Functional dizziness is one of the most frequent functional disorders in adult patients.The termfunctional dizziness is not a nosological entity,but comprises several diagnoses.This study is aim to summarize the typical symptoms of functional dizziness and signs and symptoms of non-functional dizziness.

Promoting blood circulation by removing blood stasis has a long history in peripherial blood vessel diseases treatment.Based on years of practice,the paper illustrated common methods and principles of treatment on pheripherial blood vessel diseases in promoting blood circulation by removing blood stasis treatment,which gives us new ideas on importance of peripherial blood vessel diseases treatment with promoting blood circulation by removing blood stasis.

Objective Clinical data of patients who received rotational atherectomy (RA) combined with drug-eluting stent implantation (DES) in TEDA International Cardiovascular Hospital were retrospectively analyzed to evaluate it's safety,short-term and long-term prognosis.Methods A total of 60 patients who underwent RA were consecutively enrolled in the study in TEDA International Cardiovascular Hospital from September 2012 to September 2015.Pre and post procedure coronary angiography and clinical information were collected.Long term outcomes were obtained by outpatient clinical follow-up or telephone interview.We analysed angiographic data.Results Among 60 patients with 65 lesions,RA combined with drug-eluting stent implantation was successful performed in 62(95.3%) lesions and postoperative stenosis degree drop from (90.7±6.2)% to (19.5±6.6)%.4 cases(6.7%)developed complications and were treated accordingly during procedure with satisfactory results.Overall incidence of in-hospital MACCE was 1.7% with one case (1.7%) of myocardial infarction.The mean follow-up time was (23.3±10.6) months.In stent restenosis occurred in 1 case(1.7%) 10 months after operation.Stent thrombosis occurred in 1 case(1.7%) 16 months after operation and myocardial infarction (MI) occurred in 1 case(1.7%) 7 months after operation.One patient died 14 months after operation and another patient died 17 months after operation.Both of them were considered as cardiac death.There was no mortality of other causes recorded.Long-term MACCE was 9.5% and TLR is 5.1%.Conclusions Rotational atherectomy combined with DES implantation in the treatment of severe coronary artery calcification lesions has high success rate, good safety profile and good short and long-term prognosis.

Objective To study the characteristics of pharmacokinetics and pharmacodynamics of insulin dry powder inhalation and its relative bioavailability as compared with subcutaneous injection of regular insulin. Methods In this open,single-center,randomized,two-period,cross-over,euglycemic glucose clamp study,18 healthy volunteers(14 men and 4 women),aged(24.9?1.7)years,with body mass index(20.6?1.2)kg/m~2, received the insulin dry powder inhalatin(80 U)or regular insulin(15 U)subcutaneous administration.The blood samples of this study at 0,20,30,40,50,60,70,80,90,100,110,120,135,150,165,180,195, 210,225,240,270,300,330,360,390,420,450 and 480 rain were taken for serum insulin measurement, meanwhile,glucose infusion rates(GIR)were determined per 5 minutes over a period of 8 hours.Results The C_(max)were(57.9?17.8 vs 114.5?29.7)mU/L(tested vs reference preparation),T_(max)were(46.7?45.6 vs 107.8?33.7)min,GIR_(max)were(3.35?0.98 vs 5.17?1.75)mg?kg~(-1)?min~(-1)and T_(GIRmax)were(88.3?17.0 vs 151.9?34.6)min.The relative bioavailability was(10.26?2.25)%,and the relative bioefficacy was(14.33?7.26)%.Conclusion The study shows that insulin dry powder inhalation is absorbed via lungs and its action sets in earlier than that of the regular insulin injected subcutaneously.These pharmacokinetie and pharmacodynamic data may provide a reliabe guide for further clinical trial.

Objective To investigate the effects of hydrogen sulfide on autophagy and the apoptosis after acute spinal cord injury in rats. Methods Thirty-six adult male SD rats (250-300 g) were randomly divided into three groups (n=12 for each group):sham operation group (Sham group), spinal cord injury group (Model group) and hydrogen sulfide pre-treatment group (H2S group). Allen’s method was used to establish the rat model of spinal cord injury. Rats of sham operation group re?ceived only laminectomy. Rats of H2S group received sodium hydrosulphide injection intraperitoneally (50μmol/kg) 1h after spinal cord injury, and Model group was given the same amount of saline solution. Rats in the three groups were sacrificed 24 h after spinal cord injury, then the spinal cord was removed. The expressions of LC3, p70S6K and Cleaved caspase-3 were detected by Western blot assay. The expression of LC3 was also detected by immunofluorescence. The cell apoptosis was as?sessed by TUNEL stain. Results Compared with Sham group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were increased in Model group, but the expression of p70S6K decreased and cell apoptosis increased in Model group (P<0.01). Compared with Model group, the expression levels of LC3Ⅱ/LC3Ⅰand Cleaved caspase-3 were decreased significant?ly, while the expression of p70S6K increased and cell apoptosis decreased significantly in H2S group (P < 0.01). Conclu?sion Hydrogen sulfide can inhibit autophagy and reduce cell apoptosis after acute spinal cord injury in rats.

AIM: To explore the localization and expression of transfo rming grow th factor-? 1,2 (TGF-? 1,2 ) and alpha-smooth muscle actin (?- ASMA) in fetal a nd adult skins. METHODS: Skins of 15 cases of fetuses with different gestational ages and 5 cases of adults were taken, embedded with paraffin wax, and sectione d. Immunohistochemistry method and pathological method were used to detect the e xpression intensity and distribution of TGF-? 1,2 and ?-ASMA. RESULTS: Positive immunohistochemical signals of TGF-? 1,2 and ?-A SMA were found in fetal and adult skins. In skins derived from young fet us, the positive signals of these three proteins were very weak. Along with the incr ement in gestational age, the positive cellular rates of TGF-? 1,2 and ?- ASMA were elevated pro gressively. In elder fetal and adult skins, TGF-? 1,2 were mostly distributed i n epidermal cells, endothelial cells and some fibroblasts, while ?-ASMA was mainly located in myofibroblasts and sweat gland epithelial cells. CONCLUSION: The endo genous TGF-? 1,2 might be involved in the cutaneous development at embryoni c stage, in the cutaneous structure maintenance at adult stage, and in the wound healing af ter injury.

OBJECTIVE To investigate the pathogen spectrum distribution in respiratory tract infection during the past twelve years.METHODS The method was retrospectively analyzed.RESULTS A total of 7596 strains in(clinical) specimens were isolated.It showed that the isolating rate of Gram positive cocci,Gram negative bacilli and fungis was 34.56%,48.62% and 10.10%,respectively.The isolating rate of Gram positive cocci was 25.96% between Jan 1991 to Dec 1996,the most commonly isolated bacteria of which were Staphylococcus(aureus),Streptococcus pneumoniae and ?-hemolytic streptococci,with isolating rates being 6.85%,4.84 % and(4.26%),(respectively);the isolating rate of Gram negative bacilli was 63.33%,the most commonly isolated bacteria of which were Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae,with isolating rates being(8.46%),7.97% and 7.09%.The isolating rate of Gram positive cocci was 37.91% between Jan 1997 to Dec 2002,the most commonly isolated bacteria of which were S.aureus,?-hemolytic streptococci and Str.pneumoniae,with isolating rates being 10.28%,7.02% and 6.68%,respectively;the isolating rate of Gram negative bacilli was 47.64%,the most commonly isolated bacteria of which were P.(aeruginosa),E.coli and K.pneumoniae,with isolating rates being 8.19%,7.07% and 5.21%,respectively.The isolating rate of fungi was 6.06% and 11.43%,respectively during the two stages,the most commonly pathogen of which was Candida albicans.(CONCLUSIONS) The pathogen spectrum distribution in respiratory tract infection during the past twelve years has changed significantly.The isolating rate of Gram positive cocci and fungi,respectively is gradually increasing,but that of Gram negative bacilli is decreasing.

BACKGROUND: Bone marrow mesenchymal stem cell transplantation is superior to neural stem cell transplantation to repair spinal cord injury; however, the therapeutic effect is unstable and possibly related to microenvironment.OBJECTIVE: To study the differentiation of cultured in vitro bone marrow mesenchymal stem cells (BMSCs) into neurocytes by establishing a microenvironment and to observe differential expression of protein.DESIGN, TIME, AND SETTING: Observational contrast study was performed at the Laboratory of Neurobiology, Basic Medical College, Harbin Medical University from July 2005 to May 2007.MATERIALS: Adult Wistar rats and newborn fetal rats were used in this study.METHODS: Spinal cord was obtained from fetal rats to culture neurocytes. While, BMSCs were separated from bone marrow of adult rats, and they were then cultured in vitro, proliferated, and labeled with red fluorescin PKH26. BMSCs and neurocytes were individually cultured in the BMSCs group and the neurocyte group, respectively. In addition, BMSCs and neurocytes were co-cultured in vitro in double-layer culture dish in the co-culture group and the layered combination group, respectively.MAIN OUTCOME MEASURES: The obtained cells after 7-day culture were immunofluorescently detected by neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP). Surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) technique was used to analyze associated protein that was apparently changed during the differentiation from BMSCs into neurocytes.RESULTS: Seven days after co-culture, BMSCs were morphologically shared like neurocytes. Immunofluorescence indicated that NSE- and GFAP-positive ratios of BMSCs in the co-culture group were significantly higher than the layered combination group (P < 0.05); while, the ratios in the layered combination group were significantly higher than BMSCs alone group (P < 0.05). Five protein expressions were changed during the differentiation from BMSCs into neurocytes, for example, TIP39_RAT and CALC_RAT expressions increased in the layered combination group, which were 5.344 and 2.805 times as the primary expressions; INSL6_RAT, PNOC_RAT, and PCSKI_RAT expressions decreased, which were 0.380, 0.499, and 0.437 times as the primary expressions.CONCLUSION: By a microenvironment, both BMSCs and neurocytes in the co-culture and layered combination groups can differentiate into neuroblasts; while, contact differentiation ratio is higher than non-contract one. The differentiation is closely related to five proteins, including TIP39_RAT, CALC_RAT, INSL6_RAT, PNOC_RAT, and PCSK1_RAT.

Objective To evaluate measures in the prevention of pancreatic fistula after distal pancreatectomy.Methods Clinical data of 124 cases of distal pancreatectomy performed during 2000 and 2009 in our hospital were retrospectively analyzed,including 86 cases of pancreatic carcinoma,12 cases of pancreatic pseudocyst and pancreatic benign tumor,18 cases of gastroenteric tumor with pancreatic body/tail invasion,3 cases of chronic pancreatitis with body/tail pseudocyst,5 cases of pancreatic injury.Cases were divided into two groups retrospectively by ways the stump pancreas were closed.Group A included 63 cases in which the stump end was closed by simple interrupted mattress suture,group B including 61 cases in those the stump was sutured by interrupted mattress combined with a safe ligation of the main pancreatic duct.Results Pancreatic fistula occurred in 22 cases in group A,the incidence was 34.9％,among the 22 cases,10 cases were high-flow type,12 cases were low-flow type; while the pancreatic fistula occurred in 9 cases in group B,the incidence was 14.7％,there was no high-flow type fistula.Conclusions Interrupted mattress suture combined with interlocking suture and suture of main pancreatic duct is effective in decreasing the rate of pancreatic fistula after distal pancreatectomy.

Objectives To prospectively investigate the diagnostic accuracy,image quality and radiation doses of prospectively ECG-triggered high-pitch spiral acquisition computed tomography coronary angiography (CTCA) using Flash dual-source CT for the diagnosis of significant coronary stenoses.Methods Seventy-three patients underwent both CTCA and CCA.CTCA was performed using a Flash dual-source CT system with data acquisition at a high-pitch of 3.4.CCA served as the standard of reference.Radiation dose values were calculated using the dose-length product.Results There were 925 vessel segments in 73 patients.(1)Diagnostic accuracy: the sensitivity,specificity and positive and negative predictive values were 93.2％ (164/176),96.4％ (722/749),85.9％ (164/191),98.4％ (722/734) for segment assessment and 98.4％ ( 123/125 ),87.4％ ( 83/95 ),91.1％ ( 123/135 ),97.6％ ( 83/85 ) for vessel assessment and 100％ (44/44),89.7％ ( 26/29 ),93.6％ ( 44/47 ),100％ ( 26/26 ) for patient assessment.( 2 ) Image quality: there were 2 coronary segments of right coronary artery and one segment of left circumflex artery with non-diagnostic image quality.There was no non-diagnostic image quality in left anterior descending artery.(3) Radiation dose: the effective radiation dose was ( 1.14 ± 0.10) mSv.Conclusions CTCA using the prospectively ECG-triggered high-pitch spiral mode of the Flash dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low dose.