Objective To explore the correlation between the depression status of patients with post-stroke depression(PSD) and nerve function defect.Methods 75 patients in the first 24h of acute stroke onset were selected.According to the Zung depression self rating scale(SDS),75 cases were divided into simple stroke patients group and PSD group,and the Hamilton depression scale (HAMD) and Scandinavian nerve function defect rating scale (SSS) were used for further evaluation.The score results were statistically analyzed.Results Of 75 cases with acute stroke,32 cases(42.7％) were diagnosed PSD.Admission day 2,at the end of 1,2 and 3 weeks,the HAMD scores between PSD patients and simple acute stroke group had statistically significant differences (all P ＜ 0.01).The HAMD scores of three groups of PSD patients (light,medium,heavy) appeared obvious changes with the prolonged time,which were significantly higher than the simple stroke group.The SSS score of simple stroke group and mild PSD patients increased with prolonged observation time,the difference between the two groups was significant (q =9.75,P ＜ 0.05).The SSS score of moderate and severe PSD patients decreased with prolonged observation time,compared with the simple stroke group,the differences were statistically significant(q =50.23,46.82,all P ＜ 0.05).In simple stroke patients and mild PSD patients,HAMD scores and SSS score had no correlation (r =0.062,P ＞ 0.05).In moderate and severe PSD patients,HAMD score and SSS score had correlation (r =4.682,P ＜ 0.05).Conclusion The incidence rate of PSD in acute brain stroke patients was 42.7％,and in patients with moderate and severe PSD,HAMD scores correlated with the degree of nerve function defect.Early intervention on depression treatment and promote the recovery of neural function is also important.

10mg/L(n=22) group,and CRP10mg/L group with CRP10mg/L group and the concentration of CRP inverse correlation with serum ALB,Fe,Hb levels.Conclusions The elevated concentration of CRP is considered to be the most common cause of decreased EPO or hyporesponsiveness to EPO in CRF anemia patients. CRP level can predict whether CRF anemia,dificult or easily degree of the anemia correction for CRF patients,all that provide evidence for improving CRF anemia.

ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Objective To improve the recognition of diagnosis, treatment and leukemia transformation of primary myelofibrosis (PMF). Methods One case with PMF which transformed into acute myeloid leukemia (AML) was reported and the literatures on this topic were reviewed. Results The patient was diagnosed according to the 2008 version of the WHO classification of PMF leukemia transformation was diagnosed after 2.5 years. The JAK2 V617F gene mutation was detectable both before and after leukemia transformation. The outcome of low dose chemotherapy could keep a short time. Conclusion JAK2 V617F gene could remain detectable after leukemia transformation in PMF patients. It is difficult to control the disease progress by low dose chemotherapy.

Objective To investigate the synergistic effect of methotrexate (MTX) and cyclophos phamide (CTX) on cell cycle and cyclin D1 of periphery blood lymphocytes (PBLs) and bone marrow byflow cytometry. Methods Wistar rats were randomly divided into four groups including normal control, MTX and cyclophosphamide combination group, MTX and CTX only treatment groups respectively. PBLs were isolated for flowcytometry analysis for the changes of cell cycle and the expression of cyclin D1 at week 0, week 3,week 9, week18 and week 27. Mice were dissected and the changes of lymphoeytes cell cycle and the expressions of cyclin D1 in the bone marrow were measured at week 0, week 3, week 9, week 18 and week 27 increased and the ratio of phase S cells was decreased (P>0.05). In the CTX treatment group, there was no statistical difference in ratios of each phase. In the MTX and CTX combination treatment group, the proportion of phase G0/G1 cells decreased significantly and the percentage of phase S cells increased in both PBLs and bone marrow ceils (P<0.05). And there was no statistical significant difference in different time points after marrow between different groups or different dissecting time points. Conclusion MTX combined with CTX has been shown to have antagonistic effect on cell cycle. However, this effect is not via the cyclin DI pathway.

Objective To characterize the relationship between such phenotypes and the patterns of genetic mutations in the corresponding resistance genes in drug-resistant Mycobacterium tuberculosis (MTB)isolates in Shenzhen of China during 2007-2008.Methods According to standard of WHO,International Union Against Tuberculosis and Lung Disease(IUATLD),136 strains of MTB were collected by performing drug sensitivity test(DST)to isoniazid,rifampicin,streptomycin,ofloxacin and kanamycin on Lowenstein-Jensen in 1%proportion method.Genetic mutations in the corresponding resistance genes (rpoB,katG,rpsL,rrs1,gyrAB,rrs2)in these MTB isolates were identified by PCR,followed by DNA sequencing of the purified PCR products.The minimal inhibitory concentration(MIC)values of the aforementioned anti-tuberculosis drugs were determined for these MTB clinical isolates by two-fold dilution method in vitro.Results A total of 123 isolates were collected,73 isolates were drug resistant.50 isolates were drug susceptible.Among the isolates that were resistant to isoniazid,rifampicin,streptomycin.ofloxacin and kanamycin,the proportion of isolates that harboured mutations in the respective genes was 84.6%,93.6%,65.9%,100%,61.1%.For katG gene,the mutation detected were S315T or S315N.For rpoB,the most frequently found changes were S531L(30/44,68.2%)and H526D(9/44,20.5%)or H526R(1/44,2.3%).The reported mutations that K43R and KS8Q were founded in the rpsL locus and 491C→T and 513A→C were founded in the rrs1 gene related with streptomycin-resistant strains.For gyrA,all gyrA mutations were clustered in codons 90,91,and 94 apart from the S95T that was natural polymorphism.accounted for 81.1% of the ofloxacin-resistant isolates,and condon 91 was the most frequently mutated.No mutation were found in gyrB.The most frequent substitution were 1400 A→G(9/11,81.8%)and 1483 G→T(2/11,18.2%)in a specific region of the rrs2 gene related with kanamycin-resistant strains.No mutations except S95T of gyrA detected in the drug-susceptible isolates.The MIC values of clinical drug-resistant strains that the same drug-resistant group contains a different resistance phenotype are basically the same with the relevant resistance genes in the same mutation.Associated resistance mutations in different sites varied significantly with their MIC values.Conclusion The mutation characterization of drug-resistant and drug-suscep-tible isolates of MTB have been shown to vary according to geographic region,phenotypic characteristics exist difference in resistance levels due to different muntants of drug-resistant gene.

Background and purpose: Currently, intraoperative radiation therapy (IORT) has become the adjuvant therapy of cancer. The study was to establish the daily quality assurance (QA) program and analyze dosimetric characteristics’ long-term stability for mobile IORT accelerator. Methods:The QA program of this study included two parts:safety and functionality and energy and output. The two years’ QA datasets were acquired and analyzed to investigate the stability of energy and output. Results:All safety and functionality tests passed on a daily basis. The energy index was (0.666±0.015)mm, (0.839±0.009)mm, (0.781±0.010)mm, (0.724±0.009)mm and the output dose error was (0.511 ± 0.671)%, (0.278 ± 0.516)%, (0.368 ± 0.532)%, (0.382 ± 0.912)%for all energy, respectively. There was no signiifcant time trend in the dosimetric characteristics. Conclusion:The daily QA program is suitable for mobile IORT accelerator. The long-term stability is acceptable for IORT in clinical use.

Objective To analyze the mutations of FMS-like tyrosine kinase 3 internal tandem duplication (FLT3/ITD) in bone marrow cells of patients with newly-diagnosed acute myeloid leukemia (AML).Methods The mutations of FLT3/ITD in 96 AML cases were detected by polymerase chain reaction (PCR)and the clinical features of FLT3/ITD positive patients were analyzed.Results FLT3/ITD mutations were identified in 18 patients (18.8 ％),2 cases were M2,11 cases were M3,2 cases were M4,3 cases were Ms.Patients with FLT3/ITD mutations presented higher initial white blood cell count than that of patients without FLT3/ITD mutations [18.0×109/L (3.6×109-137.6×109/L) vs 6.3×109/L (4.5×109-113.0×109/L),t =3.04,P ＜ 0.05].Out of FLT3/ITD positive patients,13/16 (81.3 ％) obtained complete remission and 13 patients remained in first remission in a median follow-up of 10 months(6-15 months).Conclusion The mutations of FLT3/ITD are frequently identified in newly-diagnosed AML patients,patients with FLT3/ITD mutations present high white blood cell count.

Objective To investigate the distribution and antibiotic resistance of gram-negative bacilli for better antimicrobial therapy in our hospital.Methods A retrospective analysis was conducted for the 1 060 strains of gram-negative bacilli isolated from clinical specimens during 2013.Results Of the 1 060 gram-negative bacterial strains isolated during 2013,E.coli,K . pneumoniae,P .aeruginosa and A.baumannii were the leading pathogens,accounting for 29.3%,22.8%,11.5% and 9.9%,respectively.The prevalence of extended spectrum-lactamases (ESBLs)positive strains was 63.7%,32.2% and 28.0% in E.coli,K .pneumoniae and P .mirabilis,respectively.The Enterobacteriaceae strains were highly sensitive to carbapenems.The percentage of the P .aeruginosa isolates resistant to meropenem,imipenem or amikacin was lower than 30%.The percentage of the Acinetobacter spp.(A.baumannii accounted for 70.9%)strains resistant to meropenem and imipenem were 25.0% and 26.2%.Conclusions Most of the gram-negative bacilli are resistant to multiple antimicrobial agents. We should strengthen the monitoring of the antibiotic resistance of gram-negative bacilli and optimize antimicrobial therapy.

Objective To explore the efficacy and safety of the bronchoscopic high frequency electrocoagulation combined with balloon dilatation in treating tuberculosis inflammatory airway constriction. Methods According to the different methods of treatment, 55 patients with tuberculosis airway constriction were randomly divided into two groups, the balloon dilatation group (26 cases) and combination group (29 cases). The patients in balloon dilatation group underwent bronchoscopic balloon dilatation and the patients in combination group underwent bronchoscopic balloon dilatation combined with high frequency electrocoagulation. The patients of the two groups accepted endoscopic therapy once a week. Effective rate of recanalization for the narrow airway, frequency of effective treatment and the time of tuberculosis bacterium vanishing was recorded. Intraoperative and postoperative complications were also observed. Three months after the treatment, all patients accepted bronchoscopic to observe and assess the airway restenosis rate. Results After treatment, the effective rate in balloon dilatation group and combination group had no significant difference[69.2%(18/26) vs. 89.7% (26/29 )](P＞ 0.05 ),but frequency of effective treatment and time of tuberculosis bacterium vanishing had significant difference[(3.5 ±1.3) times vs. (1.5 ± 1.1) times, (23.3 ±3.6) d vs.(13.2 ±2.3) d](P<0.01). There was no significant difference on the intraoperative and postoperative complications between two groups (P＞0.05). The airway restenosis rate was 33.3%(6/18) in balloon dilatation group and 7.7%(2/26) in combination group after treatment for 3 months (P ＜0.05). Conclusions Combination of bronchoscopic balloon dilatation and high frequency electrocoagulation is an efficacy and safety way for the tuberculosis inflammatory airway stenosis. It can reduce the frequency of interventional therapy, shorten the time of tuberculosis bacterium vanishing, and may also decrease the airway restenosis rate.