OBJECTIVE:To evaluate the clinical efficacy of cinepazide maleate in combination with magnesium sulfate for traumatic subarachnoid hemorrhage.METHODS:A total of 160 patients with traumatic subarachnoid hemorrhage were randomly assigned to 4 groups:Control group(n=40)received conventional therapy alone(hemostasis,dehydration,hormone and drugs promoting recovery of nervous function;Group Ⅰ(Control group,n=40)received cinepazide maleate plus conventional therapy;Group Ⅱ(n=40)received magnesium sulfate plus conventional therapy,and Group Ⅲ(n=40)received cinepazide maleate in combination with magnesium sulfate in additional to the conventional therapy.All the drugs were given in every 12 h for 14 consecutive days.Transcranial Doppler(TCD)examination was scheduled at 0,3,7,14 days after admission to observe the incidences of cerebral angiospasm(CVS)and patients' prognosis.RESULTS:There were significant differences between Group Ⅲ and the other 3 groups(Control group,Group Ⅰ and Group Ⅱ)in the incidence of CVS,the change of the blood flow rate of the middle cerebral artery and patients' prognosis at 3 and 6 months respectively(P

Objective To evaluate the effects of angiostatin on vascular endothelial growth factor expression in human tongue squamous cell carcinoma cells.Methods Subcutaneous xenografts of human tongue squamous cell carcinoma(Tca8113)cell line in BALB/c nude mice were employed and eighteen mice were randomly divided into three groups(6 mice each):the PBS group injected with PBS,the AS group injected with 250 ng purified angiostatin,and the AS group injected with 30 ?g purified angiostatin.Reagents were injected intraperitoneally twice daily and tumor volume was calculated twice weekly for 21 d,then animals were sacrificed and each tumor specimen was divided into two parts after surgical resection.The first part was submitted to both immunocytochemistry for VEGF,VEGFR1,VEGFR2 and CD34,and TUNEL apoptosis assay.The second part was prepared for semi-quantitative RT-PCR analysis of VEGF,VEGFR1 and VEGFR2 mRNA abundance.Results There was an increase of apoptotic index(AI)(P

BACKGROUND: Multilevel cervical disc herniation accompanying ossification of posterior longitudinal ligament (OPLL) can seriously hurt the spinal cord. Which way of operative approach is more preferable is still uncertain. Whether one-stage combined anterior and posterior operation can achieve better effects remains unclear.OBJECTIVE: To explore the therapeutic effect of one-stage anterior and posterior operation for the treatment of multilevel cervical disc herniation accompanying OPLLMETHODS: Seventeen patients with multilevel cervical disc herniation and OPLL were treated by one-stage anterior and posterior operation at the Department of Orthopaedics, Tongji Hospital, were selected, including 11 males and 6 females, aged 42-74 years,mean aged 51.5 years. X-ray film, CT or MRI before operation showed the cervical cord was compressed by the multilevel herniated cervical discs or the ossified posterior longitudinal ligament. The stability and fusion of the injured segments were observed by regular postoperative X-ray film.RESULTS AND CONCLUSION: All patients were received a 6-36 months follow-up (24.5 months on average). The postoperative JOA scores were (12.88±2.47) points, which was greater than that of preoperatively [(6.41±1.28) points, P<0.05]. The improvement-rate of the spinal function after 6 months included 5 excellent cases, 7 good cases, and 4 fair cases. The excellent-good rate was 71%. All the patients got completely reduction, and all grafts got fused at 3-4 months after operation. The cervical intervertebral height and lordosis were satisfied maintained and there was no complication related to internal fixation breakage, loosening or displacement. It suggested that one-stage anterior and posterior operation can provide satisfied decompression earlier and rebuild the spinal stability in time, which is a safe and effective surgical intervention for multilevel cervical spondylotic myelopathy accompanying OPLL.

Objective In order to know the influence factors about treatment compliance among patients with type 2 diabetes,and then offer certain positive reference for health education and prevention.Methods Selected 504 patients with type 2 diabetes among 4 hospitals in Guangzhou,interviewed them by self-designed questionnaire.The interview contents included patients' basic socio-demographic characteristics,treatment compliance,diabetes knowledge,social supprot and self-efficacy,and then analyzed the datum about the interview.Results After adjusting for gender,disease course,patients' type,education level,and incoming level,multiple linear regression analysis indicated that drug treatment compliance was positively associated with age,subjective social support,objective social support and degree of support utilization.Lifestyle was positively associated with age,objective social support and degree of support utilization.Conclusions There are several factors associated with the treatment compliance of patients with type 2 diabetes,enhance paitents' self-efficacy and carry out health education are the keys to promote their treatment compliance.

Objective:To understand the current situation of college students'sleep quality and the effect of rumination and psychological resilience on sleep quality.Methods:A total of 406 college students from two universities in Wuhu city were randomly selected and investigated by the general information questionnaire,Pittsburgh sleep quality index scale,rumination scale and psychological resilience scale.Pearson correlation analysis was used to analyze the correlation between rumination,psychological resilience and sleep quality.Multiple linear stepwise regression was used to analyze the influence of college students'self-improvement and symptom rumination on sleep quality.Finally,Bootstrap mediating effect was used to test the mediating effect of symptom rumination between self-improvement and sleep quality.Results:There were 107(26.4%)college students with sleep problems.The overall level of rumination and its dimensions were positively correlated with the total score of sleep quality(P＜0.05),and the self-improvement factor of psychological resilience was negatively correlated with the total score of sleep quality(P＜0.05).Self-improvement and symptom rumination had certain predictive power for sleep quality.Symptomatic rumination was a mediating variable between self-improvement and sleep quality,and the mediating effect value was-0.025.Conclusions:The sleep situation of college students is not optimistic.Reducing college students'rumination and improving their psychological resilience can effectively improve their sleep quality and promote the development of physical and mental health.

Objective?To determine and analyze the problems of nurses during using printed Intensive Care Delirium Screening Checklist (ICDSC) for evaluating through user requirements analysis, which is necessary for information systems development, so as to provide a basis for developing an ICDSC interactive strategy. Methods?Two methods, the documentation method and task check method, were used to analyze user requirements of printed ICDSC. The retrieval words of documentation method were "ICDSC" and "intensive care delirium screening checklist". This study retrieved documents on using and evaluation of ICDSC publishing in PubMed, Springer, Elsevier, CNIAHL, CNKI and WanFang Data from January 2000 to December 2017. The find what focused on description related to problems of Intensive Care Unit (ICU) nurses during using printed ICDSC. The task check method was used to select ICU nurses as user representatives to assess delirium of four patients cases provided by researchers using printed ICDSC. Each case all perfectly completed 8 appraising tasks from ICDSC assessments. Researchers observed and recorded problems of ICU nurses during fulfilling the task. Nurses' sample size was based on information saturation (till no new information occurred). Results?A total of 7 articles among 144 ones retrieved referred to problems of nurses during using printed ICDSC to assess delirium including time-consuming, failing to understand items, deficiency/inaccuracy in nursing record. A total of 15 ICU nurses were selected in task check method. Results showed that the problems included time-consuming, omitting items, failing to understand items, scoring mistakenly, deficiency/inaccuracy in nursing record. Conclusions?There are problems such as time-consuming, omitting items, failing to understand items, scoring mistakenly and assessed information without inaccurate source in using printed ICDSC. The interactive strategy should be developed according to these problems.

Objective To analyze the clinical features and clinical significance of patients with inflammatory bowel disease (IBD) complicated by thrombosis.Methods From March 14th,2001 to February sixth 2017,at Nanjing General Hospital of Nanjing Military Command,27 IBD patients with thrombosis diagnosed by clinical symptoms,endoscopy,imaging and pathology were enrolled.During the same period,81 gender and age matched IBD patients without thrombosis were included in the control group.The basic data,information of IBD diagnosis and treatment and thrombotic events of patients were collected and analyzed.T-test and Chi-square test were performed for statistical analysis.Binary logistics regression was used for risk factors analysis.Results The mean age of diagnosis of IBD patients with thrombosis was (44.8 ± 15.8) years,which was higher than that of the IBD patients of control group ((36.0 ± 14.4) years),and the difference was statistically significant (t =2.69,P =0.008).Among 27 IBD patients with thrombosis,arterial thrombosis was 51.9％ (14/27),deep venous thrombosis of the lower extremity veins was 29.6％ (8/27),portal venous system involved was 11.1％ (3/27),pulmonary embolism was 3.7％ (1/27) and disseminated intravascular coagulation accounted for 7.4％ (2/27).Nine patients (33.3％,9/27) underwent surgery six months before the diagnosis of thrombosis.The results of binary logistic regression indicated that the age of diagnosis and vascular catheterization were independent risk factors for thrombosis in IBD patients (odds ratio (OR) =1.04,95％ confidence interval (CI) 1.01 to 1.07,P=0.01;0R=5.64,95％ CI 1.39 to 22.96,P=0.02).After medicine treatment or surgery,81.5％ (22/27) of the patients improved,9.1％ (2/22) were worse and 13.6％ (3/22) died.Conclusion Screening and prevention of thrombosis should be paid attention in IBD patients with a history of vascular catheterization,at active phase and older age when diagnosed.

Background:Nonalcoholic fatty liver disease(NAFLD)is the liver manifestation of metabolic syndrome,and may be related with the incidence of colorectal polyps. However,studies on the correlation between NAFLD and colorectal polyps are rare. Aims:To investigate the correlation between NAFLD and colorectal polyps. Methods:Clinical data of 130 asymptomatic patients accepted physical examination were retrospectively analyzed. Detection rates of NAFLD and colorectal polyps were evaluated,and the correlations with body mass index(BMI),hs-CRP,triglyceride,low density lipoprotein,total cholesterol,alanine aminotransferase(ALT),glutamyltranspeptidase(GGT)were analyzed. Results:Compared with non-NAFLD patients,the detection rate of colorectal polyps in NAFLD patients was significantly increased (66.3% vs. 40.0%,P=0.003 9),BMI,triglyceride and ALT were significantly increased(P<0.05). However,no significant differences in hs-CRP,low density lipoprotein,total cholesterol and GGT were found between NAFLD and non-NAFLD patients. Compared with non-colorectal polyps patients,the average age of patients with colorectal polyps was higher(P =0.013),and detection rate of NAFLD was significantly increased(72.6% vs. 47.4%,P =0.003 9). However,no significant differences in BMI,hs-CRP,triglyceride,low density lipoprotein,total cholesterol,ALT,GGT were found between colorectal polyps group and non-colorectal polyps group(P>0.05). Conclusions:NAFLD may be closely correlated with the incidence of colorectal polyps.

The clinical data of a patient with non-classical 21-hydroxylase deficiency ( 21-OHD) were retrospectively analyzed. The CYP21A2 gene analysis was performed on the patient and his family members by PCR-DNA direct sequencing. It was found that the proband had a heterozygous mutation [ point mutation:p.Ile173Asn, p. ( Ile237Asn, Val238Glu, Met240Lys ), p. Val282Leu, p. Gln319Ter, p. Arg357Trp, insertion mutation: p.Leu308Phefs?6, deletion/insert mutation: p. Arg484Profs]. Among the members of the family, the patient's eldest sister and three paternal members all carried the p.Val282Leu heterozygous mutation, and the patient's second sister and two maternal members carried the same p. Val282Leu homozygous mutation and other compound heterozygous mutations just as the proband. The proband presented a non-classical phenotype with ultimately normal height and fertility. It is suggested that the potential phenotype of the disease is related to the residual activity of its allele, and there exists a good genotype-phenotype correlation.

Objective To discuss the application value of work flow optimization based on hospital information system to shorten waiting time , improve nursing efficiency and ensure infusion safety in infusion center.Methods Process management combined with information technology was used to optimize the unreasonable work flow in infusion center .Self-designed questionnaire was used to compare the time between patients'arrival and leaving as well as the correct rate of nurses'transcription and typing of infusion cards before and after optimization .Results The average waiting time was ( 92.15 ±70.57 ) s before optimization and (64.34 ±37.59)s after, with statistically significant difference (Z=-6.704,P<0.01).The correct rate of transcription and typing of infusion cards improved from 96.5% to 99.3%, with statistically significant difference (χ2 =11.806 , P<0.01 ) .Conclusions The work flow optimization based on hospital information system can improve nurses'working efficiency, shorten patients'waiting time, reduce adverse incidence due to wrong transcription and typing of infusion cards and ensure the drug safety , so as to give patients effective and safe treatment and nursing in the infusion center .