Objective To investigate the relationship of serum cholinesterase(CHE) level with the severity and prognosis in patients with acute cerebral infarction. Methods A total of 325 patients with acute cerebral infarction were recruited as patients group,and another 101 healthy sub?jects were selected as control group. Velocity method was employed to detect the level of serum CHE. Patients with acute cerebral infarction were then divided into different groups according to the infarcts diameter and the modified Rankin scale(mRS)at 1 year post stroke. The collected data were analyzed statistically. Results The level of serum CHE in small and medium area infarction group was higher than control group(P<0.01);the level of serum CHE in large area infarction group was lower than control group(P<0.01);the level of serum CHE was negatively correlated with infarct size,NIHSS and the mRS score(r=-0.302,-0.232,-0.455,P<0.001). The level of CHE,age,NIHSS and infarcts diameter was identified as independent influence factors for prognosis of acute cerebral infarction. Conclusion Early phase of serum CHE level is closely related with the infarct size and illness severity index in patients with acute cerebral infarction,which could be an independent factor affecting the prognosis of cere?bral infarction.

Animals ; Autophagy ; Biomarkers, Tumor ; metabolism ; Caveolin 1 ; deficiency ; metabolism ; Drug Delivery Systems ; Humans ; Myofibroblasts ; pathology ; Neoplasms ; metabolism ; pathology ; Prognosis ; Stromal Cells ; metabolism ; Tumor Microenvironment

Objective:By applying moxibustion to the eight confluent points in different periods of time,to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa.Methods:A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time,i.e.Chen (7:00-9:00),Wu (11:00-13:00) and Xu (19:00-21:00).The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions (different periods of time,different genders,different acupoints and different states of the acupoints) based on Fei Teng Ba Fa.Results:Finally,thirty subjects dropped out and 438 subjects were included.The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa:latencies of the closing points and adjunct points were significantly different in different periods of time (P＜0.05);the latencies of the males were significantly longer than those of the females (P＜0.05);there was no significant difference in the latency between the left and right sides (P＞0.05);in the female group,there was a significant difference in the latency between the lower-limb points and the upper-limb points (P＜0.05).The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state:in the period of Wu (11:00-13:00),the latencies of the opening points were significantly longer than those of the closing points and adjunct points (P＜0.05);for men,their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points (P＜0.05);despite the gender,the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points (P＜0.05);in the female group,the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points (P＜0.05).Conclusion:Based on Fei Teng Ba Fa,the pain thresholds of the eight confluent points vary in different periods of time,gender,acupoint location and opening/closing state,which can be taken as the evidence of making time-based acupuncture-moxibustion prescriptions.

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

Objective To evaluate the efficacy and safety of adefovir dipivoxil(ADV)in treating patients with hepatitis B e antigen(HBeAg)positive chronic hepatitis B.Methods In this randomized,double blind,placebo-controlled,multicenter trial,210 eligible patients with HBeAg positive chronic hepatitis B were recruited and randomized(randomization ratio was 2:1)receiving ADV 10 mg/d for 48 weeks(ADV+ADV group,n=142)or placebo for 24 weeks followed by ADV 10 mg/d for 24 weeks(PLB+ADV group,n=68).The primary endpoint was virological response. The secondary endpoint was serologic response(HBeAg loss rate and HBeAg seroconversion rate) and alanine aminotransferase normalization rate.Results After 24 weeks therapy,mean reduction of hepatitis B virus(HBV)DNA level comparing with that of baseline was 3.12 log_(10)copy/mL in ADV +ADV group while it was 0.95 log_(10)copy/mL in PLB+ADV group.The percentages of patients with HBV DNA clearance(HBV DNA level

Objective To investigate the status and influencing factors of convalescent patients with heroin dependence in compulsory detoxification.Methods A total of 90 convalescent patients with heroin dependence in compulsory detoxification were recruited and investigated with a self-designed scale,General Self-efficacy Scale (GSES),Social Support Assessment Scale (SSRS) and Self-rating Depression Scale (SDS).Results The mean score of the self-efficacy was (20.97±2.26) points.Multiple regression analysis showed that depression,social support and daily dose of heroin use were influencing factors of the self-efficacy,which could explain 59.1％ of the variance.Conclusions Improving the self-efficacy of convalescent patients with heroin dependence in compulsory detoxification can enhance physical and psychological health and decrease the relapse.

A gap is found between the existing quality of care,and social expectations and the PDCA model.Peking University People's Hospital applied the quality control circle in building a supervision platform for medical quality and sustained improvement of civilized services.This study demonstrated the efforts in this regard made by the hospital,and the major outcomes of the platform in its 6-year practice in identifying service defects,optimizing service processes and sustained improvement of medical services.In addition,it also shared insights on enhanced real-time supervision,standardized management,and long-term mechanisms of the hospital.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.

Objective To explore the risk factors of severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,and antimicrobial drug resistance among these isolates.It may help to prevent and control the disease and promote to rational use of antibiotics.Methods We conducted the case-control study in our PICU.It included 89 patients with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia as case group and 68 patients with severe pneumonia caused by Klebsiella pneumonia as control group during the same period.To compare the two groups on irrationality use of antibiotics (especial for third generation cephalosporin),length of stay,tracheal cannula,time of mechanical ventilation and underlying conditions (malnutrition,congenital heart disease,heredity and metabolic disease).Antimicrobial susceptibilities among 89 multi-drug resistant Klebsiella pneumonia isolates were analyzed.Results There were 63 cases (70.79％) for irrationality use antibiotics in case group,while there were 27 cases (39.70％) in control group (P ＜ 0.01).The cases for length of stay over 7 days in case group (48 cases,53.93％) were more than those cases with the same situation in control group (12 cases,17.65 ％) (P ＜ 0.01).Thirty-eight cases (42.69 ％) needed mechanical ventilation therapy in case group,while 16 cases (23.53％) needed mechanical ventilation therapy in control group (P ＜ 0.01).The cases for duration of mechanical ventilation over 5 days in case group (18 cases,20.22％) were more than those cases in control group (5 cases,7.35％) (P ＜0.05).The cases with underlying disease in case group (13 cases,14.61％) were more than those cases in control group (2 cases,2.94％) (P ＜ 0.05).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to carbapenems.Conclusion Several risk factors are associated with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,including irrational use of antibiotics (especial for third generation cephalosporin),long term of length of stay,endotracheal intubation,long term of mechanical ventilation,and having underlying disease (malnutrition,congenital heart disease,heredity and metabolic disease).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to Carbapenems.Carbapenems should be used as first-line drugs for severe pneumonia caused by multi-drug resistant Klebsiella pneumonia.

Objective To investigate SLC25A13gene mutation in neonatal intrahepatic cholestasis caused by citrin defi-ciency (NICCD). Method A total of 17 children with NICCD were collected. PCR-RFLP method was used to analyze the most common eight mutations of SLC25A13 gene in Chinese populations and results were analyzed together with routine laboratory examinations. Results In the 17 NICCD patients, there were six cases of homozygous mutation, three cases of compound heterozy-gous mutation and eight cases of single heterozygous mutation in SLC25A13 gene. Three kinds of mutations detected were 851del4 (73.1%), 1638ins23 (11.5%) and IVS6+5G>A (15.4%). The seventeen cases showed classical NICCD symptoms of low birth weight, pathological jaundice. And laboratory data suggested liver dysfunction, hyperbilirubinemia, hyperbileacidemia, hy-poproteinemia, hypoglycemia, coagulation disorders, hyperlactacidemia and hyperammonemia. Conclusions 851del4, 1638ins23 and IVS6+5G>A are hot spots of SLC25A13 gene mutation in Chinese populations. PCR-RFLP is a rapid, convenient and reliable technology for NICCD molecular diagnosis.