It has been proved that erythropoietin has neuroprotective effect and therapeutic action on cerebral ischemia in vivo and in vitro. The mechanisms of these actions may be involved in anti-exitotoxicity of aminoglutaric acid, regulating the synthesis of nitric oxide, antioxidation, antiinflammatory, inhibiting neuron apoptosis, accelerating angiogenesis, neurogenesis, neurotrophy and others. In addition, exogenous erythropoietin can enter brain tissue through blood-brain barrier and exert neuroprotection. So it is indicated that erythropoietin can be expected to be a new drug to prevent and treat cerebral ischemia.

Phosphodiesterase(PDE) is hydrolase of 3',5'-cyclic adenosine monophosphate(cAMP) and 3',5'-cyclic guanosine monophosphate(cGMP).PDE3 are composed of two genes and distributed widely in vivo.Its inhibitors have been applied in antiplatelet aggregation and vasodilation.It has been reported that PDE3 inhibitors have neuroprotective effects on cerebral ischemia,which may provide new methods to prevention and therapy of cerebral ischemia.

The change of hemodynamics and hemorrheology induced by hypoxia challenge in the dog were investigated. The results showed that hypoxia caused significant decrease of cardiac output,increased pulmonary artery pressure and pulmonary vascular resistance. Hypoxia also caused increase of blood viscosity. In terms of changes of the reduced viscosity is directly related to the deformation and agglutination properties of red blood cells.

Objective To investigate the effects of Omaha system which is applied to seniors with chronic disease in medical nursing home.Methods 48 seniors with chronic diseases in medical nursing home were chosen through convenience sampling methods,the Omaha system was applied to assess nursing problem,carry out nursing intervention,score outcome before and after the intervention,SPSS13.0 was used to enter data for statistical analysis.Results Seniors with chronic disease in medical nursing home had 29 nursing problems,accounting for 69.05％,4 intervention categories was used,69 of targets selected,accounting for 90.79％,after the intervention,KBS score was (3.85 ±0.89),(3.92±0.83),(4.05 ±0.77),higher than (3.07±0.83),(3.16±0.75),(3.61±0.77) before the intervention,and the difference was statistically significant.Conclusions The application of Omaha system can improve the level of cognition and behavior and state of seniors with chronic disease in medical nursing home.

Objective To compare the effects of medroxyprogesterone acetate (MPA) and compound norethisterone enanthate (CNE) on the susceptibility of BABL/c mice to lower reproductive tract infection with chlamydia trachomatis (Ct). Methods A total of 60 BALB/c mice were randomly and equally divided into 6 groups:MPA-pretreated control group and CNE-pretreated control group inoculated with MyCoy cell suspensions in the vagina on the 5th day after single treatment with MPA and CNE respectively, blank control group receiving no treatment, MPA-pretreated infected group and CNE-pretreated infected group inoculated with 1 × 107 inclusion-forming units(IFU)of Ct serovar E in the vagina on the 5th day after single treatment with MPA and CNE respectively, control infected group inoculated with the same quantity of IFU of Ct serovar E in the vagina but receiving no pretreatment. On day 4, 7 and 14 after inoculation, vaginal irrigation fluid was obtained from all the mice for cell culture of Ct. Three mice were randomly selected from each of these groups at the above three time points and sacrificed, and vaginal and uterine tissue specimens were obtained for hematoxylin-eosin(HE)staining and microscopic examination. Chi-square test and Fisher's exact test were conducted to compare infection rate among different groups. Results No growth of Ct was observed in the three control groups at the above time points. The culture-positive rate of Ct was 1/10 on day 4 but 0 on day 7 and 14 in both the CNE-pretreated infected group and control infected group, 7/10 on day 4, 2/7 on day 7 but 0 on day 14 in the MPA-pretreated infected group. Fisher's exact test revealed that the culture-positive rate of Ct was significantly higher in the MPA-pretreated infected group than in the control infected group and CNE-pretreated infected group on day 4 (both P =0.03), but similar among the three infected groups on day 7 (P = 0.23). Both the MPA-pretreated control group and infected group showed an increase in endovaginal mucus, thinning of vaginal stratified squamous epithelium, mucification of vaginal epithelium, presence of secretions in vaginal lumen and submucosal infiltration of a few inflammatory cells on day 4, 7 and 14, as well as appearance of pathological changes (including the presence of large quantities of purulent secretions in lumen, mild tissue edema and submucosal infiltration of a few inflammatory cells) in the vagina on day 4. Vaginal tissues were normal in both the CNE-pretreated infected group and control group at the above three time points, but mild tissue edema, lumen expansion, secretion retention and infiltration of scattered inflammatory cells were observed in the uterus on day 4 after inoculation. Conclusions MPA can arrest the estrous cycle of mice at diestrus with the mucification of vaginal epithelium, which may increase the susceptibility to Ct vaginal infection in mice. In contrast, CNE has no obvious effect on the estrous cycle and susceptibility to Ct vaginal infection despite of the appearance of pathological changes in the uterus.

Objective To investigate the antibiotic resistance of extended-spectrum-β-1actamases (ESBLs)-producing Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) isolates and the risk factors of bloodstream infections caused by these strains.Methods Clinical data of 131 patients with E.coli or K.pneumoniae-induced bloodstream infections admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University during September 2009 and June 2014 were retrospectively analyzed.Species identification and antimicrobial susceptibility test were performed by Vitek 2 system,and ESBLs production was tested by standard disk diffusion method.Logistic regression analysis was performed to identify the risk factors of bloodstream infections induced by ESBLs-producing strains.Results Among 131 patients,65 were infected with ESBLs-producing strains,and 66 were infected with non-ESBLs-producing strains.The resistance rates of ESBLs-producing strains were above 50％ for penicillin,aztreonam and third/fourth generation cephalosporins,which were significantly higher than those of non-ESBLs producing strains.The resistance rates of ESBLs-producing E.coli and K.pneumoniae to carbapenems and piperacillin/tazobactam were 0-2.0％,2.3％ and 0-14.3％,26.7％,respectively.The univariate analysis revealed that patients with exposure to cephalosporins in recent 3 months (x2 =18.322,P ＜ 0.01),prior infection with ESBLs-producing strains (x2=14.610,P＜0.01),indwelling catheter in recent 3 months (x2 =13.016,P ＜ 0.01),history of hospitalization in recent 3 months (x2 =11.269,P ＜ 0.01),exposure to quinolones in recent 3 months (x2 =10.638,P ＜ 0.01),nosocomial infection (x2 =8.205,P ＜ 0.01),history of indwelling deep venous catheter or percutaneous central catheter in recent 3 months (x2 =4.817,P ＜ 0.05) and exposure to glucocorticoid hormone in recent 3 months (x2 =4.265,P ＜ 0.05) were associated with infection of ESBLs-producing strains.Multivariate Logistic regression analysis revealed that exposure to quinolones in recent 3 months (OR =6.851,P ＜ 0.01),prior infection with ESBLs-producing strains (OR =6.344,P ＜ 0.01),exposure to cephalosporins in recent 3 months (OR =3.719,P ＜ 0.01),and indwelling catheter in recent 3 months (OR =3.180,P ＜ 0.05) were independent risk factors for ESBLs-producing E.coli or K.pneumoniae infection.Conclusions ESBLs-producing E.coli or K.pneumoniae isolates are highly resistant to most antibiotics,and multidrug-resistance is common.Carbapenems were still the most effective antibiotics against ESBLs-producing E.coli or K.pneumoniae infection.Rational use of cephalosporins and quinolones,strictly following aseptic technique in operation,strict use of indications for indwelling catheterization,and completely eradicating ESBLs-producing strains in previous infections may be helpful in reducing bloodstream infections by ESBLs-producing E.coli or K.pneumoniae.

Objective To genotype the clinically isolated strains of M.leprae by genome sequencing analysis. Methods PCR amplification was used to produce the 200 bp partial rpoT gene fragments from 2 standard strains and the isolated strains of M. leprae isolated from clinical specimens in 7 areas of China. The fragments were sequenced by BigDye Terminator Cycle Sequencing Reaction kit. Results① 12 rpoT－ 91/97bp DNA fragments and 2 rpoT－ 194/200 bp DNA fragments were obtained from 13 clinically isolated strains of M. leprae by PCR amplification;② based upon genome sequencing analysis, a component of 3－ copy or 4－ copy“ GACATC” repeat sequence was found in the nucleotide sequence of rpoT－ 194/200 bp DNA fragment. Conclusion The genome sequencing analysis can be used to objectively and accurately genotype M.leprae, and it is a useful tool for epidemiological study on transmission and infection of leprosy. However, the longer DNA fragments are necessary when sequencing analysis is conducted. Therefore this method needs further improvement because only the shorter DNA fragments amplified from paraffin－ embedded tissue.

Objective To screen primers used in polymerase chain reaction (PCR) for detecting Trichomonas vaginalis. Methods Three pairs of PCR primer reported in the literatures (TVA5-TVA6, TV1-TV2 and TVK3-TVK7) were screened. For each PCR, four components, including primers, Mg2+, dNTPs and Taq polymerase, were optimized using Taguchi methods to determine the optimal PCR conditions. With the optimal conditions, the sensitivities of three PCR were compared. Vaginal swabs were collected to detect Trichomonas vaginalis by culture and PCR, and the PCR with highest sensitivity was evaluated. Results All three PCR were of high specificity, and the PCR with primers of TVK3-TVK7 had the highest sensitivity. Of 25 clinical vaginal swabs, T. vaginalis was detected in 7 samples by the culture, however, it was detected in 8 samples by the PCR. All culture-positive samples were also positive by PCR. Conclusions The PCR with the primers of TVK3-TVK7 is highly sensitive and specific, which could be useful to detect T. vaginalis in vaginal swab samples.

Objective Using video tracking system to compare the effects of the locomotor activity between theophylline and caffeine in mice.Methods The KM mice were treated by theophylline and caffeine(both at 1,3,10,30,100 mg/kg)intraperitoneally respectively.After 10 min,the locomotor activity in the open field was recorded for 2 hours.The locomotor track,the total distance,the distances and distance ratio to total distance in central region were analyzed to evaluate the effects of these drugs on locomotor in mice.Results The mice administrated theophylline and caffeine both increased the total distances,and had similar bell-shaped dose-effect relationship.The distances reached the highest at 30 mg/kg theophylline((311±128)m)and 10 mg/kg caffeine ((279±89)m).The larger doses of caffeine inhibited the activity,and the total distance during 0～0.5 h was significantly decreased at the dose of 100 mg/kg(P＜0.05).Theophylline(30 and 100 mg/kg)and caffeine (30 mg/kg)significantly increased the distance ratio in central region(P＜0.01)and decreased the distance ratio in peripheral region(P＜0.01).Conclusion Theophylline and caffeine increase the total distance and the distance ratio in central region in mice,but have different valency and efficacy.

Objective To identify high-risk group among gastric cancer patients treated with curative resection and more than D1 dissection, and investigate the indications for proper adjuvant therapy.Methods 297 patients who met the following enrolled criteria were retrospectively analyzed:treated between January 2002 and December 2004, primary gastric or gastroesophageal cancer, underwent curative gastrectomy and more than D1 lymphadenectomy, pathologically staged as T3-4N0-1M0,or TxN2-3M0.The overall survival (OS), disease-free survival (DFS), local-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were calculated, and possible prognostic factors were analyzed.Results The median follow-up time was 61 months.The follow-up rate was 92.3%.The 5-year OS, DFS, LRFS and DMFS were 57.9%, 52.2%, 70.6% and 71.7%, respectively.Four independent prognostic variables identified for OS, DFS, LRFS and DMFS using multivariate analysis were Borrmann type (Ⅰ+Ⅱ/Ⅲ+Ⅳ), total number of dissected lymph nodes (>18/≤18), number of positive lymph nodes (0-3/≥4), and 6th AJCC TNM stage (Ⅱ+Ⅲ a/Ⅲ b+ⅣM0)(χ2=3.94-16.34,P<0.05).If one unfavorable prognostic factor was scored as 1, according to the total scores of the four prognostic factors, four risk groups were generated as low (score:0), low-intermediate (score:1), high-intermediate (score:2) and high risk group (score:3 or 4).The 5-year OS, DFS, LRFS and DMFS were 85.7%, 61.0%, 58.6% and 38.6%(χ2=31.20,P<0.01) in low risk group, 85.2%, 61.3%, 48.1% and 31.8%(χ2=31.88,P<0.01) in low-intermediate risk group, 94.4%, 77.8%, 64.4% and 57.2%(χ2=18.36,P<0.01) in high-intermediate risk group and 87.9%, 75.0%, 74.2% and 55.5%(χ2=19.30,P<0.01) in high risk group.Conclusions Even with R0 resection and more than D1 lymphadenectomy, the outcome was poor for gastric cancer patients with two or more unfavorable prognostic factors.Prospective study is warranted to evaluate the efficacy of adjuvant concurrent chemoradiotherapy for this group of patients.