To understand the status of the knowledge and skills of the medical staff by using the questionnaire,the authors analyzed the differences and inadequate ness of the first-aid knowledge and skills among the hospital's new recruits to explore how to carry out a targeted first-aid knowledge and skills training.

Objective To establish a stable and reproducible experimental method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage (ICH) in rats, and to study its validation. Methods Seventy male Sprague-Dawley rats were randomly divided into ICH groups and sham-operated groups. ICH was produced by microinjection of 40 ?l fresh autologous blood or saline into the right caudatum. Dynamic CT perfusion imaging in measurements of regional cerebral blood flow adjacent to hematomas was performed. Then, rats were sacrificed, and the TTC stain and histopathological examination were carried out. The ratios of side-to-side were measured at the regions around the hematomas by personal computer aided mapping. Results The gradient of perihematomal hypoperfusion was revealed by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) maps in ICH groups. The alternation of rCBF around the hematomas were fluctuated, and rCBF reduction was most pronounced at 1 hour after ICH, then, the rCBF gradually returned, and returned to the peaks at 6 hours and 24 hours after ICH respectively. TTC stain did not show infarction around the hematoma. Histopathological study demonstrated there was a transitional zone between ICH and the normal brain tissue, and the astrocytic swelling and neuronal degeneration were observed in the peri-ICH regions. The inflammatory cell infiltration and capillaries hyperplasia were also seen around the ICH. Conclusion The method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage in rats is stable and accurate. Perfusion CT and its parameter analysis may play an increasing role in delineating the hypoperfusion around hematomas. The experimental method is suitable and validated to the study of secondly injury after ICH in vivo.

Objective To evaluate the therapeutic effect of sho-saiko-to silymarin on liver fibrosis due to chronic hepatitis B.Methods 90 patients with liver fibrosis due to chronic hepatitis B virus(HBV) were randomly divided into therapy group and control group.50 patients in therapy group were given sho-saoko-to and silymarin;While 40 patients in control group were given silymarin only,they were all treated for 6 months.The changes were observed including liver function,serum liver fibrosis and virology indexes before and after treatment in two groups.Resuits Indexes of liver function and serum liver fibrosis in therapy group were improved obviously(P<0.05 or P<0.01),while better clearance to HBV is comparable to control group(P<0.05).Conclusion The treatment with sho-saiko-to combined silymarin on liver fibrosis due to chronic hepatitis B had explicit clinical effect.

AIM: To study the quality standard for Shuwei Capsule (Resina Ferulae, Rhizoma Corydalis, Radix Aucklandiae, etc.). METHODS: Radix Aucklandiae, Rhizoma Cyperi were identified by TLC, and ferulic acid was determined by HPLC. RESULTS: TLC spots developed were fairly clear, and the blank test showed no interference. Ferulic acid showed a good linear relationship in the concentration range of 0.007～0.056?g and the average recovery was up to 98.51%, RSD was 2.64%. CONCLUSION: The method is simple with strong specificity and good reproducibility, and can be used as the quality control of this preparation.

Objective To investigate the progress of pathology of the perihematomal tissue, and to study the relationship between the pathology and the changes of regional cerebral blood flow after intracerebral hemorrhage(ICH) in rats. Methods ICH was produced by microinjection of fresh autologous blood into the right caudatum in rats. CT perfusion imaging and computer-aided mapping in measurements of regional cerebral blood flow adjacent to the hematomas were performed in seventy SD rats at 1h, 3h, 6h, 12h, 24h, 48h and 72h respectively after the ICH. The parameters of regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV) and mean transit time(MTT) were calculated respectively. After the CT examination, the histopathological examination of TTC, HE and ultrastructure staining were carried out. Results The gradient of perihematomal hypoperfusion was revealed on CT perfusion maps. The rCBF and rCBV around the hematomas reduced pronouncedly, and the MTT delayed. TTC staining did not show infarction around the hematoma. Histopathological study demonstrated the astrocytic swelling and neuronal degeneration in the peri-ICH regions. The inflammory cell infiltration and capillaries hyperplasia were also observed around the ICH. Under the electronic microscope, the pathological changes of ultrastructure were revealed. In the early stage of ICH, there existed swelling of astrocytes, loosing of myelin sheath lamina, but no clear changes occurred in neurons. With the delay of ICH, the cellular injury around hematomas exacerbated progressively, more swelling of astrocytes, slight degeneration of neurons and local fragmentation of myelin sheath lamina were observed.Conclusion The perihemorrhagic and distant ischemic injury can be induced by the pronounced reduction of cerebral blood flow in the early stage of ICH. The cellular injury around hematomas exacerbates progressively in the acute stage of ICH. There is a perihematomal penumbra affecting multiple mechanisms of cellular injury.

Objectives To investigate clinical features and the risk factors for 30-day death in elderly chest pain patients.Methods In the prospective study,514 patients with acute chest pain leading to emergency department visit were selected from March 2012-August 2010 and grouped into elderly group (aged≥65 years,n=309) and non-elderly group (aged< 65 years,n=205).The patient's clinical data during 30-day follow-up period were recorded for analysis and comparison.Multivariate regression analysis was used to investigate the risk factors of death.Results Among 514 cases with acute chest pain,30(5.8%)patients with all-cause death included 24 cases in group of 309 (7.8%) elderly patients and 6 (2.9%) cases in group of 205 non-elderly patients during 30 day follow-up period.Univariate regression analysis showed that female,low SBP,Killips' classification ≥ Ⅱ,high level of serum troponin T and creatinine,coronary artery ischemia were more likely to died during 30 day follow-up period.And female and Killips' classification ≥ Ⅱwere the independent factor for 30-day death in the elderly[OR:3.55 (95%CI:1.00-12.59) and 5.90 (95%CI:1.31-26.63)]respectively.Conclusions Elderly patients with acute chest pain for first emergency department visit are at high risk for 30-day death.Female and cardiac function Killips' classification ≥ Ⅱ,high levels of serum troponin T and creatinine and coronary artery ischemia are associated with 30-day death in patients with acute chest pain for first emergency visit.Female and Killips' classification ≥ Ⅱare the independent risk factor for 30-day death.

OBJECTIVE:To observe the effect of Astragalus injection as an adjunctive therapy on the biology in patients with schizophrenia and its clinical efficacy. METHODS: A total of 100 patients with schizophrenia were randomly assigned to trial group(n=50) or control group(n=50). The trial group received routine antipsychotic drugs plus Astragalus injection (40 mL?d-1, iv gtt) for 7 days, and the control group received antipsychotic drugs alone without addition of traditional Chinese medicine for 7 days. All the patients received for a total of 4 courses of treatment. Besides, both groups received additional benzodiazepine but not other hipnotics. RESULTS: After treatment, there were significant differences between the trial group and the control group in ECG QTc duration, sugar level, therapeutic efficacy, PANSS scores (total score and the sub-item scores) and adverse reactions etc(P

Objective To assess the diagnostic value of determining infarct core and penumbra using CT perfusion source images (CTP-SI) mismatch model in hemispheric stroke less than 9 hours.Methods "one-stop shop" CT examination including non-contrast enhanced CT (NCCT), CTP, CT angiography (CTA) were performed in 24 patients with symptoms of stroke less than 9 hours.The Alberta Stroke Program Early CT Score (ASPECTS) were analyzed on arterial phase CTP-SI and venous phase CTP SI using Wilcoxon rank-sum test, then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median (min-max) scores of ASPECTS on arterial phase CTP-SI, venous phase CTP-SI and follow-up imaging were 9.0 ( 2.0-10.0 ), 9.3 ( 6.5-10.0 ) and 9.0 ( 7.0-10.0 ),respectively. ASPECTS measured on arterial phase CTP-SI significantly differed from the ASPECTS on venous phase CTP-SI ( Z =-2.812, P = 0.005 ).Moreover, the linear regression analysis showed significant correlation between the ASPECTS on venous phase CTP-SI and follow up imaging ASPECTS ( Beta =0.715,P = 0.003 ).Conclusion CTP-SI mismatch model provides a method of choice in predicting penumbra and infarct core in hemispheric stroke.

Objective To investigate the relationship between oxidative stress and lipid metabolism characteristics in elderly patients under different status of thyroid function. Methods Eighty-six newly-diagnosed elderly patients with thyroid diseases,83 non-elderly patients with thyroid diseases and 20 normal subjects as control were selected.and 47 hyperthyroidism and 39hypothyroidism in elderly,43 hyperthyroidism and 40 hypothyroidism in non-elderly were diagnosed according to diagnostic criteria of the thyroid disease.The levels of fasting plasma malondialdehyde(MDA),superoxide(SOD)and oxidized low density lipoprotein(OX-LDL)were measured by thiobarhiturates,colorimetric method and enzyme linked immunosorbent assay(ELISA).Meanwhile,lipid profile and thyroid function were also measured,SOD/MDA ratio was calculated. Results Lipid profiles in the elderly hyperthyroidism group were significantly higher than those in the non-elderly group(P＜O.05 or P＜0.01)but were significantly lower than those of normal control group(P＜0.05 or P＜0.01).The plasma MDA[(10.23±6.29)μmol/L vs.(3.66±2.53)μmol/L vs.(7.37±4.58)μmol/L],free fatty acids(FFA)[(0.86±0.58)mmol/L us.(0.45±0.12)mmol/L vs.(0.61±O.46)mmol/L]and SOD levels were significantly higher in elderly patients with hyperthyroidism than in normal control and non-elderly hyperthyroidism groups(P＜0.05 or P＜O.01).In the patients with hypothyroidism,the plasma MDA[(9.03±5.98)μmol/L vs.(6.59±3.18)μmol/L vs.(3.66±2.53)μmol/L],OX-LDL[(387.36±71.04)μg/L vs.(355.22±45.01)μg/L vs.(324.53±56.19)μg/L],TC,LDL-C,non-HDL-C,LP(a) and Apo-B100 levels were significantly higher in the elderly group than in the non-elderly and normal control groups(P＜0.05 orP＜0.01).The SOD/MDA ratio was significantly lower in the elderly patient groups with hyperthyroidism or hypothyroidism than in normal control and non-elderly groups(all P＜0.01).In a multiple step-wise regression analysis.FT4 and FFA were independent factors related tO MDA in hyperthyroidism group,and non-HDL-C and LDL-C were independent factors related to MDA inhypothyroidism group. Conclusions Serious lipid metabolic disorder exists in newly-diagnosed and untreated elderly patients with hyperthyroidism and hypothyroidism.It is suggested that oxidative stress is obviously strengthened in elderly patients with thyroid function disorder and that the degree of oxidative stress is correlated with lipid metabolic disorder.

Objective To investigate the expression profile of macrophage inhibitory factor (MIF) in heart and renal tissues of sepsis mice. Method The sepsis model was established by Cecal ligation and puncture (CLP) in mice. Thirty male BALB/c mice were randomly divided into five groups: sham operation group, the twelfth hour, twenty-forth hour, thirty-sixth and forty-eighth hour group after CLP. MIF mRNA were semiquantitat-ed by the reverse transcription polyraerase chain reaction(RT-PCR), Western Blotting was used for MIF protein. The measured data were analyzed with one-way ANOVA. Results MIF mRNA and protein expressions in heart tissue signifiantly increased at the twelfth hour, peaking at the thirty-sixth hour, and a high level was maintained till the forty-eighth hour after CLP. But in the kidney tissue of models, the content of MIF reached peak at the twenty-forth hour and started to decrease at the forty-eighth hour after CLP. Conclusions The content of MIF in heart and kidney tissues of sepsis models was higher than that in the sham group, especially from the twelfth hour to forty-eighth hour after CLP. It indicates that MIF as a kind of late cytokine might participate in dysfunction of organs in mice with sepsis.