Unexplained syncope (UPS) is a common clinical disease.It may occur at all ages.But the pothogenisis of UPS is still unclear.There are many researches at home and abroad reporting that the cardiovascular system has endogenous circadian rhythm.And the circadian variations of autonomic nervous system,ambulatory blood pressure,and heart rate variability may contribute to the observed circadian rhythm of cardiovascular.Sudden cardiac and cerebral events are most common in the morning.The time rhythm of UPS may have potential implications for management.

OBJECTIVE:To develop an RP-HPLC method to determine the camphor in Bohenao zhangnao nose drops. METHODS:The HPLC separation was carried out on a Supelcosil C18(150 mm?4.6 mm,5 ?m) column.The mobile phase consisted of methanol-water(70∶30) at a flow rate of 1 mL?min-1.The column temperature was 25 ℃ and the detective wa-velength was set at 289 nm. The content was computed using external standard method. RESULTS:The linear range of cam-phor was 0.1～1 mg?mL-1(r=0.999 8) with recovery rate ranged from 100% to 103%(RSD

Objective To evaluate the effect of different skin flap management methods on post operative (subcutaneous) fluid collection and skin flap necrosis after modified radical mastectomy for breast cancer. (Methods) A retrospectively analysis of clinical data of 119 cases of breast cancer operated by modified (radical) mastectomy in our hospital in recent four years. Statistically analyse the relationship between 4 different skin flap management methods to postoperative subcutaneous fluid collection and skin flap necrosis. Results 43 out of 119 cases developed postoperative subcutaneous fluid collection and/or skin flap necrosis. There were 13 cases with complication of subcutaneous fluid collection, 3 cases with skin flap necrosis among 79 (cases) treated by transverse incision;20cases with complication of subcutaneous fluid collection, and 7 cases of skin flap necrosis among 40 cases treated by longitudinal incision; 23cases with complication of subcutaneous fluid collection, and 8 cases of skin flap necrosis among 60 cases treated by "skin flap management type one"; 23cases with complication of subcutaneous fluid collection, and 2 cases of skin flap necrosis among 59 cases treated by "skin flap management type two". Conclusions A transverse incision after subcutaneous (injection) of 1∶400 adrenaline saline solution, plus the use of scalpel dissection and the technique of skin flap fixation by the "rivet" method can effectively decrease postoperative development of subcutaneous fluid (collection) and necrosis of incisional skin margins.

Objective To explore the change in nutritional status of perioperative gastrointestinal cancer patients. Methods The nutritional status of 207 gastrointestinal cancer patients who were to undergo elective radical surgery was evaluated by SGA within 48h of admission and 7 days after operation. The investigation results went through analysis. Results Body weight was significantly decreased 7 days after operation compared with 48h of admission, the prevalence of malnutrition 7 days after operation was higher than 48h of admission; weight loss, change of food intake and decreased functional activity were the related factors of change in nutritional status of perioperative gastrointestinal cancer patients. Conclusions There was a decreased nutritional status among perioperative gastrointestinal cancer patients, and appropriate nutrition intervention program and treatment should be taken to improve clinical outcomes according to the risk factors.

Objectives To establish real-time fluorenscence quantitative polymerase chain reaction ( RFQ-PCR ) for measurement of the expression level of guanylyl cyclase-C(GC-C) in the Peripheral blood mononuclear cell(PBMC)in 30 blood donors, 10 cases colorectal cancer tissue and 1 case T84 human colon cancer cell line. Methods Specific primers and TaqMan probe have been designed,and fluorenscence of the PCR product was detected continuously during amplification. According to the standard curve created by plasmid DNA, the expression level of GC-C in clinical samples has been determined using software, and the results were presented as the ratios of GC-C mRNA to?2-microgluobulin(?2M)mRNA. Results The detection range of the assay was from 101 pg/ml to109pg/ml,the coefficient of variation values of both intra-experimental and inter- experimental reproducibility were 6. 87% to 11. 12% and 8. 86% to 15. 19% . None of 30 blood donors and 11 benign intestinal patients expressed GC-C mRNA,it was expressed in 31/37 colorectal cancer patients. The expression level of GC-C mRNA in colorectal cancer patients was 0. 88?0.06,and the expression level of its in colorectal carcinoma tissue and T84 cells were 0. 86?0.07/ug tissue and 0.0082/per cell. Conclusions This assay had high sensitivity,specificity and reproducibility.

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Objective To explore the feasibility of 256-slice whole-brain CT perfusion (CTP) in evaluate graft reperfusion after surgical revascularization and hemodynamic alterations before and after surgery in Moyamoya disease. Methods Twenty-five cases with Moyamoya disease were scanned on a 256-slice CT.CTP was performed pre- and post- surgical revascularization. The wolumetric CT angiographic ( CTA ) images were generated from volumetric data acquired at the arterial phase of CTP. CBF, CBV, TTP and MTT were measured in functional maps at the operated side within middle cerebral artery perfusion areas and contralateral mirroring areas. Relative CBF( rCBF), relative CBV (rCBV), relative TTP (rTTP), relative MTT (rMTT) were also obtained. Differences in perfusion CT values pre- and post operation were assessed with the paired t test or matched-pairs signed-ranks test. Data with normal distribution was present as : (x-)± s,while those with the non-normal distribution were present as M ( P25-P75 ). Results All the direct graft patencies were displayed on volumetric CTA. No significant differences were found between volumetric CTA and conventional CTA. Postoperative CBF, rCBF and rCBV values of the operated side [ 72. 86 (55.54-112. 19) ml · 100 g-1 · min-1 , 1. 31 ( 1.05-1.73), 1.45 ±0. 62] were significantly higher than those before operation [46.72(28.57-57.67) ml · 100 g-1 · min-1, 0.53(0.33-0.82), 1.01 ±0.36](Z=- 2.72, - 2. 98, t = - 2. 85, P ＜ 0. 05 ). Postoperative MTT, TTP and rTTP values of the operated side [ (3.98 ± 2. 36 ) s, ( 17.56 ± 4. 38 ) s, 1.01 ± 0. 09 ] were significantly lower than those before operation [(5.43±2.07) s,(19.40±3.87) s,1.14±0.28] (t=2.41,2.17,2.17, respectively, P＜0.05).However, no significant differences were detected for changes of CBV and rMTT after revascularization ( P ＞0. 05). Conclusion 256-slice CT has the potential value for the non-invasive assessment of both the graft patency and cerebral hemodynamics changes in moyamoya disease after surgery with administration of one contrast medium bolus in a single examination.

Objective To compare the efficacy and cost of surgical clipping and endovascular embolization in the treatment of anterior and posterior communicating artery aneurysm and to conduct cost-effectiveness analysis. Methods The data of treatment outcomes and costs in patients with anterior or posterior communicating artery aneurysms admitted to Huashan hospital from 2002 to 2006 were analyzed using a retrospective cohort study. Results A total of 302 patients were included in the study. They were divided into surgical clipping group (n = 150; 65 males, age [48. 11 ±9. 94] years), interventional treatment group (n = 152;75 males, age [52. 56 ± 11. 09] year). The age of the former was lower than that of the latter (t = -3. 670, P =0. 000). There was no significant difference in preoperative clinical conditions (such as location of aneurysms and Hunt-Hess grade) between the two groups. The good outcome rate in the interventional treatment group was significantly higher than that in the surgical clipping group (84. 87% vs. 74. 67%, χ2 = 4. 875, P = 0. 027). There was no significant difference in hospital mortality (5. 33% vs. 3. 94%,χ2 =0. 328, P =0. 567) and complication rate (26.67% vs. 19. 74% , χ2 =2.036, P =0.154) between the surgical clipping group and the interventional treatment group, but the intraoperative aneurysm rupture (10. 67% vs. 3. 95%, χ2 =5.047, P =0.028) and the incidence of postoperative intracranial infection (6/144 vs. 0/152, χ2 = 6.203, P =0.014) in the surgical clipping group were higher than those in the interventional treatment group. The length of hospital stay in the interventional treatment group was significantly shorter than that in the surgical clipping group ([10. 0 ± 7. 0] dvs. [23.0 ± 11. 0] d, Z = -10. 35, P ＜0.001). The median cost of treatment was 95 327.63 %,yuan in the interventional treatment group, and the interquartile range (IQR) was 26 312. 98 yuan; it was significantly higher than the surgical clipping group (median 30 072. 01 yuan, IQR 11 178. 54 yuan) (Z = -14.449, P＜0.001). Compared with the surgical clipping group, while the mRS score improved in the interventional treatment group 0. 10, the cost was about 66 438 yuan, so that the surgical clipping was more cost-effective. Conclusions The efficacy of the intervention treatment of anterior and posterior communicating artery aneurysms is better than that of the surgical clipping The mortality and total complication rate are almost the same with the surgical clipping Thehospital stay is shorter, but the cost of treatment is higher. From an economic point of view, the surgical clipping is more cost-effective.

Objective To evaluate the clinical efficacy of emergent endoscopic injection of tissue adhesive (N-oclyl-a-cyanoacrylate) combined with endoscopic variceal ligation (EVL) for esophageal and gastric varices bleeding. Methods Data of 21 patients with acute esophageal and gastric varices bleeding who received emergent endoscopic injection of tissue adhesive and EVL were retrospectively studied. Results The instant hemostatic rate was 95% (20/21) with no severe complications. Conclusion Emergent endoscopic injection of tissue adhesive combined with EVL is an effective and safe therapy for esophageal and gastric varices bleeding.

In 48 postoperative cases using ear-clinoidal line positioning in radiofrequency thermocoagulation for treatment of trigeminal neuralgia,observing its recurrence and postoperative pain and complications in a five-year review. The successful rate of puncturing one time was 100%. Pain disappeared completely in 46 cases with one therapy. Two cases alleviated pain and decreased outbreak times. No recurrence and postoperative complications were observed. The vertical distance between the needle tip and the ear-clinoidal line were confirmed 8-10 mm in the third branch, 6-7 mm in the twice branch, 4-5 mm in the first branch. In order to avoid the first branch of trigeminal nerve injury, the vertical distance must be less than 6 mm, and the needle tip can not exceed ear-clinoidal line.