Objective To study the relationship between helicobacter pylori (HP)infection and hemicrania.Methods The serum HP IgG level and ~ 14 C expiration test were detected in patients with HP infected. The patients with hemicrania, health and at attack stage or interval stage or any degree attack stage of hemicrania were observed the condition of HP infection. The curative effect of HP patients treated with traditional method and plus with three combined anti-HP infection treatment was observed.Results The positive rate of HP infected in patients with hemicrania was higher than that of control(81.0% vs 30.96%, P

Objective To investigate the changes of vertebral-basal artery and regional cerebral blood flow(rCBF) in patients with olivopontocerebellar atrophy(OPCA).Methods 10 patients with OPCA were examined by digital subtraction angiography(DSA) and single-photon-emission-computed tomography(SPECT),and compared with the control group(patients with vertigo or transient ischemic attack).Results In OPCA group,there were 5 cases with small vertebral artery(50%),4 cases with single vertebral artery(40%),9 cases with small and little vessels(90%),10 cases with poor stain in later arterial phase(100%) could be seen by DSA.The lower rCBF in cerebellum and brain stem were seen in 8 cases(80%)by SPECT.In control group,there were 3 cases(15%),4 cases(20%),4 cases(20%),3 cases(15%) and 7 cases(35%) respectively.There were significant differences between the two groups(all P

Objective To assess the diagnostic value of MSCT in congenital bridging bronchus (BB).Methods Three-dimensional (3D) reconstructed CT images including MPR,MinIP,MIP,VR were respectively analyzed in 12 patients with congenital bridging bronchus on postprocessing workstation.Results Six of 12 BB patients were type Ⅰ bridging bronchus which originated from the left main bronchus at the level of fourth and fifth thoracic vertebral body,while the right bronchus was originated from the normal carina at the level of second and third thoracic vertebral body.The average angle of normal carina was about 59.2°,and the average angle of pseudocarina where BB originated from the left main bronchus was about 108.8°.The left main bronchus proximal to the origin of BB showed significant stenosis,with 1-2 mm width and 17 mm length in the involved segment.Six cases were type Ⅱ bridging bronchus,the right bronchus was absent in normal carina,BB originated at the level of fourth and fifth thoracic vertebral body,the average angle of pseudocarina was about 131°,the whole right lung was supplied by BB.The lower portion of trachea had stenosis in all 6 patients with 2-3 mm width and 30 mm length in the involved segment The lower portion of the trachea was found moving to the left in 4 patients and the left pulmonary artery sling was found in 2 patients.Conclusion MSCT can afford a definite diagnosis of BB by showing the morphology of trachea,bronchus,carina and relationship with surrounding organs with 3D reconstructions.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.

Objective To investigate the mechanism of myocardial ischemia and reperfusion-induced acute lung injury (ALl) and protective effect of ischemic postconditioning.Methods Forty SD rats were allocated to sham group,myocardial ischemia/reperfusion group (reperfusion group),ischemic postconditioning group (postconditioning group),and ischemic postconditioning + phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibiting group (inhibitor group) according to the random number table,with 10 rats per group.Myocardial ischemia/reperfusion was induced by left anterior descending coronary artery occlusion.Postconditioning was performed within 1 minute before reperfusion consisting of 3 10 s cycles of reperfusion followed by 10 s occlusion.Lung was immediately removed 120 minutes after reperfusion for HE stain,immunohistochemical detection of inflammatory factors and apoptosis factors,TUNEL assay of cell apoptosis,and Western blot of protein kinase B (Akt),phospho-Akt (p-Akt),glycogen synthase kinase-3β (GSK-3β),and phospho-GSK-3β (p-GSK-3β).Results Down-regulated B-cell lymphoma-2 (Bcl-2) and IL-10 and up-regulated Bcl-2 associated X protein (Bax),cysteinyl aspartate specific proteinase-3 (Caspase-3),IL-6 as well as IL-8 were observed in other 3 groups compared with sham group (P ＜0.01).Moreover,down-regulated Bax,Caspase-3,IL-6,IL-8 as well as TUNEL and up-regulated Bcl-2 as well as IL-10 were observed in reperfusion group compared to postconditioning group and tensor group (P ＜ 0.01).No statistical differences were found among the four groups in levels of Akt,p-Akt,and GSK-3β,but level of p-GSK-3β was significantly down-regulated in reperfusion group compared to other 3 groups(P ＜ 0.01).Conclusion Development of ALI may relate to down-regulation of p-GSK-3β evoked directly by the release of inflammation factors in early period of myocardial ischemia/reperfusion and ischemic postconditioning may attenuate the condition.

Objective To evaluate the effects of ischemic postconditioning on brain injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Diabetes mellitus was induced by intraperitoneal streptozotocin 60 mg/kg and confirmed by blood glucose level ＞ 16.7 mmol/L.Thirty male Sprague-Dawley rats,weighing 220-280 g,in which diabetes mellitus was successfully induced,were randomly allocated into 3 groups (n =10 each) using a random number table:group sham operation (group S),group I/R and group ischemic postconditioning (group P).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery in I/R and P groups.Group P received 3 cycles of 10 s reperfusion followed by 10 s ischemia at the end of myocardial ischemia.The rats were sacrificed at 120 min of reperfusion and the brains were removed for microscopic examination and for determination of cell apoptosis (by TUNEL) and expression of interleukin-6 (IL-6),IL-8,IL-10,glycogen synthase kinase-3 beta (GSK-3β) and phosphorylated GSK-3β (pGSK-3β) (by immuno-histochemistry).Apoptotic index was calculated.Results Compared with group S,apoptotic index was significantly increased,IL-6 and IL-8 expression was up-regulated,and IL-10 and pGSK-3β expression was downregulated in I/R and P groups (P ＜ 0.01).Compared with group I/R,apoptotic index was significantly decreased,IL-6 and IL-8 expression was down-regulated,and IL-10 and pGSK-3β expression was up-regulated in group P (P＜0.01).There was no significant difference in GSK-3β expression among the 3 groups (P ＞ 0.05).The pathologic changes were significantly attenuated in group P as compared with group I/R.Conclusion Ischemic postconditioning can attenuate brain injury induced by myocardial I/R in diabetic rats,and inhition of activity of GSK-3β may be involved in the mechanism.

Objective To evaluate the imaging features and causes of cerebral cortical laminar necrosis(CLN) in children,to improve understanding this sign.Methods The imaging and clinical data of 33 children diagnosed with CLN were analyzed retrospectively.The imaging features of CT and MRI were summarized and compared according to their etiologies.Results Children cerebral CLN involved multiple lobes of bilateral hemicerebrum, including the cortical region, subcortical region and basal ganglia region, and linear or gyral shape,patchy shape and punctate shape abnormal density or signal were demonstrated.The typical imaging features were high-signal intensity over the lateral cortical surfaces or along the gyri on T1WI and FLAIR.Diffusion weighted imaging(DWI) showed high signal with restricted diffusion on acute-stage, and Gd-DTPA enhancement demonstrated linear or gyrate enhanced appearance on early-stage.The extent of CLN of cerebral infarction was relatively limited.Acute anoxic encephalopathy showed an early imaging change and extensive involvement.While chronic anoxic encephalopathy and inflammatory encephalopathy showed a late imaging change and a longer existence.Conclusion Children cerebral CLN may have various causes and imaging features,and show characteristic chronological signal changes on imaging studies.The different causes result in the different patterns for CLN in distribution and time distribution.

Objective:To investigate the effect of different ventilation time in the prone position on patients with endogenous/exogenous ARDS.Methods:30 endogenous/30 exogenous ARDS patients were randomly devided into 4 groups,ventilation in the prone position for 2 h and 4 h.Recording the score of APCHEII,oxygenation index,the absorption situation in X-ray,HR,MAP,extubation time,the time out of ICU.Results:The APCHEII scores HR and MAP in four groups have no significant statistics (P＞0.05);4h ventilation for endogenous ARDS patients has a better indicators than 2 h in oxygenation index,the absorption situation in X-ray,extubation time and the time out of ICU (P＜0.05);2 h and 4 h ventilation for exogenous ARDS patients can improve indicators above,two groups have no significant statistics (P＞0.05),the results of exogenous groups are precede than endogenous group (P＜0.05).Conclusion:Ventilation in the prone position can improve the situation of ARDS patients,both endogenous patients and exogenous patients.Exogenous ARDS patients have a better treatment effect after the ventilation of 2h,however,endogenous patients need longer time and have a non-ideal prognosis.

Objective To compare the ameliorating effect of collagen peptide chelated calcium (CPCC) and estrogen on the bone quality in ovariectomized rats in order to serve the development of safe drugs for prevention of osteoporosis (OP).Methods Bilateral ovariectomized rats were divided into ovariectomized group (OVX),sham group,17β-estradiol injection group (OVX+E2) and CPCC gavage group (OVX+CCCP).Bone and serum indices of these groups were assessed and compared at 9 weeks after treatment.Results Bone density of the OVX group was significantly lower than the sham group (P<0.01),indicating that the rat OP model was successfully established.Like estrogen,CPCC inhibited the abnormal changes of all indices and maintain similar levels with those of the sham group (P>0.05),while the body weight gain of the E2 group at weeks 8 and 9 was significantly lower than those of the sham group (P<0.01).As regarding the prevention of bone loss,the Mg and Ca levels of the E2 group were significantly lower than those of the moderate and high dose CPCC groups.The Cu level was not significantly different compared with the sham group,while those in the moderate and low dose CPCC groups were significantly higher than the sham group.The Mn,Zn and hydroxyproline levels of the E2 group were significantly lower than those of the sham group,while the CPCC group maintained levels similar to that of the sham group.In regarding to the inhibiting effect on the increased blood BGP and StrACP,the E2 group was still maintained at levels similar to that of the OVX group,while those of the CPCC group were significantly lower than the OVX group.As regarding the decreased blood Ca,the E2 group was not significantly different with that of the OVX group,while that of the CPCC group was significantly higher than the OVX group.Conclusions CPCC is more effective than estrogen in ameliorating the bone quality of ovariectomized rats.

Objective To investigate MRI findings and its relationship with clinical grading and prognosis of infant muggy syn-drome (IMS).Methods Twenty five cases of IMS diagnosed newly and nine cases of IMS with follow-up were collected.MRI find-ings were retrospectively analyzed and compared with their clinical data.Results Seven early abnormal signs could be shown on cer-ebral MRI examination.There was no correlation between the clinical grading and three abnormal signs,which were subdural effu-sion,supratentorial cerebral edema and subarachnoid hemorrhage (P >0.05).In contrast,the other four abnormal signs (abnormal signal of subcortex and cortex,diffuse cerebral hemorrhage,basal ganglia and corpus callosum edema or infarction,large area cere-bral infarction)were closely related to the severity of clinical symptom (P <0.05).MRI findings had certain correlation with clinical classification.Conclusion MRI can objectively reflect the serious change of brain damage in IMS,and provide important information for clinical therapy and prognosis.