BACKGROUND: It is indicated in latest research that in cerebral protective measures of cerebral vasospasm induced by subarachnoid hemorrhage due to various factors in acute stage, mild hypothermia has been drawn the attention specially and it has been recommended in clinical practice. But such therapy is generally limited in experimental research and aneurysm hemorrhage, the clinical research on subhypothermia probably provides important influence on cerebral vasospasm in severe craniocerebral injury.OBJECTIVE: Based on cerebral vascular hemodynamical indexes (CVDI),the cerebral protection of subhypothermia was observed on cerebral vasospasm in severe craniocerebral injury.DESIGN: Randomized controlled experiment.SETTING: Department of Neurological Surgery of No.16 Hospital of Chinese PLA and General Military Institute of Neurological Medical Science in Zhujiang Hospital Affiliated to First Military Medical University of Chinese PLA.PARTICIPANTS: Totally 36 cases of severe craniocerebral injury were selected in General Military Institute of Neurological Medical Science in Zhujiang Hospital Affiliated to First Military Medical University of Chinese PLA from July 1997 to August 1999, which were randomized into the control and treatment group, 18 cases in each one. At same period, 24 cases with normal CVDI were screened and taken as normal group. All of receptors participated in the experiment in volunteer.METHODS: In both the control and treatment group, the treatment was applied with anti-inflammation, stopping bleeding, fluid limitation, dehydration, supporting, hyperbaric oxygen, etc. In the control, the normal body temperature was maintained and in treatment group, anus temperature was dropped to about 33 ℃ in 4 hours to 8 hours, which was maintained for 3-test was given on the day of injury (0), on the 1st, 3rd, 7th, 14th and 21st days assay was done on the day of injury (0), on the 1st, 3rd, 7th, 14th and 21st days successively, in which, minimum blood velocity (Vmin) and minimum blood flow (Qmin) reflect blood supply of distal cerebral vessel and blood flow.Cerebral vessel resistance (CVR) reflects smooth degree of cerebral microcirculation. Dynamical resistance (DR) reflects auto-regulation of cerebral vessel. Criteria of evaluation: Recovery state of consciousness was justified according to Glasgow Coma Scale (GCS) in 1 week after injury. The outcomes were evaluated according to Glasgow outcome scale (GOS) in 3 months (5 score: good, 4 score: moderate handicapped, 3 score: severely handicapped, 2 score: vegetative state and 1 score: death). The case over 4 score indicated good outcome.ery of consciousness and outcomes in 1 week after injury in the control and treatment group.RESULTS: Totally 36 cases of severe craniocerebral injury entered result phases after injury in the control, named hypoperfusion phase (0 day), hyperperfusion phase (1-3 days), cerebral vasospasm phase (4-14 days) and improving phase (＞15 days). In treatment group, 3 phases were manifested,named hypoperfusion phase (0 day), improving phase (1-3 days) and recovery phase (＞ 4 days), without hyperperfusion phase. Eight cases and 2 cases of cerebral vasospasmodic changes in CVDI presented in the control in focus: The maximum volume (140.9±22.95) cm3 was on the 14th day after injury in the control and that (95.83-±14.97) cm3 was on the 3rd day in treatment group. On the 14th day after injury, the volume in treatment group in 1 week after injury: It was 22.2% (4/18) in the control and 55.6%(10/18) (P ＜ 0.05) in treatment group. Improving outcome rate: It was 38.9% (7/18) and 66.7% (12/18) in treatment group.CONCLUSION: Subhypothermia reduces incidence of cerebral vasospasm by stabilizing cerebral circulation after severe craniocerebral injury, especially by inhibiting acute hyperperfusion after the injury so that the volume of cerebral edema in focus is lessened remarkably and the prognosis is improved.

Objective To compare the effects and cost of peripheral intravenous catheter (PIV) and peripherally inserted central catheter (PICC) on very low birth weight infants (VLBWI).Methods From July 2013 to August 2015,95 VLBWI with PICC (PICC group) and 90 VLBWI with PIV (PIV group) admitted to the Neonatal Intensive Care Unit (NICU) of Changzhi Maternal and Child Care Hospital were included in the analysis.The two groups were compared in body mass increase,average length of hospital stay,incidence of catheter-related complications,and care cost and effect.Results The body mass increase per weak was higher in the PICC group than in the PIV group,with statistically significant difference (P ＜ 0.05).The average length of hospital stay in the PICC group was shorter than that in the PIV group [(48.2 ± 5.2) d vs.(53.2 ± 8.1) d,P ＜ 0.05].The incidence of catheter-related complications was lower in the PICC group than in the PIV group (35.4％ vs.44.9％),including phlebitis (PICC group,21 person-times;PIV group,169 person-times),liquid leakage or exosmose (PICC group,2 person-times;PIV group,185 person-times),and catheter prolapse (PICC group,3 person-times;PIV group,145 person-times) with statistically significant differences (all P ＜ 0.05),and catheter blockage (PICC group,7 person-times;PIV group,84 person-times) and other complications such as venous embolism and infection (PICC group,1 person-time;PIV group,3 person-times) with no statistically significant differences (all P ＞ 0.05).The average monthly cost in the PICC group (1 951.5 yuan) was lower than that in the PIV group (2 008.5 yuan),and the cost of single insertion in the PICC group (1 691.5 yuan) was higher than that in the PIV group (129.9 yuan),the cost-effectiveness was better in the PICC group than in the PIV group (30.22 vs.36.45).Conclusions For VLBWI,PICC can reduce the times of venous puncture,the incidence of complications,and promote body mass increase.However,the monthly cost was similar between the two groups in this study,possibly because of the short-time of this study.The advantages in cost-effectiveness of PICC may become more prominent when the catheter dwelling time extends.

AIM: To establish HPLC fingerprint of Viticis Fructus. METHODS: Hypersi ODS2 column was used, with mixtures of methanol and water as mobile phase in a gradient mode. The detection wavelength was set at 270 nm . The flow rate was 1.0 mL ?min -1 . RESULTS: The RSD% of precision and reproducibility was less than 5%. CONCLUSION: The method can be used for quality control of Viticis Fructus

Objective To investigate the value of high-sensitivity C-reactive protein (hs-CRP) combined with high-sensitivity cardiac troponin T (hs-cTnT) for prognosis of patients with acute coronary syndrome (ACS).Methods One hundred and eighteen patients with ACS were selected from July 2011 to December 2012.According to the clinical feature,they were divided into unstable angina pectoris (UAP) group (38 cases),non ST segment elevation myocardial infarction (NSTEMI) group (38 cases) and ST segment elevation myocardial infarction (STEMI) group(42 cases).They were followed up for 3 months,and the incidence of cardiovascular events and cardiac death was observed.Twenty healthy people were selected as control group.Results The serum level of hs-CRP on admission in UAP group,STEMI group,NSTEMI group was higher than that in control group,and NSTEMI group was highest.And there was significant difference between NSTEMI group and STEMI group,and also between NSTEMI group and control group (P ＜ 0.05).The serum level of hs-cTnI was increased in STEMI group and NSTEMI group.The increased degree in STEMI group was higher than that in NSTEMI group,and there was significant difference (P ＜0.05).The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-CRP ≥ 3 mg/L on admission in UAP group and NSTEMI group,STEMI group was 6/11,40.0％ (12/30),46.4％ (13/28),which was higher than that in patients with the serum level of hs-CRP ＜ 3 mg/L[11.1％(3/27),3/8,5/14],and there was significant difference(P＜ 0.05).The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-cTnT≥ 1.0 μ g/L on admission in NSTEMI group and STEMI group was 16.7％(5/30) and 18.4％(7/38),which was higher than that in patients with the serum level of hs-cTnT ＜ 1.0 μ g/L (1/8,1/4),and there was significant difference (P ＜ 0.05).Conclusion Significantly increased hs-CRP is an important predictor of poor prognosis of ACS patients.hs-CRP combined with hs-cTnT is helpful in early identification of high-risk patients.Giving intensive treatment to these patients in time and monitoring closely after discharge can reduce the happening of cardiovascular events.

Objective To explore the role and relationship of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9 ) in risk stratification and prognosis assessment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods We recruited 114 patients with NSTE-ACS and classified them into three groups according to the GRACE risk stratification:high-risk,intermediate-risk and low-risk groups.Another 5 8 patients were recruited as controls.Arterial blood was collected before angiography for the measurement of serum NT-proBNP and MMP-9 .Gensini score was used to evaluate the degree of coronary artery stenosis.All the patients were followed up for 6 months and MACE was observed and recorded.Results ① The levels of lg NT-proBNP and MMP-9 significantly differed between the groups (P<0.05).② ROC curve analysis showed that lg NT-proBNP could predict MACE of NSTE-ACS;area under the curve was 0.795,the cutoff value was 2 .0 6 9 ,corresponding to the NT-proBNP value of 1 1 6 .5 6 ng/L.MMP-9 could predict MACE of NSTE-ACS;area under the curve was 0 .6 9 6 ,the cutoff value was 3 2 .4 9 ng/ml;both of the abnormal indexes could predict MACE with the sensitivity of 80.41%,specificity of 82.19%,and Youden’s index of 0.63.③ Cox regression analysis showed that abnormal MMP-9 and NT-proBNP levels were independently related to the incidence of MACE by the value of OR as 3.751.Conclusion MMP-9 and NT-proBNP may be used as serological indicators in risk stratification of NSTE-ACS. The combined use of NT-proBNP and MMP-9 increases the power of predicting MACE.

Objective To understand the management status quo of migrant workers with chronic hepatitis B (CHB) to ex‐plore the management countermeasures and improve the survival quality for tamping the foundation of the healthy project .Methods Totally 300 migrant workers with CHB were performed the living quality evaluation and investigation on the service needs ,com‐pliance ,economic condition ,categories and proportion of reimbursement by adopting the supplementary revision of SF‐36 living quality scale and general information questionnaire ;the influencing factors of their living quality were performed the univariate anal‐ysis and multivariate stepwise regression analysis .Results The statistical analysis found that whether convenient for outside visit‐ing hospital ,categories and proportion of reimbursement ,whether normalized antiviral therapy ,whether conducting examination and follow up at regular intervals and liver disease specific symptoms were the influencing factors of living quality in the migrant work‐ers with CHB(P<0 .05);the living quality in the patients with outside convenient visiting hospital ,high reimbursement proportion , normalized antiviral therapy and examination and follow up at regular intervals was significantly higher than that in the patients with inconvenient outside visiting hospital ,low reimbursement proportion ,non‐normalized anti‐viral therapy and examination and follow up without regular intervals(P<0 .05);the liver disease specific symptom score showed the positive correlation trend with the living quality score (B=7 .657 ,SD=2 .650 ,t=2 .889 ,P=0 .004) .Conclusion It is necessary to improve the patient′s medical needs ,reimbursement type and proportion ,increase the compliance of patient′s normalized examination and follow‐up at regular in‐tervals and standard antiviral treatment ,thus to realize the standardized examination and treatment in CHB patients ,prevent or de‐lay the disease progression ,avoid liver cirrhosis and decompensated hepatopathy ,reduce the occurrence of HCC ,improve the quality of life and prolong the survival period .

Objective To investigate the effects of telmisartan on the expression of angiotensin converting enzyme2 (ACE2) mRNA in monocyte-derived macrophages of hypertensive patients companied with diabetes.Methods 62 essential hypertensive patients companied with diabetes were randomly divided into two groups:regular treatment group,and telmisartan group.Then the content of ACE and ACE2 in serum was detected by ELISA,and the expression of ACE mRNA and ACE2 mRNA in monocyte-derived macrophages of patients was detected by RT-PCR before and after having been treated.Results (1) After having been treated for 4 weeks and 12 weeks,the blood pressure of the patients in two groups were decreased significantly,Comparing with regular group,telmisartan group seemed to have more obvious therapeutic effect (P ＜ 0.05) ; (2) After having been treated for 12 weeks,glycosylated hemoglobin diseased in both group,but there was no significant difference between the two group (P ＞ 0.05) ; (3) In telmisartan group,the content of ACE2 in serum was increased after having been treated for 12 weeks than that in regular treatment group,[(23.9 ± 8.2) U/L vs (16.3 ± 8.9) U/L,P ＜ 0.05] ; and the expression of ACE2 mRNA in monocyte-derived macrophages in telmisartan group was obviously increased after 12 weeks comparing with regular treatment group (0.73 ±0.06 vs 0.51 ±0.04,P ＜0.01).Conclusion The role of telmisartan in decreasing blood pressure and it's advantage to the metabolism of glucose are partly related with the up-regulation of ACE2 mRNA.

Objective To analyze the space-time characteristic of traumatic brain injury (TBI) caused by Chinese Wenchuan earthquake and discuss opportunity and mode of medical intervention. Methods A retrospective study was done on 92 patients with TBI admitted into our department during Chinese Wanchuan earthquake.Results All 92 patients came from champaign located at northwest of Chengdu. Of all, 76 patients were admitted within 12 hours after earthquake. Surgical operation Wag done on 10 patients, of whom 3 died.Conclusions In the early period after earthquake, TBI patients make a large proportion and have fast change of injury severity. All patients come from champaign with conven-ient transportation. For TBI patients, early emergent operation after admission can significantly elevate success rate of mcdical intervention.

Objective To investigate the relationship of glycated hemoglobin (HbA1c),fibrinogen (Fbg)and cystatin C (Cys C)with the severity of coronary artery lesions in non-diabetic patients.Methods We enrolled 358 patients who received coronary angiography (CAG)in this study.They were divided into coronary artery disease (CAD)group and non-CAD group according to CAG results.Moreover,according to different clinical types of CAD,all the CAD patients were further classified into stable angina pectoris (SAP)group and acute coronary syndrome (ACS)group.We calculated Gensini score and divided CAD group into A,B and C subgroups by Gensini score.HbA1 c,Fbg,Cys C and other clinical data were measured and compared between groups,and the correlation analysis was used to find the relationship of HbA1c,Fbg and Cys C with Gensini score.Results The levels of HbA1 c,Fbg and Cys C were significantly higher in groups A,B and C than in non-CAD group.When Gensini score increased,the three indexes were increased too (P<0.05).The levels of HbA1c,Fbg and Cys C were significantly higher in ACS group than in SAP and non-CAD group (P<0.05).After adjustment for the influencing factors, HbA1 c was still associated with Fbg (P<0 .0 5 ).The levels of HbA1 c and Fbg were closely related to Gensini score (P<0.05).Conclusion In non-diabetes patients,HbA1c and Fbg are significantly related to the severity of coronary artery stenosis,and Cys C may not be an independent risk factor of coronary artery stenosis.

Objective To study the relationship of the plasma levels of miRNA-491-5p in Han population in Shaanxi Province and the changes of single nucleotide polymorphisms (SNP ) of the target gene matrix metalloproteinases-9 (MMP-9 ) of miRNA-4 9 1-5 p (has-miR-4 9 1-5 p ) with the incidence risk and prognosis of premature coronary artery disease (pCAD)through the case-control design.Methods In this study,we made a consecutive recruitment of 270 pCAD cases in the case group and 300 cases in the control group.Using the polymorphism method of polymerase chain reaction and restriction fragment length (PCR-RFLP),target gene MMP-9 of has-miR-491-5p and rs1056628 genotypes was detected to compare the association between the variant genotypes and pCAD.Results In the changes of rs1056628C-A polymorphisms,compared with that of CC genotypes (the incidence was 42%),the risks of having coronary heart disease in the individuals carrying CA and AA genotypes were 31%,the difference was statistically significant (P=0.045).The risks of developing coronary heart disease in the individuals carrying CA and AA genotypes were reduced more significantly in the population with low total cholesterol (TC),and low low-density lipoprotein cholesterol (LDL-C).Conclusion Target gene MMP-9 of has-miRNA-491-5p rs1056628C-A polymorphism is associated with the reduced incidence risk of pCAD,and carrying C alleles is an independent risk factor for pCAD.