目的探讨预测脑卒中康复结局的重要因素和可靠的预测模型。方法采用回顾性研究的方法,对北京博爱医院1999年1月—2001年7月收治的225例首次脑卒中患者的临床资料进行分析。患者的功能状态按照自行设计的日常生活活动能力 (activitiesofdailyliving ,ADL)量表进行评定。 结果尽管许多因素都会影响患者的功能恢复,但最有意义的3个因素是年龄、入院时的功能状态(ADL入院)和发病到康复治疗的间隔时间 (onset addmisioninterval,OAI)。年龄较小、ADL入院值较高、康复训练开始较早患者的ADL出院值较高。年龄与ADL增加值无关。预测模型:ADL出院 =49.52—0.14×年龄+0.66×ADL入院-0.03×发病到康复治疗间隔时间(R2=0.62,P=0.0001)。结论根据此模型,可预测患者出院时的功能状态(ADL出院),制定合理的康复目标和康复训练计划。

Objective To evaluate the application effect of evidence-based care model in hemostasis by compression in patients after renal biopsy.Methods 80 patients undergoing renal biopey from December 2006 to December 2009 in our hospital were chosen as the research object.They were randomly divided into the control group and the observation group with 40 patients in each group.The control group was given routine nursing,and the observation group was treated with evidence-based care model for nusing.The re-bleeding rates,satisfaction degree and the SAS,SDS score,mastering degree of related knowledge,treatment compliance for the two groups before and after nursing were compared.Results The ineidence rate of bleeding in the observation group was higher than the control group,satisfaction degree was higher,and the SAS,SDS score,related knowledge,treatment compliance were all better than the control group,there were significant differences.Conclusions The effect of evidence-based care model in hemostasis by compression after renal biopsy is better.It can significantly reduce the incidence of adverse circumstances and improve the negative emotional state of patients.

Data of key medical disciplines and talented personnel training in Jiangsu Province were analyzed,and a plan for their future development is proposed.

Objective To clone the genes coding for cysteine proteases (CPs, TvCPs) from Trichomonas vaginalis and to analyze their genetic variations with the related sequences from NCBI database (GenBank) and T. vaginalis Genome Project database from The Institute for Genomic Research (TIGR). Method TvCP genes were amplified using PCR, and inserted into vector pET28b or pBS-T. The recombinant plasmids were then transformed to Escherichia coli BL21 or Top10 strain. The recombinant plasmids were used for sequencing. Homologous TvCP genes were blasted based on NCBI GenBank and TIGR T. vaginalis Genome Project database. The sequences of cloned TvCP genes were aligned and clustered by Clustal X (1.83 version) with retrieved sequences. Comparisons of amino acids among cathepsin L-like TvCPs, human L-like cathepsins and papaya papain were performed using DNAstar software, and their phylogenic tree was constructed based on neighbor-joining method using Clustal X. Results Two TvCP3 clones and one TvCP2 had a high identity of more than 99% with their responding TvCPs. Three clones of TvCP4 genes, GZ-CP4-clone 1-3, belonged to two members of a family showing a high percentage identity of more than 97.5% with the sequences of TvCP4 genes from databases (GenBank and TIGR) both at amino acid and nucleotide levels. Nine homologous TvCP4 pro-enzymes with 304 amino acids and other two members with deletions of N-terminal sequence existed in T. vaginalis sharing a similarity of 62.3-96.7% amino acids, which may evolve by means of gene replication and deletion. TvCP1-4, TvCP12, TvCP25 and CP65 had an identity of 61-88.2% at amino acid levels. So far, all reported sequences of C1 family from T. vaginalis belonged to capanthesin L-like subfamily with the same enzymatic active sites, conserved cysteine residues and similar structural features such as ERFNIN-like motif in pro-enzyme region, suggesting that they might result from gene duplication and mutations. Conclusion TvCPs belong to cathepsin L-like family with genetic diversity, but they have the same active amino acid residues, cysteine residues and similar structural characteristics, suggesting that they may derive from one ancestor.

目的探讨不同年龄组脑卒中患者康复结局的预测模型。方法对462例首次发病的脑卒中患者的临床资料进行回顾性分析。采用自行设计的日常生活活动能力(ADL)评定量表对其进行评定。结果总回归方程为:ADL出院=55.09+0.593ADL入院-0.17年龄-0.02OAI,复相关系数R=0.75,决定系数R2=0.56,校正的决定系数R2adjus=0.56;60岁以下年龄组回归方程为:ADL出院=52.27+0.51ADL入院-0.03OAI,R=0.69,R2=0.48,R2adjust=0.48;60岁以上年龄组回归方程为:ADL出院=34.46+0.73ADL入院,R=0.8,R2=0.64,R2adjus=0.64。60岁以上年龄组的预测模型准确性较高。结论按年龄分组可提高对脑卒中患者康复结局预测的准确性。

Fourteen compounds were isolated by column chromatography from the ethyl acetate extract of the seeds of Brassica campestris. Their structures were elucidated by physicochemical properties and spectroscopic data analysis. The isolated compounds were respectively identified as (5Z,7E)-4, 4-dimethyl-5-acetyl-5, 7-nonadienoic acid (1), indole-3-carboxaldehyde (2), blumenol A (3), vinylsyringol (4), sinapinic acid (5), sinapic acid ethyl ester (6), protocatechuic acid (7), crinosterol (8), campesterol (9), 7-oxo-stigmasterol (10), kaempferol (11), 2,5-dihydroxybenzoic acid (12), syringic acid (13) and daucosterol (14). Compound 1 was a new compound and the other compounds were isolated from this plant for the first time except for compounds 4, 5 and 13.
Brassica ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Seeds ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To study the effects of emergency operation with 2~5 cm incision to treat fresh closed heel tendon disjunction.Method 23 cases of fresh closed heel tendon disjunction were operated in post-injury 3~12 hours and the incisions were 2~5 cm long. Results None of these cases was complicated with wound infection or cutaneous necrosis.The follow-up was from 6 months to 6 years,averaging 2.2 years;in which,according to the Arner-Lindholm standards,20 were excellent,3 were good.Conclusion A satisfactory effect can be obtained through the smaller incision to treat the fresh closed heel tendon disjunction.

Objective To explore the effect of posterior internal fixation surgery with pedicle screw/rod instrument system in the treatment of thoracic vertebrae fracture-dislocation complicated with a severe thoracic injury. Methods In the 8 cases examined, the range of injury was from T5 to T9, including 1 case of compression fracture-dislocation and 7 cases of burst fracture-dislocation according to Hanley and Eskey’ s classification. According to Frankle’ s classification, 4 were grade A, 3 were grade B, 1 was grade C. All cases were complicated with multiple fractures of bilateral ribs, pulmonary contusion and haemothorax. After the pathogenic condition being stable, reduction and internal fixation were performed with the posterior surgery pedicle screw/rod instrument system. In 5 cases, spinal canal anterolateral decompression was performed homeochronously. The intervals between accidents and operation were 3 to 9 days. Results Operations were performed safely in all patients. The reposition of the alignment and height of vertebraes was good. Postoperative CT scanning showed: in 2 cases, bone block occupied about 10% volume of vertebral canal, and 1 was 50%. The follow-up were 4～36 months, averaging 15 months. No postreduction disposition, internal fixation loosening or breakage occurred. The Frankel’ s classification of neurological function was improved by 1 grade on average. Conclusions After a positive treatment of thoracic injury, it is safe and feasible to treat the fresh thoracic vertebrae fracture-dislocation with the posterior surgery pedicle screw/rod instrument system, and the curative effects are satisfied.

OBJECTIVETo investigate the influence of total flavonoids of Elsholtzia splendens (TFES) on isolated ischemia/reperfusion rat hearts and its underlying mechanisms.

METHODSHearts isolated from male SD rats were perfused on the Langendorff apparatus and subjected to global ischemia for 30 min followed by 120 min of reperfusion. The cardiac infarct size was measured by TTC staining. Hemodynamic parameters and the level of lactate dehydrogenase (LDH) in the coronary effluent were measured. Absorbance at 520 nm was determined in isolated cardiac mitochondria exposed to 200 micromol/L CaCl2 to detect the opening of the mitochondrial permeability transition pore.

RESULTSPretreatment with TFES (1, 10, 100 microg/ml) for 5 min decreased infarct size and LDH release and improved the recovery of the left ventricular developed pressure. In mitochondria, the decrease of absorbance at 520 nm evoked by CaCl2 was greatly inhibited by TFES.

CONCLUSIONTFES prevents myocardial ischemia/reperfusion injury, and this cardioprotective effect is probably via inhibiting mitochondrial permeability transition pore opening.

Animals ; Cardiotonic Agents ; pharmacology ; Disease Models, Animal ; Flavones ; pharmacology ; In Vitro Techniques ; Lamiaceae ; chemistry ; Male ; Mitochondria, Heart ; drug effects ; Mitochondrial Membrane Transport Proteins ; drug effects ; Myocardial Reperfusion ; Myocardial Reperfusion Injury ; prevention & control ; Rats ; Rats, Sprague-Dawley