BACKGROUND: Studies have shown that mild hypertension and hypothermia both offer cerebral protection against focal cerebral ischemia,and their possible synergistic effect may provide even better neuroprotective effects.OBJECTIVE: To investigate the mechanism of cerebral protection by induced hypertension combined with mild hypothermia against focal cerebral ischemia and reperfusion, through observation of the changes in the infarct volume and blood-brain barrier(BBB) in rats.DESIGN: A randomized controlled experimental study based on experimental animals.SETTING: The departments of neurology of two university hospitals and department of dermatology in a municipal hospital.MATERIALS: The study was carried out in the Laboratory of Department of Neurology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology and Laboratory of Department of Neurology, People' s Hospital of Wuhan University from March to July 2001. Sixty-four Wistar rats weighing 180 to 230 g were purchased from the Experimental Animal Center of People' s Hospital of Wuhan University.INTERVENTIONS: Sixty-four rats were randomly divided into control group, hypertension group, mild hypothermia group, and combined therapy group, each group consisting of 16 rats. Reperfusion was initiated after a 3-hour focal cerebral ischemia of the 16 rats, and at 2 hour during the ischemia, the rats in the hypertension and mild hypothermia group were treated with hypertension for 3 hours and mild hypothermia, respectively, and those in the combined therapy group received both treatment. The rats in the control group received no treatments for ischemia and reperfusion. Twenty-four hours later, all rats were killed for examination.MAIN OUTCOME MEASURES: The scores of neurological deficits, infarct volume and degree of BBB damage.RESULTS: The scores for neurological deficits, infarct size and volume of Even' s blue staining were 2. 12 ±0. 54, (17.65 ±4.78)%, and(56.63± 10.70) mm3, respectively, in hypertension group, and 2. 14 ±0.69,(16. 21 ± 3.79)%, and(53.52 ± 8.44) mm3 in mild hypothermia group,and 1.78 ±0. 61, (11, 31 ±3.64)%, and 38.45 ±5.25 mm3 in combined therapy group, which were all decreased significantly as compared with the control group[2.70 ±0. 64, (28.34 ±4. 13)%, and(94.87 ± 15.34) mm3].The combined therapy group had the smallest infarct size and volume of Even's blue staining among the three treatment groups( P ＜ 0.05).CONCLUSION: Hypertension and mild hypothermia may reduce the infarct volume and alleviate BBB damage during focal cerebral ischemia and reperfusion in rats, and the effects of combined treatment are more obvious.

Objective To explore the effects of clinical psychological intervention on anxiety and depression in hemodialysis patients .Methods Hemodialysis patients were randomly divided into two groups:psychological inter-vention group and control group ,25 patients in each group .In intervention group ,besides routine clinical treatment and nursing measures ,we analyzed the clinical information of the patients ,consulted the relevant documents ,combined the evidence and clinical experience ,and finally conducted the psychological intervention .Self-Rating Anxiety Scale and Self-Rating Depression Scale of these patients were analyzed .Results Before the intervention , the SAS and SDS scores of intervention group and control group were (57.3 ±1.5) versus (56.9 ±1.6) and (55.3 ±2.3) versus (56.1 ±3.5),respectively.The t values were 0.912(P>0.05) and 0.955(P>0.05),respectively.After interven-tion,the score before and after the trial between these two groups were significantly different (P<0.05).The SAS and SDS scores of intervention group and control group were (16.4 ±0.9) versus (10.1 ±1.3) and (14.3 ±2.1) ver-sus (9.7 ±1.5),respectively.Conclusion Clinical psychological intervention can effectively relieve anxiety and depression in hemodialysis patients .

Objective To study the changes of six sex hormones corresponding to the follicle growth during the normal menstrual cycle of Chinese women.Methods Thirty Chinese women with regular menstrual period and average age of (28.8±3.2) years were selected for the study by Peking Union Medical College Hospital in September,2010.Growth of follicles was monitored by using transvaginal sonography.Six sex hormones,including follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P),testosterone (T),and prolactin (PRL) were measured by chemoluminescence immunoassay every day during a menstrual cycle.Nonparametric statistical analysis was used.ResultsMenstrual cycle of all the patients was in the range of 25 to 39 d,with mean of (29.5 ± 3.1) d.Length of follicular phase and luteal phase was 15.3 and 14.4 d,respectively.Number of days from antral follicle to emergence of dominant follicle,and from the latter to ovulation,was 6.2 and 8.9 d,respectively.Average diameter of preovulatory follicle was 19.33 mm.Both FSH and LH reached peak on the day before ovulation.P started to increase before ovulation and remained at a high plateau from 6th to 9th day after ovulation.Both PRL and T reached peak after ovulation,near the end of a menstrual cycle.Conclusions A small rise of LH and P emerges just 1 to 2 d before ovulation,indicating the maturing of follicle.PRL and T shows cyclic changes as follicle grows.Therefore,PRL and T levels should be measured in the early follicle phases in the clinical practice so that leading the impact of menstrual cycle minimal.

Objective To investigate the effect of implanted cortical electrical stimulation (CES) on the expression of Nissl bodies and growth-associated protein 43 (GAP-43) in the brain after ischemic injury,and its mechanism.Methods Models of middle cerebral artery occlusion (MCAO) were established in 23 male Sprague-Dawley rats.They were randomly divided into a CES group (CES,n=13) and a no stimulation group (NS,n=10) and electrical stimulators were implanted in both groups.CES was applied for 14 d in the CES group but not in the NS group.The expression of Nissl bodies and GAP-43 around the infarct were quantified using version 6.0 of the ImagePro Plus system.Results In the CES group the Nissl bodies had a deep color,and their percentage of area was higher than that in the NS group.The GAP-43 positive expression area also had a relatively deep color,and the average percentage of positive expression area was also higher than that in the NS group.Conclusions CES can enhance the expression of Nissl bodies and GAP-43 after cerebral infarction.This suggests that CES can promote axon growth and the formation of new neural circuits.

Objective To compare the effect of different flow rate of oxygen inhalation on relieving scapuledynia after laparoscopic cholecystectomy(LC) with carbon dioxide pneumoperitoneum. Methods 100 patients adopted LC were divided into the 2 L/min group (n=50), the 4 Ldmin group (n=50), both re-ceived oxygen inhalation 6 hours after LC. The incidence and degree of scapulodynia and the blood- gas analysis were analyzed. Results The incidence of scapulodynia after LC in the 4 L/min group was signifi-cantly lower than that of 2 L/min group. PaCO2,PaO2 and pH in the 4 L/min group were different from those of the 2 L/min group. Conclusions Increasing flow rate of oxygen inhalation can relieve incidence and degree of scapulodynia after laparoscopic cholecystectomy.

Objective:To develop a UPLC method for the simultaneous determination of 5 components in Guilong Kechuanning tablets including paeoniflorin, berberine hydrochloride, alkaloid, cinnamic acid and cinnamaldehyde. Methods:An ACQUITY UPLC BEH C18(2.1 mm ×100 mm,1.7 μm)chromatographic column was used;the mobile phase was acetonitrile(A)–0.1% formic acid solution (B) with gradient elution (0-10 min, 85% A;10-13 min, 10% A;13-15 min, 85% A) at a flow rate of 0. 4 ml·min-1, the detection wavelengths were:0-1. 8 min, 230 nm;1. 8-6. 0 min, 345 nm;6. 0-9. 0 min, 285 nm;9. 0-12. 0 min, 345 nm, and the column temperature was 30℃. Results:The linear range of paeoniflorin, berberine hydrochloride, alkaloid, cinnamic acid and cinna-maldehyde was 0. 060-1. 202 μg(r=0. 9999),0. 100-2. 010 μg(r=0. 9999),0. 040-0. 794 μg(r=0. 9994),0. 015-0. 302 μg(r=0.9999) and 0.042-0.850 μg(r =0.9999), the average recovery (n = 6) was 99.63%,99.26%,100.17%,98.80% and 100. 26%, and the RSDs were 0. 39%,0. 97%,0. 73%,1. 00% and 0. 71%, respectively. Conclusion:The method is simple, accu-rate and reproducible. It can be used for the quality control of Guilong Kechuanning tablets.

Objective:To develop a UPLC method for the simultaneous determination of 5 components in Guilong Kechuanning tablets including paeoniflorin, berberine hydrochloride, alkaloid, cinnamic acid and cinnamaldehyde. Methods:An ACQUITY UPLC BEH C18(2.1 mm ×100 mm,1.7 μm)chromatographic column was used;the mobile phase was acetonitrile(A)–0.1% formic acid solution (B) with gradient elution (0-10 min, 85% A;10-13 min, 10% A;13-15 min, 85% A) at a flow rate of 0. 4 ml·min-1, the detection wavelengths were:0-1. 8 min, 230 nm;1. 8-6. 0 min, 345 nm;6. 0-9. 0 min, 285 nm;9. 0-12. 0 min, 345 nm, and the column temperature was 30℃. Results:The linear range of paeoniflorin, berberine hydrochloride, alkaloid, cinnamic acid and cinna-maldehyde was 0. 060-1. 202 μg(r=0. 9999),0. 100-2. 010 μg(r=0. 9999),0. 040-0. 794 μg(r=0. 9994),0. 015-0. 302 μg(r=0.9999) and 0.042-0.850 μg(r =0.9999), the average recovery (n = 6) was 99.63%,99.26%,100.17%,98.80% and 100. 26%, and the RSDs were 0. 39%,0. 97%,0. 73%,1. 00% and 0. 71%, respectively. Conclusion:The method is simple, accu-rate and reproducible. It can be used for the quality control of Guilong Kechuanning tablets.

Objective To describe the evolution of oculomotor nerve paresis (ONP) after endovascular packing of posterior communicating artery aneurysms (PcomA) to prospectively evaluate the effect of mecobalamine treatment on ONP prospective recovery.Methods A total of 56 patients with ONP attributable to PcomA,treated with coils in our hospital from July 2007 to January 2013,were enrolled in a randomized,controlled open study,and 55 of them got follow up;embolization+mecobalamine treatment was performed in 28 and embolization treatment was in 27.The degrees of ONP were recorded one year after treatment.Results All patients succeeded in one year follow-up; 31 patients (56.4％) achieved complete resolution of ONP,19 (34.5％) partial improvement and 5 (9.1％) no changes.The complete recovery rate in the embolization+mecobalamine treatment group was 71.4％ (20/28) and that in the embolization treatment group was 40.7％ (11/27),with statistically significant differences (P＜0.05).Conclusion Endovascular treatment is highly efficacious in treating ONP-inducing PcomA and mecobalamine treatment can promote the recovery of oculomotor nerve palsy after embolism.

Objective To investigate the evolution of posterior communicating artery (PcomA) aneurysm-induced oculomotor nerve paresis (ONP) and the factors affecting the outcome of ONP after endovascular packing of PcomA.Methods A total of 55 patients with ONP attributable to PcomA,admitted to our hospital from July 2007 to January 2013,were chosen in our study; their clinical data were retrospectively analyzed.The recoveries of ONP were analyzed;univariate analysis and multivariate Logistic regression were used to explore the possible influencing factors of recovery.Results At least one year follow up showed that there was a complete resolution of ONP in 31 patients (56.4％),partial improvement in 19 (34.5％) and no changes in 5 (9.1％).Multivariate Logistic regression analysis indicated that preoperative degrees of paralysis (OR=5.366,95％CI:1.253-22.974,P=0.024),preoperative paralysis time (OR=5.518,95％CI:1.398-21.774,P=0.015) and mecobalamine treatment (OR=6.988,95％CI:1.659-29.431,P=0.008) were significantly associated with the recoveries ofoculomotor nerve function after endovascular treatment.Conclusion Endovascular treatment can promote the recovery of PcomAaneurysm-induced ONP,and preoperative degrees of paralysis,preoperative paralysis time and mecobalamine treatment are factors influencing the complete recovery of ONP.

Objective:To investigate the awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai on the extended prescription policy of the family doctor contract service, and to analyze the influencing factors.Methods:From March to May, 2021, the cluster random sampling method was used to select one community health service center in Fengxian district, Shanghai, and a smart voice telephone assistant survey was conducted among the contracted residents aged 18 and above in the area, to understand their awareness of the extended prescription policy. χ2 Test was used for single factor analysis on the influence of different factors on the policy awareness of the contracted residents, while a multivariate analysis was performed by binary logistic regression, presenting P<0.05 as statistically significant. Results:A total of 13 495 " 1+ 1+ 1" contracted residents were surveyed via phone calls. Their awareness rate of extended prescription policy was 67.5% (9 115/13 495), while those with higher awareness rates were patients with ≥2 chronic diseases (92.3%), patients with 1 chronic disease (88.5%) and those aged 81 and above (88.4%). Logistic regression analysis showed that age, marital status, the number of chronic diseases and signing duration were all independent factors influencing the awareness of extended prescription policy (all P<0.05), while whether the residents were key population groups presented no significant influence on the awareness of extended prescription policy ( P=0.431). Conclusions:The awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai to the extended prescription policy needs to be further improved and publicity should also be strengthened to extend the policy benefit coverage.