Objective To investigate the instant clinical efficacy of intra-arterial infusion of fasudil combined with routine anti-vasospasm for symptomatic cerebral vasospasm (SCVS). Methods The clinical data of 21 patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm, who were admitted to authors' hospital during the period from May 2010 and February 2014, were retrospectively analyzed. The lesions included Fisher gradeⅡ(n=2), gradeⅢ (n=16) and gradeⅣ (n=3). Endovascular embolization of the aneurysm was carried out within 48 hours after the confirmation of the diagnosis with total cerebral DSA;no bleeding occurred during the operation and routine anti-vasospasm therapy was given. Within 4-9 days after the onset of the disease, all 21 patients presented SCVS. Half dose systemic heparinization, superselective intra-arterial infusion of fasudil (30 mg fasudil+250 ml saline, lasting for 30 min) were adopted. Reexamination of angiography performed at 15 min after fasudil infusion was employed, and the results were evaluated with NIHSS score by comparing the preoperative findings. Results Imaging examination performed after the treatment showed that significant improvement was obtained in 15 patients and no obvious changes in 6 patients. Clinical symptoms were remarkably improved in 11 patients, partially improved in 4 patients and remained unchanged in 6 patients. The mean NIHSS score was improved from preoperative 28.6 to postoperative 21.2. Conclusion For the treatment of symptomatic cerebral vasospasm, superselective intra-arterial infusion of fasudil is effective and safe, and it has good clinical application value.

Objective: To explore the clinical and prognostic features of lipoprotein glomerulopathy (LPG) in renal allografts. Methods: Retrospective analysis was performed for two case of LPG in renal allografts. The onset time was 6 and 9 years after living transplantation respectively. Initial symptoms included proteinuria and hypoproteinemia. Color Doppler ultrasound showed an enlarged graft size and greater parenchymal echogenicity. One patient had hyperlipemia and elevated apolipoprotein E (ApoE). Methylprednisolone pulse was offered with an early control of hyperlipidaemia and proteinuria by fenofibrate and angiotensin-converting enzyme inhibitors (ACEIs). Yet it had no effect on graft function. The definite diagnosis was made by graft biopsy. Pathological examination indicated non-homogeneous lipid deposition in glomerular capillary, glomerular sclerosis, mesangial hypercellularity and tubular atrophy. Results: During a follow-up period of 8 and 10 years post-transplantation, two cases eventually lost their grafts within 2 and 1 year after biopsy respectively. With long-term dietary control and drug therapy, regular dialysis continued and both awaited a second transplantation. Conclusions LPG is generally steroid-resistant and refractory in renal allografts. And routine biopsy is recommended for patients with a high risk of occurrence. Early controls of hyperlipemia and hypoproteinemia and other risk factors should be also properly managed.

Objective To use the "three-dimensional quality structure" model as a theoretical basis, based on multiple evidence-based evidence, to construct ICU nursing sensitivity quality indicators, and to provide reference for the evaluation and monitoring of ICU department nursing safety quality. Methods Evidence-based and Delphi methods were used to complete 3 rounds of inquiry among 27 experts to obtain consensus opinions of experts and to determine nursing quality indicators. Results Of the 30 articles included, 17 wereⅢA, 10 wereⅣA, 2 wereⅤA, and 1 wasⅤB. According to the"three-dimensional structure theory"model, the included indicators were sorted out and a total of 12 items were obtained. The effective recovery rate of 3 rounds of questionnaires was 96.6％, 100.0％, and 96.4％. The authoritative coefficients were 0.899, 0.895, and 0.909, and the coordination coefficients of the first, second, and third indexes were 0.340, 0.379, and 0.403, respectively,with significance (P<0.01). The final ICU nursing sensitivity quality indicator consists of 3 first-level indicators, 15 second-level indicators and 69 third-level indicators. The selection of indicators at all levels gradually converges. Conclusions The established ICU nursing sensitivity quality index accords with the principle of scientificity and practicality, and can be used for ICU department nursing quality assessment.

ObjectiveTo establish a polymerase chain reaction（PCR） method to accurately discriminate the crude materials of Murrayae Folium et Cacumen， Murraya exotica and M. paniculata. MethodBased on the difference in chloroplast genome sequences of M. exotica and M. paniculata， species-specific identification primers P03 and P04 of M. exotica and M. paniculata were designed according to single nucleotide polymorphism （SNP） on the chloroplast genome. A multiplex allele-specific PCR identification method was established for the identification of M. exotica and M. paniculata following the optimization of annealing temperature， number of cycles， and primer concentration ratio. The established PCR method for identification was explored and verified in terms of tolerance and feasibility by investigating the type of Taq polymerases and PCR system model. ResultIn this multiplex allele-specific PCR identification method， about 330 and 230 bp of specific fragments were amplified from DNA templates of M. exotica and M. paniculata， respectively， under the following conditions：cycle number of 31， annealing temperature of 60 ℃， and primer concentration ratio of P03 and P04 of 1∶2. Consistent results were obtained for samples from different sources. ConclusionThe multiplex allele-specific PCR identification method established in this study can accurately identify the origin of Murrayae Folium et Cacumen， which can be used for the simultaneous identification of M. exotica and M. paniculata by the length of fragments in a single identification assay.

Objective : To investigate the protective effect of dimethyl fumarate(DMF) on maternal intrahepatic cholestasis(ICP) during pregnancy induced by di(2-ethylhexyl) phthalate(DEHP) exposure and its mechanism. Methods : Thirty-two 8-week-old female institute of cancer research(ICR) mice were randomly divided into 4 groups: Ctrl group, DEHP group, DMF group and DEHP+DMF group. DEHP and DEHP+DMF groups were treated with DEHP(200 mg/kg) by gavage every morning at 9:00 a.m. DMF and DEHP+DMF groups were treated with DMF(150 mg/kg) from day 13 to day 16 of gestation by gavage. After completion of gavage on day 16 of pregnancy, maternal blood, maternal liver, placenta, and amniotic fluid were collected from pregnant mice after a six-hour abrosia. The body weight of the mother rats and the body weight of the fetus rats were sorted and analyzed; the levels of total bile acid(TBA), alkaline phosphatase(ALP), aspartate aminotransferase/alanine aminotransferase(AST/ALT) in serum and TBA in liver, amniotic fluid and placenta were detected by biochemical analyzer; HE staining was used to observe the pathological changes of liver tissue; Quantitative reverse transcription PCR(RT-qPCR) was used to detect the expression levels of tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-1, IL-18 and NOD-like receptor thermal protein domain associated protein 3(NLRP3) in the liver; Western blot was used to detect the expression of the nuclear factor KappaB(NF-κB) and NLRP3. Results : Compared with the control group, the body weight of the DEHP-treated dams and pups decreased(P<0.05); the levels of TBA, ALP, AST/ALT in the serum of dams and the levels of TBA in the liver, amniotic fluid, and placenta of dams increased(P<0.05); the histopathological results showed that liver tissue was damaged, bile ducts were deformed, and there was inflammatory cell infiltration around them; the levels of inflammation-related factors TNF-α, IL-6, IL-1, IL-18 and NLRP3 transcription in maternal liver increased(P<0.05); the expression of NF-κB and NLRP3 protein in maternal liver significantly increased( P<0. 05). Compared with the DEHP group,the body weight of both dams and fetuses significantly increased in DEHP + DMF group( P<0. 05); the levels of TBA,ALP,AST/ALT in the serum of dams and amniotic fluid of fetuses decreased( P<0. 05); the degree of liver lesions was improved; the transcription levels of inflammation-related factors TNF-α,IL-6,IL-1,IL-18 and NLRP3 in maternal liver decreased( P<0. 05); the expression of NF-κB and NLRP3 protein in maternal liver significantly decreased( P<0. 05). Conclusion DMF can effectively protect the DEHP exposure to lead to female ICP,and its mechanism may be through inhibiting the NF-κB/NLRP3 pathway and reducing liver inflammation.