Objective To investigate the relationship between the stenosis of clinically relevant artery or the characteristics of carotid plaques and frequent transient ischemic attacks(TIA).Methods Seventy-nine consecutive patients sufiered TIA attribute to carotid territory in the acute phase(within 7 days )who had been admitted to neurology department of Xuanwu Hospital from August 2005 to January 2007 were retrospectively analyzed.Patients with nonatherosclerotic vasculal disease were excluded.According to the times of TIA from the first attack to the day of hospitaliztion(within 7 days)patients were divided into two groups:those who had sparse TIA(onsets＜3 times),and those who had multiple TIA(onsets≥3 times).All patients underwent the examination of DSA.carotid ultrasound and transcranial doppler.The degree of stenosis of clinically relevant artery and the characteristics of carotid plaques were compared between the two groups.According to degree of stenosis of relevant artery,we defined as normal or＜50%stenosis.50%-69%stenosis.70%-99%stenosis or occlusion.According to the characteristics of carotid plaques we divided into stable or unstable plaques.Resuits Patients with TIA in carotid territory had more intracranial artery diseases.The middle cerebral artery was the most commonly involved artery(5 1.2%).the extracranial internal carotid artery was the next(37.2%).Multiple TIA were more likely to have a short duration of symptoms≤10 min than sparse TIA(x2=5.343,P=0.021).A significant stenosis of clinically relevant artery(≥50%)was demonstrated more frequently in the multiple TIA group(66.7%)than in the sparse TIA group(35.3%,x2=7.655,P=0.006).No significant correlation was observed between the multiple TIA and characteristics of carotid plaques in the focus side(x2=0.939,P=0.332).Conclusions Frequent TIA is significantly associated with a short duration of symptoms and≥50% stenosis of clinically relevant artery.Transient flow reduction by hemodynamic compromise may he an important mechanism of frequent TIA.

Objective To investigate the correlation between stenosis or occlusion of vertebralbasilar artery and the location of infarctions in pontine. Methods All 139 patients with acute pontine infarction who were admitted to the Department of Neurology,Xuanwu Hospital,Beijing,during February,2005 and September,2007 were studied. All patients received the examinations of head MRI and digital subtraction angiography (DSA). Patients with possible cardiac embolism were excluded from the study. All the cases were then divided into four groups: A( paracentral artery group); B (short rotary artery group); C (long rotary artery group) and D (combined group). Results In all 139 cases,78 cases (56. 1% ) were in A group,3 (2. 2% ) in B group,7 (5.0%) in C group and 51 (36.7%) in D group. Fifty-six cases (40. 3% ) have occlusion in vertebral artery,60 cases (43.2%) have stenosis of vertebral artery. Cases having stenosis or occlusion in basilar artery are 14 cases (10. 1% ) each. Sixteen cases (11.5%) have unimpaired vertebral-basilar artery. A group is related to occlusion of vertebral artery and basilar artery and unimpaired artery ( x2 =3. 945,6. 824,4. 485 ,P = 0. 043,0. 021,0. 041 respectively). D group is related to occlusion of basilar artery ( x2 = 10. 952,P = 0. 006). Logistic binary analysis found that A group is more related with occlusion of vertebral artery ( OR = 2. 261 ),while D group is more related to occlusion of basilar artery ( OR = 15. 750). Conclusions There is a significant correlation between stenosis or occlusion of vertebral-basilar artery and the locations of infarctions in pontine. The physicians are suggested to perform the examinations on cerebral vessels such as brain MRI or DSA in patients with infarctions in pontine.

Objectives To assess whether prodromal transient ischemic attack (TIA) has beneficial effects on type 2 diabetic patients and those had acute fasting hyperglycemia with the first-ever acute anterior circulation infarction.Methods One hundred and seventy patients with first-ever ischemic acute anterior circulation infarction were involved.According to whether they had type 2 diabetes mellitus,patients were divided into group A (non-diabetic patients) and group B (diabetic patients).Mean infarct volume was also compared between patients with pro-TIA and without pro-TIA in group A and B,and each group with acute hyperglycemia too.Results In group A,prodromal TIA was associated with a smaller infarct volume (M: 2.61 cm3 vs 5.99 cm33 Z=-2.69,P=0.007).On the contrary,in group B,there was no significant difference in infarct volume (M: 3.25 cm3 vs 11.0 cm3,Z=-1.699,P=0.08) between patients with and without prodromal TIA.In group A patients absent with acute fasting hyperglycemia,infarct volume significantly smaller in patients with prodromal TIA than in those without (M: 2.69 cm3 vs 6.46 cm3,Z=-2.34,P=0.019) ; In patients with acute fasting hyperglycemia,there was no a significant difference in infarct volume (M: 2.61 cm3 vs 5.69 cm3 ,Z=-1.218,P=0.27).However,among group B patients present or absent with acute impaired fasting glucose,there was no significant difference in infarct volume in patients with or without prodromal TIA.Conclusion Diabetes mellitus and the acute fasting hyperglycemia might prevent the ischemic preconditioning.

OBJECTIVE:To establish a turbidimetric method for the determination of the potency of the crude drugs and tablets of oxytetracycline. METHODS: By turbidimetric method in which Staphylococcus aureus was used as the test organism with biomass concentration of 1.0%～1.5% (V/V). The culture temperature was 37 ℃ and the culture time was about 4 h. The method was compared with the cup-plate method in potency. RESULTS: The linear range of oxytetracycline was 0.05～0.4 IU?mL-1. The average recovery of the crude drug of oxytetracycline was 99.59% (RSD=2.0%) and that of oxytetracycline tablets was 99.51% (RSD=1.91%), showing no significant difference as compared with the cup-plate method in contents. CONCLUSIONS: The method was sensitive and rapid yet with few influencing factors thus applicable for the determination of the potencies of oxytetracycline and its tablets.

Objective To investigate the evidence of effective therapy of transient ischemic attacks (TIA) through the study on the regional cerebral blood flow and the function of neurocyte in the symptom free phase Methods Forty one patients with TIA and 45 controls were examined by single photon emission computed tomography (SPECT), computed tomography cerebral perfusion imaging (CTPI) and the positron emission tomography (PET) Results The abnormal rate of SPECT examination was 95 1%, and abnormal perfusion rate of CTPI was 63 4% These results revealed that there were reduction of regional cerebral blood flow in above half of TIA patients SPECT showed abnormal in some patients with normal CTPI show, which was possibly because of abnormal function of neurocyte, and the latter was confirmed by PET Conclusion Patients with TIA should have not only abnormal function of neurocyte, but also have reduction of regional cerebral blood flow in the intermittent phase The therapy of TIA should be emphasized in order to prevent TIA relapse and the occurrence of irreversible changes

BACKGROUND: Orotracheal intubation with conventional Macintosh laryngoscope often makes strong alterations in hemodynamic responses. Compare with the Macintosh laryngoscope, the Airtraq~((R)) laryngoscope has weak effect on throat irritation. However, the contrast effect on hemodynamics remains still unknown. OBJECTIVE: To compare the hemodynamical responses to orotracheal intubation between Airtraq~((R)) laryngoscope and Macintosh laryngoscope. DESIGN, TIME AND SETTING: A randomized comparative observation was performed at Department of Anesthesiology, Dalian Second People's Hospital between October 2008 and April 2009. PARTICIPANTS: A total of 40 patents scheduled for surgery under general anesthesia requiring orotracheal intubation were randomly divided into Airtraq~((R)) laryngoscope group and Macintosh laryngoscope group, with 20 cases in each group. METHODS: After standard intravenous anesthetic induction, orotracheal intubation was performed with Airtraq~((R)) laryngoscope or Macintosh laryngoscope. Common Airtraq~((R)) laryngoscope was used in the Airtraq~((R)) laryngoscope group, and an endotracheal tube with internal diameter of 8.0 was inserted. No. 3 lens were used in the Macintosh laryngoscope group, and an endotracheal tube with internal diameter of 8.0 was inserted. MAIN OUTCOME MEASURES: Glottic exposure time, tracheal intubation time, noninvasive heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before (T0) and after (T1) anesthetic induction as well as at 0 minute (T2), 1 minute (T3), 2 minutes (T4), and 3 minutes (T5) after intubation, as well as rate-pressure product (RPP). RESULTS: The glottic exposure time in Airtraq~((R)) laryngoscope group was significantly longer than that in Macintosh laryngoscope group (P < 0.01), while the tracheal intubation time in Airtraq~((R)) laryngoscope group was significantly shorter than that in Macintosh laryngoscope group (P < 0.01). Compared with pre-induction (T0), the SBP, DBP, and RPP of the two groups decreased significantly after anesthetic induction (T1) (P < 0.05), but the HR did not change remarkably (P > 0.05). Compared with T1, all hemodynamical values at T2, T3, T4 and T5 in Airtraq~((R)) laryngoscope group did not increased sign ificantly (P > 0.05). In Macintosh laryngoscope group, HR and RPP at T4, SBP, DBP, HR and RPP at T2 and T3 increased significantly compared with T1 (P < 0.05). In Macintosh laryngoscope group, HR and RPP at T2, T3 and T4 were significant higher than that in Airtraq~((R)) laryngoscope group (P< 0.05). CONCLUSION: In comparison to the Macintosh laryngoscope, tracheal intubation with the Airtraq~((R)) laryngoscope resulted in less alterations in hemodynamical responses.

0.05). In Macintosh laryngoscope group, HR and RPP at T4, SBP, DBP, HR and RPP at T2 and T3 increased significantly compared with T1 (P

Objective To investigate the evolution of diffusion indices in the pyramidal tract with Wallerian degeneration(WD)due to cerebral infarction using diffusion tensor imaging(DTI),and to study the relationship between early changes of diffusion indices and motor deficit.Methods Fifteen patients (13 males and 2 females)with acute cerebral infarction(within 7 days)were recruited from the Neurology Department from Mar 2006 to Jan 2007.A11 patients were assessed with DTI.National Institutes of Health Stroke Scale(NIHSS),Bathel Index(BI),modified Rankin Scale(mRS)and Motricity Index(MI)within 7 days from onset,and at the second week.DTI was performed with SIEMENS Trio 3.0 T MR scanner.The placement of region of interest(ROI),measurement of diffusion indices were performed by DTI Studio software.The mean diffusivity(MD),the fractional anisotropy(FA),the first eigenvalue (λ1),the second eigenvalue(λ2),and the third eigenvalue(λ3)were computed.Results At the second week.NIHSS was 6.93±3.39.BI 45.33±26.01,mRS 4.33±0.90.and MI 69.47± 60.71.At the second week from onset.MD of the pyramidal tract at the levels of the middle slice of pons and the superior slice of medulla oblongata showed no significant differences between both the two sides at second week from onset. Other ROI showed significant differences between both sides.MD.FA and λ1 of affected side were lower than the unaffected side.λ2 and λ3 of the affected side were higher than the unaffected side.Positive correlations were found between FA and BI(r=0.530,P=0.042),FA and MI(r=0.543,P=0.036)at the second week.Negative correlations were found between FA and NIHSS(r=-0.613,P=0.015)at the second week.Conclusions DTI can detect the changes in the pyramidal tract due to WD within 7-14 days after ischemic stroke.including a decrease of the fractional anisotropy.the first eigenvalue and increased the second and the third eigenvalues.The fractional anisotropy of the second week from onset is related to the outcome of the motor function.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.

Objective: To establish a determination method for the related substances in josamycin and josamycin tablets by HPLC. Methods:High performance liquid chromatography was used. The column was Ultimate-AQ-C18(250 mm ×4.6 mm,5 μm), the mobile phase respectively was mobile phase A of 0. 2 mol·L-1 tetrabutylammonium hydrogen sulphate R-0. 2 mol·L-1 disodium hydrogen phosphate(pH 3. 0)-acetonitrile R-water(3∶5∶24∶68) and mobile phase B of 0. 2 mol·L-1 disodium hydrogen phosphate (pH 3. 0)-acetonitrile R-water(5∶50∶45). The flow rate was 1. 5 ml·min-1 with the detection wavelength of 232nm. The column temperature was 50℃. Results:The main component josamycin had a good separation with the other related substances. The resolution between josamycin and the related substances with the relative retention time of 1. 1-fold of josamycin was above 1. 7. The detection limit of josamycin was 1. 43ng. In josamycin raw materiel and josamycin tablets, the percentage of related substance A and B was less than 1. 5%. The percentage of related substance D was below 2. 0%. The percentage of related substance E was less than 3. 0%. The percentage of the other maximum related substances was less than 1. 0%. The percentage of all related substances was less than 12%. The percentage of related substance C was less than 1. 0% in josamycin raw materiel while 3. 0% in josamycin tablets. Conclusion:The method is accurate, sensitive and reliable in the determination of related substances in josamycin and josamycin tablets.