Objective:To explore the correlation between blood pressure and prethrombotic state indexes in patients with chronic heart failure (CHF) .Methods:A total of 96 cases with NYHA classⅡselected from inpatients of our department from Apr 2010 to Feb 2013 were enrolled into CHF group ,another 90 patients with normal cardiac function were regarded as normal control group .Daytime ,nighttime and 24h blood pressure and related indexes of prethrombotic state were detec-ted in both groups .Correlation between blood pressure variability and prethrombotic state indexes were analyzed .Results:Compared with normal control group ,there were significant rise in nighttime diastolic blood pressure [nDBP ,(80.53 ± 7.73) mmHg vs .(84.74 ± 8.74) mmHg] ,daytime systolic blood pressure standard deviation [dSSD ,(11.87 ± 4.98) mm-Hg vs .(14.97 ± 5.12) mmHg] ,night time SSD [nSSD (11.62 ± 4.83) mmHg vs .(15.05 ± 5.42) mmHg] and 24hSSD [24hSSD ,(12.98 ± 3.22) mmHg vs .(15.75 ± 5.08) mmHg] , P<0.01;and significant increase in plasma levels of von Willebrand factor [vWF ,(75.64 ± 6.83) IU/dl vs .(90.75 ± 7.32) IU/dl] ,D-dimer [ (0.31 ± 0.03) g/L vs .(0.73 ± 0.13) g/L] and plasminogen activator inhibitor-1 [PAI-1 ,(22.33 ± 1.14) μg/L vs .(27.46 ± 1.15) μg/L] in CHF group ,P<0.01 all .In CHF patients ,24hSSD were positively correlated with vWF and granule membrane protein (GMP-140) levels (r=0.403 ,0.452 ,P<0.05 both) ,24hDSD and nDSD were positively correlated with GMP-140 level (r=0.421 ,0.413 ,P<0.05 both) ,there were no significant correlation among other blood pressure variability indexes and PTS indexes , P>0. 05 all .Conclusion:In CHF patients ,blood pressure variability and prethrombotic state indexes levels significantly rise ,the both are significant positive correlation .

OBJECTIVE To investigate the clinical effect of Ashi Dispel-itch solution on treatment of diabetic-candidal vaginitis.METHODS Totally 322 patients were randomly divided into 2 groups,one group was treated with Ashi Dispel-itch solution by fumigating and soaking ill section while the control group with Jieyin solution.The curative effect was divided into 4 grades according to symptoms,body appearance,level of pH,etc.RESULTS The total effective rate due to Ashi Dispel-itch solution was 93.5% and was significantly higher than that of Jieyin solution(P

Objective To study the dynamic changes and clinical significance of D-D, t-PA and PAI in patients with acute renal failure during the process of different methods of blood purification. Methods Thirty-seven ARF patients were divided into three groups: HD group, HDF group and HF group. Plasma D-D level, t-PA and PAI activity were determined 1 hour, 4 hours before and after treatment. Normal control group consisted of fourteen healthy people. Results ① Plasma D-D level and PAI activity in ARF patients were obviously higher than those in control group, while t-PA activity was lower(P0.05). ③ After 4 hours of the treatment, compared with HD group, HDF and HF groups had significant difference in plasma D-D level, t-PA and PAI activity(P

Objective: To analyze the association of thrombocytosis with the prognosis of patients with gastric cancer.Methods: The clinical materials of 782 patients with gastric cancer who underwent initial surgery in our hospital between January 1995 and December 1999 were retrospectively analyzed.Kaplan- Meier and Log-Rank test were used to analyze the data.Prognostic factors were analyzed by multivariate Cox proportional hazards model.Results: Thrombocytosis oc-curred in 11.4% (87/782) patients.The platelet level was not significantly different among patients of different gender, tumor stage, and histological differentiation (P>0.05).However, a significant difference was observed in the platelet level among patients with different age and surgical approach (P<0.05).The 1-, 3-, and 5-year survival rates were 75.0%, 40.1% and 28.9% in patients without thrombocytosis and 52.8%, 16.9%, and 13.5% in patients with thrombocytosis (P=0.002).Univari-ate analysis showed that histological differentiation, pathological stage, surgical approach and thrombocytosis significantly affected the survival of patients.While age and gender had no significant impact on patient survival.Multivariate analysis showed that pathological stage, surgical approach, and thrombocytosis were independent prognostic factors for gastric can-cer.The relative risk of death of patients with thrombocytosis was elevated by 1.454 times (RR=1.454, 95% CI: 1.135～1.861, P=0.005).Conclusion: Thrombocytosis is an independent prognostic indicator for the survival of initially treated pa-tients with gastric cancer.

AIM:To compare the reliability and plaque area between using high-cholesterol diet and high-cho-lesterol diet with corn oil to establish a rabbit atherosclerotic model .METHODS:Eighteen New Zealand rabbits were ran-domly divided into 3 groups (6 rabbits each):normal diet group (group C), high-cholesterol diet group (group H1) and high-cholesterol diet containing 6%corn oil group (group H2).All rabbits were fed for 12 weeks, and their body mea-sured was weighed at the end of every weeks .The serum levels of high-density lipoprotein cholesterol ( HDL-C) , low-den-sity lipoprotein cholesterol ( LDL-C) , total cholesterol ( TC) and triglyceride ( TG) were measured by automatic chemistry analyzer at 0 week and 12 weeks.At the end of 12 weeks, the thoracic aorta of 8-cm length since aortic root was isolated from the rabbit after anesthesia , and stained with Sudan IV or oil red O to verify the existence of plaque .The percentage of plaque area (PA/IA) in the intima area was further calculated by ImageJ 2x software.RESULTS:At the end of 12-week feeding, the serum levels of HDL-C, LDL-C and TC in both group H1 and group H2 were significantly higher than those in group C, and serum TG in group H2 was significantly higher than that in group C .Serum HDL-C in group H2 was signifi-cantly higher than that in group H1, but no significant difference of serum LDL-C, TC and TG between group H1 and group H2 was found .There was no plaque in the intima in group C , and plaques were observed in the intima of all rabbits in group H1 and group H2.Rabbit atherosclerotic models in both group H 1 and group H2 were established with a success rate of 100%.The values of PA/IA in group H1 [(49.74 ±18.78)%] and group H2 [(56.95 ±26.74)%] were both sig-nificantly higher than that in group C (0%), and no significant difference of PA/IA between group H1 and group H2 was observed.CONCLUSION:High-cholesterol diet with or without corn oil can establish a rabbit atherosclerotic model with a success rate of 100%after 12-week feeding , and the percentage of plaque area in the total aortic intimal area is not differ-ent in the 2 feeding methods .

Objective To study the efficacy of medication management, symptom management and community reentry skills-training modules to prevent rural patients with schizophrenia from relapse and increase their social function.Methods 89 subjects were randomly assigned to the skills training group (45 cases) and the control group (44 cases). Both groups received the same treatments, but the skills training courses were given to the skills training group for twelve weeks when the subjects were addmitted into the trial and at their one-year follow-up timepoint respectively. And a two-year follow-up was carried out. All subjects were evaluated with PANSS, SDSS, relapse and employeement.Results 89 subjects had completed the study. The skills training group demonstrated clinical Results significantly superior to those of the control group on overall improvement according to PANSS and SDSS. Substantially, statistically significant advantages of the skills training group were related to 1) the rate of relapse (11.1% vs 31.8%), 2) the rate of employment (37.8% vs 15.9%).Conclusion Medication management, symptom management and community-re-entry skills-training modules are effective in reducing patients' psychiatric symptoms, preventing them from relapse and increasing their social function.

Ferroptosis is a new type of cell death proposed in recent years. It refers to the excessive accumulation of reactive oxygen species under iron dependence, which leads to fatal lipid peroxidation of cells and ultimately leads to cell death. Fatty liver is extremely sensitive to ischemia-reperfusion injury and poorly tolerated. It’s still not understood well, and the therapeutic options are limited for the fatty liver patients. The pathophysiological characteristics of ferroptosis and fatty liver ischemia-reperfusion injury are similar, and the discovery of ferroptosis may provide a new treatment strategy for fatty liver to prevent ischemia-reperfusion injury. This article mainly reviews the mechanism of ferroptosis and the targets related to ferroptosis in fatty liver ischemia-reperfusion injury.

Objective　To establish Huashan diagnostic criteria and clinical classification system for Hirayama disease.Methods　Retrospective analysis 359 cases of puberty onset,upper extremity muscle atrophy as main clinical manifestations,and complete clinical data from September 2007 to August 2018.There were 348 males and 11 females(31.6:1 male and female)in this group.The average age of onset was 16.7±2.2 years,the average age of visits was 19.2±4.5 years,and the average duration of treatment was 29.3±45.4 months.Descriptive study of the clinical manifestations,radiologic and neurophysiological findings of this group of patients,the Huashan clinical diagnostic criteria of Hirayama disease were established by including 100% of the clinical manifestations,imaging and neurophysiological findings.According to the following parameters,the clinical classification system of Hirayama disease was proposed.The parameters specifically included:the muscle atrophy involves the upper limbs,whether the quadriplegia was active or hyperactive,the Babinski sign positive and other pyramidal tract damage,whether it was accompanied by sensory dysfunction such as upper limb numbness,muscle atrophy location,and the progress of clinical symptoms or electrophysiological examination within 6 months.Thirty patients were randomly selected from the above 359 cases.Four orthopedic surgeons who were not involved in the classification system completed the clinical classification within the specified time.The Kappa value was used for the credibility evaluation.Results　The Huashan diagnostic criteria of Hirayama disease included clinical manifestations,imaging examinations and neurophysiological examinations.The main diagnostic indicators were:1)occult onset puberty,more common in men;2)localized muscle atrophy and weakness in the upper extremities;3)compared with the cervical neutral MRI,the MRI of cervical flexion showed that spinal cord was significantly shift forward and the anterior spinal cord was narrowed or disappeared.4)MRI T2 weighting of the cervical flexion showed cyst-wall separation behind the spinal cord;5)Neurophysiological examination showed that the affected muscles were neurogenic damage.6)The affected parts are limited to the middle and lower neck segment.At the same time,it was necessary to combine imaging and neurophysiological manifestations to distinguish cervical spondylosis with upper limb muscle atrophy and motor neuron disease.According to the clinical characteristics of different patients,Hirayama disease can be divided into type I-III.Type I:72.1%,one-sided upper limb or one upper limb-based hand inner muscle and forearm muscle atrophy.According to whether progress of symptoms or electrophysiological examination was seen in the past 6 months,type I can be divided into:Ia.stable period.Regular follow-up assessment was recommended.If the disease progressed,to wear a cervical collar was suggested;surgery could be done if necessary;Ib.progression period,it was recommended to use a cervical collar,and regularly evaluate,if patients could not wear cervical collar for long,it was recommended to operate.Type II:14.2%,unilateral upper limb or one upper limb-based hand inner muscle and forearm muscle atrophy with pyramidal tract injury.Surgery was recommended.Type II:13.7%,atypical Hirayama disease,including upper limb proximal muscle atrophy,symmetrical double upper limb muscle atrophy,and sensory disturbances associated with upper limb numbness.Wear a cervical collar,and follow-up and assess closely,and choose surgical treatment if necessary.The credibility evaluation showed that the average Kappa value of the classification was 0.732(0.688-0.834),which is a basic credibility.Conclusion　The Huashan diagnostic criteria of Hirayama disease was conducive to the early diagnosis.The clinical classification system of Hirayama disease has good credibility and good clinical intervention guidance value.

Objective　To investigate the impact of the loss of attachment on the outcomes in Hirayama disease(HD)patients treated with anterior cervical discectomy and fusion(ACDF).Methods　A total of 26 patients(23 males and 3 females)who were diagnosed as HD and received 2 levels of ACDF surgery from February 2014 to November 2016 were enrolled in the present study.All patients took the MRI at both flexion and neutral position pre-operation and MRI at flexion position post-operation.The measured parameters related to performance of "loss of attachment" include:the distances between the posterior edge of the spinal cord and the cervical spinal canal(x),the anterior and posterior wall of the cervical spinal canal(y),the anterior-posterior(a)and the transverse diameter(b)of spinal cord cross sections.The value of the cervical spinal cord deformation(flexion position a/b)and the cervical spinal cord forward movement(flexion position x/y-neutral position x/y)were calculated,and the centrums refer to the performance of "loss of attachment" were also recorded.DASH scores and grip strength on both sides were recorded before and 1 year after operation.The 26 patients were divided into two groups,17 patients(17/26,65.4%)in improvement group with the decreased DASH scores and the other 9 patients(9/26,34.6%)in no improvement group.Logistic regression and ROC curve were used to analyze the influence factor of anterior cervical discectomy and fusion(ACDF)surgery on patients with Hirayama disease.Results　After surgery,the value of a/b significantly increased(t=4.27,P=0.001)and x/y significantly decreased(t=10.25,P=0.001).The performance of "loss of attachment" in 88.5%(23 of 26)patients disappeared after surgery,while the DASH score(P=0.06),and the grip strength of severe and mild side(P=0.36 and P=0.42)shew no obvious change.65.4%(17 of 26)patients shew a decrease in DASH scores after operation,the remaining 34.6%(9 of 26)patients shew no obvious change,several even with a mild increase.The segments refer to performance of "loss of attachment",the value of the cervical spinal cord de-formation and the cervical spinal cord forward movement shew a difference between the two group(t=-5.56,P=0.001;t=3.06,P=0.005;t=-3.76,P=0.001).The logistics regression analysis with the above three independent variable confirmed that the value of segments that refer to "loss of attachment" was the factor of the post-operative efficacy of ACDF surgery on patients with Hirayama disease(OR=6.963,P=0.001).And the ROC curve shew AUC=0.902,Jordan index=0.83,critical value=4.5.Conclusion　The anterior cervical discectomy and fusion(ACDF)surgery can effectively improve the loss of attachment at the surgical segments,and prevent the progress of upper limb dyskinesia.And range of the longitudinal separation refers to "loss of attachment" can impact the outcomes of ACDF surgery,more segments for fusion may be need in order to improve the outcomes of those patients with the range more than 5 segments.

Objective　To investigate the predictive value of dynamic F wave in the treatment of Hirayama disease(HD)after anterior cervical fusion and internal fixation.Methods　From February 2014 to January 2016,thirty-six patients with HD were included in this study(age:17.9±2.6 years,height:173.1±6.2 cm,disease duration:20.1±13.1 months;male to female ratio:35:1),and all of these 36 patients underwent anterior cervical autogenous iliac fusion and internal fixation.All of these patients underwent bilateral dynamic F-wave detection(The F-wave was tested on the cervical standard position and at least 30 minutes after cervical flexion)on the median nerve before operation and 3-5 days after operation.The latency and maximum amplitude of M-wave,the persistence of F-wave,the shortest latency of F-wave,the ratio of F/M and the persistence of repeated F-wave were measured.Dynamic F-wave abnormalities were defined when repeated F-wave was only found during neck flexion or the standard-flexion difference of each measurements of F-wave was more than 2 standard deviations from the normal value(the shortest latency of F-wave:0.6±0.5 ms,persistence of F-wave:7.3%±5.7%,the ratio of F/M:1.1±1.0).Furthermore,these patients with HD accepted both bilateral grip strength and hand function score(disabilities of arm,shoulder and hand,DASH)before and 1 year after operation.According to the presence of abnormal dynamic F-wave before operation,patients were divided into abnormal dynamic F-wave group and normal dynamic F-wave group.Fisher exact test was used to compare the percentage of the patient with improved DASH score in both patient groups after operation.Both DASH score and bilateral grip strength were analyzed by paired sample t test before and after operation.Results　Before operation,eleven(11/36,30.6%)patients with HD had abnormal dynamic F-wave,and there was no significant difference of age(t=-0.849,P=0.412),duration(t=1.110,P=0.282),DASH scores(t=2.002,P=0.055)and handgrips(more-symptomatic side:t=-0.673,P=0.507;symptomatic side:t=-1.729,P=0.094)between the patients with or without preoperative dynamic F-wave abnormalities.One-year follow-up demonstrated that significantly greater number of the patients presented with reduced DASH scores in the patients with preoperative dynamic F-wave abnormalities(10/11,90.9% vs 12/25,48.0%;P=0.025).Compared with the patients without preoperative dynamic F-wave abnormalities,the patients with preoperative dynamic F-wave abnormalities showed reduced DASH scores after operation(t=2.347,P=0.041).Furthermore,abnormal dynamic F-waves disappeared soon after operation in ten patients(90.9%,10/11)with preoperative dynamic F-wave abnormalities,and DASH scores reduced significantly in these ten patients after operation(4.4±3.8 vs 1.5±0.4,t=3.094,P=0.013),and the DASH score in another patient whose dynamic F wave did not disappear after operation increased significantly one year after operation(preoperative vs.postoperative:6.66 vs 9.87).Conclusion　Dynamic F-wave can be used as a preoperative evaluation method for HD to predict the recovery of upper limb function after operation.At the same time,the comparison of dynamic F-wave before and after operation is an effective and immediate method to evaluate the effectiveness of surgical treatment of HD.