The growth of brain metastasis needs appropriate microenvironment, and the change of normal brain microenvironment is the basis for exploring metastasis with MRI. Through the local magnetic field changes and the application of contrast agents for improving the discrepancy of the cerebral tissue, MR can accurately detect brain metastasis in position, number, size, and shape. MR with contrast-enhanced technique is the first choice for screening brain metastasis. The application of all kinds of new MR techniques, sequences and intracellular contrast agents can not only further improve the specificity of detection, but also improve the sensitivity of MRI, which is favorable to formulating reasonable treatment and prolonging the lifetime of the patients. The microenvironment of brain metastasis and advances in the new MR techniques were reviewed in this article.

Objective To study the effect of modified Shengmal decotion treating viral myocarditis, and on the basis of syndrome differentiation, to discuss the type and period for treating VM.Methods The PubMed, Embase, the Cochrane Library, the Chinese biomedical literature database(SinoMed), China hownet(CNKI), and VIP database(VIP) were retrieved for the articles on VM treated by modified Shengmal decoction with RCT method. RevMan 5.0 software was adopted for Meta-analysis.ResultsA total of 7 articles and 495 patients were involved. The results showed the modified Shengmal decoction treatment group had statistical difference to the control group in treating VM[OR(95%CI) was 3.61 (2.11,6.16),Z=4.70,P<0.01]. Among them, the decoctions contalning milkvetch root or not had statistical difference compared to the control group[contalning milkvetch root[OR (95% CI) was 2.67 (1.29, 5.52),Z=2.64,P=0.008; not contalning milkvetch rootOR (95%CI) was 5.11 (2.30,11.38),Z=3.99,P<0.01].Conclusion Modified Shengmal decoction has certaln effects in treating VM of Qi and yin deficiency type or VM in the advanced stage showing Qi and yin deficiency. The effectiveness of adding milkvetch root in Shengmal decoction to treat VM should be further discussed, the use of milkvetch root must be based on the premise of careful syndrome differentiation.

OBJECTIVE To evaluate the antibacterial activities of cefoperazone combined with sulbactam against Gram negative bacteria,and compare with other antimicrobial agents.METHODS The antibacterial activities of 10 frequently used antibiotics against 1 670 strains of clinical isolated Gram negative bacteria were studied by using agar dilution methods according to the NCCLS 2002.RESULTS The results showed imipenem was the most active tested against Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae,followed by cefoperazone-(sulbactam),which had similar activities as imipenem against the non-fermentative strains such as Pseudononas aeruginosa,and Acinetobacter spp,but cefoperazone-(sulbactam) had higher susceptibility to imipenem-(resistant) Stenotrophomonas maltophilia.CONCLUSIONS Cefoperazone-sulbactam has good and broad spectrum(antibacterial) activities especially against Gram negative(bacteria,) and is expected to have a bright prospect in the treatment of severe hospital infections induced by Gram negative bacteria.

OBJECTIVE To investigate the tendency of bacterial distribution and resistance of hospitial infections,and to provide the reference for the clinical treatment and infection control in hospital.METHODS Bacteria isolated from patients in our hospital from Jan 2004 to Dec 2005 were identified by ATB expression,and bacterial susceptibility tests were performed on strains using Kirby-Bauer method.RESULTS A total of 3066 pathogens strains were isolated,among them 927 strains were Gram-positive cocci(30.2%).The most common pathogens of them were Staphylococcus.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) accounted for 69.0% and 77.6%,respectively.In our data,no vancomycin resistant S.aureus were isolated.There were 2134 strains of Gram-negative bacilli(69.6%),the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.The ESBLs producing strains of E.coli and K.pneumoniae accounted for 30.1% and 40.1%,respectively.The highest susceptible to Gram-negative bacilli was carbapenem,then were cefoperazone/sulbactam,piperacillin /tazobactam and cefepime.Mainly pathogenic bacteria were multi-resistant to some antibiotics.CONCLUSIONS Drug resistance of the nosocomial infection bacteria is a serious problem.It's important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.

Objective To observe the effect of compound rehmannia on SOD and ATP enzyme in the brain of SAM-P/8 dementia mice and the change of apoptosis neuron cells.Methods SAM-P/8 mice were divided randomly into three groups:experimental group,treatment group and model group.Mice in experimental group were lavaged by compound rehmannia(2ml/day,individual).Mice in treatment group were lavaged by donepezil hydrochloride(400mg/kg,individual),and mice in normal group and model contrast group were lavaged by equal sodium chloride.After 3 weeks,we observed mice′s behavior in every group and investigated the changes of SOD,Na+-K+-ATP enzyme by immunohistochemistry and investigated the changes of apoptosis cells peak by FCM.Results Compound rehmannia could improve learning and memory ability of the SAM-P/8 mice,strengthen SOD,Na+-K+-ATP activity and reduce apoptosis neurons in brain.Conclusion Compound rehmannia can significantly improve the Alzheimer's mice learning and memory ability,strengthen the energy of brain cells,and increase resistance to free radical antioxidant capacity,reduce the neuron apoptosis and has a good relatively protection and care to SAM-P/8 mice brain neurons.

Objective To investigate the incidence of middle ear barotrauma due to hybaric oxygen therapy by using Health Education Atlas.Methods 100 patients were divided into two groups by random number table. The research group(49 patients)was educated by Health Education Atlas.The control group(51 patients)was educated by traditional education approach.During the first three days,we observed and recorded the eardrum injury and asked patients ear discomfort everyday.Results The incidence rate of middle ear barotrauma of the research group was 6.1%,which of the control group was 19.6%.The eardrum injury of the research group was milder than the control group(χ2 =4.02,P <0.05).Conclusion Education using Health Education Atlascan reduce the incidence of middle ear barotrauma due to hybaric oxygen therapy.

Objective To observe the clinical efficacy of Kechuanning capsules for the treatment of chronic obstructive pulmonary disease (COPD) in stable phase.Methods Totally 110 patients with stable COPD were randomly divided into the therapy group and the control group, 55 cases in each group. Patients in both groups were given ipratropium bromide solution for inhalation. On the basis of western medicine treatment, the therapy group took Kechuanning capsules orally at the same time, 4 softgels for each time, 3 times a day;on the basis of western medicine treatment, the control group took the same amount of placebo capsules. The treatment lasted three months. Meanwhile, the clinical efficacy, BODE index, CAT score and ADRs of patients in the two groups were observed.Results The clinical efficacy in the therapy group was 96.00% (48/50), and 88.24% (45/51) in the control group, with statistical significance (P<0.05). BODE index and CAT score in the two groups decreased and the therapy group was lower than the control group (P<0.05). Liver and kidney function had no obvious abnormalities in the treatment group before and after treatment.Conclusion Kechuanning capsules can effectively reduce the BODE index and CAT score in patients with stable COPD, improve patients' life quality and clinical outcomes, and no obvious side effect has been found.

Objective To observe the effects of Kechuanning capsules on airway inflammation cells and inflammatory mediators in patients with COPD.Methods Totally 110 patients with stable COPD were randomly divided into therapy group and control group, 55 cases in each group. Both of the groups were given compound ipratropium bromide solution for inhalation, at the same time, patients in the therapy group took Kechuanning capsules orally, 4 softgels each time, 3 times a day, and patients in the control group took the same amount of placebo capsules. The treatment lasted three months. Differential counting of inflammatory cells and levels of inflammatory factors in serum and sputum supernatant were observed.Results In terms of differential counting of inflammatory cells, the sputum neutrophils of the therapy group decreased significantly (P<0.05) and macrophages increased (P<0.05) after treatment, with statistical significance compared with the control group (P<0.05). In terms of inflammatory mediators, the levels of IL-6, IL-8, LTB4 in serum did not change significantly (P>0.05) in two groups before and after treatment;IL-6, IL-8, LTB4 levels in the sputum supernatant of the therapy group were lower than those before treatment (P<0.05), with statistical significance compared with the control group (P<0.05). Conclusion Kechuanning capsules have an obvious inhibitory effect on airway inflammatory cells in patients with stable COPD as well as the release of inflammatory mediators.

Objective To extract,detect and validate the BACE1 expression-regulating lncRNA BACE1-AS containing in the plasma of patients with AD in Chinese Han people,so as to provide a research basis for plasma BACE1-AS in AD to be a plasma molecular markers and a new target for treatment.Methods The study included 27 AD patients and 28 normal individuals whose age,sex,education,etc.were matched between AD and controi group.Total RNA extraction of plasma was performed using guanidine isothiocyanate-phenol chloroform method.Target gene amplification was executed by RT-PCR Kit.Gel electrophoresis and its imaging analysis were performed on the RT-PCR amplified products.Target gene amplified products were sequenced,its sequence consistency with gene bank-reported sequence were compared,and differences in target gene transcription between the two groups were statistically analyzed.Results The positive expression rates of BACE1-AS were 18.5％(5/27 cases)in ADgroup and 0.0％ in control group,respectively(P=0.023).In comparison between two groups,there was a significant difference (P =0.023).Gene sequencing confirmed the consistent between BACE1-AS gene sequence of 3 patients with AD and Gene Bank's BACE1-AS sequence.But the two other AD cases showed individual base replacement.Conclusions Compared with the healthy control group,patients with AD show specific BACE1 expression-regulating lncRNA BACE1-AS in plasma of AD patients,which provides theoretical basis for BACE1 AS as a biomarker of AD diagnosis and a new target in therapy of AD.

Objective: To construct a model for clinical identification of spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS), so as to provide insights into early identification of SF and SFTS. Methods: The clinical data of laboratory-confirmed SF and SFTS patients in secondary and tertiary hospitals in Lu'an City, Anhui Province from May 2017 to May 2021 were retrieved from Chinese Disease Prevention and Control Information System. Factors affecting SF were identified using a logistic regression model, and the model for early identification of SF and SFTS was created. The model fitting effect was evaluated using Hosmer-Lemeshow test, and the value of the model for identification of SF and SFTS was evaluated using the area under the receiver operating characteristic curve (AUC). Results: Data of 62 SF cases and 115 SFTS cases were included. Multivariable logistic regression analysis showed that rash (β=5.994), C-reactive protein (β=4.409), white blood cell (β=-3.176) and platelet (β=-3.234) were included in the model, which were scored 6, 4, -3 and -3, with a total score ranging from -5 to 10. Hosmer-Lemeshow test revealed a high model fitting effect (χ2=3.245, P=0.662). The AUC of the model was 0.992, and the sensitivity and specificity were 0.935 and 0.991 if the cutoff was 1. Conclusion A model for early identification of SF and SFTS that includes four variables of rash, C-reactive protein, white blood cell and platelet has been created, which has a high accuracy.