Objective To investigate the effect of orphan nuclear receptor NR4A1 expression on oxygenglucose deprivation (OGD)-induced apoptosis in cultured rat cerebellar granule neurons and its possible mechanisms.Methods Primary rat cerebellar granule neurons were cultured for 7 to 8 days,and then treated with OGD.The activity of cultured rat cerebellar granule neurons was assessed by methyl thiazolyl tetrazolium (MTT) assay,apoptosis was detected with flow cytometry,the expressions of NR4A1,caspase-3 and cytochrome c were determined by Western blot analysis,NR4A1 mRNA expression was detected with real-time polymerase chain reaction.The rat cerebellar granule neurons were transfected with lentiviral vector-encoding rat NR4A1.The apoptotic rates and expressions of caspase-3 and cytochrome c in rat cerebellar granule neurons transfected with NR4A1 were detected after OGD.Results The activity of rat cerebellar granule neurons decreased significantly,the apoptotic rate increased significantly,the expressions of NR4A1 mRNA and protein as well as caspase-3 and cytochrome c incrased significantly along with the OGD time.NR4A1 was overexpressed,apoptosis rate was significantly reduced in rat cerebellar granule neurons transfected with NR4A1.The expressions of caspase-3 and cytochrome c were significantly reduced in the rat cerebellar granule neurons transfected with NR4A1 after OGD.Conclusions NR4A1 overexpression may reduce OGD-induced apoptosis in rat cerebellar granule neurons by downregulating the expressions of caspase-3 and cytochrome c.

Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85％ ) was significantly better than group B ( 53.12％ ) ( x2 =5.18,P ＜ 0.05 ).The fatality rate of group A (9.09％ ) was significantly lower than group B ( 18.75％ ) ( x2 =5.32,P ＜ 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P ＜ 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.

0.05). Conclusions Inductive chemotherapy with 5 fluorouracil, cisplatin, bleomycinA5 plus radiotherapy may improve the outcome of esophageal cancer, with the toxic and side effects of the combined modality severer than radiation alone, but they are well tolerated.

Objective To estimate the cost of community medical aid programs for the urban poor in Shenyang, Chengdu, Xining and Yinchuan so as to provide the primary basis for improving the compensation mechanisms for such programs. Methods A survey was made on the cost consumption of six major categories in the course of health service delivery and the amount of various community health services actually delivered by the pilot community health service institutions in 2003. The cost of each service program was estimated and then the cost of medical aid programs for the urban poor was estimated. Results The per capita cost of the medical aid programs for the poor in the cities was less than 5 yuan and the total cost of the medical aid programs accounted mostly for 0.05‰ or so of the financial expenditure of each of the cities. Conclusion The government ought to make rational compensation for community medical aid programs, the cost of which is low. Setting up community health service based mechanisms of medical aid for the poor conforms to the actual condition of our country.

Objective:To investigate the risk factors for anterior circulation and posterior circulation symptomatic intracranial atherosclerotic stenosis (sICAS).Methods:The clinical data of patients admitted to Hebei General Hospital for ischemic stroke or transient ischemic attack (TIA) and diagnosed with sICAS by digital subtraction angiography from May 2019 to May 2020 were retrospectively included. The patients were divided into anterior circulation group and posterior circulation group according to the stenosis sites, and the distribution of sICAS and its risk factors were analyzed.Results:A total of 134 patients with sICAS were enrolled, including 82 males (61.2%) and 52 females (38.8%). Their age was 60.28±11.46 years; 115 (85.8%) had ischemic stroke and 19 (14.2%) had TIA. There were 92 patients (68.7%) in the anterior circulation group and 42 (31.3%) in the posterior circulation group. Body mass index (BMI), systolic and diastolic blood pressure levels, as well as the proportion of patients with hypertension, diabetes, smoking and drinking in the posterior circulation group were significantly higher than those in the anterior circulation group (all P<0.05). Multivariate logistic regression analysis showed that higher BMI (odds ratio [ OR] 1.191, 95% confidence interval [ CI] 1.029-1.379; P=0.019), hypertension ( OR 4.073, 95% CI 1.135-14.616; P=0.031) and diabetes ( OR 2.783, 95% CI 1.149-6.738; P=0.023) were independently correlated with the posterior circulation sICAS. Conclusions:Compared with anterior circulation, high BMI, hypertension and diabetes are the independent risk factors for posterior circulation sICAS.

Objective:To investigate the effect of the timing of intra-aortic balloon counterpulsation (IABP) treatment on the clinical efficacy of patients after severe cardiac surgery.Methods:A prospective study was conducted on 64 patients with IABP after cardiac surgery in Gaozhou People′s Hospital of Guangdong Province from March 2018 to March 2020.According to the time of IABP treatment, 33 patients were divided into early treatment group (severe cardiac surgery<6 h) and late 31 cases in treatment group (≥6 h after severe cardiac surgery): two groups of mean arterial pressure(MAP), left ventricular ejection fraction (LVEF), mechanical ventilation time, IABP indwelling time, ICU stay time, central venous oxygen saturation(ScvO2), N terminal pro B type natriuretic peptide(NT-proBNP), lactate clearance rate, complications and follow-up.Results:After 48 hours of IABP, MAP and LVEF in the early treatment group were (79.47±7.07) mmHg and (45.20±3.86)%, respectively, and those in the late treatment group were (71.38±6.26) mmHg and (41.66±4.49)%.There were significant differences between the two groups ( t value was 34.604, 29.375 respectively all P<0.01). The mechanical ventilation time (71.56±5.98) h, IABP indwelling time (68.31±10.10) h, ICU stay time (5.84±1.04) d in the early treatment group, and those in the late treatment group (82.79±4.96) h, (89.49±9.97) h, (6.82±1.07) d. There were significant differences between the two groups ( t value was 70.093, 72.855, 31.859 respectively, all P<0.01). The ScvO 2, NT-pro BNP and lactate clearance rate in the early treatment group were (71.66±5.45)%, (1 698.36±1 032.98) ng/L and (30.12±2.29)%, respectively at 48 hours after IABP, and those in the late treatment group (66.03±4.61)%, (2 898.43±1 383.29) ng/L and (20.47±1.92)%.There were significant differences between the two groups ( t value was 38.279, 34.379 respectively, all P<0.01). The incidence of complications were 18% (6/33) and 41.94%(13/31) in the early treatment group and the late treatment group.There was significant difference between the two groups( P=0.038). Conclusion:Early use of IABP treatment can improve the patients′ hemodynamic and serological indicators, reduce the patient′s mechanical ventilation time, IABP time, ICU monitoring time and complications.

Objective To evaluate the inverse distance weighted(IDW) in revealing the characteristics of spatial distribution of water fluoride in Heze City,Shandong Province.Methods A geographic information system (GIS) database of water fluoride was established in Heze City of Shandong Province using the data of endemic fluorosis surveys collected by Endemic Disease Prevention Institute in Shandong Province during 2005-2007.IDW spatial interpolation was applied to predict the distribution of fluoride in drinking water in 139 towns of Heze City.Sensitivity and specificity were calculated.Results Mean water fluoride levels in 10 counties of Heze City were all higher than 1.0 mg,/L,and the water fluoride in Cao County,Juye,Mudan District and Juancheng were higher than 2.0 mg/L.Of all 139 townships of Heze City,129 were higher fluoride townships where fluoride was ＞ 1.0 mg/L,10 were lower fluoride townships(≤ 1.0 mg/L).IDW spatial interpolation showed that the water fluoride of most areas in Heze City were ＞ 1.0-2.0 mg/L.The areas with water fluoride of ＞ 2.0-3.0 mg/L were mainly located in eastern Juancheng,northern Mudan District,north-central Chengwu,central and southern Juye,southeastern part of Caoxian and eastern part of Shan Town.Regions of water fluoride ＞ 3.0 mg/L were mainly distributed in Xieji and Wanfeng towns of Juye County,Jishan town of Juancheng County,Sunlaojia town of Caoxian and Dusi town of Mudan County.The internal verification results showed that the sensitivity,specificity and overall accuracy rate of IDW used for predicting water fluoride content was 100.00％ (129/129),10.00％ (1/10) and 93.53％ (130/139),respectively.While the external verification results showed that the sensitivity,specificity and overall accuracy rate of IDW for predicting water fluoride content was 100.00％(31/31),11.11％(1/9) and 80.00％(32/40),respectively.Conclusion With the application of IDW interpolation,it is feasible to infer the overall spatial distribution based on the monitoring data,and to reveal the spatial characteristics of water fluoride in Heze City,Shandong Province.

A series of phthalazine ketone compounds were synthesized and the structures were confirmed by H NMR and HR-MS spectrum. All target compounds were obtained through 7 steps, including selective reduction, nitration, bromination, ring enlargement, reduction, Knoevenagel and acylated reaction. The compounds were evaluated for their immunosuppressive effects of T-cell proliferation and inhibitory activity of IMPDH type II in vitro, as well as their structure-activity relationship were assessed. Several compounds exhibited strong immunosuppressive properties, especially compounds 7f and 7h, with IC50 values of 0.093 micromol x L(-1) and 0.14 micromol x L(-1) respectively, which were superior to mycophenolic acid. The information obtained from the studies may be useful for further research on the immunosuppressive agents.

Objective To research the diagnostic value of troponin in the acute myocardial infarction after cardiac surgery.Methods The prospective study method was used.One hundred and thirtyfour patients of cardiac surgery were selected as observation group,36 patients of thoracic surgery were selected as control group.All the patients were given continuous electrocardiogram monitoring and measured troponin I,and the results were compared between the 2 groups.Results There was no statistical difference in the troponin I before anesthesia between the 2 groups (P ＞ 0.05).The troponin I 4 h after surgery was (13.010 ± 14.829) μg/L in observation group,(0.019 ± 0.007) μg/L in control group,there was statistical difference (P ＜ 0.05).One case of observation group happened the acute myocardial infarction after cardiac surgery,the troponin I was ＞ 40.000 μ g/L.Conclusions The troponin is obviously increased in the early stage in most patients of cardiac surgery,the false positive rate in diagnostic acute myocardial infarction is higher according to the troponin.For troponin,it will need the more evidence of evidence-based medicine to establish the diagnosis of acute myocardial infarction after cardiac surgery.

Objective To examine the practice and value of comprehensive geriatric assessment(CGA)in geriatric care by conducting comprehensive evaluation of hospitalized elderly patients.Methods CGA was carried out in 91 hospitalized patients at our hospital from July 2015 to October 2015.Patients aged 65-75(6 cases),76-85(38 cases)and ＞85-99 years(47 cases)were assigned into three Groups.The incidence of geriatric syndromes ineach age group was calculated,and characteristics of geriatric syndromes among the patients were analyzed.ResultsFrailty had the highest incidence among all age groups 69(64.8％).In Group 65-75 years old,pain was mostfrequently reported 2(33.3％);in Group 76-85 years old,the three most frequent syndromes were frailty,dementiaand falls;in Group 85-99 years old,frailty,polypharracy and rnalnutrition occurred most often.Up to 37.4％％ of the patients showed coexistence of 3-4 common geriatric syndromes,and only 14.2％ of the patients had none Conclusions Frailty,dementia,falls,polypharrnacy,and malnutrition are the most common geriatric syndromes in hospitalized elderly patients.Coexistence of multiple geriatric syndromes is common among these patients.