Objective To investigate the clinical efficacy and safety evaluation of fibrinolytic,anticoagulant and antiplatelet drug combination treatment in patients with progressive ischemic stroke (PIS). Methods Ninety cases with PIS were randomly divided into the treatment group (47 cases) and the control group (43 cases). The patients in the control group were given combination therapy of Diemailing, Nadroparin calcium and Ozagrel,while the combination therapy of Defibrase, Diemailing, Nadroparin Calcium and Ozagrel were given in the treatment group. The plasma fibrinogen (Fib), prothrombin time (PT), part enabled prothrombin time (APTT), liver and kidney function were observed. The clinical efficacy was evaluated after 14 days treatment. Results After treatment,the total effective rate of the treatment group was 89.4% ,which was significantly higher than that of the control group (67.4%) (P ＜ 0.05). After treatment, the PT and APTT levels of the treatment group were respectively (19.76± 5.53)s and (35.43 ± 6.03)s,the control group were respectively(17.26 ± 1.49)s and (35.71±5.64) s, the PT and APTT increased significantly compared with the pre-treatment condition in both groups (P ＜ 0.05), while the difference between the two groups was not statistically significant (P ＞ 0.05). The Fib level was (1.51 ±0.42)g/L in the treatment group,and (3.10 ±0.69)g/L in the control group. In the treatment group the Fib level was significantly lower than the control group and the condition before treatment(P ＜0.05). We found no significant difference between conditions before or after the treatment in the control group (P ＞ 0.05). The incidence of adverse clinical events showed no significantly difference between the treatment group and control (P ＞0.05). Conclusions Applying of fibrinolytic, anticoagulant and antiplatelet drug combination treatment in patients with PIS has a good efficacy and safety,which is good for clinical application.

Objective To investigate the possible role of interleukin (IL)-10 secreted by peripheral CD+CD25+ regulatory T (Treg) cells in the formation of seroresistance state in patients with syphilis.Methods Venous blood samples were obtained from 28 serofast patients with syphilis and 28 healthy controls.Flow cytometry (FCM) was performed to determine the proportion of CD4+CD25+IL-10+ T cells in peripheral CD4+ cells,and to quantify the protein expression of IL-10 in CD4+CD25+ Treg cells.Magnetic activation cell sorting (MACS) system was used to separate CD4+CD25+ Treg cells in high purity followed by the detection of IL-10 mRNA expression with real time PCR.Results A significant increase was observed in the proportion of CD4+CD25+IL-10+ T cells in peripheral CD4+ cells,as well as protein and mRNA expression levels of IL-10 in the serofast patients with syphilis compared with the healthy controls (all P ＜ 0.01).However,no statistical correlation was observed between rapid plasma reagent (RPR) titer and any of the above three parameters in these patients (all P ＞ 0.05).Conclusion The high level of IL-10 secreted by CD4+CD25 + Treg cells may contribute to the formation of seroresistance state in patients with syphilis.

Objective To investigate the clinical characteristics,diagnosis,therapy and maternal and perinatal prognosis of generalized pustular psoriasis of pregnancy.Methods Clinical data for seven inpatients with generalized pustular psoriasis of pregnancy were retrospectively analyzed from January 1,2005 to December 31,2012.Results Three patients had family history of psoriasis and five had previous history of psoriasis.All skin lesions were large patches of erythema,with needlepoint to miliary size pustules and scales.Two patients had oral involvement and three had nail involvement.Biopsy and bacterial culture were performed on five patients,in whom histopathological changes of pustular psoriasis were found,and bacterial culture was negative except in one patient.Among the patients,four had confirmed cause of disease; six patients were complicated with fever; four had increased leukocytes; seven had elevated neutrophils and C-reactive protein;five had increased total protein; and six had increased albumin.The disease was diagnosed according to the clinical manifestations and laboratory tests.Comprehensive treatment with glucocorticosteroids,antibiotics and local treatment were performed.Four patients had live births,and three patients underwent odinopoeia.Two babies were healthy,one had died,and another had varus foot deformity.Three patients had pustular relapse after labor.Conclusions Fetal-placental functions of patients with generalized pustular psoriasis of pregnancy should be monitored closely.Early diagnosis,treatment and termination of pregnancy can improve the maternal and perinatal prognosis.

Objective: To evaluate the effects of isoflurane-nitrous oxide on hemodynamics in patients undergoing cardiac valve replacement. Method:Hemodynamics values were measured with Swan-Ganz technique. Thirty-nine patients were divided into two groups according to their cardiac function before surgery. The patients with cardiac function Ⅱ degree were belong to group Ⅰ and those with cardiac function Ⅲ-Ⅳ degree to group Ⅱ. Result:CI,LVWI, RVWI,HR and MAP decreased significantly in both groups after induction of anesthesia without change in SI. During tracheal intubation and sternotomy,CI and LVWI decreased,PTRI and SVRI increased,particularly in group Ⅱ. During aorta and vena cava intubation the changes of hemodynamics were relatively complicated with CI and SI improved in group Ⅱ and further decreased in group Ⅰ. After CPB,MPAP,PAWP,PTRI and SVRI were decreasad in different degree in both groups with significant increased in CI and SI in group Ⅱ. Conclusion:Induction and maintenance anes thesia with 1.0%-1.5% isoflurane and 40%-50% N_2O are suitable in patients with impaired cardiac function.

BACKGROUND:Separating umbilical cord blood stem cells using tubes has low efficiency,and microbial contamination easily occurs during this process,therefore,safety cannot be ensured in clinical application.lt is urgent to find a method for separating umbilical cord blood stem cells to treat femoral head necrosis.OBJECTIVE:To establish a high efficient,safe,and clinically valuable method to separate umbilical cord blood stem cells.DESIGN,TIME AND SETTING:A self-control experiment was performed at the First Department of Surgery,Zhengzhou Second People's Hospital,Institute of Blood Constituent Application,Henan Red Cross Blood Centre between February 2006 and August 2007.PARTICIPANTS:Eight male patients with femoral head necrosis,averaging 40.6 years of age,were included in this study.Of these patients,4 had the history of hormone application.An average of 90 mL umbilical cord blood was harvested from each healthy normal full term neonate from Maternal and Children Health Care Hospital of Zhengzhou City.The quadruple bags used for separating umbilical cord blood stem cells consisted of 1 main bag,1 empty bag,and 2 physiological saline bags,provided by Shandong Weigao Holding,China.METHODS:Within 6 hours after collection,umbilical cord blood was centrifuged in the empty bag of quadruple bag,which was connected with an aseptic filling machine.After centrifugation,partial blood plasma was discarded,and the remaining erythrocytes were thoroughly mixed by adding hetastarch.Five minutes later,the mixture was diluted with physical saline at 1:1.Umbilical cord blood was slowly added into the main bag (at 1:1),in which,human lymphocyte separating medium was pre-added.After cantrifugation,the upper layer of solution,i.e.,monocyte-rich solution,was transferred into another empty bag.Within 24hours of preservation,after suspension with umbilical blood plasma,umbilical cord monocytes were transfused into patients with femoral head necrosis via superficial vein on the hand back,monocytes≥1×108/portion,2 portions once.There were three treatment courses,each involving three transfusion sessions,one session every 4 days,and a 2-3-month interval between two treatment courses.MAIN OUTCOME MEASURES:Cell recovery rate and cell viability of umbilical cord blood monocytes and improvements in clinical symptoms.RESULTS:The separation of quadruple bags could obtain umbilical cord blood monocytes with high recovery rate.Furthermore,microbial contamination hardly occurred in the process of separation.Hip joint pain relieved or disappeared to different extents in all 8 patients,with an effective rate of 100%.Abduction and internal rotation of hip joint,ambulation distance,and gait were markedly improved.At 6 months after cell transplantation,5 patients presented with changed bone density in femoral head necrosis regions,2 showed normal femoral head morphology,and the remaining 1 exhibited no obvious changes.Joint effusion was reduced or disappeared in 12 hips.Magnetic resonance images showed that femoral head morphology had been improved in various degrees in 9 hips,but no changes in 3 hips.No complications,fever,or allergies occurred during and after cell transplantation.CONCLUSION:The method of separating stem cells from umbilical cord blood in junction with aseptic interface technology is highly effective,safe,and clinically valuable.Multiple intravenous transfusions of umbilical cord blood stem cells provide a novel approach for systemic treatment of femoral head necrosis.

To prepare polyrotaxane-camptothecin conjugates and evaluate its anti-tumor effect, polyrotaxane-camptothecin conjugates were successfully synthesized, and the release behavior was performed; MTT assay and cell morphology were used to examine the inhibition of cells' proliferation effect in vitro. The experimental study of the antitumor effect on S180 mice in vivo was also performed to further evaluate the anti-tumor effect of conjugate. The result showed polyrotaxane-camptothecin conjugates can effectively inhibit the proliferation in a dose dependent effect. In vivo study and cell morphology observation of S180 mice showed significant decrease in growth of tumor, degree of tumor infiltration and blood vessel number. The result indicated anti-tumor mechanism may be through affect the angiogenesis and reduced blood supply to tumor cells and then leading to necrosis.

Objective To evaluate the efficacy of acting κ opioid receptor for prevention of high altitude pulmonary edema (HAPE) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),hypobaric hypoxia group (group H),normal saline + hypobaric hypoxia group (group NH),U50488H (a selective kappa-opioid receptor agonist) + hypobaric hypoxia group (group UH),and nor-binaltorphimine (norBNI,a selective kappa-opioid receptor antagonist) + U50488H + hypobaric hypoxia group (group NUH).The rats were put into the hyperbaric chamber and exposed to hypobaric hypoxia (atmospheric pressure 355 mmHg,partial pressure of oxygen 74 mmHg) for 2 days to induce HAPE.At 3 days before HAPE,normal saline 0.5 ml,U50488H 1.25 mg/kg,and nor-BNI 2.0 mg/kg were injected intraperitoneally once a day in NH,UH,and NUH groups,respectively,and in addition U50488H 1.25 mg/kg was injected intraperitoneally 10 min later in NUH group.After 2 h exposure to hypobaric hypoxia,mean pulmonary artery pressure (mPAP) was detected,and arterial blood samples were collected for determination of serum malondialdehyde (MDA) and erythropoietin (EPO) levels.The rats were then sacrificed and lungs were removed for microscopic examination and for determination of the levels of nitric oxide (NO),inducible nitric oxide synthase (iNOS),MDA,superoxide dismutase (SOD),endothelin-1 (ET-1),thromboxane B2 (TXB2),and 6-keto-prostaglandin F1α (6-keto-PGF1α) in lung tissues.Lung water content and TXB2/6-keto-PGF1α ratio was calculated.Results Compared with group C,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio,and serum MDA and EPO levels were significantly increased,and iNOS,NO and SOD levels were decreased in the other four groups (P ＜ 0.05).Compared with group H,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio and serum MDA and EPO levels were significantly decreased,and iNOS,NO and SOD levels were increased in UH group (P ＜ 0.05),and no significant changes were found in the indexes mentioned above in NH and NUH groups (P ＞ 0.05).The pathological changes of lung tissues were significantly attenuated in group UH as compared with H group.Conclusion Acting κ opioid receptor can produce prevention for HAPE in rats,and inhibition of lipid peroxidation and correction of the imbalance between vasoconstrictive factors and vasodilative factors may be involved in the mechanism.

Objective To investigate the clinical efficacy of liver resection combined intraoperative choledochoscope for intra‐hepatic biliary calculi .Methods A retrospective analysis of clinical data in seventeen patients with intrahepatic biliary calculi ,who have been received liver resection combined intraoperative choledochoscope in the department of hepatobiliary surgery during 2005 to 2014 was conducted .According to the distribution of intrahepatic bile duct stones ,six cases located in left liver lobe ,five cases lo‐cated in left half liver ,three cases located in liver section Ⅵ ,one case located in liver section Ⅶ ,one case located in liver section Ⅷ , one case located in left liver lobe associated with right posterior lobe lower segment .Seventeen cases were treated with hepatolobec‐tomy or segmental liver resection (single clamp method combined first hilar occlusion) ,among which six cases received hepatic left lateral lobectomy ,five cases received left hemihepatectomy ,three cases received partial hepatic resection in paragraph Ⅶ ,one case received partial hepatic resection in paragraph Ⅶ and one in Ⅷ ,one case received the left lateral lobe combined right posterior lower segmental resection ,ten cases at the same time received choledocholithotomy and T tube drainage .Results All patients were cured without serious complications ,no long term stone recurrence .Conclusion Liver resection combined intraoperative choledochoscope is positive and effective treatment for intrahepatic biliary calculi patients .

Objective To investigate the sedative effects of different doses of dexmedetomidine with mid-azolam in spinal anesthesia. Methods 130 cases of spinal anesthesia were randomly divided into 2 groups,group D1 and group D2,with 65 cases in each group. Patients in 2 groups were given midazolam and dexmedetomidine with different doses. The heart rates ,blood pressure ,SpO2 ,Narcotrend value and Ramsay sedation scores were recorded at mutiple time points. The working time ,maintaining time of sedative effect ,and adverse reactions were compared between 2 groups. Results MAP,HR and NT decreased significantly in 2 groups(P < 0.05,respec-tively). The keeping time was relatively longer in group D1 compared with group D2(P<0.05). The working time was faster in group D2 compared with group D1. The rate of bradycardia in group D2 was relatively higher than that in group D1. Conclusion Good sedative effect can be obtained by drug in 2 groups. Group D1,with midazolam 0.05 mg/kg+dexmedetomidine 0.3μg/kg,may have a certain advantage in anaesthesia in the spinal canal.

Objective: To evaluate the status of protein and amino acids in farmers who consumed cereals predominately in Henan province, China. Method: Socioeconomic information of 101 selected families was obtained by interviewing; food consumption data were gathered by 12 separated 24 h recalls, and FFQ method. Results: The protein intake was 74 g/capita/day in average, 87% from plant sources. Lysine is the first limiting amino acid . By anthropometric measurements of children aged 5-12 years, 26% of them were stunted and 40% underweight. Conclusion: The total amount of protein matched adult requirements, but was insufficient for children growth. Lysine fortification and other measures may be suggested for relieving child undernutrition.