Objective To investigate the clinical significance of the serum levels of sICAM-1,ET,MCP-1 and APN in patients with acute cerebral infarction(ACI).Methods 120 patients with ACI were selected and divided into different groups according to the size of infarction and clinical neurologic impairment degree score.The serum levels of sICAM-1,ET,MCP-1 and APN were detected by enzyme-linked immunosorbent assay.A healthy control group which approximately matched the experimental group included 30 persons.Results The serum sICAM-1,ET and MCP-1 levels in the patients with ACI were significantly higher than those in the healthy groups (all P ＜ 0.05).The serum levels of sICAM-1,ET and MCP-1 were increased steply with the volume of infarction and the clinical neurologic impairment degree score,the differences between the groups was significant (all P ＜ 0.05).The serum APN levels.In the patients with ACI were significantly lower than that in the healthy groups (P ＜ 0.05).The serum levels of APN were decreased steply with the volume of infarction and the clinical neurologic impairment degree score,the differences between the groups were significant (all P ＜ 0.05).Conclusion The sICAM-1,ET,MCP-1 and APN may play an important role in the pathogenesis of ACI.The serum levels of sICAM-1,ET,MCP-1 and APN are closely correlated with the clinical neurologic impairment degree score and the volume of infarction,which may be of great value in predicting acute cerebral infarction and the severity of cerebral infarction.

Objective To study the angiographie characteristics of coronary heart disease (CHD) patients with type 2 diabetes mellitus.Methods 292 patients with CHD underwent a selective angiography were selected,the characteristics of coronary arteriongraphy were compared in CHD patients with type 2 diabetes mellitus and nondiabetic group.Results In type 2 diabetes mellitus group,the degree of stenosis was higher than that in nondiabetic group (78.01% vs 52.32% )(P < 0.05 ), and the rate of three-vessel disease was higher than that in nondiabetic group (59.57% vs 36.42% )(P <0.05).Conclusion The angiographic characteristics were different in CHD patients with or without type 2 diabetes mellitus.Patients with type 2 diabetes mellitus was associated with more severity of lesion and more lesion vessel.

Objective To investigate the efficacy and safety of plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB). Methods 158 patients with BPH were randomly divided two groups: 81 patients treated by plasmakinetic enucleation and resection of the prostate by divided into three parts and blocking blood flow in advance (PKERPDPB), 77 patients treated by plasmakinetic resection of the prostate (PKRP). All patients were evaluated preoperatively and at 1, 6, 12 months after surgery by IPSS, QOL, Qmax and PVR. Operation time, resected adenoma weight, catheterization time, hospital stay and complications were documented. Results There were no significant differences in preoperative parameters. The resected adenoma weight in the PKERPADPB group was heavier than that in the PKRP group, the difference was significant. Compared with PKRP, PKERPDPB required a longer operation time, but resulted in less hemoglobin decrease, less catheterization time and hospital time. During the 1, 6, 12 months of follow-up, there was no significant difference in Qmax, IPSS, PVR and QOL between the groups. Conclusion PKERPDPB was statistically superior to PKRP in blood loss, catheterization time, hospital stay but inferior in operation time. It was a safe and effective treatment for BPH.

Objective To explore the effect of prospective nursing on preventing constipation for patients with acute myocardial infarction(AMI). Methods 43 AMI patients during July 2008 and June 2010 in our hospital were classified as the observation group, besides the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation, prospective nursing was implemented.Through the retrospective analysis of medical record, 41 of AMI in our hospital during March 2006 and June 2008 were classified as the control group, they were given the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation and the nursing intervention after occurrence of constipation. The defecation condition was assessed for the two groups of patients on admission and the defecation and mortality rate was compared on the eighth day of hospitalization. Results There was significant difference in constipation and mortality rate between the two groups of patients during hospitalization. Conclusions The prospective nursing for AMI patients to prevent constipation can obviously reduce the incidence of constipation, thus to avoid serious complications caused by constipation and reduce mortality.

Objective To investigate the feasibility and superiority of combined spinal epidural anesthesia incesarean section.Methods 100 lying-in women who experienced cesarean section were collected and divided into combined spinal epidural anesthesia group(CSEA,n=50)and continuous epidural anesthesia group(CEA,n=50).The change of heart rate(HR),blood pressure(BP)and saturation of peripheral oxygen(SpO2),HR and BP of lyingin womeu in pre-anesthesia,5min,15min post-anesthesia and the time of taking effect,time between beginning of anesthesia and laboar of newborn were observed.The side effects of surgical anesthesia and Apgar score of newborn were compared between the two groups.Results There were no difference in clinical data,change of HR,BP and spO2 between two groups.The anaesthetic time of taking effect and the time between beginning of anesthesia and labour of newborn in group CSEA were shorter than in group CEA(all P＜0.05).Conclusion The combined CSEA and CEA was safe and efficient in cesarean section,and CSEA had greater efficacy than CEA in cesarean section.

Objective To explore the correlation between obstructive sleep apnea syndrome(OSAS)and developing hypertension.Methods Clinical data of 124 OSAS patieats with high blood pressure were retrospectirely,and according to the degree of hypoxemia they weredivided into three groups,monitoring of the night and 7h polysomnography figure,compare each group,woke up blood pressure changes before bedtime.Results 124 patients with hypertension OSAS clinical manifestation:snoring 124 cases(100.0％),daytime sleepiness 74 cases(59.7％),wake up in the night to suppress 49 cases(39.5％),night apnea 39 cases(31.5％),woke up oppressed 26 patients (21.0％),since morning headache 19 patients(15.3％).OSAS merger hypertension,light,medium,heavy hypoxemia between groups of blood pressure,blood pressure after come before a statistically significant difference(P ＞0.05).Conclusion Hypoxia was associated with high blood pressure.

Objective To explore the clinical value of laparoscopic-assisted vaginal hysterectomy(LAVH)in large uterus.Methods Retrospective analysis was conducted on clinical data of 94 patients(whose uterus were as big as 10-18 gestational weeks)who received hysterectomy from January 2005 to March 2007,in which 56 cases were performed laparoscopic-assisted vaginal hysterectomy(LAVH group)and 38 cases vaginal hysterectomy(VH group).The operation time,blood loss,postoperative hospital stay,and the incidence of postoperative complications were compared between the two groups.Results Compared with VH group,there were a lower chance of abdominal hysterectomy(0/56 vs 5/38,?2=5.389,P=0.020),a shorter operation time [(149?11)min vs(179?14)min,t=-11.610,P=0.000] and a shorter postoperative hospital stay [(5.8?1.4)d vs(7.3?3.6)d,t=-2.825,P=0.006] in the LAVH group.There were no significant differences in blood loss,morbidity and time to first flatus between the two groups.Conclusions The LAVH extends the indications of VH,ensuring the safety of VH for the uterus bigger than 10 gestational weeks,therefore it is an operative procedure to be recommended.

Objective To explore the effect of nerve growth factor(NGF) in the lower respiratory tract and the visceral afferent system of asthmatic guinea pigs. Methods By means of immunohistochemistry and in situ hybridization combined with the micro-image analysis to investigate the alterations of NGF immunoreactivity and mRNA expression in asthmatic guinea pig. Results The positive NGF immunoreactivity was increased in airway epithelia,C-7-T-5 spinal ganglia and correspondent spinal dorsal horn in the asthmatic guinea pigs compared with the controls(P

Objective To investigate the clinical efficacy of inserting a ureteral access sheath under direct view in flexible ureteroscopy with the help of rigid ureteroscope.Methods From March 2013 to July 2015,there were 68 patients accepted a ureteral access sheath in flexible ureteroscopy with the help of rigid ureteroscope for the treatment of kidney stones.There were 46 cases male,22 cases female,aged from 22 to 76 years old,average 43.9 years.There were 68 cases with backaches or hematuria.There were 48 cases with single stone,20 patients with multiple stones.There were 5 cases with stones on both sides.The stone diameter were from 1.2 to 2.5 cm,the average (1.83 ± 0.16) cm.There was no hydronephrosis in 18 cases,mild hydronephrosis 42 cases.The operations were carry out under general anesthesia.By using rigid ureteroscope placed zebra guidewire,then intercept F8 single lumen tip to 1.0 cm section on rigid ureteroscope,was placed into a modified 42 cm ureteral access sheath.Then the modified 42 cm ureteral access sheath was inserted under direct view with the help of rigid ureteroscope.Preoperative patient characteristics,radiographic stone size,operation time,success rate of lithotripsy,serious complications especially ureteral injury was recorded.4 weeks and 12 weeks after operation,ultrasound and/or CT were reexamined to assess the success rate of lithotripsy and the incidence ureteral stricture.Results All the procedures were successful.The operation time was (62.2 ± 6.5)min,the hospital stay was (3.1 ± 0.2) d.The success rate of ureteral access sheath completely placement was 97.1％,partially placement was 2.9％.Postoperative complications included Clavien classification grade Ⅰ 6 cases and grade II 2 cases.The postoperative follow-up averaged (12 ± 1.2) months for all case.The success rate of lithotripsy was 76.5％ in 4 weeks postoperative,and it was 95.6％ in 12 weeks.During the follow-up,compared with the preoperative cases,62 cases were not found to increase the degree of hydronephrosis.There were 58 cases (58/62) without hydronephrosis.4 cases were mild hydronephrosis (4/62).CT showed normal ureter 52 cases (52/52).Conclusions It was safe and reliable procedure with good results.It would be a safe procedure to inserting a ureteral access sheath under direct view in flexible ureteroscopy with the help of rigid ureteroscope.

The enrollment physical examination,as a real assessment of the physical and health condition for those high school graduates,is of great referencing significance for their major selection.Therefore,during the examination process,medical staff involved should enhance their recognition for relevant legal regulations,and fully respect graduates′ rights of privacy and informed consent,to ensure the impartiality,fairness,reality,and effectiveness of the assessment result,and guarantee the legal rights of high school graduates.