Objective To study T lymphocyte subsets levels in acute zoster patients and investigate its relation to the zoster associated pain.MethodsAccording to the visual analogue scales(VAS) in the acuter phase, 60 patients with herpes zoster were divided into two groups: group A (VAS≤6) and group B (VAS＞6). According to the follow-up results, patients were divided into another two groups: group C (PHN not developed) and group D (PHN developed). 25 healthy volunteers with a similar age and gender range as the patients were recruited as control group. T lymphocyte subsets were detected by fluorescence-activated cell sorter (FACS). ResultsThere was no significant difference in gender and age between groups (P＞0.05). T lymphocyte subsets were significantly decreased in four groups compared with the control group (P＜0.05), and the CD4 +subsets in group B were significantly decreased compared with group A (P＜0.05). The CD4 +/CD8 + ratios were significantly higher in group A and C than in control group, higher in group A than B and higher in group C than in group D (P＜0.05). The visual analogue scales(VAS) in group D were significantly higher than in group C (P＜ 0.05).Conclusions Cellular immunity function is decreased with the lower percent of the T lymphocytes subsets in the elderly patients with acute herpes zoster, especially in severe patients. The CD4 +/CD8 + ratios and the visual analogue scales may be associated with the the risk of post herpetic neuralgia.

To investigate the pathogenesis of Broca-like and Wernicke-like conduction aphasia. Methods 7 cases with Broca-like aphasia (Group A), 7 cases with Wernicke-like aphasia (Group B) and 10 healthy volunteers (Group C) participated in the study. Broca'sarea, Wernicke's area, and the arcuate fasciculus were analyzed by diffusion tensor imaging, and their fractional anisotropy (FA) weremeasured and compared; The fiber construction of Broca's and Wernicke's areas were also compared by diffusion tensor imaging-fibre tractography.Results In Group C, All of the FA was higher in the left hemisphere than in the right hemisphere (P<0.05); In Group A, the FA ofthe Broca's area and anterior segment of the arcuate fasciculus were less in the left than in the right hemisphere (P<0.05)； In Group B, theFA of the Wernicke's area and posterior segment of the arcuate fasciculus were less in the left than in the right (P<0.05). Conclusion Conductionaphasia results not only from arcuate fasciculus destruction, but also from disruption of the associated cortical area. A lesion involvingBroca's area and the anterior segments of the arcuate fasciculus would lead to Broca-like conduction aphasia, whereas a lesion involvedWernicke's area and posterior segments of the arcuate fasciculus would lead to Wernicke-like conduction aphasia.

Objective To study the effect of Sildenafil in the treatment of hypoxemia after operation of cyanotic congenital heart disease.Methods A total of 34 cases with hypoxemia after operation of cyanotic congenital heart disease were collected between January 2009 to January 2015.They took Sildenafil with the dosage of 0.3-0.5 mg/kg every 6 hour.The change of heart rate (HR),systolic blood pressure (SBP),central venous pressure (CVP),pulmonary artery pressure (PAP),arterial partial pressure of oxygen [pa (O2)],arterial partial pressure of carbon dioxide [Pa (CO2)],oxygenation index [pa (O2)/FiO2],peak airway pressure (Ppeak),positive inotropic drug score (PIDS) and the lower bound of liver were observed at 4 time points,including before taking the medicine,after taking the medicine for 1 hour,after taking the medicine 1 day and after the ventilator was removed.Based on the data,the therapeutic effects of Sildenafil were studied.Results All 34 cases were cured.At the time point of 1 hour after taking Sildenafil,PAP,CVP and Ppeak decreased significantly,but pa (O2) and pa (O2)/FiO2 increased significantly (P ＜ 0.05).At the time point of 1 day after taking Sildinafil,SBP increased steadily,but PAP and CVP continued to get lower,and PIDS decreased significantly,while the liver lower bound was significantly reduced (P ＜ 0.05).At the time point of removing the ventilator,pa (O2) reached to (144.12 ± 26.25) mmHg,and hypoxemia was corrected,but PAP was reduced to (37.47 ± 3.77) mmHg,PIDS decreased to (17.56-± 1.94) scores,and heart failure was corrected.Compared with the previous 3 time points,there were statistically significant differences (P ＜ 0.05).Conclusion Sildenafil can highly selectively decrease pulmonary vascular resistance and obviously promote the correction of hypoxemia after operation of cyanotic congenital heart disease.

Objective:To investigate the influencing factors of post-dialysis hypertension in maintenance hemodialysis (MHD) patients.Methods:This study was a cross-sectional and retrospective study. The patients receiving hemodialysis from January 9, 2017 to January 14, 2017 in 5 hemodialysis centers of Beijing area were selected. Post-dialysis hypertension was defined as an event characterized by an average increase of more than 15 mmHg in post-dialysis mean artery pressure (MAP) compared to intradialytic 3 h MAP during 3 consecutive hemodialysis sessions. Post-dialysis stable blood pressure was defined as an event characterized by an increase of less than 15 mmHg or a decrease of less than 10 mmHg in post-dialysis MAP compared to intradialytic 3 h MAP, with the exception of patients with post-dialysis hypertension and post-dialysis hypotension. The patients were divided into hypertension group and stable blood pressure group based on whether they had post-dialysis hypertension, and the differences of clinical data between the two groups were compared. The influencing factors of post-dialysis hypertension were analyzed by multivariate unconditional logistic regression.Results:A total of 491 MHD patients were enrolled in this study, including 65 patients (13.2%) in the hypertension group, 406 patients (82.7%) in the stable blood pressure group and 20 patients (4.1%) in the hypotension group. The age, blood calcium before dialysis and the proportion of patients using 1.75 mmol/L Ca 2+ dialysate in the hypertension group were higher than those of the stable blood pressure group, and pre-dialysis serum intact parathyroid hormone and pre-dialysis serum uric acid in the post hypertension group were lower than those of the stable blood pressure group (all P<0.05). The age, pre-dialysis serum intact parathyroid hormone, pre-dialysis serum calcium, pre-dialysis serum uric acid, dialysate Ca 2+ concentration of statistical differences between hypertension group and stable blood pressure group ( P<0.05), and post-dialysis serum calcium, pre-dialysis total serum cholesterol, application of β receptor blocker, gender of univariate analysis ( P<0.1) were included into the logistic regression equation as covariates. Multivariate logistic regression analysis showed that using 1.75 mmol/L Ca 2+ dialysate was the independent influencing factor of post-dialysis hypertension (with using 1.50 mmol/L Ca 2+ dialysate as reference, OR=2.930, 95% CI 1.282-6.694, P=0.011). The age and pre-dialysis serum calcium of statistical differences between hypertension group and stable blood pressure group ( P<0.05), and pre-dialysis serum sodium and pre-dialysis serum uric acid of univariate analysis ( P<0.1) were included into the logistic regression equation as covariates. The older age ( OR=1.046, 95% CI 1.000-1.093, P=0.049) and higher pre-dialysis serum calcium ( OR=21.847, 95% CI 2.111-226.075, P=0.010) were the independent influencing factors of post-dialysis hypertension when the 1.50 mmol/L Ca 2+ dialysate was used. Conclusions:The independent influencing factor of post-dialysis hypertension is using 1.75 mmol/L Ca 2+ dialysate, while the independent influencing factors of post-dialysis hypertension are the older age and the higher pre-dialysis serum calcium level when the dialysate Ca 2+ concentration was 1.50 mmol/L.