Objective To detect P0.1 and respiratory function of patients with cerebral infarction(CI)and analyze the effect of cerebral infarction on respiratory function. Methods Arterial blood gases, respiratory drive and lung function were measured in 35 cases with CI and 15 healthy controls. The figures were analyzed by SPSS 10.0. Results The PaO0.2 (mm Hg, 75.80±4.12, 1 mm Hg=0.133 kPa), SaO2(%,94.97±0.78) and Plmax(kPa,4.076±2.443) were lower than those in the healthy control group (88.68±3.77, 96.40±0.48 and 7.747±0.599,t=-8.310,-5.731,-5.439,all P=0.000). P0.1 max and P0.1/MV in the CI group were lower than those in the healthy control group;the P0.1 did not have significant difference in these two group; the P0.1/P0.1max and P0.1/Plmax in the CI group were significantly higher than those in the healthy control group; the PImax was correlated with PO2, O2sat, P(A-a) O2, P0.1max, P0.1, P0.1,/PImax, P0.1/P0.1max, FVC, FEV1.0 and PEF; the PEmax was correlated with P0.1/ PImax, FVC, FEV1.0 and PEF. Conclusion The respiratory function of patients with CI has been impaired, the oxygenated index is cut down and the respiratory drive and respiratory drive store are decreased.

Objective To clinically analyze the feature of paroxysmal hemicrania in order to improve our cognition toward it.Methods Eight patients,3 men,5 women,aging 17 to 74 years old,were prospectively analyzed over the past 2 years in our hospital.Results Their age of onset was from 9 to 60years old(mean 42.5±16.3).Seven of the 8 cases were treated with indomethacin,out of whom 5 got an immediate and complete response and one of them remitted partially.Another stopped taking indomethacin because of gastroenteric side effects.She was treated with verapamil and prednisone and partial relief was gained.Conclusions Paroxysmal hemicranial is a rare benign disorder.which needs our improved understanding.The patient who is diagnosed with paroxysmal hemicranial should firsfly receive indomethacin.and standard anti-cluster headache medications or other non-steroid anti-inflammatory drugs is used if she/he can not get relief and (or)tolerate the adverse effects.

Objective To take nursing measure through analysis on the risk factors of recurrent stroke in the aged.Methods Total 96 subjects were analyzed retrospectively.The risk factors were compared on the urban and the rural through analyzing their clinical characteristics.Results There were more diabetes mellitus and blood lipid disorder and obesity in urban than those in rural.There was also a difference in hypertension between the urban and the rural.Conclusion The recurrence of stroke in the aged is owing to many factors.The different measure should be taken by different reasons.

strains that could produce raw starch-digesting glucoamylase were isolated from soil and mildewed rice.The highest raw starch-digesting glucoamylase activity strain named OR-1 was identified as Rhizopus.sp.The raw starch-digesting glucoamylase activity of the strain is 90U/mL.Through UV and NTG mutagenesis,the raw starch-digesting glucoamylase activity raised to 200U/mL and 325U/mL respectively.The RDA were 70% and 65% respectively.

AIM: The purpose of this study was to determine whether the signal transduction systems were activated at the molecular atrial tissue level in patients with atrial fibrillation (AF) and whether atrial expression of extracellular-signal regulated kinase (ERK) and protein phosphatases is altered. METHODS: Atrial tissue sample of 30 patients undergoing cardiac surgery were examined. 20 patients had AF, 10 patients had no history of AF. The mRNA expression of calcineurin B and MKP-1 were detected by semi-quantitative RT-PCR. ERK1 and phospho-ERK1 were analyzed at the protein level by Western blot. RESULTS: Western blot analysis showed that atrial fibrillation did not induce significant change in ERK1 expression level in the left atrium. In contrast , phospho-ERK1 content was increased in the patients with AF in comparison with those who had sinus rhythm (SR). The mRNA expression of calcineurin B and MKP-1 in the patients with AF were significantly higher than that in patients with SR. CONCLUSION: The activation of extracellular-signal regulated kinase and protein phosphatases may have correlation with the initiation or maintenance of atrial fibrillation.

Objective To investigate the value of MR intravoxel incoherent motion (IVIM)imaging and dynamic susceptibility contrast-enhanced(DSC)perfusion imaging in astrocytoma grading.Methods 22 patients with high grade astrocytoma and 28 patients with low grade astrocytoma underwent conventional MRI and IVIM,DSC scanning before operation.Parameters of IVIM included standard diffusion coefficient(ADCstandard ),slow diffusion coefficient(D),fast diffusion coefficient(D? ),fractional perfusion-related volume (f)values,and parameters of DSC included relative blood volume(rCBV),relative blood flow(rCBF)values of tumor solid part were measured quantitatively.The values between the two groups were compared by two samples t-test.By using ROC curve to evaluate the diagnostic efficacy of using IVIM and DSC alone or jointly.Results The ADCstandard ,D,rCBV,rCBF values of tumor solid part had significant differences between the groups(P<0.01).The D? and f values were no significant differences (P=0.130,P=0.379).The area under the ROC curve of the values showed that ADCstandard (0.823),D(0.854),rCBV(0.858),rCBF(0.871),D+rCBV(0.952),D+rCBF(0.953).Conclusion The D,rCBV,rCBF values are helpful to determine the grade of astrocytomas.The use of IVIM in combination with DSC may improve the diagnostic accuracy of astrocytoma grading.

Objective To explore the bacterial flora distribution characteristics and drug resistance of pus bacterial culture in a‐cute mastitis and to analyze thechange trend of drug resistance spectrum to provide a evidence‐based basis for the rational use of an‐timicrobial agents in clinic .Methods The pus collected from 207 cases of acute mastitis was conducted the bacterial culture .The bacterial identification and antibacterial susceptibility test were performed by adopting the manual experiment combined with the DL‐96 system .Partial drug susceptibility test was performed by combining with the K‐B method .Results Among 207 specimens , 82 strains of pathogenic bacteria were detected with the detection rate of 39 .6% ,including 51 strains (62 .2% ) of staphylococcus aureus ,7 strains (8 .5% ) of pseudomonas aeruginosa ,4 strains (4 .9% ) of staphylococcus intermedius ,4 strains (4 .9% ) of staphy‐lococcus epidermis ,3 strains (3 .7% ) of acid‐producing klebsiella bacteria and each 1 strain of staphylococcus hemolyticus and other 13 kinds of bacterium .The resistance rates of staphylococcus aureus to azithromycin ,erythromycin and clarithromycin were 92 .2% ,84 .3% and 84 .3% respectively ,indicating that macrolides drugs had a higher overall drug resistance rate and were not suitable for selection and use;the resistance rates of moxifloxacin and ciprofloxacin were 3 .9% and 4 .1% respectively ,the MRSA detection rate was 27 .5% .The resistance rates of Pseudomonas aeruginosa to ticarcillin/clavulanic acid was 85 .7% ;the drug resitance rate of cefoperazone was 83 .3% ;which of gentamycin and amikacin was 71 .4% ;which of aztreonam was 14 .3% ;which of ceftazidime was 28 .6% and which of meropenem was 28 .6% .Conclusion The majority of detected bacteria in pus from the pa‐tients with acute mastitis are Staphylococcus aureus ,followed by pseudomonas aeruginosa ,which is different from that reported by other literatures ,showing the bacterial distribution has regional difference .Staphylococcus aureus has high resistance rate to macrol‐ides antibacterial drugs ,but is highly sensitive to ciprofloxacin and moxifloxacin;Pseudomonas aeruginosa has higher resistant rate to ticarcillin/clavulanic and cefoperazone ,but it is highly sensitive to aztreonam ,ceftazidime and meropenem .Empirical medication should be comprehensively considered by combining with drug resistance spectrum of Staphylococcus aureus and Pseudomonas aeruginosa ,and the sensitive drugs should be selected according to the drug susceptibility results after the antimicrobial susceptibili‐ty test for conducting the targeted medication .

Objective To investigate the roles of phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway and its regulatory protein peroxisome proliferator-activated receptor γ (PPAR γ) and phosphatase and tension homologue deleted on chromosome 10 (PTEN) in regulating insulin sensitivity in rats with fetal growth restriction (FGR).Methods Sixteen pregnant rats were randomly divided into two groups including FGR and control groups on the 12th day of pregnancy (eight in each group).The FGR group was given low protein diet (8％ of casein) and restriction diet to establish the neonatal rat model of FGR.All maternal rats after delivery and newborn rats after weaning on 21 days after born were fed with normal diet.Each time blood samples were collected from eight newborn rats of each group to measure levels of fasting plasma glucose (FPG) and fasting insulin(FINS) at the time points of 21 days,two and four months after birth.Then insulin resistance index (IRI) and insulin sensitivity index (ISI) were calculated to evaluate insulin sensitivity.Expression of PI3K,AKT,PPAR γγ,PTEN and glucose transporters 4 (GLUT4) in skeletal muscle at mRNA and protein levels were measured at 21 days,two and four months after birth with real time fluorescence polymerase chain reaction and Western blot,respectively.Relationships between the expression of key molecules of PI3K/AKT signaling pathway and insulin sensitivity were analyzed.T-test,and Pearson's correlation analysis were used for statistical analysis.Results (1) The average birth weight of newborn rats in the FGR group was lower than that of the control group [(4.37± 0.69) vs (7.03±0.55) g,t=-20.75,P＜0.05].The incidence of FGR in the FGR group was 93.33％ (70/75).(2) Compared with normal offspring,those in the FGR group showed significantly increased FPG [two months after birth:(5.53± 0.58) vs (7.49 ± 0.38) mmol/L,t=8.08;four months afterbirth:(6.35±0.66) vs (8.94±0.90) mmol/L,t=6.58],FINS [two months afterbirth:(9.18±0.66) vs (14.67± 1.90) mU/L,t=7.71;four months after birth:(33.08±2.76) vs (56.33±2.81) mU/L,t=16.71] and IR1 (two months after birth:2.25±0.31 vs 4.90±0.81,t=8.63;four months after birth:9.30±0.90 vs 22.44±3.10,t=1 1.51),but decreased ISI (two months after birth:0.020 ± 0.002 vs 0.009± 0.001,t=-10.1 4;four months after birth:0.005±0.000 vs 0.002 ±0.000,t=-14.91) at two and four months after birth (all P＜0.05).(3) Compared with normal offspring,those in the FGR group showed decreased expression of PI3K (21 days after birth:0.082±0.028 vs 0.019±0.004,t=-6.29;two months after birth:0.020±0.003 vs 0.010±0.005,t=-4.78;four months after birth:0.014±0.004 vs 0.003±0.001,t=-7.87) and GLUT4 (21 days after birth:0.132±0.057 vs 0.041 ±0.019,t=-4.32;two months after birth:0.183±0.084 vs 0.069±0.017,t=-3.74;four months after birth:0.248±0.069 vs 0.113±0.040,t=-4.74) at mRNA level at 21 days,two and four months after birth (all P＜0.05).Compared with normal offspring,decreased expression of PPAR γ (two months after birth:0.028±0.002 vs 0.012±0.005,t=-3.70;four months after birth:0.030±0.008 vs 0.012±0.005,t=-3.80) and increased expression of PTEN (two months after birth:0.020±0.004 vs 0.045±0.014,t=5.09;four months after birth:0.023±0.007 vs 0.034±0.009,t=2.57) at mRNA level were observed in offspring of the FGR group at two and four months after birth (all P＜0.05).(4) Compared with normal offspring,expression of PI3K protein (21 days after birth:0.22±0.01 vs 0.17±0.02,t=-6.62;two months after birth:0.27±0.03 vs 0.16±0.02,t=-7.25;four months after birth:0.18±0.01 vs 0.09±0.02,t=-9.79) and GLUT4 protein (21 days after birth:0.21 ±0.01 vs 0.03±0.01,t=-27.29;two months after birth:0.10±0.01 vs 0.06t±0.01,t=-3.90;four months after birth:0.13 ±0.01 vs 0.08± 0.02,t=-8.10) decreased in offspring in the FGR group at 21 days,two and four months after birth (all P＜0.05).Compared with normal offspring,those in the FGR group showed decreased expression of PPAR γ protein (two months after birth:0.10 ± 0.01 vs 0.07± 0.01,t =-7.29;four months after birth:0.09±0.01 vs 0.08±0.01,t=-2.83),but increased expression of PTEN at protein level (two months after birth:0.10±0.01 vs 0.15±0.02,t=6.01;four months after birth:0.09±±0.01 vs 0.13±0.02,t=5.51) at two and four months after birth (all P＜0.05).(5) The IRI levels in offsprings in the FGR group were negatively correlated with the expression of PI3K,GLUT4 and PPAR γ at protein level (two months after birth:r=-0.90,-0.92 and-0.79;four months after birth:r=-0.92,-0.75 and-0.73,all P＜0.05),but positively correlated with the expression of PTEN at protein level (r=0.87 and 0.86,both P＜0.05) at two and four months after birth.Conclusions The abnormal expression of the key molecules of PI3K/AKT signaling pathway precedes the decrease of insulin sensitivity in newborn rats with FGR and the expression regulatory protein PPAR γ and PTEN are also changed,suggesting that these molecules may induce the impairment of insulin sensitivity in rats with FGR and be involved in the development of insulin resistance.

Objective To explore the clinical effects of enema combined with massage therapy on jaundice in premature infants.Methods Seventy-five premature infants with jaundice were randomly divided into 3 groups,enema combined message therapy group(group A),abdominal massage therapy group(group B),and double-side phototherapy group(group C).All 3 groups were received the same formula fee-ding,intravenous nutrition and identical drug treatment.Group A was given enema with mixed kaiselu and normal saline together with 60 times clockwise abdominal massage once a day for 2 weeks.Group B only received abdominal massage twice per day for 2 weeks.Transcutaneous bilirubin(TB) indexes of all the premature infants in the 3 groups were detected and transformed into total TB concentrations every morning,through version of MINOLTA JM-102 transcutaneous bilirubin radiometer made in Japan.When TB index counted more than 196.58 ?mol/L,group A and B were given single-side phototherapy for 24 hours.Neither enema nor abdominal massage was given to group C,and double-side phototherapy was applied when TB indexes were above 196.58 ?mol/L.Daily TB indexes,duration of jaundice and phototherapy,time of meconium exhaustion,defecation times in each day,incidence of constipation and feeding intolerance were recorded.Results Duration of jaunhospitalized and phototherapy were significantly shortened in group A compared with those of the other groups.In 34 premature infants who were hospital for at least 2 weeks,TB indexes in group C were lower than those in group B on the 9th day.On the 12th day and the 14th day,TB indexes in group A and C were lower than those in group B(Pa

OBJECTIVE To investigate the existence of genes for beta-lactam antibiotic resistance and for aminoglycosides modification enzymes(AMEs) in Pseudomonas aeruginosa(PAE) isolates from ICU patients and analyze the homology among strains.METHODS ?-Lactamase genes including TEM,SHV,OXA-10,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA,FOX,MOX and oprD2,were detected by PCR amplication in 21 PAE isolates.The genes for AMES including aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰwere determined by PCR amplification as well.RESULTS Among 21 isolates 21(100%),2(9.5%),1(4.8%),2(9.5%)and 4(19.0%) were positive for TEM,SHV,GES,CARB and VIM genes,respectively.The deletion of oprD2 gene was found in 14 out of 21 strains.Other ?-lactamase genes were absent in all isolates.As for AME genes,aac(3)-Ⅱ,aac(6″)-Ⅰ,aac(6)-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ and aac(3)-Ⅰgenes were present in 19.0%,23.8%,9.5%,4.8%,and 19.0% of 21 isolates,However,aac(3)-Ⅰ gene was no position in any isolates.CONCLUSIONS P.aeruginosa carries various beta-lactamase and AME genes in ICU patients.Genetic cluster analysis suggested that clonal propagation result in nosocomial infection of PAE.