Objective To investigate the transition of uropathogens and drug resistance in patients with type 2 diabetes(T2DM)complicated with urinary tract infection(UTI)in recent 10 years.Methods A total of 392 cases of T2DM with UTI were included in the study.The patients were divided into 2 groups according to time of hospitalization:group A(January 1998 to December 2002)and group B(January 2003 to December 2007).Clinical information,distilbution of uropathogens and antibiotic resistance between the two groups were analyzed.Results The most common pathogens isolated were Escherichia coli(50/152,32.89%),followed by Candida albicans(21/152,13.82%)and Enterococcus faecium(15/152,9.87%).Of the various pathogenic organisms isolated in group B,there were 16 new species not seen in group A.Escherichia coli was found to have higher resistant rates to ciprofloxacin and ceftriaxone in group B than in group A(80.8%vs.42.8%,26.9%vs.0,respectively).Enterococcus faecium was found to be more susceptibility to tetracycline in group B than in group A(0 vs.100.O%).Conclusion Species of uropathogens in T2DM patients ale increased,and the isolates are of high drug resistance,which should be noted in clinic.

To study the pharmacokinetics of ginsenosides Rg1 and its metabolites after iv and oral administration in Wistar rats, the LC-MS/MS method was selected to determine ginsenosides Rg1 and its metabolites in plasma and their pharmacokinetic parameters were calculated. After oral administration of ginsenosides Rg1 to rats, ginsenosides Rg1, Rh1, F1 and protopanaxatriol (Ppt) could be detected in plasma. Their Tmax were 0.92, 3.64, 5.17, and 7.30 h, respectively; MRT were 2.68, 5.06, 6.65, and 5.33 h, respectively; AUC(o-t), were 2 363.5, 4 185.5, 3 774.3, and 396.2 ng x mL(-1) x h, respectively. After iv administration of ginsenosides Rg1 to rats, ginsenosides Rg1, Rh1 and FI could be detected in plasma. Their T1/2betaS were 3.12, 5.87, and 6.87 h, respectively; MRTs were 1.92, 5.99, and 7.13 h, respectively; AUCo-tS were 1 454.7, 597.5, and 805.6 ng x mL(-1) x h, respectively. So, it can be concluded that after oral administration, the amounts of metabolites were higher than the prototype in vivo, and the distribution and elimination of the metabolites were relatively slow. After iv administration, the amount of prototype were higher than that of the metabolites in vivo, and the distribution and elimination of the metabolites were relatively slow.

Objective To compare the body weight,height,head circumference of premature babies fed by different ways,and to analyze the advantages and disadvantages.Methods 260 premature infants were selected as the research subjects,according to random number table,they were divided into four groups.Group A:premature infant formula feeding,80 cases;Group B:pure breast feeding group,60 cases;Group C:normal full term formula feeding,60 cases;Group D:premature infant formula mixed breast feeding,60 cases.All children were fed at the first 12 to 24h after birth.The body weight,height,head circumference and catch up full term time were evaluation index. Results After correct gestational age 40 weeks,group B children'weight,height,head circumference were higher than other groups,group C was the lowest levels,the difference was statistically significant (F =3.563,P <0.05).Correct gestational age 1,3,6 months later,group A children'weight,height and head circumference index were higher than other feeding group,the level of group D was the second,the lowest level was group C,the differences were statistically significant (F =3.011,2.853,2.779,all P <0.05).In 6 months,group A,38.8% (31 /80),was the fastest one to reach the full term infant,the difference was statistically significant (χ2 =29.149,P <0.05).At other time,the pur-suing number of group A was bigger,but there was no statistically significant difference.Conclusion For premature babies,preterm infant formula milk powder or premature infant formula and milk feeding way is better than that of pure breast feeding and normal full term milk powder,which can guarantee the children's nutrition demand,shorten the time of pursuing full term infant,promote baby's health.

Objective To observe the hypoglycemic effect of total flavonoids from mulberry tree leaf (MTF) on diabetic rats and the effect of MTF on disaccharidases from rats. Methods Diabetic rats were treated with MTF, and then the change of blood glucose of these rats was observed; the brush border membrane from the small intestine of rats was stripped and homogenized, which was incubated with MTF and disaccharides, and the inhibitory rate of MTF on disaccharidases was determined. Blood samples from portal and peripheral veins were separately collected at 30, 60, 120 min after maltose solution was infused into small intestine in vivo, then the difference of blood glucose concentration between portal and peripheral veins was determined. Results MTF exerted a hypoglycemic effect on diabetic rats by inhibition of disaccharidases, the inhibitory rate of sucrase, maltase and lactase was 68.0%, 47.1%, 27.8% respectively, the difference of blood glucose concentration between portal and peripheral veins was also reduced. Conclusion The hypoglycemic effect of MTF on diabetic rats is probably via the inhibitory effect on small intestine disaccharidases in rats.

Objective:To investigate the protective effect of intratracheal transplantation of different dose of human umbilical cord mesenchymal stem cells (MSCs) in rats with acute lung injury induced by severe burns.Methods:Seventy-five male Wistar rats were randomly divided into five groups:Sham(group A),Saline group(group B) and different doses of hUMSCs transplantation groups(C,D and E).The dosage ofhUMSCs was 1 × 105,5 × 105 and 1 × 106 respectively.Rats inflicted by 50 ％TBSA Ⅲ degree scalding employed as the model.After modeling,rats in group B and transplantation groups were immediately fluid resuscitated.Transplantation groups were intratracheally administered different dose hUCMSCs (0.2 mL),and group B were given normal saline in the same dose intratracheally.The lung tissue samples were collected on day 1,day 3 and day 7 after administration.HE staining was used to observe the pathological changes of lung tissue.MPO and CD68 immunohistochemical staining were used to observe the positive expression of neutrophils and macrophages in lung tissue.Results:Lung pathology showed that alveolar cavity was clear,alveolar structure integrity,occasionally a small amount of inflammatory cells of group A at each time point.At 1 day after scald,group B and the transplantation group (group C,D,E)the alveolar septum was thickened,and there was visible pulmonary capillary hyperemia,as well as a large amount of inflammatory cell infiltrations in the pulmonary capillaries and alveolar space.At 3 day,group B and the transplantation group alveolar structural damage,pulmonary hemorrhage and inflammatory cell infiltrations were better than those in 1 day.Compared with group B,the alveolar structure was clear and the septum was thinner,but there was no significant difference between the transplantation groups.On the 7 day after scald,the lung injury in the transplanted group was significantly less than group B,and the recovery of the injured lung tissue in E group was the most obvious.The number of the MPO positive cells increased significantly on the first day after scald (P ＜0.05) compared with group A,but there was no significant difference between the two groups.Compared with B group,the number of positive cells in transplantation group was significantly reduced at 3 and 7 day after scald,(P＜0.05),and the number of positive cells in group E was significantly lower than other groups (P＜0.05).CD68 staining showed a significant increase in positive cells in each group on day 1 (P＞ 0.05).The number of positive cells decreased in 3 day after transplantation (P＜0.05),but there was no significant difference between the transplantation groups.The number of positive cells in transplantation group was significantly lower than group B (P＜0.05) after 7 day.Compared with group C and D,there was significant difference in group E (P＜0.05).Conclusions:Intratracheal transplantation of different dose hUCMSCs have protective on severe burns induced acute lung injury models;the protection mechanisms may be that the hUCMSCs transplantation can inhibit the invasion of the inflammatory cells in lung tissues,and the optimal dosage is 1 × 106.

Objective To investigate the prevalence of adult epileptic patients with interictal depression symptoms(IDs) and identify early predictors of IDs. Methods Adult patients with epilepsy were recruited ( n =110,45 females and 65 males) ,age between 16 and 67 years ( median 24 years). The sociodemographic and clinical factors of patients were recorded. Hamilton Depression Scale ( HAMD ) were applied to evaluate interictal symptoms of depression ( at least 72 hours after the last epileptic seizure). According to HAMD score,the epileptic patients were divided into IDs ( ≥8 ) and non-IDs(＜8) groups. The sociodemographic and clinical factors were compared between the two groups to identify the prevalence and early predictors of IDs in adult epileptic patients.Results The prevalence of IDs in adult patients with epilepsy was 38.2% ,49.0% in active epilepsy and 12.1 %in seizure freedom. 30.0% ,5.5% ,and 2.7% were experiencing mild-to-moderate (HAMD score≥8),moderateto-severe ( ≥ 18 ) and severe ( ≥25 ) depression. 42 patients who met the HAMD score≥8 were classified as IDs group,and the remaining 68 patients were classified as non-IDs group. With multiple stepwise backward logistic regreasion, independent predictors of IDs were epileptic seizures ( OR = 8. 845, P = 0. 003 ); symptomatic or cryprogenic epilepsy ( OR = 3.132, P = 0. 045 ); prolonged duration of illness ( OR = 1. 106, P = 0.004 ) and employment status (OR =0. 154, P=0.001 ). There were no relationship between seizure frequency and severity of IDs ( Kruskal-Wallis test, x2 = 4.5, P = 0. 104). Conclusion IDs is a frequent psychiatric comorbidity in adult patients with epilepsy. The prevalence of IDs is higher in those with active epilepsy compared with those in seizure freedom and most of them are mild-to-moderate. Epileptic seizure, symptomatic or cryprogenic epilepsy, prolonged duration of illness and employment status are independent predictors of IDs, but seizure frequency has nothing to do with the IDs severity of patients.

Objective To assess the neuropsychological characteristics in active epileptic patients and investigate itsrisk factors. Methods Ninety adult epileptic patients included 60 active epileptic patients (two or more unprovoked seizures within 12 months) and 30 age-, sex-, education-, course of disease- and seizure type-matched seizure-free subjects (without epileptic seizure for at least 1 year) . The neuropsychological tests including trail making test,digit symbol test, verbal fluency test,digit span test and hamilton depression scale( HAMD) ,were used to detect mental and motor speed, attention, language, working memory and depression symptoms respectively. The neuropsychological tests were compared between active and seizure-free epileptic patients and identified the risk factors of neuropsychological deficits in active epileptic patients. Results Compared to seizure-free subjects, active epileptic patients had significantly worse scores in digit symbol test, verbal fluency test, digit span test ((47.45 ±18. 812) vs(56.40 ±13. 631), (25. 25 ±8. 163) vs(30.40 ±8. 414), (10. 39 ±2. 228) vs( 11. 80 ± 2.074) respectively) ; more time to accomplish the trail making test A and B((64. 35 ±31.710) vs( 45. 47 ± 16. 309) , ( 133. 18 ± 47. 331 ) vs ( 98. 00 ± 35. 003 ) respectively) ; and higher scores in depressive symptoms ((9.12 ±6.219)vs(3.77 ±3.997) ,all P<0.05). Within active epileptic group,significant predictors of neuropsychological deficits were identified in a stepwise linear regression analysis: advancing age was significantly negatively correlated with digit symbol test(β = -0. 468, P = 0. 000) , digit span test (β = -0. 439, P = 0. 000), trail making test A (β =0.365, P = 0.003) and B(β = 0.346, P=0.002) ; higher scores on depressive symptoms was significantly negatively correlated with digit symbol test (β = -0.244, P = 0.015) ; mental work,high-education level and monotherapy were positively correlated with some of the cognitive function subscales. Conclusion This study suggests that active epilepsy can have a direct adverse effect on cognition and depression symptoms. Multi-drug therapy, severity of depression symptoms, advancing age, low-education level and non-mental work are the predictors of neuropsychological impairment in active epilepsy. In addition, good seizure control even after 1 year can have a beneficial impact on cognitive and depression prognosis.

Two eases of Hashimoto's encephalopathy (HE) are reported and relative literature is reviewed in this article.Both cases were female,with disturbance of consciousness and dementia as initial symptoms.Marked increase of anti-thyroid antibodies was found in serum of the patients.The symptoms disappeared after steroids and maintenance therapies.A total of 126 cases of HE in Chinese literature were retrieved from 2006 to 2015 through the databases of China National Knowledge Infrastructure and Wanfang Med Online.The male/female radio was 1 ∶ 6 with an average age of 51.3 years.The clinical manifestations included cognitive impairment (44.5％),epilepsy (38.3％),psychiatric disorders (27.3％),stroke-like symptoms (25.8％),disturbance of consciousness (24.2％),and extrapyramidal symptoms (20.3％).Good response to steroids was observed in 77.2％ HE patients.Analysis indicates that HE is an autoimmune disease with the presence of neurological and psychiatric manifestations,elevated titers of anti-thyroid antibodies in serum and well response to steroids,with a good prognosis.

Objective To evaluate the feasibility of sentinel lymph node biopsy (SLNB) in patients with vulvar cancer. Methods Twenty-one patients with vulvar squamous cancer undergoing radical surgery admitted in Cancer Hospital of Chinese Academy of Medical Sciences from Oct.2004 to Apr.2008, were enrolled in the study. SLNB procedure was performed with blue dye alone in the first eleven patients, while the later ten patients, a combination procedure with radioactive tracer and blue dye was used to detect sentinel lymph node (SLN). All resected nodes were submitted to the pathological examination, which was considered as the gold standard to determine the efficacy of SLNB. The complications related to SLNB were also observed during the study. Results The sentinel node was identified in 20 patients (95%), included 8 cases with unilateral SLNs and 12 cases with bilateral SLN. A total of 83 SLN were identified with a mean number of 4.2 per patient (range, 1-9) or 2.6 per groin (range, 1-6). Difference between the mean number of SLN (4.4 per patient, 2.5 per groin) identified by blue dye or by combined procedure (3.9 per patient, 2.7 per groin) was not statistically significant (t=0.459,P=0.652;t=-0.421,P=0.717). Twenty patients were detected to positively superficial inguinal SLN and one of them also positively bilateral deep femoral SLN, 8 (10 groins) of them were detected positively nodal metastases. Among of eight patients, 7 (9 groins)of them were detected more than one SLN involved, while 1 of them were detected false-negative node involved. The false negative rate of was 10%(1/10), negative predictive value was 96%(22/23). No complications were attributed to the study. Conclusions SLNB procedure in vulvar cancer is feasible and safe. SLN identification appears to be highly accurate for detecting metastases in the ipsilateral inguinal lymphatic basins.

Objective To evaluate the etiology, clinicopathological characteristics, treatment and prognosis of VIN Ⅲ. Methods Thirty-five patients with VIN Ⅲ admitted in Cancer Hospital of Chinese Academy of Medical Sciences between 1993 and 2008 were analyzed retrospectively. Results All 35 patients attended to hospital with the symptoms of pruritus vulvae and lumps. Among of them, there were 28 (80%) cases whose lesions presented as multiple plaques, while 7 (20%) eases lesion were monofocal.Fifteen out of 35 eases had coexistent with human papillomavirus (HPV) related lesions, and there were the evidence of HPV in 22 patients whose pathologic sections revealed koilocytes. 34 cases (97%) except one received different types of surgical resections, including wide local resection (14/34), simple vulvectomy (16/34) and simple vulvectomy plus perianal skin resection (4/34), while there two cases shown positive cut-edges and one of them received radiotherapy postoperatively. Four out of the 34 cases recurred locally in 2, 4, 6 and 22 months and received surgical treatment again or laser therapy, respectively. The median follow-up period was 66 months ( range 1-166), and none of them were died of the disease itself except one case died of the concurrent cervical cancer. Among 26 cases received the investigation of the quality of life,there were nine cases (35%) suffered from sexual dysfunction after the operation, and one of them received vulvoplasty. Conclusions VIN Ⅲ has good prognosis. The development of VIN Ⅲ may be related to the infection of HPV, because most of them concurrent with HPV diseases. Its primary treatment is surgical resection, while affecting on the quality of life.