Post-stroke spasticity is a series of symptoms after stroke,such as hand and foot urgency,unflexion and extension of muscles,etc.In order to deeply understand the cognition of post-stroke spasticity of ancient Chinese physicians and comb out their therapeutic thoughts,this study took the General Catalogue of Chinese Ancient Books of Traditional Chinese Medicine as a bibliographic reference,all the ancient Chinese literature on spasms after stroke was retrieved manually and by computer,and then sorted and analyzed,and classified them by longitudinal time,and extracted the description about post-stroke spasticity,including medical classics,prescriptions,clinical evidence,medical records and so on.And this paper verified and summarized the etiology,pathogenesis,functional and indications and prescription characteristics of spasticity after stroke,in order to deeply understand systematic theories and treatment ideas of the ancient medical practitioners in the bud,development and mature stages of their understanding of spasticity after stroke,and provide the theoretical basis for the later doctors to understand this disease and the modern clinical treatment of traditional Chinese medicine.

Post-stroke spasticity is a series of symptoms after stroke,such as hand and foot urgency,unflexion and extension of muscles,etc.In order to deeply understand the cognition of post-stroke spasticity of ancient Chinese physicians and comb out their therapeutic thoughts,this study took the General Catalogue of Chinese Ancient Books of Traditional Chinese Medicine as a bibliographic reference,all the ancient Chinese literature on spasms after stroke was retrieved manually and by computer,and then sorted and analyzed,and classified them by longitudinal time,and extracted the description about post-stroke spasticity,including medical classics,prescriptions,clinical evidence,medical records and so on.And this paper verified and summarized the etiology,pathogenesis,functional and indications and prescription characteristics of spasticity after stroke,in order to deeply understand systematic theories and treatment ideas of the ancient medical practitioners in the bud,development and mature stages of their understanding of spasticity after stroke,and provide the theoretical basis for the later doctors to understand this disease and the modern clinical treatment of traditional Chinese medicine.

Objective:To evaluate the value of target blood pressure management based on cerebral oximetry index (COx) during cardiopulmonary bypass (CPB) in preventing postoperative delirium (POD) in patients with acute type A aortic dissection (ATAAD).Methods:One hundred and fifty-seven patients with ATAAD, aged 18-64 yr, regardless of gender, were divided into 2 groups by a random number table method: traditional experience group (group C, n=81) and COx management group (group M, n=76). The mean arterial pressure in group C was maintained in the traditional range of 60-80 mmHg during CPB. In group M, the mean arterial pressure range was obtained based on the COx and maintained within this range during CPB. The primary outcome assessed was the development of delirium within 7 days after surgery. Secondary outcomes included other postoperative complications, tracheal extubation time, and duration of cardiac intensive care unit stay. Results:Compared with group C, the incidence and severity scores of POD were significantly decreased, the duration of POD was shortened, the duration of POD was shortened, the extubation time and duration of cardiac intensive care unit stay were shortened, and the incidence of postoperative cerebral infarction and acute kidney injury was decreased in group M ( P<0.05). Conclusions:Target blood pressure management based on COx during CPB is helpful in reducing the occurrence of POD and improving the prognosis of patients undergoing surgery for ATAAD.

OBJECTIVE:To study the absorption features of Silymarin enteric coated-polyllactic-co-glycolic acid (PLGA) nanoparticles in rat in situ intestine perfusion model and colonic adenoma Caco-2 cell model. METHODS:HPLC method was used to determine the content of silymarin. The absorption rate constant(Ka)and apparent absorption coefficient(Kapp)of Silymarin sus-pension,Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were investigated in duodenum,jejunum, ileum and colon of rat in situ intestine perfusion model;the apparent permeability coefficient (Papp) of those drugs containing low-concentration,medium-concentration and high-concentration(20,40,60 μg/mL)of silymarin in Caco-2 cell model were also investigated. RESULTS:Compared with Silymarin suspension,Ka and Kapp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were all increased in duodenum,jejunum,ileum and colon(P<0.05);compared with the correspond-ing concentration Silymarin suspension,two-way Papp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanopar-ticles containing low-concentration,medium-concentration and high-concentration of silymarin were all increased in Caco-2 cell model (P<0.05);there was no statistical significance between Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles (P>0.05). CONCLUSIONS:Silymarin enteric coated-PLGA nanoparticles can effectively increase the intestinal ab-sorption,cellular uptake and transmembrane transport rate of silymarin.

Objective: To study correlation between heart rate variability (HRV) and arteriosclerosis in patients with essential hypertension (EH).Methods: A total of 139 EH patients from our hospital were enrolled as EH group.According to carotid-femoral pulse wave velocity (PWV), they were divided into normal subgroup (n=65, PWV<9 m/s) and abnormal subgroup (n=74, PWV≥9 m/s).Another 60 healthy adults undergoing physical examination in our hospital during the same period were selected as healthy control group.HRV indexes, PWV, carotid intima-media thickness (IMT) and number of carotid plaques were compared among all groups.Correlation among above indexes were analyzed in EH patients.Results: Compared with healthy control group, there was significant reduction in standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording[SDANN, (142.3±21.4)ms vs.(119.3±16.5)ms], significant rise in low frequency[LF, (341.7±37.9)Hz vs.(695.4±43.3) Hz], high frequency[HF, (519.1±33.6) Hz vs.(636.8±39.5)Hz], LF/HF[(0.6±0.3) vs.(1.0±0.2)], PWV[(7.44±0.82) m/s vs.(11.13±0.65) m/s]and IMT[(1.03±0.24)mm vs.(1.74±0.41)mm]in EH group, P<0.01 all;in EH group, compared with normal PWV subgroup, there was significant reduction in SDANN, and significant rise in LF, HF, LF/HF, IMT and mean number of carotid plaques in abnormal PWV subgroup, P<0.05 or <0.01;Pearson correlation analysis indicated that in EH patients, PWV and IMT were significant inversely correlated with SDANN (r=-0.713,-0.699, P<0.01 both), significant positively correlated with LF, HF, LF/HF and carotid plaques (r=0.506~0.935, P<0.01 all), and PWV was significant positively correlated with IMT (r=0.883, P=0.001).Conclusion: In EH patients, SDANN, LF, HF, LF/HF of HRV are significantly correlated with arteriosclerotic extent.Besides lowering blood pressure , HRV etc.related with artery pathological changs should also be treated.

Objective To investigate the clinical application value of real‐time PCR in the detection of bloodstream infection pathogens .Methods A total of 92 blood samples from 80 patients in our hospital were collected for conducting real time PCR de‐tection and conventional blood culture .The sensitivity and specificity were compared between the two methods .Results Among 92 samples ,66 samples (71 .7% ) were negative in both assays .Ten different pathogens were detected by either blood culture system or real‐time PCR or by both methods .Seven positive samples were detected by both assays .The consistence of the two methods was 79 .3% .The negative predictive value of real‐time PCR was 0 .94 ,the sensitivity was 0 .64 and the specificity was 0 .82 .Among them ,15 samples were positive in real‐time PCR ,while negative in blood culture system ,4 samples were positive in the blood cul‐ture ,whereas were negative in the real‐time PCR .The pathogens cultured in 2 samples were not in the detection range of real time PCR ,moreover real time pCR could not detect Candida glabrata .Conclusion Real time PCR is a valuable method for rapidly detec‐tion the sample of bloodstream infection ,but cannot completely replace the blood culture test .

Objective To analysis the effect of salbutamol combined with noninvasive ventilator on TNF-α,IL-6,IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure.Methods 60 patients who were diagnosed with chronic obstructive pulmonary disease with respiratory failure were collected.All patients were randomly divided into experimental group and control group,30 cases in each group. Patients in the control group received noninvasive ventilator treatment, patients in the experimental group were given salbutamol treatment on the basis of control group treatment, after the treatment, the serum levels of TNF-α,IL-6,IL-8 and serum CK-MB activity were detected in all patients.Results After treatment, compared with control group, the serum level of TNFαwas lower in the experimental group,and the difference was statistically significant(P<0.05); the serum level of IL-6 and IL-8 were lower in the experimental group(P<0.05); the serum CK-MB activity was lower in the experimental group(P<0.05).Conclusion The salbutamol combined with noninvasive ventilator can significantly reduce the serum levels of TNF-α, IL-6, IL-8 and serum CK-MB activity in patients with chronic obstructive pulmonary disease with respiratory failure, reduce the inflammatory reaction and reduce the myocardial damage,and have a guiding significance for clinica.

Objective:To establish an HPLC method for the determination of the content of magnolol and honokiol in Cortex mag-noliae Officinalis formula granules and compare the content of the formula granules from different manufacturers. Methods:An HPLC was used to determine the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The analysis was carried out on a Hypersil C18 (250 mm × 4. 6 mm, 5 μm) chromatographic column. Acetonitrile-water was used as the mobile phase with gra-dient elution and the flow rate was 1. 0 ml·min-1 . The detection wavelength was set at 294 nm, the sample size was 20 μl and the column temperature was 25℃. Results:The linear range was 0. 873-26. 190μg·ml-1(r=0. 999 5) for magnolol, the average recov-ery was 99. 24% with RSD of 2. 00%(n=6) and that was 0. 732-21. 980μg·ml-1(r=0. 999 0) for honokiol,and the average recov-ery was 99. 89% with RSD of 1. 33%(n=6). The difference in the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers was notable. Conclusion: The method is simple, repeatable and feasible, and can be used for the quality control of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The content difference in magno-lol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers suggests that it is necessary to standardize the planting and selecting of Chinese medicine, and develop scientific and unified production technology and quality standard for the formula granules.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

BACKGROUND: Distally based flap pedicled with the distal nutritional vessels in forearm is especially suitable for reconstructing the tissue defects in the distal end of hands, while high rotation point cannot satisfy the requirements of reconstructing the distal injuries or defects in hands, and severer lesion may even be caused in the donor site.OBJECTIVE: To study the anatomic proceeding of artery perforators in distal radial margin of forearms, so as to provide anatomic basis for the design of distally based compound flap pedicled with the nutrient vessel of cephalic vein in distal radial margin of forearms.DESIGN: Single sample experiment.SETTING: Center for Clinical Anatomy of the Department of Orthopedics,Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command.MATERIALS: The experiment was conducted in the Laboratory of Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command between August and December 2004. The upper extremities of 30 cadavers injected with a mixture of red gelatin into the artery (provided by the Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command) were adopted.METHODS: The vascular external diameter and distance were measured with sliding caliper and ruler with radial styloid process as the marker.MAIN OUTCOME MEASURES: ① The perforator artery in distal radial margin of forearms. ② The nutrient vessels of cephalic vein. ③ The relationship of blood supply between the nutrient vessels and vicinal bone and skin as well as the lateral antebrachial cutaneous nerve. ④ The superficial and deep communicating branches of cephalic vein.RESULTS: The perforator artery in distal radial margin of forearms derived from: 6-11 cutaneous branches of radial artery with external diameter of (0.7±0.3) mm; 2-6 cutaneous branches of superficial palma with the external diameter of (0.5±0.3) mm; 1-2 recurrent cutaneous branches of the styloid process of radius with the external diameter of (0.5±0.1) mm; 1-2 cutaneous branches of snuff tobacco with the external diameter of (0.6±0.2) mm. At 8.0-15.0 cm above radius styloid process there were 1-3 intermuscular cutaneous branches of radial artery with an initial external diameter of (1.1±0.2) mm, distributing in the exposureregion and corresponding skin of middle and inferior segments in radius. The above-mentioned perforator arteries all developed into cutaneous branch, fascia branch, periosteum branch, cephalic vein and nutrient vessel branch of distal cutaneous nerve,and constituted the vascular chain, the by-pass of cephalic vein, vascular chain of cutaneous nerve stem as well as superficial, deep fascias and periosteal vascular net.CONCLUSION: The perforator artery in distal radial margin of forearms is the source of nutrient vessels in cephalic vein, while the nutrient vessels share an isogeny with the nutrient vessels derived from vicinal bone, skin and lateral antebrachial cutaneous nerve, which provide an anatomic basis for designing the distally based compound flap pedicled with the nutrient vessels of cephalic vein. The rotation point of compound flap pedicled with the recurrent branch of radius styloid process (or branch of snuff tobacco) can reach the surface of rotation joint, which can be adopted in the transposition and reconstruction of distal tissue defects in hands.