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.

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

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

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 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.

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 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 investigate the incidence and pregnancy outcomes of premature rupture of membranes (PROM) in pregnant women in Beijing.Methods A retrospective multicenter study of 18 534 cases delivered in Beijing Obstetrics and Gynecology Hospital,Beijing Friendship Hospital,Daxing MCH Hospital and Tongzhou MCH Hospital from January 2011 to December 2011,was conducted.Results Among 18 534 cases,PROM occurred in 4 504 cases (24.30％),including 3 910 cases of in term PROM (21.10％) and 594 cases of preterm PROM (3.20％).The incidence of premature delivery was 6.17％ (1 144/18 534),and among 1 144 cases of premature delivery 547 cases were PROM (47.81％);the incidence of PROM was 22.75％ (3 957/17 390) in term delivery.The overall cesarean section (CS) rate was 48.50％ (8 989/18 534) and that in pregnant women with PROM was 35.55％ (1 601/4 504),but the CS rate in pregnant women without PROM was 52.66％ (7 388/14 030).The rate of postpartum hemorrhage was 13.12％ (210/1 601)in CS cases and 4.17％ (121/2 903) in vaginal delivery cases (x2 =121.361,P=0.000).The mean hospital stay for PROM was (5.3±2.9) d in CS cases and (4.3±2.3) d in vaginal delivery cases (t =-12.136,P =0.000).Conclusions Without severe maternal or fetal complications,the incidence of PROM is relatively high in Beijing region and PROM may not increase the maternal or fetal complications.Vaginal delivery is the main mode of delivery for PROM.Cesarean section may not cause less neonatal complications,but may lead to more postpartum hemorrhage and longer hospital stay.

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.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.