Objective To observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia (VAD).Methods Eighty cases with VAD were randomly divided into the treatment group (40 cases) and the control group (40 cases).The control group were given 30 mg nimodipine for three times a day ;The treatment group was given additionally three times a day of 0.2 g butyiphthalide for 12 consecutive weeks.The Mini-Mental State Examination (MMSE),Clinical Dementia Rating (CDR),and Activities of Daily Living (ADL) scores were used for the assessment of cognitive function.The assessments were done before and after treatment.The adverse effects were also recorded.Results In the treatment and the control groups,the MMSE,CDR and ADL scores (MMSE:23.17 ± 1.89,19.43 ± 2.04; CDR:1.06 ± 0.11,1.21 ±0.50;ADL:40.11 ±5.10,41.22 ±4.80) after treatment were significantly improved than those (MMSE:16.54 ± 1.98,16.28 ± 2.11 ; CDR:1.78 ± 0.25,1.75 ± 0.31 ; ADL:47.45 ± 5.22,46.75 ± 5.31) (MMSE:t =2.42,P ＜0.05,t =2.34,P ＜0.05 ;CDR:t =1.67,P ＜ 0.05,t =1.54,P ＜0.05 ;ADL:t =6.73,P ＜0.05,t =5.24,P ＜ 0.05) before treatment.After 12 weeks of treatment,the MMSE,CDR and ADL scores in the butyiphthalide group were significantly improved than that in the control group (t =1.85,1.84,5.91,respectively; P ＜ 0.05).No serious adverse events were recorded during the treatment.Conclusion Butyiphthalide and nimodipine can prominently improve,better than nimodipine alone,the cognitive function of patients with vascular dementia.Moreover,its security and tolerability are good.

ObjectiveTo observe the clinical effects of Jianwei yuyang capsule combined with triad-therapy of western medicine on helicobacter pylori-related peptic ulcer in elderly.MethodsEighty patients above 60 years with peptic ulcer infected with helicobacter pylori were divided into two groups by random,and were treated with Jianweiyuyang capsule combined with triad-therapy of western medicine or triad-therapy of western medicine for 4weeks.The endoscopy and biopsy staining were used to analyze the cure rate and the helicobacter pylori eradication rate at the 6th week after the end of the treatment,and the main symptom improvement were observed.ResultsIn the treatment group,the cure rate,the helicobacter pylori eradication rate and total effective rate were significantly higher than control group.The two groups were significantly different ( P ＜ 0.05).ConclusionJianweiyuyang capsule combined with triad-therapy of western medicine was a more ideal treatment program for helicobacter pylori-related peptic ulcer in elderly.

Objective To investigate the expression of neive growth factor (NGF) in the ectopic endometrium in adenomyosis patients,and explore the relationship between NGF expression and innervation or pain scales.Methods From Mar.2009 to Oct.2009,45 adenomyosis patients undergoing hysterectomy in Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study,which were classified into 33 cases in pain group and 12 cases in non-pain group based on symptom.The degree of dysmenoreal,chronic pelvic pain and dyspareunia was evaluated by visual analogue scale,including no pain,mild to moderate pain and severe pain group.In the mean time,26 patients with leiomyoma or cervical intraepithelial neoplasia Ⅲ (CIN Ⅲ)undergoing hysterectomy were defined as control group.Ectopic endometrium from experimental group and eutopic endometrium from control group were collected in the surgery.The expression of NGF was examined by immunohistochemistry.The density of protein gene product (PGP)9.5 positive nerve fibers was detected by immuno-fluorescence.Results The NGF level and the density of PGP 9.5 positive nerve fibers in adenomyosis pain group (0.25 ± 0.08,16 ± 8) were higher than adenomyosis painless (0.19 ± 0.05,P =0.007 ; 11 ± 5,P =0.018) and control group (0.18 ± 0.05,P =0.000;9 ± 4,P =0.000).The NGF level and the density of PGP9.5 positive nerve fibers in severe dysmenorrheal group(0.29 ± 0.07,19 ± 10) were higher than mild to moderate dysmenorrheal (0.22 ± 0.07,P =0.018 ; 13 ± 4,P =0.035) and painless group (0.18 ± 0.05,P =0.000 ; 11 ± 5,P =0.006) of adenomyosis patients.There was no difference of NGF level and the density of PGP 9.5 positive nerve fibers in chronic pelvic pain group and no chronic pelvic pain group of adenomyosis patients,so was dyspareunia group and no dyspareunia group.Conclusion The increased NGF level of adenomyosis nodules and improving innervation might be involved in the mechanism of adenomyosis related pain.

Objective To understand the nursing working environment and working-family conflict in the operating room nurses,and analyze the correlation between the two.Method Tolly 190 nurses in the operating room were surveyed by general information questionnaire,PES-NWI (the practice environment scale of the nursing work index) and Work-Family Conflict Scale.Results The total nursing work environment (95.48 ± 6.34) averaged (3.08 ± 0.44),and the total score of working-family conflict was (56.67 ± 4.56),averaged (3.15 ±0.48).There was a negative correlation between nurses' perceived nursing work environment and work-family conflict(P＜0.05).Conclusions Nurses in the operating room think that the operating environment of the operating room is at the middle-high level;the nurses'working and family conflict is at the middle-high level,and the nurses' perceived nursing work environment is the main factor that affects the work-family conflict of the nurses in the operating room.Nursing managers should pay attention to the creation of good nursing work environment,improve the operating room nurses recognition of the work environment,so as to effectively alleviate the conflict of nurses work and family.

OBJECTIVE To retrospectively investigate the ciprofloxacin-resistance rate of Escherichia coli(ECO) and its main impact factors,and then guide empiric therapy for its infection. METHODS We looked up relative data in Hubei Network for Surveillance of Bacterial Antimicrobial Resistance.WHONET 5.2 Software was used to analyze resistance rates,and SAS software to perform univariate and multivariate Logistic regression assay. RESULTS Ciprofloxacin-resistance rate of ECO was and is on the rising,meanwhile,its resistance rates were different for laboratory,patient origin,age group,gender and so on,and the differences were all very significant(P

BACKGROUND:Separating umbilical cord blood stem cells using tubes has low efficiency,and microbial contamination easily occurs during this process,therefore,safety cannot be ensured in clinical application.lt is urgent to find a method for separating umbilical cord blood stem cells to treat femoral head necrosis.OBJECTIVE:To establish a high efficient,safe,and clinically valuable method to separate umbilical cord blood stem cells.DESIGN,TIME AND SETTING:A self-control experiment was performed at the First Department of Surgery,Zhengzhou Second People's Hospital,Institute of Blood Constituent Application,Henan Red Cross Blood Centre between February 2006 and August 2007.PARTICIPANTS:Eight male patients with femoral head necrosis,averaging 40.6 years of age,were included in this study.Of these patients,4 had the history of hormone application.An average of 90 mL umbilical cord blood was harvested from each healthy normal full term neonate from Maternal and Children Health Care Hospital of Zhengzhou City.The quadruple bags used for separating umbilical cord blood stem cells consisted of 1 main bag,1 empty bag,and 2 physiological saline bags,provided by Shandong Weigao Holding,China.METHODS:Within 6 hours after collection,umbilical cord blood was centrifuged in the empty bag of quadruple bag,which was connected with an aseptic filling machine.After centrifugation,partial blood plasma was discarded,and the remaining erythrocytes were thoroughly mixed by adding hetastarch.Five minutes later,the mixture was diluted with physical saline at 1:1.Umbilical cord blood was slowly added into the main bag (at 1:1),in which,human lymphocyte separating medium was pre-added.After cantrifugation,the upper layer of solution,i.e.,monocyte-rich solution,was transferred into another empty bag.Within 24hours of preservation,after suspension with umbilical blood plasma,umbilical cord monocytes were transfused into patients with femoral head necrosis via superficial vein on the hand back,monocytes≥1×108/portion,2 portions once.There were three treatment courses,each involving three transfusion sessions,one session every 4 days,and a 2-3-month interval between two treatment courses.MAIN OUTCOME MEASURES:Cell recovery rate and cell viability of umbilical cord blood monocytes and improvements in clinical symptoms.RESULTS:The separation of quadruple bags could obtain umbilical cord blood monocytes with high recovery rate.Furthermore,microbial contamination hardly occurred in the process of separation.Hip joint pain relieved or disappeared to different extents in all 8 patients,with an effective rate of 100%.Abduction and internal rotation of hip joint,ambulation distance,and gait were markedly improved.At 6 months after cell transplantation,5 patients presented with changed bone density in femoral head necrosis regions,2 showed normal femoral head morphology,and the remaining 1 exhibited no obvious changes.Joint effusion was reduced or disappeared in 12 hips.Magnetic resonance images showed that femoral head morphology had been improved in various degrees in 9 hips,but no changes in 3 hips.No complications,fever,or allergies occurred during and after cell transplantation.CONCLUSION:The method of separating stem cells from umbilical cord blood in junction with aseptic interface technology is highly effective,safe,and clinically valuable.Multiple intravenous transfusions of umbilical cord blood stem cells provide a novel approach for systemic treatment of femoral head necrosis.

Objective To investigate the combination effect of cetuximab and irradiation on colorectal carcinoma CL187 cell line and underlying molecular mechanism.Methods CL187 cells with or without cetuximab treatment were irradiated by 0,4 and 8 Gy X-rays,then cell death percentage was determined by MTT 24 and 48 h post-irradiation.Clone forming assay was used to evaluate the cell reproliferation ability.Cell cycle distribution,apoptosis,and necrosis were analyzed by flow cytometry.Western blot was used to detect the protein expressions of DNA-PKcs,Ku70 and Ku80.Results The cetuximab enhanced the percentage of radiation-induced cell death,while descreased the cloning formation capacity and increased radiosenvtivity (t =-6.14、-6.53,P ＜0.05).The SER of cetuximab on CL187 cell line approached to 1.38.In addition,cetuximab also increased radiation-induced G0/G1 phase arrest (t=-4.64,P＜0.05) and the percentage of apoptosis and necrosis (t=-9.16,P ＜0.05),but it descreased the expression levels of DNA-PKcs,Ku70 and Ku80 proteins.Conclusions The cetuximab treatment might enhance the inhibitory effect of irradiation on colorectal carcinoma CL187 cell line by influencing cell cycle distribution,cell apoptosis,and the expression of DNA repair proteins.

Objective To investigate the effect of folic acid on the DNA methylation of tumorrelated genes promoters in healthy human peripheral blood mononuclear cells(PBMC). Methods Ten healthy volunteers were divided into two groups, and were randomized to receive either 5 mg folic acid (n=5)or placebo(n = 5) , one time per day for 3 months. The serum folic acid concentration was detected with chemiluminescence enzyme immunoassay kit before and after the intervention. The methylation statuses of five tumor-related genes promoter, including oncogenes c-myc, c-Ha-ras,tumor suppressor genes p16INK4A, E-cadherin and mismatch repair gene hMLH1 in PBMC were detected by bisufite sequencing. Results After folic acid intervention, the level of serum folic acid increased significantly in intervention group (t= -4. 739,P<0. 05) , however no significant difference in control group. After three-month folic acid intervention, the level of methylation of oncogene c-myc promoter increased from 4%, 3. 3%, 4. 1% before intervention, one week after intervention, one month after intervention respectively to 8%(t= -4. 079,P<0. 05), while no significant change in placebo taken group. Before and after the folic acid intervention, there was no significant difference of DNA methylation of other tumor-related genes promoter, including c-Ha-ras、E-cadherin、p16INK4Aand hMLH1. Conclusion Folic acid intervention can up-regulate DNA methylation of oncogene c-myc promoter, but can not affect the promoter methylation status of tumor suppressor genes E-cadherin,p16INK4Aand hMLH1.

Objective To detect the change of CD47 on T-lymphocyte subsets marked by CD3 + CD4+ and CD3+ CD8+ in the acute graft versus host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore its clinical significance.Methods The peripheral blood of 30 patients was collected before and every two weeks from hematopoietic reconstitution after allo-HSCT.The expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was detected by flow cytometry,and the relationship between their expression and the occurrence of aGVHD was analyzed.Results The percentage of CD3+ CD4+-and CD3+ CD8+-marked T-lymphocyte subsets showed no statistically significant difference between aGVHD group and non-aGVHDgroup [(38.95 ± 6.18)％ vs.(37.38 ± 4.6)％,and (22.35 ± 3.32)％ vs.(20.34 ±4.56) ％,respectively] (P＞0.05).The expression levels of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was obviously increased in aGVHD group when compared to before transplantation and non-aGVHD group after transplantation,and that had no changes in non-aGVHD group when compared to before conditioning regimen after transplantation.Mean fluorescence intensity of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ [(93.70 ± 14.88) and (70.09 ± 12.51)] in aGVHD group significantly increased as compared with non-aGVHD group [(71.27-± 11.32) and (53.93 ± 8.35)] (P＜0.05).There was no significant difference in the expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ before and after transplantation in non-aGVHD group (P＞0.05).Moreover the expression of CD47 on T-lymphocyte subsets marked by CD3 + CD4 + and CD3 + CD8 + changed correspondingly with the outcome of aGVHD in aGVHD group.Conclusion The change of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ andCD3+ CD8+ is valuable to monitor the aGVHD after allo-HSCT,which may provide a new means for the early detection of aGVHD.

Objective To systematically evaluate the efficacy and safety of amlodipine (A)/hydrochlorothiazide(H) versus val‐sartan(V)/hydrochlorothiazide(H) in treatment of essential hypertension .Methods Literature was retrieved online in Cochrane Li‐brary ,PubMed ,OVID ,MEDLINE ,EMBASE ,CBM ,CNKI ,VIP and Wan fang database up to November 2013 .Relevant magazines were retrieved manually .Quality of the included studies was assessed and Meta‐analysis was performed with RevMan 5 .2 software . Results Seven randomized controlled trials(RCTs) were finally included .Meta‐analyses showed that :in terms of lowering ABP ,V/H group was more effective than A/H group ,the difference was statistically significant (P<0 .05);there was no significant differ‐ence in the decreased value of clinic BP and the control rate of blood pressure between A /H group and V/H group(P>0 .05) .Ad‐verse events occurred less frequently with V/H group compared with A/H group ,the difference was statistically significant (P<0 .05) .Conclusion A/H treatment of essential hypertension is inferior to V/H ,and has more adverse events .