To retrospectively analyze the clinical data of 305 cases with apoplectic sequela admitted at our general geriatric nursing ward from January 2000 to December 2011.The subjects were divided into 2 groups:hypoalbuminemia and non-hypoalbuminemia.Advanced age (OR =5.624),chronic heart failure (OR =2.298),conscious disturbance (OR =1.575),dysphagia (OR =1.565),complete bedridden (OR=2.874),pneumonia (OR =3.725) and bedsore (OR =5.336) were risk factors for hypoalbuminemia in the patients with apoplectic sequela.And hyperglycemia(OR =0.066)was a protective factor for it.

Objective To observe the effect of monochromatic infrared energy(MIRE)on diabetic periphe- ral neuropathy(DPN).Methods Seventy-four subjects with diabetic peripheral neuropathy who were tested by Semmes-Weinstein monofilaments(SWM)were randomized into 2 groups:a conventional management group and a conventional management plus MIRE group.Then the patients'sensory function and other DPN symptoms were evalu- ated by the SWME and the score of Michigan Neuropathy Screening Instrument.Results After treatments,there was a decrease(P＜0.01)in the number of the sites insensitive to SWME(grade 5.07),and MNSI scores were sig- nificantly decreased(P＜0.01).The MIRE management was more effective than conventional management.Con- clusion Monochromatic infrared energy is perhaps a safe,non-pharmaceutical and non-invasive method for the treat- ment of diabetic peripheral neuropathy.

C erbB 2 is overexpressed in 20%～30% of human breast cancers,this oncoprotein plays an important role in predicting response to chemotherapy in breast cancer.Overexpression of c erbB 2 in breast cancer is associated with resistance or sensitivity to certain chemo therapeutic drugs, c erbB 2 can be expected to be a biological marker to direct chemotherapy in the treatment of breast cancer.

Objective To compare the effect of the tissue adhesive Histoacryl and traditional suturing treatment on the cracked wounds on children's craniofacial skin. Methods About 152 children patients with cracked wounds children's craniofacial skin from March 2015 to June 2015 were divided into two groups according to their parents' will. Group A, with 77 patients, was treated by the tissue adhesive Histoacryl and Group B, with 75 patients, was treated by traditional suturing. The two groups were compare in terms of the treatment time and effect. Result The treatment time of Group A was significantly shorter than that of Group B (P<0.001), while there was no significant difference between the two groups in the level of wound healing (P>0.05). Conclusions Compared to the traditional suturing, the tissue adhesive Histoacryl is advantageous, for its easy operation, short treatment time, prominent efficacy and beautiful appearance. Moreover, it can relieve the pain of children during the treatment.

Objective To study the effects and safety of levocarnitine and shuxuetong in treatment of the patients with chronic renal failure.Methods 94 patients with chronic renal failure were selected as research object,and they were randomly divided into group A(levocarnitine and shuxuetong group) 47 cases and group B(shuxuetong group) 47 cases.Group A were treated with levocarnitine oral solution and shuxuetong,and group B were treated with shuxuetong,then the percentage of effectiveness,incidence of adverse reactions of group A and group B and serum BUN,Scr,Hcy were analyzed.Results The percentage of effectiveness of group A was higher than that of group B,but the incidence of adverse reactions of the two groups had no difference,and the serum BUN,Scr,Hcy of group A and group B before the treatment had no differences(P＞0.05),those of group A and group B after treatment were compared there were significant differences(all P＜0.05).Conclusion The effects of levocarnitine oral solution and shuxuetong in treatment of patients with chronic renal failure were better.

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

Objective To evaluate the role of combination of three-vessel views in ultrasound diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.Methods The data of 66 cases of fetal aortic arch and pulmonary arterial branch anomalies were retrospectively analysed,including echocardiographic data,autopsy and operation records and postnatal follow-up results.Echocardiogaphic features and display frequencies on three vessels and trachea view(3VT),three vessels view(3VV)and three vessels and pulmonary arterial branches view(3VP)were summarized.Results There were 52 cases of aortic arch abnormalities,including 32 cases of right aortic arch with left ductus arteriosus,4 cases of double aortic arch,7 cases of aberrant right subclavian artery,6 cases of coarctation of aorta and 3 cases of interruption of aortic arch.Fourteen cases were diagnosed pulmonary aterial branch abnormalities,including 1 0 cases of crossed pulmonary arteries,2 cases of anomalous origin of left pulmonary artery from aortic arch and 2 cases of pulmonary artery sling.The display frequencies of fetal aortic arch and pulmonary arterial branch anomalies on 3VT,3VV and 3VP were 80.3%,19.7% and 39.4%.Conclusions The combination of three-vessel views is of great value in prenatal diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.

Objective To explore the clinical value of hs-CTnT among acute myocardial infarction patients.Methods 60 acute myocardial infarction patients were treated from July 2014 to October 2016 in our hospital, set as the observation group where venous blood samples were collected on admission, 4 hours after admission, 12 hours after admission and the control group (60 health human where the venous blood samples were collected in the morning), respectively.The hs-CTnT, myohemoglobin, creatine kinase isoenzyme and tropnin T were recorded for analysis.Results On arrival of hospital, the positive rate of CK-MBmass, Myo, hs-cTnT, cTnT was 75.0%、71.7%, 90.8%, 80.0%, respectively.Hs-cTnT positive rate raised to 100.0% and CK-MBmass (83.3%), Myo (75.0%), cTnT (88.3%) after 4 hours.Besides, after hospitalization, the hs-cTnT positive rates raised up.The rates apparently increased at different times (P<0.05).The positive predictive value was 90.0% and sensibility 91.0%, which was significantly higher than other indicators (P<0.05).Conclusion The high sensitivity and specify of hs-cTnT indicator level could be one of the early diagnosis index for acute myocardial infarction.

Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.

Objective: To investigate the anatomic basis of vascularized ulnar nerve graft by the pedicle of the superior collateral ulnar artery (SCUA).Methods: Twenty-two fresh cadaver upper extremities injected intra-arterially with latex were dissected to study the extrinsic blood supply of the ulnar nerve.Other 6 fresh upper extremities were used to analyze the blood supply range of SCUA inside the ulnar nerve by microangiographic and histological methods,Results: The ulnar nerve was supplied by a branch of the lateral thoracic artery or directly by the axillary artery in the axillary section, by branches of SCUA in the upper arm. And by branches from the anastomosis of the collateral arteries and the posterior branch of the recurrent ulnar artery in the elbow. SCUA could supply the whole ulnar nerve from the axilla to the wrist. Conclusions: The ulnar nerve can be used as a vascularized nerve graft by the pedicle of SCUA in treatment of brachial plexus roots avulsion by C7 transfer from healthy side.