Objective To study the expression of hemeoxygenase-1 (HO-1) and change of superoxide dismutase (SOD) activity in perihematoma after intracerebral hemorrhage (ICH). Methods The rats were randomly divided into sham operating group and intracerebral hemorrhage group.Rat ICH models were induced using stereotactic infusion autologous blood 50 ?l into the caudate nucleus. At the due time, the rats were killed and brain tissues were removed for detection of HO-1 and measurement of SOD by immunohistochemical and xanthine hydrocarbonylation methods. Results Following ICH, few HO-1 positive cells were observed in brain tissue perihemota at 6 h, peaked at 48 h ( P0.05), then decreased gradually and reached the minimum at 72 h ( P0.05). The change of SOD in brain tissue perihematoma was negatively correlated with the expression of HO-1 (r=-0.878, P

BACKGROUND: Promoting immunological function of patients with chronic obstructive pulmonary disease (COPD) can control development of COPD.OBJECTIVE: To investigate the effect of bufei yishen granule on pulmonary ventilation function and immunological function of COPD patients and compare with placebo.DESIGN: A randomized grouping comparison and placebo controlled study.SETTING: Respiration Department of the First Affiliated Hospital of Henan Traditional Chinese Medical.PARTICIPANTS: A total of 62 COPD patients selected from Department of Respiration of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine from January 1999 to October 2004,were randomly divided into two groups :Observation group and control group with 31 in each group.METHODS: Patients in observation group were treated with bufei yishen granule consisting of ginseng, mongolian milkvetch root, largehead atractylodes rhizome, divaricate saposhnikovia root, dwarf lilyturf tuber, Chinese magnoliavine fruit, malytea scurfpea fruit, medicinal evodia fruit, Chinese cster pillar fungus, Chinese eaglewood wood, scorpion, almond, thunberg fritillary bulb, szechwan lovge rhizome, etc., produced by Pharmaceutic Department of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine. Each granule of 1 g contained an equivalent of 5.78 g raw drugs. Three times a day with 10 g for each; and patients in control group were treated with placebo consisting of hawthorn fruit and malt. The dosage and medication were the same as those in observation group. Both therapies were respectively administered in a treatment course of two months. Before and after the therapy course,the followed indexes were measured.① Assay of immunological function: The levels of IgG, IgA and IgM from blood serum were detected with simple agar diffusion.② Assay of Ag level in nucleolus organizer region (Ag-NORs): The ratios non-histone staining acidity non-histone vs core area (IS%) was calculated by staining the activating lymphocytes of the blood by silver staining technique with microscope image analysis technique. ③ Assay of pulmonary function: The pulmonary function was measured by Sensor Medics Ros System in all of the people with the levels of forced expiratory volume in first second (FEV1.0), mean maximu expiratory flow (MMEF), peak expiratory flow (PEF), once after and before treatment. The examination was repeated three times in order to obtain the peak number. The difference of the three examinations was within ±5%.MAIN OUTCOME MEASURES: Comparison of T lympholeukocyte subpopulation and pulmonary ventilation function in the patients before and after 1 course.RFSULTS: Data of totally 62 patients was entered the final analysis without any loss.① Comparison of pulmonary ventilation function of patients in the two groups before and after 1 course: FEV1.0, MMEF, PEF,and ratio of FEV1.0 and forced vital capacity (FEV1%) in observation group were significant higher than those before treatment (t=2.12-3.41,P ＜ 0.05-0.01), thoseindexes in observation group were higher than those in control group (t=2.54-3.17, P ＜ 0.05-0.01). ② Changes of T lymphocyte subgroups of patients in the two groups before and after 1 course:The levels of CD3+, CD4+, CD4+/CD8+ in observation group after 1 course were high.er than those before treatment (t=2.71-13.20, P ＜ 0.01), but the level of CD8+ was decreased as compared with that before treatment (t =8.63, P ＜ 0.01). The levels of CD3+, CD4+, CD4+/CD8+ in observation group were higher than those in control group (t=2.85-11.84, P ＜ 0.01), but the level of CD8+ was decreased as compared with that in control group (t =5.83, P ＜ 0.01).CONCLUSION: The bufei yishen granule can obviously improve the pulmonary ventilation function and immunological function of COPD patients,and its intervention is superior to that of placebo.

ObjectiveTo observe the effects of finger-acupuncture massage on the fine motor functions of children with cerebral palsy. Methods40 children with cerebral palsy following diplegia were randomly divided into two groups: observation group(n=20) and control group(n=20). The control group was treated with rehabilitation training, while the observation group received finger-acupuncture massage and the rehabilitation training. All patients were assessed by Peabody Developmental Motor Scale before and after the treatment.ResultsThere was no statistically significant difference in fine motor between the two groups before the treatment (P>0.05). There was a significantly difference in fine motor quotient(FMQ), grasp capacity index, and capacity index of visual-motor integration both in the observation group and the control group between before and after the treatment (P<0.001). There was also a difference in fine motor quotient (FMQ), grasp capacity index, capacity index of visual-motor integration between the observation group and the control group after the treatment(P<0.05).ConclusionFinger-acupuncture massage combined with rehabilitation training can improve fine motor functions of children with cerebral palsy following diplegia.

Objective To observe the effects of the acupuncture on muscle strain of lower extremities adductors for children with spastic cerebral palsy. Methods 100 children with spastic cerebral palsy were divided into treatment group (n=50) and control group (n=50) randomly.The control group accepted routine rehabilitation, and the treatment group accepted acupuncture in addition. The passive range of motion (ROM) of adductor angle, D and E domains of Gross Motor Function Measure (GMFM-88) were observed before and after treatment. Results ROM and GMFM-88 improved after treatment (P<0.05), and improved more in the treatment group than in the control group (P<0.05). Conclusion Acupuncture can release muscle strain of lower extremities adductors of children with spastic cerebral palsy and improve the motor function.

Objective To evaluate the impact of sequence on the quality of bowel preparation in patients with anesthesia for same-day sequential bidirectional endoscopy and propose the optimal procedural sequence.Methods Single center blinded randomized observational study.Sixty-five patients were randomized to either the gastroscopy-first group or the colonoscopy-first group.Bowel cleanliness according to Boston bowel preparation scale (BBPS) scores were evaluated,also done the propofol dosage,caecal intubation time,procedure duration and complications.Results The BBPS score of entire colon showed no difference (6.72 ± 1.34 vs.6.89 ± 1.50,P =0.638),but the BBPS of ileal-cecum portion was higher in the colonoscopy-first group (1.21 ±0.54 vs.1.55 ±0.73,P =0.035).The total procedure time,propofol dosage and complications were similar between the two groups.Conclusion The bowel cleanliness of ileal-cecum portion in colonoscopy-first group is better than that of gastroscopy-first group during sequential bidirectional endoscopy in patients with propofol sedation.We propose colonoscopy first in patients with suspicious ileal-cecum lesion.

Objective To explore the prevalence of self reposed mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital.Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire(CV-MDQ)and the Chinese Version 32 items hypomania check list(CVHCL-32).The positive mania symptoms were elevated with at least seven positive mania items reported by the CVMDQ.The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32.Results The internal consistency(Cronbach alpha)of the CV-MDQ was 0.808(95% CI=0.767～0.845,P<0.01).The internal consistency(Cmnbach alpha) of the CV-HCL-32 was 0.916(95% CI=0.898～0.930,P<0.01).11 patients(10.8%) reported positive mania symptoms by the CV-MDQ.14 patients (13.7%)had been reported positive hypomania symptoms through the CV-HCL-32.The ability of discriminating mania or hypomania between the two scales was significantly different(Kappa=0.227,P<0.05).Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32.the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode(35.0 vs 50.5,z=-2.065,P<0.05),much longer months in total disease course(60.0 vs 22.0,z=-2.102,P<0.05)and present episode (12.0 vs 6.0,z=-2.180,P<0.05),and much higher frequency of relapse(2.5 vs 1.0,z=-2.168,P<0.05),but no significant differences at age,gender and education.No significant differences appeared between CV-MDQ positive and negative group.Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with depressive disorders who are diagnosed by ICD-10 in general hospital.whether CV-HCL-32 is superior to CV-MDQ when screening bipolar Ⅱ disorder is worthly further study.

Face ; pathology ; surgery ; Humans ; Myocutaneous Flap

Objective To prospectively investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of acute kidney injury (AKI) following adult cardiac surgery. Methods Twenty-nine hospitalization patients undergone cardiac surgery were enrolled in the study. Serial blood and urinary samples were collected immediately before incision and at various time intervals after surgery. The primary outcome measure was acute kidney injury, defined as a 50% increase in the level of serum creatinine (Scr) from baseline. Results Fourteen of 29 developed acute kidney injury. The diagnosis time point with Ser was at 24 (10, 48) h after cardiac surgery. By contrast, the concentration of urinary NGAL rose from a median of 3.42(1.60, 9.92) μg/L at baseline to 20.51(13.42, 50.02) μg/L at admission to ICU (P=0.006),and the median concentration of urinary NGAL in patients who developed AKI was significantly higher at admission to ICU compared with patients who did not develop AKI [20.51 (13.42, 50.02) μg/L vs 2.91 (0.72,8.61) μg/L, P=0.002]. As to urinary NGAL at admission to ICU, the area under the receiver-operating characteristic (ROC) curve was 0.824, the sensitivity was 85.7% and the specificity was 80.0% with a cutoff value of 10.95 μg/L. Significant correlation was found between urinary NGAL at admission and the levd of Scr at 24 h in ICU (r=0.545, P=0.002), as well as estimated GFR (r=-0.546,P=0.002). Conclusion Urinary NGAL concentration is significantly higher in patients developing postoperative AKI at the early time of admission to ICU, which may be a useful early biomarker of AKI after adult cardiac surgery.

Objective To assess the outcome of de-epithelialied ileocystoplasty combined with strengthened pelvic floor in patients with neurogenic bladder.Methods Twelve patients (9 male,3 female) aged from 18 -27 years (averaged 25 years) with neurogenic bladder received de-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor,and were evaluated by urodynamic parmeters,upper urinary tract image appearance,and serum creatinine before and one year after operation.Results After operation,the max cystometric capacity (412 ± 32 ml),bladder compliance (26.2 ± 4.0ml/H2O),relative safety cystometric capacity (368 ±26 ml) and max flow rate (20 ±3 ml/s) were respectively significantly higher than those preoperation(247 ±27 ml,4.4 ± 1.2 ml/cm H2O,206 ±24 ml,11 ±2ml/s,P ＜ 0.05).Moreover,the post voided residual (26 ± 8 ml) and detmsor leakage point pressure (17.8 ±3.6 cm H2O) were significantly lower than those of preoperation (136 ± 25 ml,63.1 ± 4.9cm H2O,P ＜0.05).The vesicoureteral reflux disappeared in five (63％) cases,and was relieved in the remaining three cases.Of the five cases with renal insufficiency,three (60％) cases had normal serum creatinine level,none had increased serum creatinine levels.After operation,late healing occurred in two ( 17％ ) cases,intestinal obstruction in one (8％),vesicoabdominal fistula in one (8％),and no cases had mucous urine.Clean intermittent self-catheterization was performed in one case (8％) to empty the bladder due to a fever resulting from urinary tract infection,the remaining 12 (92％) cases could empty their bladders through abdominal pressure.Conclusions De-mucosalized seromuscular ileocystoplasty combined with strengthened pelvic floor results in a good outcome for the patients with neurogenic bladder.

Objective To investigate the markers in early diagnosis of acute kidney injury (AKI) in patients undergoing heart surgery.Methods Markers included serum cystatin C (CyC),and urinary neutrophil gelatinase-associated lipocalin(NGAL),interleukin 18(IL-18),retinol binding protein(RBP)and N-acetyl-β-D-glucosaminidase(NAG).Twenty-nine cardiac surgical patients hospitalized were enrolled in the study.Serial blood and urine samples were collected immediately before incision and at various time intervals after surgery.The primary outcome measure was AKI.defined as a 50%increase in Scr from baseline. Results The cohort consisted of 29 patients aged(62.9±13.7)years,and baseline Scr was(73.2±11.9)μmol/L.There were no significant differences in demographics between cases and controls,while the aortic clamp time was predictably longer in AKI cases as compared to controls[(60.63±13.92)vs(43.00±9.20)rain,P<0.05].Each biomarker difiered significantly between cases and controls at least one timepoint.Optimal AUCs were for CyC at 10 houm with sensitivity (ST)0.71,specificity(SP)0.92,AUC=0.83(0.67-1.00),cut-off(CO)1.31 mg/L;NGAL at 0 hour with ST 0.84,SP 0.80,Auc=0.85(0.70-1.00),CO 49.15 μg/g Ucr;IL-18 at 2 hours with ST 0.85,SP 0.73,AUC=0.81(0.64-0.97),CO 285.65 ng/g Ucr;RBP at 0 hour with ST 0.75,SP 0.67,AUC=0.77(0.60-0.95),CO 2934.65μg/g Ucr and NAG at 4 hours with ST 0.86,SP 0.67,AUC=0.72(0.53-O.92),CO 37.05 U/mg Ucr.Using a combination of all the 5 biomarkers analyzed at the optimal time-point as above,an AUC of 0.98(0.93-1.02)(P<0.01)in this limited sample was able to obtain. Conclusions Application of serum and urinary biomarkers for the prediction of AKI in patients undergoing cardiac surgery is highly dependent on the sampling time.Of the evaluated markers,uNGAL has the best predictive profile.uRBP also shows similar predictive power.Combining all the five above biomarkers is able to predict significantly more cases,suggesting that the use of more than one marker may be beneficial clinically.