Objective To investigate effect of leptin on nerve function in patient with Parkinson disease .Methods 68 cases patients with PD were selected and randomly divided into two groups, according to random number table, from October 2013 to December 2014 in the hospital.34 cases in control group were treated with conventional therapy, and 34 cases in experimental group were treated with leptin, with a consecutive treatment of twelve weeks.The score of activity of daily living scale ( ADL ) and mini-mental state examination ( MMSE ) were analyzed pre and post-treatment. ResuIts After treatment, the ADL score of experimental group was significantly lower than that of control group ( P<0.05 ) , MMSE score of experimental group was significantly higher than that of control group (P<0.05).The adverse reactions in both groups were minor.ConcIusion Leptin has good curative effect in treatment of Parkinson disease, and could significantly improve the neurological function of patients, with mild adverse reactions.

Atrial fibrillation (AF) is an independent risk factors for stroke.The stroke outcome in patients with AF is poor.The mortality and morbidity were also higher.As for the higher risk of stroke in patients with AF,the application of anticoagulant drugs is needed.Apixaban is an emerging oral direct Ⅹ a factor inhibitor in recent years.Compared to the traditional anticoagulants,such as warfarin,apixaban shows certain advantages in the prevention of stroke and systemic embolism in patients with AF.

Objective To explore the effects of fasudil on inhibiting vascular smooth muscle cells (VSMCs) proliferation in vitro,increasing cell apoptosis,and inhibiting the Ras-MEK 1/2-ERK 1/2 pathway.Methods Healthy male SD rats (80～100 g) were selected.VSMCs were separated by the thoracoabdominal aortic vascular membrane dissection.Cultured VSMCs were randomly divided into 5 groups:serum-free group; serum group; serum + 1 μmol/L fasudil intervention group; serum + 10 μmol/L fasudil intervention group; serum + 100 μmol/L fasudil intervention group.The proliferation and migration of VSMCs were detected by MTT method and wound healing assay.Cell cycle and apoptosis of VSMCs were examined by flow cytometric analysis.The mRNA expressions of pro-apoptotic protein (Bax) and anti-apoptotic protein(Bcl-2) were determined by RT-PCR method,and the ratio of Bax/Bcl 2 was calculated.Western blot were performed to detect the protein expressions of Ras,MEK1/2,ERK1/2 and Akt in VSMCs.Results Fasudil inhibited rat VSMCs proliferation and migration,and blocked FBS-induced progression from the G0/G1 phase to S phase in a dose-dependent manner.Fasudil inhibited the early and late apoptosis in VSMCs,increased Bax mRNA expression and inhibited Bcl 2 mRNA expression.Fasudil significantly inhibited the protein expressions of FBS-stimulated intracellular Ras,phosphorylated MEK1/2,ERK1/2 in a dosedependent manner,but did not affect the protein expression of phosphorylated Akt.Conclusions Fasudil can attenuate VMSCs proliferation by blocking Ras-MEK1/2-ERK1/2 pathway and increasing cell apoptosis.

Objective For analyzing the outcome of toe transplantation Methods From 1992 to 2001, 24 cases of defect of fingers were treated with toe transplantation, including second toe transplantation for thumb in 19 cases, for index finger in 1 case, and for middle finger 2 cases, as well as second toe and third toe transplantation for middle and ring fingers in 2 cases Results The transplantated toe survived in 23 cases The reconstituted fingers and thumbs showed good shape and excellent function Conclusion Careful examination, reasonable design of reconstrction plan, and fine manipulation to protect blood vessels from trauma induced by operation play a key role in the toe transplantation, especially in the presence of abnormal blood vessels

Objective To report the clinical result of island flaps of hand in reparing of hand skin defects Methods According to location of skin defect, thirty eight cases with skin defect in hand were repaired by different types of island flap on hand Results The repair effect was satisfactory, almost all flaps were transplanted successfully, except two flaps The postoperative follow up period was 6 to 18 months, the blood supply, elasticity and texture of flaps were fine Conclusion Transfering of different types of island flap of hand is an easy, safe and reliable method with fewer complication

Hypertensive disorder complicating pregnancy is a special disease during pregnancy,and it is the key reason for rising death rate of maternal and perinatal infants.Its etiology and pathogenesis are not yet fully elucidated.It is generally accepted that placenta damage plays a central role in hypertensive disorders complicating pregnancy.In recent years,studies have shown that hypoxia inducing factor-1 (HIF-1),vascular endothelial growth factor (VEGF)and its receptor family are important regulatory factors associated with hypertensive disorders complicating pregnancy.In this article,we discussed the relationship between the two factors and hypertensive disorders complicating pregnancy.

Objective To investigate the predictive value of cardiovascular risk factors in coronary atherosclerotic heart disease.Methods A total of 400 patients who underwent coronary angiography (CAG) in our hospital was divided into multiple vascular lesion group,single vascular lesions group,and non-CAD group according to the result of CAG and their clinical data were analyzed retrospectively.The correlation between cardiovascular risk factors and coronary artery lesions was analyzed,and the independent risk factor of CAD was screened by multi-factorial logistic regression analysis.Results There was significant difference in total cholesterol (TC),triglycerides (TG),high density lipoprotein cholesterol (HDLC),fasting blood glucose (FBG),inflammatory cells,carotid artery plaque,brachial-ankle pulse wave velocity (baPWV),high-sensitivity C-reactive protein (Hs-CRP) between the CAD group and the non-CAD group (P ＜ 0.05 or P ＜ 0.01).The number of coronary artery lesion branch was increased significantly when risk factors,such as age,body mass index(BMI),hypertension,diabetes mellitas,smoking,carotid artery plaque,TG,TC,low density lipoprotein cholesterol (LDL-C),FBG,WBC,monocytes (M),neutrophils (N),neutrophils/lymphocytes (N/L),baPWV,and Hs-CRP.Other risk factors including TC,HDL-C,L were decreased with a statistically significant difference (P ＜ 0.05).There was no significant relation among,and left ventricular ejection fraction (LVEF)％.The most significant risk factor was carotid artery plaque that was independently associated with coronary heart disease (b =1.264,P ＜ 0.01),followed by smoking (b =1.204,P ＜0.01),HDL-C (b =1.104,P ＜0.01),TC (b =1.082,P ＜0.01) diabetes mellitus (b =0.956,P ＜0.01),baPWV increased (b =0.741,P ＜0.01),WBC (b=0.721,P ＜0.01),hypertension (b =0.602,P ＜0.01),the age (b =0.538,P ＜0.01),and HsCRP(b =0.421,P ＜ 0.01).Conclusions The results suggest that the hypertension,hyperlipidemia,smoking,age,baPWV,inflammatory cells,Hs-CRP,and carotid artery plaque was a significant independent CHD risk factors.

Objective To systematically assess the clinical efficacy and safety of apixaban versus enoxaparin in the prevention of venous thromboembolism (VTE) after major orthopedic surgery.Methods Based on the principles and methods of Cochrane systematic review,the Cochrane Library,PubMed,EMBASE,Chinese Bio-medicine Database,China Journal Full-text Database,VIP Database were searched from their establishment to March 2012 in whatever languages.Related journals were handsearched as well.Randomized controlled trials (RCTs) of comparing apixaban and enoxaparin in the prevention of venous thromboembolism after major orthopedic operation were included.Cochrane Collaboration' s tool was used for assessing risk of bias in the included trials.Cochrane Collaboration' s software RevMan 5.1 was used for statistical analysis.Results Four RCTs totaling 12 897 patients were included.Apixaban treatment showed significant differences in aspects of total VTE and all-cause mortality [relative risk (RR) =0.63,95％ CI(0.41,0.96)],major VTE [RR =0.59,95％ CI(0.19,0.98)] and symptomatic deep vein thrombosis (DVT) [RR =0.50,95％ CI(0.26,0.97)] when compared with enoxaparin,but the difference in fatal pulmonary embolism was insignificant[RR =1.57,95％ CI(0.41,5.99)].For patients undergoing total knee arthroplasty,apixaban was associated with significantly fewer major bleeding events[RR =0.55,95％ CI(0.32,0.96)] and fewer total bleeding events[RR =0.79,95％ CI(0.66,0.95)] than enoxaparin.For patients undergoing total hip replacement,however,the two treatments revealed no statistically significant differences.With regard to the incidence of drug-related serious adverse events,the two treatments displayed no significant difference[RR =0.97,95％ CI(0.59,1.58)].Conclusion Apixaban is effective in the prevention of VTE after major orthopedic surgery and can significantly reduce the risk of postoperative VTE.

Objective To screen the risk factors of liver metastasis in patients with postoperative colorectal cancer and to set up a mathematic model.Methods One hundred and sixty-eight patients received radical surgery were retrospectively analyzed.Logistics model regression was used to identify the risk factors and ROC test to complete a mathematic model.Results The 3 and 5-year incidence rate of liver metastasis was 25.0％ and 33.3％,respectively.The risk factors of liver metastasis were lymph node metastasis (LNM),tumor invasive depth (TID),histological grading (G) and preoperative serum tumor markers (PSMs).The mathematic model was:logit (P) =-0.931 + 0.973 × LNM + 0.302 x TID + 0.637 x G + 0.042 x PSMs.Conclusion The risk factors of liver metastasis were LNM,TID,G and PSMs,and the mathematic model could be set up.

Objective To identify the outcomes and effect of applying the health check-up nursing quality control system developed as supervised by JCI quality assessment standards.Methods The monitoring system for nursing quality in the health check-up department is established within the framework of the hospital quality improvement committee and in line with characteristics of the department.Quality improvement tools may be called into play for analysis and decision making to revolve critical problems found in health check-up nursing,upgrading nursing quality and customer satisfaction.Results Significant rise of health check-up quality and customer satisfaction for nurses,and the nurses are trained in quality control knowledge and get further involved in quality management of their department.Conclusion Health check-up nursing management system under the JCI standard is conducive to raising the nursing quality,and helps nurses with problem analysis and solution.