OBJECTIVE: To investigate the effects of deproteinised calf blood injection(DCBI) on blood glucose and lipid metabolism and its ameliorating effect on insulin resistance(IR) in model rats with type 2 diabetes mellitus(T2DM) complicating cerebral infarction.METHODS: Rats were fed with high fat and high glucose diet and injected with streptozotocin(STZ) vial caudal vein to duplicate T2DM model,followed by duplication of middle cerebral artery occlusion(MCAO) rat model.Then the rats were assigned to model group,sham-operated group,DCBI low and high dosage group(30,60 mg? kg-1?d-1 intraperitoneally),and rosiglitazone control group;meanwhile,another normal group was established.After receiving the corresponding drugs for 5 weeks for each group,fasting blood glucose(FBG),serum insulin(FINS) and sugar tolerance(OGTT) were determined,and levels of insulin resistance index(IRI),insulin sensitivity index(ISI),total cholesterol(TC),triglyeride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and free fatty acid(NEFA) levels were computed.RESULTS: As compared with model group,in DCBI-treated model rats with T2DM complicating cerebral infarction,FBG were significantly decreased,sugar tolerance increased significantly(P0.05);IR was ameliorated(P

ObjectiveTo explore the surgical techniques, efficacy and the management of complicated ocular trauma with anterior-posterior segment complications such as cyclodialysis. Methods Fifty-five patients (55 eyes) with complicated ocular trauma were enrolled in this study. Among them, there were 35 cases with eyeball contusion and 20 cases of eyeball rupture. Preoperative visual acuity was from no light perception to 0. 15, intraocular pressure (IOP) ranged from one to 10 mm Hg (1 mm Hg=0. 133 kPa).Cyclodialysis, vitreous hemorrhage or retinal detachment were revealed by B-ultrasound and ultrasound biomicroscopy (UBM). Cyclodialysis clefts ranged from one to 12 clock-hours. All patients underwent 3-port pars plana vitrectomy with gas/silicone oil tamponade and ciliary body reattachment by cryotherapy (cyclodialysis clefts ≤ three clock-hours) or suture fixation ( cyclodialysis clefts ＞ three clock-hours).Healing after surgical trauma, visual acuity, intraocular pressure, intraocular hemorrhage, ciliary body and retinal reattachment were followed up. Results In one month after surgery, UBM showed 54 patients out of 55 patients had good ciliary body reattachment. Gonioscopy revealed cyclodialysis still existed in one patient, and this was cured by a second surgical suture fixation. In three months after surgery, ocular trauma healed in all 55 patients, the visual acuity ranged from no light perception to 0. 15, with a best corrected visual acuity of 0.8. The ciliary body and retina had good reattachment. IOP of 52 patients was normal; IOP of three patients was still lower than 10 mm Hg. Three patients had secondary glaucoma which was treated by glaucoma surgery. Conclusions Complicated ocular trauma with cyclodialysis can be treated with vitrectomy and cryotherapy or transscleral sutures. The procedure is safe and effective.

We reported perioperative nursing care of a patient with autogenous frozen ovarian pelvic transplantation after cervical cancer radical hysterectomy.Nursing priorities included:preoperative multidisciplinary assessment of the patient,including assessment of physical condition,activity of frozen frozen ovarian tissue and appropriate recovery time,autologous transplantation site,psychological status,and corresponding nursing interventions were provided.Nurses cooperated with surgeons during frozen ovarian resuscitation and other related operations.Health education and discharge guidance were provided after surgery,and the patient was informed about the importance of revisit and self-monitoring.The surgery was successful and the patient was discharged 3 days after surgery.There was no significant change in endocrine levels during revisit one month after surgery,but the patient considered symptoms of menopause had alleviated.

Objective To study the feasibility and security about misoprostol combined with fentanyl and propofol applied in visualization of artificial abortion.Methods 1270 cases of pregnant women who requested termination of pregnancy and voluntarily accepted abortion were selected.In the observe group,634 cases of pregnant women received oral misoprostol about 600 mg 90 minutes before surgery.After anesthetized by fentanyl and propofol,painless artificial abortion using visual abortion instrument was carried out.In the control group,636 cases of pregnant women anesthetized by fentanyl and propofol via the venous were carried out artificial abortion.The degree of cervical relaxation,loss of blood,total dose of propofol,surgical time,recovery time,the incidence of abortion complications and so on were observed.Results In the observation group and the control group,the average dosage of propofol are( 14.15 ± 2.37) ml and (16.90 ± 4.52) ml respectively;The average time required for surgery are ( 146.1 ± 38.2) s and ( 199.7 ± 37.3 ) s respectively;the average time required for awakening are ( 6.01 ± 1.90 ) min and ( 8.81 ± 2.02 )in;In the observation group,there are 405 ( 63.9% ) cases of cervical laxity markedly,in the control group,including 145 ( 22.8% ) cases of cervical laxity markedly,there is statistical significance ( P ＜ 0.05 ) between the observation group and the control group.There are no abortion syndrome in both groups.Conclusion Misoprostol combined with fentanyl and propofol was the first choice for painless artificial abortion using ultrasound visualization.

Objective To investigate the feasibility and safety of transumbilical laparoscopic single-port choledocholithotomy in the treatment of common bile duct stones. Methods The clinical data of four patients who underwent transumbilical laparoscopic single-port choledocholithotomy at Shengjing Hospital of China Medical University from January to June, 2010 were retrospectively analyzed. The operation method and postoperative effects were reviewed. Results All the operations were successfully carried out. The mean operation time was 100 minutes and the mean blood loss was 62. 5 ml. All patients were cured without the occurrence ofcomplications except for one patient who had a peritoneal infection and was cured after surgical drainage. Conclusion Transumbilical laparoscopic single-port choledocholithotomy is safe and feasible, but indications should be strictly followed.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability in patients suffering from mild cognitive impairment (MCI) after ischemic stroke.Methods Forty five ischemic stroke survivors with MCI but not meeting the criterion for diagnosis as dementia were recruited, and were randomly assigned into an rTMS group (32 patients) and a control group (30 patients) according to a random number table.Both groups received the routine drug therapy of medicine and cognitive function training, and the rTMS group was additionally given rTMS over the left dorsolateral prefrontal cortex at 5 Hz and 80％ motor threshold.The treatments lasted for 4 weeks.The Montreal Cognitive Assessment (MoCA) and auditory event related potential (ERP) were tested for both group before and after the treatment.Results After the treatment, two groups showed significant improvements in the average score of MoCA compared to that before the treatment, and that of the rTMS group was significantly higher than that of the control group.For both groups, the P300 latency shortened and the amplitude increased after the treatment.Moreover, the latency and amplitude of the rTMS group increased to 355.67 ± 16.43 ms and 8.69 ± 1.65 μV, respectively, after the treatment, significantly shortened and lengthened than that of the control group [(372.76 ± 23.35 ms and 7.03 ± 3.04 μV), respectively].Conclusions rTMS can significantly improve the cognitive ability of ischemic stroke survivors in a relatively safe way.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on the motor function of lower limbs of patients with cerebral infarction.Methods Sixty stroke survivors with lower limb dysfunctionwere randomly assigned to an rTMS treatment group or a control group,each of 30.Both groups were given routine medication and rehabilitation treatment,while the treatment group was additionally provided with 4 weeks of rTMS treatment of the contra-lesional M1 at 1 Hz and 90％ motor threshold.The Fugl-Meyer motor assessment (FMA) and maximum walking speed (MWS) were used to assess both groups before and after the treatment and 2 weeks later.Adverse reactions were also recorded.Results Before the intervention,no differences were found between the two groups.After the treatment and two weeks after that,significant improvement was observed in the average FMA and 10 m MWS of both groups,with significantly more improvement in the treatment group than among the controls.No obvious adverse reactions were observed in either group.Conclusions rTMS can improve the motor function of the affected lower limbs of stroke patients safely.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive ability of patients after ischemic stroke. Methods 45 patients with mild cognitive impairment (MCI) after ischemic stroke were randomly assigned into control group (n=22) and observation group (n=23). Both groups received routine drugs and cognitive training. The observation group received rTMS over the left dorsolateral prefrontal cortex (DLPFC) (5 Hz, 80% motor threshold) in addition for 4 weeks. Results The score of Montreal Cognitive Assessment (MoCA), P300 latencies and amplitudes improved after treatment in both groups (P<0.001), and were better in the observation group than in the control group (P<0.05). The MoCA score was negatively related with P300 latency (r=-0.851, P<0.05). There was no severe adverse effect during the treatment. Conclusion rTMS could improve the cognitive ability of patients with MCI after stroke, with little side effect.

Objective:To study the abnormal suppressive capacity of regulatory T cells ( Tregs) to effector cells,Th17 cells and Th9 cells in patients with mild to moderate asthma attack.Methods: Recruited asthmatic patients (n=30) and healthy control (n=30),collected peripheral venous blood from healthy control and asthmatic patients in mild to moderate attack stage respectively,and then isolated CD4+CD25+CD127-/low Tregs and CD4+CD25-T effect cells with immunomagnetic beads method ( purity was above 90%).The effect cells were cultured with PHA stimulation with or without Tregs.Measured the proliferation (3H-Thymidine), expression of RORC and PU.1 ( RT-PCR) genes,production of IL-17 and IL-9 ( LUMNEX) in effect cells with or without Tregs inter-vention.Analyzed the abnormality of Th17 and Th9 cells and the supressive capacity of Tregs on Th17 and Th9 cells in patients with asthma attack,comparing with control group.Results:Tregs of asthmatic patients could suppress the proliferation of effector cells,but less effectively than healthy control (P=0.03).In asthmatic patients,RORC expression and IL-17 production increased (P<0.05), and the suppressive capacity of Tregs to RORC expression decreased, when compared with healthy group ( P<0.05 ) .In asthmatic patients,IL-9 production of effector cells increased significantly (P<0.05),but PU.1 expression was higher than healthy group only with intervention of Tregs ( P=0.04 ) .And the suppressive capacity of Tregs to the expression of PU.1 and production of IL-9 in patients with asthma attack did not decrease (P>0.05).Conclusion:The suppressive capacity and amount of Tregs decreased,but the specific gene expression and cytokines production of Th17 cells and Th9 cells were upregulated in patients with mild to moderate asthma attack.This deficiency for the suppressive capacity of Tregs to Th17 but not Th9 cells may indicate some pathogenesis of asthma devel-opment.

Objective To investigate the feasibility of modified rapid Carba NP test for the detection of carbapenemase,and analyze the differences between the modified method and Carba NP test.Methods A total of 264 strains of gram-negative bacillus,including 164 carbapenem-resistant strains and 100 sensitive strains,were collected,and their carbapenemase were detected by Carba NP test and the modified rapid Carba NP test,respectively.The differences between the two tests were evaluated based on PCR as a reference.Results Among 164 carbapenem-resistant strains,carbapenemase gene was detected in 144 strains by PCR.The carbapenemase gene was negative in 100 sensitive strains.Among 164 carbapenem-resistant strains,135 were positive for the Carba NP test,while 130 for the modified rapid Carba NP test.One hundred of sensitive strains were negative for the two Carba NP tests.Compared with the results of PCR,the sensitivity,specificity and Kappa value of the Carba NP test were 91.7％ (132/144),97.5％ (117/120) and 0.886,respectively,while those of the modified rapid Carba NP test were 89.6％ (129/144),99.2％ (119/120) and 0.879,respectively.There was no significant difference in the positive rates between Carba NP test and the modified rapid Carba NP test (x2 =1.45,P ＞ 0.05).Conclusion The modified rapid Carba NP test which has high consistency with the PCR method,is faster and cheaper than the Carba NP test,and may be applied to epidemiologic survey and the early monitoring of nosocomial infections.