OBJECTIVE:To investigate therapeutic efficacy and safety of Salviae miltiorrhizae and ligustrazine hydrochloride injection in the treatment of vertebro-basilar artery insufficiency(VBI)after cerebral infraction. METHODS:128 patients with VBI after cerebral infraction were divided into observation group and control group according to random number table,with 64 cases in each group. Both group received general treatment. Control group was additionally given Shuxuetong injection 6 ml added into 0.9%Sodium chloride injection 250 ml,ivgtt,qd. Observation group was additionally given Salviae miltiorrhizae and ligustrazine hy-drochloride injection 10 ml into 0.9% Sodium chloride injection 250 ml,ivgtt,qd. Both groups received treatment for consecutive 2 weeks. Clinical efficacies of 2 groups were observed as well as blood lipid,vertebro-basilar artery blood velocity and blood viscosity before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observa-tion group was 95.31%,which was significantly higher than 79.69% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in blood lipid,vertebro-basilar artery blood velocity and blood viscosity between 2 groups(P>0.05). After treatment,above indexes of 2 groups were improved significantly,and blood lipid and vertebro-basilar ar-tery blood velocity of observation group were significantly better than control group,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Salviae miltiorrhizae and ligustrazine hydrochloride injection shows significant therapeutic efficacy for VBI after cerebral infraction,can significantly improve blood lipid,vertebro-basilar artery blood velocity and blood viscosity with good safety.

Objective To analyze the diagnosis and treatment of pancreatic trauma with main pancreas duct break. Methods Forty-four cases of severe pancreatic trauma with main pancreas duet break were retrospectively analyzed including their diagnosis and different operation performed according to the severity of pancreatic trauma. Results All of severe pancreatic trauma could be diagnosed by CT scan and B-ultrasonic examination. But the main pancreas duct break or not should be determined by surgical exploration. Emergency operations were performed for all cases , distal part pancreaticojejunostomy in 27 cases; modified duodeno-divertiulaization in 3 cases, duode-nojejunostomy in 3cases, pancreaticeduodenectomy in 2 cases, 41 cases were cured. The mortality was 6.8%. Conclusion CT scan is the most helpful means to diagnose pancreatic trauma. An appropriate and timely emergen-cy operation is the key to reduce mortality.

Objective This study was designed to investigate the role of apoptosis-inducing factor on neonatal rat cardiomyocytes apoptosis induced by TNF-a,and to detect the effect of IL-10 on the apoptosis rate of cardio-myocytes apoptosis induced by TNF-α.Methods Neonatal rat cardiacmyocytes in primary culture were exposed to TNF-α( 100ng/ml)for 12 hours,18 hours,24 hours,TNF-α( 100ng/ml) for lohours pretreated by IL-10(50ng/ml) 1 hour,or IL-10(50ng/ml) for 19hours.Apoptotic cells were detected by flow cytometry and Hoechest 33258 dye; Western blot were used to determine the apoptosis-inducing factor protein expression.Results The apoptosis rate of cardiomyocytes increased in TNF-α 12 hours group than that of control[ Flow cytometry (5.08 ±0.79% ) vs ( 2.2± 0.77)% ,P <0.05],and reach the peak in TNF-α 18 hours group compared with control[ Flow cytometry(14.39± 2.31)%vs(2.2±0.77)%,P<0.01;Hoechst 33258 dyeing(18.936±2.791)% Vs(2.890± 1.326)% ,P< 0.01];also elevated in TNF-α 24 hours group vs control[Flow cytometry(4.61±0.84)% vs(2.2 ±0.77)% ,P< 0.05].AIF expression:Increased expression of AIF in the cells treated by TNF-α( 100 ng/ml) 12 hours,reached highest in TNF-α( 100 ng/ml) for 18 hours group and decreased in TNF-α( 100 ng/ml) 24 hours group compared with control;AIF expression is not decrease in TNF-α( 100 ng/ml) 18 hours pretreated by IL-10(50 ng/ml) for 1-hour group comparing with TNF-α( 100 ng/ml) 18hours group.Conclusion The study demonstrated that AIF contributed to TNF-α induced apoptosis of rat cardiomyocytes; IL-10 alleviated the apoptosis of rat cardiacmyocytes induced by TNF-α,and AIF may not its mechanism.

Objective To investigate diagnosis and surgical treatment of primary retroperitoneal malignarnt tumor.Methods Retrospectively analyzed the clinical data with primary retroperitoneal tumor.Results Twenty-eight eases with benign tumor and 47 cases with malignant tumor underwent total resection,only 17cases with malignant tumor underwent local resection.Conclusion The diagnosis B-ultrasonography,CT and MR of primary retroperitoneal tumor is very important for preparative of preoperation and to estimate of involved organ.Involved organ resection and repeated operation for recurred tumor improve cure rate.

Objective:To investigate the effect of early enteral nutrition combined with Bacillus in the treatment of patients with digestive tract perforation.Methods:59 patients with emergency digestive tract perforation were randomly divided into experimental group (EN plus Bacillus,n =31) and control group (TPN,n =28).The patients in the experimental group were given enteral nutrition plus Bacillus after first days (＜ 24 h),and the control group was treated with parenteral nutrition support on the first day after surgery.The average hospitalization time,length of ICU stay,incidence of complications,and serum C-reactive protein in the two groups were analyzed.Results:The average length of hospitalization time,ICU stay,recovery of bowel function and eating time were significantly shorter in the experimental group than in the control group(P ＜ 0.05).There was no significant difference in nutrition index between the two groups during the perioperative period (P ＞ 0.05).The C-reactive protein in the experimental group was significantly lower than that in the control group fourth days after operation (P ＜ 0.05).The incidence of postoperative wound infection in the experimental group was significantly lower than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of other complications.Conclusion:Early administration of enteral nutrition combined with Bacillus can significantly shorten the intestinal function recovery time,decreasethe average hospitalization days,reduce the postoperative wound infection rate and thus improve the outcome of patients with digestive tract perforation.

Objective To evaluate the value of intermittent splenic artery occlusion in the treatment of iatrogenic splenic injury and the cause of ischemia reperfusion injury.Methods Experimental animals using dogs were divided into experimental group and control group according to whether the splenic artery was blocked.The animal model of iatrogenic splenic injury was established by general anesthesia.Experimental group was treated with intermittent splenic artery blockage combined with gelatin sponge oppression of the wound to stop bleeding.The first time of splenic artery occlusion was 15 min and continued for 10 min and for another 5 rmin if still bleeding.Then hemostatic effect after removing blocking and oppression was observed.Control group was only treated with gelatin sponge compression to stop bleeding.Blood samples and tissue samples were collected before blocking and after reperfusion for 2 hours in experimental group,and before compression and relieving the compression for 2 hours in control group.IL-1 (interleukin),SOD (superoxide disproportionation enzyme),MPO (myeloperoxidase),MDA (malondialdehyde) and caspase-3 (aspartame acid cysteine protease) were detected.Results The control group still had bleeding,while the experimental group had successfully stopped bleeding.Serum markers before and after occlusion in the experinental group were IL-1 (124.4 ± 106.8 vs.121.2 ± 105.1),SOD (4.7 ± 2.7 vs.5.2 ± 1.8) and MDA (8.8 ±6.5 vs10.8 ±7.5).There were no significant differences on serum markers in two groups after occlusion/oppression including IL-1 (121.2 ± 105.1 vs.162.8 ± 73.8),SOD (5.2 ± 1.8 vs.4.7 ± 2.8) and MDA (10.8 ±7.5 vs.9.6 ±6.6) (P＞0.05).Histological indicators before and after occlusion in the experimental group included MPO (0.62 ±0.23 vs.0.68 ±0.21) and Caspase-3 (0.90 ±0.29 vs.0.86 ± 0.26),and there was no statistical difference on MPO (0.68 ±0.21 vs.0.86 ±0.23 after two sets of experiments) and Caspase-3 level (0.86 ± 0.26 vs.1.21 ± 0.18) (P ＞ 0.05) in two groups after occlusion/ oppression.Conclusion The therapeutic effect of intermittent splenic artery occlusion combined with gelatin sponge compression hemostasis is safe and effective and without obvious ischemia reperfusion injury.

] AIM: To investigate the expression of the urotensin Ⅱ (UⅡ) receptor GPR14 in the aorta of apoE knockout mouse. METHODS: The expression of GPR14 in the aorta of apoE knockout C57BL/6J mice at various ages (18 weeks, 28 weeks, and 38 weeks old, respectively) was determined with competitive RT-PCR. A binding assay of [ 125 I]-UⅡ on the aortic tissue was also performed in 28 weeks group. RESULTS: We found significant upregulation of GPR14 mRNA at all three ages. Compared with wild type group at the same age, the GPR14 mRNA level in apoE knockout mice increased 54.2% in 18 week group (P

Objective To measure the present situation of medical students' learning adaptability and find the influencing factors in order to revise Learning Adaptability Scale for medical students.Methods A stratified sampling method was used to collect 1 180 medical students from Harbin Medical University.Using the internal consistency reliability test,the reliability of the revised student learning adaptability scale was verified.Five common factors were extracted by the exploratory factor analysis of the principal analysis method,and Logistic regression was used to analyze the influencing factors of medical student learning adaptability.Results The revised Student Learning Adaptability Scale (Cronbach's Alpha=0.914) consists of 27 measurement items.It includes five dimensions,namely self-directed learning,information utilization,environment choice,stresses response and goal orientation.The results showed that the adaptability of medical students was moderate (3.28 ± 0.52),and the influencing factors included job position (OR =1.496,95％ CI=1.114-2.009),academic achievement (OR =1.638,95 ％ CI=1.386-1.936),satisfaction with learning (OR=2.160,95％CI=1.745-2.673),professional satisfaction (OR=1.369,95％CI=1.092-1.718),professional interest (OR =1.426,95％ CI=1.186-1.715) and employment prospects (OR =1.526,95％ CI=1.251-1.862).Conclusion The reliability and validity of the Student Learning Adaptability Scale is appropriate.Medical students' learning adaptability is influenced by many factors.

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.