Objective To investigate the usage of antiplatelet drugs(APD)therapy in ischemic stroke with a history of intracranial hemorrhage(ICH)and impact of APD therapy in recurrences of the ICH and the ischemic stroke. Methods In a retrospective study, all survivors of ischemic stroke with ICH who visited our hospital previous to this study were followed by clinic visit or by telephone interview and recurrent ICH, ischemic stroke, and APD use were recorded. Kaplan-Meier plot and Logistic regression were used to assess the effect of APD on recurrent ICH and isclemic stroke. Results Recurrent ICH was more common in patients with lobar hemorrhage compared than patients with deep hemorrhage. APD use was more common for prevention of myocardial infarction and atrial fibrillation. APD use did not increase ICH recurrence (OR = 1. 149, 95% CI 0. 376-3.513, P=0.808)and did not shorten duration of ICH recurrence(X2=1.257, P=0.262); however, it did reduce ischemic stroke recurrence(OR=0.410, 95% CI0. 203-0.826, P=0.013)and prolonged duration(X2 =14.315, P=0.001). Conclusion APD use was not associated with ICH recurrence and was beneficial to recurrence ischemic stroke in this observation study.

Objective To investigate the prevalence of anxiety and depression one month before idiopathic benign paroxysmal positional vertigo (BPPV) episode. Methods Patients from Vertigo Clinic of Department of Neurology, West Campus, Chaoyang Hospital, were enrolled from January 2014 to June 2016. For patients with first visiting idiopathic BPPV, Hamilton Anxiety Scale and Hamilton Depression Scale were used at the consulting room by an experienced neurologist to reflect the emotional state one month before idiopathic BPPV episode. The occurrence rate of mood disorders was compared with usual model. Results One hundred and eighty five patients with idiopathic BPPV, aged 28 to 82 (57.6±12.0) years, 19.5% (36/185) being male, 80.5% (149/185) being female, were enrolled into this research. No anxiety, probable anxiety, definite anxiety and severe anxiety accounted for 15.1% (28/185), 33.0% (61/185), 47.6% (88/185) and 4.3% (8/185), respectively;no depression, probable depression, definite depression and severe depression accounted for 18.4% (34/185), 48.6% (90/185), 29.2% (54/185) and 3.8% (7/185), respectively;no mood disorders, probable mood disorders, definite mood disorders and severe mood disorders accounted for 11.4% (21/185), 33.5% (62/185), 49.2% (91/185) and 5.9% (11/185), respectively;total definite mood disorders and severe mood disorders accounted for 55.1% (102/185), higher than usual model (14.4%)Conclusion Anxiety and depression is common before idiopathic BPPV episode.

ObjectiveTo research collateral pathways and collateral grading through digital subtract angiography(DSA) and their relation to clinical prognosis.MethodsCollateral pathways and collateral grading of 49 cases suffered from severe internal carotid artery (ICA) stenosis (70% -99% ) were assessed through DSA.Incidence of stroke,TIA or cerebral hemorrhage were observed in the following 12 months.Results①In all the subjects,no collateral pathway exist in 9 cases(18.9%),and primary and secondary collateral pathways occurred in 39(79.6% ) and 25(51.0%)cases.Pathway is not related to clinical prognosis.②There were 9 ,15 and 25 cases in 0 grade,1 -2 grade and 3 -4 grade collateral circulation and the complication ratio is 44.4%,50.66% and 24.00% respectively.Incidence of ischemic cerebrovascular disease is significantly higher in 3 - 4 grade patinets than those in 0 and 1 - 2 grade pation(x2 =4.856,3.242;all P ＜ 0.05 ).ConclusionsCollateral levels but not pathway were correlated with clinical prognosis in patients with severe stenosis of internal carotid artery.

BACKGROUND: Gene chip of expression spectrum is used to make contrastive analysis of the changes of gene expression of histocytes derived from different individuals, tissues, cell cycles, developmental stages, differentiating stages, physiological and pathological status, and stimulating conditions.OBJECTIVE: To investigate gene expression changes of cerebral tissues of mice at different phases after ischemia/reperfusion injury, and screen out and understand genes related to cerebral ischemic/reperfusion injury.DESIGN: A randomized and controlled animal study.SETTING: Laboratory of the Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital affiliated to Capital University of Medical Sciences;Laboratory of Shanghai Biostar Gene Chip Co., Ltd.MATERIALS: The experiment was performed in the Laboratory of Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital affiliated to Capital University Medical Sciences, and the Laboratory of Shanghai Biostar Gene Chip Co., Ltd. from September 2002 to October 2003. Totally 20 male mice of C57BL/6 species were selected and randomized into 4 groups with 5 in each group: 48-hour and 10-day sham-operation groups and 48-hour and 10-day cerebral ischemia-reperfusion groups.METHODS: The bilateral common carotid arteries of mice in cerebral ischemia/reperfusion group were blocked with clamp for 20 minutes to establish models of cerebral ischemia/perfusion injury. The bilateral common carotid arteries of mice in sham-operation group were separated without clamp. We killed the mice by breaking off their necks at the 48th hour and 10th day after operation. Expression changes of cerebral tissues of mice were detected with BiostarM-20 s gene chip of expression spectrum.MAIN OUTCOME MEASURES: Changes of gene expression of cerebral tissues of mice in each group.RESULTS: A total of 20 mice were involved in the result analysis. ①Differential expression gene in 48-hour sham-operation group and 48-hour cerebral ischemia/reperfusion group showed that the number of up-regulated expression genes was 30. Among them the most obvious up-regulated gene was related to DNA synthesis, repair and transcription. The number of down-regulated expression genes was 119. Among them the most obvious down-regulated gene was protein phosphatase 1 (PP1) gene related to cellular signal and transferrin protein. ② Differential expression gene between 10-day sham-operation group and 10-day cerebral ischemia/reperfusion group showed no up-regulated gene, but 7 down-regulated genes, and the most obvious down-regulated gene was the one that related to cell apoptosis.CONCLUSION: At the 48th hour after cerebral ischemia/reperfusion, upregulated gene is the one that related to DNA synthesis, repair and transcription, which is helpful for cerebral tissue repair after cerebral ischemia/reperfusion. Genes related to cell signal and transferrin are down-regulated, and can level off barrier of endothelial cells and relieve cerebral ischemia/reperfusion injury. At the 10th day after cerebral ischemia/reperfusion, cell apoptosis-related gene is down-regulated, and can accelerate apoptosis and aggravate injury of cerebral cells, which may be related to delayed neuronal necrosis.

It is important to meet the need of modern high-technology war during the new period in which our army change the modes of generating combat capabilities .How to more scientifically and effectively improve the soldiers′physical quality and reserve ability will play a key role in soldiers′operations training .Therefore,the metabonomic analysis will pro-vide a new idea for the military physical training monitoring .The application of metabonomics to military fitness training monitoring is described in this paper .

ObJective To measure the level of MDA and SOD in cerebrospinal fluid from patients with cysticercosis indifferent stages and to investigate their effects on this dieases. Methods Forty-nine patients with a single cysticercus incerebral parenchyma and twenty normal controls parlticipated in the study. According to the magnetic resonance imaging(MRI) results, patients were divided into four stages. The level of MDA,SOD in CSF were tested. The data were analyzedwith the software of SPSS. Results The amount of SOD was significantly decreased in all stages except the fourth stage,while the level of MDA was increased in all the stages,and reached its peak in the second stage. There was a negative cor-relation between SOD and MDA. Conclusion The data suggested oxygen free radicals may be a main mechanism of para-site killing.

AIM: To investigate whether three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) can be used as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease before stent implantation. METHODS: Thirty-three patients with suspected intracranial arterial stenosis received 3D TOF MRA and digital subtraction angiography (DSA) examinations in Chaoyang Hospital Affiliated to Capital Medical University between March 2007 and April 2008,and were included for this study. Two physicians blindly estimated stenosis,patient history,and clinical information of 363 vascular segments from 33 patients,including bilateral internal carotid artery (ICA),anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery,and basilar artery (BA). Stenosis was categorized as 30%-49%,50%-69%,70%-99%,and 100%. For each kind of stenosis,sensitivity,specificity,positive predictive value,negative predictive value,K and P values of MRA were calculated,respectively,as compared to DSA. RESULTS: A total of 42 diseased vascular segments were identified. Compared to DSA,for intracranial stenosis 50%-69%,3D TOF MRA showed sensitivity 100%,specificity 96.8%,positive predictive value 62.1%,negative predictive value 100%,K value 0.751,and P value 0.000; For intracranial stenosis 70%-99%,the corresponding value was 100%,98.6%,70.6%,100%,0.821,and 0.000,respectively; For intracranial stenosis 30%-49%,it was 25.0%,99.7%,66.7%,98.3%,0.356,and 0.000,respectively.CONCLUSION: For high sensitivity and specificity to intracranial stenosis 100%,70%-99%,or 50%-69%,compared to DSA,3D TOF MRA is a reliable screening tool for preoperational evaluation of intracranial vascular stenosis and occlusive disease.

Objective To discuss the treatment method and effect of the application of the dorsal branches island flaps of the digital arteries in clinic.Methods During January,2010 to February,2015,a total of 20 cases of palmar soft tissue defect of the 2nd-5th distal segments of single fingers were incorporated and repaired by the dorsal branches island flaps of the digital arteries in the base of the distal phalanx.The size of the selected flaps was 3.5 cm × 2.5 cm-2.0 cm × 2.0 cm.In addition,palmar soft tissue defect (n =15) of the 2nd-5th middle and distal segments of single fingers were repaired by the dorsal branches island flaps of the digital arteries at the 1/3 site of the proximal digital arteries,and the selected flaps size was 4.5 cm × 2.5 cm-3.0 cm × 2.0 cm.Full-thickness skin graft urethroplasty was used in the donor sites.Flap shape,texture,sensory recovery and texture of the skin region,function recovery of the wounded fingers were followed up at 1,3,and 6 months after operation.Results Thirty-five patients were followed up from 6 to 13 months (average of 7 months).All flaps survived completely in the incorporated 35 cases postoperatively.Flaps had satisfactory appearance,fine texture,and soft texture in the skin transplantation area.The postoperative improvement of sensory function was between S2 and S3,and the two-point discrimination was 10-15 mm.Assessment of the upper limb function using the standard issued by the Hand Surgery Society of Chinese Medical Association graded 23 cases as excellent,10 cases as good,and 2 cases as fair.Conclusion The dorsal branches island flaps of the digital arteries are characterized by easy dissection,reliable blood supply,and no major blood vessels needed to be sacrificed,which is an effective procedure for finger soft issue defect repairing.

Objective To construct Four in One informational teaching model based on cloud platforms, simulation training, nursing micro-lectures and multidimensional evaluation investigate, and to explore the effect of theFour in Oneinformational teaching model applied in Medical Nursing teaching. Methods Two classes students of 2014 were selected by randomized sampling and were divided into experiment group and control group, the experiment group operated the Four in One informational teaching mod, the control group operated regular teaching. After the experiment,using the medical nursing theory test, the skill test, the questionnaire survey to evaluate the teaching effectiveness. Results The theoretical examination score, skill examination score and overall results of experiment group were (78.81±6.44), (82.01±5.22), (80.41±6.32) points, while (71.12±8.12), (76.74±6.3), (75.57±5.51) points of control group, and the difference was statistically significant (t=5.47, 4.86, 3.22, P<0.01 or 0.05). The students' interested in the informational teaching model of the experimental group reached 78.72%(37/47) and learning satisfaction reached 91.48% (43/47). Conclusions The Four in One informational teaching model applied in Medical Nursing teaching can improve the study effect .

Objective To examine the pathological changes in the liver of an AIDS patient with complicated infection of Pneumocystis carinii(PC). \ Methods\ A liver biopsy was made. The tissue was stained with HE, PAS, Giemsa, GMS, and acid\|fast staining, and examined under light microscope and transmission electron microscope. \ Results\ Granulomas (acid\|fast negative) in the tissue and numerous pathogens (PAS positive) in hepatic sinusoids were detected. Giemsa and GMS staining and electron microscopy all confirmed that the pathogen was Pneumocystis carinii. \ Conclusion\ The pathological findings revealed a diffuse extrapulmonary infection of Pneumocystis carinii in the patient of AIDS.