Objective To study the effect of vitro thrombolytic test on the consumptions of urokinase(UK) in thrombolytic therapy of acute cerebral infarction.Methods The patients of acute cerebral infarction were treated with UK at the dose determined by vitro thrombolytic test,and then were given UK 40MU each day in the later 7 days.The degree of neurologic impairment,fibrinogen(Fbg) level,polyreaction speed(FMPV) and maximum luminosity(ODmax) were examined at different time point.Results Thrombolytic therapy could significantly reduce neurologic impairment as compared with control group((P

ObjectiveTo evaluate validity,reliability and sensitivity of Chinese version quality of life in epilepsy inventory for adolescents (QOLIE-AD-48).Methods 143 cases of young epilepsy patients were tested with QOLIE-AD-48 and analyze validity,reliability and sensitivity of the scale.ResultsPolymerization/discriminant validity showed that there was correlation above 0.4 about each question within the subscale and its component table.Structural validity showed that all of the component list was significantly associated with total score (P ＜ 0.01 ).The cronbach's α coefficient of the scale was 0.92,and 0.62 ～ 0.90 of the subscale,and ICC was 0.81.Good sensitivity was the total score decline with the increase of seriousness.ConclusionChinese version QOLIEAD-48 has good validity and reliability and sensitivity.

Aim To investigate the role of TNF-αin propofol-induced neuronal apoptosis and long-term cog-nitive impairment in neonatal rats .Methods Seven-day-old SD rats were randomly divided into 3 groups:Control group ( n =12 ) , P ( single ) group ( n =6 ):propofol 50 mg · kg -1 was injected intraperitoneally (ip.)once;P(repeated) group(n=6):propofol 50 mg · kg -1 was injected ip.once daily, and for seven times. Hippocampal TNF-αlevel was measured 2 hours after propofol anesthesia , there were two time points(n=6) in Control group as control levels (post-natal day 7 for P ( single ) group and postnatal day 13 for P ( repeated ) group ) .In another experiment , 7-day-old rats were randomly divided into 5 groups:Con-trol group; P ( single ) group; P ( repeated ) group; P ( single ) +ETN group: ETN ( etanercept ) 0.4 mg · kg -1 was injected intracerebroventricularly 30 min be-fore propofol administration; P ( repeated ) +ETN group:ETN 0.4 mg· kg -1 was injected intracerebrov-entricularly 30 min before the 1st and 4th administration of propofol , which was injected ip .for seven times , once daily .Hippocampal neuronal apoptosis was detec-ted at postnatal day 7 [ P ( repeated ) and P ( repeated )+ETN groups not involved at this time point ] , 13, 21 and 35 , cognitive function was measured at postnatal day 36 to 41 using Morris water maze test .Results Propofol with different exposure times could increase hippocampal TNF-αlevels(P<0.05,P<0.01);in P ( single ) group, active caspase-3 positive neurons in hippocampal pyramidal cell layer were much greater than control level only at postnatal day 7 ( P<0.05 ) , there were no changes of escape latency or platform crossing times compared with control ( P>0.05 );in P ( repeated ) group, active caspase-3 positive neurons were more significantly increased at postnatal day 13, 21 and 35 than those in control group ( P<0.01 ) , es-cape latency was increased or platform crossing times were decreased more significantly than control in Morris water maze test ( P <0.01 ); after etanercept was ad-ministered intracerebroventricularly , there were no sig-nificant changes of active caspase-3 positive neurons , escape latency and platform crossing times after propo-fol anesthesia compared with control ( P>0.05 ) .Con-clusion TNF-αmediates hippocampal neuronal apop-tosis and long-term cognitive impairment induced by propofol in neonatal rats , and long-term cognitive im-pairment may be related with persistent neuronal apop-tosis.

Objective:To assess the effect of patient-controlled intravenous analgesia (PCIA) with different postoperative analgesics on prognosis after colorectal surgery. Methods:A total of 460 colorectal cancer patients (TNMⅠ-Ⅱ) who underwent elective surgery within January 2010 to December 2012 in Chongqing Cancer Hospital were randomly divided into five groups for PCIA with sufentanil, dezocine, butorphanol, morphine, and tramadol. We evaluated the analgesic efficacy, detected NK cell activity and Th1/Th2 ratio from peripheral blood, and observed short-term complications and long-term cancer recurrence and metastasis. Healthy volunteers served as the control group. Results:The morphine group displayed a VAS score of less than 3 in the rest state and showed the longest hospital stay and the highest incidence of pruritus (P<0.05). The incidence of postoperative nausea and vomiting was the highest in the tramadol group (P<0.05). NK cel activity and Th1/Th2 ratio decreased in al experimental groups after surgery. NK activity and Th1/Th2 ratio returned to the control level 7 days after surgery in the tramadol and sulfentanil groups and 14 days after surgery in the dezocine and butorphanol groups (P>0.05), whereas those in the morphine group remained low (P<0.05). The incidences of cancer recurrence and metastasis were ranked as follows:morphine>butorphnol>dezocine>sufentanil>tramadol. Conclusion:Tramadol and sufentanil used in PCIA after colorectal surgery could facilitate the recovery of immune function and reduced the incidence of recurrence and metastasis.

Objective To evaluate the low-dose dual-source whole-body CT angiography in assessing the arteries of Takayasu’s arteritis (TA).Methods Low-dose whole-body CT angiography(CTA)was performed in 57 consecutive patients with suspected TA. The scanning parameters were performed with tube voltage 80 kV and attenuation-based tube current modulation with a referenced tube current at 300 mAs.The volume CT dose index (CTDIvol)and dose-length product (DLP)were obtained for all scans.Subjec-tive and objective image quality of different arteries were assessed in seven anatomic territories,including intracranial,cervical,tho-racic,abdominal,upper extremity,thigh and shank.In addition,CT findings of whole-body arteries were recorded.Results Forty out of fifty-seven patients with definite diagnosis of TA enrolled in this study.Mean CTDIvol and DLP for all patients were (2.5± 0.9)mGy and (403.7±91.4)mGy·cm,respectively.The scoring order of subjective and objective iamge quality was neck,chest, abdomen,thigh,upper extremity,head and shank.5.9% of intracranial arteries,3.3% of lower extremity arteries and 0.5% of upper extremity arteries were extra detected.Conclusion The extra CT findings of intracranial,lower extremity and upper extremity arter-ies provides a more comprehensive evaluation of whole-body arteries involvement.

Objective To summarize the characteristics of epidemiology,clinic and radiography of mycoplasma pneumoniae pneumonia(MPP) in children.Methods Two hundred and one MPP patients were selected as our subjects who hospitalized in Kailuan General Hospital Affiliated to Hebei United University from Jan.to Dec.2013.All clinical data were recorded.Results Of 412 children with pneumonia,201 children were developed MPP(48.97％).There was significant difference among different age groups regarding of MPP incidence rate(x2 =62.04,P ＜ 0.05),and the highest incidence was in school-age group(71.59％).There was significant difference among the different month,and the MPP cases were more occurred at January,July,September,October and November.The main clinical manifestations were cough (201cases,100％),fever(136 cases,67.66％),moist rales (168 cases,83.58％),breathing (58 casses,28.86％).And parts of children (23.38％) were complicated with extra pulmonary symptoms.The blood WBC of most MPP patients were without obvious increase and blood WBC of 136 cases(67.66％) was less than 10 × 109/L.The cases with hsCRP (＜ 5 mg/L or-10 mg/L) accounted for 36.32％ or 22.39％.Imaging examination results showed that 64 cases were with bronchovascular shadow,73 cases with spot and schistic shadow,64 cases with lobar pneumonia and 3 cases with pleural effusion.Conclusion Clinicians sholud make the early diagnosis and treatment of MPP based on epidemiology,clinical and image comprehensive characteristics of MPP.

Objective To study direct economic loss of healthcare-associated infection (HAI)in hospitalized children with acute respiratory infection (ARI),and the influence in satisfaction degree of children’relatives.Methods Clinical data of 1 039 children with ARI in a pediatrics ward between April 1,2012 to March 31,2013 were analyzed retrospective-ly.50 patients with HAI were in case group and 50 patients without HAI were in control group.The difference in medical cost and the degree of satisfaction of children’s relatives were compared between two groups.Results Medical cost of pa-tients in case group was significantly higher than control group([P 25 - P 75 :￥3 095.54 - ￥4 779.48]vs [P 25 -P 75 :￥1 744.14-￥2 382.07],Z =5.89,P <0.01).The expenses in medicine,laboratory examination,diagnosis and treatment,and nursing in case group were all higher than control group,there were significant differences between two groups(all P <0.01 );Hospitalization day of case group was significantly longer than control group ([P 25 -P 75 :9 d-15 d]vs[P 25 -P 75 :6 d-8 d],Z =5.79,P <0.01 ).Satisfaction degree of patients’relatives in case group was significantly lower than control group (Z =8.22,P <0.01).Conclusion HAI occurred in ARI children can increase medical cost,prolong length of hospital stay and decrease satisfaction degree of patients’relatives.

Objective To prospectively investigate the association between serum uric acid concentration and the risk of brain infarction in Chinese adults.Methods In this prospective cohort study,a total of 95 738 participants (aged 18-98 years old) were included and were categorized into sex-specific quintiles according to serum uric acid concentration which were collected during 2006-2007 by health examinations.The study was followed up for an average of 4 years.We used Cox regression models to calculate hazard ratios (HR) and their 95％ confidence intervals (CI).Results (1) Higher concentrations of serum uric acid were associated with older age,obesity,higher blood pressure,higher serum concentrations of total cholesterol,triglycerides,and high sensitivity C-reactive protein,smoking,alcohol drinking,history of hypertension,hyperlipidemia and atrial fibrillation,and antihypertensive medication use.(2) The incidence of brain infarction for sex-specific quintiles were 0.84％ (33/3913),0.35％ (14/3985),0.44％(17/3888),0.54％ (21/3909),0.91％ (35/3860) in women (x2 =15.676,P =0.003) and 1.18％(180/15 238),1.26％ (191/15 170),1.11％ (170/15 323),1.45％ (221/15 216),1.82％ (277/15 236)in men (x2 =36.641,P =0.000).(3) After adjusting for potential confounders,including age,body mass index,blood pressure,fasting plasma glucose,total cholesterol,triglyceride,smoking,alcohol,and medical history of major chronic conditions and antihypertensive medication use,the HR (95％ CI) of brain infarction across serum uric acid quintiles were 2.06 (1.14-3.72),0.91 (0.45-1.84),1.00 (ref),1.11 (0.58-2.09),1.31(0.73-2.34) in women and 1.07 (0.86-1.34),1.02 (0.47-2.25),1.00 (ref),1.23(1.00-1.52),1.24(1.01-1.52) in men.Conclusions In this prospective cohort study,we find a U-shaped relationship between serum uric acid concentrations and brain infarction,a higher risk of developing brain infarction in association with low or high serum uric acid concentrations.Women with lowest or highest serum uric acid concentrations and men with higher serum uric acid concentrations are more likely to develop brain infarction.This probably because women have lower serum uric acid concentrations relative to men.Confirmation of our findings in larger cohorts with longer follow-up duration is warranted.

ObjectiveThe study is to investigate the predictive values of dosimetric parameters and patient related factors in severe acute radiation pneumonitis (SARP) after concurrent chemoradiotherapy in non-small cell lung cancer (NSCLC).Methods In all,147 NSCLC patients treated with concurrent chemotherapy and 3DCRT between 2006 and 2010 was collected.Independent sample t test was used to compare parameter values between patients with SARP and those without SARP.Logistic regression was used to identify significant determined factor.Predictive value of each parameter was tested by ROC analysis.Pearson correlation was used to analyze correlations between parameters.Represent factors were identified by factor analysis.ResultsThe incidence of SARP was 9.5％ ( 14/147 ).The means lung dose (MLD),V20,V30,V40,and V50 ( x2 =4.87 -6.84,P =0.009 -0.025,respectively ) were determining factors for SARP.Our datasets shows that for SARP ＜5％,MLD,V20,V30,V40 and V50 should be ≤16.77 Gy,V20≤34.15％,.V30 ≤23.62％,.V40 ≤ 18.57％,V50 ≤ 13.02％.ROC analysis show that areas under MLD,V20,V30,V40 and V50 curves was corresponding to 0.678,0.661,0.667,0.677,and 0.651,respectively.In addition,the sensitivity and specificity of each parameter at cutoff values are:78.0％ and 48.1％ for MLD;42.9％ and 82.0％ for V2o ;78.6％ and 52.9％ for V30 ;71.4％ and 61.7％ for V40,and 57.1％ and 67.7％ for V50.Factor analysis suggest that we can choose 1 or 2 parameters from MLD,V20,or V30,and another from V40 or V50 for predicting.The incidence of SARP was greater in patients with tumorsin right lower lung than other locations ( 22.2％ vs 6.7％,x2 =6.19,P =0.0 2 3 ).Conclusions The MLD,V20,V30,V40 and V50 are determining factors for SARP.As predictive value of each parameter alone is relatively week,using two or more parameters to predict SARP is recommended.

OBJECTIVE To explore the application of the modified scalp coronal incision in the treatment of zygomatic and zygomatic arch fracture, and analyze its prognosis. METHODS A retrospective analysis of 236 cases with zygomatic and zygomatic arch fracture from 2008 to 2016 was performed. They were treated with zygomatic and zygomatic arch fracture open reduction and firm fixation by the modified scalp coronal incision and postoperative mouse rehabilitation. After 3-6 months, the infection of incision, facial paralysis, occlusal, degree of mouth opening, facial deformity and subjective satisfaction index were followed up. The prognosis and recovery were evaluated. RESULTS 1. All of the patients had no postoperative incision infection, subcutaneous hematoma, temporal region sag, bald, and permanent facial paralysis. They all got satisfied face recovery. 2. All patients with occlusal disorders and limited mouth opening obtained functional occlusal and ideal degrees of mouth opening. Satisfaction was 97％. CONCLUSION The modified coronal scalp incision in the reconstruction of 3 d structure of zygomatic and zygomatic arch, has the advantages of a clear operation field and accurateresetting, good restoration of face, concealed scar. It contributes to the protection of the facial nerve and vascular structureand reduces the incidence of surgical complications.