Objective:To study the clinical value of ginkgobiloba extract in the treatment of epilepsy.Method:68 patients were divided into two groups,the control group and the treatment group. The patients in the control group were treated with sodium phenytoin,tegretol,or diazepam. In the treatment group,ginkgobiloba extract was given in addition to the antiepilepsy drugs used in the former group.Results:In the treatment group,the total effective rate were significantly higher than that of the control group (P＜0.05).Conclusion:Ginkgobiloba extract was a safe and effective addition to the pool of antiepilepsy drugs.

Objective To explore curative effect of Xiyanping and vidarabine in treatment for children with viral encephalitis and its impact on T cells subgroup.Methods Methods In June 2012~October 2014, randomly selected 106 cases of children patients with viral encephalitis, as the research object.Randomized divided into observation group (n=53) cases, control group(n=53).Both two group were performed routine therapy, and then control group was given Xiyanping treatment, observation group was given Xiyanping combined with vidarabine treatment.1 continuous week treatment, compared two groups of T cell subgroup number and symptoms disappear time.Results In the two groups after treatment of T cell subgroup CD3 +, CD4 +,CD8 +was significant increase in the number of observation group increased number was significantly higher than the control group,and statistically significant differences ( P<0.05 ) .The observation group’s antifebrile time ( 2.5 ±1.1 ) d; headache, vomiting disappear time ( 3.6 ±2.2 ) d;disturbance of consciousness disappear time (2.6 ±1.3) d and length of hospital stay (9.3 ±2.4) d were significantly lower than the control group (4.7 ±2.8) d, (6.5 ±2.3)d, (4.3 ±2.2) d, (14.2 ±3.6) d, which were statistically significant differences (P<0.05).Observation group’s curative effect for instituting accounted for 73.58%, good rate 92.45%, were significantly higher than the control group 52.83%, 77.36%.which were statistically significant differences (P<0.05).The complication rate of observation group was 16.98%, mortality was 0%,were significantly lower than that of 33.96%, 9.43% of the control group;Cure rate of observation group (90.57%) was significantly higher than that of 49.06% of control group. Observation group severe sequela incidence 11.32% was significantly lower than that of 39.62% of control group and statistically significant differences (P<0.05).Conclusion Xiyangping combined with vidarabine in treatment for children with infantile viral encephalitis can significantly increase the number of T cell subgroup, improve immune function in children with, and curative effect is remarkable and high security.

Objective To investigate the influence of neoadjuvant chemotherapy on the occurrence of postoperative nausea and vomiting ( PONV) after radical mastectomy. Methods A total of 286 breast cancer patients, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective modified radical mastectomy under general anesthesia in our hospital, were divided into either non?chemotherapy group ( n=106 ) or neoadjuvent chemotherapy group ( n=180 ) . General anesthesia was induced with iv propofol 2 mg∕kg, rocuronium 0. 6 mg∕kg and sufentanil 0. 2 μg∕kg. The patients were endotracheally intubated. The concentration of sevoflurane inhaled was adjusted according to the value of bispectral index, and bispectral index value was maintain at 40-50. Ondansetron 8 mg and flurbiprofen axetil 100 mg were injected intravenously at 30 min before the end of surgery. If vomiting occurred for 2 consecutive times, and continuous nausea and vomiting appeared from the time point after extubation to 24 h after surgery, and the patients required treatment, rescue medication was used. The occurrence and severity of PONVwithin 24 h after surgery and requirement for rescue medication were recorded. Results Compared with non?chemotherapy group, the incidence of PONV within 24 h after surgery and requirement for rescue medication were significantly increased, and the severity of PONV was aggravated in neoadjuvent chemotherapy group (P<0.05). Conclusion Neoadjuvant chemotherapy before surgery can increase the risk and severity of PONV after modified radical mastectomy.

BACKGROUND:Recently,the development of tissue-engineered technique lms broadened the study of artificial esophagus.Some investigators have inoculated esophageal epithelial cells cultured in vitro onto compound polymer material and successfully constructed tissue-engineered esophagus.OBJECTIVE:To investigate the feasibility of tissue-engineered artificial esophagus by combining dog esophageal epithelail cells and an acelhilarized porcine thoracic aorta allogenic matrix.DESIGN:An experimental observation.SETTING:Central Laboratory,Taishan Medical College.MATERIALS:This study was carried out in the Central Laboratory.Talshan Medical College from June to December in 2004.Three hybrid dogs,24-hour-old,were provided by the Laboratory Animal Center,Taishan Medical College.The protocol was performed in accordance with ethical guidelines for the use and care of animals.The experimenhal instruments and reagents were as follows:CO2 incubator(MCO-15AC,SANYO),hypothermal high-speed centrifuge(RC-26,Dupont),trypsin,transferrin,type Ⅱ collagenase(Gibco),dulbecco's modified eagle's medium(DMEM),DispaseⅡ isolated enzyme,and rat monoclonal anti-keratin antibody(Sigma).METHODS:Acellularization of porcine aortas was performed by a method of enzyme-detergent.Esophageal epithelial cells of hybrid dogs were in vitro isolated,cultured and proliferated.Next,they were inoculated onto an acellularized porcine thoracic aortas allogenic matrix seaffold.Three and seven days later,the growth of esophageal epithelial cells on the acellularized matrix was observed under an electron microscope.MAIN OUTCOME MEASURES:Morphology of esophageal epithelial cells cultured in vitro;Biocompatibility of acellular matrix and dog esophageal epithelial cells.RESULTS:The acellularized procedure resulted in an almost complere removal of the cells and the loose three-dimensional matrix.The acellular matrix could be reseeded with expended esophageal epithelial cells in vitro.and esophageal epithelial cells had the potential of spread and proliferation.CONCLUSION:Acellular matrix possesses satisfactory biocompatibility for allogenic esophageal epithelial cells.Tissue-engineered artificial esophagus can be generated in vitro by a combination of esophageal epithelial cells and allogenic aceilularized matrix.

Objective:To investigate the impact of human umbilical cord-derived mesenchymal stem cells on the activation ,the survival of human peripheral blood mononuclear cell ( hPBMC) and the proportions of each human lymphoid subgroup .Methods:PB-MC were isolated from healthy donors by density gradient centrifugation , then cultured in MSC-CM as treatment group after being acti-vated by OKT3.Each lymphoid subgroup proportion was analyzed by flow cytometry to observe the difference between treatment and control group .The effect of MSC-CM on activated PBMC for the production of IFN-γand IL-10 were tested by ELISA .The level of ap-optosis was assessed by flow cytometry with Annexin-V/PI as fluorescent marker .Results:Compared with the control group , MSC-CM down-regulated the ratio of CD4 +T cell to CD8 +T cell, and increased the proportion of CD4 +CD25 +CD127low Treg cell, thus other subgroup had no significant difference .MSC-CM inhibited the production of IFN-γby PBMC, but promoted the secretion of IL-10, and protected PBMCs from apoptosis when activated with OKT 3.Conclusion:hUC-MSC may play a role of immunosuppression by promo-ting the proliferation and activation of Treg cell .This kind of inhibitory activity is neither relied direct or indirect contact with the lym -phocytes , nor influenced by inducing immune cells apoptosis .

Objective:To establish a scientific and practical evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke based on three-dimensional quality model, so as to scientifically evaluate the nursing quality in thrombolytic period.Methods:Based on the three-dimensional quality structure model, read the literature related to intravenous thrombolysis in ischemic stroke patients, and used semi-structured interview to construct the framework of nursing quality evaluation index system for patients with ischemic stroke during thrombolytic period. Delphi method was used for expert consultation, and the results were analyzed.Results:The positive coefficient of the two rounds of expert consultation was 100%, and the degree of authority in the first round was 0.881, and that in the second round was 0.879. The coefficient of variation of 10 second level indexes and 51 third level indexes were all smaller than 0.15.The second round of coordination coefficients were 0.504 for the first-level index, 0.509 for the second-level index, and 0.541 for the third-level index. The chi-square test was all P<0.001.The weight values of structural quality, process quality and result quality indicators were 0.189, 0.601, 0.210, respectively. The evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke was constructed, including 3 first level items (structure quality index, process quality index, result quality index), 10 second level items and 51 third level items. Conclusions:Consulting experts are highly motivated, authoritative, and coordinated. It also provides managers with standard and practical tools for evaluating the quality of intravenous thrombolytic care for ischemic stroke.

OBJECTIVE: To evaluate the relation of EB virus latent membrane protein-1 (LMP-1) and the phenotype of epithelial-mesenchymal transition (EMT) and cervical lymph node metastasis in nasopharyngeal carcinoma. METHOD: Based on histopathology and MRI imaging, nasopharyngeal biopsy tissues from 88 patients with nasopharyngeal carcinoma were divided into 3 groups: pathologic metastasis (18), MRI metastasis(40) and without metastasis (30). The expressions of LMP-1, STAT3, Twist, E-Cadherin and Vimentin were examined immunohistochemically in biopsy tissues. RESULT: LMP-1 expression was found in 35 of 88 biopsy tissues with a positive rate of 38.7%. The positive rates of LMP-1 in groups of pathologic metastasis, MRI metastasis and without metastasis were 38.9% (7/18), 47.5% (19/40) and 30.0% (9/30), respectively, and significant difference were not found among three groups. The expression of LMP-1 was positively correlated to both expressions of Twist and Vimentin (r = 0.276 and 0.282, are P < 0.01), but not to both expressions of STAT3 and E-Cadherin. The positive expressions or abnormal expression of STAT3, Twist, Vimentin and E-Cadherin were found in 57 of 88 (64.8%), 48 of 88 (54.5%), 22 of 88 (20.0%)and 53 of 88 (60.2%), respectively. Significant differences in the expression of STAT3, Twist, Vimentin and E-Cadherin were all found among groups of pathologic metastasis, MRI metastasis and without metastasis, respectively (are P < 0.05). The expression of STAT3 was positively correlated to both expressions of Twist and Vimentin (r = 0.712 and 0.316, P < 0.01). CONCLUSION EMT plays important role in cervical lymph node metastasis in nasopharyngeal carcinoma. LMP-1 may be only as one of upstream factors associated with the EMT, but not the decisive factor for cervical lymph node metastasis.
Adult ; Aged ; Aged, 80 and over ; Cadherins ; metabolism ; Epithelial-Mesenchymal Transition ; Female ; Herpesvirus 4, Human ; metabolism ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; virology ; Neck ; pathology ; Nuclear Proteins ; metabolism ; STAT3 Transcription Factor ; metabolism ; Twist-Related Protein 1 ; metabolism ; Vimentin ; metabolism ; Viral Matrix Proteins ; metabolism ; Young Adult

Objective To establish new classification criteria for early rheumatoid arthritis (E-RA) based on large samples of early inflammatory arthritis patients and to evaluate the value of this criteria in China.Methods Patients who had arthritic complaints with disease duration less than one year were enrolled.They were divided into RA group and non-RA group according to the clinical diagnosis by experienced rheumatologists.The clinical and laboratory parameters were analyzed and those with high sensitivity or specificity were selected as the new classification criteria.Statistical analysis was carried out by using t test,x2 test and Logistic regression.Results ① A total of 803 patients with early inflammatory arthritis were included in this study.Five hundreds and fourteen patients were diagnosed as early RA and 251 were diagnosed as other rheumatic diseases,and the diagnosis of 38 patients remained unestablished by the end of follow-up.② New E-RA classification criteria were established based on the parameters with high sensitivity and/or specificity.The sensitivity of the new E-RA criteria was 84.4％,which was higher than 1987 ACR criteria (58.0％),while the corresponding specificities were similar,which were 87.4％ and 93.6％ respectively.③ Compared with the complex scoring system of 2010 ACR/EULAR criteria,the E-RA criteria was more simple and practical.The diagnostic sensitivity and specificity of E-RA criteria were higher than those of 2010 ACR/EULAR criteria reported in the literatures.④ New classification criteria based on scoring system using Logistic regression analysis was established.The sensitivity of this criteria was 86.4％,which was higher than 1987 ACR criteria (58.0％).Conclusion The diagnostic value of the E-RA criteria developed in this study for early RA is better than 1987 ACR criteria,and is more simple than 2010 ACR/EULAR criteria.It may be used as a new classification criteria for early RA diagnosis.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.