The hereditary diffuse gastric cancer (HDGC) is associated with CDHI (E-cadherin gene)germline mutations, and accounts for about one-third of the familial gastric cancer (FGC) cases. The other two thirds FGC cases which are not fit the diagnosis standard of HDGC remain lack of clear molecular diagnosis basis. The current disposal of prophylactic gastrectomy in FGC according to E-cadherins genetic counseling, has clinical significance only in part of HDGC.

OBJECTIVE:To evaluate the value and social effect of the regulation by the indicator of drug proportion. METH-ODS:The scientificity and rationality of pharmaceutical proportion and the regulation activity by the indicator of drug proportion was analyzed by analyzing the connotation and influential factors of drug proportion and the method of comparative study,qualita-tive analysis and quantitative analysis. RESULTS:There was great difference in connotation and value between international drug proportion and domestic one. Indicator of drug proportion had no direct relation to pharmaceuticals consumption control and rational drug use;the value and effect of the regulation activity in a hospital by the indicator of drug proportion were far from complete and required further research. CONCLUSIONS:Health administrative department and policy decisions department should further re-search and objectively evaluate the value and effect of the regulation activity in a hospital by the indicator of drug proportion. Whether the regulation activity in a hospital by the indicator of drug proportion carry out based on scientific verification;if neces-sary,the indicator of drug proportion should be cancelled or adjusted in hospital management and evaluation indicator system.

BACKGROUND: To assess the association between relevant brain computed tomography (CT) parameters at different time and neurological prognosis in adult comatose survivors after cardiac arrest (CA). METHODS: A total of 94 CA patients who underwent early and late CT scans (within 24 h and 24 h to 7 d respectively after CA) between January 2018 and April 2020 were enrolled in this retrospective study. According to the Cerebral Performance Category (CPC) score at hospital discharge, the patients were divided into either a good outcome (CPC 1-2) group or a poor-outcome group (CPC 3-5). The grey-to-white matter ratio (GWR) and the proportion of cerebrospinal fluid volume (pCSFV) were measured. In predicting poor outcomes, the prognostic performance of relevant CT parameters was evaluated, and the comparison analysis (expressed as the ratio of parameters in late CT to those in the early CT) of different CT time was conducted. RESULTS: Totally 26 patients were in the good-outcome group, while 68 patients were in the poor-outcome group. The putamen density, GWR, and pCSFV in late CT were significantly lower in the poor-outcome group (P<0.05). The ratios of GWR and pCSFV in the poor-outcome group were significantly decreased according to comparison analysis of different CT time (P<0.05), while there was no significant difference in the ratio of putamen density. GWR-basal ganglia <1.18 in late CT showed the best predictive value. The ratio of pCSFV <0.98 predicted unfavorable neurological outcomes with a sensitivity of 65.9% and a specificity of 93.8% (P=0.001). CONCLUSIONS: Brain CT performed >24 h after CA may be a good choice as a neuroimaging approach to evaluating prognosis. To predict neurological prognosis, comparison analysis of different CT time can be used as another promising tool in comatose CA survivors.

Objective To study the arterial stiffness in maintenance hemodialysis (MHD)patients and to explore the associated factors. Methods Ninety MHD patients and 36 healthy controls were enrolled in the study.Automatic pulse wave velocity (PWV) measuring system was applied to examine carotid-femoral pulse wave velocity(CFPWV)and carotid-radial PWV(CRPWV)as the parameters reflecting central elastic large arterial and peripheral muscular medium-sized arterial elasticity respectively.Blood pressure and biochemical parameters were detected.Backward muhiple linear regression analysis was used to assess the influencing factors of arterial stiffness.Results CFPWV and CRPWV in MHD patients were greater than those of healthy controls [(13.22±3.23)m/s vs(10.67±2.11)m/s and(9.58±1.87)m/s vs(8.81±1.09)m/s,all P＜0.05].Backward multiple regression analysis demonstrated that age and pulse pressure were positively correlated with CFPWV,while dialysis duration,calcium phosphorus product,parathyroid hormone,low density lipoprotein and mean arterial blood pressure were signiticantly correlated with CRPWV.Volume reduction after single dialysis session could not improve arterial stiffness ofMIlD patients.Conclusions Arterial stiffness of large artery and peripheral muscular medium-sized artery increases in MHD patients.Age and pulse pressure are major determinants of large artery stiffness.Peripheral muscular medium-sized arterial stillness is more easily influenced by dialysis-associated factors.

Objective:To observe adjuvant curative effect and adverse reactions of montelukast in the treatment of children with bronchial asthma and its effect on recurrence. Methods:Totally 180 cases of children with bronchial asthma were randomly divided in-to the control group and the observation group with 90 ones in each. The control group was treated with oxygen and budesonide terbutal-ine inhalation, intravenous methylprednisolone sodium succinate and the other conventional treatment methods, and the observation group was additionally treated with montelukast sodium tablets 5 mg, po, qd. The treatment course was three months, and then expira-tory dyspnea, disappearance time of asthma and wheeze and adverse drug reactions in the two groups were evaluated. After 3-6-month follow-up, the recurrence was compared between the two groups as well. Results: The disappearance time of dyspnea, asthma and wheeze in the observation group was shorter than that in the control group (P<0. 05), the total effective rate in the observation group was 96. 67%, which was significantly higher than that in the control group (73. 33%, P<0. 05). The mean follow-up duration was (5. 1 ± 0. 3) months, and the recurrence rate was 8. 51% in the observation group, which was significantly lower than that in the con-trol group (31. 43%, P<0. 05). During the treatment, no significant adverse drug reaction was appeared in the two groups. Conclu-sion:The conventional drug treatment combined with montelukast can rapidly improve the clinical symptoms and reduce recurrence with promising safety, which is worthy of clinical application.

Objective: To revise the Online Game Addiction Inventory(OGAI) and examine its psychometric properties.To explore the relationship between OGAI and Self Efficacy of middle school students.Methods: A sample of 1299 middle school students completed the OGAI and Self Efficacy Inventory(SEI).Results: With exploring factor analysis,4 factors were extracted,i.e.Addictive Behavior,Emotional Arousal,Shame & Dissatisfaction and Dysfunction.The reliability of the revised inventory was 0.93 and that of 4 sub-scales ranged from 0.70 to 0.92.Addictive Behavior,Shame & Dissatisfaction and Dysfunction were negatively correlated with Self Efficacy.Emotional Arousal did not correlate with OGAI.Conclusion: The revised Online Game Addiction Inventory(OGAI) is a reliable and valid measurement.OGAI and SEI are significantly related.

Objective To discuss clinical effect of bronchodilator treatment on patients with chronic obstruc-tive pulmonary disease.Methods According to the exclusion criteria,106 patients were selected and randomly divid-ed into two groups,the control group were given glucocorticoid therapy,the study group was given glucocorticoid +bronchodilator treatment;lung index,including forced expiratory volume in one second,forced vital capacity,and the percentage of forced expiratory volume in one second of forced vital capacity of the two groups were compared,and the patientˊs clinical curative effect was observed.Results The patients of the study group of three indicators:forced expiratory volume in one second,forced vital capacity,forced expiratory volume in one second of forced vital capacity percentage were (1.6 ±0.8)L,(3.4 ±0.4)L,(48.6 ±2.3)%,which were higher than those of the control group, the differences were statistically significant (P <0.05);The total effective rate of the study group was 96.3%,which was higher than 81.2% of the control group,the difference was statistically significant (P <0.05).Conclusion The clinical effect of glucocorticoid +bronchodilator on patients with chronic obstructive pulmonary disease is good,which can effectively improve patient forced expiratory volume in one second,forced vital capacity,forced expiratory volume in one second percentage of forced vital capacity,and can avoid illness development,significantly improve the treat-ment efficiency.

Objective To investigate the effect of transarterial infusion ( TAI) chemotherapy on estrogen receptor ( ER) and progesterone receptors ( PR) expression in breast carcinoma tissue. Methods Samples of 81 patients with breast carcinoma were selected in this study. ER and PR mRNAs levels in the samples were determined by RT-PCR. Immunohistochemistry was employed to measure ER and PR expressions in different samples before and after TAI chemotherapy. Western blotting was used to assay ER and PR proteins level in the samples before and after the chemotherapy. Results RT-PCR results indicated that ER mRNA level was increased in 43 cases ( 53. 1% ) and PR level in 33 cases ( 40. 7% ) . Meanwhile,both ER and PR mRNAs levels were increased in 25 cases ( 30. 9% ) . Immunohistochemistry results showed that ER level was up-regulated in 35cases ( 43. 2% ) ,and PR level in 21 cases ( 26. 0% ) . Both ER level and PR level were up-regulated in 16 out of 81 cases( 19. 8% ) . Western blotting also suggested that the both proteins levels of ER and PR were up-regulated in some patients after the chemotherapy. Conclusion Transarterial infusion neoadjuvant chemotherapy affects the mRNA and protein level of the hormone receptors,which facilitates the subsequent killing effect of chemotherapy on tumor cells. ER and PR expressions should be determined after the transarterial infusion chemotherapy,which might provide a guide for the subsequent treatment and prognosis.

To screen anti idiotypic single chain variable fragments(anti Id scFv)against hepatitis C virus NS4A(HCV NS4A)so as to lay a foundation for developing anti Id scFv vaccine againist the hepatitis C virus. The recombinant phage antibody library was panned by hepatitis C virus NS4A monoclonal antibody which was coated in a microwell plate. After five rounds of biopanning, 82 clones specific to HCV NS4A antibody were determined with the enzyme linked immunoadsorbent assay(ELISA). The specificity of anti idiotypic scFv was identified by ELISA and competitive inhibition assay. The DNA sequence of the positive clone was determined. The result showed that HCV NS4A anti Id scFv had a specific combination character with hepatitis C virus NS4A monoclonal antibody. The DNA sequence data showed that the anti Id scFv coding gene included 789 bp. The results suggested that the anti Id scFv fragments to HCV NS4A monoclonal antibody could be successfully selected by recombinant phage antibody library screening technique, which might pave a way for the study of new preventive and therapeutic strategy of hepatitis C using anti Id scFv.

To screen HCV core mimotopes,HCV core monoclonal antibody was used as immobilized molecule,and a 12 mer phage peptide library was biopanned and positive clones were selected by enzyme linked immunoadsorbent assay(ELISA), competitive inhibition assay, and DNA sequencing. 10 positive clones were chosen for DNA sequencing. From the experiment and sequencing comparison results,one epitope was confirmed as a mimotope of HCV core protein. The study might provide a new approach for HCV therapy and vaccine development.