Ductus Arteriosus ; surgery ; Ductus Arteriosus, Patent ; drug therapy ; therapy ; Humans ; Ibuprofen ; administration & dosage ; therapeutic use ; Indomethacin ; administration & dosage ; therapeutic use ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; drug therapy ; surgery ; therapy ; Ligation ; methods ; Treatment Outcome

OBJECTIVE:To investigate the effects of early before PCI and immediate application of tirofiban on coronary blood flow and myocardial perfusion in patients with high risk acute coronary syndrome (ACS). METHODS:100 high risk ACS patients were randomly divided into observation group and control group,with 50 cases in each group. Two groups were given tiro-fiban;observation group was given medicine 10 μg/kg within 3 min,4-6 h before PCI,with the velocity of 0.15 μg/(kg·min)till 24 h after PCI. Control group was given medicine at the beginning of PCI,route of administration was same as observation group. The incidence of TIMI blood flow grading,TIMI myocardial perfusion grade (TMPG),cTn Ⅰ,PAR and main adverse cardiac events(MACE)were compared between 2 groups before and after treatment. RESULTS:After operation,the patients of 2-3 grade TIMI blood flow and 2-3 grade TMPG in 2 groups were significantly more than before;the patients of 2-3 grade TMPG in observa-tion group was significantly more than in control group,with statistical significance(P<0.05). After treatment,cTn Ⅰof 2 groups were significantly increased,while PAR were significantly decreased,with statistical significance compared to before operation (P<0.05);but there was no difference between 2 groups (P>0.05). There was no statistical significance in the incidence of MACE between observation group(8.0%)and control group(16.0%)(P>0.05). CONCLUSIONS:Early application of tirofiban before PCI can effectively improve coronary blood flow and myocardial blood supply in high risk ACS patients.

Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.

Objective:To study the clinicopathological and immunohistochemical features of hepatic malignant vascular tumors. Methods:H E and immunohistochemistry were used to study 6 angiosarcoma and 5 epithelioid hemangioendothelioma (EHE) of the liver. Patients were aged 0.5 68 years, 7 were females and 4 were males. Results:Patients presented with nonspecific symptoms. Macroscopically,the tumors were usually multiple (3 13.7 cm in diameter) and were frequently hemorrhagic and multinodular. Histologically,there was a wide morphologic spectrum among cases. Six angiosarcoma included areas similar to cavernous and capillary hemangioma,spindle cell and epithelioid sarcoma. In the hepatic EHE,the tumor were comprised of dendritic and epithelioid cells that often contained vacuoles representing intracellular lumina. The stroma was fibrous with myxohyaline areas. Immunohistochemically,all tumors were positive for at least one endothelial marker(factor Ⅷ related antigen and /or CD 34 ). Conclusion:Hepatic malignant vascular tumor is very rare, the angiosarcoma of the liver is highly malignant with short survival. The prognosis of EHE is usually much better than that of angiosarcoma, surgical resection can obtain prolonged survival. The diagnosis can be made based on histological and immunohistochemical features of the tumor.

Inflammatory bowel disease( IBD)is a chronic and nonspecific intestinal inflammatory disease caused by multiple factors such as environment,genetic susceptibility and immune disturbance. Autophagy plays an important role in cellular homeostasis and immune. Autophagy abnormalities may be involved in the pathogenesis of IBD. Genome-wide association studies(GWAS)have provided compelling evidence that autophagy related genes,including ATG16L1,IRGM and NOD2,are significantly associated with IBD. This article reviewed the abnormal autophagy in pathogenesis of IBD.

Objective] To sum up professor Cong Pin’s clinical experience in diagnosing and treating pharyngitis. [Method]From etiology and pathogenesis, clinical differentiation and treatment experience, it expounds professor Cong Pin ’s clinical thought and diagnosis and treatment features. [Result] In her view, in the matter of etiology and pathogenesis, we should pay more attention to wind-evil and heat-evil in six evils and the malfunction of liver, spleen and stomach; paying more attention to symptom than signs in differentiation and valuing tongue diagnosis; therefore forming treatment rules and methods of reinforcing spleen for harmonize stomach, soothing the liver to stretch Qi, clearing wind to remove heat, tonifying Yin to produce moist, stretching Qi to activate blood and reducing phlegm to resolve masses, coordinated with outer therapy for promoting Qi to activate blood and stretch rheumatism; applying external treatment in intractable pharyngitis. It has been proved effective. [Conclusion] Pro. Cong Pin has her own experience in pharyngitis including the etiology and pathogenesis, the clinical differentiation, the application of prescription and the external treatment, having high clinical application value.

Objective To analyze the occurrence of sharp injuries among health care workers(HCWs),and put forward suggestions for safety management of sharp inj uries.Methods Recorded form of sharp inj uries reported in a hospital in August 2006-July 2015 were analyzed retrospectively,relevant data were analyzed statistically.Results A total of 211 sharp injuries occurred among HCWs were reported,sharp injuries mainly occurred among nurses(n=118,55.92%)and doctors(n=83,39.34%);117(55.45%)sharp injuries occurred in HCWS whose length of service was≤5 years;the main occurrence locations of sharp injuries were surgical ward(n=67,31.75%),internal medicine ward(n=65,30.81%),and outpatient as well as emergency departments(n=33,15.64%);the main de-vices causing sharp injuries were syringe needle(n=91,43.13%),suture needle(n=34,16.11%),and scalp nee-dle/transfusion needle(n=27,12.80%);the main injury-related manipulations were all types of injection(n=40, 18.95%),intravenous transfusion (n=38,18.00%),and surgical suturing/cutting (n=36,17.06%).The main opportunities of injuries was during manipulation(treatment,examination,operation,n=109,51.66%).Among bloodborne pathogens contaminated devices,contaminated by HBV,HCV,and HIV were 95 (76.61%),25 (20.16%),and 4 cases(3.23%)respectively.There was no bloodborne pathogen infection occurred.155(73.46%) of 211 HCWs were inoculated hepatitis B vaccine.Conclusion Prevention of sharp injuries should be focused on nurses and doctors who work for≤5 years,HCWs in surgical ward,internal medicine ward,and outpatient as well as emergency departments.Prevention of sharp inj uries during manipulations such as inj ection,intravenous transfu-sion,suturing/cutting should be intensified.Related hospital departments should improve the reporting process and intensify follow-up.

OBJECTIVE: To investigate the anti-depressant effect of icariin (Ica)in rats with depression caused by chronic unpredictable mild stress (CUMS) as well as the relevant mechanism. METHODS: The depression-like rat model with chronic unpredicted mild stress was established. Rats were randomly divided into normal control, CUMS model, CUMS+Fluoxetine (10 mg·kg-1) and CUMS + Ica(10, 20, 40 mg·kg-1) groups. Drugs or vehicle were administrated after stress procedures for 21 d. Open-field test (OFT), sucrose preference tests (SPT)and forced swim test (FST) were used to evaluate the anti-depressant effects of Ica. The concentrations of the monoamine neurotransmitters including noradrenaline (NA), dopamine (DA), and 5-hydroxytryptamine (5-HT)in prefrontal cortex, hippocampus, and striatum were measured by HPLC-ECD. RESULTS: Behavioral test indicated that crossing score and rearing score in OFT and sucrose preference index in SPT of model group were significantly lower than normal control group(P<0.01), while immobility time in FST was significantly increased (P<0.01). Compared with those in normal control group, the neurotransmitters including NA, DA and 5-HT were significantly decreased (P<0.01) in prefrontal cortex, hippocampus, and striatum in rats of CUMS. Ica and fluoxetine reversed those changes induced by CUMS. CONCLUSION: Ica improves the depression-like behaviors of rats induced by CUMS, of which the mechanism might be increasing the contents of monoamine neurotransmitters including NA, DA and 5-HT.

Glioma is the most frequent type of intracranial tumors,which is always associated with epilepsy.The type,location and pathological grade of glioma is closely related to incidence and efficacy of epilepsy.Recent re search shows that glioma and the factors around it may effect on the balance between excitation and inhibition system of brain.The detailed pathogenesis of epilepsy remains to be studied.

Objective To investigate the analysis of collateral circulation in patients with acute symptomatic internal carotid artery occlusion (ICAO)and its clinical significance. Methods Seventy-two consecutive patients with symptomatic ICAO diagnosed by digital subtraction angiography (DSA)were enrolled retrospectively. The American Society of Intervention and Treatment Neuroradiology / Society of Interventional Radiology (ASITN/ SIR)scores were used to evaluate the collateral circulation in the region of ICAO,and the collateral circulation of the patients with different causes,different clinical manifestations, and different types of infarcts were compared. Results Of the 72 patients with ICAO,61(84. 7%)had atherosclerotic occlusion,8(11. 1%)had cervical dissection,and 3 (4. 2%)had cardioembolism;55 patients (76. 4%)had cerebral infarction and 17(23. 6%)had transient ischemic attack. There were no significant differences in the ASITN/ SIR scores among the different causes (P > 0. 05). The ASITN/ SIR scores in patients with cerebral infarction and transient ischemic attack were 2. 64 ± 0. 80 and 3. 29 ± 0. 69 respectively. There was significant difference (P < 0. 05). In patients with cerebral infarction,the ASITN/SIR scores in patients with internal watershed infarction and regional cerebral infarction only were 2. 43 ± 0. 68 and 2. 36 ±0. 51 respectively,they were lower than the patients with only external watershed infarction only and/ or cerebral infarction in cortical territory (3. 42 ±0. 90,P <0. 05). Conclusion Atherosclerotic occlusion is the most common cause of ICAO. ASITN / SIR scores may reflect the conditions of collateral circulation in patients with ICAO. The occurrence of internal watershed infarction and regional infarction indicates the collateral circulation is poor,and need for further therapeutic intervention.