Age-related white matter changes are common in the elderly and are considered as manifestation of arteriolosclerotic small vessel disease. Most recent studies have shown that the white matter changes are associated with cognitive impairment and dementia, urinary incontinence, gait disturbances, depression and increased risk of stroke and death. Although the clinical phenotypes of the white matter changes have been extensively studied, to date, only few clinical trials have been conducted in this area. In this review, we discussed the current understanding in the epidemiology, pathogenesis, imaging features, chemical biomarkers, clinical importance, and management of age-related white matter changes, with special emphasis in studies that were conducted among Asians.

Objective: To prepare betahistine dihydrochloride sustained-release matrix tablets. Methods: The tablets were pre-pared with water soluble HPMC matrix, and the release behaviors were investigated by single factor study. The formula and preparation procedures were optimized by orthogonal design. Results:The optimal technology was as follows:using 60% HPMC K15M as the ma-trix material, calcium hydrogen phosphate as the filler, 10% PVP in 90% alcohol as the bonding agent;wet granulation compression technique was used to prepare the tablets with the tablet weight of 500mg. The in vitro drug release fits a Higuchi equation and the drug can be sustained-released within 12 h. Conclusion:The preparation technology is simple and the tablets have sustainol release behav-ior.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.

Objective To research the expression of mitofusin-2 (mfn2) and tumor metastasis suppressor genes (nm23)in bladder cancer cells and its correlation with clinical pathological feature. Methods Immunohistochemistry was used to measure the expression of mfn2 and nm23.Sixty-five cases of bladder cancer were sampled,which include fif-ty cases of male and fifteen cases of female. TNM stage:Forty-seven cases were in stage I;Ten cases were in stage II; Five cases were in stageⅢ; Three cases were in stageⅣ. Other fifteen cases were sampled from normal bladder or benign tumor of bladder as control . All cases were collected from department of pathology,affiliated Hospital of hebei union university. Results The positive expression rate of mfn2 in bladder cancer tissues was significantly higher than those in normal blad-der tissues and benign tumor of bladder(χ2=32.528,P<0.05);The positive expression rate of nm23 in bladder cancer tis-sues was significantly lower than those in normal bladder tissues and benign tumor of bladder (χ2=19.719,P<0.05);the high expression level of mfn2 in bladder cancer was associated with tumor differentiation and TNM stage(P<0.05),but not corre-lated with age,sex,lymph node metastasis and clinical grade. The low level of nm23 was associated with TNM stage,clinical grade and LN metastasis. Conclusion The positive expression rate of mfn2 was increased in bladder cancer. It indicated that there was a close relationship between mfn2 and the occurrence and development of bladder cancer;The expression rate of nm23 was decreased in bladder cancer,it may be a predictor for metastasis and prognosis of bladder cancer.

Humans ; Muscular Dystrophy, Duchenne ; Research ; trends

Objective To analyze the distribution and antimicrobial resistance of pathogenic strains in wound infec-tion,and provide scientific evidence for rational use of antimicrobial agents in treatment of wound infection as well as reducing the emergence of drug-resistant organisms.Methods Data about pathogenic strains isolated from wound specimens of patients with wound infection in a hospital between June 2011 and April 2014 were analyzed retrospectively.Results A total of 965 pathogenic strains were isolated from wound specimens,the main infection sites were limbs(50.47%);infected patients mainly distributed in department of orthopaedic surgery(44.97%);trauma and incisional wound infection were the major infection types(47.98%,36.48%,respectively).Among iso-lated pathogens,gram-positive bacteria,gram-negative bacteria,and fungi accounted for 37.20%,59.59%,and 3.21 % respectively.The main gram-positive bacteria were highly susceptible to vancomycin,teicoplanin,and linezolid,the main gram-negative bacteria were highly resistant to most commonly used antimicrobial agents except cefoperazone/sulbactam,piperacillin/ tazobactam,imipenem,and meropenem.Conclusion Patients with wound infection are mainly distributed in department of orthopedics,the main infection types are trauma and surgical site infection,antimicrobial resistant rates of the major gram-positive and gram-negative bacteria are both high.Sur-geons,especially orthopedics surgeons,should pay attention to the culture of pathogens and monitoring of antimi-crobial susceptibility,use antimicrobial agents rationally,and strengthen the prevention and control of surgical site infection,so as to reduce the infection incidence and occurrence of drug-resistant organisms.

Objective To investigate the clinical efficacy of vertebral pedicle screw fixation for lumbar fractures without nerve injury. Methods A total of 100 patients with vertebral fractures from February 2012 to December 2012 in our hospital were researched.According to the order of the patient admitted to the hospital,50 patients from February 2012 to June 2012 were divided into observation group,50 pa-tients from 2012 July to December 2012 were divided into control group.The observation group were treated with vertebral pedicle screw fixa-tion,the control group were treated with a four nail fixation.The therapy and complications between two groups were compared after treatment, and the satisfaction of two groups were investigated.Results There was no significant difference in vertebral anterior height compression rate and Cobb angle between two groups before treatment(t =0.356 9,t =0.633 6,P =0.721 9,P =0.527 8),but after a week of treatment,ver-tebral anterior height compression rate and Cobb angle in observation group was better than those of the control group,the difference was sta-tistically significant(t =2.705 7,t =2.840 2,P =0.008 0,P =0.005 5).After one-year follow-up,there was no significant difference in effi-cacy between two groups(t =0.914 7,t =0.464 6,P =0.362 6,P =0.643 2).The postoperative complication rate of observation group was 4%,compared with 16% of control group,the difference was statistically significant (χ2 =4.000 0,P =0.045 5).The satisfaction rate of patient in observation group was 96%,compared with 84%of the control group,the difference was statistically significant (u =2.477 9,P =0.013 2). The fracturesof patients in two groups after 12 months were cured,without aggravating circumstances in nerve damage .Conclusion The ver-tebral pedicle screw fixation can effectively correct angular deformity,restore vertebral body height,strengthen the stability of the spine for treatment of patients with lumbar vertebrae without nerve injury.

Objective To analyze the relationship among serum hepatitis B virus (HBV ) envelope large protein (HBV‐LP ) , HBV‐DNA and HBV marker(HBV‐M ) for investigating the clinical significance of HBV‐LP to reflect the HBV in vivo replication in the patients with HBV infection .Methods Total 540 cases of chronic HBV infection treated in the Longgang District Hospital of Traditional Chinese Medicine from April 2013 to September 2015 were selected .The real‐time fluorescence quantitative PCR meth‐od was used to detect serum HBV‐DNA ,HBV‐LP and HBV‐M were detected by the enzyme linked immunosorbent assay (ELISA) . The correlation among HBV‐LP ,HBV‐M and HBV‐DNA were analyzed .Results The positive rate of HBV‐LP in HBeAg‐positive patients was 96 .39% ,and which of HBV‐DNA was 93 .33% ,there was no statistically significant difference between them (P>0 .05);The serum HBV‐LP level was positively related with the logarithmic value of HBV‐DNA copies ;the positive rate of HBV‐LP in HBeAg‐negative patients was 63 .33% ,and which of HBV‐DNA was 51 .11% ,the difference between them was statistically significant(P<0 .05) .Conclusion HBV‐LP can effectively reflect the HBV in vivo replication in the patients with chronic hepatitis B and its sensitivity is higher than that of HBeAg ,HBV‐LP can even more reflect the HBV in vivo replication status in patients with HBeAg‐negative chronic hepatitis B .

Objective To analyze risk factors of multiple drug-resistant infections in neonatal intensive care unit (NICU). Methods The clinical data from 284 hospitalized pediatric patients were retrospectively analyzed from June 2011 to July 2015 . The differences between 59 cases with multiple drug-resistant infections and 225 cases with non-multiple drug-resistant infections were compared and analyzed by logistic regression. Results All of 284 cases were single birth. Fifty-nine cases ( 13 . 13 ± 9 . 03 days old) had multiple drug-resistant infections, in which 42 were males and 17 were females. Two hundred and twenty-ifve cases ( 14 . 21 ± 8 . 34 days old) had non-multiple drug-resistant infections, in which 175 cases of males and 50 cases of females. Single factor analysis showed that 8 factors, including gestational age, birth weight, days in hospital, Apgar score at birth, mechanical ventilation, parenteral nutrition, and the categories and duration of use of antimicrobial agents, were the risk factors of multiple drug-resistant infections (P?