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.

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 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.

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 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 evaluate the application value of inhibitor enhanced modified carbapenemase inactivation method (imCIM) in the detection of class B carbapenemase.The differences between imCIM and EDTA disc potentiation test (EDPT) were comparatively analyzed.Methods A total of 181 strains of carbapenem insensitive strains were collected,among which there were 44 strains of Klebsiella pneumoniae,44 strains of Escherichia coli,43 strains of Acinetobacter baumannii and 50 strains of Pseudomonas aeruginosa.The 83 strains of carbapenem-sensitive strains were composed of 25 strains of Klebsiella pneumoniae,16 strains of Escherichia coli,25 strains of Acinetobacter baumannii and 17 strains of Pseudomonas aeruginosa.The class B carbapenemase in the 264 strains of pathogenic bacteria was screened by imCIM and EDPT,and PCR results were used as gold standard.The statistical analysis wasperformed with consistency check,related-sample Wilcoxon signed rank sum test,independent samples Kruskal-Wallis H test and ROC curve.Results Among the 181 strains of carbapenem insensitive strains,PCR results of 144 strains were positive for drug resistance gene.The samples of class A,B and D of carbapenemase were 39,77 and 28 strains respectively.The results of imCIM showed that 70 strains were positive,and the other 111 strains were negative.The imCIM results of 166 strains were consistent with those of PCR.The results of EDPT showed that 72 strains were positive,and the other 109 strains were negative.The EDPT results of 134 strains were consistent with those of PCR.The results of PCR,EDPT and imCIM of 83 carbapenem sensitive strains were negative.The sensitivity and specificity of imCIM were 85.71％ (66/77) and 97.86％ (183/187),and the value of Kappa was 0.859.The sensitivity and specificity of EDPT were 66.23 ％ (51/77) and 88.77 ％ (166/187),and the value of Kappa was 0.561.The difference of inhibition zone of imCIM (AdimCIM) was different from EDPT(AdEDPr) and the difference was statistically significant (Z =-6.941,P ＜ 0.05).In the imCIM detection,the AdimciM level of class B carbapenemase showed different population distribution position from class A and D carbapenemase with the statistically significant difference (x2 =108.887,P ＜ 0.05).The areas under the ROC curve of imCIM and EDPTwere 0.988 (95％CI:0.977 to0.999) and0.936 (95％CI:0.909 to0.963),respectively.Conclusion imCIM should be accurate,efficient and convenient for screening of carbapenem phenotype for its high sensitivity and specificity,and suitable for epidemiological monitoring.

Objectives To investigate the clinical significance of the airway inflammation mediators,eosinophil cationic protein (ECP) and urinary leukotriene E4 (LTE4),in children with respiratory syncytial virus (RSV) bronchiolitis. Methods A total of 120 inpatients with RSV bronchiolitis were classified into atopic and non-atopic groups. And 30 healthy subjects were se-lected as normal controls. Urinary LTE4 was determined by ELISA and ECP concentration in nasopharyngeal secretions (NPS) was tested by UniCAP100 allergen detector. The differences among groups were compared. Results The urinary LTE4 level in atopic group (172.21 ± 67.29 pg/ml) was elevated significantly (P<0.01) than that of non-atopic group (78.21 ± 28.78 pg/ml) and control group (44.22±16.14pg/ml). Significance was also found between non-atopic and control groups (P<0.01). Statistical anal-ysis indicated that urinary LTE4 positively correlated to serum IgE and ECP in children with RSV bronchiolitis (r=0.57,0.49;P<0.01). Conclusions The level of urinary LTE4 and ECP in NPS can provide the reference for treatment and prognosis of children with RSV bronchiolitis.