Objective To investigate the effect of comprehensive rehabilitation on the stroke.Methods 120 cases of stroke divided into rehabilitation group(60 cases)and control group(60 cases).They were assessed with Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI),and Satisfaction with Life Scale(SWLS)before and 1 month,3 months and 6 months after treatment respectively.Results The scores of FMA,MBI and SWLS were improved significantly in rehabilitation group,especially in the 1st month,while that of control group presented the tendency of decline.Conclusion Comprehensive rehabilitation is effective on motion function,activity of daily living and quality of life of stroke patients.

Background The pathogenesis of dry eye has not been clearly established.There are more and more evidences to suggest that it is associated with ocular surface inflammation mediated by immunity.But how T helper cell 17 (Th17) plays its role in dry eye remains unclear.Objective The aim of this study was to investigate the expressions of Th17 related cytokines in ocular surface with dry eye.Methods A prospective cohortl study was designed.This protocol was approved by Ethic Commission of Peking University Third Hospital,and written informed consent was obtained from each subject prior to entering this cohort.Twenty female patients with Sjigren syndrome (SS group),20 patients with non-SS dry eyes and 20 normal volunteers were recruited in Peking University Third Hospital during 2011-2012 duration and all the subjects were menopausal female with the age 50 years old or more.The ocular surface disease index (OSDI)questionnaire designed by Schiffman was performed firstly,and then tear breakup time (BUT),corneal fluorescein staining and Schirmer Ⅰ test (S Ⅰ t) were carried out in the subjects.Expression of Th17 related cytokines mRNA were measured using PCR-Array.The correlation between IL-17A and ocular surface parameters was analyzed.Results The OSDI scores of the SS dry eye group,non-SS dry eye group and normal control group were 50.00 (33.50,66.50),45.00 (35.50,55.00) and 3.00 (0.00,5.00),the S Ⅰ t values were 2.50 (1.00,4.00),5.00 (2.00,5.00) and 15.50 (10.00,18.50),the BUT were 2.00 (1.00,4.00),4.00 (3.00,5.00) and 10.00 (10.00,12.00),the corneal fluorescein staining score were 8.50 (6.00,12.00),5.50 (4.00,7.00)and 0.00 (0.00,0.00),respectively,and significant differences were seen among the SS group,non-SS dry eye group and normal control group (x2=34.11,28.13,93.66,92.25,all at P＜0.01).The relative expression values of IL-17A mRNA,IL-6 mRNA,IL-8 mRNA,IL-22 mRNA and IL-23 mRNA in the ocular surface were 1.98±0.16,11.64±1.32,6.67±1.12,1.88±0.18 and 1.78±0.17 in the SS group patients,and 1.45±0.17,1.32±0.14,1.12 ±0.13,1.23 ±0.15 and 1.23 ±0.13 in the non-SS dry eye group patients,respectively,with significant differences between the two groups (all at P＜0.01).IL-17A level on the ocular surface was significantly negative correlated with BUT (r =-0.56,P＜0.01) and positive correlation with corneal fluorescein staining scores (r=0.44,P=0.01).Conclusions Expressions of Th17 related cytokines in the ocular surface increased in patients with dry eye,especially in those with SS.IL-17A level in ocular surface is associated with BUT and corneal fluorescein staining scores,suggesting that immune is involved in the pathogenesis and devlopment of dry eye.

Objective To investigate the incidence rate, high risk factors and hemodynamic changes of patent ductus arteriosus (PDA) in premature infants, and to give suggestions abo ut clinical monitoring and management of PDA in premature infants. Methods Echocardiography was performed on 86 non-ventilated or weaned from ventilator-pr emature infants at 2 to 5 days of age,whose gestational age was 28 to 36 weeks. All premature infants diagnosed as PDA were followed up clinically and by Echoc ardiography until discharged. Results Twenty-two infants diagnosed as PDA at mean 3 days of age, mean gestational age was (33.l?2.0) weeks. Ductus in 16 infants (out of 20 infants) closed spontaneo usly when repeated echocardiography at mean 8.5 days of age. For 4 remaining PDA infants, ductus closed in 2 cases (l treated with indomethacin). One ductus reo pened because of sepsis, and 3 infants discharged with opened ductus at their 2l , 40 and 47 days of age respectively. Single and multiple Logistic analysis indi cated that the lower the birth-weight ,the higher the incidence of PDA (?2=2. 8907 P=0.0891); neonatal asphyxia and suffered from severe diseases (neonat al respiratory distress syndrome, sepsis) were high risk factors of PDA (?2= 4.3729 P=0.0365;?2=11.6590 P=0.0006). Premature infants with PDA h ad good heart function,although their LA/AO ratio increased slightly (1.0810?0. 18 vs 1.00?0.07,P= 0.048).Conclusions PDA incidence at 3 days of life in 33 weeks premature infants is 25.6%, 85% PDA disappeares spontaneously during follow-up. Low birth-weight asphyxia, severe diseases and symptomatic PDA are high risk factors of PDA. Ductus can reopen in premature infants. J Appl Clin Pediatr,2005,20(2):129-131

Curriculum reform is very important to an university.In the Pharmaceutical Analysis Department,the principal for a curriculum plays a positive role not only in the teaching,but also in the scientific research and the service for the society.

Objective To evaluate the clinical efficacy of Yinhe gargle on infected root canals. Methods Forty-seven cases of root canal infection ( involving 48 affected teeth) were randomly divided into two groups. The experimental group (22 cases involving 22 affected teeth) was given intracanal medicament with Yinhe gargle, and the control group ( 25 cases involving 26 affected teeth) was given root canal disinfection with camphor phenol. After intracanal medicament for one week, therapeutic effect and safety were evaluated in the two groups. Results ( 1) During root canal disinfection, none of the subjects had adverse reaction such as hypersensitiveness or cauterization of soft tissue. Canal obturation was available after the first intracanal medicament for the infected root canals. (2) After intracanal medicament for one week, the effective rate in the experimental group was 95.45%, and was 100.00%in the control group, the difference being in significant (P>0.05). Conclusion Yinhe gargle has similar disinfection effect to camphor phenol on infected root canals, and it can be used as disinfection medicament for root canals.

Objective To investigate the effect of hydromorphone postconditioning on ischemiareperfusion (I/R) injury in isolated rat hearts and the role of mitochondial permeability transition pore (mPTP).Methods Male Sprague-Dawley rats, aged 2-3 months, weighing 250-320 g, were used in the study.The rats were heparinized and anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The hearts were excised, and perfused in a Langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 4 groups (n=10 each)using a random number table: control group (group C), group I/R, hydromorphone postconditioning group (group H), and hydromorphone postconditioning + mPTP opener lonidamine group (group HL).Group C was continuously perfused with K-H solution for 120 min.Group I/R was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group I/R was perfused with K-H solution for another 30 min.Group H was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group H was perfused with K-H solution containing 0.3 μmol/L hydromorphone for 10 min, and then with K-H solution for 50 min.Group HL was perfused with K-H solution for 30 min, the perfusion was then suspended for 30 min, and group HL was perfused with K-H solution containing 0.3 μmol/L hydromorphone and 30 μmol/L lonidamine for 10 min, and then with K-H solution for 50 min.At 30 min of equilibration (T0), and 30 and 60 min of reperfusion (T2,3), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (LVDP) , ±dp/dtmax, heart rate (HR), and coronary flow (CF) were measured.The concentrations of lactic dehydrogenase (LDH), creatine kinase-MB (CK-MB) , and troponin-T (Tn-T) in the coronary effluent were determined at T0 and T3.The coronary effluent was collected at T0 and 15 min of reperfusion (T1),nicotinamide-adenine dinucleotide (NAD+) concentrations were measured using enzyme-linked immunosorbent assay to reflect the degree of mPTP opening.The myocardial infarct size was determined at T3 by TTC staining.Results Compared with group C, LVDP, HR, ±dp/dtmax and CF were significantly decreased, and LVEDP was increased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were increased in group I/R (P＜0.05).Compared with I/R and HL groups, LVDP, ±dp/dt CF and HR were significantly increased, and LVEDP was decreased at T2,3, and the concentrations of LDH, CK-MB and Tn-T in the coronary effluent, myocardial infarct size at T3, and NAD+ concentrations in the coronary effluent at T1 were decreased in group H (P＜0.05).Conclusion Hydromorphone postconditioning can reduce myocardial I/R injury in isolated rat hearts, and the mechanism is related to inhibition of mPTP opening.

Objective To evaluate the efficacy of hydromorphone for patient-controlled intravenous analgesia (PCIA) after hip replacement in elderly patients.Methods Seventy patients, aged 65-75 yr, weighing 40-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral hip replacement, were randomly divided into either analgesia with hydromorphone group (group H, n =35) or analgesia with fentanyl group (group F, n=35).After a loading dose of 20 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained hydromorphone 0.25 mg/kg and tropisetron 10 mg in 120 ml of normal saline in group H.After a loading dose of 1 μg/kg of hydromorphone was injected at the beginning of skin closure, a PCA pump was connected, and the PCIA solution contained fentanyl 25 μg/kg and tropisetron 10 mg in 120 ml of normal saline in group F.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and the background infusion at a rate of 2 ml/h in both groups.Tramadol 0.5 mg/kg was injects intravenously as rescue analgesic, and visual analogue scale score was maintained ≤ 3.The Ramsay sedation score,the number of attempts and the number of tramadol administration were recorded at 24 and 48 h after operation.The adverse effects within 48 h after operation and patient's satisfaction with analgesia were recorded.Results There was no significant difference in the Ramsay sedation score, the number of attempts and the number of Tramadol administration between H and F groups.Compared with group F, the incidence of adverse effects such as postoperative nausea, vomiting, respiratory depression, drowsiness, urinary retention, was significantly decreased, and the level of satisfaction with analgesia was increased in group H.Conclusion Hydromorphone provides accurate efficacy for PCIA after hip replacement in elderly patients, with fewer adverse effects and higher level of patient' s satisfaction.

Objective To investigate the relationship between androgen level and body adipose tissue content and distribution via a cross sectional survey in healthy women aged 40 to 60 years. Methods A total of 222 women were divided into 4 groups according menstruation status, i.e. reproductive stage, early perimenopausal stage, late perimenopausal stage and postmenopausal stage. Serum level of dehydroepiandrosterone (DHEA), total testosterone (TT) and sex hormone binding globulin (SHBG) were measured. Free androgen index (FAI) was calculated. Body adipose tissue content and distribution were measured by dual-energy X-ray absorptiometry. Results In women aged 40 to 60 years, DHEA, TT and FAI level of reproductive stage women was (12.3±4.1) nmol/L, (0.56±0.22) nmol/L and 1.15 (quartile:0.71 to 1.85), respectively. DHEA, TT and FAI level of early perimenopausal stage women was (12.0±3.4) nmol/L, (0.56 ± 0.24) nmol/L and 1.37 (quartile: 0.89 to 1.61), respectively. DHEA, TT and FAI level of late perimenopausal stage women was (14.2 ± 4.7) nmol/L, (0.62 ± 0.18) nmol/L and 1.38 (quartile:1.12 to 1.63). DHEA, TT and FAI level of postmenopausal stage women was (11.6±3.5) nmol/L, (0.45±0.22) nmol/L and 0.94 (quartile:0.47 to 1.49). DHEA, TT and FAI level of perimenopausal stage women was comparable with those of reproductive stage women (P>0.05), however, TT and FAI level of postmenopausal women was significantly lower than those of reproductive stage women (P=0.001, 0.014). The total adipose percentage of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were (35 ± 6)%, (35 ± 5)%, (37 ± 4)%and (37 ± 5)%. The adipose percentage in“android”area of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were (43±5)%, (43±4)%, (47±5)%and (46±5)%. The total adipose percentage was similar in 4 groups (P=0.312). Compared with reproductive stage women, adipose percentage of“android”area increased in late perimenopausal and postmenopausal women (P=0.026). Women with higher FAI level presented higher adipose tissue content and higher percentage of centrally distributed adipose tissue (r=0.28, P=0.003). Conclusions Body adipose tissue tends to distribute centrally from perimenopausal stage. Androgen level is related to body adipose tissue content and distribution, but may not be the main reason of changes of fat distribution in middle life women.

ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.

Objective To investigate the effect of propofol on autophagy in SD rat heart during myocar-dial ischemia-reperfusion (I/R) injury. Methods Twenty-one male SD rats were randomly divided into three groups as follows (n = 7): the sham operation group, in which rats underwent sham operation without tightening of the coronary artery sutures; the myocardial ischemia-reperfusion group , in which rats were induced by occlud-ing the left anterior descending coronary artery for 30 min , followed by 120 min reperfusion and 0.9% NaCl in-fusion at 3 mL/(kg·h) at 10 min before occluding the left anterior descending coronary artery; the myocardial ischemia- reperfusion- propofol group, in which rats underwent I/R and propofol infusion at 6 mg/(kg·h) at 10 min before occluding the left anterior descending coronary artery. Before tightening of the coronary artery, at 30 min post-tightening of the coronary artery and at 120 min post-reperfusion, HR、 LVSP and ± dp/dtmax of rats were recordedin each group. Atter 120 min post-reperfusion, the serum concentrations of cTnT was measured. The in-jured cardiac tissue was collected to investigate the ultrastructure change under the TEM and to determine the levels of mTOR and p-mTOR. Results No signifcant differences in HR, LVSP and ± dp/dtmax before tighten-ing of the coronary artery. But, at 30 min post- tightening of the coronary artery, compared with groupⅠ, the HR, LVSP and ±dp/dtmax were significantly decresed in groupⅡ and Ⅲ(P < 0.05). Then, at 2 h post-reper-fusion, compared with groupⅠ, the HR, LVSP, ±dp/dtmax and the level of p-mTOR were significantly de-creased, but the serum concentration of cTnT was significantly increased in groupⅡ(P < 0.05); but, compared with groupⅡ, the HR, LVSP, ± dp/dtmax and the level of p-mTOR were significantly increased, the serum concentration of cTnT and the level of mTOR were significantly decreased in group Ⅲ(P < 0.05). Conclusions These data suggest that propofol could heighten the level of p-mTOR, and attenuate the expression of mTOR dur-ing the myocardial ischemia-reperfusion injury in SD rats.