Objective To investigate the relationship between Oxfordshire community stroke project(OCSP) classification and imaging classification in acute cerebral infarction. Methods Two hundred and thirty-six patients with acute cerebral infarction were retrospectively evaluated with OCSP classification and imaging characteristics. Results According to OCSP classification,of all the 236 patients with acute cerebral infarction,28(11.9%) experienced total anterior circulation infarction(TACI),71(30.1%) partial anterior circulation infarction(PACI),94(39.8%) lacunar infarction(LACI),and 43(18.2%) posterior circulation infarction(POCI).The consistency was found in 171 cases(72.5%) between the OCSP classification and imaging classification,with the accuracy of 76%(25/33) for TACI,81%(34/42) for PACI,71%(81/114) for LACI and 66%(31/47) for POCI. Conclusion OCSP classification can predict the location and size of cerebral infarction with a high accuracy,and is well consisted with the imaging findings.

From the aspects of advantages, barriers, opportunities and challenges, this paper analyzed the environmental factors of Shanghai medical resources serving people in the Pan-Yangtze River Delta. As envisaged by the author, such services will provide medical resources information to patients from outside Shanghai, probe into feasible ways to medical insurance based on experiences drawn from serving such patients, help with the resources integration of medical systems in Shanghai, and probe into the potentials of telemedicine and distant medical e-learning, as well as improve hospital management levels and service functionality.

During the period of 11th Five-Year Plan,the Natural Science Foundation of China Peking University First Hospital acquired has improved in the total amount and project types.An analysis was made on the status of grant application and support in Peking University First Hospital as well as on the management method of the grant,offering some suggestions for the general hospitals on the management and development of Natural Science Foundation.

Objective To investigate the feasibility of reducing spine metal artifacts with metal artifacts reduction technique (WARP) at 3.0 T MRI.Methods This study included 15 cervical and 14 lumbar spine cases.The image quality of WARP sequences and conventional sequences were compared (5 score evaluation scale) as well as the signal to noise ratio (SNR) and contrast noise ratio (CNR) of the image artifacts.The scanning time was recorded.Paired-t test and Mann-Whitney test were used respectively to compare the SNR and CNR,and qualitative scoring between the two sequences.P＜0.05 was considered to indicate a significant difference.Results The image distortion and blur of the WARP sequences were obviously reduced as compared to the conventional sequences.The SNR and CNR of artifacts of the WARP sequences were lower than that of the conventional sequences (All P＜0.05).The image quality scores of WARP sequences in cervical and lumbar spines[4(3 to 5) and 4(3 to 5)] were higher than that of conventional sequences[3(2 to 4),3(2 to 4)](P＜0.05).The scanning time of cervical spines in WARP sequence(14 min 9 s) was increased by 64 s (8.2％),and the time of lumbar spines (13 min 41 s) decreased by 9 s (1.1％).Conclusion The WARP sequences at 3.0 T could effectively reduce the artifacts of metallic prosthesis in cervical and lumbar spine without prolonging the scanning time at 3.0 T MRI.

Objective To evaluate the association between R353Q polymorphism of the coagulation factor Ⅶ gene and cerebral infarction in Chinese Han people. Methods Restriction fragment length polymorphism(PCR-RFLP) methods was adopted to detect FⅦR353Q genotype and R、Q allelomorphie gone frequency of 100 cerebral infarction(CI) patients and 106 healthy people. Results There was FⅦR353Q polymorphism in the CI patients and healthy subjects. RR and RQ genotype could be found in the control group and CI group. RR and RQ genotype dis-position consistented with Hardy-weinberg equilibrium. In CI group,RR genotype was in 91 cases,RQ was in 9 cases and QQ in 0 case(the distribution frequencies were 91.00% ,9.00% and 0), and in the healthy subjects, those are 94 cases, 12 cases and 0 case(88.70% ,11.30% and 0). In the control group and CI group,R allele genotype fre-quencies were 94.33% and 95.50%, and Q were 5.67% and 4.50%. There was not significantly different in the R353Q polymorphism (χ20.3027, P=0.5822);Q allele genotype was not significantly different between the cases of control group and CI patients(χ20.2865, P=0.5925). Conclusion There are the FⅦR353Q polymorphism in Han population,however,the idea that the Q allele is a protective factor in CI is not supported.

Objective To investigate the effect of acute hypervolemic hemodilufion (AHHD) on EC50 of propofol by target-controlled infusion (TCI) for loss of consciousness (LOC). Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-64 yr scheduled for vertebral eolunm or total hip replacement surgery were randomly divided into 4 groups (n = 15 each) : group Ⅰ target plasma concentration of propofol (Tp) ;group Ⅱ target effect-site concentration of propofol (Te) ;group Ⅲ AHHD + Tp and group Ⅳ AHHD + Te. All the patients recoived iv infusion of lactated Ringer's solution 0.7 ml·kg-1 ·h-1 via peripheral vein for 30 min. At the same time 4% gelofusion 15 ml/kg was infused over 30 min via internal jugular vein in group Ⅲ and Ⅳ. At the end of gelofusine infusion TCI of propofol was started. The initial target concentration was set at 1.2 μg/ml. After the target concentration was steadily maintained for 30 s, the consciousness of the patients was evaluated by an anesthesiologist not involved in the study using OAA/S scale. The target concentration was increased in 0.3 μg/ml increment until the patients lost consciousness (OAA/S = 0). The target plasma concentration and effect-site concentration were then recorded. EC50 and 95% confidence interval (CI) of propofol for LOC were calculated by probit analysis. Results The ECho (95 % CI) of propofol for patients in group Tp, Te, AHHD + Tp and AHHD + Te (group Ⅰ-Ⅳ) were 3.74 (3.46-4.16), 2.32 (2.17-2.42), 4.12 (3.81-4.32) and 2.38 (2.14-2.56) μg/ml respectively. EC50 was significantly higher for loss of consciousness in AHHD + Tp group (group Ⅲ)than in Tpgroup (group Ⅰ), but there was no significant difference in EC50 between group Te and group AHHD + Te. Conclusion AHHD can increase the EC50 of target plasma concentration of propofol by TCI for LOC but has no effect on EC50 of target effect-site concentration.

Objective To study the protective effects of ischemic postconditioning and preconditioning against ischemic reperfusion injury of skeletal muscle.Methods According to different treatment methods on ischemia-reperfusion injury,forty Wistar rats were divided into I/R group,IPost group,IPC group,IPC + IPost group,control group.Using a rat amputation-like model,Wistar rats underwent temporary amputation at the level of the femur,excluding the femoral vessels.By measuring MDA,MPO,the extent of skeletal muscle infarction,protective effects of postconditioning and preconditioning,postconditioning combined with preconditioning were observed.Results In the Ipost group,IPC group,IPC + Ipost group,MDA and MPO at one hour of reperfusion and extent of muscle infarction at 6 hour of reperfusion was lower than group IR (P ＜ 0.05).In the Ipost group,MDA,MPO and extent of muscle infarction was similar to group IPC + Ipost; In the Ipost group,MDA and MPO was lower than group IPC,extent of muscle infarction was similar to group IPC.Conclusion Ischemic postconditioning at the beginning of reperfusion can protect skeletal muscle against ischemic reperfusion injury.Preconditioning also protect skeletal muscle against ischemic reperfusion injury,but preconditioning combined with postconditioning don't offer additional benefit over preconditioning or postconditioning alone.

OBJECTIVE To investigate the site of nosocomial infection in ICU,distribution and resistance of bacteria in order to make the intervention strategy.METHODS Antimicrobial susceptibility of pathogenic bacteria isolated from nosocomial infection patients in ICU from Jul 2006 to Jul 2008 was performed by Kirby-Bauer method.RESULTS The main pathogens of nosocomial infection in ICU were Gram-negative organisms(48.09%),Gram-positives(38.93%),and fungi(12.98%).The most common pathogens were Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,fungi,and S.haemolyticus.All strains of S.aureus and S.haemolyticas were antimicrobial sensitive to vancomycin,teicoplanin and linezolid.All A.baumannii strains were antimicrobial sensitive to cefoperazone/sulbactam.They were resistant to other antimicrobial agents.CONCLUSIONS Gram-negative organisms are the main pathogenic bacteria of nosocomial infection in ICU,but the percentage of Gram-positives and fungi is increasing,S.aureus is the most main pathogenic bacterium of nosocomial infection in ICU.S.haemolyticus is also a main pathogenic bacterium.The pathogenic bacteria of nosocomial infection in ICU are highly resistant to the most antimicrobial agents.

Objective To evaluate the correlation between CYP3A4 enzyme and analgesia with fentanyl after gynecological operation. Methods One hundred and fifty-nine ASA Ⅰ or Ⅱ patients, aged 30-50 yr, scheduled for elective myomectomy or abdominal total hysterectomy, were enrolled in this study. Anesthesia was induced with midazolam, remifentanil, propofol and succinylcholine and maintained with iv infusion of propofol and remifentanil and intermitent iv injection of atracurium. Venous blood samples were obtained for determination of the plasma 1'-hydroxymidazolam and midazolam concentrations at 1 h after iv injection of midazolam. The ratio of the 1'-hydroxymidazolam concentration to the midazolam concentration was used to reflect the effect of CYP3A4 enzyme. Pain was assessed with visual analog scale (VAS) after consciousness was regained. When VAS score ＞ 4,the patients were given fentanyl 10 μg every 5 min until VAS score ≤ 4 and then PCIA with fentanyl was performed. VAS score was maintained ≤4. The times of successful delivery within 24 h after operation and during the period of 24-28 h after operation and fentanyl consumption within 48 h after operation were recorded. Pearson correlation was used to analyze the data. Results There was no correlation between the effect of CYP3 A4 enzyme and the times of successful delivery or fentanyl consumption, and the correlation coefficients were 0.16, 0.13 and 0.11 respectively ( P ＞ 0.05). Conclusion CYP3A4 enzyme is not the major enzyme metabolizing fentanyl.

Objective To investigate the effects of Kangpa bolus on behaviors, dopamine and its metabolites of striatum in animals with Parkinson' s disease (PD). Methods The mice models of muscle tremor and rigor were established to observe the antagonism of Kangpa bolus. Step-down and step-through tests were used to evaluate the effects of Kangpa bolus on learning and memory function in mice. The rat model of PD was established to observe the effects of Kangpa bolus on rotation behaviors. The contents of DA and homovanillic acid( HVA) in the injured side of striatum were detected by ELISA. Results Compared with model group(723. 1 ±79.3) s,the duration of tremor in mice shortened significantly (P < 0. 01) in Kangpa bolus high dose and middle dose group ((548.0±27.0)s,(590.9 ±28.7)s). Compared with model group(3194.5 ±251.7)s,the duration of rigor in mice shortened significantly(P<0.01) in Kangpa bolus all dose group((2300.1 ±352.5)s,(2478.2 ±276.6)s, (2559.3 ±207.6) s). In step-down test, compared with model group (3. 10 ±0.74), the number of errors decreased significantly(P<0.01) in Kangpa bolus high dose and middle dose group (1.60 ±0. 97,1. 80 ±0.63). In step-through test, compared with model group( 2.30 ± 0. 68), the number of errors decreased significantly (P < 0.01) in Kangpa bolus high dose and middle dose group(0.80 ±0.79,1.10 ±0.74). Compared with model group (340.6 ±18.8) , the number of rotations of PD rats in thirty minutes reduced significantly (P< 0.01) in Kangpa bolus high dose and middle dose group(286.5 ± 12.1,296.6 ± 12.7) after three weeks treatment. Compared with model group(9.43 ±1.79,0. 87 ±0.12) nmol/L,the contents of DA and HVA in the injured side of striatum increased significantly(P<0. 01 ) in Kangpa bolus high dose( 18. 9 ±4. 01,1. 50 ± 1. 39) nmol/L and middle dose group (17.3±3.01,1.39±0.53)nmol/L Conclusion Kangpa bolus has some therapeutic effects on the animals of PD.