Objective: To investigate the effect of colloidal solution infusion on cerebral blood flow in patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Methods: Thirty patients diagnosed as aneurysmal subarachnoid hemorrhage with digital subtraction angiography (DSA) were divided into a vasospasm group (n = 12) and a control group (n = 18) according to whether they had cerebral vasospasm or not. After evaluating the regional cerebral blood flow (rCBF) of the bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery with Xe-CT, the colloidal solution (succinylated gelatin, 4 mL/kg) was injected intravenously in the patients of the vasospasm group within 30 minutes. Xe-CT was performed again, and the changes of rCBF before and after the colloidal solution expansion were compared. The changes of blood pressure, heart rate, and central venous pressure before and after infusion were documented. Results: Circled digit oneThe rCBF of bilateral anterior cerebral artery, middle cerebral artery and posterior cerebral artery was more than 30 mL·100 g-1·min -1 in the control group. The rCBF was lower than 30 mL·100 g-1·min-1at least in 1 blood supplied region in the vasospasm group (72 blood supply regions altogether) , in which CBF were lower than 25 mL·100 g-1·min-1 in 7 blood supplied regions. Circled digit twoBefore and after the expansion, there were no significant differences among the systolic and diastolic blood pressure, mean arterial pressure, and central venous pressure in the vasospasm group (P >0.05). Circled digit threeOf the 65 vessels with rCBF >25 mL·100 g-1·min-1 there were no significant differences in rCBF before and after the expansion (P = 0.272) ; of the 7 vessels with rCBF ≤ 25 mL·100 g-1·min-1, the rCBF increased from 20 ± 3 mL·100 g-1·min-1to 34 ± 6 mL·100 g-1·min-1. There were significant differences (P <0.01). Circled digit oneOne year follow-up after the procedure, there was no significant difference in GOS score between the 2 groups. Conclusion: Colloidal solution expansion may increase the rCBF of the ischemic regions in patients with cerebral vasospasm and help to improve the prognosis of the patients.

OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged

Objective: To evaluate the service competence of 99 smoking cessation clinics in Zhejiang Province, so as to provide reference for the improvement. Methods: The questionnaire, prepared by Tobacco Control Office of Chinese Center for Disease Control and Prevention, was used to investigate all the smoking cessation clinics in Zhejiang Province, to score the basic and developmental indicators, and to assess the qualified rates ( basic indicators >50 points and total scores >60 points ). Results: There were 99 smoking cessation clinics, with 52 in secondary hospitals and 47 in tertiary hospitals. The overall assessment scored from 11 to 96 points, with an average of ( 53.99±16.56 ) points. The smoking cessation clinics in secondary and tertiary hospitals scored ( 53.92±15.88 ) points and ( 54.06±17.45 ) points. The scores of basic and developmental indicators were ( 45.66±12.16 ) points and ( 8.33±5.39 ) points, with the scoring rates of 65.23% and 27.77%. The overall assessment of 43 smoking cessation clinics were qualified and the rate was 43.43%, which was 44.23% in secondary hospitals and 42.55% in tertiary hospitals. Conclusion The qualified rate of smoking cessation clinics in Zhejiang Province was 43.43%, which was similar between second hospitals and tertiary hospitals.

Objective:To investigate the effect of the new nanomaterials,polyamidoamine dendrimers PAMAM-D,mediated foreign gene human decay accelerating factor(hDAF) for xenotransplantation transfected pig sperm cells.Methods:PAMAM-D/hDAF cDNA compounds were made.The compounds were divided into 0.2 μg,0.4μg,0.6μg,0.8 μg and 1.0μg groups (each group adding corresponding dose of PAMAM-D in accordance with the N/P ratio 10:1,20:1,40:1),then were digested by restriction enzymes.The compounds were incubated with washed pig sperm cells.Then the transfection efficiency was detected by in situ hybridization in the different groups.Results:The PAMAM-D molecule can prevent electrophoretic migration of DNA in the compound.After digested the compounds by restriction enzymes,DNA can not be degraded.The transfection efficiency was different in different groups.Among the total,the efficiency was higher in both groups of 0.4 μg and 0.6μg than that of others.The top was the group of 0.4 μg linear plasmid plus PAMAM-D when the N/P ratio was 20:1(47.5%±O.2%,167% vs control group).Conclusion:PAMAM-D can improve the efficiency of exogenous gene transfeeted pig sperm cells,which can reinforce the stable binding of exogenous DNA to sperm cells.

AIM To investigate the effects of melatonin on rats colitis induced by acetic acid and its mechanism. METHODS The rats colitis model was produced by acetic acid enemas. The experimental animals was divided into 6 groups: normal group,model group,5 ASA group(100 mg?kg -1 ),MT group(2 5,5 0,10 0 mg?kg -1 ), and treated intracolonic with saline,5 ASA and MT correspondingly (1 time per day, from the 24 h after the establishment of colitis model to the end of the experiment). At the end of the experiment, the mucosal damage index(CMDI),the level of myeloperoxidase(MPO), the score of histology(HS) in rats colon and the occult blood test(OB) in feces were observed and measured, meanwhile, the content of malondiadehyde(MDA), glutathione peroxidase(GSH Px),catalase (CAT), superoxide dismutase(SOD), nitric oxide(NO) in rats colon were detected. RESULTS After being treated with acetic acid, the exetent of OB, CMDI, HS and the level of MPO in model group were more higher than that in normal group, MT(2 5,5 0,10 0 mg?kg -1 ) ameliorated the exetent of CMDI and OB and reduced the level of MPO, MT(10 0 mg?kg -1 ) alleviated the HS of rats in model group. Meanwhile in model group, the content of MDA,NO in colon elevated, but the content of GSH Px,SOD and CAT in colon reduced remarkably. MT intracolon depressed the content of MDA,NO in colon, promote the contents of GSH Px?SOD and CAT in colon. CONCLUSION Treatment with MT shows beneficial effects on the mucosal damage of rats colitis induced by acetic acid.

Objective:To investigate the clinical features and treatment outcome of Kallmann syndrome(KS) caused by fibroblast growth factor receptor-1(FGFR1) gene mutation in 4 patients.Methods:Targeted next-generation sequencing(NGS) was performed on thirty KS and normosmic idiopathic hypogonadotropic hypogonadism(nIHH) patients. FGFR1 mutation was identified in four KS patients. The clinical data, laboratory and imaging examinations, and treatment outcome were retrospectively analyzed.Results:Four male patients, aging from 11 to 22 years old, presented as micropenis, and with olfactory dysfunction. Among them, two had history of cryptorchidism, three had history of cleft lip and palate repair surgery. The most severe patient presented with short stature, left microtia and dental agenesis. FGFR1 heterozygous mutation was identified in all four patients, two were point mutation(p.Y374X; p. E670K), and the other was frameshift mutation(p.S346Yfs*61; p.S723*fs*1). One patient, who started treatment of the pulsatile GnRH pump during his youth, succeeded in having two babies.Conclusion:Patients with Kallmann syndrome caused by FGFR1 mutation presents complex clinical manifestations. Besides dysosmia, micropenis, microrchidia, and delayed pubertal development are the main clinical manifestations in male patients. Symptoms such as cleft lip and palate are helpful for early recognition. Genotyping analysis is crucial to confirm the diagnosis. The pulsatile GnRH pump can produce satisfactory therapeutic effect, but the age of initiating therapy should be carefully considered.

Objective:To evaluate the efficacy and safety of capecitabine-based regimens in treating patients with liver metastases from breast cancer. Methods:A total of 163 patients with liver metastases from breast cancer who received capecitabine-based regimens between January 1, 2000 and Dec 31, 2011 were retrospectively reviewed. The clinicopathological characteristics and treatment outcomes of these patients were evaluated. Results:Of the 163 patients retrospectively analyzed, 109 received docetaxel plus capecitabine (TX) and 54 received vinorelbine plus capecitabine (NX). TX treatment achieved objective responses in 59 patients (54.1%), including complete response in four patients, partial response in 55 patients, and stable disease in 25 patients. In patients who received NX, the objective response and clinical benefit rates were 50.0%and 70.4%, respectively;one patient had a complete response, 26 patients had a partial response, and 11 patients had a stable disease. The safety profiles of TX treatment were more favorable and predictable compared with NX treatment, with a low incidence of grade 3/4 adverse events in hematological and non-hematological toxicities. Results showed that median overall survival after liver metastases (LMS), progression-free survival (PFS), and post-metastasis survival (MSR) were 26, 8, and 28 months in the TX arm. LMS, PFS, and MSR were longer in the TX arm than in the NX arm. Conclusion:Capecitabine-based regimens showed tolerance in patients with liver metastases from breast cancer. TX treatment had a tendency of lower toxicity and was more effective compared with NX treatment.

Objective To investigate the value of the application of the fresh first morning midstream urine in cytological study of bladder cancer patients. Methods The results of the fresh first and second morning midstream urine cytological studies for 52 bladder cancer patients were analyzed.Continual three urine samples and single urine sample were treated as study objects respectively. The positive rates in different tumor stages and grades were evaluated. Results The positive rate of overall 52 patients was 78. 8 % (41/52) in fresh first morning midstream urine and 80. 8% ( 42 / 52) in the fresh second morning midstream urine. While in 156 single urine samples, the positive percentages were 56.4%(88/156) and 60. 9% (95/156). The positive rates of the fresh first and second morning midstream urine were 69.7% (23/33) and 72.7% (24/33) respectively in grade 1- 2 patients, and 44.4 % (44/99) and 48. 5 % (48/99) in 99 single urine samples. The positive rates of 42 non-muscle invasive bladder cancer patients were 73. 8% (31/42) and 76.2% (32/42) in the fresh first and second morning midstream urine, while in 126 single urine samples, the positive rates were 54.8% (69/126)and 57.1% (72/126). There were no significant differences between positive rate of the fresh first and second morning midstream urine in diagnosis of bladder cancer, low grade bladder cancer and nonmuscle invasive bladder cancer. Conclusion The fresh first morning midstream urine can be used for urine cytological study in the diagnosis of bladder cancer, even in the diagnosis of low stage and low grade bladder cancer.

The quality markers (Q-markers) of traditional Chinese medicine (TCM) have become a topic of interest in TCM research in recent years. Nonetheless, there is still no consensus on how to scientifically characterize TCM Q-markers. Our study establishes an identification method for TCM Q-markers based on the analytical hierarchy process (AHP) and the entropy weight comprehensive method. By constructing an evaluation system encompassing the target layer, the factor layer and the control layer, AHP can be used to analyze the weight of three core TCM quality attributes, including effectiveness, testability and specificity. Following that, the entropy weight method is employed to analyze the specific indicators for each attribute based on the literature and experimental data. Finally, the comprehensive weight of each index is obtained by combining the two weights, and the comprehensive weight and the specific value of each component is multiplied and summed to obtain the integrated score ranking, and thereby identify the TCM Q-markers. Taking Shaoyao Gancao decoction as an example, the analysis revealed that the top 8 components are as follows: paeoniflorin > quercetin > albiflorin > glycyrrhizic acid > naringenin > liquiritin > oxypaeoniflorin > benzoylpaeoniflorin, and can be identified as Q-markers of Shaoyao Gancao decoction. This study not only provides support for the establishment of quality standards and process quality control of TCM formulae, but also provides innovative ideas and methods for quantitative evaluation and accurate identification of TCM Q-markers.

Objective To learn the smoke-free environment and smoking status at or below county-level governments of Zhejiang Province, and to promote a smoke-free government.Methods By multi-stage random sampling method, 4 cities were selected in Zhejiang Province, then 4 counties were selected in 4 cities, finally12 governments were selected in 4 counties.With the methods of field observation,interview and questionnaire survey,smoke-free environment and smoking behavior , tobacco related knowledge of civil servants were investigated.Results A total of 12 governments and 405 civil servants were investigated.The smoke-free environment of 12 governments were relatively well.The total smoking rate of civil servants was 17.78%, and the highest was 26.67% in Jiande City, and the lowest were 9.00% in Zhuji City.For the civil servants ,male(26.62%), aged 50-(40.74%),divorced or widowed(40.00%),graduation of technical secondary school (33.33%),cadre of section rank(57.14%),above 20 years' work(28.81%),smoking anywhere at home(50.00%), smoking in certain areas at work(22.95%)were significantly higher.The rate of cognition on the hazards of smoking was lower among the smokers than that of non-smokers (P<0.05).The rate of agreement on MPOWER tobacco control strategies and smoking bans in public places were lower among the smokers than that of non-smokers (P<0.05).Non-conditional logistic regression analysis showed that age of 30-39(OR=9.87,95%CI:1.45-67.29),50-(OR=9.87,95%CI:1.45-67.29), smoking anywhere at home(OR=12.28,95%CI:2.95-51.18),and smoking in certain areas at home(OR=6.57,95%CI:3.07-14.08) may be the risk factors about smoking behavior.Conclusion The situation of smoking control at or below county-level governments in Zhejiang Province was good, and smoking rates has declined.But tobacco related knowledge and behavior of civil servants were relatively insufficient.Aiming at the problems found in the investigation, it is necessary to strengthen education on smoking control among civil servants, and to promote a smoke-free government.