There are more prognostic factors affecting the patients with cerebral hemorrhage, including bleeding volume, bleeding site, cause of bleeding, and blood pressure regulation during acute phase. Among them, the regulation of blood pressure during acute phase is a man-controlled important factor. However, the ideal blood pressure level has not yet to he determined at present. Therefore, more clinical trials are needed to determine the exact time window of blood pressure management in patients with intracerebral hemorrhage during acute phase and the range of blood pressure control.

OBJECTIVE:To observe the clinical efficacy and safety of triple therapy of aspirin,clopidogrel and urinary kallidi-nogenase in the treatment of recurrent transient ischemic attack. METHODS:180 patients with recurrent transient ischemic attack were randomly divided into control group and observation group. Control group was orally treated with Aspirin enteric-coated tab-lets 100 mg,once a day + Clopidogrel hydrogen sulfate tablets 75 mg,once a day. Based on the treatment of control group,obser-vation group was additionally treated with Urinary kallidinogenase for injection 0.15 PNA unit adding into Sodium chloride injec-tion 100 ml by intravenous injection,once a day. The treatment course for both groups was 2 weeks. The clinic data was observed, including clinical efficacy,and LDL,HDL TC and TG levels before and after treatment,recurrence rate of cerebral ischemia,inci-dence of cerebral infarction and adverse reactions after 6 months of follow-up. RESULTS:The total effective rate in observation group was significantly higher than control group,and the recurrence rate of cerebral ischemia and incidence of cerebral infarction were significantly lower than control group(P<0.05). After treatment,HDL level in 2 groups were significantly higher than be-fore,and observation group was higher than control group;levels of LDL,TC and TG were significantly lower than before,and observation group was lower than control group(P<0.05). There were no severe adverse reactions in groups during treatment. CON-CLUSIONS:Triple therapy of aspirin,clopidogrel and urinary kallidinogenase has significant efficacy in the treatment of transient ischemic attack,with good safety.

Objective　To observe the ER ultrastructures in humn embryonic epithelial cells of colonic mucosa、renal tubule and hepatocytes and also their alterations in embryogenesis.Methods　Transmission electromicroscopy technique.Results　With the embryonic development, the ER increased in amount, became complex in structure and with its characteristic ER structures in different cells. Conclusion　The changes of ER structures are one of the characters during cell differentiation.

Objective To explore the application of continuous subcutaneous insulin infusion (CSII) in elderly type 2 diabetic patients. Methods Elderly group(n = 415) and control group (n= 461) received the transient CSII intensive treatment. The different regiments and the incidence of hypoglycemia were observed between the two groups. Results The average duration reaching the target blood glucose and the insulin dosage at the target time were similar between the two groups (P>0.05). The insulin basal rate in the elderly patients was lower than that in control group. The incidence of hypoglycemia, especially at night, was significantly higher in the elderly patients.Conclusions CSII could control blood glucose effectively in elderly type 2 diabetic patients, but the basal insulin dosage should be decreased to reduce the risk of hypoglycemia.

Objective To compare the efficacy of insulin aspart and human soluble insulin on postprandial glucose control and blood glucose excursion in type 2 diabetic patients managed with insulin pump therapy. Methods All of 345 hospitalized type 2 diabetic patients were randomized divided into two groups. One group underwent insulin pump therapy with insulin aspart (aspart group, 173 cases),another group with human soluble insulin (humulin R group, 172 cases). Capillary glucose concentrations were measured at 9 time points,including preprandial,2 hours postprandial,bedtime (22:00),midnight(0:00) and 3:00 every day during the treatment. The change of blood glucose at each time point and the variation of postprandial blood glucose excursion was compared between the two groups. The frequency of hypoglycemia was also evaluated. Results After treatment, fasting blood glucose and post breakfast and post dinner blood glucose levels were decreased more significantly in the aspart group than those in the humulin R group. And a significantly smaller postprandial blood glucose excursion was shown in the aspart group compared with that in the humulin R group (P< 0.05). The time to achieve good glycemic control in the aspart group was (4.40 ± 2.16) d, significantly shorter than that in the humulin R group[(5.68 ± 2.29) d](P< 0.05). The incidence of hypoglycemia was significantly lower in the aspart group (P <0.05). Conclusion Insulin aspart results in better control of blood glucose and less glycemic variability compare with human soluble insulin in type 2 diabetic patients during delivery by continuous subcutaneous insulin infusion.

Objective:To observe the impacts of herb-partitioned moxibustion,warm moxibustion and electroacupuncture on the basic fibroblast growth factor(bFGF)and collagen type Ⅰ(Col Ⅰ)in colons of rats with Crohn' disease(CD),and discuss the mechanism of acupuncture therapy on the intestinal fibrosis in CD.Methods:The model rats were developed by TNBS as multiple proinflammatory method.The rats were randomly divided into 5 groups:a normal group,a model group,a warm moxibustion group,an electroacupuncture group and a herb-partitioned moxibustion group.The treatments were carried out at Tianshu(ST 25)(bilateral)and Qihai(CV 6)in different treatments.The immunohistochemistry was used to detect the expression position of Col Ⅰ and bFGF.Results:The expressions of Col Ⅰ and bFGF in colons of rots in the model group significantly increased(compared with the normal group,P<0.01).After the herb-partitioned moxibustion,warm moxibustion and electroacupuncture,the expressions of Col Ⅰ and bFGF reduced markedly in the rats with CD(P<0.01).The expression of bFGF and Col Ⅰ in the colons had an obvious correlation in the Spearman rank correlation analysis.Conclusion:Acupuncture treatment reduced the abnormally high levels of expressions for Col Ⅰ and bFGF in colons.Col Ⅰ and bFGF participated in the fibrosis.Acupuncture treatment may reduce the bFGF expression in colons to regulate the excessive deposition,treating the intestinal fibrosis in CD.

Objective To study the regiments of continuous subcutaneous insulin infusion (CSII) in admitted type 2 diabetic patients, and to analyse the factors related to its effectiveness and insulin dosage. Methods A total of 1 276 type 2 diabetic patients were treated by CSII. The total efficacy of CSII was evaluted. The use of CSII was also analysed in the newly diagnosed patients, elderly patients, and patients with obese or infectious disease. Results The excellent control of blood glucose were achieved in (5.7±2.6)days in the dosage more early and quickly in the newly diagnosed group than that in the previously diagnosed group after the blood glucose levels achieved good control. The percentage of the patients reached the clinical relieve was also higher in the newly diagnosed group. The incidence of hypoglycemia was significantly higher in the elderly patients with lower basal insulin dosage at night. The bolus insulin dosage in the obese patients was higher than that in the non-obese patients. The patients with infectious disease usually have a higher basal insulin dosage than those without infectious disease. The days needed for achieving good control of blood glucose and the insulin dosage were related to infectious factors, the basal blood glucose and obesity. Conclusion The application of CSII among the patients is varied with different conditions. Blood glucose level, body mass index and infection factors are important to determine the initial insulin dosage.

Objective To explore the effect of adiponectin on the pathophysiology and treatment of type 2 diabetes. Methods 50 patients with newly diagnosed type 2 diabetes were given insulin intensive therapy.Body mass index(BMI), blood lipids, blood glucose, insulin and adiponectin were measured before and after the insulin treatment.36 healthy persons were selected to match for sex and age with diabetes patients. Results In type 2 diabetes patients, before insulin intensive treatment,the level of adiponcetin was 4.28(2.11-6.38)μg/L and arose to 12.26(8.22-16.00)μg/L after 12.6±2.1 day insulin treatment.In healthy persons, the level of adiponectin was 9.56(7.92-11.61)μg/L.There was significant difference among the three groups.Adiponectin was negatively correlated with BMI and triglyceride and positively correlated with insulin action index (IAI) and high density lipoprotein (HDL). Conclusions Adiponectin plays a major role in the pathophysiology and treatment of newly diagnosed type 2 diabetes.

Objective To study the anti-inflammatory,antitussive,and analgesia effects of Jinhua qingre capsules.Methods The anti-inflammatory effect was assessed by the methods include xylene-induced mouse auricular swelling and histamine-induced pigment oozing from skin vessel in rats;The antitussive and analgesic effect were assessed by ammonia water induced cough model and acetic acid-induced twisting method.Results In anti-inflammation experiment,the high dose (12 g·kg-1) and moderate (6 g·kg-1) groups of Jinhua qingre capsules showed significant inhibitory effect on auricular swelling and significant difference compared with control group (P ＜ 0.01,P ＜ 0.05.);the high dose (10 g· kg-1) and moderate dose (5 g·kg-1) groups of Jinhua Qingre capsules play a marked inhibitory role in the increase in mouse peritoneal capillary permeability (P ＜ 0.01,P ＜ 0.05).In antitussive experiment,high dose (12 g· kg-1) and moderate dose (6 g· kg-1) groups had significant inhibitory effect on cough caused by ammonia water (P ＜ 0.01,P ＜ 0.05) compared with control group.In analgesic experiment,the high dose (12 g·kg-1),moderate dose (6 g·kg-1),and low dose (3 g·kg-1) groups effectively reduced the writhing frequency of mice (P ＜ 0.01,P ＜ 0.05).Conclusion Jinhua qingre capsules have potential effects on anti-inflammatory,antitussive,and analgesic.

Objective:To investigate the efficacy of different surgical treatments for hypertensive cerebral hemorrhage in older adult patients and their effects on traumatic stress and cerebral edema.Methods:A total of 100 older adult patients with hypertensive cerebral hemorrhage who received treatment in Zhejiang Xin'an International Hospital from January 2018 to June 2020 were included in this study. They underwent either craniotomy (craniotomy group, n = 50) or hard channel minimally invasive puncture drainage (minimally invasive puncture group, n = 50) according to the willingness of patients and their close relatives. Perioperative indexes, Barthel index after treatment, nerve injury indexes before and after treatment, prognosis related indexes, trauma stress indexes and brain edema were compared between the two groups. Results:Operative time, intraoperative blood loss and postoperative hospital stay in the craniotomy group were (147.21 ± 31.35) minutes, (289.74 ± 22.75) mL and (42.74 ± 6.82 ) days, respectively, which were significantly longer or greater than (41.88 ± 7.19) minutes, (4.62 ± 0.88) mL and (16.27 ± 4.02) days in the minimally invasive puncture group ( t = 38.73, 62.17, 23.17, all P < 0.001). Barthel index at 1 and 3 months after treatment in the minimally invasive puncture group was (63.11± 9.64) and (93.51 ± 11.38), respectively, which was significantly greater than (44.78 ± 8.85) and (81.29 ± 10.37) in the craniotomy group ( t = 3.17, 6.21, both P < 0.05). Before treatment, there were no significant differences in nerve injury index, prognosis index, trauma stress index and brain edema between the two groups (all P > 0.05). At different time points after treatment, each indicator in the minimally invasive puncture group was significantly superior to that in the craniotomy group (all P < 0.05). Conclusion:Hard channel minimally invasive puncture drainage exhibits advantages over traditional craniotomy in the treatment of hypertensive cerebral hemorrhage in older adult patients. Hard channel minimally invasive puncture drainage can more greatly reduce injury to brain tissue, better control nerve injury and brain edema, and more remarkably improve patient's quality of life than traditional craniotomy.