Recurrent cerebral infarction (RCI) is very common in clinical practice. Intracranial and extracranial vessels diseases closely associate with the recurrence of cerebral infarction. Hypertension, diabetes, high homocysteine, etc., result in vascular stenosis and more in-farction recurrence by atherosclerosis and arterial plaque formation. Study of the etiology of RCI is important for the secondary prevention of cerebral infarction.

The activity of the solubilized receptor was assayed by precipitating the receptor with acetone in the presnce of egg phosphatidyleholine liposomes. It was found that the binding of ~(125)I-LDL to fetal liver receptors rose significantly with the increase of fetal age. During the same period, the total cholesterol (TC) and LDL-eholesterol (LDL-C) levels in fetal serum declined progressively. The correlation between fetal age and concentration of TC and LDL-C were -0.80(P

Objective To evaluate the effects of low tidal-volume ventilation on blood gases and respiratory mechanics during open heart surgery in children with acyanotic congenital heart disease. Methods Forty NYHA class Ⅰ-Ⅱ patients with atrial or ventricular septal defect aged 3-6 yrs weighing 12-18 kg undergoing open heart surgery were randomly divided into 2 groups according to the tidal volume of mechanical ventilation: group A low tidal volume(V_r=7ml?kg~(-1),n=20) and group B conventional tidal volume(V_T=9 ml?kg~(-1), n=20). The respiratory rate(RR) was 21-23 bpm, I: E ratio 1:2 and FiO_2 100% in both groups. The patients were premedicated with intramuscular morphine 0.1 mg?kg~(-1) and scopolamine 0.01 mg?kg~(-1). Anesthesia was induced with midazolam 0.1 mg?kg~(-1), fentanyl 10 ?g?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with infusion of fentanyl 4 ?g?kg~(-1)?h~(-1) and vecuronium 80 ?g?kg?h~(-1) supplemented with isoflurane inhalation(

Objective To investigate the clinical effect, influencing factors of 1 280 patients with ureteral calculi undergoing ESWL.Methods The data of 1 280 patients with ureteral calculi treated by ESWL for the first time in our hospital were retrospectively studied.There were 962 males and 318 females,age 23~78 years old,average 45.7 years old.Stones were located in the left ureter in 810 cases and right ureter in 470 cases.All patients were treated with ESWL for the first time.The lithotripsy rate, stone free rate, influencing factors and the incidence of complications after ESWL were compared over follow up period of there months.Results The overall successful fragmentation rate for all levels of stone in single session achieved 97.6%(1 249/1 280).The failure rate was 2.4%(31/1 280).Conclusion ESWL is indicated as a first choice in the treatment for patients with ureteral stones.The concrete impacted in ureteral mucosa is the key cause of failure to ESWl in ureteric stone.Once the fragments has not been cleared after ESWL, it suggests that other therapy modality should be selected.

Objective To evaluate the efficacy and safety of the pneumatic lithotripsy through ureteroscope for the treatment of ureteral calculi.Methods A total of 920 patients underwent ureteroscopic lithotripsy using pneu-matic lithotripsy 259 upper,375 middle,and 286 lower ureteral stone were treated.Results The overall successful fragmentation rate for all levels of ureteral stones in a single session achieved 94.0% (864 /920),failure rate 6.0%(56 /920).28 cases failed because of ureteral stricture.24 cases of stone moved up into the kidney.All worst -cases were in dewelled shock wave lithotripsy ESWL.Conclusion Ureteroscopic lithotripsy using pneumatic lithotripsy is a highly effective,minimally invasive and safe therapy for ureteral calculi.It is indicated as a first choice for treatment patients with ureteral stones,especially for the ones with the middle and lower uneteral stones.Develop particularly suitable for basic hospital.

Objective To investigate the situation of the activities of daily living(ADL)for elderly people in Changsha,and analyze the influencing factors. Methods Questionnaire survey on ADL was held in 2239 elderly people(ranging from 60 to 91 years old),and the influencing factors including age,sex,family structure,marital status,education level,occupation,common chronic diseases and medical care consciousness were analyzed. Results Going to the toilet irregularly hadthe highest injury rate in physical self-maintenance viability(18.2%).But in instrumental ADL,the highest injury rate occurred while shopping(26.3%).Advanced age,living alone,losing spouse,sickness and the lack of medical care awareness were the major factors that influenced the ADL of the elderly people. Conclusions The ADL is an important indicator which reflects the health condition of elderly people.Advanced age,living alone,losing spouse,having many chronic diseases and lacking in medical care awareness are risk factors.

Objective To explore the effect of prospective nursing on preventing constipation for patients with acute myocardial infarction(AMI). Methods 43 AMI patients during July 2008 and June 2010 in our hospital were classified as the observation group, besides the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation, prospective nursing was implemented.Through the retrospective analysis of medical record, 41 of AMI in our hospital during March 2006 and June 2008 were classified as the control group, they were given the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation and the nursing intervention after occurrence of constipation. The defecation condition was assessed for the two groups of patients on admission and the defecation and mortality rate was compared on the eighth day of hospitalization. Results There was significant difference in constipation and mortality rate between the two groups of patients during hospitalization. Conclusions The prospective nursing for AMI patients to prevent constipation can obviously reduce the incidence of constipation, thus to avoid serious complications caused by constipation and reduce mortality.

0.05).While the expression of C-erbB-2 rather than ER and PR was correlated to lymph node metastasis(P

Objective To study the clinical features of pulmonary Langerhans cell histiocytosis.Methods Restrospectively review of 7 cases of pulmonary Langerhans cell histiocytosis proved by pathology with the clinical,physical,radiological,pathological and pulmonary function presentation.Results Seven cases were all male,aged from 17 to 37.Four of them are cigarette smokers.The major symptoms were cough and laboring dyspnea,and pneumothorax presented in five cases.As to pulmonary function presentation,obstructive pattern presented in three cases,restrictive pattern and mixed pattern presented in two cases respectively,and the carbon monoxide diffusing capacity was decreased in four cases.The abnormalities present predominantly in the upper and middle lung fields on chest high-resolution CT scan.Lung cysts and reticular changes presented in six cases and nodules presented only in one case.The diagnosis was established by surgical lung biopsy.The positive cases of staining for the S-100,CD1a antigens,and CD68 were 7/7,4/5 and 5/6 respectively.Conclusion PLCH patients are typically young adults,often present with cough,laboring dyspnea and pneumothorax.Pulmonary function presentation is nonspecific and the carbon monoxide diffusing capacity may be decreased.The characteristic features of HRCT are bilateral reticulonodular areas and cysts change that predominantly involved the upper and middle lung zones with relative sparing of the lung bases.The pathologic feathers are interstitial infiltration of bronchiole walls and epithelium by LCH cells and cyst formation.The staining for CD1a antigens and the S-100 proteins is positive by immunohistochemical analysis.

Objective To investigate the effect of ethanol using by neurolytic celiac plexus block(NCPB)on the Bispectral index(BIS)during anaesthesia with propofol and remifentanil.Methods Thirty-six patients,ASA Ⅰ～Ⅲ,undergoing pancreatic cancer surgery were studied.Patients were maintained with propofol(6～9mg·kg～·h-1)and remifentanil(0.1～0.3μg·kg～·min-1)to keep the BIS between 38 and 50.After 30minutes of stable anesthesia,patients in control group were treated with NCPB by 0.9%NS 30ml,while patients in ethanol group were employed NCPB at the same time by 75%ethanol 30m1.BIS values,mean arterial pressure(MAP),heart rate(HR)were recorded 5minutes before the injection and one,five,fifteen,twenty five,thirty five,forty five minutes after that.Results Therewas no significant change in BIS,emodynamic variables compared to preinjection values in the control group.15min to 45min after injection of four point,BIS values and MAP of ethanol group decreased significantly,as compared with before injection,the same time point compared with the control group had statistically significant difference(P＜0.001).No significant changes in HR were observed throughout the observation.Conclusion Ethanol used in the operation of NCPB was additive to the anesthesia depth during the anesthesia of propofol and remifentanil.