Objective To observe the prognosis 90 days after attack and the correlation among various risk factors in patients with transient ischemic attack (TIA). Methods The data of 90 days follow up and related risk factors of 61 patients clinically diagnosed with TIA were analyzed.We also compared the prognosis of those patients according to the change on diffusion weighted imaging (DWI). Results The incidence of various kinds of severe vascular events in 61 patients within 90 days was 16.4% (10/61). Among the patients with abnormal change on DWI, the incidence was 50% (8/16). However the incidence was 4.7% (2/43) in the patients with normal DWI. There was a statistical difference between the two groups (P

Objective To investigate the injury of members nation earthquake emergency relief team(NERT) in Wenchuan earthquake, and to explore right measures to protect themselves in emergency relief.Method The injury of 187 members of rescue team,who took emergency relief of"5·12" Wenchuan earthquake from 12 May to 29 May 2008, was registered according to International classification of Diseases (ICD). Results Medical staff have treated the members for 268 times, dennatogic and subcutaneous tissue disease accounted for 35.4%, masele,skeleton and connective tissue disease accounted for 26.9% ,disease of respiratory system ac-counted for 13.4% .More members responsible for search injured fixed medical aid post,the treatment times were 224,accounting for 91.0% times (91.0%). Conclusions Sufficient medical preparation,fixed medical aid post,psychological quide are very important for members of relief team.

OBJECTIVE To study the distribution and drug resistance conditions of inpatients in our hospital and make us antibiotics use reasonable.METHODS Retrospective analysis was conducted from all the pathogens of the clinical specimens from 2007-2008 and the data were analysed.RESULTS A total of 5508 pathogens were isolated from 2007-2008.Among 2441 pathogens(44.32%),there were Gram-negative bacilli(Enterobacteriaceae 1715 pathogens,Nonfermenters 707 pathogens,Vibrionaceae 19 pathogens),1154 pathogens(20.95%) were Gram-positive bacilli,1906 pathogens(34.60%) were Fungi.There were 331 pathogens which extended spectrum ?-lactamases(ESBLs) of Enterobacteriaceae(19.30%).The resistance of Escherichia coli to amikacin,ceftazidime,gentamicin,ciprofloxacin,piperacillin resistance rates were 10.94%,60.53%,62.08%,82.01%,86.46%,resistance of Enterobacter cloacae to amikacin,ciprofloxacin,gentamicin,piperacillin,ceftazidime resistance rates were 30.61%,46.29%,52.96%,55.20%,53.05%,resistance of Klebsiella pneumoniae to ciprofloxacin,amikacin,gentamicin,ceftazidime,piperacillin resistance rates were 13.04%,15.90%,16.90%,20.17%,30.07%,The resistance of E.coli,E.coli to ceftazidime,gentamicin,ciprofloxacin,piperacillin were not found were than 60.00%,E.cloacae to gentamicin,piperacillin,ceftazidime not more than 50.00%,K.pneumoniae to ciprofloxacin,amikacin,gentamicin,ceftazidime resistance rates more than 30.00%,not found E.coli,E.cloacae,K.pneumoniae PEI-pei South-resistant strains.The resistance of Pseudomonas aeruginosa to imipenem,amikacin,ciprofloxacin were less than 20.00%,the resistance rate of Acinetobacter baumannii more than 40.00%;of 199 methicillin resistant staphylococcus were not found out vancomycin-resistant S.aureus strains.CONCLUSIONS More of the pathogens show multiple drug resistance.It is urgent for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.

OBJECTIVE To know the status of management knowledge and disposal process of medical waste in village.METHODS Questionnaire was conducted among crowds randomly selected from Huishi,taipin,Gangou and Hepan town in Huining country of GanSu province.RESULTS The understanding rate of management regulation of medical waste among crowd in these four town was 12.31%;The touching opportunity to medical waste was very high;When medical waste was manipulated,people of chooseing to bury accounted for 12.15%,choosing to throw 43.35%,choosing localized manipulate accounted for 4.43%;The phenomenon of throwing medical waste was very serious(85.77%).CONCLUSIONS The understanding rate of management regulation of medical waste are not high,wehereas the touching opportunity was very high in the village.At the same time,the phenomenon of throwing medical waste was very serious and correct manipulating rate are not high.So we should strengthen the education of correlated policy,formulate eligible manipulating method,improve and consummate scientific management system of the medical waste in village.

This study examined whether 1-methyl-tryptophan [1-MT, an indoleamine 2, 3-dioxygenase (IDO) inhibitor] could reduce CD4(+)CD25(+) regulatory T cells (Tregs) proliferation and improve the anti-tumor efficacy of dendritic cells (DCs) pulsed with tumor cell lysate in the mice bearing pancreatic adenocarcinoma. The models of pancreatic adenocarcinoma were established in C57BL/6 mice by subcutaneous injection of Pan02 cells. Eight mice which were subcutaneously injected with PBS served as control. The expression of IDO was determined in tumor draining lymph nodes (TDLNs) and spleens of the murine pancreatic adenocarcinoma models. The prevalence of Tregs was measured in the TDLNs and spleens before and after 1-MT administration. The dendritic cells were pulsed with tumor cell lysate for preparing DC vaccine. The DC vaccine, as a single agent or in combination with 1-MT, was administered to pancreatic adenocarcinoma mice. The anti-tumor efficacy was determined after different treatments by regular observation of tumor size. The results showed that the levels of IDO mRNA and protein in tumor-bearing mice were significantly higher than those in the normal control mice. The percentage of Tregs in the spleen and TDLNs was also higer in tumor-bearing mice than in normal control mice (P<0.05). Foxp3 expression was significantly lower in the TDLNs and spleens of tumor-bearing mice administrated with 1-MT than that in normal control mice. Furthemore, in the mice that were administered 1-MT plus DC vaccine, the tumor was increased more slowly than in mice treated with DC vaccine or 1-MT alone, or PBS on day 36 (P<0.01). Our results indicated that 1-MT may enhance anti-tumor efficacy of dendritic cells pulsed with tumor cell lysate by downregulating the percentage of Tregs.

Objective: To biomechanically compare the initial stability of two cervical interbody cages with different surfaces on human specimens.Methods: Flexibility of twenty-three cervical motion segments (two groups) were tested in axial rotation, flexion/extension and lateral bending, intact and after implantation of a cervical interbody fusion cage (SynCage-C Curved, SynCage-C Wedged). An implant pullout concluded testing. Changes in range of motion (ROM) were analyzed.Results: Both cages were effective at reducing ROM in all directions, with no significant differences in effacency. The pullout force differed significantly between the two cages, the SynCage Curved being higher. Conclusion: Differences of surfaces of the two cages don't affect their initial stability. The cage with a better contoured surface had a higher pullout force.

In April 10, 2010, an earthquake measuring magnitude 7.1 shocked Yushu County,Qinghai province. For medical rescue, the National Earthquake Disaster Emergency Rescue Team was sent to Yushu right away. Rescue work in Yushu was faced with such difficulties as short preparative time, heavy workload, high exposure to various acute high altitude diseases (AHAD), and a number of other diseases frequently found on the cold plateau. To ensure the rescue work a success, the team took a series of measures including efficient preparative procedure, scientific and logical procedure in the emergency medical aid operations, reliable and effective handling of AHADs, along with sufficient self protection for team members.

Objective To observe the protective effect of gradual ischemic postconditioning (IP) capable of improving reperfusion on reperfusion injury in patients with ST-segment elevation acute myocardial infarction (STEAMl) undergoing primary percutaneous coronary intervention (PPCI).Methods 102 in-patients with STEAMI undergoing PPCI in the Department of Cardiology in the First People's Hospital of Kunshan City Affiliated to Jiangsu University from February 2011 to August 2014 were enrolled in this study. They were divided into three groups by a random number table: IP group (32 cases), gradual IP group (30 cases) and routine reperfusion group (40 cases). In IP group, after the opening of the infarction related blood vessel, ischemic postconditioning within the first minute of arterial reperfusion was made through three episodes of 1 minute inflation and 1 minute pressure withdrawn of an angioplasty balloon, and then persistent reperfusion was carried out. In the gradual IP group, the patients received three times of gradual angioplasty balloon inflation and denation, 1 minute/1minute, 30 seconds/30 seconds and 15 seconds/15 seconds respectively, presenting the gradual change of IP time. In the routine reperfusion group, after the opening of blocked blood vessel, the patients underwent routine PCI to persistently recover the coronary artery blood supply. The changes of related lead ST segment regression (Sum-STR), incidence of reperfusion arrhythmia, corrected thrombolysis in myocardial infarction (TIMI) franle count (CTFC), peaks of MB isoenzyme of creatine kinase (CK-MB), left ventricular ejection fraction (LVEF) and frequency of adverse events in follow-up period were compared among the three groups.Results The baseline characteristics were comparable in three groups. The incidence of ventricular premature beats was significantly lower in gradual IP group than that in routine reperfusion group [30.0% (9/30) vs. 55.0% (22/40),P < 0.05], and although theincidence of ventricular premature beats was lower in IP group than that in routine reperfusion group [34.4% (11/32) vs. 55.0% (22/40)], no statistically significant difference was found (P > 0.05). The incidence of ventricular tachycardia was significantly lower in IP and gradual IP groups than that in routine reperfusion group [15.6% (5/32), 13.3% (4/30) vs. 40.0% (16/40), bothP < 0.05]. The incidences of ventricular fibrillation, bradyarrhythmia and sinus arrest were lower in IP group and gradual IP group than those in routine reperfusion group, but no statistically significant differences were found (allP > 0.05). In IP group and gradual IP group, the Sum-STR incidence, CTFC, CK-MB peaks were lower than those of routine reperfusion group [Sum-STR: (56.7±18.3)%, (57.3±21.5)% vs. (44.6±21.6)%; CTFC: 25.47±5.37, 24.46±6.41 vs. 31.62±7.56; CK-MB peaks (U/L): 126.3±78.5, 121.6±82.5 vs. 147.4±72.5; allP < 0.05], the effect of gradual IP group being the best among the three groups. The levels of LVEF were slightly higher in IP and gradual IP groups than the level in routine reperfusion group (0.507±0.042, 0.511±0.062 vs. 0.497±0.062), but no statistically significant difference was found (bothP > 0.05). In routine reperfusion group, one patient died because the ventricular fibrillation could not be corrected and another one died of no-reflow during operation. Each group had 1 patient died during the 4 weeks of follow-up after operation, in the routine reperfusion group, one died of refractory heart failure, and the cause of death of other two patients, one in IP group and another in gradual IP group, was considered due to subacute thrombosis in stent. Major bleeding events were not found in each group.Conclusion Gradual IP can ameliorate myocardial reperfusion injury more significantly in patients with STEAMI undergoing PPCI.

Objective To investigate autophagy and proteasome system alteration in vivo and in vitro of diabetic nephropathy (DN) model rats.Methods Rat glomerular mesangial cells were primaryly cultured,and cell proliferation was tested by MTT assay.The mesangial cells were cultured under different concentrations of glucose (5.4 mmol/L for normal control and 30 mmol/L for high glucose) for 0,8,16,72 hours.The expression of autophagy (LC3) and proteasome (PSMAs) proteins was examined by Western blotting analysis.Spontaneous type 2 diabetes model OLETF and its normal control LETO rats were observed for 36 weeks.The levels of blood glucose and 24 hours urinary protein were evaluated in every 4 weeks.All the rats were sacrificed at the 36th week,and renal pathological changes were semi-quantitively analyzed.The expression of PSMAs and LC3 proteins was also examined in kidney cortex by Western blotting.Results Under high glucose concentrations,the abundance of PSMAs and LC3 proteins significantly reducedin the mesangial cells at 8 hours.There was no significant difference at other time points.The levels of blood glucose and 24 h urinary protein in OLETT rats exhibited progressive increase compared to those in LETO rats (all P＜0.01).And glomerular sclerosis index and tubulointerstitial injury index were significantly higher than those in LETO rats (all P＜0.01).The abundance of PSMAs proteins was significantly reduced in renal cortex of OLETF rats compared with LETO rats,while the abundance of LC3 proteins had no significant difference between two groups.Conclusion Proteolytic system dysfunction may play a role in pathogenesis of DN.

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.