OBJECTIVE:To explore the effects of risperidone combined Ningxin yizhi capsule on the cognitive function,neuro-logic function and living quality of cerebral infarction. METHODS:110 patients with cerebral infarction were randomly divided in-to control group(55 cases)and observation group(55 cases). All patients received aspirin,statins,penicillins,physical rehabilita-tion and other conventional treatment;based on it,control group orally received Risperidone tablet with initial dose of 0.5 mg, once a day,1 week later,the amount of drugs was adjusted according to the patient's tolerance and conditions,0.5 mg was in-creased every week,with maximum dose of less than 2 mg,no other antipsychotic drugs except risperidone. Observation group ad-ditionally received 0.9 g Ningxin yizhi capsule,3 times a day. The treatment course for both groups was 2 months. Montreal cogni-tive assessment (MoCA) score,neurobehavioral cognitive status tests scale (NCSE),National Institutes of Health Stroke Scale (NIHSS)score,activities of daily living scale(ADL)score and table of daily living-Barthel Index(Barthel-Index)before and af-ter treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:Before treatment,there were no signifi-cant differences in the MoCA scores,NCSE scores,NIHSS scores,ADL scores and Barthel-Index in 2 groups (P>0.05). After treatment,the MoCA scores,NCSE scores,ADL scores and Barthel-Index in 2 groups were significantly higher than before,and observation group was higher than control group,NIHSS scores were significantly lower than before,and observation group was lower than control group,the difference was statistically significant(P<0.05). And there was no significant difference in the inci-dence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treatment,risperidone combined Ningxin yizhi capsule can significantly improve the cognitive function,neurologic function and living quality of cerebral infarction,with good safety.

Objective To explore the relationship between Type A Behavior and Defense Style. Method 49 medical students and 34 doctors were investigated by the Defense Style Questionnaire (DSQ) and Type A Behavior Questionnaire (TABQ). Results Immature and middle defense styles were more used by Type A subjects than Type B and Type M subjects (P＜0.05). TABQ total score was significantly associated with immature and middle defense styles (P＜0.001 or P＜0.05). Conclusion Immature and middle defense styles were associated with Type A Behavior.

Hospitals frequently end up losing medical lawsuits due to the following factors: inappropriate appointment of legal representatives, misconception and wrong application of the standard of proof required for lawsuits, ignorance of the time limit for submitting lawsuit documents, and lack of communication with the judges on the proof value of medical literature. In order to guarantee their legitimate rights and interests, hospitals ought to appoint health lawyers and medical experts as their legal representatives, have a good grasp of the standard of proof of reasonable probability, adhere to the time regulations in lawsuits, strengthen communication with the judges with regard to medicine, and understand the legal rules of arbitration. Only by doing so can their legal rights and interests avoid being encroached upon.

Objective To analysis the relationship between the single nucleotide polymorphisms (SNPs) of G196A, C270T, G11757C, G712A and haplotypes frequencies of brain-derived neurotrophic factor (BDNF) gene and Chinese Han population with sporadic Alzheimer's disease (sAD). Methods The genotype and allele frequencies of BDNF G196A, C270T, G11757C and G712A were analyzed by polymerase chain reaction-restriction fragment length polymorphism technology in 106 sAD patients and 110 healthy controls. The software SHEsis was used to analyze the linkage disequilibrium and the haplotypes between the two groups. Results There were statistically differences in T allele frequeny of C270T (sAD vs control: 0.9% vs 4.5%) and A allele freguency of G712A (sAD vs control: 0.5% vs 4.5%) and in GG genotype frequeny of G712A (sAD vs control: 95.4% vs 91.8%) (all P

Objective To discuss the expression of tumor necrosis factor-like weak inducer of apoptosis ( TWEAK) in serum, urine and renal tissue in lupus nephritis( LN) . Methods The serum and urine levels of TWEAK were assessed by ELISA in LN patients and normal controls. Immunohistochemistry was used to detect the expressions of TWEAK in the kidney of patients and healthy controls. Results The serum and urine concentrations of TWEAK and MCP-1 were significantly higher in LN patients than those in healthy controls(P<0. 01). In addition,the level of serum TWEAK showed positive correlation with SLEDAI and negative correlation with serum C3 level ( P <0. 01),the expression of urine TWEAK showed positive correlation with SLEDAI (P<0. 05). In healthy renal tis-sues TWEAK was distributed mainly in renal tubules and rarely seen in glomerular while the expressions of TWEAK increased in renal tubular and glomeruli stainings were found in LN paitients. TWEAK could induce increased mac-rophage migration, may be involved in the pathological progression of lupus nephritis. Conclusion TWEAK may play key roles in the pathogenesis of LN. Meanwhile, TWEAK in serum and urine may be useful as markers of dis-ease activity. The change of TWEAK maybe associated with the pathology category of LN.

Objective To research the role of Helicobacter pylori(Hp) on chronic hepatitis B.Methods The seroprevalence of Hp infection and the quantity and genotyping of HBV DNA in 376 patients with chronic hepatitis B,including chronichepatitis group,cirrhosis group and HBV-related hepatocellular carcinoma(HCC) group,were detected,and compared with control and gastritis groups.Results Hp seropositivities in chronic hepatitis B group(56.2%),cirrhosis group(69.9%),HCC group(75.0%) were higher than that in control group(43.4%)(P0.05),the Hp seropositivities in cirrhosis and HCC groups were higher than that in chronic hepatitis group(P0.05).Conclusion Seroprevalence of antibodies to Hp in patients with chronic hepatitis B increases significantly,and Hp seropositivity increases with the pathological changes of chronic hepatitis B.

Objective To analyze the seroprevalence of Helicobacter pylori (H. pylori) infection and its specific genes in liver tissues of chronic hepatitis B virus (HBV) infected patients, and to investigate the effect of H. pylori on development of chronic HBV infected liver diseases. Methods Five hundred and two patients infected with HBV and 429 sex-and age matched healthy controls were enrolled in the case-control study. All subjects were tested for presence of antibodies against H. pylori using ELISA. Fifty-six liver biopsy samples were amplified by polymerase chain reaction (PCR) using Helicobacter genus-specific 16S rRNA primers. The positive samples were further amplified using specific primers of H. pylori cagA, vacA and glmM genes. Results H. pylori infection was accounted for 63.9% in HBV infected patients, which was higher than that in healthy controls (43.4%,P<0.05). Moreover, the seroprevalence of H. pylori in patients with hepatocellular carcinoma (HCC, 29/36,80.6%) or cirrhosis (64/83,77.1%) was higher than that in patients with chronic hepatitis (228/383,59.5%, P<0.01). Helicobacter genus-specific 16S rRNA was found in 17,7 or 11 of patients with cirrhosis, HCC or chronic hepatitis. Twenty-one samples were confirmed as H. pylori DNA by PCR. Conclusions The seroprevalence of antibody against H. pylori was higherHelicobacter can be detected in liver tissues of HBV infected patients. H. pylori might play the role in the development in HBV infected patients compared with healthy controls. Besides H. pylori, other of chronic hepatitis to cirrhosis and HCC.

Objective To observe the changes of the height of intervertebral discs of the segments adjacent to the fusional and instrumental area after the operation and the relation between the changes of height of intervetebral discs in the adjacent segments and the angle of the pedicle screw.Methods Thirty-one patients who underwent internal fixation from September 2004 to March 2006 were retrospectively analyzed.The intervertebral discs height of adjacent segment was studied.The influence of"Suspensory fixation"on the changes of height of adjacent intervertebral discs was compared.The relation between the changes of the height of the upper adjacent intervertebral discs and the angle of pedicle screw was analyzed.Results The mean follow-up period for the patients was 13.5 months(10-16 months).In the operating-group,the height of the adjacent intervertebral disc decreased slightly,but the changes had no statistical significance(P＞0.05).Between the group fixed between L5 and S1 and group fixed between L4and L5,the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).In the group fixed between L4 and L5,there had no obvious difference between the changes of the height of the upper adjacent intervertebral discs and the changes of the height of the lower one(P＞0.05).When the operating-group were divided into two groups according to the angle of pedicle screw (＜6°or＞6°),the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).But there had positive and correlative relation between changes of the height of the adjacent intervertebral discs and the angle of pedicle screw(r=0.373,P=0.039).Conclusion "Suspensory fixation"has no different influence on the changes of height of adjacent intervertebral discs.There has no difference on the risk of degeneration between upper and lower segment adjacent to the fusional area.There has positive and correlative relation between the changes of height of the upper intervertebral discs adjacent to the fusional area and the angle of pedicle screw,that is,the bigger the angle is,the more clearly the height of adjacent intervertebral discs will change.

Objective To observe the efficacy of cumulative dose of polyethylene glycol-interferon (Peg-IFN)α-2a combined with ribavirin in patients with decompensated hepatitis C virus (HCV)-related liver cirrhosis , and to evaluate the effects of anti-virus therapy on the progress of the disease . Methods From January 2005 to March 2009 ,patients with decompensated HCV-related liver cirrhosis were enrolled ,also included patients received partial splenic embolization .Peg-IFNα-2a combined with ribavirin therapy was given to patients whose blood cell met interferon (IFN) therapy standards .The dosage of Peg-IFNα-2a and ribavirin was adjusted according to the tolerance of the patients .After the treatment ,the patients were followed-up for 24 weeks .The patients whose blood cell did not meet IFN therapy standards and the patients unwilling to receive anti-virus therapy were assigned to control group and were followed-up for 96 weeks .The total amount of medication was calculated according to cumulative exposure dose . Sustained virological response (SVR ) , recurrence rate , liver function and disease progression were observed .The t test or Chi-square test was performed for comparison between groups and rate of disease progression was analyzed with Kaplan Meier curve .Results After anti-virus therapy , SVRs of patients with cumulative dose of Peg-IFNα-2a and ribavirin over 60% (include 60% ) were 27 .3%(12/44) and 27 .7% (13/47) ,respectively ;the recurrence rates were 7/19 and 35 .0% (7/20) ,respectively . In patients with cumulative dose less than 60% ,SVRs were 1/7 and 1/4 ,respectively ,and the recurrence rates were both 1/2 ;the differences of different doses was not statistically significant (all P>0 .05) .At the 24th week of follow-up after therapy ,the Child-Pugh score of combined therapy group was 7 .9 ± 1 .4 , which was lower than that before treatment (8 .5 ± 1 .2) ,and the difference was statistically significant (t=2 .33 ,P=0 .02) .At the 96th week of follow-up ,the Child-Pugh score of control group was 10 .0 ± 1 .6 ,which was higher than that before treatment (8 .5 ± 1 .4) ,and the difference was statistically significant (t=5 .82 , P<0 .01) .The disease progression rate of combined therapy group was 15 .7% , which was lower than that of control group (32 .4% ) ,and the difference was statistically significant (χ2=4 .34 ,P= 0 .04) .Conclusion The application of non-standard dosage of Peg-IFNα-2a combined with ribavirin in the patients with decompensated HCV-related liver cirrhosis can achieve virological response once the cumulative dose reached certain standards ,improve Child-Pugh scores of patients and slow disease progression .

OBJECTIVE:To observe the efficacy and safety of levofloxacin and capreomycin combined with chemotherapy regi-men in the treatment of multi-drug resistant tuberculosis(MDR-TB). METHODS:84 MDR-TB patients were randomly divided in-to observation group (42 cases) and control group (42 cases). Observation group received 0.75 g Capreomycin sulfate for injec-tion,addint into 100 ml 0.9% Sodium chloride injection,intravenous infusion,once a day+0.4 g Levofloxacin hydrochloride tab-let,orally,once a day+0.2 g Protionamide tablet,orally,3 times a day+0.3 g Pasiniazid tablet,orally,3 times a day+0.5 g Pyra-zinamide tablet,orally,4 times a day. Control group received 0.4 g Amikacin sulfate injection,adding into 100 ml 0.9% Sodium chloride injection,once a day,intravenous infusion+0.3 g Ofloxacin tablet,orally,twice a day+Protionamide tablet (the same dose with observation group)+Pasiniazid tablet (the same dose with observation group)+Pyrazinamide tablet (the same dose with observation group). All patient were given 0.1 g Glucuronolactone tablet,orally,3 times a day. The treatment course for both group was 12 months. Sputum negative conversion rate,negative conversion time,symptom improvement time,lesion absorption and lung cavity closing,and cell immune indexes (CD4+CD25+/CD4+,CD4+CD25+CD127low/CD4+),IL-17 level before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The sputum negative conversion rate,ab-sorption rate,lung cavity closing and narrowing cases in research group after 3,6,9,12,18 months treatment were significantly higher than control group,sputum negative conversion time,symptom improvement time in observation group were significantly lower than control group,the differences were statistically significant(P<0.05). Before treatment,there were no significant differ-ences in CD4+CD25+/CD4+,CD4+CD25+CD127low/CD4+,IL-17 level in 2 groups(P>0.05). After treatment,CD4+CD25+/CD4+,CD4+CD25+CD127low/CD4+ in 2 groups were significantly lower than before,and observation group was lower than control group,IL-17 level was significantly higher than before,and observation group was higher than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CON-CLUSIONS:Levofloxacin and capreomycin combined with chemotherapy in the treatment of MDR-TB,it can reduce T regulatory cells,increase IL-17 level,do not increase the incidence of adverse reactions.