Objective: To evaluate the effect of glucocorticoid on the treatment of acute cerebral stroke. Methods: Seventy-six patients with acute cerebral infarction were randomly divided into two treatment groups which included the group of intravenous infusion with dexamethasone 10 mg, Xuesaitong 0.4 g, and sodium citicoline 0.5 g Qd,and the group without dexamethasone treatment. Results: The infarction area enlarged on CT scan and the deficits of neural function accelerated in dexamethasone group. There was no change on CT scan and no neural function deterioration in patients without dexamethasone treatment. Conclusion:Side effect is obtained with the early use of dexamethasone for the treatment of acute ischemic cerebral stroke.

Objective:To understand the medication safety events about cephalosporin in our hospital in order to provide evidence for the better medication safety of cephalosporin. Methods:Adverse drug reaction ( ADR) reports, medication error ( ME) reports and drug quality problem records about cephalosporin in our hospital were collected and the critical indicators in the reports were analyzed. Re-sults:The ADR reports selected in our hospital were mainly reported by pharmacists. More males were involved in the related patients, and young adults were in the majority. Second and third-generation cephalosporin were the major drugs used in the reports. The damages in skin and its appendages were the major damages in organs. The ME reports selected in our hospital were totally reported by pharma-cists. Errors in frequency and dose of drug administration were the most common, and the main causes were lack of knowledge and train-ing. No serious quality problem in cephalosporin was found in our hospital, and the inner and outer packaging in damaged conditions was the most common problems in our records. Conclusion:Cephalosporin as one widely used antibacterial agent is considered safe and effec-tive. Because of its large amount of application, cephalosporin should be paid more attention by health care professionals. MEs should be avoided as far as possible. ADRs should be treated timely and properly in order to decrease medical disputes. More attention should be paid to ensure security of drug use for patients.

Plasma cell gingivitis is a rare form of gingival hyperplasia,mostly located in mucous membrane and characterized by swollen gums.Pathological examination showed dense plate shaped gathering of plasma cells in the connective tissue.Diagnosis relies on pathological examination.The cause of the disease is unknown,may be associated with allergic reactions.Expectant treatment is often use for the disease. Relapse of the lesion is commot,but canceration is rare.One case of plasma cell gingivitis followed for 2 years is presented,and the clinical manifestation and treatment are discussed in this paper.

The intraspecies quorum sensing system of Streptococcus mutans is involved with com genes family.ComE is a kind of response regulator and act as a promoter to the quorum sensing genes.S.mutans comE mutant strain IFD140?comE was constructed using the inframe-deletion system via twice homologous recombination.In current genetic studies of S.mutans,insertion duplication and allelic exchange mutagenesis techniques routinely create polar effects to downstream genes.In-frame deletions are essentially free of these polar effects because the mutation does not introduce any genetic markers.By PCR,sequencing and RT-PCR,it was confirmed that IFD140?comE has only 717bp deleted within the comE gene and the transcription of the downstream gene comD was not interfered.The research of the morphological characteristics indicated that IFD140?comE formed clumps and cells accumulated at the bottom of the glass tubes and light-microscopic observations displayed that the mutant strain formed significantly longer chains compared to those formed by the wild strain.The successfully construction of IFD140?comE lay a foundation for further quorum sensing research.

Objective To investigate the difference of leucorrhea routine tests results among 3 periods of pregnancy in pregnant women.Methods Vaginal cleanliness,the presence of clue cells,trichomonas and fungi were tested for 3 103 obstetric outpatients who were pregnant and treated in the hospital.The test results were analyzed and compared.Results Among pregnant women in different periods of pregnancy,the difference in the proportion of vaginal cleanliness degree Ⅲ and fungal infection rates were statis-tically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal cleanliness degree Ⅱ,difference of fungi infection rate was statistically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal clean-liness degree Ⅳ,the difference of positive rates of fungi,trichomonas and clue cells were statistically significant(P <0.05).In addi-tion,there are a number of mixed infections.Conclusion Vaginitis during pregnancy should be early detected,diagnosed and trea-ted.

OBJECTIVE To understand the pathogenicity of Staphylococcus epidermidis causing urinary tract infection. METHODS Thirty five isolates were collected in the patients with urinary tract infection during 2003-2004 to test the minimal inhibitory concentration(MIC) to erythromycin,ampicillin,cefoxitin,ceftriaxone,teicoplanin,ciprofloxacin,tetracycline,trimethoprim-sulfamethoxazole and vancomycin.The genes of ermA,ermB,ermC,msrA,mecA,and icaA were amplified by PCR.The biofilm producing of the isolates was determined by the quantitative method.The pulsed-field gel electrophoresis(PFGE) was used to discriminate the homology among the isolates. RESULTS Among the isolates,MRSE accounted for 71.4%.The antibiotic susceptibility to erythromycin,ampicillin,ceftriaxone,ciprofloxacin,tetracycline and trimethoprim-sulfamethoxazole were 22.8%,6.34%,34.9%,26.9%,44.4% and 62.2%,respectively,whereas to teicoplanin and vancomycin were 99.2% and 100%.All the isolates resistant to cefoxitin carried mecA.ermC Was the predominant determinant among the erythromycin resistant isolates.Among the 14 icaA positive isolates,10 isolates were biofilm producing.All the isolates were classified into 18 types by PFGE. CONCLUSIONS The high and multiple antibiotic resistance of S.epidermidis isolates causing urinary tract infection were shown.The detection of icaA gene in clinical S.epidermidis isolates was a signal of their pathogenicity.

AIM:To investigate the timing and efficacy of vitrectomy for patients with vitreous hemorrhage(VH) due to proliferative diabetic retinopathy(PDR).METHODS:Retrospective analysis.Patients who presented to our hospital between Feburary 2012 and May 2014 with VH secondary to PDR treated with vitrectomy were included.All patients were divided into three groups according to the duration of VH.A group was less than 1mo for 22 eyes, B group was 1-3mo for 23 eyes, C group was more than 3mo for 25 eyes.All patients underwent intravitreal injection of ranibizumab 1-2wk before vitrectomy, and supplemented or finished panretinal photocoagulation (PRP) intraoperatively or postoperatively.Patients with cataract accepted phacoemulsification and intraocular lens implantation.Eyes filling silicone oil were implanted intraocular lens in the second phase.All patients were followed up 24 to 42mo (mean:28.7mo).We assessed the intraoperative complications such as hemorrhage, iatrogenic retinal hole, and postoperative complications such as vitreous hemorrhage, neovascular glaucoma.Macular edema and best corrected visual acuity were observed at every follow-up.RESULTS:There was no significant difference for other baseline data (P>0.05) but DR stage between three groups (P=0.033).There was significant difference of last follow up visual acuity between three groups (P<0.001).The significant difference can be seen between group A and B (P=0.03).The same outcome showed between Group A and C(P<0.001).There was no significant difference between Group B and C (P>0.05).The percentage of visual acuity was 0.5 and above in the three groups were:41%, 23%, 0 respectively.The patients with visual acuity of less than 0.1 were 5%, 26% and 40% respectively.Silicone oil filling rate of three groups were:9%, 26%, 40% respectively and there was no significantly difference between three groups on postoperative complications (P>0.05).CONCLUSION:Patients with VH due to proliferative diabetic retinopathy undergoing early vitrectomy may get better visual acuity than who accepting delayed vitrectomy.

AIM: To investigate the clinicopathological features of orbit primary liposarcoma. METHODS: By means of histological, ultrastructural and immunohistochemical studies, the clinical and pathological features of two cases of orbit primary liposarcoma were analyzed and compared with 6 cases of primary retroperitoneum liposarcoma. RESULTS: Two cases of orbit primary liposarcoma were young persons. The majority of cases of primary retroperitoneum liposarcoma were aged over 40 years. The tumors were located at the retrobulbar region, and involved the wall of eyeball and optic nerve. The tumor cells of case 1 were round, with abundant eosinophilic granules in the cytoplasm, and there were lipoblasts in the tumor cells of two cases. Local recurrence following excision occurred in case 2.Immunohistochemical expression of S100 protein was positive in all cases, and CK (AE1/AE3), desmin, MyoD1, melanoma were negative. Ultrastructure observation showed lipid drops in the tumor cells in case 2 of orbit primary liposarcoma. CONCLUSION: Primary liposarcoma of the orbit may recur.The diagnosis was based on histological,ultrastruc-tural observation and immunohistochemical staining.

Objective RNA interference refers to post-transcriptional gene silencing caused by double strands RNA.To investigate the effect of EGFR receptor on esophageal carcinoma,the expression vector of HER4 gene targeted small interfering RNA was constructed to observe its silencing effect in human esophageal carcinoma cell line Eca-109,in order to find a promising method for the gene therapy of this disease.Methods Two complementary oligo DNA strands targeting HER4 gene were designed and synthesized according to the principles of designing siRNA.After annealing,oligo DNAs were inserted into SUPER.neo+gfp vector,then enzyme digestion analysis and DNA sequencing were applied.After transfecting it into human esophageal carcinoma cell line,we detected the level of expression of HER4 gene through real-time quantitative PCR and Western Blot.Results The enzyme digestion analysis and DNA sequencing show that HER4 gene targeted small interfering RNA and its expression vector were constructed successfully,and after transfection,the expression of HER4 gene in esophageal carcinoma cell line was suppressed greatly.Conclusion HER4 gene targeted small interfering RNA and its expression vector were constructed successfully,and could decrease the expression of HER4 gene in Eca-109 cell line,which laid the foundation for the following experiment.

Objective To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis.Methods A population sample of adult patients in Donghuamen community,Dongcheng district and Qinghe community,Haidian district,Beijing from April 2012 to January 2015,who had wheeze within the last 12 months,underwent detailed investigation,including a clinical questionnaire,pulmonary function tests,total serum IgE levels,blood eosinophil level and a peak flow diary.Nine variables were chosen as evaluating parameters,including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity (FVC) ratio,pre-salbutamol FEV1,percentage of post-salbutamol change in FEV1,residual capacity,diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level,peak expiratory flow (PEF) variability,serum IgE level,cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration).Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified.Results (1) Four clusters were identified by hierarchical cluster analysis.Cluster 1 was chronic bronchitis in smokers with normal pulmonary function.Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation.Cluster 3 included COPD patients with heavy smoking,poor quality of life and severe airflow limitation.Cluster 4 recognized atopic patients with mild airflow limitation,elevated serum IgE and clinical features of asthma.Significant differences were revealed regarding pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1％ pred,postsalbutamol change in FEV1 ％,maximal mid-expiratory flow curve (MMEF)％ pred,carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)％ pred,residual volume(RV)％ pred,total serum IgE level,smoking history (pack-years),St.George' s respiratory questionnaire (SGRQ) score,acute exacerbation in the past one year,PEF variability and allergic dermatitis (P ＜ 0.05).(2) Four clusters were also identified by two-step cluster analysis as followings,cluster 1,COPD patients with moderate to severe airflow limitation;cluster 2,asthma and COPD patients with heavy smoking,airflow limitation and increased airways reversibility;cluster 3,patients having less smoking and normal pulmonary function with wheezing but no chronic cough;cluster 4,chronic bronchitis patients with normal pulmonary function and chronic cough.Significant differences were revealed regarding gender distribution,respiratory symptoms,pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1 ％ pred,post-salbutamol change in FEV1 ％,MMEF％ pred,DLCO/VA％ pred,RV％ pred,PEF variability,total serum IgE level,cumulative tobacco cigarette consumption (pack-years),and SGRQ score (P ＜ 0.05).Conclusion By different cluster analyses,distinct clinical phenotypes of chronic airway diseases are identified.Thus,individualized treatments may guide doctors to provide based on different phenotypes.