Objective To investigate the expression and clinical significance of clusterin (CLU ) in acute cerebral infarction (ACI) .Methods A total of 154 inpatients with ACI within 48 h of the first onset in the First Affiliated Hospital of Nanchang Uni‐versity from May to December 2013 served as the ACI group and divided into subgroups according to the neural function defection degree and whether having plaque .Contemporaneous 45 individuals undergoing the healthy physical examination were selected as the control group .The serum CLU and complement C3 levels were detected .The National Institutes of Health Stroke Scale (NIH‐SS) and Barthel index scores were conducted ,the rehabilitation course and outcome until 90 d after onset were followed up ,and the comparative analysis on serum CLU level was performed .Results The serum CLU and complement C3 levels in the ACI group were significantly higher than those in the control group ,the differences were statistically significant (P<0 .01) ,moreover serum CLU was positively correlated with the complement C3 level in ACI patients(r=0 .430 ,P=0 .000) .The CLU level in the patients with plaque and severe neural function defection was higher than that in the patients without plaque and mild neural function defec‐tion ,the differences were statistically significant (P<0 .01 or P<0 .05) .Except serum CLU level had no statistical difference be‐tween the recovery group and significantly effective group (P>0 .05) ,the serum CLU level had statistically significant differences among other prognosis types of the patients groups (P<0 .01 or P<0 .05) .The lower the serum CLU level ,the rehabilitation the better .Conclusion CLU play a role by regulating the complement system after cerebral infarction occurrence ,serum CLU level is correlated with carotid arterial plaque ,neurological function defection degree and prognosis in ACI patients ,which can serve as one of biochemical indicators for evaluating the disease condition and guiding prognosis in ACI patients .

The ubiquitin-proteasome system(UPS) containing ubiquitin-activating enzyme(E1),ubuquitin-conjugating enzyme(E2s),ubiquitin-ligase(E3s) and 26S proteasome,is involved in the degradation of most intracellular proteins.One major function of UPS is to prevent accumulation of non-functional and potentially toxic proteins.Moreover,it has become clear that the UPS fulfills an important function in most aspects of eukaryotic biology,such as inflammation,cell proliferation,intracellular signaling,transcriptional control,and apoptosis.Recent studies demonstrated that the UPS regulates the initiation and progression of atherosclerosis,ischemia-reperfusion injury,familial cardiomyopathies,hypertrophic and heart failure.This review briefly summarizes current knowledge about structure,function,regulation of UPS and its pathophysiological role in cardiovascular diseases.

Myocardin is a remarkably potent transcriptional coactivator which specifically expresses in cardiovascular system and directly binds to serum response factor.It activates transcription of a subset of SRF-regulated genes encoding cardiomyocytes and smooth muscle cells contractile proteins.Abnormal expression of myocardin is associated with cardiovascular diseases including atherosclerosis,myocardial hypertrophy and hypertension.Here,recent developments in the structure,expression and regulation of myocardin and its relation with cardiovascular diseases are reviewed.

Objective To determine the median effective dosage of 0.5% ropivacaine for ultrasoundguided lateral popliteal sciatic nerve block. Methods Twenty-three ASA Ⅰ or Ⅱ patients of both sexes, aged 19-20 yr weighing 52-90 kg received lateral popliteal nerve block guided with ultrasound for foot and ankle surgery.The volume of 0.5% ropivacaine injected was determined by the response of the previous patient using an up-anddown technique. The initial volume was 18 ml. Each time the volume increased/decreased by 2 ml.Successful nerve block was defined as complete loss of pinprick sensation in both tibial and common peroneal nerve distribution with concomitant inability to perform plantar or dorsal flexion of the foot 30 min after injection. Results The median effective dosage of 0.5% ropivacaine resulting in complete block of the sciatic nerve in 50% patients was 13 ml (95% confidence interval 11.3-14.9 ml).Conclusion The median effective dosage of 0.5% ropivacaine for ultrasound-guided lateral popliteal sciatic nerve is 13.0 ml.

Objective To study glucose,creatinine,urea nitrogen and serum ET-1 of patients with acute cerebral infarction,and to explore the relationship between neurologic impairment and ET-1 levels.Methods The glucose,creatinine,urea nitrogen and serum ET-1 were retrospectively analyzed in 50 patients with acute cerebral infarction ( ＜ 24 h) and 50 patients with non-neurological diseases.ET-1 determined by 125I radioimmunoassay.Results There were no significant differences in glucose,creatinine and urea nitrogen of acute cerebral infarction ( P ＞ 0.05 ) ; Compared to the control groups,ET-1 levels was significantly higher ( P ＜ 0.01 ),and levels of serum ET-1 in acute cerebral infarction were significantly correlated with their neurological deficits ( P ＜ 0.01 ).Conclusions Levels of serum ET-1 can severd as diagnostic and prognostic indicator of acute cerebral infarction.

Previous studies have agreed that the levels of neuron-specific enolase (NSE)and S100B protein have an important value for the severity of cerebral infarction and prognosis estimation. This article reviews the relationship between the serological changes of NSE and S100B and cerebral infarction, infarct volume, severity of neurological deficits, infarct location,and prognosis, as well as the advances in research on the evaluation of therapeutic drugs.

Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.

Objective To explore the risk factors of lower extremity deep venous thrombosis (LEDVT) of neurosurgical patients, and to provide references for identifying the most susceptible population and taking preventive measures. Methods A total of 68 cases of neurosurgical patients with LEDVT in three general hospitals from August 2010 to August 2013 were collected. The design method of one to one matching case-control study was used controlling age, sex and neurosurgical disease. Univariate and multivariate analyses were performed to determine the probable risk factors among two groups. Results The univariate analysis showed that coma, paralysis and limb immobilization, infection, trauma and fracture, lower limbs central venous catheterization, trachea cannula or tracheotomy, mechanical ventilation, surgical operation, dehydration and blood transfusion were significantly related to the incidence of LEDVT ( Χ2=4.50-33.23, P<0.05 or 0.01). The Logistic multivariate regression analysis showed that coma (OR=9.410, 95%CI 1.689-52.423), paralysis and limb immobilization (OR=4.950, 95%CI 1.432-17.105), infection (OR=2.927, 95%CI 1.162-7.373) and lower limbs central venous catheterization (OR=6.072, 95%CI 2.187-16.858) were independent risk factors for the development of LEDVT. Conclusions We should pay attention to patients with high risk factors of LEDVT and take preventive measures early to avert the formation of LEDVT.

Objective To investigate the preventive effect of health education on prevention of vaginitis among Guangzhou ’ s career women.Methods 479 career women with confirmed diagnosis of vaginitis in 2013 were cured and followed up for 1 year.Pa-tient were divided into Control Group (n=202) and Observation Group (n=277) according to whether accompanied the health edu-cation on prevention of vagnnitis.The recurrence rate of vaginitis during the 1 -year follow -up was compared between the two groups.Results In Control Group, 192 patients (95.05%) finished the follow -up, and in Observation Group, 260 patients (93.86%) finished the follow-up, there was not statistical difference in accomplishment ratio of follow -up (p>0.05).The recur-rence of rate of vaginitis was statistical higher in Control Group (72/192, 37.50%) than that in Observation Group (64/260, 24.62%) (P<0.05).Conclusion Health education could reduce the recurrence rate of vaginitis significantly.

ObjectiveTo assess the effect of balloon o f ureter through ureteroscopy for management of ureter stenosis.Met hods42 cases ureter stenosis underwent balloon dilation of ureter,2 2 being male,20 being female.The average age was 46 years.There was 5 ureteropel vic junction stenosis,8 upper ureter stenosis,5 middle part stenosis,24 lower pa rt stenosis.The length of stenosis was from 0.5 cm to 2.0 cm.Result sThe balloon dilating catheter was passed over the ureter stenosis area and was put in proper position in 39 cases.3 cases were failed(7.2%). 37 ca ses successfully underwent balloon dilation of the ureter on one session.All pat ients were followed up for 6 to 24 months(mean 14 months).The degree of hydronep hrosis decreased with no recurrence in 37 cases(88.1%).2 casese failed to gain the effect after the double-J stent was removed(4.7%). There are no serious co mplication found in all patients.ConclusionsBalloon di lation of ureter offers many advantages,such as:good result,repeatable and reduc ing the cost and hospital stay.