Objective:To investigate the clinical effects of transcranial ultrasound to arterial recanalization in acute ischemic stroke patients.Methods: Eighty cases of patients with acute ischemic stroke from February 2010 to May 2013 in our hospital were chosen as the experimental objects, and were divided into experimental group and control group randomly. The control group were treated with urokinase and transcranial ultrasound, the experimental group were treated with urokinase and placebo. The clinical effects of each group were compared.Results: The experimental group in the 2h and 24h when the recanalization rate was obviously higher than the control group, and the difference is statistically significant(x2=8.916,x2=8.155,P<0.05). Symptoms improved rate of patients in the 2h and 24h in the experimental group was obviously higher than that of the control group, and the difference was statistically significant. The experimental group prognostic good rate was 56.09%, while the control group was 23.08%, the difference was statistically significant(x2=9.081,P<0.05). The two groups had no statistically significant difference in mortality(x2=0.005,P<0.05). Conclusion: Patients with acute ischemic stroke with transcranial ultrasound treatment can significantly improve the prognosis of the patients condition, improve the rate of recanalization.

Objective To study the natural history of mild cognitive impairment (MCI) progress to dementia and to evaluate the efficacy of acetylcholinesterase inhibitor (AChEI) donepezil on MCI.Methods Ninty-eight patients with MCI including amnestic MCI and non-amnestic MCI were retrospectively analyzed. The patients with donepezil or not were separately divided to two groups while they were matched by sex, age,degree of MCI and possession of the ApoE?4 allele.The rate of conversion from MCI to dementia, measured with the Mini-Mental State Examination (MMSE),Alzheimer's Disease Assessment Scale- Cognitive section(ADAS-Cog) and Wechsler Memory Scale-Revised (WMS-R),was compared between the two groups.Results In aMCI group,the rate of conversion dropped by 15.1% and 8.3% (P0.05).Conclusion Donepezil could postpone the conversion of MCI to dementia.

Objective To investigate the interest,cognition degree,participation degree and current situation of the advanced undergraduate clinical students in our college,to discuss the reason for low level of students' scientific research quality,in order to provide the reference to making research training programs for them.Methods The advanced undergraduates of seven-year and five-year clinical program interned in orthopedics department from January to June in 2014 were selected with cluster sampling method,and investigated anonymously by questionnaires and interview.120 students were investigated by questionnaire,and 120 effective questionnaires were taken back.30 students were interviewed.Results The results showed that 90.0 percent (n=108) of students were interested in scientific activity,and 47.5 percent (n=57) of students had participated in scientific lectures.In interviews,students think factors hindering the research on the participation in scientific research are:1)too many courses and heavy school tasks;2) absence of relative knowledge;3) lack of support from college;4) tough condition for scientific training;5) immature management system.Conclusion The advanced undergraduate clinical students had great interest in scientific activity,but had few opportunities to take part in,leading to their low level of scientific research quality.A variety of measures should be taken to bolster their scientific training.

Objective To determine the correlation between high serum levels of homocysteine (Hcy), low folate and
vitamin B12 levels and the clinical index of neonatal hypoxic ischemic encephalopathy (HIE), providing the reference for the diagnosis and treatment of neonatal patients with HIE. Methods Totally 94 cases of neonatal patients with HIE (32 mild, 40 moderate, and 22 severe) treated by Tianjin children’s hospital from April 2010 to April 2011 were enrolled. The control group was 20 cases of neonatal patients with neonatal swallowing syndrome at the same period. The serum levels of Hcy, folate and vitamin B12 were compared between four groups. Results There were significant differences in serum levels of Hcy, folate and vitamin B12 between four groups (P<0.05). Compared with the control group, there was higher level of Hcy and lower levels of folate and vitamin B12 in HIE groups. The Hcy levels increased with the deterioration of HIE in three HIE groups. The serum level of vitamin B12 was significantly lower in severe group than that in moderate group (P<0.05). Conclusion The serum Hcy level has certain reference value in tassessment of the severity of HIE. The supplementation of folate and vitamin B12 may play an active role in the process of the treatment in neonatal patients with HIE.

Objective To investigate the levels and distribution of radon in dwellings in Shenzhen cities of China.Methods A total of 108 low-,multi-,middle-and high-rise buildings were selected.Indoor radon concentrations were measured by using solid track detector.Results The arithmetic mean of indoor radon concentrations in Shenzhen was 64 Bq/m3,and geometric mean was 58 Bq/m3,in range of 15 to 155 Bq/m3.The average indoor radon concentration in Bao'an district was 50 Bq/m3 with the lowest value,and that in Pingshan new district was 87 Bq/m3 with the highest value.There were 12 measuring points where indoor radon concentrations were higher than 100 Bq/m3 in Shenzhen,accounting for 11.1％ of the total number.Shapiro-Wilk test showed that the frequency distribution of indoor radon concentration in Shenzhen follows lognormal distribution (P ＞ 0.05).The indoor radon concentrations showed a downward trend from 1990 to 2015.The indoor radon concentration decreases with the elevated floors except 10th and above floors.Conclusions The indoor radon concentrations in Shenzhen increased by 35％,compared to the previous investigations.It is recommended that efforts continue to improve radioactive materials standards about building material and to enhance the natural ventilation in high-rise buildings in order to lower the radiation hazards from radon.

The theoretical basis, significance and feasibility of tutor system for undergraduates in medical informa-tion education were studied.It was considered that the tutor system for undergraduates is an effective means for training medical information talents as it can help the undergraduates to know what role they will play in itheir future po-sition and the professional knowledge they should master, ncrease their study interests and stimulate their study motives by providing the professional skill education service in an order form.The management model of tutor system for under-graduates was put forward according to the significant features of undergraduate course education and cross subjects, the various requirements of professional skills, and the low study motives in domestic medical information education.The problems to which attention should be paid in implementing the tutor system for undergraduates were elaborated .

Objective To explore the effect of endoplasmic reticulum stress (ER stress) in uric acid?induced phenotypic change in renal tubular epithelial cells (HK?2). Methods (1) HK?2 cells were cultured with 0, 75, 150, 225, 300 mg/L uric acid for 24 h in vitro. (2) The cells were divided into normal control group, ER stress inhibitor 4?PBA (5 μmol/L) group, uric acid (150 mg/L) group and 4?PBA+uric acid group for 24 h. Morphological changes of HK?2 cells were observed under inverted microscope. MTT assay was used to detect the proliferation of HK?2 cells treated with 150 mg/L uric acid for 24, 48 and 72 h. The protein expressions of α?smooth muscle actin (α?SMA), vimentin, snail, glucose regulated protein 78 (GRP78) and the phosphorylation of eukaryotic initiation factor 2α(p?eIF2α) in HK?2 cells were measured by Western blotting. Results Compared with the control group, HK?2 cells in uric acid groups (150, 225, 300 mg/L) showed fibroblast?like appearance. The protein expressions of α?SMA, vimentin, snail, GRP78 and p?eIF2α in 150 mg/L and 225 mg/L uric acid groups were higher than those in the control group (all P<0.05). The proliferation of HK?2 cells in 150 mg/L uric acid group was lower than that in control group at 48 and 72 h (all P<0.01). Compared with the uric acid group, the cell morphology in 4?PBA+uric acid group was improved, and the protein expressions ofα?SMA, vimentin, snail, GRP78 and p?eIF2α were decreased (all P<0.05). Conclusions Uric acid may induce the phenotype transformation of renal tubular epithelial cell, and ER stress is involved. 4?PBA may inhibit the uric acid?induced ER stress response and phenotypic transformation, and may be beneficial in attenuating uric acid?induced renal tubular damage.

Objective To test whether the prophylactic small dose amitriptyline has any beneficial influence on the rate of poststroke depression (PSD) by clinical experiment. Methods All 123 patients with first stroke were divided into the intervention group and the control group according to the block randomization tables. The patients in the intervention group were treated with 12. 5 mg amitriptyline every night for more than 1 month and the control group was blank Before and at the end of the observation, the rate of PSD and activities of daily living (ADL), degree of neurological deficit (NIHSS) of all the subjects were assessed. Results At the end of the one-month treatment, the intervention group had lower rate of PSD (16. 4% ) than the control (51.6%);and they had lower score in NIHSS (2. 83 ± 1.74 vs 3. 64 ±1.93) and higher score in ADL (93.0 ± 16. 1 vs 87.0 ± 37. 1) than the control. Multivariate Logistic regression analysis showed: the change of ADL score was closely related to the rate of PSD (RR =3.01 ,P =0. 04); the change of NIHSS score was closely related to the rate of PSD ( RR = 2. 42, P = 0. 03 );prophylactic small dose amitriptyline was closely related to PSD ( RR = 3.11, P = 0. 01 ). Conclusions Prophylactic small dose amitriptyline can decrease the rat of PSD, reduce the neurologic impairment and improve the activity of daily living.

Objective To assess the value of susceptibility weighted imaging(SWI) in the diagnosis of intracranial hemorrhage. Methods Forty patients with intracranial hemorrhage underwent MRI scanning (GE Signa HDe 1.5 T), which included T2WI, T1WI, T2 * WI and SWI. Of them, DWI was conducted in 37 cases and enhanced MRI was conducted in 10 cases additionally. After post processing on the workstation, both magnitude and phase images of SWI were acquired for further analysis. The images of all sequences were scored from 1 to 3, according to their ability of depicting the lesions. Statistical analysis was conducted to compare the scores among these sequences. Results On SWI, the scores in detecting the lesions, their margin and adjacent veins were 2. 8, 2. 8, and 2. 8 respectively. The scores of those were 1.8, 1.7,and 0.0 on T1WI, 2.3, 2.0 and 0.0 on T2WI, 2.0, 2.1 and 0.2 on T2* WI, respectively. There was statistical difference between the scores on SWI and those on T1WI, T2 WI and T2 * WI ( P < 0. 01 ). The numbers of micro hemorrhagic lesions that could be observed on SWI, T1WI, T2WI, DWI and T2 *WI were 402, 55, 61, 84 and 188 respectively. There was statistical difference in showing micro hemorrhagic lesions between SWI and T1WI, T2WI, DWI, T2 * WI (P < 0. 01 ). Conclusion SWI is sensitive to visualize the hemorrhagic region, and has predominant advantage over conventional MR sequences including T2 * WI in detecting intracranial hemorrhage, especially cerebral microbleeding. According to the features of the paramagnetic and diamagnetic lesions, radiologists can differentiate hemorrhage and calcification with phase images.

BACKGROUND:Anterior cervical plate can maximize the intervertebral space height,expand intervertebral foramen,restore cervical physiological antecurvature,prevent instability due to implant micromovement,and increase graft fusion.However,the selection of entire autologous bone or Ti-mesh bone graft remains uncertain in application of anterior cervical plate.OBJECTIVE:To compare the complications of three different intervertebral fusion methods in anterior cervical decompression surgery.METHODS:A total of 92 cases of cervical spondylotic myelopathy were treated by anterior cervical decompression and three different intervertebral fusion methods.They were followed up for at least 3 months.Of them,6 underwent bone grafting alone,21 underwent autogenous bone graft with cervical plate-screw fixation,and 65 underwent pyramesh with anterior cervical plate-screw fixation.Complications were observed in all cases.RESULTS AND CONCLUSLON:A total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation,1 suffered from pseudoarthrosis formation,and 1 suffered from donated ilium.Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height,and 3 suffered from pain of donated ilium.Eleven of 65 pyramesh with anterior cervical plate-screw fixation suffered from titanium mesh subsidence,1 case suffered from breakage of fixation screw.Simple autogenous bone grafting surgery was rarely used due to long duration of external fixation and too much complications.Autogenous bone grafting with anterior cervical plate-screw fixation surgery has shortage of grafted bone absorption and pain of donated ilium.Pyramesh with anterior cervical plate-screw fixation surgery overcomes the shortage of donated iliac pain,but remains the shortage of titanium mesh subsidence and lose of intervertebral height.