Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Heart ; physiopathology ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Young Adult

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Objective To compare the safety and efficacy of intravenous thrombolysis for patients with acute cerebral infarction in a second-grand class-A hospital and a third-grand class-A hospital. Methods Twenty-one consecutive patients with cerebral infarction treated with alteplase for intravenous thrombolysis were enrolled in a second-grand class-A hospital (Fengtai Hospital,Beijing)prospectively from January 2012 to December 2013 as the study group,and 65 patients in a third-grand class-A teaching hospital (Xuanwu Hospital,Capital Medical University,Beijing)admitted at the same period for intravenous thrombolysis were used as a control group. The differences of efficacy and safety of intravenous thrombolysis in patients of both groups were compared. The primary outcome measures were Barthel Index (BI)at day14 after onset and the modified Rankin Scale (mRS)scores at discharge. The main safety indicator was the incidence of serious adverse events (SAEs)after thrombolysis (symptomatic intracranial hemorrhage and death). Results (1 )In the primary outcome measures,the proportions of mRS≤2 at discharge in the study group and the control group were 71. 4%(n=15)and 58. 5%(n=38)respectively. At day 14 after thrombolysis,the proportions of BI ≥60 were 61. 9%(n=13)and 64. 6%(n=42)respectively. There were no significant differences between the two groups (P>0. 05). (2)The incidences of the primary serious adverse events were 4. 8%(n=1)and 6. 2%(n=4). There was no significant difference (P>0. 05). Other secondary outcome measures,such as the early reperfusion rate,recanalization rate,and the proportion of neurological improvement at day 14 after thrombolysis and the overall incidence of cerebral hemorrhage had no significant differences. The case referral proportion (9. 5%,n=2)of the study group had a trend of lowering than the control group (27. 7%,n=18)P=0. 09. (3)The out-hospital time delay, in-hospital time delay,and overall time delay of the study group were less than those of the control group, and the mean time was 75 ± 33 vs. 102 ± 50 min,and 72 ± 41 vs. 111 ± 38 min,147 ± 41 vs. 212 ± 47 min. There were significant differences (P<0. 01). Conclusion The second-grand hospital selected by our study can relatively safely and effectively perform intravenous thrombolysis for acute cerebral infarction with alteplase. Moreover,the intravenous thrombolysis of the second-grand hospitals may reduce the case referral ratio and visiting time.

Objective To investigate the protective effects of extract of Xihuangcao Tea on chemical hepatic injury in mice and rats.Methods Mouse models of chemical hepatic injury were induced by CCl4 and rat models of jaundice by ?-naphthylisothiocyanate(ANIT).Then extract of Xihuangcao Tea was administered and enzyme activity of SGPT in the serum was measured in the mice.The serum level of total billirubin was determined in the rat jaundice models.Results Compared with the models,the enzyme activity of SGPT was significantly reduced and serum total bilirubin level decreased in extract of Xihuangcao tea groups(P

BACKGROUND:Elderly patients have more loose bone. After fractures, bones are mostly crushed. Simultaneously, many elderly patients experience many internal diseases. Various organs have dysfunction. Surgery tolerance is poor, which also brings difficulty in treatment with internal fixator, and increases the risk of therapy. Thus, the choice of internal fixation method is not uniform. OBJECTIVE: To compare and analyze the repair effects of proximal femoral nail anti-rotation blade and anatomic proximal femoral locking plate in treatment of unstable intertrochanteric fractures in the elderly. METHODS:A total of 100 elderly patients with unstable intertrochanteric fractures were selected from the Youyi Branch, Kunshan First People’s Hospital from April 2011 to June 2013. They were randomly assigned to two groups. Patients in the experimental group received internal fixation with proximal femoral nail anti-rotation blade. Patients in the control group received anatomic proximal femoral locking plate. After treatment, folow-up was conducted. Operative indexes, postoperative Harris score for hip function and incidence of complications were compared and analyzed in both groups. RESULTS AND CONCLUSION: No significant difference in various indexes was detected in both groups (P > 0.05). Harris scores were significantly better in the experimental group than in the control group (P < 0.05). Postoperative complications were significantly less in the experimental group than in the control group (P < 0.05). These results indicated that internal fixation of proximal femoral nail anti-rotation blade for unstable intertrochanteric fractures in the elderly achieved satisfactory results in the recovery of joint function and had the advantage of few complications.

Objective To explore the correlation of rhinovirus infection and the morbidity of asthma in children.Methods The RV gene in nasopharyngeal secretion of 30 children with asthma acute exacerbation(asthma group),30 children in asthma clinical remission(remission group) and 30 healthy children (control group) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The total serum IgE(T-IgE) was determined by chemiluminescence.The eosinophil(EOS) count (EOS%) of peripheral blood and lung function were also measured.Results The rhinovirus infection rate was 36.67% in asthma group and 3.33% in remission group.No rhinovirus was detected in control group.The rate of rhinovirus infections in asthma group was significantly highter than that in remission group and control group(?2=7.50,13.47 Pa0.05). FEV1% was (62.73?13.54)% in asthma rhinovirus infection and (86.42?17.78)% masthma with no rhinovirus infection.There was remarkable difference between 2 groups(F=14.553 P﹤0.05). The T-IgE was (836.32?44.801) kU/L and EOS% was 10.63?4.09 in asthma group with rhinovirus infection.The total IgE was (439.10?231.28) kU/L and EOS% was 5.04?2.64 in asthma group with no rhinovirus infection.There was significant difference between 2 groups(U=2.475,F=20.806 Pa0.05).Conclusions There is a close correlation between rhinovirus infection and acute attack of asthma(or worsening asthma) in children. Asthma exacerbations would be likely to happened easier because of rhinovirus infection in asthmatic children with high T-IgE.

AIM:To investigate the effect of case-based learning ( CBL) teaching combination with paper review method in the teaching of ophthalmology residents. ·METHODS:The study was conducted from 2015 to 2016. The residents in Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital were included in the research. During the year of 2015, the traditional lecture-based learning ( LBL) method was applied (as a control group). During the year of 2016, the CBL teaching combination with paper review teaching method was applied (as an experimental group). At the end of the course, exams and questionnaires were conducted to evaluate the teaching effect of two different methods. The exams consisted of theoretical and operational assessment. The teaching satisfactions, learning interests, scientific research interests and clinical abilities were included in the questionnaires. The data was analyzed by SPSS 16. 0. ·RESULTS:The results of final exams indicated that the scores of the experimental group (88. 2±6. 5) were higher than the control group ( 75. 6 ± 6. 0 ). The difference showed statistically significant (t=6. 68, P<0. 05). The results of questionnaires indicated that students showed much more satisfied with CBL teaching combination with paper review teaching method ( 91%) than traditional teaching method (50%, x2 =8. 84, P<0. 05). Students in the experimental group improved learning interest ( x2 =6. 29, P<0. 05), increased research interest (x2=4. 54, P<0.05) and approved clinical ability (x2 =4. 25, P<0. 05). The comparison of two groups showed the statistically difference (P<0. 05). ·CONCLUSION: CBL teaching combination with paper review teaching method is beneficial to improve the teaching effect, and it is also beneficial to train residents'clinical skills and research abilities.

Objective To evaluate the safety,biocompatibility and efficacy of transcatheter closure of atrial septal defect(ASD)with no stainless-steel-screw occluder in canine model.Methods The device was constructed from superelastic Nitinol wires tightly woven into two flat disks and sewed with polyester fibers inside,with a pliable loop on the right-atrial-disk of the device,connecting to the delivery cable.ASD was created by transcatheter puncture and balloon dilatation and then closed by occluder under fluoroscopy in the catheterization laboratory.The location and the influence of the implanted device on function of tricuspid valve and mitral valve were evaluated by echocardiography.At 1,2,3 and 6 months after the operation,the animals were killed and autopsy was conducted.Results Eight dogs with puncture-produced ASD underwent ASD closing procedure successfully.The occluder showed no influence on the function of MV and AV demonstrated by echocardiogram.The two disks of the implanted device were covered with a smooth intact neogenesis layer in all dogs.Endocardial cells fully covered the surface of the two disk without inflammating reaction 3 months later. There was no evidence of corrosion on the surface of the nitinol wire removed from the dog after 6 months.Light microscopic examination of the liver,kidney,lung and spleen showed no evidence of embolization and inflammation.Conclusion Transcatheter ASD occlusion with new-type occluder is safe,feasible,effective and good biocompatibility with a good prospective clinical application.

Objective To study prognosis of patients with fulminant hepatitis after plasma ex- change treatment using model for end-stage liver disease(MELD)scoring system.Methods 160 pa- tients were randomly divided into plasma exchange group and control group,and MELD score was calculated according to the original formula for each patient.The efficacy of plasma exchange was as- sessed by mortality and improvement in biochemical parameters and MELD score.Results The levels of total bilirubin(TBIL),INR and MELD score of patients whose MELD scores were between 30 and 40[TBIL,(379.4?40.4)?mol/L; INR,2.5?0.2; MELD,30.8?3.8]were lower than before PE treatment[TBIL,(509.7?64.6)?mol/L;INR,3.5?0.3;MELD,37.3?3.5].The levels of TBIL and INR and MELD score of patients whose MELD scores were higher than 40 [TBIL,(595.6?61.5)?mol/L;INR,3.8?0.4;MELD,39.8?3.5]were lower than before PE treatmem [TBIL, (650.4?66.3)?mol/L;INR,4.4?0.6;MELD,45.2?4.2].The mortality of patients in PE group with MELD score from 30 and 40 was 50.0%,while it was 86.7% in control group,showing significant differ- ence between PE group and control group(P＜0.01).The mortality of patients with MELD scores higher than 40 was 91.2% in PE group and 100% in control group,showing no significant difference between these two groups(P＞0.05).Conclusions Plasma exchange treatment can decrease the serum TBIL level, INR and MELD score of patients with fulminant hepatitis and improve liver function.Compared with the control group,plasma exchange can significantly decrease the mortality of patients in PE group with MELD score from 30 to 40,but no effect on patients with MELD score higher than 40.

OBJECTIVE To assess the method and reliability of the platysma myocutaneous flap with posterior based pedicle for defects in the region of parotid gland and masseter muscle.METHODS The clinical data of 6 patients who were reconstructed with platysma myocutaneous flap with posterior based pedicle for defects in the region of parotid gland and masseter muscle from 2006 to2007 were studied. The blood supply and design of the flap,the keys in operation and the outcome after operation were also discussed.RESULTS All the patients were followed up from 2 months to one year.The color of the platysma myocutaneous flap was matched with the facial skin.All the operation results were satisfied. CONCLUSION Platysma myocutaneous flap has abundant blood supply.The operation is easy and reliable.It is suitable for reconstruction of the defects in parotid gland and masseter muscle region.