Objective To know the relative factor of progression in ischemic stroke during hospitalization and the risk degree of the risk factor, establish the individuation treatment system in acute ischemic stroke under the framework of standardization. Methods Six hundred and thirty-eight acute ischemic stroke patients' condition changes whose neural function depletion degree scored not more than 25 at that time of hospitalization were retrospectively analyzed. Scored once every 3 days. The gaining scores total to 10 to be determined stroke was progressed. Analyzed every influencing factor,and evaluated their risk degree to progressing stroke. Results Total 256 cases [40.13% (256/638)] state of illness turned to exacerbation,64 cases [25.00% (64/256)] were confirmed progressing stroke,CT showed foci extended; 192 cases [75.00%(192/256)] who only showed symptoms and physical signs dilation were confirmed to have incorrect treatment. Dehydrator and vasodilator agent application, simple systolic blood pressure decreasing [＜ 110 mm Hg (1 mm Hg =0.133 kPa)], hyperlipoidemia, diabetes mellitus were the important factors for progressing stroke (P＜ 0.05),especially when all risk factors appeared on 1 case. Conclusions The key of treatment is to protect half backspaced cerebral cell's normal functions in acute ischemic stroke, keep normal metabolism,avoid or control the water fall effect occurrence. If every influencing factor is disadvantage to cerebral cell's perfusion, oxygen consumption should be confirmed the risk factors in the progress of ischemic stroke. Not only know important of the standardization treatment, but also know the interest of individuation treatment, which combined with the patient's condition closely.

Random clustering was conducted among a total of 1068 residents aged 18 years or older at a certain Shanghai community.And they completed a questionnaire survey.Logistic data processing and model building were performed.The respondents were willing to go to a community health center for the following reasons:close proximity (88.4％),excellent service attitudes (40.4％) and low drug prices (37.8％).No statistically significant differences existed in terms of first choices of community health service,occupation,monthly income and-walking distance (P ＞ 0.05).However,statistically significant differences existed in education level,age and chronic diseases (P ＜ 0.05).

Infiltrated immune cells and cytokines in the tumor microenvironment may play different functions that appear tightly related to clinical outcomes.Radiotherapy mainly kills tumor cells through radiobio-logical effect,meanwhile it can indirectly change tumor immunologic microenvironment,and has a local or dis-tant anti-tumor immunological effect cooperatively.Animal experiments and clinical trials of radiotherapy com-bined with immunotherapy display well applied prospects,but the mode of radiotherapy in combined treatment needs further research.

Objective To observe the effect of reteplase on the thromboelastogram tracing of patients experiencing acute is-chemic stroke(AIS).Methods Selected 43 AIS inpatients in the Third People’s Hospital of Liaocheng from October,2013 to August,2015,who received reteplase less than 4.5 hours after the onset of syndrome of AIS.Blood samples were obtained before reteplase administration and at 0.5,1,2 and 4 hours after reteplase administration and measured by thromboelastogra-phy.Results The parameters R,K,Angle and MA of the thromboelastogram had changed after beginning administration of reteplase.The R value at 0.5 h after thrombolysis was significantly higher than that before thrombliysis,however,the R Value at 1h after thrombolysis was the most highest,and the K value.At 0.5 h after thrombolysis was the highest.At 0.5 h after thrombolysis MA and Angle values were the lowest,the differences were statistically significant (P<0.001).Conclu-sion The study suggests that the thromboelastogram is an useful tool for determining changes in the coagulation system of patients receiving reteplase.

目的分析手足徐动型脑瘫患儿的肺功能改变,探讨康复评价的客观指标。方法用肺功能仪,在平静呼吸(潮气呼吸)下检测32例脑瘫患儿的肺功能,并与30例健康儿的数据进行对比和统计分析。结果脑瘫患儿的通气功能和呼吸运动学指标均有改变,与对照组相比各参数有非常显著性差异(P<0.01)。结论手足徐动型脑瘫患儿存在肺功能改变,不容忽视。

Objective:To observe the clinical curative effects of sequential therapy of estrogen and progesterone in the patient after second curettage with residual uterine cavity. Methods:Totally 60 patients after second curettage with residual uterine cavity were ran-domly divided into the treatment group (30 cases) and the control group (30 cases). The treatment group was treated by sequential therapy of estrogen and progesterone,while the control group was selected curettage and treated with Xinshenghua granules, and the treatment course was 21 days. The serum level ofβ-human chorionic gonadotropin (β-HCG) , stop time of vaginal bleeding, menstrual restore time and clinical curative effect were evaluated and compared between the two groups. Results:After the treatment, the serum level of β-HCG, stop time of vaginal bleeding and menstrual restore time in the treatment group were lower than those in the control group (P<0. 05, P<0. 01). The clinical effective rate of the treatment group was 90%, while that of the control group was 93. 33%, and there was no statistically significant difference between the two groups (P>0. 05). Conclusion:The sequential therapy of estro-gen and progesterone can improve clinical symptoms and promote the functional recovery of uterus, which is worthy of clinical promo-tion.

Objective To investigate the effects of taurine treatment on retina ultrastructure and glutamate receptor GLAST mRNA expression in diabetic rat.Methods Diabetic rats were fed with 1.2% taurine for 3 months.Reverse transcription and polymerase chain reaction(RT-PCR) were employed to detect the expression of GLAST mRNA.Changes of retinal ultrastructure of rats were observed with transmission electronic microscope. Results From the first to the third month,the(mRNA) expression of GLAST gradually decreased in diabetic rat retina.Taurine could up-regulate the expression in this period.Membrane disc arrange was disordered and mitochondria swelled in STZ diabetic rat retina,which were ameliorated after taurine treatment.Conclusion Taurine can up-regulate the mRNA expression of GLAST and restrain excitotoxicity of glutamate.These observations suggest that taurine may play a role of nerve protection.

Objective: The purpose of this study was to determine whether taurine had retinal neuroprotective effects against glutamate-induced excitototxicity, especially in retinal ganglion cells (RGCs) damage in adult rat. Methods: We used a rat model of retinal glutamate excitotoxicity induced by intravitreal injection of 40 nmol glutamate in one eye. The retinal damage was evaluated by counting the number of cells in the ganglion cell layer (GCL) in flat mount preparations of whole retinas, examining the a- and b-waves in the electroretinogram (ERG), hematoxylin-eosin (HE) staining, and observing ultrastructure of retinas. Results: After intravitreal injection of glutamate, thinning of inner retinal layers, smaller a- and b-waves in the ERG were observed, and degenerative changes were observed in inner nuclear layer and RGCs by electron microscopy. These damages could be prevented by 25mg/kg bw taurine (intraperitoneal injection). 5mg/kg taurine had unremarkable effect. In animals that received intravitreal injection of glutamate, there was significant reduction (53%) in total cell numbers in GCL, with 75% reduction in RGCs. 25mg/kg bw taurine-treated animals showed a significant reduction in glutamate- induced RGCs loss. Conclusion:Repeated application of taurine can prevent glutamate-induced retinal neuronal cell damage, especially in RGCs and retinal functional damage in rats.

This paper described the practice of using the bank card as a medical card.This practice is designed to fully leverage the financial service system of major banks in China and premium medical resources,as it may optimize medical service flows of registration,doctors' visit and charging at the hospital.This reform aims at creating an information integrating bank cards and hospital cards featuring practicality,convenience,security and high-tech,so as to improve medical service and provide the patients with a better experience in seeing doctors.

Objective To evaluate the applicability of Mini-Nutritional Assessment(MNA),Short-Form Mini-Nutritional Assessment(MNA-SF)in the malnutrition screening of patients with Alzheimer's disease(AD).Methods MNA and MNA-SF were performed in 267 AD patients.The correlation between the screening results were compared.Results According to MNA,the rates of malnutrition,potential malnutrition,and normal nutritional status were 59.7%,20.9%,and 19.4%,respectively.The sensitivity was 73.4%and the specificity was 60.1%.According to MNA-SF,the rates of malnutrition and normal nutritional status were 70.4%and 29.6%.The sensitivity was 50.6%and the specificity was 92.4%.The screening results of these two tools were significantly correlated(r=0.924,P<0.01).Conclusions MNA and MNA-SF are reliable tools for evaluating the nutritional status of AD patients.While MNA-SF is more convenient and feasible,the combination of these two tools may be helpful.