ObjectiveTo investigate the characteristics of the ambulatory blood pressure of acute cerebral infarction patients in the first 24 hours from onset and to study the relationship between their neurological deficit and characteristics of blood pressure.MethodsBlood pressure in 31 acute cerebral infarction patients (within 24 h) was measured serially during the first 24 hours in hospital with ambulatory blood pressure monitoring. Their neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS) on the first and the fifth day. Results83.87% nocturnal blood pressures decreased less than 10%. In multiple linear regression analysis, 24 h diastolic blood pressure (DBP) becomes the only and the most important factor to NIHSS on the first day. The patients with improved NIHSS on the fifth day showed lower nocturnal DBP and mean arterial pressure (MAP) than those of patients with unimproved NIHSS.ConclusionNot only the level but also the circadian of ambulatory blood pressure in acute cerebral infarction patients is significantly abnormal, especially for the reduction of nocturnal blood pressure decrease. On the first day, the neuroulogical deficit and blood pressure influence each other. The patients with higher nDBP and nMAP on the first day may be associated with poor early neurological function outcomes.

Objective To explore the impacts of 24-hour medical records archiving on the DRGs grouping ratio and payment.Methods Retrospective survey was made in a tertiary hospital in Beijing during its pilot from November 18,2011 to May 31,2012.The study covered such categories as the 24-hour medical records archiving ratio,48-hour medical records archiving ratio,DRG grouping ratio and payment for discharged patients prior to and after the practice of such archiving requirement.The data were subject to a multilinear regression analysis.Results The practice of 24-hour archiving,since in place,has significantly raised the 24-hour ratio,48-hour ratio,DRG grouping ratio and payment ratio,with the differences statistically significant (averaging P＜0.0001).DRGs payment amount is positively correlated to the number of DRGs grouping (regression coefficient 0.75284,P＜0.0001).DRGs grouping amount is positively correlated to the number of 24-hour medical records archiving (regression coefficient 0.44233,P＜0.0001).Conclusion The 24-hour archiving practice has significantly raised DRGs grouping and payment ratio,making it one of requisites for hospitals to successfully carry out DRGs payment system.

Air Pollutants ; analysis ; Chromatography, High Pressure Liquid ; methods ; Paraquat ; analysis ; Workplace

Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; Humans ; Lung ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; Perfusion Imaging ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Emission-Computed, Single-Photon ; methods

BACKGROUND: Inhaled glucocorticoids(IGC) are powerful anti_inflammatory agents used in the treatment of asthma. But it is still uncertain whether long-term use of the IGC affects bone metabolism in asthmatic patients, especially women.OBJECTIVE: To investigate if the prolonged treatment with IGC to Chinese asthmatic woman has a detrimental effect on bone mass and metabolism.DESIGN: A matched controlled study based on the patients SETTING:Clinical Laboratory and the Department of Respiratory Medicine, First Affiliated Hospital, Nanjing Medical University.PARTICIPANTS: From February 1998 to February 2002, forty female Chinese patients with bronchial asthma, regularly followed up at our outpatient clinic, all in the Nanjing area, none of them having a history of chronic systemic GC use, agreed to take part in the study, were selected and divided into two groups: therapeutic group (IGC group): 20 asthmatic women, aged 18-63 years, 5 menopausals, received IGC therapy regularly for at least 5 months; Control group: 20 asthmatic women, aged 18-60 years, 5 menopausals, never received IGC received conventional bronchodilators . They were matched individually for sex, age and menopausal status.METHODS: Bone mineral density (BMD) at the lumbar spine (2-4),femoral neck, trochanter, ward's triangle and total body of femur were measured by dual energy X-ray absorptiometry, BMD were expressed as a absolute value and a T score considered as a SD from peak bone mass respectively. Meanwhile, BMD was also expressed as a percentage (%), which was defined by comparing the BMD absolute value of subjects and BMD normal value of isosexual age cohorts. Osteocalcin and some other markers of bone metabolism were measured by radio immunoassay in two groups.daily dose and accumulative total dose of IGC and BMD in the IGC group.RESULTS: There were no significant difference between two groups in BMD and T score (including the lumbar spine (2-4), femoral neck,trochanter, ward' s triangle and total body of femur) (P ＞ 0.05). There were also no significant correlation between daily dose of IGC and BMD of above 5 parts in the IGC group (r=-0.325 to -0.1102, P ＞ 0.05). But,there were significantly negative correlation between the accumulative total dose of IGC and BMD at lumbar spine2-4,femoral neck and ward's triangle(r=-0.495 ,-0.517,-0.531 ,P ＜ 0.05).There were no significant correlation between the accumulative total dose of IGC and T score of above 5 parts in the IGC group (r=0.443to 0.295 ,P ＞ 0.05). There was negative correlation between the age and the BMD at ward's triangle in the IGC group(r=-0.506,P ＜ 0.05). However ,BMD at 5 locus were not correlated with the age in control group (r=-0.079 to 0.326, P ＞ 0.05).Osteocalcin and some other markers of bone metabolism were no significant difference between two groups (P ＞ 0.05).CONCLUSION: The data suggests that there is no significant influence of IGC on bone mineral density and bone metabolism in asthmatic women,but if continuing exposures to high doses over many years,there may be a detrimental effect on bone mass and metabolism in women, especially elder or postmenopausal asthmatic women treated with IGC who may be more susceptible to any bone mineral loss caused by IGC.

Objective To confirm the association between the“Tip-Apex Distance (TAD)”and cut-out of the lag screw from the femoral head.and to analyze other factors leading to the cut-out.Methods The complete radiographic and clinical data of 106 patients with femoral intertrochanteric fractures were available for this study. They were 65 men and 41 women,with an average age of 52.4 years (range,20 to 83 years).According to Evans classification.19 cases belonged to typeⅡ.25 to typeⅢ,32 to typeⅣ,29 to typeⅤ,and one to type R.The bone quality was classified by Singh rating system:44 cases were rated as typeⅥ.34 as typeⅤ,23 as typeⅣand five as typeⅢ.They were treated with open reduction and fixation with 135?dynamic hip screw (DHS).According to the finding of Baumgaertner that“TAD”beyond 25 mm would grcatly increase the risk of cut-out,the patients could be divided into two groups:59 cases with“TAD”less than 25 mm and 47 greater than 25 mm.Results The mean duration of follow-ups was 14.45 months (range,4.5 to 28.0 months).Of the 15 cases whose“TAD”was more than 30 mm,one had the cut-out.Of the seven cases whose“TAD”was more than 40 mm,two had the cut-out (P=0.000). The average age of the three patients was 78.7 years (range:75 to 83 years) and 27.1 years older than that of the 103 patients whose fracture healed (P=0.000).They belonged to the unstable intertrochanteric fracture of the femur (two to Evans type V and one to type R).The reduction was assessed as excellent in 43 cases,good in 47 cases,fair in nine cases (of whom one had the cut-out),poor in seven cases (of whom two had the cut-out). Conclusions The cut-out of the lag screw from the femoral head can be caused by age,fracture type and stability of reduction and“TAD”.The greater the“TAD”value,the greater possibility of cut-out.

Purpose:To study the expression of CD44v6 protein in breast carcinoma and its prognostic significance. Methods:100 cases of formalin-fixed paraffin-embeded female breast invasive ductal carcinoma tissues were retrospectively analyzed using EnVision~(TM) immunohistochemical method with the monoclonal antibody CD44v6.Statistical analysis was based on the Log-rank test and Cox analysis.Results:Sixty-six of 100 cancer tissues expressed CD44v6.Positive staining was mainly on the cell membranes.There was significant correlation between CD44v6 immunoreactivity and lymph node me- tastasis and TNM stage.The 5-and 10-year survival rates were 82.76% and 78.37% of patients with CD44v6 low-expres- sion tumors,and 64.1% and 49.88% of those with CD44v6 high-expression tumors,respectively;the difference between the two groups of patients was significant(P

Objective To investigate the clinical value of homemade uniform drainage system and application results in continuous lumbar drainage of cerebrospinal fluid. Methods A total of 75 patients underwent continuous lumbar cistern drainage of cerebrospinal fluid in patients with mechanical sampling were randomly divided into two groups, the control group (35 cases) using the traditional methods of continuous lumbar cistern drainage, the test group (40 cases) with self-designed uniform drainage device, compared with two groups of 24 hours from fluid volume flow control and the incidence of adverse reactions and the workload of nurses. Results The drainage rate equilibrium, the frequency of inspections and time respectively and the incidence of adverse reaction were (1.07 ± 0.35)/h, (23.67 ± 7.23) min/d and 5.00%(2/40) in the test group, less than that in the control group (2.14 ± 0.83)/h, (48.54 ± 11.69) min/d and 25.71%(9/35), there were significant differences (t=8.547, 7.641, χ2=16.347, all P <0.05). Conclusions In order to control the workload of nurses and reduce the incidence rate of adverse reactions, it is worth to promote the application of the continuous lumbar cistern drainage.

Tendon adhesion easily occurs after the operation.The outcome of tendon repair can be affected by adhesion, in-terfering with their normal gliding function.With increasingly deepened konwledge of the tendon healing process and continuous devel-opment of sciences related to medicine, a variety of effective approaches are provided to prevent tendon adhesion.Antioxidants are new orientations that are provided for prevention of tendon adhesion.Although most researches are only limited to animal experiments, the outcomes are positive.This paper reviews the mechanisms and relevant characteristics of tendon adhesion prevention in order to have a better understanding on the roles of antioxidants for preventing tendon adhesion.

BACKGROUND:Orthotopic lung transplantation model in a rat is the key to investigate the chronic rejection after lung transplantation. However, the precise surgical technique and difficult operation limit the application of the model. OBJECTIVE:To improve the process of anesthesia and lung transplantation, and to establish a rapid, safe and reversible rat lung transplantation model. METHODS:A total of 42 rats were used to establish the model, including 21 donor models and 21 receptor models. The donor lung was excised by median sternotomy with dissection of the left lung and implantation of cuffs (intravenous catheters cut into 1.5 mm sections). The left lung was implanted in the recipient by lateral thoracotomy using the cuffs for anastomoses. The duration of surgery and success rate of transplantation were recorded and calculated. RESULTS AND CONCLUSION:The survival rate of rats after lung transplantation was 100%. The time of left donor lung extraction was (35.3±5.1) minutes in average. The time of placing cuff in donor lung was (12.5±4.6) minutes in average. The surgical procedure time of recipient was (50.2±3.3) minutes. The time of arteriovenous and bronchus casing anastomosis was (27.7±6.2) minutes. After pulmonary artery and vein blood flow was disparked, the whole lung turned red rapidly, blood perfusion was sufficient, venous returned unimpeded;after mechanical ventilation resumed, al graft lungs expanded wel . This improved anesthesia and lung transplantation technique in rats can provide a valid, reliable and reproducible animal model for studying immune responses and rejection in lung transplantation.