Nonvalvular atrial fibrillation (NVAF) is the most common type of arrhythmia and an independent risk factor for ischemic stroke.Warfarin effectively decreases the risk factors for ischemic stroke in patients with NVAF,but substantially increases the risk for severe bleeding.Currently,most clinical guidelines recommend using the CHADS2 score for stroke risk stratification in NVAF patients to guide antithrombotic treatment.Although its application is simple and convenient,the CHADS2 score has been debated because of many limitations; especially some common stroke risk factors were not included.By comparison,the CHA2 DS2-VASc scores have included more risk factors for stroke.It can better identify the truly low-risk patients.Among the AF patients with CHADS2 score of 0 to 1,CHA2DS2-VASc scores may provide the important information for stroke risk,and thus help the decision-making of the anticoagulant therapy.

Poria cocos, which refers to the dry sclerotium of Poria cocos (Schw.) Wolf, is used as a traditional Chi-nese medicine (TCM). This review summarized the chemical constituents of P. cocos, their bioactivity and the extrac-tion technology of polysaccharides and triterpenes in order to provide in-depth study on the development and appli-cation of P. c oc os .

Studies have shown that the compliance of secondary prevention of ischemic stroke is not ideal. Among the factors that impact the compliance of secondary prevention, the correlation of the gender, age or disease severity has no clear conclusion. However, the married, the higher proportion of medical reimbursement, a better understanding of the disease, early intervention, the doctor's degree of attention, and a good doctor-patient relationship may improve the compliance of secondary prevention of ischemic stroke.

Objective To observe the clinical therapeutic effects of Yishen-Jianpi-Huoxue Decoction on the adolescent patients with Polycystic Ovary Syndrome (PCOS).Methods 42 patients diagnosed of PCOS of spleen and kidney deficiency syndrome were recruited in to traditional Chinese medicine group and treated with Yishen-Jianpi-Huoxue Decoction,and 35 patients of PCOS were recruited into control group and guided with the healthy lifestyle.The course of the treatment was 3 months.The menstrual cycle,body mass index (BMI),F-G score,GAGS score,basal body temperature (BBT),and endocrine related inspection were analyzed before and after the treatment.Results The clinical symptoms and related laboratory tests were improved in both groups after the treatment,but the effects of traditional Chinese medicine group was much better than the control group in BMI(23.11+3.64),GAGS score(7.33±7.06),FINS(14.73+8.97) mmol/L,and HOMA-IR (3.13 ±1.94),P＜0.05 or ＜0.01.Conclusion Yishen-Jianpi-Huoxue Decoction can improve the clinical symptoms and endocrine condition of edolescent PCOS patients.

Objective To explore the clinical effect of laparoscopic splenectomy caused by liver cirrhosis portal hypertension .Methods 38 patients treated with splenectomy as a result of hypersplenism induced by liver cir-rhosis portal hypertensions were selected .Laparotomy splenectomy was used in 18 cases ( OS group ) , laparoscopic splenectomy was used in 20 cases(LS group).Operation time , amount of bleeding during operation ,duration of hos-pital stays,liver and kidney function,blood routine,AYM were retrospectively analyzed.Results Compared with the preoperative group,LS ALT 2D after operation,postoperative 3~6d were significantly decreased(t=6.75,9.32,all P<0.05);3~6d AST levels after operation in LS group significantly decreased (t=8.87,P<0.05);LS group 2D after operation,postoperative 3~6d GGT levels were significantly lower than that of the preoperative (t=6.54,10.76, all P<0.05);group LS patients urea nitrogen levels falling postoperation ,there was statistically significant difference (t=3.43,P<0.05),leukocyte levels,PLT and HBG in the two groups increased postoperation ,these were statistical-ly significant difference(t=19.32,10.21,8.42,6.76,9.32,13.32,all P<0.05),OS group increased more obvious-ly.Conclusion LS has a better treatment effect on hypersplenism caused by liver cirrhosis ,which is worthy of popu-larization and application .

A total of 114 cases of femoral hernia undergoing 3D Prolene patching via femoral approach were examined for duration of surgery , length of stay , recurrence , postoperative pain and complications.Among them, 53 cases received both pre-and post-operative Doppler ultrasonic examinations.The vein thrombus ,diameter and flow rate of femoral vein were observed to compare with the pre-operative data to learn whether it had difference or not.The operative duration was 13.3 minutes.There was no event of recurrence ,compression,stricture or thrombosis of femoral vein.

Depression is a difficult problem because of its unresolved etiology , complex pathogenic factors ,and unknown path-ogenesis in the field of neuroscience .In recent years,the research of the pathogenesis in depression had made important progress at home and abroad .This article elaborates the mainstream hypothesis of depression mechanism to broaden the understanding depression in the fields of neurobiochemical study , neuroendocrine and neural plasticity studies .

Objective To evaluate the significance of serum prealbumin, bilirubin/albumin( B/A )ratio and brainstem auditory evoked potential (BAEP)for early predicting the bilirubinic neurotoxicity caused by early neonatal hyperbilirubinemia. Methods According to the gestational age, birth weight and the intervention criterion of neonatal jaundice, 94 neonates (newborn infants with a age of 1-7days) with hyperbilirubinemia were divided into two groups, one was term neonates with normal BAEP, the other was term neonates with abnormal BAEP. We detected their serum levels of total bilirubine, prealbumin, BAEP and calculated B/A ratio. Result The prealbumin levels was significantly lower and B/A ratio was higher in group of abnormal BAEP than those of control group ( P < 0. 01 ), while the levels of total bilirubin were not significantly different between the two groups ( P > 0. 05 ). In group of abnormal BAEP , there was a negative correlation between the level of serum prealbumin and the B/A ratio (r = -0. 637, P <0. 01 ). Conclution Prealbumin may be a sensitive indicator for early predicting bilirubinic toxicity like B/A ratio and BAEP.

Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups ( n = 16 each). Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose (in normal saline) during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose (in normal saline) during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy (T0), immediately after induction of anesthesia (T1), at the beginning of operation (T2), and at 20,40and 60 min (T3-5) and 2 h after operation ( T6 ). MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose (in normal saline) during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.