Objective To investigate the death risk of patients with severe cerebral vascular disease. Methods The clinical data of 80 cases of patients with severe cerebral vascular disease were analyzed retrospectively. According to the clinical outcome,80 cases were divided into the survival group and death group,and the factors of death risk were analyzed by Logistic regression.Results The cases of the survival group and death group patients were 59 cases(73.75%) and 21 cases(26.25%) respectively.After multiple regression analysis,age,temperature, glasgow coma score,hypertension,stroke,diabetes,chronic obstructive disease,digestive tracthemorrhage,pneumonia, intracranial hemorrhage or infarction and multiple organfailure were correlated with the death of patients with severe cerebral vascular disease significantly(P=0.023,0.011,0.002,0.028,0.004,0.023,0.029,0.028,0.001,0.007, 0.001).Conclusion The death of patients with severe cerebral vascular disease is associated with age,combined disease,syndrome and disease attributes.

Objective　To determine the changes of serum IL-10 level in perioperative period in patients with hepatocellular carcinoma (HCC) and discuss its significance. Methods　The serum IL-10 level was determined with ELISA in 30 patients with HCC and 30 healthy volunteers. Results　The serum IL-10 level was significantly higher in the perioperative period in patients with HCC than in the healthy volunteers. In the patients with HCC, the level was higher before than after the operation. Meanwhile, it was markedly higher in patients with poorly differentiated tumor or the tumor with a diameter over 5 cm than in those with well-differentiated tumor or the tumor with a diameter less than 5 cm (P<0.01). Conclusion　HCC cells might produce IL-10 that may participate in immune response of HCC. Furthermore, IL-10 might be a factor that can reflect the differentiation grade, assess the prognosis and predict recurrence of HCC.

Objective To study the effect of glucosides of cbaenomeles speciosa (GCS) on the expression of EP2 and EP4 in synovial tissues from rats with adjuvant arthritis. Methods Complete Freund's adjuvant (FCA) was used to induce adjuvant arthritis (AA) in rats. The synoviocytes from AA rats were collected and incubated. Synoviocytes proliferation was determined by 3-(4,5-dimethylthiazal-2yl) 2,5-dipbeny+hetrazoliumbromide (MTT) assay. Levels of prostaglandins E2(PGE2) and cAMP were determined by radioim-munoassay (RIA). The expression of EP2 and EP4 was detected by Western blot analysis. Results GCS significantly inhibited the proliferation of synoviocytes. GCS decreased the level of PGE2 and increased the level of cAMP. The results of correlation analysis demonstrated that GCS inhibited synoviocytes hyperplasia by increasing the level of cAMP in synoviocytes. The results of Western blot analysis demonstrated that GCS significantly improved the expression of EP2 and EP4. Condusion These results suggest that restoring normal transduction of the EP-G protein-cAMP signal pathway may be one of the most important mechanisms of GCS.

Rcsult of field cultivation test by protoplastic fusion technique for biological cngln ering breeding of Poria cocos in Huoshan county, Anhui Province was reported for the first time. A fusion strain F1 was obtained from parents P1, P6578 by separation, fusion, marker of hypha protoplast and identification of recombinat. It was cultivated simultaneously with P1, P5778 for comparison. Results showed that the average cellal outputs were 1.73, 0.5 and 2.20kg respectively.As the output of strain F1 is intermediate between its parent P1 and P578, the result is considered to be unsatisfactory. The reason for such result was discussed.

Objective To investigate the efficacy of contrast-enhanced ultrasound (CEUS) in diagnosing liver, gallbladder, spleen and renal diseases. Methods 27 patients with liver diseases, 30 patients with gallbladder diseases, 5 patients with renal diseases, 5 patients with renal trauma and 6 patients with spleen disease were examined by CEUS. Results There were 3 cases of primary hepatocellular carcinomas, 4 cases of metastatic hepatic carcinomas, 4 cases of liver abscess, 10 cases of hepatic hemangiomas and 3 cases of liver repture with active bleeding. The diagnostic coincidence rate of CEUS was 90%. 30 patients with gallbladder polyposis were diagnosed by CEUS, and the diagnostic coincidence rate was 100%. 5 cases with renal diaseses included 1 of renal abscess, 1 of renal column hypertrophy and 3 of renal hemangioma. In 5 cases with renal trauma, there were 3 cases with renal contusion and 2 cases with renal rupture and active bleeding. The coincidence rate was 61%. In 6 cases with spleen diseases, there were 1 case with splenic infraction, 1 case with splenic abscess and 4 cases with splenic rupture and hemorrhage. The coincidence rate was 100%. Conclusion CEUS has great value of clinical application in diagnosis of liver, gallbladder, spleen and renal diseases.

Objective To investigate the effect of venous indwelling needle on peripherally inserted central catheterization (PICC).Method Seventy-eight critical patients underwent PICC through external jugular vein using venous indwelling needle at the emergency treatment.Result The success rate for one-time puncturing was 97.4%,without any complications.Conclusion PICC through external jugular vein using venous indwelling needle is advantageous for its safety,fewer complications and longer indwelling duration.

Objective To evaluate the application of 64-slice computed tomography (CT) and software-assisted image analysis in preoperative evaluation and surgical planning of hilar cholangiocarcinoma. Methods The clinical data of six patients with hilar cholangiocarcinoma who were admitted to The First Affiliated Hospital of Sun Yat-sen University from June to December, 2009 were retrospectively analyzed. All six patients underwent 64-slice CT scanning before the operation, and then three-dimensional (3D) reconstruction of the liver, tumor, blood vessels and bile ducts was achieved with the assistance of Myrian (R) XP-Hepatic software. The relationships of the tumor, blood vessels and bile ducts were illustrated in the 3D model. Virtual liver resection was carried out for surgical planning. Results The 3D models of the liver, tumor, blood vessels and bile ducts were successfully constructed . The 3D models were able to be rotated and magnified as necessary. Preoperative evaluation and surgical planning were in accordance with actual surgery. The relative accuracy of the software-assisted image analysis system for calculating the hepatic volume to be resected was 5%. Patients recovered well without occurrence of hepatic failure. Conclusion Sixty-four-slice CT scanning and software-assisted image analysis are important for preoperative evaluation and surgical planning of hilar cholangiocarcinoma.

Objective To compare the clinical efficacy and prognosis between classical infra-patellar (IP) and supra-patellar (SP) intramedullary nailing in the treatment of tibial shaft fractures.Methods A retrospective analysis was conducted of the 68 patients with tibial shaft fracture who had been treated from June 2012 to December 2014 and completed follow-ups.They were 59 males and 9 females,18 to 87 years of age (mean,43.7 years).Of them,38 were treated through the SP approach and 30 through the IP approach.The 2 groups were compared in terms of surgery-related indexes,The Hospital for Special Surgery (HSS) knee function score and Johner-Wruhs evaluation for clinical efficacy at 1,3,6,and 9 months postoperation.The 2 groups showed no significant differences regarding preoperative general data(P ＞ 0.05).Results The 68 patients obtained an average follow-up of 6 months (range,from 1 to 9 months).Intra-operative accumulative fluoroscopy time in the IP group(2.1 ± 1.1 s) was significantly less than in the SP group(3.3 ± 1.8 s) (P ＜ 0.05).The number of limited open reduction (1),intra-operative bleeding volume (128.6 ± 164.1 mL) and number of second intra-operative shifting (4) in the SP group were significantly smaller than in the IP group(7,216.2 ± 195.9 mL and 10,respectively) (P ＜ 0.05).The HSS score in the SP group at 9 months (80.8±7.Spoints) was significantly higher than in the IP group (74.0±5.4points)(P ＜0.05).The clinical good to excellent rate at 9 months for the SP group (97.4％) was significantly higher than for the IP group (70.0％) (P ＜ 0.05).There were also significant differences between the 2 groups in postoperative adverse events like knee pain(P ＜ 0.05).No wound infection,limb shortening,internal fixation loosening or rupture,fracture nonunion or mal-union happened in either of the 2 groups.Conclusions In the treatment of tibial shaft fractures with intramedullary nailing,the supra-patellar surgical approach may effectively reduce the incidence of postoperative knee pain so that it can prevent degenerative changes of the knee joint in the long term.It may also lower the incidence of intraoperative second shifting.It also has the advantages of limited incision,simplicity,and limited scaring.In short,it may be superior to the classical infra-patellar approach.

To identify the isolated suspicious strain of Campylobacter jejuni from the blood of bacteremia patient in Guizhou Province ,China ,conventional and molecular techniques (specific mPCR and NAP-mPCR) were used to identify suspi-cious bacteria strains .Results showed that Campylobacter jejuni suspicious colonies were cultured in bacteremia patient blood samples .The strain was identified as Campylobacter jejuni ssp . jejuni by conventional tests and was identified as Campy-lobacter jejuni by genus specific mPCR .Then the strain was classified as Campylobacter jejuni ssp . jejuni by subspecies NAP-mPCR .The strain was identified as Campylobacter jejuni ssp .jejuni isolated from the blood of bacteremia patient and Campylobacter jejuni can be identified subspecies by NAP-mPCR .

Objective To study the content changes of wilforlide A in Xinfeng capsules before and after compatibility.Methods The content of wilforlide A was determined in Xinfeng capsules ester content and in Tripterygium wilfordii Hook.f.single solution by TLCS method.Developing solvents:chloroform and methanol (85:1),scanning wavelength:230 nm.Results Wilforlide A showed a good linear relationship in 1.700-5.100p g,the regression equation is Y =1 118.766 + 3 253.751 X (r =0.999).The average recovery of the wilforlide A in Xinfeng capsules was 102.84％,and RSD was 3.64％.The average recovery of the wilforlide A in the Tripterygium wilfordii Hook.f.single decoction was 98.14％,and RSD was 2.21％,compatibility levels before and after the change (compatibility with 0.179mg/g,0.136mg/g after compatibility).Conclusion The established TLCS method was simple,specific and accurately quantitative.The comparative study found that the compatibility of Xinfeng capsules Tripterygium reduced the content of wilforlide A,which may be related to decreasing toxicity.