Objective To investigate the effect of oxiracetam on (Hcy), high sensitive C-reactive protein (hs-CRP), uric acid (UA) and cysteine protease inhibitor (Cys C) and blood lipid index level in patients with acute cerebral hemorrhage.Methods 98 patients with acute cerebral hemorrhage were randomly divided into observation group ( n =49 ) and control group ( n =49 ) .The control group was given routine treatment, the observation group was given oxiracetam treatment on the basis of control group.Two groups were treated for 2 weeks.Results The observation group after treatment NIHSS score lower than control group(P<0.05), GCS score and ADL score higher than control group (P<0.05);The serum levels of Hcy, hs-CRP, Cys, C levels lower than control group post-treatment, while the level of UA was higher than that of control group (P<0.05);The observation group TG, TC, LDL-C levels were lower than control group post-treatment ( P <0.05 ); Two groups had no severe adverse reactions. Conclusion Oxiracetam by reducing and Hcy in patients with acute cerebral hemorrhage hs-CRP, Cys C level, increased UA level, and improve blood lipid function, and thus improve symptoms.

Objective To explore the value of 2 dimension and color Doppler flow imaging (2D CDFI) in detection of deep venous thrombosis of the lower limbs. Methods One hundred and one patients, 118 limbs clinically suspected as deep venous thrombosis were examined by CDFI and ascending phlebography. Results The sensitivity of ultrasonogram was 94 4% and accuracy was 98 4%. The highest incidence is 30 4% in the femoral vein. With the ratio 2 2∶1, the incidence of left lower limbs was much higher than the right. Because of different pathological changes in acute, subacute and chronic thrombosis, there are diverse character in 2D CDFI. Conclusions Deep venous thrombosis of the lower limbs can be diagnosed by 2D CDFI, which is a noninvasive, easy and accurate method.

Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.

Multiple myeloma is a more common malignant disease in blood medicine,which is characterized by hyper-proliferation and accumulation of malignant plasma cells in the bone marrow,resulting in a large number of monoclonal immunoglobulins and their fragments,leading to damage to the terminal organs.Of which about 80％ of patients have multiple myeloma bone diseases (MBD),which seriously affected the quality of life and prognosis of patients.We have found that the main cause of MBD are contributed to inhibition of osteoblasts,activation of osteoclast and affecting the occurrence by a variety of cytokines and pathways.This article will review and introduce the occurrence and development of MBD related to the latest factors and treatment.

BACKGROUND: Prognosis is determined by degrees of outside force and time of spinal cord compression after spinal cord injury. The former factor cannot be changed, but the latter one can be changed through relieving spinal cord compression as early as possible to promote nervous function recovery.OBJECTIVE: To compare the effect of surgical intervention time on nervous function recovery within 72 hours and 10 to 14 days after cervical spinal cord injury.DESIGN: Randomized controlled and before-after controlled study.SETTING: Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University.PARTICIPANTS: A total of 32 patients with cervical spinal cord injury were selected from the Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University from April 1998 to August 2001.All patients were divided into two groups according to randomly alternative criteria. There were 16 cases including 10 males and 6 females in early surgical group (within 72 hours) and there were also 16 cases including 12males and 4 females in delayed surgical group (within 10-14 days).METHODS: Patients in early surgical group were undertaken operation at 72 hours after hospitalization, and patients in delayed surgical group were at 10-14 days after hospitalization. Frankel grade, sensory and motor scores were recorded according to criteria set by American Spinal Injury Association before operation and within 24 months after operation.MAIN OUTCOME MEASURES: ① Sensory and motor scores before and after operation; ② Frankel grade before and after operation.RESULTS: ① Improved level of sensory score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (42.6±20.2, 19.2±19.1, P ＜ 0.01). ② Improved level of motor score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (39.7±17.8, 17.3±18.6, P ＜ 0.01). ③Improved level of Frankel grade in early surgical group was superior to that in delayed surgical group (P ＜ 0.01).CONCLUSION: Nervous function recovery of patients with acute cervical spinal cord injury who were suffered from operation within 72 hours is superior to that of those within 10 to 14 days. Therefore, surgical intervention should be undertaken as early as possible in order to promote nervous function recovery after cervical spinal cord injury.

Objective To investigate the pregnancy opportunity and outcome of patients with sysmetic lupus erythematosus (SLE).Methods We carried out a retrospective analysis of the clinical information of patients who suffered from SLE complicated with pregnancy and were hospitalized to People's Hospital of Peking University from December of 1992 to February of 2012.Chi-square test were used for statistical analysis.Results Forty-nine cases of patients with SLE complicated with pregnancy had 52 pregnancies in total.In 27 cases of planned pregnancies,24 cases(89％ )resulted in live births and 5 cases( 18％ ) had flares during pregnancy.Of the 24 live births,3 cases( 12％)were premature deliveries and 4 cases(17％) had low birth weight infants.In 25 cases of unplanned pregnancies,12 cases (48％) resulted in live births and 20 cases (80％) had flares during pregnancy.Of the 12 live births,6 cases(50％ ) were premature deliveries and 6 cases (50％) were low birth weight infants.The patients in the planned pregnancy group tended to have flares during pregnancy more frequently than those in the unplanned group (P＜0.01),the former were more likely to have live births than the latter (P＜0.01) and were less likely to have premature delivery (P＜0.05).Conclusion Patients with SLE should have planned pregnancy and need collaborative supervision of both rheumatology and immunology department and obstetric department to improve live birth rate,decrease premature delivery and the activity of SLE during pregnancy.

Objective To evaluate the effects of different concentrations of remifentanil on the expression and distribution of gap junction protein connexin 43 (Cx43) in the cardiomyocytes of rabbits.Methods Healthy adult rabbits of both sexes,weighing 2.0-2.5 kg,were anesthetized with pentobarbital sodium.Their hearts were rapidly excised and retrogradely perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃.After 15 min of stabilization with K-H solution,the 24 isolated hearts were randomly divided into 4 groups (n =6 each) using a random number table:control group (group C),and low,medium and high concentrations of remifentanil groups (R1-3 groups).The hearts were continuously perfused with K-H solution at 37 ℃ in group C.The hearts were perfused for 60 min with K-H solution containing remifentanil 12,25 and 50 ng/ml in R1-3 groups,respectively.The myocardial specimens were then obtained from the anterior wall of the left ventricle for detection of the expression and distribution of Cx43 by Western blot and immunohistochemistry,respectively.Results The expression of Cx43 was gradually down-regulated in C and R1-3 groups in turn (P＜0.05).Compared with group C,there was a tendency for the proteins localized at end-to-end contact sites of ventricular cardiomyocytes to localize at side-to-side contact sites in R1-3 groups,and the distribution was messy in R1-3 groups.Conclusion Remifentanil dose-dependently down-regulates the expression of Cx43 and changes the distribution of Cx43,which may be one of the mechanisms of remifentanil-induced arrhythmia in rabbits.

Objective To evaluate the efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil.Methods Forty patients undergoing general anesthesia,aged 20-55 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or 1Ⅱ,were randomly divided into control group (group C) and aminophylline group (group AP),with 20 patients in each group.At 30 min before induction of anesthesia,normal saline 20 ml was infused intravenously in group C,and aminophylline 3 mg/kg was infused intravenously in group AP.Midazolam 0.1 mg/kg was then injected intravenously.Remifentanil 2 μg/kg was injected intravenously after the patients fell asleep and then artificial ventilation was performed.Vecuronium 0.1 mg/kg,fentanyl 3 μg/kg,and etomidate 0.3 mg/kg were injected intravenously 7 min later.The patients were then endotracheally intubated and mechanically ventilated.HR and MAP were recorded before induction of anesthesia (T0),after falling asleep (T1),and at 0,1,3,5 and 7 min (T2-6) after the end of remifentanil injection.Low frequency (LF) and high frequency (HF) were recorded at T0,T1 and T2,and the ratio of LF/HF was calculated.Results Compared with the baseline value at T0,MAP and HR were significantly decreased at T2-6 in the two groups,and LF and HF were decreased at T1,and LF/HF ratio was increased at T1 in group AP.HR and LF/HF ratio were significantly higher,and LF and HF were lower at T1 in group AP than in group C.Conclusion The efficacy of aminophylline for prevention of the negative chronotropic effect of remifentanil on the hearts of patients is good.

Objective:To explore the vailation of serum sP-selectin,sE-selectin,levels in the patients of pre-diabetic,simple type 2 diabetes mellitus (T2DM) and T2DM with coronary heartdisease(CAD).To investigate the possible mechanism that sP-selectin, sE-selectin accelerate type 2 diabetes mellitus.Methods: Level of serum sP-selectin, sE-selectin was assayed by ELISA in type 2 diabetes with or without coronary heart disease (32 and 34 cases respectively),pre-diabetic (32 cases) and control group(32 cases). Meanwhile BMI,BP,FBS,FINS,TG,CHO,HDL-C,LDL-C,HbA1C were determined in all cases as well as in control group.Results:The serum levels of sP-selectin and sE-selectin in pre-diabetic,type 2 diabetes mellitus with or without coronary heart disease groups were significantly higher than the control group ( P<0.01 ).There was significant positive correlation between serum levels of sP-selectin,sE-selectin and these items including FBG ,FINS,TG,HbA1C,HOMA-IR(P<0.01);but sE-selectin was negatively correlated with HDL-C (P<0.05).Conclusion:sP-selectin,sE-selectin,are risk factors in the initiation and progression of pre-diabetic,type 2 diabetes with or without coronary heart disease;sP-selectin and sE-selectin possibly accelerate type 2 diabetes by inducing insulin resist-ance.

Objective:To describe the secular trends of premarital medical examination ( PME ) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate. Methods:The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the infor-mation on the health policies was from official governmental websites. According to the main health poli-cies, the calendar years were categorized into 3 periods:1996 to 2003 was mandatory PME period;2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period. Results: During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37. 7%. During the mandatory PME period, the rate ranged 52 . 7% -67 . 7% with an average of 60 . 9% ( urban 71 . 5%, and rural 51 . 7%) . In 2004 , the first year when the PME became voluntary, the rate was abruptly dropped to 2. 6%, and thereafter gradually increased to 11 . 5% in 2008 . As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52. 3% (urban 49. 8%, and rural 54. 6%) in 2013. The in-creasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 pro-vinces had rates of >90% ( Guangxi 97 . 5%, Fujian 96 . 0%, Ningxia 95 . 4%, Zhejiang 93 . 4% and Anhui 90. 1%), whereas some provinces were stuck at a low rate, including developed and underdeve-loped provinces/cities. The PME rate in 2013 was 27. 4% for Shanghai, 25. 5% for Guangdong, 12. 4%for Chongqing, 5. 8% for Beijing and 4. 6% for Tianjin. Underdeveloped provinces were Guizhou (6. 4%) and Qinghai (1. 8%). Conclusion:As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated;for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.