Objective To investigate the effect of atorvastatin calcium with different doses on inflammatory cytokine and carotid atherosclerotic plaque of patients with cerebral infarction.Methods One hundred and seventy-eight patients with cerebral infarction admitted into our hospital from January 2014 to June 2015 were divided into low dose (LD) group and high dose (HD) group.Ninety patients in LD group were treated with atorvastatin calcium in a dose of 10 mg/d,and eighty-seven patients in HD group were treated with atorvastatin calcium in a dose of 20 mg/d.The serum levels of lipid including TC,TG,LDL-C,HDL-C,inflammatory cytokine including hs-CRP,IL-6,TNF-α,and carotid atherosclerotic plaque of both groups were analyzed and compared before and after treatment.Results After six months of treatment,the serum levels and inflammatory cytokine of patients in both groups showed remarkable improvement (P ＜ 0.05),and those in HD group were significantly better than those of LD group (P ＜ 0.05).Additionally,compared with those before treatment,changes in carotid atherosclerotic plaque of patients in LD group were not obvious,while those in HD group markedly decreased,and which were significantly lower than those of LD group (P ＜ 0.05).Conclusion Atorvastatin calcium with HD of 20 mg/d showed a better capability on improving serum levels of lipid,inflammatory cytokine,and carotid atherosclerotic plaque of patients with cerebral infarction than those with LD of 10 mg/d.

Objective To investigate the values of recombinant tissue type plasminogen activator (rt-PA)) in the treatment of acute cerebral infarction complicated with atrial fibrillation.Methods Used the prospective research methods,74 patients of acerebral infarction complicated with atrial fibrillation in Xi'an XD Group Hospital from February 2015 to August 2016 were selected and were equally divided into the observation group and the control group accorded to the principle of random envelope drawing.The control group was treated with urokinase intravenous thrombolytic therapy,the observation group was treated with rt-PA intravenous thrombolytic therapy,and the prognosis of the two groups were observed.Results There were no significant differences in gender,age,time window,disease,systolic blood pressure and diastolic blood pressure compared between the two groups.The treatment efficiency in the observation group and control group were 94.6％ and 75.7％,the observation group was significantly higher than that of the control group (P ＜ 0.05).After treatment,the mRS scores in the observation group and the control group were (5.22± 1.83) points and (7.29± 1.45) points,were significantly lower than those before treatment of (10.24± 1.31) points and (10.19 ± 1.52) points (P ＜ 0.05),and the observation group was significantly lower than the control group (P ＜ 0.05).In the observation group,the symptomatic intracerebral hemorrhage and non symptomatic cerebral hemorrhage were 5.4％ and 2.7％ respectively,so that were 18.9％ and 16.2％ in the control group that the observation group were significantly lower than those of the control group (P ＜ 0.05).Conclusion Intravenous thrombolysis with recombinant tissue type plasminogen activator of patients with acute cerebral infarction combined with atrial fibrillation is safe and effective,it can promote the improvement of neurological function,and has good application value.

Objective To discuss whether Saccharomyces boulardii sachets can improve the eradication rate and reduce some untoward effects of gastrointestinal tract when adding in the Helicobacter pylori (Hp) standard quadruple therapy.Methods 249 cases infected with Hp were randomly divided into control group(124 cases) and treatment group (125 cases).The control group was treated with standard quadruple therapy:colloidal bismuth pectin capsules,100 mg,tid,po;furazolidone tablets,0.1 g,bid,po;amoxil capsule,1 g,bid,po;rabeprazole sodium enteric-coated capsules,20 mg,qd,po.The treatment group was treated with Saccharomyces boulardii sachets(0.25 g,bid,po)besides.Both groups were treated for 4 weeks.Evaluate the effect of Hp eradication rate by using the method of intent of treatment (ITT) analysis and consistent scenario set (PP)analysis.Results According to the ITT analysis,the eradication rate of control group was 89.52%,and that of treatment group was 96.00%.According to the PP analysis,the eradication rate of control group was 90.00%,and the rate of treatment group was 97.39%.Both analysis results showed the eradication rate of Hp in treatment group was significantly higher than control group(P<0.05).As for reducing the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra,control group was obviously lower than treatment group (P<0.05).Conclusion Compared with standard quadruple therapy only,adding Saccharomyces boulardii sachets can significantly improve the eradication rate of Hp and obviously reduce the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra.It is worth to be generalized and applied in clinical practice.

Objective:To analyze the clinical characteristics and treatment effect between bilateral(bi-)and unilateral(uni-) sudden sensorineural hearing loss(SSNHL).Method:Four hundred and eighty cases of SSNHL were retrospective study,which were divided into two groups of bi-SSNHL(n=40) and uni-SSNHL(n=440).Clinical characteristics and treatment effects were compared of the two groups.Result:The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%),compared with 56.4 percent of patients with uni-SSNHL.Conclusion:Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect,that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.

Objective To evaluate the neurotoxicity induced by multiple exposures to sevoflurane anesthesia in the neonatal rats.Methods Thirty-two healthy SPF Sprague-Dawley rats of both sexes,aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=16 each) using a random number table:control group (group C) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group C.Morris water maze test was carried out on postnatal day 32-36 to assess the cognitive function.On postnatal day 21 and 36,8 rats in each group were selected and anesthetized,and the cerebrospinal fluid was collected for determination of the concentrations of amyloid β-protein by enzyme-linked immunosorbent assay.Results Compared with group C,no significant change was found in the escape latency,movement time spent in the effective region of the platform,movement distance,the number of entries into the effective region,percentage of residence time,percentage of movement distance,and percentage of the number of entries (P＞0.05),and the concentrations of amyloid β-protein in the cerebrospinal fluid were significantly increased on postnatal day 36 in group Sev (P＜0.05).Conclusion Multiple exposures to sevoflurane anesthesia can induce central neurotoxicity,but do not induce changes in the cognitive function in the neonatal rats.

Obj cetive A large number of recent studies show that sevoflurane anesthesia may cause learning and memory dysfunction.The aim of this study was to explore changes of learning and memory ability and hippocampal volume in infantile rats after neonatal interrupted and repeated inhalation of 2.6% sevoflurane through detecting the learning and memory ability by Morris water maze and the hippocampus volume by MRI.Method s Thirty two neonatal SD rats were randomly devided into two groups (n=16):experimental group and control group.Rats inhalated 2.6%sevoflurane in the experimental group and 1 L/min O2 +1 L/min Air in the control group at the postnatal days of 7, 14 and 21 (P7, P14, P21). The learning and memory ability was determined by the Morris water maze test from P31 to P37;The brains of rats were scanned by mag-netic resonance imaging ( MRI) machine under anesthesia with 1%sodium pentobarbital at P37, and the brain and bilateral hippocampal volumes were measured. Results ①In the place navigation test, the escape latency had no significant difference between the two groups (P>0.05).In the spatial probe test, the dwelling time, movement distance and number of entering times in platform quadrant decreased slightly in experimental group compared with those in the control group, while there was no significant difference (P>0.05).②The brain volume [(1.53 ±0.18) cm3 vs (1.60 ±0.13) cm3] and right hippocampal volume [(16.15 ±1.76)mm3 vs(16.46 ±1.71)mm3] had no significant difference between the two groups (P>0.05).The left hippocampal volume [(16.46 ±1.71)mm3] was decreased in the experimental group compared with the control group [(18.10 ±2.53)mm3](P<0.05). Conclusion The learning and memory ability has no significant changes in in-fantile rats after neonatal interrupted and repeated sevoflurane inhalation and MRI examination of hippocampal volume is not sufficient for the diagnosis of cognitive dysfunction.

Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.

Objective To evaluate the feasibility and security of general anesthesia for elective surgery in infants with mild upper respiratory tract infections (URI). Methods A total of 169 cases of infants underwent general anesthesia for elective surgery, ASAⅠorⅡ, both sexes, aged 20 days to 36 months, were divided into URI group (n=41) and non-URI group (n=128), according to the preoperative symptoms of URI. The general data, the perioperative and postoperative respiratory-related complications were observed and recorded. Results (1) There was a higher incidence rate of breath holding during the operation in URI group than that of URI group. There were no significant differences in cough, sputum, blood oxygen saturation (SpO 2)<0.95, fever, glossoptosis between two groups. No fever was found in both groups. There was a higher incidence rate of sputum after operation in URI group. There were no significant differences in other complications including cough, SpO2<0.95, fever, glos?soptosis and incidence rate of breath holding between two groups. No laryngospasm and bronchospasm were found during operation and after operation in two groups. (2)The incidence of postoperative cough and fever increased, while the inci?dence rates of SpO2<0.95 and glossoptosis were lower after operation compared with those during operation in non-URI group. In URI group, the incidence rate of postoperative fever was higher,and SpO2<0.95 and breath holding was lower. There were no significant differences in other complications in URI group. Conclusion It is feasible and relatively safe to implement tracheal intubation general anesthesia for the infants with mild URI under thorough preoperative assessment and careful opera?tive management.

[ ABSTRACT] AIM:To study the expression profiles and the role of Ca 2+/calmodulin-dependent kinase II delta ( CaMKIIδ) during osteoclast differentiation .METHODS:Mouse RAW264.7 cells were induced by receptor activator of nuclear factor κB ligand ( RANKL) at 50μg/L for osteoclastogenesis .Tartrate-resistant acid phosphatase ( TRAP) staining and bone resorption lacunae examination were performed to verify osteoclast formation .The expression of CaMKIIδat mR-NA and protein levels was also determined by immunofluorescent cytochemistry , RT-qPCR and Western blot at days 0, 1, 3 and 5.RESULTS:TRAP positive multinuclear cells with bone resorption function were formed after 5 d of induction. The mRNA levels of CaMKIIδdetected by RT-qPCR were 1.028 ±0.041, 2.478 ±0.087, 10.524 ±1.284 and 42.914 ± 2.667 at days 0, 1, 3 and 5, respectively, while the protein levels of CaMKIIδ detected by Western blot were 0.762, 0.963, 1.802 and 3.136, respectively.The changes of protein level were also verified by immunofluorescence cytochemis -try, in which the fluorescence intensity increased in a time-dependent manner (P<0.05).CONCLUSION:The expres-sion of CaMKIIδincreases with the differentiation of osteoclasts .CaMKIIδmay play a key role in the osteoclastogenesis .

Objective To evaluate the effects of multiple exposures to sevoflurane anesthesia on the expression of apolipoprotein E (ApoE) in the hippocampus of neonatal rats.Methods Twenty-four pathogen-free Sprague-Dawley rats (12 males,12 females),aged 7 days,weighing 15-20 g,were randomly divided into 2 groups (n=12 each) using a random number table:control group (group Con) and multiple exposures to sevoflurane anesthesia group (group Sev).On postnatal day 7,14 and 21,2.6％ sevoflurane was inhaled for 2 h in group Sev,while the mixed gas of oxygen and air was inhaled instead of sevoflurane in group Con.Morris water maze test was carried out on postnatal day 31-37 to assess cognitive function.The rats were then sacrificed,and the hippocampus was removed to determine the expression of ApoE protein in hippocampal CA1,CA3 and DG regions (by immunohistochemistry) and the expression of ApoE mRNA (by fluorescent quantitative real-time reverse transcriptase polymerase chain reaction).Results There was no significant difference between the two groups in cognitive function (P＞0.05).Compared with group Con,the expression of ApoE protein in hippocampal CA1 and CA3 regions and ApoE mRNA was significantly up-regulated in group Sev (P＜0.05),and no statistically significant change was found in the expression of ApoE protein in hippocampal DG region in group Sev (P＞0.05).Conclusion Multipie exposures to sevoflurane anesthesia can up-regulate the expression of hippocampal ApoE and produce mild neurotoxicity without causing changes in cognitive function in neonatal rats.