Objective To analyse subtyping of iscbemic stroke by the criteria of Trial of Org 10 172 in Acute Stroke Treatment (TOAST), its distribution, and relationship between TOAST subtypes, its risk factors and recurrence. Methods Clinical data of 441 patients of ischemic stroke were collected prospectively during October 1, 2006 to September 30, 2007. All the patients were classified by TOAST criteria into five major subtypes and followed-up for one year since its first episode. Dates of its recurrence and death due to recurrence were recorded. Results All the 441 patients with ischemic stroke could be subtyped etiologically according to TOAST criteria as follows: etiology undetermined in 42.3 percent, small-vessel occlusion in 30.9 percent, large-artery atherosclerosis in 17.3 percent, cardioembolism in 9.3 percent, and others in 0.2 percent, without statistically significant difference in its gender and age distributions. Recurrence rate of iscbemic stroke in one year since its first episode for varied subtypes was 33.3 percent for cardioembolism, 14. 6 percent for etiology undetermined, 13.7 percent for large-artery atherosclerosis and 6.9 percent for small-vessel occlusion, respectively. There was no significant difference in risk factors for varied subtypes of iscbemic stroke, including history of smoking, hypertension, diabetes, cardiac disease, and serum levels of total cholesterol, low-density lipoprotein cholesterol, fihrinogen and glucose. Conclusions Varied subtypes of iscbemic stroke had different risk factors and recurrence rate by TOAST criteria, which can be used as an etiologic classification for its secondary prevention.

ObjectiveTo explore the application of evidence-based nursing in ulcer pressure prevention of patients in cardiovascular surgery department and effect evaluation. MethodsEvidence-based nursing was applied to 342 patients in our department from January 2008 to October 2010,and the nursing effect was evaluated. ResultsNon of the 342 patients suffered ulcer pressure,the course of disease was shortened and the treatment effect was increased. ConclusionsApplication of evidence- based nursing in cardiovascular surgery patients can significantly reduce the occurrence of pressure ulcers,greatly improve the patients' quality of life,and also can increase the observation,analysis and problem solving ability of nursing staff.

Objective To observe the effect of parecoxib united with local anaesthesia analgesia system on analgesia after radical resection of liver cancer. Methods Ninety patients undergoing elective radical resection of liver cancer were randomly assigned to three groups, with 30 patients in each group. The patients in parecoxib group (P group) received parecoxib 40 mg through vein before the end of operation for 30 min, and were injected parecoxib 40 mg at 12 h, 24 h and 46 h after operation. The patients in local anethsia analgesia system group (L group) received embedding hypodermic pervasion canal in incision subcutaneously, then connected the pump with 0.25% ropivacaine 250 ml, with infusion speed of 4 ml/h.The patients in united group(U group)receiced the same methods with those in P group and L group. When the patients'visual analogue scale (VAS) scores were higher than 5 scores, they were given muscle injection of pethidine 50 mg. The VAS scores and Ramsay sedation scores at the time of tracheal extubation (T0), postoperative 2 h(T1), 6 h(T2), 12 h(T3), 24 h(T4) and 48 h(T5), the adverse reaction rate, dosage of pethidine, and analgesia satisfaction were compared. Results The resting and movement of VAS scores and Ramsay sedation scores at each time in P group and L group had no significant difference (P>0.05). The resting and movement of VAS scores and Ramsay sedation scores at each time in U group were significantly better than those in P group and L group (P<0.05). The rate of nausea and vomiting in three groups had no significant difference among three groups (P > 0.05). The rate of drowsiness in U group was significantly lower than that in P group and L group:6.67%(2/30) vs. 26.67%(8/30) and 23.33%(7/30), P < 0.05. The analgesia satisfaction in U group was significantly higher than that in P group and L group:93.33%(28/30) vs. 56.67%(17/30) and 53.33%(16/30), P<0.05. Conclusions The analgesia effect of the parecoxib united with local anaesthesia analgesia system for radical resection of liver cancer is perfect.

Objective To study the effect,safety and quality of life of different operation opportunity on the patients with ureteral calculi after extracorporeal shock wave lithotripsy.Methods From July 2015 to September 2016,45 patients with ureteral calculi who received lithotomy after 2 times of extracorporeal shock wave lithotripsy (ESWL) in our hospital were selected as observation group.Another 45 cases who received more than 3 times of ESWL and turend to lithotomy at the same period were selected as control group.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 95.56％ (43/45),which was significantly higher than 71.11％ (32/45) of the control group,the difference was statistically significant (χ2=9.680;P=0.002).The incidence rates of obstruction(17.78％),infection (26.67％) and hydronephrosis (24.44％) in the observation group were significantly lower than those in the control group (42.22％,64.44％ and 60.00％),the differences were statistically significant (χ2=6.402,12.947,11.660;P=0.011,0.000,0.001).The scores of diet [(83.2±12.6)points],spirit[(85.6±13.3)points],sleep[(87.3±15.4)points] and psychological score[(85.9±13.6)points] in the observation group were significantly higher than those of the control group [(75.1±11.4)points,(76.2±11.6)points,(77.4±13.2)points and (73.2±10.7)points],the differences were statistically significant (t=3.003,4.038,3.514,4.513;P=0.004,0.000,0.001,0.000).The satisfaction rate of patients(97.78％) of the observation group was significantly higher than 77.78％ of the control group,the difference was statistically significant (χ2=8.389;P=0.004).Conclusion Patients with ureteral calculi who received more than 2 times of ESWLand the stones in the body has not been effectively removed,should be accepted as soon as possible stone surgery treatment,it can improve the clinical effect,reduce the incidence of complications,improve the quality of life of patients.

Objective To assess the feasibility of applying intensity-modulated radiotherapy(IMRT)simultaneous integrated boost(SIB)to replace conventional radiotherapy(CR)plus brachytherapy of whole pelvis in locally advanced cervical eaneer(LACC).Methods Five LACC patients based difference position of uterus were chosen and worked out CR and IMRT SIB plans respectively.Dose distributions were compared between IMRT SIB and CR.Results When uterus was in ante-,neutral-,retro-pnsition and deviation respectively,IMRT SIB could provide enough and homogeneous dose distribution for target volume and reduce irradiated volumes and doses for organs at risk(recta,bladder and small intestine)than CR.The doses of the A,B,and fundus of uterus were higher in IMRT SIB than CR.However,in ease of small intestine was close to or encircled the uterus,the targets volume dose would be inadequacy.Conclusions LACC IMRT SIB's dose distribution is better than CR(except excess ante-position)and may help to treat those patients who couldn't be suitable with brachytherapy.

Objective To study the characteristics of liver function damage in brucellosis and provide theoretical basis for clinical treatment.Methods One hundred and thirty-six hospitalized patients with brucellosis from Endemic Disease Prevention and Control Center of Wulanchabu City from January 2011 to October 2012 were selected randomly as the research subjects.Parameters of Alanine transaminase (ALT),Aspartate transaminase (AST),Alkaline phosphatase (ALP),Gamma glutamyltransferase (γ-GT),Total protein (TP),Albumin (ALB),Albumin/globulin (A/G),total bilirubin (TBIL) and Direct bilirubin (DBIL) were determined.The means of liver function parameters with mid-value of all the reference ranges were compared by one sample t test;Parameters of liver function were analyzed in 70 acute and 66 chronic brucellosis by two independent-samples t test.Results The means of ALT,AST,ALP,γ-GT,TP,ALB,TBIL and DBIL ((x):36.18,28.20,95.87,29.29 U/L,65.08,40.84 g/ L and 19.76,5.86 μmol/L) in the 136 samples of brucellosis serum were significantly different from the medians of their reference ranges ((x):20.50,18.50,85.00,24.50 U/L,69.00,43.50 g/L and 11.80,3.40 μ mol/L,t =9.46,9.19,4.55,2.22,-2.71,-4.99,5.58,11.32,all P ＜ 0.05);A/G was not significantly different ((x):2.14,2.00;t =0.94,P ＞ 0.05);Parameters of liver function were not significantly different between acute and chronic brucellosis (all P ＞ 0.05).Conclusions This study confirmed that the liver function of the 136 patients with brucellosis is impaired.The level of the liver function impairment is usually mild and moderate and no difference in acute and chronic brucellosis is found.

Objective To assess the clinical efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS) in the treatment of adenomyosis. Methods Forty-two patients with adenomyosis diagnosed by clinical symptoms, MRI, laparoscopy and/or chromatic colour type-B ultrasound were treated with LNG-IUS, and the menstrual blood volume, severity of dysmenorrhea and uterine volume were observed three months later. Results After 3 month treatment of LNG-IUS, the menstrual blood volume reduced significantly to (27?11)% of that before treatment. The uterine volume was decreased from (143?33) cm 3 to (115?22) cm 3( P

Objective To investigate the risk factors of postoperative infection in patients with liver transplantation.Methods Clinical data and laboratory findings of 1 1 3 patients undergoing liver transplantation admitted in Beijing Chaoyang Hospital,Capital Medical University during January 201 1 and December 201 4 were retrospectively analyzed.Among 1 1 3 patients,postoperative infection occurred in 35 patients,multivariate Logistic regression analysis was performed to identify the risk factors of postoperative infection.Results Univariate analysis showed that length of hospital stay,model for end-stage liver disease (MELD)score,preoperative use of antibiotics,duration of postoperative respirator use,length of ICU stay, dosage of albumin,days of parenteral nutrition,intra-abdominal hemorrhage,fasting blood glucose,blood concentration of immunosuppressant (FK506 ),the duration of prophylactic use of antibiotics and pleural effusion were associated with postoperative infection (t =2.56,3.1 9,2.71 and 5.05;χ2 =3.87,5.75,4.66 and 5.46;Z =4.88,3.69,5.86 and 3.90;P <0.05 or <0.01 ).Multivariable logistic regression analysis showed that preoperative use of antibiotics (OR =35.03,95% CI:6.48 -94.64,P <0.01 ),duration of postoperative respirator use (OR =1 .02,95%CI:1 .01 -1 .04,P <0.01 ),days of parenteral nutrition (OR =1 .20,95%CI:1 .07 -1 .35,P <0.01 ),postoperative fasting plasma glucose(OR =1 .46,95%CI:1 .1 0 -2.1 6,P <0.05),the duration of prophylactic antibiotics use (OR =1 .1 0,95%CI:1 .33 -1 .86, P <0.05),and pleural effusion(OR =5.70,95%CI:1 .02 -31 .84,P <0.05 )were independent risk factors of postoperative infection.Conclusion Taken account of possible risk factors,effective prevention and control measures should be taken to prevent postoperative infection after liver transplantation.

Objective:To investigate the effect of Xanthium mongolicum Kitag. ethanol extract (EXM) on airway inflammation induced by house dust mite (HDM) in mice with allergic asthma, and to explore the possible mechanism. Methods:The mice were randomly divided into blank group, model group, positive control group and low, medium and high dose groups, with 6 mice in each group. The low, medium and high dose groups were intragastrically administered with 100, 200 and 400 mg/kg of EXM, and the positive control group was given 1.56 mg/kg salbutamol solution. Mice in the blank group and the model group were intragastrically administered with equal volume of solvent, once a day for 8 consecutive days. Except the blank group, the other groups were sensitized with HDM on the 3rd, 4th and 5th days after administration to establish asthma models. After administration, the number of eosinophils (EOS), total cells and various kinds of cells (neutrophils, macrophages, lymphocytes and EOS) in bronchial irrigation fluid (BALF) of mice were observed. The levels of serum IgE and inflammatory factors (IL-4, IL-5, IL-10 and IL-13) in BALF and lung tissue were measured by enzyme-linked immunosorbent assay (ELISA). Pathological and inflammatory changes of bronchial smooth muscle in mice were observed by HE and PAS.Results:Compared with the model group, the number of EOS significantly decreased ( P<0.01 or P<0.05), the total cells count, macrophages, neutrophils, lymphocytes and EOS in BALF significantly decreased ( P<0.01), the content of IL-4 (142.59 ± 16.51 ng/L, 70.47 ± 20.63 ng/L vs. 212.18 ± 58.51 ng/L), IL-5 (57.49 ± 5.49 ng/L, 47.47 ± 6.30 ng/L vs. 72.65 ± 19.11 ng/L), IL-10 (98.51 ± 18.31 ng/L, 71.85 ± 9.15 ng/L vs. 120.16 ± 23.35 ng/L), IL-13 (85.81 ± 23.66 ng/L, 39.99 ± 17.37 ng/L vs. 149.07 ± 33.19 ng/L) in BALF significantly decreased ( P<0.05), and the content of IL-4 (154.55 ± 25.70 ng/L, 143.30 ± 22.19 ng/L vs. 214.68 ± 31.95 ng/L), IL-5 (87.49 ± 5.95 ng/L, 61.84 ± 8.14 ng/L vs. 97.65 ± 12.10 ng/L), IL-10 (91.28 ± 18.69 ng/L, 62.04 ± 9.39 ng/L vs. 117.80 ± 20.72 ng/L), IL-13 (196.48 ± 15.90 ng/L, 132.02 ± 6.86 ng/L vs. 238.42 ± 28.41 ng/L) in lung homogenate significantly decreased ( P<0.05), the serum IgE level in the high dose group significantly increased ( P<0.05). Conclusion:The Xanthium mongolicum Kitag. can inhibit allergic asthma induced by HDM, which may be through inhibiting the secretion of inflammatory cytokines by pulmonary macrophages.

Objective To evaluate the quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery under etomidate?based anesthesia. Methods Thirty patients of both sexes, aged 13-32 yr, weighing 40-65 kg, of ASA physical statusⅠorⅡ, undergoing elective scoliosis correction surgery, were randomly assigned into etomidate group ( group E, n=15 ) or propofol group (group P, n=15) using a random number table. Anesthesia was induced with etomid 0.3 mg∕kg (group E) or propofol 2mg∕kg ( group P ) injected intravenously, midazolam, fentanyl and rocuronium. The patients were mechanically ventilated after naso?tracheal intubation. Etomidate 0.6-1. 2 mg · kg-1 · h-1 and propofol 8- 10 mg·kg-1 ·h-1 were infused intravenously during surgery in E and P groups, respectively. Both remifentanil and cisatracurium were used for maintenance of anesthesia in the two groups. Cisatracurium infusion was stopped before wake?up test. The infusion rate of propofol was adjusted to 4 mg·kg-1 ·h-1 at 15 min before wake?up test. After the scoliotic angle was corrected, infusion of etomidate and propofol was stopped, and the infusion rate of remifentanil was adjusted to 0.025μg·kg-1 ·min-1 in both groups. The wake?up time was recorded, and the quality of wake?up was assessed. Mean arterial pressure (MAP) and heart rate were recorded before anesthesia ( T0 ) , immediately before the patients were awakened ( T1 ) , when the patients responded to commands from doctors ( T2 ) , and after anesthesia was deepened ( T3 ) . At T0 , the end of surgery ( T4 ) , and 24 h after surgery ( T5 ) , blood samples were collected from the internal jugular vein for determination of plasma cortisol concentrations. Results The patients were awakened successfully in the two groups, and there were no significant differences in the wake?up time, quality of wake?up, and MAP, HR and plasma cortisol concentrations at each time point between the two groups. MAP and HR were significantly higher at T2 than at T0 in the two groups. MAP and HR were within the normal range during wake?up test, and no patients developed severer cardiovascular events in the two groups. Conclusion Etomidate?based anesthesia provides better quality of intraoperative wake?up test in the patients undergoing scoliosis correction surgery, which is similar to that of propofol?based anesthesia.