The quality control of medical links runs through the whole process of medical service. Through the identification, management and quality control of key medical links, such as the system of making ward rounds by three levels of doctors, perioperational control, emergency treatment, writing of medical records, medical safety control, and management of critically ill patients, the entire staff's awareness of medical quality has been enhanced, the overall medical quality has been improved and sound social and economic benefits have been attained.

Objective To study the clinical curative effect of Tongqiao Huoxue decoction combined with edaravone and hyperbaric oxygen for treatment of delayed encephalopathy after carbon monoxide poisoning (DEACMP). Methods A prospective study was conducted. Forty-six patients with DEACMP admitted into Yidu Central Hospital of Weifang Medical College from January 2012 to January 2014 were randomly divided into observation group (23 cases) and control group (23 cases). The basic treatments of two groups were identical. Based on the basic treatments including hyperbaric oxygen and citicoline sodium injection etc, the observation group was treated with our-self made Tongqiao Huoxue decoction which could be modified in accord to the individual differentiation of syndromes in traditional Chinese medicine (the composition of decoction included Paeoniae Radix Rubra 15 g, Chuanxiong Rhizoma 15 g, Persicae Semen 15 g, Carthami Flos 15 g, Zingiberis Rhizoma Recens 3 pieces, Jujubae Fructus 2 pieces, Moschus 0.5 g, Allium Fistulosum 1 segment). The decoction was administered orally or by nasogastric gavage, one dosage everyday for 1 month, and in the mean time, edaravone intravenously drip 30 mg was given to the observation group twice a day for 14 days. The control group was given hyperbaric oxygen and other conventional treatment for 30 days. The clinical therapeutic effect and adverse reaction were observed after treatment for 30 days. The changes of intelligent level were detected by Hasegawa dementia scale (HDS), and the changes of latency of P300 were measured by electromyologram/evoked potential instrument in two groups before and after treatment. Results The total effective rate in observation group was significantly higher than that in control group [91.3% (21/23) vs. 65.2% (15/23), P < 0.01]. Elevation of creatinine occurred in 1 case, moderate increase in alanine aminotransferase (ALT) appeared in 1 case, and both of them were reduced to normal after treatment in observation group; no adverse reaction occurred in control group. The HDS scores were significantly higher 30 days after treatment than those before treatment in the two groups [control group:13.4±2.8 vs. 6.8±2.3, observation group:20.8±3.4 vs. 6.6±2.5, both P<0.05]. The latency of P300 after treatment was significantly lower in two groups than that before treatment [control group (ms): 355.7±25.7 vs. 385.5±27.8, observation group (ms): 337.3±24.6 vs. 386.8±25.4, both P < 0.05], the change in observation group being more significant [the HDS score: 20.8±3.4 vs. 13.4±2.8, the latency of P300 (ms): 337.3±24.6 vs. 355.7±25.7, both P<0.05]. Conclusion Tongqiao Huoxue decoction combined with edaravone and hyperbaric oxygen has favorable cognitive effect on patients with DEACMP, thus, it can be used extensively in clinic.

Objective:To establish a set of comprehensive appraisal indicator system for the full-time scientific research personnel in Level-three general hospitals, improve the management of full-time scientific research personnel at hospital.Methods:Firstly, an initial indicator system was established by literature review and in-depth interviews with experts. Secondly, Delphi method was used to screen the indicators to confirm the indicator system. Finally, Analytic Hierarchy Process (AHP) was used to determine the weights of indicators at all levels, consistency tests were also conducted.Results:A set of comprehensive appraisal index system for full-time scientific research personnel in Level-three general hospitals was established, including four first-level indicators, which covered the comprehensive quality, scientific research capacity, scientific research performance and academic impact, as well as other 17 secondary indicators and 53 third-level indicators. Among these indicators, the scientific research performance has the largest weight value (0.5224), and according to the consistency test results, CR was less than 0.1. Besides, through the consistency test, the weight assignment is reasonable.Conclusions:The appraisal index system of full-time scientific research personnel in Level-three general hospitals is reliable. It can be used as a tool for evaluation of full-time scientific research personnel, which also provide reference for other hospitals to improve the management of full-time scientific research personnel.

Objective To investigate the expression of micro RNA (miR)-126 in brain ischemic injury tissues of diabetic rats and its significance in angiogenesis.Methods Fifty adult female rats were randomly divided into five groups according to random number table:diabetic group,cerebral ischemia group,diabetic+cerebral ischemia group,miR-negative+diabetic+cerebral ischemia group and miR-126 mimics+diabetic+cerebral ischemia group (n=10).The models of diabetic and (or) focal cerebral ischemia were esblished,respectively.The rats in the later two groups were injected with 10 μg miR-negative control or 10 μg miR-126 mimics through ateral ventricle.Twenty-four h after cerebral ischemia modeling,the neurological functions of rats were assessed by using Zea-Longa scoring criteria,and infarct areas in the brain slices were analyzed by TTC staining.The expressions of miR-126,platelet-endothelial cell adhesion molecule-1 (PECAM-1),vascular endothelial cadherin (VE-cad) and vascular endothelial growth factor (VEGF) in the ischemic cortex tissues were detected by real time-PCR.Results The neurological scale scores and cerebral infarct volumes of rats in miR-negative+diabetic+cerebral ischemia group and diabetic+cerebral ischemia group were significantly higher than those in the diabetic group and cerebral ischemia group (P＜0.05);and those in the miR-126 mimics+diabetic+cerebral ischemia group were significantly lower than those in the miR-negative+diabetic+cerebral ischemia group,diabetic cerebral ischemia group and cerebral ischemia group (P＜0.05).The relative mRNA expression levels of miR-126,PECA M-1,VE-cad and VEGF in the ischemic cortex tissues of cerebral ischemia group,diabetic+cerebral ischemia group,miR-negative+diabetic+cerebral ischemia group were significantly lower than those in the diabetic group (P＜0.05);those in the diabetic+cerebral ischemia group and miR-negative+diabetic+cerebral ischemia group were significantly lower than those in the cerebral ischemia group (P＜0.05);those in the miR-126 mimics+diabetic cerebral ischemia group were statistically higher than those in the diabetic group,cerebral ischemia group,diabetic cerebral ischemia group and miR-negative+diabetes cerebral ischemia group (P＜0.05).Conclusion Up-regulation of miR-126 could help relieve diabetic ischemic brain tissue injury and improve neurological function,which might be related to the regulation ofangiogenesis after cerebral ischemic injury.

Objective To investigate the expression changes of miR-335 in rats with focal cerebral ischemia and their mechanisms. Methods Fifty adult healthy male SD rats were randomly divided into sham-operated group, model group, miR-335 transfection group, negative control group and blank plasmid group (n=10). The focal cerebral ischemia rat models in the later 4 groups were constructed by Longa method. After model making, rats in the miR-335 transfection group were injected recombinant plasmid pcDNA3.1-miR-335 and stearamide (SA) liposome mixture into the lateral ventricle, rats in the negative control group were injected pcDNA3.1-negative control and SA liposome mixture into the lateral ventricle, rats in the blank plasmid group were injected pcDNA3.1(+) and SA liposome mixture into the lateral ventricle, and rats in the sham-operated group and model group were injected the same volume of saline. Twenty-four h after ischemia, the neurological deficit of these rats were assessed by Zea-Longa scale. These rats were sacrificed, and the brain infarct volumes were measured by TTC staining; the miR-335 expression in cerebral ischemia tissues of rats was detected by using real-time fluorescence quantification PCR (RTFQ PCR); the protein expressions of cell adhesion molecule 1 (CD31) and vascular endothelial growth factor (VEGF) in cerebral ischemia tissues of rats were detected by Western blotting. Results As compared with those in the sham-operated group, the neurological function scale scores and brain infarct volumes of rats in model group, miR-335 transfection group, negative control group and blank plasmid group were significantly increased (P<0.05); the neurological function scale scores and brain infarct volumes of rats in miR-335 transfection group were significantly decreased as compared with those in the model group (P<0.05). As compared with those in the sham-operated group, the relative miR-335 expression level in the cerebral ischemia tissues of the model group, miR-335 transfection group, negative control group and blank plasmid group were statistically decreased (P<0.05); miR-335 transfection group had significantly increased relative miR-335 expression level as compared with the model group (P<0.05). As compared with those in the sham-operated group, the CD31 and VEGF protein relative expression levels in the cerebral ischemia tissues of the model group, miR-335 transfection group, negative control group and blank plasmid group were significantly decreased (P<0.05); as compared with those in the model group, the CD31 and VEGF protein relative expression levels in the miR-335 transfection group were statistically increased (P<0.05). Conclusion Up-regulation of miR-335 expression might improve cerebral ischemic tissue injury; it might be related to promote the angiogenesis in cerebral ischemia tissues.

Objective To investigate the effect of down-regulation of human lung adenocarcinoma metastasis-associated transcript 1 (MALAT1) on microglial activation and its possible mechanism.Methods BV2 microglial cells were cultured in vitro and divided into a normal control group (no treatment),a lipopolysaccharide (LPS) treatment group (cultured with 100 ng/mL LPS),a MALAT1 interference group (transfected with MALAT1 interference sequence + cultured with 100 ng/mL LPS) and a control sequence group (transfected with control sequence + cultured with 100 ng/mL LPS).Real-time fluorescence quantitative PCR was used to detect the expression ofMA LA T1 mRNA in the cells.Western blotting was used to detect the expression of NF-κB protein and IκB-α protein in the cells.Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of IL-1β,IL-6,IL-10 and TNF-α in each group.Nitric acid reduction method (Griess method) was used to detect nitric oxide (NO) concentration in each group.Results The relative expression levels of MALA T1 mRNA and NF-κB protein were significantly increased,the relative expression level of IκB-α protein was significantly decreased,the levels ofIL-1β,IL-6,IL-10 and TNF-α and the release of NO in the cell supernatant were significantly increased in the LPS treatment,MALAT1 interference and control sequence groups than in the normal control group (P＜0.05).The relative expression levels of MALAT1 mRNA and NF-κB protein were significantly decreased,the expression level of IκB-α protein was significantly increased,the levels ofIL-1β,IL-6,IL-10 and TNF-α and the release of NO in the cell supematant were significantly decreased in the MALAT1 interference group than in the LPS treatment and control sequence groups (P＜0.05).Conclusions Down-regulation of MALA T1 gene expression may inhibit the inflammatory response induced by LPS-induced BV2 cell activation.The mechanism might be related to the inhibition of NF-κB signaling pathway.

Objective To investigate the effect of up-regulation of miR-132 on expressions of angiopoietin-1 (Ang-1)/endothelium-specific tyrosine kinase receptor 2 (Tie2) in focal cerebral ischemia reperfusion injury of rats.Methods Forty adult healthy SD rats were randomly divided into sham-operated group,cerebral ischemia group,miR-132 mimic group and negative control group (n=10).The models of middle cerebral artery occlusion in the later three groups were established by using modified Longa suture method.Rats in the miR-132 mimic group and negative control group were injected miR-132 mimic 15 μg and negative control 15 μg via paracele.Rats in each group were sacrificed 24 h after ischemia,and the brain tissues were collected;the total infarct volumes were calculated by TTC staining.The mRNA expressions ofmiR-132,Ang-1 and Tie2 in ischemic cerebral cortex tissues were detected by real-time fluorescence quantitative PCR.The protein expressions of Ang-1,Tie2,CD31 and vessel endothelial growth factor (VEGF) in ischemic cerebral cortex tissues were detected by Western blotting.Results The total infarct volume in the miR-132 mimic group was (27.92±3.05) mm3,which was significantly smaller than that in the cerebral ischemia group and negative control group ([51.34±2.86] mm3 and [50.46±2.57] mm3,P＜0.05).The relative mRNA expression levels of miR-132,A ng-1,Tie2,and the protein expression levels of Ang-1,Tie2,CD31,VEGF in the ischemic cerebral cortex tissues of the miR-132 mimic group were significantly higher than those in the negative control group,cerebral ischemia group and sham-operated group (P＜0.05);and those in the negative control group and cerebral ischemia group were significantly higher than those in the sham-operated group (P＜0.05).Conclusion Up-regulation ofmiR-132 expression could improve the ischemic states of ischemic stroke in rats,which might be related to Ang-1/Tie2 increased expressions to promote angiogenesis in ischemic brain tissues.

Objective To evaluate the predictive values of interleukin (IL)-2 and soluble interleukin 2 receptor (sIL-2R) in the serum and cerebrospinal fluid in early intracranial infection,and provide the reference for choosing diagnostic markers of early intracranial infection after craniotomy.Methods From January 2014 to January 2016,36 patients with intracranial infection after craniotomy in our hospital were chosen as infection group,and 45 patients without intracranial infection were as non-infection group.The body temperature and levels ofcerebrospinaI fluid glucose,blood white blood cell (WBC),cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R were compared between the two groups.The diagnosis values of IL-2 and sIL-2R in serum and cerebrospinal fluid in intracranial infection were analyzed by receiver operating characteristic curve (ROC) curve.The sensitivity and specificity of IL-2 and sIL-2R in the serum and cerebrospinal fluid in intracranial infection were compared between the two groups.Results The body temperature of the two groups showed no statistical difference (P＞0.05).As compared with those in the non-infection group,the glucose of cerebrospinal fluid in the infection group significantly decreased (P＜0.05),the blood WBC,cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R in the infection group significantly increased (P＜0.05).The areas under of curve for body temperature,glucose of cerebrospinal fluid,blood WBC,cerebrospinal fluid WBC,serum IL-2,cerebrospinal fluid IL-2,serum sIL-2R and cerebrospinal fluid sIL-2R,respectively,were 0.671,0.718,0.698,0.741,0.714,0.927,0.722 and 0.968;the sensitivity of those indexes,respectively,was 61.1％,63.9％,69.4％,91.7％,88.9％,91.7％,86.1％and94.4％;the specificityofthoseindexes,respectively,was 48.9％,82.2％,60.0％,55.6％,62.2％,88.9％,66.7％ and 91.1％.Conclusion The IL-2 and sIL-2R levels in serum and cerebrospinal fluid have decided values in diagnosis of intracranial infection after craniotomy,but the sensitivity and specificity of IL-2 and sIL-2R in cerebrospinal fluid are higher than others.

OBJECTIVETo explore the role of sphingomyedlin phosphodiesterase 1 (SMPD1) gene mutations in the pathogenesis of Parkinson's disease (PD).

METHODSFor 110 Chinese patients with PD, all exons of the SMPD1 gene were sequenced, and the results were compared with reference sequence from GenBank to identify possible mutations.

RESULTSA novel heterozygous mutation Ex2:c.677C>A/p.P226Q (likely pathogenic) was identified in a patient, which resulted in substitution of Glutamic acid by Proline at position 226. In addition, two known single nucleotide polymorphisms (SNPs) Ex1:c.107T>C/p.V36A (benign) and Ex6:c.1522G>A/p.G508R (benign), and three previously reported SMPD1 mutations Ex2:c.T371T>G/p.L124R (uncertain significance), Ex2:c.636T>C/P.(=)(benign) and Ex6:c.1598C>T/p.P533L (uncertain significance) were identified. The novel p.P226Q mutation and p.P533L mutation were predicted to have a possibly damaging effect on the structure and function of SMPD1 protein, which in turn may lead to PD.

CONCLUSIONThe mutation rate of the SMPD1 gene was 3.64% among Chinese PD patients. Genetic variants of SMPD1 may increase the risk of PD.