Objective To investigate whether vitamin B complex supplements would reduce stroke-related disabili-ty in hyperhomocysteinemia (Hhcy) patients with recent ischemic stroke. Methods One thousand patients with brain infarc-tion and Hhcy were assigned to receive either a daily dose of vitamin B complex (treatment group, n=500) or not (control group, n=500) on the base of conventional secondary prevention medications for a period of 2 years. The neurological dys-function was assessed by National Institutes of Health Stroke Scale (NIHSS) and stroke disability was evaluated by Barthel Index (BI) score. High performance liquid chromatographic method with fluorescence detection was used for the determina-tion of total plasma homocysteine levels. After 2 years of follow-up, the patients in the treatment group, whose tHcy level was reduced by 3-μmol/L or more, was defined as the treatment subgroup. Results The homocysteine levels were significantly reduced after 3, 12 and 24-month treatment than those of control group (P＜0.05). A lower NIHSS scale was found at 12, 18 and 24-month in treatment group compared with that in control group (P＜0.05), no significant differences at other time points between two groups (P>0.05). For the BI score, there were no significant differences at any time points between two groups (P>0.05). After 2 years of vitamin B complex supplementation, there were lower NIHSS scale and higher BI scale in treatment subgroup than those of control group (P＜0.05). Conclusion The lower level of tHcy induced by vitamin B inter-vention may be beneficial to the improvement of neurological deficit in patients with ischemic stroke.

Objective To investigate the existence and variance of quinolone-resistance genes in a group of pan-drug resistant of Acinetobacter baumannii ( A.baumannii ).Methods Twenty strains of pandrug resistant A.baumannii were isolated from patients registered in Affiliated Hospital of Nantong University from January 2011 to April 2011.Drug target genes to quinolone (gyrA,parC) and quinolone-resistance genes mediated by mobile genetic elements [ qnrA,qnrB,qnrS,aac(6')-Ⅰ b-cr,qepA] were analyzed by PCR and verified by DNA sequencing.Results In all 20 strains of A.baumannii,the sense mutation was found in the quinolone resistance-determining region of the gyrA gene in the form of TCA to TTA at codon 83 (Ser-83-Leu).Moreover,in the quinolone resistance-determining region of the parC gene sense mutation was found in the form of TCG to TTG at codon 80 (Ser-80-Leu) and 3 synonymous mutations were CCC to CCT at codon 40,GTA to GT]T at codon 41 and CGT to CGC at codon 44.And parC gene was a new mutation.However,mutations were not found in quinolone-resistance genes mediated by mobile genetic elements [ qnrA,qnrB,qnrS,aac( 6 ' )-Ⅰ b-cr,qepA ].Conclusion Quinolone-resistance-determining region play a key role in resistance to quinolones in this group of A.baumannii.To our knowledge,this is first report about the emergence of the new mutation of parC gene in China.

Objective To investigate the clinical features of neonatal lower respiratory tract infection (LRTI)with respiratory syncytial virus(RSV),and to explore the relationship between clinical features and recurrcnt cough or wheezing after discharge.Methods From May 2008 to May 2013,the data of 41 neonates diagnosed as LRTI with RSV infection in New Century International Children's Hospital were analyzed retrospectively.The clinical features and follow-up results were observed.Results All the neonates had cough,92.7％ (38/41 cases) had choking,85.4％ (35/41 cases) had runny nose and nasal obstruction,31.7％ (13/41 cases) had fever,65.9％ (27/41 cases) had wheezing sound during physical examination,29.3％ (12/41 cases)of the neonates were accompanied with bacterial infection(n=29),in which 50.0％ (6/12 cases) were infected by staphylococcus aureus.Compared to the neonates only with RSV infection,the proportion of fever was higher in those with RSV combined with bacterial infection (n =12)(x2 =6.034,P ＜ 0.05),and there were no statistical differences between the neonates with or without bacterial infection in white blood cell count and with or without shadow in chest X-ray(x2 =0.859,2.064,P =0.485,0.202).Compared with the neonates without family history of atopy,the neonates with the family history of atopy were more likely to get wheezing (88.2％ vs 57.1％,x2 =4.871,P ＜ 0.05) during primary infection.During the follow-up,there was higher proportion of children with family history of atopy in the group with subsequent recurrent cough and/or wheezing than in the group without subsequent recurrent cough and/or wheezing (71.4％ vs 26.3％,x2 =6.388,P ＜ 0.05).Conclusions Cough,choking are most common symptoms in neonatal LRTI with RSV,and there is no wheezing sound during phy-sical examination in some neonates.LRTI with RSV is likely combined with bacterial infection.Wheezing is more common in the neonates with family history of atopy.The RSV LTRI neonates with family history of atopy incline to get subsequent recurrent cough or wheeze after discharge.

Objective To investigate the correlation between serum cystatin C (CysC) levels and cerebral microbleeds (CMBs) in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled.Susceptibility weighted imaging was used to identify the presence of CMBs.Particle-enhanced turbidimetric immunoassay was used to detect the levels of serum CysC.Results A total of 485 patients with acute ischemic stroke were enrolled,including 151 (31.1％) with CMBs.The level of serum CysC of the CMB group was significantly higher than that of the non-CMB group (1.24± 0.13 mg/L vs.1.02± 0.11 rmg/L; t=4.261,P＜ 0.001).Multivariate logistic regression analysis showed that the increased serum CysC level was an independent risk factor for the presence of CMBs in patients with acute ischemic stroke (each increase in one standard deviation,odds ratio 4.063,95％ confidence interval 2.142-8.127; P ＜0.001).Multiple linear regression analysis showed that the number of CMBs in patients with acute ischemic stroke increased with the increasing serum CysC level after adjusting for other confounders (r2 =0.361,P =0.017).Conclusions In patients with acute ischemic stroke,the serum CysC levels are independently associated with the CMBs,and the number of CMBs increases with the serum CysC level.

Recent studies have confirmed that both CD40 molecule and its ligand CD40L played important roles in various stages of atherosclerosis.The critical cell component of atherosclerosis- endothelial cells,macrophages,and smooth muscle cells on which there are expressions of CD40 and CD40L.The combination of both induces human vascular endothelial cells expressing various active media,participating in the formation of atherosclerosis.However,blocking the CD40-CD40L pathway can prevent atherosclerosis or prevent the plaques from progressing.CD40L may participate in thrombosis and activation of platelet.The soluble CD40L levels increase persistently in patients with acute cerebral infarction and acute coronary syndrome.Some drugs may down-regulate CD40L level.It has provided a new approach for preventing the occurrence of vascular events.

Objective To investigate protective effects and mechanism of folic acid on brain neural cells in preeclampsia rat model.Methods Adult pregnant Wistar rats were randonly divided into 4 groups (n = 10 in each group).Rats in model group were injected intraperitoneally with homocysteine (Hcy,200 mg · kg-1 · d-1) daily and were injected subcutaneously every other day with monosodium glutamate (MSG,1 g · kg-1 · 48 h-1) from the 10th day of pregnancy to establish the model of preeclampsia. Lowdose folic acid (low dose group 10 ng · kg-1· d-1) and high-dose folic acid (high dose group 20 mg · kg-1 · d-1 ) were given intragastric administration with folic acid tablets dissolved in saline daily at the same time of establishing model.Rats in control group were injected or intragastric administration with the same dose of saline as above up to the 20th day of pregnancy.Brain tissue was fixed on the 20th day of pregnancy, so was that plasma folic acid was measured with automatic electro-chemiluminescence.Rats' immunohistochemical staining.bcl-2 mRNA and protein expression changes were observed by using reverse transcription(RT) -PCR and western blot.Results ( 1 ) Plasma folate concentrations were ( 39.5 ± 3.4 )nmol/L in low dose group and (40.1 ±5.4) nmol/L in high dose group, which were all significantly higher than (26.9 ± 6.7 ) nmol/L in model group( P ＜ 0.01 ).Plasma folate in low dose and high dose group did not show significant difference( P ＞ 0.05 ); ( 2 ) Apoptosis cell were 48.2 ± 9.1 in low dose group and 44.7 ±8.3 in high dose group, which were significantly lower than 75.8 ± 10.1 in model group (P＜0.01).However, apoptosis cell in low dose and high dose group did not show significant difference( P ＞0.05 ) ;(3 )significant difference( P ＞ 0.05 ); (4) bcl-2 mRNA and protein expression were 0.98 ± 0.49 and 0.89 ±0.52 in low dose group and 0.95 ± 0.38 and 0.92 ± 0.47 in high dose group which was significantly higher than 0.62 ± 0.20 and 0.45 ± 0.37 in model group ( P ＜ 0.01 ); bcl-2 expression in low dose and high dose group showed no significant difference ( P ＞ 0.05 ).Conclusions Folic acid has a protective role on neural activation and promoting bcl-2 gene and protein expression.

0.05).P300 and amplitudes of the mismatch negativity(MMN) of group A were lower than that of group B.PL of MMN was obviously prolonged.By comparing PL of group A with thar of group B,there was obvious difference(P

Objective To investigate the relationship between blood pressure variability (BPV) and neurological deteri?oration (ND) during the acute phase in patients with hypertensive minor ischemic stroke. Methods A total of 200 hyperten?sive patients with acute minor ischemic stroke were recruited in this study. Patients were divided into two groups: stable group (n=182) and deterioration group (n=18) according to the neurological prognosis. Values of BPV in 24 h ambulatory blood pressure, 24 h systolic blood pressure variation coefficient (24 h CVSBP), 24 h diastolic blood pressure variation coeffi?cient (24 h CVDBP), day time systolic blood pressure variation coefficient (dCVSBP), day time diastolic blood pressure variation coefficient (dCVDBP), night time systolic blood pressure variability (nCVSBP) and night time diastolic blood pressure variability (nCVDBP) were compared between two groups. The related factors of BPV were analyzed by binary logistic method in the acute phase of patients with hypertensive minor ischemic stroke. Results There were significantly higher levels of 24 h CVSBP [17.75%(17.54%,19.26%) vs 12.78% (10.67%,14.39%)], 24 h CVDBP [25.48%(20.77%,27.87%) vs 17.95% (14.88%, 21.46%)], dCVSBP [18.61%(17.65%,20.65%) vs 12.30%(10.10%,14.75%)], dCVDBP [25.65%(21.25%,29.78%) vs 17.76%(14.89%,22.19%)] in deterioration group than those of stable group (P<0.01). Results of binary logistic regression analysis showed that values of 24 h CVSBP and dCVSBP were risk factors for neurological deterioration in the acute phase of patients with hypertensive minor ischemic stroke. Conclusion The increased 24 h BPV and day time BPV are correlated with neurologi?cal deterioration during the acute phase in hypertensive minor ischemic stroke patients. BPV should be concerned in the acute phase and secondary prevention in patients with ischemic stroke.

Objective To investigate the relationship between total homocysteine (tHcy) and carotid intima-media thickness (CIMT) in brain infarction patients. Methods Sixty patients with fasting plasma tHcy levels ≤10μmol/L (non-Hhcy group), 60 patients with fasting plasma tHcy levels>10μmol/L and≤15μmol/L (H1 group), and 60 patients with fast-ing plasma tHcy levels>15μmol/L (H2 group) were chosen in hospitalized patients with acute cerebral infarction. Values of CIMT were detected in three groups of patients. The clinical biochemical indicators including triglyceride (TG), total choles-terol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), folic acid (FA), Vitamin B12 (VitB12) and glycated hemoglobin (HbA1c) were also detected. Results There was signifi-cant difference in CIMT between three groups (P<0.01). The value of CIMT increased in H2 group [0.98(0.90, 1.05)mm] com-pared with that of non-Hhcy group [0.85(0.80, 0.95)mm]. The value of CIMT increased in H2 group compared with H1 group [0.98(0.90, 1.05)mm vs 0.85(0.85, 0.95)mm], P<0.05). There were significant differences in tHcy, FA and VitB12 between three groups. Based on the log-transformed values of CIMT as the dependent variable, multiple stepwise linear regression showed significant associations of the following variables with increased CIMT: increasing age, the history of smoking, the history of diabetes, higher LDL-C and tHcy levels. Conclusion Brain infarction in patients with higher tHcy level often have lower levels of FA and VitB12, and increased CIMT. When the level of tHcy >15 μmol/L, there is more significantly higher level of CIMT. The increased CIMT level was associated with some cerebrovascular risk factors in patients with brain infarction.

Objective: To establish the quality control standards for Shimingbao Granules.Methods:Radix Angelical Sinensis, Cortex Phellodendri and Pericarpium Citri Reticulatae in granules were identified by TLC. The content of paeoniflorin in Shimingbao Granules was determined by HPLC with external standard. Results:The average recovery was 97.54% and RSD was 1.7%( n =5). The RSD in a duplicate test was 1.7%( n =5). Conclusion: These methods are simple, accurate and specific and can be used for the quality control of Shimingbao Granules.