BACKGROUND: Prevention of tissue damage during early hours of cerebral ischemia has remained a major challenge in acute stroke management.Whether the application of hyperbaric oxygen (HBO) can protect cerebraltissue or not remains a question to be answered.OBJECTIVE: In cerebral ischemia-reperfusion rat model we studied the change on CGRP and β-endorphine levels and the therapeutic implication with hyperbaric oxygenation.DESIGN: A randomized controlled animal study.SETTING: Animal Research Department of Capital University of Medical Science.MATERIALS: The experiment was carried out at the Animal Research Department of the Capital University of Medical Science from December 2003 to February 2005. Sixty three healthy Sprague-Dewey female rats were randomly divided into 9 groups. There were 7 in the sham operation group. Four groups with 7 in each group received cerebral ischemia followed by reperfusion (IR) and blood sample taken at 6, 24, 48 and 96 hourrespectively. Another 4 groups (IR-HBO) with 7 in each received cerebral ischemia and reperfusion under hyperbaric oxgenation with blood sampling at 6, 24, 48 and 96 hours.INTERVENTIONS: With the exception of sham operation groups, animals in all the experimental groups were exposed to global cerebral is chemia of 20 minutes duration. Sham operation group and the IR groups remained under the normal atmospheric pressure. The HBO chamber was flushed with 100% oxygen for 5 minutes and raised the pressure in 5 minutes to a steady pressure at 0.2MPa. Rats in IR-HBO groups were put into the chamber with inhalation of 100% oxygen for 45 minutes and decompression was done for 15 minutes. The rats in HBO group were placed into the HBO chamber after 3-hour post reperfusion on the first day and this treatment was repeated for three consecutive days, always at the same time.Plasma was collected after 6 hours, 24 hours, 48 hours or 96 hours post cerebral reperfusion, respectively.MAIN OUTCOME MEASURES: The level of CGRP and β-EP in the plasma were measured by RIA (Radio-immunoassay).RESULTS: Sixty-three rats entered the final analysis. ① At 6-hour ischemia-repefusion: CGRP in HBO group was increased (64.12±18.16) ng/L and the onset time was earlier than that in IR group and the level was higher than those in IR group (32.62 ±11.72)ng/L and sham operation group (49.09±8.59)ng/L at the same time point (F=6.614, P ＜ 0.001, P ＜ 0.05). Β-EP level in 6-hour HBO group was slightly increased, but recovered at 24-hour, 48-hour, 96-hour HBO groups. ② At 24-hour and 48-hour ischemia-reperfusion: The plasma CGRP levels of the HBO group recover within 24-hours [(43.53±22.73)ng/L, F=0.390; (46.02±10.64)ng/L,F=0.969, P ＞ 0.05]. ③ 96-hour ischemia-reperfusion: CGRP increase in the IR group (81.74±20.64)ng/L was higher than that in the sham operation group (49.09±8.59)ng/L and the HBO group (40.98±20.52)ng/L at the same time point (F=6.419, P ＜ 0.01); and also obviously higher than those in 6-hour, 24-hour and 48-hour IR group (F=10.806, P ＜ 0.01).The β-EP level at 96-hour HBO group was decreased to the lowest as compared with that in the sham operation group [(370.00±130.15)ng/L,(872.30±403.92)ng/L, F=3.691, P ＜ 0.05].CONCLUSION: ① HBO in the early period of cerebral ischemia can reduce the onset of injury of cerebral tissue through increasing CGRP level and decreasing β-EP level; ②The more times treated by HBO, the better is its therapeutic effect.

Objective To discuss the influence of psychological nursing on the therapeutic effect of patients with newly diagnosed type 2 diabetes. Methods Patients (60 cases) who received psychological nursing were set as the nursing group. Patients (65 cases) who did not received psychological nursing were set as the control group. The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment was observed. Results The number of patients who received early insulin treatment and whose fasting plasma glucose return to normal value on the 7th and 30th days after treatment in the nursing group was higher than that of the control group (P<0.01). Conclusions Psychological nursing of patients with newly diagnosed type 2 diabetes could make patients obey doctors' advice and accept early insulin treatment to control plasma glucose and delete the toxicity of high concentration of plasma glucose as soon as possible.

Opioid analgesics are potent pain-killer and are widely used in clinical practice.Opioid receptors are classified into μ,δ,κ subtypes.Most of the currently available opioid analgesics are μ opioid receptor agonists, but they cause undesired side effects such as physical dependence, respiratory depression and constipation and so on.The antalgic activity of δ receptor agonist is weaker than that of μ agonist, but it can modulate the activity of μ receptor and prevent its addiction. Therefore, discovering and designing compounds with μ/δ dual action is a new way for finding analgesics with low toxicity and less side effects.This review summarizes the development of compound with dual μ/δ activities and provides a new strategy for designing analgesics with low toxicity and less side effects.

Objective To investigate the factors associated with awareness of dyslipidemia among residents in Beijing.Methods Cross-sectional data of 3 373 patients with dyslipidemia from CCEIP were analyzed.The patients were seleted from 10 054 residents from Daxing,Chaoyang,Haidian,and Xicheng Districts of Beijing during June-August,2007.The socioeconomic status and awareness of dyslipidemia were surveyed by questionnaires.The risk factors for cardiovascular diseases(CVDs),such as hypertension,obesity and diabetes,were assessed by physical examination and fasting blood analysis.Results (1)Awareness of dyslipidemia was improved with the increase of patients' age (P

Objective To investigate the effects of Xuanfeitongfufang Decoction on expressions of MD-2, NF-κB protein and its mRNA in lung of the rats with acute lung injury caused by LPS. Methods Wistar rats were randomly divided into normal group, model group, dexamethasone group and Xuanfeitongfufang Decoction large-, medium-, small-dose group, each group had eight rats. The ALI rat model was established by LPS tail-intravenous injection (6 mg/kg). The rats in Xuanfeitongfufang Decoction groups were pretreated by Xuanfeitongfufang Decoction (15.12, 7.56, 3.78 g/kg) for 3 days before LPS induced ALI. The rats in dexamethasone group were pretreated by dexamethasone (5 mg/kg). MD-2, NF-κB protein and its mRNA were measured by immunohistochemistry and PCR. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the expression of MD-2, NF-κB protein and its mRNA were obviously increased in model group (P<0.01). Compared with model group, the expression of MD-2, NF-κB protein and its mRNA were obviously decreased in Xuanfeitongfufang Decoction groups and dexamethasone group (P<0.01), and there was no obvious difference between Xuanfeitongfufang Decoction groups and dexamethasone group. Light microscope observation indicates that there were large areas of pulmonary hemorrhage and necrosis in model group. While in Xuanfeitongfufang Decoction group and dexamethasone group, the pathological manifestations were much more ameliorated than those of the model group. The lung bronchiale inflammation appeared occasionally, and the edema was lightly. Conclusion Xuanfeitongfufang Decoction can lessen the injury of lung tissue and has protective effects on rats with ALI, the mechanism is possibly related to the inhibition of the expressions of MD-2 and NF-κB protein and its mRNA in injured lung tissues.

Objective:To evaluate the effect of a hand hygiene culture program on hand hygiene compliance in a three grade A hospital .Methods:Direct observation methods were used to assess the hand hygiene compliance and hand hygiene quality .Results:After the hand hygiene culture program , the hand hygiene compliance rate and the hand hygiene accuracy rate of doctors raised from 30 .2%and 66 .7%to 65 .3%and 85 .8%.Those of the nur-ses raised from 52.2%and 80.0%to 87.6%and 93.3%.Conclusion:The hand hygiene program increased the hand hygiene compliance and reducing thd risk of hospital infection occurred .

Objective To evaluate the effects of modified method of fixation and withdrawal of needles in intravenous infusion.Methods The modified method of two-step fixation and withdrawal of needles was adopted in emergency transfusion room of our hospital from September 2013.In January 2015,during every day's low peak period 12:00-14:00,246 emergency transfusion patients were chosen and divided into the traditional group (122 cases,using three-step fixation and withdrawal of needles) and the modified group (124 cases,using two-step fixation and withdrawal of needles) according to transfusion order.The pain degree caused by withdrawal of needles using Numeric Rating Scale (NRS),time consumption of fixation and withdrawal of needles and rate of adhesive pastes abscission was assessed by nurses and compared between two groups.Results The incidence of pain in the modified group was lower than that of the traditional group [48.39％ (60/124) vs.81.97％ (100/122)],x2=30.49,P＜0.05.The time consumption of fixation and withdrawal of needles in the modified group was shorter than that of the control group [(7.55 ±2.01) seconds vs.(10.88 ±2.72) seconds;(2.44 ±0.84) seconds vs.(11.55 ± 4.62) seconds],Z=8.70,13.55,P＜0.05.Therate of adhesive pastes abscission in the modified group was lower than that of the control group [4.0％(5/124) vs.18.9％ (23/122)],x2 =13.39,P＜0.05.All the difference between two groups was statistically significant.Conclusions The modified method of fixation and withdrawal of needles can relieve the pain caused by withdrawal of needles.Nurses can operate easily,adhesive pastes is fixed sturdily,which is popular among nurses and patients.

Objective To explore the significance of proton magnetic resonance spectroscopy(1H- MRS)in patients with amyotrophic lateral sclerosis(ALS).Methods Single-voxel1 H-MRS was carried on the preeentral gyri in 110 patients with ALS and 24 patients with lower motor neuron syndrome (LMNS) compared with 89 healthy controls.The upper motor neuron involvement of the patients was assessed by upper motor neuron(UMN)signs and the reflex scale,and the disease severity was evaluated by the AIJS function rating scale(ALS-FRS)and APPEL ALS rate scale(AARS).Results Compared with the healthy controls(1.62±0.18),the NAA/Cr of patients with ALS(1.40±0.25)remarkably decreased (t= -5.007,P=0.000),however,it did not change in patients with LMNS(1.60±0.17)as compared with that of the controls.The NAA/Cr of patients with ALS was also lower than that of patients with LMNS(t= -2.660,P=0.009).Furthermore,the NAA/Cr of patients with definite ALS was lower than those of patients with probable and possible ALS(definite vs probable:t=-2.626,P=0.010;definite vs possible: t=-2.537,P=0.013).On the other hand,patients with pronounced UMN signs had a lower NAA/Cr ratio than those with probable UMN signs(t=-2.827,P=0.006).In patients with asymmetric clinical presentation,the NAA/Cr ratio was significantly lower in the precentral gyrus contralateral to the clinically predominantly affected side(t=-2.652,P=0.011).The NAA/Cr was correlated with the reflex scale scores,ALS-FRS score,and AARS and its sub-items(P＜0.05). Conclusions 1H-MRS is useful in studying ALS.The marker NAA/Cr of precentral gyrus may reflect the UMN degeneration in ALS,which is related to the disease severity and progression.However,it might not be helpful in the early diagnosis and differential diagnosis of the disease.

Objective To observe the safety and efficacy of oncolytic adenovirus (H101) implantation under EUS guidance combined with gemcitabine in patients of non-operative pancreatic cancer.Methods From May 2007 to December 2007,6 patients with non-operative pancreatic cancer were enrolled in the study.H101 were implanted into 3 sites of the tumor under EUS guidance.Gemcitabine Was siren systemicly on d2,d9 and d16 after implantation, and repeated 1 month later.Tumor size and perfusion were assessed by computed reconstruction and perfusion imaging.Changes of clinical indices,adverse effects and complications were also recorded.Results All patients completed the two periods of treatment as planned.Tumor size decreased in 5 cases(18.21%-38.65%),but without statistical difference (P=0.078).The area of liver metastasis Was found decreased in 1 ease.Perfusion imaging showed significant increase of mean transit time(P=0.049) and improvement in blood flow,blood volume and permeability surface at 2 weeks after the treatment. KPS increased in 2 patients and pain score decreased in 3 patients.Three patients died 2.5,2.5 and 3 months respectively after the procedure.while 3 other patients are still alive with the survival time of 3,5 and 10 months. Major adverse effects associated with H101 implantation were fever and flu-like symptoms.Mild acute pancreatitis occurred in 1 cage.Conclusion EUS guided oncolytic adenovirus implantation in advanced pancreatic cancer is feasible and safe.With the combination of gemcitabine,it is capable of shrinking the tumor size,destroying the angiogenesis of the tumor and improving the patients'living quality.

Objective:To evaluate risk factors and available treatments of extramedullary relapse (EMR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid leukemia.Methods:A total of 280 patients were retrospectively analyzed from January 2008 to December 2018 in Affiliated Cancer Hospital of Zhengzhou University. Clinical data were collected including disease patterns, pre-transplantation status, chromosome karyotype, conditioning regimen, types of donor, extramedullary disease before transplantation and graft-versus-host disease (GVHD). The log-rank test and Cox proportional hazard model were uesd for univariate analysis and multivariate analysis, respectively.Results:Twenty patients developed EMR (7.14%). The median time of EMR was 7.5 (1-123) months after allo-HSCT. The mortality of EMR was 80% (16/20). Univariate analysis identified disease patterns, second complete remission (CR2) or progressive disease before transplantation, extramedullary disease, abnormal karyotype and conditioning regimen without total body radiation as significant factors correlated to EMR ( P<0.05). Multi-variable analysis revealed that CR2 or progressive disease ( RR=3.468,95% CI 2.189-7.786), abnormal karyotype ( RR=1.494,95% CI 1.020-2.189) and extramedullary disease before transplantation ( RR=8.627,95% CI 3.921-18.452) were independent risk factors of EMR. Conclusions:The clinical outcome of EMR after allo-HSCT is poor.It is crucial to comprehensively assess and identify EMR as early as possible.