Anticoagulation is one of the important approaches in the prophylaxis and treatment of iSCheroic stroke.However.it may increase the risk of bleeding events in reducing the risk of recurrent stroke at the same time.This article reviews the status of anticoagulants in the prophylaxis and treatment of ischemic stroke by retrospecting their application in the prevention and treatment of ischemic stroke and the study of new anticoagulants.

Objective To investigate the etiology of early postoperative hyperbilirubinemia after liver transplantation.Methods The clinical data of 87 cases of liver transplantation and the etiology of early postoperative hyperbilirubinemia after liver transplantation were analyzed.Results The incidence of early postoperative hyperbilirubinemia after liver transplantation was(52.87 %).In 21 postoperative complications,17((80.95 %)) were associated with hyperbilirubinemia.The causes of hyperbilirubinemia were as follows in turn: ischemic-reperfusion injury(n=(25,28.73 %)),complications of(common) bile duct(n=23,(26.44 %));acute rejection(n=19,(21.84 %));others(n=13,(14.94 %)).(Conclusions) The early postoperative hyperbilirubinemia is the most common clinical manifestation in(patients) undergoing liver transplantation and can be taken as a reliable clinical mark for the postoperative complications and liver functions.The etiology of early postoperative hyperbilirubinemia after liver transplantation is very complicated.Early diagnosis and treatment is helpful to improve the survival of patients undergoing liver transplantation.

Objective To explore the features, diagnosis and treatment of pulmonary infection after kidney transplantation. Methods The clinical data of 31 pulmonary infection cases among 150 patients underwent kidney transplantation were analyzed retrospectively. Results The 31 patients with pulmonary infection after kidney transplantation included 9 cases of simple bacterial infection, 3 cases of fungus infection, 5 cases of CMV infection, 1 case of TB, 10 cases of mixed infection, and 3 cases of infection with unclear pathogen. 27 cases of the patients(27/31,87.1%) were cured, while 4 cases died of pulmonary infection. Conclusion Pulmonary infection is a common and severe complication after kidney transplantation. Early etiological diagnosis, the prompt treatment of antibacterium,antivirus and antifungus, adjustment of immunosuppression regime, and strengthening the support therapy would improve the curative rate.

目的探讨急性颈髓损伤院内急救护理及早期并发症的防治。方法对34例颈髓(C3 -5)损伤患者进行回顾性调查。结果 34例颈髓损伤患者经急诊救治,32例并发症得到控制,入院治疗,2例死亡。结论伤后正确处理,对危及生命的并发症早发现、早治疗是提高抢救成功率的关键。

Objective To investigate the clinical characteristics of diffuse alveolar hemorrhage. Methods 12 patients with diffuse alveolar hemorrhage hospitalized in Guangzhou NO.1 Hospital were included in the research, whose clinical characteristics were analyzed. Results 7 cases of the 12 diffuse alveolar hemorrhage cases were male and 5 cases were female. 8 cases were caused by ANCA associated vasculitis , 1 cases by connective tissue disease, 1 cases by poisoning, and 2 cases of unknown etiology (medication could be considered). The clinical manifestations were fever (91.67%), hemoptysis (100%), anemia (100%), and dyspnea (3.33%). Conclusion Diffuse alveolar hemorrhage is a life-threatening clinical syndrome. It can be caused by many causes. It should be considered if there is the presence of hemoptysis, dyspnea, anemia, etc. Timely examination and early intervention can effectively improve the prognosis of the disease.

[Abstract ] Objective Modern pharmacological studies confirmed Zhigancao Decoction total extract, single active ingredients and their combinations could obviously inhibit arrhythmia.This study was to investigate the effects of Zhigancao Decoction medicated serum combined with myocardial tissue/silicon substrate microelectrode arrays (MEA) on rapid atrial pacing(RAP). Methods New Zealand white rabbits were randomly divided into normal control group, normal serum control group, Zhigancao Decoction medica-ted serum group and water decoction group, 8 in each group.After the establishment of an atrial fibrillation rabbit model, the field ac-tion potential duration ( fAPD) of the right atrial appendage ( RAA ) tissue was measured and the effections of Zhigancao Decoction medicated serum and water decoction on the fAPD of RAA were observed. Results The successful modeling of rapid atrial pacing induced atrial fibrillation in rabbits contributed to the significant shortening of fAPD 12 h after pacing compared to that before pacing ([174.30 ±1.36]ms vs[162.48 ±0.88]ms, P<0.05).After giving 10%~25% Zhigancao Decoction medicated serum and water decoction, the fAPDs of RAA tissue in rabbits with atrial fibrillation were prolonged, which represented positive dose-response relation-ship.The fAPDs of the rabbits given serum containing 10%, 15%, 20%and 25%Zhigancao Decoction were respectively (170.81 ± 0.61)ms, (171.00 ±0.46)ms, (179.08 ±0.67)ms, (179.76 ±2.26)ms, which were longer than those of water decoction group ([163.82 ±0.780]ms, [163.66 ±0.95]ms, [174.06 ±1.32]ms, [176.84 ±1.19]ms), and the difference was statistically sig-nificant (P<0.05). Conclusion The fAPD can be taken as one index of cardiac electrophysiological change, and 10%~25%Zh-igancao Decoction medicated serum can lead to fAPD extension in rabbit model of atrial fibrillation, which might be the electrophysio-logical mechanism of anti-atrial fibrillation.

Objective: To study the relationships between the expressions of E-cadherin and ki-67 in the tissues of heatocellular carcinoma(HCC)and the prognosis of HCC patients after hepatectomy as well as their clinical pathology. Methods: We examine the expressions of E-cadherin and ki-67 in 255 HCC tissues by tissue microarray and PV-6000 two-step method of immunohistochemistry and analyze the correlations between their expressions and clinical pathological data, 1-year recurrent rate and overall survival time after hepatectomy. Results: The expression of E-cadherin correlated with the tumor size and the 1-year recurrent rate of positive group was higher than that of the negative group. The expression of ki-67 correlated with vascular invasion and differentiation of the tumor, the positive group showed a higher 1-year recurrent rate and a shorter overall survival time. Multivariate Cox regression analysis indicated that the expression of ki-67 was an independent risky factor. Conclusions: The negative expression of E-cadherin and the positive expression of ki-67 predict a higher recurrent rate of early stage. The expression of ki-67 is an independent risky factor which can be used to evaluate the prognosis of patients with HCC after hepatectomy.

OBJECTIVE: To study the experience of clinical features and treatment of deep cervical necrotizing fasciitis. METHOD: All 29 cases of cervical necrotizing fasciitis patients were diagnosed by CT, 12 cases underwent tracheostomies, lateral neck incisions and drainage operations, the other 17 patients underwent lateral neck incisions and drainage operations. Sequently washing, dressing changes and anti infection treatments were taken. RESULT: Twenty-eight cases were cured, 1 cases died. During a follow-up of half a year,no relapse. CONCLUSION When patient was sufferd the cervical necrotizing fasciitis, surgical operation for exploration should be taken as soon as possible,and incision and drainage in the treatment of cervical abscess would obtain a satisfactory curative effect, which would prevent serious complications.
Adult ; Aged ; Fasciitis, Necrotizing ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck

Objective To investigate renal expression of ApoE in human lupus nephritis (LN) and its relationship with renal damages.Methods Renal expression of ApoE was examined in 40 LN patient biopsy samples by immunohistochemieal staining.The relationship between ApoE levels" and renal pathologic changes,renal injuries was analyzed.Results Only weak ApoE expression was found in normal renal tissue.The expression of ApoE was significantly higher in LN patients [ glomerular:(31.2±11.0) vs (3.0±1.6);tub-ular:(71.64±8.90) vs (0.60±0.06)].The expression of ApoE was higher in class IV than non-class IV LN [glomerular: (38.4±4.5) vs (18.0±4.6);tubular: (77.6±2.5) vs (60.0±3.2)].Spearman's relation-ship analysis showed that the expression of ApoE in glomerular and tubular was closely related to the renal histological score activity index and functional changes in LN (P＜0.01).Conclusion The expression of ApoE is high in renal tissues of LN,especially in class IV,and the high expression may be associated with LN activity and progressive renal dysfunction.

Objective To investigate the distribution of blaOXA-51-like genes and the clonal relation-ship among Acinetobacter baumannii strains isolated from three teaching hospitals in Guangzhou , China. Methods Fifty-two Acinetobacter baumannii isolates were genotyped by multilocus sequence typing (MLST).eBURST algorithm was performed to define clonal complexes (CCs).blaOXA-51-like genes were am-plified by using polymerase chain reaction ( PCR) and sequenced .Results MLST grouped the A.bauman-nii isolates into 5 existing sequence types (STs) and 7 new STs.STn4 carried allele G1 with a T→C muta-tion at the 3rd nucleotide site (nt3) on the gpi111 locus.STn5 carried allele A1, possessing A→C muta-tions at nt156 and nt159 on the gltA1 locus.ST195 and ST208 accounted for 69.2%of all isolates.Clonal relationship analysis showed that ST 195 and ST208 belonged to CC92.Fifty-one A.baumannii isolates car-ried OXA-66 and the rest one carried OXA-199.Conclusion A.baumannii strains that belonged to CC92 and carried OXA-66 were the predominant genotype circulating in Guangzhou , China.