Objective To study the efficacy of esomeprazole in treatment of asthmatic patients with gastroesophageal reflux (GER) symptoms. Methods Sixty-nine asthmatic patients with GER symptoms were received esomeprazole 40 mg daily and mosapride 5 mg three times daily for 8 weeks. After that, esomeprazole 20 mg and mosapride 5 mg daily were prescribed to the patients for sustained therapy. The effect of asthma control was evaluated according to criteria for asthma control level made by Chinese Society of Respiratory Disease Asthma Group. All patients were followed up for 2 years.Results It was revealed that complete asthma control was achieved in 39 patients, well control in 25 patients and the total effective rate was 93 %. Asthma-control medication was stopped in 42 patients,dose reduced to 1/2 in 18 patients and continuous therapy in 9 patients. During 2 years follow-up, 58 patients were benefited from the treatment with complete asthma control and seldom attack of asthma was seen in 11 patients with reduced frequency and severity. Conclusion The symptoms of asthmatic patients with GER symptoms can be improved by esomeprazole, so that their quality of life areimproved.

Objective To explore the efficacy and safety of mosapride combined withpancreatic kallikrein in the treatment of diabetic neurogenic bladder(DNB).Methods According to the digital table,120 patients with DNB were randomly divided into the control group and the observation group,each group 60 cases,All patients received basic treatment,including reducing blood glucose,reducing blood pressure,nutrition nerve and regulating blood lipids,and the observation group was accepted the treatment of original enzyme plus mosapride pancreatic kinin on basis of the above treatment.The treatment time of the two groups was both 3 weeks,The effect,blood sugar,blood hpids,urodynamic,quality of life,and the incidence of adverse reactions were observed.Results The total effective rate of the observation group was 93.33％,which was significantly higher than that of the control group (65.00％) (χ2 =14.602,P ＜ 0.01) ；the adverse reaction rate of the observation group was 8,33％,which was significantly lower than that of the control group(20.00％)(χ2 =11.368,P ＜ 0.01),Conclusion Mosapride combined with pancreatic kallikrein in thetreatment of DNB has better effect,and could significantly improve the clinical symptoms and quality of life of patients.So it should be promoted and applied.

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Objective To investigate the effects of serum levels of leptin, IGF-1, BDNF and inflammatory markers in patients with post-stroke depression(PSD). Methods By using Hamilton rating scale for depression (HAMD) ,46 patients with post-stroke depression were recruited and 50 patients without depression as the control group. Two weeks after the onset of stroke, serum levels of leptin, insulin growth factor(IGF-1), hs-CRP, intracellular adhesion molecule (ICAM-1) and brain-derived neurotrophic factors (BDNF) were measured by enzymelinked immunosorbent assay(ELISA). Results The levels of leptin and IGF-1 in patients with PSD were significantly higher than that of the control group (( 57.4 ± 14.32) ng/ml vs (17.53 ± 11.62) ng/ml, P = 0. 002;(120.86 ±28.66) ng/ml vs (66.5 ± 17.51) ng/ml, P=0. 004 respectively). The serum levels of leptin and IGFI were positively correlated with the HAMD score(r=0. 724, P＜0. 01; r=0. 641, P＜0. 01 respectively). There was no significant differences in the levels of hs-CRP((2.3 ±0.42) mg/dl vs (2.2 ± 0.28) mg/dl, P= 0. 767),ICAM-1 (( 182.6 ± 50.27) ng/ml vs (178.7 ± 51.14) ng/ml, P = 0. 812) and BDNF(( 25.8 ± 8.35) ng/ml vs (24.2 ±7.48)ng/ml, P = 0.580)in the two groups. Conclusion The serum levels of leptin and IGF-1 may be associated with post-stroke depression and may be the markers of PSD in the old stroke patients.

Objective To fit the functional relation between Percentage Depth Dose and depth by Newton Interpolation. Methods After analyzing the data of Percentage Depth Dose from different manufacturers' linear accelerators, the average of Percentage Depth Dose with same depth was calculated, and then the average data was determined. The interval was set and the interpolation node was selected for simulating the cubic polynomial with PDD and depth. Results Comparing the calculated values by the function with the measured ones, the error was less than 1%. Conclusion The function simulated with Newton Interpolation is applicable in routine clinical radiotherapy and research.

OBJECTIVE To investigate the incidence of nosocomial infection in ICU patients,risk factors.and measures to prevent infection.METHODS The nosocomial infection of ICU patients in the hospitals from Nov 2005 to Jun 2009 was investigated using the method of target monitoring.The nosocomial infection rate was regulated by the method of ASA.The invasive procedure and the associated infection rate were analyzed.RESULTS Among 833 inpatients in ICU,92 suffered from nosocomial infection,The nosocomial infection rate was 11.04%.and the nosocomial infection rate per day was 4.43% after modified by the method of ASA.The incidence of patients was 5.37%.Totally 145 strains of bacteria were isolated,and the dominant pathogens were Gram-negative bacilli(56.55%).CONCLUSIONS The patients in ICU are susceptible population of nosocomial infection,A.baumannii is the dominating pathogen to cause nosocomial infection in intensive care units.Target monitoring in ICU is an effective surveillance method to reduce the prevalence of nosocomial infection.

Objective To study calcium chelator BAPTA-AM antagonize the cellular oxidative stress induced by hydrogen peroxide ( H2 O2 ) and to explore the effect of calcium ion on the cell degeneration mediated by NLRP3.Methods The SHSY5Y cell model of oxidative stress was made by hydrogen perox-ide,then the cell model was treated with calcium ion carrier A23187 or BAPTA-AM,a higher efficiency cal-cium chelating agent.The cells were divided into 4 groups:H2O2 treatment group,H2O2+A23187 group, H2 O2+A23187 +BAPTA-AM group and control group.NLRP3 protein was detected by Western blot,and Caspase-1 and IL-1βwere detected by ELISA.Results NLRP3 expression was significantly increased in cells treated by hydrogen peroxide(P<0.05) .The NLRP3 protein continued to increase, and the expression of Caspase-1((57.1±19.2)pmol/L) and IL-1β((484.2±49.5)pg/ml) protein was also increased signifi-cantly in cells treated by A23187,and the difference had statistically significant for caspase-1 or IL-1βin H2O2+A23187 group compared with those in control group(Caspase-1:(26.8±12.9)pmol/L,IL-1β:(326.9 ±52.1) pg/ml) (P<0.05, P<0.01) .NLRP3,Caspase-1 and IL-1βwere all significantly reduced after adding a high-er efficiency calcium chelating agent BAPTA-AM.Conclusion Calcium overload is likely to enhance the oxidative stress induced by hydrogen peroxide and engender neurodegeneration mediated by NLRP3 inflammasome.

Objective To explore the microsurgical treatment strategy of ruptured anterior communicating artery aneurysms.Methods From September 2009 to February 2013,thirty-three patients with ruptured anterior communicating artery aneurysms were treated with microsurgical clipping via modified pterion approach.The clinical and follow-up data were analyzed retrospectively.Results At 3 to 44 months period followed-up after microsurgical clipping of ruptured anterior communicating artery aneurysms were obtained in 32 patients.According to Glasgow Outcome Score,the curative effects score were 5 in 28 cases,four in 2 cases,three in 1 case and death in 1 case.Conclusion Microsurgical clipping of ruptured anterior communicating artery aneurysms via modified pterional approach was an effective method with sufficient exposure.It has less invasiveness to the brain tissue,reliable neck clipping and satisfactory results.Safety and effectiveness of this procedure are based on preoperative radiological evaluation of three-dimensional morphological specificity of aneurysms,identification of the parental arteries and its branches,as well as temporary proximal occlusion.

Objective To develop a simple model for the noninvasive diagnosis of liver fibrosis in patients with chronic hepatitis B and to testify its diagnostic value. Methods One hundred and ninety patients with chronic hepatitis B who had undergone liver biopsy were divided into 2 groups:one for developing the model(n=110) and one for validation(n=80). Histological staging of liver fibrosis,assessed blindly and independently by 2 pathologists,was determined according to Scheuer fibrosis score.Twenty markers involved in the study were analyzed initially in the estimation group to derive a predictive model to discriminate the stages of fibrosis.The model created was then assessed with receiver operating characteristic curve(ROC)analysis. It was also applied to the validation group to test its accuracy. Results Haptoglobin(HPT),γ-glutamyl transpeptidase(GGT)and platelet were identified by logistic regression analysis as independent factors of fibrosis. A model developed from the above three markers was established to predict the stage of fibrosis(S). In ROC analysis,the area under curve(AUC) for identifying S≥1,S≥2,S≥3 and S=4 was 0.832,0.835,0.820 and 0.843 respectively. The model had a similar AUC in the vatidation group without statistically significant difierence. Using a cut-off of ＜0.18, significant fibrosis (S≥2)could be excluded in 27 patients of the total patient population(negative predictive value 90%).Similarly,applying a cut-off ≥0.70,significant fibrosis could be identified correctly in 67 patients of the total patient population(positive predictive value 82.7%).The model had a high level of diagnostic value in patients with HBeAg-positive chronic hepatitis B as well as in patients with HBeAg-negative chronic hepatitis B(AUC for identifying S≥2,0.857 vs 0.802). Restricting biopsy to patients with intermediate scores(≥0.70 and ＜0.18) may prevent liver biopsies in 58.4% of the patients while maintaining 84.7% accuracy. Conclusions A model including HPT,GGT and platelet is a simple and reliable index for predicting significant fibrosis in patients with HBeAg-positive chronic hepatitis B as well as in patients with HBeAg-negative chronic hepatitis B.

OBJECTIVE To investigate the distribution and drug resistance status of extended-spectrum ?-lactamases producing(ESBLs) Klebsiella pneumoniae and to provide the basis for clinic anti-infective treatment.METHODS To use ATB-expression analyzer to identify the microbe.The drug susceptibility was tested with the K-B method and the ESBLs producing strains detected by diffusion confirmed test.RESULTS Among 137 strains of identified K.pneumoniae,34.3% of them(47 strains)produced ESBLs,and most had been shown in geriatrics ward.The drug resistance rate of ESBLs producing K.pneumoniae was higher than that in non-producing ESBLs one.So imipenem should be considered to be a preferred antibiotic when used on K.pneumoniae seriously infected cases.CONCLUSIONS The drug resistance of K.pneumoniae is a serious problem,we should pay attention on the status of ESBLs distribution,based on the susceptibility to choose the reasonable antibacterial to avoid the producing ESBLs bacteria spread out.