Complications that follow ischemic stroke are common,frequency ranging from 28% to 95%.It may either directly lead to death or prevent optimal recovery.54% of deaths after ischemic stroke are attributed to medical complications.Most complications occur during the first week,and stroke severity is the most important risk factor.The common serious medical complications are chest or urinary tract infection,deep venous thrombosis,pulmonary embolism,cardiac events,gastrointestinal bleeding,hyperglycemia,pressure sores.Falls,shoulder pain and depression are also common complications.Most of medical complications are preventable or treatable to some extent if recognized,so preventive strategies and appropriate treatment should be employed as early as possible.Prevention,early recognition,and management complications could improve short-term and long-term prognoses after ischemic stroke.

Objective:To analyze the lymphocyte activation from patients with different activities of multiple sclerosis (MS) and its clinical signifiance. Methods: The positive percentage of CD69 and HLA-DR were determined on peripheral blood (PB) or cerebrospinal fluid (CSF) lymphocytes by flow cytometry from 28 patients with relapsing-remitting MS (relapses n - 20, remission n = 8) , 12 patients with relapse MS and 11 patients with relapse MS after glucocorticoid treatment. ResultS:The percentage of HLA-DR+ and CD3+ /HLA-DR+ on PB lymphocytes in relapses MS group were higher than in remission MS group and controls. The percentage of CD3+ /HLA-DR+ on PB lymphocytes in remission MS group were higher than in controls. The percentage of CD69+ , HLA-DR+ and CD3+ /HLA-DR+ were higher in CSF than in PB of patients with relapse MS. There was no significant correlation between the levels of CD69+ , HLA-DR+ , CDS+ /HLA-DR+ and the time of onset of clinical relapse, duration, clinical disability scale score(EDSS) . In patients with relapse MS, there was significant positive correlation between CD69+ expression on CSF lymphocytes and blood brain barrier damage, intravenous glucocorticoid treatment caused a significant changes in the positive percentage of HLA-DR on PB lymphocytes. Conclusion:The findings support that lymphocyte activation involvement of MS pathogenesis. Lymphocyte activation may be as a marker of disease activity in MS.

Objective:To observe the influence of Naoxintong on expression of glucose-regulated protein 78(GRP78) and GRP94 in the striatum of rats with focal cerebral ischemic injury,so as to investigate their possible protective mechanism on cerebral ischemic injury.Methods:Ninety rats were equally randomized into 3 groups(n=30): sham operated group,ischemic group(Focal transient cerebral ischemia model was established with intraluminal occlusion of left middle cerebral artery) and Naoxintong pre-treated group(Treated with Naoxintong 5 d before ischemic injury).The expression of GRP78,GRP94 in rats striatum was detected by histological method,immunohistochemistry staining and semiquantitative RT-PCR at the different time points(6,12 and 24 h after ischemic treatment).Results:The focal transient cerebral ischemia model was successfully established in rats.Histological results showed that the degree of focal cerebral ischemic injury in Naoxintong pre-treated group was significantly lower than that in ischemic group.Immunohistochemistry staining and RT-PCR results illustrated that the expression of GRP78 and GRP94 in ischemic group was lower than that in sham operated group at each time point after ischemic treatment((P

Objective To investigate the effects of source to image receptor distance (SID) on the image quality and entrance surface dose (ESD) in the chest digital radiography (DR) for infants.Methods Anthropomorphic chest phantoms were exposed to 60 kVp and different values of SID ( 150 -80 cm with the interval of 10 cm,totally 8 groups) so as to record the values of mAs and ESD.The SID values of 110 cm and 90 cm with the moderate and low ESD values were selected for clinical test.Forty-two hospitalized infants,aged 12 months (8 months to 2 years) underwent chest DR with the SID of 110 cm before admission and 90 cm before discharge respectively.The values of ESD were recorded and compared.Three experienced experts assessed the quality of 84 pieces of images.Results The values of mAs and ESD decreased gradually along with the decrease of the SID from 150 cm to 80 cm.All the 84 images from the 42 infants met the demands for diagnosis.There was no significant difference in the score of image quality of the group with the SID of 110 cm (4.4±0.3) and 90 cm(4.2±0.4) (t=0.453,P＞0.05).The value of ESD of the group with the SID of 90 cm was significantly lower than that of the group of SID of 110 cm by 0.003 4 mGy ( t =12.001,P ＜ 0.05 ).Conclusions The image quality of chest DR could meet the demands for diagnosis in spite of the value of SID,however,the SID value in chest DR significantly might influence the ESD.The SID value of 90 cm shoud be recommended in chest DR for infants.

BACKGROUND: Apart from anticoagulation property and suppressing platelet congregation capability, tongxinluo preparation has been proved by traditional Chinese medicine to possess certain function for protecting endothelial cells.OBJECTIVE: To observe the influence of Chinese medicinal herb "tongxinluo" compound on adhesion molecule expression in brain ischemia-reperfusion (IR) animal model.DESIGN: Randomized and controlled experiment.SETTING: Department of Neurology, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA.MATERIALS: This experiment was conducted at the laboratory of the Department of Neurology, Shanghai Changzheng Hospital, between October 2002 and January 2003. Totally 25 male SD rats were randomized into sham-operation group of 5 rats, model group of 10 rats and tongxinluo group of 10 rats.METHODS: Middle cerebral artery was occluded using thread-bolt method to induce focal brain IR model in rats. In sham-operation group,nylon thread was placed around the external carotid artery approximating to the branch of internal carotid artery, and the other procedure was the same as that in model group. Rats in tongxinluo group were given tongxininfusion before IR for 1 consecutive week, which was replaced by physiological saline of the same dosage in model group and sham-operation group. Brain tissues were obtained under anesthesia condition and cut into slices; conventional HE staining, immunohistochemical and in situ hybridization staining were conducted.MAIN OUTCOME MEASURES:① The number of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)positive microvessels following IR injury.② The number of ICAM-1 and VCAM-1 mRNA positive microvessels following IR injury.RESULTS:① In sham-operation group,ICAM-1,VCAM-1 protein andICAM-1 mRNA positive microvessels could not be observed in hemispheric cortex and basal ganglion at the operative side.② In model group,the positive expression of ICAM-1, VCAM-1 protein and ICAM-1 mRNA obviously increased at the ischemic side at 6-hour reperfusion following 2-hour ischemia.③ In tongxinluo medication group,the positive protein and mRNA-expressing microvessls were found remarkably reduced in number in ischemic side hemispheric cortex and basal ganglion [(10.42 ±1.98),(12.42±2.14)/HP; (8.54±2.00), (11.12±1.56)/HP] (P ＜ 0.05), but the positive VCAM-1 protein-expressing microvessels did not change remarkably (P ＞ 0.05).CONCLUSION: Tongxinluo can suppress ICAM-1 transcription and translation following rat brain IR, thus attenuating inflammatory injury induced by brain ischemia.

Objective To observe the distributions of epidermal growth factor receptor(EGFR),transforming growth factor ?(TGF ? 1,? 2,? 3)and thyroid transcription factor 1(TTF 1)in developing lungs,and to discuss their functions and relationships each other. Methods The expression of EGFR and TGF ? was examined in mouse fetal lungs by immunohistochemistry.TIGER image analysiser was used in TTF 1 quantitative study. Results 1.In the early developmental phase,EGFR localized in the epithelium of airway surface,TTF 1 was expressed predominantly in the nuclei of distal lung buds and TGF ? was expressed in the bronchioles with localization patterns.2.At the late developmental phase,the positive reactions of EGFR and TTF 1 were mainly detected in alveolar cells.TGF ? expressed in mesenchymal at high levels.3 The average optical density(A A )of TTF 1 in the distal epithelial cells increased gradually during the development,while their volume(VOL)and volume integrated optical density(VI A )all decreased.Conclusion\ The functions of EGFR,TGF ? and TTF 1 might be respectively different at different developmental stages.They not only stimulate the process of branching morphogenesis,but also modulate epithelial maturation and differentiation.\;[

Objective:To explore the levels of adhesion molecules in peripheral blood leucocyte from patients with multiple sclerosis(MS) and after intravenous methylprednisolone(MP) treatment.Methods:The positive percentag of intercellular adhesion molecule 1(CD54)?integrin LFA 1 ? subunit(CD18)?very late antigen 4 ??? subunit(CD49d?CD29) and L selectin(CD62L) were determined on lymphocytes and monocytes by flow cytometry from 28 patients with relapsing remitting MS (relapses n=20,remission n=8) and 20 controls.Results:The positive percentage of CD49d?CD29 on lymphocytes and monocytes,CD54 and CD62L on monocytes in relapses MS group were higher than in remission MS group and controls(P0.05).Conclusion:The adhesion molecules expression on peripheral blood leucocyte were elevated in MS patients and it may be suitable to be as a marker of MS activity.

Objective:To observe the expression changes of adhesion molecules in peripheral blood leukocytes and serum soluble adhesion molecules in acute ischemic stroke after treatment with bartroxobin. Methods:Treatment group( n =8) was given bartroxobin (20 BU in 3 d) and other routine treatment;Control group( n =18) was similar to treatment group except for bartroxobin.The expression of CD11b,CD18,CD62L,CD54 on polymorphonuclear and monocyte were measured by flow cytometry, soluble ICAM 1 and VCAM 1 were measured by enzyme linked immunosorbent assay in consecutive patients[within 12,24,48 h( P

Objective To investigate the antibiotic resistance and the phenotype and genotype of metallo-β-lactamase in clinical isolates Chryseobacterium spp.Methods The MIC of 18 antibiotics in 50 Chryseobacterium spp.isolates was detected by agar dilution method.Phenotype of metallo-β-laetamase was detected by three-disc synergy test and modified three dimension test.Polymerase chain reaction(PCR)detection for metallo-β-lactamase gene was conducted for all isolates,and then the DNA sequence analysis was conducted for the PCR products which are positive for metallo-β-lactamase and identify genotype.conjugation experiment was used to study the transmission of metallo-β-lactamase encoding gene.pIs of β-lactamase was measured by isoelectric focusing assay. Results The antibiotic resistance of 50 clinical isolates of Chryseobacterium spp.against imipenem,Meropenem was 82.0%and 82.0%respectively.However,these isolated had high resistance to gatifloxacin.levofloxacin and rifampin compared with other antibiotics.Phenotype detection showed 33 isolated produced metallo-β-lactamase using three-disc synergy test and modified three dimension test,and the incidence of producing metallo-β-lactamase was 66.0%.Twenty isolateds producing Chryseobacterium indologenes were detected to have metallo-β-laetamase genotype by PCR amplification,among them 9 isolates containing blaIND-1 genotype and 10 isolateds containing blaIND-2 genotype.Strain CI-25 was identified to represent blaIND-LIKE genotype.Fourteen Chryseobacterium meningosepticum were detected to have metallo-β-lactamase genotype by PCR amplification,including 15 blaB and 2 blaGOB. The number of strain producing blaB1,blaB2,blaB3 and blaB11 in Chryseobacterium meningosepticum was 2,5,4 and 4,respectively. Conjugation experiments showed that metallo-β-lactamase encoding gene cannot be transfered. The extracted plasmid of 4 strains did not harbor metallo-β-lactamase gene.Strain C-5 was proved to have blaIND-1 gene,but its phenotype and IEF of metallo-β-lactamase was negative.Conclusions Chryseobacterium spp.had high frequency of multidrug resistance and high incidence for producing metallo-β-lactamase,and thus it was difficult to be treated.The gene of metallo-β-lactamase located on chromosome of Chryseobacterium spp.and cannot be transfered.There was negative or low lever of expression of blaIND-1.

Objective To explore clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithoto-my. Methods 400 patients with renal lithiasis or superior segment ureter lithiasis in our hospital were divided into group A and group B. 200 cases of group A received neotype controllability artifiicial nephrohydrosis;200 cases of group B received conventional artificial nephro-hydrosis. The puncture duration, amount of bleeding and times of puncture of the two groups were compared. Results 195 cases in Group A were developed renal tract for PCNL effectively,157 cases were developed renal tract for PCNL effectively in Group B. The puncture duration, amount of bleeding and times of puncture of group A and group B were respectively (1. 8 ± 0. 7) vs. (2. 5 ± 1. 2) min,(112. 7 ± 51. 0) vs. (270. 2 ± 89. 3) mL,(1. 1 ± 0. 2) vs. (1. 8 ± 0. 7) times. The differences were significant. Conclusion Neotype controllability artificial nephrohydrosis can develop renal tract for PCNL effectively.