLE in Yunnan, whilst the T allele of +3035C/T may be a risk factor for SLE.</p>

Comparison of Contrast-enhanced Transcranial Doppler with Transesophageal Echocardiography in Patent Foramen Ovale Detectionin Acute Cerebral Ischemic Patients / 中国康复理论与实践

@# Objective To evaluate the effect of contrast-enhanced transcranial Doppler (c-TCD) for detection of patent foramen ovale (PFO) comparing to transesophageal echocardiography (TEE). Methods 28 ischemic stroke patients with PFO detected with TEE were evaluated with TCD bubble study at rest and under Valsalva maneuver (VM). Results PFO was identified in 20 cases (71.43%) at rest by TCD bubble study. When VM was performed, PFO was detected in 24 cases (85.71%). There was no relevant in sensitivity of c-TCD with PFO size (P>0.05). Conclusion c-TCD is an excellent method for PFO identification with high sensibility while under VM. C-TCD can be used as a screening method for suspected PFO in patients with stroke test before TEE.

Effects of Acetazolamide on the expression of aquaporin-4 of gastric mucosal in rats with endotoxemia / 中国基层医药

ObjectiveTo explore the effects and significance of acetazolamide on the expression of aquaporin-4(AQP4) of gastric mucosal in rats with endotoxemia. Methods30 SD rats were randomly divided into 3 groups: Sham operated control group( Control group) ,endotoxemia group( EDT group) and acetazolamide group( ATL group).The immunohistochemistry was used to assess the expression of the AQP4 in the gastric mucosal tissues. The serum tumor necrosis factor-α(TNF-α) and interleukin-1 β(IL-1β) levels in each group were measured by radioimmunoassay. ResultsThe expression of AQP4 and the levels of serum TNF-αt and IL-1 ββ in EDT group were higher than those in control group( P ＜ 0.01 ). After the ALT treatment, the expression of AQP4 and the levels of serum TNF-α and IL1 β in ALT group were lower than those in EDT group( all P ＜0.01 ) and the expression of AQP4 in the gastric mucosal tissues in ALT group was also lower than those in EDT group( P ＜0.01 ). ConclusionThe raising of AQP4 expression and increasing of serum TNF-α, IL-1β take part in the progress of gastric mucosal injury in rats with endotoxemia. ALT could protect the gastric mucosal tissues by lowering the AQP4 expression and reducing the levels of serum TNF-α and IL-l β.

NIHSS with CT Angiography for Clinical Prognosis of Acute Ischemic Stroke at Ultra-early Stage / 中国康复理论与实践

@#ObjectiveTo evaluate the value of National Institute of Health Stroke Scale (NIHSS) combined with CT angiography(CTA) to predict the clinical outcome of acute ischemic stroke patients at ultra-early stage.Methods70 patients with acute ischemic stroke underwent brain CTA within 6 hours from symptom onset and were divided into two groups according to NNIHSS score, and clinical outcome was compared between two groups.ResultsThere were 38 patients with arterial occlusion on CTA and 32 patients with normal CTA. The percentage of occlusion on CTA for patients presenting with more severe neurological deficits was higher than those patients with slight to moderate deficits. The patients with occlusion on CTA and presenting with more severe deficits had a poor clinical outcome (P<0.01). 78% of patients with normal angiograms had good outcome, only 44.7% patients with arterial occlusion had a good clinical outcome(P<0.05). Both CTA evidence of vessel occlusion and admission NIHSS score correlated with clinical outcome measured by discharge NIHSS score(r=0.25, P=0.04 and r=0.73, P=0.000 respectively). The sensitivity and specificity for predicting clinical outcome by using the NIHSS score alone was 56.65% and 85.29%, and positive predictive value (PPV+) was 80.00%. There was a sensitivity of 63.89%, a specificity of 73.53%, a PPV+ of 71.88% if CTA showed vessel obstruction. If NIHSS scores combined with CTA to predict clinical outcome, the result showed a sensitivity of 70.11%, a specificity of 91.18%, a PPV+ of 88.00%.ConclusionThose patients with vessel occlusion on CTA appear to have a worse clinical outcome. NIHSS combining with CTA may increase specificity for judging prognosis and guide treatment.

NIHSS with CT Angiography for Clinical Prognosis of Acute Ischemic Stroke at Ultra-early Stage / 中国康复理论与实践

@#ObjectiveTo evaluate the value of National Institute of Health Stroke Scale (NIHSS) combined with CT angiography(CTA) to predict the clinical outcome of acute ischemic stroke patients at ultra-early stage.Methods70 patients with acute ischemic stroke underwent brain CTA within 6 hours from symptom onset and were divided into two groups according to NNIHSS score, and clinical outcome was compared between two groups.ResultsThere were 38 patients with arterial occlusion on CTA and 32 patients with normal CTA. The percentage of occlusion on CTA for patients presenting with more severe neurological deficits was higher than those patients with slight to moderate deficits. The patients with occlusion on CTA and presenting with more severe deficits had a poor clinical outcome (P<0.01). 78% of patients with normal angiograms had good outcome, only 44.7% patients with arterial occlusion had a good clinical outcome(P<0.05). Both CTA evidence of vessel occlusion and admission NIHSS score correlated with clinical outcome measured by discharge NIHSS score(r=0.25, P=0.04 and r=0.73, P=0.000 respectively). The sensitivity and specificity for predicting clinical outcome by using the NIHSS score alone was 56.65% and 85.29%, and positive predictive value (PPV+) was 80.00%. There was a sensitivity of 63.89%, a specificity of 73.53%, a PPV+ of 71.88% if CTA showed vessel obstruction. If NIHSS scores combined with CTA to predict clinical outcome, the result showed a sensitivity of 70.11%, a specificity of 91.18%, a PPV+ of 88.00%.ConclusionThose patients with vessel occlusion on CTA appear to have a worse clinical outcome. NIHSS combining with CTA may increase specificity for judging prognosis and guide treatment.

Clinical observation of Pentoxifylline combined with mechanical ventilation in acute respiratory distress syndrome / 中国基层医药

Objective To explorer the clinical effects of Pentoxifylline(PTX group) with mechanical ventilation in patients with acute respiratory distress syndrome(ARDS). Methods 64 patients with ARDS were randomized into a control group(n = 32 ,ARDS conventional treatment) and a PTX group(n = 32 ,PTX 50ml iv bid in addition to the conventional treatment). The patients were closely monitored with their curative effect, blood gas indexes and serum levels of TNF-α and IL-8 after the treatment. Results The PaO_2 and PaO_2/FiO_2 got significantly higher in the PTX group than in the control group on 3d and 7d (P ＜ 0.05). The serum levels of TNF-α and IL-8 and the mortality of ARDS were significantly decreased in the PTX group after the combined with Pentoxifylline (P ＜ 0.05 or P ＜0.01). Conclusion The treatment combined with the Pentoxifylline can effectively improve the Oxygenation and prognosis of ARDS patients by inhibiting the inflammatory responses.

Clinical study of effect of temporary cardiac pacing on the acute poisoning patients with serious bradycardia / 中国基层医药

Objective To explore the value of using the temporary cardiac pacing on the acute poisoning patients with serious bradycardia. Methods 38 cases of the acute poisoning patients with serious bradycardia patients were treated randomly with temporary cardiac pacing(pacing group,18 cases) and drug therapy(control group,20 cases) and then treated their poisoning. Results 18 cases of pacing group were right ventricular pacing successfully and placed the temporary cardiac pacemaker,with the further treatment of poisoning, the efficiency of anti-bradycardia was 100% ,the poisoning cure rate was 89% ;The control group were 60% and 65% respectively;There were statistically significant difference between two groups ( P < 0.05 ). Conclusion The treatment of temporary cardiac pacing were exactly for the acute poisoning patients with serious bradycardia. It could effectively improve the rate of patients' resuscitation.

Use of Antibacterials During Different Periods in Burn Wards / 中华医院感染学杂志

0.05).The grade of antibiotics tended to decline with the increase in of dressing change freqnency so it could decrease the expenditure of antibiotics.The rate of fungal infection lowered while hospitalization did not appear to be prolonged.CONCLUSIONS After the analysis of the use of antibacterials for burn patients,we find that the proper use of antibiotics and the increase in dressing change would lower the grade of antibiotics and expenditure,at the same time they do not increase the rate of bacterial infection and fungal infection,and do not prolong the duration of patients hospitalization time.