Objective To observe the efficacy of Shuilongjian in treating cerebellar infarction, and compare with the pure western medicine. Methods 67 inpatients with cerebellar infarction enrolled were divided into two groups according to the method of random digits table, 36 cases in the treatment group and 31 cases in the control group. The control group was given 500 mL dextran by venoclysis, once a day. The treatment group was given Shuilongjian as an additional drug. The therapeutic effect was evaluated according to the nerve function and the total capability in dealing with daily activities. Result All the 67 cases of cerebellar infarction were included in the analysis. The effective rate of the treatment group was better than that of control group with 83.3% and 58.1% (P

During medical activity,there are theory and realism spring of that the right of emergency treatment is in conflict with the right of informed consent.Simply investigating responsibilities is of no avail to solve the conflicts.To Interpret the real reasons of the conflict through legal and ethical aspects.To avoid and reduce conflict,the effective measures are that perfecting the rules of relevant law,elucidating the rights and obligations of hospital and medical staff;regulating the contents of informed consent form and strengthening medical ethics education.

0 05), and the postoperative pain degree score was (2 0?0 7) points and (2 5?0 8) points respectively (t=-3 02, P

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

OBJECTIVE To find out fulminate epidemiological features of Stenotrophomonas maltophilia in ICU and the ways to prevent and treat this nosocomial infection.METHODS The case histories from 4 inpatients who developed S.maltophilia infection in the same ward from Feb 5 to 16,2006,were studied retrospectively to find out the reasons of its onset and its treatment based on the sputum culture results.RESULTS The fulminate S.maltophilia was found from the rail of the patient bed,the connection part of water container of 2 respiratory machines of exhalation valve assembly and the liquid of ultrasonic aeriation machine.CONCLUSIONS The infection is a localized one.The main reasons of the infection are unthorough disinfection of respiratory machine and the contamination of medical treatment environment.Whenever the infection is found in the ward,the thorough disinfection needs immediately,and no new patient admitted.

Eleven patients underwent acetabulum revision using modified anterolateral approach due to acetabulum loosening but femoral prosthesis in sound fixation following total hip arthroplasty in Department of Joint Surgery,Tianjin Hospital between August 2002 and February 2005. During the mean follow-up of 4.2 years,all 11 patients gained primary stable fixation and good function. One patient underwent another revision due to infection; one developed femoral prosthesis loosening and underwent femoral revision. X-ray of the other patients showed no loosening or dislocation or radiotransparent region surrounding the prosthesis. One patient developed lateral femoral cutaneous nerve injury and relieved 6 months later.

From February 2002 to May 2007,9 cases(9 hips) of periprosthetic fractures during the primary total hip arthroplasty for developmental dysplasia of the hip were selected,including 1 male and 8 females aged 52-69 years.In the primary total hip arthroplasty,femoral prosthesis with the same size as intramedullary reamer and acetabular prosthesis with 2 mm diameter larger than acetabular reamer were used.The pain,function,range of motion and degree of deformity were accessed using the Harris score.The patients were followed for 1-6 years.Among the 9 patients with periprosthetic fractures,4 acetabular fractures were stable which were treated by additional augmentation screws,and 1 fracture was unstable which was treated by structural bone grafting and additional screws.And there was one Vancouver type AG fracture which was treated by cerclage wire,3 Vancouver B1 fractures which were fixed by locking compression plate(LCP) or cerclage wire,and one Vancouver type C fracture which was also fixed by LCP.No component loosening or migration was found in the postoperative X-ray.The mean Harris score was 87.2 at the final follow-up.The results of the study show that during the primary total hip arthroplasty in patients with developmental dysplasia of the hip,the oversize of the acetabular component should be controlled to equal to or less than 2 mm.For patients with severe osteoporosis,acetabular components with the same size to reamer are recommended combined with additional screws,or cemented cup.When an acetebular fracture is found during total hip arthroplasty,we could use additional screws or bone grafting.Once a periprosthetic femoral fracture occurs during the operation,methods of fixation should be selected based on the type of the fracture and stability of the prosthesis.

Objective To evaluate the effect of health education on the old male patients with primary hypertension.Methods 120 old male patients with primary hypertension were randomly selected from the whole group and educated with health knowledge related to blood hypertension, and the changes of life style and blood pressure after health education were recorded.Results Most of the patients changed their unhealthy life style. Among these patients, more than 80% were able to have a stable emotion, regular daily life, stop smoking and less drinking, there were 66% cases with a healthy diet. The systolic pressure of the patients declined significantly after health education (P<0.01).Conclusion The health education is an efficient way to control hypertension in the official-service outpatient department.

Blood lipid level and its associations with insulin resistance were studied in patients with impaired glucose tolerance (IGT).Two hundred and twenty first degree relatives of type 2 diabetes mellitus were grouped into normal glucose tolerance (NGT) and IGT groups according to results of oral glucose tolerance test.Compared with the NGT group,the IGT patients had higher serum levels of total triglyceride (TG),total cholesterol (TC),low density lipoprotein-C (LDL-C) but a lower serum level of high density lipoprotein-C (HDL-C).Homeostasis model of assessment for insulin resistance index (HOMA-IR) and area under curve of insulin (AUCI) also increased.A positive relationship was found between TG and HOMA-IR (or AUCI),but a negative relationship existed between HDL-C and HOMA-IR.In conclusion,abnormal blood lipid metabolism is present in IGT patients and it has a close correlation with insulin resistance.

Objective To construct bispecific antibody BsAb1/17 against both IL-1β and IL-17A,express and purify the biologically active BsAbl/17 protein in prokaryotic system for further studies and applications. Methods VH1VL17-CL and VL1VH17-CH1 gene segments were constructed by overlap-PCR.Restriction enzyme sites Nco Ⅰ and BamH Ⅰ were designed at the 5'and 3' end primers respectively. The products of overlap-PCR were ligated to the Nco Ⅰ/BamH Ⅰ -prepared pET-27b vector. The recombinant plasmids pET-27b-VH1 VL17-CL(petA) and pET-27b-VL1 VH17-CH1 ( petB ) were transformed into E. coliRosetta separately. The expressing products were analyzed by SDS-PAGE and Western blot. Neutralization activity of the bispecific antibody for blocking the induction of IL-18 expression by IL-1β in human T cells was determined by real-time PCR. Neutralization activity of the bispecific antibody for blocking the induction of IL-6 expression by IL-17A in HeLa cells was determined by ELISA assay. Results The structure of the plasmids pET-27b-VH1 VL17-CL(petA) and pET-27b-VL1 VH17-CH1 (petB)was confirmed by DNA sequencing. After induction, the fusion proteins were expressed mainly as inclusion bodies. The purity of the both proteins exceeded 90%. SDS-PAGE analysis suggests the relative molecular mass of both products expressed by petA and petB were approximately 38× 103, which is in accordance with the theoretical value. The results of Western blot and ELISA test demonstrated that BsAb1/17 molecule had binding ability to both IL-1β and IL-17A. The BsAb1/17 could block IL-1β to stimulate human T cell to express IL-18 and block IL-17A to stimulate HeLa cell to express IL-6. Conclusion We successfully constructed a novel bispecific antibody BsAb1/17 against both IL-1 β and IL-17A, and expressed biologically active BsAb1/17 protein in prokaryotic system.