Objective To investigate the serum lipoprotein (Lp) (a) level in patients with acute ischemic stroke and the prediction for short-term functional outcome. Methods The levels of serum Lp(a) were measured in 210 patients with acute ischemic stroke (within 24 h after onset) and 100 healthy people matched the gender and age. The patients were assessed with National Institutes of Health Stroke Scale (NIHSS) as admission, and modified Rankin Scale (mRS) as discharge. Results The median of Lp(a) was 325 mg/L (IQR: 180~545) in patients,significantly more than 148 mg/L (IQR: 69~265) in the normal controls (P<0.001). Level of serum Lp(a) was an independent variable for functional outcome (OR=1.004, 95%CI: 1.001~1.007, P<0.001) and death (OR=1.006, 95%CI: 1.001~1.008, P<0.001) in patients. In the receiver operating characteristic curve, the area under curve was more in the combined model [Lp(a) and NIHSS] than the NIHSS alone.Conclusion Serum Lp(a) increased in the in patients with acute ischemic stroke, and may predict the short-term outcome independently.

Flow cytometry (FCM) is used for multi parameter and rapid quantitative analysis of biological particles,such as all cells,microorganisms and synthetic microspheres in fast line flow state.It is also a modern cell analysis technology for the separation of specific groups.In recent years,FCM has been applied in the field of assisted reproductive medicine.FCM plays an important role in the diagnosis of immune infertility and predicting the fertilization ability of sperm.This article aims to review FCM application in peripheral immune cell surface marker detection for infertility patients,and research on the structure and function of sperm cell.

Objective To investigate the improving effects of Shenshao decoction on myocardial structure and function in diabetic cardiomyopathy,and its effect on expression of TLR4/MyD88-dependent pathway signal in diabetic cardiomyopathy.Methods Diabetes mellitus was induced in 8-week-old male Wistar rats by a single intraperitoneal injection of streptozotocin.The changes of plasma myocardial enzyme (CK, LDH) and high sensitive C reactive protein (hsCRP) were measured.Cardiac function was measured by left ventricular intubation.Hematoxylin and eosin staining and electron microscopy were used to observe the changes of myocardial morphology and ultrastructure in rats.Expression of Toll-like receptor 4(TLR4), myeloid differentiation protein 88(MyD88), and nuclear factor-κB P65(NF-κB P65) were tested by immunohistochemistry.Results After 6 weeks of treatment, the left ventricular diastolic and systolic functions were obviously improved;the degrees of myocardial fibers and mitochondrial damage were obviously relieved;the content of CK, LDH and hsCRP decreased (P< 0.05), and hsCPR was positively correlated with CK and LDH (r=0.823,r=0.819,P < 0.05).The expressions of TLR4, MyD88, NF-κB P65 were significantly decreased (P< 0.05).There was no significant difference in the above mentioned indicators between the control group and control+Shenshao decoction group (P> 0.05).Conclusions Shenshao decoction can reduce the myocardial injury in diabetic cardiomyopathy and improve cardiac diastolic and systolic functions.The mechanism may be related to attenuated inflammation by TLR4/MyD88 dependent signaling pathway.

Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.

Objective To evaluate the effects of nursing intervention on the beliefs and behavior of early detection of breast cancer. Methods Four communities in Shanghai were selected by convenient sampling process. Then these four communities were randomly assigned to intervention group and control group. One hundred and eighty women who met the criteria of this study were selected from each group by convenient sampling process.Altogether 739 women were recruited. In intervention group,a one-year nursing intervention guided by health belief model was implemented,such as health education seminars,telephone follow in the third,sixth,and ninth months,and flyers of breast health care in the sixth month. Control group only received conventional education. Results After intervention women became aware of breast cancer (B=0.210,P＜0.01),perceived more benefits from attending early breast cancer detection (B=0.105,P＜0.01),and less difficulties in attending the activities of early detection of breast cancer (B=-0.086,P＜0.05). The number of women who performed breast self-examination once per month increased and more women received clinical breast examination (OR=3.0946) and mammogram after intervention (OR=2.746). Conclusion The nursing intervention,guided by health belief model,is helpful to improve women's beliefs and behaviors of breast cancer detection.

Objective To investigate the effect of ulinastatin on brain injury in the pediatric patients undergoing living-related liver transplantation (LRLT).Methods Sixty pediatric patients with congenital biliary atresia,of both sexes,aged 6-10 months,weighing 6.5-9.5 kg,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,scheduled for elective LRLT,were randomly divided into either control group (group C,n =30) or ulinastatin group (group U,n =30) using a random number table.Starting from the end of anesthesia induction to the end of surgery,ulinastatin 10 000 U/kg was infused intravenously in group U,while the equal volume of normal saline was infused intravenously in group C.Before operation,at 30 min of anhepatic phase,and at 3 and 24 h of neohepatic phase,blood samples were drawn from the central vein for determination of the concentrations of S-100β protein and neuron-specific enzyme in serum (by enzyme-linked immunosorbent assay) and concentrations of interleukin-6 (IL-6),IL-10 and IL-18 in serum (by radio-immunity method).Results Compared with group C,the serum concentrations of S-100β protein,neuron-specific enzyme,IL-6 and IL-18 were significantly decreased,and the serum concentration of IL-10 was significantly increased at 30 min of anhepatic phase and 3 and 24 h of neohepatic phase in group U (P＜0.05).Conclusion Ulinastatin 10 000 U/kg infused intravenously during operation can reduce brain injury in the pediatric patients undergoing LRLT.

Objective To explore the characteristics and its clinical significance of troponin I(cTnI),myo-cardial enzymes and intraoperative hemodynamic changes in the pediatric patients undergoing living donor liver trans-plantation. Methods Liver transplantation was performed in 50 congenital biliary atresia children who were ranged from grade Ⅲ or Ⅳ in Tianjin First Central Hospital from January 2013 to December 2014 according to the American Society of Anesthesiologists(ASA),meanwhile,the method of the combined intravenous - inhalation anesthesia was ap-plied during operation. Blood samples were drawn from central vein before skin incision(T0 baseline),at 30 min of an-hepatic phase(T1),30 min of neohepatic phase(T2),and 12 h,36 h after operation(T3,T4). Levels of cTnI,crea-tine kinase(CK),lactate dehydrogenase(LDH)and α - hydroxy butyric acid dehydrogenase(α - HBDH)were mear-sured,respectively. Furthermore,heart rate(HR),mean arterial blood pressure(MAP),central venous pressure(CVP) and arterial blood gas analysis[pH value,pa(O2 ),pa(CO2 ),and base excess(BE)]were monitored at the moment of T0,T1,T2 as well as the end of surgery. Results The levels of cTnI,CK,LDH and α - HBDH in T1 - T3 were in-creased,and there was a peak at the T2 compared with the baseline at T0(all P ﹤ 0. 05). At T3 and T4,cTnI,CK, LDH and α - HBDH levels significantly decreased compared with those at T2(all P ﹤ 0. 05),the levels of cTnI were (0. 06 ± 0. 02)μg/ L,(0. 37 ± 0. 52)μg/ L,(0. 05 ± 0. 02)μg/ L,CK levels were(344. 6 ± 209. 5)U/ L,(466. 1 ± 116. 4)U/ L,(219. 3 ± 111. 5)U/ L,LDH levels were(552. 3 ± 414. 9)U/ L,(966. 4 ± 454. 1)U/ L,(322. 8 ± 108. 8) U/ L,and α - HBDH levels were(301. 6 ± 124. 0)U/ L,(456. 4 ± 168. 4)U/ L,(146. 2 ± 80. 2)U/ L,respectively. The levels of hemodynamics significantly changed in anhepatic phase and neohepatic phase. Compared with T0:T1,HR ac-celerated,MAP,CVP decreased,BE value increased,and the differences were statistically significant(all P ﹤ 0. 05);T2,open vena cava and back to the blood volume surge,CVP,MAP increased,HR decreased but still higher than T0, BE value further increased,and the differences were statistically significant(all P ﹤ 0. 05). After the surgery,various hemodynamic indexes fell to preoperative levels,the levels of HR were(103. 1 ± 5. 9)times/ min,(128. 8 ± 8. 5) times/ min,(115. 1 ± 0. 3)times/ min,(103. 5 ± 5. 9)times/ min,MAP levels were(59. 7 ± 9. 1)kPa,(48. 7 ± 5. 4) kPa,(58. 6 ± 7. 1)kPa,(59. 1 ± 8. 6)kPa,CVP levels were(7. 5 ± 4. 3)kPa,(3. 9 ± 4. 6)kPa,(5. 8 ± 3. 5)kPa, (7. 2 ± 4. 1)kPa,BE levels were( - 1. 5 ± 5. 0)mmol/ L,( - 0. 4 ± 5. 7)mmol/ L,(1. 0 ± 3. 8)mmol/ L,(2. 4 ± 2. 2)mmol/ L,respectively. Conclusions The myocardial injury may appear during the perioperation of pediatric living donor liver transplantation and gradually aggravated during the anhepatic phase. The worst injury peaks at 12h and it gradually returns to the preoperative level 36 h postoperativelly.

Objective To investigate whether specific cellular uptake of 99Tcm-survivin-ASODN in nude mice bearing human HCC is influenced by its cytosine content.Methods Three kinds(A1,A2,A3) of synthesized survivin ASODN with three cytosine contents(10％,20％,30％),20 bases per single-strand were prepared.They were labeled with 99Tcm by conjugating with a bifunctional chelator HYNIC,purified through Cellufine GH-25 and then encapsulated with liposome.Antisense gene imaging and the biodistribution of 99Tcm-HYNIC-survivin ASODN in nude mice bearing HCC were performed.The data were analysed by Kruskal-Wallis H test.Results At 4 h post injection,all the 3 labelled compounds showed increased uptake by tumor,liver and kidney.With increase in cytosine content,the uptake increased in kidney (％ID/g:1.50±0.06,2.80±0.09 and 3.96±0.03),and decreased in tumor (％ID/g:2.08±0.08,1.69±0.01 and 1.20±0.09).T/NT in imaging (4.49-4.93,4.12-4.21,3.35-3.85;H=12.50,P＜0.05) and in biodistribution (4.08-4.94,4.02-4.18,3.66-3.85;H=10.82,P＜0.05) were all significantly different.Conclusion ASODN with lower cytosine content shows higher uptake by HCC tumor cells and less stasis in kidneys,thus providing better quality in antisense gene imaging.

Objective The incidence of alcoholic fatty liver increases year by year in recent years .The aim of this study was to establish an animal model of AFL to investigate the pathogenesis of hepatic fibrosis . Methods This study involved 40 male Japa-nese rabbits aged (17.01 ±1.54) d and weighing 1.00-1.52 kg, which were equally randomized to an experimental group and a control group.The animals in the former group received lavage of 10 mL of 50%ethanol twice a day, with normal feedstuff and water, while those in the control group received normal feedstuff and water only .We performed ultrasonography for dynamic liver presentation before and at 12, 16, and 20 weeks after feeding, followed by pathological observation of the livers . Results After 12 weeks of eth-anol garage , fatty liver was observed in 18 of the rabbits and it deteriorated with the prolonged time of administration . The body weight was significantly decreased in the experimental rabbits as com-pared with the controls at 16 weeks ([2.48 ±0.30] vs [2.78 ± 0.15] kg, P<0.05) and 20 weeks ([2.61 ±0.44] vs [3.10 ± 0.13] kg, P<0.05).Ultrasound and pathological grading showed 1 mild, 3 moderate, and 13 severe cases of fatty liver in the experimen-tal group, but none in the control , and pathological examination re-
vealed similar results (1 mild, 4 moderate, and 12 severe cases of fatty liver) in the former group.At 20 weeks, alcoholic fatty liver was found mainly in the S3-S4 stage. Conclusion Alcoholic fatty liver models could be successfully established in rabbits by etha-nol garage and ultrasonography is useful for monitoring the development and progression of the condition .

Objective Folate receptors ( FRs) , overexpressed on the surface of a variety of tumor cells , are potential targets for tumor targeting therapy .This study aimed to prepare an FR-mediated drug nanocarrier with folate conjugated pullulan acetate ( FPA) to target chemotherapeutic agents to FR-overexpressed tumor cells and investigate its tumor-suppressing effect in vitro. Methods The cytotoxicity of epirubicin-loaded FPA nanoparticles ( FPA/EPI NP) against HepG2 and Hela cells was evaluated by MTS assay.The HepG2 and Hela cells were divided into five groups to be treated with NPs (NP control), chlorpromazine, chloro-quine, amiloride, and folate, respectively, followed by detection of the fluorescence intensity by flow cytometry . Results FPA/EPI NP was successfully formulated into NPs , with the mean particle size of (268.5 ±12.0) nm, by dialysis with an almost spherical shape . The drug-loading rate and entrapment rate of FPA/EPI NP were (6.45 ±1.04) and (72.45 ±11.50) %, respectively.The survival rates of the HepG2 and Hela cells were both >95%after 24 hours of incubation with FPA NP at 5, 40, 200, 400 and 1000μg/mL and 90.0%after 72 hours.The survival rates of the HepG2 cells treated with 5, 40, 200, 400 and 1000μg/mL FPA/EPI NP for 24 hours were (92.3 ±5.2), (70.4 ±4.6), (50.0 ±4.0), (41.1 ±4.1) and (27.0 ±3.6) %, respectively.Compared with the NP control group, the Hela cells of the chlorpromazine , amiloride and folate groups showed a significantly lower rate of NP uptake (P<0.05), and so did the HepG2 cells pretreated with chlorpromazine or amilo-ride (P<0.05).At 72 hours, the half maximal inhibitory concentrations (IC50) of FPA/EPI NP against HepG2 and Hela cells were 168 and 105μg/mL, respectively . Conclusion Clathrin-mediated endocytosis and macropinocytosis are involved in the internaliza-tion of FPA/EPI NP in HepG2 cells, while clathrin-and FR-mediated endocytosis in that of Hela cells .FPA NP may serve as a new drug carrier for tumor-targeted therapy .