Objective To study the clinical evaluation of calf blood as a combination of aspirin and aspirin for ischemic stroke and its effect on peripheral blood BCL-2,BAX and Caspase-3,IL-6 and pathogens.Methods 128 patients with ischemic stroke were enrolled in our hospital from September 2014 to October 2016.The patients were divided into observation group and control group by throwing coin method.The control group was treated with oral aspirin tablets and some conventional medical treatment,and the observation group on the basis of this increase in calf blood to the protein injection for treatment,the hemorheology,Barthel index,the national institutes of health stroke scale(NIHSS score)and peripheral blood BCL-2,BAX and Caspase-3 protein content of two groups were recorded before and after treatment.Results After treatment,the total effective rate in the observation group(96.9％)was significantly higher than that in the control group(71.9％),the NIHSS score and hemorheological index of the observation group were significantly lower than those of the control group,Bclhel index was significantly higher than that of the control group,the content of BCL-2 protein in the peripheral blood of the observation group was significantly higher than that of the control group,the levels of BAX and Caspase-3 protein in the peripheral blood of the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.05).Conclusion The clinical effect of calf blood protein injection combined with aspirin in the treatment of ischemic stroke can not only improve the daily life ability of patients,but also can improve the hemorheology and peripheral blood BCL-2; BAX,Caspase-3 protein content.

Objective To explore the effect of transport procedure adopted on intra-hospital transport of critically ill patients. Methods Three hundred and fifteen critically ill patients(control group)were intra-hospital transported adopting traditional method,while 309 ones(experimental group)adopting transport procedure. The occurrence rate of accidents of both groups and satisfactory rate of nurses in which the patients were admitted.Result The occurrence rate of accidents in experiment group was lower than that in control group and the satisfactory rate of nurses on transport procedure was higher than that on traditional method with statistical difference(P<0.01).Conclusion The application of transport procedure can effectively minimize the risk of critically ill patients during intra-hospital transport and increase satisfactory rate of medical staffs.

OBJECTIVE:To optimize the formula of piribedil hydrochloride orally disintegrating tablets and to investigate their related indexes.METHODS:Taking the contents of crospovidone(PVP XL)(disintegrating agent),amylum pregelatinisatum(loading agent) and Gum Acacia(glidant) as factors,the disintegrating time(td),the wet time(t) and the suspend stability(?A) as the evaluate indexes to carry on the orthogonal experimental to optimize the formula.The dissolution curve of the optimized formula was drawn.RESULTS:The optimized formula for the piribedil hydrochloride orally disintegrating tablets were as follows:the contents of crospovidone(PVP XL),amylum pregelatinisatum and Gum Acacia were 15%,20%,and 15% respectively.The prepared orally disintegrating tablets disintegrated completely within 30s and dissolved basically within 2min.CONCLUSION:The prepared preparation can meet the related standards specified of China Pharmacopeia.

Abstract Frailty is a clinical state characterized by increased vulnerability due to the decline of multiple organ functions. It is clinically manifested as slow movement, reduced activity, low energy level and involuntary weight loss. Frailty heightens the risk of disability, long-term hospitalization and mortality in the elderly when they face stressful events. Early assessment of frailty and personalized interventions can prevent and delay its progression, thereby reducing the occurrence of adverse events. This article reviews the literature on frailty published both domestically and internationally from January 2015 to January 2024. It provides an overview of the tools for assessing frailty in the elderly, such as the Clinical Frailty Scale, Frailty Index, Fried Frailty Phenotype, FRAIL Scale, and biological markers, and the management of frailty, including exercise, nutritional interventions, oral health management, and medication management, so as to provide the evidence for early assessment and intervention of frailty.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.

[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Objective To investigate the effect of intrathecal administration of a mixture of butorphanol and ketamine on cAMP-PKA-CREB signal transductian pathway in the spinal dorsal ham of the rats with inflammatory pain. Methods Twenty-four male SD rats, weighing 240-280 g,in which intrathecal catheters were successfully placed, were divided into 4 groups randomly (n = 6 each): inflammatory pain group (group IP), butorphanol group (group B), ketamine group (group K), and butorphanol + ketamine group (group BK). The inflammatory pain was induced by injection of 5% formalin 50 μl into the plantar surface of left hind paw. Normal saline 10 μl, butorphannl 12.5 μg, ketamine 50 μg, and a mixture of butorphanol 12.5 μg and ketamine 50 μg was injected intrathecally 30 min before subcutaneous injection of formalin in group IP, B, K and BK respectively.Pain intensity score (PIS) was used to assess pain behavior every 5 min within an hour after subcutaneous injection of formalin. The animals were killed at 2 h after subcutaneous injection of formalin, and the L5 segment of the spinal cord was removed for determination of protein kinase A (PKA) and phosphorylated cAMP response element binding protein (p-CREB) expression using immunohistochemistry. Results Fonnahn administration induced pain behaviour expressed as two phases. PIS scores, PKA and p-CBEB expression, and staining scores were significantly lower during the fast and second phases in group BK than in group IP (P < 0.05 or 0.01), while no significant differences were found in the indices mentioned above between group B and IP and between group K and IP (P>0.05). Conclusion lntrathecal injection of a mixture of butorphanol and ketamine can reduce inflammatory pain in rats, and the mechanism may be related to the cAMP-PKA-CREB signal transduction pathway.

Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.

Objective To investigate the therapeutic effects of atorvastatin on pulmonary fibrosis of rats induced by Bleomycin (BLM). Methods Fourty-two female Wistar rats were randomly divided into 7 groups: the control group(group C) , the model group which was furtherly divided into group 2-week (M2) , 4-week (M4) , 6-week (M6) , and atorvastatin-treatment group which was furtherly divided into group 2-week (A2) , 4-week (A4) , 6-week(A6). Group M and A were induced to pulmonary fibrosis by the method of BLM endotracheal injection, while group C was injected with saline. On 2nd day, group A were given orally atorvastatin by 10 mg/kg · d. Rats were seperately killed on 2nd, 4th and 6th week. After intratracheal injection of BLM, alveolitis and pulmonary fi-brosis were evaluated by pathology, hydroxyproline concentration and PaO_2. Results The lung coefficient of group M2, M4, A2 and A4 was significantly higher than that of group C. The degree of pulmonary fibrosis in group A4 and A6 was improved as compared with group M4, M6. Alveolitis and pulmonary fibrosis in group A were improved compared with those in group M. Hydroxyproline concentration in group A and M were significantly higher than that in group C. While A4 was lower than M4 (P <0. 01). There was a decrease in PaO_2 after exposure to BLM, espe-cially in group M2 (P <0. 01). Improvement in PaO_2 was documented in groups A, compared with M. Conclusion Atorvastatin has centtain efficacy in treatment of pulmonary fibrosis of rats. The effect was significant on 6th week after treatment, which suggest that the effect is correlated positively to the carly treatment.