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.

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

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.

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.

The article analyzes the TCM etiology, pathogenesis of geriatrics and pathological basis and clinical treatment medication of several common geriatrics. Chinese herb formula with function of invigorating the kidney and promoting blood circulation has the preferable curative effect on geriatrics, so we consider that kidney defi ciency and blood stasis is the main pathogenesis of geriatrics. Invigorating the kidney and promoting blood circulation is an important treatment of geriatrics, and should be followed through the whole therapeutic process.

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 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 provide references for the accountability of civil liability induced by different causes.METHODS:Literature retrieval and case study were applied to analyze the civil liability of pharmaceutical manufacturers and medical institution in medication misadventures.RESULTS & CONCLUSIONS:At present it is difficult for patients who suffered from medication misadventures caused by drug quality defects,drug adverse reaction or medication errors to claim.The main reasons are imperfect relevant law system and the vacancy of compensation mechanism of drug-induced injury events.It is suggested to establish technology institution for evaluating medication misadventures,state relief and compensation system and encourage pharmaceutical manufacturers to buy products liability insurance.

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 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 .