OBJECTIVE:To observe clinical efficacy and safety of tanshinone ⅡA sulfonate combined with alprostadil in the treatment of acute cerebral infarction. METHODS:56 patients with acute cerebral infarction were randomly divided into treatment group(36 cases)and control group(20 cases). Control group was given tanshinone ⅡA sulfonate 60 mg intravenously,qd,for 10 days. Treatment was additionally given Alprostadil injection 10 μg intravenously,30 min drop lrote,qd,the two group for 10 days,on the basis of control group. Therapeutic efficacy and BI were observed at the end of a treatment course. RESULTS:The ef-fective rate of treatment group and control group were 91.67% and 75.00%,with statistical significance(P<0.05). BI score of 2 groups after treatment were better than before,and the treatment group was better than the control group after treatment,with statis-tical significance (P<0.05). No obvious ADR wad found in both groups. CONCLUSIONS:Tanshinone ⅡA sulfonate combined with alprostadil is effective in the treatment of acute cerebral infarction with good safety.

Objective To analyze the demographic characteristics,composition characteristics as well as influencing factors of the cost of hospitalization of patients with lung cancer in Gansu Province in order to help reduce their expenses. Methods The basics,healthcare records and expenses of patients diagnosed with lung cancer in a third-level grade-A hospital in Lanzhou were extracted between 2010 and 2014 through the hospital information system(HIS)database.The Wilcoxon rank-sum test was used to analyze the difference of expense composition over the past five years and the difference between subgroups.The forward,backward and stepwise selection method was used to select variables and the multi-linear regression analysis was adopted to explore the influencing factors of the cost of hospitalization.Results A total of 2778 eligible lung cancer patients were collected.The statistical analysis showed that western medicine cost (36.39%)and treatment cost (22.46%)accounted for the most of the total expense.The length of hospital stay was the No.1 influencing factor of the cost of hospitalization,followed by the acceptance of surgery,the year of admission and charge type. Conclusion Regulating drug use,enhancing treatment regimens,giving psychological guidance,strengthening hospital management and improving medical resources allocation may be effective measures to reduce the cost of hospitalization and lighten the economic burden for lung cancer patients in Gansu Province.

Objective:To investigate the effects of acupoint massage on cognitive function and sleep quality in elderly patients with hypertension. Methods:A total of 68 elderly patients with hypertension were enrolled, and their ages were all over 60 years old. They were divided into a control group and a treatment group by simple random method, with 34 cases in each group. Patients in the control group were treated by routine psychological health guidance and sleep knowledge education, while patients in the treatment group were treated by acupoint massage on the base of the interventions given to the control group. Both of their treatment courses were 3 months. Pittsburgh sleep quality index (PSQI) scores and mini-mental state examination (MMSE) scores before and after treatment were recorded and compared. Results:Two groups’ PSQI scores before treatment had no significant difference (P>0.05). After 3 months of treatment, their PSQI scores were statistically different (P<0.05). There was also no between-group statistical difference in MMSE score before treatment (P>0.05), but there was a significant difference after treatment (P<0.05). Conclusion:Acupoint massage for elderly patients with primary hypertension can improve their sleep quality and enhance their cognitive function, thus it is worthy of being applied in clinical nursing work.

BACKGROUND: Insulin-like growth factor-1 (IGF-1) is a peptide hormone, it has been proved a promotion role on the proliferation of precursor cells. OBJECTIVE: To explore the intravenous injection of IGF-1 on the proliferation, migration and differentiation of neural stem cells in rats after cerebral ischemia. METHODS: Eight adult male SD rats were randomly divided into control group and experimental group, with 40 rats in each group. The rats in two groups were used to prepare models of focal cerebral ischemia using modified suture method, the rats in the experimental group were treated with tail vein injection of IGF-1, according to 100 μg/kg computation, the injection was given for 6 continuous days; in the control group, rats were given equal volume of saline. The rats were decapitated at 7, 14, 21, 28 days following intervention, respectively, and rats in each group were given intraperitoneal injection of the BrdU at 1 day before death. Immunohistochemistry and double staining were applied to detect the expressions of BrdU-positive cells, PSA-NCAM-positive cells, BrdU + PSA-NCAM double-positive cells, and BrdU + MAP2 double-positive cells. RESULTS AND CONCLUSION: The number of BrdU-positive cells and PSA-NCAM positive cells reached the peak at 7 days after ischemia; BrdU + PSA-NCAM double-labeled-positive cells could be detected in ischemic bilateral subependymal zone and dentate gyrus, the number was the most at 7 days, then followed by a gradual decrease; the BrdU + MAP2 double-positive cells began to increase from 14 days, and then gradually increased along with the decrease of BrdU + PSA-NCAM double-positive expression, showing a reverse trend. Intravenous injection of IGF-1 can induce the proliferation, differentiation and migration of neural stem cells in rats following ischemic brain injury.

Background Clinical effectiveness of intavitreal injection of glucocorticosteroid for macular edema has been verified,especially triamcinolone acetonide(TA).However,the efficacy and safety of combination of TA with macular laser grid photocoagulation for macular edema is concerned. Objective This clinical trial was to evaluate the efficacy and safety of intravitreal injection of TA combined with macular laser grid photocoagulation in the treatment of macular edema. Methods A case-cohort study was designed.One hundred and twenty eyes of 120 patients with macular edema from diabetes or retinal vein occlusion were included in this study.The patients were randomized into trial group and control group,with the matched age,course,visual acuity,intraocular pressure (IOP).The patients of the trial group received intravitreal injection of TA combined with macular laser grid photocoagulation,and those of the control group were managed with macular laser grid photocoagulation only.Best corrected visual acuity ( BCVA),optical coherence tomography(OCT),fundus fluorescein angiography(FFA) and IOP were examined before TA injection and 1 week,1 month,3 months,6 months after treatment and compared among different time points between two groups.Written informed consent was obtained from each patient prior to entering this trial. Results Compared with TA injection before,the BCVA was significantly elevated in the trial group 1 week,1 month,3 months and 6 months after TA injection( all P=0.000),however,no obvious improvement of visual acuity was found in the control group before and after treatment at any time point (P＞0.05 ).At various time points,the visual acuity was significantly improved in the trial group than the control group (P =0.037,0.000,0.002,0.046 ).Macular thickness was significantly decreased at various time points after TA injection in comparison with before TA injection in the trial group(all P=0.000),but no significant change in macular thickness in the control group between before and after treatment at any time point( P＞0.05 ).Macular thickness was lower in the trial group compared with the control group at various time points after treatment ( P＜0.05 ).Recurrence of macular edema was seen in 7 eyes ( 1 1.67％ ) 4-6 months,and the IOP raise( ＞21 mmHg)was found in 11 eyes( 14.1％ )after TA injection in the trial group.Conclusions Intravitreal injection of TA combined with macular laser grid photocoagulation can be an effective method in the treatment of macular edema.However,recurrence of macular edema or increase of IOP may occur in a few patients within 6 months after TA injection.A long-term follow-up should be performed for the evaluation of efficacy and safety after intravitreous injection of TA.

Owing to the increasing morbidity and pulmonary infection,management of pulmonary function has become an important problem for COPD patients who undergo surgery.Surgical patient with respiratory disease such as COPD has declined lung function before operation,then increased the risk of post-operative pulmonary complications.Ipratropium bromide can significantly improve pulmonary function.Therefore,we hypothesis the treatment with nebulized ipratropium bromide will benefit the perioperative patients with COPD.A randomized,double-blind,placebo-controlled,parallel-group,multi-center trial (Ipratropium bromide in Peri-Operative COPD study,IPO-COPD study)has been conducted to evaluate the efficacy and safety of nebulized ipratropium bromide in Chinese perioperative patients with COPD under general anaesthesia.A total of 192 COPD patients who satisfied the eligibility criteria were randomly assigned(1∶1) to one of the two treatment groups(ipratropium bromide 500 μg or normal saline 4 ml) for 11 days.Measurements will include the change of the forced expiratory volume in 1 second(FEV1),the forced vital capacity(FVC),blood gas analyses and main post-operative pulmonary complications.

Aiming at the malpractice of traditional education mode,we have carried out a series of experimental teaching reform on laboratory immunology,including developing compositive and devised experiments,applying the fruit of scientific research into experimental teaching,doing the special discuss after immune experiments as well as going to clinical laboratory to learn termly,which can adequately embody the students' principle part and the teachers' leading role,and improve the students' comprehensive qualities.

· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.

Objective To investigate the error monitoring function damages on the patients with schizo?phrenia ( SCH) . Methods A total of 32 patients with schizophrenia were compared with matched 34 health con?trols ( HC) on the error monitoring tasks which were compiled by E?Prime. Results The comparison between SCH group ((713.22±174.52)ms,( 491.14±170.29) ms,( 1060.31±130.84) ms,(8.28±12.55)time,( 8.00± 7.53)time respectively) and HC group ((560.73±156.94) ms,(395.62±188.03) ms,(989.85±104.33) ms, (2.97±4.13) times,(3.12±6.50) times) on the reaction time of choice,assessment,incongruent condition,the numbers of uncertain and the numbers of dropout were significant ( t=-3.737, P=0.000;t=-2.159, P=0.035;t=-2.426, P=0.018;t=-2.282, P=0.022;t=-2.824, P=0.006) . The SCH group and HC group did not signifi?cantly difference in Full Correct((124.72±23.74)/(131.74±21.96)times),Full Error((15.69±17.64)/(13.35± 18.63)times),Part Correct((6.83±10.40)/(4.21±7.03)times),Part Error((2.91±10.91)/(0.62±1.10)times) and Accuracy((0.831±0.161)/(0.874±0.159))(P>0.05).There was no significantly correlation among the course of disease,HAMA,HAMD and the error monitoring. Conclusion These results demonstrate that the error monitoring function damages on the patient with SCH may be involved in the dysfunction of anterior cingulate cortex.

Objective: To investigate the effects of Ala-Gln induced heat shock protein 70 (HSP70) expression on myocardial ifbrosis and connexin43 (Cx43) remodeling in experimental rats’ model.
Methods: A total of 32 SPF male SD rats were randomly divided into 4 groups:①Control group,②Model group, the rats received isoprenaline (ISO) 5m/(kg·d),③Intervention group, the rats received ISO+Ala-Gln 0.75mg/(kg·d),④Quercetin group, the rats received ISO+quercetin 100mg/(kg·d)+Ala-Gln+DMSO. n=8 in each group. All animals were treated for 7 days and killed in 4 weeks for relevant examinations. HE and Masson staining was conducted to observe myocardial ifbrosis, then calculate collagen volume fraction; immunohistochemistry was applied to measure myocardial HSP70 expression,
extracellular signal regulated kinase (p-ERK1/2) and Cx43 distribution, then conduct semi-quantitative analysis by speciifc soft ware.
Results: HE and Masson staining indicated that Control group had no obvious myocardial ifbrosis, Model group and Quercetin group had obvious ifbrosis, and Intervention group showed less ifbrosis than the other 2 groups, all P<0.01. The fibrosis level was similar between Intervention group and Control group, P>0.05. The myocardial HSP70 expression was similar among Control, Model and Quercetin groups, P>0.05, while HSP70 expression was signiifcantly higher in Intervention group than the other 3 groups, all P<0.01. The myocardial p-ERK1/2 level was lower in Intervention group than Model and Quercetin groups, all P<0.01. The myocardial Cx43 level was similar between Control group and Intervention group with linear distribution, while it was higher in Intervention group than Model and Quercetin groups with disordered distribution, all P<0.01.
Conclusion: Ala-Gln inducing the higher expression of HSP70, which may reduce myocardial ifbrosis in experimental rats, it could be because of HSP70 down regulating p-ERK1/2 expression and inhibiting ERK signaling pathway.