Objective To observe the efficacy and safety of huperzine A combined with memantine in patients with Alzheimer disease (AD).Methods Sixty-five cases of AD were randomly divided into control group(32 cases) and treatment group(33 cases) by order of admission.The patients in control group were given memantine.The patients in treatment group were given huperzine A combined with memantine.The efficacy and safety was observed and compared between two groups.Results The mini-mental state examination score after treatment of 24 weeks in treatment group was higher than that in control group [(17.9 ± 1.8) scores vs.(16.2 ± 1.2) scores,P ＜ 0.05].The AD assessment scale of cognitive scale score after treatment of 24 weeks in treatment group was lower than that in control group [(19.9 + 4.8) scores vs.(22.2 ± 5.2) scores,P ＜ 0.05].The superoxide dismutase level after treatment of 24 weeks in treatment group was higher than that in control group [(102.4 ± 2.3) U/L vs.(95.4 ± 7.6) U/L,P ＜ 0.05].The neuron-specific enolase level after treatment of 24 weeks in treatment group was lower than that in control group [(6.3 ± 1.2)μ g/L vs.(7.4 + 1.4)μ g/L,P ＜ 0.05].During treatment,patients showed no serious adverse reactions.Conclusion Huperzine A and memantine has synergistic effects,the combined treatment in AD is safe and reliable.

The QCC campaign at the emergency center was themed as minimizing incidence of risky transport of critically ill patients,which aimed at continued quality improvement by means of conditions review,problem analysis,measures making,and procedure improvement.The incidence of risky transports dropped from 26％ to 0.9％ in six months.Another promising outcome was a sharp betterment of clinical nurse management. It has proved that QCC can effectively downsize risky transports of critically ill patients,making it a functional means to improve nursing quality.

Objective To investigate the pancreas size and echo characteristics of patients with glucose metabolism disorders including type 2 diabetes,and to study its related factors.Methods One hundred and fifty-seven patients from Nanjing Drum Tower Hospital with normal glucose metabolism,impaired glucose regulation,newly diagnosed type 2 diabetes and established type 2 diabetes were collected.The average gray scale intensity of the liver,kidney,pancreas region of interest was measured by using the histogram method.Then the liver and kidney echo ratio,liver attenuation coefficient was calculated,and the fat content of liver was determined by using formula.The size of pancreas head,body and tail was detected by ultrasound,and the sum of three values was used as the pancreas size indicator.Univariate and multivariate logistic regression analysis was performed on the size of pancreas and intensity of echo.Results The size of pancreas ranged from 2.39 ～ 6.09 cm with a mean size of (4.43 ± 0.59) cm,and the size was ≤ 5 cm in 130patients,＞5 cmin 27 patients.The intensity of echo ranged from 41.0 ～ 190.6 with a mean number of 120.0 ±31.1,and the intensity of echo was ≤120 in 83 patients,＞ 120 in 74 patients.The content of liver fat ranged from-1.11％ ～ 62.50％ with a mean number of (15.67± 11.97)％.Univariate logistic regression analysis suggested the size of pancreas was related to age and obesity,and pancreas echo was related to obesity degree,types of participants,the level of blood glucose,and grade of fatty liver (all P ＜ 0.05).Multivariate logistic regression analysis indicated obesity degree is the most important factor for prediction of pancreas size and echo (P ＜ 0.05).Conclusions Quantitative ultrasound measurement of pancreas size and echo can reflect the degree of fat infiltration of pancreas,and it has some clinical value.

Objective To study the risk factors of severe acute pancreatitis(SAP) complicated with MODS at the early stage.Methods One hundred and seven SAP patients served as A group,who admitted from Janurary 1995 to December 1999.One hundred and thirty patients served as B group who admilted from Janurary 2000 to 2005.Age,sex,Ranson' score,APACHEⅡ ,CT score,biliary tract obstruction,hypoxia,lung infection,shock,abdomen compartment syndrome,hyperlipemia,pleural effusion,and mortality were analyzed.Results Twenty-five in the A group and 28 in B group two were complicated with MODS at the early stage.There existed difference in Ranson's score,APACHEⅡ,CT score between patients with and without MODS(P

Objective To discuss the allocation of oral medical resource in west area of Chongqing,and investigate the caries prevalence in these population.Methods Study samples was raised with the multistage stratified random cluster sampling method,then data was analyzed to compare the allocation of oral medical.Resource,awareness degree on oral health and caries prevalence in each age grade between urban and rural area.Results In west area of Chongqing,the allocation of oral medical resource and awareness degree on oral health were better in urban area than those in rural area.In each age grade,the caries prevalence is higher in rural area,when compared with that in urban area.In addition,the caries prevalence of 5 years old group and 12 years old group is the same between male and female in both urban area and rural area (P＞0.05).Nevertheless,in 35-44 years old and 65-74 years old group,the caries prevalence was higher in female compared with male in both urban area and rural area (P＜0.05).Conclusion In west area of chongqing,the rural allocation of oral medical resource is bad and needs improvement,the awareness of oral hygiene is weak among population of rural area.In west area of Chongqing,women in 35-44 years and 65-74 years old should pay more attention to caries prevention and treatment.

Objective To investigate the protective effect of Gabexate mesilate(GM)on D-galactosamine- lipopolysaccharide-indneed acute liver failure in rats.Methods The model of acute liver failure in rats was produced by injection of D-galactosamine(D-GalN)and lipopolysaccharide(LPS).The alanine aminotransferase(ALT),aspartate aminotransferase(AST)in serum and malondiadehyde(MDA)content,superoxide dismutase(SOD)and glutathione peroxidase(GSH-PX)activities in liver homogenate were assayed by spectrophotometry.The levels of turnout necrosis factor-?(TNF-?),interleukin-?(IL-?)and interleukin-6(IL-6)were determined by ELISA method.Hepatic pathological examination was observed.Results 25 mg?kg~(-1),50mg?kg~(1),100 mg?kg~(-1) of GM significantly decreased the serum transaminase activities,the infiltration of inflammatory cells,and MDA content,hut didn't reduce SOD and GSH- PX activities in liver homogenate.GM significantly reduced TNF-?,IL-1?and IL-6 levels in serum.Conclusions GM showed significant protective effects on acute liver failure in rats.

BACKGROUNDLung cancer is one of the most common cancers worldwide and its mortality rate has increased year after year. Molecular biology has contributed to make people's understanding to the disease at the gene level. A new idea will be given to the early diagnosis and treatment for lung cancer with the method of molecular biology which can be used to find the association between some genes and lung cancer. The aim of this study is to evaluate the relationship between polymorphism of codon 72 (BstU I single nucleotide polymorphism, BstU I SNP) in p53 gene and susceptibility and radiosensitivity of non-small cell lung cancer (NSCLC) in Chinese population.

METHODSThe BstU I single nucleotide polymorphic sites at condon 72 in exon 4 of p53 gene in 50 patients with NSCLC as well as 50 healthy controls were inspected by polymerase chain reaction-restricted fragment length polymorphism assay and the relationship between BstU I SNP and susceptibility and radiosensitivity of NSCLC was analysed by case-control test.

RESULTSThe allelic distribution of the three genotypes (A1/A1, A1/A2, A2/A2) in healthy controls was 32.0%, 42.0% and 26.0% respectively, which differed slightly from that of lung cancer patients, which was 28.0%, 32.0% and 40.0%. These allelic and genotype differences between control and lung cancer groups (A1/A1 OR=0.83, 95% CI 0.36-1.27 and A2/A2 OR=1.90, 95% CI 0.82-4.42) were insignificant. The patients with A1/A1 or A2/A2 genotype were sensitive to radiotherapy and the patients with A1/A2 were not sensitive to radiother-apy (Chi-square=9.2, P < 0.05), the effective rate to radiotherapy were 71.4%, 70.0% and 25.0% respectively.

CONCLUSIONSThere is no significant relationship between the BstUI SNP in p53 and susceptibility in NSCLC .The p53 BstU I SNP is closely associated with radiosensitivity of NSCLC in the Northern Chinese population.

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.

Objective:To detect the expression levels of neuropilin1 (NRP1)mRNA and miR-9 in non-small cell lung cancer (NSCLC)tissue samples, and to explore the correlations between the expressions of NRP1 mRNA, miR-9 and the clinicopathological characteristics of the patients with NSCLC.Methods:Informed consent was obtained from each patient before surgery.The tissue samples including 45 NSCLC tissue ,45 adjacent carcinoma tissue and 45 normal lung tissue were collected from China-Japan Union Hospital of Jilin University from 2010 to 2011.qRT-PCR was used to detect the expression levels of NRP1 mRNA and miR-9 in three kinds of lung tissue, and the correlation between the expressions of NRP1 mRNA, miR-9 and clinicopathological characteristics of the patients with NSCLC was analyzed.Results:Compared with normal tissue,the expression level of NRP1 mRNA in adjacent carcinoma tissue had no change (P>0.05),but the expression level of NRP1 mRNA in non-small cell lung cancer tissue was significantly decreased (P<0.05).Compared with normal tissue,the expression level of miR-9 in adjacent carcinoma tissue had no change (P>0.05),but the expression level of miR-9 in non-small cell lung cancer tissue was significantly increased (P < 0.05 ). Furthermore, in adjacent carcinoma tissue, the expression level of miR-9 in the males was lower than that in the females (P<0.05 ). In NSCLC tissue, the expression level of NRP1 mRNA had no relationship with sex,age,differentiation degree,TNM stage and clinical stage,but was significantly correlated to the histological subtype and lymph node metastasis (P<0.05).In NSCLC tissue,the expression level of miR-9 had no relationship with age, pathological type, lymph node metastasis, differentiation degree,TNM stage,and clinical stage (P>0.05),but was correlated to the sex (P<0.05). Conclusion:The expression level of miR-9 is up-regulated and the expression level of NRP1 mRNA is down-regulated significantly in non-small cell lung cancer tissue. The detection of the expression level of NRP1 mRNA contributes to j udge the histological subtype and lymph node metastasis of NSCLC.

A sensitive, selective and simple liquid chromatography tandem mass spectrometry(UPLC-MS/MS)method was developed for determining of daptomycinin human plasma and effluent. The analyte was extracted from plasma samples by SPE method, separated through a Phenomenex Kinetex C18 column(50 mm×2. 1 mm, 1. 7 μm)using isocratic mobile phase consisting of 0. 1% formic acid-acetonitile(75 ∶25), and analyzed by electro-spray ionization(ESI). The precursor to product ion transitions of m/z 810. 9→159. 1 and m/z 286. 2→217. 2 were used to measure daptomycinand the internal standard, respectively. The method was validated over a concentration range(plasma: 1-200 μg/mL, effulent: 0. 005-20 μg/mL). The intra- and inter-day precision values were less than 10% and accuracy values 90%-110%. The stability of daptomycinin human plasma and effluent under different storage conditions met the requirements of bioanalytical method. The concentration of daptomycin is significant lower in the septic shock patient, when give a dose of 6 mg/kg, the cmax and AUC0-24 h of steady state decreased by 50% and 60% respectively; the increase in capillary permeability and interstitial oedema during sepsis and septic shock may enhance drug distribution. By the way, daptomycin can be cleared via continuous veno-venous hemofiltration(CVVH)for nearly 16%. In summary, on the treatment of continuous renal replacement therapy(CRRT)in patients with septic shock with daptomycin therapy, the suggested dose should be increased, and the drug monitoring should be carried on.