Objective To explore the hemodynamic changes in the brains of newborns with intracranial hemorrhage.Methods Totally,61 newborns,born in Anyang Maternal and Child Health Hospital of Henan Province,with intracranial hemorrhage diagnosed by ultrasound in early neonatal period,and 50 healthy newborns,also born in the same hospital from December 1,2010 to June30,2012,were selected.Intracranial hemorrhage newborns were graded according to the severity of hemorrhage and divided into mild (n=45) and severe groups (n =7).The peak systolic flow velocity (Vs),end diastolic velocity (Vd),mean flow velocity (Vm) and resistance index (RI) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) of brain were measured by Doppler ultrasound.Ttest was applied for statistical analysis.Results Among the 61 neonates with intracranialhemorrhage,12(19.7％) were grade Ⅰ,42(68.9％) were grade Ⅱ,6(9.8％) were grade Ⅲ,and one (1.6％) was grade Ⅳ.The Vs,Vm and Vd of MCA and ACA in the mild and severe intracranial hemorrhage group were significantly lower than those in the control group,the differences were statistically significant [MCA:(55.1±9.1) cm/s,(53.0±6.5) cm/s vs (60.1± 10.3) cm/s;(34.2±6.1) cm/s,(32.5±5.2) cm/s vs (38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3± 4.0) cm/svs (20.2±5.3) cm/s.ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s vs (45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s vs (28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s vs (15.9±3.8) cm/s,all P＜0.05].But the RI values were significantly higher in the control group,the differences were statistically significant (MCA:0.70 ± 0.10,0.77 ± 0.07 vs 0.62 ± 0.10 ; ACA:0.67±0.06,0.73±0.08 vs 0.61±0.05;all P＜0.05).TheVs,Vm and Vd of MCA and ACA in the severe intracranial hemorrhage group were significantly lower than in the mild hemorrhage group,while the RI values were significantly higher,and the differences were statistically significant (all P＜0.05).Conclusions Newborns with intracranial hemorrhage have significant hemodynamic changes in the brain and more prominent changes could be found in those with severe intracranial hemorrhage.

Objective:To evaluate therapeutic effect and safety of Firebird stent combined tirofiban on acute myocar‐dial infarction (AMI) .Methods :A total of 86 AMI patients treated in our hospital from Aug 2011 to Aug 2013 were selected .According to random number table method ,patients were divided into combined treatment group (n=50 , received Firebird stenting combined tirofiban treatment ) and routine treatment group (n=36 ,received bare metal stenting) .Patients were followed up for 12~18 months ,therapeutic effects ,incidence rates of clinical events were compared between two groups .Results:After PCI ,compared with routine treatment group ,there were significant reductions in percentage of TIMI class 1~2 (13.9% vs .4.0% ) and corrected TIMI frame [ (29.2 ± 4.4) vs .(21.4 ± 5.1)] ,significant rise in percentage of TIMI class 3~4 (86.1% vs .96.0% ) in combined treatment group , P<0.05 all;on six months after PCI ,compared with routine treatment group ,there were significant reductions in inci‐dence rates of subacute thrombosis (2.8% vs .0% ) and myocardial infarction (2.8% vs . 0% ) in combined treat‐ment group (P<0.05 both);on 12 months after operation ,compared with routine treatment group ,there were sig‐nificant reductions in incidence rates of angina pectoris (16.7% vs .6.0% ) ,subacute thrombosis rate (11.1% vs . 0% ) ,myocardial infarction (8.3% vs .0% ) ,heart failure (2.8% vs .0% ) and rehospitalization rate (11.1% vs . 0% ) in combined treatment group , P<0.05 or <0.01 .Conclusion:Firebird stent combined tirofiban possesses sig‐nificant therapeutic effect on acute myocardial infarction ,and it's safe and reliable ,which is worth extending .

Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum glucose, hepatic and renal function, routine urine analysis (UA) were measured in 50 healthy subjects, and in 50 elderly patients with hypercholesterolemia before and after 4 weeks treatment with simvastatin (20mg daily for 4 weeks). Results 1. After simvastatin treatment for 4 weeks, the fasting serum level of lipids in elderly patients with hypercholesterolemia was significantly lower than before treatment (P＜0.01). 2. CD63 and CD41a were decreased after treatment compared with before, respectively (1.36 0.34) vs (4.26 1.06), (P＜0.01) and (123.54 19.73) vs (253.78 16.75), (P＜0.01).3. Changes in serum lipid level tended to be positively correlated with the declines in CD63 and CD41a, but there was no statistical significance (P＞0.05). Conclusions The results suggested that lipid lowering therapy with simvastatin inhibit platelet activity.

Objective To study the accuracy of improved resistance index (RI) in judging the prognosis in renal allograft with reversed diastolic flow. Methods According to the transplant nephrectomy, patients with reversed diastolic flow in renal allograft were classified into two groups:surgical group (n = 5) and nonsurgical group (n = 19). The differences in improved RI between two groups were compared by using Student's t test. Improved RI was defined as a ratio of peak systolic velocity plus peak diastolic velocity divided by peak systolic velocity. Receiver operating characteristic (ROC) curve was constructed for improved RI to evaluate diagnostic accuracy in judging the prognosis in renal allograft with reversed diastolic flow. Results Improved RI in surgical group ( 1.57 ± 0. 26)was higher than in nonsurgical group (1.22 ± 0. 08) (P＜＜0. 05). Areas under ROC curve for improved RI was 0. 979. An improved RI threshold of 1.31 had 100 % sensitivity, 90 % specificity, 71%positive predictive value, and 100 % negative predictive value for renal allograft with reversed diastolic flow loss as the maximum Youden index was 90 %. Applying this cutoff value to predict the function of renal allograft with reversed diastolic flow recovery, the accuracy was 92 % (maximum) or 83 %(minimum). Conclusion Improved RI can not only serve as a useful noninvasive index to predict renal allograft with reversed diastolic flow loss, but also to predict the function of renal allograft with reversed diastolic flow recovery.

Objective To explore the effect of residual renal function(RRF)on the quality of life in uremia patients with peritoneal dialysis(PD).Methods 64 patients with uremia who underwent PD for 3 months or more were selected.According to the residual glomerular filtration rate(rGFR),the patients were divided into RRF group[35 cases with rGFR≥1mL· min-1·(1.73m2)-1] and non-RRF group[29 cases with rGFR≤1mL· min-1 ·(1.73m2)-1].The patients were followed up at 3-month intervals.The quality of life was assessed using the SF-36.Results The calcium,phosphorus,parathyroid hormone,serum creatinine,C-reactive protein,serum albumin,total urea removal,serum potassium,total urea clearance in the non-RRF group were(2.29±0.25)mmol/L,(1.68±0.42)mmol/L,275.68 ng/L,(1 121.58±215.36)μmol/L,(11.02±14.35)mg/L,(31.01±3.26)g/L,(100±50)mL/d,(3.48±0.78)mmol/L,(1.71±0.28),respectively,which in the RRF group were(2.21±0.19)mmol/L,(1.59±0.35)mmol/L,147.43ng/L,(872.56±264.68)μmol/L,(5.34±8.97)mg/L,(3.43±0.59)mmol/L,(33.21±4.62)g/L,(5.34±8.97)mg/L,(33.21±4.62)g/L,(800±200)mL/d,(3.79±0.59)mmol/L,(2.01±0.41),respectively,the differences between the two groups were significant(t=2.316,2.149,2.353,3.881,2.229,7.213,2.243,2.212,4745,all P<0.05).The total physical health measurement[(48.13±18.32)points and the physiological function[(46.61±21.79)points] in the non-RRF group were significantly lower than those in the RRF group[(56.02±18.12)points,(46.61±21.79)points,t=2.379,2.341,all P<0.05].There was no significant difference between the two groups in the total mental health and SF-36(P>0.05).Univariate linear regression analysis showed that rGFR was not associated with SF-36 overall score.Multivariate linear regression analysis found that SF-36 overall score and serum calcium,phosphorus,parathyroid hormone,serum creatinine,C-reactive protein,peritoneal ultrafiltration volume had relevance(t=4.102,2.412,2.174,4.259).Conclusion There was no significant difference in overall quality of life scores and mental health scores between the RRF group and the non-RRF group.RRF was not directly related to the quality of life of the patients.

OBJECTIVETo observe the therapeutic effect of acupuncture treatment on stroke according to the acupoint selection of "Najia method of Ziwua Liuzhu" and to investigate the mechanism.

METHODSOne hundred and ninety cases were randomly divided into a Ziwu Liuzhu group (n=95) and a routine acupuncture group (n=95). Five shu points on different meridians were selected according to the Tiangan (Heavenly Stems)-tables of "Najia method of Ziwu Liuzhu" in the Ziwu Liuzhu group, and the treatment was carried out within the period from Chen (7:00-9:00 AM) to Si (9:00-11:00 AM). In the routine acupuncture group, Fengchi (GB 20), Shuigou (GV 26), Waiguan (TE 5), etc. were selected to treat the patients immediately on first visit. The therapeutic effects of two groups were assessed by the scores of neural functial cinl deficiency, status of total living ability, blood rheological indexes and clinical comprehensive effectiveness.

RESULTSThe total effective rate of 95.8% in the Ziwu Liuzhu group was significantly better than 80.0% in the routine acupuncture group. The scores of neural functional deficiency, main items of blood rheology and total living ability in the Ziwu Liuzhu group were significantly lower than those in the routine acupuncture group (all P < 0.05).

CONCLUSIONAcupuncture treatment in the period from Chen to Si according to the acupoint selection of "Najia method of Ziwu Liuzhu" has a significant clinical effectiveness which is related with improvement of the indexes of blood rheology.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Hemorheology ; Humans ; Male ; Meridians ; Middle Aged ; Stroke ; blood ; physiopathology ; therapy

Objective To investigate the clinical effect of vagus nerve preserving pericardial devascularization plus subtotal splenectomy in treating portal hypertension with a history of variceal bleeding.Methods The clinical data of 33 cases of portal hypertension with variceal hemorrhage treated with vagus nerve preserving selective pericardial devascularization plus subtotal splenectomy from April 2004 to December 2013 (study group) were compared with that of 34 cases treated with pericardial devascularization plus splenectomy (control group).Results There was no mortality in two groups.The postoperative gastric drainage during the first 72 h were(1 525 ±30) ml in the study group and (2 130 ±40) ml in control group(P ＜0.05).Portal vein thrombosis developed in one case in the study group and 15 cases in the control group(P ＜ 0.05).Postoperative 3-year recurrent gastroesophageal varices hemorrhage was 15％ in the study group and 25％ in the control group (P ＜ 0.05).Postoperative 5-year variceal hemorrhage recurrence rate were 28％ in the study group and 30％ in the control group (P ＞ 0.05).Conclusions Maitaining vagus nerve selective pericardial devascularization plus subtotal splenectomy is of less postoperative complication and lower portal vein thrombosis rate and better patients' survival compared with pericardial devascularizatim plus total splenectomy.

Objective To Know the present situation of diabetes′ self-management ,explore its influencing factors and provide theoretical evidences for conducting diabetic health education and improving patients′ level of self-management .Methods Using random sampling method ,we took 483 cases of diabetic patients concluded inpatient and outpatient from a first class hospital and two community hospitals who meet the inclusion criteria from March 2011 to April 2013 in Chongqing city .All patient were investi-gated with diabetes self-management questionnaire scale .Results 500 questionnaires ,received 483 valid questionnaires ,and the ef-fective rate of recovery is 96 .6% .Among 483 cases of diabetic patients in the investigation ,78 .7% of patients understood diabetes knowledge from medical staffs .In the aspect of following the treatment plan :drug plan had the best executive power with 59% ;the average score of diabetes knowledge was (41 .747 ± 10 .23) ,score index was 51 .5% ;82 .2% of patients did ,not understand their value of glycated hemoglobin ,44 .5% of patients did not understand the two-hour postprandial blood glucose ;The average score of diabetes′self-care behaviors was(3 .59 ± 1 .249) ,score index was 51 .29% ,different score index accompany with different self-man-agement levels .Educational level ,retirees ,diet control ,blood glucose monitoring ,the understanding of diabetes knowledge were pro-tective factors for receiving health education .Conclusion Patients grasp diabetic knowledge are poorly in average ,the present situa-tion of patients′self-management is not optimistic ,it is better to increase the health education of diabetes′ self-management ,and make great efforts to improve diabetes′self-management skills .

Objective To investigate the association between arterial compliance and fundus oculi arteriosclerosis in elderly people. Methods A total of 73 elderly subjects,including 61 elderly patients with fundus oculi arteriosclerosis and 12 healthy volunteers were recruited into the study.Capacitive arterial compliance(C1)and oscillatory arterial compliance(C2)were measured by DO2020 Cardiovascular Profiling Instrument.Moreover,fundus photographs were measured using Canon figure fundus camera. Results There were significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean artery pressure,pulse pressure,capacitive arterial compliance (C1),and oscillatory arterial compliance(C2)between patients with fundus oculi arteriosclerosis and healthy volunteers(all P<0.05).In multiple regression analysis,the grade of fundus oculi arteriosclerosis was significantly correlated with SBP,DBP,mean artery pressure and pulse pressure (r=0.357,0.261,0.342,0.280,all P<0.05).Moreover,there were significant correlations between the grade of fundus oculi arteriosclerosis and Cl(r=-0.281,P<:0.05),and C2(r=-0.308,P<0.01). Conclusions These findings underscore the efficacy of C1 and C2 in identifying patients with fundus oculi arteriosclerosis.

BACKGROUND:The internal structures of the colagen-heparan sulfate scaffold and human nerve are very similar. OBJECTIVE: To explore thein vivo biocompatibility of colagen-heparin sulfate scaffold. METHODS:Forty pigs were randomly divided into two groups, 20 in each group: observation group and control group. Medulo-puncture needle was inserted 1.0 cm adjacent to the midline of anterior fontanele into the subarachnoid space, and then removed gradualy. Colagen-heparin sulfate scaffold was implanted into the observation group, and no treatment was given in the control group. Brain tissues were observed under transmission electron microscope, and cel apoptosis and Caspase-3 expression were detected at days 1, 3, 7, 14 and 30 after surgery. RESULTS AND CONCLUSION:Under the electron microscope, there were some damaged neurons in the observation group with the emergence of demyelination changes in the myelinated nerve fibers; positiveexpression of Caspase-3 protein was found at the junction between the brain tissue and scaffold as wel as within the scaffold, but no positive expression was found in the surrounding tissue. There was no cel apoptosis within 30 days after surgery except for individual apoptotic neurons both in the observation group and control group. The number of apoptotic cels in the observation group was higher than that in the control group at days 1, 3, 7, 14 days after surgery (P < 0.05), but there was no difference between the two groups at 30 days after surgery (P > 0.05). Caspase-3 protein expression was at a low state in the two groups, but the protein expression of Caspase-3 was higher in the observation group than the control group at days 3 and 7 after surgery (P < 0.05). These findings indicate that the colagen heparin sulfate scaffold has good biocompatibility in the porcine brain.