Objective To investigate the safety of tanshinone Ⅱ A sodium sulfonate in treatment of acute cerebral hemorrhage.Methods One hundred and seventy-two patients with acute cerebral hemorrhage were divided into tanshinone treatment group with 84 cases (tanshinone Ⅱ A sodium sulfonate + traditional treatment) and traditional treatment group with 88 cases (traditional treatment) according to the method of treatment.The safety (including neural function defect,adverse reactions,rebleeding rate and mortality and so on) were determined before treatment,and 2,4 weeks after treatment.Results The chinese stroke scale (CSS) scores in tanshinone treatment group after treatment of 2,4 weeks were lower than those in traditional treatment group [(13.2 ± 4.3) scores vs.(17.4 ± 5.6) scores,(8.7 ± 3.5) scores vs.(12.8 ± 4.6) scores],there were significant differences (t =5.498,6.556,P ＜ 0.01).The total effective rate in tanshinone treatment group was significantly higher than that in treatment group [83.3 ％ (70/84) vs.65.9 ％ (58/88)],there was significant difference (x2 =6.854,P ＜ 0.01).After treatment with tanshinone Ⅱ A sodium sulfonate in tanshinone treatment group,5 cases of mild skin rash,3 cases of nausea,vomiting,to turn for the better after symptomatic treatment.There was not other adverse reactions in the observation period.The mortality,rebleeding rate in tanshinone treatment group were lower than those in traditional treatment group,but there were no significant differences (P ＞ 0.05).Conclusions Early application of tanshinone Ⅱ A sulfonate treatment in acute cerebral hemorrhage has significantly efficacy,in the process of the clinical application is safe amd reliable.It is worthy of clinical popularization.

Objective:To introduce the method of cylindrical abdominoperineal resection(APR)for low rectal cancer.Methods:Cylindrical APR was performed for 6 patients with advanced ultralow rectal cancer according to standard protocol in Stockholm from February to May in 2009.The procedure involved careful mobilization of the mesorectum as low as the origins of the levator muscle.After stoma formation,the abdomen was closed,the patient was rotated into the prone position,and an extended perineal dissection was performed.This included the sphinctercomplex and followed the inferior surface of the levators to a point laterally where they originated on the pelvic sidewall.This point should be just inferior to the level where the abdominal procedure was terminated.Results:The cylindrical technique removed more tissue in the distal rectum.There was no bowel perforation,perineal wounds were uneventfully.One patient developed perineal seroma.One patient developed peritoneocele hernia of pelvic floor.Conclusion:Cylin-drical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in CRM involvement and intraoperative perforations,which should reduce local disease recurrence.

OBJECTIVE:To discuss the correlation between antibacterial drug use and the bacterial drug resistance in the hospital where the authors work.METHODS:The DDDs of antibacterials during the period from2002to2004were counted,and the correlation between DDDs and bacterial drug resistance was analyzed.RESULTS:The total DDD of the antibacterials increased by47.14%in this period.To2004,the resistance rates of4major pathogens to9commonly used categories of antibacterials were more than44%.The DDDs of amoxicillin/clavulanate potassium,ampicillin sodium/sulbactam sodium,cefoperazone sodium/sulbactam sodium increased by4,19.8and7times,respectively in the3years,the resistance rates of pathogens to which also evidently increased,among which staphylococcus aureus increased by over22%.CONCLU_ SION:The hospital should strengthen the administration of antibacterial drug use in many ways to reduce the bacterial drug resistance.

Objective To investigate the effect of serum CYFRA21-1 and SCCAg levels on the prognosis of patients with cervical cancer radiotherapy.Methods 100 cases of cervical cancer were diagnosed by pathological examination in our hospital from October 2008 and October 2011,Using radioimmunoassay(RIA) in detection of serum CYFRA21-1 and SCCAg level,Pearson and Spearman correlation is used to study the relationship between serum CYFRA21-1 and SCCAg level and cervical cancer patients with clinical features,using the Cox regression model of CYFRA21-1 and SCCAg level and uterine cervix cancer death or recurrence and metastasis of the relationship.Results 100 cases of patients with cervical cancer,endpoint events in 21 cases,LNR4 patients appear higher risk of endpoint events about 44.3%,CYFRA21-1 and SCCAg levels were with cervical cancer patients with CA-125 values,tumor staging,depth of tumor invasion into positive correlation,and the age of patients,no significant correlation,tumor differentiation(P=0.013),serum CYFRA21-1 levels(P=0.02),serum SCCAg levels(P=0.03),depth of tumor invasion(P=0.04) is cervical cancer patients with endpoint events independent risk factors.Conclusion CYFRA21-1 and SCCAg levels were closely related to the prognosis of patients with cervical cancer radiotherapy.

AIM　To study the characteristic of th e rapidly activating component (Ikr) and the slowly activating compone nt (Iks) of the delayed rectifier K+ current in guinea pig hypertrop hi ed ventricular myocytes induced by thyroxine. METHOD　The whole c ell patch clamp techniques were used. RESULTS　In hypertrophied ve ntricular myocytes, the magnitude of IKr and IKs were great ly augmented with more positive depolarizations, and the degree of increase of IKr tail and IKs were greater than that of IKr an d IKs tail, respectively. By measuring the amplitude of tail currents which reflected the degree of activation, the activation curve of IKs was shifted toward more negative potential, but that of IKr was marked ly unaffected in hypertrophied myocytes. CONCLUSION　Hypertrophied ventricular myocytes induced by thyroxine obviously increased IKr and IKs.

Objective To decrease tumor local recurrence after abdominoperineal resection (APR)for low rectal cancer using cylindrical abdominoperineal resection. Methods From February 2009 to February 2010 cylindrical APR was performed in 15 patients of advanced ultralow rectal cancer at the Department of General Surgery, Qilu Hospital of Shandong University, according to the standard protocol as described by Holm. The procedure involves careful mobilization of the mesorectum as far down as the origins of the levator muscle. Ater stoma formation, the abdomen is closed, the patient is rotated into the prone position, and an extended perineal dissection is performed. This includes the sphincter complex and the inferior surface of the levators to a point laterally where they originate on the pelvic sidewall. This point should be just inferior to the level where the abdominal procedure was terminated. The coccyx is often removed in continuity with the main specimen to improve direct visualization of the dissection.Results The cylindrical technique removed more tissue in the distal rectum. There was no bowel perforation, perineal wounds were primary healing. One patient developed perineal seroma. One patient developed peritoneocele hernia of pelvic floor. Conclusions Cylindrical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in intraoperative perforations, which should reduce local disease recurrence.

Objective To explore the clinical value of therapeutic alliances of oviduct recanalization and video-laparoscope in the treatment of infertilitas feminis caused by multiple salpingemphraxis. Methods Sixty-seven patients with salpingemphraxis in 127 oviducts complicated with adhesions in fimbriated extremities were enrolled into our study. All the patients underwent separation of adherences in fimbriated extremities and neostomy using a video-laparoscope 2 to 3 days after selective oviduct recanalization. The therapeutic effects were retrospectively reviewed focusing on recanalization rate of proximal three segments, complete recanalization rate, and pregnancy rate and relevant complications during the follow-up period were analyzed. And patients with infertilitas feminis in the follow-up period underwent repeated salpingography to determine whether oviduct was repeatedly obstructed. Results The therapeutic alliance of oviduct recanalization and video-laparoscope were performed successfully in this cohort. Owing to the treatment of oviduct recanalization, recanalization rate of proximal three segments was 97.6% oviducts (124/127). Due to the alliance of oviduct recanalization and video-laparoscope, complete rate of oviduct were 98.4% (122/124). One year after operation, the pregnancy rate, ectopic pregnancy rate, and non pregnancy rate were 58.2% (39/67), 4.5% (3/67), and 37.3% (25/67), respectively. The patients with non pregnancy were composed by repeated oviduct obstruction in 25.4% (17/67) and non obstruction in 11.9% (8/67). Conclusion Therapeutic alliances of oviduct recanalization and video-laparoscope could be an effective method for the treatment of infertilitas feminis caused by multiple salpingemphraxis, and be helpful for the enhancement of pregnancy rate.

Objective To explore the method and management of pre-hospital care and raise the level of traffic injuries in pre-hospital care by summarizing the clinical features of death patients with severe tragic accident trauma Methods The basic data of 62 death patients with severe traffic accident trauma was analyzed according to death report statistics of severe traffic accident trauma from January 1st,2005 to December 31th,2008 Results Brain injury death accounted for most of traffic accident trauma death.The mortality rate of brain injury in the wounded wag 8.28%(13/157),but of asphyxia and hemorrhagic shock was 2.55%(4/157),3.18%(5/157)respectively in 2005.With the development of treatment and rescued in time, the mortality rate reduced to 6.11%(11/180),0,0.56%(1/180)in 2008.Conclesions It should be trying to shorten the time of pre-hospital care for pafients with trsffic accident trauma,especially in patients combined with hemorrhagic shock,asphyxia,severe brain injury.It is concluded that rapid and effective pre-hospital care can significantly reduce death rate and self-help or each other rescue training would also be effective to reduce mortality.

BACKGROUND: Vitamin A deficiency disorders (VADD) is a healthy problem of children in the world, especially in the west of China and remote areas, and the nutritional intervention is needed.OBJECTIVE: To compare the improved effects of biscuits fortified with three different doses of vitamin A on the vitamin A status in children aged 3-6 years and explore ap ideal dose of vitamin A supplement for preventing VADD.DESIGN: Randomized controlled observation.SETTING: Health Surveillance Institute, Chongqing Municipal Health Bureau; Staff Room of Nutrition and Food Hygiene, College of Public Health, Chongqing University of Medical Sciences; Center for Children Nutrition, Children's Hospital, Chongqing University of Medical Sciences.PARTICIPANTS: The investigation was done between March and December 2002. 753 children aged 3-6 years from 8 kindergartens in Banan district of Chongqing city were enrolled with the agreement of their guardians. They were divided randomly into 4 groups: 30% recommended intake group, 100% recommended intake group, 20 000 international unit (IU) and 200 000 IU groups.METHODS: ① The biscuits fortified with 30% recommended intake of vitamin A (500 IU) were once given to people of the 30% recommended intake group (177 cases) every day. ②The biscuits fortified with 100% recommended intake of vitamin A (1666 IU) were once given to people of the 100% recommended intake group (173 cases) every day. ③The biscuits fortified with 20 000 IU of vitamin A were once given to people of the 20 000 IU group (209 cases) every week. ④The soft gelatin capsule with 200 000 IU of vitamin A were once given to people of the 200 000 IU group (194 cases).Height, body mass, serum retinal, prealbumin, haematoglobin and retinal binding protein of all children were measured before intervention and after intervention for 3 months. Above indexes were rechecked after supplement for 9 months in 87 children of 30% recommended intake groupMAIN OUTCOME MEASURES: ①Prevalence rate of VADD before in-tervention and after intervention for 3 months in children of every group.② Serum retinal, serum prealbumin, serum retinal binding protein,haematoglobin, height and body mass of children before intervention and after interventional for 3 months in every group.RESULTS: Because of lose of samples and detective technology, only 580 children' examination results were got by rechecking. ①Comparison of the prevalence rate of VADD of children in every group: Three months supplementation later, the prevalence of VADD in every group all decreased sig nificantly [1.48%,1.42%,1.21%, 2.16% ;6.78%,6.54%,8.61%,8.25%(χ2=3.86-8.57, P ＜ 0.05-0.01 )]. ②Comparison of serum retinal, serum prealbumin, serum retinal binding protein, haematoglobin, height and body mass of children of every group: After supplement for 3 months, except prealbumin and haematoglobin in the 30% recommended intake group ,other indexes in each group all increased significantly (t=2.52-37.44, P＜ 0.05-0.01 ). The increase of serum vitamin A in the 20 000 IU group was larger than that in the other groups (F=4.62,P＜ 0.01 ). The increases of haematoglobin, prealbumin and height in the 30% recommended intake group were less than those in the other groups (F=5.04-7.78 ,P ＜ 0.01 ).After supplement for 9 months, the increases of haematoglobin and prealbumin in the 30% recommended intake group were larger than those in the other groups (F= 11.62,10.21 ,P ＜ 0.01). The increase of serum retinal was still lower than that in the 20 000 IU group (F=4.21 ,P ＜ 0.01 ).CONCLUSION: Supplement with biscuits fortified with 3 different doses of vitamin A and capsule with 200 000 IU of vitamin A can improve obviously the nourished status of vitamin A and the level of ferrohemoglobin, in which 30% recommended intake and 100% recommended intake have small risk, and everyday supplement can maintain stably the level of vitamin A. That may be suitable for the long-term supplement for children, and the effect of 30% recommended intake was better than that of 100% recommended intake.

Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.