Objective To analyze the epidemiological trend and distribution of stroke mortality in residents of Tianjin, China. Methods The study was based on 102 718 died cases with stroke in Tianjin between 1999 and 2006. The death cause and the stroke typing were coded according to the ICD -9 and ICD -10. Standardized mortality rates were calculated for stroke and its subtypes, adjusted for age and sex according to the world standard population of the Year 2000. The age, sex and geographic distribution of the stroke and its subtype mortality were analyzed. Chi-square tests were used to determine the statistical significance of mortality trends and differences. Results Stroke mortality rate in Tianjin declined from 133.52 / 100 000 / year in 1999 to 102.52 / 100 000/year in 2006. Cerebral infarction accounted for more than 50% of stroke mortality. The stroke mortality rate for males (120.17 / 100 000 to 157.74 /100 000) was higher than that for females (84.87/100 000 to 109.31/100 000). Stroke mortality rates elevated with age (P

Cerebral microbleed is a cerebral small vessel disease.The detection rate is 4.5％ to 84.9％in different populations.Vascular cognitive impairment is the general name of various cerebrovascular diseases and their risk factors caused varying degrees of cognitive impairments.Studies have shown that cerebral microbleed is closely associated with vascular cognitive impairment.This article reviews the relationship between cerebral microbleed and vascular cognitive impairment in different populations,different degrees and different locations.

Objective To investigate the effects of vitamin K1 in the adjuvant treatment of spasmodic cough in pertussis syndrome children,and its impacts on length of hospital stay.Methods 87 pertussis syndrome children were randomly divided into two groups,among which 41 cases in the control group were treated with the therapies such as anti -infection,respiratory support,antispasmodic,expectorant et al,while 46 cases in the treatment group were treated additionally with vitamin K1 on the basis of the control group.Then compared the duration and hospital stay of the two groups with spasmodic cough.Results The disappeared time of spasmodic cough in the treatment group was (7.22 ±1.33)d and hospital stay was (9.52 ±1.84)d,which in the control group were (15.51 ±2.73)d,(18.71 ± 3.30)d respectively,and there were statistically significant differences(t =-18.310,-16.269,all P <0.01).In the treatment group,the total effective rate was 93.5%,there were 18 cases with markedly effective,25 cases with effective and 3 cases with ineffective.Correspondingly,there were 7 cases markedly effective,23 cases effective, 11 cases ineffective,and total efficiency rate was only 73.1% in the control group,the difference was statistically significant(χ2 =4.285,P <0.05 ).Conclusion Vitamin K1 to alleviate spasmodic cough in children has a significant effect,which can reduce the duration of the cough time and hospital stay in pertussis syndrome children, and also can improve the clinical effect.

Objective To analyze the risk factors of 30-day mortality in patients with malignant hilar obstruction (MHO) after percutaneous transhepatic biliary metal stent deployment. Methods One hundred and fifty-nine consecutive patients with MHO caused by cholangiocarcinoma or gallbladder carcinoma were enrolled in this study. Percutaneous transhepatic biliary stent (PTBS) implantation was carried out in all the patients. Independent predictors for 30-day mortality were evaluated by logistic regression analysis. Covariates that were incorporated into the multivariate analysis were the variables that reached statistical significance (P < 0.1) in univariate analysis. Two-tailed, P value of less than 0.05 was considered to be statistically significant. Results The 30-day mortality of patient with MHO after metal stent deployment was 9.4%. Univariate analysis indicated that the differences in WBC (OR = 1.224.95%CI [1.07 - 1.44], P < 0.01), INR (OR=78.75, 95%CI [5.02-1 235.70], P<0.01), PT(OR=1.55, 95%CI [1.18-2.04], P<0.01), BUN (OR=1.19, 95%CI [1.02- 1.38], P < 0.05), CRE(OR = 1.02, 95%CI [1.000 - 1.041], P < 0.1) and lymph nodes metastasis(OR = 0.334. 95%CI[0.105 - 1.131], P < 0.1) were statistically significantly between 30-day mortality group and non-30-day mortality group. Multivariate analysis showed that statistically significant differences in WBC (OR = 1.19, 95%CI[1.026 - 1.380], P < 0.05), INR(OR = 151.5, 95%CI [3.13 - 5 440.7], P < 0.05) and CRE (OR = 1.025, 95%CI [1.002 - 1.048], P < 0.05) also existed palliative treatment for patients with malignant hilar obstruction. Active preoperative measures to improve hepatic and renal functions as well as to control infection are necessary in order to reduce 30-day mortality.

Since intra-arterial chemotherapy with the help of implantation of port-catheter system (PCS) was first used in the surgical field in 1981, PCS has been widely employed in the field of interventional radiology. Intra-arterial chemotherapy by implantation of PCS has some certain advantages such as minimal invasion, no need of general anesthesia, etc. Ten randomized clinic trails have been already reported, which indicate that intra- arterial chemotherapy with PCS is obviously superior to systemic chemotherapy in treating hepatic metastasis form colorectal cancer. As for the treatment of advanced biliary tract cancer, pancreatic carcinoma and hepatocellular carcinoma, the relevant reports can be found only in several phaseⅠ/Ⅱclinical trials or in some retrospective cohort studies. This paper aims to make a comprehensive review about the indications, clinical applications and complications of PCS in treating abdominal tumors in order to improve the clinical practice.

Objective To investigate the correlation between cognitive function and cerebral microbleeds (CMBs) in patients with acute cerebral infarction.Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective.CMBs were counted according to the findings of MRI.The general conditions,CMB site and leukoaraiosis severity of the patients were recorded in detail.The cognitive function of the patients was assessed with the Montreal cognitive assessment scale (MoCA) the next day in the hospital.MoCA assessment follow-up was conducted at 3,6 and 9 months.The changes in cognitive function of the patients with acute cerebral infarction and its relationship with CBMs were analyzed.Results A total of 82 patients with ischemic stroke were enrolled in the study,33 of them had CBMs and 49 had no CBMs.The systolic blood pressure (155.03 ± 19.68 mm Hg vs.142.20 ± 21.22 mm Hg;t =2.762,P =0.007) and the National Institutes of Health Stroke Scale (NIHSS) score (6.21 ±4.57 vs.4.00 ±3.98; t =2.322,P =0.023) in the CBM group were significantly higher than those in the non-CBM group.Multivariate logistic regression analysis showed that the systolic blood pressure level (odds ratio [OR] 1.032,95％ confidence interval [CI] 1.008-1.057; P=0.009) and the NIHSS score (OR 1.163,95％ CI 1.013-1.311;P=0.014) were the independent predictors of CBMs in patients with acute cerebral infarction.CMBs were closely associated with MoCA scores,and the longer follow-up time,the correlation would stronger.The executive function (rs =0.318,P =0.004),visual space function (rs =0.403,P =0.000) and calculation function (rs =0.362,P=0.001) in patients with CMBs were significantly impaired.The more serious of CMBs,the lower of the scores in above 3 cognitive domains,and the damage would be more serious.Conclusions CMBs are closely associated with cognitive function impairment in patients with acute cerebral infarction.The more serious of CMBs,the more serious of cognitive function impairment will be,and with the extension of time,cognitive function impairment in patients with CMBs will aggravate.

Objective To determine the effect of inhaling rosemary compound essential oil on learning and memory and the expression of choline acetyl transferase (ChAT) in the CA1 region of the hippocampus in rats with vascular dementia (VD).Methods A modified 2-VO method was used to induce permanent brain hypoperfusion,and thus VD,in 60 male SD rats aged 2 months.They were then randomly divided into a normal control group (n =10),a sham-operation group (n =10),a model group (n =10),a rosemary compound essential oil group (n =10) and an edaravone group (n =10).The rosemary compound essential oil group inhaled a compound of the essential oils of rosemary,eugenol and peppermint once a day; the edaravone group was given a daily injection of edaravone injecta.Both the interventions lasted for 65 days.A water maze was used to test their learning and memory abilities.Morphological damage in the CA1 region of the hippocampus and the expression of ChAT were also observed.Results The learning and memory abilities of the model group were significantly weaker compared with the sham-operated group and the normal controls.The rats in the rosemary compound essential oil and edaravone groups were obviously better than those in the model group,but there was no significant difference between rosemary compound essential oil group and the edaravone group.The morphological damage observed in the hippocampus and striatum of the model group was significantly greater,on average,than that observed in the rosemary compound essential oil group and the edaravone group.The average number of ChAT positive units in the CA1 region of the hippocampus was significantly greater in both the rosemary compound essential oil group and the edaravone group compared with the model group,but there was no significant difference between the rosemary compound essential oil group and the edaravone group.Conclusions Inhaling rosemary compound essential oil can improve the learning and memory abilities of rats with VD caused by permanent chronic brain hypoperfusion.It decreases the damage to the neurons of the hippocampus,increases the expression of ChAT,and shows a therapeutic effect on VD,at least in rats.

Objective To establish a qualitative and quantitative determination of glyphosate in serum using ultraviolet spectro-photometry(UV) to provide basis for clinical diagnosing and treating glyphosate poisoning .Methods The mixture of 0 .5 mL serum and 0 .2 mL 10% methanol solution of perchloric acid was shocked and centrifuged with 10 000 r/min for 5 min .A nitrosyla-tion reaction conducted on supernatant and 50 μL serum nitrosylation liquid was detected by UV scanning .Results The results of serum theophylline absorption maxima was(243 ± l) nm and the concentration of 10 .0-60 .0 μg/mL range linear regression equa-tion was Y=0 .0173 8X+0 .036 3(r= 0 .999 8) .The recovery rate was from 85 .5% to 102 .4% and the relative standard deviation (RSD) was from 3 .50% to 4 .90% .The intra-day and inter-day RSD were 3 .79% -5 .10% and 3 .88% -4 .55% .The minimum de-tectable concentration was 5μg/mL .Conclusion This method is simple ,rapid and accurate results for detecting glyphosate poison-ing .

To develop a standard defibrillation energy source which can output monophasic and biphasic de-fibrillation impulses and can display standard energy values. The storage capacitor was charged by single-end flyback transformator and discharged through the H bridge composed of insulated gate bipolar transistor (IGBT). Impulse voltage and current were collected by divider while discharging, and the energy value was calculated by STM32. The en-ergy value and waveform were displayed through the control module. The energy source could output both monophsic and biphasic waveforms, and the accuracy of displayed value was higher than ±2% or ±1 J. The standard defibrillation energy source can be used as standard device for defibrillator analyzer, and the metrological trace-ability system of defibrillation energy may come to be completed.

Objective To observe the feasibility, safety and efficacy of percutaneous coronary intervention (PCI) for treatment of chronic total occlusions (CTO)by only the guidewire versus by the guidewire dependent on balloon. Methods The 108 patients with CTO confirmed by coronary angiography and treated with PCI from March 2009 to March 2011 were enrolled in this study, including 59 cases with old myocardial infarction, 22 unstable angina cases and 27 stable angina cases. The clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac events (MACEs) during follow-up were retrospectively analyzed between group A (only by the guide wire) and group B (by guide wire dependent on balloon). Results The 88 of 108 patients (81.5%) got successful operations. The success rate of CTO was a little higher in group B than in group A [80.0%(52/65) vs. 83.7%(36/43), P＞0.05]. The rate of total complications was more in group A than in group B [10.8%(7/65) vs. 2.3%(1/43), P＜0.05]. No death occurred during operation, no MACE occurred after operation in hospital and no patients underwent emergency coronary artery bypass graft (CABG) in the two groups. Conclusions The PCI for treatment of CTO used by the guidewire dependent on balloon shows a safety and effecary.