Mild stroke refers to ischemic stroke with mild neurological defects.In recent years,its incidence rate has increased gradually.However,there is no standardized definition for mild stroke,and there is a great controversy about whether to conduct thrombolytic therapy for mild stroke.The conventional wisdom holds that the patients with mild stroke should not be treated with intravenous thrombolysis;however,many studies have indicated that the short-term and medium-term outcomes are poor in patients with mild stroke without receiving thrombolytic therapy,and many patients with mild stroke may benefit from thrombolytic therapy.This article summarizes about the definition of mild stroke and the clinical studies of thrombolytic therapy in recent years,hoping to provide reference for clinicians in order to make better clinical decisions.

OBJECTIVETo observe the impact of acupuncture on the subjective symptom, sleep quality and sleep efficiency in the patients of insomnia differentiated as spleen deficiency or non-spleen deficiency in terms of the spleen and stomach theory.

METHODSSixty patients with insomnia were divided into a spleen deficiency group and a non-spleen deficiency group, 30 cases in each one. In the two groups, acupuncture was applied at Sishencong (EX-HN1), Shenmen (HT 7), Sanyinjiao (SP 6), Zusanli (ST 36) and Tianshu (ST 25). The treatment was given once every other day, five times as one course, and two courses were required. The Athens Insomnia Scale (AIS) was used to observe the changes in the patients' subjective symptoms. The Pittsburgh sleep quality index (PSQI) was adopted to observe the changes of patients' sleep quality. The sleep efficiency was applied to observe the changes in sleep time. The clinical efficacy was determined.

RESULTSThe total effective rate was both 80. 0% (24/30) after 5 and 10 treatments in the spleen deficiency group and was 76. 7% (23/30) and 80. 0% (24/30) respectively in the non-spleen deficiency group. The differences were not significant between the two groups (both P >0. 05). The AIS total scores and PSQI total scores were reduced apparently after 5 and 10 treatments as compared with those before treatment (all P<0. 01). The difference at each time point was not significant between the two groups (all P>0. 05). The sleep efficiency after 5 and 10 treatments was all improved as compared with that before the treatment in the two groups (all P<0. 01).

CONCLUSIONAcupuncture based on the spleen and stomach theory achieves possibly the same clinical efficacy in the patients of insomnia differentiated as those with spleen deficiency and non-spleen deficiency. It relieves the subjective symptoms and improves the sleep quality and sleep efficiency in the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Spleen ; physiopathology ; Stomach ; physiopathology ; Treatment Outcome

Objective: To assess the potential significance of proliferating cell nuclear antigen (PCNA) labelling indexes (PCNA-LI) and AgNORs number in evaluation of proliferative activity of Wilms′ tumor. Methods: A silver staining for AgNORs and an immunohistochemical method PCNA staining were performed on the biopsy specimens taken from 34 children with Wilms′ tumor. Results: No significant differences were observed between PCNA-LI and the pathological types and clinical stages, whereas fraction of S-phase and PI and the number of AgNORs were significantly higher in patients with PCNA-LI≥25% than that in patients with PCNA-LI<25%. The number of AgNORs/cell correlated well with both pathological types and clinical stages. The combination of PCNA-LI and AgNORs can accurately reflect the proliferative activity of cancer cells in Wilms′ tumor. Conclusion: The current pathological types and clinical stages may reflect the aggressive activity in Wilms′ tumor, but insufficient. The simultaneous determination of PCNA-LI and AgNORs count could be used as the essential complementarity of conventional pathological types and stages for accurate evaluation of biologic behaviour of Wilms′ tumor.

Objective To discuss the effect of DNA extraction of bloodstain on the filter paper with four methods of solid phase absorption.Methods 180 bloodstain samples on the iflter paper, each one contains 1 microlitre anticoagulation peripheral venous blood, divided into 4 groups with 45 samples, respectively. All samples were treated with four methods of solid phase absorption, i.e. DNA IQ? System, D-shield sensitive DNA Extraction Kit, High efficiency Silica Bead DNA Extraction Kit and Conventional silica bead method. The concentration of DNA and the results of STR typing of four groups were compared each other.Results The concentration of DNA was 3.764±1.790μg/mL and 3.634±1.112μg/mL by using D-shield sensitive DNA Extraction Kit and High efifciency Silica Bead DNA Extraction Kit, respectively. However, the concentration of DNA by using Conventional silica bead method group (3.350±1.250) was not signiifcantly different from each other (P<0.05), while the concentration of DNA extracted with above three methods were higher than by using DNA IQ? System (1.864±1.207)(P<0.001); Signiifcant differences of peak height existed between DNA IQ? System and other three methods (P<0.001); As the same time, the peak height of samples by using High efficiency Silica Bead DNA Extraction Kit and Conventional silica bead method were signiifcantly different from D-shield sensitive DNA Extraction Kit (P<0.01).Conclusions The DNA extracted in bloodstain on the iflter paper by using D-shield sensitive DNA Extraction Kit, High efifciency Silica Bead DNA Extraction Kit and Conventional silica bead method was more than DNA IQ? System. Meanwhile, the quality of DNA using High efifciency Silica Bead DNA Extraction Kit and Conventional silica bead method may be higher.

[ABSTRACT]OBJECTIVETo evaluate the accuracy of the watch peripheral arterial tone (Watch-PAT) in the diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSA total of 51 outpatients who had chief complaint of sleep snoring were carried out Watch-PAT test and polysomnography (PSG) simultaneously, and the results were statistically compared.RESULTSFifty one patients, consisted of 44 males and 7 females, had the mean age of (45.7±12.0) years (±s) and the mean body mass index of (28.8±3.6) kg/m2.The mean PSG apnea hypopnea index (AHI) was (45.69±12.02) events per hour, and mean Watch-PAT AHI was (35.49±24.49) events per hour. Significant correlation has been detected between Watch-PAT AHI and PSG AHI (r=0.878,P<0.001). The sensitivity and specificity of Watch-PAT were 97.73% and 85.71%, when PSG-AHI≥5/h events per hour was setting as the threshold value to diagnose OSAHS. The diagnostic efficiency of Watch-PAT has been tested by ROC curve, and the area under the curve approached to 0.997.CONCLUSIONThe Watch-PAT was proved as a portable and reliable device of screening patients who were suspected OSAHS.

Objective To investigate MR findings and analysis of misdiagnosis of atypical invasive pituitary adenoma.Methods The MR findings of twenty cases of atypical invasive pituity adenomas confirmed by pathology were reviewed ,which were misdiag-nosed as chordomas or meningiomas.Results All the twenty cases showed iso-or slightly hypo-signal on T1 WI,iso-or slightly hy-per-signal on T2 WI;Enhanced scan displayed heterogeneous enhancement.The dynamic enhancement curve showed rapid enhance-ment phase.The bilateral cavernous sinuswere infringed in nine cases,in which the pituity and pituity stalk were not well seen. Among the twenty cases,twelve cases with suprasellar and anterior cranial fossa extension were misdiagnosed as meningiomas;eight cases with clival destruction were misdiagnosed as chordomas.Conclusion The MR features of atypical invasive pituity adenomas are various.In order to avoid misdiagnosis,a comprehensive analysis should be based on a variety of signs.

Objective To observe the clinical effects and safety of Angongniuhuang Pill (a traditional Chinese medical preparation)adjuvant to haloperidol for the treatment of Intensive Care Unit (ICU)patients in postoperative delirium.Methods A prospective study of 243 postoperative patients with delirium adimitted in Intensive Care Unit of Xinjiang Medical University First Affiliated Hospital (January 2013-December 2014),by using confusion assessment method of Intensive Care Unit (CAMICU).All of 243 patients with delirium were randomly divided into two groups by computer randomization software (SAS 9.1):group A in which patients were treated with Angongniuhuang Pill adjuvant to haloperidol and group Fin which patiets were treated with haloperidol alone.The end of two intervention methods was determined by two consecutive CAMICU showing negative or the treatment were ended up at seven days treatment.The data of general information,and the results of treatment were recorded and analized by statistical software SPSS 19.0.The measurement data was expressed as mean ±standard deviation;the comparision between two groups was tested by t test;and repeated measurement was analised by variance.Count data was described as number and constitution ratio;and intergroup comparision was tested by Chi-square test. Results There was no significant difference in general information between two groups.The delirium duration and ICU treatment time in group A were shorter than those in group F [(3.0 ±0.9)d vs.(3.8 ±1.0) d,P =0.010; (6.2 ± 1.4) d vs.(6.7 ± 1.5) d,P = 0.008].When delirium was diagnosed (T0),all patients had EEG abnormalities.As treatment went on,EEG abnormal rate gradually declined.At day one (T1),there was no statistically significant difference in EEG findings between group A and group F (95.7% vs.97.5%,P = 0.045 ).At day two (T2 )and day three (T3 ),there was statistically significant difference in EEG findings between group A and group F (65.5% vs.77.7%,P =0.038;42.2% vs.56.2%,P = 0.032).The levels of S100βprotein,interleukin-6 (IL-6),tumor necrosis factor α(TNF-α)in two groups at T0 were all elevated without noticeable difference.These markers were all deceased at T1,T2,T3,but the speed of descend in group A was relatively faster than that in group F.The differences were statistically significant (S100β:time effect P <0.01,inter-group effectp =0.002,interaction effectp =0.686;IL-6:time effect P <0.01,inter-group effectp =0.034,interaction effectp =0.01;TNF-α:time effect P <0.01,inter-group effectp =0.003,interaction effectp =0.516). The discharge rate in group A after improvement of general condition was higher than that in group F (89.7% vs.79.3%,P =0.029).The incidence of postoperative complications and mortality 28 days after operation in group A were lower than those in group F (45.7% vs.58.7%P =0.045;12.9% vs. 24.0%,P =0.028).Conclusion During the treatment of delirium,Angongniuhuang pill adjuvant to haloperidol was a better method compared with using haloperidol alone in respect of effectiveness and safety perspectives.It may be a novel approach to the treatment for delirium by the combination of Chinese and Western medicine.

Objective To assess the technical efficiency and subsystem technical efficiency of the healthcare institutions in China,including that of management system and medical system.Methods Panel data of 31 provinces' healthcare institutions were selected,and Network DEA was adopted to assess such input indicators as managerial staff and health technical personnel,and such output indicators as medical revenue and number of medical visits.Results The technical efficiency of healthcare institutions is as lower as an efficiency mean of 0.853 in five year.Provinces of Zhejiang,Shandong,Henan,Guangdong and Tibet have maintained a higher level.The healthcare system breaks down into two independent subsystems of the management subsystem and medical subsystem.The mean of the former one is 0.937,higher than 0.783 of the latter.The number of medical revenue and that of patients in the non-effective provinces were relatively inadequate.Conclusions Healthcare resources allocation in China needs to be optimized.It is imperative to adjust the input-output ratio,improve medical service quality via scientific management.

OBJECTIVE To study the absorption,distribution and excretion of 2-fluorine-6-trifluoromethylpyridine (JJBD) in rats.METHODS [14C] Radioactivity isotope tracing method was used.Male SD rats were ig given a single dose of JJBD 10 and 100 mg·kg-1 (radioactivity:3.7 GBq·kg-1).Concentrations of rat plasma,tissue,feces,urine and bile were determined with a liquid scintillation counting (LSC) analyzer.Toxicokinetics (TK) parameters were fitted using WinNonlin.RESULTS TK parameters of JJBD 10 and 100 mg · kg-1 in male SD rats were as follows:area under the curve (AUC（0-t）) was 22 548±1579 and (203 395±27 586) h·iμg Eq.·L-1,half time (t1/2) was 15.8±1.0 and (14.1±0.9) h,peak time (Tmax) was 4.0±3.0 and (6.0±5.0) h,peak concentration (Cmax) was 1450±355 and (7776±1703) μg Eq.·L-1.JJBD was mainly distributed in fat,livers,kidneys,stomachs and intestinal walls.The concentration of JJBD in most of the tissues reached peak values after 4 h.However,JJBD couldn't be detected in the muscle,thymus gland,brain,gonad or spleen.Excretion rate of JJBD was 43.1％ in urine,29.7％ in feces and 9.97％ in cleaning solution within 0-168 h.JJBD could be excreted through bile at a rate of 28.1％ within 0-72 h.CONCLUSION JJBD can be absorbed immediately and excreted slowly in SD rat.There is no accumulation risk.The distribution of JJBD in vivo is very extensive,but cannot go through the blood-brain barrier.JJBD is mostly excreted through feces and urine.

目的探讨启蒙教育对提高脑瘫患儿智力和注意力集中能力的作用。方法组织启蒙教育班,对25名脑瘫患儿通过游戏、手工、学儿歌、音乐、辨色、认识方位等多种形式开发智力 ,培养注意力集中能力。结果经启蒙教育后,患儿智商比教育前明显增高(χ2=4.13,P<0.05),注意力集中能力明显增高。结论启蒙教育可提高脑瘫患儿的智力和注意力集中能力,促进患儿的全面康复。