group was also higher than that in the control group, Z=2.39, P<0.05,all which had significant difference, P<0.05.While no significant difference was found in the scores of the Geriatric Depression Scale or the Cornell Scale of Depression Disease between two groups, Z=1.21, P>0.05. Conclusions Reminiscence therapy improves cognitive function, the ability of self-care and social communicate of patients with mild to moderate dementia patients,so that it can improve further patients′quality of life.

Objective To study whether a lactose-free,hydrolyzed protein formula would ameliorate feeding intolerance and weight gain in very low birth weight infants.Methods The study was conducted on very low birth weight infants ( gestational age ≤34 weeks, birth weight ≤1500 g) in our NICU from August 2010 to August 2013. According to the number of admission, the cases were assigned into lactose-free hydrolyzed protein formula group ( hydrolyzed protein group) and preterm formula group. The data of basic information ( gestational age, birth weight, way of labor, sex, asphyxia ), commencement of feeding time ( days) , enteral caloric intake, parenteral nutrition caloric intake, The time ( days) required to regain birth weight, weight gain index, days of parenteral nutrition, prealbumin level, feeding intolerance, the incidence of necrotizing enterocolitis ( NEC ) and extrauterine growth retardation(EUGR)werecollected.Results A total of 83 infants were recruited in the study. 40 infants were in hydrolyzed protein group and 43 infants were in preterm formula group. There were no differences between groups for basic information ( P>0. 05). The weight gain index of hydrolyzed protein group was higher than that of preterm formula group (13. 5 ± 2. 4 g/d vs. 11. 9 ± 3. 7 g/d, P=0. 036). There were less cases of feeding intolerance in hydrolyzed protein group than in preterm formula group & nbsp;(28/40 vs. 38/43, P=0. 038). The differences of the incidence of NEC (1/40 vs. 2/43) and EUGR (21/40vs.25/43)showed no significance statistically.Conclusions Lactose-free hydrolyzed protein formula can obviously improve feeding intolerance and early weight gain of premature infants.

Objective To explore the feasibility of blood oxygen level-dependent (BOLD) MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group (n=7) and stage 2 kidney injury group (n=10). All of the enrolled subjects underwent BOLD examination and T2* relaxation rates (R2*) of renal cortex and medulla of split kidney, and the ratio between them (R2*med/cor) were measured separately. One-way analysis of variance (ANOVA) were performed on the control group and chronic hepatitis b patients group (kidney injury stage 1 and stage 2 group) to compare the difference of renal cortical and medullary R2*values and R2*med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2* values and R2*med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were(16.87 ± 0.74)/s,(17.88 ± 0.73)/s,(20.29 ± 2.87)/s, respectively;the medullar R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were (28.07±1.03)/s,(31.14±2.49)/s,(32.81±3.28)/s, respectively;R2*med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant (F values were 17.779, 19.170 and 3.439 , all P<0.05). Furthermore, the renal cortical and medullary R2* values of chronic hepatitis b patients were significantly higher than the control group, and the the renal cortical R2* value of the patients in stage 2 kidney injury group was also higher than the stage 1 kidney injury group. The area under curve (AUC) of ROC of the renal cortical and medullary R2*values and R2*med/cor to diagnose chronic HBV hepatitis-induced early kidney injury were 0.903, 0.949 and 0.526, respectively. Conclusion It's feasible and has great value to use renal BOLD MRI for the diagnosis of chronic hepatitis b-induced early kidney injury, and the renal cortex is more sensitive than the medulla to the kidney injury.

Objective To investigate the influence of serum containing Qingre Chubi Decoction ( QCD) on the THP-1 cell viability and the release of interleukin 1 beta ( IL-1β) stimulated by monosodium urate crystals in vitro. Methods The cultured human monocyte THP-1 strain were divided into blank serum group, model control group, and high-, middle- and low-concentration ( volume fraction being 20%, 10%, 5%) QCD-containing serum groups. Except for the blank serum group , the other groups were all given 500 mg/L of monosodium urate crystals. On culturing hour 0, 12, 24 and 48, THP-1 cell viability was tested by methy1 thiazolyl tetrazolium celorimetry ( MTS) method. On culturing hour 48, the content of IL-1β in the supernatant of THP-1 cells was detected by enzyme-linked immunosorbent assay ( ELISA) . Results The THP-1 cell viability in various groups was increased along with the prolongation of culturing time. The THP-1 cell viability in the model control group was increased as compared with that in the blank serum group at different time points (P<0.05 or P<0.01) . And the content of IL-1β in the model control group was increased significantly as compared with that in the blank serum group on culturing hour 48 (P<0.01) . The THP-1 cell viability in various QCD-containing serum groups on culturing hour 12 and 24, and in high- and middle-concentration QCD-containing serum group on culturing hour 48 was decreased significantly as compared with that of the model control group at the same time point ( P<0.05 or P<0.01) . The content of IL-1β in various serum containing QCD groups was markedly decreased as compared with that in the model control group on culturing hour 48 ( P<0.01) . Conclusion Serum containing QCD can inhibit the viability of THP-1 cells stimulated by monosodium urate crystals, and the possible mechanism is related with the inhibition of IL-1 release.

The brain-gut axis is an important pathway for the interaction between the central nervous system and the gastrointestinal tract. Ischemic stroke can promote the imbalance and displacement of intestinal flora, and the intestinal flora and its metabolites in turn can affect the occurrence, development and outcome of ischemic stroke. This article reviews the related literature on ischemic stroke and intestinal flora, in order to review the relationship between the two and related mechanisms, and to prospect the stroke treatment of targeting intestinal flora.

Objective:To investigate the effects of ovarian cancer ascites-derived exosomes on the stem cell properties and invasion ability of ovarian cancer stem-like cell (OCS-LC).Methods:(1) A2780 cells were induced into OCS-LC in serum-free medium, and authenticating their stem-like properties by sphere-forming test, differentiation test and CD 133 marker detection. (2) Exosomes from ascites and A2780 cell were extracted by ultracentrifugation, then authenticating them. The morphology of exosomes was observed by the transmission electron microscope, exosome particle size was measured by nanoparticle tracking analysis (NTA). The expressions of heat shock protein 70 (HSP-70), CD 63 and CD 9 were detected by western blot. (3) The exosomes from ovarian cancer ascites and tumor cell supernate were co-cultured with OCS-LC. The groups were divided into control group, ascites-derived exosomes (ADE) group (ADE+OCS-LC group), and cells-derived exosomes (CDE) group (CDE+OCS-LC group). The sphere-forming ability was evaluated by sphere-forming cycle, maximum sphere diameter and sphere-forming rate of each group; the expression of CD 133 was detected by immunofluorescence staining under microscope; quantitative real-time (qRT)-PCR was used to detected the expression levels of octamer-4 (Oct-4), Nanog mRNA of the signature genes in the stem cells of each group; the metastasis ability of each group was measured by transwell assay. Results:(1) Identification of OCS-LC: sphere-forming experiment showed that the suspension of OCSC single cells was grown in serum-free medium in secondary sphere-forming. Differentiation function experiment showed that OCS-LC were differentiated into adherent A2780 cells by changing the growth mode in serum containing medium. Flow cytometry showed that the proportion of CD 133 positive ( CD133+) cells in OCS-LC group was (18.9±0.9)%, significantly higher than that of control group (0.6±0.5)% ( t=38.570, P<0.01). (2) Under transmission electron microscope, clear lipid bilayer structure was observed in ADE and CDE, and one side presented a concave hemispheric or cup like structure. NTA showed that the diameter of exosomes mainly ranged from 30 to 100 nm, with an average diameter of 67.2 nm. Western blot analysis showed that the specific protein molecules HSP-70, CD 63 and CD 9 were positive. (3) Three groups′ OCS-LC could continue to grow into spheres, and the group of ADE+OCS-LC showed two growth modes, most of the cells continued to grow into spheres, while a small part of cells grew in adherent differentiation. The sphere-forming rate of OCS-LC in the control group, ADE+OCS-LC group, and CDE+OCS-LC group were (1.05±0.20)%, (4.15±0.10)%, and (10.45±0.25)%, the sphere-forming cycle of OCS-LC in the three groups were (15.3±1.5), (10.3±0.6), and (6.7±0.6) days, and the maximum diameters of OCS-LC were (100.3±3.2), (145.2±5.1) and (170.0±2.1) μm, respectively. And the differences were statistically significant (all P<0.05). After co-culture of exosomes with OCS-LC, the sphere-forming ability of cells in the group of CDE+OCS-LC was prior to ADE+OCS-LC group (all P<0.05). Immunofluorescence staining showed that the number of CD 133 green fluorescent chromophore cells in OCS-LC groups [(46.2±2.1)%, (58.4±2.2)%] was significantly higher than that in the control group [(26.6±1.5)%] after the addition of exosomes in co-culture, the positive rate of CD 133 was higher than that in the control group( F=187.588, P<0.05). The qRT-PCR results showed that the expression levels of Oct-4 mRNA in ADE+OCS-LC and CDE+OCS-LC groups were 3.46±0.24, 4.03±0.31, compared with that in control group (1.04±0.12), the differences were statistically significant ( F=134.932, P<0.05). The mRNA expression levels of Nanog were 1.57±0.32, 2.66±0.15, which were significantly higher than that in the control group (1.00±0.07), and the differences were statistically significant ( F=49.329, P<0.05). And the expression of both in CDE+OCS-LC group increased more significantly than ADE+OCS-LC group (all P<0.05). The number of invasive cells in the three groups of OCS-LC were: control group 30±5, ADE+OCS-LC group 102±4, CDE+OCS-LC group 210±7, and there were statistically significant differences among three groups ( F=820.800, P<0.05). Compared with the control group, the number of invaded cells in the co-culture group were significantly increased ( P<0.05), and the CDE+OCS-LC group had the higher cell invasion ability then the ADE+OCS-LC group ( t=23.202, P<0.05). Conclusions:Exosomes derived from ovarian cancer ascites could enhance and maintain the stemness of OSC-LC, and promote the invasion of tumor cells. Moreover, CDE is superior to ADE.

Objective To study the distribution characteristics and drug resistance of non-fermenting bacterial infection in intensive care unit (ICU) at a tertiary hospital during seven consecutive years,and to provide evidence for rational use of antibiotics in ICU.Methods A retrospective analysis was conducted.The related data about non-fermentative bacteria obtained from clinical specimens,collected from lower respiratory tract,blood,urine,bile and other secretions of ICU patients admitted to Binzhou Medical University Hospital from January 2009 to December 2015 were retrospectively analyzed.The distribution characteristics and drug resistance of non-fermentative bacteria,and isolation rate of multiple drug resistance (MDR) strains were analyzed.Results 2 672 strains of nonfermentative bacteria were isolated during seven consecutive years,accounting for 57.9％ gram negative (G-) bacilli (2 672/4 613),and 35.2％ of all bacteria (2 672/7 587).The top five were Acinetobacter baumannii (38.4％),Pseudomonas aeruginosa (34.6％),Onion burkholderia cepacia (9.9％),Stenotrophomonas maltophilia (6.2％),and Pseudomonas fluorescens (5.6％).Non-fermentative bacteria were mainly isolated from the lower respiratory tract (60.9％).Isolation of the non-fermentative bacteria accounted for over 50％ of G-bacilli during seven consecutive years,and the isolation rate of the top five types of bacteria showed no obvious change,while positive rate of Acinetobacter baumannii showed a tendency to increase (obviously from 26.5％ in 2009 to 50.2％ in 2015),and a lowering trend of positive rate of Onion burkholderia cepacia,Stenotrophomonas maltophilia,and Pseudomonas fluorescens was obvious (from 15.6％,10.6％,13.0％ in 2009 to 5.6％,7.4％,1.4％ in 2015 respectively) was observed.The isolation rate of Pseudomonas aeruginosa was stable (about 30％) during seven consecutive years.The drug susceptibility results showed that the resistant rates of Acinetobacter baumannii against imipenem,meropenem,aminoglycosides and third-generation cephalmsporins were all higher than 70％,while its resistant rate to cefoperazone-sulbactam was relatively lower (40.2％-68.1％)with relatively higher sensitivity rate (23.6％-46.0％).In contrast,the resistant rates of Pseudomonas aeruginosa against antibiotics were low,while the sensitivity rate to fourth-generation cephalmsporins cefepime (58.3％-87.7％)and third-generation cephalmsporins was high (ceftazidime:55.6％-79.3％,piperacillin-tazobactam:62.5％-86.2％,cefoperazone-sulbactam:46.0％-89.8％).From 2009 to 2015,the incidence of MDR strains of Acinetobacter baumannii showed an obvious increasing tendency (from 68.0％ to 84.1％);in contrast,the incidence of MDR strains of Pseudomonas aeruginosa did not show an obviously increase in incidence from 2009 to 2012,on the other hand,it showed a decreasing tendency from a peak 68.6％ in 2012 to 23.5％ in 2015.Conclusions The isolation rate of non-fermentative bacteria was high and the drug resistance situation was serious.Therefore,it is important to grasp the knowledge regarding distribution characteristics,drug resistance and variation of non-fermentative bacteria in ICU.It is not only beneficial for both rational use of antibiotics,improve efficacy but also helpful in reducing the emergence of drug resistance stains.

Objective:To investigate the clinical characteristics of idiopathic hypereosinophilic syndrome (IHES) with gastrointestinal manifestations,and to improve the level of diagnosis and treatment of IHES. Methods:The clinical materials, process of diagnosis and treatment and prognosis of 9 patients diagnosed as IHES with gastrointestinal manifestations were retrospectively analyzed. Results:The average age of 9 patients was (22.66± 12.86)years old,and the ratio of male and female was about 1.25∶ 1. The main clinical manifestations included abdominal pain,diarrhea and abdominal distension.The eosinophil percentages in peripheral blood and bone marrow of the patients were (42.66 ± 19.88 )% and (39.33 + 15.99 )%, respectively.The ascites exudate cytology examination showed eosinophil infiltrated.The results of gastroscope or colonoscope showed mucosal hyperemia and edema,scattered bleeding spots, and dark red granular hyperplasia; the colon was affected frecuently.The histological biopsy confirmed that the mucosal was infiltrated by eosinophils.The abdominal CT of 6 patients showed that the walls of stomach or bowel were thickened.The abdominal symptoms disappeared,and the ascites was absorpted in 9 patients after the treatment of glucocorticoid.After 2 years of follow up,2 patients had relapse, others had no recurrence.Conclusion:Performing the routine diagnosis and treatment of gastrointestinal diseases, the clinicians should consider the possibility of IHES in order to avoid the misdiagnosis and delayed treatment. When IHES is diagnosed,steroid treatment should be performed in preference.

Objective To explore the effects of hand-arm bimanual intensive training (HABIT) in group on functional independence and quality of life of children with hemiplegic cerebral palsy. Methods From November, 2015 to September, 2016, 20 children with hemiplegic cerebral palsy were randomly divided into control group (n=10) and experimental group (n=10). Both groups received routine occupational therapy, and the experimental group received HABIT in group one hour per day additionally, for eight weeks. They were assessed with the Carroll Upper Extremities Functional Test (UEFT), Functional Independence Measure Children's Edition (WeeFIM) and Chinese Version Pe-diatric Quality of Life Inventory (PedsQLTM) 3.0 Cerebral Palsy Module respectively before and after treatment. Results After treatment, the scores of UEFT, WeeFIM and the PedsQLTM3.0 improved in both groups (t>3.970, P<0.05), and were higher in the experimental group than in the control group (t>2.306, P<0.05). Conclusion HABIT in group could improve the fine function of upper extremity and hands coordina-tion of children with hemiplegic cerebral palsy, and enhance the functional independence and quality of life.