Objective To research the clinical evaluation of potassium dehydroandrograpolide succinate injection in the treatment of COPD combined with CAP and its influence on plasma IL-33, PCT and hs-CRP levels.Method 91 patients with COPD combined with CAP in our hospital from April 2015 to August 2016 were selected and divided into the observation group (48 cases) and the control group (43 cases).The control group was given routine treatment, the observation group was given on the basis of the above treatment of potassium dehydroandrograpolide succinate injection.The clinical efficacy and plasma IL-33, PCT and hs-CRP levels were compared between the two groups after treatment.Results Before treatment, the IL-33, PCT, hs-CRP of two groups of patients had no significant difference.After treatment, the total effective rate of the observation group was 91.67% higher than that of the control group 74.42%, the difference was statistically significant (P<0.05).All the clinical symptoms time of the observation group was significantly lower than that of the control group, and the clearance rate of the observation group (85.42%) was significantly higher than that of the control group (67.44%), the difference was statistically significant (P<0.05), the indexes of the two groups of patients were decreased, the indexes of the observation group significantly lower than that in control group, the difference was statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group .Conclusion Potassium dehydroandrograpolide succinate injection can significantly improve their plasma IL-33, PCT and hs-CRP levels, the respiratory pathogen and inflammatory mediators are effectively removed, and has good clinical effect, and no serious adverse reactions during treatment.

Objective To investigate the relationships among distal contractile integral (DCI), ineffective esophageal motility (IEM)and gastroesophageal reflux through high resolution manometry (HRM)in patients with gastroesophageal reflux disease (GERD).Methods A total of 69 patients with GERD were enrolled.All patients received HRM and 24 hour pH and impedance monitoring examination. Pearson correlation analysis was performed to analyze the correlation between DCI,number of invalid swallowing and DeMeester score.All the patients were divided into three groups according to the number of invalid swallowing in 10 times of 5 mL liquid swallowing test.Patients with 5 to 10 invalid swallowing was in IEM group (n=21),one to four was in abnormal motility group (n=19),and zero was in normal motility group (n=29).The t test was performed for comparison of average DCI,average DCI of residual effective swallowing,DeMeester score,acid reflux time,bolus exposure time and proximal reflux times
among the three groups.Results Among the 69 patients with GERD,there was negative correlation between DCI and DeMeester score (r=-0.363,P =0.003)in 10 times of 5 mL liquid swallowing test;the number of invalid swallowing was positively correlated with DeMeester score (r=0.374,P =0.002). The mean DCI in 10 times of 5 mL liquid swallowing of normal motility group,abnormal motility group and IEM group was (1 458.96±545 .10),(986.48 ±577.50)and (288.50 ±167.25 )mmHg·s·cm, respectively,and that of IEM group was lower than normal motility group and abnormal motility group (t =-11 .42 and -2.12,both P <0.05).The average DCI of residual effective swallowing of normal motility group,abnormal motility group and IEM group was (1 458.96 ± 545 .10 ),(1 187.90 ± 669.40)and (450.78 ±350.73 )mmHg ·s ·cm,respectively,and that of IEM group was also lower than normal motility group and abnormal motility group (t = -8.05 and -5 .27,both P <0.01 ).The DeMeester score of IEM group (15 .42±8.79)was higher than that of normal motility group (6.34±3.45),and the difference was statistically significant (t=2.43,P <0.05).The acid reflux time and bolus exposure time of IEM group were (54.93 ± 37.07 )min and (0.64 ±0.49 )%,respectively,which were longer than abnormal motility group ((37.37±22.66)min,(0.52 ±0.24)%)and normal motility group ((21 .22 ± 13.98)min,(0.39 ±0.14)%),and the differences were statistically significant (t =2.36,2.17,2.60 and 2.54,all P <0.05).The total number of reflux of IEM group and abnormal motility group were 67.10± 32.94 and 57.26±38.90,which were both more than that of normal motility group (44.61 ±23.84),and the differences were statistically significant (t =2.48 and 2.17,both P <0.05 ).Conclusions DCI and the number of invalid swallowing can predict reflux condition of GERD patients in a certain degree.The contraction strength of esophageal body was the weakest and esophageal clearance was the worst in IEM group.

Objective Clinical studies show that the level of C-reactive protein ( CRP ) markedly increases in the acute phase of cerebral hemorrhage .However , the correlation of the CRP level with early neurological deterioration ( END) in patients with basal ganglia hemorrhage remains unclear .This study investigated the correlation between CRP and END in basal ganglia hemorrhage . Methods This study included 142 cases of basal ganglia hemorrhage diagnosed by cranial CT between Jan 2010 and Dec 2012 .END was defined as any decrease in Canadian Stroke Scale ( CSS) score≥1 point in the first 48 hours after stroke onset .We compared the baseline data between the END and non-END patients and evaluated the correlation between CRP and END by logistic regression analy -sis. Results END was found in 31 (21.8%) of the 142 patients.Univariate analysis of the END versus non-END cases showed that hyperglycemia (29.03 vs 11.71%, P=0.018), neutrophil count ([11.8 ±1.2] vs [7.8 ±7.7] ×109/L, P=0.019), CRP (P=0.001), hematoma expansion (54.83 vs 19.81%, P=0.001), hematoma volume ([23.6 ±21.9] vs [14.8 ±12.7] mL, P=0.005), and intraventricular hemorrhage (68.75 vs 28.83%, P<0.001) were significantly associated with END .Logistic regression a-nalysis indicated that the CRP level (OR=1.072, 95%CI:1.034-1.112, P=0.001), intraventricular hemorrhage (OR=4.162, 95%CI: 1.498 -11.564, P =0.006), and hematoma expansion (OR=5.297, 95%CI:1.906-14.723, P=0.001) were correlated with END in the patients during their hospital stay .ROC analysis man-ifested the predictive value of the CRP level for END in basal ganglia hemorrhage (OR=0.812, 95%CI: 0.732 -0.891, P <0.001). Conclusion The elevated level of CRP is significantly correlated with END in patients with basal ganglia hemorrhage and therefore can be re-garded as a predictive factor for this condition .

AIM To study the effects of sera derived from rats administrated Lugu Ganoderma Lucidum (LGL) on the expression of adhesion molecules ICAM 1 and VCAM 1 induced by oxidative low density lipoprotein (ox LDL) and glycated albumin METHODS The expression of ICAM 1 and VCAM 1 on the surface of endothelial cells was detected by endothelial cell enzyme linked immunosobent assay (ELISA) and flow cytometric technique RESULTS The results by cell ELISA demonstrated that the sera derived from the rats administrated 0 12 g?kg -1 p o of LGL did not show significant effects on theexpression of ICAM 1 induced by ox LDL, but the sera from the rats administrated 0 24 g?kg -1 , 0 72 g?kg -1 po for ten days produced significant effects of inhibiting the expression of ICAM 1 induced by ox LDL and the expression of ICAM 1 and VCAM 1 induced by glycated albumin The results by flow cytometric techniques showed that the sera from the rats administrated 0 72 g?kg -1 for ten days produced the same effect on ICAM 1 induced by ox LDL and glycated albumin CONCLUSION Lugu Ganoderma Lucidum can inhibit the expression of adhesion molecules on the surface of endothelial cells induced by ox LDL and glycated albumin.

AIM To establish an efficient and convenient system for expressing functional proteins. METHODS Xenopus leavis females were injected with HCG, eggs were harvested next morning and dejellied by 2% cysteine, from which the Xenopus leavis egg cell free translating system was prepared. Through subcloning technique, TFAR19 gene was cloned to pBluescript SK plasmid which was linearized by enzyme, then transcript and capped in vitro to synthesis the cRNA of TFAR19. RESULTS This cRNA was translated in freshly prepared cell free translating system, the product was identified by Western Blot. CONCLUSION The results showed that this translating system could efficiently translate TFAR19 cRNA and be a very useful translating tool.

Objective To investigate the effect of progressive neurological deterioration ( PND) of cerebral watershed infarction on early prognosis. Methods The consecutive patients with cerebral watershed infarction admitted in the Department of Neurology,Jinling Hospital,Nanjing University School of Medicine and their cerebral watershed infarctions confirmed by the imaging examination from March 2009 to March 2014 were enrolled. The clinical features, laboratory indicators and imaging features of internal watershed infarction,cortical-type watershed infarction,and mixed watershed infarction were identified and analyzed. The National Institutes of Health Stroke Scale was used to score neurological deficit. The modified Rankin scale ( mRS) was used to score the prognosis of patients. Single factor analysis was used to compare the differences between the groups. At the same time,the correlation between PND and poor prognosis of cerebral watershed infarction at day 90 was analyzed by multivariable Logistic regression analysis. Results A total of 89 patients with cerebral watershed infarction were enrolled,including 43 cortical-type watershed infarctions,36 internal watershed infarctions, and 10 mixed watershed infarctions. Single factor analysis indicated that the incidences of PND of internal watershed infarction and mixed watershed infarction were significantly higher than the cortical-type watershed infarction (36. 1% [n=13],50. 0% [n=5], and 16. 3% [n=7],respectively;P=0. 018). At day 90,28 patients had poor prognosis,and mRS was (3.4±1. 0) scores at day 90. There was significant difference in the types of infarction between the patients with poor prognosis and patients with good prognosis (P<0. 05). In patients with poor prognosis, most of them were internal watershed infarctions,accounting for 50. 0% (14/28),while in patients with good prognosis,most of them were cortical-type watershed infarctions(57. 4% [35/61]). The incidence of PND in patients with poor prognosis was significantly higher than that in patients with good prognosis (57.1% [16/28] vs. 14. 8% [9/61];P<0. 05). The result of multivariate Logistic regression analysis showed that after adjustment for confounding factor, PND was independently associated with the poor prognosis of cerebral watershed infarction at day 90 (OR 6. 969,95%CI 2. 451-19. 869;P<0. 01). Conclusion Compared with the cortical-type watershed infarction, the patients with internal watershed infarction is more prone to have PND, and PND is independently correlate with the poor prognosis at day 90.

Objective To discuss the effects of acupuncture therapy on resting state functional magnetic resonance imaging (fMRI) in patients with ischemic stroke; To explore the central mechanism of acupuncture therapy.Methods Ten is chemic stroke patients with hemiplegia limbs and ten matched control subjects were included. Treatment group was given anti-platelet aggregation, anticoagulation, and nutrition brain cell therapy. At the same time, acupuncture therapy was given, taking Jianyu, Quchi, Shousanli, Waiguan, Hegu, Zusanli, Fenglong, Yanglingquan, Sanyinjiao, and Taichong, with even reinforcing-reducing method, and retaining the needle 30 min, manipulating needle every 10 min, once a day, 5 times a week, needle stopping for 2 d, for continuous 30 d. The health group did not undergo any treatment. BOLD-fMRI imaging technique was used, and based on RSET1.8 software, the parameters of brain activity before and after treatment were observed by amplitude of low frequency fluctuation (ALFF) method. The Results were compared with healthy group. Results Before treatment, the ALFF value of left caudate nucleus, putamen and globus pallidus in the treatment group was lower than that in the health group, and the ALFF value of bilateral precentral and postcentral gyrus, left grus frontalis superior, gyrus frontalis medius, gyrus temporalis medius and precuneus was higher than the health group (P<0.05). After treatment, the ALFF value in left caudate nucleus, putamen and globus pallidus in the treatment group was higher than that before treatment, and the ALFF value in left gyrus frontalis superior, gyrus frontalis medius and precuneus decreased than before group (P<0.05).Conclusion In the resting state of the ischemic stroke patients with hemiplegia limbs, the principal injured brain regions are caudate nucleus, putamen and globus pallidus. Acupuncture has a regulatory role for these brain areas, presumably may be the central mechanism of efficacy.

An electrospray/ultraviolet lamp dual-source ion trap mass spectrometer was developed for the rapid detection of gas and liquid samples.The instrument used the discontinuous atmospheric pressure sampling technique that both the electrospray ions and gaseous analytes were sampled and transferred using a pinch valve device.The two ionization sources were generally suitable for different kinds of analytes and provided complementary applications.Electrospray was used for the ionization of polar compounds in solution, while the UV ionization source was mainly applied for the analysis of gaseous organic compounds.A variety of samples such as anisole, toluene, 2,4-dimethylaniline, arginine, reserpine and aspartame were employed to test the performance in different working mode of the instrument.The results showed that the two sources were feasible for ionization of different types of samples, and different types of molecular ions could be generated when 2,4-dimethylaniline was analyzed.The two ionization sources could be used alternately or simultaneously without interference, and the working mode was also switched to fit the application requirements.The dual-source configuration was an effective way to extend the applications for miniature mass spectrometers.It did not significantly increase the size of the instrument, but provided more versatile analysis to meet the need for the measurement of different types of samples.

Objective Cerebral microbleeds (CMBs) are important indicators of cerebral small vessel disease .However, it is still unclear whether endothelial dysfunction is involved in CMBs .The aim of this study is to investigate the correlation between CMBs and soluble E-selectin (sE-selectin) in patients with acute ischemic stroke . Methods Based on the results of MRI (3.0 T) susceptibility weighted imaging , we divided patients with first acute ischemic stroke into a CMBs group ( n=63 ) and a non-CMBs group (n=63), and recruited another 45 volunteers with normal MRI findings as controls .We collected and conducted comparative a-nalysis on the demographic data , biochemical variables ( including the sE-selectin level ) , vascular risk factors , and the number of CMBs of the patients . Results Ordinal logistic regression analysis showed a significantly positive correlation between sE -selectin and the number of CMBs (OR=1.062, 95%CI:1.023-1.103, P=0.002), higher systolic blood pressure associated with more CMBs (OR=1.014, 95%CI:1.002-1.025, P=0.021). Conclusion Serum sE-selectin is significantly positively correlated with and can be used as a biological marker for the severity of CMBs .

Objective To investigate the related factors and prognosis of pulmonary hypertension (PAH) in hemodialysis (HD) patients for early diagnosis and intervention of PAH.Methods A retrospective cohort study was conducted in 183 long-term hemodialysis patients with complete follow-up data from January 1,2010 to December 30,2015 from the blood purification center of the Third Affiliated Hospital of Sun Yat-sen University.The follow-up deadline was December 30,2017,and the endpoints were death and cardiovascular events.The clinical data,laboratory examinations,cardiac color Doppler ultrasound parameters and prognosis of patients with and without PAH were compared.Multivariate logistic regression was used to analyze the risk factors for PAH in HD patients.The survival rates were calculated by Kaplan-Meier method,and the survival curves were compared by Log-rank test between the two groups.A multivariate Cox proportional hazard regression model was used to examine the association between PAH and all-cause mortality in HD patients.Results Of the 183 hemodialysis patients,79(43.2％) were female,104(56.8％) were male,and the age was (56.1±16.9) years,of which 72(39.3％) were complicated with PAH.Compared with the non-PAH group,patients in the PAH group was older and had a longer duration of dialysis (both P ＜ 0.05).The left atrial diameter (P=0.002) and the proportion of valvular calcification (P=0.004) were significantly higher in the PAH group than that in the non-PAH group.Logistic regression analysis showed increased age (OR=1.027,95％ CI 1.001-1.053,P=0.041) and increased duration of dialysis (OR=1.129,95％ CI 1.004-1.269,P=0.042) were risk factors for PAH in HD patients.After a median follow-up of 27.8 months,Kaplan-Meier survival analysis showed that all-cause mortality was higher in the PAH group than that in the non-PAH group ~x2=5.636,P=0.018).The main cause of death in two groups was cardiovascular event.Afteradjusting for age,diabetes mellitus,duration of dialysis,valvular calcification,and hypertension,Cox regression showed that PAH increased the risk of all-cause mortality in HD patients (HR=1.894,95％ CI 1.083-3.313,P=0.025).Conclusions HD patients complicated with PAH are more common and the prognosis is poor.Increased age and increased duration of dialysis may be risk factors for PAH in HD patients.Regular color Doppler echocardiography is helpful for early detection and diagnosis of PAH.