Remote ischemic postconditioning can induce cerebral ischemic tolerance and have neuroprotective effects.It has provided a novel strategy for the treatment of ischemic cerebrovascular disease.In recent years,the mechanism research of remote ischemic postconditioning and clinical applications have made significant progress and have shown encouraging prospects of clinical transformation.

Objective To understand the drug resistance status of extended-spectrum beta-lactamase(ESBLs)-producing Esche-richia coli (E.coli)and Klebsiella pneumonia (KPN ),and the prevalence situation of TEM and SHV genotype in Wusu city.Meth-ods E.coli and KPN isolated in two hospitals of Wusu city from July 2011 to June 2013 were collected and the drug sensitivity test was performed by the disk diffusion method (K-B method),the ESBLs preliminary screening and the phenotypic confirmatory test were carried according to the guideline of CLSI,and at the same time DNA of ESBLs producing strains was extracted and the TEM and SHV genes among them were tested by PCR and the electrophoresis method.Results Totally 221 strains of E.coli and 153 strains of KPN were collected,among them ESBLs producing strains were 37 strains and 43 strains respectively,and the detec-tion rate of ESBLs in KPN was higher than that in E.coli(χ2 =6.942,P <0.01).The drug resistance of two kinds of bacteria were similar,the resistance rate of ESBLs producing strains to beta lactam antibacterial drugs was obviously higher than that in non-en-zyme producing strains,which was mostly more than 90%;the resistance rate to penicillin and the first or second generation cepha-losporins was almost 100%;which to gentamicin and ciprofloxacin was above 50%;while which to carbapenem was lower,less than 5%.The detection rates of TEM and SHV genes were 72.9% and 54% in ESBLs producing E.coli and 81.4% and 65.1% in KPN respectively,the detection rates were basically consistent without statistically significant differences between them (P >0.05).Conclusion The detection rate of ESBLs producing E.coli and KPN in Wusu city is higher,the drug resistance situation is severe,and TEM,SHV are the important genotypes of ESBLs.

Objective To study the feasibility of cerebral perfusion weighted imaging(PWI)using superparamagnetic iron oxide particles(SPIO)Resovist in normal rabbits,and investigate the methodology and the proper contrast agent dose of SPIO in PWI.Methods All 30 rabbits were randomly divide into 5 groups(n=6 for each),group A,B,C,D were divided according to the different dose of Resovist(4,8,16 and 32 μmol Fe/kg)and group E was operated as control study with 0.2 mmol/kg Gd-DTPA.The dynamic MR perfusion imaging series were acquired in each group.The signal intensity time curves were analyzed in gray matter and white matter,and the parameters(rCBV,SRRmax,QrCBV,QSRR max)were calculated and compared in all groups and correlated with control one.Results a bolus injection was succeed for all studies.and a dose-dependent strong reduction in signal intensity of gray and white matter in all groups was demonstrated.The rCBV values of gray and white matter for group A,B,C,D and E were(50.48±3.84),(25.57±2.10);(94.69±2.60),(45.33±3.14);(141.13±6.26),(67.67±4.65);(243.75±5.90),(162.06±5.14);and(84.60±3.60),(41.36±2.18)ml/100 g,respectively.The SRRmax values of gray and white matter for group A,B,C,D and E were(13.70±1.50)%,(7.38±0.41)%;(31.01±4.06)%,(16.49±2.35)%;(43.81±3.42)%,(21.64±4.14)%;(64.49±5.35)%,(43.61±5.78)%;and(27.78±2.98)%,(14.42±2.25)%;respectively.The QrCBV values for group A,B,C,D and E were 1.98±0.07,2.09±0.11,2.09±0.07,1.50±0.01,and 2.05±0.03,respectively,and the QSRR max values for group A,B,C,D and E were 1.85±0.11,1.88±0.06,2.06±0.25,1.49±0.09,and 1.94±0.12,respectively.All above values among group were significantly different(P＜0.01).For the QrCBV and QSRR max values between group,there were no significant difference between group A and B,B and C,A and C;while the values of group A was significantly larger than those of group D(P＜0.01).Condusion Resovist(SPIO)can be used in the study of MR perfusion weighted imaging in the brain,and the proper contrast agent dose is 4-16 μmol Fe/kg.

Objective To develop a portable, easily-used and effective fracture fixation material during emergency treatment of battle wound. Methods Based on vacuum plasticity, macromolecule particles were filled into prefabricated bag, in which the air was deflated. The bag became stiff. When it was bound with belt, it acted as fracture fixation. Results Experiments showed that this kind of splint attached closely with body without any accessorial material. The effect was good without any restriction from region or environment. Conclusion This kind of fracture fixation splint has advantages in operation time, applicable parts and fixation effects compared with other fixation material.

According to relevant national laws and regulations, practitioner training was included into laboratory animal science teaching reform.By adjusting the training content and teaching method and use of animal models of typical human diseases, the transformation of training mode was realized and improved.By the assessment of basic theory in combination with practical operation, the thinking ability and hands-on skill of the practitioners are much improved. Through classroom instruction, experimental teaching, quality assessment and tracking survey, the evaluating process of the training quality of training teaching is performed.Therefore, the teaching reform of the laboratory animal science based on the training of practitioners is established.

Objective To evaluate the predictive value of procalcitonin (PCT),C-reactive protein (CRP)and white blood cell (WBC)for the severity of community-acquired pneumonia(CAP)in adult and elderly patients.Methods A total of 1 12 hospitalized patients with community acquired pneumonia from May 2013 to September 2014 were selected,and they were divided into the adult group(n=50)and the elderly group (n =62).The PCT,CRP and WBC levels in patients with severe and non-severe pneumonia were compared,and the correlation between those inflammatory markers and pneumonia severity index (PSI),British Thoracic Soci-ety CURB-65 Score(CRUB-65)were analyzed in each age group.Results PCT and CRP levels,PSI and CURB-65 scores in adult and elderly patients with severe pneumonia were higher than those in patients with non-severe pneumonia of corresponding age group (P < 0.05 ).Moreover,PCT had significant positive correlation with PSI and CURB-65 scores in the elderly group (P <0.05).But no correlation were found between the two kinds of scores and PCT in adult group as well as CRP,WBC in the two age group(P >0.05).Conclusion PCT and CRP might be useful markers to evaluate the severity of CAP,and PCT has a higher pre-dictive value in elderly patients with CAP.

Objective To analyze CT findings of solitary fibrous tumors of the pleura (SFTP) for differentiating benign and malignant lesions.Methods CT findings of 20 benign and 11 malignant SFTPs proved by pathology were retrospectively reviewed. The size,margin,internal structures,blood supplies,invasion to adjacent structures or metastasis and pleural effusion were analyzed and compared between malignant and benign groups.Results The mean diameter of malignant lesions( median diameter:13.5 cm) was larger than that of the benign ( median diameter:7.6 cm,F =6.411,P =0.017 ).Malignant lesions tended to be more heterogeneous (9/11,P =0.002),more invasive to adjacent structures ( 6/11,P =0.001 ) than benign lesions ( 4/20,0/20 ).Serpiginous vessels ( 10/11,P =0.008 ) and pleural effusion (6/11,P =0.038 )were more common in malignant lesions than those in benign lesions (8/20,3/20).Calcification could be found in both benign (2/20) and malignant lesions ( 2/11,P =0.6 ).Furthermore,3D CT angiography could show blood supplies into tumor in 12 lesions (4 benign and 8 malignant SFTPs).Conclusion CT and 3D CTA are helpful in differentiating benign from malignant SFTPs and evaluating the excision of SFTPs.

OBJECTIVE:To explore the clinical efficacy and safety of cetuximab combined with NP regimen and radiotherapy in the treatment of advanced non-small cell lung cancer(NSCLC). METHODS:76 cases of advanced NSCLC were selected and randomly divided into control group and observation group according to different therapy methods,with 38 cases in each group. Control group received NP regimen(cisplatin 25 mg/m2+navelbine 12.5 mg/m2)+thoracic IMRT;observation group was additional-ly given cetuximab 400 mg/m2(first day),with maintenance dose of 250 mg/m2 weekly and last for 13 weeks. Short-term efficacy, survival situation were compared between 2 groups as well as the levels of T lymphocyte,Th1,Th2,immuneglobulin(Ig) and complement. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 86.84%,which was significantly higher than that of control group(65.79%),with statistical significance(P<0.05). Average survival period and 2-year survival rate of observation group were 18.70 months and 55.26%,which were significantly longer or higher than those of control group (14.75 months,31.58%),with statistical significance (P<0.05). The improvement rate of survival quality was 94.74% in observation group,which was significantly higher than 68.42% in control group,with statistical significance (P<0.05). After treatment,the levels of CD4+,CD4+/CD8+ and IgG were significantly increased in 2 groups,while the levels of CD8+, Th1,Th2 and Th1/Th2 were significantly decreased;the observation group was better than the control group,with statistical signifi-cance(P<0.05);there was no statistical significance in the levels of CD3+,IgA,IgM and complement 4 between 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Cetuximab combined with NP regimen and radiotherapy can improve clinical efficacy of advanced NSCLC,improve survival quality,prolong survival time and promote the recovery of Ig,complement and T lymphocyte,with good safety.

Objective To evaluate blood oxygen level-dependent (BOLD) MRI on assessing renal damage after injection of iodine contrast medium with a 3.0 T system. Methods Routine MRI examination,including T1WI and T2WI, and BOLD MRI were performed in 29 SD rats with a 3.0 T system before the injection of iodine contrast agent and 20 min, 24 h, 48 h, 72 h after the injection, respectively. T2 * and R2 * ( = 1/T2 * ) measurements were obtained in the cortex, inner and outer medulla of kidney,respectively. The results obtained before contrast agent administration were considered as the self-controls.AVONA test were used for the comparison of R2 * values in different parts of both kidneys before contrast agent administration. Two-sample t test was used to compare R2 * values before and at each time point after contrast agent administration, and R2 * values in different parts of the kidneys. Results Before contrast agentadministration, R2 * values in outer medulla in both sides of kidney [R2 *left oM = (31.76 ± 2.73 ) / s,R2 * right OM = (32.77±3.07) /s] were higher than those in cortex [R2 * left c=(30.20±3.48) /s,R2 * right c = (28.84 ±3.11 )/s] and in inner medulla [ R2 * letf IM = (29.54 ± 2.42) /s, R2 * right IM =(28.37±2.80) /s ] ( F = 3.357 and 14.961, P＜ 0.05 ). There was no statistical significance in R2 *values in the three parts between left and right kidney, including cortex, outer and inner medulla (P＞0.05). After contrast agent administration, R2* values in outer medulla changed obviously, which reached to the peak values at 20 minutes after contrast agent administration [R2* left OM = ( 43.57 ± 3.84 )/s,R2*right OM= (44.58±3.13) /s] and dropped from 24 hours [R2*left OM = (42.07 ±4.82) /s,R2* right OM = (42.89±3.40) /s]. R2* values in inner medulla and cortex only presented slight changes.Conclusion R2* values reflected the changes of oxygen content in renal cortex and medulla quantitatively,which helped for detecting medullar ischemia and hypoxia. BOLD MR imaging could offer a feasible method for evaluating oxygen metabolism and renal injury in cortex and medulla.

Objective To evaluate the prevalence and clinical significance of IgG,IgA and IgM isotypes of anti-peptidylarginine deiminase 4 (anti-PAD4) antibodies in early rheumatoid arthritis (RA).Methods IgG,IgA and IgM isotypes of anti-PAD4 antibodies were measured in the sera of 88 RA patients with disease duration less than 2 years,62 patients with other rheumatic diseases and 57 healthy subjects.The diagnostic performance of IgG,IgA and IgM isotypes of anti-PAD4 antibodies and their relationship with disease duration,DAS28,ESR,CRP,anti-CCP antibodies and rheumatoid factor (RF) were evaluated.Data analysis were performed using t test,U test and Spearman's association analysis.Results ① The sensitivities of IgG,IgA,and IgM isotypes for early RA were 28.41％,36.36％ and 9.09％ respectively.The specificities of IgG,IgA and IgM isotypes were 94.12％,93.28％ and 95.80％ respectively.② IgA isotype was positively correlated with age (r=0.234,P=0.028),DAS28 (r=0.309,P=0.007),ESR (r=0.382,P=0.000) and CRP (r=0.291,P=0.008),while negatively correlated with disease duration (r=-0.295,P=0.006).③ IgA isotype was positively correlated with IgG isotype (r=0.451,P＜0.01).In the IgG negative patients,the positivity of IgA isotype was 29％(18/63),which indicated that the IgA isotype might be helpful in diagnosing RA in IgG isotype negative patients.Conclusion Anti-PAD4 antibodies can be detected in early RA,primarily with IgA and IgG isotypes.IgA isotype has negative correlation with disease duration,indicating that IgA isotype of anti-PAD4 antibody may play a role in the very early stage RA.