This study aimed to study the criteria of two-way referral between tertiary-care hospital and communityhealth-care service center for patients with cerebralhemorrhage and a protocol of implementation to promote its treatment and rehabilitation.The criteria of two-way referral between tertiarycare hospital and community health-care service center for patients with cerebral hemorrhage after surgical operation were formulated on a trial basis with mutual consultation by the department of neurosurgery,Shenzhou hospital affiliated to Shenyang Medical College and Hunhewan Community Health-Care Service Center,Heping district,Shenyang. Totally,91 patients of cerebral hemorrhage admitted to the hospital during October 2007 to September 2010 were recruited for the study,46 in the intervention group with two-way referral and 45 in the control group by self-referral determined by their family members.All the patients of the two groups were followed-up for three years.During the follow-up in the intervention group,40 of 46 (95％) patients could comply with taking medication ordered by physicians,ability of daily living remarkably improved by Barthel index in 21 (50％),physical function recovered well in 33 (79％),34 (81％) could insist in self-monitoring and 32 (76％) could visit physicians for regular consultation,all these being significantly better than those in the control group (64％,31％,28％,25％ and 25％,respectively) (P ＜0.01 ).Medical and rehabilitative cost for patients with cerebral hemorrhage accounted for 575 RMB yuan per month in intervention group,as compared to 2246 RMB yuan for those in control group.Two-way referral for patients with cerebral hemorrhage can reduce their medical cost and promote their better rehabilitation.

Objective To evaluate the operation of laparoscopic splenectomy(LS),its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique,the indications for LS were widened,the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery.The application of hand-assisted technique is safe and feasible for giant spleen.With the accumulation of surgical experiences and technique development,LS will be extensively used in clinic.

Objective:To investigate the effects of extracts of aqueous joint during CIA development on the HUVEC proliferation in vitro and expression of VEGF Methods: 3H TaR incorporation was used to estimate the HUVEC proliferation by extracts of aqueous joint and VEGF, and was used cultured in an absolutely serum free medium Results:Extracts of aqueqous joint during CIA development stimulated proliferation of HUVEC and this proliferation was inhibited by the anti VEGF neutralizing antibody Conclusion:The expression of VEGF in the extracts of the aqueous joint during an early stage of CIA development increased and expressed biologically active

Adult ; Cord Blood Stem Cell Transplantation ; adverse effects ; Cytomegalovirus ; Cytomegalovirus Infections ; complications ; Female ; Hemolysis ; Humans

Aortic Aneurysm, Abdominal ; therapy ; Humans

Objective To discuss the clinical significance of fetal encephalic accumulated fluid revealed by prenatal ultrasonography.Methods Prenatal ultrasonography was performed on 8426 women at more than 20 weeks' gestation.Totally 150 women with fetal encephalic accumulated fluid more than 5 mm were included in this study.The changes of fetal encephalie accumulated fluid and the associated anomalies were observed regularly every 2 weeks until delivery.The live infants were followed up regularly.Results The incidence of fetal encephalic fluid was 1.8%,including 72 cases with fluid in the fetal anterior or posterior cornu of unilateral ventricle,46 cases with accumulated fluid in fetal posterior fossa,32 cases with fluid in more than 2 sites.Generally,the accumulated fluid in fetal encephalus was first diagnosed at 17-40 gestational weeks,with a median of(26?5)weeks.Most of them were found between 29-32 gestational weeks(63 cases,42.0%),and the maximum amount of accumulated fluid was also found between 29-32 weeks(70 cases,46.7%).Spontaneous regression of intracranial fluid could be seen in 111 fetuses (74.0%).The period of fluid regression ranged from 29 to 40 weeks of gestation,of which the average gestational week was(36?2)weeks.Additionally,the most frequent period of regression was in the first two thirds of the three trimesters of pregnancy.The incidence of defected infants was 3.8%,10.2% and 67.4%,respectively,when the amount of accumulated fluid was less than 10mm,10-14 mm and more than 15 mm.And the accumulated fluid in more than 2 sites was also a risk factor of defected fetuses,with an incidence of 60.0%.Conclusions Most cases could be diagnosed between 29-32 gestational weeks, and the maximum amount of accumulated fluid is also observed in this period.The more fluid in fetal encephalus,the more sites the fluid distributed in,the more defected fetuses or infants would be observed.So in cases of more than 15 mm of fluid,or accumulated fluid in more than 2 sites,anomalies should be observed extremely carefully.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Treatment Outcome

Chinese cobra (Naja naja atra) cardiotoxins are three-fingered family with 60～62 amino acids bind by four disulfide bonds. CardiotoxinⅢ (CTXⅢ) is one of the major toxic component which can cause hemolysis and cytotoxicity. However, there is no report on the fusion expression of CTXⅢ in soluble form so far. The cloning, expression and purification of recombinant CTX Ⅲ (rCTXⅢ) from Naja naja atra in E. coli and in yeast Pichia pastoris were reported here. CTXⅢ gene, fused with enterokinase in E.coli His-patch Thioredoxin expression system, were expressed in soluble form and released by osmotic-shock treatment. CTX Ⅲ gene was also cloned and expressed in the methylotropic yeast Pichia pastoris pPIC9K expression vector in the first time. The yield of the secretion level was 9.5 mg/L. Using straightforward one-step chromatography procedure, the rCTXⅢ, with three additional amino acids (GYT) at the N-terminal site, was purified to a purity of more than 90% and recovery yield of 65%. The purified rCTX Ⅲ was further characterized by cytotoxic assay with IC50 4.66μg/ml. An effective expression and purification system for recombinant CTXs in P. pastoris was developed, this system will permit us the ready isolation of active cardiotoxins. This protocol can also be easily used for the production of the toxin in a larger scale with low cost.

Unclear cultivating aim and training plan as well as tutors' lacking of experience are the main problems of the postgraduate education for clinical medicine professional degree,which will cause the quality of clinical postgraduate training to fall greatly.Through the analysis,the author proposes increasing management authority of rotating disciplines for graduates,establishing tutor groups in rotating disciplines,making clear training plan,increasing the clinical simulation skill training courses,training and optimizing the professional master's tutors,which is to fit the needs of the postgraduate education for clinical medicine professional degree and to provide related references.

Objective To investigate the signal transduction pathway mechanisms of rats with liver fibrosis regulated by leptin and interfering effects of mistletoe alkali .Methods The hepatic fibrosis in rats model was established by injecting carbon tetrachloride .Forty-five SD rats were randomly divided into normal group ,model group and therapeutic group.All rats except rats in normal group were intraperitoneally injected with 40%carbon tetrachloride in peanut oil with a dose of 2.0 mL/100g according to the body weight twice a week for 8 weeks.Then, the therapeutic group was given mistletoe alkali (8g/(kg· d)) for 8 weeks via gastrogavage.Rats in normal and model group were served with distilled water at the same time.At the end of the 16th week, blood and tissue specimens were taken from all the rats .The influence of mistletoe alkali on liver morphology in liver fibrosis rat model was reviewed by HE and Masson staining .The effects of mistletoe alkali on the expression of Leptin and its receptor ( OB-Rb ) in HSC in fibrosis rat model were determined by immunohistochemistry (IH).The expression of JAK2, STAT3 and the activity of phospho -JAK2, phospho-STAT3 were detected by Western blotting analysis .Results The degree of fibrosis of the model group was more severe than the normal group and the treatment group , which suggested that mistletoe alkali can reverse liver fibrosis in rats . Immunohistochemical staining showed that mistletoe alkali reduced the hepatic expression of leptin and OB -Rb in rats with liver fibrosis in comparison with their expression in the model group .Compared with the normal group , the expression of JAK2 and STAT3 increased in the model group .However, the expression of JAK2 and STAT3 decreased in the medication groups compared with the model group .Conclusion Mistletoe alkali can effectively ameliorate liver fibrosis in rats possibly through inhibiting hepatic leptin and its receptor expressions , which through inhibiting hepatic leptin and its receptor expressions , thus inhibit the JAK2/STAT3 signaling pathway .