Objective To investigate the reason of anti-Dia combined with anti-E antibodies inducing incompatibility in blood crossmatching.Methods Retrospectively analyse a case of patient treated in the hospital,whose blood crossmatching failed for sev-eral times.Through blood typing,direct Coombs test,irregular antibody screening,adsorption and elution experiments to determine the patient′s blood type,possible irregular antibodies,cell spectral response pattern.Results Forward blood typing:anti-A antibody (-),anti-B antibodies(-);Reverse blood typing:Ac (++++),Bc(++++),RBC(-),Oc(-);Rh blood grouping:anti-c an-tibody(-),anti-C antibody (+ + + +),anti-D antibody (+ + + +),anti-e antibody (+ + + +),anti-E antibody (-),direct Coombs test(-).Patient′s serum contained anti-E and anti-c antibodies.Conclusion Irregular antibodies in the serum of patients is an important cause of crossmatch discord.

Exosomes are small membrane vesicles approximately 40-100 nm in diameter released by a variety of cell types.Exosomes contain proteins, lipids, mRNA and microRNA, and play important roles in intercellular communication.This article reviews the sources, general features and biological function of exosomes, as well as its possible role and mechanism in the pathophysiology and neurological recovery of ischemic stroke.

ObjectiveTo explore the clinical value of application of metoprolol and nifedipine in the treatment of asymptomatic myocardial ischemia for the elderly.Methods56 cases of elderly patients with silent myocardial ischemia were chosen.They were randomly divideded into the metoprolol group of 28 cases and nifedipine group with 28 cases according to the number table.The incidence of complications during treatment in the metoprolol and nifedipine group were analyzed.The seizure frequency and onset time in the two groups of patients were compared before and after treatment.ResultsThe onset time in the two groups,before treatment had no statistically significant difference[the number of attacks:(19.6±3.2) times/week compared with(18.9±2.8) times/week;attack time:(5131±352)s vs (5130 ± 348 ) s,all ( P ＞ 0.05 ).After treatment,there were statistically significant differences for the number of attacks and attack time [the number of attacks:(4.6 ± 2.1 ) times/week compared with ( 7.4 ± 2.1 )times/week,onset tine:(900 ± 140) s vs ( 1440 ± 240 ) s ( all P ＜ 0.05 ).All patients can tolerate the treatment period,there was no cases of myocardial infarction occurs.ConclusionThe metoprolol and nifedipine for the elderly treatment of silent myocardial ischemia was more secure,and metoprolol was more effective than nifedipine.

Objective To study algorithm expression of the optimal reconstruction increment with which images could be reconstructed without loss of z-direction spatial resolution for multislice spiral CT.Methods Using Gauss function and signal sampling principle,an algorithm expression was deduced to calculate the optimal reconstruction increment with which images could be reconstructed without loss of zdirection spatial resolution.Spiral slice sensitivity profile (SSP) phantom was scanned using Somatom Sensation 64-slice spiral CT and temporal bone protocol as those used for clinic,axial images were reconstructed with slice thickness of 0.600 mm and increment of 0.100,0.300,0.400 and 0.500 mm respectively.Then SSPs and full width at half maximum (FWHM) were measured and modulation transfer functions were obtained by Fourier transfer from SSPs.Axial CT scan of 7 normal temporal bones in 6 patients were obtained by the same CT system and parameters as above.Coronal MPR images of temporal bone out of different reconstruction increment were obtained and the quality of reconstructed images were independently assessed by three senior radiologists using a four-point scale and blinded the information of reconstruction.Experimental data were processed and two-way ANOVA(in which Dunnett t test was selected for multiple comparisons) was performed with statistic software SPSS10.0.P ＜ 0.05 was considered as significant difference.Results (1) The measured FWHM of reconstruction slice thickness of 0.600 mm was 0.665 mm,so the optimal reconstruction increment calculated with the algorithm expression in this article was 0.296 mm(≈0.300 mm).Objective evaluation showed that there was obviously aliasing in high spatial frequency range of MTF curve when reconstruction increment was more than 0.300 mm,i.e.both 0.400 and 0.500 mm.Clinical scores of coronal MPR images of temporal bone reconstructed with different increment had significant difference(F =505.374,P ＜ 0.01).Treating reconstruction increment of 0.100 mm as a control group and comparing another groups against it,there was no significant difference for reconstruction increment of 0.300 mm (t =-0.222,P ＞ 0.05),while there were significant difference for 0.400 and 0.500 mm (t =-1.333、-15.889,P ＜ 0.05,P ＜ 0.01).Conclusion It was proved that the angorithm expression deduced in this article was proper because of the consistence between the calculated value and the results from objective and clinical evaluation.The optimal reconstruction increment without loss of z-direction spatial resolution is 0.445 times as large as FWHM for multislice CT.

ObjectiveTo investigate effects of 8Hz 90dB and 8Hz 130dB infrasound on hippocampi ultrastructure of SD rats.Methods60 male SD rats were randomly divided into the control group and experimental group. Rats of experimental group were exposed to 8Hz 90dB or 8Hz 130dB infrasound 2 hours every day for 1,7,14, 21,28,35 and 42 days. As soon as the exposure finished,the right hippocampus of rat was taken and examined by electron microscopy.ResultsHippocampus ultrastructure of rats was changed after only one day exposure to infrasound and the longer exposure to infrasound, the worse ultrastructure changed. But during the latter period,damages of hippocampus ultrastructure became lighter. Different rules were observed between 90dB and 130dB groups.ConclusionInfrasound of 8Hz 90dB and 8Hz 130dB can make hippocampus ultrastructure of rats damaged mainly as denaturalizations. These changes are nonliner with time, and the hippocampus of rats has adaptability to infrasound.

Objective In order to evaluate the nutritional effect of early enteral nutrition in patients of Chinese domestic gastric cancer surgery,using evidence-based medicine methods,and supply evidence for clinical nutrition intervention.Methods CBM,Chinese academic Journals,Wanfang database and VIP Information Resource System were searched from January 2000 to March 2013 to collect the published clinical randomized controlled trials literatures of nutrition support in patients of Chinese domestic gastric cancer surgery according to inclusion and exclusion criteria of literature,using the Cochrane System Evaluation Handbook independent,double-blind principle of the literature methodology quality evaluation.Finally Meta analysis was conducted by using RevMan5.2 software.Results 14 articles were enrolled in the study,Meta analysis results showed that:early enteral nutrition comparing with parenteral nutrition in postoperative gastric cancer patients:the WMD of serum albumin was 1.55,95％ CI (0.81,2.29); the WMD of serum transferrin was 0.34,95％CI (0.30,0.38);the WMD of postoperative anal exhaust time was-20.66,95％CI (-23.91,-17.40).Conclusions Early enteral nutrition is better than the parenteral nutrition,which can restore adequate serum protein source for patients,and can recover the gastrointestinal digestion and absorption function of itself earlier,which is worthy of clinical promotion.

ObjectiveTo study the nursing strategy and high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery. Methods672 critically ill patients in department of neurosurgery in our hospital from January 2007 to September 2011 were selected as research object,and the rate of lower respiratory tract infection and high risk factors were studied and analyzed,and they were taken care of with special nursing. Results54 cases of 672 patients were with lower respiratory tract infection,the rate was 8.04％.Infection rate of elderly patients,patients of poor nutrition state,patients with underlying diseases was higher than those of other patients.Infection rate of patients with invasive operation,sputum suction,application of respirator,longer operative time and oxygen inhalation time was higher than those of other patients.Infection rate of patients with longer hospitalization time,emergency operation,application of many antibiotics and complication of preoperative infection of other site was higher than those of other patients,there were significant differences.The infection was well controlled with special nursing and treatment,four patients died of primary diseases. ConclusionsThe high risk factors of critically ill patients complicated with lower respiratory tract infection in department of neurosurgery include personal factors,treatment operation factors and other factors,and it can be controlled by special nursing and treatment.

Objective To observe the effect of the advanced glycation end products(AGEs)on the iNOS expression in cultured cardiac microvascular endothelial cells.Methods Cultured the cardiac microvascular endothelial cells in vitro.After AGEs of the different dose(50～200 mg/L)and different times(0～24 h)played the role on the cells,we determined the NO generation and iNOS protein expression of all groups.Results NO generation and iNOS protein expression increased with the AGEs-dose increasing and treatment time.The results were significantly different.Conclusion These results demonstrate that AGEs may induce iNOS to produce toxic NO in cardiac microvascular endothelial cells,then the diabetic cardiomyopathy occures.

ObjectiveTo investigate the effective method of preventing blood return when using nitroglycerin for patients with heart failure. Methods Using physiological saline solution or 5% glucose with nitroglycerin pumped into the same vein for patients at the same time, and then observed the condition of blood returning, recorded the critical drop-speed which can effective prevented blood return. Observed the influence of added solution on heart function of patients with heart failure. Results Pumped physiological saline solution or 5% glucose with nitroglycerin in the same time with the speed of 5ml/h can effective prevent the blood return, and the added solution can not influence the heart function for patients with heart failure significantly. Conclusion Pumped physiological saline solution or 5% glucose with nitroglycerin into the same vein at the same time can effective preventing the blood return, and the added solution can not influence the heart function for patients with heart failure significantly.

Objective To study the diagnostic value of susceptibility weighted imaging (SWI) in diffuse axonal injury (DAI) and investigate the relationship between SWI and clinical prognosis. MethodsTwenty patients (15 males and 5 females) with DAI were included in this study. Routine sequences (T1WI, T2WI and FLAIR) and SWI were performed on a 3.0 T MRI scanner. There were 8 cases whose Glasgow score scale (GCS) ranged from 3.0 to 5.0, 4 cases from 6.0 to 8.0 and 8 from 9.0 to 12.0. The interval time between injury and examination were from 3 hours to 20 days. The number and volume of lesions observed on SWI and routine sequence were compared using Mann-Whitney U-test and paired t-test. Pearson correlation was used to analyze the relationship between the number and volume of all lesions and GCS. Results The lesions showed punctate, beaded, patchy and cord-like hypointense signal with various size on SWI (lesion diameter <2.0 cm). Distribution of lesions was multifocal with clear boundary. Routine MRI scan found a total of 78 lesions, while SWI sequence detected 424 lesions. The number of the lesions found on SWI was more than that on conventional MRI (U=-15.447,P＜0.01). The total volume of the lesions measured on routine MRI and SWI were 19 340 mm3 and 38 042 mm3, respectively. The total volume measured on SWI was more than that on routine MR (t=5.870,P＜0.01). The number and volume of all lesions were negatively correlated with GCS (r=-0.802, -0.767, P＜0.01). Conclusion SWI sequence could find more bleeding lesions than the routine MRI sequences. The number and the volume of the lesions were closely related to GCS. SWI showed high value in the diagnosis and prediction of the prognosis of DAI.