Objective To study the effects of macrophage migration inhibitory factor (MIF) on spinal cord injury. Methods C57BL/6 mice with injury at T9 ~T10 were taken as spinal cord injury ( SCI) model, and they were divided into the operated group and the sham oper-ated group. Immunohistochemistry was used to detect expression changes of MIF during 72 hours after operation. Reverse transcriptase-poly-merase chain reaction ( RT-PCR) was used to test changes of mRNA level. And double staining immunofluorescence techniques was used to show expressions of MIF and RhoA. Results Expression of MIF at acute stage (72 hours after injury) increased significantly. Results of RT-PCR showed that mRNA levels of MIF and RhoA both increased. There were statistical differences between the two groups (P<0. 05). Con-clusion In acute stage after SCI, MIF increased in the activated microglia. MIF accumulated in oligodendrocyte-like and astrocyte-like cells in injured spinal cord, which might contribute to inhibitory environment for regeneration. Moreover, mRNA level of MIF raised with the in-crease of RhoA mRNA level, which indicated the potential inhibition of MIF to axonal regeneration in CNS.

Objective: On the basis of typical cases, the objective of this study is to assess the service quality of primary healthcare institutions under the vertically integrated model from the perspective of demanding side.Methods: The vertical model between Renhe Hospital and Lixian Township Health Center was selected as the case study.Quantitative data were collected by exit review using Primary health-Care quality service Assessment Tool (PCAT)-Chinese version from the patients seeking services in Lixian.Quantitative data were analyzed by descriptive statistics and multiple linear regression equations while qualitative data were analyzed by thematic framework analysis.Results: Under the vertical model, the PCAT total score was 20.09.The scores on the first diagnosis, continuity of care, and comprehensiveness of care and coordination of care were 6.59, 3.27, 4.58 and 5.62 respectively.The scores on the three dimensional extensions, family-centered, community-oriented, medical culture were 3.07, 1.86 and 2.67 respectively.The difference was significant for the PCAT total score between a number of visits and the length of waiting time for services in Lixian.Conclusions: Under the vertical model, primary healthcare institutions did better in the first diagnosis while weaker in continuity and the three dimensional extensions.With the development of the integration, the primary healthcare institutions need to strengthen the continuity and downward referral in the future.Future researches and follow-up, analysis is needed to track the impact of the vertically integrated model.

Objectives To explore the route of ESBL producing bacteria in neonatal faeces, and to investigate the gene and drug resistance of ESBL producing bacteria in intestinal tract of neonates. Methods Fecal samples of healthy newborns and their mothers were collected, and bacterial cultures were carried out using selective ESBL medium. The positive strains were identified by Time-of-flight mass spectrometry. ESBL genotyping and resistance gene detection were performed by whole genome sequencing technique. Results In 146 neonatal fecal specimens, the positive rate of ESBL producing bacteria was 8.90％,and the positive rate in the first time stool was 3.23％. Seventy-two hours after birth, the positive rate of fecal ESBL producing bacteria was 13.10％. Among the 13 ESBL producing strains, there were 9 strains of CTX type, 3 strains of TEM type and 1 strain of SHV type. Nine strains of CTX include five types such as CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. The positive rate of ESBL producing bacteria was 21.6％ in 167 mothers' fecal specimens. The ESBL genotype included 24 strains of CTX type, 6 strains of TEM type, 4 strains of SHV type and 2 strains of QnrS type. Twenty-four strains of CTX include CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. There were 2 or 3 ESBL genotypes in 12 maternal and neonatal specimens. It was detected to have 6 types of resistance gene such as aadA5, strA, strB, sul1, sul2 and dfrA17 in 49 strains of ESBL producing bacteria in maternal and neonatal strains. Resistance genes were exactly the same in the neonates as in mothers who were detected to have ESBL producing bacteria. A variety of resistance genes were detected in feces in 7 neonates and 23 mothers. Conclusions The neonates in hospital may be detected to have ESBL produing bacteria in the intestinal tract at the same time as their mothers or separately. However, there are many ways for neonates to have ESBL producing bacteria in intestinal tract. There are many genotypes and resistance genes of ESBL producing bacteria.

Objective To study the therapeutic effect of intravitreal injection of ranibizumab combined with vitrectomy for the treatment of neovascular glaucoma (NVG). Methods The clinical data of 21 NVG patients who had underwent vitrectomy were retrospectively analyzed. The patients were treated with intravitreal injection of ranibizumab 0.5 mg, then were given the vitrectomy after 3 to 5 d after treatment. The whole retinal photocoagulation was performed during the operation. Cataract surgery was combined in 16 patients, and ciliary photocoagulation was combined in another 15 patients. All patients were followed up for 6 to 12 months, and the intraocular pressure, visual acuity and neovascularization of iris (NVI) were observed. Results The rate of NVI symptoms resolving completely 3 weeks after operation was 80.95％(17/21). The intraocular pressure 1 week, 1 month, 3 months and 6 months after operation was significantly lower than that before operation: (18.6 ± 5.1), (14.3 ± 4.8), (12.8 ± 4.4), (15.1 ± 3.7) mmHg (1 mmHg=0.133 kPa) vs. (42.8 ± 7.3) mmHg, and there was statistical difference (P<0.05). Two months after operation, 2 cases were not able to control by chemicals, and were treated with transscleral cyclophotocoagulation. Six months after operation, the intraocular pressure was completely controlled in 15 cases, and conditionally controlled in 6 cases. No ocular hypotension occurred. The visual acuity was not improved in 4 cases, but the rest were improved in different degrees. Conclusions For the patients of NVG combined with vitreous hemorrhage and obvious proliferation, intravitreal injection of ranibizumab in the first place, and then combined with vitrectomy, whole retinal photocoagulation and ciliary photocoagulation can obtain good effect.

Objective To analyze the factors affecting the efficacy of postoperative radiotherapy (PORT) in node-positive non-small cell lung cancer (NSCLC). Methods 480 patients with stage N_1-N_2 NSCLC after radical surgery were retrospectively reviewed. Of them, 267 patients received adjuvant chemotherapy and 121 received PORT. All patients were grouped based on the N stage, tumor size and lymph node positive ratio (the percentage of positive lymph nodes from the detected lymph nodes, LNPR). Group 1 included patients with tumor size ≤3 cm and LNPR ≤33%, group 2 was tumor size > 3 cm or LNPR > 33%, and group 3 was tumor size > 3 cm and LNPR > 33%. The endpoints were the local recurrence free survival (LRFS) and overall survival (OS). Kaplan-Meier method and Cox's proportional hazards regression model were used for the statistic analyses. Results PORT improved the overall survival only in patients with N_2 disease. Both tumor size and LNPR significantly influenced the efficacy of PORT. The 5-year LRFS for patients with vs. without PORT in the group 1, 2 and 3 were 55% vs. 60% (χ~2 = 0.03,P-0.869), 42% vs. 50% (χ~2 =0.31,P=0.547),and 62% vs. 52% (χ~2=4.25,P=0.036), respectively;and the corresponding OS were 22% vs. 50% (χ~2 = 1.65 ,P =0. 199), 26% vs. 22% (χ~2= 0. 13,P=0.786) and 42% vs. 16% (χ~2= 15.33,P=0.000), respectively. Conclusions Tumor size and LNPR significantly impact the efficacy of PORT . For patients with stage N_2 NSCLC , PORT could improve local recurrence free survival and overall survival when tumor size > 3 cm and LNPR >33%.

objective To investigate the clinical relevance of antinuclear antibodies (ANA)in patients with systemic sclerosis(SSc).Methods Clinical data were collected from 283 patients with SSc admitted to Peking Union Medical College Hospital(PUMCH)from 1981 to 2009.A retrospective analysis was carried out.Results In the 283 patients,253(89.4%)were female.The mean age at onset was 35.9±12.6 years and mean disease duration 4.3 ±4.5 years.There were 125(44.2%)patients with diffuse SSc(dcSSc) and 158(55.8%)with limited cutaneous SSc(lcSSc).Of all the patients,96.8%were positive for ANA,54.4% for anti-Scl-70 antibodies,6.4%for anticentromere antibodies(ACA),23.7%for anti-ribonucleoprotein(RNP) antibodies,7.1%for anti-Sm antibodies,25.1%for anti-SSA antibodies,7.1%for anti.SSB antibodies,and 1.1%for anti-Jo-1 antibodies.No patients were positive for anti-rRNP antibodies.Only one patient was positive for both anti-Scl-70 antibodies and ACA.The positivity rate of ACA in patients with leSSe was higher thanthat in those with dcSSc(P<0.05).Conclusion The detection of antinuclear antibodies is helpful for the diagnosis,classification,prognosis evaluation and management of SSc.

AIM: To explore interaction and biological behaviou r changes of two kinds of cells-blastocysts and hepatocarcinoma cells in the same microenvi ronment. METHODS:The models of mouse blastocysts co-cultured wit h human hepatoca rcinoma cell lines were established, then biological behaviours and mutual effe c ts of the two kinds of cells in co-culture system were observed. RESULTS: Co mpared with control group, hepatocarcinoma cells with differently invasive and met astatic potential significantly enhanced the rates of blastocyst hatchment , at t achment and outgrowth(P0 05). The blastocyst ha tched and attached to hepatocarcinoma cells with differently invasive and metast atic p otential. Then, differential trophoblasts invaded hepatocarcinoma cells. The clear-cut interfaces were gradually formed between both sides. Hepatocarcinoma cells o n interface showed changes of growth direction and cell shapes and did not inv ade blastocysts. CONCLUSIONS: Hepatocarcinoma cells promoted bla stocyst develo pment. Blastocysts implanted and invaded hepatocarcinoma cells with differentl y i nvasive and metastatic potential in vitro, which indicate that blastocyst i mplan tation in vitro does not relate with the kinds and differential level of int erac tional cells and the low selectivity maybe relate with high adaptability of earl y life.

Objective To evaluate the effectiveness and safety of hyperbaric oxygen (HBO) therapy as an adjunctive therapy for children with dyskinetic cerebral palsy. Methods Seventy-one children with dyskinetic cerebral palsy aged 6 mouths to 2 years were randomly assigned to a HBO group ( n = 35 ) or a control group ( n = 36).All children were given conventional rehabilitative treatment, but the children in the HBO group in addition received 40 sessions of HBO therapy. HBO was administered for 1 h with 85% ～ 90% oxygen at 1.4 atmospheres absolute pressure. All the treatments in both groups continued for 8 weeks. Gross motor function was evaluated with a gross motor function measure ( GMFM ), global motor performance was assessed with a psychomotor development index (PDI), and intelligence was assessed with a mental development index (MDI). Clinical assessments were done before and after treatment. At the same time, hearing impairment was measured using brainstem auditory evoked potentials (BAEPs) in the HBO group. Results All outcomes in both groups improved significantly over the course of study. The average improvement in GMFM in the control group was significantly greater than in the HBO group but other differences were not statistically significant. Hearing impairment developed in 8 children treated with HBO.Conclusion There was no evidence that HBO therapy improved the condition of children with dyskinetic cerebral palsy, and there is a risk of side effects with HBO therapy.

Near-infrared (NIR) was used as rapid analysis method to identify the sulfur fumigated Puerariae Lobatae Radix. NIR spectra of the cross-sectional and longitudinal selection of samples were acquired. Principal component analysis was conducted. The samples were randomly selected. The different pretreatment methods were compared. Discriminant models were established for every type of spectra to calculate the recognition rate. The orthogonal test and nonparametric test were used to test data normality. The result showed that absorbance values of different sections were different due to the different structure, and the raw spectra were analyzed by PCA method. The result founded that the cumulative contribution rate was arrived at 99.2% while the PC numbers were arrived at 3. The pretreatment method based on the MSC + 1D + Savitzky-Golay was the best to establish the model. For the 50 models constructed with cross-section and longitudinal spectra and total spectra, the recognition rate were (94.4 ± 0.66)%, (94.4 ± 0.66)%, (95.3 ± 0.65)%, respectively, and no difference was observed. The NIR method could be used to identify the sulfur fumigated Puerariae Lobatae Radix.
Chemistry, Pharmaceutical ; methods ; Discriminant Analysis ; Drugs, Chinese Herbal ; chemistry ; Fumigation ; Pueraria ; chemistry ; Spectroscopy, Near-Infrared ; Sulfur ; chemistry

Adult ; Female ; Follow-Up Studies ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza, Human ; diagnosis ; Pregnancy ; Respiratory Distress Syndrome, Adult ; diagnosis ; virology