BACKGROUND: It is of great significance to understand the effects of different components of blood pressure on the occurrence of cerebrovascular diseases and administer proper decompression treatments in various situations.OBJECTIVE: To study the relationship of increased pulse pressure with the occurrence and severity degree of cerebral infarction by analyzing the data of pulse pressure recorded in hospitalized patients with acute cerebral infarction.DESIGN: Case-control analysis.SETTING: First Affiliated Hospital of Harbin Medical University.PARTICIPANTS: A total of 300 patients hospitalized at the First Affiliated Hospital of Harbin Medical University between June 2002 and January 2003 for ischemic cerebral infarction were enrolled, including 196males and 104 females aged (57.9±11.9) years. Another 199 persons who came to the same hospital for physical examination at the same period were set as normal group, including 110 males and 89 females aged (55.9±12.4)years.METHODS: ① Measurement of blood pressure: Systolic pressure and diastolic pressure of each person were recorded with mercury sphygmomanometer at the site of brachial artery of the right upper extremity and pulse pressure was calculated. ② Evaluation of neurological impairment:Upon hospital admission, each patient with ischemic cerebral infarction was evaluated with the stroke scale made by the National Institute of Health (NIHSS), in which a higher score means more severe infarction.MAIN OUTCOME MEASURES: ① Comparison of blood pressure parameters of subjects in the two groups. ② Distribution of different pulse pressure levels in the two groups. ③ Comparison of pulse pressure of subjects of different age in the two groups. ④ Results of non-parameters tests of neural function loss in cerebral infarction patients with different pulse pressure levels.RESULTS: ① Mean systolic pressure: It was significantly higher in the case group than in control group [(152±22), (133±19) mm Hg, t' =10.494,P ＜ 0.01]. Mean diastolic pressure: It was higher in the case group than in control group [(93±14), (81±11) mm Hg, t' = 10.129, P ＜ 0.01]. Meanpulse pressure: It was higher in the case group than in control group [(59.61±11.86), (51.93±14.10) mm Hg, t' =5.612, P ＜ 0.05]. Pairwise corre lation analysis showed that Pearson correlation coefficient between pulse pressure and systolic pressure was 0.789 (P ＜ 0.01); Pearson correlation.coefficient between pulse pressure and diastolic pressure was 0.169 (P ＜ 0.01). Therefore, there was a close correlation between pulse pressure and systolic pressure. ② Pulse pressure was distributed between 60 mm Hg and 69 mm Hg in most subjects in the case group, which accounted for 27.7%.It was 40-49 mm Hg in control group, which accounted for 35.7%. It indicated that the incidence rate was high when the pulse pressure was over 60 mm Hg in cerebral infarction. ③ Pulse pressure increased with age.The level of pulse pressure in 40-69 years case group was higher than that in 40-69 control group [(54±16), (45±9)mm Hg, t=4.86, P=0.000]. ④ Patients with cerebral infarction of different levels of pulse pressure were given non-parameter tests of neurological impairment evaluation. The resuits of Kruskal-Wallis test were χ2=4.779, P=0.572 ＞ 0.05; results of median test were as x2=8.365, P=0.213 ＞ 0.05. The results of the two non-parameter tests suggested that there was no significant differences in hospitalization evaluation, that is, although the pulse pressure increased obviously in cerebral infarction, the degree of increase had no correlation with the severity of neurological impairment.CONCLUSION: The increase of pulse pressure is related to the occurrence of cerebral infarction and is also an important factor for evaluating cerebral infarction. However, pulse pressure change is not related to the severity of cerebral infarction.

Objective:Through monitoring the pH of the growth medium,to evaluate the growth and/or acid production ability of Candida albicans on silicon elastomer incorporated with two different antifungal agents.Methods:Antifungal agents(AntimTM-AM and Conval pag-40)were added at concentrations from 0% to 2%,and antibacterial effect of the material in saliva and serum groups were examined.The third group added nothing was served as the control.Results:Each group with 2% antifungal agents showed great inhibitory effects on the acid production and /or the growth of C.albicans.These inhibitory effects consisted of a delay in the onset of rapid pH decline,decreased with the rate of pH change and increased in minimum pH.As a result,Conval pag-40 showed a significantly greater antimicrobial effect than AntimTM-AM.Conclusion:Silicone elastomer material incorporated with antifungal agents have strong antibacterial ability and can satisfy the requirements of clinical application.

Objective To investigate the characteristics of optical coherence tomography (OCT) in eyes with repaired idiopathic macular hole (IMH) after operation and the relation with recovery of visual acuity. Methods The characteristics of OCT images of 24 patients (25 eyes) with repaired IMH after vitrectomy,internal limiting membrane(ILM)peeling and auto-serum healing were analyzed retrospectively. In the patients with IMH, the macular hole was found in 9 eyes at stage Ⅱ, 13 eyes at stage Ⅲ, and 3 eyes at stage Ⅳ. Examinations of best-corrected visual acuity, slit-lamp biomicroscopy with fundus contact lens, fundus photography, fundus fluorescein angiography(FFA) and OCT were performed on the patients 3 to 24 months after surgery. Results OCT images of the repaired IMH were categorized into 3 patterns: U-type (5 eyes) with relative normal foveal contour; V-type (7 eyes) with steep foveal contour;W-type (13 eyes) with foveal defect of neurosensory retina, but without warped hem of retinal hole or cystic formation. Postoperative visual acuities were improved in all of the patients and the best ones were in group U-type. Conclusion Characteristics of OCT images of repaired IMH may be related to the postoperative visual acuity.

In this study, we aimed to investigate the regulatory effect of troglitazone (TGZ) on aromatase activity (AA) in human ovarian granulosa cells. The granulosa cells obtained from women who underwent in vito fertilization were treated with various concentrations of TGZ and/or retinoid X receptor ligand (RXR) LG100268 (LG), for 24h, and then cellular AA and the level of P450arom mRNA were determined. The treatment of the cells with TGZ for 24 h resulted in a dramatic inhibition of AA in a dose dependent manner. While the treatment with LG alone inhibited AA, the combined treatment with both TGZ and LG caused a much more reduction in AA. The changes in AA by TGZ and/or LG were associated with comparable changes in P450arom mRNA assessed by RT PCR. These results suggested that TGZ directly inhibited AA in human granulosa cells probably via nuclear receptor system which was composed of peroxisome proliferator activated receptor ?(PPAR?):RXR heterodimer.

Objective To study the moderate hypothermia with iced saline given intravenously with ice cap and ice sheet used in patients with severe stroke or craniocerebral trauma in order to clarify its clinical therapeutic effect and recovery of neurologic function for providing reliable clinical data.Methods A total of 84 patients suffered severe stroke (cerebral hemorrhage or cerebral infarction) or traumatic brain injury with GCS (Glascow Coma Scale) ＜8 admitted within 24 hours after onset were enrolled for study.The exclusion criteria were functional decompemsation of heart,liver,kidney and lung as cardiovascular complications of hypertension,hematological and other diseases,and craniocerebral trauma with multiple injuries of thorax,abdomen and extremities.Patients were divided into observation group and control group (n =42 in each group).The patients of two groups were managed to maintain respiratory tract patent,prevention of infection,dehydration,reduction of intracranial pressure and treated with Cytidine Diphosphate Choline,piracetam,ganglioside sodium and other conventional therapy.In control group,patients treated with ice cap and ice sheet,whereas in observation group,patients were treated with iced saline injected intravenously in addition to ice cap and sheet.At admission,the GCS score of patients was assessed and 6 months later,GCS score and Glascow Outcome Scale,(GOS) score of patients were determined,and 12 months after the treatment,quality of life score were evaluated by KPS.Results The time from onset of stroke or from trauma accident occurred to initiation of hypothermia treatment and time from initiation of hypothermia therapy to the target temperature reached in observation group were (8 ±4) hours and (3± 1 )hours respectively,and in control group,they were ( 16± 5) hours and (6 ± 2) hours,and there were significant differences between two groups ( P ＜ 0.05 ).The mean GCS score of patients at 6 months in the observation group and in the control group were (7.01 ± 1.12) and (4.02 ± 1.11 ) respectively (P ＜0.05 ) ; whereas the GOS score at 6 mouths of patients was categorized into good outcome,disabled outcome and poor outcome,and the good outcome in the observation group was significantly better than that in the control group (P ＜ 0.05 ),and no statistically significant difference in disabled outcome was found between two groups (P ＞ 0.05),and the poor outcome of GOS score was significantly lower in observation group than that in control group ( P ＜0.05 ).Twelve months after the treatment,the long-term quality of patients'life assessed by KPS score in observation group was significantly better than that in control group ( P ＜ 0.05).Conclusions The moderate hypothermia therapy by using iced saline administered intravenously combined with ice cap and ice sheet for severe stroke and head trauma patients conferred better therapeutic effects than the treatment with ice cap and ice sheet.

Objective To evaluate the effect of sevoflurane on the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in hippocampal neurons of rats.Methods Forty-eight pathogen-free healthy adult Sprague-Dawley rats of both sexes,weighing 210-280 g,aged 3-4 months,were divided into 4 groups (n=12 each) using a random number table:control group (group C) and 1%,3% and 5% sevoflurane groups (S1,S2 and S3 groups).In S1,S2 and S3 groups,1%,3% and 5% sevoflurane were inhaled for 1 h,respectively.Morris water maze test was performed at 1 and 7 days after anesthesia to assess the cognitive function.Six rats in each group were sacrificed after the end of the test.The brains were then removed and the hippocampi were isolated for detection of the expression of α7nAChR (by Western blot) and contents of tumor necrosis factor-alpha and interleukin-1 (by enzyme-linked immunosorbent assay).Results Compared with group C,the number of crossing the platform was significantly decreased at 1 and 7 days after anesthesia in group S1,the time of staying at the target quadrant was significantly shortened,the number of crossing the platform was decreased,and the rate of time of staying at the original platform quadrant and rate of swimming distance at the original platform quadrant were decreased at 1 and 7 days after anesthesia in S2 and S3 groups,and the contents of tumor necrosis factor-alpha and interleukin-1 were significantly increased,and the expression of α7nAChR was down-regulated at 1 and 7 days after anesthesia in S1,S2 and S3 groups (P<0.05).Compared with group S1,the expression of α7nAChR was significantly down-regulated at 1 and 7 days after anesthesia in S2 and S3 groups (P<0.05).Compared with group S2,the expression of α7nAChR was significantly down-regulated at 1 day after anesthesia in group S3 (P<0.05).There was no significant difference in each parameter of Morris water maze test among group S1,group S2 and group S3 (P>0.05).Conclusion The mechanism by which sevoflurane induces inflammatory responses in hippocampi is related to down-regulation of α7nAChR expression in hippocampal neurons of rats.

Objective Estimating clinical effects of the Therapy of Potassium L-aspartate Injection on Hypokalemia.Methods These hypolalemia patients from the Renji hospital of Shanghai Jiaotong University and Other Two Hospitals,and from March 2007 to May 2008,which were caused from various kinds of reasons.The test group (42 patients) were intravenous dripped by using three rami potassium L-aspartate injection added in 5% Glucose (or saline) 750 mL,the control group (44 patients) were gived two rami chloratum Kalium injection added in 5% Glucose (or saline) 750 mL,the Kalium were 1.10 g/d in both groups,once per day,time of therapy was 7 day.Results The test and control groups effective power after therapy were 86.67% and 91.11%,respectively,there was no significant difference (P=0.3998).The Kalium dose of test group was advanced from (3.18?0.23) mmol/L before testing to (3.73?0.37) mmol/L after therapy,the elevated average was (0.61?0.46)mmol/L,and there was no significant difference (P=0.4722).The accumulation power of Kalium recovery were (51.11?7.45)%,(77.78?6.20)%,(86.67?5.07)%,at the second,the fored and the sevened day,respectively.There was no significant difference between the two groups (P=0.1430).Conclusion The clinical effect was correspond between three rami potassium L-aspartate injection added in 5% Glucose (or saline) 750 ml and the Isodose chloratum Kalium injection,by once per day,and seven days of therapy,which can treat hypokalimeia caused from various kinds of reasons.

Objective:To investigate the effects of titanium surface modified by micro-arc oxidation (MAO)on the collagen secre-tion and the expression of osteogenesis-related genes of MC3T3-E1 cells.Methods:Pure titanium discs were divided into two groups:Titanium with modified surface by MAO(MAO group)and titanium with polished surface(PT group).Tissue culture polysty-rene plates (TC)were used as controls.Surface morphology of the samples was examined by field-emission scanning electron micros-copy(FESEM).Surface roughness of samples was measured by surface roughness meter.MC3T3-E1 cells were cultured on the sur-face of the samples and the collagen secretion on the samples was measured by sirius red-based colorimetric microassay after 12 days of culture.On day 16 of culture,the expression of osteogenesis-related genes was examined by RT-PCR.Results:A porous oxide layer was observed on the surface of MAO treated samples and the surface roughness was more than that of PT group(P<0.01 ). Cells in MAO group showed higher collagen secretion than in PT or TC groups(P<0.05).MAO treated surface induced higher OSX, COL-Iα1 and OPN expression than PT.Conclusion:MAO treated titanium surface may induce more collagen secretion of MC3T3-E1 cells than PT.

Objective To report the improved operative technique and clinical results of reversed saphenous neurocutaneous vascular flap. Method Under the guidance of Doppler flowmeter,a reversed saphenous neurocutaneous vascular flap pedicle with the perforating branches of the tibialis posterior artery were designed to repair the skin defects of the middle and lower leg,the ankle and the foot. Results The modified flaps were applied in 7 cases,all flaps survived completely. The size of the flaps ranged from 15cm?8cm to 5cm?4cm,the location of the perforating branches were 8～20 cm above the medial malleolus. The colour and texture of the flaps were excellent,the outline and functional results were satisfactory after 6～18 months follow up. Conclusions The flap is easy to design and dissect,blood supply is reliable,it is suitable for repairing the soft tissue defects of the middle and lower leg,the ankle and the foot. It is a new type of flap combining the neurocutaneous vascular flap with the perforator flap.

Objective There were few studies of prediction on type 2 diabetic patients with acute pulmonary thromboembo?lism.To evaluate the performance of the Padua score, revised Geneva score and Wells PE score in the prediction value of diagnosis of type 2 diabetes mellitus with acute pulmonary thromboembolism( APTE) . Methods 151cases with suspected APTE of type 2 diabe?tes were collected from January 2013 to December 2015 by a retrospective case analysis mode. Among 151 pations,80 cases had diag?nosed with pulmonary thromboembolism.The receiver operating characteristic (ROC) curve was used to evaluate the probability of type 2 diabetic patients with APTE predicted by the Padua, the revised Geneva and the Wells PE score. We calculated the Youden Index for the cut?off point. Results The area under curve( AUC) of the ROC curve in the Padua score, revised Geneva score and Wells PE score for APTE was 0.804±0.035、0.635±0.045 and 0.705±0.043. The area under the ROC curve of the Padua score was the highest and there was a significant difference compared with the revised Geneva( P<0.016 7) . The comparison of Padua score and Wells PE for the predication value was no statistically significant difference ( P>0.016 7) . The comparison of revised Geneva score and Wells PE for the predication value was no statistically significant difference ( P>0.016 7) . The cut?off of Padua score was 3 points and Youden Index was 0.51. The cut?off of Revised Geneva was 3 points and Youden In?dex was 0.24. The cut?off of Wells PE score was 1 points and Youden Index was 0.39. Conclusion Padua score, revised Geneva score and Wells PE score in predicting diabetes patients have some ex?tent clinical value terms, which Padua score has higher predictive value than the Revised Geneva.The predictive value of Padua score and Wells PE score was equivalent.However, the predictive value of Padua score is limited.