Objective A large number of traditional Chinese medicine(TCM)are widely used for the treatment of patients with cerebral hemorrhage in China. The aim of this study is to systematically review the existing clinical evidences on TCM treatment for cerebral hemorrhage. Methods Randomized controlled trails(RCTs) of TCM treatment of cerebral hemorrhage were identified, eligible studies were included, the methodological quality of inclusive trails was assessed by the modified Jadad scale. The Cochrane Collaberation’s Revman 5.20 was used for data analysis. Results 69 RCTs were available and included. Meta-analysis indicated that relative risk of overall effective rate of Sanqi, Ciwujia, Chuanxiongqin and Naoxueshu were significant difference; SMD(95% CI) of neural function defect score was SMD=-0.46, 95%CI(-0.56,-0.35)of Sanqi, Danshen, Qingkailing, Liangxuetongyufang;SMD(95%CI) of the reduce of cerebral hemorrhage was SMD = -0.98, 95% CI(-1.32, -0.63)of Danshen, Dahuang, Ciwujia, Qingkailing, Liangxue-Tongyufang. Conclusions The evidence currently available showed that the TCM which included do not increase the death rate and adverse reaction of the patients with cerebral hemorrhage, TCM could reduce neurological deficit and improve the absorption of hematoma.

Objective To construct pcDNA3 1(+)GDNF recombinant eukaryotic expression plasmid and to investigate its expression in eukaryotic cells. Methods The coding sequence of GDNF was amplified from rat astrocytes by reverse transcription PCR (RT PCR) and cloned into pcDNA3 1(+) eukaryotic expression vector The recombinant pcDNA3 1(+)GDNF plasmid was then transfected into eukaryotic cells mediated by using Fu Gene 6 method Analysis by restricting enzyme digestion and DNA sequencing were carried out to demonstrate the sequence of the plasmid GDNF protein and its activity were then determined using pcDNA3 1(+)GDNF plasmid transfected eukaryotic cells Results RT PCR product is 640 bp specific segment Analysis by restricting enzyme digestion and DNA sequencing of pcDNA3 1(+)GDNF recombinant showed results from restricting enzyme were 640 bp and 300 bp segments respectively DNA sequencing revealed that GDNF cloning was successful The recombinant plasmid can express active GDNF protein in eukaryotic cells Conclusion The study on the role of both GDNF and gene therapy is significant in the treatment of Parkinson disease

Complaints of medical consumers are caused by a good many factors,which aim at distincting medical pur?pose further,asking for economic compensation and justice,and punishing complained individual or complained hospital.It’s a realistic proposition on howto treat,reduce and avoid complaints,and maintain a correct attitude by units which ac?cept the complaints.

[Objective]To present the basis for qualitative control by analyzing the components of polyphenols in Phyllantuus urinaria L.[Method]Raw material was extracted by 50% ethanol,then purified by acetic ethyl.The extract was injected into LC/MS after filtering with micro-membrane.[Result]The polyphenols mainly consisted of rutin,phyllansusiin,ellagic acid,etc,but less free gallic acid.[Conclusion]The total content of these compounds should be used for qualitative control instead of gallic acid.

Objective To compare the efficacy and safety of prourokinase,reteplase and urokinase on the patients with acute ST -segment elvation myocardial infarction.Methods According to random number table,the eligible patients with acute ST -segment elvation myocardial infarction were randomly divided into prourokinase group (50mg,n =34),reteplase group (36mg,n =42)and urokinase group (1 500 000IU,n =32).The patency of infarct related coronary artery was estimated by coronary angiography at 90min after administration of thrombolytic agents.The adverse reaction was also observed including bleeding and the major adverse cardiac events(MACEs).Results The patency of culprit vessel in the prourokinase group was 76.50% (≥TIMI 2 flow),which in the reteplase group was 83.30% (≥TIMI 2 flow),and which in the urokinase group was 53.10% (≥TIMI 2 flow),respctively.Both of prourokinase group and reteplase group were higher in the patency than theurokinase group(χ2 =8.27,P =0.004). The MACEs and bleeding adverse reaction(prourokinase group 17.65%,reteplase group 28.57%,urokinase group 42.19%)showed that security of prourokinase group was securer than reteplase group and urokinase group(χ2 =6.36,P =0.012).Conclusion Both of prourokinase and reteplase are effective for the patients with acute myocardial infarction with ST -segment elvation,and prourokinase is safer.

Transanal total mesorectal excision (taTME) is a hot topic surgical approach in the field of colorectal surgery. However, the therapeutic effect of this surgical approach is controversial. Based on the accumulated experience and evidence, the domestic and international consensus and guidelines on taTME have been updated and improved. The importance of taTME registry study is emphasized again in the 'International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision' published in 2020. The implementation of prospective case registration is the fundamental premise to ensure the quality of data and the advancing data collection methods and online platform construction can further improve the quality of data. Based on the latest taTME international consensus, the authors discuss the importance of case registry study to improve the data quality of taTME registry study and provide reliable and timeliness evidence based medicine in the field of colorectal surgery.

Objective To investigate the application of whole-body diffusion-weighted imaging (WB-DWI),and to detect bone metastasis in malignant tumor patients.Methods A total of 118 malignant tumor patients prospectively underwent WB-DWI,standard MRI/CT in suspicious bone metastases parts within one week after inspection.Final diagnosis of the bone metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.The differential diagnosis value of apparent diffusion coefficient (ADC) in benign and malignant bone metastases was compared with the variance analysis.Results Area under ROC curve value of WB-DWI with standard MRI/CT (0.999) was larger than that of WB-DWI (0.944) and standard MRI/CT (0.983),and the specificity,accuracy and positive predictive value were also the highest(100.0 ％,97.4 ％,100.0 ％).The ADC values of malignant bone metastases were significantly lower than those of benign lesions[(0.71±0.15)×10-3 mmTs vs (1.50±0.23)×10-3 mm2/s] with a statistically significant difference(F =261.587,P ＜ 0.001).Conclusion WB-DWI is the beneficial supplements of standard MRI/CT.Which can be used for assessment and differential diagnosis of bone metastases in malignant tumor patients combined with ADC value.

In recent years, the Gut Microbiota-Brain Axis theory has pointed out that there is an interaction between gut microbiota and central nervous system diseases.A number of studies have shown that there is a link between gut microbiota and depression, Parkinson's disease, and Alzheimer's disease.The association between gut microbiota and stroke has also attracted wide attention.This article reviews the association between gut microbiota and stroke.

BACKGROUND: Flash visual evoked potential(fVEP) can reflect the integrity of visual pathway from retina to pulvinar cortex. The utilization of its characters can accurately evaluate the injury situation of visual conduction pathway.OBJECTIVE: To investigate the feasibility and effects of fVEP on non-traumatic monitoring of intracranial pressure.DESIGN: A repeated measurement design based on patients.PARTICIPANTS: Totally 197 patients with brain injury including 138males and 59 females with an average of(38 ±9) years old were selected from the First Affiliated Hospital of Chongqing Medical University and Xuanwu Hospital Affiliated to Capital University of Medical Sciences. The selected diseases were: epidural hematoma( n=20),subdural hematoma(n = 26),cerebral contusion( n = 4),subdural hematoma companied with cerebral contusion( n = 92),and cerebral contusion companied with intracerebral hematoma( n = 55).METHODS: The level of intracranial pressure of 197 patients with brain trauma was detected with fVEP and epidural manometry. Data of traumatic surveillance were collected after the completion of fVEP. Changes of blood pressure and heart rate in patients were recorded simultaneously.MAIN OUTCOME MEASURES: fVEP results,and levels of intracranial pressure.RESULTS: The average intracranial pressure of 197 patients with brain trauma was(2.75 ± 0.64) kPa,( 1.54 - 4. 02 kPa) . The dispersion of both traumatic and non-traumatic surveillance was relatively big in patients with confirmed visual pathway injury. No typical wave was induced by fVEP in2.79% of patients. Scatter diagram suggested that the consistence between fVEP and epidural manometry was relatively good. Linear regression analysis showed that heart rate was the most sensitive one to the fluctuation of intracranial pressure (β = -0. 369) followed by systolic pressure (β= 0. 316),while diastolic pressure was not so sensitive (β = 0. 147). There was negative correlation between heart rate and intracranial pressure,which could quite sensitively reflect the fluctuation of intracranial pressure,systolic pressure was the next,and diastolic pressure was not easily to be affected by the changes of intracranial pressure.CONCLUSION: Non-traumatic surveillance,fVEP,has favorable consistence with traumatic detection,which can quantitatively evaluate the changes of intracranial pressure non-traumatically.

Objective To investigate efficacy and effect on liver function of the experimental therapy with balloon catheter to block the main artery temporarily and then pressurize chemoembolization to treat hypovascular liver cancer. Methods Eighty patients with hypovascular liver cancer requiring interventional therapy were randomly divided into two groups.The experimental group was treated with the new therapy and the control group was treated with traditional therapy. The lipiodol-filling status and maximum diameter of the tumor was analyzed for a midterm outcome,and the change of AFP and liver function were evaluated.Mann-Whitney test was used for data between two groups,Friedman test was used for data of each group,and Spearman nonparameter relevant analysis was used for efficacy indexes.Results ( 1 ) All Patients have confirmed diagnosis of hypocvascular liver cancer and got balanced baseline. ( 2 ) Lipiodol-filling status:the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 1,3,12 months (Z =-2.135,- 2.939,- 2.686 ; P =0.034,0.004,0.007 ),but no statistically significant difference in 6 month ( Z =- 1.170,P =0.242 ).The status of lipiodol-filling of experimental group ( x2 =2.593,P =0.459 ) was more stable than control group ( x2 =10.886,P =0.012).(3) Maximum diameter of the tumor:the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 3,12 months ( Z =- 2.734,- 2.733 ; P =0.006,0.006),but no statistically significant difference in 1,6 month ( Z =- 1.692,- 1.895 ;P =0.091,0.058). But neither of two groups showed statistically significant difference in change of maximum diameter of the tumor ( x2 =5.500,P =0.139 ; x2 =6.509,P =0.089 ).Relation between lipiodol-filling and maximum diameter showed positive correlation in 3 month ( r =0.257,P =0.035 ). (4) Stratified analysis was used for data of AFP according to AFP value before therapy,and two groups showed no statistically significant difference for patients belonging to 20-1000 μg/L by Pearson Chi-square test. (5)Two groups showed no statistically significant difference for data of liver function before therapy and in 1,3,6months ( Z =- 1.073,- 1.314,-0.518,-0.549;P=0.308,0.189,0.604,0.583).Conclusions According to the midterm result of this experiment,the experimental therapy increased lipiodol-filling and decreased maximum diameter of the tumor significantly in 3 and 12 months correspondingly,but no significant difference was observed in AFP and liver function between groups yet. So the long-term efficacy and its influence to lung metastasis and survival rate need further research.