Objective To explore the application values of magnetic resonance diffusion weighted imaging (DWI)and diffusion tensor imaging (DTI)in the early diagnosis of cerebral infarction.Methods 1 2 1 patients with single side cerebral infarction were di-vided into five groups by disease time,the brain examination was performed by conventional MRI,DWI and DTI in every case.The le-sions were observed and compared in different sequences imaging.Mean diffusivity(MD)and fractional anisotropy(FA)values of cere-bral infarction lesions and the symmetrical positions in normal hemispheres were measured and compared.The correlations between relative MD(rMD)value,relative FA(rFA)value and disease time were analyzed.Results The display rate on DWI in showing ultra-acute and acute cerebral infarction lesions was 100%,which was superior to that on other sequences of conventional MRI obviously (P<0.05).Compared with the healthy sides,MD values of infarction lesions were lower at ultra-acute and acute phase(P<0.001), but at sub-acute phase,there was no statistically difference between the affected and normal sides(P>0.05).MD value was higher at early chronic and late chronic phase(P<0.001);FA values had no consistent changes at ultra-acute phase(P>0.05),but at the later separate phases,FA values reduced successively(P<0.001).The rMD value of infarction lesions was positive correlated with disease time(rs=0.990,P<0.001).The rFA value of infarction lesions was negative correlated with disease time(rs=-0.994,P<0.001). Conclusion DWI is susceptive in showing cerebral infarction lesions at hyper-early phase.DTI can be used to determine the clinical phase and appraise the inj ured extent of cerebral infarction accurately by measuring the parameters.Combination of DWI and DTI can provide a basis for clinical individual treatment programs selection and prognostic evaluation.

Objective To supply anatomic foundation for TRAM and DIEP flaps breast reconstruction with both sensory innervation and rectus abdominis muscle function preserved. Methods Dissections of T8～T12 nerves in anterior abdominal wall were performed on 9 embalmed female cadavers (18 sides). By reconstructing DIEP flaps in 15 cases, the natures of the intercostal nerves and the relations with deep inferior epigastric perforators were investigated. Results Most intercostal nerves pierced the rectus abdominis muscle in the lateral one third. There were interconnections between muscular branches of segmental nerves. Sensory branches traveling with vascular perforators were divided into medial branch and lateral branch. The mean length of pure sensory nerve was (27.6?12.2)mm. Conclusion It is possible to preserve sensory innervation by coapting lower intercostal nerves to the 4th thoracic nerve in TRAM and DIEP breast reconstruction. Sparing lateral one third of rectus abdominis muscle does not cause denervated atrophy in the rectus abdominis muscle after TRAM breast reconstruction.

OBJECTIVE:To explore hospital pharmacists service mode and the subject construction of hospital pharmacy. ME-THODS:Through reviewing the transformation process of hospital pharmacy and pharmacist's duty,the present structure,con-tent,working model and achievements of pharmacy in our hospital were introduced based onlarge pharmacyof taking clinical pharmacy as core,paying attention to personnel training,technical innovation,physican,pharmacist and nurse cooperation,multi-ple discipline integration,etc.;the direction of hospital pharmacy was explored. RESULTS:Many adjustments were made to facili-tate the smooth and orderly development of hospital pharmacy under the new situation,as that establish the rational drug use and quality safety system,drug supply and operation management system working mode;that the development strategy of pharmacy was identified asfocusing on the rational drug use,combining the management functionandproviding professional pharmaceuti-cal care for the clinic and patients,providing professional technical support for the hospital decision and medical management;that the construction of clinical pharmacy specialty/key discipline and drug clinical trial technology platform in accordance with the international standard and so on were lined in the project of pharmacy;that quality control circle was cited,pharmaceutical supervi-sion and pharmaceutical care were expanded to the public and the fine;that a fine,professional pharmacist team was cultured. CONCLUSIONS:The construction of future hospital pharmacy needs the concept oflarge pharmacywith multi-disciplinary inte-gration to develop towards standardization,refinement,specialization and modernization.

Objective To explore the nutritional status and it's relative factors of patients with Parkinson's disease ( PD) .Methods One hundred and eighty PD patients were sellected in this study.All the motor and non-motor symptoms of PD patients were evaluated by PD scales, and mini Nutritional Assessment ( MNA )-SF questionnaires were used to evaluate their nutritional status.Results The differences of PD duration, Unified PD Rating Scale Ⅲ ( UPDRSⅢ) , H-Y stage and non-motor systems between normal nutritional status and abnormal nutritional status PD patients were statistically significant (P<0.05-0.01).The forward binary Logistic regression model indicated that H-Y stage (OR=2.35,95%CI:1.24-4.45,P=0.007) and depression (OR=1.39,95%CI:1.25-1.67,P<0.001) were closely associated with abnormal nutritional status.Conclusion The disease itself, motor systems and non-motor systems are closely associated with nutritional status in PD patients.

Objective To compare the clinical efficacy of clopidogrel and clopidogrel in the treatment of myocardial ischemia in patients with coronary heart disease (CHD).Methods86 patients with myocardial ischemia of coronary heart disease from January 2016 to January 2017 in our hospital, were randomly divided into group A (n=43) and group B (n=43), group A was treated with ticagrelor treatment, group B was treated with clopidogrel treatment, clinical curative effect were compared between the two groups.ResultsThe total effective rate in group A was 86.04% was significantly higher than 72.09% in group B, the difference was statistically significant (P<0.05);The number of ST segment descent in group A was (36.17±4.22) times,ST segment continuous decline time (120.29 ±13.53) s ST continued to decline time (120.29±13.53) s, heart rate (65.27±3.18) times/min, systolic blood pressure (105.44±2.17) mmHg, diastolic blood pressure (63.11±3.14) mmHg were significantly lower than the control group (P<0.05);group A patients with triglyceride,total cholesterol,plasma viscosity trimming rate, whole blood viscosity at low shear rate, and whole blood high shear rate were significantly lower than those in group B (P<0.05).ConclusionCompared with clopidogrel, Grillo can effectively improve the blood microcirculation of myocardial ischemia in patients with coronary heart disease, coronary heart disease,relieve myocardial ischemia caused by coronary heart disease The clinical efficacy is remarkable, and it has the value of popularization and Application.

Objective To develop a rapid ,convenient ,sensitive and specific method for the detection of marine Vbrio vulnificus by using loop‐mediated isothermal amplification(LAMP) technique ,and evaluate the specificity and sensitivity of this method . Methods According to marine Vibrio vulnificus cytolysin(vvhA) gene sequence published by GenBank ,a set of LAMP primers were designed .LAMP and polymerase chain reaction(PCR) amplification were carried out in 47 strains of bacteria(including 20 strains of Vibrio) and specificities of LAMP and PCR were compared .Serial ten‐fold dilutions of an overnight Vibrio vulnificus M06 culture were prepared in sterile saline solution ,and compared the sensitivity of LAMP with that of PCR after extracting DNA tem‐plates .A recombinant plasmid containing fragment of vvhA gene was constructed and set as a standard positive control of LAMP assay .Results False‐positive results occurred in the conventional PCR ,while in the LAMP assay positive amplifications were only seen in strains of Vibrio vulnificus and no false‐positive or false‐negative results were generated among 47 strains of bacteria ,which indicated that primers had high specificity .Additionally ,the results of electrophoresis were consistent with those after adding the calcein .The detection limit of LAMP was 4 × 10 CFU each reaction for detecting vvhA gene in pure culture ,which was 10‐fold more sensitive than that of conventional PCR(4 × 102 CFU each reaction) .It indicated that LAMP assay had good sensitivity .Repeated the test twice ,the detection results of LAMP and PCR were both stable .Conclusion An LAMP detection method for marine Vibrio vulnificus has been developed ,which is highly specific ,sensitive ,convenient and suitable for rapid field detection and point‐of‐care testing .

Objective To understand the occurrence of surgical site infection (SSI)following class I incision operation in a tumor hospital,explore the continuous surveillance and improve effectiveness,so as to provide reference for further inter-vention.Methods Targeted surveillance on thyroid surgery patients undergoing classⅠincision operations in a hospital in January-June 2013 were performed by medical record review,bedside observation,dressing change observation and patient follow-up,the surveillance result was compared with that of the same period of 2010.Results There was one case of SSI in January-June 2013 and January-June 2010 respectively,SSI rate was 0.20% and 0.18% respectively,there was no significant difference(P =1.000).In January-June 2013,prophylactic perioperative antimicrobial usage rate was 0.20%,which was lower than 27.21% of 2010;the coincident rate of indication for antimicrobial use was 100%, which was higher than 6.67% of 2010,the difference was statistically different(all P <0.001).Conclusion Targe-ted surveillance on SSI is helpful for the rational perioperative use of antimicrobial agents,the reducing of antimicro-bial prophylactic use doesn’t lead to the increase of class Ⅰ incision SSI.

Dens invaginatus is a relatively rare tooth malformations,this paper reports a case of lateral incisor with typeⅢdens invaginatus with periradicular pathosis and without pulp involvement.The tooth was treated by root canal therapy and followed up for one year,the prog-nosis was good.

Alzheimer's disease (AD) is a complex neurodegenerative disorder which seriously causes the dementia in elderly people and afflicts millions of people worldwide. Drug discovery for Alzheimer's disease therapy has been a hot research area and a big challenge, in which development of acetylcholinesterase (AChE) inhibitors design was the most active and some AChE inhibitors are commercially available for AD medication already. However, practical using of commercial AChE inhibitors showed their limited usefulness and related adverse effects. Thus, it is extremely urgent to find novel AChE inhibitors with higher potency and less adverse effects. Based on the accurate crystallographic studies about AChE, strategies for multi-binding site AChE inhibitors have been formed, followed by design of the multi-target directed ligands. In this review, the structures and binding modes of commercial AChE inhibitors were briefly discussed, together with the development of AChE inhibitor design for AD therapy: from multi-binding site inhibitors to multi-target directed ligands.

ASIA Impairment Classification is the standard for spinal cord injury. With or without anal sphincter contraction will tell the degree of injury. Now, many articles have introduced the anal sphincter manometry and electromyogram. We should study whether there is any relationship between the manometry, electromyogram and ASIA.