Objective To study the clinical effect of low-molecular-weight heparin combined with edaravone in the treatment of progressive cerebral infarction.Methods 60 patients with acute progressive cerebral infarction in 72 hours were randomly divided into treatment group received edaravone combined low-molecular-weight heparin(n=30)and control group received low-molecular-weight heparin(n=30).The primary efficacy was evaluated by NIHSS(the National Institutes of Health Stroke Scale).ADL(Activities of daily living)and clinical effect.Results Our study showed that the score of NIHSS on 7th day post-therapy and 14th day post-therapy in treatment group was lower than that in control group(t=15.987 and 11.756,both P＜0.01).However,the score of ADL in the theatment group on 14th day post-therapy was higher than that of control group(t=62.56,P＜0.01).The overall clinical responserate of treatment group was higher than that of control group(x2=13.695,5.769,all P＜0.01).Conclusion Edaravone combined with low-molecular-weight heparin has remakable effect on the treatment of progressive cerebral infarcti.

Objective To investigate the neuroprotective effect of soluble epoxide hydrolase (sEH) inhibitor 12-(3-adamantan-l-yl-ureido) dodecanoic acid (AUDA) on focal cerebral ischemia/reperfusion in rats and its mechanisms.Methods Sixty male Sprague-Dawley rats were randomly divided into sham operation and saline control groups,as well as low-dose (0.157 ml/kg),medium-dose (0.235 ml/kg) and high-dose (0.314 ml/kg) AUDA groups (n =12 in each group).Four rats in each group were selected for infarct volume,cell apoptosis and p-Akt immunohistochemistry detection.A model of middle cerebral artery ischemia/ reperfusion was induced by the suture method.The corresponding dose AUDA or equal volume of saline was injected intraperitoneally before reperfusion in each AUDA group and the saline control group.Neurological deficit scores were performed at 24 h of reperfusion.2,3,5 triphenyltetrazolium chloride (TTC) staining was used to detect infarct volume.TdT-mediated dUTP nick end labeling (TUNEL) was used to detect apoptotic cells of brain tissue in the periinfarction area.Immunohistochemical method was used to detect p-Akt expression of brain tissue in the peri-infarction area.Results TTC staining showed no infarction was observed in the sham operation group.The infarction volumes in the saline control group as well as the low-dose,medlum-dose and high-dose AUDA groups were 254.146 ± 25.481,212.679 ± 7.514,150.188 ± 33.997,and 99.563 ± 3.415 mm3,respectively.There were significant differences (F =39.637,P =0.000).The each dose AUDA group was significant less than the control group (all P=0.000).The medium-dose AUDA group was significantly less than the low-dose AUDA group (P=0.002),and the high-dose AUDA group was also significantly less than the low-dose AUDA group (P =0.000) and medium-dose AUDA group (P =0.006).TUNEL staining showed that a small number of apoptotic cells (6.400 ± 1.477/high-power field) were observed in the sham operation group.The numbers of apoptotic cells in the saline control group as well as in the low-dose,medium-dose and high-dose AUDA groups were 57.550 ± 13.067,47.030 ± 8.423,34.530 ± 4.393 and 26.400 ± 2.683/high power field,respectively.Each dose AUDA group was significantly less than the saline control group (all P ＜0.01).The medium-dose and high-dose AUDA groups were significantly less than the low-dose AUDA group (P ＜ 0.01),and the high-dose AUDA group was also significantly less than the medium-dose AUDA group (P ＜0.01).Immunohistochemistry showed that only a few p-Akt-positive cells (3.325 ± 1.438/high power field) were observed in the sham operation group.The numbers of p-Akt-positive cells in the saline control group as well as the low-dose,medium-dose and high-dose AUDA groups were 9.450 ±2.531,16.400 ± 3.865,22.875 ± 7.974,and 29.300 ± 3.203/high-power field,respectively.Each dose AUDA group was significantly more than the saline control group (all P ＜0.01).The medium-dose and high-dose AUDA groups were significantly more than the low-dose AUDA group (all P ＜0.01).The high-dose AUDA group was also significantly more than the medium-dose AUDA group (P ＜ 0.01).Conclusions The inhibition of sEH may decrease neuronal apoptosis and reduce infarct volume in the peri-infarction area by upregulating the PI3K/Akt pathway.It has a neuroprotective effect for focal cerebral ischemia/reperfusion in rats.

Objective To compare the efficacy and adverse reactions of TA regimen (docetaxel +epirubicin) and immunization therapy of TA regimen combined with dendritic cell (DC)-cytokine induced killer cell (CIK) in treating the patients with metastatic breast cancer (MBC).Methods Clinical data of 43patients with MBC received treatment in our hospital from January 2011 to January.2013 were retrospectively analyzed.Patients included were divided into two groups according to the treatment,simple treatment group (TA regimen,control group,22 cases) and combined treatment group (TA regimen + DC-CIK cell,observation group,21 cases).The curative effect,improvement situation of clinical symptoms,adverse reactions and changes of T cell immune phenotype in peripheral blood of patients before and after treatment in the two groups were compared.Results The total efficiency of treatment in observation group (85.7％) was higher than that in control group (63.6％),and the difference was statistical significant (x2 =4.949,P =0.026).Among the incidences of all kinds of adverse reaction appeared during the treatment in two groups,the white blood cells count decreased was the highest in observation group (76.2％) and in control group (59.1％),the difference had no statistical significance (x2 =0.858,P =0.36).After treatment,the rates of fatigue,loss of appetite,insomnia and night sweats of patients in observation group were lower than those in control group (23.8％ vs.54.5％,x2 =4.246,P=0.04;19.0％ vs.54.5％,x2 =5.795,P=0.02;19.0％ vs.50.0％,x2 =4.532,P=0.03).TheCD3+(60.4±12.3vs.47.4±12.8,t=3.393,P＜0.01),CD3+/CD4+(41.7±9.6 vs.28.1±10.5,t=5.442,P＜0.01),CD4+/CD8+ (1.5 ±0.2 vs.1.0±0.2,t =8.195,P＜0.01),NK cells(27.35.9vs.15.3±6.1,t=6.643,P＜0.01),NKTcells(14.7±l.4vs.6.0±1.2,t=11.020,P ＜ 0.0l) after treatment in observation group were obviously higher than those in control group.Conclusion Comparing with the pure TA scheme,the curative effect of immunization therapy of TA regimen combined with DC-CIK cell in treating the patients with MBC is better.It significantly improves the immune functions of patients with MBC,and does not increase adverse reaction.

This paper reports clinical and cytogenetic studies on 20 cases of congenital ovary dysgenesis (Turner syndrome). The clinical studies included the history, physical and pelvic examinations, blood FSH, LH and estradiol determinations, and pneumoperitoneography, Cytogenetic studies on the karyotype of lymphocytes were performed with G,C banding and high resolution chromosome banding techniques. There were karyotypes with 45,X in 12 cases,46, XX/45,X in 2 cases, 45,X/46,XX/46,XXp- in 2 cases, 45, X/46,Xi (Xq) in 2 cases,45,X(Xqace) in one case and 46,Xi(Xq) in one case. One of these patients (46,XX/45,X) had a term pregnancy, and a girl has grown well. Treatment was mainly low-dose estrogen replacement therapy with cyclic administration of progesterone. These patients were followed up from four months to 20 years. Six of them were married with normal sexual activity. The patients' height was increased by 2 to 10 cm after treatment. It is concluded that the supporting treatment is beneficial whenever the diagnosis is made.

Objective To study clinical feature of diagnosis of pancreatic cancer,in order to reach early diagnosis.Methods 70 cases of pancreatic cancer from ours in-patients 1990 to 2000 were reviewed and analyzed.Results The number of patients with stage Ⅰ～Ⅱ were only 8 cases(11 4%). 40 patients (57 1%) hospitalized within one month after they felt ill.19 cases(29 1%) were diagnosed as pancreatic cancer within one month,including 5 patients(26 3%) with stage Ⅰ or Ⅱ .Abdominal pain(73 4%),jaundice(10 1%) and discomfort of upper abdominal(5 8%) were the most common initial symptoms.misdiagnosis were 40(57 1%) cases .The most common misdiagnosis were chronic gastritis(21 4%),chromic cholecystitis(7 14%) and peptic ulcer(5 71%).The serum levels of CA199,CA125 were higher in 16/18 cases (88 9%) and 6/7 cases (85 7%) respectively. Three cases in stage I or II were found higher serum CA125 and other tumor marker normal.Five patients were diagnosed as diabetes within five months before the diagnosis of the cancer.Conclusions For most of the patients with pancreatic cancer ,usually they were definite diagnosis in moderate or advanced stage. So the status of the diagnosis of pancreatic cancer is disappointed . Hospitalizing late,being misdignosed and developing quickly were the main causes;The most common misdiagnosis are chronic gastritis, cholecystitis and peptic ulcer;elevation of serum CA199 and CA125 are sensitive to diagnose pancreatic cancer. Detections of CA125 and hyperglycemia may favour earlier diagnosis of pancreatic cancer.

Objective To study the effects of chronic intra-abdominal hypertension (IAH) on the functions of vital organs. Methods From January 2004 to January 2008, 30 chronic massive ascites related IAH patients were enrolled including 12 colonic cancer cases, 7 pancreatic cancer cases, and 11 gastric cancer cases. Control group included 30 cases of gastrointestinal carcinoma without ascites hence no IAH. The specific malignances in this group were colonic cancer in 15 cases, pancreatic cancer in 8 cases, and gastric cancer in 7 cases. Age, gender and cancer stage were matched between the two groups. Symptoms in digestive, respiratoy and circulatory system and liver and kidney functions were recorded and KPS scores were compared respectively. Results The symptoms of abdominal distention in chronic IAH group and control group were presented respectively by 15 cases(50%) and 5 cases (17%) (P < 0.01). Symptoms of heart-throb or hypotension in the two groups by 10 cases (33%) and 3 cases (10%) respectively(P<0.05). Symptoms of asthma or chest distress in the two groups by 9 cases(30% ) and 1 cases (3%) respectively (P< 0.01). Liver function were abnormal in 16 cases (53%) and 6 cases (20%) respectively (P < 0.01 ), kidney functions were abnormal in 14 cases (47%) and 1 case( 3% ) respectively ( P <0.01 ) . There were 22 cases (73 %) and 7 cases (23 %) respectively ( P < 0.01 ) in the two groups with KIS score being lower than 40. Conclusions Chronic IAH causes malfunctions of vital organs deteriorating patients general status and even leading to abdominal compartment syndrome.

Objective To study the transformation mechanism of triterpenes in processing of Alisma orientalis. Methods The triterpene transformations of A. orientalis pre and post-processing were comparatively analyzed by techniques of HPLC and Packed Column Supercritical Fluid Chromatography (SFC). Results In baked processing (70 ℃) of A. orientalis, little alisol B 23-acetate was transformed into alisol A 24-acetate and alisol B.However, more alisol B 23-acetate was transformed into alisol A 24-acetate and alisol B, then both of them were further transformed into alisol A in processing under high temperature (160-200 ℃). Conclusion Transformation of alisol B 23-acetate has two routes when A. orientalis is processed under high temperature: For one, alisol B 23-acetate is rearranged into alisol A 24-acetate which could be deacetylated into alisol A; for the other; it is deacetylated into alisol B first, then transformed into alisol A.

Aim To evaluate the effect of 15-hydroxy eicosatetraenoic acid(15-HETE) on the tension of isolated internal carotid artery(ICA) rings in normoxic or hypoxic rats in order to find out the pathophysiological effect of 15-HETE in ischemic/hypoxic brain tissues.Methods Sixteen healthy Wistar rats were randomly divided into two groups(n=8): group A with normal oxygen supply(FiO_2 21%) and group B with hypoxia(FiO_2 10%).9 days later,the rats were killed and the ICA rings were prepared.15-HETE in different concentration were added accordingly,and the after washing up,blockers of different kinds of K~+ channels such as 2 mmol?L~(-1) 4-AP,10~(-2) mol?L~(-1) TEA and 10~(-6) mol?L~(-1) GLYB were added to the KH solution separately,followed by the administration of 10~(-6) mol?L~(-1) 15-HETE.The isometric tension was recorded using a four-channel force-displacement transducer.Results The ICA tension was significantly increased both in groups A and B by 15-HETE in concentration-dependent manner(P0.05,n=8).Furthermore,10~(-2) mol?L~(-1) TEA,10~(-6) mol?L~(-1) GLYB had little effects on the tension of rings.Application of 10~(-6) mol?L~(1) 15-HETE after administration of TEA or GLYB induced nearly the same increase in ICA tone as it happened in the group administered with 10~(-6)mol?L~(-1) 15-HETE alone.Conclusion 15-HETE can induce brain vasoconstriction especially under the hypoxic condition.Voltage-dependent potassium channels play an important role in 15-HETE induced constriction.

Objective To investigate clinical effect of reattribution-cognitive-pharmacy model (RCPM) in the treatment for irritable bowel syndrome(IBS). Methods 125 subjects with diarrhea predominant irritable bowel syndrome (IBS-D) were divided into two groups randomly. 62 patients in group A were treated with 10 ～ 20 mg of paroxetine without any other medication or psychological interview and 63 patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 ～ 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency ,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain ,and 42 reported a reduction in stool frequency ,and 3 patients stopped taking paroxetine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain ,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B,54 cases reported a reduction in abdominal pain,and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.

Objective To investigate the effect of electromyographic biofeedback motion sensing game on upper limb function in chil-dren with obstetric brachial plexus palsy (OBPP). Methods From March, 2013 to February, 2014, 41 children with OBPP were randomly as-signed into conventional rehabilitation group (n=21) and motion sensing game group (n=20). Both groups underwent a comprehensive course of rehabilitation, and the motion sensing game group received upper limb occupational therapy in the motion sensing game, for four weeks. They were assessed with Mallet shoulder function scale and the surface electromyogram (EMG) of the deltoid muscle when abduct-ing the shoulder before and after treatment. Results Before treatment, there was no significant difference in the Mallet scores between two groups (t=0.730, P>0.05), the scores improved after treatment in both groups (t>5.085, P<0.05), and the scores after treatment and the D-val-ue scores before and after treatment were higher in the motion sensing game group than in the conventional rehabilitation group (t>3.195, P<0.01). The integral EMG (iEMG) value, average EMG (aEMG) value and maximum EMG (EMGmax) value of the deltoid muscle improved in the motion sensing game group after treatment (t>4.420, P<0.05), however, only aEMG and iEMG improved in the conventional rehabili-tation group (t>2.282, P<0.05). All of them after treatment and the D-value were higher in the motion sensing game group than in the con-ventional rehabilitation group (t>2.155, P<0.05). Conclusion Electromyographic biofeedback motion sensing game therapy plays a role in the rehabilitation of upper limb function and muscle strength in children with OBPP.