Objective To investigate the treatment delay in patients with acute cerebrovascular disease in different levels of hospital in Qingdao area and to analyze its influencing factors. Methods A total of 700 patients with acute cerebrovascular disease from the city, county and township hospitals in Qingdao were selected from June 2008 to February 2009. A questionnaire survey was used to investigate and analyze the visiting time in patients with stroke and its possible influencing factors. Results The average visiting rate in patients with acute cerebrovascular disease was 30% within 4.5 hours after the onset in Qingdao area. The average visiting rate of the township hospitals was lowest (26%), of the city hospitals was moderate (28%), and of the county hospitals was highest (36%). For the city hospitals, the male patients usually delayed the visiting. The patients with high school or higher education level, urban medical insurance, 120 transportation, and the National Institutes of Health Stroke Scale (NIHSS) ＜ 3 could usually he treated timely; For the county hospitals, the patients with secondary school or lower education level, 120 transportation, and NIHSS ＜3 could usually be treated timely. For the township hospitals, the patients with NIHSS ＞ 7 and unconsciousness could usually be treated timely. Conclusions The patients with acute cerebrovascular disease in the city, county and township hospitals in Qingdao area had significant treatment delay. Of those, 120 transportation and higher levels of education could decrease the treatment delay of patients. Therefore, perfecting stroke emergency network, raising people's level of education, and strengthening propaganda and education on stroke knowledge in all levels of hospitals are essential for timely treatment of stroke patients.

OBJECTIVE:To establish a method for identification of Cornus officinalis and its Preparations. METHODS: LC-MS method was adopted. The separation was performed on Hypersil C18 column (150 mm?2.1 mm,5 ?m) with a mobile phase of methanol-acetic acid(84 ∶ 16) at a flow rate of 0.2 mL?min-1. The column temperature was set at 30℃. Mass spectra were equipped with an electrospray ionization (ESI) source with negative ion detection model as ion scanning. The conditions of determination were sheath gas flow rate of 1.5 L?min-1,sweep gas flow rate of 0.45 L?min-1,spraying voltage of 4.5 kV, high temperature capillary temperature of 350℃ and scan range of 110～600 amu. RESULTS: The three-level mass spectrometry of the ursolic acid and oleanolic acid was well separated. The results were stable. Three-level mass spectrometry of ursolic acid and oleanolic acid were established and identification of C. officinalis preparations was carried out.CONCLUSION:Three-level fragment peaks of fat-soluble constituents of C. officinalis can be used for indentification of C. officinalis and its preparations.

Objective To investigate the effect of penehyclidine hydrochloride (PHCD) on tramadol dependence and c-fos,△ FosB and M5 receptor expression in relevant brain regions in rats.Methods Thirty male adult SD rats weighing 180-220 g were randomly assigned to 3 groups (n =10 each):control group (group C),tramadol dependence group (group T) and PHCD group (group P).Tramadol dependence was induced by subcutaneous 10 mg/kg once a day for 7 consecutive days in groups T and P.PHCD 1.5 mg/kg was injected intraperitoneally on day 8 in group P,while in groups C and T the equal volume of normal saline was injected intraperitoneally instead of PHCD.The rats underwent conditioned place perference test at 30 min after intraperitoneal injection.The time spent in drug-paired side (gray area) was recorded.The rats were sacrificed after the conditioned place perference testand the brain was removed.The relevant brain regions (ventral tegmental area,prefrontal cortex,nucleus accumbens )were separated for determination of c-fos,△ FosB expression by Western blot and M5 receptor mRNA expression by RT-PCR.Results Compared with group C,the time spent in the drug-paired side (gray area) was significantly prolonged,and c-fos,△FosB and M5 receptor mRNA expressions were up-regulated in group T,△FosB and Ms receptor mRNA expressions were down-regulated in group P ( P ＜ 0.05 or 0.01 ).There was no significant difference in time spent in the drug-paired side (gray area) and c-fos expression between groups C and P( P ＞ 0.05).Compared with group T,the time spent in the drug-paired side (gray area) was significantly shortened,and c-fos,△ FosB and M5 receptor mRNA expressions were down-regulated in group P (P ＜0.01).Conclusion PHCD can significantly inhibit tramadol dependence by down-regulating c-fos,△FosB and M5 receptor expression in relevant brain regions.

Objective To quantitate coronary tortuosity and provide favorable conditions for understanding the hemodynamic effects caused by coronary tortuosity.Methods We obtained all images from 72 patients who received coronary computed tomo-graphy scanning.After image post-processing,we extracted the medial axis of three main coronary vessel and analysed its coordi-nates on three dimensions.Then we calculated the tortuosity coefficient of coronary artery.Results Tortuosity coefficient was 6.66±7.54 in anterior descending,13.43±12.85 in left circumflex,and 1 7.61 ±7.67 in right coronary artery.We had proved its validity by the changes in morphology with simulated shapes.Conclusion We proposed a new method for quantitating coronary tor-tuosity,by computed tomography coronary imaging.The measurement results would not be affected by projection plane,vessel length or other artificial factors.

Objective To evaluate the effect of acupuncture on the quality of recovery during the early period after gynecological laparoscopic surgery using the Quality of Recovery?40 questionnaire ( QoR?40). Methods Sixty patients, aged 20-60 yr, with body mass index of 18.5-28.0 kg∕m2, of American Society of Anesthesiologists physical status ⅠorⅡ, scheduled for elective gynecological laparoscopic surgery, were equally and randomly divided into either control group ( group C ) or acupuncture group (group Acu) using a random number table. Bilateral Neiguan (PC6) and Hegu (L14) acupoints were stimulated for 30 min starting from the time point before skin incision and immediately after the end of surgery. The quality of recovery was assessed using the QoR?40 on 1 day before surgery, and at 24 and 48 h after surgery. The patient′s cognitive function was assessed using Mini?Mental State Examination. The requirement for rescue analgesics was recorded. The occurrence of nausea and vomiting was also recorded. Results Compared with group C, the global QoR?40 and Mini?Mental State Examination scores were significantly increased, and the incidence of nausea and vomiting and requirement for rescue analgesics were decreased at 24 and 48 h after surgery in group Acu ( P<0. 05 ) . Conclusion Acupuncture can improve the quality of recovery during the early period after gynecological laparoscopic surgery using the QoR?40.

AIM: To explore the effect of endoplasmic reticulum stress on cardiac myocyte apoptosis in mouse congestive heart failure induced by myocardial infraction.METHODS: The mouse model of heart failure was established by ligating the left anterior descending coronary to produce acute myocardial infarction.Thirty-two mice were divided into 4 groups: sham group and groups of post-operation at time points of 2,4 or 6 weeks,respectively.The ventricular dilatation and left ventricular functions were assessed by echocardiography.The expression of GRP78,CHOP,caspase-12,cleaved caspase-12,JNK and phosphorylated-JNK was detected by Western blotting.The cardiac myocyte apoptosis was determined by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling(TUNEL).RESULTS: The cardiac expression of endoplasmic reticulum chaperones GRP78 was significantly increased in the hearts with functional failure.The upregulated expression of CHOP,phosphorylated-JNK and cleaved caspase-12 illuminated that the CHOP-JNK-caspase-12 dependent pathways for endoplasmic reticulum-initiated apoptosis were activated in the heart with functional failure by myocardial infraction.CONCLUSION: These findings suggest that the congestive heart failure induced by myocardial infraction is associated with endoplasmic reticulum stress and activation of CHOP,JNK,caspase-12 dependent pathways for endoplasmic reticulum-initiated apoptosis.

Objective: To observe the efficacy and safety of 308 nm excimer light combined with compound triamcinolone acetoniazole cream in the treatment of chronic hand eczema. Methods: From February 2016 to August 2017, 62 patients with chronic hand eczema admitted to the First People's Hospital of Taicang were divided into two groups using random digital tables, with 31 cases in each group.The treatment group was given 308nm excimer light combined with compound triamcinolone acetoniazole cream.The control group was treated only with compound triamcinolone acetoniazole cream.The effect after 4 and 8 weeks of treatment were determined in both two groups. Results: After 4 and 8 weeks of treatment, the effective rates in the treatment group were 35.48% and 87.10%, respectively, which in the control group were 29.03% and 61.29%, respectively.After 8 weeks of treatment, the difference between the treatment group and the control group was statistically significant(χ²=5.39, P<0.05). Conclusion 308 nm excimer light combined with triamcinolone acetoniazole cream in the treatment of chronic hand eczema has good clinical effect and less adverse reactions, and the recurrence rate is low.

Objective:To study on the effects of gastrointestinal function and portal vein hemodynamics applicated with abdominal hot compressing with evodiae fructus and crude salt after hepatectomy.Methods:A total of 60 patients who underwent hepatectomy were randomly divided into 2 groups by random number table method, with 30 in each group. The control group was treated with conventional basic western medicine, while the treatment group was treated with medicinal evodiae fructus and crude salt hot compress on abdomen on the basis of the control group. The portal vein diameter (PVD), portal venous flow velocity (PVV), recovery time of main clinical indexes, clinical symptom scores and liver function indexes were dynamically monitored at different observation time points.Results:The scores of abdominal distension, nausea and vomiting in the treatment group were significantly lower than those in the control group 3 days after treatment ( t values were -3.489 and -2.740, respectively, all Ps<0.05). The recovery time of bowel sounds, first exhaust time and first defecation time in the treatment group were significantly earlier than those in the control group ( t values were -3.622, -4.297 and -4.151, respectively, all Ps<0.01). With the extension of treatment time, ALT in 2 groups showed a gradual downward trend ( P<0.05 or P<0.01), DBIL in control group was significantly higher at 3 days after treatment than before ( t=-2.157, P=0.039), and TBIL was significantly lower at 7 days after treatment than before ( t=2.175, P=0.038). The PVD ( t values were 3.528, 2.160) and PVV ( t values were 11.096, 4.264) of the treatment group were significantly higher than those of the control group 3 and 5 days after treatment ( P<0.01 or P<0.05). Conclusion:Early application of abdominal hot compressing with evodiae fructus and crude salt hot compress on abdomen after hepatectomy can improve the portal vein blood circulation and promote the rehabilitation of gastrointestinal function in patients with hepatectomy.

Objective:To investigate the value of event-related brain potentials (ERPs) for evaluating the effect of repeated high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke depression.Methods:Sixty-four depressed stroke survivors were divided at random into an observation group and a control group, each of 32. Thirty-five healthy volunteers constituted a healthy control group. All of the patients were treated with 150mg/d of venlafaxine for 6 weeks. The observation group was additionally given rTMS five times a week for 6 weeks. Before and after the treatment, both patient groups were evaluated using the Hamilton depression scale (HAMD-17) as well as the visual P300.Results:After the treatment the average HAMD-17 scores of the two patient groups had decreased significantly, but with significantly greater improvement in the observation group. The total effective rate of the observation group after treatment (87.5%) was significantly higher than the control group′s rate (62.5%). Before the treatment the latency and amplitude of Cz and Fz in both patient groups was significantly delayed and lower than in the healthy group. After the treatment the average Fz amplitude in the observation group had risen and the latency had moved forward significantly compared with the other two groups. No significant differences were observed among the control group before and after the treatment. Before the treatment the average P2 and P3 latencies of the two patient groups were significantly longer than in the healthy group, while the amplitudes were significantly lower. After the treatment the average latency of P2 and the average P3 latency and amplitude of the observation group were significantly better than before the treatment. No significant differences were observed in the healthy control group.Conclusions:High-frequency rTMS can affect post-stroke depression. The MMN and visual P300 instruments can be used for rehabilitation evaluation.

Objective To evaluate the efficacy and safety of the modified docetaxel plus prednisone scheme for the metastatic castration resistant prostate cancer patients who got poor tolerance to chemotherapy.Method The clinical data of 50 metastatic castration resistant prostate cancer who received docetaxel + prednisone chemotherapy from March 2010 to October 2015 were analyzed retrospectively.23 cases received the modified DP regimen (modified group),27 cases received the standard DP regimen (standard group).The median age of the modified group and the standard group were 69 years (47-80 years) and 63 years (52-77 years) (P =0.005).There were 19 and 24 cases with pain in modified group and standard group respectively;10 and 19 cases with lymph node metastasis respectively;3 and 4 cases of visceral metastasis respectively;all of the 50 patients were complicated with bone metastasis.For the pathological Gleason score,there were 7 cases scored ≤7 points,13 cases scored ≥ 8 points and 3 cases unscored in the modified group;7 cases scored ≤7 points,15 cases scored ≥8 points and 5 cases unscored in standard group.There was no significant difference of the pain,metastasis,and Gleason score between the two groups (P ＞ 0.05).Progression free survival (PFS),overall survival (OS)and adverse events were analyzed using Kaplan-Meier curves,and the differences were assessed using the log-rank test.Results In the modified group and standard group,the median follow-up times were 11.0 months and 14.0 months respectively,the median chemotherapy cycles were 4.5 cycles and 5.0 cycles respectively;OS were 18.0 months and 27.5 months respectively (P =0.746).The PFS of the two groups were 6.0 months and 5.2 months,respectively (P =0.822).The PSA response were 13 cases and 17 cases in the modified group and standard group respectively (P =0.615),and the pain response were 8 cases and 7 cases (P =0.927),grade 3 to 4 adverse events were 3 cases and 14 cases (P =0.003).The main adverse events were blood toxicity,neutrophils,gastrointestinal reaction,edema,fatigue and oral mucositis etc.Conclusions Compared with the standard DP scheme,the modified DP scheme had no significant difference in OS,PFS,pain response rate and PSA response rate,while the incidence of grade 3 to 4 adverse events was significantly reduced.Modified DP scheme may be a better choice for patients with metastatic castration resistant prostate cancer who get poor tolerance to chemotherapy.