ObjectiveTo determine the diurnal variation,moon phase,and seasonal variation in the onset of stroke. MethodsThe time parameters,including the time,the moon phase and the season of the stroke occurrence for 905 in-patients from 1989-2001 were investigated.ResultsThere was a significant difference (D=0.155,P<0.01) for circadian rhythm in the onset of 321 cases with cerebral infarction,and the incidence frequency at dawn was much higher than that at other time,but the difference of the moon phase and seasonal rhythm in the onset of cerebral infarction were not significant(P>0.05).There were not diurnal variation,moon phase and seasonal rhythms in the onset for cerebral haemorrhage(P>0.05).ConclusionsThe cerebral infarction occur more frequently at dawn time.

Objective:To explore the correlation between blood pressure and prethrombotic state indexes in patients with chronic heart failure (CHF) .Methods:A total of 96 cases with NYHA classⅡselected from inpatients of our department from Apr 2010 to Feb 2013 were enrolled into CHF group ,another 90 patients with normal cardiac function were regarded as normal control group .Daytime ,nighttime and 24h blood pressure and related indexes of prethrombotic state were detec-ted in both groups .Correlation between blood pressure variability and prethrombotic state indexes were analyzed .Results:Compared with normal control group ,there were significant rise in nighttime diastolic blood pressure [nDBP ,(80.53 ± 7.73) mmHg vs .(84.74 ± 8.74) mmHg] ,daytime systolic blood pressure standard deviation [dSSD ,(11.87 ± 4.98) mm-Hg vs .(14.97 ± 5.12) mmHg] ,night time SSD [nSSD (11.62 ± 4.83) mmHg vs .(15.05 ± 5.42) mmHg] and 24hSSD [24hSSD ,(12.98 ± 3.22) mmHg vs .(15.75 ± 5.08) mmHg] , P<0.01;and significant increase in plasma levels of von Willebrand factor [vWF ,(75.64 ± 6.83) IU/dl vs .(90.75 ± 7.32) IU/dl] ,D-dimer [ (0.31 ± 0.03) g/L vs .(0.73 ± 0.13) g/L] and plasminogen activator inhibitor-1 [PAI-1 ,(22.33 ± 1.14) μg/L vs .(27.46 ± 1.15) μg/L] in CHF group ,P<0.01 all .In CHF patients ,24hSSD were positively correlated with vWF and granule membrane protein (GMP-140) levels (r=0.403 ,0.452 ,P<0.05 both) ,24hDSD and nDSD were positively correlated with GMP-140 level (r=0.421 ,0.413 ,P<0.05 both) ,there were no significant correlation among other blood pressure variability indexes and PTS indexes , P>0. 05 all .Conclusion:In CHF patients ,blood pressure variability and prethrombotic state indexes levels significantly rise ,the both are significant positive correlation .

Employee Assistance Programs is to promote organization management and is one way to improve organization per-formance.Employee Assistance Programs, involving all aspects of working and life of employees, is a long-term project to help em-ployees solving problems through psychological and behavioral counseling, guidance, training and other ways.This article analyzes the necessity of using EAP in hospital management and introduces the main steps of EAP, which provides guidance and help of using EAP in hospital management.

Statins are a class of cholesterol-lowering drugs for effectively reducing the risk of cardiovascular events,including myocardial infarction and stroke.Clinical trials and meta-analyses have shown that the treatment with statins may increase the risk of new-onset diabetes mellitus.This article reviews the evidence of statins inducing diabetes mellitus,the possible mechanisms,and clinical significance.

Radical operation is very essential for gastric cancer, and the reasonable digestive tract reconstruction is an important part affecting the prognosis and quality of life of patients.After gastrectomy, the most basic requirements for reconstruction include prevention of gastrointestinal fluid reflux, keeping food storage and emptying function, physiological pathways and endoscopic inspection of biliary tract, pancreas and gastric remnant.In addition, technical level of reconstruction,safe operation, low invasion and suture technique cannot be ignored.Since complex digestive tract reconstruction can cause many complications, the method in the research stage should be carefully chosen.

ObjectiveTo investigate the clinical efficacy of primary and connecting point combination acupuncture in treating mild and moderate depression.MethodPatients meeting the inclusion criteria were randomly allocated to observation and control groups. Both groups of enrolled patients took fluoxetine hydrochloride (Prozac). The observation group received meridian-unblocking acupuncture at yuan-primary points and luo-connecting points and the control group, acupuncture at routinely selected points in the eleventh-five textbook. Treatment was given for four consecutive weeks. The Hamilton Depression Scale (HAMD) 24-item score was recorded in the patients before and after one month of treatment. The therapeutic effects were evaluated according to the score reduction rate in the two groups.ResultThere wasa statistically significant post-treatment difference in the HAMD 24-item score between the two groups (P<0.05). The total efficacy rate was83.3% in the treatment group and70.0% in the control group. There was a statistically significant post-treatment difference in therapeutic effect between the two groups (P<0.05). ConclusionMeridian-unblocking acupuncture at yuan-primary points and luo-connecting points is more effective than conventional acupuncture in proving the symptoms in patients with mild or moderate depression.

Objective To evaluate the effect ofBazheng powder combined with levofloxacin on renal tissue injure of patients after renal extracorporeal shockwave lithotripsy.Methods A total of 100 patients with renal calculus were randomly divided into a Bazheng powder group (50 patients) and a control group (50 patients). ESWL was used in the 2 groups. After ESWL operation, patients in the control group were administered with large amount of drinking water and appropriate exercises to promote stone removal. And on this basis, ethanesulfonic acid levofloxacin was administered for successive 3 days. TheBazheng powder group was additionally addedBazheng powder on the basis of the control group for 15 days. 15 days later, C Cys and NGAL and therapeutic effect in both groups were evaluated.Results The total effective rate of theBazheng powder group was significantly better than the control group (96%vs. 60%,χ2=16.842,P<0.01). The serum Cys C (0.97 ± 0.10 mg/Lvs. 1.13 ± 0.25 mg/L,t=4.202) and NGAL(4.04 ± 1.32 g/Lvs. 6.91 ± 2.96 g/L,t=6.262) in the Bazheng powder group decreased, the serum Cys C (0.95 ± 0.12 mg/Lvs. 1.09 ± 0.20 mg/L,t=4.244) and NGAL(4.66 ±1.57 g/Lvs. 7.19 ± 1.81 g/L,t=7.762) levels in the control group were also decreased after the treatment (P<0.01), andBazheng powde group of postoperative urinary NGAL level was significantly lower than the control group (t=2.137,P=0.035).ConclusionBazheng powder combined with ESWL can accelerate renal calculi removal and repair renal injury after ESWL operation. We also speculate that the best interval is 2 weeks for two lithoclasty operation.

In addition to the function of killing the tumor cells directly,radiotherapy can induce the changes of quantity and function of the immune cells in the tumor microenvironment,which affects the function of anti-tumor immunity.Clarification of the effects of radiotherapy on quantity and function of the immune cells in the microenvironment can provide a theoretical guidance in the treatment of tumor.

Scirrhous gastric carcinoma is a special type of gastric carcinomas and accompanied with highly interstitial fibrosis and diffuse cellular infiltration.Scirrhous gastric carcinoma is mainly composed of poor-differentiated adenocarcinoma and signet-ring cell carcinoma,with the clinical features of Borramann 4,thickening and stenosis of stomach wall,high peritoneal and lymph node metastases rates and poor prognosis.R0 resection and postoperative chemotherapy with S-1 as a main way are necessary for the patients who are able to undergo curable resection.The palliative operation should be applied to patients with ileus and urinary obstructions caused by peritoneal metastasis because of limited effect of surgical treatment.Chemotherapy is the best choice for patients who are not able to undergo curable resection,conversional therapy can improve the prognosis of patients,and preoperative S-1/CDDP combination chemotherapy is an expectable therapy.Moreover,controlling peritoneal metastasis and effect of intraperitoneal chemotherapy are much anticipated.The efficiency of molecular targeted therapy by bevacizumab and gene therapy by adenovirus remain further study.

Objective To compare the curative effect of transumbilical single port laparoscopic appendectomy and conventional laparoscope appendectomy .Methods 80 cases with acute appendicitis were divided into single hole group and routine group according to the operation mode ,40 cases in each group .The two groups were given transum-bilical single port laparoscopic appendectomy and conventional laparoscopic appendectomy ,respectively.The clinical efficacy was compared between the two groups .Results The patients in two groups were given successful operation without converted laparotomy .The postoperative anal exhaust time of the single hole group was (21.7 ±6.2)h,which was significantly shorter than that in the routine group [(26.9 ±7.3)h](t=2.18,P<0.05).However,the operation time,intraoperative bleeding amount ,postoperative length of stay ,intraoperative and postoperative complication had no obviously statistical differences between two groups (P>0.05).The patients were followed up for 3-21 months,no appendix stump inflammation , appendiceal stump fistula , adhesive ileus and other remote complication appeared . Conclusion Transumbilical single hole has safe and minimal invasive advantages on appendectomy , which can be favorable for the postoperative recovery of bowel function and cosmetic result .If it′s difficult to excise appendix , relevant operation skills shall be applied in accordance with the appendiceal lesions ,which can effectively reduce the occurrence of complication .