Objective To analyze clinical characteristics of crohn's disease in the elderly in order to reduce the rate of misdiagnosis in Crohn's disease in elderly people.Methods Patients with Crohn's disease were divided into elderly group (n=80) and young and middle-aged group (n=100).Clinical manifestations,complications,laboratory test results and misdiagnosis rate were retrospectively analyzed.Results Diarrhea rate was higher in elderly group than in young and middle-aged group (62.5％ vs.28％,x2 =21.54,P＜0.05).The incidence of bloody/pus stools was lower in elderly group than in young and middle-aged group (16.3％ vs.30.0％,x2 =4.621,P＜0.05).Ileus and perianal diseases incidence rates were lower in elderly group than in young and middle-aged group (20.0％ vs.36.0％,1.3％ vs.8.0％,x2=5.538 and 4.263,P＜0.05).Crohn's disease showed more decreased serum albumin,decreased hemoglobin and ESR in elderly group,which accounted for 48.8％,41.3％,and 38.8％ respectively,but there were no differences between the two groups (all P＞0.05).Compared with young and middle-aged group,Crohn's disease was more likely misdiagnosed as colon cancer and ischemic bowel disease in elderly group (x2 =16.05 and 16.07,both P＜ 0.05).Crohn's disease was more likely misdiagnosed as appendicitis,intestinal tuberculosis and ulcerative colitis in young and middle-aged group than in elderly group (x2=4.707,6.210,4.792,respectively,all P＜0.05).Conclusions Crohn's disease in elderly people occurs with more severe diarrheas,less blood and pus stools,less obstruction and perianal lesions as compared with young group,to which we should pay more attention.

Objective Research of Enterococcus faecalis and Enterococcus faecium to our hospital in patients with severeurinary tract infection status and to compare the resistance ,to provide a basis for clinical rational use of antimicrobial agents .Methods From 2011 January -2014 December in our hospital with severe urinary tract infections in patients with isolated 172 strains of En‐terococcus were analyzed ,with the French bioMerieux ATB microorganism identification instrument identification of Enterococcus , using the disc diffusion method (K‐B) was used in drug sensitivity test ,by using WHONET 5 .6 software test data analysis and processing .Results A total of 172 strains of Enterococcus ,the separation of Enterococcus faecalis and Enterococcus faecium rates were 68 .0% (117 strains) and 32 .0% (55 strains);drug sensitive test showed that two kinds of Enterococcus to Linezolid、vanco‐mycin、Ti Koa Laing、tigecycline are more sensitive (resistance rate < 5% ) ,in addition to these 4 drugs ,for the other 12 kinds of antimicrobial resistance has significant difference (P< 0 .05);there were 5 strains of vancomycin resistant Enterococcus ,the 3 strains of Enterococcus faecalis ,2 strains of Enterococcus faecium ,Nailinai temozolomide of 3 strains of Enterococcus faecalis ,En‐terococcus faecium strain .Conclusion Multi drug resistant Enterococcus isolated from our hospital in patients with severe in urine samples of serious ,there are two kinds of resistance strain differences in Enterococcus ,we should strengthen the monitoring of clini‐cal bacteria ,Linezolid、vancomycin、Ti Koa Laing、tigecycline preferred treatment of Enterococcus infections .

OBJECTIVE:To observe the long-term toxicity of Kangjun xiaoyan tablets in rats.METHODS:Rats were treated with Kangjun xiaoyan tablets at doses of 30,15,and 7.6 g?kg-1?d-1(150,75 and 38 times of clinic daily dose 0.2 g?kg-1?d-1) for 12 weeks.Parameters including body weight,organ index,the indexes of haematology and biochemistry were obtained,and histopathological examination was performed.RESULTS:There were no significant differences between Kangjun xiaoyan tablets-treated group and normal control group in appearance and behavior,body weight,organ coefficient,the indexes of haematology and biochemistry.No significant pathological changes related to drug toxicity in the pathological examination nor the delayed toxicity reaction was noted.CONCLUSION:Long-term administration of Kangjun xiaoyan tablets exhibited no overt toxicity in rats,suggesting the safety of the clinical intended dosage.

BACKGROUND: Both apoptosis suppression gene Bcl-2 and apoptosis in duction gene Bax take parts in the apoptosis of neurons in ischemic penum bra. Whether would the polypeptide from chlamys farreri that is proved to be of anti-oxidation and anti-apoptosis in vitro protect the ischemic neurons from apoptosis? OBJECTIVE: To observe the effect of chlamys farreri on the Bcl-2 and Bax protein-associated apoptosis in penumbra and its role in neuron protection. DESIGN: A randomized trial.SETTING: Department of Anatomy, Medical College of Qingdao University.MATERIALS: The trial was conducted in Nerve Anatomy Laboratory of Medical College of Qingdao University from March to April 2000. The subjects were 32 adult Wistar rats that were randomly and averagely assigned into 4 groups: polypeptide chlamys farreri group, sterile water group, model control group and sham group. The chlamys farreri was provided by the Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences.INTERVENTIONS: Model of brain ischemia and reperfusion was made in rats in polypeptide chlamys farreri, sterile water and model control group by occlusion of middle cerebral artery. The model was not established in rats in sham group. The rats in chlamys farreri group received intraperitoneal injection of chlamys farreri of volume fraction 0. 1 at the dose of 0. 1 mL/kg each day for 2 days prior to modeling and an extra injection 15 minutes just before modeling. And the rats in sterile water group received intraperitoneal injec tion of sterile water with the dose of 0. 1 mL/kg each for two days and an extra injection 15 minutes before modeling. Those in model control group and sham group were exposed to nothing. Then models were established in rats in chlamys farreri, sterile water and model control group by inserting 4-0 nylons sutures from external carotid artery through bifurcation of carotid artery,extracranial and intracranial segments of internal carotid artery till the initial part of middle cerebral artery to make acute ischemia of middle cerebral artery perfusion area. The model was considered successful by the presentation of Horner' s syndrome, adduction-flexion of right forearm when tail being lifted and right turning during walk of the rat. The rats in sham group underwent the same procedures as that in the other groups except for the occlusion of middle cerebral artery. Then brains of the rats were taken for immunohistochemical determination of Bcl-2 and Bax proteins. The protein expression was expressed by absorbance of the products of their immunological reaction.MAIN OUTCOME MEASURES: The expression differences betweenBcl-2 and Bax proteins in penumbras of the groups.RESULTS: There were 32 rats entered the stage of analysis after complement of subjects. ① Bcl-2 expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0.453±0.048,0.510±0.061,0.211±0.023, F=683.78, q=21.13 to 24.74, P ＜ 0.01), and that in chlamys farreri group(0. 954 ±0. 059) was more than that in model control group and sterile water group( q = 38.08 to 41.69, P ＜ 0.01) . ② Bax expression in penumbra: The absorbance in model control group and sterile water group were higher than that in sham group (0. 834 ±0. 082, 0. 790 ±0. 102, 0. 125 ±0. 017, F=590.44, q =49.57 to 51.98, P ＜ 0.01 ) ] and that in chlamys farreri group (0.471 ± 0. 045 ) was suppressed as compared with that in model control group and sterile water group(q=23. 80 to 26. 23, P ＜0. 01).CONCLUSION: Chlamys farreri is capable of increasing Bcl-2 protein and decreasing Bax protein in cerebral penumbra to brake the initiation of neuron apoptosis after ischemia-reperfusion and preserve neuronic function in penumbra.

Objective To observe changes of plasma thrombinogen segment 1+2(FI+2)and D-dimer(D-D)in multiple trauma patients and exphlore their relations with traumatic disseminated intra-vascular coagulation(DIC). Methods A total of 66 multiple trauma patients were divided into minor injury group(ISS＜16 points,21 patients)and severe multiple trauma group(ISS≥16 points,45 pa-tients).Then.severe multiple trauma group were divided into DIC group(12 patients)and non-DIC group(33 patients).Another 10 healthy pemons were served as control group.Venous blood was collect-ed once in the control group and that collected from other groups at days 1,3 and 7 after injury.The F1 +2 concentrarion was detetrained with ELISA.and the D-D concentration was measured by automated la-tex enhanced immunoassay. Results The F1+2 and D-D levels in the minor injury group and sever multiple trauma group were both higher than that of the control group.In the meantime.the F1+2 and D-D levels in severe injury group were remarkably higher than that in the minor injury group.The plasma F1 +2 and D-D levels were elevated continuously in traumatic DIC group and remarkably higher than that in the non.DIC group.in which the plasma F1+2 and D-D levels gradually declined.Plasma F1+2 and D-D levels had significantly positive correlations at days 1,3 and 7 after injury. Conclusions Hiigher levels of F1+2 and D.D at acute stage is not only relevant to the injury severity,but also closely to the occurrence of traumatic DIC after injury.Detection of plasma F1+2 and D-D levels may play an impor-taut role in early prediction of DIC.

Objective To investigate the microcirculative route of the arterialized venous flap.Methods Selecting 15 Chinese white rabbits designed the model of arterialized venous flap by anastomosis with from the central artery to central vein.The reversed blood flow perfusion was directly observed by the "ear windows" under the microscope and,simultaneous recording the changes in the microcirculation of the flap.Results All of the flaps were alived.The structure of the capillary net in the flap was a stereo-net .In the early arterialized stage,the upstream blood flows quickly in the venule;there was no blood flowing in the capillary net with the opening of the capillary net,the reconstructed procedure of the non-physilogical microcirculation was accomplished:the arterial blood mainly flow through small vein and venule,finally arrived the capillary net.Conclusions Keep up the drainage vein free,the arterialized venousflap could be alived by reconstructed effective microcirculation through the venous system.

Objective To investigate the clinicopathologieal features of serous microcystic adenoma of the pancreas. Methods Clinicopathological analysis, histochemieal and immunohistochemical studies were performed in 12 cases of serous microcystic adenoma of the pancreas with follow-up. Results The patients included 9 females and 3 males who ranged in age from 35 to 70 (mean=51.5). Seven patients were discov-ered by check-up incidentally and 5 for the symptoms as upper abdominal uncomfortable or pain. Tumors varied in size from 2.0 cm to 13 cm in maximal diameter(mean=6.0 cm), and all had a multicystic appear-ance. Histologically, all tumors were composed of numerous microcysts lined by a single layer of cuboidal or flattened cells. The tumor cells contained clear cytoplasm with glycogen and centrally located round nuclei mostly uniform without any atypia. Mitoses were very rare or absent. Histochemically, the tumor cells were positive for PAS and negative for AB-PAS. Immunohistochemieally, the tumor cells revealed diffuse positivi-ty of cytokeratins and epithelial membrane antigen, whereas CEA, CgA, Syn, CD34, Vimentin, P53 and S-100 protein were negative. Follow-up in 10 patients (range from 12 to 71 months) showed no recurrence of serous cystadenomas. Conclusion Serous microcystic adenoma of the pancreas is an extremely rare tumor. It is often non-symptomatic. Its diagnosis is mainly dependent on its unique morphological immunohistochemical features. It's biology behavior is necessary to study.

Anticoagulation is one of the important approaches in the prophylaxis and treatment of iSCheroic stroke.However.it may increase the risk of bleeding events in reducing the risk of recurrent stroke at the same time.This article reviews the status of anticoagulants in the prophylaxis and treatment of ischemic stroke by retrospecting their application in the prevention and treatment of ischemic stroke and the study of new anticoagulants.

Objective] To study the impact of outpatient appointment supposed on the management of outpatient department and whole hospital. [Methods] Survey and research the average outpatient registration volume, patients' registration waiting time and the patients' satisfaction monthly during May 2011 to May 2014 when outpatient appointment was applied, and analyze the impact of outpatient appointment supposed on the management of outpatient department and whole hospital by comparing the results 3 years ago(during April 2008 to April 2011) when outpatient appointment was not applied. [Results] The number of patients with an appointment was on the rise, the total number of outpatients increased with the increase of outpatient appointment, and patients' registration waiting time was significantly shortened with higher satisfaction. The difference had statistical significance( P<0.05). [Conclusion] By outpatient appointment services, outpatient management has been optimized, with the increase of outpatients; the hospital benefits grow, and meanwhile the patients' satisfaction is improved.

Objective To assess the significance of intima‐media thickness(IM T )combined with HCY ,HbA1c and blood lipid in‐dexes in patients with cerebral infarction .Methods 100 cases of patients with cerebral infarction were enrolled in the experiment group ,and were divided into normal blood glucose group ,high blood glucose group and diabetes mellitus(DM)group .60 healthy in‐dividuals were enrolled in the control group .The serum leves of HCY and HbA1c were detected ,and the IMT was determined by u‐sing ultrasonic examination .Results The positive rate of increase of IMT in the exprement group(70% ) were higher than that in the control group(10% ) ,there were significant differences between the two groups (P<0 .05) .The levels of HCY and HbA1c and IMT were higer in the exprement group compared withthose in the control group ,there was significant difference between the two groups(P<0 .05) .The serum levels of HbA1c and IMT were higher in the high blood glucose group and the DM group compared with those in the control group ,there were significant differences between the two groups (P<0 .05) .The sensitivity ,susceptibility and accuracy of IMT combined with HCY ,HbA1c and blood lipid indexes were 97 .1% ,87 .5% and 94 .0% .Conclusion The ultra‐sonic examination combined with biochemical indexes related to cerebral infarction could increase detection rate of cerebral infarc‐tion ,and the ensitivity ,susceptibility and accuracy could also increase .