ObjectiveTo study the value of brain stem auditory evoked potentials (BAEP) in evaluating the function of brainstem and judging the prognosis in patients with severe traumatic brain injury in vegetative state. Methods30 cases with severe traumatic brain injury in vegetative state were examined by BAEP and assessed with Glasgow Coma Scale (GCS) before comprehensive rehabilitation treatment and 1 month later. The patients were re-examined by BAEP and assessed with Glasgow Outcome Scale (GOS) after 6-month in follow-up. The relationship between BAEP grade and GCS or GOS was analyzed. The variety of BAEP in regaining consciousness was also analyzed.Results The abnormal rate of BAEP was 93.3% (28/30 cases) before rehabilitation treatment while it was 86.7% (26/30 cases) after 1 month. The higher the BAEP grade was, the poorer the prognosis was. There were 12 patients who regained consciousness.The main variety in these patients was the appearance of wave Ⅴ, as well as the improvement of each wave' shape and the shortening of peak latent period. ConclusionsBAEP can evaluate the function of brain stem in patients with severe traumatic brain injury in vegetative state and provide evidences for prognosis. The appearance of wave Ⅴ prompts the recovery of function of brain stem as an index of cerebral electrophysiology in improvement of consciousness.

Objective To study the effect of cream of bedsore on the treatment of severe bedsore.Method One hundred and twenty patients were randomly divided into treatment group and control groups Ⅰ and Ⅱ,respecially 40 patients,given systemic treatment.Results The decubitus wound healing of treatment group was significantly better than the other two groups,the total effective rate being 85%,P ＜ 0.01.In the treatment group,pathogenic bacteria culture positive rate on decubitus wound was significantly lower than the two control groups,inhibition rate being 78%,P ＜ 0.05.Staphylococcus aureus,Pseudomonas aeruginosa,Escherichia coli and so on were inhibited.Conclusions In the treatment group,bedsore healing ointment was significantly better than Western medicine used in the control groups.It can improve the microcirculation of the blood perfusion,promote the establishment of collateral circulation,increase the affected area nutrition,improve the local tissue ischemia,hypoxia-induced metabolic disorders,and remove the necrotic tissue,and promote tissue repair and regeneration,the granulation growing,and the effect of epithelial healing.

Background and purpose:Chemotherapy plays an important role in the treatment of gastric cancer.It is becoming a direction that the choice of chemotherapeutic agent for the clinic will be based on the levels of some relative gene expressions in the tumor tissue.As the key enzymes of fluoropyrimidines,the expression levels of thymidylate synthase(TS) and thymidine phosphorylase(TP) may correlate with the response of tumor to chemotherapy.This study was to investigate the expression of TS and TP mRNA in gastric cancer tissues and their correlation with prognosis.Methods:The expression levels of TS,TP mRNA in 51 gastric adenocarcinoma tissues were detected by real-time quantitative reverse transcription polymerase chain reaction(RT-PCR).Results:The median expression levels of TS,TP mRNA were 0.94 and 21.20,respectively.There was significant difference in terms of disease-free and overall survival between the gastric cancer patients with high and low TS mRNA expression level(P0.05)but not overall survival(P0.05).Conclusions:The expression levels of TS,TP mRNA may serve as prognostic markers for gastric cancer patients treated with FU-based adjuvant chemotherapy.

Objective To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in hu-mans,so as to provide a reference for its application in clinical practice. Methods The sera collected from the patients with neurocysticercosis,echinococcosis,taeniasis and healthy people,respectively,were checked by ELISA for specific IgG anti-bodies against T. solium cysticercus,as described in the instruction of the kit. Results Of the 30 patients with neurocysticerco-sis at active stage,28 showed seropositive reaction,indicating a sensitivity of 93.33%. There were no positive reactions in the 100 healthy people. Two of the 42 persons with taeniasis were seropositive with an infection rate of 4.76%. Forty-one of the 60 persons with echinococcosis showed positive reactions,suggesting that the cross reaction rate of the kit with echinococcosis was 68.33%. Conclusions The assessed ELISA kit has a reasonably high sensitivity but a poor specificity,and the cross reaction rate with echinococcosis is very high. It is urgent to improve the sensitivity and specificity of the diagnostic kit for detection of T. solium cysticercosis in China.

Objective To investigate ?-Lactamase coding genes and OprD2 gene in multidrug-resistant Pseudomonas aeruginosa isolated from Xiangfan region in Hubei province.Method Polymerase chain reaction(PCR) was used to detect various ?-Lactamase coding genes including TEM、SHV、OXA、PER、GES、IMP、VIM、plasmid type AmpC ?-Lactamase DHA 、MIR and OprD2 in 35 strains of Pseudomonas aeruginosa.Results The detection rate of ?-Lactamase coding genes TEM、OXA、plasmid type AmpC ?-Lactamase DHA were 51.4%、17.1% and 2.9% respectively, all of the tested strains of Pseudomonas aeruginosa lossed OprD2 gene,but SHV、PER、GES、IMP、VIM、MIR genes were negative.Conclusion The study indicated that these Pseudomonas aeruginosa carried genes of TEM、OXA、plasmid type AmpC ?-Lactamase DHA and lossed OprD2 gene, which was the essential resistance mechanism of Pseudomonas aeruginosa to Beta-lactam antibiotics in local aera.

OBJECTIVE To study the mechanisms of imipenem resistance in Pseudomonas aeruginosa.METHODS PCR method was used to detect and analyze P.aeruginosa imipenem-resistance associated IMP gene and VIM gene of metallo-?-lactamases and outer membrane protein D2(OprD_2) gene.RESULTS All 35(imipenem)-resistant P.aeruginosa strains were negative for IMP gene and VIM gene of metallo-?-lactamases;and for OprD_2 gene;but 23S rRNA gene of all 35 P.aeruginosa strains was positive.CONCLUSIONS The study suggested that in(Xiangfan) area,Hubei Province P.aeruginosa doesn′t produce metallo-?-(lactamases),but in genetics it is(identified) that the loss of outermembrane protein D2(OprD_2) gene is the(essential) mechanisms of imipenem(resistance) in P.aeruginosa in Xiangfan area,Hubei Province.

ObjectiveTo measure the level of T lymphocyte subsets and immunoglobulin in cervical spinal cord injury. Methods36 cases with cervical spinal cord injury were measured in T lymphocyte subsets and immunoglobulin of vein blood before and after the rehabilitation therapy. By comparing with control group, the state of immune functional in the injury was analyzed.ResultsThe cellular and humoral immune were inhibited distinctly. The level of CD3+,CD4+,CD4+/CD8+ and IgG of TBI group were lower than the level of control group. The CD3+ and CD4+/CD8+ were improved after treatment. The immune state of complete injury was inhibited more seriously than incomplete injury. ConclusionsThe cellular and humoral immune of cervical spinal cord injury were inhibited. The more seriously of the injury, the more inhibited of immune function.

Objective To determine the effect of community family visit on patients with metabolic syndrome.Methods According to the diagnostic criteria set up by the Diabetes Society of the Chinese Medical Association 220 patients with metabolic syndrome were equally divided into two groups:family visit group and control group.The family visit group was followed up by full-time medical staff regularly,while not interfering with the control group.After one year before and after the intervention,the relevant indicators were compared between the two groups.Results The levels of SBP,DBP,TG,TC,LDL-ch,24-hour urine protein were lowered markedly by intervention (P＜0.05).HDL-ch increased compared to the previous (t= 7.921,P＜0.05),but body mass index were not significantly changed.Before and after the intervention the levels of SBP,DBP,TG were ideal This was followed by significant improvement of fasting plasma glucose (FPG),two hours after meal blood glucose (2 hPG),TC,HDL set standards,24-hour urine protein body mass index.Compared with the control group,the family visit group showed siguificant improvement of related indicators except body mass index and TC.Condusion Intervention by family visit is effective in improving the vales of metabolic syndrome.

ObjectiveTo investigate the effect of different cyclic strengths on expressions of phospholipase A2 (PLA2) and cyclooxygenase (COX) in human tenocytes.MethodsHuman tenocytes were uniaxially stretched with different stretching intensity (4％, 8％ and 12％) under 0.5 Hz for four hours.Non-stretched tenocytes were applied to the control group.The expressions of cytosolic PLA2(cPLA2), COX1 and COX2 were measured by Western blot and RT-PCR.The secretion of secretory PLA2 (sPLA2) was measured by ELISA.Results The mRNA expressions of cPLA2, COX1 and COX2 in control group, 4％, 8％ and 12％ stretch groups showed an increase trend.But protein expressions of cPLA2 and COX1 in 4％ stretch group were increased insignificantly compared with the control group (P ＞ 0.05).Protein expressions of cPLA2 and COX1 in 8％ and 12％ stretch groups were increased more significantly compared with the control group (P ＜ 0.01).The COX2 expression in 4％,8％ and 12％ stretch groups showed statistical difference compared with that in the control group (P ＜0.01) and the difference increased with stretch intensity.There was no different expression of sPLA2 between 4％ stretch group and control group (P = 0.260).However, expression of sPLA2 was increased markedly in 8％ and 12％ stretch groups (P ＜ 0.01).ConclusionsThe expressions of human tendnocytes PLA2, COX1 and COX2 in vitro are positively correlated with stretch intensity.PLA2/COX system may be a new molecule target in clinical treatment of tendinopathy.

ObjectiveTo evaluate the clinical results of minimally invasive ankle arthrodesis with percutaneous cannulated screws.MethodsBetween April 2005 and October 2010, 12 patients with the ankle arthrodesis for unilateral severe arthritis (Kellgren-Lawrence class Ⅲ) were prospectively analyzed, including 2 cases of rheumatoid arthritis, 8 cases of post-traumatic arthritis, and 2 cases of osteoarthritis. There were 7 males and 5 females with an average age of 42.0 years(range, 25-7 1). The average disease duration was 7.3 years (range, 1-21). The anterior median incision of 3.0-5.0 cm was made to explore the ankle joint.The cartilage of tibial-talus joint was completely debrided. Two guide pins were inserted from posterosuperior to anteroinferior, and cannulated screws were implanted to fix ankle joint. All patients were physically examined with an extended protocol of questionnaires and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Scales. Ankle fusion in all patients was evaluated by clinical examination, and conventional radiography including anterior-posterior, lateral and mortise views of the ankle. ResultsAll 12 patients were followed up postoperatively for an average of 21.5 months(range, 6-55), and were proved be bone union by clinical examination and radiology with a mean of 13.5 weeks (range, 9-21). The AOFAS rating scale improved from a mean of 42.8±8.6 points at pre-operation to a mean of 66.6±5.4 points at post-operation 6 months,showing significant difference(t=-3.075, P=O.012), and to a mean of 72.3±4.6 at the final follow-up, also showing significant difference with pre-operation (t=-8.595, P=-0.006). There was no infection,local skin necrosis, screw loosing, and so on. ConclusionThe minimally invasive ankle arthrodesis with percutaneous cannulated scews is a recommend procedure, with mini-invasion, short surgery time, high fusion rate, good clinical outcomes, few complications.