BACKGROUND: The incidence of cognition disturbance after cerebral infarction is about 20% -30% and effective drugs for its prevention and treatment are anticipated.OBJECTIVE: To investigate the effect of nicergoline on cognition disturbance after cerebral infarction and explore its mechanism.DESIGN: Randomized controlled trial based on patients.SETTING: Neurological department in a medical university.PARTICIPANTS: A total of 60 patients admitted to the Neurological Department of the Second Hospital Affiliated to Chongqing Medical University for cerebral infarction during October 1999 and April 2001 were recruited in this study, and randomly divided into two groups, nicergoline treatment group and control group with 30 in each.METHODS: Mini-mental state examination(MMSE) score was evaluated and cerebral blood flow was determined with transcranial Doppler' s ultrasonography within one week after admission and three months after admission, respectively, and data were analyzed with SPSS software.MAIN OUTCOME MEASURES: MMSE score and velocity of blood flow in treatment and control groups.RESULTS: MMSE score in memory, calculation and recollection decreased significantly[ (1.2 ± 1.3), (2. 2 ± 2. 1) and(1.0 ± 1.7), respectively] in control group but did not change much[ (3.9 ± 1.4), (4. 4 ± 1.9) and(4.0 ± 1.6) ]in treatment group. The velocity of blood flow in control group decreased apparently, while it increased in treatment group[(58.31 ±10. 15) and(65.79 ±9.74) cm/s in the right middle cerebral artery].CONCLUSION: Nicergoline can prevent and treat vascular cognition disturbance, and improvement of blood supply may be one of the mechanisms.

Based on a typical medical record from Treatise on Febrile Diseases, Synopsis of Golden Chamber and Warm Diseases Theory Comprehensive Practical Training Course, this article set group discussion as clues, and analyzed the connection and differences of etiology and pathogenesis by combining febrile diseases, golden chamber, and warm diseases. It emphasized the establishment of clinical thinking in medical records and divergent thinking extended from clinical thinking. Through the analysis of the typical medical record, this article hoped to provide references for the comprehensive study and application of febrile diseases, golden chamber, and warm diseases.

Objective To study the gait characteristics of spastic diplegia cerebral palsy children. Methods The gaits of 26 spastic diplegia cerebral palsy children were analyzed. Results and Conclusion There were significant differences between spastic diplegia cerebral palsy children and 20 healthy subjects in both temporal-spatial parameters (stride time, stride length, stance time (%), cadence, speed) and kinematic parameters (the joint angle of hip, knee, ankle occurring at heel-contact, toe-off, the maximal extension in stand phase, maximal flexion in swing phase and total excursion on sagittal plane).

105 copies/mL would develop liver-related complications, such as cirrhosis, hepatocellular carcinoma and liver failure. Available evidences indicate that control of HBV replication with antiviral drugs can decrease the incidence of these complications and mortality.

Objective To investigate the distribution and antibiotic susceptibilities of quantitatively cultivated bacteria from bronchoalveolar lavage fluid (BALF) samples. Methods Totally 312 BALF samples were streak inoculated to chocolate,blood and MAC plates with 10 μL annulus,and the bacterial colony ＞ 104 CFU/mL was considered pathogenic bacteria. The identification of pathogenic bacteria was carried out with Vitek 2-Compact,and Kirby-Bauer disc agar diffusion method,Etest and dilution method were used for antibiotics sensitivity test.Results Totally 216 (69.2％) strains of pathogenic bacteria were isolated.The major gram-negative strains were Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Escherichia coli, and the major gram-positive strains were Staphylococcus aureus,Streptococcus pneumoniae and Staphylococcus epidermidis.The resistance rate of Pseudomonas aeruginosa to aztreonam was high,but lower than 30％ to piperacillin/tazobactam,imipenem,cefepime,ofloxacin,ceftazidime and amikacin.Staphylococcus aureus was highly resistant to erythromycin,benzylpenicillin and clindamycin,but it was sensitive to furadantin,vancomycin,quinupristin/dalfoprisdn,tigecycline and linezolid.Conclusion The positive rate of BALF cultivation is high,and the main pathogenic bacteria Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli are resistant to several commonly used antibiotics.

Objective To explore the potential legal issues about mandatory nursing intervention in psychiatric wards,and put forward the strategies of nursing management.Methods The causes and the potential legal issues of the action of psychiatric nurses to carry out mandatory nursing intervention were analyzed.Results There were legal issues on the right to life and health,the right of informed consent,the right of personal freedom and the right of personality respected about mandatory nursing intervention in psychiatric wards and there might be negligence,misconduct and responsibility of violating the laws and regulations.Conclusions While carrying out mandatory nursing intervention in psychiatric wards,nurses need to respect the patients,make related informed well,protect various related rights of patients and families,implement seriously the relevant system so as to make mandatory nursing interventions more humanized,scientific,standardized,programming,and avoid the occurrence of medical disputes.

In order to construct a recombinant attenuated Salmonella typhimurium expressing Helicobacter pylori (H. pylori) urease subunit B(UreB), UreB gene fragment amplified by PCR was cloned into the prokaryotic expression vector pTC01 after sequencing, then transformed into attenuated Salmonella typhimurium SL3261 to acquire SL3261/pTC01-UreB. The expression of H. pylori UreB in SL3261 was detected by Western blot. Tewelve weeks after oral immunization of mice with this vaccine, anti-UreB IgA antibodies in mouse intestinal fluid and IgG antibodies in serum were determined by ELISA. IFN-? and IL-10 contents in the supernatant of spleen cell culture were also assessed by ELISA. The results showed that 61kD protein was expressed in SL3261/pTC01-UreB that could be recognized by anti-H. pylori UreB antiserum by Western-blot. The multiple oral immunizations with SL3261/pTC01-UreB could induce significantly H. pylori-specific mucosal IgA response as well as serum IgG responses. Moreover, there was significant increase of IFN-? and IL-10 contents in the supernatant of spleen cell culture in SL3261/pTC01-UreB group. These results suggested that the attenuated Salmonella typhimurium expressing H. pylori UreB may be used as oral vaccine against H. pylori infection. Its effect against H. pylori infection also needs to be further evaluated in animal models.

Objective To establish attenuated S. typhimurium expressing Helicobacter pylori (H.pylori) urease subunit B (UreB) and determine whether it could be used as oral vaccine against H.pylori Methods H.pylori (SS1 strain) UreB gene fragment amplified by PCR was cloned into the prokaryotic expression vector PTc 01 after sequencing, then transformed into attenuated S.typhimurium SL3261 to acquire SL3261/PTc 01 UreB. The expression of H.pylori UreB in SL3261 was detected by Western blot. Twelve weeks after oral immunization of mice, antibody responses were evaluated using serum and intestinal fluid by ELISA. In vitro stability of PTc 01 UreB plasmid in S. typhimurium SL3261 was confirmed by growing in Luria Bertani medium to 60 generations. Results The UreB gene fragment amplified by PCR was consistent with the sequence of the H.pylori UreB by sequence analysis. Enzyme digestion revealed that the correct PTc 01 UreB was obtained. Western blot showed that 61kD protein was expressed in SL3261/PTc 01 UreB which could be recognized by anti H.pylori UreB antiserum. Anti UreB IgA antibodies in mouse intestinal fluid and IgG antibodies in serum were determined by ELISA. After 60 generations of continuous culture, the recombinant plasmid PTc 01 UreB was stable in SL3261 and had no obvious toxicity. Conclusion The attenuated Salmonella typhimurium expressing H.pylori UreB may be used as oral vaccine against H.pylori infection.

Aphasia is common after stroke, and seriously influences the family and social communication of the patients. As a safe and noninvasive therapy, repetitive transcranial magnetic stimulation (rTMS) is used to induce or enhance neural plasticity, including promoting the recovery of aphasia after stroke. This paper reviewed mechanism of speech recovery and the application of rTMS for aphasia after stroke.

Objective To study the regularity of cerebral edema in middle cerebral artery occlusion rats and the influence of rehabilitation training on edema. Methods 120 male Sprague-Dawley rats were randomly assigned to normal control group (n=24), no-intervention group (n=24), resting plus natural feeding group (n=24), resting plus natural feeding and special nutrition group (n=24), and training group (n=24). Bederson score was used to evaluate the neurological function, and the dry-wet weight way was used to measure brain water content on the 1st day, 3rd day, 5th day, and 7th day. Results There was no significant difference in the other 4 groups except the normal group on the 1st day, 3rd day, and 5th day (P>0.05). However, neurological function in the training group was better than that in the other 3 groups except the normal control group on the 7th day (P<0.01). Except the normal control group, the brain water content decreased most rapidly in the training group and slowest in the resting groups after the 3rd day. Conclusion Rehabilitation training could accelerate the recovery of neurological function and release cerebral edema in rats with focal cerebral ischemia.