Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.

BACKGROUND:Currently the ultrasound-guided continuous femoral nerve block has been widely used as a postoperative analgesia method after knee replacement surgery, but there are stil some technical and practical details issues to be studied. OBJECTIVE:To evaluate the effect of ultrasound-guided imaging and safety evaluation of different puncture techniques and needle choice in the ultrasound-guided continuous femoral nerve block after total knee arthroplasty.METHODS:One hundred and sixty patients undergoing total knee arthroplasty were randomly divided into four groups, with 40 cases in each group. Continuous femoral nerve block was done after general anesthesia induction. Patients in each group were respectively punctured using 20 G needle (diameter 1.1 mm) out-of-plane approach, 20 G needle (diameter 1.1 mm) in-plane approach, 18 G needle (diameter 1.3 mm) out-of-plane approach, and 18 G needle (diameter 1.3 mm) in-plane approach. Patient-control ed analgesia pump was used 30 minutes before the end of surgery. The operating time of continuous femoral nerve block was recorded. The visual analogue scale scores at rest, active functional exercise and continuous passive movement state on 6, 24, 48, 72 hours after total knee arthroplasty were estimated. The presses of the pump, time of first walk, daily walk times and complication of continuous femoral nerve block were observed. RESULTS AND CONCLUSION:The operating time of continuous femoral nerve block in group D was shorter than that in other groups (P<0.05). There was no difference of visual analogue scale scores, the presses of the pump, time of first walk, and daily walk times among each group. The incidence of puncture site pain in group C was higher than that in other groups (P<0.05). The best ultrasound imaging was obtained by using 18 G needle in-plane approach for ultrasound-guided continuous femoral nerve block after total knee arthroplasty, and the complication incidence was not increased.

Heart rate variability (HRV) is an important point to judge a person's state in modern medicine. This paper is aimed to research a person's fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV's characteristics of fatigue crowd based on the database provided by Physio-Net. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.
Fatigue ; diagnosis ; Heart Rate ; Humans ; Regression Analysis

Objective To evaluate the clinical effect of different temperature of fluids and blood infusion on postoperative recovery quality in elderly patients undergoing total knee arthroplasty (TKA).Methods One hundred and fifty-six cases of elderly patients (male 42,female 1 14,aged 65-85 years,ASA Ⅰ or Ⅱ)scheduled for selective single TKA were recruited and divided into three groups randomly(n =52 each),normal temperature group (group NT),constant temperature group (group CT)and warming temperature group (group WT).Patients of group NT were infused with blood or fluids of room temperature (22-24 ℃)and surgical area were flushed with fluid of room tem-perature too.Patients of group CT were infused with blood or fluids of 37 ℃ by heating apparatus and temperature of fluids used to flushing was 37 ℃ too.Otherwise,in group WT,the tempreture of blood and fluids for infusion were kept at 37 ℃ and the surgical area were flushed with fluid of 39 ℃. The nasopharyngeal temperature were recorded on time points of before anesthesia (T0 ),30 min (T1 )and 1 h (T2 )after surgery beginning,30 min (T3 )and 1 h (T4 )after surgery.Time of sponta-neous breathing,time of eye opening on call,time of fully conscious,extubation time and Steward scores of patients were recorded too.And the cognitive function were evaluated by Postoperative Quality Recovery Scale (PQRS)on time points of 1 5 min and 40 min after extubation and the 1,3, 30 d after surgery.Results Compared with T0 ,the nasopharyngeal temperature of three groups were significantly decreased at T1-T4 (P <0.05 or P < 0.01 ).The nasopharyngeal temperature of group CT and group WT were significantly higher than in group NT at T1-T4 (P <0.01).And the nasopha-ryngeal temperature of group WT was significantly higher than in group CT at T4 (P <0.05).Com-pared with group NT,time of eye opening on call and spontaneous breathing in groups CT and WT were significantly shorter (P < 0.01 ).Time of fully conscious in group WT was obviously shorter than in group NT (P <0.01),and the Steward score in group WT was significantly higher than in group NT (P <0.05).Compared with before extubation,the cognitive function scores in all patients at 1 5,40 min after extubation and 1,3,30 d after surgery were increased significantly (P <0.01).The cognitive function scores in group CT and group WT at all time points were significantly higher than that in group NT (P <0.05).And the cognitive function scores in group WT was significantly higher than that in group CT at 30 d after surgery (P <0.05).Conclusion The elderly patients undergoing TKA receiving blood transfusion and infusion at 37 ℃ and flushing the area with fluid at 39 ℃ can prevent the occurrence of hypothermia and improve the postoperative recovery quality and cognitive function recovery.

Objective To explore the role of ? chemotactic factor- MCP-1 in the pathogenesis of congestive heart failure by detecting its expression changes.Methods PBMCs were collected from 25 patients with congestive heart failure and 10 healthy controls. RT-PCR was used to detect the mRNA expression of MCP-1 in PBMCs. Correlation of the clinical indexes of heart failure patients with to their MCP-1 mRNA expression levels were analysed.Results The expression level of MCP-1 in the heart failure patients was higher significantly than that of controls (P

Objective To evaluate intra- and interatrial asynchrony and its determinants in aged patients with paroxysmal atrial fibrillation (PAF) by using tissue Doppler imaging. Methods Ninty-one patients without PAF (control group, including 40 elder patients and 51 non-elder patients) and 52 aged patients with PAF were included. As to assessment of intra- and interatrial synchronicity, the atrioventricular plane were selected on the right atrial (RA) free wall, interatrial septum (IAS), and left atrial (LA) free wall. The time differences from the onset of the P wave to the onset of the A wave at the left atrium (P-LA), the IAS (P-IAS), and the right atrium (P-RA) were measured. Intra-atrial asynchrony was defined as the differences between P-IAS and P-RA (RA asynchrony) and between P-LA and P-IAS (LA asynchrony). Interatrial asynchrony was defined as the difference between P-LA and P-RA. Stepwise regression was made to determine the influencing factors for atrial asynchrony in aged patients with PAF. Results Compared with the control group, aged patients with PAF had significant LA and interatrial asynchrony (P＜0.01). Multivariate stepwise regression demonstrated that systolic blood pressure (x2), age (x1) and left ventricular mass index (LVMI x5) entered the regression equation in aged patients with PAF (Y=-57.241+0.481 x1+0.223 x2+0.294 x5). Conclusions Aged patients with PAF have LA and interatrial asynchrony. LVH, aged and SBP are important factors leading to these asynchronies in the aged patients with PAF.

Objective:To evaluate the preventive effect of Danshen Shuizi Capsule on vascular restenosis after stent implantation.Methods:48 patients with endovascular stent implantation were randomly assigned to control group(n=25) (treated with western medicines)and treatment group(n=23)(treated with Danshen Shuizi Capsule)after endovascular stenting implantation.The intraluminal diameter of stenting segment was measured by QCA at 6 months after stent implantation.Results: The diameter of reference vessel in two groups was not significantly different.The intraluminal diameter of stent segment in the treatment group was not larger than that in the control group(2.22?0.21)mm vs(2.18?0.25)mm.The index number of vessel diameter reduction in treatment group was not less than that in the control group(0.50?0.16)mm vs(0.51?0.11)mm.The rate of restenosis(18.4%)and reintervention(13.1%)in treatment group were not lower than those in the control(20%,12%).However,the complication in treatment group was significantly lower than that in control group.Conclusion:These findings indicated that endovascular was useful for the prevention of endovascular restenosis after stent implantation with fewer complications

OBJECTIVE:To establish a simple and rapid preparation technique of Rifampicin eye drops.METHODS:The calculating quantity of hydrochloric acid was used to dissolve Rifampicin,then the equimol quantity of potassium hydroxide was added to neutralize the acid and yield potassium chloride,whose quantity was designed according to the prescrip?tion.RESULTS:Neutralization reaction not only overcame the difficulty of Rifampicin's dissolution in water,but also avoided the irritation to eyes caused by using ethanol as solvent.CONCLUSION:The method is well-versed in design,simple in preparation and controllable in quality.

Objective To explore the protective effects and possible mechanisms of Polydatin (PD)on hypoxic-ischemia brain injury(HIBD) in neonatal rat by means of spatial learning memory and the expression of synaptophysin in hippocampal CA1. Methods Thirty-seven neonatal SD rats were divided into 3 groups at random: normal sham-operated group( no hypoxia and ischemia); HIBD group( no medication) ;PD treatment group. 7-old-day rat' s model of HIBD was established by left carotid artery ligation and 2 h hypoxia. Morris water maze test was used to evaluate cognitive function in the rats after 28-day-old( 21-day later after HI). Immunohistochemical method was used to measure the expression of synaptophysin after the end of Morris water maze test. Results Morris water maze results showed that the mean escape latency of the shamgroup (SG) ,HIBD group (HIBD) and PD treatment group (PD) were (39. 55 ±8. 08) s, (52. 37 ±8.03) s and (43.29 ± 7. 63 ) s respectirely. For PD and SG, the mean escape latency was significantly shorter than the HIBD (P ＜0.05). After training,the mean escape latency in the three groups of rats was shortened gradually. The frequency of platform crossings were 5. 29 ±2.62、2. 36 ± 1.80、4. 25 ± 1. 66 in the SG,HIBD and PD respectirely. The frequency of platform crossings in PD was higher than that of HIBD ( P ＜ 0. 05 ). The swimming time in target quadrant were ( 15.74 ± 3.85) s, ( 10. 63 ± 3.66) s and ( 14. 32 ± 2. 52 ) s in SG, HIBD and PD respectirely. For HIBD ,the swimming time in target quadrant was significantly shorter comparing to SG and PD ( P ＜ 0. 05 ). The expression of synaptophys in hippocampal CA1 in PD ( 0. 295 2 ± 0. 044 3 )were evidently higher than that in the HIBD group (0.261 2 ±0.032 3) at 3 week after operation (P ＜0. 05). Conclusion Spatial learning memory deficits and the decrease of synaptophys in hippocampal CA1 could be induced by hypoxic-ischemia. Polydatin could improve the learning and memory ability in neonatal rats following hypoxic-ischemia brain damage. The mechanisms of improvement with Polydatin treatment is associated with the enhancement of expression of synaptophys.

Objective To investigate the protective effects and possible mechanisms of polydatin(PD) on hypoxic-ischemia brain damage(HIBD) in neonatal rat by means of the expression of intercellular cell adhesion molecule( ICAM)-1 in cortex. Methods Fifty-four SD rats were divided into 3 groups at random, shame group (no HIBD), HIBD group (no medication) ,and PD treatment group. 7day-old rat's HIBD model was established by Rice's method. ICAM-1 expression in brain after HIBD was measured in different time by Immunohistochemitry technique. Results In sham group, there were less brain microvessel immunostained positively. In HIBD group,the number of ICAM-1 immuno-positive staining blood vessels increased significantly after 6h, 12h reached peak point. ICAM-1 immunoreactive staining of blood vessels levels continued in the peak after 24h. In PD treatment group, ICAM-1 expression on brain microvascular endothelial decreased after HIBD 6h, 12h, 24h, which was significant compared with HIBD group( P < 0. 05 or P < 0. 01 separately). Conclusion The expression of ICAM-1 was involved in the procedure induced by hypoxic-ischemia. After HIBD, polydatin would downregulate ICAM-1 expression in cerebral microvascular endothelial, and inhibite the inflammatory response.