Objective To investigate the effects of panax notoginseng saponins(PNS) on the expression of IL-10 and TNF-α in the brain after focal cerebral ischemia-reperfusion injury in rats,and the mechanism was explored.Methods 30 male adult Sprague-Dawley rats were randomly divided into sham-operation group,ischemia-reperfusion group and PNS treatment group,10 rats in each group.The middle cerebral artery occlusion(MCAO) was established with ischemia-reperfusion group.The rats received continuous gastric lavage for 4 weeks,who were observed for 3 days and then killed to the detect the expression of IL-10 and TNF-αin ischemic region by ELISA,immunohistochemistry and RT-PCR.The behavioral ability score in rats were tested.Results Compared with the sham-operation group and ischemia-reperfusion group,the expression of IL-10 was increased,while the expression of TNF-α was decreased significantly in PNS treatment group,behavior score of PNS treatment group increased significantly than that of ischemia-reperfusion group.Conclusion The panax notoginseng saponins can reduce the neurons injury after focal cerebral ischemia-reperfusion injury in rats partly by regulating the expression of IL-10 and TNF-α in the brain.

Objective:To discuss the performance management method for large medical equipments in hospitals.Methods:13 large medical equipments in a large hospital were selected as samples and the economic efficiency analysis method and comprehensive evaluation method were aaplied to carry out performance management of medical equipment.Results:11 sets of medical equipment had good economic returns,the remaining 2 sets of equipments had a greater degree of loss due to lack of business and lack of qualification.Conclusion:Performance management of large medical equipments would help change the efficiency management of equipment from extensive to elaborate management.

Objective To analyze the characteristics of ocular symptoms of Sjgren syndrome and to examine the relation between signs and symptoms.Design Prospective case series.Participants 36 patients with Sjgren syndrome diagnosed by rheumatisms.Methods A self-designed questionnaire was used to investigate 4 symptoms of patients including dryness,grittiness,soreness or irritation,burning or watering.A series of clinic tests were completed as follows:break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.The positive rate of such symptoms was calculated.The consistency of the symptoms and signs were compared.Main Outcome Measures Break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.Results Patients with Sjgren syndrome were marked by ocular symptoms.There were efficient statistically significant correlations between grittiness and fluorescein corneal staining,lissamine green conjunctival staining,break-up time(P

Objective To evaluate the effect of linoleic acid on lipopolysaccharide (LPS)-induced release of inflammatory factors in the macrophages of mice.Methods The peritoneal macrophages obtained from C57BL/C mice were seeded in 24-well plates at a density of 4× 105 cells/well and in 6-well plates at a density of 2× 106cells/well.The cells were incubated and attached to the wall overnight in a 5％ CO2 incubator in humidity at 37 ℃.The experiment was performed in 2 parts.Part Ⅰ The cells in 24-well plates were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C);LPS group;3 different concentrations of linoleic acid groups (LA1-3 groups).The sterile anhydrous alcohol 1 μl was added in group LPS,0.1,0.5 and 1.0 mol/ml linoleic acid 1 μl were added in LA1-3 groups,respectively,and 30 min later 100 μg/ml LPS 1 μ,l was added in LPS and LA1-3 groups.The culture medium was collected at 6 h after LPS administration to measure the concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in the supernatant by enzyme-linked immunosorbent assay.PartⅡ The cells in 6-well plates were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C);LPS group;0.5 mol/ml linoleic acid group (group LA).The sterile anhydrous alcohol 1 μl was added in group LPS,0.5 mol/ml linoleic acid 1 μl was added in group LA,and 30 min later 100 μg/ml LPS 1 μl was added in LPS and LA groups.At 1 h after administration of LPS,the expression of Toll-like receptor 4 (TLR4) was determined by flow cytometry,and the expression of phosphorylated nuclear factor kappa B (NF-κB) p65 (p-NF-κB p65),phosphorylated extracellular signal-regulated protein kinase (p-ERK) and phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) was determined by Western blot.Results Part Ⅰ Compared with group C,TNF-α and IL-6 concentrations in the supernatant were significantly increased in LPS and LA1 3 groups (P ＜ 0.05).Compared with group LPS,TNF-α and IL-6 concentrations in the supernatant were significantly decreased in LA1 3 groups (P＜0.05).Compared with group LA1,TNF-α and IL-6 concentrations in the supernatant were significantly decreased in LA2 and LA3 groups (P＜0.05).Compared with group LA2,TNF-α and IL-6 concentrations in the supernatant were significantly decreased in group LA3 (P ＜ 0.05).Part Ⅱ Compared with group C,the expression of TLR4,p-NF-κB p65,p-ERK and p-p38 MAPK in macrophages was significantly up-regulated in LPS and LA groups (P＜0.05).Compared with group LPS,the expression of TLR4,p-NF-κB p65,p-ERK and p-p38 MAPK in macrophages was significantly down-regulated in group LA (P＜0.05).Conclusion Linoleic acid can inhibit LPS-induced release of inflammatory factors in the macrophages of mice,and the mechanism may be related to the inhibition of TLR4 signaling pathway activation.

BACKGROUND:The correct method selected according to the specific type and characteristics of lumbar disc herniation can achieve satisfactory effect, but in clinic, there stil some patients have recurrence symptoms after treatment. OBJECTIVE:To investigate the recurrence factors of spinal implant internal fixation for the treatment of lumbar disc herniation, as wel as the intervention measures. METHODS:Fifty-two patients with recurrence symptoms of lumbar disc herniation after internal fixation from January 2002 to December 2007 in the Department of Orthopedics, the 306th Hospital of PLA were retrospectively analyzed, including 28 male cases and 24 female cases, the average age was 43.2 years, ranged from 25-52 years. The time form first internal fixation to the recurrence was 3-192 months, average 38 months. The patients had the symptoms of lumbar and bilateral/unilateral leg pain and numbness. Al the patients underwent the anteroposterior radiographs of lumbar spine and the hyperextension and flexion lateral X-ray films to evaluate the stability of the lumbar spine. Lumbar magnetic resonance imaging was used to observe the intervertebral disc situation of the segment treated with lumbar internal fixation as wel as the spinal stenosis and disc degeneration. RESUTLS AND CONCLUSION:Among the 52 patients, 22 cases had recurrence lumbar disc herniation on the same segment after first internal fixation;four cases had recurrence symptoms caused by the spondylodiscitis after implant internal fixation;five cases had scar adhesions caused nerve compression on the site treated with internal fixation;10 cases had the symptoms of lateral recess and nerve root canal stenosis on the site treated with internal fixation;11 cases had recurrence symptoms caused by lumbar instability after internal fixation. It has reality clinical significance to analyze the reasons of recurrence of lumbar disc herniation after internal fixation

Objective To analyse distribution and antibacterial resistance status of pathogenic bacteria isolated from blood cul‐tures of hospitalized infants ,in order to provide references for rational use of antimicrobial agents in the treatment of bloodstream infection .Methods A total of 299 strains of pathogenic bacteria isolated from positive blood culture specimens from infants(3 or less than 3 months of age) suspected with bloodstream infections in this hospital from January 2011 to May 2015 were collected ,the bacteria identification and drug sensitivity test were carried out by using the VITEK 2 Compact automatic microorganism analyzer . The composition and antibacterial resistance of these isolates were analyzed .Results Among the 299 strains of pathogenic bacteria , there were 169 strains of gram‐positive cocci(accounted for 56 .5% ) ,including 95 strains of coagulase negative Staphylococcus (ac‐counted for 31 .8% ) which was the main isolates ,and followed by 28 strains of Staphylococcus aureus(accounted for 9 .4% );there were 120 strains of gram‐negative bacilli (accounted for 40 .1% ) and mainly were Escherichia coli (53 strains ,accounted for 17 .7% );otherwise ,there were 8 strains of fungi (accounted for 2 .7% ) and 2 strains of gram‐positive bacillus (accounted for 0 .7% ) .The results of drug susceptibility test indicated that the gram‐positive cocci had multiple drug resistance to antibacterial a‐gents except for vancomycin and linezolid;the gram‐negative bacilli shown multiple drug resistance except for amikacin ,imipenem and meropenem .The fungus ,however ,displayed high sensitivty to all antifungal drugs .Conclusion Gram‐positive and gram‐nega‐tive bacteria are the main pathogens of hospitalized infants with bloodstream infection ,and are severely resistant to antibacterial a‐gents .Rational use of antimicrobial agents should be recommend for improving clinical efficacy and prohibiting the emergence of drug‐resistant strains .

Objective To explore the effects and safety of bevacizumab monotherapy on radiationinduced brain necrosis in patients with head and neck cancer.Methods Twenty-three patients with radiation-induced brain necrosis received intravenous injection of bevacizumab 5 mg/kg every 2 weeks for 4 cycles.Before and 2 weeks after the treatment LENT/SOMA scoring system,Montreal Cognitive Assessment (MoCA),and MRI were used to evaluate the scores of subjective and objective items,cognitive scores,and the extent of edema.Adverse effects were observed.Results Two patients suffered from grade 2 rhinorrhagia after the first dose and had to give up the therapy.Twenty-one patients received the full dose of bevacizumab and showed improvement in clinical signs and symptoms.The MoCA score after treatment was significantly higher than that before treatment (t =3.166,P ＜ 0.05).MRI T2-weighted image showed that the volume of brain edema was decreased by (53.9 ± 22.13)％ on average (Z =-5.645,P ＜0.05).One patient showed mild exacerbation of the extent of focus on MRI after the second cycle therapy but still showed significant improvement at the end of four cycles.Of the 21 cases that successfully finished the whole treatment,one suffered from grade 2 rash and one had mild intracranial hemorrhage,however,no grade 3 to 5 adverse reactions were observed.Conclusions Bevacizumab monotherapy may have a rapid and safe therapeutic effect on radiation necrosis.

BACKGROUND: Coronary artery disease (CAD) risk in type Ⅱ diabetics is one of the hot topics in clinical research.OBJECTIVE: By using electron-beam tomography(EBT) technology, heart scans were performed to investigate coronary artery lesion in type Ⅱ diabetics and their CAD risks were evaluated as well.DESIGN: Comparative study based on type Ⅱ diabetics complicated with coronary artery lesion.SETTING: Gerontology department in a hospital affiliated to a military medical university of Chinese PLA.PARTICIPANTS: From January 2002 to June 2004, 93 inpatients between the ages of 36 and 78 in the Gerontology Department of Xijing Hospital, an affiliation to the Fourth Military Medical University of Chinese PLA, were selected(male 80, female 13) . Totally 25 of all the patients proved normal by physical examinations were set as normal control(male 22, female 3) group; other inpatients were divided into the abnormal blood glucose group and the coronary heart disease (CHD) group respectively according to their examination results. Of the 57 patients in the abnormal blood glucose group,49 were male and 8 were female. This group was divided into two subgroups:the impaired glucose tolerance group(IGT) containing 29 patients and the diabetes group containing 28 patients. In this group, 44 patients have had heart symptom of different extent. Of the 11 patients in the CHD group, 9 were male and 2 were female. Inclusion criteria: patients with type Ⅱ diabetes were defined by American Diabetes Association in 1979; patients with CHD were defined in the report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on the standardization of clinical nomenclature and criteria for diagnosis of ischemic heart disease in 1979, and they were all confirmed by coronary angiography. Exclusion criteeases.METHODS: Both plain EBT heart scanning and contrast-enhanced heart scanning were performed on the 93 patients to evaluate the occurrence of coronary artery calcification(CAC), the number of stenosed coronary arterie,and the number of soft plaques. Additionally, other examination results including blood glucose, blood HbA1c and blood lipid were also collected for comparison between the conditions of coronary artery and assessment of the CHD risk among groups.MAIN OUTCOME MEASUREMENTS: In all the groups, the occurrence of CAC, the number of stenosed coronary arteries and the number of plaques were compared, and the CHD risk was analyzed.RESULTS: The occurrence of coronary artery calcification was significantly increased in all the study groups as compared with the control group(x2 = 18.88, P < 0. 01 ). Increasing trend was also observed in the study groups when calculating the number of branches with coronary stenosis and plaques ( F = 10. 758, P < 0. 01; F = 9. 991, P < 0.01 ). CHD risk in diabetes was estimated to be 7. 514 (95% confidence interval, 1. 885 -63. 778).CONCLUSION: Coronary artery lesion can be easily observed in type Ⅱ diabetics,and high CHD risk is predicted in this population. Early diagnosis of CAD and early rehabilitation intervention in grade 2 are extremely important in improving the quality of life and reducing the disability ratio of type Ⅱ diabetics.Huang C, Gao JY, Wong XM, Li R, Yang AL, Zheng MW, Xue FB. Risk analysis of coronary artery disease in type Ⅱ diabetics.

Objective:To compare the applicability and consistency of NRS2002,SGA and MNA in general surgery hospitalized patients and analyze the effect in clinical outcomes of NRS resuits with respect to each tool.Method:The 150 patients hospitalized in our hospital were chosen as object of study,to screen and evaluate nutritional risk of patients by NRS 2002,SGA and MNA,respectively,on the second hospital day,then to compare the consistency of NRS results with respect to the four tools on clinical outcomes.Results:The applicabilities of hospital NRS2002,SGA and MNA were alternatively 97.25,97.25％ and 98.35％.The evaluation of patients' NRS corresponding to different four tools was consistent.The effects of screening results of MNA,NRS2002 and SGA on clinical outcomes were most closely related.Conclusion:The three nutritional evaluation tools can be applied to the screening of malnutrition in General Surgery.The effects of screening results of NRS2002 and SGA on clinical outcomes were most closely related.

Objective To investigate the prognostic value of prognostic nutritional index (PNI) in patients with non-small cell lung cancer.Methods A total of 179 patients with non small cell lung cancer was enrolled in our hospital from November 2010 to January 2014.All patients were pathologically confirmed to be non small cell lung cancer.The clinical data of patients were collected,and the PNI values of each patient were calculated.The patients were divided into 4 groups according to the patients in the PNI of the patients in the treatment group (PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group).The survival curve was drawn by Kaplan-Meier method,and the difference of progression free survival (DFS) and overall survival (OS) of each group was compared by Log-rank method.Results (1) compared with PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group,there was signifi cant difference in age,smoking and KPS score (P ＜ 0.05).(2) the PNIQ0-25 group had a median overall survival of 11.5 months (95％ CI:6.6 ～ 15.4),the 3 year survival rate was 6.7％;PNIQ25-50 group had a median overall survival of 12.2 months (95％ CI:9.1 ～ 18),the 3 year survival rate was 6.4％ in PNIQ50-75 group;the median overall survival was 14.1 the month of (95％ CI:8.7 ～ 13.3),the 3 year survival rate was 11.4％,the PNIQ75-100 group had a median overall survival of 15 months (95％ CI:12.3 ～ 17.8),the 3 year survival rate was 11.6％.The Log-rank test,the four groups of patients with a significant difference in overall survival (x2 =15.6,P =0.001).(3) the PNIQ0-25 group had a median progres sion free survival was 5 months for (95％ CI:4.3 ～5.6),the 3 year progression free survival rate was 4.4％;PNIQ25-50 group had a median progression free survival was 6.4 months for (95％ CI:4.7 ～8.1),the 3 year progression free survival rate was 4.3％ in the PNIQ50-75 group;the median progression free survival was 7.4 months (95％ CI:6 ～ 8.7),the 3 year progression free survival rate was 9.1％ in PNIQ75-100 group,the median progression free survival was 8.9 months for (95％ CI:6.4 ～ 10.8),the 3 year progression free survival rate was 9.3％ by Log-rank test,survival was statistically significant was no difference between the four groups (x2 =26.7,P =0.000).Conclusions PNI has a good application value in the prognosis of patients with non-small cell lung cancer.