[Objective] To investigate the effects of Naoyi'an (NYA) on the expression of ICAM-1 in the brain of rats with experimental intracerebral hemorrhage.[Methods] The rats model of intracerebral hemorrhage was prepared by type Ⅶ collagenase injected into globus pallidus under stereotaxic apparatus.Then,the expression of ICAM-1 with or without intervention with NYA was determined in the brain of these animals respectively by in situ hybridization and western blot technique.[Results] Among the modeling animals,the expression of ICAM-1 was increased after the operation.In contrast,the expression of ICAM-1 was significantly down-regulated in the rats treated by NYA(P

Objective To observe the effect of electroacupuncture on migraine. Methods 60 patients were divided into electroacupuncture group (30 cases) who received electroacupuncture, and control group (30 cases) who received local nerve block. Results In the electroacupuncture group, 22 (73.33%) cases were cured, 6 (20.00%) cases were obviously improved, 2 (6.67%) cases were improved. While in control group, 17 (56.67%) cases were cured, 5 (16.67%) cases were obviously improved, 8 (26.67%) cases were improved. There was significant difference between these two groups (P<0.05). The time of treatment was less in the electroacupuncture group than in the control (P<0.05). Conclusion Electroacupuncture is effective on migraine.

Objective To study clinical value of percutaneous intrabiliary expandable metallic biliary stenting (EMBS) for treatment of malignant obstructive jaundice. Methods One hundred and sixty patients with malignant obstructive jaundice were treated with EMBS ( EMBS group) . Thirty patients underwent only external drainage by PTCD were recruited as control. The patency rate of stent,decline of bilirubin and the complication were analyzed retrospectively. Both groups were followed up for three months. The Kaplan-Meier method (log-rank test) was used to compare the survival period between the two groups. Results Anorexia,skin pruritus and color of urine alleviated at a certain degree in both groups.In the EMBS group,plasma total bilirubin was(218. 78 ±2. 29) μmol/L pre-stent,and decreased to (134. 90 ±2. 34), (83. 18 ±2.40) , (40. 74 ±2. 29) μmol/L at the 7,14,21 days after the stenting, respectively; direct bilirubin was (128.82 ±2.40) μmol/L pre-stent, and decreased to (81.28 ± 2. 34), (51. 29 ±2. 45) and (25. 70 ±2.40)μmol/L at the 7,14,21 days after the stenting ( P =0. 000). In the PTCD group,plasma total bilirubin was (223. 57 ± 2. 58) μmol/L pe-stent, and decreased to ( 145. 68 ± 2. 57 ) ,(87.57 ±2.58) ,(38.65 ±2. 20) μmol/L at the 7,14,21 days after the stenting,respectively;direct bilirubin was (127. 6 ±2. 59)μmol/L pre-stent,and decreased to (79. 78 ±2. 70) ,(58. 36 ±2. 46) and (29.46 ±2. 20)μmol/L at the 7,14,21 days after the stenting,respectively ( P <0.001 ). No significant difference was found between the two groups at any time point ( P > 0. 05). Complications occurred in 34 patients in the EMBS group and the incidence rate was 20. 62% . Two or more complications occurred in 9 patients. In the PTCD group, complications occurred in 60.00% of the patients. In the EMBS group, 14 patients were failed to follow up, and 136 died. The median length was 214 days. In the PTCD group,all patients were followed up and all died,with a median length of survival of 75. 5 days. The survival analysis showed that the EMBS group survived longer than the PTCD group (P =0. 000). Conclusions EMBS placement showed better effect than PTCD. Compared to PTCD, internal drainage of metallic stents lead few complications and faster recover, and can improve the life quality and prolong survival time of patient with malignant obstructive jaundice. The placement of metallic stents is recommended as a preference for palliative therapy of malignant biliary obstruction.

ObjectiveTo recover the effect of rehabilitation therapy on the automatic nervous system(ANS)of patients with stroke. MethodsThe multiple index measurement was applied to measure ANS after stroke in 31 patients. The therapy of the Bobath,Brunnstrom and Rood were used as the basic methods for 3 months.ResultsThe balance index of the automatic nerve after treatment by the rehabilitation therapy was higher markedly than before(P<0.01).There is a correlativity with recovery of the movement function. Conclusions The rehabilitation can improve the function of automatic nerve.

OBJECTIVETo explore the perioperative cardiovascular dysfunction and its relevance to age in patients with silent coronary heart disease (or silent myocardial ischemia), and explore the clinical treatment and recovery of perioperative arrhythmias.

METHODSOne hundred and eighty cases were selected from selective surgery patients with silent myocardial ischemia (SMI). Among the cases, 130 patients older than 51 years old were divided into 51 - 60 year-old group, 61- 70 year-old group and 71 - 80 year-old group. Control group was set up by other 50 patients younger than 51 years old. Electrocardiogram data of 24 h before the operation, 24 h after the operation and 48 h after the operation were continuously monitored by dynamic electrocardiogram (DCG). The electrocardiogram data of ST shifting, arrhythmia incidences of different type and at different time were analyzed by professional doctors. At the same time, the treatment and recovery of perioperative arrhythmia were recorded.

RESULTSAs the age increase, the magnitude and duration of ST shifting appeared upward trend compared to the control group (P < 0.05, P < 0.01). The incidence of ST elevation in 71 - 80 year-old group was higher than the control group (P < 0.05). The ST depression duration in 61 - 70 and 71 - 80 year-old group and ST elevation magnitude in 71 - 80 year-old group were higher than 51 - 60 year-old group (P < 0.05). Compared to the control group, the incidence of accelerated idioventricular rhythm (AIR) in 61 - 70 year-old group and the incidence of sinus bradycardia (SB), ventricular premature beat (VPB), ventricular tachycardia (VT) in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). Compared to the 51 - 60 year-old group, the incidence of atrial fibrillation (AF) in 61 - 70 year-old group and the incidence of VP, VT, AF in 71 - 80 year-old group were higher (P < 0.05, P < 0.01). The arrhythmia incidences in 24 h after operation were higher than 48 h after operation and 24 h before operation (P < 0.01). As the age increase, the recovery incidence by removing inducement was decreased, but the recovery incidences by drug and electric-shock treatment were increased (P < 0.05).

CONCLUSIONOld SMI patients have high levels of perioperative myocardial ischemia and arrhythmia, and 24 h after operation is the period of high incidence.

Aged ; Aged, 80 and over ; Cardiovascular System ; physiopathology ; Coronary Disease ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Perioperative Period

ObjectiveTo investigate hepatocyte growth factor (HGF) levels in the tissue and serum of patients with chronic hepatitis,cirrhosis or hepatocellular carcinoma (HCC),and analyze the clinical significances of HGF for HCC.MethodSurgical specimens from 97 patients were collected during Dec.2003 to Aug.2008 in the Third Central Hospital.The patients were prospectively enrolled and categorized into four groups:normal subjects ( n =11 ),chronic hepatitis B or C ( n =6＝,cirrhosis ( n =20)and HCC ( n =60 ) including well-differentiated ( n =21 ),moderately differentiated ( n =23 ),poorly differentiated (n =16) specimens.N0 (n =24),N1 (n =21 ),N2 (n =54) and N3 (n =43) were tissues respectively removed from liver at 0,1,2 or 3 cm beyond the margin of tumor.HGF mRNA expression in liver tissues was determined by real-time quantitative reverse transcription- (RT)-PCR.Serum HGF levels in the other cases of normal subjects ( n =20),chronic hepatitis B or C ( n =20),cirrhosis ( n =20) and HCC (n =57) were measured by ELISA.The Kaplan-Meier method with log-rank test was employed for survival analysis.Univariate and multivariate analyses were performed to identify prognostic factors in each group.ResultsThe HGF mRNA in normal subjects,chronic hepatitis,cirrhosis,N3,N2,N1,N0 and HCC were0.99(0.78-1.66),2.15(1.06-3.40),1.78(1.18-2.73),4.59(2.67 -8.63),3.86 ( 2.25 - 6.45 ),3.12 ( 1.59 - 5.74 ),2.92 ( 0.88 - 5.99 ) and 0.48 ( 0.19 - 1.06 ) respectively.The serum concentration of HGF in the normal subjects,chronic hepatitis,cirrhosis and HCC patients were (0.31 ± 0.05 ),(0.65 ± 0.07 ),( 1.27 ± 0.30 ) and ( 2.06 ± 0.66) μg/L respectively.The highest level of HGF mRNA was found in N3,while the HGF mRNA expression in HCC was [ (2.14 ± 0.52 ) μg/L] lower than that not only in the non-tumor tissues,but also in the normal control ( U =196.50,P =0.03 ).The serum concentration of HGF was significantly higher in patients with chronic hepatitis,cirrhosis or HCC than in normal subjects.The serum HGF level of HCC was bounced after hepatectomy (t =2.70,P ＜0.01 ).On the logistic regression analysis,the tumor numbers and Child-pugh were related with the levels of the tissue HGF mRNA and serum HGF of HCC,OR were0.15 (95％CI:0.03-0.72,P＜0.05) and0.13 (95％CI:0.27 -0.89,P ＜0.05 ),respectively.Univariate analysis using the Cox proportional hazards model in the complication groups revealed that the levels of the tissue HGF mRNA and serum HGF were significant risk factors of death for HCC,OR were 0.02 (95％ CI:0.00 - 0.52,P ＜ 0.05 ) and 10.01 (95％ CI:1.16 -86.23,P ＜ 0.05 ),respectively.On the Log-rank analysis,no statistically difference in the cumulative survival was found between the two groups categorized by median (0.49) of tissue HGF mRNA 2 - AACT (X2 =0.13,P =0.72).While the HCC patients were dichotomized by their the median(0.69 μg/L) of serum HGF concentration,the death risk for the patients with higher levels of HGF was increased 2.84 fold than those with lower levels (95％ CI:1.03 - 7.92,P ＜ 0.05 ).ConclusionHGF mRNA expression is decreased in tumor tissues,while its level in tumor adjacent live and serum is significantly elevated and is in association with shortened postoperative survival of HCC patients.

Objective • To explore the value of stress hyperglycemia ratio (SHR) in predicting the prognosis of patients with acute myocardial infarction(AMI). Methods • A total of 434 patients diagnosed as having AMI were enrolled from October 2014 to October 2015. Immediate blood glucose, glycosylated hemoglobin (HbA1c) and SHR of each subjects were collected and calculated. Patients with and without diabetes were divided into several groups according to the occurrence of in-hospital and 2-year major adverse cardiovascular and cerebrovascular events (MACCEs). Indicators above were evaluated to predict the prognosis of patients with AMI. Results • Immediate blood glucose (P=0.003) and SHR (P=0.005) were significantly higher in MACCEs group than those in 2-year MACCEs-free group. Among AMI patients with diabetes mellitus, SHR in hospital MACCEs group was significantly higher than that in MACCEs-free group (P=0.001). Among AMI patients without diabetes, values of immediate blood glucose (P=0.001) and SHR (P=0.001) were higher in 2-year MACCEs group than those in MACCEs-free group. All-cause mortality was the highest (P=0.047, P=0.007) in the highest SHR group (three-digit relationship), no matter with or without diabetes mellitus. AMI patients with and without diabetes were further divided into two groups according to the median of SHR. High SHR could better predict in hospital MACCEs rate in AMI patients with diabetes as well as 2-year MACCEs rate without diabetes (P=0.023, P=0.000). Conclusion • Abnormal stress hyperglycemia is a risk factor of long-term poor prognosis in AMI patients. The value of SHR is more valuable in predicting the poor prognosis of AMI than immediate blood glucose, no matter the patients with or without diabetes.

Objective • To explore the safety and feasibility of using sutureless technique of argon beam coagulator in laparoscopic partial nephrectomy. Methods • A total of 10 patients receiving laparoscopic partial nephrectomy with argon beam coagulator in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from October 2016 to October 2017 were selected. The clinical efficacy and safety of the operation was retrospectively analyzed. Results • The average age of the 10 patients was 50.4 (24.0-73.0) years, the average size of the tumor was 2.1 (1.5-2.5) cm, and the average RENAL score was 5. All of the 10 patients underwent intraoperative renal artery occlusion. Intraoperative scissors were used to completely remove the tumor and remove the tumor bed after the resection. Then the argon beam coagulator was repeatedly used for hemostasis. After hemostasis was completed, the hemostatic gauze was covered on the surface of the tumor bed. The mean operation time was 95.0 (60.0-108.0) min, and the average thermal ischemia time of the renal artery occlusion was 7.8 (5.5-10.0) min. The average blood loss was 86 (50-150) mL during the operation. The average decrease of hemoglobin was 11.8 (3.0-22.0) g/L on the first day after operation. The mean indwelling catheterization time was 2.7 (1.5-3.5) d, the average time of hospitalization was 5.2 (4.0-7.0) d, the extraction time of drainage tube after operation was 2.6 (1.0-4.0) d, and the flow rate was 38.5 (10.0-80.0) mL. Conclusion • Argon knife spray coagulation has good efficacy and safety in patients with renal tumor renal resection, especially for some exophytic renal tumors, which has short operation time, less damage of hot ischemia, good postoperative effect, no increase in hospitalization time after surgery, reduced economic burden of the patients, being worthy of popularization and application.

Objective: To compare the clinical efficacy of cross puncture technique with traditional puncture technique in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: Patients with OVCF treated with percutaneous vertebroplasty (PVP) were selected. According to the puncture method, the patients were divided into cross puncture group and traditional puncture group, with 70 cases in each group. The clinical data, imaging parameters, pain score, dysfunction score, overall satisfaction and related complications of the two groups were compared before and after operation, and the clinical efficacy of the two groups was evaluated. Results: Compared with the traditional puncture group, the wedge angle in the cross puncture group decreased at 6 and 12 months after operation (both P=0.000), while the leading edge height increased (P=0.012, P=0.000). During the follow-up, there was no significant difference in pain score and dysfunction score between the two groups. Compared with the traditional puncture group, the proportion of the excellent and great grades (Odom standard) of patients in the cross puncture group was higher (P=0.000, P=0.003), and the incidence of vertebral collapse, kyphosis deformity and spinal stenosis were lower (P=0.000, P=0.002, P=0.031). Conclusion: At 6 and 12 months after operation of cross puncture PVP, the follow-up changes of wedge angle and leading edge height of vertebral body were smaller than those of traditional puncture technique, that is, more stable. The incidence of vertebral collapse was lower, and the overall satisfaction of the curative effect was higher.

Objective To identify the different causes of atrial fibrillation (AF) in Chinese by coronary artery angiography,and to compare the episode of stroke in different patients.Method A total of 782 adult patients diagnosed with AF were identified from Anzhen Hospital over a 8-year period.There were 273 patients with rheumatic valvular AF and 509 patients with nonvalvular AF.The results of electrocardiogram,echocardiography and coronary artery angiography were retrospectiwely analyzed to find out the proportion of causes and to compare the episode of stroke in patients with rheumatic valvular AF with those having nonvalvular AF.Results The patients with rheumatic valvular atrial were significantly younger than of coronary heart disease (52.40?5.03 years old vs 64.30?3.25 years old,P