Objective To investigate the evidence of effective therapy of transient ischemic attacks (TIA) through the study on the regional cerebral blood flow and the function of neurocyte in the symptom free phase Methods Forty one patients with TIA and 45 controls were examined by single photon emission computed tomography (SPECT), computed tomography cerebral perfusion imaging (CTPI) and the positron emission tomography (PET) Results The abnormal rate of SPECT examination was 95 1%, and abnormal perfusion rate of CTPI was 63 4% These results revealed that there were reduction of regional cerebral blood flow in above half of TIA patients SPECT showed abnormal in some patients with normal CTPI show, which was possibly because of abnormal function of neurocyte, and the latter was confirmed by PET Conclusion Patients with TIA should have not only abnormal function of neurocyte, but also have reduction of regional cerebral blood flow in the intermittent phase The therapy of TIA should be emphasized in order to prevent TIA relapse and the occurrence of irreversible changes

Background Panretinal photocoagulation (PRP) is an effective method for diabetic retinopathy (DR).However,PRP causes macular edema and visual impairment.The application of compound anisodine,a vascular dynamic drug can alleviate the adverse effect of PRP,but its effectiveness is not verified yet.Objective This study aimed to investigate the clinical therapeutic effect of compound anisodine on retinal functional damage following PRP in the eyes with non-proliferative diabetic retinopathy (NPDR).Methods A prospective cohort study was carried out from August 2013 to February 2014 in Beijing Tongren Hospital.One hundred and ten eyes with NPDR were included and PRP were performed.The operative eyes were randomized into the compound anisodine group (64 eyes) and control group (46 eyes).Compound anisodine solution of 2 ml was injected via temporal subcutaneous tissue since the second day after photocoagulation,and the injection was performed once per day for 4 courses in 3-day interval between each course (1 course for 14 days) in the compound anisodine group,and no any drug was used in the control group.The visual acuity,30° to 60° ring visual field and flash electroretinaogram (F-ERG) were examined before photocoagulation and 1 day,1 month and 2 months after photocoagulation to compare the retinal function between the two groups.ResultsThe vision acuity improved in 55 eyes in the compound anisodine group with the rate 85.94％,and that in the control group was 11 eyes with the rate 23.91％,showing a significant difference between the two groups (x2 =15.425,P =0.000).The mean sensitivities of visual field were (4.15 ± 1.42),(3.94 ± 1.40) and (4.81 ± 1.41) dB in 1 day,1 month and 2 months after photocoagulation in the compound anisodine group,which were significantly higher than (3.76± 1.52),(3.53± 1.55) and (3.64 ± 1.50) dB of the control group (t =1.39,1.44,1.15,all at P＜0.05).The amplitudes of a-wave and b-wave of F-ERG were all higher in the compound anisodine group than those in the control group in various time points after photocoagulation (all at P＜0.05).Conclusions The injection of compound anisodine via temporal subcutaneous tissue can relieve visual functional damage caused by PRP in NPDR eyes.

Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study.A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients,20 eyes) and the 532 nm group (12 patients,21 eyes).577 nm group and 532 nm group received 3-4 times PRP with single-point mode.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Before treatment and 1 day,1,3,6 and 12 months after treatment,the changes of best corrected visual acuity (BCVA),average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field,and fundus fluorescein angiography (FFA) were compared between two groups.Results The response rate was 85.0％ and 23.8％,respectively in the 577 nm and 532 nm group,the difference was statistically significant (x2 =15.43,P ＜ 0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b wave amplitude of F-ERG and the 30°-60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group,the difference were statistically significant (F =8.68,7.57,4.52;P＜0.05).The average threshold sensitivity (t=2.41,3.48,1.23),a/b wave amplitude (a wave:t=5.82,4.45,7.83;b wave:t=5.40,3.23,4.67) of F-ERG were different between 577 nm and 532 nm group at 3,6 and 12 months after treatment (P＜0.05).There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment.The average laser power were (436.25 ±54.65) and (446.43 ± 35.61) mW,number of laser spots were (1952.95 ± 299.09) and (2119.05 ± 302.69) spots,energy density were (7.60±1.30) and (7.60±3.00) mW× ms/μm2 in the 577 nm group and 532 nm group,respectively.There was no difference in average laser power (t=1.35),number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P＞0.05).Conclusion Compared with the 532 nm laser,577 nm laser treatment has better visual outcomes for NPDR patients.

Objective To compare the therapeutic effects of 577 nm laser panretinal photocoagulation (PRP) between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study from August 2013 to February 2014.A total of 29 patients (46 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group (12 patients,22 eyes) and the control group (17 patients,224 eyes).The treatment group received one time PRP of multi-point scanning mode,and the control group received 3-4 times of PRP with single-point mode.In order to evaluate its efficacy,the best corrected visual acuity was measured before treatment,and 1 day,1,2,6 and 12 months after treatment.The average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30 °-60 ° visual field,and fundus fluorescein angiography (FFA) of the change were also compared between the 2 groups.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Results The response rate was 86.4％ and 79.2％,respectively in the treatment and control group,the difference was not statistically significant (x2 =0.414,P＞0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b-wave amplitude of F-ERG in the 30 °-60 ° visual field were reduced at 1 day after treatment both in treatment and control group,the differences were statistically significant (P＜0.05).The average threshold sensitivity,a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m,6m and 12m after treatment (P＞0.05).The average laser power,number of laser spots and energy density were (537.50 ± 64.69) mW and (339.09 ± 132.09) mW,(1934.32 ± 426.38) points and (2061.42 ± 375.49) points,(0.35±0.12) mW o ms/μm2 and (1.95 ± 0.86) mW · ms/μm2 in the treatment group and the control group,respectively.The average laser power and energy density was statistically different between the 2 groups (P＜0.05),while the number of laser spots was no difference (P＞0.05).Conclusions 577 nm multi-point scanning laser can complete the PRP at one time,and achieve the same therapeutic outcomes with the single-point mode which need several times to complete the PRP in the eyes with severe NPDR,and have lower energy density,and thus relative minor function damage.

OBJECTIVE:To improve the method for the determination of 2 main components in Ticarcillin disodium and potas-sium clavulanate for injection. METHODS:HPLC was performed on the column of Waters XBridgeTM C18 with mobile phase of 0.01 mol/L ammonium dibasic phosphate solution(pH 7.0)-menthol(80:20,V/V)at a flow rate of 1.0 mL/min,the detection wave-length was 220 nm, column temperature was 30 ℃, and injection volume was 20 μL. RESULTS:The linear range was 1.95-195.22 μg/mL for ticarcillin (r=0.9999) and 0.12-12.18 μg/mL for clavulanate(r=0.9999);RSDs of precision,stability (under 4 ℃) and reproducibility tests were lower than 1.0%;recoveries were 99.3%-100.5%(RSD=0.4%,n=9) and 99.2%-101.0%(RSD=0.7%,n=9). CONCLUSIONS:The method is rapid,accurate and reliable,and can be used for the determination of 2 main components in Ticarcillin disodium and potassium clavulanate for injection.

Objective: To establish a determination method for the related substances in josamycin and josamycin tablets by HPLC. Methods:High performance liquid chromatography was used. The column was Ultimate-AQ-C18(250 mm ×4.6 mm,5 μm), the mobile phase respectively was mobile phase A of 0. 2 mol·L-1 tetrabutylammonium hydrogen sulphate R-0. 2 mol·L-1 disodium hydrogen phosphate(pH 3. 0)-acetonitrile R-water(3∶5∶24∶68) and mobile phase B of 0. 2 mol·L-1 disodium hydrogen phosphate (pH 3. 0)-acetonitrile R-water(5∶50∶45). The flow rate was 1. 5 ml·min-1 with the detection wavelength of 232nm. The column temperature was 50℃. Results:The main component josamycin had a good separation with the other related substances. The resolution between josamycin and the related substances with the relative retention time of 1. 1-fold of josamycin was above 1. 7. The detection limit of josamycin was 1. 43ng. In josamycin raw materiel and josamycin tablets, the percentage of related substance A and B was less than 1. 5%. The percentage of related substance D was below 2. 0%. The percentage of related substance E was less than 3. 0%. The percentage of the other maximum related substances was less than 1. 0%. The percentage of all related substances was less than 12%. The percentage of related substance C was less than 1. 0% in josamycin raw materiel while 3. 0% in josamycin tablets. Conclusion:The method is accurate, sensitive and reliable in the determination of related substances in josamycin and josamycin tablets.

OBJECTIVETo assess the value of stent-assistant angioplasty for intracranial vascular diseases.

METHODSThirteen patients with intracranial vascular diseases were treated consecutively by stent-assistant angioplasty for different purposes. Of these patients 7 had symptomatic intracranial artery stenosis, 3 intracranial wide-neck aneurysms, 2 intracranial pseudoaneurysms, and 1 bilateral transverse sinus stenosis. Clinical procedures and technical data of the patients were retrospectively analyzed.

RESULTSIn the 7 patients, the degree of intracranial artery stenosis reduced from 83% to 5%. Three months after the operation they exhibited good patency of stented lesions. Intracranial wide neck aneurysms (with 2 pseudoaneurysms) were successfully embolized with GDC in 5 patients. The patients with bilateral transverse sinus stenosis were implanted a self-expanded stent in the right transverse sinus. One patient failed because of the tortuous configuration of the left jugular bulb, but the patient's symptoms were improved quickly after the procedure.

CONCLUSIONStent-assistant angioplasty is a useful technique for selected intracranial vascular diseases, and it needs further investigation.

Adult ; Angioplasty, Balloon ; methods ; Cerebrovascular Disorders ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

Objective:To investigate the promoting effect of Difrarel ? on retinal function following panretinal photocoagulation (PRP) in the eyes with diabetic retinopathy. Methods:A non-randomized controlled study was performed.A total of 108 eyes of 108 patients with non-proliferative diabetic retinopathy (NPDR) were enrolled in Tongren Ophthalmology Center and Beijing Daxing District People's Hospital from December 2014 to February 2020.The patients were divided into PRP group and PRP+ Difrarel ? group according to different therapies under patients' selection.Difrarel ? was orally administered after PRP in 56 patients of PRP+ Difrarel ? group, and only PRP was given in 52 patients of PRP group.The visual acuity, 30°~60° circular visual field and multifocal electroretinogram were examined before and 1 day, 1 month, 3 months, 6 months, 12 months after PRP.The central macular thickness (CMT) was measured by optical coherence tomography, and fundus neovascularization was observed by fluorescein fundus angiography at 6 and 12 months after PRP.The study protocol was approved by an Ethics Committee of Beijing Daxing District People's Hospital (No.2021-F4). Results:Visual improvement rate was 57.14% (32/56) and 32.69% (17/52) in PRP+ Difrarel ? group and PRP group at the end of following-up, respectively, showing a significant difference between two groups ( χ2=3.56, P<0.05). The visual field mean sensitivity was significantly different at different time points in two groups ( Fgroup=4.77, P<0.05; Ftime=6.51, P<0.05), and was lower after PRP than those before treatment in both groups (both at P<0.05), and was significantly higher in PRP+ Difrarel ? group than PRP group at 3, 6, 12 months after PRP (all at P<0.05). The P1 amplitude density in 3 to 5 rings in PRP+ Difrarel ? group were higher than those in PRP group, and the differences were statistically significant (all at P<0.05). There was no significant difference in CMT between the two groups at different time points ( Fgroup=3.57, P>0.05; Ftime=1.23, P>0.05). No new blood vessels and non-perfusion area were found in both groups. Conclusions:Oral Difrarel ? can improve retinal function after PRP in the eyes with NPDR.

Objective:To investigate the risk factors and their warning value for the occurrence of sepsis in patients with severe multiple trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 92 patients with severe multiple trauma admitted to Yuyao People′s Hospital from July 2019 to October 2021. There were 71 males and 21 females, with the age range of 36-55 years [(45.5±13.6)years]. The injury severity score (ISS) was 20-29 points [(25.3±6.4)points]. The patients were divided into sepsis group ( n=32) and non-sepsis group ( n=60) according to whether sepsis occurred during hospitalization. Data were recorded for the two groups, including gender, age, basic diseases, cause of injury, number of injury sites, ISS, post-injury complications, and levels of aryl hydrocarbon receptor (AHR), C-reactive protein (CRP) and procalcitonin (PCT) at 1, 3 and 5 days after injury. The above data were analyzed to identify their correlation with the occurrence of sepsis in patients with severe multiple trauma by univariate analysis. The independent risk factors for sepsis in patients with severe multiple trauma were determined by multivariate Logistic regression analysis. The warning value of the single or combined risk factors for the occurrence of sepsis in patients with severe multiple trauma was evaluated by the receiver operating characteristic (ROC) curve and area under the curve (AUC). Results:By univariate analysis, it was demonstrated that the occurrence of sepsis was correlated with ISS, level of AHR at day 1 after injury, level of CRP at day 3 after injury and level of PCT at day 3 after injury ( P<0.05 or 0.01), but not with age, sex, basic diseases, level of AHR at 3, 5 days after injury, level of PCT at 1, 5 days after injury and level of CRP at 1, 5 days after injury (all P>0.05). By multivariate Logistic regression analysis, higher ISS ( OR=1.12, 95% CI 1.01, 1.24, P<0.05), level of AHR at day 1 after injury ( OR=1.30, 95% CI 1.10, 1.52, P<0.01) and level of PCT at day 3 after injury ( OR=1.81, 95% CI 1.08, 3.03, P<0.05) were found to be strongly correlated with the occurrence of sepsis. ROC curve analysis showed that higher ISS (AUC=0.69, 95% CI 0.57, 0.76) and level of AHR at day 1 after injury (AUC=0.79, 95% CI 0.68, 0.90) had warning value for the occurrence of sepsis, and the warning efficiency of combined panel was much better (AUC=0.86, 95% CI 0.77, 0.95). Conclusions:Higher ISS, level of AHR at day 1 after injury and level of PCT at day 3 after injury are independent risk factors for the occurrence of sepsis in patients with severe multiple trauma. ISS, AHR and combination of both exhibit good warning value for the occurrence of sepsis in patients with severe multiple trauma.

Objective To evaluate the effect of mild hypothermia on inositol-requiring enzyme 1 (IRE1) signaling pathway during myocardial injury after cardiac arrest and resuscitation in swine.Methods Twenty-one healthy male white swine,weighing 33-41 kg,were divided into 3 groups using a random number table method:sham operation group (group S,n =5),cardiac arrest-cardiopulmonary resuscitation group (group CA-CPR,n=8),and mild hypothermia group (group MH,n=8).The model of cardiac arrest and resuscitation was established based on the previously reported method.The catheters placed in the left femoral artery and right internal jugular vein were connected to the PiCCO Monitor system,and another pacing catheter was advanced from the right external jugular vein into the right ventricle.Ventricular fibrillation was induced by using a 1 mA alternating current through the pacing catheter.Once ventricular fibrillation was successfully induced,mechanical ventilation was discontinued for 8 min,and then cardiopulmonary resuscitation was initiated.Epinephrine 20 μg/kg was administered at 2.5 min of resuscitation followed by repetition every 3 min.Defibrillation was delivered at 5 min of resuscitation,and then spontaneous circulation was evaluated.If return of spontaneous circulation was not achieved,cardiopulmonary resuscitation was immediately resumed for 2 min and then defibrillation was delivered again.Mechanical ventilation was continued for 30 h after successful resuscitation.Animals in group S only underwent surgical preparation without experiencing cardiac arrest and resuscitation.At 5 min after successful resuscitation,body temperature was cooled down to 33 ℃ by using a cooling blanket,and then maintained at this level until 24 h after resuscitation,followed by 5 h of re-warming at a rate of 1 ℃/h in group MH.The temperature was maintained at 37.5-38.5 ℃ with the aid of surface cooling blanket in the other two groups.At 1,6,12,24 and 30 h after resuscitation (T1-5),the values of stroke volume (SV) and global ejection fraction (GEF) were recorded,and meanwhile 2 ml of blood samples was obtained via the femoral vein to measure the concentration of serum cardiac troponin Ⅰ (cTnI) (by enzyme-linked immunosorbent assay) and activity of serum creatine kinase-MB (CK-MB) (by immunosuppression).The swine were sacrificed at 30 h after resuscitation,and then myocardial specimens from the left ventricle were obtained for determination of the expression of caspase-3 (by immunohistochemistry),cell apoptosis (by TUNEL),and expression of IRE1 and casepase-12 (by Western blot).Apoptosis index was calculated.Results Compared with group S,SV and GEF were significantly decreased and the serum CK-MB activity was increased at T1-5,the concentration of serum cTnI was increased at T2-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was up-regulated,and apoptosis index was increased in CA-CPR and MH groups (P＜0.05).Compared with group CA-CPR,the SV and GEF were significantly increased and the concentration of serum cTnI was decreased at T2-5,the activity of serum CK-MB was decreased at T3-5,the expression of IRE1,caspase-12 and caspase-3 in myocardium was down-regulated,and apoptosis index was decreased in group MH (P＜0.05).Conclusion The mechanism by which mild hypothermia mitigates myocardial injury after cardiac arrest and resuscitation may be related to inhibiting IRE1 signaling pathway in swine.