BACKGROUND: Blood platelet is active commonly appeared in both acute and recovery stages in ischemic cerebral apoplexy. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) are closely correlated with the blood platelet function.OBJECTIVE: To observe the therapeutic effects of compound danshen drop on clinical prevention and treatment of transient cerebral ischemic attack (TIA) and the influence on serum cAMP and cGMP.DESIGN: Randomized control experiment.SETTING: Department of Neurology of Binzhou Medical College affiliatedHospitalPARTICIPANTS: Totally 180 TIA patients participated in the experiment in volunteer in the clinic of Neurological Department of Affiliated Hospital of Binzhou Medical College from September 2000 to April 2001. Based on randomized number scale, 3 groups were divided according to dosages of compound danshen drop. In 10 drops/d group, there were 60 cases, of which 35 cases were male and 25 cases female, aged varied from 50 to 70 years, averagely (54.3±7.2) years old. In 20 drops/d group, there were 60 cases, of which, 32 cases were male and 28 cases female, aged varied from 49 to 62 years, averagely (55.7±5.1) years old. In 30 drops/d group, there were 60 cases, of which, 33 cases were male and 27 cases female, aged varied from 52 to 69 years, averagely (54.9±5.5) years old.METHODS: In 10 drops/d group, the drug was given once per day, 10drops each time. In 20 drops/d group, the drug was given twice per day,10 drops each time. In 30 drops/d group, the drug was given three times per day, 10 drops each time. Four weeks after medication, 3 mL blood was collected from each patient in the morning. With radioimmunoassay, the contents of cAMP and cGMP in serum were determined. Each case was tions, gem bleeding, epistaxis, subcutaneous bleeding, mouth numbness,headache, dizziness, etc.tack: In 10 drops/d group, there were 1 case in internal carotid arterial system, 2 cases in vertebral arterial system, 1 case of cerebral infarction and 2 cases of myocardial infarction. In 20 drops/d group, it was 2, 2 and 1 cases successively and in 30 drops/d group, it was 1, 2, 1 cases succesgroup: There were 1, 2 and 4 cases of harmful accident and side effects in three groups successively, of which, peripheral numbness of mouth 1 case in 10 drops/d group, 1 case of either peripheral numbness of mouth or headache in 20 drops/d group, gastrointestinal reaction 1 case, peripheral numbness of mouth 2 cases and dizziness 1 case in 30 drops/d group.There was no gem bleeding, epistaxis and subcutaneous bleeding, and no patient was withdrawn the treatment due to above-mentioned side effects.With comparison among groups, significant difference was not indicated The contents of cAMP were (21.22±3.94), (22.5±3.67), (23.1±7.7) ng/Land cGMP were (3.67±1.18), (4.74±2.12), (4.6±0.7) ng/L successively in three groups (P ＞ 0.05).CONCLUSION: During second-grade prevention of TIA, compound danshen drop presents definite therapeutic effects, which is basically same in comparison of dosages. Simultaneously, no remarkable side effects appear.

Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for the diagnosis and treatment of biliary and pancreatic disorders. ERCP in the patients with surgically altered anatomy (SAA) is more technically demanding with high risks of procedural failure and complications, and it is challenging for the endoscopists. Recently, the development of endoscopic devices and the improvement of operator skills have led to SAA-ERCP progresses. The success rate of ERCP and the incidence of complications are similar to those of the patients with normal anatomy. This paper reviews the recent advances on SAA-ERCP, including the effectiveness and safety, and endoscopy and assisted techniques, and summarizes the clinical features of SAA-ERCP.

Objective To investigate the clinical value of total hysterectomy in the treatment of cervical intraepithelial neoplasia. Methods We retrospectively analyzed the clinicaldata of 283 patients undergoing total hysterectomy for cervical intraepithelial neoplasia in Changhii Hospital of Second Military Medical University from Jan. 2009 to Dec. 2016. Among the patients, 206 cases received loop electrosurgical excision procedure CLEEP) before total hysterectomy (pre-operative LEEP group), 28 only received total hysterectomy directly after colposcopy biopsy (hysterectomy group) and 49 received LEEP during total hysterectomy (intra-operative LEEP group). The changes of pathological grade and the lesion residual rates of the patients before and after operation were compared. The effect of clinicopathological features (age, pregnancy times, partus times, abortion times, menopausal years, pathology, human papilloma virus (HPV) infection, tumor family history and so on) on postoperative residual lesion were analyzed by univariate and multivariate analysis. Results The cure rate, lesionresidual rate, pathological downgrade rate and pathological upgrade rate in the pre-operative LEEP group was 35. 92%(74/206), 64. 08%(132/206), 63. 11% (130/ 206) and 3. 88% (8/206), respectively, and two cases with canceration were found. In the hysterectomy group, the consistent rate of pathological diagnosis before and after operation, pathological downgrade rate and pathological upgrade rate were 57. 14%(16/28), 35. 71 %(10/28) and 7 14%(2/28), respectively, and one case with invasive carcinoma was found after operation. The lesion residual rate, pathological downgrading rate and pathologicil upgrading rate in the intra- operative LEEP group were 40. 82% (20/49), 65. 31% (32/49) and 8. 16% (4/49), respectively, and two cases with invasive carcinoma were found after operation. Univariate analysis showed that age and menopausal years were the factors influencing lesion remaining after LEEP (P<0. 05). Multivariate analysis showed that patients with longer menopausal years had lower risk of lesion remaining (P = 0. 02). The pregnancy times, partus times, abortion times, lesion involving glands, positive margins, HPV infection and family history of cancer had no significant effects on postoperative lesion remaining. Conclusion Total hysterectomy plays an important role in preventing the recurrence of cervical precancerous lesion and reducing the incidence of invasive carcinoma. It is suitable for people with few screening opportunities, poor follow-up conditions and no fertility requirements. Patients with high grade intraepithelial lesion who are not menopausalor have short menopausal years need to be followed up more closely and can receive total hysterectomy if necessary.

Objective To study the effect of acanthopanax senticosus Saponins (ASS) on expression of brain-derived neurotrophic factor (BDNF) and nerve growth, factor (BDGF) and nerve growth factor (NGF) in rat spinal cord after spinal cord injury, so as to explore the protective effect of ASS against spinal cord injury. Methods A total of 45 male rats were evenly randomized into three groups: sham operation group, model group and ASS intervention group. The experimental animals were anesthetized with 10% chloral hydrate and then acute spinal cord injury model was made, using modified Alien’s method. After modeling the sham group received normal feeding, the model group was intraperitoneally given normal saline for 7 consecutive days, and the ASS intervention group was given appropriate dose of ASS for 7 consecutive days. Then ELISA was used to detect the serum malondialdehyde (MDA) and superoxide dismutase (SOD) the pathological changes of spinal cord tissue were observed, and the expression of BDNF and NGF was examined by Western blotting analysis. Results Compared with the sham group, the other two groups had signilicantly increased serum MDA (P<0. 05) and significantly decreased SOD level (P<0. 05), with notable spinal cord injury; besides, the two groups also had significantly increased expression of BDNF and NGF protein in the spinal cord tissue (P<0. 05). Compared with the model group, ASS group had significantly improved spinal cord injury, with significantly decreased serum MDA content (P<0. 05) and increased SOD content and BDNF, NGF expression in the spinal cord tissue (P<0. 05). Conclusion ASS can promote BDNF and NGF protein expression in neurons of spinal cord, improving repair of damaged neurons and protecting spinal cord against acute injury in rats.

Objective To explore the effect of renal sympathetic denervation (RDN) on cardiac remodeling in myocardial infarction (MI) rats and to investigate the related mechanism. Methods MI rats were induced by ligation of the anterior descending coronary artery. A total of 30 Wistar rats were randomly assigned to MI group (n = 10), MI + RDN group (rats with RDN one weekafter MI, n = 10), and Sham group (n = 10). Four weeks after modeling, the left ventricular cardiac remodeling and function of ratswere examined by echocardiography; the cardiac tissues in the infarct border zone were stained with Masson trichrome for fibrotic analysis. Protein expressions of collagen I, collagens H and transforming growth factor (TGF-(3i) were evaluated by immunohistochemistry. Results Compared with the MI group, the MI + RDN group had significantly increased ejection fraction (EF) and fractional shortening (FS) and significantly decreased left ventricular internal dimensions at end systole and end diastole (all P<0. 05). The results of Masson staining showed that RDN after MI attenuated the collagen deposition around the border area of the infarct region. RDN treatment also inhibited the protein expression of collagen I, H and TGF-β1 in the border area of MI rats (P<0. 05). Conclusion RDN treatment can attenuate cardiac remodeling and improve lett ventricular function after MI, which might be associated with the inhibition of myocardial TGFβ1 expression and the subsequent suppression of collagen deposition.

Objective To observe the clinical characteristics of kidney transplant patients combined with coronary heart disease, and to analyze the safety and efficacy of coronary angiography and percutaneous coronary intervention for them. Methods Six kidney transplant patients underwent coronary angiography in our department between 2005 and 2011. The clinical characteristics, coronary angiography data and prognoses of the patients were retrospectively analyzed. Results Three patients had normal coronary angiograms and the other 3 combined with diabetes mellitus also had coronary heart diseases as found by coronary angiography. One case had unstable angina and was implanted with a total of 5 stents during 2 sessions. Another case had acute inferior wall myocardial infarction (caused by complete occlusion of the right coronary artery) was implanted with 2 stents. The other case had acute non-ST-segment elevation myocardial infarction and coronary angiography revealed multi-segment diffuse lesions in 3 arteries; stent implantation failed in this patient. There was no significant difference in renal functions before and after coronary angiography in the 6 patients, and there was no deterioration of renal function during the follow-up. Conclusion Coronary angiography and percutaneous coronary intervention are safe and feasible for kidney transplant patients, and they can greatly improve the quality of life of the patients.

Osteoporotic fracture is a clinical problem resulting in significant morbidity and mortality. The main treatment for osteoporosis is bisphosphonate therapy. Bisphosphonates can inhibit the bone resorption by osteoclasts, inhibit bone alteration, and maintain bone mass. In recent years, basic and clinical studies have not found evidence that the use of bisphosphonates for the inhibition of fracture healing. Therefore, for the patients with confirmed osteoporotic fracture, bisphosphonate should be used to reduce the risk of re-fracture. The authors summarize the related studies in the bisphosphonate intervention for osteoporotic fracture and recommend postoperative use of bisphosphonate for osteoporotic fracture.

Aged ; Bone Nails ; Hip Fractures/surgery* ; Humans ; Retrospective Studies ; Treatment Outcome

Objective: To explore the efficacy of open reduction and internal fixation in the treatment of senile osteoporotic ankle fractures. Methods: A retrospective case series study was conducted to analyze the data of 26 elderly patients with osteoporotic ankle fractures which all caused by sprain from June 2012 to June 2018 in Changhai Hospital, including 10 male and 16 female patients aged from 60 to 93 years (mean, 69.72 years). In these 26 patients, three had medial malleolus fractures, four had lateral malleolus fractures, six had double ankle fractures and 13 had cotton's fractures. According to the Lauge-Hansen type, all 26 patients can be classified into four types: 5 with supination external rotation type, 4 supination adduction type, 16 with pronation-external rotation type and 1 with pronation abduction type. All the patients received open reduction and internal fixation. Plate fixation was used for lateral and posterior malleolus fractures, plate fixation and cannulated screws were applied to fix the comminuted posterior malleolus fracture while in the comminuted internal malleolus fracture, the steel plate was used only when needed. Early professional functional rehabilitation training and active anti-osteoporosis treatment were applied. All the operation time and bleeding volume were recorded, and the reduction of fracture plus the healing of wounds were observed. At last follow-up, American Orthopedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Scale was used to evaluate the treatment effect and the Visual Analogue Scale (VAS)to evaluate the therapeutic effect and the subjective satisfaction of the patients. Complications were recorded as well. Results: All patients were followed up for 12-48 months (mean, 23.6 months). Operation time ranged from 30 to 95 minutes (mean, 70 minutes) and bleeding volume ranged from 10 to 150 ml (mean, 70 ml). All patients got satisfied reduction of fracture within 25 patients' incision healing in first intention, although one has fat liquefaction. AOFAS Ankle Hindfoot Scale improved from preoperative (84.4±10.8)points to (31.9±11.4)points at last follow-up (P<0.01), and the results were excellent in five patients, good in 17, fair in three and poor in one, with the excellent and good rate of 85%. VAS improved from preoperative(1.85±0.73)points to (9.23±0.28)points at last follow-up (P<0.01). Among 26 patients, 5 with ankle stiffness of different degree recovered after rehabilitation care, and 2 with internal malleolus fractures had bone displacement when receiving rehabilitation care, with no side effect on basic function. No serious complications such as wound infection or skin necrosis were found. Conclusion For osteoporotic ankle fractures in the elderly, open reduction and internal fixation can promote functional recovery and relieve pain.

OBJECTIVETo investigate the correlation of perihematomal free radical level and neuronal apoptosis following the intracerebral hemorrhage (ICH).

METHODSAnimals were randomly divided into 4 groups: sham operation group, model group, 1 mg/kg edaravone group, and 3 mg/kg edaravone group. Each group was then divided into seven subgroups, in which the rats were correspondingly killed at 6 h, 12 h, 24 h, 48 h, 72 h, 7 d or 14 d (n = 1 in each subgroup of the sham group, and n = 6 in each subgroup of the other 3 groups). By Horseley-Clarke technique, autoblood (80 microL) were administered into the left caudate putamen of SD rats in a double administration-withdrawal way. Rats in the sham group were needled in but not administered with autoblood. The ICH model was then evaluated by Bederson's scale. Around the hematoma, the levels of malonaldehyde (MDA) and hydroxyl radical were tested by spectrophotometer, and the process of apoptosis was tested by terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling (TUNEL) method.

RESULTS(1) ICH significantly increased the levels of MDA and hydroxyl radicals. Significant differences in MDA and hydroxyl radical contents were observed among the four groups. (2) In the sham group, a small number of TUNEL-positive cells were found. In the other three groups, the TUNEL-positive cells were observed at 6 h, increased significantly at 24 h, and reached peak level at 3 d, then fell profoundly at 7 d, but remained detectable at 14 d. (3) The positive correlation existed between apoptosis and free radical level (r = 0.2003), and existed between apoptosis and MDA content (r = 0.6563) in the brain.

CONCLUSIONPost-hemorrhagic apoptosis was related to the production of free radicals, indicating that the elevated free radicals following the ICH could induce neuron and glial cell apoptosis.

Analysis of Variance ; Animals ; Antipyrine ; analogs & derivatives ; therapeutic use ; Apoptosis ; drug effects ; physiology ; Cerebral Hemorrhage ; drug therapy ; metabolism ; physiopathology ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Free Radical Scavengers ; therapeutic use ; Hydroxyl Radical ; metabolism ; In Situ Nick-End Labeling ; methods ; Linear Models ; Male ; Malondialdehyde ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors