Objective To observe the change of serum anti-brain antibodies after cardiopulmonary resuscitation,and investigate the clinical significance.Methods A total of 27 cases of cardiopulmonary resuscitation after cardiac arrest patients with success and survival more than 12 weeks were divided into two groups according to Glasgow Coma Scale (GCS) score:mild and moderate group with GCS score ≥ 8 scores (12 cases) and severe group with GCS score≤7 scores (15 cases).The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after recovered in the spontaneous circulation (ROSC) was compared between two groups,and compared with control group (15 cases of healthy persons).Results The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after ROSC were significantly higher than those in control group [(1.34 ± 0.23),(1.30 ± 0.27) kU/L vs.(0.28 ± 0.05) kU/L,(1.38 ± 0.33),(1.44 ± 0.30) kU/L vs.(0.28 ±0.05) kU/L,(1.44 ±0.31),(1.51 ±0.33) kU/L vs.(0.28 ±0.05) kU/L,(1.53 ±0.27),(1.67 ±0.36) kU/L vs.(0.28 ±0.05) kU/L,(1.72 ±0.25),(1.93 ±0.44) kU/L vs.(0.28 ±0.05) kU/L,(1.98 ±0.45),(2.15 ±0.52) kU/L vs.(0.28 ±0.05) kU/L],and there were significant differences (P＜ 0.01).The serum anti-brain antibody levels in severe group were significantly higher than those in mild and moderate group,and there were significnat differences (P ＜ 0.05).Conclusions The serum anti-brain antibody levels after cardiopulmonary resuscitation rise significantly.Anti-brain antibody may be used as a biochemistry marker to judge degree and prognosis of brain injury with patients after cardiopulmonary resuscitation.

Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.

OBJECTIVETo evaluate the safety and effectiveness of Shengji Ointment (SO) (by external use) in treating infective ulcer patients with yang syndrome (YS).

METHODSA multicenter, stratified, randomized controlled clinical study was used in this study. A random digit table was formed in the ratio of 3:1,440 infective ulcer patients of YS from 5 centers were recruited, 330 in the treatment group (external use of SO, exchange once every 24 h) and 110 in the control group (external use of Votalin, exchange once every 24 h). The therapeutic course consisted of 21 days. The ulcer area, wound depth, pain degree were observed before treatment at day 3, 7, 14, and 21, and safety indices monitored at the same time.

RESULTSThe ulcer area was significantly reduced in the treatment group after 21-day medication, obviously superior to that of the control group (P = 0.002). Ulcer areas at different time points were analyzed. From the 7th day of medication the reduced area was obviously less in the treatment than in the control group (P = 0.002). Besides, the longer the more obvious difference. Compared with the control group, the healing rate of ulcer area, the pain disappearance rate, and the healing rate of ulcer depth were all obviously improved in the treatment group (all P < 0.01). No adverse event occurred in the two groups.

CONCLUSIONSExternal use of SO was safe and effective in treating infective ulcer patients with YS. It could accelerate wound healing with better analgesic effect.

The information system of 301 Hospital One-Card service, was designed to enable outpatients to register online via mobile ends, pay in real-time, and hierarchical examination-diagnosis among other services. As the hospital HIS system cannot link to the Internet directly, the system could make use of the Internet application front end of China′s financial platform, and such means of 2D-barcodes and APP. This innovation could improve outpatient experience, keep confidential of medical information and patients′privacy, and change on-site registration to appointment in advance.

Objective To investigate effect of BCG polyose nuclear acid combined with adapalene Gel in the treatment of flat wart.MethodsFrom January 2015 to May 2016, 100 flat wart patients were selected in our hospital, the patients were divided into observation group and control group, each group 50 cases, the control group was given Adapalene Gel therapy, the treatment group was treated with BCG polyose nuclear acid on the basis of control group, the therapeutic effect of the two groups were observed.ResultsThe total effective rate of the treatment group was 84.0%(42/50), and the control group was 60.0%(30/50)The treatment effect of observation group was significantly better than the control group (P< 0.05);The skin lesion score of observation group after treatment was (4.22±1.05) scores, which was significantly lower than that in the control group (P< 0.05);There was no significant difference in T lymphocyte subsets between the observation group and the control group;After treatment, the lgG and lgM in observationgroup were higher than before treatment (P< 0.05);The adverse reaction rates of the observation group and the control group were 14.0%(7/50) and 18.0%(9/50), the difference was not statistically significant.ConclusionThe therapeutic effect of BCG polyose nuclear acid combined with adapalene gel in the treatment of flat wart is better, it can improve the humoral immune function of patients, and it is safe and reliable.

To evaluate the mini traumatic endovascular therapy for Budd Chiary syndrome (BCS). BCS was divided into three types on the basis of angiography. Among them, types Ⅰ and Ⅱ can be sequentially clarified into six sub types. 56 cases accepted endovascular therapy. Types Ⅰa, Ⅰb, Ⅱa, and Ⅱb accepted PTA and stenting. Types Ⅰc and Ⅱc accepted PTA plus stenting and spleen pulmonary shunting. Stents were successfully deployed in 54 cases with a success ratio of 96.7%. 2 failures occurred, among which 1 died of pulmonary emblization and 1 of hydropericardium. It is concluded that appropriate classification of BCS may be very helpful in the selection of proper therapy. The method of endovascular intervention is mini traumatic and simple. It is feasible for most types of BCS, and also a kind of safe and effective therapy, which can replace most open surgeries.

Objective To explore the dynamic changes of D-dimers during pregnancy and early puerperium (within 3 days postpartum). Methods A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women′s Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy (≤12 gestation weeks), middle pregnancy (12-28 gestation weeks), late pregnancy (>28 gestation weeks), 1 postpartum (within 48 hours postpartum) and 2 postpartum (48-72 hours postpartum). The D-dimers concentrations in different groups were compared. The effect of delivery mode on D-dimers of early pureperium was analyzed. The correlation between D-dimers and the thromboembolic disease was also explored. In this study, Student′s t-test and Wilcoxon rank sum test were used for statistical analysis. D-dimers concentration≤0.5 mg/L was used as the normal range. Results (1) D-dimers concentrations during pregnancy were higher than the non-pregnant women (P<0.01), but there was no statistical difference between early pregnancy and late pregnancy (P=0.820). D-dimers concentration in the 1 postpartum group was higher than that of early pregnancy group or late pregnancy group (P<0.01). But in the 2 postpartum group, it was lower than early pregnancy, late pregnancy and 1 postpartum groups. (2)D-dimers in cesarean section cases was significantly higher than in vaginal delivery cases in each period of pregnancy and early pueprium.(3)The 95%CI of D-dimers in early pregnancy, late pregnancy, 48 hours after vaginal delivery, 48-72 hours after vaginal delivery, ≤48 hours after cesarean section, 48-72 hours after cesarean section were 0.58-8.28, 0.47-11.52, 1.04-9.59, 0.87-5.22, 1.07-11.58 and 1.00-6.23 mg/L, respectively.(4)In 6 cases with thromboembolic disease, D-dimers was 6.89-19.89 mg/L, with the mean value of 13.66 mg/L. It was significantly higher than normal range. In 3 cases, all after cesarean section, with lower extremity vein thrombosis within 48 hours postpartum, the D-dimers concentrations, 9.77, 8.65 and 6.89 mg/L respectively, were in the 95%CI of the study population after cesarean section. Conclusions D-dimers concentration of 0.5 mg/L is not suitable for venous thromboembolism screening during pregnancy. D-dimers concentration in pregnancy and early puerprium is higher than non-pregnancy. It increases in the very early period postpartum and decreases with time. D-dimers should not be a routine screening test to exclude thromboembolic disease in pregnant women without high risk factors and clinical manifestation of thromboembolic disease.

Objective To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods A retrospective analysis was conducted in 135584 women who delivered in Women′s Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups.(1) The diagnosis was consistent prenatally and postnatally in 715 cases(58.99%,715/1212) as the diagnosis group.(2)In 312 cases (25.74%,312/1212), the diagnosis was made after birth as the missed diagnosis group.(3)In 185 cases (15.26%,185/1212), the diagnosis was made prenatally but excluded after birth as the misdiagnosis group. The disease classification was made, and the risk factors, clinical manifestations, lab results, the time of termination and perinatal outcomes were recorded in the 3 groups. The reasons of missed diagnosis and misdiagnosis were analyzed. Results (1) In the 1212 cases, the diagnosis of placental abruption was confirmed in 1027 cases, with the incidence of 0.76%(1027/135584). The rate of missed diagnosis was 30.38%(312/1027), and the rate of misdiagnosis was 0.14%(185/134557). (2) There were significant differences in the degree of placental abruption among the 3 groups (P＜0.05). (3)Significant differences were found among the 3 groups regarding the ratio of hypertensive disorders, trauma, induced labor and advanced maternal age (all P＜0.05). (4) There were statistically significant differences among the 3 groups regarding the incidence of vaginal bleeding, persistent abdominal pain and uterine tenderness, bloody amniotic fluid, increased uterine tension and stillbirth (all P＜0.05). (5) There was no significant difference in the rate of abnormal fetal heart rate mornitoring among the 3 groups (P=0.22). The differences were statistically significant among the 3 groups when regarding the incidence of abnormal ultrasound finding and abnormal blood coagulation (P＜0.01), with the highest incidence of abnormal ultrasound in the diagnosis group (68.1%) and the highest incidence of abnormal coagulation in the misdiagnosis group (24.9%). (6)There was statistically significant difference among the 3 groups when comparing the ratio of termination of pregnancy within 24 hours (P=0.01). (7) There were statistically significant differences among the 3 groups when the ratios of postpartum hemorrhage, DIC, neonatal asphyxia and perinatal death were compared (all P＜0.05). The highest incidence of postpartum hemorrhage was in the diagnosis group (17.9%) and the lowest was in the misdiagnosis group (5.4%). The highest incidence of DIC was in the diagnosis group (3.9%) and the lowest was in the misdiagnosis group (0). The highest incidence of neonatal asphyxia was in the diagnosis group (30.6%) and the lowest was in the misdiagnosis group (7.6%). And for perinatal death, the highest incidence was in the diagnosis group (12.6%), the lowest was in the misdiagnosis group (2.2%). Conclusions Placental abruption could be misdiagnosed when depending on risk factors, such as trauma. And it could be missed diagnosis during the induction of labor. Uterine contraction, abnormal fetal heart rate mornitoring, abnormal ultrasound and abnormal coagulation function are important in the diagnosis of placental abruption.

Objective To analyze the ischemia degree of initial electrocardiogram in the patients of acute ST-segment elevation myocardial infarction (STEMI) and investigate its value in the predicting cardiogenic shock (CS) after percutaneous coronary intervention (PCI).Methods Three hundred and ninety patients with STEMI from the onset of symptoms to admission within 12 h were divided into two groups based on grade Ⅱ ischemia (group A,248 cases) or grade Ⅲ ischemia (group B,142 cases) in the initial electrocardiogram.Clinical data,TIMI risk score,ST-segment resolution (STR),CS and cardiovascular events (hospital mortality,ventricular arrhythmias,reinfarction) were recorded in all patients.Results The gender,time from onset to balloon opening,smoking,hypertension,type 2 diabetes,hyperlipidemia,stroke,postoperative TIMI flow 3 grade,coronary artery lesions and lesions in the left main stem between two groups was not statistically significant (P ＞0.05).In group B,the rate of ST segment resolution ＞ 50％ was significantly lower than that in group A [53.2％ (132/248) vs.29.6％ (42/142)] (P ＜ 0.01).The incidence of CS,in-hospital death,malignant ventricular arrhythmias in group B was higher than that in group A,and the difference was statistically significant (P ＜ 0.05).The age,left ventricular ejection fraction,TIMI risk score ＞ 3 points,Killip grade ＞ 1 grade,anterior myocardial infarction between two groups was statistically significant (P ＜ 0.05 or ＜ 0.01).The indicators that were statistically significant in the univariate analysis were included into Logistic regression model and analyzed,with CS-related factors as independent variables and CS as the dependent variable and found that age (P =0.008),Killip class ＞ 1 grade (P =0.049),ST segment resolution rate (P =0.008) and grade Ⅲ ischemia (P =0.001) as independent predictors of CS after PCI.Conclusions Grade Ⅲ ischemia is an independent predictor of CS after PCI in STEMI patients.And it has predictive value for hospital mortality and ventricular arrhythmias.

Objective:To observe the effect of electroacupuncture (EA) for Alzheimer’s disease (AD). Methods:A total of 30 eligible cases were treated by needling Shenting (GV 24), Baihui (GV 20), Dazhui (GV 14), Fengfu (GV 16), Mingmen (GV 1) and Yongquan (KI 1). Upon arrival of qi, the G6805-II electric stimulator was connected to Shenting (GV 24) and Baihui (GV 20) (one pair), to Dazhui (GV 14) and Fengfu (GV 16) (one pair) and to bilateral Yongquan (KI 1) (one pair) for 25 min, using continuous wave at the frequency of 2-100 Hz and voltage of 2-4 V. With a tolerable intensity, the EA was conducted once a day for 10 d (one treatment course). There was a 3-day interval between two courses. After three courses, the therapeutic efficacies were evaluated using the mini-mental state examination (MMSE), revised Hasegawa dementia scale (HDS-R), activities of daily living (ADL) and neurological function defect scale (NFDS). Results:After EA treatment, the MMSE and HDS-R scores were significantly increased (P<0.01) and the ADL and NFDS scores were significantly decreased (P<0.01). Conclusion:EA is effective for AD and can improve the overall intelligence and repair neurologic deficits in AD patients.