Objective To explore the influence of diastolic blood pressure to prognosis of patients with acute cerebral infarction. Methods Clinical data of 200 patients with acute cerebral infarction were retrospectively reviewed Patients were divided into three groups based on diastolic blood pressure(DBP)when admission;hypotensive group(DBP＜70 mm Hg),normotensive group(DBP;70-90 mm Hg)and hypertensive group(DBP ＞ 90 mm Hg).Constituent ratio of patients with different level of DBP were calculated and prognosis were compared among the three groups. Results Of all the total patients with acute cerebral infarction,8%(16)presented with hypotension,12%(24)were normotensive and 80%(160)were hypertensive.In the hypotensive group,50%(8)patients died as compared to 17%(4)in normotensive group and 38%(60)in hypertensive group,among all the cases,patients with bypotension or hypertension seemed like to have a higher mortality than normotensive group(P=0.037;x2=3.993,P=0.046),and there was no significant diffenence between two group with hypotension or hypertension. Conclusion The patients with diastolic blood pressure of less than 70 mm Hg or more than 90 mm Hg were predictors of poor outcome.

Objective To explore the role of transcranial doppler(TCD) on therapeutic effects of intravenous thrombolysis for patients with acute cerebral infarction by using transcranial doppler to make dynamic detection pre and pro-intravenous thrombolysis. Methods 60 patients with the final diagnosis of acute cerebral infarction were selected according to the inclusion criteria and exclusion criteria standard promissory. Recombinant tissue type plasminogen activator as the intravenous thrombolysis agent was used 4.5h later onset of the disease in all these cases, and TCD monitoring was preformed to understand the sitiations of the target blood vessels pre and pro-thrombloysis treatment on the 6,12 hours and 24 hours,the 2st day and the 7th day,all the data offered by which was used to adjust the treatment protocois of antiplatelet and anticoagulant therapy after 24 hours. All patients were followed up for 3 months,among whom prognostic evaluation, situations of revascularization was carried out as well as the complications of secondary intracranial hemorrhages and reocclusion basing on the neurologic impairment Score and the Thrombolysis in Brain lschemia(TIBI) respectively. Results No patient was dead after following-up for 3 months and 17 cases with basi- healing(28.3%) ,20 cases with excellence(33.3%), 16 cases got better(26.7%) ,3 cases with inefficiency (5.0%), and 4 cases became deterioration (6.7%). According to the Thrombolysis in Brain lschemia( TIBI), 22 cases got 4-5 level( 36.7 %), 31 cases with 2-3 level ( 51.7% ), and 7 cases got 0-1 level ( 11.6 % ). Among all these cases ,4 cases were found with secondary intracranial hemorrhages (6. 7% ) and 5 cases with reocclusion ( 8.3% ) Conclusion Dynamic detection with transcranial doppler pre and pro-intravenous thrombolysis could improve the therapeutic effect on patients with acute cerebral infarction, and reduce its complication, which is important for the clinical wrok and deserving consulting.

Objective To explore the role of hypothermia in curing patients with acute cerebral infarction. Methods 40 patients with final diagnosis of acute cerebral infarction in our department from 2007-3 ～ 2009-1 were selected and randomly divided into hypothermia group and normathermia group. Both groups were treated with the same approach except the hypothermal intervention in hypothermia group. Prognosis,infarct size and the rate of revas-cularization were compared between the groups after 1 month following up. Results When compared with the normathermia group,the hypothermia group had better prognosis and less infarct size after treating,but statistical significance could not find in two groups in the rate of revascularization. Conclusion Under a series of mechanism,hypothermia could grow down the local infarct size and make important sense to improve the prognosis of patients with acute cerebral infarction.

AIM: The differentiation theory on kidney turbidity is used to recognize the relevant characters of Alzheimer disease. METHODS: The analysis is carried on the interrelationship between kidney turbidity and Alzheimer disease in the aspects of pathology, pathogenesis and clinical manifestations. RESULTS: It was discovered in modern neural pathological examination that in the patients with Alzheimer disease, the cerebral cortex was atrophic, the convolution becomes flat, the cerebral groove was widened, the ventricle was extended, brain weight was declined and cortical nerve cells were de creased in various degrees. All of those changes were the manifestations of kidney essence deficiency in Chinese medicine. The main mechanism on neuron loss caused by Alzheimer disease was that oxygenic free radical works on nerve neurons and induces the increased Ca2+ inner-flow. Con cerning to the theory of Chinese medicine, oxygenic free radical was taken as "kidney turbidity". In the patients with Alzheimer disease, insufficient kid ney essence resulted in malnourishment of heart. In addition, upward dis turbance of kidney turbidity and abnormality of heart mind projected the brain and affected brain function, resulting in recent memory disturbance that was the initial symptom of Alzheimer disease. CONCLUSION: Concerning to the treatment of Alzheimer disease, Chinese medicine emphasizes not only on reinforcing kidney and filling-up essence, but also rather on eliminating kidney turbidity, for which, the method of re solving turbidity and damp is applied specially.

Objective To investigate the protective effects of ulinastatin on express of GRP 78、CHOP and caspase-12, the molecules related to endoplasmic reticulum stress (ERS),after ischemia reperfusion injury in rats.Methods Ninety rats were equally randomized into 3 groups(n=30): Sham group (S group,n=30), Ischemia -reperfusion group (I/R group, n=30), Ulinastatin group (U group, n=30).Focal transient cerebral ischemia model was established with intralu-minal occlusion fo left meddle cerebral artery .Made through 2 hours of temporary middle cerebral artery occlusion , followed with 24 hours of reperfusion .The pathological results were investigated by HE staining and the cerebral injury situation was e -valuated by neurological deficit scores .Infract volume was measured by TTC staining , apoptosis was detected by TdT -medi-ated dUTP and nick end labeling (TUNEL), and expression of GRP78, CHOP and caspase -12 were meastured by western blot.Results Compared with the S group , the number of apoptotic cells were significantly increase in I /R group and U group (P<0.05);infarct volume and expression of GRP -78, CHOP and caspase-12 were significantly increased in I/R group and U group (P<0.05).The infarct volume and the number of apoptotic cells were significantly less in U group than in I/R group ( P<0.05 ) .GRP78 expression was higher in U group than in I/R group ( P<0.05 ) , however CHOP and caspase-12 expression was less in U group than in I/R group (P<0.05).Conclusion Ulinastatin has a protective effect on cerebral ischemia reperfusion injury , which may related to increased GRP 78, decreased CHOP and caspase -12 expres-sion and to inhibition of the ERS -induced apoptosis pathway .

ObjectiveTo study the method and effect of individualized education on children with learning disability (LD).Methods30 children during 7-10 year old in a local boarding elementary school were chosen and guided individually as the following: sensory integration dysfunction drill, subtle motion drill, life skills drill, cognitive capability drill, behavior therapy, game therapy, music therapy and parents education. One and a half year later, the index of Sensory Integration Rating Scales and study marks were determined and compared with that of the normal children.ResultsThere is not significant difference between the LD children and the normal ones in the sensory integration of behavior and the learning achievement.ConclusionIndividualized education is a valid approach improving the potentiality of the LD children\'s physiology and psychology.

Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula. Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic frac-ture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively. The mean diameter of maximum urethrovagi-nal fistula was approximately 2.3 cm. The parias anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas, and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again. Results Fifteen patients were followed up for 6 to 80 months, and they gained normal voiding, with no urine leakage, urinary incontinence and urethra] stricture occurring. Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.

Objective To investigate the diagnosis and treatment outcomes of testieulax endodermal sinus tumor. Methods Twenty-four cases diagnosed with testieular endodermal sinus tumors from November 1996 to April 2007 were retruspeetively reviewed. Eighteen patients presented with stage Ⅰ disease, 4 presented with stage Ⅰ , and 2 presented with stage Ⅲ. Inguinal radical or-chieetomy were performed in all patients. Retroperitoneal lymph node dissection was performed in 8 ea-ses. Results The histological structures were rather complicated in 24 tumors. Twenty-three eases (96%) were found with reticular pattern, 22(92%) with hyaline body, 20(83%) with glandlike structure, 16(67%) with Shiller-Dural body, and 13(54%) with solid formation. The former 3 kinds were regarded as the main diagnostic criteria. Twenty-one eases were followed up for 20 months to 12 years. During the follow-up, 2 patients died of the disease. Condesions Early diagnosis and combi-nation therapy, including radical orehieetomy and chemotherapy, are the keys to improve the curative effect of testieular endodermal sinus tumors. Active surveillance of AFP is critical for monitoring the recurrence and metastasis of this tumor.

Objective:To establish an HPLC method for the determination of paclitaxel and docetaxel in plasma to provide refer-ence for the individualized treatment regimen and the evaluation of curative effect and adverse reactions. Methods:Paclitaxel and do-cetaxel were used as the internal standard for each other. The samples were precipitated by acetonitrile and separated on a DikMA Dia-monsil C18 column with a mixture of acetonitrile-water (55: 45) as the mobile phase. The flow rate was 1. 2 ml·min-1 . The column temperature was set at 25℃. Paclitaxel and docetaxel were detected by UV-detection (λ= 227 nm). Results: A linearity was ob-tained within the range of 0. 078-10. 0 mg·L-1 for paclitaxel and docetaxel. The limit of quantitation was 0. 039 mg·L-1 . The aver-age recovery of paclitaxel and docetaxel was 99. 85% and 100. 35%, respectively. The inter- and intra-day RSD were both less than 5% and the RSD for freeze-thaw stability was below 10%. The plasma concentration of paclitaxel in clinical samples was within the range of 0. 18-6. 16 mg·L-1 and obvious individual difference was shown. Conclusion:Therapeutic drug monitoring is very important due to the obvious differences in plasma concentration of paclitaxel and docetaxel. The established method is sensitive, accurate, con-venient and rapid in r the therapeutic drug monitoring, and is useful for the adverse drug reactions monitoring and pharmacokinetic study.

Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula.Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic fracture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively.The mean diameter of maximum urethrovaginal fistula was approximately 2.3 cm.The paries anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas,and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again.Results Fifteen patients were followed up for 6 to 80 months,and they gained normal voiding,with no urine leakage,urinary incontinence and urethral stricture occurring.Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.