ObjectiveTo investigate the relationship between microalbuminuria (MAU) and short-term outcome in patients with acute ischemic stroke.MethodsThe consecutive patients with acute ischemic stroke admitted to hospital were enrolled prospectively.The first urine specimen was taken on the following morning after admission for detecting urine albumin/creatinine ratio (UACR).UACR 30-300 mg/g was defined as MAU positive.Stroke severity was evaluated with the National Institutes of Health Stroke Scale (NIHSS) at admission and the modified Rankin Scale (mRS) was used to evaluate functional outcome at discharge, and good outcome was defined as mRS score of 0 to 2.ResultsA total of 244 patients with acute ischemic stroke were enrolled, including MAU positive in 53 patients (27.12%), and poor outcome in 67 patients (27.50%).Univariate analysis showed that age, baseline NIHSS score, systolic blood pressure, fasting blood glucose, globulin, D-dimer, white blood cell count, neutrophils, and the proportions of ischemic heart disease in patients of the MAU positive group were significantly higher than those of the MAU negative group (all P<0.05).Multivariate logistic regression analysis showed that MAU (odds ratio [OR] 1.520, 95% confidence interval [CI] 1.151-1.794;P=0.031), baseline NIHSS score (OR 1.570,95% CI 1.357-1.808;P<0.001) were the independent risk factors for short-term poor outcome in patients with acute ischemic stroke.ConclusionsThe incidence of MAU is high in patients with acute ischemic stroke.MAU positive can be used as one of the independent predictors of short-term poor outcome in patients with acute ischemic stroke.

Objective To investigate the effects of different doses of ulinastatin on severe thermal injuryinduced myocardial damage in rats. Methods One hundred and eighty female SD rats weighing 180-220 g were usedin this study. Thirty percent of the total body surface (TBS) was shaved chemically with 20% sodium sulphate and then exposed to 92 ℃ water for 18 s. The animals with third degree thermal injury involving 30% of the TBS were randomly divided into 3 groups (n = 60 each): group Ⅰ thermal injury (group TI); group Ⅱ and Ⅲ received intraperitoneal ulinastatin 40 000 and 80 000 U/kg respectively immediately after thermal injury (group U1 , U2). The TI group received equal volume of normal saline IP instead of ulinastatin. Blood samples were taken from abdominal aorta before (baseline) and at 1, 3, 6, 12 h after thermal injury for determination of serum concentrations of cTnI, IL-1β, IL-6, IL-10 and TNF-α (10 samples at each time points). Ten animals were sacrificed at each time point after blood sampling. The myocardial specimens were obtained for microscopic examination and measurement of MDA content and SOD activity. Results Compared with group TI, the serum concentrations of cTnI, IL-1β, IL-6 and TNF-α and MDA content in myocardium were significantly decreased and the myocardial SOD activity was significantly increased in group U1 , while in group U2 the senum concentrations of cTnI, IL-Iβ, IL-6 and TNF-α and myocardial MDA content were significantly increased and the myocardial SOD activity was significantly decreased. There was no siginificant difference in the serum concentrations of IL-10 among the three groups. Microscopic examination showed that myocardial damage was accentuated in group U2 as compared with group U1. Conclusion Ulinastatin 40 000 U/kg can ameliorate severe thermal injury-induced myocardial injury through inhibition of inflammatory response and lipid peroxidation response, whereas ulinastatin 80 000 U/kg accentuates myocardial damage.

Objective To investigate the status of foot care behavior and related knowledge of patients with type 2 diabetes in suburbs of Beijing, and analyze their possible influencing factors. Methods A convenient sample of 108 patients with type 2 diabetes was surveyed using questionnaire. Results The patients'average scores of daily foot care behaviors were (4.85 ± 4.48 ), among 10 behaviors, the correct rate of "checking feet" and "trimming nails" were lower. Average scores of related knowledge about foot care were (14.03 ±4.46), among 20 items, the correct rate of "shoes with bootlace and velcro should be chosen "、"diabetic foot was related to misfeasance in wearing socks and lightish socks was suitable for patients with diabetes" were lower. By multiple stepwise regression analysis, scores of the behaviors were related to the patients' identity level with preventability of diabetic foot, and scores of the related knowledge were related to patients' identity with importance of foot care and patients' course of disease. Conclusions The behaviors and related knowledge about foot care of suburban patients with type 2 diabetes should be improved.

Objective To assess the value of detecting sympathetic skin response (SSR) in the diagnosis of autonomic dysfunction in patients with Parkinson disease (PD). Methods SSR measurement was performed in 47 PD patients and 20 healthy control subjects and the results were compared. The SSR was also comparatively analyzed between patients with and those without autonomic dysfimction. Results Compared with the healthy controls, the PD patients showed significantly lowered mean amplitude (2.56±1.47 vs 1.87±0.26, P<0.05) and prolonged latency (1.42±0.29 vs 1.55± 0.18, P<0.05) of the SSR in the upper limbs, with also lowered mean amplitude (0.76±0.39 vs 0.49±0.21, P<0.05) and prolonged latency (2.04±0.27 vs 2.13±0.16, P<0.05) in the lower limbs. Compared with the PD patients without autonomic dysfunction, those having autonomic dysfunction showed significantly lowered mean amplitude (1.89±0.33 vs 1.75±0.21, P<0.05) and prolonged latency (1.53±0.15 vs 1.56±0.17, P<0.05) of SSR in the upper limbs and lowered mean amplitude (0.51±0.17 vs 0.46±0.20,P<0.05) and prolonged latency (2.08±0.24 vs 2.17±0.18, P<0.05) in the lower limbs. Conclusion The results of SSR measurements are consistent with the clinical manifestations of the PD patients. SSR can be of value in the diagnosis of autonomic nerve dysfunction in PD.

OBJECTIVETo investigate the morphologic changes of upper airway in obstructive sleep apnea and hypopnea syndrome (OSAHS) associated with micrognathism before and after orthognathic surgery and distraction osteogenesis, and subsequently to instruct clinical jobs effectively.

METHODSNine OSAHS patients associated with micrognathism (8 males, 1 female, mean age: 28.6 years) received orthognathic surgery and (or) distraction osteogenesis, and the curative effect was evaluated according to the subjective feelings and PSG. Upper airway structure before and after the treatment was measured by Somatom Sensation 16 CT scanner.

RESULTSAll 9 patients were clinically cured. The transverse length, the cross section area, and especially the sagittal length of the upper airway were obviously increased after the orthognathic surgery. The changes involved mainly in the velopharyngeal region and the laryngopharyngeal region, but not in the laryngopharyngeal region.

CONCLUSIONSThe orthognathic surgery and distraction osteogenesis can treat the OSAHS patients with microgonathism effectively by increasing their velopharyngeal and laryngopharyngeal sagittal length of upper airway.

Adolescent ; Adult ; Female ; Humans ; Male ; Micrognathism ; complications ; diagnostic imaging ; surgery ; Osteogenesis, Distraction ; Pharynx ; diagnostic imaging ; Polysomnography ; Sleep Apnea, Obstructive ; diagnostic imaging ; etiology ; surgery ; Tomography, Spiral Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo study 3 different strategies of urine drainage following hypospadias urethroplasty, the clinical nursing in their application, and their effects.

METHODSWe retrospectively analyzed the clinical data of 595 cases of hypospadias treated by urethroplasty. After surgery, 133 of the patients underwent urine drainage by suprapubic cystostomy (group A), 202 by urethral stent- tube indwelling (group B), and 260 by early initiative micturition with the urethral stent-tube (group C). All the patients received routine postoperative nursing care required for hypospadias repair.

RESULTSOperations were successfully completed in all the cases. Group C showed a remarkably shorter hospital stay and lower incidence rates of urinary fistula and urethral stricture than groups A and B (P<0.05), but there were no significant differences in the three indexes between A and B (P<0.05).

CONCLUSIONFor urine drainage following hypospadias repair, early initiative micturition with the urethral stent-tube can significantly reduce postoperative complications, decrease difficulties and workload of nursing care, and shorten the hospital stay of the patient.

Cystostomy ; Drainage ; methods ; Humans ; Hypospadias ; surgery ; Length of Stay ; Male ; Postoperative Complications ; prevention & control ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stents ; Urethra ; surgery ; Urethral Stricture ; prevention & control ; Urinary Fistula ; prevention & control ; Urine ; Urologic Surgical Procedures, Male

Anemia, Hemolytic ; etiology ; Child ; Diagnosis, Differential ; Female ; Hepatitis ; etiology ; Hepatolenticular Degeneration ; complications ; diagnosis ; Humans

OBJECTIVETo investigate the contents of paeoniflorin in different combination Jingzhixuefuzhuyu.

METHODUsing RP-HPLC to determine the contents of paeoniflorin in different combination Jingzhixuefuzhuyu extracts, an ODS column was used with a mobile phase of MeOH-H2O-HAC(25:75:0.15) and DAD detector at the wavelength of 230 nm.

RESULT AND CONCLUSIONDifferent combinations of Jingzhixuefu zhuyu had great influence to the contents of paeoniflorin.

Benzoates ; analysis ; Bridged-Ring Compounds ; analysis ; Bupleurum ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Glucosides ; analysis ; Monoterpenes ; Paeonia ; chemistry ; Plants, Medicinal ; chemistry

Objective To analyze obese children serum lipid level in order to understand the relationship between serum lipid and cardiovascular disease in obese children.Methods One hundred and fifty-three children(109 male and 44 female)aged 4-16 years old with obesity who attended the outpatient clinic of Beijing Children′s Hospital were collected.Percentage body fat (%BF),body fat (BF),fat-free mass (FFM) was estimated by using bioelectrical impedance analysis (BIA) and calculate.Waist and hip circumference,waist-to-hip ratio (WHR) was estimated by soft tape measure and calculate.Skinfold thickness of scapular bone below (S) and triceps muscle (T),S/T rate was estimated by skin fold meter and calculate.Serum total cholesterol (TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),apolipoprotein(Apo) AI and Apo B levels were also measured.SPSS 11.0 software was used to analyzed the data.Results The cardiovascular disease related was the prevalence of high TC levels(3.3%)or high LDL-C level(6.0%) and high TG level(24.7%) was rather low.HDL-C level was reduced in 31.3% of obese children.In children over 10 years old,%BW and %BF showed a weak correlation with HDL-C(r=-0.202,-0.211).Conclusions In obese children,serum lipid as well as Apo level should be exa-mined in order to evaluate angiocardiopathy.

BACKGROUND:The safety and efficacy of paclitaxel-eluting stents (Taxus DES) has been proved by international researchers in clinic investigations.Based on further inclusion criteria,the incidence of in-stent restenosis is still lower than that of bare-metal stent.OBJECTIVE:TO observe restenosis of Taxus DES and the effect on local vessels through applying the follow up of coronary angiography and to investigate the biocompatibility of stent and host.DESIGN:Following-up observation.SETTING:Department of Cardiology,General Hospital of Chinese PLA.PARTICIPANTS:A total of 297 patients who had undergone coronary Taxus DES implantation for coronary artery disease were selected from Cardiovascular Department of General Hospital of Chinese PLA from May 2003 to May 2005.There were 265 males and 32 females and their ages ranged from 36 to 76 years.All patients provided informed consent,and the experiment had got confirmed consent from local ethic committee.METHODS:All patients were implanted Taxus DES and received the follow up within 6 and 12 months.In addition,at 6 months after operation,coronary angiography was used to measure the reference vessel diameter (RVD) and the minimal lumen diameter(MLD),calculate diameter restenosis rate and observe late loss.MAIN OUTCOME MEASURES:Coronary angiography at 6 months after Taxus DES implantation and biocompatibility of stent and host.RESULTS:①Quantitative angiographic analysis(QCA):Angiographic follow-up showed that the late loss of in-stent was significantly higher than that of pro-in-lesion and dis-in-lesion(P＜0.05).②Coronary angiography in-stent restenosis:In 134 angiographic follow-up patients,a total of 14 patients experienced restenosis,and the incidence was 10.4%(14/134).The patterns of restenosis were diffuse in-stent in 7 patients and the rate of revascularization was 6.7%.③Stent aneurysm:Angiographic evidence of aneurysm was observed in one patient among follow-up cases,and the rate of which was 0.75% (1/134).④Clinic follow-up major adverse cardiac events(MACE):Among 297 patients,one patient was attracted sudden death 5 months after intervention (0.34%; 1/297),and one patient was suffered subacute thrombosis 5 days after stent implant (0.34%;1/297),and late thrombosis occurred in 2 patients.The general rate of MACE was 1.35%.CONCLUSION:①The late loss of Taxus DES mainly takes place in in-stent.The patterns of restenosis of Taxus DES are in majority of diffuse in-stent,and the incidence of MACE is low.②Taxus DES possibly results aneurysm in local vessels.The follow up indicates that Taxus DES has a good biocompatibility to patients.