Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system.The biomarkers that are tested in cerebrospinal fluid (CSF) is important for diagnosis,prognosis and treatment efficacy of MS.Therefore,CSF tests are essential in MS patients.This review summarized and discussed the CSF biomarkers in MS,including the clinical widely used biomarkers and research on potential biomarker candidates.

OBJECTIVE:To provide reference for comprehensive intervention and management of chronic disease in China.METHODS:The global chronic disease trends and disease burden were summarized;theoretical framework,practice and experience of international chronic disease management were summarized and analyzed as well as enlightenment on domestic chronic disease management.RESULTS&CONCLUSIONS:Worldwide prepresentative chronic disease theory model mainly involved USA chronic disease nursing model and WHO innovation care for chronic conditions.Main experience of international chronic disease management is that managing based on community,confirming preferential intervened disease types,adopting standardized clinical diagnosis and treatment pathway,designing rational transfer treatment system,providing patient self-management support.At pres ent,chronic disease management have been improved in China,but is still poor in community management.It is necessary to strengthen community medical staff training about chronic disease prevention and treatment and health education for social group.

0 05), respectively.Conculsion Transduction of NKG 5SV into NK cell can augment its cytotoxic activity by enhancing its cytolytic ability.

ObjectiveTo investigate the clinicopathological features,immunohistochemical phenotype of pancreatic acinar cell carcinoma.MethodsEight cases of pancreatic acinar cell carcinoma admitted to our hospital from January 2001to January 2011were retrospectively analyzed. The clinicopathological characteristics,and immunohistochemical staining for phenotype were analyzed,then the follow-up data were summarized.ResultsAll 8 patients with pancreatic acinar cell carcinoma was male,with a median age of 47 years old.Tumors were located in the pancreatic head in 4 patients,pancreatic body and tail in 4 patients.The average tumor size was 4.5 cm × 4.0 cm × 3.2 cm,the section appeared as gray or gray-red and presented as solid or cystic lesions.Larger tumors were often accompanied by hemorrhage and necrosis.Microscopically,the tumor cells arranged in acinic,cord,trabecular or solid nests.The cytoplasm was abundant and eosinophilic.The nuclear was round,oval,slightly atypia.lmmunohistochemical staining showed diffusely positive for CAM5.2,α-AT,α-ACT and focally positive for CA19-9,CEA,E-cad,β-cat and MUC-1 and only occasionally positive for AFP,NSE,Syn and CgA.Follow-up data showed there was one case of postoperative death due to postoperative pancreatic leakage with abdominal infection.Liver metastasis occurred in 4 cases,among whom,2 cases died.ConclusionsPancreatic acinar cell carcinoma is a rare epithelial malignant tumor of pancreas,with distinct phenotype characteristics.

l 1H-MRS was good for clinical purpose.

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Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Hospital of Qiqihar during 2015.Methods Antimicrobial susceptibility test was carried out according to a unified protocol using automated system from January 1,2015 to December 31,2015.The results were analyzed with WHONET 5.6 software according to the 2014 breakpoints of Clinical and Laboratory Standards Institute.Results A total of 5 162 clinical isolates were collected,of which 28.1％ (1 450/5 162) were gram-positive cocci and 71.9％ (3 712/5 162) were gram-negative bacilli.About 36.5％ (255/698) ofS.aureus isolates and 81.4％ (180/221) of coagulase negative Staphylococcus isolates were resistant to methicillin.No S.aureus and coagulase negative Staphylococcus isolate were found resistant to vancomycin or linezolid.Enterococcus isolates showed low resistance to vancomycin and linezolid.One strain of E.faecium was found resistant to vancomycin.ESBLs were produced in 39.9％ (298/747) ofE.coli,26.1％ (294/1 127) ofKlebsiella spp.,and 15.6％ (12/77) ofP mirabilis strains.The Enterobacteriaceae strains were less resistant to imipenem,beta-lactam/beta-lactamase inhibitor combination and amikacin.About 36.6％ (163 / 445) of A.baumannii isolates and 1.8％ (13/715) of P.aeruginosa isolates were extensively drug-resistant strains.Conclusions Antibiotic resistance poses a serious threat to clinical practice,to which more attention should be paid.Clinical microbiology lab should make more efforts to provide better support to clinical therapy.

OBJECTIVE To investigate the resistance of Acinetobacter baumannii(ABA),and the mechanism of imipenem resistance in A.baumannii.METHODS All specimens were identified by VITEK-60 and the drug resistance was detected by Kirby-Bauer test.Three dimensional test was used to detect ESBLs and AmpC.PCR and DNA sequencing were performed to determine VIM,IMP,OXA-23 and OXA-24 ?-lactamases.Outer membrane protein was analyzed by SDS-PAGE,Reserpine synergistic inhibition test was used to study the active efflux mechanism.RESULTS Totally 120 strains were isolated from sputum(76.9%),and 16 strains from secretion(10.3%).ICU was the main infected department(51 strains,32.7%).The resistance to sulperazone was the lowest(20.5%),and to imipenem accounted for 38.5%,Of the 20 imipenem resistant strains,10 strains were ESBLs positive(50%),and 20 strains were AmpC positive(100%).VIM,IMP and OXA-24 ?-lactamases were not detected out,19 strains(95%) produced OXA-23.Compared to the imipenem-sensitive strains,the resistant strains lacked the outer membrane protein of 22?103,29?103 and 33?103.The MICs of A.baumannii to imipenem were not decreased by reserpine which demonstrated that excretive mechanism was negative.CONCLUSIONS ICU is the main infected department for ABA.The resistance rate is increasing for longer-term usage of carbopenem;OXA-23 production is the important resistance mechanism in ABA,AmpC production and outer membrane protein lacking show close relation to the drug-resistance in A.baumannii.

Objective To study the protection effect of dexmedetomidine and ulinastatin on acute lung in-jury caused by hepatic ischemia reperfusion. Methods 50 rats were randomly divided into 5 groups: the blank group, saline group, the dexmedetomidine group, the ulinastatin group, the dexmedetomidine and ulinastatin group. Ischemia-reperfusion models were established and drugs were administrated through femoral vein. The levels of MDA, SOD and ICAM were detected. Results Compared with the blank group, the rest of the groups of PaO2, pH and SOD activity were significantly lower (P < 0.05), and BE, pathological grading, MDA, ICAM levels were significantly higher (P<0.05). PaO2, pH and SOD activity of ulinastatin group were significantly lower in the phys-iological saline group (P < 0.05), BE, pathological grading, MDA level, ICAM levels were significantly elevated in the physiological saline group (P<0.05). Conclusion Combination of dexmedetomidine and ulinastatin have protection effect on acute lung injury caused by hepatic ischemia reperfusion, its mechanism may be related to in-hibit neutrophil aggregation, improve their antioxidant capacity and inhibition of lipid peroxidation.

ObjectiveTo develop a quantitative method for simultaneously determining multi-components in Rhei Radix et Rhizoma using one chemical reference substance.MethodsThe contents of multi-components were calculated by the UV relative correction factors (RCFs) of chrysophanol,physcion,and rhein to emodin.ResultsThe values of RCFs at 274 nm for rhein,chrysophanol,and physcion to emodin were 0.712,0.674,and 1.051.The calibration curves were linear over the ranges of 0.02-4.08,0.02-4.12,0.07- 12.92,and 0.02-3.68 μg/mL for rhein,emodin,chrysophanol,and physcion,respectively.The contents of emodin in 18 samples were determined by the extemal standard method,and the contents of the other three anthraquinone aglycones were calculated according to their RCFs.ConclusionNo significant difference is found in comparison with the classical method,indicating that the RCFs have high reliability within their linear ranges and could be used in quality control of Rhei Radix et Rhizoma.The quantitative analysis of multi-component with a single marker is especially suitable for herbal medicines containing unstable or hard to be purified components as quality control markers.