Objective To discuss the clinical efficacy of point-injection with nerve growth factor (NGF) in treatment of infantile cerebral palsy.Methods According to the time order,50 cases with cerebral palsy were randomly divided into the treatment group(30 cases) and the control group (20 cases).Both groups were given the conventional treatment of Bobath mainly exercise therapy,homework therapy and the language therapy.In addition,the treatment group was given the treatment of point-injection with NGF.Gesell scale was used to evaluate all the patients before and after treatment.Results After treatment,the Gesell evaluation of the treatment group was higher than control group,and the difference was statistically significant (t =-2.096,-2.187,-2.048,-2.053,-2.225,all P ＜0.05).Conclusion On the basis of rehabilitation training,point-injection with NGF could improve intelligence,motor function and language in children with cerebral palsy,and the efficacy was obvious.

Objective To study the diagnosis,management and prognosis of persistent m?llerian duct syndrome (PMDS). Methods 2 cases of PMDS associated with transverse testicular ectopia were reported.Clinically there was azoospermia or testis tumor.Corporeal hysterectomy and orchidopexy were performed and the testis tumor was excised. Results Vascular supply and hormonal function of the testis were normal in both 2 patients after 2 year's follow up. Conclusions PMDS is an inherited male pseudohermaphroditism. Every effort should be made to preserve the testis and its fertility function when surgical management is needed.The possible development of testis tumor should be kept in mind and closely observed.

Objective To assess the effect of chloramine disinfection on the formation of drinking water disinfection by-products(DBPs )and their mutagenicity.Methods The bacterial indices,chloroform and carbon tetrachloride content in the finished water samples using liquid chlorine and chloramine disinfection respectively were determined in August,2001(plentiful water season)and in March,2002(low water season).The mutagenicities of organic extracts from the water samples were tested using Ames test.The levels of DBPs and the mutagenic activities of water samples treated with different disinfection methods were compared.Results The total count of bateria and coliform bacteria were0/ml and0/L respectively at free chlorine con-centration of about 1mg /L in the chloraminated drinking water,which decreased81%-84%compared with those of the chlori-nated drinking water samples.The carbon tetrachloride concetration were all

Objective To investigate the effect of nifedipine on brain edema and neurological function in patients with cerebral hemorrhage . Methods 72 patients with ICH from October 2013 to October 2015 in our hospital were selected, and randomly divided into experimental group and control group, 36 cases in each group.The control group used dehydration to reduce intracranial hypertension, improve cerebral circulation, promote nutritional metabolism and anti infection and other conventional treatment,and the experimental group daily intravenous infusion of 1.0 mg of nifedipine on the basis of control group, a course of ten days.The activity dependence, clinical efficacy, MESS score, ICH score, BI score, brain hematoma and brain edema volume were observed and compared between the two groups before and after treatment.Results After treatment, the activity dependence of the experimental group was significantly better than that of the control group ( P <0.05 );the clinical effective rate of the experimental group was significantly higher than that of the control group (P<0.05).BI scores of both groups were increased after treatment, MESS scores were reduced(P<0.05);The BI score of the experimental group was significantly higher than that of the control group (P<0.05),and the MESS score was significantly lower than that of the control group (P <0.05).The volume of cerebral hematoma and the volume of cerebral edema were significantly reduced after treatment in both groups (P<0.05),there was no significant difference in the volume of cerebral hematoma between two groups,there was significant difference in the volume of cerebral edema between two groups (P <0.05).Conclusion Nifedipine can effectively reduce cerebral edema in patients with cerebral hemorrhage, reduce the degree of neurological deficit, improve clinical efficacy.

Objective To explore the clinical efficacy of atorvastatin calcium in the treatment of chronic congestive heart failure(CHF).Methods According to the order of admission with single and double,132 CHF patients were randomly divided into control group and study group,66 cases in each group.The control group was given routine treatment,and the study group was treated with atorvastatin calcium on the basis of routine treatment.The clinical efficacy was assessed.Before and after treatment,the serum TC level was measured,the left ventricular ejection fraction(LVEF) and heart left ventricular end diastolic diameter(LVDD),heart index(CI) were assessed by echocardiography.The adverse reactions during treatment were observed.Results The total effective rate of the study group was 92.42%,which was higher than 83.33% of the control group,the difference was statistically significant(x2=9.35,P<0.05).The serum TC of the study group after treatment was (3.24±0.75)mmol/L,which was lower than (4.70±0.86)mmol/L of the control group,the difference was statistically significant(t=8.96,P<0.05).The level of LVEF of the study group after treatment was (46.39±6.35)%,which was higher than (44.60±5.82)% of the control group,the difference was statistically significant(t=9.47,P<0.05).The levels of LVDD and CI were (47.06±5.39)mm and (2.60±0.62)L·min-1·m-1 respectively,which were lower than (49.53±6.17)mm and (2.97±0.69)L·min-1·m-1 of the control group,the differences were statistically significant(t=10.31,9.40,all P<0.05).There was no significant difference in adverse reactions between the two groups(x2=2.04,P>0.05).Conclusion Atorvastatin calcium in the treatment of CHF patients on the basis of routine treatment has better clinical effect.It can significantly reduce TC and significantly improve cardiac function,and has high safety.

Objective To compare the time-course of relaxant effect of rocuronium between patients with ocular and generalized myasthenia gravis (MG).Methods Twenty-seven ASA physical status I or Ⅱ patients with MG of both sexes,aged 12-64 yr,with body mass index of 17-26 kg/m2,scheduled for elective extended thymectomy,were divided into 2 groups according to Osserman stage:ocular group (group O,n =10) and generalized group (group G,n =17).Anesthesia was induced with iv injection of fentanyl 2 μg/kg,midazolam 0.05 mg/kg,and propofol 1.5 mg/kg.All patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg-1 · h-1 and remifentanil 0.2 μg· kg-1 · min-1.Twitch tension was monitored in the adductor pollicis muscle by train-of-four stimulation of the ulnar nerve (intensity 60 mA,interval 12 s,frequency 2 Hz,wave length 0.2 ms).Rocuronium 0.6 mg/kg was injected intravenously after calibration.Mean arterial pressure (MAP),HR,heart rate variability (HRV) and low frequency and high frequency (LF/HF) ratio was recorded.The onset time of muscle relaxation,time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were recorded.Results Compared with the baseline value,there were no significant changes in MAP,HR,HRV,LF/HF ratio at all time points in the two groups (P ＞ 0.05).Compared with group O,there was no significant change in the onset time of muscle relaxation,and the time for T1 to recover to 25％,time for T1 to recover to 50％ and recovery index were significantly prolonged in group G (P ＜ 0.05).Conclusion The duration of rocuronium-induced neuromuscular block is significantly longer in patients with generalized MG than those with ocular MG,while the onset time is comparable between the two groups.

Objective To investigate the effect of exercise on calcium modulin in myocardial sarcoplasmic re-ticulum of animal type 1 diabetes model in rat. Methods A total of 40 Spragne-Dawley rats were randomly dividedinto 4 groups : a normal control group, an exercise training group, a diabetes group and a diabetes plus exercise-traininggroup. At the end of 4- week-exercise training after the establishment of the diabetes model by intraperitoncal injectionof sterptozotocin, the animals were sacrificed and the level of blood glucose, insulin, blood fat and glycosylated serumprotein were tested. The gene expression of calcium modulin proteins was measured by reverse transcription-polymerasechain reaction, and the Western blotting technique was used to measure the protein of sarcoplasmic endoplasmic reticu-lure Ca<'2+> -ATPase (SERCA2) and phaspholamban (PLB). Results The level of biochemical indicator of exercisegroup is not affected when comparing with that of the control group, but significantly changed in diabetic group ( P <0. 01 ) ; The level of blood glucose, insulin, blood fat and glycosylated serum protein were ameliorated in diabetic rats inthe exercise training group. No significant changes in mRNA level of SERCA2, PLB and ryanodine receptor type 2(RYR2) were observed between control and diabetic group, the same to protein expression of SERCA2 and PLB. Butexpression of calcium modulin mRNA was significantly increased in exercise group and diabetic rats in the exercisetraining group comparing with that of the control and diabetic groups ( P < 0.01 ), the same to protein expression ofSERCA2 and PLB. Conclusion Exercise exerted good protective effects on the myocardial injury with 1 type diabetesrat, which might attribute to the upregnlated expression of SERCA2, PLB and RYR2 in diabetic rat heart.

Objective To study the effects of esmolol on fluid responsiveness and hemodynamic parameters in patients with septic shock.Methods A prospective self-control study was conducted.Fifteen septic shock patients undergoing mechanical ventilation admitted to Department of Critical Care Medicine of Yijishan Hospital from January 2015 to August 2015 were enrolled.All patients enrolled in this study were given the treatment based on American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus 2012.Esmolol was intravenously injected at a beginning rate of 6 mg·kg-1·h-1, and then the dose was adjusted to reduce heart rate by 10％ from baseline.The changes in hemodynamic and systemic oxygen metabolism indexes were monitored by pulse indicator continuous cardiac output (PiCCO) before and 2 hours after the esmolol administration, and the fluid responsiveness was evaluated by stroke volume variation (SVV).SVV ≥ 10％ was considered to be a positive fluid responsiveness.Results In 15 patients, 9 were male and 6 female, with an age of 65 ± 16.Among them 10 patients suffered from pulmonary infection, and 5 patients with abdominal infection.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 21 ±9;sequential organ failure score (SOFA) was 8 ±4.28-day mortality was 40.0％.SVV was significantly decreased after esmolol infusion as compared with baseline [(14 ± 5)％ vs.(17 ±7)％, t =2.400, P =0.031].Heart rate [HR (bpm): 100±4 vs.112±8, t =8.161, P =0.000], cardiac output [CO (L/min):6.13 ± 1.45 vs.7.88 ± 1.82, t =4.046, P =0.001], cardiac index [CI (mL·s-1·m-2): 51.51 ± 11.00 vs.66.18 ± 11.48, t =4.131, P =0.001], stroke volume index [SVI (mL/m2): 31.0 ± 6.4 vs.35.4 ± 6.5, t =2.577, P =0.020], the maximum rate of left ventricular pressure rise [dp/dt max (mmHg/s): 927±231 vs.1 194±294, t =3.775, P =0.002], global ejection fraction (GEF: 0.21 ±0.05 vs.0.24±0.06, t =3.091, P =0.008), cardiac function index (CFI: 5.03 ± 1.37 vs.6.59 ± 1.92, t =4.769, P =0.000) showed significant decrease during esmolol infusion.On the other hand, central venous pressure [CVP (mmHg, 1 mmHg =0.133 kPa): 9±3 vs.8±3, t =-3.617, P =0.003], diastolic blood pressure (DBP, mmHg: 69± 15 vs.66± 13, t =-2.656, P =0.019), systemic vascular resistance index (SVRI, kPa·s·L-1·m-2:206.8±69.8 vs.206.8±69.8, t =-3.255, P =0.006) were significantly increased during esmolol infusion.No significant difference was found in systolic blood pressure [SBP (mmHg): 120 ± 25 vs.123 ± 18, t =0.678, P =0.509],mean arterial pressure [MAP (mmHg): 86 ± 18 vs.85 ± 14, t =-0.693, P =0.500], global end diastolic volume index [GEDVI (mL/m2): 614 ± 84 vs.618 ± 64, t =0.218, P =0.830], extravascular lung water index [EVLWI (mL/kg):5.99±1.50 vs.5.73±1.14, t =-1.329, P =0.205], central venous oxygen saturation (ScvO2: 0.711±0.035 vs.0.704 ± 0.048, t =-0.298, P =0.773), arterial blood lactate [Lac (mmol/L): 3.1± 0.3 vs.3.0 ± 0.4, t =-0.997, P =0.345],and difference of central venous-arterial carbon dioxide partial pressure [Pcv-aCO2 (mmHg): 4.1 ± 0.9 vs.4.7 ± 0.5,t =1.445, P =0.182] as compared with those before esmolol treatment.Conclusion Heart rate control with esmolol infusion may reduce fluid responsiveness, cardiac function, heart rate and cardiac output without adverse effect on systemic perfusion in septic shock patients.

Objective To evaluate clinical value of MGFA classification and QMG score on pre-dicting late extubation after thymectomy for myasthenia gravis(MG).Methods Total of 61 patients with MG received extended thymectomy from January 2007 to February 2012 were enrolled.Patients were divided into two groups:normal extubation group contained the other 47 patients without pro-longed postoperative mechanical ventilation and delayed extubation group included 14 patients with prolonged postoperative mechanical ventilation.The following factors were evaluated:gender,age, weight,MGFA classification,QMG score,history of steroid hormones or anticholinesterase drugs be-fore operation,the function of liver and kidney before operation,preoperative electrolyte,preoperative hemoglobin content,etc.Receiver operator characteristic curve (ROC)was plotted,and the predictive value, sensitivity and specificity of preoperative MGFA clinical classification and QMG score predicting postoperative ventilation in MG were calculated.Results Fourteen patients(22.95%)de-veloped breathing support after the anaesthetic or endotracheal intubation again in 48 hours.the area under ROC curve(AUC)for preoperative MGFA clinical classification predicting postoperative ventila-tion was 0.723 in MG,it had the sensitivity of 78.5% and specificity of 63.8%.The AUC for QMG score predicting postoperative ventilation was 0.866,the QMG score threshold value of 8.5 had the sensitivity of 78.6% and specificity of 87.2%.Conclusion MGFA classification and QMG score can predict late extubation after thymectomy in patients with myasthenia gravis.

OBJECTIVE: To investigate the effect of dxamethasone (DEX) on the expression of Tregs in allergic rhinitis (AR) mice, and explore the mechanism of glucocorticoid in the treatment of AR. METHOD: AR murine model was established by sensitization and challenge with OVA, besides intervention treatment with DEX was carried out in AR model. The behavior observation was used to evaluate the improvement effect of DEX on AR symptoms. The morphological characteristics of nasal tissues were observed by HE staining after fixation and decalcification. The mononuclear cells were obtained by grinding spleens, and the total RNA was extracted for reverse transcriptase polymerase chain reaction to investigate the level of mRNA expression of Foxp3. The changes of CD4+ Foxp3+ Tcells in spleen of mice were analyzed by flow cytometry. RESULT: BALB/c mice received OVA sensitization followed by OVA intranasal challenge, the frequencies of sneezing and nose-scratching increased significantly in AR group (44. 50 ± 5. 61 and 72. 94 ± 8. 76) compared with control group (12. 68 ± 1. 87 and 26. 76 ± .2. 89), P<0. 01; The frequencies decreased significantly in DEX group (26. 04 ± 3. 93 and 56. 79 ± 5. 64), P< 0. 05 compared with AR group. The continuity of nasal mucosa ciliated columnar epithelium in AR group was destroyed and appeared to be repaired in DEX group. Inflammatory cells infiltration was also markedly decreased by DEX treatment. The proportion of CD4+ Foxp3+ T cells in AR group (3. 89 ± 0. 39)% decreased, P<0. 01 vs control group (4. 63 ± 0. 15) %. DEX treatment induced production of Tregs (6. 89 ± 0. 49)%, P<0. 05 vs control group. DEX significantly increased the expression of Foxp3 mRNA (P<0. 05) compared with AR and control group. CONCLUSION DEX reduce upper airway allergic inflammation effectively, which may be mediated by promoting the expression of Foxp3 and inducing the amplification of Tregs in vivo.
Administration, Intranasal ; Animals ; Dexamethasone ; pharmacology ; Disease Models, Animal ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Inflammation ; drug therapy ; Mice ; Mice, Inbred BALB C ; Nasal Mucosa ; drug effects ; Ovalbumin ; RNA, Messenger ; Rhinitis, Allergic ; drug therapy ; T-Lymphocytes, Regulatory ; drug effects