OBJECTIVE To study the clinical characteristics and the prevention measures of the hospital-acquired pneumonia in senile dementia patients.METHODS We analyzed retrospectively the cognitive function(using mini-mental state examination,MMSE) and activities of daily living(Barthel Index) of 113 senile dementia patients who were hospitalized in the Department of Neurology between Jan 2003 and Oct 2008(31 confirmed cases were treated as infected group,and the remaining 82 cases as control group),and found out the risk factors for infected with hospital-acquired pneumonia,the pathogenic bacteria and their resistance,then formulated prevention and control measures.RESULTS Among 113 senile dementia patients,31 cases were infected with hospital-acquired pneumonia,and these patients had obviously lower MMSE scores and ADL scores than the non-infected patients(P

Objective To explore the relationship between retinal vascular occlusion and carotid artery atherosclerotic (CAA) plaque by color Doppler ultrasonography.Methods Carotid artery color Doppler ultrasonography was performed in 65 patients with retinal vascular occlusion (case group) and 50normal controls (control group).To acknowledge the role of the CAA plaque in the ocurrence of retinal vascular occlusion by the detection rate of CAA plaque and stenosis degree of carotid arteries.Results The detection rate of CAA plaque was 64.62％(42/65) in case group,which was higher than that in control group [22.00％(11/50)],and there was significant difference (P＜0.05).Mild stenosis had 34 cases,moderate stenosis had 6 cases,severe stenosis had 2 cases in case group,and 8,3,0 case respectively in control group.There was significant difference in stenosis degree of carotid arteries between two groups (P ＜ 0.05).Conclusions CAA plaque is closely related to the ocurrence of retinal vascular occlusion.Color Doppler ultrasonography is the simplest and most effective method to monitor CAA plaque which has clinical significance in prevention and treatment of retinal vascular occlusion.

Objective To observe the clinical efficacy of fasudil combined with fibrinogenase for injection on sudden sensorineural hearing loss of old people. Methods Ninety old patients with sudden sensorineural hearing loss were randomly divided into fasudil group, fibrinogenase group and combined group (n=30 in each group).After the treatment, improvement of deafness and tinnitus were compared among the three groups. Hemorrheology, coagulation function, blood routine examination, liver and kidney function profile, and blood lipid were compared before and after the treatment. Results The total effective rate of deafness was significantly higher in the combined group ( 93. 3%) than in the fasudil group ( 90. 0%) and the fibrinogenase group (86.7%) (both P<0.05).The total effective rate of tinnitus was significantly higher in the combined group (93.3%) than in the fasudil group (83.3%) and the fibrinogenase group (80.0%) (both P<0.05).After the treatment, blood viscosity and coagulation function were significantly improved in the three groups (all P<0.05).As compared with the fasudil group and the fibrinogenase group, blood viscosity was significantly improved in the combined group (both P<0.05). Conclusion Fasudil combined with the fibrinogenase for injection for sudden sensorineural hearing loss of the old people has preferable curative efficacy, and can effectively improve clinical symptom, blood viscosity and coagulation function of sudden sensorineural hearing loss.

Objective To observe the clinical effect of acupuncture combined with ganglioside and mecobalamine injections on idiopathic facial palsy (IFP).Methods A total of 120 IFP patients were divided into a ganglioside group,a mecobalamine group and a consociation group,each of 40.All were given routine drug and acupuncture treatment,while the ganglioside and mecoblamine groups were additionally provided with the corresponding injections of ganglioside and mecobalamine,respectively.The treatment was administered once daily for a total of 14 days.All the groups were evaluated using the House-Brackmann facial nerve grading system before and after the interventions of 14 days ended.The compound muscle action potential (CMAP) wave amplitude and R1 incubation,the motor nerve conduction velocity (MCV) and the sensory nerve conduction velocity (SCV) of the affected facial nerves were observed and compared before and after the 14 days of treatment.Results The total effectiveness rate of the consociation group (95.0％) was significantly higher than that of the ganglioside (90.0％) or the mecobalamine group (87.5％).After the treatment the CMAP wave amplitude had improved significantly and the R1 latency had shortened significantly in the consociation group compared to the other 2 groups.The average MCV and SCV of the consociation group had also improved significantly compared with the other two groups.Conclusion Acupuncture combined with ganglioside and mecobalamine injections is an effective therapy for idiopathic facial palsy.It can improve the patient's clinical symptoms,shorten the CMAP wave amplitude and R1 latency on the affected side and improve MCV and SCV.

Objective To observe the effect of buflomedil on patients with vascular dementia. Methods Sixty - four patients with vascular dementia were randomly divided into two groups.The buflomedil group of 32 patients was treated with buflomedil 150-200 mg,once a day for 20 days. The control group of 32 patients was treated with citicolinum 750 mg, once a day for 20 days. Then their MMSE, ADL, HDS and WMS were evaluated and the hemorheologic indexes were measured in both groups before and after treatment, respectively. Results In buflomedil group the scores of MMSE, ADL,HDS and WMS were (22.43?3.03) score,(24.43?8.72) score,(23.41?2.81) score,(70.34 ?18.45) score as that were(20. 58?3. 81) score, (29. 23?14. 36) score, (20. 34?6. 24) score, (60.15?22.49) score in control group.There was significant difference between the two groups(P

Physiology is the main course in the education of preclinical medicine.And the functional experiment education is one of the important ingredients in it.The teaching style should be open,the students capability of independent thoughts should be raised and at the same time their precise scientism and cooperation spirit should be cultivated following the basic outline of teaching.

Objective To explore the effect of stromal cell-derived factor-1 α (SDF-1 α) on inducing recruitment of bone marrow-derived cells (BMDCs) to wound area. Methods BMDCs were isolated from bone marrow, cultured with routine method and identified by CXCR4 antibody. Cells cultured with CXCR4 antibody (100 ng,/mL) for 6 hours were labeled with CM-DiI and injected into the tail vein of full-thickness incisional wound model (set as anti-CXCR4 group). BMDCs labeled with CM-DiI without antibody treatment were injected to the rats in BMDCs group, and rats were injected with DMEM/F12 serum-free medium in the control group. The quantity of labeled BMDCs at the wound site and the percentage of wound closure were measured. Results (1) All BMDCs expressed CXCR4. (2) The percentages of wound closure at days 7 and 14 in BMDCs group (7 d: 41.3% ±4.6%; 14 d:92.3% ±2. 1%) were significantly higher than those of control group (7 d: 29.3% ±2. 3%; 14 d: 77.3% ±2.5%) and anti-CXCR4 group (7 d: 30.7% ±4.6% ;14 d: 85.7% ±1.5%) (P＜0.05). The percentage of wound closure of anti-CXCR4 group was significantly higher than that of control group at day 14(P ＜ 0.05). (3) The number of CM-DiI labeled BMDCs at wound site at days 7 and 14 in BMDCs group [7 d: (535 ±84) cells/hpf; 14 d: (769 ±124) cells/hpf) were greater than those of anti-CXCR4 group [7 d: (335 ±97) cells/hpf; 14 d: (521 ± 127) cells/hpf] (P＜0.05). Conclusions BMDCs participate in the cutaneous wound healing. SDF-1α plays an important role in recruiting BMDCs to wound area.

Peroral endoscopic myotomy (POEM) has emerged as a rescue treatment for recurrent or persistent achalasia after failed initial management. Therefore, we aimed to investigate the efficacy and safety of POEM in achalasia patients with failed previous intervention. We searched the MEDLINE, Embase, Cochrane, and PubMed databases using the queries “achalasia,” “peroral endoscopic myotomy,” and related terms in March 2019. Data on technical and clinical success, adverse events, Eckardt score and lower esophageal sphincter (LES) pressure were collected.The pooled event rates, mean differences (MDs) and risk ratios (RR) were calculated. A total of 15 studies with 2,276 achalasia patients were included. Overall, the pooled technical success, clinical success and adverse events rate of rescue POEM were 98.0% (95% confidence interval [CI], 96.6% to 98.8%), 90.8% (95% CI, 88.8% to 92.4%) and 10.3% (95% CI, 6.6% to 15.8%), respectively. Seven studies compared the clinical outcomes of POEM between previous failed treatment and the treatment naïve patients. The RR for technical success, clinical success, and adverse events were 1.00 (95% CI, 0.98 to 1.01), 0.98 (95% CI, 0.92 to 1.04), and 1.17 (95% CI, 0.78 to 1.76), respectively. Overall, there was significant reduction in the pre- and post-Eckardt score (MD, 5.77; p<0.001) and LES pressure (MD, 18.3 mm Hg; p<0.001) for achalasia patients with failed previous intervention after POEM. POEM appears to be a safe, effective and feasible treatment for individuals who have undergone previous failed intervention. It has similar outcomes in previously treated and treatment-naïve achalasia patients.

OBJECTIVE To study the effects of the curcumin derivative bisdemethoxycurcumin （BC） promoting neuronal differentiation of neuroblastoma cells Neuro-2a （N2a） in mice and its mechanism. METHODS The effects of BC （1， 2， 4， 6， 8， 10 μmol/L） on the viability of N2a cells were detected by MTT assay to determine the concentration range of drug treatment. The control group， retinoic acid （RA） group （10 μmol/L） and BC groups （1， 2 and 4 μmol/L） were set up， and the length of neural protrusions of the differentiated cells was measured and the cell differentiation rate was calculated after 48 h and 72 h of culture. Compared with 0 min group， Western blot was used to detect the phosphorylation levels of protein kinase B （Akt）， extracellular- signal regulated kinase 1/2 （ERK1/2）， and p38 mitogen-activated protein kinase （p38） proteins in cells treated by 4 μmol/L BC for 5， 15， 30， 60， 120 min. After intervention with inhibitors LY294002 （LY） and PD98059 （PD）， the effects of BC on Akt and ERK1/2 protein phosphorylation levels and promoting neural differentiation were further validated. RESULTS According to the MTT experiment， the BC concentrations for subsequent induction of cell differentiation were determined to be 1， 2， and 4 μmol/L. After 48 hours of differentiation， compared with the control group， the cell differentiation rate in RA group and BC 1， 2 and 4 μmol/L groups， the length of cellular neural processes wjxhhxx413@163.com in the BC 4 μmol/L group significantly increased （P＜0.05 or P＜0.01）；after inducing differentiation of BC for 72 hours，compared with the control group， the cell differentiation rate and the length of cellular neural processes in the RA group， the cell differentiation rate in the BC 4 μmol/L group， and the length of cellular neural processes in the BC 2 μmol/L group all significantly increased （P＜0.05 or P＜0.01）.Compared with the 0 min group， the phosphorylation levels of Akt， ERK1/2， and p38 proteins in cells of the 5， 15， 30， 60 and 120 min groups increased to varying degrees after treated by 4 μmol/L BC， and some differences were statistically significant （P＜0.05 or P＜0.01）. After adding the inhibitor LY/PD， compared with the BC group， the phosphorylation level of ERK1/2 protein in the PD+BC group cells were significantly reduced （P＜0.01）， and the cell differentiation rates in the LY group， LY+BC group， PD group， and PD+BC group was significantly reduced （P＜0.01）. CONCLUSIONS BC promotes N2a cell differentiation mainly by increasing cell differentiation rate and neural protrusion length. The mechanism may be related to the activation of mitogen-activated protein kinase/ ERK and PI3K/Akt signaling pathways.