OBJECTIVE:To observe the effect of ulinastatin on related parameters of patients with successful cardiopulmonary resuscitation (CRP) after cardiac arrest but concurrent post-resuscitation syndrome (PRS). METHODS:76 patients with successful CRP after cardiac arrest and PRS were randomly divided into test group and control group. Control group was given conventional treatment;test group was additionally given ulinastatin 200 000 U adding into 0.9% Sodium chloride injection 20 ml by intrave-nous injection,every 12 h. The treatment course was 7 d for 2 groups. The myocardial enzyme parameters (m-AST,HDBH and CK-MB)in ROSC immediately,24 h,48 h and 72 h,renal function parameters(Cr,BUN);predictors of disease(ALB and Lac) and incidence of adverse reactions and survival rate in 2 groups were observed. RESULTS:All above-mentioned parameters in 2 groups showed flutuations in ROSC immediately,and test group was better than control group,the differences were statistically sig-nificant(P<0.05);patients with adverse reactions in test group were significantly less than control group,survival rate was signifi-cantly higher than control group,the differences were statistically significant(P<0.05). CONCLUSIONS:Ulinastatin can effective-ly control the inflammatory response factor of PRS patients,improve parameters of critical illness and survival rate.

Objective To compare the autoantibody detection and enzyme linked immunosorbent assay of protein chip in the diagnosis of rheumatoid arthritis (RA).Methods 81 cases of RA were given autoantibodies protein chip and enzyme linked immunosorbent assay(ELISA),the project included rheumatoid factor(RF)and anti cyclic citrullinated peptide antibody(Anti -CCP),anti nuclear factor(APF),anti keratin antibody(AKA)and anti-nuclear antibody(ANA),recorded the test results,time and cost,the income data were statistically analyzed.Results Patients with RA autoantibody protein chip for detection of CCP,AKA,RF,APF,ANA positive rates were 93.83%, 92.59%,90.12%,95.06%,92.59%,ELISA for the detection of CCP,AKA,RF,APF and ANA positive rates were 95.06%,91.36%,92.59%,91.36%,93.83%,two detection methods had no significant differences(χ2 =1.908, 1.345,1.764,2.246,1.102,all P >0.05);autoantibody detection protein chip required time and cost were respec-tively (1.33 ±0.19)h,(151.24 ±29.83)yuan,which were significantly less than the detection of ELISA (6.81 ± 1.24)h,(899.67 ±121.35)yuan,the differences were statistically significant(t =7.989,8.235,all P <0.05 ). Conclusion The detection of antibody protein chip for RA diagnosis with high accuracy,short time,less cost,help the doctor to diagnose the disease quickly obtain test results.

Objective To investigate the differences in the clinical application of the etiological subtypes of ischemic stroke according to the TOAST,ASCO and CISS criteria.Methods A total of 167 consecutive patients with fist-ever ischemic stroke were enrolled in the study.They were classified with the TOAST,ASCO and CISS criteria,respectively.The differences and consistency of subtype diagnosis of each etiology were compared.Results Compared with TOAST,ASCO grade 1 significantly increased the proportion of patients in a large atherosclerosis group (23.4％ vs.19.8％ ;x2 =4.167,P =0.031) and decreased that in a small vessel disease group (32.9％ vs.38.3％ ; x2 =4.923,P =0.022); similarly,CISS also significantly increased the proportion of patients in the large atherosclerosis group (37.1％ vs.19.8％ ;x2 =27.034,P ＜0.001)and decreased that in the small vessel disease group (19.2％ vs.38.3％;x2=25.289,P ＜ 0.001).However,ASCO grade 1 (34.1％ vs.28.1％;x2 =3.682,P=0.052) and CISS (32.9％ vs.28.1％;x2 =0.880,P =0.268) did not decrease the proportion of patients in a cryptogenic group.The consistency of the 3 typing methods was between moderate (other etiology group of TOAST/ASCO-1,κ =0.434) and excellent (cardioembolism group of TOAST/ASCO-1,κ =0.967).Conclusions Both ASCO-1 or CISS typing may not decrease the proportion of the patients with the subtype of cryptogenic stroke,but the consistency among all the subtypes was better.The design and characteristics of the diagnostic criteria in all subtypes with the 3 criteria should be considered in clinical practice.

Etiologic classification of ischemic stroke is the basis for epidemiological investigation, risk factor screening developing individualized treatment plan and prognostic measures. The etiologic classifications, such as TOAST, CCS, and ASCO, are more generally accepted methods at present. This article reviews the advantages and disadvantages from the diagnostic criteria and clinical application.

The study of tumors' proteomics is a research hotspot in China and abroad in recent years.The development of theory and technology in proteomics has provided new ideas and research field for cancer research.This paper reviewed the commonly used technical means of proteomics and its research progress on diagnosis,therapy and other aspects of pancreatic carcinoma.

Objective:To evaluate MRI manifesattions of intradural metastases of medulloblastomas.Methods:The clinical data and MRI of 6 cases with intradural metastasis of medulloblastomas were reviewed retrospectively.Results:21 masses were found in 6 cases,mostly in lumbar segment.Most of them were oblong or fusiform shagped.The size averaged 1.8 cm?2.3 cm.They had the similar signal intensity with those in brain,but hemorrhage,cyst and calcification were less common.Conclusion:MRI plays an importment role in diagnosis of intradural metastases of medulloblastomas. [

OBJECTIVE:To establish an HPLC method for the determination of Icariine in Qianlietong tablets.METHODS:Hypersil ODS(200 mm?4.6 mm,5 ?m) column was used for the HPLC determination,and the mobile phase consisted of acetonitrile-water(30∶70) at a flow rate of 1.0 mL?min-1.The detection wavelength was 270 nm.RESULTS:Icariine has good linear relationship in the range of 0.050 6～0.506 0 ?g(r=0.999 9).The average recovery was 102.67%(RSD=0.99%,n=6).CONCLUSION:The established method is simple,reproducible,specific and suitable for the quality control of Qianlietong tablets.

Objective To observe the application of alkaline cleaning agent in disinfection and supply room cleaning of medical devices, to evaluate the cleaning quality. Methods The 800 contaminated medical instruments collected from February 2016 to February 2017 in municipal maternal and child health hospital were divided into control group (February 2016 to August 2016) and study group (September 2016 to March 2017 ) according to different time periods,with 400 pieces in each group.In the reference group, the instrument was washed with multienzyme detergent, and the study group was cleaned with alkaline detergent. The cleaning of 2 groups of instruments was observed and compared. Results The total excellent and good rate of instrument cleaning in the study group was 97.25％ (389/400), in the reference group was 89.50％(358/400), the difference between the two groups was statistically significant (P<0.05); the cleaning safety, practicality, economy, comprehensive score difference of the study group was significantly better than the reference group (P<0.05). Conclusion The effect of alkaline cleaning agent used in disinfection supply room cleaning medical instruments is remarkable, and the equipment residue and microorganism can be effectively eliminated, and the utility model has the advantages of high safety and low economic cost, and has the important practical value.

Objective To investigate the value of transcatheter arterial embolization in the treatment of obstinate nosebleeding. Methods Twenty patients with obstinate nosebleed failed with conventional therapy were performed internal maxillary arterial angiography. Transcatheter arterial embolization were carried out immediately after occurance of nosebleeding. PVA or gelfoam particles were injected into the bleeding arteries under fluoroscopy control. Nasal packing was removed to see whether bleeding was stopped. Results Active bleeding occurred in all 20 patients during angiography but was stopped in all patients after embolization without severe complications. Conclusions Transcatheter arterial embolization is an useful mini-invasive method in the treatment of obstinate nosebleeding.

Rare diseases, also known as "orphan diseases", refer to diseases with very low incidence. Countries and regions define rare diseases according to epidemiological standards, economic standards of rare drugs and disease severity. The World Health Organization (WHO) has suggested the prevalence rate of less than 6.5 to 10 per 10 000 people to define rare diseases. In May 2018, "China's First List of Rare Diseases" was released, including 121 rare diseases. Most rare diseases are hereditary diseases with early onset, severe disease, and poor prognosis. About 75% of rare genetic diseases occur in the neonatal period or childhood, which are important part of human birth defects and brings a huge burden to society and families. The effective prevention and treatment of rare diseases is one of the important goals of building a "Healthy China". With the development of molecular biology technology and the continuous research and development of advanced medical products in the field of gene therapy, the level of clinical diagnosis and treatment of rare diseases has risen to a new level, which provides a possibility for the cure of some rare diseases. In China, most rare diseases rely on imported drugs, which cost a lot and bring heavy economic burden to patients. Improving the medical insurance system for rare diseases has become a difficult point in the current medical reform. This paper mainly discusses the definition of rare diseases, the research status, efforts and future development direction of rare diseases in China, in order to deepen the understanding and response of medical workers and the whole society to rare diseases.