Aged, 80 and over ; Atrial Fibrillation ; complications ; Embolism ; complications ; Female ; Heart Atria ; pathology ; Heart Diseases ; complications ; Humans ; Myocardial Infarction ; etiology ; Thrombosis ; complications

Objective To investigate the magnetic resonance imaging(MRI) in the diagnosis of congenital anorectal malformation.Methods Fourteen patients with congenital anorectal malformation received pelvic and sacrococcygeal MRI scan with 5 normal controls.The morphological changes of puborectalis and anal sphincter,and the abnormalities of anus,rectum,sacral vertebra and genitourinary system were observed.Results The best developed puborectalis and anal sphincter were showed in 13 cases,the better developed in 3 cases,the least developed in 3 cases,respectively.There were 7 cases with abnormalities of sacral vertebra and 5 cases with abnormalities of genitourinary system.Conclusion MRI examination plays an important role in the diagnosis of congenital anorectal malformation.The morphological changes of puborectalis and anal sphincter,and the abnormalities of sacral vertebra and genitourinary system can be determined by the MRI examination, which is important in clinical therapy planning and accessing the curative effect.

Objective To explore brain activity features during the resting state in alcohol dependent individuals,and study the relationship between the brain activity features and alcohol dependent individuals' clinical symptoms.Methods Twenty-four alcohol dependent individuals and 22 healthy control subjects,well matched in gender,age,education and handedness,were enrolled as the alcohol dependent group and control group respectively.AGE 3.0 T MR scanner was used to acquire all the subjects' resting state data. DPARSF software was used to process resting functional MRI data,and then the whole brain fractional amplitudes of low frequency fluctuation (fALFF) data were acquired.Two-sample t test statistical analysis was made to access fALFF difference between the two groups. Results In comparison with the control group,the alcohol dependent group showed reduced fALFF in bilateral medial prefrontal gyrus,right inferior occipital gyrus,left precuneus,left inferior temporal gyrus,and left posterior lobe of cerebellum (0.64-1.69 vs.0.87-1.78,t =- 4.23- - 2.79,P ＜ 0.05 ). fALFF was increased in the alcohol dependent group at the anterior cingulate,bilateral inferior frontal gyrus,right middle frontal gyrus,bilateral insular lobe,bilateral dorsal thalamus ( 0.86-1.82 vs. 0.76-1.58,t =3.56-3.96,P ＜ 0.05 ).Conclusion Alcohol dependent individuals had abnormal activity at the bilateral prefrontal lobe,anterior cingulate,bilateral dorsal thalamus,bilateral insular lobe,left posterior lobe of cerebellum et al,during the resting state,and these abnormal activities might be related with clinical manifestation and pathophysiology.

OBJECTIVE：To study the improvement effects of ica riin（ICA）on cognitive function in schizophrenia model rats and its mechanism. METHODS ：SD rats were divided into blank control group ，model group ，ICA low-dose ，medium-dose and high-dose groups （15，30，60 mg/kg）. Except for blank control group ，other groups were given N-methyl-D-aspartate receptor antagonist MK- 801（0.2 mg/kg）intraperitoneally to induce schizophrenia rats models ，once a day ，for consecutive 14 days. After modeling，ICA groups were intragastrically administered with the corresponding drugs ，while blank control group and model group were intragastrically administered with the same volume of water ，once a day ，for consecutive 7 days. The behavioral com changes of rats were detected by Morris water maze test ，open field test ， forced swimming test and Y maze test pathological changes of hippocampus were observed by Nissl staining；the levels of cholinergic indexes [acetylcholine （Ach），choline acetyltransferase （ChAT） and acetylcholinesterase （AchE）] in cerebral tissues were detected by ELISA. The expression of BDNF ，ERK and CREB mRNA in cerebral tissue were detected by RT-PCR ；expression or phosphorylation level of BDNF ，ERK，CREB protein ，apoptosis related proteins （Bcl-2，Bax and Caspase- 3）were detected by Western blot. RESULTS ：Compared with blank control group ，escape latency ，distance at T 1-T3， cumulative immobility time and the expression of Caspase- 3 protein in cerebral tissues were significantly increased in model group （P＜0.05）；the times of crossing platform ，alternation rate ，the number of Nissl staining positive neurons in hippocampus tissues ， the levels of Ach and ChAT in cerebral tissues ，Bcl-2/Bax ratio ，mRNA and protein expression of BDNF ，mRNA expression of ERK and CREB ，the phosphorylation of ERK 1/2 and CREB were significantly decreased （P＜0.05）.Compared with model group ， escape latency ，distance at T 1-T3，cumulative immobility time ，the number of Nissl staining positive neurons ，AchE level in cerebral tissues and relative expression of Caspase- 3 protein were significantly decreased in ICA high-dose group （P＜0.05）；the times of crossing platform ，alternation rate ，levels of Ach and ChAT in cerebral tissues ，Bcl-2/Bax ratio ，mRNA and protein expression of BDNF ，mRNA expression of ERK and CREB ，the phosphorylation of ERK 1/2 and CREB were increased significantly（P＜0.05）. Above indexes in ICA low-dose and medium-dose groups were partially improved significantly than model group（P＜0.05）. CONCLUSIONS ：ICA can improve cognitive function in schizophrenia model rats.Its mechanism may be related to regulating cholinergic system ，inhibiting neuronal apoptosis ，and promoting the expression of BDNF/ERK/CREB signaling pathway.

Objective To understand the current status of healthcare-associated infections (HAI) among inpatients in medical institutions of Wuhan, and to provide a scientific basis for improving the management of healthcare-associated infections. Methods A combined method of bedside investigation and case review of the patients’ medical records were used to investigate all hospitalized patients in 31 hospitals. Results A total of 42 429 inpatients were investigated, of whom 938 had HAI (2.21%), and 7 561 had community-associated infection (CAI, 17.82%). The top three departments with the highest prevalence rate of HAI were ICU (17.95%), hematology (8.49%), and neurosurgery (6.57%), while the top three departments with the highest prevalence rate of CAI were burns (75.00%), pediatric non-neonatal group (70.26%) and respiratory department (67.53%). Both healthcare-associated infections and community infections were mainly in the lower respiratory tract, which accounted for 47.33% and 53.00%, respectively. The main pathogens of both HAI and CAI were Gram-negative bacteria, which accounted for 65.03% and 57.73%, respectively. The use rate of antimicrobial drugs was 31.74%, and the detection rate of pathogenic bacteria before antimicrobial treatment was 55.77%. The three departments with the highest rates of the use of antibacterial drugs were the pediatric non-neonatal group (78.20%), the department of burns (75.00%) and the department of urology (73.24%). Conclusion ICU, hematology department, and neurosurgery department were high-risk departments for healthcare-associated infections. Pediatrics, burns, and urology departments were the departments with high use of antibacterial drugs. The pathogenic bacterial detection rate has declined, which needs to be strengthened.

AIM: To establish individualized drug therapy strategy for patients with rejection and hyperglycemia after liver transplantation. METHODS: Clinical pharmacist collaborated with the surgeons and participated in the diagnosis and treatment of rejection and hyperglycemia after liver transplantation. Taking together liver function, therapeutic drug monitoring, drug-drug interactions between tacrolimus and wuzhi capsule, individualized drug therapy was adapted to improve the prognosis. RESULTS: The patient recovered well and survived in good health till now. CONCLUSION: It is highly suggested that clinical pharmacists actively involved in treatment of more severe and difficult-to-treat disease and design the individualized dosing regimens. This will largely contribute in reduced adverse drug reaction, improved safety and effectiveness in drug use as well as the quality of life in the "post-transplantation era".