Objective To determine the occurrence and baseline predictive factors of early neurological deterioration ( END) among mild ischemic stroke patients.Methods Mild ischemic stroke patients admitted in the hospital were prospectively enrolled.Univariate and multivariate Logistic recession analyses were used to analyze the demographic data, risk factors of ischemic stroke, clinical, brain imaging and laboratory data.Risk factors of END were identified.Results From June 2012 to August 2013, a total of 319 patients with mild ischemic stroke were enrolled, 45 patients (14.1%) of them experienced END.Univariate analysis showed that baseline NIHSS ( U=3522.000,P=0.000), baseline systolic blood pressure (t=2.871,P=0.004), proportion of symptomatic large artery severe stenosis or occlusion (χ2 =52.564,P=0.000) and proportion of large artery atherosclerosis among TOAST subtypes (χ2 =47.287,P=0.000) in END group were significantly higher than those in non-END group. Multivariate logistic regression analysis showed that baseline systolic blood pressure>142 mmHg (1 mmHg=0.133 kPa) (OR=3.954, 95%CI:1.693-9.236, P=0.001), symptomatic large artery severe stenosis or occlusion (OR=3.170, 95%CI:1.170-8.583, P=0.023) and baseline NIHSS (OR=2.038, 95%CI:1.359-3.057, P=0.001) were associated with END.Conclusions About 14.1% of the mild ischemic stroke patients can occur END.Baseline systolic blood pressure>142 mmHg, symptomatic large artery severe stenosis or occlusion and higher baseline NIHSS were the independent risk factors of END.

Objective To investigate the functional outcome in patients with mild ischemic stroke and to identify its risk factors for poor outcome.Methods The patients with mild ischemic stroke treated within 72 hours after onset were enrolled prospectively.According to modified Rankin Scale (mRS) scores at day 90 after onset,the patients were randomly divided into either a poor outcome group (mRS score ＞2) or a good outcome group (mRS scores 0-2).Univariate analysis and multivariate logistic regression analysis were used to compare and analyze the demographic data,vascular risk factors,clinical data,laboratory data,imaging data,and follow-up data.The risk factors for poor outcome in patients with mild ischemic stroke were identified.Results A total of 253 patients with mild ischemic stroke were enrolled,and 71 of them (28.1％) had poor outcome.Univariate regression analysis showed that the patients' proportions of age (t =2.037,P =0.043),baseline National Institutes of Health Stroke Scale (NIHSS) score (U =4 610.000,P =0.000),baseline mRS score (U =5 723.000,P =0.000),as well as previous history of ischemic stroke (x2 =4.950,P =0.026),severe symptomatic artery stenosis or occlusion (x2 =49.037,P =0.000),large artery atherosclerotic stroke (x2 =34.359,P =0.000),early neurologic deterioration (x2 =45.804,P =0.000),complicated by pneumonia (x2 =12.121,P =0.000) and recurrent ischemic stroke (x2 =14.305,P =0.000) of the poor outcome group were significantly higher than those of the good outcome group.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.049,95％ confidence interval [CI] 1.012-1.086; P =0.008),higher baseline mRS score (OR,2.130,95％ CI 1.212-3.743;P=0.009),higher baseline NIHSS score (OR 1.532,95％ CI 1.064-2.206; P=0.022),severe symptomatic large artery stenosis or occlusion (OR 7.569,95％ CI 3.497-16.380; P=0.000),early neurological deterioration (OR 7.369,95％ CI 2.648-20.510; P =0.000) and recurrent ischemic stroke (OR 10.450,95％ CI 3.071-35.564; P =0.000) were the independent risk factors for poor outcome.Conclusions More than one fourth of the patients with mild ischemic stroke had poor outcome.Advanced age,higher baseline mRS score,higher baseline NIHSS score,severe symptomatic large artery stenosis or occlusion,early neurological deterioration,and recurrent ischemic stroke were the independent risk factors for poor outcome.

Heat stroke (HS) is a life-threatening illness characterized by core body temperatures above 40 ℃ coupled with central nervous system (CNS) dysfunction, including delirium, convulsions, and/or coma. Its morbidity has increased dramatically in the past few decades. Multiple organ dysfunction syndrome (MODS) is not only the most serious complication of HS, but also the leading cause of deaths. Understanding the pathogenesis, characteristic and advancement pattern of MODS caused by HS will have a profound effect on the clinical treatment, research and mortality decrease. The pathogenesis, injury characteristic of each system and organ, and treatment methods were summarized in this review so as to deepen the clinical recognition of this disease.

Objective:To analyze the feature of anaphylactic shock induced by alprostadil injection. Methods: Totally 1624 pa-tients treated with alprostadil injection in our hospital from January to March 2014 were undergone adverse drug reaction monitoring. Six cases of anaphylactic shock induced by alprostadil injection were statistically analyzed. Results:6 cases of anaphylactic shock induced by alprostadil injection occurred in the department of intervention and most of thd reaction happened in arterial injection. Two lot num-ber of drugs were in high frequency. Patients showed a sharp fall in blood pressure, chest discomfor, palpitation, shortness of breath, paleness, sweating and other symptoms. After anti allergy, blood pressure, oxygen the rapy and other treatment measures vital signs gradully stabilized. Conclusion:Anaphylactic shock induced by alprostadil injection is in correlation with the administration mode of artery injection. The change of the patient' s condition and vital signs should be closely observed when we inject the patient with alpros-tadil injection. We must prevent the occurrence of serious adverse reactions.

Objective To summarize the clinical features,treatment and prognosis of bullous systemic lupus erythematosus (BSLE).Methods Clinical data were collected from 6 cases of BSLE between May 2009 and September 2015,and were analyzed retrospectively.Results Among the 6 patients,2 were male and 4 were female.The mean age of onset was 34 years.All the 6 patients presented with tense blisters and bullae arising on an erythematous base or normal skin,which were arranged in an annular pattern in 3 patients.The SLE Disease Activity Index (SLEDAI) score was ＞ 4 in all the 6 patients.Histopathological examination showed subepidermal blisters or fissures in all the patients.Direct immunofluorescence (DIF) revealed continuous linear deposition of immunoglobulin G (IgG),IgM and IgA in all the patients,linear deposition of C3 in 4 patients,and linear deposition of Clq in 2 patients at the basement membrane zone (BMZ).All the 6 patients were treated with oral glucocorticoids and hydroxychloroquine,and 2 patients were additionally treated with cyclophosphamide.During the follow-up period,adverse reactions to different extents were observed in the 6 patients.Conclusions BSLE mainly occurs in young and middle-aged people.Histopathologically,subepidermal blisters or fissures can be observed with linear deposition of IgG,IgM,IgA,or C3 along the basement membrane zone on DIF.

Objective To investigate the needs of the main caregivers of children with cerebral palsy and probe into the nursing strategies. Method One hundred and fifteen main caregivers of children with cerebral palsy participated in the survey by a general state questionnaire and the family needs questionnaire. Results The score by the family needs questionnaire was (96.13 ± 19.47), with an average score of (3.00 ± 0.61). And the top needs of the main caregivers were information and econony need. Conclusions The needs of the main caregivers of children with cerebral palsy are high. More attention should be paid to community and family-based rehabilitation and supports to those care-givers.

Objective To evaluate the pharmacological effect of Zhixie Tuire Tablets(ZTT) on human rotavirus RV709 in host cells in vitro.Methods By improved methods of methyl thiazolyl tetrazolium colorimetry assay(MTT) and cytopathic effect(CPE),the anti-rotavirus effect of ZTT on RV709 was evaluated.Results The half toxic concentration(TC50) of ZTT for MA104 was 0.49699 mg/mL.ZTT neither can directly kill human rotavirus,nor prevent human rotavirus from invasion of host cells.The halft inhibitory concentration of ZTT was 0.00519 mg/mL for RV709.Conclusion In-vitro anti-rotavirus mechanism of ZTT is related to the inhibition of the biological synthesis of rotavirus in host cells.

Objective To probe into the therapeutic mechanism of Zhixie Tuire Tablet (ZTT) for rotavirus-induced diarrhea. Methods We established the 4-day old Kunming neonatal mice model by infecting group A G3 type of rotavirus,and then gave the inoculated mice with ZTT at the dose of 0.78 g/kg for three days. Fluorescent quantification PCR method was used to detect the changes of sodium glucose transporter SGLT1 mRNA level and radio-immunity method was used for the examination of PGE2 level in neonatal mice small intestine. Results SGLT1mRNA level was lower in ZTT group than that in the normal group,the difference being significant (P 0.05). PGE2 level in ZTT group was higher than that in the normal group,but lower than that in the model group (P

AIM To investigate the pharmacokinetic behaviors of total flavonoids from Epimedii Folium in osteoporotic rats in vivo.METHODS Twelve rats were divided into model group and sham group,after which the osteoporotic rat model was established by removing bilateral ovaries.After intragastric administration with total flavonoids (500 mg/kg),HPLC-DAD was applied to detecting the plasma concentrations of total flavonoids' prototype glycosides (epimedin A,epimedin B,epimedin C,icariin) and their metabolites (sagittatoside A,sagittatoside B,2-O-rhamnosylicariside Ⅱ,baohuoside Ⅰ,icaritin) at thirteen time points (0.083,0.25,0.5,0.75,1,2,3,4,6,8,12,24 and 48 h),then the plasma concentration-time curves were drawn,followed by the calculation of pharmacokinetic parameters.RESULTS Doubled peaks were observed in the plasma concentration-time curves of total flavonoids' prototype glycosides and their metabolites in both groups.Compared with the sham group,the integrated AUC and Cmax in the model group were significantly decreased (P ＜ 0.01),as well as the prolonged t1/2 (P ＜ 0.01).CONCLUSION The in vivo absorption and metabolism of total flavonoids from Epimedii Folium are much slower in the state of osteoporosis,thus affects the efficacy.

Objective To evaluate the incidence of four aberrant behaviors in patients with pervasive developmental disorders (PDDs).Methods The abnormal behaviors during the last month in 138 PDDs patients were assessed with Aberrant Behavior Checklist and Conners Index of Hyperactivity.Results The incidence of aberrant behaviors was 61.6％ for hyperactivity,81.9％ for stereotyped behaviors,13.77％ for self-injury,and 58.70％ for irritability in PDDs patients.The occurance of irritability in autism patients was higher than that of asperger syndrome (AS) patients (x2 =5.623,P=0.018).Conclusion Stereotyped behaviors,hyperactivity and irritability are common in children with PDDs.Autism patients are more likely to exhibit irritability behaviors than AS patients.