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 .

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.

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 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 Based on the observation of the changes of symptoms, histopathology, visceral sensitivity, mast cell activation, autophagy, and Beclin-1 and Claudin-2 expression in rats, we established and evaluated a new rat model of diarrhea-predominant irritable bowel syndrome (D-IBS) induced by restraint-stress combined with capsaicin (CAP) administration.Methods Forty healthy 5-week old male Sprague Dawley (SD) rats were randomly divided into normal group, model group I, model group II and model group III, with 10 rats in each group.The D-IBS model was established by restraint-stress combined with intragastric administration of CAP (2 mL/100 g body weight, 0.125% in group I, 0.250% in group II, 0.500% in group III), tail clipping and forelimb restriction for 30 minutes every day for 2 weeks.The rats in the control group were treated with saline for 2 weeks.The number of contraction of abdominal wall and arched back were measured by Power Lab instrument.The mast cell activation was detected using aldehyde-magenta-orange G staining.Light and electron microscopic examinations were performed to detect the morphology and autophagy of colonic tissues.The expressions of Beclin-1 and Claudin-2 in the colonic mucosa were detected by streptavidin-biotin complex (SABC) immunohistochemical staining.Results All rats in the model group III died during the experiment.Compared with the control group and model group I, the stool frequency was increased and the visceral sensitivity threshold decreased in the model group II, and there were statistically significant differences between the model group II and the control and model groups I (P < 0.05).The colonic mucosa, mucosal epithelium and glands in each group showed normal morphology and there was no submucosal vasodilatation and diffuse inflammatory cell infiltration.Except for the control group, round purple-reddish staining spots were observed in the rat mucosal stroma or submucosa in the model groups I and II, indicating an increased expression of mast cells.The autophagy, expressions of Beclin-1 and Claudin-2 in the colonic epithelium were significantly increased in the model group II compared with control group and model group I (P< 0.05).Conclusions The model of D-IBS induced by restraint-stress combined with capsaicin is characterized by increased diarrhea, visceral hypersensitivity, increased mast cell expression and autophagy of intestinal epithelial cells, and disruption of the intestinal mucosal barrier.This model is simple to set up and shows similar symptoms of human irritable bowel syndrome.Therefore, it is worthy of popularization and application.

Objective To observe the bleeding risk of bivalirudin combined with ticagrelor in patients with acute ST segment elevation myocardial infarction (STEMI) during emergency percutaneous coronary intervention (PCI) .Methods A retrospective a‐nalysis of 458 patients with STEMI who underwent emergency PCI in our hospital was performed .All patients were divided into the bivalirudin group (217 cases) and the standard heparin group(241 cases) according to the anticoagulation scheme during PCI opera‐tion .All patients administered the dual antiplatelet therapy of aspirin 100 mg and ticagrelor 180 mg before surgery .Then ,all pa‐tients were administered dual antiplatelet therapy of aspirin 100 mg once daily and ticagrelor 90 mg twice daily for a long time .The clinical data were analyzed and the bleeding situation within 72 h after PCI was compared between the two groups .Results There were no statistically significant differences in gender ,age ,body mass ,smoking proportion ,occurrence rates of accompanying and complicating diseases ,RBC count ,platelet count ,Hb and PT before PCI between the two groups(P>0 .05) .The bleeding incidence rate in the bivalirudin group was significantly lower than that in the standard heparin group ,and the difference was statistically sig‐nificant (χ2 =8 .455 ,P<0 .05) .Conclusion Compared with standard heparin ,on the basis of ticagrelor use ,giving bivalirudin dur‐ing PCI process can reduce the bleeding risk of patients .

Objective To establish a scientific and practical principle , grading standard and reasonable statistical method for evaluating the protective effect of health food to gastric mucosal injury , based on general pathology and histopathological diagnosis .Methods A methodological study was conducted on rat model of acute gastric mucosa injury induced by alcoholic through comprehensive analysis and comparing shortcomings of the current standard evaluation method, and methods of semi-quantitative analysis and corresponding information statistic processing were based on characteristics of the lesion and principles of pathology .Results Gross pathological evaluation of gastric mucosa lesion was based on the area occupied and proportion in the whole gastric mucosa .Histopathological diagnosis was based on the mucous layer depth of lesion as main determination point and other lesions as reference factors .Grades of lesion were divided into no abnormality (0), mild lesions (1 point), moderate lesions (2 points), and severe lesions (3 points). Ridit statistical method was used for pathological analysis of semi-quantitative results .Conclusion A scientific and feasible evaluation method for the protective effect of health food to gastric mucosal injury was provided from the aspects of gross pathology , histopathological evaluation method , data processing method and result determination .