Objective To explore the regulating mechanism of the astrocytes on the expression of ?-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors(AMPARs) subunit in epileptogenesis. Methods The astrocytic conditional medium(ACM) was collected after being stimulated by glutamate,and then ACM was added to the cultured hippocampal neurons.The expression changes of neuronal GluR2 and protein interacting with C-kinase-1(PICK1) mRNA were detected by RT-PCR. Results In the cultured hippocampal neurons,the GluR2 mRNA expression was significantly decreased at the 2nd,8(th),and 12(th) hours after the administration of ACM compared with that in the control group(P

OBJECTIVE:To provide reference for improving the clopidogrel rational use in cerebral infarction secondary preven-tion. METHODS:Medical cases of 471 patients with acute cerebral infarction in neurology department in a hospital from 2013 to 2014 were retrospective surveyed to collect the utilization rate of clopidogrel and the combination of clopidogrel with proton pump inhibitors(PPIs)and aspirin,and the rationality was analyzed. RESULTS:The utilization rate of clopidogrel in cerebral infarction secondary prevention was 93.84%;the combination rate with PPIs was 52.49%,of which,51.72% had no drug selection or com-bined treatment basis;the combination rate with aspirin was 40.72%,cardiogenic cerebral infarction accounted for only 3.9%, non-cardiogenic cerebral infarction accounted for 96.1%,and recurrence of cerebral infarction in high-risk patients accounted for 31.11%. CONCLUSIONS:Clopidogrel in patients with cerebral infarction secondary prevention is widely used in the hospital,has high combination rate with PPIs and aspirin and low guide compliance rate. Clopidogrel should be enhanced pharmacy services, comply with evidence based medicine and improve the rationality of medication.

Objective To evaluate the clinical efficacy of continuous irrigation with recombinant human acid fibroblast growth factor (rh-aFGF) combined with negative-pressure drainage in the treatment of refractory skin ulcer.Methods A clinical trial was performed from January 2010 to December 2012.Sixty patients with refractory skin ulcer were randomly and equally classified into three groups:group A receiving continuous irrigation with rhaFGF combined with negative-pressure drainage,group B receiving irrigation of raw surfaces with rh-aFGF followed by bandaging after debridement,group C receiving covering of raw surfaces with Vaseline gauze and absorbent gauze followed by bandaging after debridement.Dressings were changed once daily in every group.The treatment lasted 21 days.The efficacy of these regimens was evaluated on day 7,14 and 21.Results At the above time points for observation,both the granulation and epithelium tissues of ulcers grew well in group A,with a decrease in the volume of wounds and area of exposed deep tissues.There was a significant increase in the cure rate and reduction rate of wound volume in group A compared with the other two groups (all P ＜ 0.01).Conclusion Refractory dermal ulcer can be treated with continuous irrigation with rh-aFGF combined with negative-pressure drainage.

Objective To study the arthroscopic operative procedure and the result for knee osteoarthritis. Methods 49 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to September 1999 were reviewved.Arthroscopic lavage,debridement or debridement Combined with drilling was performed on different patients. Results The average follow-up period was 5 years.The scale improved 36.0 after operation.No serious complication was found. Conclusions Arthroscopic debridement for osteoarthritis is satisfactory in the long-term efficacy and drilling of grade Ⅳ subchondral bone does not improve long-term outcome.

Objective To study the values of arthroscopy in the diagnosis and treatment of knee osteoarthritis. Methods A retrospective survey of 75 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to Sep 1999 was conducted.the Tindings by radiograph and those in operation were compaired. Results The average follow-up period was nearly 5 years.The scale improved 35.7 after operation.No serious complication arose. Conclusions The more severe the condition, the more consistent radiographic diagnosis is with arthroscopic findings.Radiography reflects the site of the lesion better.50% of the patients at the intermediate and late stage have meniscal lesions.It seems that meniscal lesion does not affect surgical results;having loose body indicates better results.

Robot-assisted surgery is becoming a widely popular technology and now entering total knee replacement. The development of total knee replacement is introduced in this paper with the emphasis on femur positioning technologies. The experiments and error analysis of robot-assisted surgical system for total knee replacement demonstrate that femur positioning technologies have a high precision and thus deserve to be popularized theoretically and practically.

OBJECTIVE:To investigate the effects and safety of Xingnaojing injection combined with butylphthalide on neuro-logical function,cognitive function,coagulation function and living activity. METHODS:A total of 106 patients with middle cere-bral artery infarction in Wuhan University People's Hospital during Jun. 2014-Dec. 2015 were divided into control group and obser-vation group according to random number table,with 53 cases in each group. Besides routine symptomatic treatment,control group was given Butylphthalide soft capsules 0.2 g,po,tid. Observation group was additionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL,ivgtt,qd. Both groups were treated for 14 d. The neurological function score (NI-HSS,NFDS),cognitive function score (MoCA,MMSE),coagulation function indexes (PT,APTT,FIB),BI score were ob-served in 2 groups before and after treatment. The occurrence of secondary remote damage and ADR were recorded. RESULTS:Eight patients withdrew from the study,including 3 patients of control group and 5 of observation group. Before treatment,there was no statistical significance in neurological function scores(NIHSS,NFDS),cognitive function scores(MoCA,MMSE),coag-ulation function indexes or BI scores between 2 groups (P>0.05). After treatment,NIHSS,NFDS scores and FIB of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). MoCA,MMSE,BI scores in 2 groups were increased significantly,and PT and APTT in 2 groups were prolonged significantly,and the observation group was significantly higher or longer than the control group, with statistical significance (P<0.05). The incidence of secondary remote damage in observation group (11.3%) was significantly lower than control group (41.5%),with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For middle cerebral artery infarction,the application of Xingnaojing injection combined with butylphthalide can reduce the risk of remote damage,promote the recovery of neurological function and cognitive func-tion,and improve coagulation function and living activity with good safety.

It is confirmed that chronic atrophic gastritis (CAG) caused by Helicobacter pylori is the main cause of gastric precancerous lesions.CAG is also the key determinant in gastric cancer risk assessment,which affects pepsinogen and gastrin-17 secretion.Most of the gastric cancer patients have poor prognosis,and non-invasive tools for gastric cancer screening and diagnosis are lacking.Therefore,the early detection of gastric cancer in order to reduce the disease mortality is necessary.Pepsinogen and gastrin-17 are biomarkers of gastric mucosa and gastric antra.The serological testing for the stomach-specific biomarkers offers the possibility to know preneoplastic gastric mucosal conditions.

Objective To explore the appropriat.e treatment process for elderly patients with intertrochanteric fracture in primary hospitals.Methods According with the evaluation system and the characteristics of the grassroots hospitals and elderly patients with intertrochanteric fractures,the treatment standards for risk assessment was established,and the appropriate treatment process for intertrochanteric fracture in elderly patients in primary hospitals was initially formed and tried to promote applications in three primary hospital from December 2010 to January 2012,and its feasibility and effectiveness were tested.Results 66 elderly patients with intertrochanteric fracture were treated in three primary hospital,and 38 cases were hospitalized in primary hospital,including 24 cases of osseous union in 27cases treated with expectant treatment,11 cases of surgical treatment,and the cure rate was 89.5％.Sent on the operation rate of 90.3％ cases,54.8％ of cases occurred within 2 days.The incident of complications in early stage was 25.8％.Conclusion The diagnosis and treatment process and assessment criteria of treatment risk for elderly patients with intertrochanteric fracture in the primary hospital which is initial established is simple,practical,practicable,and has good effect and certain clinical value.

Objective To investigate the impact of leukocyte-removed priming fluid on plasma inflammatory factors TNF-?,IL-6,IL-8,NE peri-CPB in infants.Methods Selected 60 infants,of less than 1-year-old,with ventricular septal defect(VSD)were randomly assigned to the experimental group and the control group.The experimental group took blood leukocyte-removed priming fluid,and the control group took banked blood-derived priming fluid.The plasma TNF-?,IL-6,IL-8,NE concentrations were determinated by using ELISA at the corresponding period of cardiopulmonary bypass(before CPB,aortic cross-clamping 10 min,aortic open 10 min,2h,6h,12h,24h and 48 h after the end of CPB).Results TNF-?,IL-6,IL-8,NE concentrations increased significantly after the start of CPB(P