Objective To compare the efficacy and safety of 7.2%hypertonic saline hydroxyethyl starch 200/0.5(HES) and 15% mannitol in the treatment of increased intracranial pressure( ICP) .Methods 112 neurosurgical patients at risk of increased ICP were randomized divided into 2 group to receive either HES or 15% mannitol at a defined infusion rate, which was stopped when ICP was<15 mmHg.Results Of the 112 patients, 58 patients received HES and 54 received mannitol 15%.In eight patients, ICP did not exceed 20 mmHg in treatment was not necessary.Both drugs decreased ICP below 15 mmHg (P<0.0001);HES within 6.0(1.2~15.0) min(all results are presented as median (minimum-maximum range) and mannitol within 8.7(4.2~19.9) min(P<0.0002).HES caused a greater decrease in ICP than mannitol (57% vs 48%; P<0.01).The cerebral perfusion pressure was increased from 60 (39~78) mmHg to 72 (54 ~85) mmHg by infusion with HES (P<0.0001) and from 61(47 ~71) mmHg to 70(50 ~79) mmHg with mannitol ( P <0.0001 ).The mean arterial pressure was increased by 3.7% during the infusion of HES but was not altered by mannitol.There were no clinically relevant effects on electrolyte concentrations and osmolarity in the blood.The mean effective dose to achieve an ICP below 15 mmHg was 1.4 (0.3~3.1) mL/kg for HES and 1.8(0.45~6.5) mL/kg for mannitol (P<0.05).Conclusion HES is more effective than mannitol 15% in the treatment of increased ICP.A dose of 1.4 mL/kg of HES can be recommended as effective and safe.The advantage of HES might be explained by local osmotic effects, because there are no clinically relevant differences in hemodynamic clinical chemistry parameters;efficacy.

Mounting evidences suggest that the ATRX (α-thalassaemia/mental retardation syndrome X-linked) and DAXX (death-domain associated protein) which encode 2 subunits of a chromatin remodelling complex required for H3.3 incorporation at pericentric heterochromatin and telomeres,and multiple endocrine neoplasia type 1 (MEN-1) genes are significantly mutated in most patients with pancreatic neuroendocrine tumors (pNETs),as are genes encoding key molecules of the mammalian target of rapamycin (mTOR) signaling pathway.These mutated genes promote deregulation of epigenetic processes such as chromatin remodeling,histone modification and activation of alternative lengthening of telomeres,and thus combined alteration of these genes may contribute to drive tumorigenesis and metastasis of pNETs which are characterized by complex patterns of phenotypes.These findings may have great significance in the diagnosis and treatment of pNETs and predicting the prognosis,as well as providing clinical implications for targeted cancer therapy.

Objective To analyze the distribution features of injury regions and severty of patients with traumatic brain injury ( TBI ) associated with muhiple injuries and discuss the influence of different injury regions and severity on their outcome.Methods Retrospective analysis was performed for clinical data of 1026 patients treated from August,2007 to August,2010. Results The majority of TBI patients associated with multiple injuries were young people( accounting for 78.07％ of the total injuries),among whom the males outnumbered females in proportion of 3.62:1,and the multiple injuries were mainly characterized by chest injuries (accounting for 46.69％ of multiple injuries).Spearman analysis indicated that Glasgow Outcome Scale (GOS) was correlated with Glasgow Coma Scale (GCS)score,age,maxillofacial region injuries,chest and abdomen injuries (P ＜ 0.05 ).Logistic regression analysis manifested that age,GCS score,and lung injury were the independent risk factors of high mortality in TBI patients associated with multiple injuries. Conclusion Low GCS scores,old age and severe lung injuries indicate a high mortality and morbidity,while injuries in extremities and pelvis have no significant influence on the outcome.

spleen(?)heart(?)muscle.The pharmacokinetics of PsD-044 in mice was fitted by an open three compartment model. The pharmacokinetic parameters calculated were shown to be essentially consistent with the determination of tissue distribution. It was also shown that PsD-044 can't pass through blood-brain barrier.

@@

Objective To provide the convenient and efficient screening program for the early detection and diagnosis of peptic ulcer by evaluatingthe clinical value of serum anti HP -IgG detection in the diagnosis of peptic ul-cer in health examination .Methods 116 participants underwent serum anti HP -IgG detection and gastroscopy ex-amination, taking the pathological biopsy results of gastroscopy examination as the gold standard .Their consistency and the diagnostic value of serum anti HP -IgG detection were compared by the Kappa consistency test .Question-naires were filled by participants after the examinations to evaluate the comfort level and conveniences during the ex -aminations as well as their overall satisfaction , and to evaluate the value of HP -IgG detection .Results 87 partici-pants were positive in serum anti HP -IgG detection , accounting for 75%, while 29 participants were negative , ac-counting for 25%.According to the results of gastroscopy examination , 29 participants were diagnosed with duodenal ulcer (25%), and 25 participants with gastric ulcer (21.55%), and 34 participants with hybrid ulcer (29.31%), and 28 participants without peptic ulcer (24.14%).Based on the results of serum anti HP -IgG detection and gas-troscopy examination, Kappa=0.744 (p=0.073) was found by the Kappa consistency test , and the consistency was good.After the calculation , the sensitivity ( the true positive rate ) was 94.25%, and the specificity ( the true negative rate) was 79.31%.The anxiety, comfort level, conveniences and patients'satisfaction of anti HP-IgG group were bet-ter than those of control group (p<0.05).Conclusion Serum anti HP-IgG detection is worthy of the clinical promo-tion as a screening program for the early detection and early diagnosis of peptic ulcer , because it boasts of high sensitivi-ty, a good consistency in gastroscopy examination ,less anxiety , convenience and satisfaction for patients .

Heart rate variability (HRV) is an important point to judge a person's state in modern medicine. This paper is aimed to research a person's fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV's characteristics of fatigue crowd based on the database provided by Physio-Net. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.
Fatigue ; diagnosis ; Heart Rate ; Humans ; Regression Analysis

The chemical composition, separation and identification of the components as well as the tumor photobiological activities of the major components of the new tumor-photochemodiagnostic and photochemotherapeutic agent photocarcinorin (PsD-007) were represented in this paper. It has been shown by the results of HPLC analysis in combination with spectroscopic determinations that PsD-007 is composed of 7 different porphyrins: MHD, DMD, MVD, AHD, HVD, Hp and Pp. The experimental results show that MHD, DMD and MVD are the major tumor photobiologically active components of PsD-007.

Objective To investigate Chlamydia trachomatis infection and gene variants in child- bearing women in Beijing. Methods Endocervical samples were collected from 177 patients in a family planning clinic and a gynecologic clinic. C.trachomatis infection was screened with a fast diagnostic kit .Major outer membrane protein(MOMP) gene was amplified by a nested PCR . A 1.1kb amplified product was obtained and studied by restriction fragment length polymorphism analysis(RFLP). Variant domains of MOMP gene VS1,VS2,VS3,VS4 were sequenced with 373A automated sequencing system. Results C. trachomatis was found in 9 of 177 samples. Four samples were identified as F genotype, 3 E genotype and 2 D genotype. Variant domains of MOMP gene, VS1, VS2, VS3, VS4 were sequenced and the results were consistent with those of RFLP, however, mutations were found in MOMP gene in 4 samples. Conclusion C.trachomatis urogenital infection has been identified in a portion of child- bearing women in Beijing. C.trachomatis can be well genotyped with RFLP or gene sequencing of MOMP gene.

Methods:188 students majorting in clinical medicine were randomly divided into two groups:the experimental group with evidence based medicine(EBM)teaching method and the control group with traditional teaching method.Results:The experimental group was better than the control group in results of theory examination and skill test,writing medical record,analyzing condition of patients and the level of student's satisfaction.Conclusions:EBM thinking training is practicable in clinical teaching.