Although the treatment of aneurysmal subarachnoid hemorrhage (SAH) has made considerable progress in recent years,its mortality and disability have not been effectively controlled.Ischemic brain injury after SAH is considered to be an important reason for the poor prognosis of patients; however,its mechanism is still not fully understood.Studies have shown that the cerebral microcirculation disturbance after SAH is closely associated with ischemic brain injury.This article reviews the advances in research on cerebral microcirculation disturbance and ischemic brain injury after SAH.

Objective To explore the dynamic changes of blood brain barrier(BBB)permeability after experimental subarachnoid hemorrhage(SAH)in rats.Methods Eighty female SD rats were divided into normal saline control group(n=10)and SAH group(n=70).The SAH model was induced by injecting 300 ?l of autologous arterial blood into the subarachnoid space near the circle of Willis via a cannula in an artificial hole between the olfactory bulb and frontal lobe.BBB permeability in cerebral cortex of SAH and normal saline rats was assessed at 6,12,24,36,48,60,and 72 h after SAH establishment by fluorescence spectrophotometer and fluorescence microscopy for Evans Blue(EB)extravasation.The ultrastructural changes in BBB were observed with transmission electron microscope.Results Compared with the control group,the changes of Evans Blue content and extravasation in cerebral cortex of SAH group peaked at 36 h(P0.05).The severe ultrastructural abnormality was found at 36 h after SAH.Conclusion The changes of BBB permeability develop at the acute stage of SAH,resulting from multiple factors together.The BBB after SAH possesses a self-repairable property.

To analysis of Dengzhan Xixin injection (DZI) in treatment of cerebral infarction (EBHM) in the real world population characteristics and concomitant medication. By selecting the 20 hospital information system (HIS) used in the database of DZI and primary diagnosis of 2 484 cases of cerebral infarction patients information, use the Apriori algorithm to construct the model, using Clementine 12.0 analysis, cerebral infarction complicating diseases, commonly used drug combination analysis of DZI. The results showed that patients with more males than females (1.63: 1); age > 46 in older persons, treatment 7-14 days accounted for the majority of patients with hypertension, cerebral infarction, diabetes, coronary heart disease and other diseases; common drug combination can be divided into seven categories: medicine of antiplatelet therapy (aspirin, clopidogrel hydrogen), hypolipidemic drugs (atorvastatin, probucol), calcium channel blockers (cinepazide), cerebral protection drugs (laci staw), to improve cerebral circulation drugs (alprostadil), other traditional Chinese medicine injection (Shuxuetong injection, Xueshuantong), treatment with underlying disease: nifedipine, metoprolol, isosorbide dinitrate etc. The clinical cure rate and improvement rate of 97.60%. The next step needs to be combined with clinical practice, carry out analysis of effectiveness and safety of the combination scheme, and provide reference for clinical rational drug use.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; complications ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections ; Male ; Middle Aged ; Young Adult

Integrity education is not only one of an important aspect of moral education topics for Medical postgraduates,but also an objective requirement in the socialist market economy.Aiming at the modern medical postgraduates'lack of credibility,this paper mainly analyzes its causes such as the limitation of postgraduates'quality and the pressure of employment and dis-cusses how to strengthen integrity education for postgraduate in medical university by bringing supervisors'leading role,enhance the standardized management of employment and upbuilding credibility file etc.

Objective To evaluate the effect and pathological characters for patients with early esophageal carcinoma and intraepithelial neoplasia after endoscopic submucosal dissection (ESD). Methods 69 patients from January 2013 to January 2016 were treated with ESD at the early stage of esophageal carcinoma and intraepithelial neoplasia. The clinical features and the size of the lesions of all the patients were collected. Then analyzed postoperative complications and pathological characteristics. Results Among 69 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The whole piece resection rate was 100.00 % (69/69), complete resection rate and curative resection rate was 95.65 % (66/69), respectively. The largest removal diameter is 7.0 cm. Biopsy accuracy was 69.57 % (48/69). Compared with biopsy, diagnostic accuracy with ESD specimens is higher. Conclusion The early esophageal carcinoma and intraepithelial neoplasia can be treated with ESD. ESD can resect lesions primarily, provide complete specimen for further pathological assessment and improve diagnostic accuracy.

The original strain was treated with UV combining LiCl. The total carotenoid yield of the strain UL-61 was 7.62mg/L, the maximal yield of astaxanthin had reached 616.8?g/g under 25℃. 8 variables including fermentation temperature, initial pH were optimized by Plackett-Burman design and Response Surface Analysis of SAS software. The temperature, initial pH and corn steep liquor were the major factors. The optimal conditions were predictted to be 16.78℃, pH4.73 and 7.06 mg/L, respectively. Under these conditions, the theroretical maximal yield of carotenoid was 3.9407 mg/L and the practical maximal yield was about 3.9261mg/L. The carotenoid production was increased by 20.4% when Phaffia rhodozyma was cultivated under the optimal conditions as compared with the control.

Objective To evaluate the efficiency and clinical value of modular flexible ureteroscope combined with Holmium laser lithotripsy for treatment of renal calculi. MethodsA total of 46 patients with renal calculi were treated with modular flexible ureteroscope combined with Ho:YAG lithotripsy in our hospital from December 2009 to May 2011.There were 19 cases in middle and upper calyx,8 cases in lower calyx,15 case in renal pelvic,and 4 cases in multiple calyxes.The calculi diameter ranged from 6mm to 31 mm (average in 15 ± 7.9 mm).Flexible ureteroscope was used to find renal calculus under epidural anesthesia,and Holmium laser lithotripsy was used at a maximum energy of 12 to 20W (0.8 - 1.0 J/15 -20Hz).F5 or F6 double-J tubes and catheters were indwelled routinely postoperatively.-examine with KUB and removethe catheter 2 days after operation.Re-examine with B-ultrasonography or KUB 4 weeks after op-eration to evaluate the stone free rate.Residual stones ≥4 mm were regarded as clinical significance of residual stone fragments. Results 45 operations were successful except one case changed to percutaneous nephrolithotomy (PCNL) because of ureteral stricture.The operation time was 45 -150 min (average in 110.4 ±25.3 min).The patients were discharged from hospital in 2 -5 days(average in 3 days) after operation.The stone detection rate was 95.6％ (44/46),and the stone free rate was 86.9％ (40/46) after one operation. No severe complications such as ureteral perforation or hemorrhea occurred. Conclusions Modular flexible ureteroscope combined with Holmium laser lithotripsy is effective and safe for treatment ofrenal calculi,meanwhile it can decrease the high maintenance costs of integrated flexible ureteroscope.

Objective　To analyze the effects of flexible ureteroscopic Holmium laser lithotripsy on renal function in the treatmen of renal calculi.　Methods　From October 2010 to March 2012,41 cases of solitary renal calculi (24 males and 17 females) were treated with flexible ureteroscopic Holmium laser lithotripsy ( FURL).Patient's mean age was 51.9 ± 15.9 years ( range from 31 to 88 years).Locations of renal calculi detected by image study were 22 cases in middle and upper calyx,9 cases in lower calyx,10 case in renal pelvis.The mean size of calculi was 16.9 ±6.0 mm (range from 10 to 28 mm).Blood samples (2 h pre-operatively,and then 2 h,12 h,24 h,48 h,72 h post-operatively) were collected and serum　NGAL,serum Cys-C were tested　Results　The measured levels of pre-operative NGAL and Cys-C were 3.5 ± 0.6μg/L,501.7±121.3 μg/L,and levels of post-operative NGAL at 2 h,12 h,24 h,48 h and 72 h were 4.2±0.8 μg/L,5.0±1.0 μg/L,4.9±1.4 μg/L,4.3± 1.1 μg/L and 3.8 ±0.1 μg/L,while the according levels of Cys-C were ( 516.4 ± 126.2 ) μg/L,( 723.8 ± 134.8 ) μg/L,( 770.4 ± 162.8 ) μg/L,(671.7 ± 138.3 ) μg/L and 574.0 ± 116.7 μg/L.Serum NGAL began to increase 2 hours after operation (P ＜0.05,and reached the peak in 12 hours,it began to decline 12 hours after surgery,but it was still higher at 72 hours than pre-operative level (P ＜ 0.05.Serum Cys-C showed no obvious ascent 2 hours after operation in FURL group ( P ＞ 0.05 ),but increased obviously 12 hours after operation and lowered down after the peak that occurred 24 hours after surgery.Serum Cys-C still remain above the baseline 72 hours after operation (P ＜0.05).　Conclusions　Flexible ureteroscope lithotripsy can cause reversible damage to renal function after surgery.

Fifteen patients with chronic renal failure(CRF)underwent laparoscopic cholecystectomy(LC)at carbon dioxide(CO2)pneumoperitoneum pressure of 10-12 mm Hg(Group A,n=9)or 13-15 mm Hg(Group B,n=6).Renal function and urinary volume(UV)of Group A showed no remarkable change following the operation.But in Group B,the levels of blood urine nitrogen(BUN)and serum creatine(Scr)were increased significantly,and creatinine clearance rate(Ccr)and UV were remarkably decreased(P＜0.05).These variants gradually retumed tO the preoperative levels after 1 week.The analysis showed that laparoscopic choleeystectomy at CO2 pneumoperitoneum pressure of 10-12 mm Hg in CRF patients might be safe.Higher CO2 pneumoperitoneum pressure could result in reversible renal Email:yuanhuizhong2000@yahoo.com.cnfunction change.

Objective To study the relation between the positive rate of platelet antibody and the frequency of platelet transfusion,the total quantity of platelet transfusion,the gender of patients,the blood group of patients through statistic analysis of the data gathered from patients.Methods A total of 5 745 results of platelet antibodies detection assay throughout the year of 2016 were gathered,and statistical relation between the positive rate of platelet antibody and the gender of patients,the blood group of patients and the frequency of platelet transfusion were analyzed.Results The results of platelet antibodies detection assay show that 108 patients were positive among 5 745 patients,and the positive rate of platelet antibody was 1.87％.There were no relations between the positive rate of platelet antibody and the gender of patients or the blood group of patients,while the positive rate of platelet antibody and the frequency of platelet transfusion were positively correlated.Conclusion Platelet antibody production could impact the therapeutic effect of platelet transfusion.Patients with platelet antibodies should receive matching platelet to ensure the therapeutic effect.