The causes of transient ischemic attack (TIA) are diverse and complex.It often attacks repeatedly and its early risk of stroke is high.Identifying etiology and pathogenesis and start the correct treatment in time are the important measures for the prevention of cerebral infarction.However,the conventional CT and MRI reveal no abnormalities in patients with TIA,and it brings difficulties to the clinical diagnosis and treatment.CT perfusion imaging can reflect abnormal cerebral blood flow perfusion in patients with TIA.CT perfusion imaging in combination with CT angiography may visually display its corresponding abnormal changes in the feeding artery and provide the valuable diagnostic information for the location of vascular stenosis,severity,plaque characteristics and collateral circulation.It has very an important significance for guiding clinicians to choose the best treatment options,improve clinic efficiency and observe efficacy.

Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Endosonography ; Humans ; Lymph Node Excision ; Neoplasm Staging ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; pathology ; surgery ; Tomography, X-Ray Computed ; methods

Diarrhoea is one of the main causes of morbidity and mortality in the developing countries,it accounts for a large part of global disease burden every year.Water and sanitation are closely associated with the morbidity of diarrhea.The recent researches were reviewed in this paper,and the effect of drinking water,sanitation and hygienic knowledge on diarrhea was discussed.The incidence rate of diarrhea was likely to decrease as water supply and sanitation were improved.

Objective Disorder of intestinal barrier function is associated with the non-alcohol fatty liver disease ( NAFLD) . The present paper aimed to explore the intestinal barrier function in the rat model of NAFLD . Methods Sixteen SD rats were ran-domly divided into an NAFLD and a normal control group of equal number .The NAFLD models were constructed by high-fat feeding . HE staining was used for pathologic examination of the liver , the levels of TNF-α, IL-1, and endotoxin (ET ) were measured by ELISA and the limulus reagent method , and the expressions of intestinal ZO-1 and Occluding were determined by real time PCR . Resu lts Compared with the normal controls , the NAFLD rats showed typical hepatic lipid deposition , with significantly increased levels of serum TNF-αand IL-1 and plasma ET and decreased expressions of intestinal ZO-1 and Occluding (P<0.05). Conclusion Intestinal barrier function is decreased in NAFLD rats .

Objective To compare the effects of two patient-controlled epidural analgesia(PCEA) after cesarean section and the incidence of nausea vomiting, lethargy and urinary retention. Methods Sixty cesarean section patients were randomly divided into two groups, each group had 30 patients. Group Ⅰ: 0.15% bupivacaine hydrochloride plus tramadoL group Ⅱ: 0.179% ropivacaine mesylate plus nefopam hydrochloride. Postoperative 0-48 hours within the period pain (visual analog score, VAS)and the corresponding time motor block level(the Bromage scale), and incidence of nausea vomiting, lethargy and urinary retention were recorded. Results VAS difference was not statistically significant (P>0.05), Bromage scores in group Ⅱ was shorter than those in group Ⅰ(P<0.05), the incidence rates of nausea vomiting, lethargy and urinary retention in group Ⅱ were lower than those in group Ⅰ(P<0.01). Conclusion Ropivacaine mesylate combined with nefopam hydrochloride PCEA analgesic effect is certain, which shows a clear superiority in the motor function recovery and reducing the incidence of adverse reactions.

Objective To observe The liver lipogenic gene expression of animal model of phlegm and dampness syndrome. Methods According to the theory "Obese people have much more phlegm and dampness", the animal model of phlegm and dampness was built by high fat feeding. After 10 weeks' high fat feeding, we examined liver HE slice, the level of lipids in the normal and model group rats .The liver lipogenic gene expression including LXRα, SREBP-1c, and FAS were detected by fluorescence real time quantative PCR. Results Compared with that of the normal group rat, there was increasing lipids both in serum and liver in the model rats. There was typical appearance of fatty accumulation in the liver cells examined by liver HE staining. The expression of SREBP-Ic and FAS was much higher in phlegm and dampness group than that in the normal group, although there was no difference in the expression of LXRα. Conclusion The fatty accumulation of liver cell in phlegm and dampness group has a close relation to the enhancement of the liver lipoganic gene expression.

Postoperative ileus( POI)is a temporary impairment of coordinated gastrointestinal motility that develops as a consequence of abdominal or non-abdominal surgery and is a major factor contributing to the prolonged hospitalization of patient. In recent years,because of the widespread use of opioid analgesics,morphine induced POI is common. This article reviewed the progress in study on mechanism and management of POI caused by morphine.

Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P<0. 05). The refraction at 1 month ( -0. 56 ± 0. 42)D and 6 months ( -0. 58 ± 0. 22)D after treatment were of no significant difference (P>0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P<0. 05),but there were no significant difference between 1 month and 6 months after treatment (P>0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.

Objective To investigate the cerebral regularity of dynamic charge and the correlation with intracranial pressure(ICP),clinical seriousness and prognosis on acute stage of intracerebral hemorrhage(ICH) patients by transcranial Doppler(TCD).Methods 54 patients with first acute supratentorial ICH 24h after onset were studied.All patients were dynamic evaluated by beside TCD on 1st,7th,21st day.The correlation of TCD with ICP,MESSS were studied.Results On the 1st day the TCD abnormity of the acute phase of the ICH occurred mainly in the anterior circulation of cerebrum,in which the cardinal manifestation was high-resistance,low-flow velocity blood waveforms,especially on the bleeding side.Continuous TCD monitoring revealed the low velocity of the cerebral blood flow increased;meanwhile the high value of PI decreased gradually and the TCD monitoring was within the normal range three weeks after the attack.The ICP had negative correlation with the VmMCA,positive correlation with the PI value.MESSS scale had negative correlation with the VmMCA,positive correlation with the PI value.Conclusions The TCD examination can be used to monitor the cerebral hemodynamics of the patients suffering from intracerebral hemorrhage.The combination of fVEP and TCD facilitate the evaluation of the dynamic changes of ICP so as to instruct lowering the ICP.