Objective To observe the effect of Xingnao Kaiqiao Acupuncture on cognitive impairment post stroke. Methods Fifty-four patients from July, 2013 to December, 2015 with cognitive impairment post stroke were randomly divided into experimental group (accepted Xingnao Kaiqiao Acupuncture and repetitive transcranial magnetic stimulation) and control group (repetitive transcranial magnetic stimula-tion only). They were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) before and 4 weeks after treatment. Results The scores of MMSE and MoCA improved after treatment in both groups (t>3.52, P<0.01), and improved more in the experimental group than in the control group (t>2.29, P<0.05). Conclusion Xingnao Kaiqiao Acupuncture may further im-proved the recovery of cognitive impairment post stroke based on repetitive transcranial magnetic stimulation.

Objective:To study dynamic changes of fragile histidine triad(FHIT) gene expression in ionizing radiation injury and radiation carcinogenesis. Methods: BEAS-2B cells were divided into 0.5,1,2,4,8,16 Gy irradiation groups and control group. In 24 h, 72 h and 10 d after irradiation, the expression of FHIT gene was studied with single-cell RT-PCR and DNA sequencing separately. Results: Different types of FHIT gene mutations occured in different phases after irradiation with different doses (All mutations were exon deletion mutations by DNA sequencing), while abnormal FHIT gene was not detected in control group. The percentage of mutation in 0.5,1,2,4,8,16 Gy dose groups was 52.6%,66.7%,57.9%,76.5%,64.7% and 81.3% respectively 24 h after irradiation;17.6%,22.2%,50.0%,47.4%,47.1% and 68.4% respectively 72 h after irradiation;and 21.1%,25.0%,60.0%,57.9%,61.1% and 68.4% respectively 10 d after irradiation. Conclusion: These results suggest that ionizing radiation can cause deletion of FHIT gene.

Objective To study the relationship between extraocular muscle thickness and exophthalmos degree in patients with thyroid-associated ophthalmopathy (TAO),so as to provide a scientific basis for guiding clinical treatment.Methods Forty seven patients diagnosed with TAO from May 2005 to May 2011,in the 451 Hospital of the People's Liberation Army were chosen in this study,and divided into TAO group(23 cases) and treatment group (24 cases).Meanwhile,another 32 healthy people were selected as control.Extraocular rectus muscles (including the medial rectus muscle,lateral rectus muscle,superior rectus muscle and inferior rectus muscle) of all participants were measured with B-scan ultrasonography,and exophthalmos degree with Hertel exophthalmometer.Results The thicknesses of medial rectus in control group,TAO group and treatment group were (3.35 ± 0.25),(4.38 ± 0.85),(3.58± 0.52)mm,respectively; the thicknesses of lateral rectus muscle were (2.95 ± 0.61),(4.24 ± 0.75),(3.65 ± 0.42)mm,respectively; the thicknesses of superior rectus muscle were (3.15 ± 0.20),(4.65± 0.68),(4.01 ± 0.15)mm,respectively; the thicknesses of inferior rectus muscle were (3.17 ± 0.72),(4.75 ± 0.52),(3.71 ± 0.91)mm,respectively; the sums of binocular rectus thickness in these three groups were (21.95 ± 0.65),(28.02 ± 1.51),(22.95 ± 0.65)mm,respectively; the difference between the three groups was statistically significant(F=2.32,2.43,2.25,2.17,5.63,all P ＜ 0.05),and TAO group was significantly higher than that in the control group and in the treatment group(all P ＜ 0.05),while there was no statistically significant between the control group and the treatment group(all P ＞ 0.05).The eyes exophthalmos degree in TAO group and treatment group were (16.82 ± 2.46),(14.52 ± 1.83)mm,respectively.The sum of the rectus muscle thickness and eyes exophthalmos was positively correlated(r =0.65,0.58,all P ＜ 0.05).Conclusions Extraocular muscle thickness in patients with TAO is positively correlated with exophthalmos degree,and using B-scan ultrasonography to detect the changes is practical for clinical diagnosis and treatment.

Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients'to EMS.Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed.Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study.The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group.Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate.A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not.Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170).Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI:0.107-0.403,OR=0.208,P<0.01) were more likely to use EMS.The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min,P<0.01).Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not.

Objective: To analyze the clinical characteristics of young patients with acute myocardial infarction (AMI), discuss the key points of health education in young patients with AMI, enhance the understanding of patients, and improve the prognosis of AMI in the young patients. Methods: hTe patients were chosen in XiangyaHospital from September 2012 to September 2013. We consulted the medical records, analyzed the clinical characteristics and results of coronary angiogram in young patients (age≤45), and compared with old patients (age≥60). Results: There were 69 young patients with AMI, about 14.2% of all the patients with AMI. Of the 69 young patients, 59 were male (85.5%) and 10 were female (14.5%). Compared with the old patients, the percentages of smoking, drinking, hyperlipidemia and overweight were much higher;the percentages of hypertension and diabetes were much lower in young patients. The coronary angiogram showed that the constituent ratios of insigniifcant disease and single-vessel disease inthe young patients were higher than those in the old patients; the constituent ratios of double-vessel disease and triple-vessel disease in the young patients were lower than those in the old patients. Conclusion: The clinical characteristics of young patients withAMI are different from the old patients.Health education should be conducted in the youth, and new diet and lifestyle should be advocated.

Objective To investigate effect of low molecular weight heparin (LMWH)on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms. Methods 90 elderly patients undergoing radical surgery were randomly divided into LMWH group (Ⅰ group,n=45)and control group (Ⅱ group,n=45). Patients inⅠ group received a subcutaneous injection of LMWH(100 u/kg,1/d)from the time before anesthesia induction to postoperative 5 days,and patients in Ⅱ group were given equal volume of saline. Venous blood samples were collected to determine level of malondialdehyde(MDA),aldose reductase(AR)activity level,superoxide dismutase(SOD)activity level,catalase (CAT)activity level,creatinine(Cr)and blood urea nitrogen(BUN)before anesthesia induction(T0 ),at the end of the surgery(T1 ),on postoperative 1 day(T2),3 days(T3)and 5 days(T4)respectively;urine specimen were also collected to measured albumin(Alb)and N-acetyl-beta-D-amino glycosidase enzymes(NAG)at the same time points. Results There were obvious statistical differences in MDA,AR,SOD and CAT at different time points by intra-group comparison (P<0.05 ). MDA and AR rose first and then fell in two groups,and both reached the peak at T2 ,whereas SOD and CAT had the opposite trends. There were obvious statistical differences in MDA,AR,SOD and CAT at T1 ~T3 (P<0.05 ). MDA and AR inⅠgroup at T1 ,T2 and T3 was lower than those in groupⅡ(P<0.05 ),whereas SOD and CAT inⅠgroup at T1 ,T2 and T3 were significantly higher than those in group Ⅱ(P<0.05). Cr and BUN of both groups were found no significant statistical difference within the group and between groups(P>0.05).Alb/Cr of both groups at T1 and T2 were significantly higher than those at T0 (P<0.05 ),while Alb/Cr in Ⅰ group at T1 was obviously lower than Ⅱgroup(P<0.05 ).NAG/Cr in both groups at T1 ,T2 and T3 were significantly higher than those at T0 (P<0.05 ),while NAG/Cr inⅡ group at T4 was still higher than that at T0 (P<0.05 ),and NAG/Cr inⅠgroup at T1 ~T4 was obviously lower thanⅡgroup (P<0.05 ). MDA and AR in both groups at T1 ,T2 were positively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ),whereas SOD and CAT in both groups at T1 ,T2 were negatively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ). Conclusion Oxidative stress reaction resulted from radical surgery of elderly patients is associated with perioperative renal damage. LMWH could reduce oxidative stress in elderly patients,and alleviate the kidney damage,as well as protect the renal function.

Objective To set up the optimized conditions,the amplification of eord blood CDCD+34 cells in vitro were analyzed by comparing the conditions such as different feeder-layers, stimulating-factors or purity/contents of those cells. Methods The cord blood CDCD+34 cells proliferation was analyzed by the methods of MTT, cell counting, and flow eytometer. The amplification and clone-forming ability of cord blood CDCD+34 cells were detected under optimized condition. Resulits The growth rates of cord blood CD+34 cell under optimized conditions(10 times) were significantly higher than that of the control(2.8 times) (P ＜0.01), and the cloneforming ability of cord blood CDCD+34 cells under optimized conditions(CFU-C 36.67±6.11) were also better than that of the control(CFU-C 16.33±1.53) (P ＜0.01). Conclusion The cord blood CD+34 cells proliferation can be promoted in the co-cultured system, and the character of the stem cells were kept well in that system.

This article shared opinions on how to effective educate clinical type postgraduates in department of neurosurgery based on the teaching models in the first affiliated hospital of Chongqing medical university. In the proposed training program,medical ethics education and comprehensive training including clinical thinking and practical skills training should be emphasized.Scientific inquisitiveness of the neurological research and the writing and oral communication in English should also be promoted.This training program will be fully committed to produce highly qualified,ethical and caring neurosurgeons for future needs of the society.

BACKGROUND:Vascular endothelial growth factor is found the strongest to promote angiogenesis, which show strong expression in synovial cells in rheumatoid arthritis.
OBJECTIVE:To evaluate the relation between the expression of vascular endothelial growth factor and microvessel density in rheumatoid arthritis.
METHODS:Col agen II and complete Freund’s adjuvant were used to induce experimental arthritis in Sprague-Dawley rats. Synovium expression of vascular endothelium growth factor and microvessel density were assayed at different time points using immunohistochemistry method, and changes in new vessels, vascular endothelial growth factor expression and arthritis index were observed along the time course. The correlations between vascular endothelial growth factor expression and number of new blood vessels as wel as between arthritis index and vascular endothelial growth factor expression were studied with linear correlation analysis and rank correlation analysis, respectively.
RESULTS AND CONCLUSION:With the time lasting, new blood vessels in the synovium proliferated, the synovium was thickened, and the arthritis index rose gradual y as wel as vascular endothelial growth factor expression and number of new microvessels were on the rise. Vascular endothelial growth factor expression was positively correlated with arthritis index (r=0.535, P<0.05) and significantly positively correlated with number of new microvessels (r=0.860, P<0.01). Vascular endothelial growth factor is involved in the course of synovium pannus response, and vascular endothelial growth factor and microvessel density may play an important role in rheumatoid arthritis pathogenesis.