Objective To observe the efficacy of Shuilongjian in treating cerebellar infarction, and compare with the pure western medicine. Methods 67 inpatients with cerebellar infarction enrolled were divided into two groups according to the method of random digits table, 36 cases in the treatment group and 31 cases in the control group. The control group was given 500 mL dextran by venoclysis, once a day. The treatment group was given Shuilongjian as an additional drug. The therapeutic effect was evaluated according to the nerve function and the total capability in dealing with daily activities. Result All the 67 cases of cerebellar infarction were included in the analysis. The effective rate of the treatment group was better than that of control group with 83.3% and 58.1% (P

During medical activity,there are theory and realism spring of that the right of emergency treatment is in conflict with the right of informed consent.Simply investigating responsibilities is of no avail to solve the conflicts.To Interpret the real reasons of the conflict through legal and ethical aspects.To avoid and reduce conflict,the effective measures are that perfecting the rules of relevant law,elucidating the rights and obligations of hospital and medical staff;regulating the contents of informed consent form and strengthening medical ethics education.

0 05), and the postoperative pain degree score was (2 0?0 7) points and (2 5?0 8) points respectively (t=-3 02, P

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

From February 2002 to May 2007,9 cases(9 hips) of periprosthetic fractures during the primary total hip arthroplasty for developmental dysplasia of the hip were selected,including 1 male and 8 females aged 52-69 years.In the primary total hip arthroplasty,femoral prosthesis with the same size as intramedullary reamer and acetabular prosthesis with 2 mm diameter larger than acetabular reamer were used.The pain,function,range of motion and degree of deformity were accessed using the Harris score.The patients were followed for 1-6 years.Among the 9 patients with periprosthetic fractures,4 acetabular fractures were stable which were treated by additional augmentation screws,and 1 fracture was unstable which was treated by structural bone grafting and additional screws.And there was one Vancouver type AG fracture which was treated by cerclage wire,3 Vancouver B1 fractures which were fixed by locking compression plate(LCP) or cerclage wire,and one Vancouver type C fracture which was also fixed by LCP.No component loosening or migration was found in the postoperative X-ray.The mean Harris score was 87.2 at the final follow-up.The results of the study show that during the primary total hip arthroplasty in patients with developmental dysplasia of the hip,the oversize of the acetabular component should be controlled to equal to or less than 2 mm.For patients with severe osteoporosis,acetabular components with the same size to reamer are recommended combined with additional screws,or cemented cup.When an acetebular fracture is found during total hip arthroplasty,we could use additional screws or bone grafting.Once a periprosthetic femoral fracture occurs during the operation,methods of fixation should be selected based on the type of the fracture and stability of the prosthesis.

OBJECTIVE To find out fulminate epidemiological features of Stenotrophomonas maltophilia in ICU and the ways to prevent and treat this nosocomial infection.METHODS The case histories from 4 inpatients who developed S.maltophilia infection in the same ward from Feb 5 to 16,2006,were studied retrospectively to find out the reasons of its onset and its treatment based on the sputum culture results.RESULTS The fulminate S.maltophilia was found from the rail of the patient bed,the connection part of water container of 2 respiratory machines of exhalation valve assembly and the liquid of ultrasonic aeriation machine.CONCLUSIONS The infection is a localized one.The main reasons of the infection are unthorough disinfection of respiratory machine and the contamination of medical treatment environment.Whenever the infection is found in the ward,the thorough disinfection needs immediately,and no new patient admitted.

Eleven patients underwent acetabulum revision using modified anterolateral approach due to acetabulum loosening but femoral prosthesis in sound fixation following total hip arthroplasty in Department of Joint Surgery,Tianjin Hospital between August 2002 and February 2005. During the mean follow-up of 4.2 years,all 11 patients gained primary stable fixation and good function. One patient underwent another revision due to infection; one developed femoral prosthesis loosening and underwent femoral revision. X-ray of the other patients showed no loosening or dislocation or radiotransparent region surrounding the prosthesis. One patient developed lateral femoral cutaneous nerve injury and relieved 6 months later.

Objective To evaluate the inhibitory effect of statins on glucose-stimulated insulin secretion (GSIS) of pancreatic islet in rat and to explore its mechanisms. Methods According to the average volume, freshly isolated or 24-hour cultured pancreatic islets were randomly divided into control group( incubated with Kreb-Ringer bicarbonate buffer), the atorvastatin group( incubated with 100 μ mol/L atorvastatin), the fluvastatin group (incubated with 100 μ mol/L fluvastatin)and the pravastatin group (incubated with 100 μ mol/L pravastatin). Stimulated by 2. 8,5. 5,11.1,16. 7 mmol/L and 25.0 mmol/L glucose respectively, the effect of 100 μ mol/L statins on ATP content and GSIS was compared in the four groups. GSIS was performed by the 37℃ bath incubation method and ATP content was measured by chemiluminescence method. Results Incubated with 100 μ mol/L atorvastatin for 30 minutes, in the presence of 16. 7 mmol/L glucose, the ATP content [(9. 54 ± 1. 64) pmol/islet vs ( 12. 33 ± 1.89) pmol/islet] and GSIS (1.60 ± 0. 21 vs 2. 39 ± 0. 30) were significantly reduced in comparison with the control group (P＜0. 05). Cultured with 100 μmol/L fluvastatin for 24 hours, the ATP content [( 10. 24 ±2.01 )pmol/islet vs (12. 31 ±2. 16) pmol/islet] and GSIS (3. 12 ± 0. 32 vs 4. 17 ±0. 37 ) were all significantly decreased at the higher glucose concentration of 16. 7 mmol/L ( P ＜ 0. 05). Conclusion Atorvastatin and fluvastatin may inhibit GSIS by decreasing ATP content in pancreatic islet and the inhibitory effect is related to the strength of its lipophilicity.

Objective To study the alveolar macrophages (AM) activation in neutropenic ARDS in children with hematologic malignancy. Methods Thirteen patients of ARDS were prospectively enrolled into the study and divided into two groups,neutropenic (5 cases) and nonneutropenic (8 cases). Bronchoalveolar lavage fluid (BALF) samples were analyzed for differential and total cell counts, and alveolar activation marker expression (HLA-DR) was determined. Results In neutropenic patients,the BALF total cell count and the macrophage absolute count were significantly lower compared to those in nonneutropenic group ((62. 6 ±9. 6)/μl vs ( 124. 0 ± 6. 7)/μl,P ＜ 0. 01 and (40. 8 ±4. 3)/μl vs (67. 6 ± 10. 7)/μl,P ＜ 0. 01,respectively). As compared with the nonneutropenic group, the percentage of AM in neutropenic patients was significantly higher (65.9% ±9. 0% vs 54. 6% ± 8. 7% ,P ＜0. 05) ,the mean percentage of AM HLA-DR expression was significantly lower (35. 3% ± 5.8% vs 62. 2% ± 5. 8%, P ＜ 0. 01 ). Conclusion These results suggest an alveolar hypocellularity and a deactivation of AM in neutropenic ARDS in children with hematologic malignancy.

Objective To investigate the expression of endostatin and angiopoietin (Ang)-2 in human ghoma and its significance. Methods The expression of endostatin and Ang-2 were measured by immunohistochemistry and endostatin mBNA by hybridization in situ in 108 cases of brain glioma and 5 cases of normal brain tissues. Results The expression of endostatin (0.0657±0.0038)and Ang-2 (0.0286± 0.0042) were significantly higher in grade Ⅲ-Ⅳ glioma patients than those in grade Ⅰ-Ⅱ ghoma patients (0.0349±0.0048,0.0084±0.0018, respectively) and normal brain tissues (0,0)(P<0.01). The expression of endostatin mRNA were significantly higher in grade Ⅲ-Ⅳ glioma patients (0.0310±0.0041) than that in grade Ⅰ-Ⅱ glioma patients (0.0152±0.0031) and normal brain tissues (0)(P< 0.01 ). Theratio of endo-stalin to Ang-2 was negatively rehted to the grade of glioma (r=-0.810,P <0.01). Conclusion The interaction of endostatin and Ang-2 plays an important role in the invasive growth and malignant development of human glioma, and may be related to the prognosis and the malignant degree of glioma.