Objective To investigate the present situations of anticoagulant treatment of non-valvular atri-al fibrillation in order to get better guidance of the clinical anticoagulant therapy and reduce the incidence of stroke caused by atrial fibrillation. Methods The clinical data of NVAF patients hospitalized in the first affili-ated hospital of Chongqing Medical University from January 1 , 2012 to December 31 , 2014 were retrospectively reviewed and analyzed in terms of basic characteristics , medical treatment plan and INR monitoring. Results A total of 1,390 patients were enrolled, 85.97% of whom needed anticoagulant therapy and 25.18% of whom were treated with anticoagulants. For 15.71% of the NVAF patients treated with warfarin , INR met the standard during hospitalization. In the study, such factors as age, coronary heart disease, history of stroke and history of bleed-ing might affect prescription of anticoagulant drugs. Conclusion Most NVAF patients need anticoagulant thera-py, but the rate of anticoagulant therapy is lower than we expected. Among those patients treated with warfarin during hospitalization , the rate of INR meeting the standard is at a lower level. The novel oral anticoagulants are not in wide use in the clinical practice.

Objective To investigate the present situation of anticoagulant therapy on the elderly non valvular atrial fibrilla‐tion (NVAF) hospitalized patients with thromboembolic complications [ischemic stroke ,transient ischemic(TIA)] .Methods A to‐tal of 255 hospital patients in the First Affiliated Hospital of Chongqing Medical University from 2012 to 2014 were recorded by retrospective case analysis .The basic characteristics ,the risk factors of AF ,the medical treatment plan and INR monitoring were analyzed respectively with SPSS20 .0 statistical software .Results A total of 255 patients were enrolled ,66 cases (25 .88% ) were treated with anticoagulation ,and 157 cases (61 .57% ) were treated by antiplatelet drugs .In patients who were taken anticoagulant drugs ,the rate of INR was 15 .15% .Conclusion In the elderly nonvalvular atrial fibrillation patients with thromboembolic compli‐cations ,the rate of anticoagulant therapy is lower than expected .More than half patients were treated by antiplatelet drugs .The pa‐tient who were treated anticoagulation therpy had a low rate of INR standard rate .

AIM: To study the effects of paroxetine on the psychological stress induced by c-fos gene expression in the rat hypothalamus paraventricular nucleus(PVN) and to explore the molecular mechanism of effects of paroxetine on the stress related anxiety disorders. METHODS: The rat psychological stress model was made by restraint stress. The cortisol was analyzed by radioimmnoassay, and expression of c-fos positive cells was detected by S-P immunohistochemical assay in the rat PVN. RESULTS: The level of cortisol and the expression of c-fos positive cells increased more significantly in the other groups than that in the control group, but decreased in the paroxetine group. The paroxetine reduced the level of cortisol and inhibited the expression of c-fos positive cells in the PVN after psychological stress. CONCLUSION: The paroxetine can regulate the nerve centre by alleviating the expression of the c-fos in the hypothalamus paraventricular nucleus(PVN)and the activation of HPA pathway.

AIM: To investigate the molecular mechanisms of antianxiety drugs on the rats with restraint stress. METHODS: The rat stress model was made by restraint stress. The behaviors of rats were tested in open field conditions, and the expression of c fos positive cells was detected by S P immunohistochemical assay in hypothalamus. RESULTS: The crossing scores, the rearing scores and the expression of c fos positive cells increased more significantly in the other groups than that in the control group, but decreased in the paroxetine group. The paroxetine inhibited the behaviors and the expression of c fos positive cells in the hypothalamic paraventricular nucleus (PVN) of rats after immobilization stress. CONCLUSION: The effects of paroxetine on the anxiety disorders in rats may be related to the downregulation of the expression of the c fos in the hypothalamic paraventricular nucleus (PVN).

Objective:To explore the expression and clinical significance of miR-143 in papillary thyroid cancer (PTC) .Methods:Tumor samples and adjacent tissues from 52 patients with PTC were obtained from Jan. 1st, 2018 to Mar. 31st, 2018 in Thyroid Surgery Department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University. Quantitative reverse-transcriptase PCR (RT-qPCR) was used to measure the expression of miR-143 in those subjects. In addition, the relationship between the expression levels of miR-143 and the clinicopathological characteristics was analyzed.Results:RT-qPCR indicated that the expression of miR-143 was down-regulated in PTC, which was significantly lower than that in adjacent tissues ( t=-21.39, 95% CI: 18.20-15.07, P<0.001) . Low expression of miR-143 was related to the number of lymph node metastasis ≥3 in central compartment ( t=10.13, P=0.012) and lateral neck lymph node metastasis ( t=-4.67, P<0.001) . Conclusion:Downregulation of miR-143 in PTC is linked to the metastasis of PTC and may be a potential target for therapeutic intervention.

Objective:To explore the clinical significance of recurrent laryngeal nerve inlet zone(RLNIZ) lymph node metastasis in papillary thyroid cancer(PTC).Methods:The clinical data of the clinicopathologic characteristics of 738 cases with papillary thyroid cancer at our centers from Jul 2017 to Jun 2018 was retrospectively reviewed. 108 cases with RLNIZ lymph node dissection for pathological examination were included. The relationship between metastasis of RLNIZ lymph node and clinicopathologic characteristics was analyzed.Results:RLNIZ lymph node was detected in 12.3%(91/738)cases, the mean lymph node number in RLNIZ was 1.5±0.7, and 30.8%(28/91) cases suffered RLNIZ lymph node metastasis. RLNIZ lymph node metastasis(LNM) is associated with tumor size( P=0.028), capsular invasion( P=0.019), No. of central compartment LNM( P<0.001) and lateral neck LNM( P<0.001). No. of central compartment LNM was found to be the independent risk factor of RLNIZ lymph node metastasis. The incidence of dysphagia and inferior parathyroid damage was 0.9%(1/108)respectively. Conclusions:RLNIZ lymph node metastasis is common among PTC patients , therefore, RLNIZ lymph node should be routinely removed especially in patients with tumor size over 1cm、suspected capsular invasion and lateral neck lymph node metastasis confirmed by preoperative imaging examination.

Objective: To explore the clinical significance of metastasis of lymph nodes between sternocleidomastoid and sternohyoid muscle (LNSS) in papillary thyroid cancer (PTC). Methods: A total of 175 patients with PTC who underwent thyroidectomy with LNSS dissection were retrospectively analyzed. Univariate and multivariate Logistic regression analyses were used to determine the independent risk factors for LNSS metastasis in PTC. Results: The rate of detectable LNSS was 70.9% (124/175) and metastasis rate was 7.4% (13/175). Of 13 cases with LNSS metastasis, 10 with the coexistence of cervical lymph node metastasis. Univariate Logistic regression analysis showed that multiple focal cancer, tumor located in the lower pole of thyroid, belt-shaped muscle invasion, lateral cervical lymph node metastasis, cN+ , the number of cervical lymph nodes with metastasis and the number of lymph nodes with metastasis in level Ⅳwere the risk factors for LNSS metastasis (P<0.05). Multivariate Logistic regression analysis suggested that tumor located in the lower pole of thyroid and the number of cervical lymph nodes with metastasis >6 were the independent risk factors for LNSS metastasis (P<0.05). Given the number of cervical lymph nodes with metastasis as a predictor for the LNSS metastasis, the sensitivity was 92.3%, the specificity was 66.7% and the accuracy rate was 68.6%. Conclusions LNSS metastasis is commom in PTC, with a metastasis rate of 7.4%. PTC in the lower pole of thyroid and the number of cervical lymph nodes with metastasis > 6 are independent risks for LNSS metastasis.