Objective To investigate the relationship between the dynamic changes of hs-CRP and IL-6 with restenosis after stent angioplasty in cerebral arterial stenosis .Methods 65 patients with cerebral artery stenosis stent angioplasty in Nanyang Mu-nicipal Central Hospital from March 2011 to March 2013 were retrospectively analyzed .The changes of hs-CRP and IL-6 levels be-fore operation and at different postoperative time points were observed and their correlation with vascular restenosis was anlyzed . Results (1)The cerebral artery stenosis degree and serum hs-CRP and IL-6 levels were positively correlated(P<0 .05) .(2)Com-paring the hs-CRP and IL-6 levels at different time points showed that the postoperative hs-CRP and IL-6 levels were significantly increased ,reached the highest at postoperative 12 h and then gradually declined .The hs-CRP and IL-6 levels on postoperative 7 d in the patients with restenosis were significantly higher than those in the patients without restenosis (P<0 .05) .(3)The hs-CRP and IL-6 levels at postoperative 6 months in the patients without restenosis were significantly decreased compared with before opera-tion ,but which in the patients with restenosis had no statistically significant differences (P>0 .05);△hs-CRP and △IL-6 had sta-tistically significant differences between the patients with restenosis and the patients without restenosis (P<0 .05) .Conclusion hs-CRP and IL-6 may play an important role in the process of restenosis after stent angioplasty in cerebral arterial stenosis .Monitoring the dynamic changes of hs-CRP and IL-6 has certain value for evaluating vascular restenosis .

Objective 　To explore the relationship between psychosocial factors and risk of vascular dementia. Methods　A cohort study of people 55 years old and over were followed up 10 years after a baseline screening. 5055 older subjects in Shanghai were stratified and cluster sampled from community. Information about psychosocial factors was collected during the baseline screening with an interview in 1987. The clinical diagnosis of dementia and vascular dementia (VD) were made according to DSM-Ⅲ-R and Hachinski Ischemic Score (HIS). In 1997,the elders who were not having dementia in 1987 were surveyed; Clinical diagnosis terms of that was made in above mentioned criteria. Then we analyzed the relationship between the psychosocial factors and VD in community elderly population by means of Logistic regression and estimated the incidence of VD.Results　1203 subjects were re-surveyed in 1997 and among them 124 new cases of dementia including 36 cases of VD were identified. By calculating the relative risk (RR) of psychosocial factors to the VD, we found that several psychosocial factors were correlated with the VD including not taking group activities, unsatisfying life, negative life events and depression (RR＞1). ADL total score are also good predictive points for VD.Conclusions　Psychosocial factor may play an important role in the vascular dementia developed.

Objective To study the rule of dynamic change of cognitive function in community elderly and predicting for dementia through using items of MMSE. Methods A 10 year follow up of cognitive function survey was carried out in the non dementia old people using Chinese version Mini Mental State Examination(MMSE). The elder people were divided into two groups (dementia group and non dementia group) according to the DSM Ⅲ R diagnostic criteria 10 years later. Results (1) A total of 1 192 subjects completed all data sheets by two surveys and 124 cases(10 4%)were identified in the second survey 10 years later. (2)Almost all the baseline item scores and its change of MMSE of the dementia group were higher than that of the non dementia group. (3)Orientation of time, serial subtration by seven, reading items of MMSE were effective predictors for the dementia, resding and orientation of time were significant predictors for Alzheimer's disease through logistic regression model. Conclusions The item analysis of MMSE is important information for the epidemiological research.

ObjectiveTo investigate the value of ultrasound in diagnosis and differential diagnosis of uterine arteriovenous fistula (UAF).MethodsUltrasound results of 12 patients with UAF were analyzed retrospectively,and were compared with uterine artery angiography.ResultsUAF showed uneven echo signals of uterine muscle wall near endometrium or cesarean section incision and irregular echo-free zone on ultrasonographies,the typical case of which displayed “honeycomblike” change.Color Doppler ultrasound showed rich blood flow in local area and lake-like or multicolored mosaic change.Spectral Doppler waveform shape was characterized as high-speed low resistance.The ultrasonographic results of UAF were consistent with those of uterine artery angiography.ConclusionUltrasonography combined with uterine artery angiography contributes to the diagnosis of UAF.

Disseminated intravascular coagulation (DIC) triggered by sepsis is a major challenge in the emergency and critical care of severely ill patients. The inflammasome is an essential component of the human immune system, and its activation can mediate pyroptosis and then release interleukin (IL)-1β and IL-18, which further activates platelets and the coagulation system and exacerbates inflammatory responses and coagulation processes, thus creating great uncertainty for the treatment and prognosis of sepsis. This article aims to review the correlation between the inflammasome and pyroptosis, as well as their impact on coagulation function, in hope of providing new insights for the clinical treatment of DIC.

Objective To evaluate the utility of multi-slice computed tomography (MSCT) in assessing acute non-reperfused myocardial infarct size. Methods Seven domestic pigs (mean weight 17.3 ± 1.9 kg) underwent ligation of the distal left anterior descending artery to establish a model of acute myocardial infarction (MI). MSCT and triphenyltetrazolium chloride (TTC) staining were performed two hours later. The following data were acquired and analyzed:MI volume (%), CT values of the infarcted region, left ventricular cavity and normal cardiac tissue at various scanning time-points (1, 5, 10, 15, 20 min after contrast injection). Results Using MSCT, the overall MI volume showed a time-dependent decrease, with a reduction of 28.87%after 20 min. The greatest reduction occurred at the 5 min time-point. In TTC staining, MI volume was 9.87%± 2.44%. When MI size, as determined by MSCT, was compared with that by TTC staining in Bland-Altman plots, there was a better agreement at 5, 10, and 15 min time-points at 1 and 20 min. Conclusions The study indicates that double-phase scanning examination using MSCT is a useful tool to assess MI size, and the optimal late-phase scanning time-point set within 5-15 min of contrast injection.

Objective To study the prognosis and pre-procedural independent risk factors for pa-tients with no-reflow (NR) phenomenon during percutaneous coronary intervention (PCI). Methods Pa-tients with or without NR phenomenon during PCI procedures from January 2000 to January 2005 were studied retrospectively. The clinical data preoperative and the incidence of major adverse cardiovascular events (MACE) between the two groups were compared. Univariate analysis and multivariate Logistic analysis were used to select the risk factors for NR phenomenon. Retrospectively was reviewed for (35.8 ± 15.3)months. Results The NR group had more significant incidence of MACE. Multivariate Logistic analysis showed that the predictive factors for NR were (1) Smoke index ≥ 300(OR = 2.81,95%CI: 1.61-4.38 ,P =0.007). (2) Fasting blood glucose level before PCI ≥ 11.1 mmol/L (OR = 3.39,95%CI: 1.51-4.89,P = 0.000 ). (3) Absence of angina pectoris attack within one month before PCI (OR = 2.39,95%CI: 1.22-3.78,P = 0.009). Conclusions The prognosis is poor for the PCI patients with NR phenomenon. Those patients whose fasting blood glucose level before PCI ≥ 11.1 mm01/L, smoke index ≥ 300 and absence of angina pec-toffs attack within one month before PCI have higher incidence of NR phenomenon.

Objective:Based on the construction of benign organizational climate of tertiary public hospitals, this paper tries to understand the practical demands of hospital staff for the internal organizational climate.Methods:A seven-dimension organizational climate questionnaire for public hospitals was designed by literature review and Delphi expert survey method. On the basis of satisfying the reliability and validity test, Kano questionnaire analysis and Better-Worse coefficient analysis were combined to identify the key climate factors to improve the satisfaction of hospital staff.Results:28 climate indicators were divided into: 9 (32.1%) attractive requirements, 7 (25.0%) one-dimensional requirements, 4 (14.3%) hybrid requirements, 6 (21.4%) must-be requirements, and 2 (7.2%) indifference requirements.Conclusions:According to Kano model classification results and satisfaction influence matrix distribution results, Some suggestions are put forward for constructing benign organizational climate in hospitals from the aspects of constructing equitable system, popularizing democratic leadership, attaching importance to cultivating scientific research and improving humanistic care.

Objective: To evaluate the clinical and radiological outcomes,and the complications of staged minimally invasive surgery for adult degenerative scoliosis, comparing with that of the conventional open surgery. Methods: From Jun 2013 to Jun 2017, a total of 42 cases of degenerative scoliosis underwent surgical treatment. Among which, 23 cases underwent staged minimally invasive surgery(MIS group) and 19 cases underwent posterior open surgery(open group). The intra-operative bleeding, and operation time were recorded.The clinical outcomes were assessed using the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for low back pain and leg pain.The radiological outcome was evaluated with Cobb angles and sagittal balance parameters (Sagittal Vertical Axis (SVA), Pelvic Incidence (PI)-Lumbar Lordosis (LL), Pelvic Tilt (PT)). The occurrence of complications was recorded. Results: The baseline demographic features of both groups (gender, age, medical comorbidity, etc.) were similar.The mean follow-up period for both groups was more than 2 years.The intraoperative bleeding in the MIS group 405.7±144.8 ml was significantly lower than that in the open group (2 005.3±728.4 ml, t=10.31, P<0.001); The total operation time 414.3±63.0 min of MIS group was significantly longer than that of the open group (304.2±51.8 min, t=6.10, P<0.001), but the operating time of each stage was shorter than the open group. The VAS score for back pain and leg pain,the ODI scores were significantly improved after surgery for both group, there was no significant difference between the two groups, but the low back pain and function in MIS group were better than the open group. The parameters of the coronal and sagittal deformity were significantly improved in both groups, correction of coronal deformity in MIS groupwassignificantly superior to the open group (F=12.02, P=0.001), there was no significant difference in sagittal balance correction between the two groups. The overall complication rate (63.2%) was slightly higher in the open group than in the MIS group (34.8%) without significant difference(χ²=3.36, P=0.07). The incidence of major complications in the open group was significantly higher than that in the MIS group (P=0.014). Conclusion Staged minimally invasive surgery can significantly relieve the patient's pain, improve functionand the coronal and sagittal balance of the patient, the early clinical and radiological outcomes were comparable to the open surgery; Minimally invasive surgery may significantly reduce the amount of bleeding and major complications. Minimally invasive surgery is safe and effective for carefully selected patients with degenerative scoliosis.However, the long-term outcomes of minimally invasive surgery remains to be followed up.

BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an important treatment for malignant hematological diseases,and delayed postoperative platelet implantation is a common complication that seriously affects the quality of patient survival;however,there are no standard protocols to improve platelet implantation rates and prevent platelet implantation delays. OBJECTIVE:To compare the safety and efficacy of oral Herombopag Olamine versus subcutaneous recombinant human thrombopoietin for promoting platelet implantation in patients with malignant hematological diseases undergoing haploid hematopoietic stem cell transplantation. METHODS:Clinical data of 163 patients with malignant hematological diseases who underwent haploidentical hematopoietic stem cell transplantation from January 2016 to October 2022 were retrospectively analyzed.A total of 72 patients who started to subcutaneously inject recombinant human thrombopoietin at+2 days were categorized into the recombinant human thrombopoietin group;a total of 27 patients who started to orally take Herombopag Olamine at+2 days were categorized into the Herombopag Olamine group;and 64 patients who did not apply Herombopag Olamine or recombinant human thrombopoietin were categorized into the blank control group.The implantation status,incidence of acute graft-versus-host disease of degree II-IV within 100 days,1-year survival rate,1-year recurrence rate,and safety were analyzed in the three groups. RESULTS AND CONCLUSION:(1)The average follow-up time was 52(12-87)months.The implantation time of neutrophils in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group was(12.95±3.88)days,(14.04±3.71)days,and(13.89±2.74)days,respectively,with no statistically significant difference(P=0.352);the implantation time of platelets was(15.16±6.27)days,(17.67±6.52)days,and(17.00±4.75)days,with no statistically significant difference(P=0.287).(2)The complete platelet implantation rate on day 60 was 64.06%,90.28%,and 92.59%,respectively,and the difference was statistically significant(P<0.001).The subgroup analysis showed that the difference between the blank control group and the recombinant human thrombopoietin group was statistically significant(P<0.001),and the difference between the blank control group and the Herombopag Olamine group was statistically significant(P=0.004).The difference was not statistically significant between the recombinant human thrombopoietin group and Herombopag Olamine group(P=0.535).(3)100-day II-IV degree acute graft-versus-host disease incidence in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group were 25.00%,30.56%,and 25.93%,respectively,and the difference was not statistically significant(P=0.752).(4)The incidence of cytomegalovirus anemia,cytomegalovirus pneumonia,and hepatic function injury had no statistical difference among the three groups(P>0.05).(5)During the follow-up period,there was no thrombotic event in any of the three groups of patients.(6)The results showed that recombinant human thrombopoietin and Herombopag Olamine could improve the platelet implantation rate of malignant hematological disease patients after haploidentical hematopoietic stem cell transplantation,with comparable efficacy and good safety.