Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.

Objective To investigate the expression of CD55 and its implication on prognosis for patients with gastric stromal tumors.Methods Expression of CD55 was detected by immunohistochemistry staining and the correlation between CD55 and clinicopathological features and prognosis were analyzed on 60 cases of primary gastric stromal tumors from January 2010 to October 2012.Results Of the 60 patients with gastric stromal tumors there were 33 males and 27 females.CD55 was mainly located in the cytoplasm of gastric stromal tumors.There was no statistical difference between CD55 expression and patients' gender and age (P ＞ 0.05).Moreover,the expression of CD55 was closely related to tumor size,mitotic counts,2008 NIH classifications,and distant metastasis at the first visit to the hospital (P ＜ 0.05).During a median follow-up of 58.5 (range 23-78) months,14 patients had tumor progression.Log-rank univariate survival analysis showed tumor size,mitotic counts,2008 NIH classifications,radical resection,distant metastasis at the first clinical visit and CD55 expression were related to progression-free survival (P ＜ 0.001).COX multivariate survival analysis showed that tumor size (HR 11.504,95％ CI:1.085-122.011,P =0.043) and CD55 expression (HR 11.819,95％ CI:1.827-76.477,P =0.01) were independent prognostic factors.Conclusions Up-regulated CD55 might play an important role in the development and metastasis of gastric stromal tumors.

Objective To evaluate the efficacy of probiotics to treat irritable bowel syndrome (IBS).Methods Publications from database including PubMed,the Cochrane Library,Embase,CNKI,CBM and WanFang Data were searched up to August 31,2014.The randomized controlled trials (RCTs) on probiotics to treat IBS were eligible.The related articles were extracted and cross-checked independently by two reviewers.Methodological quality of trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.2 software.Results A total of 17 RCTs involving 1 700 patients were included.Results of meta-analyses showed that compared with the placebo,probiotics was statistically better in improving the overall symptoms integral (SMD =-0.20,95％ CI-0.33--0.07,P =0.002),alleviating abdominal pain/discomfort (SMD =-0.19,95％ CI-0.29--0.09,P ＜ 0.001),relieving abdominal distention (SMD =-0.16,95％ CI-0.28--0.03,P =0.020),and defecation discomfort (SMD =-0.22,95％ CI-0.42--0.02,P =0.030).There was no statistical significance in the overall quality of life (SMD =-0.08,95％ CI-0.07-0.23,P =0.290) and adverse effect ratio (RR =1.08,95％CI0.79-1.49,P=0.630).Conclusion Probiotics have beneficial effects on IBS,which can improve the patients' symptoms and with less adverse reaction.Due to the bias,further large-scale,multicenter and high-quality RCTs are required to unify outcome indicators,further define sensitive strain,and standardize its usage,dosage and course of treatment.

OBJECTIVE:To observe the Hp eradication situation and safety of three kinds of drug regimen in the treatment of active chronic gastritis with helicobacter pykori(Hp)infection. METHODS:150 active chronic gastritis patients with Hp infection were randomly divided into group A(50 cases),group B(50 cases)and group C(50 cases). Group A received Omeprazole enter-ic-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day+Clarithromycin tablet 0.5 g,oral-ly,once a day. Group B additionally received Colloidal bismuth pectin capsule 150 mg,orally,3 times a day. Group C received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day,1-5 d,Omepra-zole enteric-coated capsule 20 mg,orally,twice a day+ Clarithromycin tablets 0.5 g,orally,once a day+Metronidazole tablet 0.4 g,twice a day,6-10 d. All patients treated for 10 d. Effective rate of pain relief,relief time of pain and gastrointestinal symptoms, Hp eradication rate,recurrence after 12 follow-up and the incidence of adverse reactions in all groups were observed. RESULTS:Effective rate of pain relief and Hp eradication rate in group C were higher than group B,followed by group A,relief time of pain and gastrointestinal symptoms,recurrence rate in group C were lower than group B,which was lower than group A,with signifi-cant differences (P<0.05). The incidence of adverse reactions in group C was lower than group A and group B,with significant differences (P<0.05);while there was no significant difference in group A and group B (P>0.05). CONCLUSIONS:Taking omeprazole in stages combined with antibiotics can effectively relieve abdominal pains,shorten disease course,improve Hp eradica-tion rate,reduce long-term recurrence rate in the treatment of active chronic gastritis with Hp infection,with good safety.

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.

Objective To research the relationship between the serum level of cystatin C (CysC),N-terminal pro brain natriuretic peptide (NT-proBNP) and the cardiovascular (CV) events in maintenance hemodialysis (MHD) patients,looking for a new and effective biological prediction method for cardiovascular disease (CVD).Methods According to the excluded criteria and included criteria,a total of 126 patients [male 67(53.2％),female 59 (46.8％)] were included in this study,screening out of 452 MHD patients from 3 blood purification centre,no secondary hyperparathyroidism,blood pressure controlled,hemoglobin standard,no lipid abnormalities,and without history of coronary heart disease,heart failure and arrhythmia.Participants adopted 3 dialysis treatment,including hemodialysis,hemoperfusion and hemodiafiltration.Every 3 months before the dialysis,the Cys-C,NT-proBNP,serum phosphorus,serum intact parathyroid hormone (iPTH),hemoglobin and electrocardiogram were detected.The heartbeat ultrasound was examined every 6 months,observed for 24 months and followed up for 3 years,recording the incidence and the inspection results.The correlation and the occurrence of CVD were analyzed by conducting a multiple factor logistic regression analysis.The forecast performance of Cys-C,NT-proBNP was evaluated by using receiver operating characteristic (ROC) curves and area under curves (AUC).Results Eighteen episodes of CV events occurred in 126 patients during the experiment and follow-up,including 8 episodes of heart failure,4 episodes of myocardial infarction,6 episodes of arrhythmia.Detection indexes had no statistically significant correlation (P ＞ 0.05),and the results of ECG and ultrasound heartbeat graph showed that no significant difference in cardiac structure and function before treatment (P ＞ 0.05).After 24 months duration,the research showed that the level of serum calcemia was lower,and the levels of phosphorus and iPTH were higher in hemodialysis group compared with that in the other 2 groups,and the differences had statistical significance (P ＜ 0.05).The median levels of Cys-C and NT-proBNP were 8.59 (9.74,7.10) mg/L and 7 739 (9 887,6 736) ng/L in the patients CV events occurred.Non conditional multivariate logistic regression analysis demonstrated that the increasing interdialytic weight,Cys-C,NT-proBNP,iPTH,dialysis hypotension were the independent risk factors of CV occurrence.AUCs to predict CVD occurrence in MHD patients was 0.64 (95％CI 0.53-0.71,P ＜ 0.05) and 0.79 (95％CI 0.72-0.89,P＜ 0.01) using Cys-C and NT-proBNP respectively.The cut-off values of serum Cys-C and NT-proBNP for CVD occurrence were 8.59 mg/L and 7 739 ng/L,with a sensitivity of 84.3％ and a specificity of 92.7％.Conclusions Cys-C,NT-proBNP can be used to predict the risk of CV events in dialysis patients.

Objective To explore the effect of GAS MAN assisted instruction on theory learning of volatile anesthetics in anesthesiology residency training.Methods A total of 32 residents in the first stage of anesthesiology training were enrolled and randomly assigned to either study(S) or control (C) group.Theory-test l(Test-1) was conducted for all residents after the lecture-based learning (LBL).Next,reference book self-reading strategy was used in both groups while computer-based simulation(CBS) using GAS MAN was only developed in S group.Then,theory-test 2(Test-2)was conducted for residents in both groups and residents in S group completed the questionnaire smvey.In addition,thirty-four resident teachers observed the CBS courses and completed the questionnaire smvey.Results The mean scores of Test-1 did not differ significantly between the two groups(P=0.64).However,the mean Test-2 score of S group(81.3 ± 13.6) was significantly higher than that of C group(61.3 ± 15.4) (P=0.001).100％(16/16) residents believed that CBS was beneficial to the theoretical study of volatile anesthetics,93.8％(15/16) residents considered GAS MAN could help understand the concepts and improve efficiency during self-learning.97.1％ (33/34) and 91.2％ (31/34)resident teachers agreed that CBS was helpful for analyzing complex concepts and improving study effectiveness,respectively.Conclusions CBS using GAS MAN improves theory knowledge and study effectiveness for anesthesia residents.Both residents and resident teachers find GAS MAN highly ac ceptable.Therefore,GAS MAN has the potential to be the assistant teaching tool for LBL in anesthesiology residency-training program.

Objective To evaluate the clinical value of 3.0T magnetic resonance imaging (MRI) diffusion weighted imaging (DWI) on evaluation effect of neoadjuvant chemotherapy in advanced gastric cancer. Methods 3.0 T MRI DWI examination was performed in 42 cases of advanced gastric cancer diagnosed by gastroscopy and pathology, including 32 patients were examined with DWI both before and after chemotherapy. Lymph nodes of gastric cancer lesions and display ability of stomach were measured, and the area of the apparent diffusion coefficient (ADC) values in normal stomach and tumors were compared. ADC values were compared in the same patients before and after neoadjuvant chemotherapy and analyzed along with postoperative pathological examinations. Results In a total of 40 patients who received 74 DWI examinations, ADC values in tumor and lymph nodes were significantly higher than those in normal tissue. The ADC value in tumors was (1.348 ±0.278) ×10-3 mm2/s, and in 12 cases of stomach lymph node enlargement was (1.329±0.188) ×10-3 mm2/s. However, the average ADC value of normal stomach was (2.081± 0.189) ×10-3 mm2/s with significantly lower DWI than that of the former (P< 0.001). After chemotherapy, the ADC value in tumors was increased, which was (1.572 ±0.261) ×10-3 mm2/s (P< 0.001). After neoadjuvant chemotherapy, 16 patients received gastric cancer radical prostatectomy, and postoperative pathological TRG ratings of tumor were decreased with different extent. Tumor cell density (TCD) before treatment with an average of 4.45 ×10-5 / px2, which was downgraduated to 2.48 ×10-5 / px2 after chemotherapy and surgery. Negatively correlation between TCD values and ADC values were observed. Conclusion MRI DWI examination can effectively detect advanced stomach cancer and the associated lymph node enlargement. Comparison of tumor morphology and ADC values in advanced gastric cancer before and after neoadjuvant chemotherapy has clinical value in prognosis.

Objective To explore the role and mechanism of protein disulfide isomerase A3 (PDIA3) in abnormal colonic mucosa immune response of irritable bowel syndrome (IBS) rats with visceral hypersensitivity.Methods A total of 48 SD rats were divided into blank control group (n=12),empty virus group (IBS-1) (n=12),PDIA3 silencing group (IBS-2) (n=12) and model control group(IBS-3) (n=12).The expression of CD103 in ileocecus colonic tissues was detected by immunohistochemistry.Dendritic cells (D C) of mesenteric lymph node were isolated by flow cytometry.CD4+/CD8+ T cells of spleen were separated by immune-magnetic beads sorting technique.DC and CD4+/CD8+ T cells were co-cultured.The proliferation ability of lymphocytes promoted by DC was measured by methyl thiazolyl tetrazolium (MTT).The secretion levels of interlcukin (IL) 4 and IL-9 of CD4+/CD8+ T cells stimulated by DC were determined by enzyme linked immunosorbent assay (ELISA) method.Independent sample t-test was performed for statistical analysis.Results The cell number of CD103 positive DC of rats colon of blank control group,IBS-3 group was 6.25±1.14 and 10.83± 1.03(t=10.07,P＜0.05);that of IBS-2 group was 7.42 ± 0.90,and compared with that of IBS-3 group,the difference was statistically significant (t=-9.25,P ＜ 0.05).The MTT value of CD4+ T cells proliferation stimulated by DC of blank control group and IBm3 group was 0.54±0.01 and 0.60±0.01 (t=3.373,P＜0.05);that of IBS-2 group was 0.53±0.01,and compared with that of IBS-3 group,the difference was statistically significant (t =-3.139,P ＜ 0.05).The MTT value of CD8+ T cells proliferation stimulated by DC was 0.52±0.01 and 0.59±0.00(t=3.539,P＜0.01);that of IBS-2 group was 0.54±0.01,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.183,P＜0.05).The level of IL-4 secreted by CD4+T cells promoted by DC of blank control group and IBS-3 group was 10.24±0.09 and 16.61±1.00 (t=3.222,P＜0.05);that of IBS-2 group was 11.75±0.54,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.539,P＜0.01).The level of IL-9 secreted by CD4+T cells stimulated by DC of blank control group and IBS-3 group was 15.86±10.19 and 43.51±11.32 (t=4.529,P＜0.05);that of IBS-2 group was 29.05±2.09,and compared with that of IBS-3 group,the difference was statistically significant (t=-6.841,P＜0.01).The level of IL-4 secreted by CD8+T cells promoted by DC of blank control group and IBS-3 group was 7.35±0.12 and 13.91±0.57 (t=19.557,P＜0.01);that of IBS-2 group was 8.63± 0.24,and compared with that of IBS-3 group,the difference was statistically significant (t =-14.782,P＜0.01).The level of IL-9 secreted by CD8+T cells stimulated by DC of blank control group and IBS-3 group was 29.12±5.14 and 60.70±11.02 (t=4.122,P＜0.05);that of IBS-2 group was 37.17±2.65,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.255,P＜ 0.05).Conclusions Protein disulfide isomerase A3 may mediate the process of DC activating T lymphocyte levels of related cytokines,cause abnormal immune response of colonic mucosa and promote the genesis of IBS visceral hypersensitivity.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus) in diabetes combined with nerve deafness using 1 H magnetic resonance spectros‐copy (1 H -MRS) ,and to discover the early warning indicator of nerve deafness in type 2 diabetes .Methods PTA was performed in 98 patients with type 2 diabetes (diagnosed by Endocrinology Department) ,and in 15 healthy sub‐jects in the control group .The patients were classified into four groups :the group of type 2 diabetes;type 2 diabe‐tes with unilateral and bilateral deafness ,and the normal control group .Cerebral metabolism was studied by assess‐ing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo-in‐ositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups . The Pearson correlation analysis was applied to determine blood glucose value with the nerve metabolites while the ROC curves were made for those metabolism markers to find the best diagnostic threshold .Results NAA/Cr and NAA/Cho were negatively correlated with AHI index and Cho/Cr ,mI/Cr was positively correlated with blood glu‐cose value .Significantly lower values of NAA/Cho ratio were found in patients'(diabetes without deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) .NAA/Cr and NAA/Cho ratio in diabetes with deafness were significantly lower than those in control group (P< 0 .05) ,Cho/Cr higher than those of in other groups (P<0 .05) .NAA/Cr and NAA/Cho ratio in injured and uninjured auditory cortex of diabetes with unilateral deafness were significantly lower than those of in control group (P<0 .05) ,then we made a self -comparison be‐tween the injured and uninjured auditory cortex ,finding that NAA/Cho ratio had a significant difference .All of the metabolisms were tested by the curve of ROC .The area of NAA/Cho under the ROC curve was 81% ,which had a higher accuracy .NAA/Cho equal to 1 .65 can be used as boundary indicators between diabetes without deafness and diabetes with deafness groups ,the areas of the remaining indicators under the ROC curve was<50% .Conclusion NAA/Cho may be the early warning marker of nerve deafness in type 2 diabetes .