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.

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.

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.

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.

AIM:To compare the analgesic efficacy and safety of intravenous morphine or epidural morphine combined with bupivacaine in postoperative children.METHODS:48 children scheduled for selective inferior belly or lower limb surgery under general anaesthesia or epidural anesthesia for ASA I or II,age from 3 to 10 years old,were randomly divided into 3 groups(n=16 each).Group A was given intravenous morphine for postoperative analgesia,group B was given epidural morphine in combination with bupivacaine,group C was given nonsteroidal anti-inflammatory drugs orally or pethidine intramuscularly in need as the control group.When the patients were fully awake in the recovery area,heart rate(HR),blood pressure,peripheral oxygen saturation(SpO2),respiratory rate and pain were recorded at 2,4,8,12,24 and 48 h postoperatively,side-effects were also noted.Pain was assessed using an objective pain score(OPS).RESULTS:There was no significant difference of OPS between group A and B,and the efficacy and duration of analgesia in group A and B were significantly better than those in group C(P

Objective To investigate the association adiponectin gene polymorphism with primary macroangiopathy in diabetes mellitus. Methods Type 2 diabetes mellitus (T2DM) patients were included, 56 patients complicated with atherosclerosis (AS) and 120 non-AS group. We evaluated their Gly15Gly polymorphism of adiponectin gene by PCR restriction fragment length polymorphism (PCR-RFLP). Results The AS patients were more likely to have GG genotype than the non-AS patients (25.0% vs 6.2%, P

Objective To investigate the relationship between diagnosis and treatment of the primary peritoneal carcinoma(PPC)and its prognosis.Methods The clinical materials of 10 women,who were diagnosed with PPC,were analyzed retrospectively from Mar.2000 to Nov.2006.Results We found that PPC has lower rate of incidence,higher rate of wrong diagnosis,wider spread in pelvis cavity and abdominal cavity and had no significant clinical signs and symptoms specificity.All of the patients needed cytoreductive surgery,but the majority of rudimental focus diameter is larger than 2 cm.After the operation,platinum combined other chemotherapeutic drug were needed.Conclusion Abdominal distention,ascites,abdominal pain are the main symptoms and signs of PPC.we need choose cytoreductive surgery as much as possible.Extra trauma to patients will affect restoration and survival time of patients and the effect of chemotherapy.We also found the effect of abdominal cavity chemotherapy may be better than that of chemotherapy in vein.