AIM: To establish a method for determining baicalin, jasminoidin, cholalic acid and hyodeoxycholic acid in Qingkailing Granules(chololic acid, hyodeoxycholic acid, baicalin, Fructus Gardeniae, Cornu Bubali, Flos Longicerae Japonicae, Radix lsatidis, Concha Margaritifera). METHODS: Part 1 (determination of baicalin and jasminoidin):The HPLC method was carried out on kromasil~(TM)C_(18) column(4.6 mm×150 mm,5 μm) with acetonitrile-water(10: 90)as mobile phase, gradient elution; the UV detection wavelength was at 238 nm. Part 2 (determination of cholalic acid and hyodeoxycholic acid):The HPLC method was carried out on kromasil~(TM)C_(18) column(4.6 mm×150 mm,5 μm) with acetonitrile-water-phosphonic acid(35:65:0.1) as mobile phase,gradient elution;the UV detection wavelength was at 192 nm. RESULTS: The average recoveries were 99.30% with RSD of 0.2% for baicalin; 99.50% with RSD of 0.4% for jasminoidin; 99.04% with RSD of 0.2% for hyodeoxycholic acid; 99.06% with RSD of 0.4% for cholalic acid; respectively. CONCLUSION: The assay demonstrats that the method is simple,it has the adequate accuracy and selectivity to quantify the four active components in Qingkailing Granules.

AIM: To establish a method for determining baicalin,jasminoidin,cholalic acid and hyodeoxycho-lic acid in Qingkailing Granules(chololic acid,hyodeoxycholic acid,baicalin,Fructus Gardeniae,Cornu Bubali, Flos Longicerae Japonicae,Radix Isatidis,Concha Margaritifera). METHODS: Part 1(determination of baicalin and jasminoidin):The HPLC method was carried out on kromasilTMC_18 column(4.6 mm?150 mm,5 ?m) with acetonitrile-water(10∶90)as mobile phase,gradient elution;the UV detection wavelength was at 238 nm.Part 2(determination of cholalic acid and hyodeoxycholic acid):The HPLC method was carried out on kromasilTMC_18 column(4.6 mm?150 mm,5 ?m) with acetonitrile-water-phosphonic acid(35∶65∶0.1) as mobile phase,gradient elution;the UV detection wavelength was at 192 nm. RESULTS: The average recoveries were 99.30% with RSD of 0.2% for baicalin;99.50% with RSD of 0.4% for jasminoidin;99.04% with RSD of 0.2% for hyodeoxycholic acid;99.06% with RSD of 0.4% for cholalic acid;respectively.CONCLUSION: The assay demonstrats that the method is simple,it has the adequate accuracy and selectivity to quantify the four active components in Qingkailing Granules.

Risk factors related to malnutrition were prospectively studied in 82 cases with acute ischemic stroke in our hospital during December 1,2007 and December 31,2008. The incidences of malnutrition on the first and ( 14 ± 1 )th day were 18% (15/82) and 30% (25/82). Study showed that age ( P = 0. 007 ), dysphagia ( P = 0. 043 ), malnutrition on admission ( P = 0. 003 ) were risk factors related to malnutrition on the ( 14 ± 1)th day after admission; there was no interaction between dysphagia and the other two factors, dysphagia was an independent risk factor related to malnutrition after acute ischemic stroke.

Objective To investigate the clinical rating scale appropriate to evaluate neurological impairment of ischemic stroke subtypes classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Methods 289 cases of hospitalized patients with ischemic stroke in neurological wards of the first affiliated hospital of Dalian medical university from December 1,2007 to December 31, 2009 were analyzed prospectively. Results The component ratio of ischemic stroke subtypes on the basis of TOAST etiological classification were as follows: UND (36.6%) was the largest, SAO (29.8%) followed,OC (1.7%) was the lowest. In three-month mortality, CE (15.5%) was the most, LAA (11.8%) followed, SAO (1.2%) was the lowest. In three-month relapse rate, LAA (17.6%) was the most, CE (8.6%) followed, SAO (2.4%) was the lowest. The best validity of scale assessment about LAA, CE,UND, SAO subtypes were MESSS (-0.812), ESS (0.816), NIHSS (-0.807), NIHSS (-0.795) respectively, both reliability and operability were set as medium. Conclusion In ischemic stroke subtypes classified by TOAST criteria, UND had the highest incidence (SAO has the highest incidence in the specific etiology), CE mortality was the highest, LAA had the highest rate of recurrence, SAO mortality and relapse rate were the lowest. In ischemic stroke subtypes classified by TOAST criteria, MESSS was the most suitable scale for LAA, the most appropriate scale for CE was ESS, the most appropriate scale for UND, and the SAO was NIHSS.

Objective To investigate the relative factors of vascular parkinsonism(VP),in order to provide a clinical basis for early diagnosis of VP. Methods The method of prospective cohort study was used. The first cerebral infarction was taken as the initiating event. All the cases were followed up for 4 years. When they suffered from VP or died of VP, the follow-up was termina-ted. Logistic regression model was used to analyze the risk factors for VP. Results Fifty-four pa-tients developed VP in 404 patients with first cerebral infarction,the incidence rate was 13.4%.According to the typing standard of OCSP,in the 404 patients, the incidence of VP was highest in lacunar infarction group(42 cases, 20.4%). The main risk factors for VP included age (P=0.043, OR = 1. 135,95% CI: 1. 010-1. 275),hypertension history (P=0.032, OR=2.019,95% CI: 1.247-4.746), blood viscosity (P=0.041, OR=1.724,95% CI: 1.036-3.058) and fibrinogen (P=0.001, OR=2.241,95% CI: 1.272-5.473). Conclusion During follow-up for 4 years,the incidence rate of VP in patients with first cerebral infarction is 13.4%. Lacunar in-farction is apt to cause occurrence of VP. Age, hypertension history, blood viscosity and fibrinogen are risk factors for VP. VP may be caused by multiple factors and multiple mechanisms.

Objective To analyse subtyping of iscbemic stroke by the criteria of Trial of Org 10 172 in Acute Stroke Treatment (TOAST), its distribution, and relationship between TOAST subtypes, its risk factors and recurrence. Methods Clinical data of 441 patients of ischemic stroke were collected prospectively during October 1, 2006 to September 30, 2007. All the patients were classified by TOAST criteria into five major subtypes and followed-up for one year since its first episode. Dates of its recurrence and death due to recurrence were recorded. Results All the 441 patients with ischemic stroke could be subtyped etiologically according to TOAST criteria as follows: etiology undetermined in 42.3 percent, small-vessel occlusion in 30.9 percent, large-artery atherosclerosis in 17.3 percent, cardioembolism in 9.3 percent, and others in 0.2 percent, without statistically significant difference in its gender and age distributions. Recurrence rate of iscbemic stroke in one year since its first episode for varied subtypes was 33.3 percent for cardioembolism, 14. 6 percent for etiology undetermined, 13.7 percent for large-artery atherosclerosis and 6.9 percent for small-vessel occlusion, respectively. There was no significant difference in risk factors for varied subtypes of iscbemic stroke, including history of smoking, hypertension, diabetes, cardiac disease, and serum levels of total cholesterol, low-density lipoprotein cholesterol, fihrinogen and glucose. Conclusions Varied subtypes of iscbemic stroke had different risk factors and recurrence rate by TOAST criteria, which can be used as an etiologic classification for its secondary prevention.

Malnutrition is significantly correlated with the high mortality and other poor outcomes of stroke;in turn,stroke can increase the incidence of malnutrition.Old age and swallowing dysfunction are independent risk factors of post-stroke malnutrition.The sequential nutritional support with enteral nutrition and parenteral nutrition can reduce or avoid the complications of both malnutrition and stroke,and therefore should be considered for stroke patients,especially those who are critically ill.

Objective To explore the distribution and drug resistance of pathogens causing bloodstream infection in patients in a general intensive care unit (GICU),and provide reference for the prevention of bloodstream infection and rational use of antimicrobial agents.Methods From January 2011 to December 2013,clinical data of patients who were diagnosed with bloodstream infection were reviewed retrospectively,detected pathogens and drug resist-ance were analyzed statistically.Results The major pathogens isolated from 385 patients with positive blood culture were gram-negative bacilli,which accounting for 62.34%;isolation rate of gram-positive cocci and fungi was 27.01 % and 10.65% respectively.The top five pathogens were Escherichia coli (18.18%),Pseudomonas aerugi-nosa (16.10%),Staphylococcus aureus (15.59%),Acinetobacter baumannii (13.25%),and Klebsiella pneumoni-ae (9.09%).The detection rate of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus was 72.55% and 68.34% respectively.Gram-negative bacilli was most sensitive to imipen-em and amikacin (resistant rate was 0 -35.65%).Conclusion Gram-negative bacilli are the main pathogens in blood culture from GICU in this hospital,and drug-resistant rates are high.It’s important to strengthen blood cul-ture of patients with suspected septicemia,use antimicrobial agents rationally and control infection effectively.

Compensatory of colateral circulation is a key factor affecting the outcome in patients w ith acute ischemic stroke. This article review s the development of colateral circulation and its affecting factors, and the predictive value of colateral circulation for the outcome in patients w ith acute ischemic stroke.

Three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) is effective for esophageal carcinoma treatment. Compared with conventional radiotherapy, these high precision radiotherapies can significantly improve local control and overall survival. However, local recurrence is still the most common reason for treatment failure. To improve local control, increasing target dose alone is not sufficient, while concurrent chemoradiotherpy may enhance the treatment effect for esophageal carcinoma.