Objective To explore the effectiveness of transcranial magnetic stimulation (TMS) combined with hyperbaric oxygen (HBO) in treating cerebral infarction.Methods Totally 120 patients with cerebral infarction were randomly divided into a control group,a treatment group A and a treatment group B,40 cases in each group.The control group was given conventional treatment,the treatment group A was treated by HBO on the basis of conventional therapy,and the treatment group B was treated by HBO combined with TMS,10 d for a period of treatment.Before and after 2 courses of treatment,all patients' neurological defect was evaluated using National Institutes of Health Stroke Scale (NIHSS).Their central motor conduction time (CMCT) and the expression of brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were also assessed.Results After treatment,the average NIHSS score and effective rate of the treatment group B was (7.35 ± 1.98) and 92.5％ respectively,significantly better than the other two groups.Moreover,the average BDNF content [(4.96 ± 1.20) ng/ml] and NGF content [(152.36 ± 18.01)pg/ml] of the treatment group B after treatment were significantly better than before treatment,and those of the other two groups after treatment.Conclusion TMS combined with HBO is effective in treating cerebral infarction.This may relate to its strengthening the expression of neurotropic factors.

The subjects examined were 398athletes. The method used included both questions and clinical examination. The differences of the data obtained all underwent Chi Square (X~2) test. Result of the investigation showed: the site of the highest incidence of injury was the ankle, 38.4%; the nextwas the knee, 26. 1%; the foot, 15. 3%; low back, 10. 3%; the thigh, 6. 8%; Tendo Achilles, 6. 5%; tibia, 4. 5%and fibula, 2. 3%. The incidence was relatively higher wbenever the injury had any relation with the shape ofthe knee (genu valgum, genu recurvatum), hallux Yalgus, c avus and callus and tarsal navicular. The differencesamong incidences of injury related with the shape of the lower limbs are of important statistical significance.As for the incidence of abnormal shape of limbs, genu valgum and recurvatum are outstanding in female wbilegenu varum occurs much more in male. This article is emphasized on the analysis of the mechanism of the influence of limb shape on injury;and it is thought that it is mainly due to changes in the line of force. In the authors' opinion, in the choiceof high level athletes, those who have such abnormal anatomy of their limbs should not be selected.

Objective To evaluate the clinical effect and safety of umbilical cord ligation in the fetocide of complicated monochorionic multiple gestations.Methods From January 2009 to December 2012,clinical data of 18 women with complicated monochorionic multiple gestations who experienced intrauterine percutaneous umbilical cord ligation in Peking University Third Hospital were collected.Among the patients,6 were selective intrauterine growth restriction (1 with type Ⅰ,4 with type Ⅱ,1 with type Ⅲ) ; 4 were acrania or hydropic twins; 4 were aeardiac twins,2 were complicated triplet gestation; 1 was twin-twin transfusion syndrome with right ventricular dysplasia and 1 was monochorionic diamniotic (MCDA) with caesarean section history.The procedure was performed under both endoscopic and sonographic guidance.The gestational age at the time of the procedure were 17-27 +6 weeks.The procedure and perinatal outcome were analyzed.Results (1) The procedure was performed successfully in all the 18 cases.The average duration of the procedure was 63 min (24-156 min).The blood loss was 7.6 ml (5-20 ml).The mean gestational age at the time of the procedure was 20 weeks (17-27 +6 weeks).The average birth weight of the neonates was 2441 g(1000-3400 g).(2) There were 20 fetuses survived.Two fetuses had cardiac anomalies and were terminated in the following 2-3 weeks.Intrauterus fetal demise occured in 3 twin reverse arterial perfusion syndrome (TRAP) cases 3-14 weeks after the procedure.1 case delivered as early preterm birth at 28 weeks and the neonate died of respiratory distress syndrome (RDS) and hypoxie-ischemicencephalopathy (HIE).Fourteen neonates were in healthy and normal development by 3-51 months' followup.(3) Fourteen cases delivered at more than 28 weeks (28-38 weeks,averagely 33 + 1 weeks).The gestational weeks were prolonged by 5-21 weeks (averagely 13 +4 weeks).Among them,3 case were early preterm birth (28-33 weeks) and 3 were late preterm birth (34-36 weeks).Conclusion Percutaneous umbilical cord ligation is a reliable technique for the fetocide of complicated monochrionic mutilple gestations,especially for monochronic monoamniotie pregnancies.

Objective To investigate the safety and effectiveness of transurethral bipolar plasmakinefic resection in treating urethral stricture. Methods Totally 46 patients with urethral stricture were treated with transurethral bipolar plasmakinetic resection, and they were followed up for 3～12 months to observe the clinical effects. Results The segments of urethral scar were accurately incised and resected in all the 46 cases,24～26F bougies could pass through the urethra smoothly, and miction should be kept unobstructed. Totally 41 cases were followed up postoperatively, the maximal flow rate(Qmax) was ( 18.6±4.1 ) ml/s, which was obviously ameliorated as compared with that before operation(t=14.25, P＜0.05);sexual function had no obvious changes before and after operation;no serious complications of urethral massive bleeding, urinary incontinence, fistula of urethral diverticulum,urethral perforation, rectal injury, etc. was observed. Conclusion Transurethral bipolar plasmakinetic resection is an effective method for treating urethral stricture, because it has fewer complications, faster postoperative recovery and lower recurrence.

Objective To observe the effects and the mechanism of the thoracic pressure variation on the velocity of tricuspid regurgitation in quiet respiration, to accurately estimate the pulmonary artery systolic pressure,and to verify the new proposed mechanism of respiration effects on hemodynamics using echocardiography. Methods Continuous-wave Doppler spectra of tricuspid regurgitation were recorded with Sequoia 512 in 50 patients who had stable tricuspid regurgitation. Electrocardiogram and respiratory tracing were recorded simultaneously. The velocities and the pressure gradients were recorded during different respiration phases for analyzing. Results Respiration reliably affected on tricuspid regurgitant velocity. There were three patterns of manifestation:①The velocity increased in the inspiratory phase. ②The velocity decreased in the inspiratory phase. ③The velocity changed randomly. Conclusions Thoracic pressure variations had definite effects on the velocity of tricuspid regurgitation and tricuspid gradient. This research indicated that to obtain accurate and reliable Doppler echocardiographic measurement of the pulmonary artery systolic pressure, the measurement should be at the time between inspiration and expiration.

Informationization teaching resources contain a large number of information so rea-sonable and effective application of the resources is of great significance to the teaching. The article tries to explore and work out some teaching strategies for effective application of informationization teaching resources through action research combined with literature research , questionnaire survey method , interview and other methods. The research process: the original teaching strategies of infor-mationization teaching resources were implemented , implicated and verified in the first round action research; the problems in the first round were summarized and analyzed and the original teaching strategies were adjusted and optimized in the next round action research; finally, the teaching effec-tiveness between the two rounds action research was evaluated and analyzed by the “classroom teach-ing effectiveness criteria based on the use of information technology teaching resources”. The results show that effective application of informationization teaching resources is of great help to the teaching effect. It can enhance the learners' interest in learning and improve their academic performance. Ap-propriate and rational teaching strategy should be provided flexibly according to the learning back-ground and characteristics of students as well as learning contents.

Objective To detect the virucidal efficacy of cross linked starch iodine (CSI) and its influence factors in solution and to observe the morphological changes of CSI after disinfection. Methods Sindbis virus (Sindbis) and poliovirus (polio) were used as the test viruses, and different concentrations of plasm as the organic solvent. The virucidal efficacy of CSI was observed by means of cell infection test. The morphological changes of CSI particles after disinfection were observed by scanning electron microscopy. Results CSI had the same virucidal effect on Sindbis and polio viruses in solution. After treatment with CSI at a dose of 50-100 mg/ml for 30-60 min, the viruses were inactivated by 5-7 logs TCID 50 . The virucidal efficacy of CSI enhanced in dose and time dependent manners. CSI could inactivate the viruses in D hanks solution with 10% plasma or in plasma by 2-5 logs TCID 50 and 2-3 logs TCID 50 , respectively. Electron microscopy showed that the CSI was in the form of round and oval particles with the diameter of about 100 ?m. After disinfection, the particle surface became more lubricious, but no morphological changes were observed. Conclusion CSI has effective virucidal effect on envelope viruses and non envelope viruses in solution free of organic substances, but the virucidal efficacy can be greatly affected by organic substances. There is no morphological change of CSI particles after disinfection.

0.05),but the contraction of the bronchial rings caused by histamine,potassium chloride,intracellular Ca2+ release and extracellular Ca2+ influx was signifi cantly inhibited by Shenmai injection(compare with those of control,P

Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".
Computer Systems ; Information Dissemination ; Medical Informatics ; Software

Objective To compare selective coverage and chimney technology of the left subclavian artery (LSA) in thoracic endovascular aortic repair (TEVAR).Methods Eighty-one cases were retrospectively reviewed from January 2005 to January 2013 with two different management of the LSA during TEVAR:selective coverage (SC) vs chimney (C).Technical success rates,operating time,endoleaks,and perioperative cerebrovascular accidents,spinal cord ischemia (SCI),left arm ischemic symptoms and mortality were analyzed.The survival rate was also evaluated.Statistical analysis was performed using the x2 test,t-test and Kaplan-Meier survival curve.Results There were 37 patients in group SC and 34 in group C.Operating time was (61 ± 22) min for SC,and (101 ± 20) min for C (P =0.000) ; left arm ischemic symptoms occurred in 23.4％ in group SC,and 2.9％ in group C (P =0.011).Technical success rates were 100％ and SCI were 0 for both SC and C.Endoleaks,perioperative cerebrovascular accidents,and mortality were similar between the two groups.Conclusions During TEVAR,selective coverage of the left subclavian artery is safe,effective; meanwhile,chimney technology is safe,effective for patients whose left subclavian arteries need revascularization.