Objective To investigate the risk factors of stroke-associated infection (SAI)and their correlation with immunodepression.Methods One hundred fourteen consecutive patients with acute ischemic stroke admitted with 24 hours after symptom onset were enrolled.They were divided into infection (n =45) and non-infection (n =69) groups according to whether they had infection or not within 7 days after admission.Automatic blood analyzer and flow cytometry were used to measure the peripheral blood lymphocyte count and T lymphocyte subsets on the day of admission.Univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for SAI.Results There were statistical significances in vomiting,disturbance of consciousness,dysphagia,indwelling gastric tube,indwelling catheter on admission,and the National Institutes of Health Stroke Scale (NIHSS) score 0-3 days after admission between the infection and non-infection groups.Further more,the numbers of peripheral blood lymphocytes,CD3 + and CD4 + T lymphocytes in the infection group were significantly lower than those in the non-infection group.Multivariate logistic regression analysis showed that dysphagia,the increased NIHSS score 3 days after admission,and the decreased numbers of CD4 + T lymphocytes were the independent risk factors for SAI.Conclusions The T lymphocyte immune function decreased in patients with SAI.It was the result of the combined action of various factors.Targeted prevention and treatment should be taken to reduce the occurrence of SAI.

BACKGROUND: Research on muscular fatigue has extensive value of application in fundamental research about neuromuscular system, handicapped rehabilitation engineering, objective evaluation on physiotherapeutic effect, scientific training of athletes and ergonomics etc.OBJECTIVE: To study partial muscular fatigue by using AR model parameter of needle electrode electromyography (NEMG) signal and try to reveal the quantitative relationship between local muscular fatigue process and AR model coefficient of NEMG signal.DESIGN: Human NEMG signal was taken as the subject, the changing rule of myoelectric characteristics parameter in local muscular fatigue process was studied.SETTING: NML Laboratory of China University of cience and Technology.PARTICIPANTS: 4 eases of NEMG signals were obtained from NEMG signal collection system manufactured by NML Laboratory of China University of Science and Technology. Four volunteers that selected were healthy males and their tibialis anterior muscles were tested.METHODS: Based on the theory of random signal parameter model,NEMG signals were modeled and parameter was selected, the trend of parameter of NEMG signal changing with the time increasing was studied in the muscular fatigue process. Relative programs from MATLAB language toolbox were adopted for programming.MAIN OUTCOME MEASURES: The trend of α1 parameter of NEMG signal changing with the time (fatigue process) increasing. RESULTS: There was a correlation between local museular fatigue of human body and the changing trend of α1 parameter of NEMG signal tested from the muscle, that is, α1 parameter of NEMG signal increased with the time (fatigue process) increasing.CONCLUSION: By means of the increasing trend of α1 parameter of NEMG signal with the time (fatigue process) increasing, muscular fatigue state can be better evaluated.

Anaphylaxis ; chemically induced ; Anti-Bacterial Agents ; adverse effects ; Azithromycin ; adverse effects ; Fatal Outcome ; Humans

Objective To observe the degree of choriocapillary ectasia (CCE) and sub-foveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) with different activity and discuss their relations.Methods Forty eyes of 40 CSC patients were recruited.The activity of CSC was determinate by fundus fluorescein angiography (FFA).There were 23 eyes with active CSC (active-CSC group),and 17 eyes with inactive CSC (inactive-CSC group).All eyes in both groups were examined with optical coherence tomography angiography(OCTA),and the CCE area of the choriocapillary layer was measured within a 3 mm× 3 mm zone centered on the central fovea of macula.Ectasia was classified based on CCE area,more than 66％ of examination area was high ectasia,and 33％-66％ as medium ectasia,below 33％ as low ectasia.SFCT was measured with frequency domain optical coherence tomography.The relationship between CCE degree,SFCT and CSC group was analyzed.Results Among the 23 eyes of active-CSC group,there were 5 eyes of low ectasia,12 eyes of medium ectasia,6 eyes of high ectasia.Among 17 eyes of inactive-CSC group,there were 11,4,2 eyes of low,medium and high ectasia respectively.Active-CSC group had more advanced degree of ectasia than that in inactive-CSC group(Z=-2.472,P=0.013).SFCT of active-CSC group and inactive-CSC group were (418.13±-126.15),(429.76±105.80) μm respectively,the difference was not significant (t=-0.308,P=0.760).SFCT in eyes with low ectasia,medium ectasia,high ectasia were (419.13±105.60),(381.00±125.12),(515.13±67.68) μm respectively.The difference among the three group was statistical significant (F=4.106,P=0.025).SFCT in eyes of high ectasia was obviously thicker than low ectasia and medium ectasia,the difference was statistical significant (P=0.007,0.048);the SFCT difference between low ectasia and medium ectasia did not appear statistical significance (P=0.326).There was no linear relation between SFCT and CCE degree (r=0.247,P =0.124).Conclusions Active-CSC eyes has more advanced CCE degree than inactive-CSC eyes,but SFCT is the same between the two groups.High ectasia eyes have thicker SFCT.

Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA＞0 group (n =142) 27 (19.0％) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1％) patients died (P ＜ 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95％CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P ＜ 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature ＜ 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature ＞38 ℃ and 48 h-△SOFA ＞0 because of its longer stay in EICU.

Objective To explore the causes of the misdiagnosis of spontaneous rupture of spleen.Methods 8 cases of spontaneous rupture of spleen during 1986～1998 were reviewed retrospectively.Results 5 cases were misdiagnosed, with the misdiagnosing rate of 62.5%.Conclusion For unknown upper bellyache accompanied with unexplainable loss of blood and with no history of trauma,the patients should be examined by B ultrasound or abdominal puncture should be peformed.If there is pathological process of liver and spleen such as schistosoma and hepatitis or the excessive functioning of spleen,the more attention should be paid to the occurrence of spontaneous rupture of spleen.Furthermore,the increase of the belly pressure caused by satiation or hard labour helps to diagnose such case.

Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1％) died,157 cases (36.9％) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P ＜ 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4％) than that of the negative patients (3.6％) (P ＜ 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5％) than that of the positive patients (88.5％) (P＜0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P＜0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P ＜ 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P ＞0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P ＜ 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.

Social capital is an invisible capital form that promotes the efficient allocation and utilization of resources.It plays an active role in the prevention and control of chronic diseases.The purpose of this study is to investigate the effect of social capital on the three levels prevention of stroke by means of document retrieval.Social capital is associated with both morbidity and mortality of stroke.Social participation and social support at a high level can promote the rehabilitation of stroke patients,and have a beneficial effect on improving the quality of life and the ability of daily life.Social capital is correlated with stroke related behavioral factors,such as smoking,drinking,obesity,diet and physical activity.People with high social capital stock are more likely to choose healthy behavior patterns,thus reducing the risk of stroke.We should take full account of the social capital factors,and make more comprehensive and effective completion of the three levels of stroke prevention.

OBJECTIVE:To establish a set of scientific,standard management model and rational,impartial financial system in Chinese institutes for drug control.METHODS:The types of the established institutions and the financial appropriation model of institutes for drug control in China were studied by using the methods of classification,comparison and analysis.RESULTS & CONCLUSIONS:Under super-ministry system,local management in drug control institutions at all levels is expected to be put into practice soon.It is advisable to optimize the organization and management model and financial appropriation management system such as by shifting from county level institution to district level institution and carrying out a wage system in drug control institutes in accordance with the payment level of civil servants,etc.

Objective To study morphological structural changes for different segment umbilical vessels of fetus in patients with pregnancy induced hypertension (PIH) ,and explore relationship between PIH and umbilical vessels .Methods Totally 36 umbilical cords from fetus of pregnant women without and with PIH (17 cases ,19 controls) were collected ,and take umbilical cord of placen‐tal ,middle ,and fetal segment to routine dehydration ,embedding ,section and stain .In the cases 9 women had mild preeclampsia ,6 had severe preeclampsia and 4 had eclampsia .Microscope images were obtained by digital microscope ,and lumen diameter ,wall thickness and wall‐luminal ratio of different segment umbilical vein and arteries were tested by computer image analysis software . The test results were analyzed and compared .Results From the placental end to the fetal end ,the lumen diameter and wall‐luminal ratio gradually decreased ,and wall thickness gradually increased in the umbilical vein and arteries (P<0 .05) .Compared to normal pregnant women ,the lumen diameter and wall‐luminal ratio decreased ,and wall thickness increased in patients with PIH ,and the a‐bove changes aggravated by disease severity (P<0 .05) .Conclusion PIH is associated with structural changes in the umbilical ves‐sels .These changes are more predominant in the vein than in the artery and most obvious in the fetal end .