Objective To observe the clinical effect of Zhenwu decoction combined with Linggui-Zhugan decoction on senile patients with heart failure. Methods A total of 123 patients with heart failure who met the inclusion criteria were randomly divided into 3 groups by random number table method, each group of 41 cases. The patients in the control group were treated with routine western medicine, Zhenwu decoction group was treated with Zhenwu decoction on the basis of the control group treatment, and the combined decoction group was treated with Zhenwu and Linggui-Zhugan decoction on the basis of the control group. The treatment last 4 weeks as 1 course, 2 courses in total. The TCM syndrome score, left ventricular ejection fraction, brain natriuretic peptide level, nt-probnp level and TGF-?1 level were observed, and the clinical effect was evaluated. Results After 8 weeks treatment, Palpitation (0.68 ± 0.53 vs. 0.79 ± 0.64, 1.12 ± 0.70, F=7.207), chest distress (0.66 ± 0.52 vs. 0.79 ± 0.60, 1.36 ± 0.70, F=6.367), edema (0.32 ± 0.31 vs. 0.43 ± 0.41, 0.52 ± 0.37, F=7.054), wheezing (0.62 ± 0.55 vs. 0.82 ± 0.69, 0.88 ± 0.68, F=6.634), fatigue (0.73 ± 0.47 vs. 0.94 ± 0.62, 1.49 ± 0.58, F=5.832), spontaneous sweat (0.46 ± 0.39 vs. 0.89 ± 0.62, 0.99 ± 0.79, F=7.207), insomnia (0.42 ± 0.39 vs. 0.74 ± 0.50, 0.79 ± 0.58, F=6.672) in the combination group were significantly lowere than those in the other two groups (P<0.05). The TGF-?1 (102.75 ± 15.79 ng/L vs. 121.57 ± 19.25 ng/L, 184.35 ± 23.74 ng/L, F=160.776) in the combination group was significantly lowere than that in the other two groups (P<0.01). The total effective rate was 81.8% (27/33) in the combination group, 78.1% (25/32) in the Zhenwu group, and 62.16% (23/37) in the control group. The the difference of total effective rates among three groups were statistically significant (χ2=7.089, P=0.037 ). Conclusions The Zhenwu decoction and Linggui-Zhugan decoction combined with the routine therapy can improve the symptoms and signs of elderly patients with heart failure, and reduce the serum TGF-1 level.

ctive method for previously untreated ITP patients and maintenece treatment with small-dose dexamethasone between high-dose dexamethasone contributes to improve the long-term curative effect.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

0.05).CONCLUSION: There is no pharmacoeconomic difference between aripiprazol and risperidone in the treatment schizophrenia.

Objective To explore the clinical pathologic characteristics of gallbladder cancer and prognostic factors for patients with gallbladder cancer.Methods We retrospectively reviewed 108 patients diagnosed pathologically with gallbladder cancer and treated in HuBei Three Gorges Polytechnic Medical College,Yichang Central People's Hospital and Yichang First People's Hospital from January 2003 to December 2012.Kaplan-Meier method was used to estimate survival.The association between the clinicopathologic characteristic and the prognosis in gallbladder cancer patients was assessed using Log-rank test.Cox proportional hazards model was used to determine independent risk factors.Results All patients were followed up from 3 to 102 months,the median follow-up time was 46 months.There were 77 deaths (71.3％),31 patients are alive.Survival time after operation was from 4-98 months.The mean and the median survival time were 28.4 months and 17 months respectively.The 1,2,3 and 5-year overall survival rates were 54.2％,37.5％,31.3％ and 21.6％.Multivariate analysis indicated independent risk factors were such as incidental gallbladder cancer,lymph node metastasis,poor differentiation.Conclusions Gallbladder cancer is a malignancy with poor prognosis.Incidental gallbladder cancer,lymph node metastasis,tumor poor differentiation are independent risk factors.

BACKGROUND: BALB/c and C57BL/6 mice are two inbred strains, but after voluntary movement, there is no report on how to scientifical y reasonably select behavioral experiment methods and indicators and to evaluate the learning and memory abilities of mice.
OBJECTIVE: To analyze and compare the behavioral indicators between BALB/c and C57BL/6 mice fol owing voluntary wheel running, to explore the effect of exercise on learning and memory, and to provide a reference for selecting reasonable behavioral indicators.
METHODS: 2.5-month-old BALB/c and C57BL/6 mice were randomly divided into control and voluntary wheel running groups. Independent running wheel movement of mice was recorded with VitalView system. 4 weeks later, newborn neurons were labeled via DCX immunofluorescence. Spatial learning, memory and exploration abilities were compared through new arm test, new object recognition test and Morris water maze test.
RESULTS AND CONCLUSION: (1) The mean spontaneous activity of BALB/c mice daily was 2.56 fold of that of C57BL/6 mice during wheel running (P < 0.001). (2) Hippocampal DCX-positive cel s in exercised BALB/c and C57BL/6 mice were more than those in control group. (3) Meantime, exhibited by higher frequencies to explore new arm or object, and longer time and distance of moving around them, the learning and exploring capability was improved after exercising (P < 0.001), especial y in BALB/c mice. (4) Wheel running C57BL/6 mice exhibited progressed spatial learning and memory abilities compared with control mice in Morris water maze test, characterized by decreased latency to target, elevated target crossings and longer time or distance in quadrant zone (P < 0.05). However, there was no significant difference between wheel running and control BALB/c mice. Taken these data together, voluntary wheel running contributed to hippocampal neurogenesis of BALB/c and C57BL/6 mice, accompanied by the change of learning and memory capability, which could be detected properly via both new arm test and new object recognition test, but for Morris water maze test, C57BL/6 mice might be superior to BALB/c mice.

Humans ; Intestines ; microbiology ; Liver Diseases ; Microbiota

ObjectiveTo investigate the variations and distributions of the plasmid-mediated quinolone resistance genes in clinical isolates of Shigella and their resistance to antimicrobial agents. Methodsqnr, aac(6')-Ib-cr and qepA genes were identified by polymerase chain reaction (PCR) in 137 clinical isolates of Shigella.DNA sequencing of gene-positive strains were analyzed and the conjugation experiment was performed. The minimal inhibitory concentrations (MIC) of Shigella isolates, recipient strains and transconjugants were tested by agar dilution method for quinolones and other antimicrobial agents. The genotype of transconjugants were determined by PCR and sequencing. ResultsFour (2.9％) strains of the 137 Shigella isolates were qnr gene positive, including 3 qnrS2 positive and 1 qnrB4 positive (GenBank accession numbers of the complete sequence were JF261185 and HQ917003, respectively).Furthermore,five (3.6％) aac ( 6')-Ib-cr gene-positive strains (GenBank accession number JF261186 ) and one (0.7％) qepA gene-positive strain were identified in all isolates. The conjugation experiments were successfully carried out in six out of ten PCR-positive isolates. The MIC of transconjugants against quinolones and other antimicrobial agents increased differently compared to recipient strains. Conclusions The plasmid-mediated quinolone resistance genes are lowly prevalent in clinical isolates of Shigella. However, these resistance genes have the characteristic of horizontal transfer, which indicates that more attention should be paid to this phenomenon.

Objective To dynamic monitor and analyze the characteristic of polysomnography (PSG)and melatonin levels of delirium patients in intensive care unit (ICU). Methods A prospective observational study was performed from December 2013 to April 2014. The patients admitted to ICU of Affiliated Hospital of Binzhou Medical College for more than 72 hours were evaluated with confusion assessment method for the ICU (CAM-ICU),and were divided into delirium group and non-delirium group. Sleep patterns of all the patients underwent continuous PSG for up to 24 hours were evaluated. Melatonin levels were determined every 4 hours with enzyme linked immunosorbent assay (ELISA)duration sleep monitoring. Results Eighteen patients were enrolled,and 9 were delirium patients. All the patients had sleep disorders:a decrease in rapid eye movement (REM)sleep 〔(5.91±5.26)%〕,an increase in the sleep fragmentations 〔arousal index was (15.40 ±12.79)times/h〕,and the N3 sleep stage was on the lower limit of normal 〔(14.67 ±11.10)%〕. Compared with non-delirium group,the REM sleep was significantly decreased in delirium group〔(0.10±0.20)%vs.(8.83±3.81)%,t=4.782,P=0.001〕. Melatonin levels lost rhythm between day and night,and there was no difference in melatonin between delirium group and non-delirium group (time effect:F=1.370,P=0.287;between-group effect:F=1.646,P=0.250;interaction effect:F=1.558,P=0.247). The peak of melatonin levels of delirium group appeared on 06:00 〔(137.84±62.21)ng/L〕and 14:00 〔(148.24±58.8)ng/L〕, the minimum value on 22:00 〔(64.47 ±26.97) ng/L〕. But in non-delirium group,the peak of melatonin levels appeared on 02:00 〔(63.52 ±39.75)ng/L〕,the minimum value on 10:00 〔(44.87 ±11.19)ng/L〕. Conclusions ICU patients have sleep disorders,and the delirium patients have less REM stage. Normal rhythmic melatonin secretion changes of ICU patients were lost. The delirium peak of patients appears in the daytime.

ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.