n The intra-arterial thrembolysis could improved the prognosis of basilar artery occlusion.

Objective To understand the distribution situation of respiratory viral infection among adult inpatients with respiratory infection in the emergency department.Methods The detection results data of 5 kinds of viruses RSV,IVA,IVB,PIV1,PIV2,PIV3 and ADV by indirect immune fluorescence assay in 384 adults patients with respiratory infection in the emergency department of our hospital from January 2014 to December 2015 were collected.The epidemic characteristics of different viruses were analyzed.Results Among 384 specimens,208 cases were positive in respiratory virus IgM antibody,the viral infection positive rate was 54.17%.The mixed virus infection and influenza B virus infection were most common,their viral positive rates were 26.56% and 23.44% respectively,In the mixed viral infection,the positive rate of IVA + IVB mixed infection was highest,accounting for 87.25%,which was higher than that of other kinds of mixed viral infection.The viral infection positive rate had no statistical difference between different genders(P>0.05).The viral infection rate was higher in autumn and winter,which were 66.06% and 68.37% respectively and higher than 42.31% and 34.25% in spring and summer,the difference was statistically significant(P<0.05).The viral infection rates of youth (18-45 years old) and middle-aged (>45-60 years old) were 64.94% and 63.86% respectively,which were higher than 48.45%,44.92% and 55.56% in pre-elderly (>60-75 years old),elderly (>75-90 years old) and longevous elderly (>90 years old),the differences were statistically significant(P<0.05).Conclusion The respiratory virus mixed infection and IVB infection are most common in the emergency wards,moreover the viral infection situation shows the seasonal and age characteristics,but which is not affected by sex factor.

Objective To explore the optimal timing of liver transplantation for acute liver failure,and analyze relative risk factors affecting patients' prognosis.Methods We retrospectively analyze perioperative clinical data of 50 patients suffering from acute liver failure who underwent liver transplantation between March 2005 and June 2010 in Organ Transplantation Center,the First Affiliated Hospital of Sun Yat-sen University.Patients were divided into survival group and death group.Clinical data before operation were collected and analyzed by univariate and multivariate analysis,respectively.Risk factors influencing the perioperative mortality were selected and were used to direct the operation time.Results There were 50 patients who underwent liver transplantation and 11 cases died during perioperative phase.Five patients died of respiratory infection,three of acute renal failure,one of digestive tract hemorrhage,one of primary allograft failure and one of multiple organ failure.The perioperative,one-year and three-year survival rate were 78％,74％ and 72％ respectively.In the univariate analysis,age,bilirubin level,prothrombin time,creatinine level,grade of encephalopathy and MELD score were found to be significantly different between survival group and death group.The multivariate analysis revealed that age≥65 y,INR ≥3.5,creatinine level ≥ 2.5 mg/dl and MELD score ≥ 40 were independent risk factors affecting survival.Conclusions Liver transplantation is an effective treatment of choice for acute liver failure.Appropriate timing of transplantation helps achieve a high survival rate.

Objective To evaluate the efficacy of high resolution MR T2WI combined with DWI in evaluation of pathological complete response after neoadjuvant therapy in rectal cancer.Methods Totally 364 patients with locally advanced rectal cancer who recieved neoadjuvant therapy and radical surgery,underwent MR scanning before and after neoadjuvant therapy,were enrolled in this study.The diagnostic efficacy of high resolution MR T2WI and high resolution MR T2WI combined with DWI in evaluation on pathological complete response after neoadjuvant therapy in rectal cancer were compared.Results Finally 49 cases were demonstrated pathologic complete response.Accuracy,sensitivity,specificity,positive predictive value and negative predictive value of high resolution MR T2WI and high resolution MR T2WI combined with DWI in predicting on pathological complete response after neoadjuvant therapy were 82.69％ (301/364),40.82％ (20/49),89.21％ (281/315),37.04％ (20/54),90.65％ (281/310)and 87.36％ (318/364),65.31％ (32/49),90.79％ (286/315),52.46％ (32/61),94.39％ (286/303),respectively.Sensitivity had statiatical significant difference between two methods (x2 =4.96,P=0.03).Conclusion Compared with high-resolution T2WI,the combination of DWI and high-resolution T2WI can improve the diagnostic efficacy in evaluation of pathologic complete response of locally advanced rectal cancer.

ObjectiveTo investigate the status of benefit finding in diabetic patients,and mediating effect of resilience between family support and benefit finding in diabetic patients.MethodsFive hundred and thirteen diabetic patients from a hospital of Harbin were recruited as investigative subjects from September 2015 to June 2016.The resilience scale,family adaptability,cohesion scale and benefit finding scale were used in the study.ResultsThe scores of benefit finding,resilience and family adaptability and cohesion were 55.67±12.87,70.65±10.39 and 104.25±15.38,separately.The total score of family adaptability and cohesion was positively related to the total score of benefit finding(r=0.389,P<0.05).The total score of resilience was positively related to the total score of benefit finding(r=0.155,P<0.05).The total score of family adaptability and cohesion was positively related to the total score of resilience(r=0.112,P<0.05).Benefit finding as the dependent variable,the results of hierarchical regression analysis indicated that family adaptability and cohesion (β=0.382,P<0.01),resilience(β=0.098,P<0.01)entered the regression equation.There was a partial mediating effect of resilience between family support and benefit finding in diabetic patients.The mediating effect was 0.011,accounted for 2.8% of the total effect.The resilience was the important protective factor for benefit finding.ConclusionFamily support has a direct influence on benefit finding and an indirect effect mediated by resilience on benefit finding.

Objective To elucidate the expression of gankyrin in human gastric cancer cells and it's role in nimesulide induced apoptosis. Methods Four human gastric cancer cell lines including MKN28 (well differentiated), AGS (poorly differentiated), MKN45 (poorly differentiated), and SGC7901(moderately differentiated) were cultured and treated with nimesulide. Nimesulide induced growth inhibition and apoptosis of the cells were detected by methyl thiazolyl tetrazolium assay, and confirmed by flow cytometry. The expressions of gankyrin gene and protein were further assessed by real-time PCR and Western blotting. Results Gankyrin mRNA and protein were detected in all four human gastric cancer cell lines. The proliferations of AGS and SGC7901 cell lines were significantly suppressed by nimesulide in a time-dose dependent manner. When treated with 400 μmol/L of nimesulide for 48 hours, the significant apoptosis was found in AGS cells (23.30%±2.50%) and SGC7901 cells (16.80%±1.55% ) in comparison with controls (0.57%±0.19% and 0.88%± 0.17%, respectively, all P values <0.01). Apoptosis of AGS cells induced by nimesulide was accompanied by a considerably decreased gankyrin expression that was more significant at 24 hours (0.0035±0.0014) and 36 hours (0.0980±0.0160) in comparison with controls (0.4690±0.1190, all P values<0.01). Conclusion Gankyrin expresses in human gastric cancer cell lines and may be involved in nimesulide induced apoptosis of AGS cells.

Objective To elucidate the effect of clavulanic acid (CLA) in suppressing the antibiotic resistance of Helicobacter pylori (Hp) to metronidazole (MZ) and its mechanism. Methods All Hp strains were isolated from biopsy specimens taken endoscopically and random amplified polymorphic DNA assay (RAPD) was used to certificate the distinct origin of these strains. The minimum inhibitory concentration (MIC) of CLA and MZ aganst Hp were determined by using agar dilution procedure and Epailometer test (E-test). The effect of CLA on the morphology of Hp was examined by transmission electron microscopy. Fluorescein-C6-aminopenicillanic acid (FLU-C6-APA) competition assay was used to detect the binding between CLA and penicillin-binding proteins (PBPs). Results Eleven strains were isolated. In vitro CLA could decrease the MIC of MZ resistant(1.442±0.459 vs 0.376±0.288, P=0.0077), but not affect the MIC for MZ sensitive strains significantly (P>0.05). Exposure to CLA resulted in morphological changes of Hp, including cell wall disintegration and cell lysis. Furthermore, CLA inhibited the binding of FLU-C6-APA to PBPs(30.5-33.5×103). Conclusions CLA suppresses the antibiotic resistance of Hp to MZ through its binding with PBPs which results in the morphology changes of Hp.

OBJECTIVE:To establish a method for the 5 main components (original syringin,chlorogenic acid,eleutheroside E,isofraxidin and quercetin-3-rhamnoside) in the fruits and roots of wild Acanthopanax senticosus. METHODS:UPLC was per-formed on the column of Waters ACQUITY UPLC HSS T3 with mobile phase of acetonitrile-0.3% phosphoric acid (gradient elu-tion)at a flow rate of 0.2 ml/min. Detection wavelength was 300 nm,column temperature was 30 ℃,and injection volume was 10μl. RESULTS:The linear range was 24.56-184.2 μg/ml for syringin(r=0.9993),18.454-138.405 μg/ml for chlorogenic acid(r=0.9993),8.416-63.12 μg/ml for eleutheroside E (r=0.9997),3.286-24.645 μg/ml for isofraxidin (r=0.9993) and 2.522-18.915μg/ml for quercetin-3-rhamnoside(r=0.9998);RSDs of precision,stability and reproducibility tests were lower than 1%;recover-ies were 99.14%-100.50%(RSD=0.48%,n=6)for syringing in the fruits of A. senticosus、99.03%-100.45%(RSD=0.50%,n=6) for chlorogenic acid in the fruits of A. senticosus、99.22%-100.44%(RSD=0.44%,n=6)for eleutheroside E in the fruits of A. sen-ticosus、99.80%-100.80%(RDS=0.44%,n=6)for isofraxidin in the fruits of A. senticosus、99.76%-101.10%(RSD=0.51%,n=6) for quercetin-3-rhamnoside in the fruits of A. senticosus;99.21%-101.20%(RSD=0.73%,n=6)for syringing in the root of A. senti-cosus、99.81%-101.20%(RSD=0.52%,n=6)for chlorogenic acid in the root of A. senticosus、100.00%-101.50%(RSD=0.62%, n=6)for eleutheroside E in the root of A. senticosus、99.22%-100.40%(RSD=0.47%,n=6)for isofraxidin in the root of A. senti-cosus. CONCLUSIONS:The method is simple and stable with good reproducibility,and can be used for the simultaneous determi-nation of original syringin,chlorogenic acid,eleutheroside E,isofraxidin and quercetin-3-rhamnoside in the fruits and root of wild A. senticosus.

It is an important teaching task how to make respiratory disease specialists to accept the standardization training of pulmonary function. However, the theory of pulmonary function is comparatively abstract and the training time is short, but the task is heavy. In order to explore a set of feasible training mode, the pulmonary function laboratory of Zhongshan Hospital affiliated to Fudan University carries out various forms of training, such as compiling textbooks, establishing case database, using multimedia teach-ing, arranging one-to-one guided teaching, and training the ability of doctor-patient communication.

Objective:To discuss the level changes and significance of IL-2,IFN-γ,TNF-α in patients with bladder cancer.Methods:66 patients with bladder cancer who were treated in our hospital from February 2015 to December 2016 were enrolled in this study,which was denoted by bladder cancer group,65 patients with cystitis glandularis who were treated in our hospital during the same period were selected as cystitis group,another 65 healthy persons who were examined in our hospital during the same period were selected as control group,and compared the levels of IL-2,IFN-γ and TNF-α in each group,and the levels of IL-2,IFN-γand TNF-α in patients with bladder cancer of different types and clinical stages.The correlation of IL-2,IFN-γ and TNF-α levels with pathological types and clinical stages were analyzed.Results:The levels ofIL-2 and INF-γ in bladder cancer group were significantly lower than those in cystitis group and control group,the level of TNF-α was significantly higher than that of cystitis group and control group,the difference was statistically significant (P＜0.05).There was no significant difference in IL-2,IFN-γ and TNF-α levels in different types of bladder cancer patients (both P＞0.05).IL-2,IFN-γ levels in T2 to T4 bladder cancer patients were significantly lower than Tis to T1,TNF-α level was significantly higher than Tis to T1,the difference was statistically significant (both P＜0.05).According to Spearman method evaluation correlation founded that IL-2,IFN-γlevels in patients with bladder cancer were negatively correlated with clinical stage,TNF-α level was positively correlated with clinical stage.However,there was no correlation between IL-2,IFN-γ and TNF-α levels in patients with pathological type.Conclusion:IL-2,IFN-γ expression in bladder cancer patients are decreased significantly,while TNF-α expression is increased significantly,and the above three indexes of patients are related to clinical stage,but not related to pathological type.