Objective To investigate the risk factors,clinical characteristics and outcomes in patients with acute myocardial infarction and history of stroke. Methods A total of 771 patients with acute myocardial infarction diagnosed and admitted to Xuanwu Hospital,Capital Medical University from January 2005 to March 2012 were analyzed retrospectively. They were divided into either a stroke group (n=387)or a control group (n=384)according to whether they had previous ischemic stroke or not. The risk factors for cardiovascular disease,clinical characteristics of the disease,and clinical outcomes of the patients in both groups were compared through the case control analysis. The endpoint events observed were acute ischemic stroke,cerebral hemorrhage,and cause of death during hospitalization. Results (1)The median age of the patients in both stroke and control groups was 71 (37-91 )and 62 (29-90 )years respectively. The female patients in the stroke group were more than those in the control group (n=125 vs. n=91). The incidence of complicated with hypertension (72. 9%[n=282]and 47. 6%[n=183]) and type 2 diabetes mellitus (39. 0%[n=151]and 20. 8%[n=80]respectively)were high. There was significant difference between the two groups (P<0. 01). (2)The time from the onset to admission in patients of the stroke group was longer than that in patients of the control group (median 11 h vs. 4 h). The incidence of non-ST segment elevation myocardial infarction (16. 0%[n = 62 ]and 1. 8%[n = 7 ] respectively)was higher. The incidences of complicated with gastric stress ulcer (7. 0%[n =27 ]and 2. 1%[n=8]respectively),atrial fibrillation (10. 6%[n=41]and 3. 9%[n=15]respectively),and acute pulmonary edema-cardiac function Killip class≥Ⅱ(51. 9%[n =201 ]and 37. 8%[n =145 ] respectively)were more higher. The findings of coronary angiography in patients of the stroke group were that the incidence of left main coronary artery or 3 -branch lesion higher than that of the control group (52. 9%[126/238]and 32. 4%[97/299]respectively). There was significant difference (P <0. 05). (3)The incidence of new stroke in patients of the stroke group (5. 7%[n =22 ]and 1. 8%[n =7 ] respectively)and in hospital mortality (13. 7%[n=53]and 7. 6%[n=29]respectively)were higher than those of the control group. There were significant differences (P<0. 01). Conclusion The age of the patients with acute myocardial infarction with previous identified history of stroke is older. The incidence of female patients is higher than that of the non-stroke patients,and most of them have risk factors that complicated with hypertension and diabetes mellitus. These patients often have the complications with peptic ulcer disease and heart failure,and their coronary angiography often show multi-branch lesions,and they are more prone to ischemic cardio-cerebrovascular events during the hospitalization.

OBJECTIVE:To investigate the effects of hydrophilic polymers on the stability of self-microemulsifying drug deliv-ery systems (SMEDDS). METHODS:Taking felodipine (FDP) as model drug,the content of FDP was determined by HPLC method. The effects of pure water,0.5% Kollidon VA64,HPMC E5,HPMC K100LV,HPMC K4M,PVP K30 solution,while 0.1%,0.5% and 1.0% HPMC E5 and Kollidon VA64 on residual content of dissolved FDP were determined in SMEDDS. RE-SULTS:The residual contents of dissolved FDP in SMEDDS placed in Kollidon VA64,HPMC E5,HPMC K100LV,PVP K30, HPMC K4M and pure water for 1 h were 92.7%,63.6%,50.2%,46.2%,36.0%and 24.0%,respectively. The order of maintain-ing the supersaturation state was Kollidon VA64>HPMC E5>HPMC K100LV>PVP K30>HPMC K4M>pure water. The residu-al contents of dissolved FDP in SMEDDS placed in 0.1%,0.5%,1% Kollidon VA64 and HPMC E5 and pure water for 1 h were 93.2%,95.1%,96.0% and 48.4%,62.1%,75.1%. CONCLUSIONS:Kollidon VA64 and HPMC E5 can significantly inhibit drug release in SMEDDS and be used as stabilizer of SMEDDS,wherein Kollidon VA64 was better.

Objective To investigate the empathy levels of medical students in a military medical university and explore the influencing factors.Methods Self-developed demographic information questionnaire,Jefferson Scale of Empathy (JSPE-S),Interpersonal Reactivity Index (IRI),and Chinese Perceived Stress Scale (CPSS) were used to collect data from June to October 2016.Medical undergraduate students were conveniently enrolled in the survey.SPSS 17.0 software was used for statistical analysis.T test,ANOVA,and chi-square test or Fisher exact test were used to compare the data of different categories of students.Results A total of 683 questionnaires were distributed and 594 valid questionnaires were returned,with a valid response rate of 86.97％.Students had an above-average level of medical empathy with JSPE-S score as (104.11 ± 19.66),and IRI score was (51.63 ± 10.08).There was a statically difference on level of medical empathy between groups of students with different genders,specialties,professional satisfaction,future career desire,and relative courses learning experience (P＜0.05 for all).Medical empathy was significantly negatively correlated with perceived stress (r=-0.392,P=0.000) and significantly positively correlated with perceived stress (r=0.298,P=0.000).Conclusion Targeted strategies should be conducted to improve the empathy levels of students in the military medical university.

This study was aimed to establish the pharmacokinetics-pharmacodynamics (PK-PD) model of ginsenoside Rb1 following the intravenous administration of Shengmai injection in subjects with stable angina pectoris.A total of stable angina pectoris were selected and received Shengmai injection for 14 days.Plasma samples were collected at different time points.Plasma concentrations of ginsenoside Rb1 were determined by liquid chromatography-mass spectrometry (LC/MS).The concentration-time curves (AUC) were drawn,and then the PK parameters were calculated.The systolic pressure and diastolic pressure were monitored,and the combined PK-PD model was established based on the theory of effect compartment.The results showed that PK of ginsenoside Rb1 conformed to a mono-compartment model.The effect of Shengmai injection lagged behind the concentrations of ginsenoside Rb1 in plasma.The effect exhibited good correlation with ginsenoside Rb1 in effect compartment.The relationship between effect and plasma concentrations fits the Inhibitory Effect Imax model.It was concluded that the study successfully established the combined PK-PD model of ginsenoside Rb1 in subjects with angina pectoris.The model can efficiently evaluate the effective substance of Shengmai injection.

High heterogeneity of bone and soft tissue sarcomas limits the development of molecular-targeted therapy but in turn provides an important clue to inner genomic and regulomic diversityof driver pathways that define molecular subtypes associated with patient outcome. The importance of malignant biological behaviorshave been re-emphasized, since tumor arises from the collaborative interplay of oncogenic events acquired the tissue-specifying gene expression programs to survive cancer cells and benefit multi-step tumorigenesis and neoplastic progression. Differ from most epithelial carcinomas that harbor clinically operative mutation sites, sarcomas are characterizedpredominantly by chromosomal alterations and copy-number changes, with low mutation loads. Sarcoma-specific fusion proteins produced by chromosomal translocations are common significant transcription factors, driving tumor cells exhibit an absolute dependence on "transcription addiction". It has been confirmed that cyclin-dependent kinase-7 (CDK7) plays a key role in transcriptional regulation such as cell growth and proliferation, invasion and metastasis. The dysregulated transcriptional regulation acquired during tumor development strictly depends on the essential regulation of CDK7. Targeted inhibition of CDK7 is an effective strategy to suppress tumors, especially those with specific genomic backgrounds (oncogene or fusion-gene driven) which are highly sensitive to CDK7 intervention. Emerging studies have shown that CDK7 is closely related to the malignant behaviors of bone and soft tissue sarcomas, and is expected to become a potential target for the treatment of sarcoma.

Objective:To observe the baseline characteristics and clinical efficacy in cancer patients who were treated with immune checkpoint inhibitors (ICIs) and experienced immune-related adverse events (irAEs).Methods:The clinical efficacy in cancer patients experiencing irAEs was retrospectively analyzed, and the objective response rate, progression-free survival, and overall survival were evaluated.Results:The median onset time of irAEs in 23 patients was 3.17 months. There were 47.8% (11/23) patients with multi-system irAEs, 63.3% (7/11) of which were non-simultaneous. The most common irAEs were immune-related pneumonia, hypothyroidism and immune-related liver dysfunction. Complete remission, partial remission and stable disease were respectively achieved in 0, 10 and 11 cases, while the other two patients developed progressive disease. The objective response rate was 43.5% and the disease control rate was 91.3%. With a median follow-up period of 16.5 months, 17 patients (73.9%) had progressive disease and the median progression-free survival was 9.63 months. Eight patients (34.8%) died before reaching the median overall survival. The progression-free survival and overall survival of patients with irAEs ≥grade 3 were significantly shorter than those with irAEs of grade 1-2 ( P<0.01). Conclusions:The occurrence of irAEs might correlate with the short-term efficacy and clinical benefits in patients treated with ICIs.

Objective:To explore the relationship between the childhood trauma and neruocognition in patients with schizophrenia.Methods:Sixty-two patients with schizophrenic were selected from Anhui mental health center, and sixty-three community health controls were selected. All subjects were assessed with the childhood trauma questionnaire (CTQ), Wisconsin card sorting Test (WCST), attention network test (ANT), verbal fluency test (VFT) and digit span test (DST). SPSS 17.0 was used for statistical analysis. t-test was used to compare the measurement data of normal distribution and Mann-Whitney U test was used to compare the measurement data of non-normal distribution. Spearman correlation analysis was used to analyze the relationship between CTQ score and cognitive function score. Results:Compared with health controls(34.00(30.00, 37.00), 6.00 (5.00, 7.00), 5.00(5.00, 5.00), 5.00(5.00, 5.00), 9.00(6.00, 11.00), 7.00(6.00, 10.00)), the total score of CTQ, subscores of emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect in patients with schizophrenia were significantly increased (48.50(37.75, 57.00), 9.00(6.00, 12.25), 7.00(5.00, 9.25), 5.50(5.00, 7.25), 13.00 (9.00, 16.25), 11.00(8.00, 13.00)) ( Z=-4.781--6.724, all P<0.01). Compared with the control group, the number of WCST classification completed in the patient group was lower, while the number of wrong answers, continuous answers and persistent errors increased ( Z=-5.655--6.060, all P< 0.01). The correct rate of ant decreased, but the reaction time increased ( Z=-5.796, -6.094, all P< 0.01). VFT and DST scores were decreased ( Z=-3.492--8.499, both P< 0.01). In patients with schizophrenia, CTQ sexual abuse subscore were negatively correlated with completed categories scores ( r=-0.384) and positively correlated with total errors ( r=0.360), perseverative responses( r=0.394) and perseverative errors ( r=0.381) on WCST(all P<0.01). CTQ physical neglect scores were negatively correlated with the ANT correct ratio( r=-0.400) and conflict resolution( r=-0.417) (all P<0.01). CTQ emotional neglect scores were negatively correlated with VFT scores( r=-0.345) ( P<0.01). The significant associations remained after controlling for age, education and PANSS scores. Conclusion:Patients with schizophrenia experience more traumatic events in their early years and have extensive cognitive defects. The childhood trauma has negative effects on cognitive flexibility, attention, memory and speech function in patients with schizophrenia.However, the positive correlation between childhood trauma and executive conflict of attention network needs to be further verified and explored.

The oral microbial community is widely regarded as a latent reservoir of antibiotic resistance genes. This study assessed the molecular epidemiology, susceptibility profile, and resistance mechanisms of 35 methicillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the dental plaque of a healthy human population. Broth microdilution minimum inhibitory concentrations (MICs) revealed that all the isolates were nonsusceptible to oxacillin and penicillin G. Most of them were also resistant to trimethoprim (65.7%) and erythromycin (54.3%). The resistance to multiple antibiotics was found to be largely due to the acquisition of plasmid-borne genes. The mecA and dfrA genes were found in all the isolates, mostly dfrG (80%), aacA-aphD (20%), aadD (28.6%), aphA3 (22.9%), msrA (5.7%), and the ermC gene (14.3%). Classical mutational mechanisms found in these isolates were mainly efflux pumps such as qacA (31.4%), qacC (25.7%), tetK (17.1%), and norA (8.6%). Multilocus sequence type analysis revealed that sequence type 59 (ST59) strains comprised 71.43% of the typed isolates, and the eBURST algorithm clustered STs into the clonal complex 2-II(CC2-II). The staphyloccoccal cassette chromosome mec (SCCmec) type results showed that 25 (71.43%) were assigned to type IV. Moreover, 88.66% of the isolates were found to harbor six or more biofilm-associated genes. The aap, atlE, embp, sdrF, and IS256 genes were detected in all 35 isolates. This research demonstrates that biofilm-positive multiple-antibiotic-resistant ST59-SCCmec IV S. epidermidis strains exist in the dental plaque of healthy people and may be a potential risk for the transmission of antibiotic resistance.
Anti-Bacterial Agents ; therapeutic use ; Dental Plaque ; microbiology ; Female ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; isolation & purification ; Staphylococcal Infections ; diagnosis ; Staphylococcus epidermidis ; isolation & purification