Objective Research the effect of anti-inflammatory and anti-oxidation drugs on acute stroke patients. Methods 128 patients with acute ischemic stroke are divided into two groups- combined treatment group (71) and control (57). Test serum biomarkers and evaluate neurological function and living ability before and after therapy, compare between groups and intra-group. To observe the effects of combined therapy on serum biomarkers and prognosis in acute stage. Results ( 1 ) MMP-9 of combined treatment group (3.23 ±0. 99) ng/L is higher than control (2. 82 ± 4. 21 )ng/L before therapy (P ＜0. 05). (2) The level of pre-treatment ox-LDL-Ab in combined treatment group ( 0. 08 ± 0. 01 ) U/ml higher than posttreatment (0. 07 ±0. 01 ) U/ml (P ＜ 0. 05 ). The level of pre-treatment NIHSS in control group (5.76 ±6.61) score higher than post-treatment (4.22 ±5.45) score,P＜0.05. Conclusion Combined treatment can degrade serum MMP-9 and ox-LDL in acute ischemic stroke patients, but it can't obviously improve the earlier prognosis.

Objective To explore the advantages and disadvantages of the double lumen endotracheal intubation and single -lumen endo-tracheal intubation and continuous carbon dioxide insufflation in thoracoscopic esophagectomy .Methods The clinical data of 90 patients in our department of thoracic surgery after thoracoscopic esophagectomy from January 2014 to April 2015 were analyzed .All patients were divid-ed into single-lumen endotracheal intubation (group A)and double lumen endotracheal intubation group (group B).The endotracheal intuba-tion time,operation time,incidence of pulmonary infection,intraoperative and postoperative PaO2,PaCO2,incidence of anastomotic fistula, hospitalization expenses ,length of hospital stay and the incidence of postoperative chylothorax between two groups were compared .Results The difference in intraoperative PaO2,PaCO2,incidence of pulmonary infection,endotracheal intubation time,operation time,hospitalization days and the hospitalization cost between two groups were statistical significance .The difference of the rest index between two groups were no statistical significance.Conclusion Group A has certain advantages in perioperative management ,hospitalization cost and so on,but has disadvantages in perioperative hypoxemia and carbon dioxide retention and acid -base balance disorders .

Objective To assess the incidence, types and risk factors of atherothrombotic events (AT) within 7 days after transient ischemic attack (TIA) with ABCD2 Score in Chinese patients. Methods With ABCD2 Score, we retrospectively reviewed the medical records of 198 TIA patients ,which met the inclusion criteria of our study. They were divided into a low risk group (ABCD2 ≤3) and a moderate-high risk group(ABCD2≥4) and the incidence, types and risk factors of AT within 7 days after TIA were evaluated and compared respectively with χ2 test between the two groups. Statistic significance was considered as P < 0.05. Results The order of the frequency of accompanying diseases was hypertension 68.18% (135/198), diabetes 23.74% (47/198), coronary artery disease 21.72% (43/198), ischemic stroke 15.66% (31/198) and hyperlipemia 12. 63% (25/198). AT within 7 days after TIA was observed in 6.19% (6/97) of the patients in the low risk group, all of them were suffering from TIA recurrence. In the moderate-high risk group, 14. 85% (15/101) of the patients experienced AT, including 2 eases of TIA recurrence, 10 cases of ischemic stroke, 1 case of both TIA recurrence and ischemic stroke, 1 case of angina pectoris and 1 case of myocardial infarction. There was no peripheral vascular disease or death from vascular disease. Incidence of AT within 7 days in the moderate-high risk group was significantly higher than that in the low risk group (51.70% vs 27. 27%, P < 0.05). Conclusion TIA patients with ABCD2 ≥4 are at higher risk of AT within 7 days after TIA onset.

[Objective]To study the clinical experience of Professor LIU Zhe treatment of essential tremor with acupuncture.[Methods]The paper states Professor LIU's understanding of treating essential tremor from the pathogenesis, acupuncture points and acupuncture manipulations, then summarizes the principle, regularity, and the features of acupuncture manipulations for Professor LIU treating essential tremor of different types of syndrome, so as to elaborate the clinical experience of Professor LIU. [Result] Professor LIU Zhe considers the age-dependent deficiency of qi and blood and insufficient liver and kidney syndrome to be a common one of essential tremor, as an experienced doctor, he distinguishes different types of syndrome from sign, tongue, pulse and so on. He places great emphasis on nourishing the bone marrow and tonifying liver and kidney. According to the symptoms select acupuncture points with the effects of nourishing the bone marrow and calming the liver to stop the wind, tonifying liver and kidney and supplementing qi and nourishing blood. Professor Liu sets a high value on selecting points of head and makes use of the point of Fengchi with unique acupuncture manipulations to relax cerebrovascular. In clinically, the curative effects are remarkable. [Conclusion]The unique method for treating essential tremor of Professor LIU gives some inspirations for clinic. It is worth of a deep study and spreading.

Objective To investigate the value of plasma H-FABP level and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) in severity and prognosis estimation for patients with acute pumonary embolism(APE).Methods Totally 160 APE patients were hospitalized from January 2010 to January 2015 and enrolled in this study.According to the severity of the disease,these patients with APE were divided into low-risk group,moderate-risk group and high-risk group.According to clinical prognosis,these patients with APE were divided into survival groups and death groups.Plasma levels of H-FABP were measured by enzyme linked immunosorbent assay(ELISA),and APACHE Ⅱ score were analyzed.The differences of Plasma H-FABP levels and APACHE Ⅱ score were compared and which the relationship with severity and the prognosis of APE were also assessed.Results With the increased severity in patients,the H-FABP and APACHE Ⅱ score were significantly increased (P ＜ 0.05);the H-FABP and APACHE Ⅱ score were significantly higher in death group as compared with survival group(P ＜0.05).The H-FABP levels and APACHE Ⅱ score were positive correlated(r =0.71,P =0.000).ROC curves analysis results showed that the area under curve of H-FABP was 0.854 (95 ％ CI:0.784-0.927),and optimal operating point (OOP)was 13.3 μg/L,which had 81.0％ sensiticity and 79.4％ specificity;ACU of APACHE Ⅱ was 0.861 (95％ CI:0.812-0.932),and OOP was 19.2,which had 77.8％ sensiticity and 80.4％ specificity.The AUC was 0.914 (95％ CI:0.825-0.948),and the sensitivity was 88.9％,specificity was 87.6％ when the two cutoff values were both achieved,which were higher than the single H-FABP and APACHE Ⅱ score.Conclusion The H-FABP and APACHE Ⅱ score can effectively assess severity and prognosis of APE patients,meanwhile,it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.

Objective To study the expression of NM-23 ,PCNA,p53 and S-100 in colorectal cancer tissues and their relationship.Methods Three hundred and seventy eases of elderly eolorectal cancer were labelled with NM-23,PCNA,p53 and S-100 and staged by pTNM classification.Results The positive rates of NM-23,PCNA,p53 and S-100 were 74.9% ,60.3% ,58.1% ,68.1% respectively.In elderly group,the expression of NM-23 had a neg-ative correlation with that of PCNA (r = -0.101 ,P = 0.026).However the expression of NM-23 had a positive corre-lation with that of p53 (r =0.111 ,P =0.016 ),the expression of S-100 had a positive correlation with that of p53 (r=0.112,P = 0.015 ),the expression of S-100 had a positive correlation with that of PCNA (r =-0.229,P =0.000).Conclusions In the elderly patients,NM-23,p53 and S-100 were significantly correlated with the inva-sion,metastasis and prognosis of eoloreetal cancer.PCNA may be a stimulative factor in the invasion and metastasis of colorectal cancer.NM-23 ,PCNA,p53 and S-100 can serve as effective markers in reflecting the invasion,metas-tasis and prognosis of colorectal carcinoma in the elderly.

Humans ; Radiography ; Retroperitoneal Fibrosis ; diagnostic imaging

Objective:Comparing the effect of different doses of simvastatin in lowering the serum lipid.Methods:79 patients were randomized into group A and group B,and were given simvastatin 10 mg*d-1 (group A) and 20 mg*d-1 (group B),respectively for a total of 8 weeks.Results:Comparing with baseline,in group A,TC,TG,LDL-C were decreased by 23.4%,20.0% and 30.7%,respectively (P＜0.01); HDL-C was increased by 17.5%.The content of serum TC,TG and LDL-C was decreased to the normal range in 12.8%,28.2% and 15.4% of the patients in group A.For the group B,TC,TG,LDL-C were decreased by 32.7%,22.8% and 42.8%,respectively (P＜0.01); HDL-C was increased by 13.7%.The content of serum TC,TG and LDL-C was decreased to the normal range in 65.0%,57.5% and 65.0% of the group B patients.Conclusion:Oral intake of 20 mg of simvastatin once a day can effectively reduce the serum lipid.The patients can well tolerate and no obvious side effect was observed in our study.

The widely application of the radio knife alleviates the patient's pain and improve the medical quality.The radio knife is high frequency power equipment based on the theory that electricity concentrates on the skin.It can directly cut the tissue,homeostasis and cauterize.The safety requirement of this equipment is very strict because unsafe operation will burn the tissue,cause temporal unaware hurt and even endanger the patient's life.If the safety support system is imperfect,disastrous loss or medical conflict will be caused.Users must be cautious in using and familiar with the safety and protection of the radio knife.[Chinese Medical Equipment Journal,2008,29(2):96-98,104]

Objective To evaluate the effect of noninvasive ventilation (NIV) on hypercapnic encephalopathy syndrome (HES) induced by acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods An extensive search of related literature from the PubMed, EMBASE, Cochrane library, CNKI and Wanfang databases up to January 2015 was performed. Randomized controlled trials (RCTs) and case control studies regarding comparison of the effect of NIV and conventional mechanical ventilation (CMV) on the HES were collected. Critical appraisal skills program (CASP) was adopted to assess the quality of the studies. Data including mortality, trachea intubation rate, duration of mechanical ventilation and complication rate were collected, and Meta-analysis was performed by RevMan 5.3. Results Finally, 6 studies were included with 225 subjects, among whom 112 were in NIV group and 113 in CMV group, and the average Kelly-Matthay score was 3. Compared with CMV group, the mortality [20.5% (23/112) vs. 32.7% (37/113), risk ratio (RR) = 0.63, 95% confidential interval (95%CI) = 0.40-0.98, P = 0.04], intubation rate [35.7% (40/112) vs. 100.0% (113/113), RR = 0.38, 95%CI = 0.26-0.55, P < 0.000 01], incidence of ventilation related complications [26.2% (21/80) vs. 50.6% (42/83), RR = 0.52, 95%CI = 0.34-0.79, P = 0.002] in NIV group were significantly decreased, and the duration of mechanical ventilation was significantly shortened [days: 7.1 vs. 16.2, standard mean difference (SMD) = -0.93, 95%CI = -1.39 to -0.46, P < 0.000 1]. Conclusion NIV could significantly lower the mortality rate, intubation rate, and complications in the treatment of HES induced by AECOPD under close monitoring.