There are many different kinds of drugs which can treat ischemic stroke. This study aims to analyze the clinical treatment of ischemic stroke using Chinese and western medicines and their combination scheme. Data abstracted from 15 national 3a grad hospitals' hospital information system (HIS) databases were collected, then were used frequencies to find the common used drug and type, and were used association rules to anylizs the common combined medication scheme of Chinese and western medicines. It was found that the Shuxuetong (9 015 cases, 22.66%), Danhong (7 369 cases,18.53%) and Xueshuaitong (5 302 cases,13.33%) injections were the most frequently used drugs, and blood-activating and stasis-dissolving prescription (30 384 cases, 76.39%), resuscitative prescription (6 850 cases,17.22%) and tonic prescription (5 997 cases,15.08%) were the most commonly used types of Chinese medicine. The oral dose of aspirin (20 924 cases, 52.60%), Guangxi pp injection (10 771 cases, 27.08%) and insulin injection (10 599 cases, 26.65%) were frequently used. And the types of antiplatelet agents (23 049 cases, 57.95%), vasodilator (19 608 cases, 59.29%) and antihypertensive drug (15 475 cases, 39.90%) were commonly used. The drug combination of aspirin, twenty five pearl pill, Danhong and Xueshuaitong injection were the most frequently used group and its confidence coefficient is 97.5%. The type combination of blood-activating and stasis-dissolving prescription, thrombolytic drug, insulin and vasodilator was the most commonly used group and its confidence coefficient is 97.424%. This study concludes that the drug combination of aspirin, twenty five pearl pill, Danhong and Xueshuaitong injection and the type combination of blood-activating and stasis-dissolving prescription, thrombolytic drug, insulin and vasodilator were commonly used in clinical.
Adult ; Aged ; Aged, 80 and over ; Aspirin ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fibrinolytic Agents ; therapeutic use ; Humans ; Insulin ; therapeutic use ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Stroke ; drug therapy ; Vasodilator Agents ; therapeutic use

Abnormalities, Multiple ; diagnosis ; therapy ; Asphyxia ; pathology ; Female ; Humans ; Infant ; Musculoskeletal Abnormalities ; diagnosis ; therapy ; Syndrome ; Thorax ; abnormalities

Objective To investigate the impact of paced QRS duration (pQRSd) on heart function in patients with right ventricular apical pacing. Methods Seventy-six patients with Ⅲ° atrioventricular block received pacemaker treatment were enrolled and randomized into group A (pQRSd < 190 ms, n = 52) and group B(pQRSd≥ 190 ms, n = 24). The concentration of brain natriuretic peptide (BNP),parameters of left atrial diameter (LAD), left ventricular ejection fracetion (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic dimension (LVEDD) were measured before operation, at 12 months and 24 months after implanting, respectively. The parameters of echocardiography assay, the concentration of BNP and the incidence of heart failure event after implantation were compared between two groups. Results At 12 months after implanting, LVEF of the patients in the group B decreased significantly compared with that of group A (P < 0.05). However, the echocardiography paramenters and the concentration of BNP were not significantly different between the two groups (P > 0.05). At 24 months after implanting, LAD、LVEDD、LVESD of group B increased significantly compared with those of group A [LAD,( 44.5 ± 6.2) mm vs (41.6 ± 5.1) mm, LVEDD, (52.7 ± 9.3) mm vs (48.2 ± 7.5) mm, LVESD, (37.5 ± 5.6) mm vs (33.8 ± 4.9)mm, each P < 0.05, respectively]. The concentration of BNP of group B increased significantly [(408.2 ± 102.1)ng / L vs (243.7 ± 92.8)ng / L, P < 0.001], and LVEF of the patients in group B decreased significantly compared with those of group A [(46.3 ± 6.8)% vs (51.6 ± 5.2)%, P < 0.001], respectively. No significant difference in the incidence of heart failure event (41.7% vs 26.9%, P > 0.05)between two groups during 24-month follow-up. Conclusion The prolonged paced QRS duration has a detrimental effect on long-term cardiac function during RVA pacing in patients with Ⅲ°atrioventricular block.

The research status is reviewed on taxonomic position, ecology, biological active matter and artificial cultivation of Shiraia bambusicola. Following problems are presented: whether there are new species and host specificity of Shiraia bambusicola. Since the artificial cultivation of stroma of Shiraia bambusicola has not been success, Shiraia bambusicola is in situation of emerge of itself and perish of itself so that it is not beneficial to resource protection and continual utilization of this medicinal fungus. It is pointed out that molecular biology of Shiraia bambusicola should be further researched and technology of artificial cultivation of Shiraia bambusicola should be explored in order to exploit and usage of Shiraia bambusicola.

Objective To study the risk factors related to recurrence of gastrointestinal stromal tumor (GIST) after discontinuing postoperative adjuvant imatinib mesylate (IM) treatment.Methods We retrospectively analyzed our clinical database of 138 GIST patients who received radical resection and subsequent IM adjuvant treatment at the Renji Hospital,Shanghai Jiaotong University School of Medicine between January 2006 and January 2014.Results For the entire Multivariate analysis study group,the overall 5-year recurrent free survival (RFS) rate was 54.5％.There were two tumor characteristics which were independent prognostic factors of GIST treated by postoperative IM:Ki67 index (P =0.005),and serosal invasion (P =0.026).The accuracy of comprehensive evaluation based on the two weighted variables was better than NIH staging criteria(AUC:0.714 vs.0.631).Furthermore,two risk groups were created according to the risk model with 5-year RFS of 81.3％ and 31.1％ as low-risk and high-risk groups,respectively (P ＜0.05).Conclusions For patients with intermediate or high risk in NIH classification,if there was tumor serosal invasion,or if there was no local invasion but Ki67 index ＞ 8％,extended continuous IM adjuvant treatment should be recommended after the primary tumor was radically resected.

Objective The aim of this study was to investigate the characteristic of regional cerebral glucose metabolism in patients with Wilson's disease (WD) using 18F-fluorodeoxyglucose (FDG) PET.Methods Thirteen WD patients and 12 normal controls were studied by brain 18F-FDG PET, and the data were analyzed by visual analysis, semi-quantification and statistical parametric mapping (SPM). The radioactivity ratios of lenticular nuclei, caudate, thalamus and cerebellum to cerebral cortex and the ratio of lenticular nuclei to caudate were calculated, respectively. SPSS 11.0 software for statistics was also used to analyze the data. Results In WD patients, radioactivity of lenticular nuclei and candate was significantly decreased compared with controls. The radioactivity ratios of lenticular nuclei and caudate to cerebral cortex in WD patients were both significantly lower than that in normal controls (0.95±0.05 vs 1.26±0.05, t =15, P < 0.05 ; 1.02±0.06 vs 1.17±0.05, t = 8, P < 0.05), and the ratio of lenticular nuclei to caudate in WD patients was significantly higher than that in normal controls (0.93±0.06 vs 1.09±0.06, t =9, P< 0.05). Conclusion As compared with normal controls, patients with WD had significantly decreased glucose utilization in the basal ganglia, especially in the lenticullar nuclei.

OBJECTIVETo evaluate the effect of exteral use of papaverine cream on enhancement of skin graft.

METHODSFive mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolsters. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the shrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxylin-eosin staining. The tissue structure was observed and the results were analyzed statistically.

RESULTSThe grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers.

CONCLUSIONSExternal use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.

Animals ; Contracture ; prevention & control ; Male ; Papaverine ; pharmacology ; Skin Transplantation ; adverse effects ; Swine ; Swine, Miniature ; Wound Healing ; drug effects

OBJECTIVETo explore the clinicopathologic features, treatment and prognosis of gastrointestinal stromal tumor (GIST) complicated with synchronous other alimentary malignant tumors.

METHODSClinical data of 525 patients with GIST undergoing surgical treatment from August 2004 to November 2012 in Shanghai Renji Hospital were reviewed retrospectively, among whom 46 patients presented synchronous other alimentary malignancy.

RESULTSGIST and other alimentary malignancy coexisting cases were less likely to be screened out preoperatively (2.2%, 1/46) and associated with elder age (P=0.001), more likely arise from stomach (P=0.000), smaller tumor maximum diameter (P=0.000), and lower mitotic count (P=0.000). According to NIH postoperative risk classification, there were 36 at very low risk, 9 at low risk, and 1 at high risk. Although the risk of GIST recurrence was lower for GIST and other alimentary malignancy coexisting cases, their 5-year survival rate was lower than that of patients with GIST alone (36.1%VS. 82.2%, P=0.000).

CONCLUSIONSGIST patients complicated with synchronous alimentary malignant tumor are usually low or very low risk and has minimal impact on the prognosis. Survival depends primarily on the synchronous alimentary malignant tumors. Therefore, it is reasonable to lay emphasis on the treatment of the alimentary malignant tumor, and perform synchronous resection of GIST if possible.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; diagnosis ; pathology ; therapy ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

Objective To explore the replantation methods of the amputated tisue mass of fingers. Methods Fifteen cases were replanted using the physiological blood circulation replantation and the no physi- ological blood circulation replantation.Results All eleven cases survived with the physiological blood circu- lation replantation,one case failure with no physiological blood circulation replantation.Postoperative follow up ranged from six months to two years,with an average of fifteen months,the function and appearance were satis- factory.According to Hand Surgery of Chinese Medical Association' s functional evaluation in digital replanta- tion,eleven cases were excellent and two cases were good,the excellent and good rates were up to 86.7%. Conclusion For the amputated tissue mass of fingers,the physiological blood circulation replantation is the best choose.

Renal transplantation is one of the most effective treatment methods for end-stage renal diseases. However, some recipients present with fatigue symptoms after renal transplantation. Fatigue not only affects the quality of life, but also reduces the compliance of recipients with immunosuppressive agents. To strengthen the attention of medical staff to the fatigue, make early diagnosis and deliver effective interventions for renal transplant recipients, the current situation, risk factors and intervention methods of fatigue in renal transplant recipients were reviewed in this article.