Female ; Humans ; Methotrexate ; Pregnancy ; Pregnancy, Ectopic

Objective To explore the change rule and clinical application value of hemorheologic indexes in patients with acute intracerebral hemorrhage ( ICH) . Methods The hemorheology indexes of 100 acute ICH patients ( ICH group) were detected within 24 h, and compared with 30 normal controls ( normal control group) . The effect of hemorheology index on history of hypertension, hemorrhage quantity and the hemorrhage location were analyzed. Results Compared with those in normal control group, the indexes of whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate were significantly increased and erythrocyte aggregation index, erythrocyte deformability index and hematocrit were significantly decreased in acute stage ( all P< 0. 01 ) . Blood rheology indexes were changed significantly in hypertensive cerebral hemorrhage group (all P<0. 01), the whole blood viscosity (200 s-1 and 50 s-1 ) , erythrocyte aggregation index, hematocrit and erythrocyte sedimentation rate in non-hypertensive cerebral hemorrhage group were changed significantly ( P< 0. 05 - 0. 01 ). Compared with normal the non-hypertensive cerebral hemorrhage group, the whole blood rheology indexes except erythroate sedicmnt ation rate significantly erythrocyte sedimentation rate were significantly changed ( P< 0. 05 ) . As the hemorrhage quantity increased in each groups, the whole blood viscosity ( 200 s-1 and 50 s-1 ) and plasma viscosity of cerebral hemorrhage patients were significantly increased, otherwise the erythrocyte aggregation index was significantly decreased (P<0. 05-0. 01). There were statistical differences compared the indexes of whole blood viscosity (200 s-1 and 1 s-1 ) , plasma viscosity, erythrocyte aggregation index and erythrocyte sedimentation rate among each groups of different hemorrhage locations in acute ICH patients (all P<0. 05). Conclusions The blood of acute ICH patients shows a state of concentrated, sticky, aggregation and coagulation that severely affects the prognosis. The patients with hypertension and greater hematoma changed obviously, different hemorrhage location affected differently.

Objective To review the clinical,histological and diagnostic aspects of 12 documented cases of nodular regenerative hyperplasia of the liver(NRHL),to make this condition be understood and dealt with better. Method Twelve NRHL cases were diagnosed based on liver biopsy from 300 portal hypertension patients who had been underwent splenectomy.Imaging studies were performed as part of the diagnostic evaluation.Clinical manifestation and biochemical tests were recorded at the time of diagnosis.Management and prognosis were also reviewed.Results Most patients were complicated with autoimmune disease,6 cases were diagnosed systemic lupus erythematosus and 1 was Crohn's disease and 1 suspected ulcerative colitis.Six cases were treated by prednisone and 3 cases by immunosuppressant.Eleven cases had suffered from portal hypertension.All cases had no history of viral hepatitis.Biochemical tests showed mild increase of liver enzyme and relative normal synthetic liver function.The histological finding was nodular in the hepatic parenehyma,with mild periportal fibrosis,intraportal lymphocytic infiltration,narrow and obstruction of branch of portal vein,and lack of hepatocyte necrosis.All cases were diagnosed liver cirrhosis and portal hypertension before operation.Management was directed to portal hypertension and varices bleeding with satisfactory results.Most of them keep a stable condition during the follow-up. Conclusion The NRHL was uncommon and its cause and pathogenesis was unclear,may be related with immune and hepatic blood circulation disorder.It should be considered in patients with unexplained portal hypertension and distinguished it from liver cirrhosis.Liver biopsy confirms the diagnosis.Management directed to portal hypertension may improve clinical condition.

AIM:To perform a new method for orbital implant and contracted socket through one time and its results. ·METHODS:Totally 114 patients 114 eyes, from January 2008 to June 2014, with contracted socket participated in this study. We incised the bulbar conjunctiva horizontally and excised scar tissue, then implanted the hydroxyapatite in the four extraocular muscles and tightly sutured the Tenon ' capsule. After that, we put the superior and inferior conjunctival petals backwards and sutured them to the Tenon ' s capsule. All the patients were divided into four groups according to the vertical diameter length of the conjunctival defect area:GroupⅠ:≤5mm; Group Ⅱ: 6-10mm; Group Ⅲ: 11-15mm; and Group Ⅳ: ≥16mm. These patients were followed up for 6mo to 3y to observe the conjunctival sac shaping and growth of conjunctiva. ·RESULTS:There were 64 cases in GroupⅠ, 31 cases in Group Ⅱ, 16 cases in Group Ⅲ and 3 cases in Group Ⅳ. All patients ' conjunctival defect was covered by new conjunctiva and scar tissue 4 to 6wk after surgeries. Ten cases had contracted socket; 2 cases had orbital implant exposure, requiring reoperation. Of the 114 cases, 8 had contracted socket and could use a smaller conformer, 106 could use a normal size conformer. ·CONCLUSION: When the conjunctival defect was ≤15mm, this new method can address the orbital implant and contracted socket at the same time. While it was ≥16mm, flap transplantation is necessary.

BACKGROUND: Tiantai I consists of gastrodia, Chinese angelica root, areca seed. It has been considered as the roles of invigorating the liver, nourishing marrow, heightening the intelligence and causing resuscitation. OBJECTIVE: To observe the effects of Tiantai Ⅰ on the abilities of learn ing and memory and the activity of central cholinergic system in mice withspontaneous Alzheimer disease. DESIGN: A randomized control observation. SETTING: Shenzhen Institute of Integrated Chinese and Western Medicine. MATERIALS: Male Kunming mice of 13 months old were raised to 21 months old, of which 52 with spontaneous Alzheimer disease werescreened. They were randomly divided into blank control group, westerndrug control group, Tiantai Ⅰ 6.80 and 20.41 g/kg groups, 13 mice in eachgroup. Another 13 aged mice with normal learning and memory abilitieswere selected as the normal control group at the same time. METHODS: Mice in the western drug control group were treated with0.6 mg/Kg Hydergine, those in the Tiantai Ⅰ 6.80 and 20.41 g/kg groupswere given intragastric administration of Tiantai Ⅰ of 6.80 and 20.41 g/kg, respectively, and those in the normal control group and blank control groupwere given double distilled water of the same volume. The learning andmemory results were examined by the step-down test. Freezing sections ofbrain tissue were prepared, acetylcholinesterase (AChE) fiber was showedaccording to the Hedreen method, and choline acetyltransferase (ChAT) was detected with Burt and Silver methods, the automatic image analysissystem for biomedical application was applied in the quantitative analysisof AChE fiber and ChAT activity. MAIN OUTCOME MEASURES: ① Effect of Tiantai Ⅰ on the abilities of learning and memory in mice with Alzheimer disease; ② AChE fiberarea density in temporal cortex and hippocampal CA1 region; ③ ChAT ac tivity in Meynert nuclei of basal forebrain. RESULTS: ① Tiantai Ⅰ in ameliorating the abilities of learning and mem ory in mice with spontaneous Alzheimer disease: The error times in theTiantai Ⅰ 6.80 and 20.41 g/kg groups, normal control group and westerndrug control group were obviously fewer than that in the blank controlgroup (5.08±2.18, 3.77±1.48, 3.25±1.27, 6.17±3.12, 9.31±3.65, P ＜ 0.05). ② AChE fiber area density: The AChE fiber area densities in temporalcortex were obviously higher in the Tiantai Ⅰ 6.80 and 20.41 g/kg groups, normal control group and western drug control group than in the blankcontrol group (20.19±4.18, 25.01±6.44, 26.38±6.52, 19.44±4.33, 14.36±3.21, P ＜ 0.05). The AChE fiber area densities in hippocampal CA1 region were obviously higher in the Tiantai Ⅰ 20.41 g/kg groups and nor mal control group than in the blank control group, western drug controlgroup and Tiantai Ⅰ 6.80 g/kg group (13.88±3.07, 14.11±4.36, 6.57±2.30, 10.13±2.94, 9.63±2.40, P ＜ 0.05). ③ ChAT activity: It was obviously high er in the TiantaiI 20.41 and 6.80 g/kg groups, western drug control groupand normal control group than in the blank control group (0.683±0.179, 0.589±0.179, 0.552±0.173, 0.705±0.141, 0.354±0.131, P ＜ 0.05). CONCLUSION: Tiantai Ⅰ can significantly improve the disturbances oflearning and memory in mice with spontaneous Alzheimer disease, and itcan increase the activity of central cholinergic system in a dose-dependentmanner.

Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease.Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated.Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in BUT was seen among mild,moderate and serious symptom groups ( F =11.871,P =0.000 ),and BUT in mild symptom group was delayed in comparison with moderat and serious groups( P=0.000,0.000).No significant differences were found in Schirmer Ⅰ test,tear film interferometry scores and fluorescence staining rate among three groups(F=1.432,P =0.246; F =2.799,P =0.068; x2 =6.026,P =0.050).SPEED score showed a positive correlation with OSDI score ( r =0.697,P =0.000 ). Conclusions Both OSDI and SPEED are effective tools for the evaluation of symptoms of dry eye.The two types of questionnaires are consistent in symptoms evaluation.

BACKGROUND: The early and medium medication has been proved to have a certain effect to patients with Alzheimer disease, can delay its development.OBJECTIVE: To investigate the effect of No. 1 recipe on learning and memory function of spontaneous Alzheimer disease models.DESIGN: A randomized and controlled trial.SETTING: Shenzhen City Institute of Integration of Traditional Chinese and Western Medicine.MATERIALS: The experiment was completed at the grade Ⅱ Laboratory of Shenzhen City Institute of Integration of Traditional Chinese and Western Medicine. The experimental animals were mice of Kunming strain.METHODS: Totally 52 Kunming mice, aged 21 months, with spontaneous Alzheimer disease (memory impairment) were chosen, and at random divided into 4 groups: senile dementia, western drug control, tiantai No. 1recipe 6.80 g/kg and 20.41 g/kg groups; besides 13 mice with normal learning and memory power were chosen as normal senile group. Hydergine 0.6 mg/kg was given for mice in western drug control group, tiantai No. 1recipe (orthogonally optimized) 6.80 g/kg and 20.41 g/kg were respectively given for mice in tiantai No. 1 recipe 6.80 g/kg and 20.41 g/kg groups.The medicines above were all prepared into 0.5 mL solution and given by garage, for consecutive 60 days. The mice in normal senile and senile dementia groups were given double distilled water of the same volume. The learning memory power was tested by jumping stand, comparing the numbers of learning error and memory error, latent escaping periods of learning training and latent safe platform of memory test.MAIN OUTCOME MEASURES: The improving effect of tiantai No. 1recipe on learning and memory function of spontaneous Alzheimer disease mice.RESULTS: All animals involved in the trial entered the final result analysis without any loss. The error numbers of learning and memory in tiantai No. 1 recipe 6.80 g/kg and 20.41 g/kg groups were smaller than that in senile dementia group (5.08±2.18, 3.77±1.48, 9.31±3.65; 1.85±1.21, 1.54±0.88,4.27±2.58), and the error number of learning in tiantai No. 1 recipe 6.80 g/kg group was more than that in tiantai No. 1 recipe 20.41 g/kg group. The escape latent period of learning training was smaller than that in the senile dementia group and the safe platform latent period of memory in tiantai No. 1 recipe 6.80 g/kg and 20.41 g/kg groups were longer than that in senile dementia group [(18.9±7.5), (19.9±5.9), (33.7±9.3); (91.7±32.0),(101.5±40.9), (43.6±20.7)s], and the safe platform latent period of memory in tiantai No. 1 recipe 6.80 g/kg group was smaller than that in 20.41 g/kg group.CONCLUSION: There was obvious intellectual disturbance in spontaneous Alzheimer disease mice, tiantai No. 1 recipe can remarkably improve their learning and memory impairments, with a relationship of dose-effect.

Objective To explore the influence of electrical stimulation on prefrontal cortical neurons and synaptic ultramicrostructure of hypoxic-ischemic brain damage(HIBD)in neonatal rats.Methods The sixty 7-day-old newborn healthy SD rats were randomly divided into hypoxic-ischemic group(model group),electrical stimulation(intervention)group and sham operation group(control group),which 20 for each group.The models of perinatal HIBD rats were prepared by ligation of left common carotid artery with a temporary systemic hypoxia for 2 hours.Intervention group was subject to electric stimulation for 30 minutes,once everyday after surgery.Control group and model group were not subject to electric stimulation but caught to fix in corresponding period.Fastigial nucleus electric stimulations were performed for 3 d,14 d and 21 d.Five rats were killed in each group after the application of electron microscope to observe the brain cortex neurons and synaptic ultrastructure changes.Results In model group,the neuronal shrinkage,the amount of organelles dacrease,ob-vious edema of cytoplasm,obvious swellen mitochondria,and synapse quantity decrease,synaptic space fusion,obvious synaptic vesicle were observed.Intervention group different times,mitochondria hydrops gradually alleviated,synaptic space gradually cleared,synaptic vesicle increased,pathological changes obviously lessened compared to model group at the same time,and there was no apparent abnormality compared with control group on the 21st d.Conclusion Electric stimulation can promote the ultramicrostructures recovery of HIBD rats.

Objective To investigate the effects of electrical stimulation on vascular endothelial growth factor(VEGF) and its receptor expressions of neonatal rat brain with hypoxic-ischemic brain damage(HIBD).Methods Seventy-five 7-day-old newborn health SD rats were randomly divided into sham operation group(control group,n=25),hypoxia-ischemia group(model group,n=25) and the electrical sti-mulation group(intervention group,n=25).To bulid HIBD animal model of neonatal rats,the left common carotid artery was ligated and nitrogen-oxygen gas mixture was inhaled 2 hours.Fastigial nucleus stimulation was given 12 hours after the operation in intervention group,30 min?time-1,1 time?d-1,the time length was 1 d,3 d,7 d,14 d or 21 d,respectively.There was no electrical stimulation in model group and control group.The rats in these groups were captured at the corresponding time.Five rats in each group were killed at the corresponding pe-riods after electrical stimulation,the expression of VEGF and its receptor fam-like tyrosine kinase receptor(flt-1 / VEGFR1),fetal liver kinase receptor(flk-1/KDR/VEGFR2) in hippocampus were observed by immunohistochemistry.SPSS 15.0 software was used to analyze the data.Results The expression of VEGF,VEGFR1,VEGFR2 at every time point in electrical stimulation group were higher significantly than those in model group and control group(Pa0.05).Conclusion Electrical stimulation can promote the expression of VEGF and its receptors VEGFR1,VEGFR2.