Objective To investigate the effect of intravenous thrombolytic therapy with urokinase on the neurological function and the concentration of serum matrix metalloproteinase 9 (MMP-9) in the patients with acute cerebral infarction.Methods The patients with acute cerebral infarction were divided into the experimental and control groups.The experimental group included 27 patients who were complied with thrombolytic criterion within 4.5 hours after stroke and were firstly treated by intravenous thrombolytic therapy with urokinase by 100 million units after 24 h and 300 mg aspirin by oral.The control group included 27 cases that were directly administrated by 300 mg aspirin 4.5 hours later after stroke.After 24 h,the two groups were administrated with other same conventional treatments such as neurotrophy,improvement of microcirculation,and control of blood-fat.The neurological function and dynamic concentration of serum MMP-9 were observed before treatment and after treatment.Results After treatment,the neurological deficit evaluation score in both groups was gradually reduced with the treatment time,and the neurological deficit evaluation score in the experimental group was significantly lower than that in the control group at the 1 st,3rd,and 14th day,respectively[(10.97 ± 1.53) Score vs (15.67 ±1.78)Score,t =8.35,P =0.03;(8.15 ± 1.40) Score vs(12.72 ± 3.31) Score,t =6.62,P =0.03; (5.87 ± 1.03) Score vs (11.92 ±2.05) Score,t =13.70,P =0.01].After treatment,the concentration of serum MMP-9 in both groups was reduced with the treatment time,and serum MMP-9 in the experimental group was significantly lower than that in the control group at the 1st,3rd,and 14th day,respectively[(282.84 ±37.51) ng/ml vs (316.90±36.75)ng/ml,t =3.37,P =0.00;(309.11±37.71)ng/mlvs (348.39 ±15.26) ng/ml,t =5.02,P=0.04;(264.68±31.91)ng/ml vs (302.81 ±36.30)ng/ml,t =4.10,P =0.03].Conclusions Intravenous thrombolytic therapy with urokinase can effectively reduce the neurological deficit and the produce of MMP-9 in patients with acute cerebral infarction.

Objective To investigate the clinical characteristics of diabetes complicated with peripheral neu- ropathy and increase the cognition of diabetic peripheral neuropathy in clinical work.Methods The clinical data of 160 diabetic patients were analyzed with retrospective analysis.Results 118 diabetic patients had different levels neuroelectrophysiologic abnormality,and the incidence rate was 73.8 %.The cure rate of diabetic peripheral neuropa- thy was 11.0%.Conclusion The incidence of peripheral neuropathy is high in diabetic patients,neuroelec- trophysiologic examination is a sensitive index in diagnosis of diabetic peripheral neuropathy,and the therapeutic ef- fect of diabetic peripheral neuropathy is poor.

Objective To observe the effect of δ-opioid receptor on proliferation and migration of human epidermal stem cells (hESCs) in vitro so as to offer treatment theory for skin injury.Methods hESCs from fresh foreskin tissues of normal young volunteers were isolated and cultured by enzyme digestion and differential adherence technique.Immunofluorescent staining was used to determine expression of integrin β1 and cytokeratin 19 (CK19) and flow cytometry was used for cell count.Second generation of cells were cultured for 5 consecutive days with keratinocyte serum-free medium (K-SFM) supplemented with 1 nmol/L (D-Ala2,K-Leu5)-enkephalin in Group A,with K-SFM supplemented with 1 nmol/L naltrindole and 1 nmol/L (D-Ala2,K-Leu5)-enkephalin in Group B,and with isolated K-SFM in Group C.Cellular division and proliferation were detected by MTT method.An in vitro 100 μm scratch-wound model was created on the confluent monolayer cells at 24 hours of incubation.Cells migrating from the wound margin were determined by inverted phase contrast microscope at 24,48,72,and 96 hours after wound formation,while wound closure rate was calculated at 72 hours.Results Primary cultured hESCs presented cobblestone-like shape after adherence growth,Immunofluorescence staining showed positive results for integrin β1 and CK19 and cell purity reached 95.6％.Moreover,MTT findings revealed proliferation of hESCs enhanced significantly in Group A,but lowered in Group B as compared to Group C (P ＜ 0.05).hESCs migrated from the wound margin in all groups at 24 hours.However,more migrated cells were seen in Group A than in Group C and less in Group B than in Group C.Rate of wound closure was (89.5 ±0.7)％ in Group A,(76.1 ±0.3)％ in Group B,and (81.1 ±0.6)％ in Group C at 72 hours,indicating significant differences among groups (P ＜ 0.05).Conclusion Activation of δ-opioid receptor promotes the proliferation and migration of hESCs in vitro and may be implicated in wound healing.

0.05)between the recurrent rate[2.2%(10/463)]of the CR patients with lung metastasis and the progression rate of the 152 patients.Conclusions After normalization of ?-hCG titer,patients whose lung tumors remained unchanged even after several additional courses of chemotherapy should be considered as CR patients.Follow-ups should be strictly carried out on these patients,especially at around 6 months after the completion of treatment,and particularly for high-risk and drug-resistant choriocarcinoma patients.

Objective To determine the efficacy of hysteroscopy and laparoscopy in differential diagnosis of pregnancy-related diseases,including gestational trophoblastic neoplasia(GTN),incomplete abortion and ectopic pregnancy.Methods Twenty-seven patients with a suspected diagnosis of GTN were transferred to Peking Union Medical College Hospital from September 2003 to March 2006,and underwent hysteroscopy and laparoseopy.Clinical data of patients were reviewed retrospectively.Most patients had abnormal vaginal bleeding and persistently elevated plasma beta human chorionic gonadotropin(?-hCG) level for a median(53?37)days(range,15-125 days)after evacuation.Ultrasound revealed a lesion with affluent blood flow in intrauterine,unilateral horn of uterus,or myometrium.No positive findings were revealed by computerized tomography or X-ray of the chest in all patients.Eleven patients underwent evacuation under hysteroscope,10 patients were diagnosed and treated by laparoscopy,and 6 by hysteruscopy and laparoseopy.Results Choriocarcinoma was diagnosed in 4 patients,who achieved complete remission by chemotherapy later.The diagnosis of GTN was ruled out in the other 23 patients, including cornual pregnancy in 12,pregnancy in rudimentary horn in 1,and incomplete abortion in 10,who were cured by hysteroscopic and laparoscopic surgery and postoperative adjuvant single dose methotrexate.Conclusions The major causes of pregnancy-related abnormal bleeding include incomplete abortion,eetopic pregnancy,and GTN.Hysteroscopy and laparoseopy are effective alternative of diagnosis for differentiation of GTN from non-GTN and can also offer therapeutic treatment.

0.05).Compared with control group,significant decrease in positive group was found in the interval from first evacuation of HM to resolution of serum ?-hCG level,(83?18) days versus(126?31)days(P0.05).Conclusions Once HM is diagnosed,evacuation should be performed as soon as possible,the later the evacuation begins,the higher the risks of lung metastasis and chemotherapy are.It is not necessary to worry about lung metastasis before evacuation of HM,the outcome of post- chemotherapy is very good.

Adolescent ; Adult ; Aged ; Endoscopy ; methods ; rehabilitation ; Humans ; Maxillary Sinusitis ; surgery ; Middle Aged ; Recovery of Function ; Young Adult

[Abstract] Objective To investigate the distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates, so as to provide guidance for reasonable use of antibiotics. Methods Clinical CRKP isolates were collected in Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 2014 to Dec. 2017, and the antimicrobial susceptibility test was carried out using automated instrument method and Kirby-Bauer method. The results were interpreted according to the standards of America Clinical and Laboratory Standards Institute (CLSI) or America Food and Drug Administration (FDA), and the data were analyzed by WHONET 5.6 software and SPSS 20.0 software. Results A total of 403 clinical CRKP isolates were collected, and 169 (41.9%) strains of CRKP were isolated from the specimens obtained from sputum/bronchoalveolar lavage fluid. The first isolation of CRKP was from different specimens, and there was a significant difference in the incidence of CRKP blood flow infection (P0.05). The top 3 departments in terms of isolation rates were Burn Intensive Care Unit (30.0%, 121/403), Digestive Department (8.4%, 34/403) and Emergence Intensive Care Unit (7.2%, 29/403). The antimicrobial susceptibility test showed that the drug resistance rate of the CRKP strains was more than 60.0% to all antibiotics, but tigecycline and fosfomycin. Conclusion The CRKP isolates are resistant to most commonly used antibiotics. It is necessary to strengthen the surveillance of drug resistance of CRKP isolates and take effective measures to control the spread of CRKP, especially in departments such as Burn Intensive Care Unit.

ObjectiveTo observe the effect on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia. Methods22 rabbits with transected facial nerve were divided into 2 groups randomly, control group (8 rabbits,15 sides totally), which transected facial nerve were wrapped by autologous fasia, and treament group (14 rabbits, 20 sides totally), which were wrapped by neural stem cells and autologous fasia. Six weeks after transplantation, neuro-electrophysiological test, immunohistochemical examination were done. The number and thickness of myelin in the re-connected area of transected facial nerve were observed. ResultsThe transplanted animals recovered much better than that in control group (P<0.05). Immunohistochemical examination showed a great deal of BrdU positive cells around the re-connected area of transected facial nerve. Immunohistochemical staining also found plenty of regenerative myelins in this area in the treatment group. While in control group, there were no BrdU positive cells and only a few of regenerative myelins in the same area. ConclusionTransplantation of neural stem cells combined with autologous fasia might become the new method to treat facial nerve injury.

ObjectiveTo explore the method of co-culture of Schwann cell(SCs) with fascia and provide experimental basis for repairing transected nerve.MethodsSCs were co-cultured with fascia.Double staining by anti-BrdU and anti-S-100,S-100 fluorescent staining and anti-BrdU staining were used.ResultsThere were a plenty of SCs around fascia proliferated rapidly and disposed in parallel. SCs could be distinguished from fibroblastic cells by S-100 fluorescent staining and also be staining positive by anti-BrdU antibody,implying their high proliferous ability. Anti-BrdU and anti-S-100 staining showed numerous double staining positive SCs on the fascia: nucleus was stained deep blue while cytoplasm was stained red.ConclusionMany SCs with high proliferous ability were seen on the fascia, which can be used to repair transected nerve.