Objective To observe the detection methods of cerebral vasospasm after traumatic brain injury and the impact on prognosis.Methods Twenty patients with traumatic brain injury underwent transcranial Doppler ultrasound were divided into cerebral vasospasm group and control group.Results There were 7 patients combined with cerebral vasospasm and 13 patients without cerebral vasospasm.Two patients died in cerebral vasospasm group and 1 patient died in control group.The fatality rate between two groups had significant difference (P ＜0.05).All surviving patients followed up for 1 year after being discharged.According to the Glasgow Outcome Scale,in cerebral vasospasm group,3 patients were with severe disability,1 patient was with moderate disability,1 patient restored good function.In control group,2 patients were with severe disability,2 patients were with moderate disability,8 patients restored good function.The rate of restored good function between two groups had significant differences (P ＜ 0.05).Conclusions Cerebral vasospasm can increase mortality in traumatic brain injury patients,and the functional evaluation in survival patients are even worse.Prevention of cerebral vasospasm after traumatic brain injury has important clinical significance.

MicroRNAs (miRNAs) are small non-coding RNA molecules with 21 to 24 nucleotides in length, which can regulate post-transcriptional gene expression by interacting with the 3' untranslated regions of the target mRNAs. MiRNAs are widely expressed in eukaryotic cells and involved in a variety of biological processes, such as in the development, differentiation, proliferation, and apop-tosis of cells. They also play essential roles in cell cycle regulation, migration, and tumor development. MicroRNA expression varies in different human tumors and is considered a powerful potential biological indicator in the development, diagnosis, treatment, and progno-sis of cancers. Breast cancer is one of the most common malignancies, and miRNA expression has been found to be differentially ex-pressed in various types of breast cancer. The expression and function of some miRNAs involved in breast cancer development, metasta-sis, and treatments are briefly summarized in this review.

This paper introduced the current situation of cardiac interventional therapy and put forward the fol-lowing points that medical staffs should pay attention to:the patient's right to know, right to be informed, right of communication, right of privacy, and etc. On this basis, it is suggested to solve the ethical issues in cardiac inter-ventional therapy through the implementation of clinical pathway, effective communication, humanistic care, the construction of occupational ethics, strict feedback and supervision.

Objective To study the relationship between the level of serum total bile acid(TBA)and fetal distress of intrahepatic cholestasis pregnancy(ICP).Methods 357 patients with ICP were devided into two groups,fetal distress group and non-fetal distress group.Their levels of TBA were collected retrospectively.Results The incidence rates of fetal distress rose with the increasing level of TBA.As the level of TBA was over 35umou/L,the incidence rates of fetal distress rose significantly.Conclusion The study suggest that the level of TBA maybe one of sensitive marker to preditect fetal distress.

Humans ; Neuroma, Acoustic ; surgery ; therapy

Objective To observe the clinical manifestations,therapeutic efficacy and results of bacterial culture of seven patients of scleral buckle (SB) infection after scleral bulking surgery.Methods Seven patients (seven eyes) underwent SB removal for SB infections were enrolled in this study.The patients included four males (four eyes) and three females (three eyes).The patients aged from 12 to 69 years,with a mean age of 42.7 years.There were four right eyes and three left eyes.The duration (interval between primary surgery and SB removal) ranged from two weeks to ten years,with a mean of 47.5months.Six patients were concurrent with systemic disease.All the patients were examined for visual acuity,slit lamp microscope and indirect ophthalmoscope examination.Some patients also received external eye examination and fundus photography.Whether SB exposure or not and the clinical manifestations were observed.SB removal was performed in all the patients and the SB were sent to the laboratory for bacterial culture.The follow-up time ranged from two weeks to eight months,with a mean of 3.2 months.Whether infections recurrence and retinal detachment or not were observed.Results SB exposure was in three eyes.Obvious ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes; irritation and discharge were in one eye.No SB exposure was in four eyes.Ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes.Repeated subconjunctival hemorrhage and diplopia were presented in one eye.Visual acuity decline,conjunctival sac discharge and total retinal detachment were in one eye.All patients had no intraocular inflammation.The infection was controlled after SB removal and the retina was attached during the follow up.The bacterial culture were all positive,which included Staphylococcus aureus,Staphylcoccus epidermidis and Erysipelothrix rhusiopathiae,Gram positive corynebacterium,Aspergillus flavus,Kocuria roseus,Streptococcus oralis,Maxwell Corynebacterium.Conclusions The clinical manifestations of SB infection and the pathogenic microorganisms are variable.SB removal can control the infection.

BACKGROUND: Post-stroke depression(PSD) is the most common emotional change after stroke. It has high morbidity, which also seriously affects the near and long term functional prognosis of the patients and affects the quality of life (QOL) of the patients during convalescence.OBJECTIVE: To investigate the impacts of integrated rehabilitative therapy on post-stroke depression and ability of daily life(ADL) through interventional therapy in patients with post-stroke depression.DESIGN: A randomized controlled study with the patients as subjects basedon diagnosis.SETTING: Department of cadre in a university hospital.PARTICIPANTS: Sixty cases including 34 males and 26 females hospitalized in the Department of Cadre of the General Hospital Affiliated to Tianjing Medical University between October 2001 and March 2002 were randomly divided into rehabilitation group( n = 30) and control group( n = 30).INTERVENTIONS: Patients of rehabilitation group received both routine medication and integrated rehabilitative therapy (cinesiotherapy + psychotherapy) while the patients of control group only received routine medication(decompression, improving cerebral circulation and symptomatic therapy) . Barthel index(BI) and Hamilton rating scale for depression(HAMD)were used to assess the patients at admission, the 3rd month and the 6th month during the course of the disease.MAIN OUTCOME MEASURES: BI and HAMD score at the 3rd and 6thmonth in patients of rehabilitation group and control group.RESULTS: BI at 3rd month or 6th month was (68.0 ± 2.9) or (70.0 ± 3.5)in patients of rehabilitation group, which was significantly higher than (62.0±3.3) at 3rd month and (65.0±3.8) at 6th month in patients of control group( P ＜ 0. 001, 0. 01) . HAMD score at 3rd month or 6th month was(8.9 ±4.9) or(8.7 ±5.1) in patients of rehabilitation group, which was significantly lower than(15.2 ±5.6) at 3rd month or(14. 9 ±8. 1) at 6th month in patients of control group ( P ＜ 0.05).CONCLUSION: Integrated rehabilitative therapy can effectively improve the ADL of patients with post-stroke depression and relieve depression.

This paper described the practice of real-time booking registration, in which the patients may freely choose their visit time points, by such means as the outpatient clinic, website, telephone or short messaging. Such booking registration is an important measure to improve service quality at outpatient clinics; information technology is a prerequisite for real-time booking registration; pooling of outpatient ID number resources is key to setting up the booking registration; the prepaid card deposit practice makes booking registration more efficient; enhanced management for supporting services safeguards booking registration; cooperation with qualified third parties is an effective way to accomplish booking registration in a convenient manner. This paper also probed into other issues in relation to real-time booking registration.

Objective To investigate the effects of unilateral and bilateral electrical stimulation of the upper and lower limbs on motor function following cerebral infarction and the expressions of microtubule-associated protein-2 (MAP-2) and survivin in the infarction border zone of rats. Methods Adult male Sprague-Dawley (SD) rats were randomly divided into sham operation, control, impaired limb and bilateral limbs electrical stimulation groups (each group included 32 rats). Acute cerebral infarction was mimicked using a middle cerebral artery occlusion tech-nique. After cerebral infarction for 24 h, the rats were treated daily with or without electrical stimulation. A beam walking test (BWT) was used to measure limbs motor function and immunohistochemistry and HE staining were used to detect the expressions of MAP-2 and survivin in the border zone of infarcted area after electrical stimulation treat-ment for 3, 7, 14 and 21 d. Results Comparet with the control group treatment with electric stimulation led to BWT scores increasing significantly, and bilateral stimulation was more potent in ameliorating motor function thanstimulating the impaired limb only. The expression of MAP-2 was significantly higher in eleetrieal stimulation groups than in control group from the 7th of treatment, and it was higher in bilateral stimulation group than that in unilateral stimulation group from tbe 14th day of treatment. There was no significant difference in MAP-2 expression between bi-lateral stimulation group and sham operation group at the 21st day of treatment. In electrical stimulation groups, at every time point the expressions of survivin were obviously higher than that in sham operation group, and it was higher than that in control group and peaked at the 7tb and 14th day of treatment and in bilateral stimulation group it was no-tably higher than that in unilateral stimulation group. At the 21st d of treatment the level of survivin expression drop-per; however, there was no significant difference between unilateral and bilateral electrical stimulation groups. Con-clusions Treatment with electrical stimulation, particularly in bilateral limbs stimulation, could induce MAP-2 and survivin expressions in the infarction border zone of rats. It also could promote the recovery of motor function in para-lyzed limbs after cerebral infarction of rats. The improvement might involve the up-regulation of MAP-2 and survivin expressions.

Background and purpose:Lung cancer is one of most common diseases,The number of new cases of lung cancer are more than 500 000 per year in the world and it has been ranked as number one in terms of incidence of malignant tumors in China.Unfortunately about 40 percent of the patients were diagnosed as locally advanced unresectable non-small cell lung cancer(NSCLC).Elderly patients with NSCLC also showed an increasing trend in the past years.The purpose of this study was to evaluate the efficacy and safety of gemcitabine(GEM) and carboplatin(CBP) used as induction regimen in the treatment of elderly patients with locally advanced unresectable NSCLC.Methods:42 cases of elderly patients have been cytologically and pathologically confirmed with locally advanced unresectable NSCLC,the age of the patients ranged from 65 to 75.The patients were treated with the combined regimen of gemcitabine and cisplatin.GEM 1 000 mg/m2 intravenously injected by drip on the 1st,8th day and the dosage of CBP was AUC 5 that was used on the 1st day,21 days apart to each cycle,most patients received 2-3 cycles.Treatment response was evaluated according to the criteria of RECIST(Response Evaluation Criteria in Solid Tumor),the side effect of the regimen was judged based on WHO criteria.Results:42 patients were evaluable and received a total of 89 cycles chemotherapy.There were no complete regression that could be observed,but 17 cases had partial regression(PR),22 cases with no change(NC) and 3 cases with progression disease(PD).The overall response rate was 40.5%.The main side effects were hematological toxicity.Conclusions:The GC regimen could be used as induction treatment for elderly patients with locally advanced unresectable NSCLC,and the regimen could be well tolerated and is safe in terms of side effects.