Objective To study the significance on dynamic changes of serum vascular endothelial growth factor( VECF) and matrix metalloproteinase 9( MMP-9) in patients with acute cerebral infarction. Methods 123 patients with acute cerebral infarction were selected as research object, and they were the observation group, and 80 healthy peoples at the same time were selected as control group. Then the serum VEGF and MMP-9 in patients with acute cerebral infarction after pathogenesis at first,third,fifth,seventh and fourteenth day were detected,and the correction between the levels and infarct size,prognosis were studied. Results The serum VECF and MMP-9 of observation group compared with those of control group,the change showed increased first and decreased afterwards,but the levels were all higher than those of control group (P ＜ 0.01). There were correction between the levels and infarct size, prognosis.The serum VEGF[(369.3 ± 108.7,476.2 ± 118.4,551.5 ± 144.5,661.7 ± 164.6,437.6 ± 123.9)ng/L]and MMP-9[(333.8±101.4,459.7±119.9,370.3 ±119.5,320.5 ± 129.1,255.4 ± 101.6)ng/L] in poor prognosis patients after pathogenesis at first,third,fifth,seventh and fourteenth day were all higher than those of good prognosis patients ( P ＜0.01). Conclusion The serum VEGF and MMP-9 in patients with acute cerebral infarction showed dynamic change,and there was close relationship between the levels and infarct size.

Microglia is the principal immune effector cell in brain. It plays some important roles in support, nutrition, protection, and repair in the physiological activities of neuron. Microglia can be quickly activated, which may proliferate after cerebral ischemia, and promote phagocytosis of macrophage. It exerts dual effects by producing neurotoxic molecules and neurotrophic factors. Therefore, to study the relationship between microglia and cerebral ischemia, give full play to its protective functions and reduce its damage will help to improve the therapeutic effects of cerebral ischemic injury.

Objective To examine the influence of 3R intensive nursing on working memory dysfunction of patients with early Parkinson's disease. Methods 30 patients with early Parkinson's disease were assessed by Working Memory Test Battery,and acceped 3R- nursing. The condition of working memory dysfunction was compared before and after nursing intervention. Results The patients with early Parkinson's disease had evident difference than the normal controls, especially the visualspatial working memory. After 3R- nursing, the subtest scores and dimensions were improved apparently. Conclusions The clinical effect of 3R- nursing method in patients with early Parkinson's disease has significant predominance ,so it is worth popularizing.

Objective To study the effects of bone marrow stromal cells derived neural stem cells on apoptosis and the expression of Bcl-2 and Bax after focal cerebral ischemia and reperfusion.Methods The model of middle cerebral artery occlusion (MCAO) and reperfusion was set up by Longa. Thirty-two Sprague-Dawley rats were divided into 4 groups: sham-operated group (A), ischemia control group (B), bone marrow stromal cells transplanted group (C) and bone marrow stromal cells derived neural stem cells transplanted group (D). The rats were killed on the day 7 and 14 after transplantation. The brain sections were used for terminal deoxynucleotidyl transferase dUTP mickend labeling (TUNEL) staining and Bcl-2, Bax immunohistochemical staining.Results The number of apoptotic cells in groups C and D was decreased as compared with that in group B on the day 7 and 14 after transplantation (P

OBJECTIVE:To study the analgesic and anti-inflammatory action of Lamiphlomis from different growing areas.METHODS:The analgesic action was observed with hot plate test and writhing test and the anti-inflammatory action with xylolinduced ear swelling test and acetic acid-induced peritoneal capillary permeability test in mice.RESULTS:Lamiphl_ omis could obviously inhibit the pain induced by hot plate and acetic acid as well as the ear swelling induced by xylol and the capillary permeability resulting from peritoneal injection of acetic acid.CONCLUSION:Lamiphlomis possesses analgesic and anti-inflammatory action and on this point,the actions of Lamiphlomis from three growing areas are more or less alike.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.

BACKGROUND: Common complication of traditional joint replacement is hip joint dislocation and large head joint implant can effectively solve this problem. OBJECTIVE: To investigate the preliminary efficacy of large head metal-on-metal implants for patients undergoing total hip arthroplasty. DESIGN, TIME AND SETTING: Prospective cohort study. The patients were selected from Department of Joint Surgery, Xinjiang Hospital of Traditional Chinese Medicine between February 2007 and January 2008. PARTICIPANTS: A total of 65 patients (71 hips) undergoing large head metal-on-metal implantation in Xinjiang Hospital of Traditional Chinese Medicine were selected, including 21 females and 44 males with an average age of 54.6 years (ranging 19 to 77 years). Of them, there were 28 cases of necrosis of the femoral head, 24 of hip osteoarthritis, 9 of femoral neck fracture and 4 of acetabular dysplasia. METHODS: According to age, sex, cause of disease and preoperative joint function, the patients were divided into traditional prosthesis (n=30, 33 hips, metal-on-polyethylene implant) and large head M-O-M group (n=35, 38 hips, ASR/XL prosthesis, DePuy, Motech, Warsaw, IN, USA). MAIN OUTCOME MEASURES: The pre and postoperative Harris scores for the hip, range of motion, periprosthetic radiolucency, leg-length inequality and complications were recorded and compared. RESULTS: All patients were followed-up. The traditional group was followed up for 20 months (ranging 13-28 months), and the large head M-O-M group was followed up for 17 months (ranging 10-26 months). The mean Harris score was 89 points (ranging 59-98) in traditional group, and 94 points (ranging 71-100) in large head M-O-M group (P=0.014). The range of motion of hip was improved, and the large head M-O-M group (34?) was superior to traditional group (26?, P=0.004) at 6 months after surgery; the range of motion was improved 27? in traditional group and 37? in large head M-O-M group (P=0.009) over 1 year of follow up. The leg-length inequality was 4 mm (2-11 mm) in large head M-O-M group and 7 mm (5-16 mm) in traditional group (P=0.005). Both groups exhibited periprosthetic radiolucency (≤1 mm, 2 cases in traditional group and 3 cases in large head M-O-M group). One patient in the traditional group suffered dislocation. CONCLUSION: The large head M-on-M implants in total hip arthroplasty has excellent short-term effects on patients compared with traditional prosthesis. They offer the more stability and better restoration of hip articulation function and biomechanical reconstruction.

Objective To investigate the feasibility and safety of hand assisted laparoscopic total gastrectomy with D2 lymphadenectomy for advanced cardiac cancer compared with open surgery.Methods 174 patients suffering cardiac,upper,middle or whole gastric cancer operated in our department from October 2013 to October 2014 were divided into open surgery group and laparoscopic group.Perioperative parameters were compared between the two groups.Results Patients in loparoscopic group were associated with significantly less operative blood loss [(110 ± 17) ml vs.(345 ± 95) ml,t =4.95,P =0.011],and shorter postoperative hospital stay [(8.7 ± 0.6) d vs.(14.3 ± 2.1) d,t =0.26,P =0.031],but longer operative time [(295 ± 37) min vs.(215 ± 23) min,t =3.78,P =0.004],compared with that of open surgery.There was no significant difference in the numbers of lymph node dissection between the two groups.Esophagus resection length in open group was (4.0 ± 1.2) cm,and that was (4.1 ±1.0)cm in laparoscopic group (t =0.95,P =0.147).Two patients in open group had positive margins and underwent thoracoabdominal resection.There was no difference in major complications between the two groups.Conclusion Hand assisted laparoscopic total gastrectomy for advanced cardiac carcinoma is a safe,feasible,and oncologically sound procedure compared to open procedure.

Objective To evaluate the feasibility and safety of hand assisted laparoscopic total gastrectomy for gastric cancer by two different operative approaches.Methods 191 patients of proximal or gastric corpus cancer operated at our department from Jan 2015 to Dec 2017 were divided into two groups:by outer omental bursa approach group (OBA) and through inner omental bursa approach group (IBA).Operative time,estimated blood loss,number of lymph node retrieval,times of analgesic injection,time to the first flatus and postoperative hospital stay were compared between the two groups.Results Estimated blood loss,times of analgesic injection,time to the first flatus and postoperative hospital stay were not statistically different between the two groups.The operative time was significantly shorter in the IBA than the OBA.There were no significant differences in tumor size,retrieved lymph nodes,AJCC/UICC staging and resection margins between the two groups.Conclusion Hand assisted laparoscopic total gastrectomy by the outer omental bursa approach is technically feasible and safe,and allows for adequate lymphadenectomy.

Objective To investigate the long-term prognosis and possible risk factors of acute kidney injury(AKI)following cardiac surgeries. Methods Clinical data of 941 patients undergoing open heart surgery from January 2004 to June 2007 were retrospectively analyzed.Survival and renal function of above patients were informed through telephone or clinic follow-up till February 2010.Long-term survival was analyzed using risk-adjusted Cox proportional hazards regression model. Results Of the 941 patients after cardiac surgery,275(29.2%)developed AKI and 666(70.8%)did not.Survival was worse in patients with AKI(67.8%vs 85.6%,P<0.01)and was proportional to its severity (AKIN 1,2 and 3 stages:70.7%,62.3%and 58.6%,P<0.01).Although 90.5% of patients had complete renal recovery after AKI at discharge of hospital,they still had an increased risk for death during follow-up compared with patients without AKI (69.6% vs 85.6%,P<0.01).In the Cox proportional hazards regression model,age(HR=2.238),anemia (HR=1.625),prolonged operation time (HR=1.153),AKI severity (HR=1.473)were independent risk factors for long-term prognosis after cardiac surgery.At the end of the follow-up,patients with AKI had statistically higher Scr than non-AKI patients(107.6 μmol/L vs 83.0 μmol/L,P=0.014),and among those AKI patients,34.0%progressed into CKD 3-5 stages,34.8%developed double serum creatinine. Conclusions AKI is a risk factor for the long-term prognosis of cardiac surgery.Patients with complete renal recovery after AKI still has an increased risk for death and poor renal function compared with patients without AKI.