Cerebral ischemia accounts for 70%~80%. Magnetic resonance imaging (MRI) shows infarct focus efficiently, which plays an important role in the diagnosis of ultra-early stage of ischemia and the prediction of infarcts' change. This paper reviewed the recent advance in the effect of MRI on the diagnosis and prediction of cerebral ischemia.

Protein phosphatase 2A(PP2A)is the main serine/threonine protein phosphatase of the brain,and it is involved in many physiological and pathological processes in the cell. Particularly in the pathogenesis of Alzheimer′s disease(AD),PP2A is closely related to the main pathological features of AD. Deregulation of PP2A enzymes correlates with increased tau phosphorylation, the formation of amyloid precursor protein,and the missing of neurons. PP2A as the target of drug development may bring new hope for the treatment of AD. This review introduces the structure and activity regulation of PP2A,and the role of PP2A in AD.

Nimodipine is the second generation of dihydropyridine Ca2+ antagonist. The scope of its clinical application has been expanded because of the excellent curative effects on cerebrovascular diseases. Nimodipine is commonly available on the market as oral or injection preparation,which has to be given several times per day. It may induce peripheral cholinergia side effects and has low bioavailability. Therefore,it is necessary to develop novel drug formulation with optimized delivery system. In the present review, an attempt is made to discuss the current progress of nimodipine in pharmaceutics,including the difference of market situation,safety and efficacy of different dosage forms. Meanwhile,the main research directions of new dosage forms are summarized,which can pro-vide reference for developing more efficient and convenient nimodipine preparations.

To investigate the effects of essential oil of Citrus reticulata (EOCR) on proliferation of human embryonic lung fibroblasts (HELFs), and to explore its protective effects on bleomycin (BLM)-induced lung fibrosis in rats.

OBJECTIVE:To measure and analysis the related costs of drug-induced liver injury (D1LI) from different decision makers,and to provide reference for reducing related costs of DILI,improving medical insurance system and realizing effective health resource distribution.METHODS:In retrospective study,60 cured or recovered DILI inpatieuts were randomly selected as subjects from medical record management system of 4 hospitals in Henan province during Jun.2014-Jun.2015.Demographic character istic,clinical characteristic and related cost of DILI were analyzed retrospectively and the cost structure was also analyzed from different decison makers (patient,society,medical insurance payer).RESULTS:The total direct medical cost of 60 cases was 584 113.05 yuan,and total direct non-medical cost was 31 093.15 yuan and total indirect cost was 169 379.95 yuan.The total cost of DILI of fered by patients was 616 296.38 yuan;the total cost of DILI offered by society was 784 586.15 yuan;the total cost of DILI offered by medical insurance was 168 289.77 yuan.CONCLUSIONS:DILI results in serious economic damage for patients and society,deserving attracting extensive attention worldwide.The study provide reference for reducing patient's medical burden and improving medical insurance system,and contribute to optimize medical resource distribution.

Objective To investigate the value of initial absolute lymphocyte counts (ALC) in predicting the prognosis of children with primary immune thrombocytopenia(ITP).Methods The initial clinical data of 214 children with incipient ITP were retrospectively analyzed and followed up for more than one year.Statistical analysis was made to find out the influence factors for the prognosis of patients with ITP in children to evaluate the predictive value of ALC on assessing the prognosis of ITP in children,and to analyze the association between ALC and outcomes and the clinical value of prognostic stratification.Results The remission rate of children with ITP was 71.5％ in 12 months.Multivariate unconditioned Logistic analysis showed that disease duration,the infection history,response to treatment and ALC were independent risk factors for chronic ITP(all P ＜ 0.05).Cutoff value of initial ALC was 3.005 × 109/L,sensitivity and specificity of value were 71.9％,83.6％.Three months and 12 months no remission rate of ITP in children between ALC ＞ 3.005 × 109/L and ≤ 3.005 × 109/L had statistical significant difference (24.2％ vs 64.9％,8.3％ vs 54.2％,x2 =42.13,P ＜0.001).There was no statistical difference in therapy efficacy between 2 groups(x2 =5.098,P ＞ 0.05).Remission rate between the ≤5 years old group and ＞ 5 years old group was statistical difference based on age stratification(x2 =22.371,22.177,all P ＜ 0.01).ITP in children were stratified into low risk group,intermediate risk group,high risk group based on the initial ALC and infection history,with remission rates in 3 month respectively 75.8％,54.1％,22.8％,respectively,and 91.6％,68.4％,31.6％ in 12 months,respectively;there were statistically significant differences (x2 =44.867,68.802,all P ＜ 0.001).Conclusions Initial ALC is an independent effecting factor in the prognosis of children with ITP.Initial ALC could be used for stratifying patients with the infection history before 6 weeks and supposed to be a predictive index for the prognosis of ITP in children.

Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with lidocaine for management of perioperative analgesia in children. Methods Thirty pediatric patients, aged 2-6 yr, weighing 8-23 kg, scheduled for elective unilateral high ligation of hernial sac, were equally and randomly assigned into either lidocaine group ( group L ) or dexmedetomidine mixed with lidocaine group ( group DL) using a random number table. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg in group L. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg mixed with dexmedetomidine 1 μg∕kg in group DL. Postoperative analgesia was assessed using FLACC scale. When FLACC score ≥4, ibuprofen suspension 10 mg∕kg was given orally. The consumption of ibuprofen was recorded within 8 h after operation. The onset time of caudal block and duration of analgesia were recorded, and adverse effects were observed. Results Compared with group L, the onset time of caudal block was significantly shortened, the duration of analgesia was prolonged, and the requirement for ibuprofen was decreased in group L. There was no significant difference in adverse effects between the two groups. Conclusion Addition of dexmedetomidine 1 μg∕kg to caudal lidocaine can significantly optimize the efficacy of caudal block with lidocaine alone for the management of perioperative analgesia in children.

Objectives To investigate the effect of IL-17 on proliferation and secretion of IL-1βin the human mesangial cell line (HMCL) and explore the molecular mechanism. Methods The proliferation of HMCL induced by IL-17 was detected by MTT, the secretion of IL-1βin HMCL was measured by ELISA and the expression of NF-κB was detected by immunocyto-chemistry. Results IL-17 did not impact HMCL proliferation (P>0.05) but dose-and time-dependently promoted the secretion of IL-1β(P<0.05). And the expression of NF-κB induced by IL-17 increased comparing to that in the control group (P<0.05). Con-clusions IL-17 may induce HMCL to secrete IL-1βvia NF-κB pathway that results in kidney injury.

Objective To investigate the effect of interleukin(IL)-17 on podocyte-associated factors and apoptosis in podocytes and explore the molecular mechanism.Methods The podocytes were used as the object of study.The apoptosis of podocytes induced by IL-17 in a dose（1nm/ml，10nm/ml，50nm/ml，100nm/ml） and time（12h，24h，48h，72h） way and the protein expression of Fas and FasL of podocytes induced by IL-17 were detected by flow cytometrey.The podocytes were divided into the blank control group and 100ng/ml IL-17 induction group.The expressions of mRNA of Nephrin，WT1，Synaptopodin，Podocylaxin，Fas and FasL were measured by Real-time RT PCR.The proteins of WT1，Caspases8，Caspases3 in podocyte were detected by immunocytochemistry method.Results IL-17 promoted the apopotosis of podocyte in a dose and time way（P<0.01），and increased the expression of Fas，Caspase 8 and Caspase 3 in podocyte（P<0.01）.IL-17 decreased the expression ofPodocylaxin （P<0.05），but had no effect on Nephrin，WT1，Synaptopodin，and FasL in podocyte（P＞0.05）.Conclusion IL-17 may causerenal injure by inducing the apoptosis of podocyte and decreasing the expression of Podocylaxin in podocyte.

OBJECTIVE:To provide reference for standardized management of skin test of cephalosporin injection in our hos-pital. METHODS:In retrospective analysis,skin test of 8 kinds of cephalosporin [cefotaxime(1.0 g),cefotaxime(0.5 g),cefoti-am (1.0 g),cefotiam (0.5 g),ceftazidime (0.5 g),cefminox (0.5 g),cefminox (1.0 g),ceftriaxone (1.0 g)] and the cost of skin test, related cost of allergic reaction induced by cephalosporin injection were analyzed statistically during Sept. 1st, 2015-Aug. 31th,2016. The cost of skin test of cephalosporin injection was compared with allergic reaction cost reduced by skin test. RESULTS:The positive rate of 100330 patients who used above 8 kinds of cephalosporin injections was 6.27%;the rate of skin test was 82.49%;the direct cost of skin test was 3434411.72 yuan;the indirect cost was 141985.12 yuan;the cost of pa-tient was 3162901.44 yuan;the cost of medical insurance was 259096.28 yuan;the cost of the whole society was 3576396.84 yuan. From the perspective of the whole society,the cost of skin test of cephalosporin injections was(447049.61±247395.07)yuan, and allergic reaction cost reduced by skin test was (316075.48 ± 260600.49)yuan. The cost of skin test was significantly higher than allergic reaction cost reduced by skin test,with statistical significance(P<0.05). CONCLUSIONS:Skin test of cephalosporin injection is low in positive rate,has high expense. The government standardizes the management of skin test of cephalosporin injec-tion and reduces the economic burden of patients under the premise of ensuring the safety of drug use.