Intravenous recombinant tissue plasminogen activator (rtPA) thrombolysis is the most effective therapy for acute ischemic stroke. Its most serious complication is symptomatic intracerebral hemorrhage. The overall incidence reported in the literature is 6%. It is correlated with the wascular injury and the increased vascular permeability. Some clinical features, imaging and laboratory tests can predict the risks of the complication of intracerebral hemorrhage. The mortality and disability are very high in patients with the complications of intracerebral hemorrhage after thrombolytic therapy, and their prognosis is very poor. This article reviews the classification, incidence, predictive factors, and prognosis of intracerebral hemorrhage after thrombolysis.

Objective To investigate the major clinical manifestations and their effect on prognosis in patients with posterior circulation stroke (PCS).Methods The clinical data of 129 consecutive hospitalized patients with acute PCS confirmed by clinical and imaging were registered prospectively,and they were followed up for 3 months.The patients were divided into a good prognosis group (modified Rankin scale [ mRS] score ≤ 2) and a poor prognosis group (mRS score ≥ 3) according to their mRS scores.Results 90.7％ patients had 4 to 12 symptoms and signs,only 1 presented an isolated symptom.The most common symptoms and signs were unilateral.Crossed paralysis (1.6％) or quadriplegia (0.8％ ) was rare.Univariate analysis showed that the symptoms of unilateral limb weakness (relative risk [RR] 1.262,95％ confidence interval [ CI] 1.030-1.546; P =0.030),slurred speech (RR 1.434,95％CI 1.133 - 1.816; P=0.004),dysphagia (RR 2.216,95％ CI 1.131 -4.341; P =0.017),and the signs of decreased unilateral muscle strength (RR 1.288,95％ CI1.047-1.583; P=0.021),central facial/tongue paralysis (RR 1.467,95％CI 1.164- 1.850; P=0.002),dysarthria (RR 1.468,95％CI 1.154- 1.867; P=0.002),ocular motor dysfunction (RR 3.073,95％CI1.346 - 7.017; P =0.005),and conscious disturbance (RR 5.736,95％ CI 1.268 - 25.946; P =0.023) were the risk factors for poor prognosis,while ataxia (RR O.478,95％ CI 0.284 -0.804; P =0.002) was associated with good prognosis.Multivariate logistic regression analysis demonstrated that after adjusted for all risk factors,the baseline National Institutes of Health Stroke Scale (NIHSS) (odds ratio [ OR] 1.513,95％ CI1.107-2.066; P=0.009),dysarthria (OR,7.11,95％ CI 1.207-41.877; P=0.030),ocular motor dysfunction (OR 8.653,95％ CI 1.230- 60.887; P=0.030),and large-artery atherosclerotic stroke (OR5.482,95％ CI 1.008 -29.803; P =0.049) were the independent risk factors for poor prognosis in patients with PCS,while ataxia (OR 0.251,95％ CI 0.067- 0.941; P=0.040) was independently associated with good prognosis of the patients.Conclusions The clinical manifestations in patients with PCS are complex,the majority of their symptoms and signs are unilateral.Most of the patients showed a variety of symptoms,and the isolated symptoms axe rare.Some symptoms and signs may indicate the prognosis of patients.

Objective To survey the outcome of the Orientation and Mobility (O&M) Skills Training projects, a communities based rehabilitation which was advancing in Yunnan. Methods 310 blind subjects in model areas were assessed with the Assessment Standard of O&M Training for the Blind. Results 98.7% of subjects improved their mobility skills after receiving O&M skills training, that was 44.5% could walk independently in short distance, 34.5% in long distance, and 19.7% in complex surroundings in detail. There was no difference (P>0.05) among the different gender, educated level, and visual loss level, however, there was significant difference (P<0.05) made by the age level and the causes of disability of vision. Young and middle-aged subjects have better training result than the aged, as well as the congenital blind ones than the postnatal ones. Conclusion O&M skills training in Community Based Rehabilitation Services is effective for visual rehabilitation.

Objective: To compare the difference of intensity modulated radiation therapy (IMRT),3-D imensional conformal radiation therapy (3DCRT) for patients with upper esophageal carcinoma. Methods: Ten patients with upper esophageal carcinoma were treated by intensity modulated radiation therapy and 3-D imensional conformal radiation therapy at the same TPS, the difference of exposure dose between target area and critical organ was compared by dose volume histogram(DVH) with the plan target volume (PTV) must reach 95% of the prescription dose. Results: There was significant difference in dose of 95% plan target volume (PTV) (P <0.05) IMRT better than 3D-CRT. For two target conformal index and the prescription dose coverage of GTV percentage IMRT was better than 3DCRT. IMRT reduced maximum dose of spinal cord (P <0.05). There was no difference in the dose of lung and heart (P >0.05). Compared with 3D-CRT, IMRT planning has better dose distribution and protection of normal tissue. Conclusions: IMRT was better than 3DCRT, IMRT is the best radiation therapy.

Objective:Adopting RP-HPLC method,to study and establish the fingerprint of smilacis rhizome.Methods: YMC-Pack ODS-A(5 ?m,4.6 mm?250 mm) chromatographic column,acetonitrile-0.05% phosphoric acid solution gradient elution were applied;with flow rate of 0.8 ml/min and UV detector at 290 nm.Results: Technology investigation indicated that the analytical method this study established has a better reproducibility.The similarity of smilacis rhizoma fingerprints from different sources is better;smilacis rhizome and its three confusions fingerprints are apparently different.Conclusion: HPLC fingerprint analysis can be a method for quality control of medical material of smilacis rhizoma.

Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.

Objective:To analyze the clinical characteristics and treatment effect between bilateral(bi-)and unilateral(uni-) sudden sensorineural hearing loss(SSNHL).Method:Four hundred and eighty cases of SSNHL were retrospective study,which were divided into two groups of bi-SSNHL(n=40) and uni-SSNHL(n=440).Clinical characteristics and treatment effects were compared of the two groups.Result:The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%),compared with 56.4 percent of patients with uni-SSNHL.Conclusion:Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect,that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.

Objective To observe the effect of oxidized low-density lipoproteins (Ox-LDL),15-Deoxy-△ 12,14-prostaglandin J2 ( 15d-PGJ2 ),leukotrienes B4 ( LTB4 ) on mRNA expressions of peroxisome proliferator activated receptor γ2 ( PPARγ2 ),receptor activator of NF-κB ligand (RANKL),alkaline phosphatase ( ALP),and osteoprotegerin(OPG) in osteoblastic cells of rats; and to investigate the influence of these PPARγ2 endogenous ligands on bone metabolism.Methods Rat osteoblastic cells were cultured in vitro for 24 h in medium with different PPARγ2 endogenous ligands at various concentrations ( the final concentrations of Ox-LDL were 0,12.5,25,50μg/ml; the final concentrations of 15 d-PGJ2 were 0,10,20,30 μmol/L; the final concentrations of LTB4 were 0,0.1,1.0,10 μ mol/L).RT-PCR was performed to determine the mRNA expressions of PPARγ2,RANKL,ALP,and OPG in osteoblastic cells.Results RT-PCR analysis showed that Ox-LDL,15d-PGJ2,and LTB4 all down-regulated the mRNA expressions of RANKL,ALP,and OPG,while up-regulated the mRNA expressions of PPARγ2 in osteoblastic cells in a dose-dependent manner.Significant differences were found in interclass comparisons( P＜0.05 or P＜ 0.01 ).Conclusions These findings suggest that Ox-LDL,15d-PGJ2,and LTB4 suppress the expressions of osteogenic genes through activating the transcription activity of PPARγ2,and this may be a plausible mechanism of senile osteoporosis.

OBJECTIVE:To evaluate the effects of arginine-enriched total parenteral nutrition(TPN)on the nutritional and immune parameters of patients undergoing abdominal surgery.METHODS:67 patients undergoing abdominal surgery were randomly assigned to receive routine TPN(control group,n=24),TPN plus 15 g arginine(n=25,trial group Ⅰ)or TPN plus 30 g arginine(n=18,trial group Ⅱ)for 3 days postoperatively.RESULTS:Arginene-enriched TPN significantly improved postoperative nitrogen balance,promoted the recovery of plasma-albumin and total protein,and elevated the levels of CD4+ and CD4+/CD8+,but no significant difference was noted for immunoglobulin,complement C3 and complement C4 during trial period.CONCLUSION:Arginene-enriched TPN can improve patients' postoperative nutritional and immune parameters and enhance the efficacy of TPN support.

This article was aimed to study effect of D-ribose on the high-energy phosphate metabolism of skeletal muscle tissues of tired mice. The model was made by burden swimming. And then, the mice were divided into four groups, which were the model group, D-ribose group, caffeine group, and D-ribose with caffeine group). Intragastric administrations of drugs were given to all mice in four groups, three times per day. And all mice continued to swim for three days. The time of swimming was recorded. Gastrocnemius of mice were removed after swimming or 3 days later to measure the concentration of ATP, ADP, AMP and IMP with the HPLC. The results showed that compared with the control group, the time of burden s wimming was significantly prolonged for mice in the D-ribose group and the D-ribose with caffeine group. After three-day recovery, the concentration of ATP, AMP and IMP of gastrocnemius in the D-ribose group and the D-ribose with caffeine group mice was significantly increased. There was no significant difference in the caffeine group mice. It was concluded that D-ribose is involved in the high-energy phosphate metabolism of skeletal muscle tissues of tired mice . D-ribose promotes the recovery of ATP concentration in the gastrocnemius of tired mice, and prolongs the time of burden swimming. Therefore, it has a certain anti-fatigue effect .