OBJECTIVE:To investigate the effects and safety of rosuvastatin on blood lipid and thyroid nodules in elderly pa-tients with dyslipidemia. METHODS:70 elderly patients with dyslipidemia were selected and randomly divided into control group (33 cases) and treatment group (37 cases). Control group was treated with routine treatment as abstain from tobacco and drink, low fat diet,Aspirin enteric-coated tablets 100 mg at bed time;treatment group was additionally treated with Rosuvastatin calcium tablet 10 mg at bed time,on the basis of control group. Both groups received the treatment for consecutive 12 weeks. BMI,blood lipid and the size of thyroid nodules were compared between 2 groups before and after treatment,and the occurrence of ADR was also observed. RESULTS:There was no significant difference in BMI between 2 groups before and after treatment (P>0.05). There was no significant difference in blood lipid level and the size of thyroid nodules between 2 groups before and after treatment (P>0.05). The blood lipid level and the size of thyroid nodule of 2 groups were improved significantly after treatment,and the treatment group was significantly better than the control group,with statistical significance(P<0.05). 2 pationts of creatment suf-fered from the increase of ALT but recovered withont angtreatment. CONCLUSIONS:Rosuvastatin can significantly improve blood lipid and decrease thyroid nodules in elderly patients with dyslipidemia with good safety.

Objective To discuss the experience of using the new dressings in the treatment of refractory wounds in the department of orthopedics. Methods Wound care team gave the treatment and nursing to 7 cases of refractory wounds in the department of orthopedics, used the new type of wound dressings. Results Among 7 cases, 5 cases were cured and discharged. The granulation growth of the wound was good, and the wound was healed after the transfer surgery of the joint flap. One patient had reached the healing rate of 90% after discharging, and recovered after being followed up for 22 days. Conclusions The correct assessment of the wound, reasonable choice of the new dressing, a good job of anti-infection treatment and the skin protection around the wound can effectively promote healing of the refractory wound after fracture, reduce the cost of health care, and bring the satisfaction to the patients and their families.

Objective To observe the influence of Sishen Pill on the NF-κB p65 mRNA and protein expressions of colonic mucosa in rats with experimental ulcerative colitis (UC), and identify its underlying mechanism of action. Methods The experimental rats were divided into blank group, model group, Sishen Pill group and SASP group. The models were prepared by TNBS/ethanol enema. Sishen Pill group was intragastrically administrated by Sishen Pill extract 5 g/kg, SASP group by SASP 0.3 g/kg, and blank group and model group by equal volume of normal saline. The morphological injury of colonic mucosa was observed and scored with the naked eyes, and NF-κB p65 gene and protein expression were detected by RT-PCR and immunohistochemical method. Results Inflammation and ulceration on the colonic mucous membrane were found in the model group by naked eyes, and had significant difference with the blank group (P<0.05). The relative expression amount of NF-κB p65 gene and protein of colonic tissues were increased in the model group compared with the blank group (P<0.01). Compared with the model group, the relative expression amount of NF-κB p65 gene and protein in Sishen Pill group were decreased (P<0.05, P<0.01). Conclusion Sishen Pill has effect for treating UC, which is probably related to the activation of NF-κB signal transduction pathway.

Objective To observe the effect of Sishen Pill on ICAM-1 mRNA and protein expression of colonic mucosa in rats with ulcerative colitis (UC), and identify its mechanism. Methods Taolly 40 SPF Wistar rats were randomly divided into blank group, model group, Pill group and SASP group. Except the blank group, UC model was prepared with TNBS/ethanol enema. Pill group was given Sishen Pill 5 g/kg, and SASP group was given SASP 0.3 g/kg by gavage, blank group and model group was given the same volume physiological saline for three weeks. Morphological injury of colonic mucosa was observed and scored. ICAM-1 gene and protein expression were detected by RT-PCR and immunohistochemical method. Results Inflammation and ulceration were found on the colonic mucous membrane of rats in the model group. The expression of ICAM-1 gene and protein of colonic tissues of rats in the model group increased compared with that of the blank group (P<0.01). Compared with the model group, the expression of ICAM-1 in Pill group decreased (P<0.05, P<0.01). Conclusion Sishen Pill can decrease the expression of ICAM-1 mRNA and ICAM-1 protein, inhibit the infiltration of inflammation cells, prevent and reduce colon tissue damage, and play a vital role in the treatment of UC.

Objective To investigate the correspond of microsatellite instability (MSI) on the prognosis and the effect of chemotherapy for colorectal cancer.Methods The publications about the MSI of colorectal cancer from January 2011 to October 2012 were searched.The Web of Knowledge and MEDLINE (PubMed) databases were used for searching English articles.The CNKI and WanFang databases were used for searching Chinese articles.Statistical analysis and graphics were performed with Comprehensive Meta Analysis V2 software.Results Thirty papers were included in this study.For the prognostic Meta-analysis,MSI-H was a protective factor for the overall survival of patients (OR =0.634,0.558-0.720; P ＜ 0.001).Simultaneously,MSI-H was a protective factor for the disease-free survival of patients (OR =0.571,0.479-0.681; P ＜ 0.001).After using of 5-Fu,the survival rate of MSS/MSI-L patients could be significantly elevated (OR =0.515,0.433-0.611; P ＜ 0.001).However,the survival rate of MSI-H patients did not increase significantly (0.631,0.302-1.318; P =0.220).Conclusions Both the overall survival and disease-free survival of MSI-H patients were significantly better than that of MSS/MSI-L patients.For MSS/MSI-L patients,the chemotherapy effect was remarkable.However,for MSI-H patients,there was no statistics difference between chemotherapy and no-chemotherapy group.

Objective:To investigate the expression and relationship of differentiated embryo-chondrocyte expressed gene1(DEC1) and the signal tranducers and activator of transcription3 (STAT3) in gastric cancer tissues,and the significance of the two genes in gastric carcinogenesis. Methods:Immunohistochemistry method of SP was adopted to discover the expression of DEC1 and STAT3 in 59 gastric cancer tissues,19 normal tissues distant from tumor were regarded as control. Results:The positive expression rate of DEC1 in gastric cancer tissues was 71.2%(42/59),which was significantly higher than that in normal para-cancer tissues(26.3%)(P0.05). STAT3 expression was associated with TNM staging,invasion depth,lymph node involvement and tumor grade (P0.05). Conclusions:DEC1 expression was higher in gastric cancer tissues than that in normal para-cancer tissues distant from tumor,and was correlated with STAT3 in gastric cancer. DEC1 and STAT3 are both transcription factors,therefore the co-activation of DEC1 and STAT3 may play an important role in the carcinogenesis and development of gastric cancer.

Objective To investigate molecular types and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in Zhejiang province.Methods One hundred and fourty-seven clinical MRSA isolates were collected from 11 grade A tertiary hospitals during January 2009 and December 2010 in Zhejiang province.Minimal inhibitory concentrations (MICs) of 13 antimicrobial agents were determined by agar dilution.Multilocus sequence typing (MLST),staphylococcal cassette chromosome mec (SCCmec) typing and spa typing were used to examine the homology of the strains,and drug resistance patterns were compared among different molecular types.Simpson index was used to determine the discriminatory power of three typing methods.Results Fourteen STs were identified in 147 MRSA isolates,of which ST239 (75 isolates),ST5 (24 isolates) and ST59 (23 isolates) were the most prevalent clones.Four SCCmec types (types Ⅱ to Ⅴ) were identified in 141 isolates,and 6 isolates were not typed.SCCmec type Ⅲ was the predominant type (76 isolates),which was followed by type Ⅳ (32 isolates),type Ⅱ (24 isolates) and type Ⅴ (9 isolates).All MRSA isolates yielded 23 spa types,in which t030 (57 strains),t437 (17 strains),t002 (15 strains) and t037 (12 strains) were the predominant spa types.MRSA strains were sensitive to linezolid,teicoplanin,vancomycin and norvancomycin,but were highly resistant to other antibacterial agents,especially in strains carrying clone ST239 or of SCCmec type Ⅲ.The discriminatory power of MLST,SCCmec and spa typing were 0.6885,0.6577 and 0.8165,respectively.Conclusion The predominant clone of MRSA strains in Zhejiang province was ST239-SCCmec Ⅲ-t030-MRSA,and these strains are highly resistant to most antibacterial agents,so that the surveillance of MRSA in hospital should be strengthened.

Objective To analyze the epidemiological characteristics of Klebsiella pneumoniae car-bapenemase(KPC)-producing Escherichia coli(E. coli)strains isolated in Hangzhou,China. Methods A total of 25 KPC-producing Escherichia coli strains were collected from four hospitals in Hangzhou from July 2012 to January 2014. Antibiotic susceptibility of the isolates to 22 common antimicrobial agents was deter-mined by using Kirby-Bauer(K-B)disk diffusion method. PCR analysis and gene sequencing were used for bla KPC gene screening. The modified Hodge test was performed to detect the production of carbapenemase. Pulsed-field gel electrophoresis(PFGE)and multi-locus sequence typing(MLST)were used for homology analysis. Results All of the 25 clinical isolates were confirmed to be KPC-producing E. coli strains,harbo-ring the blaKPC-2 gene. These KPC-producing isolates showed high drug resistance rates and were resistant to almost all β-lactam antibiotics. PFGE typing classified the 25 isolates into three main homologous clone groups,including clone group A(4 isolates),clone group B(5 isolates)and clone group C(2 isolates), and some single clones(14 isolates). MLST typing classified the isolates into eight ST types,including ST131(14 isolates),ST167(3 isolates),ST2003(3 isolates),ST410(1 isolate),ST457(1 isolate), ST1463(1 isolate),STnew1(1 isolate)and STnew2(1 isolate). The typing results of PFGE and MLST were consistent with each other. Conclusion The prevalent KPC-producing E. coli strains in Hangzhou, China were ST131 type,which were resistant to multiple antibiotics and had been detected in several hospi-tals. The epidemic of KPC-producing E. coli strain often occurred at some special wards,such as Intensive Care Unit(ICU)and emergency ICU.

Objective To investigate the feasibility and safety of endovascular recanalization of chronic occlusion of large intracranial artery.Methods From January 2009 to January 2017,the clinical and imaging data of 15 patients with chronic occlusion of large intracranial artery admitted to the Department of Interventional Neuroradiology,Xuanwu Hospital,Capital Medical University for endovascular recanalization were analyzed retrospectively.Twelve patients were V4 segment occlusion of vertebral artery and 3 were internal carotid artery occlusion.Preoperative whole brain digital subtraction angiography (DSA) was used to assess the occlusion length and location.High-resolution magnetic resonance imaging (MRI) was used to evaluate the nature of occlusion and the feasibility of recanalization.The intraoperative bilateral femoral artery sheath placement was conducted in 13 cases,one side was used for recanalization and stenting,and the other side was compensated by filling the distal occlusion of the artery through collateral circulation as the reference path map,and increased the feasibility of recanalization.According to the thrombolysis in cerebral infarction (TICI) grades after procedure,the forward flow after recanalization was systematically evaluated,and grade ≥2b was defined as the success of recanalization.Results The median time between the first onset of symptoms and recanalization was 50 (range,18-365) days.The occluded recanalization sites included intracranial segment of vertebral artery in 12 cases and intracranial segment of internal carotid artery in 3 cases.Recanalization was successful in 13 cases and recanalization failure of the intracranial segment of vertebral artery was in 2 cases.Recanalization was successful in 13 cases,and intracranial vertebral artery recanalization failed in 2 cases.Of the 13 patients of successful recanalization,the forward flow of angiography returned to grade TICI 3 in 12 cases after recanalization,and returned to TICI 2b in 1 case;the symptoms of 7 cases were improved,the symptoms of 4 cases did not have any change,and the symptoms of 2 patients aggravated after procedure and developed transient ischemic attack or stroke.After 11 patients were followed up for a median of 39 (3-89) months,the median mRS score was 1 (0-2).Conclusion For recanalization of chronic large intracranial artery occlusion,using preoperative high-resolution magnetic resonance imaging evaluation and intraoperative bilateral sheath placement technique may increase the patency rate and reduce the perioperative complications.

Objective To evaluate the imaging changes of the arterial wall and lumen at the site of intracranial large artery lesions with high-resolution magnetic resonance imaging (HR-MRI) before and after Wingspan stent implantation.Methods From December 2013 to December 2014,9 patients with symptomatic intracranial arterial stenosis (stenosis rate:70%-99%) admitted to the Department of Interventional Neuroradiology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively.The sites of the lesions included middle cerebral arteries,basilar artery,and intracranial segment of vertebral artery.Head 3D HR-MRI technique was used to analyze and compare the changes of the tube-wall enhancement areas in the lesion sites through image registration and matching.The consistency of stenosis rates measured by HR-MRI and DSA was compared through Pearson correlation analysis and Bland-Altman Plot.Results The success rate of technique was 100% without related complications.(1) After Wingspan stent implantation,the gadolinium enhancement in the vascular walls of the stenosis sites was decreased significantly compared with that before procedure.The area of enhancement decreased was 87±16% after stent implantation compared with before implantation,and the difference was statistically significant (t=2.325,P=0.049).(2) Before stent implantation,the mean stenosis rates of the HR-MRI and DSA measurements were 82±6% and 82±8% respectively,and the difference was not statistically significant (t=0.051,P=0.961);after procedure,the mean stenosis rates of HR-MRI and DSA measurements were 16±12% and 21±12% respectively,and the difference was not statistically significant (t=1.345,P=0.216).(3) The Pearson correlation coefficients of HR-MRI and DSA for stenosis rate measurement before and after stent implantation were 0.347 (P=0.361) and 0.545 (P=0.129) respectively.Bland-Altman statistical images showed that most of the data points were within the consistency limit (x-±1.96 s).Conclusions As an in vivo noninvasive imaging means,HR-MRI can be used to assess the changes of vascular walls of the lesion sites,the vascular lumen,and the original plaques after the intracranial stent release.It can also be used to evaluate the reconstruction of intracranial arterial walls.