Objective To evaluate the influence of a clinical pathway on mean length of hospital stay of ischemic stroke patients. Methods The study performed retrospective cohort study of stroke patients which were hospitalized in the Guangdong provincial hospital of TCM corresponding to the periods immediately before and after the implementation of the clinical pathway. The outcome measure was mean length of hospital stay. Results Mean length of hospital stay was significantly shortened after implementing clinical pathway. Conclusions The implementation of the ischemic stroke clinical pathway can shorten mean length of hospital stay of ischemic stroke patients and improve the utilization of medical source.

BACKGROUND: Resveratrol is a naturally occurring phytoalexin present in grapes, peanut and some herbs. It has been demonstrated to produce a variety of biological actions, such as anticancer, antiinflammation. Accumulating line of evidence supported the view that resveratrol may exert protective effect on cardiovascular system. However, its protective mechanism is not completely understood.OBJECTIVE: To investigate the anti-ischemic effect and mechanism of resveratrol (Res) on acute myocardial infarction in rats.DESIGN: Randomly grouping paralleled control study.SETTING: Pharmacological Laboratory of Harbin Medical University, Biopharmaceutical Key Laboratory of Heilongjiang Province-Incubator of State Key Laboratory.MATERIALS: The experiment was carried out in Department of Pharmacology of Harbin Medical University from March 2005 to July 2005.Totally 80 male Wistar rats weighting 250-300 g were selected in this study. Among them, 60 rats after operation successful modeling were randomly grouped into 5 groups: sham operation group, blank control group,resveratrol 5 mg/kg, 15 mg/kg and 45 mg/kg groups with 12 in each group.METHODS: Acute myocardial infarction (AMI) model was induced by ligation of the anterior branch of the left coronary artery in rat, Sham operation group: The same suture was put through but not ligated. Resveratrol group: Rats were injected with 5, 15 and 45 resveratrol mg/kg provided by Hunan Huaguang Biological Products Company Limited (batch number: 20050221, purity ≥99%) and ligated after 10 minutes. Model group: The same volume saline was injected for 10 minutes and then rats were ligated. Observe and record ST segment of standard limb lead Ⅱ electrocardiogram (ECG)after 1, 5, 10, 15, 30 minutes after ligating the left anterior decendingcoronary artery. After 6-hour ischemia, the infarct size areas was identified with the myocardium by 2, 3, 5-triphenyltetrazolium chloride (TTC) stain; the activities of serum .creatine kinase (CK)and lactate dehydrogenase (LDH) were determined by spectrophotometric method; the apoptosis in cardiomyocyte was detected by d-UTP end labeling method mediated with tagged deoxynucleotide transferase in situ (TUNEL); apoptosis-related proteins of Bcl-2, Bax and Fas expression were measured with estreptomicina avidin peroxidase chain. Measurement data were compared with t test.MAIN OUTCOME MEATURES: ST increase; the activities of serum creatine kinase (CK) and lactate dehydrogenase (LDH); the infarct size areas and the apoptosis rate in cardiomyocyte; the. expression of apoptosis-related proteins of Bcl-2, Bax and Fas.RESULTS: All of the 60 rats entered the final analysis. ① ST segment raise in high dosage group was lower than that in model group 1, 5 and 10 minutes after ligation (P ＜ 0.05), and it was also lower than that in model 15 and 30 minutes after ligation (P ＜ 0.05). This effect was dose-dependent. ② Infarct size in each dosage group was smaller than that in model group (P ＜ 0.05). This effect was dose-dependent. ③ The activities of CK and LDH in different dosages of resveratrol groups were significantly lower than those in model group (P ＜ 0.05). This effect was dose-dependent. ④ Apoptosis index in model group was higher than different dosages of resveratrol groups (P ＜ 0.05); The expression levels of Bax and Fas proteins in model group were higher than those in high and middle dosages of resveratrol groups (P ＜ 0.05); The expression level of Bcl-2 protein was lower than that in high and middle dosges of resveratrol groups (P ＜ 0.05).These effects were dose-dependent.CONCLUSION: Resveratrol can protect acute myocardial ischemic injury induced by coronary artery of ligated rats, and the effect is dose-dependent.Effect of resveratrol on myocardial ischemia is related to adjusting expressions of Fas, Bcl-2 and Bax and inhibiting myocardial apoptosis.

Objective To explore the clinical and electrophysiological features and pulmonary function of 8 Chinese patients with Kennedy's disease (KD) and to enhance the understanding for the disease.Methods Eight patients with KD,admitted to out hospital from July 2010 to December 2013 and confirmed by gene examination,were chosen in our study; their clinical and electrophysiological features,and laboratory characteristics and pulmonary function were compared with those in the healthy volunteers.Results The average age of onset in the 8 patients was (45.13±17.47) years,and the average age of diagnosis was (55.63±12.11) years.The most common complaint was leg weakness.All patients presented hemifacial spasm,tongue muscle atrophy and fibrillation,amyotrophy and gynaecomastia; creatine kinase level was elevated and endocrine disorder appeared in different degrees.The electromyogram characteristics included widespread neurogenic changes accompanied with/without sensory or motor conduction abnormalities.The forced vital capacity,forced expiratory volume in first second,maximal voluntary ventilation and peak expiratory flow rate were significantly lower,and the residual volume in the KD patients was statistically higher than that in the healthy volunteers (P＜0.05).Respiratory muscle strength (maximum inspiratory pressure and maximum expiratory pressure) decreased in the KD patients.Conclusion KD is a degenerative disease with slow clinical progression which has its own characteristics of inheritance pattern and natural course; the age of onset,repeat number of CAG sequences,pulmonary function and respiratory muscle strength may be valuable for illness evaluation.

Objective To explore the association between diabetes mellitus type Ⅱ (DM) and deglutition function of amyotrophic lateral sclerosis (ALS) patients.Methods Seventy-five ALS patients older than 45 years and admitted to our hospital from August 2008 to November 2015 were selected into this study;67 of them were without DM and 8 were with DM.Water swallow test,amyotrophic lateral sclerosis severity scale-swallow (s-ALSSS),amyotrophic lateral sclerosis functional rating scale (ALSFR-R) and videofluoroscopic swallow study (VFS) were performed to evaluate the deglutition functions of these ALS patients with or without DM,and the results of the two groups were compared.Results (1) Patients with DM had significantly higher s-ALSSS scores,ingurgitation part in ALSFRS-R scores and in parts of VFS scores,such as transportation to pharyngeal,pharyngeal transit,flow into pharyngeal before reflexion,epiglottic vallecula residue,and piriform sinus residue than patients without DM (8.88±1.34 vs.7.54±1.47,3.50±0.54 vs.2.96±0.77,2.88±0.35 vs.2.16±0.69,2.75±0.46 vs.2.09±0.69,2.88±0.35 vs.2.42±0.56,2.88±0.35 vs.2.39±0.58,P＜0.05).(2) Scores of Kubota drinking test,ALSFRS-R,VGF (including oral phase,pharyngeal phase and aspiration degree) in patients without DM were 2.15±1.12,7.18±1.41(1.78±0.69,1.69±0.60 and 3.72±0.65),and those in patients with DM were 1.88±1.34,8.00±0.93(2.13±0.64,2.00±0.53 and 4.00±0.00);no significant differences were noted between the two groups (P＞0.05),but there was a trend showing that DM patients had higher scores in these evaluations.Conclusion As compared with ALS patients without DM,ALS patients with DM get more mildly impaired deglutition function.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting both upper and lower motor neurons in the brain and spinal cord. One important aspect of ALS pathogenesis is superoxide dismutase 1 (SOD1) mutant-mediated mitochondrial toxicity, leading to apoptosis in neurons. This study aimed to evaluate the neural protective synergistic effects of ginsenosides Rg1 (G-Rg1) and conditioned medium (CM) on a mutational SOD1 cell model, and to explore the underlying mechanisms. We found that the contents of nerve growth factor, glial cell line-derived neurotrophic factor, and brain-derived neurotrophic factor significantly increased in CM after human umbilical cord mesenchymal stem cells (hUCMSCs) were exposed to neuron differentiation reagents for seven days. CM or G-Rg1 decreased the apoptotic rate of SOD1^G93A-NSC34 cells to a certain extent, but their combination brought about the least apoptosis, compared with CM or G-Rg1 alone. Further research showed that the anti-apoptotic protein Bcl-2 was upregulated in all the treatment groups. Proteins associated with mitochondrial apoptotic pathways, such as Bax, caspase 9 (Cas-9), and cytochrome c (Cyt c), were downregulated. Furthermore, CM or G-Rg1 also inhibited the activation of the nuclear factor-kappa B (NF-κB) signaling pathway by reducing the phosphorylation of p65 and IκBα. CM/G-Rg1 or their combination also reduced the apoptotic rate induced by betulinic acid (BetA), an agonist of the NF-κB signaling pathway. In summary, the combination of CM and G-Rg1 effectively reduced the apoptosis of SOD1^G93A-NSC34 cells through suppressing the NF-κB/Bcl-2 signaling pathway (Fig. 1 is a graphical representation of the abstract).
Humans ; NF-kappa B/metabolism* ; Ginsenosides/pharmacology* ; Amyotrophic Lateral Sclerosis/genetics* ; Culture Media, Conditioned/pharmacology* ; Superoxide Dismutase-1 ; Neurodegenerative Diseases ; Neurons/metabolism* ; Apoptosis