Objective To investigate the useful parameters of transthoracic echocardiography (TTE) for the diagnosis of stroke subtypes in patients with acute cerebral infarction.Methods One hundred and one acute ischemic stroke patients met all of the following criteria including ≥50 years of age,normal sinus rhythm on admission,and transesophageal echocardiography (TEE) within 7 days from the onset.The clinical significance of the TEE parameters on admission was examined for identifying intracardiac thrombus formation as follows; left atrial dimension,left ventricular end-diastolic dimension,percentage fractional shortening,left ventricular mass index,ratio of the transmitral inflow velocities (E/A),and the deceleration time of the E wave.Results There were 28 patients with E/A ≥ 1.0 (70 ± 12) years old and 73 with E/A ＜ 1.0 (73 ± 10) years old.No patients showed pulmonary congestion on chest radiography.There were no significant differences in age,TTE parameters,and plasma levels of brain natriuretic peptide between the two groups.Patients with E/A≥ 1.0 had higher incidence of left atrial appendage (LAA)thrombus formation and/or spontaneous echograhic contrast than those with ＜ 1.0 (25.0％ vs 5.5％,x2 =7.95,P ＜0.01).A significant relationship was found between E/A and emptying flow velocity of the LAA (r =-0.569,P ＜0.01).Multivariate logistic regression analysis showed E/A was an independent predictor for LAA thrombus (risk ratio 1.531 per0.1 increase,95％ confidence interval 1.129-2.076,P =0.0002).Conclusions Increased level of E/A on admission was associated with the occurrence of left atrial appendage thrombus formation in patients with acute ischemic stroke.

ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

OBJECTIVE: To explore the efficacy of the cognitive behavior therapy (CBT) for the treatment of chronic subjective tinnitus. METHOD: One hundred and fifty-seven patients were randomly divided into two groups. Sixty-eight patients of the control group were treated by masking therapy; and the other 89 patients of the experimental group were treated by CBT therapy. The score of tinnitus handicap inventory (THI) was utilized to analyze the treatment efficacy in the two groups respectively. RESULT: The effective rate assessed by of THI score in the experimental group was not significantly higher than the control group 2 months after treatment (P > 0.05), but was significantly higher than the control group 6 months and 12 months after treatment (P < 0.05 respectively). CONCLUSION The CBT therapy contributed to achieve rapid adaptation of tinnitus feeling, which shows great value of further clinical application.
Cognitive Behavioral Therapy ; Humans ; Tinnitus ; psychology ; therapy ; Treatment Outcome

Objective To investigate the prevalence of adult osteofluomsis in the endemic fluomsis areas in Tianjin and to provide scientific foundation for endemic fluorosis.Methods Stratified sampling in 55 villages were selected in 3 areas with slight,moderate and severe fluorosis regions in Tianjin from April to June in 2008.Water fluorine were tested and clinical osteofluorosis examinations were conducted to the population aging 16 and above in the villages.Tweenty villages were selected randomly in the slight,moderate and severe fluorosis regions.X-ray osteofluorosis examination were conducted to patients and suspected patients in these 20 villages.Results The geometric mean fluoride content in the water for the 3 areas were 1.35 mg/L,3.44 mg/L,5.49 mg/L,respectively.The prevalence of osteofluorosis were 36.7%(44/120),20.6%(33/160),39.4%(43/109),respectively.The prevalence of osteofluorosis Was increased gradually(r=0.534,P<0.01)and the symptoms and signs of the disease were more serious(H=84.813,P<0.01).The prevalence of X-ray diagnosis Was increased gradually(r=0.990,P<0.01)and signs of the disease were more severe(H=25.169,P<0.01)with an increase in age.There was no statistical significance of prevalence rate of osteofluorosis between males and females,regardless if it Was a clinical diagnosis(X2=0.343,P>0.05)or an X-ray diagnosis(X2=3.532,P>0.05).Conclusions Adult osteofluorosis to a certain extent is still prevalent in the fluorosis areas in Tianjin.Endemic fluorosis is still rampant.Improving water in fulorosis areas should be mandatory.

OBJECTIVETo investigate the growth activity of osteoblast on a novel strontium incorporated calcium sulfate and make comparison with normal calcium sulfate material.

METHODSOsteoblast was inoculated on samples and cell proliferation was measured on the 1st, 3rd, 5th days, and the activities of ALP and osteocalcin were observed on the 5th day. And microcosmic morphology of osteoblast was observed by scanning electron microscopy(SEM).

RESULTSOsteoblast grows robustly on tested material. Cell quantity on the surface of novel material was obviously higher than normal calcium sulfate material (P < 0.05). The activity of ALP and osteocalcin on novel material was 57.8% and 40.2% higher than on normal calcium sulfate material respectively (P < 0.05). On strontium incorporated surface, osteoblast spread well. Cells were polygonal with abundant cytoplasm and the morphology was active.

CONCLUSIONStrontium incorporated calcium sulfate can sustain robust growth activity of osteoblast, which is promising to be used for bone substitute materials.

3T3 Cells ; Alkaline Phosphatase ; metabolism ; Animals ; Bone Substitutes ; chemistry ; pharmacology ; Calcium Sulfate ; chemistry ; pharmacology ; Cell Proliferation ; drug effects ; Mice ; Osteoblasts ; cytology ; drug effects ; metabolism ; Osteocalcin ; metabolism ; Strontium ; chemistry

OBJECTIVETo explore the factors associated with perinatal death of hepatic diseases in pregnancy (HDIP) and make feasible suggestions and measures for perinatal care of high risk patients.

METHODSThe 80 perinatal death cases of hepatic diseases in pregnancy (HDIP) during 1991-2000 in our hospital were analyzed retrospectively.

RESULTSThe perinatal mortality of HDIP in our hospital during the last 10 years was 17.99 approximately 65% was in utero death. Perinatal mortality was different between male (21.64%) and female (10.11%) (P<0.01). Compared first 5 years with last 5 years author found that the perinatal mortality of HDIP had no significant decrease (P>0.05). The perinatal mortality in city and suburbs had decreased, while in the floating population from other provinces the perinatal mortality had increased. The perinatal death was mainly caused by pregnancy induced hypertension (PIH) and asphyxia. But for the HBV carrier mothers the causes of death included umbilical cord problems, premature rupture of membrane and asphyxia.

CONCLUSIONSThe perinatal death mortality was increased by HDIP, deaths were essentially associated with pregnancy induced hypertension and asphyxia and the floating population and male gender were high risks. To enhance the management of HDIP or immigration, take effective therapies of hepatitis and improvement of resuscitation of newborns are critically important.

Adolescent ; Adult ; Cause of Death ; Female ; Fetal Death ; epidemiology ; Fetal Distress ; etiology ; mortality ; Humans ; Infant Mortality ; Infant, Newborn ; Liver Diseases ; complications ; mortality ; Male ; Pre-Eclampsia ; complications ; mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Retrospective Studies ; Sex Factors

Objective To investigate the consumption status of iodized salt and iodine nutrition status of Tianjin residents,and to provide a scientific basis for iodine supplementation.Methods Sampling methods:① Salt iodine:According to The National Project of Surveillance on IDD,the iodine in salt samples from 18 Tianjin districts (counties) was tested between 2002 to 2011.②Iodine nutritional status of children:Investigation of iodine nutritional status of children was conducted four times in 2002,2005,2009 and 2011.In 2002 and 2005,two primary schools were selected in each district.By age,gender parity principle,40 subjects aged from 8 to 10 in each school were randomly selected to perform thyroid examination and 20 of them were selected to collect urine samples for determination of urinary iodine.In 2009,according to their sub-area positions in the north,the south,the east,the west and the center of each district,5 primary schools were selected in each town (if there were less than five towns in the district,all towns had been selected).Twenty subjects aged from 8 to 10 in each school were selected to collect urine samples for determination of urinary iodine.In 2011,probability sampling method (PPS) was used to select 30 primary schools,and then 40 children aged from 8 to 10 were randomly selected in each school to examine thyroids.At the same time,urine samples from 12 children of the 40 selected children were tested.③Iodine nutritional status of women of childbearing age:In 2007,2008 and 2010,150,50 and 60 women of childbearing age were selected in Hangu District,urine samples of them were collected for determination of urinary iodine.④Iodine nutritional status of pregnant and lactating women:In 2011,3 towns around each primary school were selected.Five pregnant and five lactating women were selected in each town,urine samples of them were collected for determination of urinary iodine.Test methods:①Salt iodine was tested by direct titration,while Sichuan salt and other reinforced edible salt by arbitration determination based on the General Test Method in Salt Industry-Determination of Iodide Ion (GB/T 13025.7-1999).②Thyroid was tested by B-type-ultrasound and judged according to Diagnostic Criterion of Endemic Goiter (WS 276-2007).③Urinary iodine was tested by the Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006).Results From 2002 to 2011,the consumption rate of qualified iodized salt,the rate of qualified iodized salt,the coverage rate of iodized salt,the rate of non-iodinated salt was 92.7％(43 489/46 926),97.4％(43 489/44 694),95.1％ (44 694/46 926) and 4.8％(2273/46 926),respectively.The median salt iodine was in the range of 29.2-36.7 mg/kg.Children's urinary iodine was monitored 4 times,the median urinary iodine was 228.0,221.5,191.8; and 194.7 μg/L,respectively.Children goiter rates were 2.1％(27/1258),1.6％(19/1186) and 2.1％(26/1219) of the 3 times monitored.The median urinary iodine in pregnant and lactating women was 145.2 and 136.0 μg/L.The median urinary iodine in women of childbearing age was 130.7,196.1 and 229.5 μg/L,which increased with the increase of coverage of iodized salt.Conclusions The iodine nutrition of Tianjin residents,women of childbearing age and lactating women are at appropriate level.The iodine nutrition of pregnant women is lower than appropriate level.Recommended salt iodine level in our city is 30 mg/kg,or 25 mg/kg for ordinary residents,and 30 mg/kg for pregnant women.

Objective To explore the diagnostic significance of differential cell count in induced sputum to chronic cough and assessment of airway inflammation.Methods The sputum of 335 chronic cough patients were induced.Differential cell counts were measured in these samples.The side effects were observed during the induced procedure.The final diagnosis was made based on clinical manifestation and examination findings including pulmonary function tests,provocation test,induced sputum cell differentials, etc.Results The cause of chronic cough was defined in 322 patients.The six most important causes of cough were typical asthma(TA,n=84),eosinophilic bronchitis (EB,n=62),atopic cough (AC,n= 42),cough variant asthma (CVA,n=40),gastroesophageal reflux cough(GERC,n=37),rhinitis and/ or paranasal sinusitis (PNDs,n=32),and others and indefinite cause (n=25,13).Percentage of eosinophils were significantly increased in the induced sputum of AC,EB,CVA,and GERC patients (0.005,0.052,0.059,0.234) compared with those in other causes and the healthy controls (0) (P

Objective To observe the role of rosiglitazone in unclipped kidneys of two-kidney- one-clip hypertensive rats and examine its relationship to angiotensinⅡreceptors.Methods Two- kidney-one-clip hypertensive rats were divided randomly into 4 groups as follows:positive control group (CONT),traditional antihypertensive drugs group (TAHD,reserpine 50?g?kg~(-1)?d~(-1), dihydralazine 6.25 mg?kg~(-1)?d~(-1) and hydrochlorothiazide 6.25 mg?kg~(-1)?d~(-1),regular-dose rosiglitazone group (RRGL,rosiglitazone 5 mg?kg~(-1)?d~(-1)),and high-dose rosiglitazone group (HRGL, rosiglitazone 20 mg?kg~(-1)?d~(-1)).Sham operation rats were as negative controls.Each group had 8 rats. Animals were monitored and sacrificed at 10th week.Results Blood systolic pressure in TAHD group and HRGL group was significantly lower than that in CONT group [TAHD(137?27 ) mm Hg and HRGL (143?16) mm Hg vs CONT (191?25 ) mm Hg,P＜0.05],but no significant difference between the former two groups was found.Nor did the blood systolic pressure between RRGL group [(176?18) mm Hg] and CONT group.At 10th week,rats in SHAM group and treated groups had lower urinary urinary protein excretion rate,glomerular injury score and wall-to-lumen ratio of arteriole than those in CONT group [vs CONT urinary protein excretion rate (44.60?17.40) mg/24 h,P＜0.05; vs CONT glomerular injury score 60.85?33.05,P＜0.05;vs CONT wall-to-lumen ratio of arteriole 2.33?1.01,P＜0.01,except TAHD group].Though with the similar level of blood pressure,blood glucose and lipid,HRGL,compared with TAHD group showed lower urinary protein excretion rate [HRGL (16.78?3.50) mg/24 h vs TAHD (27.94?12.79) mg/24 h,P＜0.05],decreased glomerular injury score (HRGL 18.04?7.76 vs TAHD 27.92?6.39,P＜0.05) and wall-to-lumen ratio of arteriole (HRGL 1.75?0.38 vs TAHD 2.16?0.90,P＜0.05) in the cortexes of unclipped right kidneys.The expression of type 1 angiotensinⅡreceptor (AT1R) mRNA was no difference in HRGL group and TAHD group,but the expression of type 2 angiotensinⅡreceptor (AT2R) mRNA was more intensive in HRGL group.Conclusion Rosiglitazone can protect the kidneys from hypertensive injury,especially in high dose.The beneficial effects seem incompletely dependent on the metabolism modulating and reduction of blood pressure,but in relationship to the upregulation of AT2R mRNA.

Objective To search the relationship among blood pressure,blood lipid and fat liver in childrcn with simple obesity.Methods Blood pressure,blood lipid and ultrasound of liver of 40 cases with simple obesity and 20 cases in normal control had been detected.Results there were 11 cases without complication in children with simple obesity,the simple obesity with hypertension complication were 14 cases,and the simple obesity with high blood lipid were 15 cases.The level of total cholestrrol(TC),triglyceride(TG),light density lipoprotein(LDL)and very light density lipoprotein(VLDL)in obesity children were significantly higher than those of control group(P