Cerebral microbleed is a cerebral small vessel disease.The detection rate is 4.5％ to 84.9％in different populations.Vascular cognitive impairment is the general name of various cerebrovascular diseases and their risk factors caused varying degrees of cognitive impairments.Studies have shown that cerebral microbleed is closely associated with vascular cognitive impairment.This article reviews the relationship between cerebral microbleed and vascular cognitive impairment in different populations,different degrees and different locations.

Objective To analyze the epidemiological trend and distribution of stroke mortality in residents of Tianjin, China. Methods The study was based on 102 718 died cases with stroke in Tianjin between 1999 and 2006. The death cause and the stroke typing were coded according to the ICD -9 and ICD -10. Standardized mortality rates were calculated for stroke and its subtypes, adjusted for age and sex according to the world standard population of the Year 2000. The age, sex and geographic distribution of the stroke and its subtype mortality were analyzed. Chi-square tests were used to determine the statistical significance of mortality trends and differences. Results Stroke mortality rate in Tianjin declined from 133.52 / 100 000 / year in 1999 to 102.52 / 100 000/year in 2006. Cerebral infarction accounted for more than 50% of stroke mortality. The stroke mortality rate for males (120.17 / 100 000 to 157.74 /100 000) was higher than that for females (84.87/100 000 to 109.31/100 000). Stroke mortality rates elevated with age (P

Objective To analyze the risk factors of 30-day mortality in patients with malignant hilar obstruction (MHO) after percutaneous transhepatic biliary metal stent deployment. Methods One hundred and fifty-nine consecutive patients with MHO caused by cholangiocarcinoma or gallbladder carcinoma were enrolled in this study. Percutaneous transhepatic biliary stent (PTBS) implantation was carried out in all the patients. Independent predictors for 30-day mortality were evaluated by logistic regression analysis. Covariates that were incorporated into the multivariate analysis were the variables that reached statistical significance (P < 0.1) in univariate analysis. Two-tailed, P value of less than 0.05 was considered to be statistically significant. Results The 30-day mortality of patient with MHO after metal stent deployment was 9.4%. Univariate analysis indicated that the differences in WBC (OR = 1.224.95%CI [1.07 - 1.44], P < 0.01), INR (OR=78.75, 95%CI [5.02-1 235.70], P<0.01), PT(OR=1.55, 95%CI [1.18-2.04], P<0.01), BUN (OR=1.19, 95%CI [1.02- 1.38], P < 0.05), CRE(OR = 1.02, 95%CI [1.000 - 1.041], P < 0.1) and lymph nodes metastasis(OR = 0.334. 95%CI[0.105 - 1.131], P < 0.1) were statistically significantly between 30-day mortality group and non-30-day mortality group. Multivariate analysis showed that statistically significant differences in WBC (OR = 1.19, 95%CI[1.026 - 1.380], P < 0.05), INR(OR = 151.5, 95%CI [3.13 - 5 440.7], P < 0.05) and CRE (OR = 1.025, 95%CI [1.002 - 1.048], P < 0.05) also existed palliative treatment for patients with malignant hilar obstruction. Active preoperative measures to improve hepatic and renal functions as well as to control infection are necessary in order to reduce 30-day mortality.

Since intra-arterial chemotherapy with the help of implantation of port-catheter system (PCS) was first used in the surgical field in 1981, PCS has been widely employed in the field of interventional radiology. Intra-arterial chemotherapy by implantation of PCS has some certain advantages such as minimal invasion, no need of general anesthesia, etc. Ten randomized clinic trails have been already reported, which indicate that intra- arterial chemotherapy with PCS is obviously superior to systemic chemotherapy in treating hepatic metastasis form colorectal cancer. As for the treatment of advanced biliary tract cancer, pancreatic carcinoma and hepatocellular carcinoma, the relevant reports can be found only in several phaseⅠ/Ⅱclinical trials or in some retrospective cohort studies. This paper aims to make a comprehensive review about the indications, clinical applications and complications of PCS in treating abdominal tumors in order to improve the clinical practice.

Objective To investigate the effects of vitamin K1 in the adjuvant treatment of spasmodic cough in pertussis syndrome children,and its impacts on length of hospital stay.Methods 87 pertussis syndrome children were randomly divided into two groups,among which 41 cases in the control group were treated with the therapies such as anti -infection,respiratory support,antispasmodic,expectorant et al,while 46 cases in the treatment group were treated additionally with vitamin K1 on the basis of the control group.Then compared the duration and hospital stay of the two groups with spasmodic cough.Results The disappeared time of spasmodic cough in the treatment group was (7.22 ±1.33)d and hospital stay was (9.52 ±1.84)d,which in the control group were (15.51 ±2.73)d,(18.71 ± 3.30)d respectively,and there were statistically significant differences(t =-18.310,-16.269,all P <0.01).In the treatment group,the total effective rate was 93.5%,there were 18 cases with markedly effective,25 cases with effective and 3 cases with ineffective.Correspondingly,there were 7 cases markedly effective,23 cases effective, 11 cases ineffective,and total efficiency rate was only 73.1% in the control group,the difference was statistically significant(χ2 =4.285,P <0.05 ).Conclusion Vitamin K1 to alleviate spasmodic cough in children has a significant effect,which can reduce the duration of the cough time and hospital stay in pertussis syndrome children, and also can improve the clinical effect.

Objective To observe the feasibility, safety and efficacy of percutaneous coronary intervention (PCI) for treatment of chronic total occlusions (CTO)by only the guidewire versus by the guidewire dependent on balloon. Methods The 108 patients with CTO confirmed by coronary angiography and treated with PCI from March 2009 to March 2011 were enrolled in this study, including 59 cases with old myocardial infarction, 22 unstable angina cases and 27 stable angina cases. The clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac events (MACEs) during follow-up were retrospectively analyzed between group A (only by the guide wire) and group B (by guide wire dependent on balloon). Results The 88 of 108 patients (81.5%) got successful operations. The success rate of CTO was a little higher in group B than in group A [80.0%(52/65) vs. 83.7%(36/43), P＞0.05]. The rate of total complications was more in group A than in group B [10.8%(7/65) vs. 2.3%(1/43), P＜0.05]. No death occurred during operation, no MACE occurred after operation in hospital and no patients underwent emergency coronary artery bypass graft (CABG) in the two groups. Conclusions The PCI for treatment of CTO used by the guidewire dependent on balloon shows a safety and effecary.

Objective:To express and purify a new fusion protein(RGD/tTF) for targeting therapy of cancer, and analyze its activities.Methods:The fused gene RGD/tTF was constructed by PCR, and then was inserted into vector pET22 b(+),expressed in E.coli BL21(DE3).The fusion protein was purified through Nickel-affinity chromatography column. The tTF activity of the fusion protein was analyzed by clotting assay and FⅩ activation assay. The specific binding of RGD/tTF to ?_v?_3 was analyzed by indirect ELISA.Results:The recombinant plasmid pET22 b(+)/RGD/tTF with correct sequence was obtained. The fusion protein was expressed with high yield in E.coli BL21(DE3). The purified fusion protein could activiate FⅩ and cause blood coagulation, and bind to ?_v?_3 specifically.Conclusion:The recombinant plasmid pET22 b(+)/RGD/tTF was constructed.The fusion protein retained TF activity and binding specificity to ?_v?_3, lays the foundation for studying the function of inducing thrombosis in tumor vasculature in vivo.

Objective To explore the observation and nursing on complications of artificial vessel arteriovenous fistula in hemodialysis patients. Methods The targeted treatment and nursing care were implemented according to different complications in 40 hemodialysis patients with artificial vessel arteriovenous fistula. Results A total of 25 complications happened in 13 patients. All the patients were cured without dysfunctions after targeted treatment and nursing care. Conclusion Detecting and dealing with the symptoms of complications of artificial vessel arteriovenous fistula in time is important to prolong the using time of artificial vessel arteriovenous fistula.

Objective To observe the efficacy and safety of Shenqiwuweizikeli for treating chronic insomnia.Methods One hundred and ninety-six cases of subjects were randomly divided into Shenqiwuweizikeli group (n =98) and Estazolam tablets group (n =98).The pittsburg sleep quality index (PSQI) was adopted to evaluate the clinical effects and records of adverse reactions during the study period.Also the lab routine inspection(blood routine,urine routine,liver and kidney function, electrocardiogram were conducted to evaluate safety.Results The Shenqiwuweizikeli and Estazolam tablets all had significant effects for chronic insomnia.The total effective rate of Shenqiwuweizikeli group was 92.86％ (91/98), of Estazolam tablets group was 93.88％(92/98) ,and there was no significant difference (P＞0.05).There were no abnormalities in terms of each routine inspection index.After stopping take the medicine, The adverse reactions including bounce sex insomnia(60 cases), daytime sleepiness/drowsiness (55 cases), dizziness with lacking of power and light headedness(23 cases) in Estazolam tablets group were all more than Shenqiwuweizikeli group with significant difference(P＜0.01).Conclusion The Shenqiwuweizikeli has definite efficacy and safety for treated with chronic insomnia without withdrawal of recoil and dependence.

Objective To compare the curative effect of anatomical plate and locking plate in treatment of calcaneous intraarticular fracture. Methods 67 petiants with calcaneous intraarticular fracture were randomly divided into anatomical plate group (n=33) and locking plate group (n=34) . The Bo..hler angle, the Gissane angle, the length of calcaneal axis, the width and height of calcaneous and the Maryland grade were compared at 1 week and 6 month after operation. Results (1) week after operation, the Bo..hler angle, the Gissane angle, the height and width of calcaneous, the length of calcaneal axis, the Maryland grade had no significant difference between 2 groups . 6 months after operation, the Bo..hler angle, the Gissane angle, the height of calcaneous had significant differe nce between 2 groups. There was no significant difference in the length of calcaneal axis and the grade of Maryland between 2 groups. Conclusions The locking plate group is better than anatomical plate group in major anatomical measure indicators in 6 months follow up. The therapy of locking plate is worth of clinical promotion.