Objective To evaluate the relationship between cytotoxin-associated gene-A (CagA)seropositive of Helicobacter pylori (H .pylori )infection and risk of atherosclerotic cerebral infarction(ACI).Methods Related literatures were researched through literature retrieval ,literatures were obtained by uniformed criteria of inclusion and exclusion,and Meta analysis was performed with RevMan 4.2 software.Results A total of 10 literatures which met the inclusion criteria were retrieved,all were case-control study,case group included 907 studied subjects,and control group included 966 subjects;the included population were divided into Chinese subgroup and European Caucasian sub-group.Meta analysis of CagA seropositive of H .pylori infection and risk of ACI revealed that OR of the overall popula-tion,Chinese subgroup,and European Caucasian subgroup was 2.66(2.17-3.26),2.60(1.93-3.49),and 2.71(2.05-3.59)respectively;Meta analysis of CagA seronegative of H .pylori infection and risk of ACI revealed that OR of the overall population,Chinese subgroup,and European Caucasian subgroup was 0.74(0.49-1.10),0.81(0.45-1.48),and 0.64(0.37-1.09)respectively.The funnel plot and fail-safe number showed that there was no significant publication bias, the result was stable and reliable.Conclusion Chronic infection caused by CagA seropositive strains of H .pylori may be one of the risk factors of CAI,whether the eradication treatment of seropositive strains of H .pylori influences the process of atherosclerotic diseases like CAI needs to be further studied.

Objective To describe the clinical and radiological characteristics, the etiology, clinical course and MRI findings and prognosis of reversible splenial lesion syndrome ( RESLES) are analyzed.Methods Clinical and MRI findings of adult patients who presented with RESLES were retrospectively reviewed.Corresponding to severity of disability using Modified Oxford Handicap Scale ( MOHS ) , patients were classified into favorable outcome group (MOHS≤2)and poor outcome group(MOHS≥3),clinical and neuroimaging features between two outcome groups were compared.Results Eight patients fulfilled the criteria were included, who suffered from a broad spectrum of disorders, including mild encephalitis/encephalopathy, Marchiafava-Bignami disease and antiepileptic drug withdrawal.MRI found a high signal lesion in the splenium with or without the other parts of corpus callosum and extracallosal involved.The hyperintensity disappeared or lapsed comfirmed by repeated MRI.There is an significant difference on symptoms of severe disturbance of consciousness during clinical course and MRI showed extracallosal lesions between two groups (P<0.05).Conclusions RESLES is a rare entity with wide clinicoradiological spectrum due to varied diseases and conditions.Although overall symptoms of patients with RESLES trend to relieve, the prognosis of patients with severe disturbance of consciousness and extracallosal lesions are unlikely to be favorable.

Objective:To evaluate the utilization of both parenteral nutrition and enteral nutrition drugs for the reference of clinical medication.Method:The statistics on nutrition drugs in a hospital from 2006 to 2008 were conducted by the defined daily dose method.Result:The cost ratio of the nutrition drugs to the total drug consumption increased annually.Glutamine was the leading nutrition drug according to the increase tendency of DDDs.The utilization ratio of enteral nutrition drugs to the whole nutrition drugs increased continuously,from 8.72%to 15.58%during 2006 to 2008.Conclusion:Nutritional support has attracted more and more clinical attention,and DDDs of the enteral nutrition increases rapidly.

Objective To compare the curative efficacy and safety of subcutaneous immunotherapy (SCIT) versus sublingual immunotherapy (SLIT) for allergic rhinitis.Methods A total of 127 cases of patients with allergic rhinitis in the outpatient department of our hospital from June 2009 to March 2016 were retrospectively analyzed,including 79 cases treated with SCIT and 48 cases treated with SLIT.The curative effects and adverse reactions were compared between the two groups.Results After 3-year treatment,the total effective rate in the SCIT group was 75.9%,which was higher than 72.9% in the SLIT group,but the difference was not statistically significant (χ2=0.15,P>0.05).The incidence rate of adverse reactions in the SCIT group was 26.6%,which was higher than 10.4% in the SLIT group,the difference between the two groups was statistically significant (χ2=4.79,P<0.05).Conclusion The two desensitization treatment methods all gain better effect,but SLIT has lower occurrence rate of adverse reactions.

Objective To investigate the risk factors of wound healing 30 days after treatment in patients with pressure ulcer. Methods Two hundred and forty-five hospitalized patients with pressure ulcer between January 2015 and October 2016 were selected. They were divided into the healed group and the unhealed group 30 days after the treatment. The influencing factors 13 indexes including age, gender, edema, the number of diseases, the number of pressure ulcer, the size of pressure ulcer, PUSH score (Pressure Ulcer Scale Healing), hemoglobin, serum albumin, low density lipoprotein cholesterol and blood homocysteine underwent single factor and Logistic regression analysis. Results Single factor analysis of 12 indicators of risk factors affecting healing were age, Hb, Alb, Hcy, area of ulcer and PUSH scores of the 6 indicators in the regression equation (Z=3.11-6.63, All P < 0.01), gender also entered the regression equation (χ2=0.19, P<0.01);further multivariate regression analysis showed that there were statistically significant differences in PUSH score index (χ2=10.47, P<0.01, OR=0.001, 95%confidence interval were 0.001-0.037). Conclusions Age, gender, Hb, Alb, Hcy and PU area were the risk factors of pressure ulcer healing.

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Objective To explore the clinical effect of atomoxetine on children with attention deficit hyperactivity disorder(ADHD)comorbid tic disorder.Methods The children who met the criteria of Mental Disorders Diagnostic and Statistical Manual diagnostic criteria for ADHD and tic symptoms were given systematic atomoxetine titration reaching the optimum dose.ADHD and tic symptoms were evaluated with ADHD rating scale-Ⅳ(ADHD-RS-Ⅳ)for parents Yale Global Tic Severity Scale(YGTSS),respectively.Results Twenty children with ADHD comorbid tic disorder [17 male,3 female;age range 7.58-17.0 years,mean age(10.55?2.58)years] completing systemic titration was enrolled in the study,including 10 subjects with ADHD-inattentive type,9 mixed type,and 1 hyperactive/impulsive type.The mean optimal dose was(1.19?0.21)mg/(kg?d).The total score(12.65?9.08)scores,inattention score(7.45?4.75)scores and hyperactivity/impulsivity score(3.0)of ADHD-RS-Ⅳ decreased significantly post-treatment compared with pro-treatment(31.10?8.52,17.60?3.09,and 13.0 scores,respectively,P

OBJECTIVE: To investigate the level of H2-Ab1 in the nasal mucosa of mice with allergic rhinitis. METHOD: Twenty-four female 129/sv mice were divided into 2 groups: ovalbumin (OVA) group and control. The allergic rhinitis models were induced by classical method with OVA. After the last challenge, the pathological differences between the two groups were surveyed. The levels of H2-AB1 were measured by ELISA and quantitative real time PCR. RESULT: The expression of H2-Ab1 is higher in subjects with AR than that in controls (P < 0.05). CONCLUSION The levels of H2-Ab1 were highly increased in allergic rhinitis group, which might be associated with the pathogenesis of allergic rhinitis.
Animals ; Female ; Gene Expression ; Histocompatibility Antigens Class II ; genetics ; metabolism ; Mice ; Nasal Mucosa ; metabolism ; Rhinitis, Allergic ; metabolism

BACKGROUND:Decreased function and reduced number of CD4+CD25+regulatory T cells have been considered the major manifestation of immunity dysfunction in children with primary nephrotic syndrome. Bone marrow mesenchymal stem cells have immunoregulation effects, which up-regulate CD4+CD25+regulatory T cells, inhibit proliferation of lymphocytes, and have been widely used in many immune diseases.
OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem celltransplantation on the CD4+CD25+regulatory T cells of peripheral blood in rats with primary nephrotic syndrome.
METHODS:Bone marrow mesenchymal stem cells from six Sprague-Dawley rats were isolated, passaged and utilized for cellsuspension preparation. At the third passage, bone marrow mesenchymal stem cells were used for transplantation. The remaining 30 rats were randomly and equal y divided into three groups:normal group, normal saline infusion group, and bone marrow mesenchymal stem cells group. The rat models of primary nephrotic syndrome were established by single injection of adriamycin intravenously through tail vein in the latter two groups. Rats were then treated with bone marrow mesenchymal stem cells (1×10 7 ) (bone marrow mesenchymal stem cells group) or normal saline (normal saline infusion group) through tail vein at the same time after adriamycin administration. The normal group received no treatment.
RESULTS AND CONCLUSION:Compared with the normal group, rats in the normal saline infusion group developed nephropathy characterized by ascites, proteinuria, hypoalbuminemia, hypercholastero-lnemia, and progressive renal injury. However, the proteinurine and clinical severity in bone marrow mesenchymal stem cells group were significantly ameliorated after treatment with bone marrow mesenchymal stem cells. CD4+CD25+Treg/CD4+Treg in the peripheral blood in the bone marrow mesenchymal stem cells group and normal saline infusion group were significantly higher than that in the normal group at 28 days after model establishment (P<0.05), while there was no significant difference between bone marrow mesenchymal stem cells group and normal saline infusion group (P>0.05). The expression of FoxP3 mRNA in the peripheral blood mononuclear cells of the bone marrow mesenchymal stem cells group was significantly higher than that in the normal saline infusion group and normal group (P<0.05). The bone marrow mesenchymal stem cells play a protective effect in rats with primary nephrotic syndrome, which may be related to the increase of local expression of FoxP3 and generation of CD4+CD25+Treg.

Objective We conducted a study using MRI and ambulatory blood pressure monitoring(ABPM) to determine whether an inapporpriately low nocturnal blood pressure,or an excess fall in nocturnal blood pressure,might be responsible for lacunar infarct.Method ABPM and Casul blood pressure(CBP) were examined in 35 hypertentives with lacunar infarct( LI） and 33 hypertentives without lacunar infarct as control group.Results There is no significant difference of CBP between two groups.But the mean nighttime systolic blood pressure(nSBP) and diastolic blood pressure(nDBP) in patients with lacunar infarct were significantly smaller than in patients without lacunar infarct.The ratio of nSBP/dSBP and nDBP/dDBP in SI were smaller than in control group respectively.Conclusions The results indicate that an inappropriately low nocturnal blood pressure,or an excessive fall in nocturnal blood pressure,is associated with lacunar infarct.It is necessary not only to controlhigh blood pressure but also to pay attention to circadian changes of blood pressure during the course of anti-hypertensive treatment.