Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.

Objective To investigate the effects of nicergoline on expressions of 5-hydroxytryptamine 1A receptor (5-HT1AR), D2 dopamine receptor (D2DR),α2A adrenaline receptor (α2AAR) in the hippocampal CA1 region and the serum level of apolipoprotein E4 (ApoE4) in a rat model of vascular depression (VD) . Methods Forty-eight male Sprague-Daw ley rats w ere randomly al ocated into a normal control group, a model group, fluoxetine group, a low-dose nicergoline group, a medium-dose nicergoline group, and a nicergoline high-dose group ( n=8 in each group). A rat model of VD w as induced by the ligation of bilateral common carotid arteries combined w ith chronic unpredictable mild stress (CUMS) plus single housing. The rats did not conduct CUMS or single housing in the normal control group, and the rats in the model group conducted CUMS and single housing. The rats in the fluoxetine group w ere given fluoxetine 1.3 mg/(kg· d) for gastric lavage for 3 w eeks at the beginning of CUMS and single housing. The rats in the low -, medium-and high-dose nicergoline groups w ere given nicergoline 0.9, 1.9 and 3.8 mg/(kg· d), respectively for gastric lavage for 3 w eeks at the beginning of CUMS and single housing. The normal control group and the model group w ere given equal volume of distil ed w ater for gastric lavage, once a day for 3 w eeks. Depression-like behavior w as evaluated using sucrose solution consumption and open-field test. Immunohistochemical staining and Western blot were used to detect the expressions of 5-HT1AR, D2DR, andα2AAR in the hippocampal CA1 region. Enzyme linked immunosorbent assay w as used to detect serum ApoE4 level. Results Before CUMS, the scores of horizontal and vertical movement and sucrose solution consumption in the model group, the fluoxetine group and each nicergoline group w ere decreased significantly compared w ith the normal control group (al P<0.01);w hile at 21 days after CUMS, those in the fluoxetine group and the nicergoline medium-and high-dose groups w ere significantly higher than those in the model group (al P<0.05). There w ere no significant differences betw een the fluoxetine group and each nicergoline group. The expression levels of 5-HT1A R, D2DR, α2A AR, and the serum ApoE4 in the model group, the fluoxetine group, and each nicergoline group w ere significantly higher than those in the normal control group. Those of the fluoxetine group and the nicergoline medium -and high-dose groups were significantly lower than the model group (al P<0.01), while there were no significant differences betw een the fluoxetine group and each nicergoline group. Conclusions Nicergoline can improve the depression-like behavior in VD rats. Its mechanism may be associated w ith the dow nregulation of 5-HT1AR, D2DR, α2AAR expressions and serum ApoE4 level.

Objective To investigate the effects of intensive interaction on teaching of neurology for postgraduate for master. Methods The postgraduates of grade 2010 study under traditional teaching, and the postgraduates of grade 2012 study under intensive interaction teaching. Results The score of clinical knowledge test and specialized skill test were significantly better in the grade 2012 than in the grade 2010 (P<0.05). The students were satisfied with the intensive interaction teaching. Conclusion The intensive interaction teaching is good for teaching of neurology for postgraduate for master.

Objective To study the influence of collecting blood specimen of cancer patients through PICC on blood test result and catheter-related complication,and discuss the path and feasibility of collecting blood through PICC.Methods Adopting clinical self-contrast experiment,collecting blood specimens of 100 patients at one side through PICC (the observation group)and by ordinary method at the other side of limbs (the control group),comparing the test differences of blood routine,blood biochemistry,and coagulation function,etc.between the two groups.The incidence of catheter-related complication was also observed a week after collecting blood through PICC.Results There was no statistic difference between the two groups in terms of test results.No case of catheter-related complication in a week after collecting blood occurred in the observation group.Conclusions The method of collecting blood specimen through PICC is accurate,safe and feasible,the key point is to implement scientific and standard collecting path and entry-qualification of operators strictly.

Objective To investigate the incidence of familial hepatitis B viral (HBV ) infection in the southeast part of Chongqing ,and provide information for its prevention and treatment .Methods 295 patients with HbsAg positive came from 110 families were selected and divided to different groups by gender and marital status .We investigated the infections of HBV in three generations of the immediate families .This research focused on the difference between mother-to-child transmission and father-to-child transmission ,the status of receiving HBV vaccine ,the morbidity and mortality of cirrhosis and hepatic carcinoma ,the cause of death ,and the impact of gender in three generations .Results Of the 110 cases ,the HBsAg positive rate for children with HBsAg positive mothers (more than 66 .7% ) was significantly higher than that with positive father (less than 1 .1% ) ,while there was no significant difference between male spouses and female spouses (22 .2% versus 20 .5% ,P>0 .05) .Only 23 .2% received HBV vac-cine and 2 .7% got immune globulin of HBV .8 .5% of the 295 persons had cirrhosis and 4 .4% of them had primary hepatocellular carcinoma (HCC);19 patients from 16 families died of liver diseases .39 cases of 110 patients got antiviral treatment regularly .Con-clusion As well as father-to-child transmission and close contact ,mother-to-child transmission contributed to familial HBV infec-tion ,and even more common .The high rate of familial HBV infection in this area was associated with low rate of vaccination and immune globulin of HBV .The leading cause of the high incidence of hepatocellular carcinoma and hepatic cirrhosis was substandard treatment .

Objective To discuss the appropriate timing of providing enteral nutrition through nasojejunal tube for patients with severe craniocerebral injury.Methods 126 cases of patients were divided into 3 groups randomly,providing enteral nutrition through naso-jejunal tube for the first group,the second group and the third group within 12～24 hours,48 hours later and 72 hours later after injury respectively.The nutrition situation of 3 groups was recorded 6 hours later,48 hours later,on the 5th day and the 10th day,including indicators such as total serum protein,blood albumin,serum creatinine,etc and complication cases of diarrhea,hemorrhage of digestive tract,palirrhea,aspiration,inhalation pneumonia and so on within 2 weeks after injury.Results In terms of indicators of albumin,creatinine 48 hours after injury and total protein,albumin and creatinine on the 5th day and 10th day,the first group were better than the second and third group,there were statistic differences between the three groups.Complication comparison within 2 weeks after injury:the difference of palirrhea cases among the three groups was significant,the third group had a higher ratio than the first and second group.And there was no statistic difference in the other indicators like diarrhea,hemorrhage of digestive tract,aspiration and inhalation pneumonia.Conclusions It is high time that patients with simple severe craniocerebral injury are provided with enteral nutrition through naso-jejunal tube within 12 to 24 hours,which can improve patients nutrition situation without the increase of the complications.

Objective:To detect the polymorphism of ALDH2 gene in Chinese and to guide the rational use of nitroglycerin. Meth-ods:The polymorphism of ALDH2 (Glu504Lys) was measured by colorful gene chip. Results:The polymorphism of ALDH2 from 1026 clinical samples in China was detected by gene chip. The results showed that there were three genotypes. The distribution of the three genotypes of wild type [ALDH2(504Glu)], heterozygotes [ALDH2(Glu504Lys)] and homozygous mutant [ALDH2(504Lys)] was 61. 7%(623 samples), 31. 6%(319 samples) and 6. 6%(67 samples), respectively. Conclusion:Approximately one third of Chinese patients can not be treated by nitroglycerin. The gene detection method in the study is suitable for the guide of rational drug use in hospi-tal.

Objective To investigate the diagnostic value of the real-time tissue elastography (RTE)and AST/PLT ratio in-dex (APRI)for the assessment of the early stage liver fibrosis in chronic liver disease patients.Methods Totally 90 patients with chronic liver disease were enrolled in the present study.The RTE score and the area percentage of the blue color (AREA,one of the elastic characteristics),the AST and PLT were recorded.Compared the results among different stages of liver fibrosis reported by biopsy considered as the gold standard for the assessment of liver fibrosis.The accuracy of the diagnosis of liver fibrosis by RTE scores,AREA and APRI were compared.Results RTE scores,AREA and APRI increased with the stage of liver fibrosis. Taking ≥S1 as the diagnosis standard of the early stage liver fibrosis,the area under the curve of ROC for RTE scores,AREA and APRI were 0.88,0.92,0.76 (P <0.05).Conclusion RTE is a new and promising sonography-based noninvasive method for the assessment of hepatic fibrosis in patients with chronic liver disease.Combined RTE with APRI have great clinical significance in di-agnosing the early stage liver fibrosis in chronic liver disease patients.

ObjectiveTo investigate the language cortex organization characteristics of native Chinese. Methods20 patients who underwent language mapping via intraoperative direct cortical electrical stimulation (ioDCES) under awake anaesthesia for glioma in dominant hemisphere were analyzed retrospectively. Results16 patients were identified at least one language site, 3 patients located in the frontal and 1 patient in the temporal lobe. The language sites mostly located in the perisylvian region. The frontal language sites conformed to traditional Broca's areas, but the superior temporal gyrus contained much more language sites than the middle temporal gyrus.ConclusionHigh individual variability in language organization indicates a need for revision of the classical model of language localization. Because of the samples were too small, our current dates can't fully reflect language cortex organization characteristics of native Chinese.

There are so many ways of assessment on balance, among which scale assessment is the most used method. This article introduced the frequently used balance assessment scales in clinical medicine and researches, such as Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (Tinetti POMA), Timed Up and Go Test (TUGT), Activities-specific Balance Confidence Scale(ABC), Brunel Balance Assessment (BBA), Dynamic Gait Index(DGI), Functional Gait Assessment(FGA), Balance Evaluation Systems Test (BEST), and the researches of reliability and validity on those scales. The reliable and valid tools to assess balance and gait are suggested for clinical medicine.