Objective To investigate the correlation between indexes of thrombelastogram (TEG) and hemorrhagic transformation (HT) after acute ischemic stroke.Methods The cases of acute ischemic stroke but not receiving early reperfusion therapy were recruited in our hospital from January to November 2016,and were divided into HT group and non-HT group.Their general clinical characteristics and TEG indexes were retrospectively analyzed,and comparison between two groups and multivariate Logistic regression analysis were performed.Results A total of 71 cases were enrolled and 11 of them were divided into HT group.The percentages of massive cerebral infarction and cardio-embolic stroke were significantly higher in HT group than those in non-HT group (P<0.05),whereas the levels of CI in HT group were significantly lower than thoes in non-HT group(P<0.05).Multivariate Logistic regression analysis showed that massive cerebral infarction (OR=13.172,95%CI:1.414-122.671) and CI(OR=0.554,95%CI:0.321-0.956) were independently correlated with HT(P<0.05).Conclusion CI is independently correlated with HT after acute ischemic stroke,and may be a potential predictor of HT.

Objective To investigate the clinical effect of insulin therapy in the treatment of patients with polycystic ovary syndrome .Methods 91 cases of endocrine disorders of patients with polycystic ovary syndrome were selected from September 2013 to September 2016 in Yinzhou Ningbo people’s hospital,and divided into observation group and control group,44 cases in the control group and received conventional treatment,47 cases in the observation group and received insulin sensitizer on the basis of conventional treatment.Before and after treatment, the level of sex hormones, blood glucose and insulin levels in the two groups were detected and compared,and the efficacy was determined and compared.Results Compared with before treatment,the levels of LH,FSH,E2,T,A2,Ds in the observation group were decreased,SHBG was increased,HOMA-β,HOMA-IR,FPG,FINS were decreased,the difference was statistically significant (P<0.05);compared with control group, the levels of LH,FSH,E2,T,A2,Ds in the observation group were lower,SHBG was higher,HOMA-β,HOMA-IR,FPG,FINS were lower,the difference was statistically significant (P<0.05);After treatment, the total effective rate of observation group 95.74%was significantly higher than the control group 81.82%(P<0.05).Conclusion Insulin sensitizer in treatment of polycystic ovary syndrome in patients with endocrine disorders has significantly effect,can significantly improve the patient’s sex hormone levels and blood glucose levels,adjust the patient’s insulin levels,improve the clinical treatment efficiency.

Three Modules and Three Stages proposed by guidelines on college English teaching that will be issued by the Ministry of Education gives direction for college English teaching.Through the investigation of the students' cognition and learning of English curriculum,combined with the teaching experiment,the new system of English curriculum,which reflects the characteristics of medical colleges and universities,has been preliminarily established,aiming at cultivating medical students' comprehensive English abilities in medical study and career development.Considering students' language abilities in different stages,college English curriculum can be designed in three modules,that is,English for general purpose (EGP),English for academic purpose (EAP) and intercultural communication,in three stages,that is,the basic stage,the improvement stage,and the development stage.The practice shows that the new curriculum system can promote the interaction,reform and development of teachers,teaching teams and Foreign Language Department.

Objective To study the therapeutic methods of cholecystic duct stones. Methods A retrospective analysis of the clinical data of 158 cases of cholecystic duct stones treated in the recent 6 years was made. Results 97 of the 158 cases of cholecystic duct stones were removed by open surgical operation and 61 cases by laparoscopic cholecystectomy(LC).In 49 of the 61 cases treated with LC,the cholecystic duct stones were removed together with removal of the gallbladder, and 12 by duodenoscopy after LC. Conclusions One should strive to extract the cholecystic duct stones while removing the gallbladder. If the stones or stone fragments escape into the common bile duct, they could be removed through a choledochotomy at the time of the open operation ,or by postoparative duodenoscopy in cases undergoing LC. The latter method of treatment is associated with minor trauma, quick recovery and definite therapeutic results.

Objective] To study the impact of outpatient appointment supposed on the management of outpatient department and whole hospital. [Methods] Survey and research the average outpatient registration volume, patients' registration waiting time and the patients' satisfaction monthly during May 2011 to May 2014 when outpatient appointment was applied, and analyze the impact of outpatient appointment supposed on the management of outpatient department and whole hospital by comparing the results 3 years ago(during April 2008 to April 2011) when outpatient appointment was not applied. [Results] The number of patients with an appointment was on the rise, the total number of outpatients increased with the increase of outpatient appointment, and patients' registration waiting time was significantly shortened with higher satisfaction. The difference had statistical significance( P<0.05). [Conclusion] By outpatient appointment services, outpatient management has been optimized, with the increase of outpatients; the hospital benefits grow, and meanwhile the patients' satisfaction is improved.

Objective To explore the clinical characteristics of severe hand-foot-mouth disease in children and summarize nursing experience.Method The clinical data of 32 children with severe hand-foot-mouth disease were reviewed and analyzed retrospectively. Results After standard diagnosis and treatment,all cases were cured. The average stay in hospital was(8.2±1.6)d.Conclusion The close observation,prevention of infection,skin and oral nursing are of importance for promoting curative effectiveness and prognosis.

Objective To observe the clinical significance and variation of plasma B-type brain natriuretic peptide (△BNP) levels before and after treadmill exercise test (TET) in women with coronary heart disease(CHD). Methods Sixty-one women with suspected coronary heart disease were selected (except for heart failure, blood BNP levels were normal). All patients underwent coronary angiography, were divided into two groups, 25 cases in normal group and 36 cases in coronary heart disease group. Plasma BNP levels were measured before and after the TET test, and data were compared between two groups after one week.Furthermore, the levels of△BNP before and after TET in patients with different degrees of coronary artery lesions were compared. The diagnostic value of the levels of△BNP in coronary heart disease was evaluated by the re-ceiver operating characteristic curve (ROC). Results The plasma BNP level was significantly increased after TET (44.20± 14.53) than that before the test (32.82±10.72) in coronary heart disease group (P<0.01). There were significant differences in levels of△BNP before and after TET in patients with different degrees of coronary lesions. The levels of△BNP were sig-nificantly higher in multi-vessel disease group than those of single and double lesion group (P<0.05). The level of△BNP was significantly higher in double lesion group than that of single lesion group (P < 0.05). When the level of △BNP=7.3 ng/L, the sensibility value and specificity value for the diagnosis of CHD was 82.4%and 81.5%. The area under curve (AUC) was 0.900, and 95%confidence interval was 0.796-0.962. Conclusion The detection of△BNP before and after TET has an important clinical significance in the diagnosis and evaluation of coronary heart disease in women patients.

AIM:To investigate the relationship of autophagy and reactive oxygen species ( ROS) in multiple myeloma cell line RPMI-8226 stimulated with doxorubicin.METHODS:The RPMI-8226 cells were stimulated with doxo-rubicin at different doses, and untreated cells were used as control.The protein expression of beclin 1 and LC3 was detec-ted by Western blot.ROS production was analyzed by DCFH-DA fluorescence staining.After treated with or without 3-methyladenine (3-MA), the ROS production and apoptosis in RPMI-8226 cells were determined by DCFH-DA and flow cy-tometry, respectively.After treated with or without antioxidants tempol and N-acetyl-L-cysteine ( NAC) , the expression of beclin 1 and LC3 in RPMI-8226 cells was determined by Western blot.RESULTS:The protein levels of beclin 1 and LC3Ⅱ/LC3Ⅰwere increased in the RPMI-8226 cells stimulated with doxorubicin compared with untreated group.The ROS production was increased in the RPMI-8226 cells stimulated with 2 mg/L doxorubicin compared with untreated group.After treated with 3-MA, the ROS production and apoptosis in the RPMI-8226 cells stimulated with doxorubicin were increased compared with doxorubicin group.After treated with antioxidant NAC or tempol, the expression of beclin 1 and LC3 II/I in the RPMI-8226 cells stimulated with doxorubicin was decreased compared with doxorubicin group.CONCLUSION:The autophagy and ROS levels are increased in RPMI-8226 cells stimulated with doxorubicin.Inhibition of autophagy increases the ROS production and apoptosis of RPMI-8226 cells stimulated with doxorubicin.Inhibition of ROS production reduces doxorubicin-induced autophagy in multiple myeloma cells.

Objective:To evaluate the feasibility of the 3-D surface reconstruction by multislice spiral CT(MSCT) technique in the diagnosis of impacted teeth in maxilla.Methods:Eighty two cases with impacted teeth in maxilla were examined with volumetric CT scan using MSCT,the dental reconstruction images were obtained with multiplanar reformation technique and 3D-reconstruction technique.Results:Dental surface 3D-reconstruction image could display the shape,location and eruption orientation of the impacted teeth clearly.Conclusion:3-D surface reconstruction by MSCT can provide valuable diagnostic and anatomic information of the impacted teeth in maxilla.