Cerebral small vessel disease (SVD) is an important subtype of cerebrovascular disease. It is also one of the major reasons for resulting in vascular cognitive impairment or dementia in the elderly. SVD is a small arteriovenous lesion in subcortex caused by a variety of causes, mainly causing subcortical lacunar infarction, white matter damage, microblecds and other pathological changes. There is evidence that vascular endothelial function and blood-brain barrier damage may result in small vessel structures and perivascular changes, which may be the initial factors.of causing SVD. Genetic susceptibility is also one of the risk factors that can not be ignored.

Objective To construct a set of evaluation index system for medical research project,to make the work justice and fairness,to manage the research work scientificly and standardized,to promote scientific research and hospital development closely,so as to better serve the society.Methods Based on the literature review,semi structure interview method and current medical research project evaluation index system and related management methods,a preliminary index system was formed.Using the Delphi method to carry out two rounds anonymous questionnaire consulting,the medical research project acceptance evaluation index system was finalized.Results The evaluation index system of medical research projects includes 5 first-level indexes and 21 second-level indexes.Ranking from high to low is based on the weight coefficient of the size.Conclusions Through the establishment of the index system of medical scientific research projects,the project acceptance management work has become scientifically planned,which guide scientific research project productive and improving the scientific management level and technological innovation ability.

Based on the background of knowledge economy,factors which have affected the social status of a person can be divided into five levels: physical fitness,technical ability,mental capacity,potential energy and recombination energy.This article analyzes the educational style of medical students by using five-level-ability model which judges a person from the economic angle.It aims at providing constructive opinions on innovation,enhancement and improvement of modern medical education.

Objective To investigate the application value of the XT-4000i blood cell analyzer in body fluid cell count.Methods 113 cases of body fluid specimen were collected in the hospitalized patients from September 2013 to February 2014.Then RBC and WBC counts in the collected specimens were detected whitin 1 h by XT-4000i blood cell analyzer and the manual detection method, the RBC count values were divided into 3 levels:L1 100~1 000 ×106/L,L2 1 001 ×106 ~100 000 ×106/L and L3 > 100 000 × 106/L;WBC count values were divided into 2 levels:L1 1~50×106/L and L2 >50×106/L.The correlation between the two kinds of test methods was analyzed.Results The results of RBC and WBC counts detected by the XT-4000i blood cell analyzer and the manual method had a higher correlation.The correlation coefficients were 0.931,0.996,0.865,0.942 and 0.988.Conclusion The XT-4000i blood cell analyzer can be applied in clinical fluids cell count.

Objective To observe the characteristics of electromyography of sphincter of Oddi (SO) in patients with cholelithiasis after common bile duct exploration,and investigate new methods for detecting the motility of SO.Methods The basal pressure of SO(SOBP)and electromyography of SO were detected in 33 patients with cholelithiasis who were reexamined at the Southwest Hospital from January to October,2010.All patients were divided into low SOBP group,normal SOBP group and high SOBP group.The amplitude,frequency and duration of SO spike burst(SOSB)of the three groups were compared.Results The numbers of patients in the low SOBP group,normal SOBP group and high SOBP group were 14,13 and 6,respectively.The mean SOBP of the low SOBP group,normal SOBP group and high SOBP group were(3.1±1.2),(18.5±7.6),(39.8±4.8)mm Hg (1 mm Hg=0.133 kPa).The amplitude,frequency and duration of SOSB were(41±27)μV,(5.8±1.6) times/minutes and(2.7±0.6)s in the low SOBP group,and(150±71)μV,(6.9±1.4)times/minutes and (3.4±0.7)s in the normal SOBP group,and(301±109)μV,(7.8±1.2)times/minutes and(4.2±0.7)s in the high SOBP group,respectively,with significant difference among the three groups(F=50.751,4.293,13.159,P<0.05).Conclusion The results of electromyography of SO could reflect the function of SO,and it is possible to be a prospective method in the clinical research of SO.

Objective To investigate the changes of serum bilirubin level in elderly patients with acute cerebral infarction and its significance.Methods 164 hospitalized elderly patients,who suffered from acute cerebral infarction within 1 week after onset,were divided into 2 groups according to age:group A aged over 60 years(n=85) and group B aged 40-60 years(n=79),and 66 healthy subjects aged over 40 years were collected as controls(group C).Serum bilirubin levels in all subjects were determined.The ratio of pulse pressure over mean arterial pressure(PP/MAP) in group A and B was calculated.Nerve function scores in the three groups were detected before and after 2 weeks of treatment.Meanwhile,the data of risk factors including blood glucose,blood pressure,blood lipids,smoking and drinking in group A and B were collected.Results Compared with group C,serum total,direct,indirect bilirubin levels were increased in group A and B(both P＜0.01),and the change was smaller in group A than in group B(P＜0.05).The nerve function scores was lower in group A than in group B before and after treatment [(35.2±12.6) vs.(44.3±7.9),(40.7±9.1) vs.(51.3± 4.1),t=5.58,9.73,both P＜0.01],but PP/MAP and the numbers of risk factors were higher in group A than in group B [(0.46±0.06) vs.(0.38±0.06),93.01 vs.71.20,both P＜0.01].There were no significant correlations of serum total,direct and indirect bilirubin levels with nerve function scores in group A or B(all P＞0.05).Conclusions Serum bilirubin level is increased in patients with acute cerebral infarction,but the endogenous antioxidant capacity is decreased because of aging,multiple risk factors and more serious atherosclerosis in elderly patients,and the increment of bilirubin level is relatively smaller in acute cerebral ischemia,leading to the reduced protective effect against stress.Serum bilirubin level may influence the prognosis in patients with acute cerebral infarction.

To explore the protective effect of adenovirus mediated IGF-Ⅰgene(Ad-IGF-Ⅰ)transfer on non-obese diabetic(NOD)mice. The results showed that the incidence of diabetes and degree of insulitis were significantly reduced in mice receiving Ad-IGF- Ⅰ . Treatment with Ad-IGF- Ⅰ significantly decreased apoptosis rate,expression of Fas and caspase-3, and increased expression of Bcl-xl. This study indicates the potential of IGF- Ⅰ gene therapy in protecting NOD mice from insulitis and apoptosis.

Objective To discuss the features of nosocomial infection in patients with multiple trauma in intensive care unit and the preventive measures. Method The nosocomial infections occurred in 137 patients with multiple trauma were analyzed including site of infection, pathogenic organisms and bacterial strains. Results The rate of nosocomial infection was 62.8%, mainly the lower respiratory tract infection and wound infection, the G-negative bacteria infection accounted for 67.8%, mostly Escherichia Coli, Pseudomonas aeruginosa and A cinctobacter baumanni I. The G-positive bacteria infection accounted for 32.2%, mainly Staphylococcus aureus and Coagulase negative staphylococcus. The positive detection rates of Klebsiella and pseudomonas aeruginosa were increasing year afer year. Conclusions The incidence of nosocomial infection in patients with multiple trauma is high, suggesting some appropriate preventive measures should be taken to reduce the rate of infection.

BACKGROUND: Few reports concern the effects of dendritic cells-a kind of antigen presenting cells, and interleukin-10 (IL-10) on airway hyperreactivity or inflammation. OBJECTIVE: To construct mice IL-10 recombinant adenovirus vector Ad-mIL-10 to acquire the dendritic cells modified by mIL-10, which can provide a foundation for the further study. METHODS: Mouse IL-10 (mIL-10) gene comprise of enzyme cutting spot was synthesized according to the mIL-10 gene sequence and multiclone spot of adenovirus vector, connected to pMD18-T vector and sequenced. MIL-10 was subcloned to BD Adeno-X~(TM) vector, packed and augmented in HEK 293 cells, following determine the protein expression, and the vector was transfected to mice bone marrow-derived dendritic cells. RESULTS AND CONCLUSION: Recombinant adenovirus vector Ad-mIL-10 was successfully synthesized, packed and augmented, which could highly express protein IL-10. Bone marrow-derived dendritic cells were successfully cultured and transduced in vitro. It suggested that it is feasible to transfect mice dendritic cells by Ad-mIL-10 adenovirus vector. The study can provide more sufficient theoretic evidence for the possibility of correlative gene therapy.

Objective To evaluate the role of phosphatase and tensin homolog deleted on ehromo-some ten (PTEN) protein in sevoflurane postconditioning-induced mitigation of focal cerebral ischemia-reperfusion (I/R) injury via activating PI3K/Akt pathway in rats.Methods One hundred and eight Sprague-Dawley rats,aged 2-3 months,weighing 250-280 g,were randomly assigned into 6 groups (n =18 each) using a random number table:sham operation group (group S),group I/R,I/R + sevoflurane postconditioning group (group I/R + S),I/R + normal saline group (group I/R + NS),I/R + selective PTEN inhibitor pic group (group I/R + P),and I/R + pic + sevofluraue postconditioning group (group I/R + P+ S).Focal cerebral I/R was induced by right middle cerebral artery occlusion (MCAO).The animals were anesthetized with intraperitoneal chloral hydrate.In I/R + P and I/R + P + S group,pic 20 μg/100 g (0.4 ml/100 g) was injected intraperitoneally every 3 h for 4 times before MCAO,and the equal volume of normal saline was given instead of pic in I/R + NS group.The rats in all sevoflurane postconditioning groups inhaled 2.5 ％ sevoflurane for 30 min starting from the onset of reperfusion,and the rats in the other groups inhaled oxygen for 30 min instead.At 24 h of reperfusion,neurological deficit scores (NDSs) were measured and the rats were then sacrificed.Their brains were removed for determination of infarct size (by TTC),cell apoptosis (by TUNEL),and expression of phosphorylated PTEN (p-PTEN) protein and phosphorylated Akt (p-Akt) (by Western blot).Apoptosis index was calculated.Results Compared with S group,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly increased,and the expression of p-Akt and p-PTEN protein was up-regulated in the other 5 groups.Compared with I/R and I/R + NS groups,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly decreased,and the expression of p-Akt and p-PTEN protein was up-regulated in I/R + S,I/R + P and I/R + P + S groups.There were no significant changes in the parameters mentioned above between I/R + S,I/R + P and I/R + P + S groups,and between I/R and I/R + NS groups.Conclusion Sevoflurane postconditioning can activate PI3K/Akt pathway via inhibiting PTEN protein,thus mitigating focal cerebral I/R injury in rats.