Remote ischemic preconditioning and postconditioning are two new ways to reduce ischemia-reperfusion injury.Studies in recent years have shown that it also has significant protective effect for cerebral ischemia.At the appropriate time to give appropriate strength of remote ischemic preconditioning or postconditioning may induce brain ischemic tolerance and thus produce neuroprotection.The procedures of limb ischemic preconditioning and postconditioning are simple,and the clinical application value is higher.This article reviews the protective effect of limb ischemic preconditioning and postconditioning on cerebral ischemia.

Objective To learn about polysomnography (PSG) of the patients with spinal muscular atrophy (SMA),and the improvement of the moderate-severe sleep disordered breathing(SDB) patients after non-invasive ventilation (NIV) treatment.Methods The PSG examination of 11 SMA patients in Children′s Hospital Affiliated to Capital Institute of Pediatrics was performed.The PSG results and the levels of breathing disorder of these patients were collected.These patients were divided into 2 groups as follows.The mild group:apnea hypopnea index(AHI) was between 5 to 10 times/h,or average pulse oxygen saturation(SpO2)>95%;the moderate-severe group:AHI>10 times/h,and average SpO2≤95%.The moderate-severe levels of the patients were treated with NIV.Then the improvement of PSG after the treatment was evaluated.Results Within the 2 cases of type 1 SMA,1 was moderate-severe,the other 1 was mild.There were 2 cases moderate-severer and 6 cases mild SDB cases of type 2 SMA.The only 1 case of type 3 was categorized as mild disorder.The average hypopnea index(6.3 times/h) was higher than apnea index(4.9 times/h).The indicators to distinguish the moderate-severe and mild groups were as follows:AHI,average SpO2,hypopnea index,and arousal index associated with respiratory case,and there were statistically significant differences(all P<0.05).Significant improvement in PSG of the 3 NIV-treated patients was observed and it remained in normal range.The following indicators also remarkably improved after NIV treatment were hypopnea index [(1.5±0.1) times/h vs.(11.5±4.6) times/h,t=3.741,P<0.05],AHI [(2.4±1.1) times/h vs.(17.4±8.1) times/h,t=3.196,P<0.05],and average SpO2 [(96.7±0.6)% vs.(94.3±1.2)%,t=-3.130,P<0.05].Conclusions There are different levels of SDB within SMA patients.The major characteristic of SMA patients is hypopnea.There are more moderate-severer SDB in type 1 than those in type 2.The average SpO2,arousal index associated with respiratory incidents,AHI,and hypopnea index can reflect the levels of SDB of SMA patients.Besides,the results indicate NIV treatment can significantly improve SDB of SMA patients.

Objective To explore the effects of lithium on expressions of cyclin-dependent kinase 5 (CDK5) and protein phosphatase 2A (PP2A) in the brains of chronic aluminum exposure rats so as to further understand the mechanism of lithium's inhibition on tau phosphorylation. Methods We divided 12 chronic aluminum chloride exposure rats into treatment group and non-treatment group (6 rats in each). Treatment group was given lithium chloride (200 mg/kg?d) via gastric perfusion daily for 6 weeks,while the non-treatment group sodium chloride at the same dosage and the normal group (6 non-aluminum exposure rats of the same month old) without intervention. Six weeks later,all the rats received Morris water maze test for learning memory function; CDK5 and PP2A expressions and phosphorylated tau protein level in rat hippocampus were determined by Western blotting. Results Compared with normal group,non-treatment of chronic aluminum exposure group showed higher phosphorylated tau protein level and CDK5 expression in the brain (P0.05). Conclusion Lithium may reduce tau phosphorylation and neurofibrillary tangle formation by inhibiting the expression of CDK5.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema.

Objective To evaluate the skin protection of the 3M transparent dressing joint 3MTM CavilonTM No Sting Barrie Film after peripherally inserted central catheter (PICC).Methods A total of 120 PICC catheter patients with lung cancer (observation time last about 3 months from starting the rearing pipe on the day to pipe-taken) were selected.They were divided into 2 groups by random digits table method with 60 cases each.Control group was given 3M transparent dressings stick in the PICC fixed place skin.Observation group was given 3M transparent dressings paste joint 3MTM CavilonTM No Sting Barrie Film.The incidence of complications in the PICC fixed place skin were observed and compared between 2 groups.Results The skin allergy,phlebitis,skin damage,total complications were 5,4,1,10 cases in control group after PICC catheter and 2,1,3,6 cases in observation group,and there was significant difference in the incidence of the total complications,x2=4.23,P＜0.05.Conclusion Using 3M transparent dressings joint 3MTM CavilonTM No Sting Barrie Film for skin care after PICC catheter,can effectively protect the skin after PICC catheter,reduce the incidence of adverse reactions.

Objective To investigate the hand hygiene status of urban and rural residents in Hangzhou City of Zhejiang Province to provide scientific base for health promotion.Methods Urban residents,rural residents,personnel in government institutions,urban students,rural students and enterprise workers were enrolled in this investigation.By using constant volume sampling method,fifty individuals in each group were recruited from 13 districts of Hangzhou City,and a total of 3 337 people filled in the questionnaire,which included demographic characteristics,knowledge of hand hygiene and hand washing.Logistic regression analysis and x2 test were used for data analysis.Results Correct hand-washing was found in 35.84％ urban and rural residents (urban vs.rural:41.45％ vs.27.06％).Awareness rate of hand hygiene was 35.06％.The influencing factors of proper hand washing were location,gender,age,educational level and understanding of hand hygiene.The influencing factors of awareness of hand hygiene were location,gender,age and educational level.Conclusion Hangzhou citizens had a relatively lower rate of proper hand washing,and significant difference was found between urban and rural residents; the study suggested that para-urben residents need to improve their knowledge and behavior of hand hygiene.Meanwhile,the students urgenty need to improve their hand hygiene

ObjectiveTo explore the surgical treatment of congenital heart disease combined with severe pulmonary hypertension.MethodsThirty-two patients of congenital heart disease combined with severe pulmonary hypertension were included in the study.The saturation of arterial oxygen ranged from 0.84 to 0.94 and echocardiography showed left to right slow velocity shunt in 20 eases,double direction shunt in 10 cases and no shunt in 2 cases.The pulmonary arterial pressure was 65-120 (82 ± 14) mm Hg ( 1 mm Hg =0.133 kPa).All patients received surgical repairs under cardiopulmonary bypass and were treated preoperatively with oxygen inhalation therapy,oral intake of beraprost sodium or silaenafil respectively according to the degree of pulmonary hypertension.During cardiopulmonary bypass,pulmonary artery perfusion was performed with protective solution containing ulinastatin for lung protection.Vasoactive drugs were routinely administrated postoperatively.Results Thirty-two cases underwent the surgical treatment successfully with their postoperative pulmonary arterial pressure decreased 20 -40 mm Hg and 2 cases died of severe low cardiac output syndrome and fatal arrhythmia.The mortality was 6.25％(2/32).ConclusionComprehensive perioperative management followed by radical operation can achieve a good clinical result on congenital heart disease combined with pulmonary hypertension.

ObjectiveTo investigate the myocardial protection on cardiac valve replacement surgery with creatine phosphate of myocardial GIK (GIK) in order to reduce the surgical risk and improving the efficacy.Methods126 cases were unergone surgical treatment of heart valve disease,whose cardiac function on admission wereⅢor Ⅳ. 126 patients were randomly divided into two groups. Cardiopulmonary bypass time, aortic cross clamp time, postoperative myocardial injury markers ( CK-MB, cTNI) changes, arrhythmias, heart function recovery, length of stay and mortality rate and other indicators were compared between the two groups. ResultsThe age, gender, body mass,heart disease and surgery combined data were not statistically significant between the two groups( all P ＞0. 05). The cardiopulmonary bypass time, aortic cross clamp time and mortality had no significant differences between the two groups( all P ＞ 0.05 ). The CK-MB( 21.36± 9.21 ) U/L and cTNI(0.83 ± 0. 35 ) ng/ml of creatine phosphate group were significantly lower than those of the control group. The incidence of arrhythmia in phosphocreatine group (37. 1％ ) was significantly lower than ordinary group (57.8 ％ ) ( X2 ＝ 5. 418, P ＜ 0. 05 ). ConclusionThe application of creatine phosphate GIK before valve replacement surgery could effectively reduce reperfusion injury after myocardial ischemia,myocardial protection,and significantly reduce the incidence of arrhythmia and improve heart function in patients.

Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.

Objective:To investigate the prevalence,and the factors that influence depressive symptoms among chronic respiratory disease patients in tertiary hospital.Methods:A total of 1713 outpatients and inpatients with chronic respiratory disease were selected from 8 tertiary hospitals in Jiangsu Province from July to September,2014 and screened according to the Hospital Anxiety Depression Scale-D (HADS-D).A questionnaire developed by this research group,was used to collect demographic and clinical information.Logistic regression was used to identify factors that were associated with depressive symptoms.Results:The overall rate of depressive symptoms was 46.0％.Multiple logistic analysis showed that spinsterhood (OR ＝ 0.45),higher education level (middle school /high school/technical school OR ＝0.65;college degree or aboveOR ＝0.28),BMI ≥24 (OR ＝0.71) were associated with decreased risk of depressive symptoms (P ＜ 0.05).B MI ＜ 18.5 (OR ＝ 1.52,),average income of family ≥10000 RMB (OR ＝ 1.37-1.96),limited daily activities (OR ＝ 1.72),poorer sleep quality (OR ＝ 1.45),and negative life events (OR ＝ 1.62) were associated with increased risk of depressive symptoms (P ＜ 0.05).Conclusion:The prevalence of depressive symptoms among chronic respiratory disease patients in tertiary hospitals in Jiangsu Province was higher.Marital status,education level,income,BMI,limited daily activities,subjective sleep quality,negative life events may be the related factors of depressive symptoms of chronic respiratory diseases patients.