Adult ; Extracorporeal Circulation ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Cardiovascular ; surgery ; Pregnancy Trimesters ; Thoracotomy ; methods

BACKGROUND: Visual-motor integration (VMI) test was introduced into China in the 1970s and 1990s and widely used for evaluation and identification of problems in intellectual development and learning ability in children due to its good applicability without limitations by language and cultural background.OBJECTIVE: To assess the value of developmental test of VMI in children with hearing handicap, and evaluate its practical feasibility in largescale screening of intelligence problems in these children by comparing its reliability and validity with the norms of children in Shaanxi Province and the USA.DESIGN: A controlled correlation and multiple stepwise regression analysis with randomized cluster sampling.SETTING: Neurological Department of the First Hospital Affiliated to Medical College of Xi' an Jiaotong University.PARTICIPANTS: From January 1998 to December 2000, 638 children under 18 years of age with hearing handicaps were chosen from 6 schools of deaf-mutes in Xi'an City, Xianyang City, Chang'an County, Huxian County,and Lintong County in Shaanxi Province. Another 43 children with hearing handicap including 23 male and 20 female children aged (11.62±1.98) years were selected randomly for EEG and brain electrical activity mapping (BEAM) examination, who had a mean development quotient of VMI of 86.60±15.68. The children were divided by the development quotient into two groups, namely those with development quotient ＜ 86.6 (n=20) and those with development quotient ≥ 86.6 (n=23). METHODS: ① The VMI test was performed in accordance with the Fourth edition of VMI Manual by Beery K.E. The test was terminated when the testee failed to correctly copy three consecutive geometrical figures without time limit. The scale score varied from 0 to 27. ② The reliability test included split-half reliability test in which the items were split into two parts according to odd-even number, re-test reliability that tested the same group of children again in two months and inter-examiner reliability in which two examiners were asked to grade the same test paper.③ The validity test included structural and correlation validity test. Three well-revised and already established norms of scales in China, including Hiskey- Nebraska test of learning aptitude (H-NTLA), performance scale of Wechsler intelligent scale for children (PS-WISC) and Combined Raven's test (CRT), have been chosen as the structure validity criteria. The performance IQ of PS-WISC, learning quotient of H-NTLA, percentile rank of CRT and standard score of VMI were taken respectively for each test in this study.Academic achievements and teachers' and parent's rating were used as the validity correlation criteria. During the administration procedure, a card describing the requirements in detail were presented to the deaf children with reading capacity, while for those too young to read, the teacher was asked to help translate the requirements using standard sign language, but no any hints or clues in relation with the test contents were given. ④ The test did not start until the subjects fully understood the requirement (7314/F/W DYD-300A).EEG recording was performed with the leads deposited according to the international standard 10/20 lead system. Routine EEG had been recorded at least 30 minutes for visual assessment, and stable and representative waves for 120 seconds free of biases or inferences were recorded using unipolar lead from the subjects at rest with the eyes closed and stored in computer.Experienced EEG experts were asked to select the most representative waves of 20 seconds in a double-blind manner to compute the absolute power spectrum of the brain wave.MAIN OUTCOME MEASURES: Reliability and validity of VMI test,relationship between VMI ability and cerebral electrophysiological changes.RESULTS: Totally 638 children under 18 years old with hearing handicap were involved, of whom 72 were eliminated because of lack of data, congenital disease or central nervous system diseases. Finally 566 cases were available for analysis, including 346 male and 220 female children with an average age of (12±3) years. ① The reliability of VMI reached an average of 0.92, varying from 0.63 to 0.99 in each group. The equivalent age corresponding to the scores of the VMI test norm established for the 566 healthy deaf children was lower by an average of (1.79±0.9) years than the equivalent age in the norms of the normal children in Shaanxi Province delayed and USA. ② The standard score of VMI test showed the highest correlation coefficient of 0.661 0 with the learning quotient of H-NTLA, while the correlation with PS-WISC and CRT were 0.357 6 and 0.517 4, respectively.③ Children with higher VMI score showed more powerful absolute spectrum among frequency rangesδ,θ,αl and total power spectrum in the central, parietal and occipital regions of the left hemisphere, respectively.CONCLUSION: VMI test can efficiently reflect the development status of visual-motor integration or intelligence of the school-age deaf children and represent the level of central EEG activity.

Objective To evaluate the combination use of transcatheter arterial chemoembolization (TACE), portal vein embolization (PVE) and high intensity focused ultrasound (HIFU) in treating portal vein tumor thrombus(PVTT). Methods A total of 85 patients with primary hepatocellular carcinoma complicated by PVTT, who were encountered during the period from Jan. 2011 to Feb. 2012 at authors’ hospital, were enrolled in this study. The patients were divided into the study group (n=47) and the control group (n=38). TACE, PVE and HIFU were performed in the patients of the study group, while only TACE and PVE were carried out in the patients of the control group. The therapeutic process was as follows: PVE was carried out 2 weeks after TACE was performed, and for the patients of the study group additional HIFU was conducted about 10 days after PVE procedure. Results The short-term effective rate in the study group and the control group was 89.4% (42/47) and 39.5% (15/38) respectively, and the difference between the two groups was statistically significant (P< 0.05). The 6-month, one-year, and two-year survival rate in the study group were 87.2%(41/47), 66.0%(31/47) and 27.7%(13/47) respectively; the median survival time was 15.4 months. In the control group, the 6-month, one-year, and two-year survival rate were 55.3% (21/38), 39.5% (15/38) and 10.5%(4/38) respectively;the median survival time was 10.3 months. The differences between the two groups were statistically significant (P< 0.05). Conclusion For the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus, transcatheter arterial chemoembolization, portal vein embolization together with high intensity focused ultrasound is an safe and effective therapy as it can significantly improve the therapeutic effect and prolong the survival time.

Objective To explore the relationship between the CHADS2 score and short-term prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Methods Consecutive ischemic stroke patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after stroke were registered.Patients were divided into 3 groups on the basis of CHADS2 pre-stroke score (0 to 1,2,3to 6).And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS ≤ 2reflected good prognosis,and mRS ≥ 5 implicated unfavorable outcome).After screening the risk factors affecting prognosis using univariate analysis,the relationship between CHADS2 score and prognosis was estimated using logistic regression model.Results Of 203 patients enrolled,the CHADS2 score of 0-1,2,3-6 were present in 72,53 and 78 respectively.Patients with the higher CHADS2 score had a higher initial NIHSS score (9.8,12.6,13.0,F =3.404,P =0.008 ),more likely to receive nosocomial pulmonary infection( 12.5％,34.0％,39.7％,x2 =14.643,P =0.001 ),negatively related to good prognosis (x2 =28.542,P =0.000 ) and positively related to unfavorable outcome ( x2 =23.575,P =0.000 ).Logistic regression model results suggested that CHADS2 score was an independent predictor of good prognosis and unfavorable outcome. Compared with CHADS2 score 3-6, CHADS2 score 0-1 was independently associated with good prognosis ( OR =5.018,95 ％ CI 2.055-12.560 ).And compared with CHADS2 score 0-1,CHADS2 score 3-6 was independently associated with unfavorable outcome ( OR =6.197,95％ CI1.670-22.996 ).Conclusions CHADS2 pre-stroke score appears to be useful in prediction of stroke outcome for patients with nonvalvular atrial fibrillation.After acute ischemic stroke,the patients with the lower CHADS2 score (0-1) are more likely to achieve good prognosis,inversely,the patients with the higher CHADS2 score (3-6) are more likely to achieve unfavorable outcome.

OBJECTIVE To discuss the characteristics and risk factors of nosocomial infection inpatients with chronic kidney disease.METHODS The data from chronic kidney disease(CKD) patients retrospectively analyzed.RESULTS The nosocomial infection rate of CKD patients was 14.73%,urinary tract was the most comun site,The main-pathogens were Gram-negative bacteria,and then Gram-positive bacteria and fungii.The patients with diabetic nephropathy,lupus nephritis,aging,lower glomerular filtration rate,hypoproteinemia,anemia,and long time duration were easy to get nosocomial infection.CONCLUSIONS Nosocomial infection in CKD patients is related to underlying diseases,age,kidney function,serum albumin level,hemoglobin level,duration time in the hospital.

Mobile service in libraries of domestic medical colleges and universities was investigated.The specific characteristics of specialized courses offered in medical colleges and universities, the special nature of medical sub-jects, and the unique features of medical library users were described with suggestions put forward for expanding the mobile service in libraries of domestic medical colleges and universities.

Objective To investigate the relationship between blood pressure(BP) and prognosis in three different ischemic stroke subtypes.Methods The consecutive patients with a brain infarction proven on diffusion-weighted MRI who were hospitalized within 48 hours after stroke onset between April 2007 and April 2008 were registered.All subjects with acute ischemic stroke consecutively admitted to the neurological wards of the First Affiliated Hospital of Wenzhou Medical College,were registered in the Wenzhou Stroke Registry Program.Data were collected and coded at primary registration.The BP levels were studied during the initial 7 hospital days.Survival and dependency were assessed at 3 months.Outcomes were adjusted age,consciousness level,admission NIHSS score,the decline level of systolic BP,the decline level of diastolic BP,complication and so on. Logistic regression model was used to estimate the relationship between BP and prognosis.Results A U-shaped effect was observed in each subgroup between BP and prognosis.In the subgroups of atherothrombosis,cardioembolism and small artery disease,those who had a BP of 150/95 mm Hg(1 mm Hg=0.133 kPa)on admission,140/90 mm Hg on day 1-7 would have a better prognosis.In the subgroups of atherothrombosis and cardioembolism,the decrease of BP during the first 24 hours was the independent predictor of the death and disability at 3-month.In the atherothrombosis group,when the decrease of systolic BP during the first 24 hours was greater than 20 mm Hg,the risk of the death and disability at 3-month increased 4.44 times(OR 4.44,95%CI 1.70-11.59,P=0.002).In the atherothrombosis group,when the decrease of diastolic BP during the first 24 hours was greater than 10 mm Hg,the risk of the death/disability at 3-month increased 3.70 times(OR 3.70,95%CI 1.54-8.90.P=0.00).In the cardioembolism group,the risk increased respectively 7.98 times(OR 7.98,95%CI 1.34-47.66.P=0.026)and 6.68 times(OR 6.68.95%CI 1.55-28.79,P=0.01).In the subgroups of small artery disease,the decrease of BP during the first 24 hours was not the independent predictor of the death and disability at 3-month.Conclusions A U-shaped effect is observed in each subgroup between BP and prognosis.In the subgroups of atherothrombosis and cardioembolism,the decrease of BP during the first 24 hours is the independent predictor of the death and disability at 3-month.

Objective To observe the effects of interleukin-1β (IL-1β) and pentylenetetrazol (PTZ) induced acute epilepsy and the dynamic expression of aquaporin-4 (AQP4) in hippocampus. To explore the role of IL-1β in the pathogenesis of epilepsy by regulating AQP4. Methods All rats were randomly divided into control group, IL-1β group, PTZ group, IL-1ra + PTZ group and dexamethasone + PTZ group. Observe the behavior of the rats within 60 minutes after injection and record seizure score in each group. Then immunohistochemistry and RT-qPCR were used to detect the expression of AQP4 at at 6 , 12, 24 and 36 h. Results Almost of rats in IL-1β group and PTZ group showed severe degree seizure. The rats in control group and dexamethasone + PTZ group showed no obvious seizure. The seizure of rats were more remarkable serious in PTZ group than that in the IL-1ra + pentylenetetrazole group (P < 0.05). Immunohistochemistry and RT-qPCR Show: the expression of AQP4 in hippocampus in PTZ group increased gradually after 12 h (P < 0.05), then reached in the peak after 24 h (P < 0.001). The expression of AQP4 in IL-1ra + PTZ group was lower compare with PTZ group in each time (P < 0.05). Although the expression of AQP4 in dexamethasone + PTZ group higher than the control group, it was not significantly different (P < 0.05). Conclusion The proinflammatory cytokine IL-1β break the balance of water in brain and increasing the concentration of extracellular excitatory amino acids or ions by upregulate the expression of AQP4 in order to promote the excitatory of neurons.

BACKGROUND:Stem cel therapy has been used for prevention and treatment of degenerative disc disease. Considering the special microenvironment in the intervertebral disc, the survival rate and differentiation ability of transplanted cels are decreased, which may lead to the poor efficacy of stem cel therapy. How to improve the survival ability and therapeutic effect of the transplanted cels is the focus of stem cel therapy for degenerative disc disease.
OBJECTIVE: To investigate the effects of cobalt chloride combined with hypertonic solution pretreatment on bone marrow mesenchymal stem cels that wil be transplanted for treatment of degenerative disc disease.
METHODS:(1)In vitro cel experiment: bone marrow mesenchymal stem cels were divided into three groups and subjected to normal culture medium (normal control group), 1% hypertonic mother solution (hypertonic group), 100 μmol/L cobalt chloride (hypoxia group), or 1% hypertonic mother solution plus 100 μmol/L cobalt chloride (combined group) for 1 week. Then, 2% hypertonic solution and 200 μmol/L cobalt chloride cobalt chloride were used to simulate the anaerobic and hypertonic environment intervenes in pretreated and untreated bone marrow mesenchymal stem cels for 24 hours. After that, RT-PCR was used to detect the expression of caspase-3 for apoptosis evaluation. (2)In vivo animal experiment: Sprague-Dawley rats were divided into model, cel transplantation and hypertonic plus hypoxic groups. Rat models of intervertebral disc degeneration were made in these three groups. After modeling, rats in these three groups were given no treatment, bone marrow mesenchymal stem cel transplantation or transplantation of bone marrow mesenchymal stem cels which were subjected to hypertonic and hypoxia pretreatments into the intervertebral disc. Two weeks later, immunohistochemistry and RT-PCR methods were used to detect cel distribution and related gene expression, respectively, thereby to evaluate the therapeutic effect of stem cels.
RESULTS AND CONCLUSION: (1)In vitro cel experiment: caspase-3 mRNA expression was significantly reduced in pretreated bone marrow mesenchymal stem cels compared with the untreated cels (P < 0.05). (2)In vivo animal experiment: compared with the control group, the caspase-3 and interleukin-1β in the intervertebral disc and a number of degenerative indexes were decreased in the cel transplantation. Compared with the cel transplantation group, these indicators had better outcomes in the hypertonic plus hypoxic group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels have therapeutic potential for degenerative disc disease, and have better adaptability and transplantation effects by hypertonic and hypoxia pretreatments.

Social network analysis has been a study hot spot in academic circle in recent years and is applied in several fields.After a brief description of its basic theories and study methods, its application in domestic medical and health field were analyzed with its key study hot spots summarized and its problems pointed out, in order to provide the methods that can learned in domestic medical and health studies.