Over the years,cerebral vasospasm has been regarded as one of the important factors influencing the prognosis in patients with subarachnoid hemorrhage.Studies have shown that cerebral vasospasm is associated with nitric oxide and nitric oxide synthase after subarachnoid hemorrhage,and regulating the synthesis of nitric oxide may play an active role in the treatment of cerebral vasospasm.

Purpose To assess the potentia1 of DNA image cytometry and urinary cyto1ogy in screening for urothe1ia1 carcinomas,and to find the idea1 method of ear1y diagnosis of urothe1ia1 cancer. Methods Voided urine specimens from 121 patients with urothe1ia1 carcinoma were random1y co11ected as test group and 95 patients with symptomatic uro1ogic disease but not urothe1ia1 carcinoma as con-tro1 group,a11 of the specimens were ana1yzed by both urinary cyto1ogy and DNA image cytometry. Results Urinary cyto1ogy had a higher sensitivity but 1ower specificity in diagnosis of urothe1ia1 carcinoma than that of DNA cytometry. Urinary cyto1ogy yie1ded an o-vera11 sensitivity of 85. 10%,specificity of 76. 80%. DNA cytometry revea1ed a sensitivity of 81. 80%,specificity of 81. 10%. Among the 121 urothe1ia1 carcinoma,there were 103 b1adder cancers,18 patients with upper urothe1ia1 carcinoma. For different types of urothe1ia1 carcinoma,both of the two methods demonstrated good sensitivity in the high 1eve1 tumor. And DNA cytometry had exce11ent sensitivity in the diagnosis of urothe1ia1 carcinoma in invasive b1adder cancer and upper urinary tract cancer,and both were more than 94%. Conclusions In 1ight of its high1y good sensitivity and specificity in urothe1ia1 carcinoma,especia11y in invasive b1adder cancer and upper urinary tract cancer,DNA cytometry shou1d be used to eva1uate suspect urothe1ia1 ce11s in urinary cyto1ogy specimens. Com-bined with the conventiona1 urinary cyto1ogy,the detection for urothe1ia1 carcinoma wou1d be significant1y improved.

Objective To understand drug use in children with common cold through comments on prescription and drug analysis,and to provide theoretical basis for standardizing medical treatment and promoting rational drug use.Methods A retrospective survey method was applied.Prescriptions of common cold in the department of pediatrics from Oct.to Dec.2015 were reviewed,and Excel 2013 was used for statistical analysis.Rationality of drug use was evaluated based onhospital prescription review management specification (try out),instructions and consensus of related experts at home and abroad.Results The utilization rate of antibacterial drugs was 93.4％in children with common cold of our hospital,utilization rate of antiviral drugs was 59.7％,utilization rate of compound cold medicine was 96.4％,and the rate of combined utilization of more than two kinds of compound medicine was 65.7％.Excessive medicine for common cold existed and abuse of cold medicine,antimicrobial and antiviral drug,irational drug combination in this hospital.Conclusion Clinical doctors lack cognition to common cold and cold medicines.Hospital pharmacy department should take effective pharmaceutical interventions to improve the level of rational drug use.

The studies of animal models have shown that the expression of matrix metalloprotease (MMP) is abnormal during cerebral ischemia/reperfusion,which indicating that it is associated with cerebral ischemia/reperfusion injury,especially MMP-2,MMP-3 and MMP-9 play the important roles in the pathogenesis of acute ischemic cerebrovascular disease.Understanding of the roles and expressions of MMP,the factors affecting its expression,and the studies and application of the related antibodies in cerebral ischemic/reperfusion injury may provide a new alternative for the early diagnosis,prevention and treatment of cerebral infarction.

Antigens, CD1 ; metabolism ; Child, Preschool ; Cholangitis, Sclerosing ; diagnosis ; etiology ; metabolism ; Diagnosis, Differential ; Female ; Histiocytosis, Langerhans-Cell ; complications ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver ; metabolism ; pathology ; S100 Proteins ; metabolism

Objective To study the synergistic effect of NKX6. 1 and PDX1 in inducing differentiation of fetal liver-derived mesenchymal stem cells(FL-MSCs) into the pancreatic B cells and to explore the underlying mechanisms, so as to obtain enough islet-like body for transplantation. Methods Recombinant adenovirus vector harboring both PDX1 and NKX6. 1 genes was constructed, and the vector was used to infect FL-MSCs. Then a series of cytokines were used to induce the differentiation of infected FL-MSCs into pancreatic B cells. The expressions of PDX1, NKX6.1 gene, transcription factors NGN3, NeuroDl/Beta2, MafA as well as C-peptide were examined. Results PDX1 and NKX6. 1 were detected in FL-MSCs cells 24 h after infection; cells began to express NGN3, NeuroDl, and MafA and stably expressed pancreatic B cell related factors including insulin after induction. The expression of these molecules was in a certain order. Conclusion PDX1, NKX6. 1 combined with a series of cytokines can effectively induce FL-MSCs to differentiate into pancreatic islet B cells in vitro, which might be through activation of transcription factors NGN3, NeuroDl, and MafA in turn, inducing FL-MSCs to differentiate towards endocrine precursor cells, B endocrine precursor cells and B cells in turn.

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatogra-phy ( MRCP) and endoscopic retrograde cholangiopancreatography ( ERCP) in the diagnosis of obstructive jaundice. Methods MRCP and ERCP were performed in 32 patients with obstructive jaundice, all patients were diagnosed surgically or histopathologically. Results The level of obstruction was diagnosied by MRCP and ERCP with accuracy of 90.6% (29/32) and 82. 8% (24/29) respectively(P =0. 5960) ,whereas the accuracy of combination of MRCP and ERCP reached 96. 9% (31/32) . For the etiologic diagnosis, the accuracy reached 75.0% (24/32) and 72. 4% (21/29) in MRCP and ERCP respectively ( P = 0. 9503) , whereas the accuracy MRCP and ERCP of imcombination reached 93. 8% (30/32) , significantly higher than that of MRCP( P = 0.0387) or ERCP alone(P = 0. 0245). Conclusions MRCP and ERCP are reliable and safe methods for the diagnosis of obstructive jaundice; furthermore, combination of the two procedures could improve the efficacy of diagnosis.

Objective To explore the solution to the secure problem of EMR based upon No.1 Military Medical Project.Methods The existing EMR system provides medical records service and the EMR are stored and managed in ordinary or established file format in the database server.Based upon above database characters related to EMR and the requirement of EMR security,the MRBACKUP system was developed to resolve EMR backup,recovery and dump.Results The MRBACKUP system safeguarded the security of EMR in the lowest cost,the least system resources and the highest efficiency.Conclusion The new secure solution to EMR can better resolve the security problems in the widely-used EMR in hospitals.

Objective To explore the correlated risk factors of bile duct injury induced by laparoscopic cholecystectomy ,and to reduce the rate of bile duct injury companied with LC and improved patients condition after LC .Methods One thousand two hun‐dred and forty four patients who had been done the laparoscopic cholecystectomy in our hospital were searched from December 2003 to December 2013 for their case notes .The relationship between rate of bile duct injury induced by laparoscopic cholecystectomy and gender ,age ,time of LC surgery ,pathology ,gallbladder wall thickness ,liver function levels ,the existence of the gallbladder triangle anatomical anomalies and physician experience were analyzed by logistic regression method .Results Logistic regression analysis showed that patients did LC surgery at early time ,with acute cholecystitis ,with gallstones combined effusion ,with gallbladder wall thicker than 4 mm and with gallbladder triangle anatomical anomalies were likely to have bile duct injury induced by LC (P<0 .05) .And doctor′s experience on LC is another important factor as well (P<0 .05) .Conclusion According to the correlated risk factors of bile duct injury caused by laparoscopic cholecystectomy ,methods should be employed to reduce the bile duct injury .And sharing experience between doctors and learning new techniques could be helpful ,too .

Objective To investigate the possible mechanism of recombinant human erythropoietin (rhEPO) neuroprotection by studying the effect of rhEPO on expressions of matrix metalloproteinase-9 (MMP-9) and BCL-2 following focal cerebral ischemia-reperfusion in rats. Methods A rat middle cerebral artery occlusion/reperfusion (MCAO/R) model was induced by the intraluminal filament method, and intraperitoneal injection of rhEPO was used for intervention. Histopathological changes were observed by HE staining, and the expressions of MMP-9 and BCL-2 in the cerebral cortex of ischemic side were detected with immunohisto-chemistry. Results HE staining: At all time points, the numbers of surviving nerve cells were significantly higher in the rhEPO group, and their injury degree was significantly lower. MMP-9 immunohistochemistry staining: The positive cells were observed occasionally in the normal control group and the sham-operation group; the MMP-9 positive cells at the ischemic side of brain tissue in a normal saline control group began to appear at 6 hours after reperfusion, it reached the peak at 24 hours and began to decrease at 72 hours; the change trend of MMP-9 positive cells in the rhEPO group was similar to that in the normal saline control group, but it was significantly lower than that in the normal saline control group at the same time points (t were 12. 023 6, 12. 635 0, 12. 779 6, respectively, all P <0. 01). BCL-2 immunohistochemistry staining: No positive cells were found in the normal control group and sham-operation group. The numbers of BCL-2 positive cells reached the peak at the ischemic side of brain tissue in the normal saline control group at 6 hours after reperfusion, it reached the peak at 24 hours and further decreased at 72 hours; the change trend of BCL-2 positive cells in the rhEPO group was similar to that in the normal saline control group, but it was significantly higher than that in the normal saline control group at the same time points (t were 5. 763 1,8. 110 1, and 5. 798 7, respectively, all P <0. 01). Conclusions rhEPO may inhibit cortical neuronal apop-tosis at the ischemic side by inhibiting MMP-9 expression and up-regulating BCL-2 expression so as to play a neuroprotective effect.