ObjectiveTo study the value of brain stem auditory evoked potentials (BAEP) in evaluating the function of brainstem and judging the prognosis in patients with severe traumatic brain injury in vegetative state. Methods30 cases with severe traumatic brain injury in vegetative state were examined by BAEP and assessed with Glasgow Coma Scale (GCS) before comprehensive rehabilitation treatment and 1 month later. The patients were re-examined by BAEP and assessed with Glasgow Outcome Scale (GOS) after 6-month in follow-up. The relationship between BAEP grade and GCS or GOS was analyzed. The variety of BAEP in regaining consciousness was also analyzed.Results The abnormal rate of BAEP was 93.3% (28/30 cases) before rehabilitation treatment while it was 86.7% (26/30 cases) after 1 month. The higher the BAEP grade was, the poorer the prognosis was. There were 12 patients who regained consciousness.The main variety in these patients was the appearance of wave Ⅴ, as well as the improvement of each wave' shape and the shortening of peak latent period. ConclusionsBAEP can evaluate the function of brain stem in patients with severe traumatic brain injury in vegetative state and provide evidences for prognosis. The appearance of wave Ⅴ prompts the recovery of function of brain stem as an index of cerebral electrophysiology in improvement of consciousness.

Background and purpose:Chemotherapy plays an important role in the treatment of gastric cancer.It is becoming a direction that the choice of chemotherapeutic agent for the clinic will be based on the levels of some relative gene expressions in the tumor tissue.As the key enzymes of fluoropyrimidines,the expression levels of thymidylate synthase(TS) and thymidine phosphorylase(TP) may correlate with the response of tumor to chemotherapy.This study was to investigate the expression of TS and TP mRNA in gastric cancer tissues and their correlation with prognosis.Methods:The expression levels of TS,TP mRNA in 51 gastric adenocarcinoma tissues were detected by real-time quantitative reverse transcription polymerase chain reaction(RT-PCR).Results:The median expression levels of TS,TP mRNA were 0.94 and 21.20,respectively.There was significant difference in terms of disease-free and overall survival between the gastric cancer patients with high and low TS mRNA expression level(P0.05)but not overall survival(P0.05).Conclusions:The expression levels of TS,TP mRNA may serve as prognostic markers for gastric cancer patients treated with FU-based adjuvant chemotherapy.

Objective To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in hu-mans,so as to provide a reference for its application in clinical practice. Methods The sera collected from the patients with neurocysticercosis,echinococcosis,taeniasis and healthy people,respectively,were checked by ELISA for specific IgG anti-bodies against T. solium cysticercus,as described in the instruction of the kit. Results Of the 30 patients with neurocysticerco-sis at active stage,28 showed seropositive reaction,indicating a sensitivity of 93.33%. There were no positive reactions in the 100 healthy people. Two of the 42 persons with taeniasis were seropositive with an infection rate of 4.76%. Forty-one of the 60 persons with echinococcosis showed positive reactions,suggesting that the cross reaction rate of the kit with echinococcosis was 68.33%. Conclusions The assessed ELISA kit has a reasonably high sensitivity but a poor specificity,and the cross reaction rate with echinococcosis is very high. It is urgent to improve the sensitivity and specificity of the diagnostic kit for detection of T. solium cysticercosis in China.

Objective To investigate ?-Lactamase coding genes and OprD2 gene in multidrug-resistant Pseudomonas aeruginosa isolated from Xiangfan region in Hubei province.Method Polymerase chain reaction(PCR) was used to detect various ?-Lactamase coding genes including TEM、SHV、OXA、PER、GES、IMP、VIM、plasmid type AmpC ?-Lactamase DHA 、MIR and OprD2 in 35 strains of Pseudomonas aeruginosa.Results The detection rate of ?-Lactamase coding genes TEM、OXA、plasmid type AmpC ?-Lactamase DHA were 51.4%、17.1% and 2.9% respectively, all of the tested strains of Pseudomonas aeruginosa lossed OprD2 gene,but SHV、PER、GES、IMP、VIM、MIR genes were negative.Conclusion The study indicated that these Pseudomonas aeruginosa carried genes of TEM、OXA、plasmid type AmpC ?-Lactamase DHA and lossed OprD2 gene, which was the essential resistance mechanism of Pseudomonas aeruginosa to Beta-lactam antibiotics in local aera.

OBJECTIVE To study the mechanisms of imipenem resistance in Pseudomonas aeruginosa.METHODS PCR method was used to detect and analyze P.aeruginosa imipenem-resistance associated IMP gene and VIM gene of metallo-?-lactamases and outer membrane protein D2(OprD_2) gene.RESULTS All 35(imipenem)-resistant P.aeruginosa strains were negative for IMP gene and VIM gene of metallo-?-lactamases;and for OprD_2 gene;but 23S rRNA gene of all 35 P.aeruginosa strains was positive.CONCLUSIONS The study suggested that in(Xiangfan) area,Hubei Province P.aeruginosa doesn′t produce metallo-?-(lactamases),but in genetics it is(identified) that the loss of outermembrane protein D2(OprD_2) gene is the(essential) mechanisms of imipenem(resistance) in P.aeruginosa in Xiangfan area,Hubei Province.

Objective To study the effect of cream of bedsore on the treatment of severe bedsore.Method One hundred and twenty patients were randomly divided into treatment group and control groups Ⅰ and Ⅱ,respecially 40 patients,given systemic treatment.Results The decubitus wound healing of treatment group was significantly better than the other two groups,the total effective rate being 85%,P ＜ 0.01.In the treatment group,pathogenic bacteria culture positive rate on decubitus wound was significantly lower than the two control groups,inhibition rate being 78%,P ＜ 0.05.Staphylococcus aureus,Pseudomonas aeruginosa,Escherichia coli and so on were inhibited.Conclusions In the treatment group,bedsore healing ointment was significantly better than Western medicine used in the control groups.It can improve the microcirculation of the blood perfusion,promote the establishment of collateral circulation,increase the affected area nutrition,improve the local tissue ischemia,hypoxia-induced metabolic disorders,and remove the necrotic tissue,and promote tissue repair and regeneration,the granulation growing,and the effect of epithelial healing.

ObjectiveTo measure the level of T lymphocyte subsets and immunoglobulin in cervical spinal cord injury. Methods36 cases with cervical spinal cord injury were measured in T lymphocyte subsets and immunoglobulin of vein blood before and after the rehabilitation therapy. By comparing with control group, the state of immune functional in the injury was analyzed.ResultsThe cellular and humoral immune were inhibited distinctly. The level of CD3+,CD4+,CD4+/CD8+ and IgG of TBI group were lower than the level of control group. The CD3+ and CD4+/CD8+ were improved after treatment. The immune state of complete injury was inhibited more seriously than incomplete injury. ConclusionsThe cellular and humoral immune of cervical spinal cord injury were inhibited. The more seriously of the injury, the more inhibited of immune function.

Objective To determine the effect of community family visit on patients with metabolic syndrome.Methods According to the diagnostic criteria set up by the Diabetes Society of the Chinese Medical Association 220 patients with metabolic syndrome were equally divided into two groups:family visit group and control group.The family visit group was followed up by full-time medical staff regularly,while not interfering with the control group.After one year before and after the intervention,the relevant indicators were compared between the two groups.Results The levels of SBP,DBP,TG,TC,LDL-ch,24-hour urine protein were lowered markedly by intervention (P＜0.05).HDL-ch increased compared to the previous (t= 7.921,P＜0.05),but body mass index were not significantly changed.Before and after the intervention the levels of SBP,DBP,TG were ideal This was followed by significant improvement of fasting plasma glucose (FPG),two hours after meal blood glucose (2 hPG),TC,HDL set standards,24-hour urine protein body mass index.Compared with the control group,the family visit group showed siguificant improvement of related indicators except body mass index and TC.Condusion Intervention by family visit is effective in improving the vales of metabolic syndrome.

Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.

Objective To explore the efficacy of process management on bladder function among traumatic brain injury (TBI) patients admitted to intensive rehabilitation and care unit (IRCU). Methods 33 cases were collected to control group who were cared with routing nursing during February, 2011 to December, 2012. Other 39 cases were recruited to trial group cared with process management of bladder function during January, 2013 to December, 2014. Process management of bladder function contained the establishment of process manage-ment guide, evaluation of removing catheter, nursing of bladder based on residue of urine volume and keeping a diary of urination, etc. Re-sults There were more cases with residue of urine volume less than 100 ml and less with catheter associated urinary tract infection in the tri-al group than in the control group (P<0.05). Conclusion Process management of bladder function can improve the recovery of bladder func-tion of TBI patients, shorten rehabilitation time and decrease the risk of catheter associated urinary tract infection.