Objective To investigate the relationship between the cerebral blood flow filling condition and prognosis of patients with acute severe cerebral infarction.Methods The clinical data and MR features of 10 cases of acute severe cerebral infarction were retrospectively analyzed.Results The regional cerebral blood flow(rCBF) and regional cerebral blood volume(rCBV) of 9 cases(90%) in the infarcted side decreased significantly.The reduced percents of the infarcted side reached 64.1% and 49.7% respectively.There were significant differences between two opposite sides(P=0.001,P=0.01).The MRA results showed great vessels(arteria carotis interna or arteria cerebri media) in the infarcted side were all obliterated in the all patients,and simultaneous great vessels in opposite side were narrow or occlusion in 7 cases(70%).2 cases died;and 8 cases were serious disability.Conclusions The cerebral blood flow filling of the acute severe cerebral infarction patients decrease significantly.The prognosis of the patients is quite bad.

Objective To evaluate the effect of “flying kite” technique and detachable balloon on embolization of carotid-cavernous fistulas (CCF). Methods 9 cases of CCF were treated by using“flying kite”technique, and 6 cases of CCF were treated by using detachable balloon. Results In “flying kite” treatment group, 8 cases were completely cured, and 1 case was partly cured. In detachable ballon treatment group, all 6 cases were completely cured once. Conclusion The“flying kite”technique was simple method for embolization of CCF, which didn't need special instruments and materials, and was easy to use in the basic hospitals, but it could obstruct carotid artery and lead to CCF recurrence. The embolization of CCF by using detachable balloon had a higher curative rate and recurred rarely, but it needed special instruments and skills. Detachable balloon embolization of CCF is a reliable method for the treatment of CCF. [

Objective To investigate the relationship between post-stroke pathological laughing and crying and depression.Methods Among 276 stroke patients in hospital,28 patients with pathological laughing and crying were chosen as PLC group,and other 28 patients matched with gender and age but without PLC were choosen as the control group.All patients were investigated with Hamilton Depression Scale(HAMD),PLC scale and clinical features.Results There was no significantly difference(P>0.05)in total and factor scores of HAMD between these two groups.Conclusion The pathological laughing and crying and depression seem to result from different pathogenesis.

Objective To study the pathogenesis of lower limb motor disorder in vascular parkinsonism(VP)using diffusion tensor image(DTI). Methods A case?control study was performed in a cohort of 16 VP patients and 32 PD patients. Patients were all recruited from the first affiliated hospital of China Medical University from Dec. 2011 to Dec. 2012. The lower limb motor function of those patients was assessed using measurement scales. All patients received magnetic resonance image(MRI)and diffusion tensor image(DTI). Results Patients in VP group showed more seri?ous movement disorders such as freezing of gait(gait ignition failure)than these in PD group,and the movement disorders of their lower limbs prog?ress more rapidly in VP group than the PD group. Movement disorders of their lower limbs in VP group were related to fibers in bilateral frontal lobes (P=0.008). Movement disorder of their lower limbs in PD group were related to fibers in substantia nigra(P=0.030). There are statistically signifi?cant differences in both the FA values of substantia nigra,bilateral frontal lobes and the ADC values of frontal lobes,and the pars compacta and pars reticulata of substantia nigra between these two groups(all P<0.05). Conclusion Movement disorders of bilateral lower limbs are more seriously manifested in VP patients than in PD patients. The onset movement dysfunction of bilateral lower limbs is closely related to fibers in the frontal lobe.

Objective To investigate the histological features,biological features,clinical treatment and prognosis of pancreatic acinar cell carcinoma.Methods A retrospective review of 10 patients with pancreatic acinar cell carcinoma treated in our hospital from 1999 to 2008 was conducted and the clinical features,imaging changes,pathologic feature,treatment course and follow-up data were collected.Results There were 9 men and 1 woman with a mean age of (62±8) years old.Tumors were located in the uncinate process in 1 patient,head of pancreas in 7,body and tail in 2.The median size of these tumors was 4.5 cm×4.7 cm;common bile duct and intrahepatic bile duct,pancreatic duct dilation was detected in 7 cases,and superior mesenteric vein was invaded in 2 cases.Of the 10 patients,8 received pancreaticoduodenectomy,among these 8 patients,3 had extended lymph node dissection,2 had portal vein resection and replacement;2received resection of pancreatic body and tail as well as splenectomy.Histologically,the size of these tumors were 4.0 cm×3.3 cm×3.4 cm.Macrescopically,duodenum was invaded in 5 patients,superior mesenteric vein was invaded in 2 patients and neural invasion was present in 7 cases.Lymph node metastasis was noted in 6 cases.Follow-up data was available in 9 patients and 1 patient was lost in follow-up.The survival ranged from 3 to 51 months with a median survival 18 months,and 9 patients died of tumor recurrence and metastasis after operation.Conclusions Pancreatic acinar cell carcinoma should be recognized as a distinct tumor entity and it may not be sensitive to radiotherapy or chemotherapy.The biological features of pancreatic acinar cell carcinoma should be investigated further.

Objective To analyze epidemic status and influencing factors for the poor vision of the students in Henan in 2014 and to provide the scientific basis of more targeted myopia prevention strategies.Methods The data of 34 886 students aged 9 to 18 who were involved in the students'physical fitness survey in Henan province in 2014 was used to analyze epidemic status and influencing factors for the poor vision.Results The prevalence rate of myopia among Henan students was 62.5％.In addition,high school was higher than middle school which was higher than primary school.Girl was higher than boy,and urban was higher than rural.Through the unconditional logistic regression,having breakfast three to five times a week,eating eggs three to five times a week,drinking milk unusually,doing exercise over two hours a day,and watching TV over two hours a day were the protective factors for poor vision,of which the OR were 0.850,0.883,0.864,0.830,0.738 respectively.Correspondingly,the 95％ CI were 0.776-0.931,0.813-0.960,0.812-0.920,0.722-0.955,0.681-0.799.While sleeping less than seven hours,PE class one time a week or less,refusing to run longdistance,doing homework over two hours,and playing the e-productions over two hours were the risk factors of which OR were 1.100,1.091,1.100,1.375,1.155 respectively.Correspondingly,the 95％ CI were 1.009-1.199,1.017-1.172,1.024-1.183,1.287-1.469,1.072-1.244.Conclusions The rate of the myopia among the students in Henan is still severe.There are multifarious factors related to poor vision.Therefore,much more targeted measures should be taken to prevent poor vision from developing.

Objective To investigate the safety,effectiveness and prognosis of percutaneous microwave ablation (MWA) combined with synchronous transarterial chemoembolization (TACE) to treat of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with liver metastases (LMs).Methods This retrospective study included 19 cases of GEP-NENs with LMs patients who received percutaneous MWA combined with synchronous TACE treatment from 2013 to 2016.The mRECIST standard was selected to assess the curative effect.SPSS 21.0 software was applied in the statistical analysis of overall survival (OS),progression-free survival (PFS) and factors related to prognosis.Results All patients were capable of curative effect evaluation,including 1 case of complete remission (CR),3 cases of partial remission (PR),7 cases of progressive disease (PD) and 8 cases of stable disease (SD) respectively accounting for 5 ％,16 ％,37 ％,42 ％,which exhibited 21％ of response rate (RR) and 63％ disease control rate (DCR).In the present study,the median OS and median PFS was respectively 25 months and 34 months,and the one-year survival and three-year survival was respectively 95％ and 84％.Serum CA199,the WHO classification of LMs and the tumor burden of LMs were the major risk factors of prognosis through single factor analysis of survival,which showed that G3 of the WHO classification of LMs predicted a poor OS (P＜0.05) and tumor burden of LMs was negatively related to PFS (P＜0.05).It was obviously observed that serum CgA was decreased by the therapy of percutaneous MWA with synchronous TACEfor GEP-NENs (P＜0.05).Conclusions Percutaneous MWA combined with synchronous TACE is a safe and effective method to treat GEP-NENs with LMs.

Objective: To understand physical fitness among students aged 13-18 years in Henan Province and its influencing factors. Methods: Data of 21 785 students aged 13-18 years who participated in the national physical fitness surveys in Henan Province in 2014 were analyzed based on phyical fitness indicators and the questionnarie of physical exercise. The qualified rates of physical fitness indicators were evaluated based on the "National Students Constitutional Health Standards"(2014 revised edition). Results: In 2014, the eligible rate for physical test was 85.6% for boys and 82.5% for girls. Higher eligible rate was observed among boys with sleep duration less than 7 hours, compared to those with higher than 7 hours, while lower eligible rate was more likely observed in boys who reported sweaty and tired in PE class(OR=0.76), sweay and extreme tired in PE class(OR=0.72). Higher eligible rate was more common among girls who attended exercise during recess 2-3 times per day (OR=1.18) compared to those attended exercises higher than 3 times per day. Lower eligible rate was more common among girls with sleep duration less than 7 hours (OR=0.88) and those with low attendance in school recess exercises(OR=0.77). Normal weight, living in urban area, sufficient and regular PE class, daily physical exercise for more than 1 hour, enjoying physical exercise and extracurricular sports activities or long-distance running activities have higher success rates(P<0.05). Conclusion There is a relatively high eligible rate of phyical fitness among middle school boys and girls in Henan Province. Physical fitness is related to multiple factors. These findings highlight the need to target physical fitness interventions with sufficient time allocation in PE class and physical activity so as to effectively promote the phyical quality of students.

Objective: To analyze the prevalence and associated factors of hypertension among primary and secondary school students aged 9-18 years in Henan province, and to provide scientific evidence for targeted hypertension prevention strategies. Methods: Data of 34 840 students aged 9-18 years with physical examination and questionnaire information came from National School Student Physical Fitness and Health Survey in 2014. Results: The prevalence of hypertension among primary and secondary school students aged 9-18 years in Henan Province was 11.5%. The prevalence of boys and girls was 13.1% and 9.9%, respectively, and boy’s was higher than girl’s (χ2=89.04, P<0.01). The prevalence of primary school, junior high school and senior high school was 13.0%, 12.1% and 9.2%, respectively, and primary school was higher compared with junior and senior high school (χ2=89.66, P<0.01). Binary logistic regression analysis showed that high BMI (OR=1.97), eating eggs every day (OR=1.11), attending more physical education classes every week (OR=1.16), doing more setting-up exercises during the break (OR=1.08) and playing electronic products for longer time (OR=1.09) were positively associated with risk of hypertension (P<0.05). While longer sleep time (OR=0.83) and more serious attitude toward setting-up exercises during the break (OR=0.91) were negatively associated with risk of hypertension (P<0.05). Conclusion The study documents a high prevalence of hypertension among primary and secondary school students in Henan Province, which is associated with multifarious factors. Therefore, effective prevention and control measures should be taken for different populations to prevent high blood pression.

Objective To observe the effect of early enteral nutrition (EEN) on nutritional indicators and clinical outcomes in patients with severe heart failure undergoing mechanical ventilation. Methods Thirty-four patients with severe heart failure (grade Ⅲ-Ⅳ of cardiac function) and pulmonary infections undergoing mechanical ventilation admitted to intensive care unit (ICU) of Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from May 2017 to April 2018 were enrolled. They were randomly divided into EEN group and delayed enteral nutrition (DEN) group. Both groups were given routine treatment, including mechanical ventilation, improvement of cardiac function, anti-infection, protection of vital organ function, regulation of blood sugar and adjustment of electrolyte and acid-base balance. The patients in EEN group received enteral nutrition (EN) within 48 hours after ICU admission, and in DEN group, EN was started after the patients had spent the early stage of stress and had stable vital signs (48 hours after ICU admission). The changes in serum B-type natriuretic peptide (BNP), C-reactive protein (CRP), nutritional indicators and liver function indicators at ICU admission and 7 days after treatment were compared between the two groups. The time needed for patients to reach EN target, duration of mechanical ventilation, length of ICU stay, and the 28-day mortality were recorded, and complications were observed. Results There was no significant difference in serum BNP, CRP, nutritional indicators or liver function indicators at ICU admission between the two groups. After treatment for 7 days, BNP and CRP in both groups were decreased significantly as compared with those at ICU admission [BNP (ng/L): 592.1±370.9 vs. 2 517.7±1 163.4 in EEN group, 621.9±418.8 vs. 2 251.5±1 006.8 in DEN group; CRP (mg/L): 46.0±19.6 vs. 59.8±22.5 in EEN group, 40.5±18.8 vs. 61.2±24.6 in DEN group, all P < 0.05], pre-albumin (PA) and transferrin (TF) were significantly increased [PA (g/L): 0.18±0.05 vs. 0.15±0.06 in EEN group, 0.17±0.04 vs. 0.12±0.06 in DEN group; TF (g/L): 1.6±0.4 vs. 1.5±0.4 in EEN group, 1.7±0.5 vs. 1.4±0.5 in DEN group, all P < 0.05]. However, there was no significant difference in the above indicators after treatment between the two groups (all P > 0.05). There was no significant change in liver function after treatment in both groups. The EN treatment was successfully completed in both groups. Some patients developed abdominal distension and diarrhea in varying degrees, which were alleviated by slowing down the infusion rate, supplemented by gastrointestinal motility drugs and intestinal flora adjustment drugs. The time needed to reach EN target in EEN group was significantly earlier than that in DEN group (hours: 42.4±10.2 vs. 53.8±17.1, P < 0.05), the duration of mechanical ventilation (days: 14.2±8.7 vs. 13.4±7.9), the length of ICU stay (days: 17.8±6.7 vs. 18.3±5.6) and 28-day mortality [5.9% (1/17) vs. 11.8% (2/17)] showed no significant difference as compared with those in DEN group (all P > 0.05), and it did not increase the incidence of aspiration pneumonia [23.5% (4/17) vs. 17.7% (3/17), P > 0.05]. Conclusion EEN could help to achieve nutritional goals as soon as possible, improve the nutritional status of the body, and provide conditions and basis for further treatment of severe heart failure patients.