OBJECTIVE:To observe the efficacy of urapidil hydrochloride in control of blood pressure at the perioperative stage of hemorrhagic apoplexy.METHODS:All80patients with hypertensive cerebral hemorrhage were managed with seda?tive,dehydration,hemostasis,and cerebral nerve nourishment,then when the blood pressure still remained high,or the blood pressure was hard to control after the intubation,urapidi hydrochloride was administered by intravenous infusion at the dose of250mg added with250ml of5%glucose infusion,the infusion drip was set at constant speed,with2mg/min as its starting speed,while at the same time the blood pressure and heart rate were monitored and infusion speed was adjusted every10to15min,after the target blood pressure21.2/13.2kPa was obtained,the infusion speed was kept at0.1～0.4mg/min.The blood pressure and heart rate were observed separately before the administration of urapidil hydrochloride and2,5,10,15,20and30min after the administration as well as after the operation.RESULTS:5min after the administration,blood pres?sure decreased remarkably but not to the extent to cause low blood pressure,and the heart rate increased slightly at the same time,generally not over10beats each minute.CONCLUSION:Urapidil hydrochloride decreases blood pressure steadily and safely at a manageable dosage.It can be used to control blood pressure during hemostasis and clearance of hematoma,which reduces the possibility of rehemorrhagia caused by high blood pressure during and after the operation.

Background Research demonstrated that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid GluR2 (AMPA-GluR2) is associated with amblyopia.It has been shown that levodopa and cytidine diphosphate choline can improve visual function of amblyopic children,but the mechanism is unclear.Objective This study was to explore the possible effects of levodopa and cytidine diphosphate choline on amblyopia.Methods Monocular deprivation (MD) animal models were created in 60 2-week-old SD rats by monolateral eyelid suturing and observed for 31 days and reared in natural light together with 15 other matched normal healthy SD rats.The models were randomly divided into the MD group,levodopa group,cytidine diphosphate choline group and normal saline control group,with 15 rats for each group.40 mg/kg of levodopa,80 mg/kg of cytidine diphosphate choline,I ml normal saline were given to the rats,respectively,for 28 consecutive days.Expressions of the AMPA-CluR2 protein and AMPA-CluR2 mRNA in the rat visual cortex were detected by immunohistochemistry,Western blot and real-time fluorescence quantitative PCR.Use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The expression values of the AMPA-GluR2 protein (AMPA-GluR2/β-actin) and AMPA-GluR2 mRNA (2-△△Ct) were significantly lower in the MD group than those of the normal control group (protein:0.32 ± 0.02 vs.0.64 ± 0.05,t =13.287,P＜0.05 ;mRNA:0.30±0.01 vs.0.84±0.03,t=38.184,P＜0.05).Those in the levodopa group were significantly increased in comparison with the normal saline solution group (protein:0.59 ±0.04 vs.0.33 ±0.03,t =11.628,P＜0.05 ; mRNA:0.71±0.06 vs.0.33 ±0.02,t =13.435,P＜0.05).The expression values of the AMPA-GluR2 protein and AMPA-GluR2 mRNA were significantly increased in the cytidine diphosphate choline group compared with the normal saline solution group (protein:0.52 ± 0.04 vs.0.33 ± 0.03,t =8.497,P ＜ 0.05 ; mRNA:0.48± 0.04 vs.0.33 ± 0.02,t =7.500,P＜0.05).Conclusions AMPA-GluR2 is associated with the plasticity of visual development.Levodopa and cytidine diphosphate choline may improve visual function by down-regulating the expression of AMPA-GluR2 in the visual cortex.

Objective To analyze the epidemic situation of human brucellosis in Qinghai province,in order to provide a theoretical basis for prevention and treatment of brucellosis.Methods Five counties in Qinghai province(Ping'an county,Haiyan county,Tianjun county,Dari county and Henan county) were selected as monitoring counties in 2010,and three or four townships were selected as monitoring points in each county.People aged 7 to 60 close contacted with livestock were monitored.The methods of rose bengal plate agglutination test(RBPT) and standard tube agglutination test (SAT) were used for serological testing.Brucellosis diagnosis was based on Brucellosis Diagnostic Criteria(WS 269-2007).Results A total of 2021 high-risk subjects from 5 counties were examined for brucellosis,and 76(by RBPT) of them were serologically confirmed with a positive rate of 3.76％ (76/2021),SAT positive 15 persons,the average positive rate was 0.74％ (15/2021).The number of infections was 15 cases,average prevalence was 0.74％(15/2021 ),and 3 new eases were discovered.The seasonal peak of incidence was from February to June.Most of the eases were reported dealing with slaughtering and fur processing.Conclusions The main reasons for epidemic rise are that the source of infection is not completely clear and weak awareness of self-protection in employees.So we must strengthen the quarantine,do surveillance on occupational groups and epidemic reporting work,carry out vocational training,strengthen publicity and education,and enhance the protection awareness.Thus brucellosis epidemic will be effectively controlled.

Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; surgery ; Humans ; Retrospective Studies

Objective To determine the risk factors for post-operative delirium(POD)and post-operative cognitive dysfunction(POCD)in patients undergoing spine surgery.Methods One hundred and twenty ASA Ⅰ-Ⅲ of both sexes aged 50-76 yr undergoing elective spine surgery under general anesthesia were studied.POD was assessed by Delirium Rating Scale revised 98 at 2 days after operation and the patients were assigned into POD and nonPOD group.Cognitive function was assessed by Mini-Mental State Examination(MMSE)at 1 day before and 3 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The palients were assigned into POCD and nonPOCD group.Executive function and depression were assessed by stroop interference test and Beck Depression Inventory(BDI)at 1 day before operation.Age,sex,education,alcohol consumption per week,a history of psychiatric disease,ASA physical status,Charlson comorbidity score,type of anesthesia,anticholinergic drug administration and VAS score at 1 day after operation were recorded.If there was signifirant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select risk factor for incidence of POD and POC).Results Eleven patients developed POD(9.2％)and 30 patients developed POCD(25.0％).Logistic regression model showed that lower Stroop-CW,higher BDI score,higher Charlson comorbidity score and a history of psychiatric disease were risk factors for POD,while lower Stroop-CW,higher BDI score,higher Charlson comorbidity score and higher alcohol consumption per week were risk factors for POCD.Conclusion Preoperative executive dysfunction,depression and greater preoperative comorbidity are risk factors for both POD and POCD.A history of psychiatric disease is a risk factor for POD and higher alcohol consumption is a risk factor for POCD in patients undergoing spine surgery.

OBJECTIVETo observe the therapeutic effect of Kangyi Zhongyu Decoction (KZD) combined with gonadotropin releasing hormone-a (GnRH-a) on infertile patients with severe endometriosis.

METHODSSeventy-five infertile patients with the diagnosis of endometriosis confirmed by laparoscope who were scheduled to receive in vitro fertilization and embryo transfer (IVF-ET) were randomly assigned to three groups, they were treated respectively with KZD (A), GnRH-a (B) alone and combined of both (C), and IVF-ET were applied in the patients after 3 months of treatment. The clinical efficacy and adverse reactions in the three groups were observed and the changes of serum cancer antigen 125 (CA125) and endometrial antibody (EMAb) levels before and after treatment were tested.

RESULTSScore of dyspareunia in Group A and C was obvioushy lower than that in Group B after treatment (P <0.01). Pregnancy rate in Group C was higher than that in Group A and B (P <0.05), with the adverse reactions less than in Group B (P <0.01). The positive rate of plasma EMAb was reduced obviously after treatment in Group C with the level lower than that in the other two groups (P<0.05).

CONCLUSIONThe combined use of KZD and GnRH-a is a new method in treating infertile patients with severe endometriosis with ideal effectiveness and fewer adverse reactions, and it could advance the successful rate of reproductive assistant technique.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Embryo Transfer ; Endometriosis ; complications ; drug therapy ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Infertility, Female ; drug therapy ; etiology ; Integrative Medicine ; methods ; Phytotherapy ; Treatment Outcome ; Young Adult

Objective To construct the bioartificial liver by bone mesenchymal stem cell (BMSC) and alginate scaffold. Method Alginate scaffold was used as the cell carrier for the cultivation of BMSC and the differentiation from BMSC into hepatic like cells was induced by the cell factors of HGF, EGF and FGF-4 in the scaffold in vitro. The compatibility of the cells and the scaffold was observed by microscopy and the function of the differentiatd cells was tested. The gene of AFP and ALB was detected by RT-PCR. The secretion of ALB and the urea synthesis of the cells were tested by ALB kit and urea kit respectively. The glycogen synthesis and the CK-18 was tested by the glycogen stanning method and the immunofluorescence test. Results BMSC was able to attach, grow and proliferate well in the alginate scaffold, the well compatibility was observed by microscopy. ALB and urea were detected in the cultivating medium, the gene of ALB and AFP was identified by RT-PCR. The glycogen synthesis ability and the expression of CK-18 were induced during the differentiation. Conclusion The three dimensional atginate scaffold exhibited well compatibility with BMSC, BMSC could be differentiated into the hepatic like cell in the scaffold. BMSC and the alginate scaffold could be used to construct the bioartificial liver for the hepatic tissue engineering.

Objective To explore the efficacy of transurethral resection of bladder neck(female)and urinary sphincter(male)to treat neurogenic urinary dysfunction. Methods Forty-one patients(28 women and 13 men)with neurogenic urinary dysfunction(dysuria)were retrospectively analyzed.All patients had sacral neurological damage.The mean patient age was 27(12-43)years.All patients had urinary retention and ureter dilation.Twenty-nine patients had renal function damage.Residual urine volume was 151-700 ml(mean 420 m1).MFR was 4-14 ml/s.After local anesthesia,bladder neck(female)was incised at 5,6,7 o'clock to the circle fiber.Urinary sphincter(male) was cut off at 11,1 o'clock and was dilated using sound(F24-F27).The catheterization time was 1-2 weeks. Results All 41 patients were followed up,from 2 months to 252 months,average 85 months.Thirty-six patients(88%)were completely recovered with no residual urine,no dilation of ureter and pelvis,no renal function damage.of these 36 cases,surgery was carried out once for 1 patient,twice for 20 and 3 times for 15.Five patients(12%)were not improved. Conclusion Transurethral resection of bladder neck(female)and urinary sphincter(reale)to treat neurogenic urinary dysfunction could be an effective method.

Acute Disease ; Anemia, Refractory ; etiology ; therapy ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Female ; Histocompatibility Testing ; Humans ; Leukemia ; complications ; pathology ; therapy ; Male ; Treatment Outcome

Zhangjiagang Hospital of Traditional Chinese Medicine, as a collaborative unit of the project, participated in the clinical consistency evaluation in project of TCM Practice guidelines for Prevention and Treatment of Biqiu (allergic rhinitis) organized by the State Administration of Traditional Chinese Medicine. The evaluation results showed that the guideline met the clinical practice requirements. This article summarized the clinical evaluation experience from the three aspects: The diagnosis in TCM and Western medicine is clear and definite, but the English translation needs to be considered; The definition of remission phase of Biqiu (allergic rhinitis) is difficult, to interfere by identifying the constitution is innovative; The advantages of "preventive treatment of diseases" in TCM should be fully played in role, improving the satisfaction of patients.