ObjectiveTo investigate the risk factors for recurrent ischemic stroke in patients with atrial fibrillation.MethodsThe ischemic stroke patients with atrial fibrillation were enrolled retrospectively.Their demographic and clinical data were collected.The relative risk factors for strokes were compared in the first-ever stroke group and the recurrent stroke group.Multivariate logistic regression analysis was used to determine the independent risk factors for recurrent ischemic stroke in patients with atrial fibrillation.ResultsA total of 504 ischemic stroke patients with atrial fibrillation were enrolled, including 245 males (48.6%).and 259 females (51.4%).The average age was 76.67±8.26 years.There were 314 patients (62.3%) in the first-ever stroke group and 190 (37.7%) in the recurrent stroke group.The proportions of hypertension (78.9% vs.69.4%;χ2=5.446, P=0.020), diabetes mellitus (38.9% vs.26.8%;χ2=8.181, P=0.004), and age >75 years (68.9% vs.60.2%;χ2=3.915, P=0.048), as well as the baseline systolic blood pressure (153.30±26.02 mmHg vs.148.13±26.40 mmHg, 1 mmHg=0.133 kPa;t=-2.141, P=0.033) in the recurrent stroke were significantly higher than those in the first-ever stroke group.Multivariable logistic regression analysis showed that hypertension (odds ratio [OR] 1.734, 95% confidence interval [CI] 1.121-2.682;P=0.013), diabetes (OR 1.757, 95% CI 1.188-2.597;P=0.005), and age >75 years (OR 1.680, 95% CI 1.132-2.494;P=0.010) were the independent risk factors for recurrent ischemic stroke in patients with atrial fibrillation.ConclusionHypertension, diabetes, and age >75 years were the independent risk factors for recurrent ischemic stroke in patients with atrial fibrillation.

Objective To investigate the effect of double versus single internal thoracic artery on sterna wound healing in coronary artery bypass grafting (CABG).Methods Patients undergoing CABG were randomly divided into experimental group (double internal thoracic artery group) and control group (single internal thoracic artery group) according to the number of internal thoracic artery used in operations.Experimental group:skeletonized double internal mammary arteries were harvested in all 50 cases (37 males and 13 females).Control group:skeletonized left internal mammary artery was harvested in all 50 cases (34 males and 16 females).Sterna wound healing and post-operational complications were observed.Results The incidence of poor sterna wound healing and volume of drainage after operation in the experimental group were more than those in the control group [volume of drainage on the first day:(350.67±56.86)ml vs (240.72 ±48.35)ml;total volume of drainage:(595.65 ± 102.35) ml vs (398.85 ± 75.84) ml;poor sterna wound healing rate:20％ vs 0;P ＜ 0.05 or P ＜ 0.01].The sterna wound healing rate of high-risk patients between two groups had significant difference (8 cases vs 0 case,P ＜ 0.05).Conclusions Compared to the single internal mammary artery grafting,the double internal mammary artery grafting increased the risk of sternal wound healing.

Objective To establish an HPLC method for the simultaneous determination of contents of gallic acid, corilagin and ellagic acid in aqueous extract from Sanguo Decoction. Methods The analysis was carried out on an Agilent C18 column (4.6 mm × 250 mm, 5 μm), and the mobile phase was composed of acetonitrile and 0.1%phosphoric acid aqueous with gradient elution. The detection wavelength was 260 nm. The flow rate was 1.0 mL/min at column temperature of 30 ℃. Results Gallic acid, corilagin and ellagic acid were completely separated and the peak shape was good. It showed a good linearity in the concentration range of 0.174–2.61 μg, 0.04–0.60 μg, and 0.052–0.78 μg, respectively. The average recoveries of gallic acid, corilagin and ellagic acid were 99.98%, 99.81%and 100.12%, respectively. The RSD were less than 2.0%. Conclusion This method is rapid, accurate and repeatable, which can provide references for the quality control of Sanguo Decoction.

Objective To discuss the effect of night- shift work on marital quality, and analyze the relations between the marital quality and related factors in order to explore the method to tackle the marital crisis of night- shift nurses. Methods 500 nurses were selected in general hospitals of Liaoeheng above county-level, each tested nurse filled out marital quality inventory, general well-being scale,social support scale and Eysenck personality questionnaire(EPQ), and withdrew 416 copies(effective rate 90.83%) of ef-fective questionnaire after filling independently. Results (1)There were significant difference in the var-ious scores of marital quality between the nurses and the norm. (2) The marital quality was correlated with general well-being, social support and psychoticism, neuroticism and lying degree of EPQ.(3) Multivariable linear regression which took marital quality as dependent variable ,the variables which entered the equation were age of marriage, social support, psychoticism,subjective well- being,lying degree and objective support. Conclusions (1) The marital quality of night-shift nurses was low. (2)Marital quality was positively cor-relat-ed with subjective well-being, social support and lying degree, negatively correlated with neuroticism and psychoticism. (3) Marital quality were influenced by time of marriage, social support, psycholepsy, sub-jec-tive well-being, lying degree and objective support, among which social support has a great influence.

Objective To investigate the effect of alternating shift on general well-being of nurses,and analyze its relationships with related factors. Methods Alternating shift nurses from general hospi-tals above courty-level in Liaocheng city who were engaged in clinical work were selected by duster sam-pling.Questionnnires were sent out and later gathered. The investigation tools included general well-being schedule(GWB) ,marital quality inventory, social support inventory, Eysenck personality questionnaire were used in survey. Results (1)There was difference in the score of general well-being between nurses with different ages and professional titles(P<0.01). (2)There was significant difference between GWB and oth-er factors such as marital quality,EPQ (psychoticism, neuroticism and introversion and extroversion), so-cial support(P<0.01). (3)Multivariable linear regression which took general well-being as dependent vari-able, the variables which entered the equation were neuroticism, family relationship,support utilization,psychoticism, objective support, introversion and extroversion, marriage satisfaction,arrangement of econ-omy. Conclusions (1)The older, the higher of professional tltles,the stronger general well-being of nurses. (2)Sabjective well-being and marital quality, social support, lying defense were positively corre-lated; neuroticism, psychoticism were negatively correlated. (3)Neuroticism, family relationship,support and utilization, psychoticism, objective Support, introversion and extroversion, marriage satisfaction,ar-rangement of economy can affect general well-being,among which neuroticism had great influence.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease due to glucocorticoid biosynthesis enzyme deficiency,in addition to the common types such as 21-hydroxylase,11 β-hydroxylase deficiency,also include rare types such as 3 β-hydroxysteroid dehydrogenase deficiency,17α-hydroxylase deficiency and congenital lipoid adrenal hyperplasia (CLAH).These rare types of CAH have multiple clinical manifestations,which are easily missed or misdiagnosed.This article focus on molecular genetics,pathophysiology,clinical manifestations and treatment principles of above 3 rare types of CAH.

Congresses as Topic ; Diagnostic Errors ; Head ; surgery ; Humans ; Neck ; surgery ; Otolaryngology

ObjectiveTo investigate the associations of the Oxfordshire Community Stroke Project (OCSP) subtypes with severity and outcomes of acute ischemic stroke.MethodsThe inpatients with acute ischemic stroke were enrolled prospectively and divided into total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI), and lacunar infarction (LACI) according to the OCSP classification.Demographic and baseline clinical data of the patients were recorded.The National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity, ≤8 was mild stroke and >8 was moderate to severe stroke.The clinical outcome was assessed at 90 d after onset with the modified Rankin Scale (mRS), and the favorable outcome was defined as mRS score 0-2, and the unfavorable one was defined as mRS score 3-5, death or cardiovascular event.Multivariate logistic regression analysis was used to determine the independent associations of the OCSP subtypes and stroke severity and outcomes.ResultsA total of 765 patients with acute ischemic stroke were enrolled, including 46 (6.0%) with TACI, 281 with PACI (36.7%), 229 (29.9%) with POCI, and 209 (27.3%) with LACI.There were 580 patients (75.8%) with mild stroke, and 185 (24.2%) with moderate to severe stroke;17 were lost to follow-up, 513 (68.6%) had favorable outcomes, and 235 (31.4%) had unfavorable outcomes.There were significant differences between the baseline NIHSS scores and outcomes in each OCSP subtypes (all P<0.05), in which the baseline NIHSS score in TACI was the highest, the outcome was worst, and the proportion of patients with unfavorable outcome was 89.1%;there was significant difference in the baseline NIHSS scores between the PACI and the POCI (P<0.05), however, the proportion of patients with unfavorable outcome was not the case.Multivariate logistic regression analysis showed that TACI was an independent risk factor for moderate to severe stroke (odds ratio 84.881, 95% confidence interval 20.307-354.792;P<0.001) and unfavorable outcome (odds ratio 21.472, 95% confidence interval 8.362-55.136;P<0.001).Conclusion The OCSP subtypes were independently associated with the severity and outcomes of acute ischemic stroke.

Background Animal model of fungal keratitis is an available tool to the experimental study of the pathogenesis mechanism of fungal keratitis. Current modeling methods of fungal keratitis include corneal scratching, corneal stroma injection and corneal surface lens methods. But these methods still have their own shortages. Objective This experiment was to create a fungal keratitis animal model by modifying corneal surface lens method. Methods Modified animal models of fungal keratitis were created by modified corneal surface lens method in 12 general adult New Zealand white rabbits. The filter papers soaked 108 spores / ml or A106spores / ml of spergillus fumigatus suspension were attached on the de-epithelial cornea surface and fixed with contact lens and tarsorrhaphy for 2 days, and the filter paper with physiological saline was used as control group. The symptoms of anterior segment were examined under the slit lamp in 3 ,7 and 14 days after surgery and scored based on the criteria of Dong. Corneal scraping was stained with 10% potassium hydroxide and calcofluor white stain to observed mycelium under the fluorescence microscope. Corneal tissue sections were examined by hematoxylin-eosin staining and periodic acid Schiff staining under the light microscope. The use of animal followed the Standard of Association for Research in Vision and Ophthalmology. Results Fungal keratitis models were successfully established in 6 eyes and 4 eyes in 108 spores/ml group (6/6) and 106 spores/ml group respectively. The symptom was more severer and score was higher in the eyes of 108 spores/ml group than that in 106 spores/ml group. At 3 and 7 days after surgery,the symptom scores of fungal keratitis models were higher than those of control group from 3 through 7 days with the statistically significant difference (P<0. 01) and the symptom scores of 108 spores/ml group were significantly higher than those of 106 spores/ml group (P<0. 01). At 14 days after surgery, the symptom scores of 108 spores/ml group were still higher than those of control group (P<0. 05). Fungal hyphae was seen in the corneal scrapes in 108 spores/ml group and 106 spores/ml group respectively from 3 through 7 days after surgery. Inflammatory cell infiltration, stroma cells necrosis and fungal hyphae were presented in 108 spores/ml group, and the corneal neovascularization could be observed in 108 spores / ml group 14 days later. Fungal culture revealed the positive outcome in both 3 and 7 days after surgery in 108 spores/ml group,but in 106 spores/ml group,the positive result was only in the 3rd day. Conclusion Modified corneal surface lens method is more feasible and sample in the model of Aspergillus keratitis. This animal model of Aspergillus keratitis is practical for the further study of fungal keratitis.

AIM: To investigate the effects and mechanisms of renin-angiotensin system (RAS) blockade on pancreatic islet β-cell function in rats with injection of streptozotocin (STZ) and long-term high-fat diet. METHODS: Normal male Wistar rats fed with 16 weeks-long high calorie, and high-fat diet were treated with telmisartan (TI, n=15), and injected with STZ after 24 weeks. One week later, islet function was evaluated by intravenous insulin releasing test (IVIRT). The immunoglobulin binding protein (BIP)/glucose-regulated protein (GRP78), C/EBP-homologous protein (CHOP)/growth arrest and DNA-damage-inducible gene 153 (GADD153) mRNA expression levels in the islets were detected by RT-PCR. The expression levels of insulin and Bax protein in the islets were examined by immunohistochemistry. RESULTS: The incidence of diabetes was 80%(12/15)in the high-fat diet+STZ group (HS) and 33% (5/15) in the high-fat diet+STZ+ telmisartan group (TS). Compared to HS group, maximum of insulin secretion in TS group was increased 56.9%. Early insulin secretion index (EISI) and acute insulin response (AIR) were increased by 1.98 times and 0.88 times, respectively. The expression of insulin and insulin positive cell density (PCD) were increased obviously in β-cells. The expression levels of BIP, CHOP and Bax in the islets were decreased significantly. CONCLUSION: Blockade of RAS increases the resistance to streptozotocin-induced diabetes in rats with long-term high-fat diet, and the expression of apoptosis-related molecules is downregulated in endoplasmic reticulum. The mechanism that RAS blockade improves pancreatic islets function and reduces diabetes incidence to some extent may be via attenuating endoplasmic reticulum stress.