Objective To observe the cerebral edema occurrence ,evolution and prognosis of intra-arterial thrombolytic recanali-zation in patients with acute ischemic stroke .Methods From October 2010 to October 2012 ,36 patients who underwent the intra-arterial thrombolytic therapy were cerebral recanalization .They were randomly divided into two groups :1-3 h group and >3-6 h group .The alteration of brain edema was observed by cranial CT .Their mRS .NHISS and BI were scaled and recorded before and after intra-arterial thrombolytic therapy .Results After intra-arterial thrombolytic therapy ,the occurrence rate of cerebral edema was 94% ,appeared at the onset of more than 1 hours in all patients .Long-term follow-up showed ,cerebral edema location appeared obvious cerebromalacia .Cerebral edema and clinical outcome had not significant difference between 1-3 h group and 3-6 h group . Conclusion Cerebral edema and loss of cerebral tissue occurred almost inevitability in patients who received intra-artery thromboly-sis and recanalized their cerebral artery .It indicates that good local circulation and general condition may be favorable factors that can gradually reduce brain edema .

Objective To investigate the association of serum interleukin-8 (IL-8) and myocardial enzyme levels in children with bronchopneumonia.Methods Serum IL-8 contents were measured by the radioimmunity method and serum myocardial enzyme contents were measured by the Olympus AU640 in 60 children with bronchopneumonia (mild 30 cases and severe 30 cases) as well as in 30 controls.Results Serum IL-8 contents were significantly higher in children with severe bronchopneumonia and mild bronchopneumonia than those in controls [( 2.54 ± 0.65),( 1.28 ± 0.53) μ g/L vs.(0.43 ± 0.08) μ g/L] (P ＜0.01),and serum myocardial enzyme contents (α-hydroxybutyrate dehydrogenase,MB isoenzyme of creatine kinase,creatine kinase,aspartate aminotransferase) were significantly higher in children with severe bronchopneumonia and mild bronchopneumonia than those in controls (P＜0.01).Conclusions IL-8 and myocardial enzyme may play a role in children with bronchopneumonia.Determination of serum IL-8 and myocardial enzyme levels might have important prognostic values in children with bronchopneumonia.

Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.

Objective To validate the analytical performance of three Cys C reagents with particle-enhanced turbidimetric immunoassay(PETIA) method used on the automatic biochemistry analyzer for preliminary clinical application.Methods The performance of three Cys C reagents (labeled as A, B, C) with PETIA method from Shanghai Jing Yuan Co., Beijing Leadman Co. and Beijing Jiuqiang Co. on OlympusAU2700 automatic biochemistry analyzer were assessed.According to the standard of CLSI EP6-A, EP15-A and EP7-P, the precision, linearity range, disturbance (bilirubin, hemoglobin, chyle) were assessed, and compared with those of Cys C reagent based on particle-enhanced nephelometric immunoassay(PENIA) from Dade Behring Co.. The reference ranges for Cys C in serum of 120 healthy individual were evaluated.Results The within-run CVs of the three reagents (A, B and C) were 3.08%-3.2%, 2.3%-4.15% and 1.38%-1.53% respectively.The total CV in A, B and C were 3.29%-3.44%, 2.65%-5.18% and 1.67%-1.69% respectively, lower than the stated.Limits of quantitative determination (LOQ) of the three reagents were 0.41, 0.23 and 0.07 mg/L, basically meeting the testing requirement.The linearity range was 0.22-7.26 mg/L(r=0.996), 0.20-7.72 mg/L(r=0.999)and 0.20-7.62 mg/L(r=0.997)in the three reagents, which demonstrated a sound linear correlation. For interference tests, no remarkable interference (<±10%) of reagent C was detected when bilirubin≤684 μmol/L, hemoglobin≤9.7 g/L and Chyle turbidity≤6 200 FTU; and no significant interference of reagent B was found when bilirubin≤684 μmol/L, hemoglobin≤6.79 g/L and Chyle turbidity≤6 200 FTU; when bilirubin≤684 μmol/L, hemoglobin≤4.85 g/L and Chyle turbidity≤1 240 FTU reagent A was not interfered significantly. The comparison afte and before the high-speed centrifugation reveals that the average percentage of bias for reagents A, B, C measured Cys C in chylous serum samples of patients was -8.31%, 1.52%, 1.32%, respectively.In method comparison tests, the regression equations of the three reagents compared with Dade Behring PENIA Cys C reagent were as follows:Y=0.787X+0.492 (R2=0.976), Y=1.098X+0.137 (R2=0.982) and Y=1.037X+0.249 (R2=0.996), respectively. Agreement rates of the high Cys C in reagent A, B, C and Dade Behring Cys C reagent were 80% (Kappa=0.615,P=0.000), 100% (Kappa=1.000,P=0.000), 91.2% (Kappa=0.824,P=0.000); While for reference range of preliminary clinical assessment, diagnosis coincidence rate of reagent A increased to 98.8% (Kappa=0.974,P=0.000). Conclusions When used in automatic biochemical analyzer, the three Cys C reagent with PETIA showed high precision,sensitivity, and sound correlation with Dade Behring PENIA reagents.The three reagents are all able to meet clinical test requirements, nevertheless, anti-interference capability were diffierent and the reference range should be further validated.

Objective To explore the correlation of CT perfusion imaging with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in hepatic alveolar echinococcosis (HAE).Methods Multi-slice spiral CT perfusion imaging was performed in 27 patients with HAE.Time-density curves(TDC) of the HAE peripheral area was drawn from the region of interest (ROI) with perfusion functional software.CT perfusion parameters including blood flow ( BF ),blood volume ( BV ),mean transit time(MTT) and permeability surface area product (PS) were calculated.MVD and VEGF expression of pathological specimens were examined by immunohistochemical staining with anti-CD34,anti-VEGF monoclonal antibody.The CT perfusion parameters,MVD and VEGF were compared in different types of TDC with t test.The correlation of CT perfusion parameters with MVD and VEGF were analyzed with Spearman test.Results In this group,21 cases which TDC lower than that of the liver were classified as type Ⅰ,the others 6 cases TDC higher than the liver were of type Ⅱ TDC.TDC perfusion parameters of the two types were as follows,BF:( 111.7 + 27.6),( 158.9 + 39.5 ) ml · 100 g- 1 · min - 1,BV:( 15.1 + 6.2),(26.8+8.4) ml/100 g,MTT:(7.0+4.4),(7.7+3.1) s,PS:(51.7 +17.3),(51.0+20.5) ml·100 g-1 · min-1.The significant differences of BF,BV and MVD[ (20.5 +5.4)/HP,(37.2 ±7.5)/HP,respectively ] were found between two types ( t =- 7.897,- 18.783,- 5.223,P ＜ 0.05,respectively).There were no significant differences in MTT,PS and VEGF expression(2.1 ± 1.0,3.2 ± 1.0,respectively)between two types of TDC(P ＞0.05).The correlation was found between the MVD and BF and BV in the type Ⅱ TDC group( r =0.789 and 0.878,respectively) and no correlation was found between MVD and each CT perfusion parameters in the type Ⅰ TDC group ( P ＞ 0.05 ).There was no correlation between the VEGF expression and CT perfusion parameters in two types of TDC ( P ＞ 0.05 ).Conclusion CT perfusion imaging with different type of TDC reflected different situation of angiogenesis in HAE peripheral area,which could be a potential technique to illustrate the microcirculation of this disease.

Objective To investigate the prevalence of healthcare-associated infection (HAI)in a hospital in 2013-2015,and provide reference for the improvement of HAI management.Methods Prevalence rates of HAI among patients in the First Affiliated Hospital of Zhengzhou University in 2013 -2015 were investigated with cross-sec-tional survey method,prevalence rates of HAI and constituent ratios of HAI sites in patients of different genders and different age groups were analyzed.Results In 2013 -2015,29 605 patients should be investigated,29 581 (99.92%)were actually investigated.Prevalence rates of HAI in 2013-2015 were 2.83%,2.14%,and 1 .73%,re-spectively,difference was significant(χ2 =27.521 ,P <0.01),which showed a downward trend year by year.Preva-lence rates of HAI in male was significantly higher than that of female (2.47% vs 1 .98%,χ2 =7.954,P <0.01). The prevalence rates of HAI in the age dimension was roughly U-shaped distribution in 2013 -2015.Prevalence rates of HAI in ≥70 age group was the highest(4.15%),in 0 -30 age group decreased with age,in > 30 age group increased with age.The top three sites for prevalence of HAI were lower respiratory tract (45.67%),upper respiratory tract (9.92%),and urinary tract (8.52%).Conclusion The prevalence rates of HAI decreased year by year in 2013-2015,which suggests that HAI prevention and control measures are effectively implemented.

Objective: To revised the Taiwan version successful aging inventory (SAI), and verify its reliability and validity in urban elderly in mainland China. Methods: SAI was adjusted by culture and revised by pre-test to form a formal questionnaire. A sample of 600 elderly people in Guangzhou was chosen for a face-to-face questionnaire survey through convenient sampling. Half of the sample (n=300) was randomly selected for exploratory factor analysis, and the other was used to confirm the structural validity of SAI. Results: Exploratory factor analysis extracted six common factors, including health autonomy, economic security, life adaptation, society and relative relationship, study and family. The cumulative contribution rate of six common factors was 65.366%. The fitting indexes of confirmatory factor analysis were χ²/df=1.861, CFI=0.930, IFI=0.930, TLI=0.923, GFI=0.823, RMSEA=0.054, RMR=0.073. There were significant ceiling effects in the four dimensions of health autonomy, economic security, life adaptation, and family. The internal consistency coefficient (Cronbach's α) of SAI was 0.930, and the test-retest reliability was 0.943. An average score of SAI ≥ 3.95 points was considered successful aging. Conclusion Reliability and validity of SAI are good, which can be used to measure the successful aging status of Chinese elders and track the effectiveness of health promotion measures.

Objective To evaluate the reliability and validity of the Chinese version of multidimen-sional existential meaning scale (MEMS-C) in college students. Methods The MEMS was translated into Chinese. A total of 453 college students was tested by convenience sampling method via online survery. Eighteen college students were surveyed by MEMS-C before and after a two-week interval in order to analyze the retest reliability of the scale. Results The fitting indexes of the confirmatory factor analysis were χ2=450. 510,df=74,P<0. 01,χ2/df=6. 088,GFI=0. 859,CFI=0. 930,RMSEA=0. 106,RMR=0. 074,SRMR=0. 0494. The correlation validity coefficient of the scale was 0. 617 (P<0. 01). Internal consistency relia-bility coefficient of the total scale,comprehension,purpose,and mattering factors were 0. 935,0. 893,0. 936, 0. 733. The retest reliability was 0. 908 (P<0. 01). Conclusion The MEMS-C has good reliability and va-lidity. It is suitable to measure the sense of life of college students.

Objective To investigate the clinical and electrophysiological characteristics of anti-myelin-associated glycoprotein (MAG)-associated peripheral neuropathy, as well as its antibody detection methods, treatment and prognosis. Methods Six cases of IgM paraproteinemia and anti-MAG antibody-associated peripheral neuropathy were summarized. All of the patients came from Peking Union Medical College Hospital and Qilu Hospital since April 2014 to February 2018. The clinical features, electrophysiological characteristics, and auxiliary examinations including anti-MAG antibody results were analyzed, and the treatment and prognosis were followed. Results Of the six patients, five were male and one was female. The age of onset was 50-77 years and the duration was three months to six years. All the six cases suffered from numbness of distal limbs and gradually progressed to the proximal limbs, of which three cases had muscle weakness. Walking instability occurred in five cases. One patient had electricity-like pain in the lower extremities. Reflexes in the four limbs decreased in five cases, and gloves and socks-like deep sensation decreased in six cases. Five patients underwent lumbar puncture and the cerebral spinal fluid protein ranged from 0.75 to 1.33 g/L. Serum monoclonal proteins were found in six patients, of which four were IgM kappa and two were IgG kappa and IgM kappa biclonal. Four cases were diagnosed with monoclonal gammopathy of undetermined significance and two cases were diagnosed with Waldenstr?m's macroglobulinaemia. Abnormal electromyography was detected in all the six cases, suggesting demyelinating peripheral nerve damage with secondary axonal damage, which was sensory predominant and more severe in lower limbs than upper limbs. In all the six cases, anti-MAG-IgM antibodies were all positive by indirect immunofluorescence assay based on transfected cells and peripheral nerve tissues. After the diagnosis, three patients underwent RCD (rituxima + dexamethasone + cyclophosphamide) chemotherapy. One patient improved (the modified Rankin scale (mRS) score was 3 before treatment and 2 three years after treatment), one patient was stable, and one patient was still in follow-up. One patient was treated with rituxima, and the condition improved (the mRS score was 3 before treatment and 1 one year after treatment). Conclusions MAG-associated peripheral neuropathy can present a slow progressed distal symmetric sensomotor peripheral neuropathy with predominant sensory symptoms. Electromyography shows demyelinating change. Monoclonal protein is usually IgM kappa. MAG-IgM antibodies detection by indirect immunofluorescence assay based on transfected cells and peripheral nerve tissues can support the diagnosis. RCD chemotherapy may be effective.

Objective: To investigate the effects of self-made rehabilitation on lower extremity motor function in patients with stroke hemiplegia. Methods: In total, 60 stroke patients with hemiplegia who were unable to walk, were randomly assigned to the traction training belt plus routine rehabilitation group (experimental group) and routine rehabilitation group (control group),30 cases respectively. There were five outcomes: Fugl-Meyer Motor Assessment of the lower extremity(FMA-LE), Kendall method for Manual Muscle Testing(MMT), Berg Balance Scale(BBS), Functional Ambulation Classitication(FAC) and Activity of Daily Living(ADL). Results: For patients on therapy for 12 weeks, the results of both groups were statistically significant (t=-19.185--7.971, P <0.01) . The levels of FMA-LE, BBS and FAC were 29.6 ± 3.7 and 24.9 ± 5.9 (t=3.609, P <0.05) , 31(21, 40) and 22(10, 32)(t=-2.194, P <0.05), 3(3, 4) and 3(2, 3) (t=-2.270, P <0.05) in the test group and the control group, respectively. There was no significant difference in the levels of MMT and ADL (P >0.05). Conclusions The application of traction training belt tested in this study are significant efficacy in rehabilitation effects on lower extremity motor function, muscle strength, balance function and walking ability in stroke patients with hemiplegia, and is worth being promoted.