Objective To assess the feasibility,safety,and effectiveness of early rapid icy normal saline infusion to attain mild hypothermia in cardiac arrest patients. Methods A single-center prospective randomized controlled trial was conducted. From March 2011 to October 2013,patients who had recovery of spontaneous circulation (ROSC)after cardiopulmonary resuscitation (CPR)in Beijing Daxing District People's Hospital were randomly divided into two groups. In icy normal saline group,patients received a rapid infusion of 1 000 mL of 4 ℃ normal saline intravenously to attain a mild hypothermia. In the control group,the patients were treated with ice bag on head,and axillary temperature was monitored. For all patients,rectal temperature was measured and recorded immediately and 1 hour later . The occurrence of pulmonary edema on initial chest X-ray at 6 hours ,occurrence of tremor within 48 hours,ventricular fibrillation recurring within 48 hours,and consciousness or death within 14 days were recorded. Results A total of 45 patients were enrolled,including 23 patients in icy normal saline group and 22 in control group. The patients in icy normal saline group had a rectal temperature descended from(36.7±0.9)℃to(34.9±0.7)℃1 hour later,while the patients in control group had a rectal temperature risen from(36.5±1.0)℃to(37.9±0.9)℃1 hour later. There was significant difference in rectal temperature between two groups (t=2.228,P=0.031). The number of patients who successfully awaken within 14 days in ice normal saline group was significantly larger than that in control group (13 cases vs. 7 cases,χ2=65.710,P=0.021). There was no statistical difference in the occurrence of acute pulmonary edema (4 cases vs . 6 cases),tremor (2 cases vs . 0 case),ventricular fibrillation recurrence (4 cases vs. 5 cases)and death within 14 days (11 cases vs. 12 cases,all P>0.05). Conclusions The study shows that early rapid i.v. infusion of 4℃normal saline is feasible,safe and effective for cerebral resuscitation.

Objective:To evaluate the effect of emodin on acute rejection after orthotopic liver transplantation(OLT) in rats.Methods:The LEW→BN OLT models were established.A total of 45 rats were divided randomly and equally into 3 groups:group A was treated with normal saline at dose of 0.5 ml/d intraperitoneally from 1st day to 8th day after operation;Group B,CsA at dose of 10.0 mg?kg-1?d-1;Group C,emodin at dose of 50.0 mg?kg-1?d-1.8 days after operation,6 recipients of each groups were killed for confirming rejection-active index(RAI) and hepatocellular apoptosis index(AI) by observing the pathologic change of transplanted liver in recipients.The other recipients were raised for observing the survival time.Results:Respectively,the survival time(days) of group A,B,C was 9.50?1.64,21.57?2.15,21.29?2.21.The survival time of group B,C was significantly longer than that of group A(P0.05).Respectively,the RAI of group A,B,C was 7.67?0.9,5.17?0.40,5.83?0.75 and the AI of group A,B,C was 35.83?2.32,15.83?1.33,16.50?2.35.The RAI and AI of group B,C was significantly lower than that of group A(P0.05).Conclusion:Emodin can reduce the hepatocellular apoptosis and suppress the acute rejection after OLT in rats.

Objective To analyze the relative factors for the prognosis in elderly patients with stroke,and provide theoretical basis for improving prognosis.Methods 188 elderly patients with stroke were treated in our department from Jan.2011 to Nov.2013,and clinical data was analyzed.The prognosis and relative risk factors for stroke were statistically analyzed.Results 99 cases had good prognosis,89 cases had poor prognosis,and the recovery rate were 52.7％ (99/188) and 47.3％ (89/188) respectively.The age was older in group of good prognosis than in group of poor proghosis (t=1.7930,P＜0.05).Univariate analysis showed that the age,position of cerebral infarction,size of lesions,hypertension,diabetes,drinking and smoking were associated with the prognosis of stroke (t=1.7930,x2 =8.6473,15.046,13.1334,4.1536,5.7004,5.9043,respectively,all P＜0.05),while the prognosis was not associated with gender,a family history of stroke,hyperlipidemia and heart disease.Multivariate logistic regression analyses revealed the prognosis of stroke was related with risk factors of age (OR=1.072),size of the lesion (OR=3.481),hypertension (OR=2.034),diabetes (OR=1.631) and smoking (OR=3.144).Conclusions It is beneficial to the prognosis of patients with stroke to stop bad habits and to treat hypertension and diabetes actively.

Objective To evaluate the effect of hydrogen-rich saline on inflammatory responses during transient cerebral ischemia-reperfusion (I/R) in rats.Methods Forty-five male Sprague-Dawley rats,aged 5-6 yr,weighing 180-250 g,were randomly divided into 3 groups (n =15 each) using a random number table:sham operation group (group S),group I/R and hydrogen-rich saline group (group H).The rats were anesthetized with intraperitoneal 10％ chloral hydrate 0.3 ml/100 g.Transient cerebral ischemia was induced by bilateral common carotid artery occlusion with hypotension for 15 min,followed by reperfusion.Five rats were randomly chosen from each group,and Morris water maze was used to assess the cognitive function starting from 5 days before establishment of the model.Place navigation test lasted for 5 consecutive days.The escape latency,swimming speed and swimming distance were recorded.Spatial probe test was carried out on 1 and 3 days after establishment of the model.The time of staying at the target platform quadrant,frequency of crossing the original platform and swimming speed were recorded.The rats were sacrificed after the end of spatial probe test on 3 days after the model was established,and hippocampi were removed to examine the morphology of neurons in hippocampal CA1 region with light microscope.Five rats randomly chosen from each group were sacrificed on 1 day after the model was established,and hippocampi were removed to detect the contents of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β).The rest 5 rats in each group were sacrificed,and hippocampi were removed for determination of nuclear factor kappa B (NF-κB) activity (by immuno-histochemistry).Results In place navigation test before the model was established,the escape latency and swimming distance were gradually shortened with the prolonging training time,and no significant change was found in the swimming speed with the prolonging training time in the three groups.Compared with group S,the time of staying at the target platform quadrant was significantly shortened,and the frequency of crossing the original platform was reduced on 1 and 3 days after establishment of the model,and the contents of TNF-α and IL-1β and NF-κB activity were increased on 1 day after establishment of the model in group I/R.Compared with group I/R,the time of staying at the target platform quadrant was significantly prolonged,and the frequency of crossing the original platform was increased on 1 and 3 days after establishment of the model,and the contents of TNF-α and IL-1β and NF-κB activity were decreased on 1 day after establishment of the model in group H.There was no significant change in the swimming speed during spatial probe test on 1 and 3 days after establishment of the model.Conclusion The mechanism by which hydrogen-rich saline reduces transient cerebral I/R injury may be related to inhibition of inflammatory responses in rats.

The implementation of the global budget system requires the hospitals to be supported by advanced medical insurance information management systems.The design and application of the medical insurance information management platform at the hospital can optimize management processes,improve the management level,save management costs,establish database,and promote the development of medical insurance.

Objective To investigate the chemical constituents of Citrus medica var. sareodactylis from Sichuan province, and to provide evidence for the development and utilization and quality evaluation of the medicinal material.Methods Various chromatographic techniques were used to purify the components of this herb. Compounds were identi-fied by their physical characteristics and spectral feature. Results Seven compounds were isolated from Citrus medica var. sarcodactylis, and they were identified as sibiricol (Ⅵ), 7-methylesculetin (Ⅶ), bergapten (Ⅷ), sigmasteryl acetate(Ⅸ), 5-methoxyfurfural(Ⅹ), limonin(Ⅺ), daucosterol (Ⅻ). Conclusion Compound Ⅵ, Ⅶ and Ⅸ are isolated from plants of Rutaceae for the first time.

Objective To investigate the effect of physician guidance on cigarette cessation in current smokers with chronic obstructive pulmonary disease(COPD).Methods Cigarette cessation education and routine telephone follow-up was provided for 70 COPD patients.Pulmonary function and exhaled carbon monoxide level were detected every 3 months.Results After 6 months' follow-up,28 participants(40.00%) successfully quitted cigarette smoking.Seventeen subjects (24.28%) experienced relapse,with mean cessation time(3.08±0.33) months.Once receiving physician guidance,5 re-attempted to quit cigarette smoking,and 12 reduced tobacco consumption. Sixteen subjects(22.86%) did not quit smoking,although the mean cigarette consumption per day was decreased by 60%.Nine participants (12.86%) showed no change in smoking habit. Conclusion Physician guidance could impreve the rate of cigarette cessation in COPD patients.Intensive intervention may be correlated with successful smoking cessation.

Objective To study the diagnostic value of thin-slice reconstruction of multi-slice spiral CT(MSCT) in solitary pulmonary nodule(SPN).Methods 55 cases of SPN confirmed by pathology were analysed retrospectively.All cases underwent chest MSCT scan and thin-slice reconstruction images were obtained at 10.0 mm,5.0 mm,2.5 mm and 1.25 mm thickness.The detecting rate of CT findings of SPN on different thickness CT images was evaluated,and the effect of thin-slice images and traditional CT scan in diagnosing benign and malignant pulmonary nodules ?2 test.Results(1)In detecting rate of CT findings of SPN,the thin-slice(1.25 mm) reconstruction was better than traditional CT(P

OBJECTIVE:To optimize the ethanol extraction process of anti-atherosclerosis effective fraction of Lindley eupatorium. METHODS:Using the contents of hyperin,quercetin,kaempferol and jaceosidin as indexes,the effects of ethanol volume fraction,liquid-solid ratio,extraction time and extraction times on ethanol extraction technology were investigated. By multiple index scoring method,orthogonal test was designed to optimize extraction technology,and validation test was conducted. RESULTS:The optimal extraction technology was 70% ethanol as extraction solvent with solid-liquid ratio of 12 : 1,reflux extracting for 3 times,2 h each time. Results of 3 batches of validation tests showed that the contents of 4 marker components were in high level,being 5.305 3,1.560 1,1.986 5,6.703 6 mg/g in average(RSD<1.1%,n=3). Results of validation tests were stable and reliable,and were in good agreement with the results of orthogonal tests. CONCLUSIONS:The optimized ethanol reflux extraction technology of L. eupatorium is stable and reliable,and performs well. Energy consumption and cost are suitable for industrial production.The results provide technology basis for further purification and enrichment of anti-atherosclerosis effective components of L.eupatorium.

Objective:To investigate cognitive function changes and their influential factors in patients with ischemic stroke and leukoaraiosis.Methods:A total of 500 patients with ischemic stroke who received treatment in Yiwu Central Hospital from January 2018 to October 2019 were included in this study. They were divided into simple ischemic stroke group ( n = 200) and ischemic stroke complicated by leukoaraiosis group (combination group, n = 300). The infarct location and the degree of leukoaraiosis in the combination group were analyzed. An additional 150 volunteers who concurrently underwent the Cognitive Function Test in the same hospital were selected as controls. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Patients in the combination group were divided into cognitive impairment group (MoCA score ≥ 26 points) and non-cognitive impairment group (MoCA score < 26 points) according to MoCA score. The risk factors of cognitive impairment in patients with ischemic stroke and leukoaraiosis were analyzed. Results:The scores of the MMSE, MoCA, Clock Drawing Test (CDT), Verbal Fluency Test (VFT), and Digit Span Test (DST) in the control group were (28.93 ± 2.70) points, (28.35 ± 2.74) points, (4.69 ± 1.14) points, (4.94 ± 0.42) points, and (14.33 ± 1.66) points respectively. They were (26.92 ± 2.18) points, (25.02 ± 3.52) points, (3.61 ± 1.60) points, (4.77 ± 0.46) points, and (11.73 ± 1.16) points, respectively in the simple ischemic stroke group and (24.91 ± 2.79) points, (20.70 ± 3.06) points, (2.87 ± 1.23) points, (4.07 ± 0.85) points, and (10.82 ± 0.93) points respectively in the combination group. There were significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST among the three groups ( F = 124.50, 318.50, 93.43, 112.60, 428.60, all P < 0.001). Significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST were observed between patients with different degrees of leukoaraiosis ( F = 69.09, 102.40, 20.98, 60.90, 57.00, all P < 0.001). Spearman correlation analysis results showed that the scores of the MMSE, MoCA, CDT, VFT, and DST were negatively correlated with the degree of leukoaraiosis ( r = -0.61, -0.69, -0.43, -0.56, -0.44, all P < 0.05). Logistic regression analysis results showed that age, history of smoking and drinking, history of diabetes, history of stroke, and infarct location were the independent risk factors for cognitive impairment in patients with ischemic stroke and leukoaraiosis. Education level was a protective factor against ischemic stroke and leukoaraiosis. Conclusion:The degree of cognitive impairment in patients with ischemic stroke and leukoaraiosis is related to the degree of leukoaraiosis. Age, history of smoking and drinking, history of diabetes, history of stroke, infarction location, and education level are the influential factors of cognitive impairment.