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 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 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.

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.

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 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.

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 assess the distribution of vaginal microflora in healthy women and investigate their cognition of lower reproductive tract infection-related knowledge as well as personal hygiene habits and character of behavior in seeking medical treatment. Methods Total of 1660 healthy women who had physical check-ups at the Medical Center of Renji Hospital were selected and received gynecologic examination, as well as routine examination, pH examination and bacterial culture of the vaginal discharge. In addition, 860 of them were randomly selected for questionnaire survey, in which reproductive tract infection -related knowledge and personal hygiene habits as well as behavior in seeking medical treatment were involved. Results Among the 1660 eensused women, vaginal average pH was 4. 16±0.21. The positive rate of Candida in vaginal discharge routine examination was 3.86% (64/1660), which was lower than that in aerobes culture 7.71% (128/1660). Candida alhicans was the most populous species 78.9% (101/128) ,followed by 7.8% (10/128) and 7.0% (9/128) for the Candida glabrata and Candida krusei respectively. The most populous species of vaginal microflora were hemolytic streptococcus A (63.80%, 1059/1660), Staphylococcus epidermidis (14.28%, 237/1660), and Enterococcus faecalis (D) group ( 11.44%, 190/1660). The questionnaire survey showed that 88.4% (760/860) of 860 women took active treatment when feeling unwell, 92.1% (792/860) of them had good hygiene practices, and only 21.2% (182/860) had the habit of vaginal douching. In addition, 50.0% (430/860) of them had the desire to obtain reproductive health knowledge through out-patient consultation. Conclusions Vulvovaginal Candida disease ranks the first in all types of vaginitis, among which, Candida albicans is the most populous species followed by the Candida glabrata and Candida krusei. Hemolytic streptococcus A and Staphylococcus epidermidis are the most common species of vaginal mieroflora in healthy women. The censused women have high awareness of reproductive health care and pay mueh attention to common gynecologic diseases such as lower reproductive tract infection. Nevertheless, we should strengthen the public education of reproductive health-related knowledge.