Objective To analyze the literature characteristics on environmental enrichment published in China , and provide reference for researchers .Methods The papers relevant to environmental enrichment published in CNKI database and Wanfang database were statistically analyzed from the aspects of publishing year, journal of publication, author, institution and subjects covered by the article with bibliometrics method.Results There were 422 papers published before Dec 31,2015, in which 273 papers published in 126 kinds of journals.The number of papers increased gradually, especially after 2006.The top 3 journals with the most articles published were Chinese Journal of Wildlife(28),Chinese Journal of Rehabilitation Medicine(15) and Chinese Journal of Behavioral Medicine and Brain Science(12).Xinqiao Hospital of TMMU and Fujian Medical University Union Hospital accounted for the top 2 total number of the papers, from which Yan-hui Chen and Cong-min Zhao published the more articles.Those papers covered 17 subjects, neurology, pathergasiology, biology and pediatrics were the main subjects. There were 3 kinds of animal that got enriched, the first was laboratory animals(69.6%), then zoo animals(22.9%),and farm animals(7.5%).Conclusions The research of environmental enrichment was relatively concentrated in terms of neurology and psychiatry.To improve animal welfare was mainly in the zoo animals;laboratory animal research in this direction was less .It is necessary to strengthen the work in this regard.

Environmental enrichment has become a hot topic in laboratory animal science , which is intended to im-prove the well-being of laboratory animals .This paper reviews the research in this area , focusing especially on the princi-ple and procedure of planning enrichment strategies .The consideration of housing laboratory animals should not only focus solely on animal well-being, manpower and economics , but also on the precision and accuracy of the experimental results . It also introduces the type of environmental enrichment and practice in widespread use currently .

OBJECTIVE:To observe the clinical efficacy and safety of amlodipine besylate combined with lisinopril and hydro-chlorothiazide,atorvastatin in the treatment of severe primary hypertension complicating with carotid atherosclerosis. METHODS:90 patients with severe primary hypertension complicating with carotid atherosclerosis were divided into control group (45 cases) and observation group(45 cases)according to random lottery form. Both groups were given Atorvastatin calcium tablet 20 mg/time orally,qd;control group was additionally given Amlodipine besylate tablet 5 mg/time orally,qd;observation group was additional-ly given Lisinopril and hydrochlorothiazide tablet 10 mg/time orally,qd,on the basis of control group. Both groups were treated for 8 weeks. Clinical efficacies of 2 groups were compared as well as blood pressure level,IMT,PV of carotid atherosclerosis, hs-CRP,TNF-α before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was significantly higher than that of control group,with statistical significance (P<0.05). Before treatment,there were no significant differences in SBP,DBP,IMT,PV,hs-CRP and TNF-α level(P>0.05). After treatment,the levels of SBP,DBP, IMT,PV,hs-CRP and TNF-α level in 2 groups were significantly lower than before;the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR be-tween 2 groups (P>0.05). CONCLUSIONS:Amlodipine besylate combined with lisinopril and hydrochlorothiazide,atorvastatin in the treatment of primary hypertension complicating with carotid atherosclerosis can effectively control the blood pressure level, delay the progression process of carotid atherosclerosis,reduce the inflammatory reaction degree,but dose not increase the occur-rence of ADR with good safety.

Objective To explore CT findings of pulmonary non‐tuberculosis mycobacteria (NTM ) disease .Methods Forty‐two patients with pulmonary NTM disease confirmed by the biphasic medium flora identification (NTM group) ,and 60 patients with lung tuberculosis (TB group) confirmed by the tubercle bacillus cultivation and flora identification in our hospital were included in the ret‐rospective analysis .9 CT signs and distribution features of the lesions were analyzed and compared between the two groups .The difference was statistically significant if P<0 .05 .Results Pulmonary NTM disease was more common in female patients (χ2=5 .500 ,P=0 .019) ,and the mean age was significantly older than that of the tuberculosis (t=3 .456 ,P=0 .001) .The detection rate in the right middle lobe and left tongue section was high in NTM group than in TB group (χ2 =8 .361 ,P=0 .004) .Logistic regression showed that bronchiectasis and bronchial stenosis or occlusion were independent risk factors for the NTM disease .They were important signs for the differential diagnosis from tuberculosis .Conclusion MSCT findings of pulmonary NTM disease have certain characteristic , which are helpful for the diagnosis .

Objective To observe the expressional changes of pro nerve growth factor(proNGF)apoptosis pro-signal factors after cerebral ischemia and reperfusion and discuss the protective effect of mild hypothermia on the brain injury. Methods The randomly chosen female SD rats weighing(220±10)g were divided into normal control group(Group A),cerebral isehemia and reperfusion group (Group B)and mild hypothermia group(Group C).Groups B and C were divided into 3,6 and 9 hours subgroups(eight rats per group).TUNEL methods was used to detect the apoptotic cells in the cortex after cerebral ischemia and reperfusion and treatment with mild hypothermia.The reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression changes of proNGF,Sortilin and P75gene in the cortex. Results (1)The apoptotic cells were increased with time in the Group B(P<0.05)and were more than those in the Group C in the same time point(P<0.05).(2)There found expression of all factors at all time points in three groups,which was increased with time(P<0.05).(3)The content of every factor at each time point in the Group C was less than that in the Group B(P<0.05). Conclusions (1)Mild hypothermia can decrease the apoptosis after ischemia and reperfusion injury.(2)The cell apoptosis induced by proNGF plays a very important role in the COUrse of cerebral ischemia and reperfusion injury.(3)Mild hypothermia can decrease the expression of apoptosis pro-signal to alleviate the cell apoptosis and protect the brain from ischemia and reperfusion.

Objective: To explore how to improve the ability of medical imaging professional internship integrated service, is to train talents for medical imaging specialty. Methods: The clinical practice requires students to seize the opportunity, through the participation of a large number of clinical practice, consolidate the theoretical knowledge, establish the correct clinical thinking, develop a good work ethic, improve the practical ability to work. Results: The importance of clinical practice throughout the important role of medical education, medical personnel training quality, competitive strength and student employment after graduation the actual ability to work, train more professional image. Conclusion:The medicine phantom study specialized is an emerging medicine specialty, should strengthen the organization in the clinical practice teaching important stage to manage, arranges various branches reasonably the practice time, emphasized the fundamental training, sharpens the generalized analysis ability, trains the qualified talented person.

ObjectiveTo compare the differences in stroke subtype classification between ASCO and modified TOAST.MethodsAll 425 first-ever ischemic stroke patients were recruited and classified into different stroke subtypes according to the ASCO and modified TOAST criteria.Results Comparing ASCO grade 1 with modified TOAST,more patients were classified as atherosclerosis (60.2％ vs 57.9％ ; x2 =2.68,P=0.132) and fewer as small artery disease and cardiac disease subtype (13.4％ vs 14.8％ and 8.5％ vs 8.7％ ; x2 =1.30 and 0.00,P =0.238 and 1.000,respectively).ASCO grade 1 did not reduce the proportion of cause undetermined patients compared with modified TOAST ( 15.5％ vs 16.2％ ; x2 =0.09,P =0.795 ). Agreement was showed in every subtype categories between the two approaches.Agreement for atherosclerotic cause and small artery disease was very good ( all κ over 0.81 ),and for the cardiac disease subtype was good (κ: 0.61-0.80). Conclusion Agreement can be found in every subtype categories between ASCO and modified TOAST classification.ASCO grade 1 does not reduce the proportion of cause undetermined cases compared with modified TOAST,but the subtype categories characteristics of the two approaches should be considered in practice.

Objective To evaluate the incidence of hyponatremia in patients with Guillain-Barré syndrom (GBS) and to explore whether hyponatremia is an important predictor of poor outcome.Methods All 455 GBS patients met the inclusion criteria and were divided into three groups as mild,moderate and severe GBS according to Medical Research Council sumscore (MRC sumscore) at nadir.Hyponatremia is defined as serum sodium concentration below 135 mmol/L at nadir.The incidences of hyponatremia in GBS patients with different MRC sumscore were analyzed by x2 tests.Logistic regression models were performed to determine risk factors of hyponatremia and poor prognosis.Results Of all the 455 GBS patients,mild,moderate and severe groups patients were 178,100 and 177 respectively,and 98 (21.5％) GBS patients had hyponatremia.Hyponatremia was more often detected in severe GBS cases (64,36.2％),than in mild (21,11.8％) or moderate (13,13.0％,x2 =28.921,17.074 respectively; all P ＜ 0.01) cases,but there was no significant difference between mild and moderate patients (x2 =0.086 ; P =0.769).Logistic regression analysis identified 3 predictors of hyponatremia:age ＞ 50 (OR =2.013,95％ CI 1.155-3.508,P =0.014),facial weakness (OR =2.493,95％ CI 1.423-4.369,P =0.001) and mechanical ventilation (OR =12.871,95％ CI 5.484-30.207,P =0.001).The presence of hyponatremia (OR =12.770,95％ CI3.419-47.701,P =0.001) and bulbar weakness (OR =3.391,95％ CI 1.182-9.733,P =0.023)predicted death in acute stage.Conclusion As an important predictor of poor outcome in GBS patients,hyponatremia is more likely occurred in patients with older age,facial weakness or respiratory failure.

Objective To evaluate the best cutoff points of flow velocity for diagnosing and grading middle cerebral artery (MCA) stenosis as compared with magnetic resonance angiography (MRA) in a large group of asymptomatic patients. Methods We diagnosed 148 MCA stenostic patients with conventional method using EME-TC2000 transcranial Doppler (TCD) by a single reseach technician. All patients were given a MRA within 1 week after TCD examination. The severity of MCA stenosis was categorized as normal-mild (75% and void of flow signal) on the basis of the amount of signal loss and the lumen reduction of MCA in MRA . According to the different systolic velocities as following ≥130 cm/s, ≥140 cm/s , ≥150 cm/s, ≥160 cm/s, ≥ 170 cm/s, we drown different ROC(receiver operator characteristic) curves and determined which cutoff point was the best for diagnosing and grading the MCA stenosis.Results The numbers of vessel with normal, moderate and severe stenosis were 75, 112,109 respectively in MRA, their mean MCA velocities are (121?22) cm/s, (155?21) cm/s, (199?43) cm/s respectively in TCD, there was a obvious difference of systolic velocity among these three groups. Through calculating the bigest areas under ROC, we concluded that the optimal cutoff points for diagnosing MCA stenosis was 140 cm/s (areas under ROC was 0.87, P

OBJECTIVE: To reduce the incidence of the disputes between pharmacists and patients. METHODS: The reasons for the disputes between pharmacists and patients as well as the countermeasures were analyzed. RESULTS & CONCLUSIONS: The disputes between pharmacists and patients were mainly resulted form pharmacists' dispensing error, improper service attitude or skills, or lack of the ability in dealing with the problems. The quality of pharmaceutical care can be enhanced and the incidence of disputes can be reduced or evaded through institutionalized management, standardized operation and humane concern showed to patients etc.