Objective To investigate the effect of oxiracetam on (Hcy), high sensitive C-reactive protein (hs-CRP), uric acid (UA) and cysteine protease inhibitor (Cys C) and blood lipid index level in patients with acute cerebral hemorrhage.Methods 98 patients with acute cerebral hemorrhage were randomly divided into observation group ( n =49 ) and control group ( n =49 ) .The control group was given routine treatment, the observation group was given oxiracetam treatment on the basis of control group.Two groups were treated for 2 weeks.Results The observation group after treatment NIHSS score lower than control group(P<0.05), GCS score and ADL score higher than control group (P<0.05);The serum levels of Hcy, hs-CRP, Cys, C levels lower than control group post-treatment, while the level of UA was higher than that of control group (P<0.05);The observation group TG, TC, LDL-C levels were lower than control group post-treatment ( P <0.05 ); Two groups had no severe adverse reactions. Conclusion Oxiracetam by reducing and Hcy in patients with acute cerebral hemorrhage hs-CRP, Cys C level, increased UA level, and improve blood lipid function, and thus improve symptoms.

Multiple myeloma is a more common malignant disease in blood medicine,which is characterized by hyper-proliferation and accumulation of malignant plasma cells in the bone marrow,resulting in a large number of monoclonal immunoglobulins and their fragments,leading to damage to the terminal organs.Of which about 80％ of patients have multiple myeloma bone diseases (MBD),which seriously affected the quality of life and prognosis of patients.We have found that the main cause of MBD are contributed to inhibition of osteoblasts,activation of osteoclast and affecting the occurrence by a variety of cytokines and pathways.This article will review and introduce the occurrence and development of MBD related to the latest factors and treatment.

Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.

Objective To explore the value of 2 dimension and color Doppler flow imaging (2D CDFI) in detection of deep venous thrombosis of the lower limbs. Methods One hundred and one patients, 118 limbs clinically suspected as deep venous thrombosis were examined by CDFI and ascending phlebography. Results The sensitivity of ultrasonogram was 94 4% and accuracy was 98 4%. The highest incidence is 30 4% in the femoral vein. With the ratio 2 2∶1, the incidence of left lower limbs was much higher than the right. Because of different pathological changes in acute, subacute and chronic thrombosis, there are diverse character in 2D CDFI. Conclusions Deep venous thrombosis of the lower limbs can be diagnosed by 2D CDFI, which is a noninvasive, easy and accurate method.

Objective To investigate the effect of small dose of dexmedetornidine on venous continuous infusion combined with oxycodone or fentanyl during brachial plexus blockade.Methods Sixty thyroid patients (ASA Ⅰ or Ⅱ) undergone brachial plexus anesthesia for cutting or cutting thyroid tumor patients were randomly and double-blindly into three groups (n =20 in each group).Group A:single brachial plexus anesthesia;group B:dexmedetornidine combined with fentanyl;group C:dexmedetornidine combined with oxycodone.Blood pressure (Bp),heart rate (HR),the determination of plasma norepinephrine (NE),cortisol (Cor),the concentration of blood glucose (Glu),VAS,Ramsay calm score,local anesthetics dosage and side effect formation rate at the beginning operation (To),skin incision (T1),separation of the glands (T2),gland excision (T3),and the end of the surgery (T4) were recorded.Results Compared to group A,the mean arterial pressure (MAP),HR,NE,Cor,and Glu were much lower at each time point (P ＜ 0.05) in groups B and C;Ramsay calm score and VAS score were significantly better at each time point (P ＜ 0.05);the incidence of chills and lidocaine additional quantity were significantly lower (P ＜0.01).However,compared to groups A and C,choking cough response rates were much higher in group B (P ＜ 0.01).Conclusions Small dose of dexmedetornidine on venous continuous infusion combined with oxycodone during brachial plexus blockade for thyroid patients both can eliminate the preoperative patients nervous anxiety,and effectively restrain perioperative stress response,maintain hemodynamics stable,implementation of intraoperative awaken to reduce complications.It is the new choice of anesthetic adjuvant.

BACKGROUND: Prognosis is determined by degrees of outside force and time of spinal cord compression after spinal cord injury. The former factor cannot be changed, but the latter one can be changed through relieving spinal cord compression as early as possible to promote nervous function recovery.OBJECTIVE: To compare the effect of surgical intervention time on nervous function recovery within 72 hours and 10 to 14 days after cervical spinal cord injury.DESIGN: Randomized controlled and before-after controlled study.SETTING: Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University.PARTICIPANTS: A total of 32 patients with cervical spinal cord injury were selected from the Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University from April 1998 to August 2001.All patients were divided into two groups according to randomly alternative criteria. There were 16 cases including 10 males and 6 females in early surgical group (within 72 hours) and there were also 16 cases including 12males and 4 females in delayed surgical group (within 10-14 days).METHODS: Patients in early surgical group were undertaken operation at 72 hours after hospitalization, and patients in delayed surgical group were at 10-14 days after hospitalization. Frankel grade, sensory and motor scores were recorded according to criteria set by American Spinal Injury Association before operation and within 24 months after operation.MAIN OUTCOME MEASURES: ① Sensory and motor scores before and after operation; ② Frankel grade before and after operation.RESULTS: ① Improved level of sensory score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (42.6±20.2, 19.2±19.1, P ＜ 0.01). ② Improved level of motor score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (39.7±17.8, 17.3±18.6, P ＜ 0.01). ③Improved level of Frankel grade in early surgical group was superior to that in delayed surgical group (P ＜ 0.01).CONCLUSION: Nervous function recovery of patients with acute cervical spinal cord injury who were suffered from operation within 72 hours is superior to that of those within 10 to 14 days. Therefore, surgical intervention should be undertaken as early as possible in order to promote nervous function recovery after cervical spinal cord injury.

Objective:To describe the secular trends of premarital medical examination ( PME ) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate. Methods:The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the infor-mation on the health policies was from official governmental websites. According to the main health poli-cies, the calendar years were categorized into 3 periods:1996 to 2003 was mandatory PME period;2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period. Results: During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37. 7%. During the mandatory PME period, the rate ranged 52 . 7% -67 . 7% with an average of 60 . 9% ( urban 71 . 5%, and rural 51 . 7%) . In 2004 , the first year when the PME became voluntary, the rate was abruptly dropped to 2. 6%, and thereafter gradually increased to 11 . 5% in 2008 . As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52. 3% (urban 49. 8%, and rural 54. 6%) in 2013. The in-creasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 pro-vinces had rates of >90% ( Guangxi 97 . 5%, Fujian 96 . 0%, Ningxia 95 . 4%, Zhejiang 93 . 4% and Anhui 90. 1%), whereas some provinces were stuck at a low rate, including developed and underdeve-loped provinces/cities. The PME rate in 2013 was 27. 4% for Shanghai, 25. 5% for Guangdong, 12. 4%for Chongqing, 5. 8% for Beijing and 4. 6% for Tianjin. Underdeveloped provinces were Guizhou (6. 4%) and Qinghai (1. 8%). Conclusion:As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated;for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.

Objective To investigate the pregnancy opportunity and outcome of patients with sysmetic lupus erythematosus (SLE).Methods We carried out a retrospective analysis of the clinical information of patients who suffered from SLE complicated with pregnancy and were hospitalized to People's Hospital of Peking University from December of 1992 to February of 2012.Chi-square test were used for statistical analysis.Results Forty-nine cases of patients with SLE complicated with pregnancy had 52 pregnancies in total.In 27 cases of planned pregnancies,24 cases(89％ )resulted in live births and 5 cases( 18％ ) had flares during pregnancy.Of the 24 live births,3 cases( 12％)were premature deliveries and 4 cases(17％) had low birth weight infants.In 25 cases of unplanned pregnancies,12 cases (48％) resulted in live births and 20 cases (80％) had flares during pregnancy.Of the 12 live births,6 cases(50％ ) were premature deliveries and 6 cases (50％) were low birth weight infants.The patients in the planned pregnancy group tended to have flares during pregnancy more frequently than those in the unplanned group (P＜0.01),the former were more likely to have live births than the latter (P＜0.01) and were less likely to have premature delivery (P＜0.05).Conclusion Patients with SLE should have planned pregnancy and need collaborative supervision of both rheumatology and immunology department and obstetric department to improve live birth rate,decrease premature delivery and the activity of SLE during pregnancy.

AIM:To study the effect of remifentanil on monophasic action potential and transmural dispersion of repolarization (TDR) in the 3-layer myocardium of isolated rabbit hearts .METHODS:Adult rabbits (n=18, 2.0 ~2.5 kg) were used to isolate the hearts for preparing Langendorff perfusion model .The hearts were randomly divided into 3 groups after perfusion with K-H solution for 15 min: the perfusion in control group ( C group ) continued for 60 min; the hearts in remifentanil group ( R group ) were perfused with 12 μg/L remifentanil K-H solution for 60 min; the hearts in remifentanil+aminophylline group ( RA group ) were given 60-min perfusion of 12 μg/L K-H remifentanil +30 mg/L aminophylline .The HR and 3 layers of myocardial monophasic action potential ( MAP) in the left ventricular anterior wall were recorded at time points after balanced infusion for 15 min ( T0 ) , and continued perfusion for 15 min ( T1 ) , 30 min ( T2 ) and 60 min ( T3 ) .The monophasic action potential duration of repolarization at 90%( MAPD90 ) and the transmural dispersion of repolarization (TDR) were calculated.The early afterdepolarization, delay afterdepolarization and arrhythmia were also observed.RESULTS:In R group, slower HR and prolonger MAPD90 and TDR at T1 ~T3 were observed as com-pared with those at T0(P<0.05).R group showed slower HR and longer MAPD 90 and TDR than C group and RA group (P<0.05).CONCLUSION:Remifentanil slows the HR, extends the MAPD90 and increases the TDR, thus being prone to induce reentry.Aminophylline makes HR faster and MAPD90 shorter, thereby reducing the TDR.

Objective To investigate the effects of different doses of dexmedetomidine(Dex) on rabbit sinus node and atrioventricular node.Methods A total of 24 healthy male rabbits weighing 1.5-2.8 kg,were divided into 3 groups randomly according to random number table (n =8).Group C (control),critical dosage of Dex causing sinus bradycardia D1 (loading dose of Dex was 10 μg/kg, continual pumping dose was 5 μg · kg-1 · h-1 ),six times of critical dosage of Dex causing sinus bradycardia D2 (loading dose of Dex was 60 μg/kg,continual pumping dose was 30 μg·kg-1 ·h-1 ). Rabbits were anesthetized,the right femoral artery was separated and catheterized followed by real-time monitoring of arterial blood pressure.Right external jugular vein was searched and separated,bi-polar stimulating electrode were inserted to the junction of superior vena cava and right atrium,the index of sinus node and atrioventricular node were observed by means of programmed stimulation.Si-nus node recovery time (SNRT),corrected sinus node recovery time (CSNRT),total recovery time (TRT),and atrioventricular node 2∶1 point were recorded before Dex infusion (T0 ),1 5-20 min after infusion of Dex (T1 )and 50-60 min after perfusion of Dex (T2 ).Results SNRT,CSNRT,TRT and 2∶1 point had no statistical significance.Compared with T0 ,SNRT,CSNRT and CSNRT were signifi-cantly prolonged at T1 and T2 .2∶1 point in group D1 and D2 was shortened obviously at T1 than that at T2 (P <0.05).SNRT,CSNRT and TRT of group D1 at T2 were significantly prolonged,2∶1 piont was shortened compared with T1 (P <0.05).SNRT,CSNRT and TRT of group D1 and D2 were pro-longed both at T1 and T2 than those of group C.2∶1 point was shortened in group D1 and D2 at T1 than that in group C (P <0.05).Compared with group D1,SNRT,CSNRT and TRT of group D2 at T1 and T2 were prolonged,2∶1 point was shortened obviously (P <0.05).Conclusion Load capacity of 10 μg/kg Dex apparently inhibits the function of rabbit sinus node and atrioventricular node,which is partially recovered within a short time (≤ 1 h).The inhibiting effect is more continously and re-markably in load capacity of 60 μg/kg Dex.