Objective To study the significance on dynamic changes of serum vascular endothelial growth factor( VECF) and matrix metalloproteinase 9( MMP-9) in patients with acute cerebral infarction. Methods 123 patients with acute cerebral infarction were selected as research object, and they were the observation group, and 80 healthy peoples at the same time were selected as control group. Then the serum VEGF and MMP-9 in patients with acute cerebral infarction after pathogenesis at first,third,fifth,seventh and fourteenth day were detected,and the correction between the levels and infarct size,prognosis were studied. Results The serum VECF and MMP-9 of observation group compared with those of control group,the change showed increased first and decreased afterwards,but the levels were all higher than those of control group (P ＜ 0.01). There were correction between the levels and infarct size, prognosis.The serum VEGF[(369.3 ± 108.7,476.2 ± 118.4,551.5 ± 144.5,661.7 ± 164.6,437.6 ± 123.9)ng/L]and MMP-9[(333.8±101.4,459.7±119.9,370.3 ±119.5,320.5 ± 129.1,255.4 ± 101.6)ng/L] in poor prognosis patients after pathogenesis at first,third,fifth,seventh and fourteenth day were all higher than those of good prognosis patients ( P ＜0.01). Conclusion The serum VEGF and MMP-9 in patients with acute cerebral infarction showed dynamic change,and there was close relationship between the levels and infarct size.

Humans ; Non-alcoholic Fatty Liver Disease

Objective To compare the application values of different blood transfusion modes in placenta previa cesarean section.Methods The clinical data in 82 pregnant women with placenta previa undergoing cesarean section in our hospital from February 2013 to January 2016 were collected.The patients were divided into the autologous group (autologous blood stored blood transfusion,n=42) and allogeneic group (allogeneic blood transfusion,n=40) according to different blood transfusion modes.The changes of blood routine indexes such as hemoglobin (Hb),platelet count (PLT),hematocrit (Hct),white blood cell count (WBC) and red blood cell count (RBC) in the two groups before and after operation were recorded.Postpartum blood lossb amounts,autologous and allogeneic blood transfusion volume were compared between the two groups.The pregnant outcomes were observed,and the incidence rates of blood transfusion complications were statistically analyzed.Results (1)The accumulative blood loss volume and allogeneic blood transfusion volume in the autologous group were significantly lower than those in the allogeneic group (P<0.05);(2) PLT and WBC after operation in the two groups were significantly increased,while RBC,Hb and Hct were decreased.The levels of postoperative Hb,PLT and Hct in the autologous group were higher than those in the allogeneic group (P<0.05);(3) the neonatal Apgar scores at 1,5 min after birth,and umbilical artery blood pH value showed no statistically significant difference between the two groups (P>0.05);(4)The total incidence rate of complications in the autologous group was significantly lower than that in the allograft group (P<0.05).Conclusion Adopting autologous blood stored blood transfusion scheme during cesarean section in women with placenta previa has no negative effect on maternal and neonatal outcomes,meanwhile which can reduce the incidence of transfusion complications,is safe and feasible.

Objective To reconstruct the three-dimensional(3D) image and to study on the virtual anatomy of the thigh part based on computed tomography(CT) data source. Methods Ten patients' contrast-enhanced light-speed CT images of the thigh part were chosen, “3D medical studio” was applied to read CT data, then to reconstruct and anatomize the thigh part. Results The reconstructed 3D images of the thigh part were realistically pseudocolored displayed, it was composed of four kinds of tissues(skin, muscle, skeleton and artery) and could be freely rotated and incised and restored for many times at any shape and depth on real time. Its' layers were distinct among tissues. Conclusion This research realizd partial function of virtual anatomy, it may play a definite role on regional anatomy and sectional image anatomy teaching and clinical radiology diagnosis.

Objective To compare the clinical effects between rivaroxaban and warfarin on preventing deep vein thrombosis (DVT) in elderly hip fracture patients with diabetes mellitus (DM) after operation. Methods One hundred and sixty-eight elderly hip fracture patients with DM were randomly divided into the observation group and the control group. The observation group (88 cases) were treated with rivaroxaban (10mg, po, qd) after surgery, and the control group were treated with warfarin and low molecular weight heparin calcium for 14 days. Respectively after 7, 14, 21 and 28 days, the color doppler ultrasonography was used to examination vein blood flow and the DVT of affected lamb. In addition, the levels of D-dimer and bleeding were observed during treatment. Results The incidence of DVT in observation group (2 cases, 2.23%) was significantly lower than that in control group (7 cases, 8.75%), and DVT of control group was happened on 7th day after surgery. In addition, the level of D-dimer on 7th day post-surgery in observation group significantly decreased, while it significantly decreased on 14th day post-surgery in control group (P<0.05). However, the incidence of bleeding events in observation was less than that in control group (P<0.05). Conclusion Rivaroxaban can be more effective compared with warfarin in preventing diabetes mellitus elderly hip fracture patients with postoperative DVT formation and significantly reduce the bleeding risk, with more safe and convenient.

Objective To investigate the effect of galectin-3 (Gal-3) on the pathogenesis of primary biliary cirrhosis (PBC).Methods The clinic data of 72 PBC patients at different stages were analyzed and the serum levels of Gal-3 were detected in 72 PBC patients and 20 controls by enzyme linked immunosorbent assay (ELISA).Independent t-test,variance analysis,LSD-t and Pearson correlation analysis were adopted for data analysis.Results The serum Gal-3 levels were significantly higher in PBC patients than those of healthy controls [(855±634) pg/ml,(463±446) pg/ml,P＜0.05].With the progression of disease,the levels of Gal-3,platelets,hemoglobin,albumin,IgM and complement C3 gradually declined,but the level of total bilirubin gradually elevated(P＜0.05).There was positive correlation between Gal-3 and immunoglobin IgM,complement C3 levels (r=0.330,P=0.005; r=0.357,P=0.002).There was negative correlation between Gal-3 and total bilirubin levels (r=0.350,P=0.003).Conclusion The Gal-3 can participate in the immune-mediated inflammation of PBC and the formation of liver fibrosis.The levels of Gal-3,platelet count,hemoglobin,albumin,IgM,complement C3 and total bilirubin could be regarded as laboratory parameters for the evaluation of the disease severity and prognosis.

Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel in patients required insertion of nasogastric tube before laparoscopic surgery. Methods Fifty-five ASA Ⅰ - Ⅲ patients ( Mallampati Ⅰ -Ⅲ ), aged 26-64 yr, weighing 54-73 kg, scheduled for elective laparoscopic surgery were randomly divided into 2 groups: group Ⅰ ( n= 28) and group Ⅱ ( n = 27). The size of i-gel LMA was chosen based on the patient' s weight, and i-gel LMA was inserted after induction of anesthesia with TCI of propofol and remifentanil, and iv injection of rocuronium. In group Ⅰ , the nasogastric tube was inserted through the drain tube of i-gel LMA. In group Ⅱ , the nasogastric tube was inserted through the nostril before operation. The hemodynamic parameters, SpO2 ,PETCO2 and peak airway pressure were monitored during operation. The fiberoptic laryngoscopy scores were assessed and nasogastrice tube displacement was recorled after successful LMA placement. The LMA placement time, success rate of LMA placement at the first attempt, airway sealing pressure, the occurrence of air leakage of LMA, and nasogastric tube drainage were recorded. The problems after removal of the LMA were observed and the adverse reactions within 24 h after operation were recorded. Results The hemodynamics was stable and the SpO2,peak airway pressure were within the normal range during operation in both groups. There was no significant difference in the LMA placement time, success rate of LMA placement at the first attempt, nasogastric tube drainage rate, airway sealing pressure, incidence of air leakage, fiberoptic laryngoscopy scores, problems after removal of the LMA and adverse reactions between the two groups ( P ＞ 0. 05). Conclusion i-gel LMA can provide adequate ventilation and does not interfere with the nasogastric tube drainage during laparoscopic surgery and can be used effectively for the patients required insertion of nasogastric tube before operation.

Objective Present study aimed to research the mechanism of the use of 0.2% brimonidine tartrate eye drops in the treatment of optic nerve crush injury of rat.MethodsAnimal models of optic nerve crush injury were created in 60 SD female rats by clipping the exposed optic nerve at 2 mm in retrobulbar for 6 seconds with 78 grams of reverse forceps.The successful model was identified as Marcus-gun pupil without bleeding of fundus after operation.The animals were randomly assigned to model group and brimonidine treating group,and another 30 normal SD rats were used as the normal control group.The 0.2% brimonidine tartrate eye drops was topically administered at 2 hours before operation and after operation twice per day in the brimonidine treating group.The retinas from 18 rats were isolated after 3,7,21 days for RGCs counting by H&E staining,and the retinal ultrastructure was examined under the transmission electron microscope.The retinas from the other 72 SD rats (including normal,model and brimonidine groups) were prepared for the detection of bcl-2 and bax using immunohistochemistry l,3,5,7,14,21 days after the operation.ResultsNormal and almost normal retina structure was exhibited in rats of the normal group and brimonidine treating group,but disorder of cellular arragement and decrease of retinal thickness were found in the model rats under the optical microscope.The RGCs counting was significantly different among the three groups from 3 days through 21 days after operation with the considerably declination in the model group and brimonidine treating group compared with the normal control group (P＜0.05-0.01).However,that of the brimonidine treating group was obviously increased in comparison with the model group (P＜0.01).The expression of bax in rat retina was obviously reduced (P＜0.01),but the expression of bcl-2 was increased in brimonidine group compared with the model group from 5 through 7 days after operation (P＜0.01).ConclusionThe 0.2% brimonidine tartrate eye drops has a preventive effect on optic nerve crush injury of rat,and its inhibition on apoptosis is one of the mechanisms.

Objective To evaluate the diagnostic value of transcranial color duplex sonography for vertebrobasilar arterial insufficiency (VBI). Methods Transcranial color duplex sonography was performed on 30 healthy controls and 30 VBI patients confirmed clinically to examine the flow velocities and wave form parameters of the main supra and infra tentorial basal cerebral arteries. The anterior, middle, and posterior cerebral arteries on either side of the cranium and the vertebrobasilar system were observed using a 2.0 MHz transducer of a computed sonographic system. Results The vertebral artery system resistance index and pulsitive index were significantly higher in VBI patients than those in the controls ( P

Objective To investigate the pharmacological hypothermic effect of WIN55, 212-2 on neuronal apoptosis after cardiopulmonary resuscitation. Methods Cardiac Arrest ( CA ) was induced in Sprague-Dawley rats.Five minutes after onset of CA, cardiopulmonary resuscitation ( CPR) was carried out.At 30 minutes post-resuscitation, the animals were randomized into three groups (n=10 in each group): (1) WIN55, 212-2 hypothermia group [W group, WIN55, 212-2, 1 mg/(kg· h)].(2) Normothermia group (NT group, 5%DMSO);(3) WIN55, 212-2 with normothermia group (W+NT group, WIN55, 212-2, 1 mg/(kg· h).Animals in WIN55, 212-2 hypothermia group and WIN55, 212-2 with normothermia group were dealt with continuous intravenous infusion of WIN55, 212-2 [1 mg/(kg· h)] for 4 h, while rats in NT group were infused with equal volume of 5% DMSO instead.The survival time and neurological deficit score ( NDS) were observed.The CA models were established in three groups.After rats were sacrificed, the brains were harvested for detecting histopathological changes and apoptosis of neural cell at 24 h, 48 h and 72 h after ROSC respectively.Five animals of each group were chosen randomly ( random number ) .Results Body temperatures of rats in W group decreased from 37°C to 34°C in 4 hours.Accumulated survival rate in W group was higher than that in the other two groups ( P=0.02) .NDS was significantly improved in W group than that in the other two groups ( P<0.05) .Morphological change in W group was less serious than that in the other two groups.The number of neuron apoptosis in W group was smaller than that in the other two groups.Conclusions WIN55, 212-2 inducing pharmacologically hypothermia during post-resuscitation prolonged survival and improved cerebral function in rat cardiac arrest models.The beneficial effects of WIN55, 212-2 were associated with ameliorating the histopathological damage in brain and alleviating the neuron apoptosis.