Objective To observe the clinical effect of low molecular weight heparin on the acute cerebral infarction (ACI) and the influence on hemodynamics.Methods 143 cases of ACI within 72 hours of the onset of symptoms were randomly divided into two groups:low molecular weight heparin (LMWH) and control groups.The LMWH group was added 0.4 ml LMWH subcutaneously twice a day for 10 days,in addition to the routine treatment.The indexes of hemodynamics were measured before and after treatment.Neurological scoring was used to evaluate the clinical effect.Results The effect in the treatment group was significantly superior to that in the control group (P

Objective To compare L 5 anterior roots which is mostly composed of somatic motor nerve fibers and S2 anterior roots which is mostly composed of parasympathetic nerve fibers as dynamic nerve on bladder reinnervation and functional reconstruction after spinal cord injury. Methods Randomly select one side as experimental side and the other side as control, then L 5-S2 anterior roots cross extrameningeal anastomosis in the experimental side and S2-S2 self extrameningeal anastomosis in the control side were performed in 5 dogs. The changes of bladder pressure, urethral pressure responsed to electrical stimulation of the anastomosis roots on each side were recorded in the mean time and the two groups data were compared after one year. Results There were no significant difference between the changes of bladder pressure, urethral pressure responded to the stimulation of left side and right sides anterior roots as the anastomosis operation performed. After one year, both of experimental sides L 5 and control sides S2 anterior roots established neural relationship with bladder detrusor and urethral sphincter. There were no significant difference in the change of bladder pressure responded to electrical stimulation of the anastomosis roots between experimental side (5.0?2.1) kPa and control side (4.6?1.8) kPa(P=0.17) as well. The change of urethral pressure responded to electrical stimulation of the anastomosis roots between experimental side (4.2?1.7)kPa and control side (4.4?1.6)kPa also has no significant difference(P=0.31). Conclusion In the treatment of bladder dysfunction after spinal cord injury, L 5 anterior root can serve a similar role as S2 on bladder functional reconstruction as a dynamic nerve.

Objective To retrospectively analyze the platelet count and related factors in bleeding patients with hematonosis,and to calculate the risk of bleeding when the platelet count is at each exposure level.Methods Retrospective analysis of patients from Department of Hematology Inpatients in Nanjing Drum Tower Hospital,Nanjing First Hospital and Nanjing Jiangning Hospital from July 2013 to June 2017 was collected.And the risk of bleeding for different hematonosis was calculated.Results The tolerance of the 5 categories of hematonosis to low platelet counts is compared:AA and ITP can tolerate lower levels of platelet count;MDS and AML(except M3) are more prone to bleeding;ALL is the most susceptible to bleeding.Conclusion When platelet resources are scarce,priority should be given to ALL,MDS and AML patients,in order to ensure the safety of critically ill patients.For patients with AA and ITP,the platelet infusion threshold may be reduced appropriately,in oder to reduce the incidence of platelet transfusion refractoriness.

Lesion was made individually to the various cortical areas in 14 rats.The cortico- fugal fibers terminating into cochlear nuclei were traced in sections by means of the modified Nauta and Fink-Heimer silver staining method.The results were as follows: 1.After damaging the auditory area or somato-sensory area 1(SI)of the cerebral cortex unilaterally,degenerating fibers were found bilaterally in the ventral and dorsal cochlear nuclei.This result showed that the above cortical areas have direct descending connection with the cochlear nuclei. 2.No degenerating fibers were found in the cochlear nuclei after the ablation of the motor or visual area of the cerebral cortex,which demonstrated that the cochlear nuclei do not receive descending fibers from the above cortical areas. 3.The pathway from the cerebral cortex to the cochlear nuclei was:The descending fibers which originated from the auditory area or SI area ipsilaterally passed through the capsula interna and basis pedunculi,and part of these fibers passed dorsally and downward to the lateral portion of the reticular formation of the midbrain;and from there the fibers passed through the lemniscus lateralis and dorsal acustic stria to the cochlear nuclei of the ipsilateral side.The cochlear nuclei in contralateral side also received the corticofugal fibers by way of the dorsal acustic stria.These fibers might cross to the contralateral side at the region in the posterior commissure,superior colliculus commissure and inferior colliculus commissure.

Objective To investigate the distribution and drug resistance of Pseudomonas aeruginosa(PAE) in the hospital ,so as to provide the reference for the rational drug use and the infection control in clinical .Methods The infection distribution and drug resistance of 822 isolates of PAE were analyzed .The drug sensitivity test was proceeded by dilution method ,and the results were judged according to the relevant documents of the CLSI .The data was analyzed by WHONET 5 .6 software .Results 822 isolates of PAE were mainly distributed in intensive care unit ward ,general surgical department and respiration department .The sample was 82 .1% from sputum .The infection rate was the highest in autumn(30 .0% ) .The drug resistance rate of PAE to cefperazone/sul-bactam was the lowest(7 .6% ) ,and which to amikacin was 19 .1% .The resistance rates of PAE to other drugs were all higher than 20 .0% .Conclusion PAE is a common pathogen of respiratory tract infection ,which has a high resistance rate to the current clini-cal antibacterial agents ,and doctors should pay attention to the infection caused by PAE .

Influenza is a major threat to millions of people worldwide. Vaccines and antiviral agents are two main options available to reduce the impact of the influenza virus, while anti-influenza agents are the most effective means to prevent the transmission of the highly contagious virus and to treat the epidemics of disease. At present, four anti-influenza agents have been approved by the FDA for the treatment of influenza, including two M2 protein ion channel inhibitors-amantadine and rimantadine and two neuraminidase inhibitors-zanamivir and oseltamivir. Arbidol hydrochloride, launched in Russia, is a potent inhibitor of influenza virus, too. Neuraminidase inhibitors could be classified generally by structure into six different kinds: sialic acid derivatives, benzoic acid derivatives, cyclohexene derivatives, cyclopentane derivatives, pyrrolidine derivatives and natural products. In this paper, recent progress in the research of the action mechanisms and structure-activity relationships of these anti-influenza virus agents were reviewed.

Objective To determine the contents of four effective constituents in Euphorbiae Semen decoction;To provide evidence for Euphorbiae Semen decoction into clinical application. Methods Established quantitative analysis multi-components by single marker method was used to determine the contents of diterpenoids constituents, such as euphorbia storoid, euphorbia factor L2, and euphorbia factor L3. HPLC method was used to determine the contents of aesculetin. Results Contents of euphorbia storoid, euphorbia factor L2, and euphorbia factor L3 in smashed Euphorbiae Semen decoction were 0.015 9%, 0.005 9% and 0.024 1%, respectively. However, the contents of the above three constituents could not be detected in whole Euphorbiae Semen decoction. The content of aesculetin (0.693 6%) in smashed Euphorbiae Semen decoction was more than that in whole Euphorbiae Semen decoction (0.288 2%). Conclusion Decoction digestion effect of diterpenoids constituents in Euphorbiae Semen decoction is not good. Decocting with water is not suitable for the clinical application of Euphorbiae Semen for purgation and diuresis. Aesculetin in smashed Euphorbiae Semen decoction has good decoction digestion effect, in which clinical use for antisepsis and anti-inflammation is effective.

Objective To investigate the accuracy of transthoracic echocardiography (TTE) for diagnosing left cardiac valve calcification in elderly patients.Methods In this retrospective study,410 elderly patients died in Beijing Hospital from 1982 to 2015 were collected.They all had full pathological cardiac valve examination data in the autopsy examination and full mortem TTE data.They were classified into three groups according to the year of death:group 1982-1995,group 1996-2005 and group 2006-2015,as well as into three groups according to the age of death:group 60-75,group76-90 and group 91-106.Results The sensitivity,specificity,diagnostic coincidence rate,positive likelihood ratio (PLR),negative likelihood ratio (NLR),positive predictive value (PPV) and negative predictive value(NPV) of TTE versus autopsy pathological findings as golden standard for diagnosing left cardiac valve calcification were 88.6％,28.2％,43.7％,1.234,0.405,0.298 and 0.878.Compared with group 1982-1995,the group 1996-2005 and group 2006-2015 showed the sensitivity and PPV of TTE versus golden standard autopsy findings for diagnosing left cardiac valve calcification in the elderly were increased while the specificity,PLR,NLR and NPV were decreased.Compared with group 60-75,the group 76-90 and group 91-106 showed that the sensitivity and PPV of TTE versus golden standard autopsy findings for diagnosing left cardiac valve calcification were increased,while the specificity and diagnostic coincidence rate were decreased.The sensitivity,specificity,diagnostic coincidence rate,PLR,NLR,PPV,NPV of TTE versus golden standard autopsy findings for the diagnosis of aortic valve calcification and mitral valve calcification in the elderly were 88.2％ and 44.0％,30.8％ and 75.3％,42.7％ and 71.5％,1.275 and 1.780,0.382 and 0.744,0.250 and 0.198,0.909 and 0.906,respectively.Conclusions TTE provides high sensitivity for diagnosing left cardiac valve calcification in the elderly,especially for diagnosing the aortic valve calcification,but the specificity is not satisfactory.

Objective To observe curative effects of augmentation fixation technique injected with PMMA through lateral holes of dynamical hip screw (DHS) in treatment of unstable intertrochanteric fracture of senile osteoporotic patients. Methods From January 2006 to December 2007,15 senile osteoporotic inpatients with unstable femoral intertrochanteric fracture were treated with augmentation technique injected with PMMA to the femoral head through central channel and lateral holes of DHS. Clinical data about function of hip joint and complications early after operation were observed. All patients were followed up till fractures were healed, when the hip joint function was evaluated according to Harris standarch. Results Surgical trauma indices such as operation time and bleeding volume of augmentation technique were the same as those of merely DHS fixation. All the patients could safely do hip flexion and extension exercises in the bed and completely sit up by bedside 2-3 days after operation. Six patients could do walking exercise with aid one week after operation, with no complications relating to staying in bed or to PMMA during per-operation period. All fractures were healed 3-6 months after operation, without complications like fixation loosening, cut or destruction of femoral head during postoperative follow-up period. Six months after operation, 14 patients recovered viability to normal. According to Harris standards, the results were excellent in four patients, good in 10 and fair in one, with average Harris score of 83 points. Conclusions The augmentation fixation technique injected with PMMA through lateral holes of DHS has advantages of better DHS anchoring ability in femoral heads, less surgical trauma, reliable fixation and early functional exercise and is suitable for senile osteoporotic patients with unstable intertrochanteric fractures.

Objective To evaluate the efficacy and safety of cardiac shock wave therapy(CSWT) in coronary heart disease in elderly patients.Methods Eleven patients with refractory angina pectoris were enrolled.The ischemic area was determined by the 99mTechnetium-MIBI single-photon emission computed tomography (SPECT) and coronary angiography,and treated with CSWT.The CSWT were performed during treatment of 3 months,with 9 times totally.The clinical evaluations included the clinical symptoms,Canadian Cardiovascular Society (CCS) class scores,New York Heart Association class (NYHA),Seattle angina questionnaire (SAQ),6-min walking distance and the use of dosage of nitroglycerin,left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF).The amelioration of ischemic myocardial was analyzed by SPECT.The safety of CSWT was evaluated by changes in clinical symptoms,ECG monitoring,blood pressure and oxygen saturation,blood levels of creatine kinase,creatine kinase myocardial band isoenzymes (CK-MB),troponin T (TnT),alanine transfer enzyme (ALT),creatinine (CR),brain natriuretic peptide and high sensitive C reactive protein (hs CRP).Results The CCS class scores,NYHA,6-min walking distance and the dosage of nitroglycerin were significantly improved at 4 and 12 months after treatment as compared with pretreatment.The steady state of angina pectoris and the frequency score in SAQ were significantly improved.The 21 cardio-vessel segments were treated,and the improvement rate of resting myocardial perfusion was 46.2％ (6/13),the effective rate was 38.5％ (5/13),and the obvious effective rate was 7.8％ (1/13) after treatment.The improvement rate of loaded myocardial perfusion was 57.1％ (12/21),the effective rate was 47.6％ (10/21),and the obvious effective rate after treatment was 9.5％ (2/21).There were no significant changes in levels of CK,CK-MB,TNT,ALT,Cr,BNP and hs CRP,heart rate,systolic blood pressure,diastolic blood pressure and oxygen saturation after treatment as compared with pretreatment.Conclusions The CSWT is a safe and effective treatment for coronary heart disease in the elderly,and the curative effect could maintain at least one year.