Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.

Objective To observe the effects of Ulinastatin on pulmonary vascular endothelium permeability and respiratory function in patients with extrapulmonary acute respiratory distress syndrome(ARDS exp). Methods The data of 39 patients with ARDS exp were retrospectively analyzed.According to whether treated with Ulinastatin or not, all patients were divided into Ulinastatin group(n = 21)and control group(n = 18); The level of extravascular lung water index (EVLWI), pulmonary vascular permeability index(PVPI) and respiratory function were measured before and after the treatment. Results The mortality rate of Ulinastatin group was lower than that of control group (28.6% vs 38.9%). The time of decreasing EVLWI, PVPI and improving PaO2/FiO and respiratory function in Ulinastatin group was shorter than that of control group, and the effect was superior. Conclusion Ulinastatin could reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in patients with extrapulmonary acute respiratory distress.

Objective To study wt-p53 gene's influence on the proliferation of keloid fibroblasts in vitro. Methods wt-p53 gene was transfected into keloid fibroblasts by adenovirus vector. wt-p53 mRNA was analyzed by RT-PCR; wt-p53 protein was evaluated by indirectiy immunofluorescence; The ability of proliferation of keloid fibroblasts was analyzed by cell growing curves; The cell cycle of KFB was checked by FCAS. Results The expression of wt-p53 mRNA and protein was obviously higher in the fibroblasts of the experimental group than those of control group; the rate of G_0~G_1 in cell cycle was higher in the fibroblasts of the experimental group than those of control group; at the same time, the rate of G_2~M was lower in fibroblasts of the experimental group than those of control group (P

Objective To investigate the probable pathologic basis of amido proton transfer(APT) imaging by analysing APT signal intensity and pathologic features of different grades of glioma.Methods Twenty-eight patients with glioma confirmed by postoperative pathology underwent APT scan.All the patients were divided into two groups,including 11 cases in low grade (WHO Ⅰ and Ⅱ) and 17 cases in high grade (WHO Ⅲ and Ⅳ) group.The APT rate of tumor core was measured.The specimens were processed with routine hematoxylin-eosin (HE) staining and immunohistochemistry of Ki-67 and CD34.Independent-samples t test was used to detect the difference of APT rate,cellularity,microvessel density and Ki-67 labeling indices of tumor core between low grade and high grade group.Pearson correlation analysis and multi-variable linear regression analysis were used to detect the relationship of APT rate with cellularity,microvessel density and Ki-67 labeling indices of the tumor core.Results The APT rate,cellularity and proliferation index were (2.3±0.6) ％,(9.4±2.4) ％ and (14.2±5.4) ％ in low grade group,while (3.6±0.7) ％,(18.4±4.7) ％ and (31.7±4.5) ％ in high grade group,respectively.Microvessel density was (19.0±7.4) per high-power field in low grade group and (38.9±11.3) in high grade group.There were statistical differences of the APT rate,cellularity,microvessel density and proliferation index between the low grade group and the high grade group (t=-4.94,-5.89,-5.13,and-9.28,respectively,P＜0.01).The APT rate was positive correlated with cellularity,microvessel density and proliferation index.The coefficient of correlation were 0.904,0.598,and 0.750,respectively,(P＜0.01).Multiple linear correlative analysis showed that increasing cellularity (X1),microvessel density (X2) and proliferation index (X3) were the main factors for increasing APT rate,and the correlation equation was Y=0.801 + 0.12X1-0.003X2 + 0.026X3 (F=46.437,P＜0.01,R2=0.853).Conclusions The APT signal intensity of the tumor core could reflect the pathologic features of glioma.The APT rate was positive correlated with cellularity,microvessel density and proliferation index,which indicate the higher APT rate the higher grade tumor.

Objective To evaluated the role of wt-P53 protein in telomerase regulation in keloid fibroblasts(KFBs). Methods The fibroblasts were derived from human keloid tissue which was proved by pathological diagnosis. KFBs were divided into 2 groups, the transfection group and the untransfection group. wt-p53 gene was transfected into the fibroblasts by adenovirus vectors in the transfection group. The KFBs untransfected with wt-p53 gene served as control (untransfection group). After 48 hours of transfection, the expression of wt-P53 protein was analyzed by both Western blotting and immunofluorescence method, respectively. The telomerase activity was evaluated by TRAP-ELISA after 1-7 days of transfection.Results All the KFBs from 2 groups expressed wt-P53 protein. But the expression level of wt-P53 protein in the transfection group was significantly higher than that in the untransfection group. At the same time of high expression of wt-P53 protein, the telomerase activity of KFBs in transfection group was significantly lower than that in the untransfection group( P＜0.05). Conclusion High level expression of wt-P53 protein can transiently inhibit the telomerase activity of KFBs.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

Objective To determine the effects and dosage of N?acetylcysteine( NAC) in the im?provement of the visibility in esophagogastroduodenoscopy( EGD) . Methods A prospective randomized con?trolled study was performed on 193 patients scheduled for EGD from November 2014 to July 2015 were ran?domized into five groups using digital table. In group A, 100 mg dimethicone and 2 g NaHCO3 were given. In group B,100 mg dimethicone, 2 g NaHCO3 and 20 000 U pronase were given. Group C received 100 mg dimethicone, 2 g NaHCO3 and 200 mg NAC. Group D received 100 mg dimethicone, 2 g NaHCO3 and 400 mg NAC and group E 100 mg dimethicone, 2 g NaHCO3 and 600 mg NAC.The agents were dissolved in 100 ml water for each patient.Endoscopy was completed by one endoscopist and the score of image visibility assessment was completed by 2 other endoscopists. The 3 endoscopists were unaware of grouping. The total scores, the time of washing, the time of examination and complications were compared and analysed. The total image scores of group A, B, C,D and E were 30?83±3?78, 35?69±2?88, 33?16±3?90, 34?95±3?46 and 36?76±2?91, respectively. Group A was the lowest(P<0?05),followed by group C(P<0?05). There were no differences among group B,D, and E(P>0?05).Images that were scored 3 were the most in group E.The washing times of each group were 38?00±19?10, 17?03±11?44, 15?92±10?81, 15?78 ±10?24 and 15?55±9?69, and the examination times of each group were 13?49±2?49, 9?41±1?86, 9?08± 1?80, 8?73±1?91 and 8?78±1?79 minutes.Group A was the longest in these two indices(P<0?05). There were no significant differences among group B, C, D and E ( P<0?05) . There were no significant differences in adverse effects among groups after EGD( P>0?05) . Conclusion The preoperative NAC can improve the visibility in EGD. The best dose is 600 mg, whose effects and safety were similar to those of 20 000 U, but yield to less washing time and the examination time in EGD.

Objective To investigate the imaging characteristics of USPIO-enhanced and Gd-enhanced MRI in atherosclerosis and to compare the detection rate of atherosclerotic plaque between them. Methods Thirty-five healthy male rabbits were assigned to experimental group (n=30) to establish a model of atherosclerosis by damaging aortic tunica intima with Foley′s tube in combination with a high fat diet and 5 to control group without any intervention. At week 12, USPIO-enhanced and Gd-enhanced MRI scanning were conducted to compare the signal changes of atherosclerotic plaque before and after enhancement with the 2 contrast media. Ninety seven pictures were randomly selected respectively from the pictures enhanced by the 2 contrast media to compare the detection rate plaque between them. Pthology examination was used for detection standard. For the control group , pictures were randomly selected. Results In the experimental group, 7 rabbits died of Foley′s tube damaging, 2 died of raising and 1 died of anesthesia. All 5 rabbits in control group survived. A total of 172 pathological sections were made with 134 plaques and 72 vulnerable plaques pathologically confirmed. In pictures enhanced by USPIO , 84 plaques were confirmed by HE staining with a detection rate of 86.6%. In pictures enhanced by Gd, 72 plaques were confirmed by HE staining with a detection rate of 74.2%. Detection rate of USPIO-enhanced MRI in atherosclerosis plaque was significantly higher than that of Gd-enhanced MRI (X2=3.96, P=0.046). Conclusion USPIO shows its superiority as a new contrast medium in detection of atherosclerosis plaque.

Objective To compare the default mode network (DMN) between patients with gastroesophageal reflux disease (GERD) and healthy controls (HCs).Methods Included for this study were 30 GERD patients who were treated at Department of Digestive Diseases,Zhujiang Hospital from September 2016 to December 2017 and contemporary 49 HCs who received health examination at the out-patient department.Resting-state functional magnetic resonance imaging (fMRI) was conducted for the 2 groups.Fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) were used to study significant alterations in their DMN.Results Compared with the HCs,the GERD patients demonstrated the following alterations:the ReHo values were significantly decreased in bilateral superior temporal gyri,middle temporal gyri and dorsal anterior cingulate cortexes (dACC) but significantly increased in bilateral medial prefrontal lobes,dorsal anterior cingutates,posterior cingulates,precunei,and angular gyri;the fALFF value was increased in bilateral dACC and precunei but decreased in the paracentral lobules (P＜0.05).Conjunction analyses using both ReHo and fALFF values of their DMN showed the overlapping activated brain regions lied in the paracentral lobules,dACC and precunei.The fALFF values in the paracentral lobules and the dACC of the GERD patients were negatively correlated with their disease course (r=-0.380,P=0.035;r=-0.375,P=0.041) while the ReHo values in the superior temporal gyri of the GERD patients were also negatively correlated with their disease course (r=-0.446,P=0.016).Conclusion In GERD patients,their DMN might undergo dysfunctional changes because of the abnormal activity of DMN which may be correlated with their disorder of visceral sensation.

OBJECTIVETo assess the effects of continuous blood purification (CBP) on extravascular lung water and respiratory function in patients with extrapulmonary acute respiratory distress syndrome (ARDSexp).

METHODSThe data of 31 patients with ARDSexp admitted in our department were retrospectively analyzed.Sixteen of the patients received CBP, and the other 15 patients did not (control group). The level of extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI), and respiratory function were measured before and after CPB.

RESULTSThe mortality rate was significantly lower in CBP group than in the control group (12.5% vs 33.3%, P<0.05). The patients in CPB group showed markedly earlier and significantly greater improvements in EVLWI, PVPI, PaO2/FiO, and respiratory function than the control patients (P<0.05).

CONCLUSIONCBP can reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in patients with ARDSexp.