Objective To evaluate the relationship between cytotoxin-associated gene-A (CagA)seropositive of Helicobacter pylori (H .pylori )infection and risk of atherosclerotic cerebral infarction(ACI).Methods Related literatures were researched through literature retrieval ,literatures were obtained by uniformed criteria of inclusion and exclusion,and Meta analysis was performed with RevMan 4.2 software.Results A total of 10 literatures which met the inclusion criteria were retrieved,all were case-control study,case group included 907 studied subjects,and control group included 966 subjects;the included population were divided into Chinese subgroup and European Caucasian sub-group.Meta analysis of CagA seropositive of H .pylori infection and risk of ACI revealed that OR of the overall popula-tion,Chinese subgroup,and European Caucasian subgroup was 2.66(2.17-3.26),2.60(1.93-3.49),and 2.71(2.05-3.59)respectively;Meta analysis of CagA seronegative of H .pylori infection and risk of ACI revealed that OR of the overall population,Chinese subgroup,and European Caucasian subgroup was 0.74(0.49-1.10),0.81(0.45-1.48),and 0.64(0.37-1.09)respectively.The funnel plot and fail-safe number showed that there was no significant publication bias, the result was stable and reliable.Conclusion Chronic infection caused by CagA seropositive strains of H .pylori may be one of the risk factors of CAI,whether the eradication treatment of seropositive strains of H .pylori influences the process of atherosclerotic diseases like CAI needs to be further studied.

Objective To investigate the number and activity changes of endothelial progenitor cells(EPCs) in hemodialysis patients,and explore its correlation with the risk factors of coronary heart disease.Methords Total mononuclear ceils(MNCs) were isolated from peripheral blood of patients with chronic renal failure in long-term hemodialysis and from a normal control group by Ficoll density gradient centrifugation and then were plated on humanfibronectin-coated dishes.Mter 7 days of culture,EPCs were characterized as adherent cells by double staining with FITC-UEA-I and DI-LDL,and were further identified by the expression of CD34,CD133 and KDR with flow cytometry.EPCs migration was determined with modified Boyden chamber assay.EPCs adhesive assay was performed by replanting EPCs on humanfibronectin-coated plates and then counting the adherent cells.The relationship of the EPCs' number and activity with Framingham Risk Score of ten years was also be assessed.Results Number of EPCs and the migratory & adhesive capacity were significantly lower in patients than in the control(P

Objective To investigate the effect of clinical pathway on inpatients for rehabilitation. Methods The hospital expense, the ex-pense for medicine and length of stay in hospital were compared in patients with cerebral hemorrhage, cerebral infarction, spinal cord injury and spastic cerebral palsy before (January 1st, 2012 to April 30th, 2013) and after (May 1st, 2013 to December 31st, 2015) clinical pathway implementation, 50 inpatients for each disease, totally 200 patients. Results The length of stay in hospital reduced after of clinical pathway implementation, in all the diseases (t>5.226, P<0.001), with the decrease of hospital expense for cerebral infarction (t=3.327, P<0.001). There was no significant increase in any expense in the disease (t<1.777, P>0.05). Conclusion The implementation of rehabilitation clinical pathway can reduce the length of stay in hospital for the patients rehabilitation in hospital, without increasing their cost.

Objective To evaluate the feasibility of MR PWI in judging maturity and variability of tumor vasculature in gliomas in rats.Methods Twenty male SD rats were randomly assigned to tumor group and control group.Four weeks after implantation of C6 glioma cells in the brains of tumor group and injection of saline in the brains of control group,all rats were examined using MR PWI before and after inhalation of a mixture of 10% CO2 and 90%air.PaCO2 and blood pH values of rats were monitored.Relative cerebral blood volume(rCBV)and relative cerebral blood flow(rCBF)values of tumors and normal brain tissue were measured.Brain sample were examined histologically using HE and immunohistochemical staining for smooth muscle actin(SMA).The histological features of gliomas were observed and SMA positively stained vessels of each tumor were counted manually using a light microscope.Perfusion data and pathological findings were analyzed statistically with SPSS for Windows.Results PaCO2 increased significantly[from(4.69±0.62)kPa to(7.62±0.81)kPa in tumor group and from(4.67±0.51)kPa to(7.63±0.78)kPa in control group,P＜0.05)after inhalation of the mixed gas.The rCBV and rCBF values of tumor core were remarkably greater than those of normal contralateral brain tissue.The increasing rate of rCBV and rCBF values in gliomas[(26±17)%and(26±18)%respectively]were significantly less than those in normal brain tissue[(90±32)%and(45±14)%repectively](t=5.05 and 2.355,P＜0.05)Immunohistochemical staining of 10 tumors as well as contralateral brain tissue all demonstrated positive SMA expression in the smooth muscles of the vessels.The vascular walls of positive SMA labeled vessels within tumors were thinner and their vascular lumen wider than those within normal brain tissues.The number of SMA(+)vessels in tumors[(6.7±2.8)/HP]was statistically less than that in contralateral brain tissue[(12.7±2.8)/HP](t=1.86,P＜0.01).Changing rate of rCBV,rCBF of the tumor cores and number of the positive SMA labeled vessels showed no correlation(r=0.504 and 0.607,P＞0.05),while changing rate of rCBV,rCBF in normal brain tissue correlated well with number of positive SMA labeled vessels(r=0.721 and 0.525,P＜0.05).Conclusion PWI can detect the hemodynamic change induced by PaCO2 increase in the normal brain and in the tumor.It may be a useful technique to measure maturity of tumor vessels.

Objective To investigate clinical value of Xpert M TB/RIF assay on rapid detection of M TB and rifampin‐resistant . Methods 408 cases of tuberculosis were detected by acid‐fast stain ,Solid culture and Xpert MTB/RIF ,the results were compared . Results All the samples were detected by acid‐fast stain ,culture and Xpert MTB/RIF assay ,the positive rates were 25 .00% (102/408) ,42 .16% (172/408) and 58 .09% (237/408) ,respectively .The positive rates of Xpert MTB/RIF assay were higher than acid‐fast stain and culture method ,and the difference is statistically significant(P<0 .05) .There are 168 cases of specimen which were tested positively by both culture and Xpert M TB/RIF ,the RIF resistance rates from standard drug susceptibility testing and Xpert MTB/RIF assay respectively were 26 .19% (44/168) and 27 .38% (46/168) ,and had no statistical significance(P>0 .05) .Accord‐ing to the result of drug susceptibility with proportion method ,the sensitivity and specificity of Xpert MTB/RIF in detecting RIF resistance were 97 .73% (43/44) and 97 .58% (121/124) .Conclusion Xpert MTB /RIF can quickly and accurately detect MTB and RIF resistance ,it has important clinical significance .

Objective To investigate correlation between Helicobacter pylori infection and incidence of myocardial infarction and cerebral infarction ,and serum homocysteine(Hcy) level .Methods A total of 72 patients with myocardial infarction ,86 patients with cerebral infarction and 80 healthy subjects were enrolled and detected for Hp‐IgG and serum Hcy by using enzyme‐linked im‐munosorbent assays and enzymatic cycling method .Relationship between Hp infection and serum level of Hcy were analyzed .Results The positive rate of Hp‐IgG and serum Hcy level in patients with myocardial infarction were significantly higher than healthy subjects(P<0 .05) .Among patients with myocardial infarction ,serum level of Hcy in Hp‐IgG positive patients was higher than that in Hp‐IgG negative patients(P<0 .05) .The positive rate of Hp‐IgG between patients with cerebral infarction and healthy subjects was without significant difference(P>0 .05) .Among patients with cerebral infarction ,serum level of Hcy between Hp‐IgG positive patients and Hp‐IgG negative patients were without significant difference(P>0 .05) .But serum Hcy level in patients with cerebral infarction was significantly higher than that in healthy subjects(P<0 .05) .Conclusion Hp infection might promote the occurrence of myocardial infarction by affecting serum level of Hcy .However ,there might be without obvious correlation between Hp infection and the occurrence of cerebral infarction .And there could be no direct association between high serum level of Hcy in patients with cerebral infarction and Hp infection .

Objective Pleural effusion of patients with tuberculous pleurisy was analyzed by ultra high performance liquid chromatography-mass spectrometry (UPLC-MS).Orthogonal partial least squares discriminant analysis (OPLS-DA) model was established for searching and analyzing the potential metabolic biomarkers to provide new ideas for the early diagnosis of tuberculosis pleurisy.Methods Totally 166 cases of pleural samples were collected from November 2012 to September 2013 in Tianjin Haihe Hospital (tuberculosis pleurisy 83 cases,bacterial pleurisy 31 cases,lung cancer 30 cases and heart failure 22 cases)and metabonomics quantitative analysis was conducted.Quantitative analysis of metabolic methods was enrolled.Orthogonal partial least squares discriminant analysis (OPLS-DA) model was constructed by the pattern recognition method.Based on the OPLS-DA model,potential biomarkers was filtered preliminary by variable importance in the projection (VIP) and VIP confidence interval value.The specific metabolites were determined by applying non-parametric test(Kruskal-Wallis H test)by using SPSS 17.0,and potential metabolic biomarkers were screened.Results The prediction accuracy of OPLS-DA model was 100％ (38/38),which illustrated that the model could verify the tuberculous pleurisy group and the control group accurately.Based on the data of metabolites,46 potential metabolites were finally screened and 5 metabolites were identified with statistically significant differences (P ＜ 0.05).The data of tuberculosis pleurisy group showed a significant increase in 17a,20a-Dihydroxy cholesteryl,phospholipid [20∶4 (8Z,11Z,14z,17Z)] (1 188 670.00),tocotrienols (1 051 760.00) and phospholipid(O-18:0) (434 394.00) compared with the lung cancer group(735 615.00,336 815.00,324 563.00,193 055.00),bacterial pleurisy group (1 678 805.00,598 256.50,699 384.00,343 866.00),and heart failure group(535 842.00,253 503.00,234 503.00,130 185.00) (H =26.787,18.680,26.193,21.024,P ＜0.01),and a significant decrease in L-phenylalanine(245 976.00)compared with the lung cancer group(753 033.50),bacterial pleurisy group (357 278.00),and heart failure group(586 678.00) (H =13.635,P ＜ 0.01).Conclusions The OPLSDA model constructed on the basic of UPLC-MS technology platform can verify the tuberculous pleurisy group and the control group accurately,and the study provides new ideas and methods for identifying features of tuberculous pleurisy markers and early diagnosis.

ObjectiveTo analyze characteristic changes of shoulder muscles by investigating surface electromyographic regularity changes before and after the treatment of Frozen shoulders. Methods7 cases of frozen shoulders were selected, surface electromyography (sEMG) before and after treatment were recorded by AMT-8 EMG recorder. The collected data was processed using MATLAB software integrated EMG (IEMG) value were obtained. Then the IEMG data were statistically analyzed using Stata11.0 software and compared. Results ①The differences of abduction deltoid and infraspinatus muscle IEMG values before and after treatment were statistically significant(P ＜0.05), while IEMG values changes of biceps, triceps, pectoralis major, latissimus dorsi and trapezius before and after treatment were not statistically significant (P＞0.05); changes of adduction IEMG values of all muscles were not statistically significant (P＞0.05). ②Changes of flexion IEMG values of biceps before and after treatment were statistically significant (P＜0.05), while IEMG values changes of pectoralis major, infraspinatus muscle, latissimus dorsi, trapezius, deltoid, triceps before and after treatment were not statistically significant (P＞0.05). Changes of extension IEMG values of triceps before and after treatment were statistically significant (P＜0.05), while those of pectoralis major, infraspinatus muscle, latissimus dorsi, trapezius, deltoid and biceps were not statistically significant (P＞0.05). ③IEMG values of all the muscles during external rotation, internal rotation before and after treatment IEMG were not significantly different. Conclusion①After treatment, the outreach functions of infraspinatus and deltoid muscles were improved, while adduction functions of all muscles were not improved. ②Flexion function of biceps was improved significantly after treatment as well as extension function of triceps.③Extemal rotation, internal rotation functions of all muscles were not improved significantly.

Objective To investigate the effect of midazolam combined with fentanyl as adjuvant therapy on inflammatory factors and biochemical indexes in children with serious hand-foot-mouth disease with mechanical ventilation .Methods One hundred and thirty children with serious hand-foot-mouth disease treated with mechanical ventilation were selected at Maternal and Child Health Care Hospital from January 2010 to January 2014 . The patients were divided into two groups according to the treatment regimen :58 cases treated with midazolam for sedation and analgesia as control group and 72 cases treated with midazolam combined with fentanyl as observation group . Inflammatory factors (interleukin-6 , interferon-γ ,high-sensitivity C-reactive protein and tumor necrosis factor-α) and biochemical indices (albumin ,alanine transaminase [ALT] ,aspartate transaminase [AST] ,alkaline phosphatase ,glutamate transpeptidase [γ-GT] and fasting blood glucose) before drug exposure and on withdrawal were compared between two groups .Adverse reactions were analyzed in the two groups .Continuous variables were compared using two-sample t-test , while categorical variables were compared using chi-square test . Results Interleukin-6 ,interferon-γ, high sensitive C reactive protein and tumor necrosis factor-α on withdrawal decreased significantly in both groups than those before drug exposure (all P< 0 .05) .All observation indices on drug withdrawal in observation group were significantly lower than control group (all P< 0 .05) .Levels of albumin ,ALT ,AST ,alkaline phosphatase and γ-GT were not significantly different between two time points in both groups (all P>0 .05) .However ,in observation group ,fasting blood glucose level decreased significantly on drug withdrawal compared with that before drug exposure ([5 .17 ± 0 .28] vs [10 .31 ± 1 .39] mmol/L ,t=46 .237 ,P=0 .000) ,and that was also lower than control group ([5 .17 ± 0 .28] vs [5 .85 ± 0 .34] mmol/L ,t=4 .372 ,P=0 .000) .Incidence of adverse reactions in observation group was significantly lower than control group (15 .3% vs 32 .8% ,χ2=4 .707 ,P=0 .030) . Conclusions Midazolam combined with fentanyl as adjuvant therapy is helpful to improve blood glucose , stabilize biochemical indices and reduce inflammation factor secretions in children with serious hand-foot-mouth disease with mechanical ventilation .This therapy is safe and worthy of clinical use .