Objective To investigate the effect and significance of minimally invasive removal of intracranial hematoma on the blood-brain barrier in patients with intracerebral hemorrhage (ICH).Methods Clinical data of 20 patients with ICH were randomly selected and received minimally invasive surgery (operative group) and 20 patients with ICH received expectant treatment therapy (expectant treatment group) were analyzed retrospectively,and 20 healthy people were randomly collected for control group.The blood-brain barrier (BBB) and serum myelin basic protein (MBP) concentration were analyzed.Results The BBB index of the iperative group was 0.0075 ± 0.0007,the expectant treatment group was 0.0083 ± 0.0006 and the control group was 0.0068 ± 0.0004.The BBB index in the operative group was significantly lower than that in the expectant treatment group (P ＜ 0.05),and the BBB index in these two groups was significantly higher than that in the control group (P＜ 0.01).The serum MBP concentration in the operative group was (3.29 ± 1.55) μg/L,the expectant treatment group was (6.55 ± 3.78) μg/L,and the control group was (1.12 ± 0.48) μ g/L.The serum MBP concentration in the operative group was significantly lower than that in the expectant treatment group (P ＜ 0.05),and these two groups were significantly higher than the control group (P ＜ 0.01).Conclusions The permeability of BBB in patients with ICH are increased,the BBB index and the serum MBP concentration in patients with ICH are increased,minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

The interdisciplinary nature of health economics brings certain difficulty to the teaching of this course, so it is very important to rationally design and use case teaching. According to the characteristics of the course, this paper put forward design ideas from the guiding ideology, selec-tion, categories and forms. This paper argued that teacher should play a leading role and create a good learning environment and grasp four parts of the implementation.

Chitin is one of the most important component in fungal cell wall.Biosynthesis of chitin is a complex processes and needs several chitin synthase isoenzymes.The knowledge of structure,function and regulation of chitin synthases is mainly derived from the study of Saccharomyces cerevisiae.In contrast with the 3 chitin synthases in S.cerevisiae,7 were found in most filamentous fungi.In this review the classification and function of chitin synthases are summerized,and progress in the studies on chitin synthases of filamentous fungi which are of theoretical or medical or agricultural importance,including Aspergillus nidulans,Aspergillus fumigatus and Ustilago maydis are emphasized.Recent ad-vance of research on chitin synthase as antifungal target is also discussed.

The study is to explore the effect of paeoniflorin on the level of glucocorticoid receptor, including glucocorticoid receptor-alpha (GCRalpha) and glucocorticoid receptor-beta (GCRbeta), of peripheral blood mononuclear cells (PBMCs) in rats of collagen-induced arthritis (CIA). CIA is induced in Wistar rats by an intradermal injection of bovine type II collagen emulsified with complete adjuvant. From the 14th day after primary immunization, the CIA rats were intragastrically administered paeoniflorin 25, 50 and 100 mg x kg(-1) or triptolde 20 microg x kg(-1) or paeoniflorin 50 mg x kg(-1) + RU486 15 mg x kg(-1), once a day, for 28 consecutive days. After administration, apart from PF + RU486 group all experimental rats were took blood by removalling eyeball, then separated PBMCs. The level of GCRalpha, GCRbeta in PBMCs were examined by ELISA, and the mRNA expression of GCRalpha, GCRbeta was detected by RT-PCR. All rats were sacrificed and took the joint with no immunization. The expression of IL-1beta, NF-kappaB p65, TNF-alpha, PGE2 of synovial tissue was detected by immunohistochemistry. Paeoniflorin was able to inhibit the expression of IL-1beta, NF-kappaB p65, TNF-alpha, PGE2 of synovial tissue in CIA rats. While RU486, glucocorticoid receptor's blocker, could weaken the fuction of paeoniflorin. Meanwhile, paeoniflorin obviously induced the expression of GCRalpha and GCRalpha mRNA, while obviously inhibited the expression of GCRbeta and GCRbeta mRNA. These results indicat paeoniflorine suppresses inflammatory mediator production may be relating with it regulating GCR in PBMCs of CIA rats.
Animals ; Arthritis ; chemically induced ; drug therapy ; genetics ; metabolism ; Cattle ; Collagen ; adverse effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Glucosides ; administration & dosage ; Humans ; Leukocytes, Mononuclear ; drug effects ; metabolism ; Male ; Monoterpenes ; administration & dosage ; Rats ; Rats, Wistar ; Receptors, Glucocorticoid ; genetics ; metabolism

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Objective To investigate the risk factors of wound complications following the abdominal aorta balloon occlusion in order to provide the basis for the preoperative management and reduce postoperative complications.Methods Two hundred and sixty-one patients with the sacral tumor aged over 18 were selected as subjects who hospitalized at Peking University People's Hospital from January 2006 to December 2012.All subjects were underwent sacral tumor posterior resection operation after occlusion of the distal abdominal aorta.Patients were divided into two groups according to the existence of postoperative wound disorder.The general information of the patients was collected including intra-operative data and post-operative data.SPSS19.0 software was applied for statistic analysis Results Among 261 cases,89 cases were with incision complications,and the incidence of complications was 34.1％ (89/261).There was no significant difference regarding of age,weight,preoperative complications (P ＜ 0.05).Compared with that of no complications group,operation time of wound complications group was longer ((218.27 ± 72.08) min vs.(197.40 ± 53.92) min,P =0.046),and intra-operative bleeding was more ((2368.0 ± 1984.7) ml vs.(1701.6 ±958.8) ml,P =0.000),as well as a longer balloon occlusion time ((78.0 ± 23.8) rain vs.(65.2 ± 17.8) min,P =0.005).Moreover long hospitalized periods was in wound complications group ((47.6 ± 26.3) d,vs.(26.7 ± 9.0) d,P ＜ 0.05).Single factor analysis showed that the factors including operation time,intra-operative bleeding volume,time and times of balloon occlusion balloon occlusion were related to postoperative wound complications.Non conditional logistic regression analysis shows that factors of the balloon occlusion time(OR 1.028,95％ CI 1.012-1.045,P =0.001) and block number(OR 6.266,95％ CI 1.186-33.119,P =0.031) were related to the wound healing following balloon occlusion the abdominal aorta.Conclusion The risk factors of wound complications following the abdominal aorta balloon occlusion included occurrence balloon occlusion time and blocking times.That single balloon occlusion with 60 min reduced wound complication rate.

Objective To test the diathesis-stress component in the hopelessness theory and demonstrate the mediator effect of hopelessness in depression-generating process. Methods In the 6-month longitudinal study,latent growth curve model(LGM) was used in a sample of 269 Chinese undergraduates on the base of questionnaire investigation. Results The intercept for hopelessness depression had a significant association with the intercept for negative life events (path coefficient =0.48) and depressogenic attributional style (path coefficient=0.26).The slope for hopelessness depression had a significant association with the slope for negative life events (path coefficient=0.73). The complete mediator effect of hopelessness between depressogenic attributional style and the intercept for hopelessness depression was 0.143. The complete mediator effect of hopelessness between the slope for negative life events and the intercept for hopelessness depression was 0.131. The partial mediator effect of hopelessness between the intercept for negative life events and the intercept for hopelessness depression was 0.151.Conclusion Depressogenic attributional style interacted with the occurrence of negative events to predict the occurrence of hopelessness depression. Hopelessness made partial mediator effect on the hopelessness depression-generating process.

Objective　The conditional hierarchical clustering for 1-dimensional(1-d) ordinal data was discussed.Methods　Because the individuals are ordered in 1-d,the conditional matrix was constructed with all elements in the second-diagonal are 1 and the others are 0.Distance matrix of individuals defined by some particular definition.Then the conditional-distance matrix was made for the hierarchical clustering by connecting the conditional matrix and distance matrix.This method was called 1-dimentsional conditional hierarchical clustering.An example was illustrated by this method and a Monte Carol study showed that method was feasible and robust.Results　Compared with the least-squares partition,this method is easy to understand,easy to practice and easy to compute.It also can give us a stable result.Conclusion　Because of the austere theory,the simple thought and the convenient application,it's a good method for the 1-d ordinal data.

Objective To establish the enzyme‐linked immuno sorbent assay(ELISA) method for a large‐scale screening of IgA deficiency in blood donors .Methods The indirect ELISA was adopted .The goat anti‐human IgA antibody was coated in microwell plates and labeled by horse radish peroxidase (HRP) as enzyme‐labelled secondary antibody .Results The sensitivity of established ELISA detection method was 0 .1 μg/mL .The intraassay coefficients of variation (CV) for IgA concentrations of 0 .1 ,100 μg/mL were 1 .74% to 3 .49% .The median interassay CV was 3 .48% (range:1 .83% -6 .96% ) .The assay process was 80 min . Conclusion TheELISA detection method is successfully established with high sensitivity ,strong specificity ,timesaving and easy operating and can be used for a large scale screening of Ig A deficiency and establishment of blood donors bank of Ig A deficiency .

This paper reviews outpatient security policy of typical developed countries .It provides reference for outpatient security system in China .Analysts believe that the experience for Chinese reference should be acquired in the following ways:The pooling of outpatient service is an inevitable trend in the development of health insurance , which is in principle an integral part of payment and financing system; the implementation of outpatient community first diagnosis system should be adapted to the local conditions; the community first diagnosis system is a necessary condition for capitation , so it is closely related to compensation methods and the elaborate degree of outpatient treat -ment catalog;Outpatient services should be supervised and payment policies should be developed respectively .There are two supervision models about outpatient service:external supervision and self supervision , but the key is to focus on the management of outpatient doctors .External regulation should be consistent with the current regulatory approach of the situation and patients have to bear some responsibilities for outpatient treatment expenses in some proportions , but the payment cap line should not to be low .The implementation of certain preferential policies for vulnerable groups can be considered under the harmonized system to partially reduce their medical expenses .