Objective To observe the change of door-to-needle time(DNT)and the intravenous thrombolysis rate by recombi-nant tissue plasminogen activator(rt-PA)in the patients with acute ischemic stroke (AIS)after establishing and perfecting the stroke green channel in our hospital.Methods A total of 3 990 patients with AIS in our hospital since 2010 were screened for the statistics on the number of the patients within the time window every year,conducting the analysis on the change trend of the annu-al intravenous thrombolysis rate and DNT.The change situation of DNT and the annual intravenous thrombolysis rate change were compared before the establishment of the stroke green channel and after the establishment and the continuous improvement of the stroke green channel.Results The proportion of AIS patients within the time window in our hospital was significantly lower than that in the domestic developed regions.The intravenous thrombolysis rate by rt-PA achieved the zero breakthrough since the estab-lishment of the stroke green channel in 2011.Along with the continuous improvement of the stroke green channel,the DNT median of the patients within the time window was reduced to 60 min in 2012 and 53.5 min in 2013,moreover the intravenous thrombolysis rate by rt-PA in the patients within the time window was increased from 0 in 2010 to 74.3% in 2013.Conclusion By gradually per-fecting the process of the stroke green channel and strengthening the cooperation of emergency,clinical laboratory and stroke team, DNT is reduced by a large margin and the intravenous thrombolysis rate is substantially increased,which indicates that establishing the perfecting and smooth stroke green channel in the serious pre-hospital delay areas is a necessary measure for increasing the in-travenous thrombolysis rate.

Objective To evaluate the clinical significance of classifying vertebral artery-atlas complex using angiographic CT (computed tomography angiography,CTA).Methods The CTA data of 225 patients were reconstructed three-dimensionally in Mimics.The region of V3 segment of vertebral artery and isthmus of atlas's posterior arch were reconstructed as vertebral artery-atlas complex,classify according to the relationship of the two.The complex types were classed into 3 types and 7 subtypes.Type A was conventional type,which means V3 segment locates above the isthmus of atlas.The distance between vertebral artery and atlas was larger than 1.8 mm in A1 subtype.The distance was between 1.8 and 0.6 mm in A2,and less than 0.6 mm in A3.Type B was variation of vertebral artery.Subtype B1 was far-away variation,which means artery doesn't pass around posterior arch of atlas.Subtype B2 means the artery passed underneath the arch of atlas.Type C was variation of bone.Bone structure was closed in subtype C 1,and unclosed in subtype C2.The distance between artery and atlas was measured in subtype A1 and A2.Results There were 450 cases of vertebral artery-atlas complex in the 225 patients,which could be divided into A1,including 57 (12.7％),A2,including 115 (25.6％),A3,including 194 (43.1％); B1 including 20 (4.4％),B2,including 9 (2.0％); C1,including 34 (7.6％),C2,including 21 (4.7％).More than half patients (50.2％) had different subtype in both sides.The measured value of VAD was 2.42±0.52 and 1.20±0.36 mm in subtype A 1 and A2 respectively.Conclusion Reconstructing CTA images before fixation of atlas can clearly demonstrate the complex of V3 segment of vertebral artery and isthmus of the posterior arch of atlas.Classifying the complex and choose appropriate method of inserting screws can improve the security of the operation.

Objective To analysis the frequency of 9 bp deletion polymorphism of mitochondrial DNA(mt DNA)among Miao population in three geographical regions of Guizhou.Methods Polymerase chain reaction and polyacrylamide gel electrophoresis (PCR-PAGE)were used in the study of mtDNA 9 bp deletion polymorphism,DNA sequence was used to verify the results.Results Each group who come from Basa,Shajin,Longjie in Guizhou,the frequency of 9 bp deletion of mtDNA value as 19.15%(9/47), 42.5%(17/40)and 29.55%(13/43).Short polymorphic frequency difference was statistically significant between Basa and Shajin groups(P<0.05).Conclusion The frequencies of 9 bp deletion of mtDNA are relatively high in Miao ethnic group in Guizhou. There are certain differences of the delegation frequencies among these groups.

Objective To research and develop an index system for training evaluation of national health emergency response.Methods A combinative approach was applied,including core expert group discussion,on-site investigation into parameters applied in Delphi assessment by field experts,national reviews by provincial health departments.Results Firstly,a framework of index system was constructed by core expert group based on literature;Secondly,the index was screened by mean score from field experts' investigation and suggestion of core experts,then an index system was formulated with 5 first level indexes,19 second level indexes and 46 third level indexes;Thirdly,index weight was determined according to the mean weight by field experts investigation and adjusted suggestion of core experts;Finally,the index system for training evaluation of national health emergency response was approved by Ministry of Health and applied to the whole nation.Conclusions The combinative approach is practical in research and developing index system.The index system covers a full range of related factors,and is applicable at provincial level.However,attention should be paid to improving training after evaluation.

At present, diagnostic standards and treatment guidelines for mental stress-induced myocardial ischemia have not been established.Clinical symptoms are often seen in patients, but clinical evidence of myocardial ischemia is lacking.With increasing research closely related to mental stress-induced ischemia and adverse cardiovascular outcomes, more and more attention has been paid to coronary microcirculation in stenosis or coronary microvasospasm.With mental stress as a starting point, this article analyzes the incidence and characteristics of mental stress-induced myocardial ischemia and reviews its pathological mechanisms from the perspectives of myocardial inflammatory reaction, vasoconstriction, endothelial dysfunction, sympathetic nerve conduction and genetic factors.

Atopic dermatitis is a recurrent inflammatory skin disease. Although the existing systemic and topical treatment can relieve symptoms, there are still some limitations and adverse effects. In recent years, with the in-depth study on the pathogenesis of atopic dermatitis, especially the discovery of key inflammatory molecules and development of targeted therapeutic drugs, some new therapeutic methods and concepts have been brought to clinical practice. Awareness of new progress in atopic dermatitis-related biologics, small-molecule drugs, adjuvant treatment, monitoring methods and models for managing disease, will help clinicians better treat and manage atopic dermatitis.

Objective To determine the incidence of long bone lesions and clinical characteristic in early newborn with asymptomatic congenital syphilis. Methods The syphilis antibody in 26 infants with asymptomatic congenital syphilis who were diagnosed and treated in our hospital from April 2001 to May 2004 were detected,and the clinical feature and X-ray features were analyzed.Results Twenty-six infants and their mothers all had the antibody positive of syphilis.Treponemal antibody titer were 4 times higher than their mothers in the infants blood serum.Their general conditions showed normal and had no symptoms when they were hospita-(lized).Then,there were 24 cases (92%) with positive physical signs and /or abnormal findings on the liver function tests and blood routine and long-bone radiographs.Long-bone radiographs were abnormal for approximately 38%(10 of 26)of asymptomatic newborns with congenital syphilis.Metaphysitis was shown and looked like sandwich biscuit in X-ray photograph.Conclusions Asymptomatic congenital syphilis has no symptoms in the early stage.Bone X-ray photograph should be included in the assessment of newborns with a positive serology.Further support is needed in the diagnosis and treatment of early newborns with asymptomatic congenital syphilis.

Objective: To study the relation of condylar morphology with different vertical facial types in the development of patients with skeletal Ⅲ malocclusions. Methods:180 cases with skeletal Ⅲ malocclusion were divided into children(5-11 years old), adolescence(12-17 years old) and adult(18-30 years old) groups with 60 cases in each group. Orthopantomograms of the patients with different vertical facial types were retrospectively investigated by computerized cephalometric analysis. Condylar morphology were compared among different age groups of the same vertical facial type. Results:In patients with high angle, ramus height(RH) was getting bigger with ageing(P0.05). In patients with low angle h and RH in adult group were bigger than those in adolescence or in children(P

Objective To observe the virology response after the treatment of chronic hepatitis C by polyethylene glycol interferon in combination with ribavirin and the etiological characteristics of chronic hepatitis C.Methods A retrospective analysis of chronic hepatitis C infection route,hepatitis C virus(of hepatitis C virus,HCV)load and its gene typing of 120 patients in our hospital from August 2009 to July 2012.And the patients were given pegylated interferon (PEG-IFN-2a),or ordinary interferon (IFNα) alone or in combination with ribavifin.HCV-RNA load and liver function were monitored before and after 4,12,24,36,48 weeks.Results Blood transfusion was the main way of HCV infection(71/120).109 cases (90.8％) patients with serum HCV-RNA load between 5.0 ～ 7.0 logl0 copies/ml.76 patients were made HCV viral genetics testing,test results,65 cases of HCV-RNA 1b type,2 cases of HCV-RNA 1c type,HCV-RNA 2a type and HCV-RNA 6a type and HCV-RNA type 3b was 3 cases,especially.The application of PEG-IFN-2a of the two groups was significantly better than the application of IFNα of the two groups(P ＜ 0.05).Conclusion Chronic hepatitis C is mainly to infected by blood transfusion.HCV-RNA load between 5.0 ～ 7.0 log10 copies/ml.88.2％ of the cases of genotype 1(most of which is type 1b).PEG-IFN-2a combined with ribavirin combined with individualized treatment can effectively improve SVR rates.

Objective To evaluate the effect of dexmedetomidine postconditioning combined with limb ischemic postconditioning on myocardial ischemia-reperfusion (I/R) injury in rats.Methods Fifty male Sprague-Dawley rats,aged 2-3 months,weighing 275-335 g,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S);I/R group;dexmedetomidine postconditioning group (group DP);limb ischemic postconditioning group (group LP);dexmedetomidine postconditioning combined with limb ischemic postconditioning group (group DLP).Myocardial I/R was induced by occlusion of the left anterior descending branch of coronary artery for 30 min followed by 180 min reperfusion.At 15 min before reperfusion,dexmedetomidine 50 μg/kg was injected intraperitoneally in DP and DLP groups,while normal saline 0.5 ml was injected intraperitoneally in I/R and LP groups.In LP and DLP groups,the animals underwent 10 min ischemia of bilateral hind limbs starting from 10 min before reperfusion,followed by reperfusion.Blood samples were taken from the internal carotid artery at 180 min of reperfusion for determination of the plasma creatine kinase-MB (CK-MB) and glutathione peroxidase (GSH-Px) activities and the concentrations of cardiac troponin I (cTnI),malondialdehyde (MDA),interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α).Myocardial specimens were obtained at 180 min of reperfusion for determination of the myocardial infarct size.Results Compared with group S,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly increased,and GSH-Px activity was significantly decreased in I/R,DP,LP and DLP groups (P＜0.05).Compared with group I/R,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in DP,LP and DLP groups (P<0.05).Compared with DP and LP groups,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in group DLP (P ＜ 0.05).Conclusion Dexmedetomidine postconditioning combined with limb ischemic postconditioning provides better efficacy than either alone in reducing the myocardial I/R injury in rats,and the mechanism may be related to the inhibition of lipid peroxidation and systemic inflammatory responses.