Ischemic stroke is a critical society-medicine-economy problem,and effective therapy is rather insufficient.Nowadays,method of promoting blood circulation and removing blood stasis was popularly adopted,but only enjoyed limited curative effect in segmental stage of illness in patients.In this article,we analyzed and discussed mainly concept and viewpoint on blood stasis syndrome in Traditional Chinese Medicine,moreover,and provided advanced data for experimental and clinical research in the future.

Objective To investigate the effect of di-( 2-ethylhexyl ) phthalate (DEHP) on pregnant rat and the protection of zinc.Methods Fifty rats were randomized equally into 5 groups consisting of blank (given 1 ml 0.9％ sodium chloride),corn oil (given 1 ml corn oil),zinc (given 1 ml zinc gluconate including 1.2 mg zinc),DEHP (given 50 mg · kg-1 · d-1 DEHP)and DEHP + zinc (given 50 mg· kg-1 · d-1 DEHP + zinc gluconate ).At the beginning of the experiment (about 7 d before pregnancy),the female rats were administered with corresponding drugs everyday.The pregnant rats were killed and the fetal rats were removed on 19th day.The following results in each group were recorded:the body weight and the organic weight of the female rats,the number and the weight of fetus rats and the placental weight.Results The weight and the coefficient of female rats' kidney/body,spleen/body,brain/ body,and heart/body in DEHP group compared with other groups were not statistical significance (all P ＞0.05).The coefficient of female rats' liver/body,uterus/body,and ovary/body of blank group were (4.4 ± 0.7 ) ％,( 1.26 ± 0.09 ) ％,( 0.083 ± 0.009 ) ％ respectively,corn oil group were (4.5 ± 0.6 ) ％,( 1.29 ±0.10)％,(0.084 ±0.008)％,zinc group were (4.4 ±0.4)％,( 1.26 ±0.08)％,(0.084 ± 0.009 ) ％,DEHP group were ( 5.4 ± 1.0 ) ％,( 1.11 ± 0.08 ) ％,( 0.074 ± 0.012 ) ％,and DEHP + zinc group were (4.4 ± 1.0)％,( 1.28 ± 0.10)％,(0.082 ± 0.007)％ ; in DEHP group the coefficient of female rats' liver/body,uterus/body,and ovary/body compared with other groups was statistical significance ( P ＜ 0.05 ).The fetal quantity,fetal weight and placental weight of female rats of blank group were 12.8 ± 2.7,(6.03 ±0.16) g,( 1.00 ±0.03) g respectively,corn oil group were 13.6 ±3.1,(6.07 ±0.20) g,(1.00±0.04) g,zinc group were 13.3 ±3.1,(6.16 ±0.18) g,( 1.00 ±0.05) g,DEHP group were 9.2±4.1,(4.03 ±0.09) g,(0.95 ±0.03) g,and zinc +DEHP group were 12.1 ±2.9,(6.09 ± 0.17 ) g,(0.99 ±0.03 ) g.In DEHP group the fetal quantity,fetal weight and placental weight of female rats compared with other groups were statistical significance ( P ＜ 0.05 ).Conclusion DEHP can damage female rats and fetal rats in gestation period.Zinc supplied before pregnancy can relieve the influence by DEHP.

Objective: To investigate the impact for family history of hypertension on masked hypertension (MH) morbidity with relevant cardiac damage. Methods: Our research included in 3 groups: MH group, n=250 consecutive patients treated in our hospital from 2010-01 to 2015-04, Hypertension group, n=250 and Control group, n=250 subjects with normal blood pressure. The family history of hypertension, general clinical information, routine biochemical indexes and the findings of echocardiography were studied and compared among different groups. Results: ① There were 70 (28%) patients with family history of hypertension in MH group, 87 (34.8%) in Hypertension group and 26 (10.4%) in Control group. The ratio of family history of hypertension in MH group was higher than Control group, P<0.001, while it was similar between MH group and Hypertension group, P>0.05. Logistic regression analysis presented that family history of hypertension and body mass index were positively related to the morbidities of MH (r=1.468, r=0.173) and hypertension (r=1.195, r=0.086). ② Compared with Control group, MH group had increased left ventricular mass index (85.64 ± 17.7) g/m2 vs (80.50 ± 15.53) g/m2 and the maximum blood flow velocity of aortic valve (115.74 ± 16.54) cm/s vs (112.40±14.21) cm/s, all P<0.05. In MH group, compared with those without family history of hypertension, the patients with family history had the higher left ventricular mass index (89.22 ± 19.08) g/m2 vs (84.25 ± 16.99) g/m2 and the maximum blood flow velocity of aortic valve (119.19 ± 14.97) g/m2 vs (114.39 ± 16.96) g/m2, all P<0.05. Conclusion: The subjects with family history of hypertension had the higher risk of MH morbidity with more severe cardiac damage.

Objective To understand the epidemic situation of hydatid disease in Gansu Tibetan Autonomous Prefecture(Gannan state) Gannan Province,and prevalence of the disease in population,livestock and final host dogs,and to evaluate the effectiveness of prevention and control measures.Methods In 2012:①An investigation was carried out according to the requirements of Technical Solutions of Hydatid Disease Prevalence,Gansu Province; in every county(city) of Gannan Prefecture,administrative villages were selected as survey units,by stratified cluster sampling based on the semi agricultural semi pastoral areas,pastoral areas,agricultural areas and towns.According to the proportion of the population of each layer to the population of each county,the number of people and the number of villages to be surveyed were determined.Sixteen villages were selected,and 200 people were selected in each village(from a neighboring village to make up the insufficient number in case of need),and B ultrasound method was used to carry out the census.②Children serum survey:stratification was done according to pastoral areas,semi agricultural semi pastoral areas,agricultural areas and towns population in each county(city),1 primary school was selected,children less than 12 years old were examined by B Ultrasound,and serum antibodies of Echinococcus granulosus were tested by enzyme-linked immunosorbent assay(ELISA).③ Surveillance of source of infection:in the selected villages,20 kennel households were selected in each village,dog feces was collected,and canine Echinococcus antigen was detected by double antibody sandwich ELISA method.④)Monitoring of intermediate host:1 000 sheep (or 500 cattle) were selected in each county(city),and hydatid disease was examined by anatomical method.⑤Investigation of health education was done in the form of a questionnaire survey of hydatid disease prevention knowledge and behavior survey on the awareness rate.Results The prevalence rate of population was 0.10％ (29/28 960); prevalence rate of herdsmen was 0.13％ (17/13 015); farmers prevalence rate was 0.06％(8/12 780); in children under 12 years of age,the infection rate was 2.64％ (336/12 728) ; dog infection rate were 3.90％ (117/3 001) ; livestock infection rate was 1.72％ (121/7 027); and the infection rates of cattle and sheep were 2.41％(38/1 574) and 1.52％(83/5 453),respectively.The rate increased from 40％(720/1 800) to 70％(1 260/1 800) of hydatid disease prevention knowledge awareness in farmers and herdsmen after health education.Conclusions The scope of hydatid disease in Gannan Prefecture is broad; the patient population mainly is herdsmen,and farmer is second.Epidemic factors include contact canine and vices; the farmers and herdsmen have low awareness of hydatid disease prevention knowledge.Poor production and lifestyle are difficult to change in the short term,we need to further strengthen the prevention measures.

Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis were the main features of NPE.The main approaches to the treatment were mechanical ventilation,mannitol,methylpredifiselone,intravenous immunoglobulin(IVIG),and vasoactive a-gents.And nine patients(25%)needed fluid volume resuscitation in addition.Conclusions Young children are particularly vulnerable to the Severe EV71 encephalitis with NPE.The majority of involved fatal patients are aged under 3 years.Patients may die of acute onset of NPE and/or hemoptysis with rapid progress towards cardiopul-monary failure.Early diagnosis and evaluation,respiratory support,lowering intracranial pressure and maintaining hemodynamics ale the essential therapeutic approaches.

Objective To discuss the surgical treatment of intraductal papillary mucinous neoplasms of the pancreas (IPMN).Methods The clinical data of 42 IPMN cases undergoing surgical treatment in our hospital during the past 4 years were analyzed retrospectively.Results Routine CT or MRI examination was made in 42 cases,ERCP in 6 cases,ultrasonic endoscopy in 12 cases,fine needle biopsy by endoscopic ultrasonography in 4 cases.There were 12 cases of the main duct IPMN,24 cases of branch duct IPMN,6 cases of mixed IPMN.Pancreatoduodenectomy was performed in 24 cases;6 cases underuent laparoscopic central pancreatectomy;10 cases did distal pancreatectomy,2 cases did total pancreatectomy.Postoperative pathology revealed that the malignant transformation rate of main pancreatic duct type was 66.7％,that of BD-IPMN was 12.5％ and 66.7％ of Mix-IPMN.The postoperative complication rate was 26.2％.All cases were followed up for 1 month to 4 years,with no tumor recurrence.Conclusions Imaging examination combined with endoscopic ultrasonography is the main method for clinical diagnosis of IPMN.The malignant transformation rate of MD-IPMN and Mix-IPMN is high.Most of the BD-IPMN is hyperplasia and adenoma.

Objectives:To evaluate essential medicines accessibility from the availability, drug price level and affordability perspective in Beijing. Methods:Data was collected from a sample of a Beijing social security database on diabetes in 2013 and a field research on 4 primary healthcare institutions. The essential medicine equipping rate, medium price ratio ( MPR) and poverty-inducing effect were selected as accessibility indicators. Results:Among 21 sample drugs, the nitrendipine, magnesium sulfate, sodium nitroprusside, prazosin, phentolamine and glyburide e-quipping rates are less than 15%. The 9 sample drugs MPR varied from 1. 3 to 27. 4. The hypertension, hyper-lipemia and diabete poverty-inducing rate varied from 0. 44% to 0. 70% in urban areas, and varied from 1. 17% to 1. 88% in rural areas. Conclusion:Some essential medicines in Beijing are equipped with a very low rate, but have a high price level, and the poverty-inducing population is large. We recommend strengthening the monitoring of es-sential medicines accessibility and introducing appropriate supporting policies.

Objective To investigate the psychological measurement index for the effectiveness and discrimination of drug packaging (color code) in the medicine for self-aid and mutual-aid .Methods The classical priming paradigm was used to inves-tigate whether there were influences on the recognition accuracy (ACC) and reaction time (RT) by memorizing the characteris-tics of three series of color code ,with a 2 (relevant or irrelevant priming )× 3 (color code categories) within subject experimen-tal design .Results ①The recognition (RT ) of the relevant-priming group was 1 387 .18 ms ,compared with the irrelevant-priming group 1 475 .12 ms .The independent two-sample t-test showed statistically significant difference between the relevant-priming and irrelevant-priming groups (t=2 .264 ,P=0 .02) .②The analysis of variance of factorial design showed a significant difference among the three series in the recognition (RT) (F=9 .945 ,P<0 .001) .The priming effect was significant in color code 1 and 3 ,while not significant in color code 2 .③The recognition (RT) in color code 2 was different by the judgment task :using directives< class-1 categorical attributes < class-2 categorical attributes ,consistent with the order of difficulty of the judgment task .The P value for the priming effect was 0 .03 ,0 .21 and 0 .7 in the judgment task for using directives ,class-1 cat-egorical attributes and class-2 categorical attributes .The priming effect was significant in using directives ,while not significant in class-1 categorical attributes and class-2 categorical attributes .Conclusion The priming effect of the characteristic of the color code is significant ,and the characteristic of the color code can promote the process of memorization of the medicine for self-aid and mutual-aid .

Objective:To demonstrate the concept of planning target volume (PTV) is not suitable for intensity proton therapy (IMPT) in lung cancer, plan differences were compared based on the concept of PTV and Internal target volume (ITV), aiming to provide clinical reference.Methods:Six patients were retrospectively selected and approved by the local ethics committee. Each of the six patients received two IMPT plans based on a synchronous accelerator model, developed by SINAP team (Shanghai Institute of Applied Physics, China Academy Science University) and commercial treatment system: one with the PTV-based robust IMPT (PTV-IMPT) plan and the other with ITV-based robust IMPT (ITV-IMPT) plan. Three beams were set in all plans, and the final dose was calculated using Monte Carlo dose algorithm. The plan quality and robustness of PTV-IMPT and ITV-IMPT plans were evaluated quantitatively.Results:Compared to the PTV-IMPT plan, ITV-IMPT plan showed better target conformity index (conformability index: 0.58 vs.0.43), better homogeneity index (homogeneity index: 0.96 vs.0.92), lower V 5Gy in normal lung tissue (13.1% vs.13.5%) and maximum dose in spinal cord (8.9 Gy vs. 9.5 Gy) as well as plan monitor unit (MU: 338 vs. 401) . In addition, ITV-IMPT plan showed more robust in target coverage (0.003-0.032 vs. 0.02-0.28), and normal lung tissue was also found a bit robust in the ITV-IMPT plan ( 0.06-0.11, 0.07-0.13). Conclusions:Compared with the PTV-IMPT plan, ITV-IMPT plan has the advantages of high planning quality, well robustness and better tumor motion mitigation. Therefore, ITV concept is recommended to be applied in the IMPT plan for lung cancer.

Objective:The purpose of current study was to evaluate the interplay effects in intensity-modulated proton therapy (IMPT) for lung cancer and compare the results of different Iso-energy layer repainting techniques in the mitigation of interplay effects.Methods:Eight patients with lung cancer who underwent 4DCT were retrospectively selected. A robust CTV-based IMPT plan was generated for each based on commercial TPS, considering patient setup errors ±5 mm, range uncertainties ±3.5%, and CTV time structure motion in 4DCT image. Monte Carlo dose engines were used for all IMPT plans in the final dose calculation. The 4D static dose (4DSD) and 4D dynamic dose (4DDD) were calculated using a hybrid deformable algorithm and simulated proton delivery system for interplay effects. An index[ΔI(ROI, DVH)] was developed to quantitatively evaluate the interplay effects. We applied Iso-energy layer repainting techniques with different numbers of repainting (3, 4, 5, 6, 7) to the robust IMPT plans and evaluated the difference in the mitigation of interplay effects based on the ΔI(ROI, DVH) index.Results:Due to interplay effects, the mean values of target coverage, conformity and homogeneity index reduced by 13.7%, 12.7% and 24.6%, respectively. The mean values of lung V 5Gy and V 20Gy improved by 0.8%, 3.4% and 2.6%. Compared to the IMPT plans without layer repainting, Multiple iso-energy layers repainting techniques improved the mean values of CTV coverage by 4.5%, 3.8%, 3.8%, 3.6% and 5.7%, respectively. The average values of lung V 20Gy reduced by 1.5%, 1.8%, 1.7%, 1.6% and 1.9%, respectively. Conclusions:In the robust CTV-based IMPT plans, the interplay effects degraded the target dose distribution but were mitigated using iso-energy layer repainting techniques. We recommended to use the layer repainting technique according to the characteristics of the patient.