Objective To observe the therapeutic efficacy and the safety on botulinum toxin A (BTX A) to muscle spasticity after cerebral vascular diseases (CVD).Methods 42 patients with muscle spasticity after CVD were injected with Chinese type A botulinum toxin(CBTX A).The dosage and number of injection point were determined according to the affected musclar size and the degree of muscle spasms.The injection sites were determined according to anatomy surface landmarks for location.The myodynamia of the limbs,the muscular tone (modified Ashworth score) and the function before and after injection were observed.Results The muscular tone modified Ashworth score,pace velocity,stride length and ankle ROM were remarkbly progressive after injection(P

Objective:To explore relationship among severity of cerebral infarction (CI) ,arteriosclerosis and serum level of cystatin C (CysC) in young and middle‐aged patients with atherosclerotic cerebral infarction (ACI) .Methods:A total of 82 young and middle‐aged ACI patients treated in our hospital from Feb 2013 to Sep 2015 were enrolled .According to CI volume ,they were divided into small infarction group (n=36 ) , medium infarction group (n=22 ) and large infarction group (n=24);according to CI severity ,they were divided into mild CI group (n=54) and severe CI group (n=28);ac‐cording to atherosclerotic plaque nature ,they were divided into stable plaque group (n=45) and unstable plaque group (n=37) .Another 46 healthy people were regarded as healthy control group .Serum CysC level during emergency period and recovery period and carotid intima‐media thickness (IMT) were measured and compared among all groups .Results:Com‐pared with emergency period ,there was significant reduction in serum CysC level in all subgroups of ACI during recovery period , P<0. 01 all;compared with healthy control group ,there were significant rise in serum CysC level [recovery peri‐od:(0.81 ± 0.24) mg/L vs .(1.03 ± 0.13) mg/L vs .(1.09 ± 0.19) mg/L vs .(1.18 ± 0.10) mg/L] during emergency period and recovery period in small ,medium and large infarction group ,and that of large infarction group was significantly higher than those of small and medium infarction group (P<0.01 all) .Compared with healthy control group ,there was significant rise in serum CysC level [recovery period:(0.81 ± 0.24)mg/L vs .(1.07 ± 0.15)mg/L vs .(1.19 ± 0.16)mg/L] during emergency period and recovery period in mild and severe infarction group ,and that of severe infarction group was significantly higher than that of mild infarction group ,P<0.01 all .Compared with healthy control group ,there were sig‐nificant rise in serum CysC level[(0.81 ± 0.24)mg/L vs .(1.18 ± 0.15)mg/L vs .(1.39 ± 0.27)mg/L]during emergency pe‐riod and IMT [(0.72 ± 0.10) mm vs .(1.24 ± 0.17) mm vs .(1.30 ± 0.14) mm]in stable plaque group and unstable plaque group ,and those of unstable plaque group were significantly higher than those of stable plaque group ,P<0. 01 all .Conclu‐sion:The serum CysC level significantly rises in ACI patients ,it can be used as an index for ACI prevention and treatment .

The peak plantar pressure and percentage of peak time were evaluated using the Foot scan Plate System in the walking patients without footwear. Diabetic patients with peripheral neuropathy have abnormal plantar pressure distribution, with higher peak plantar pressure in the third and fifth caput of metatarsus and hallux, and longer percentage of peak time.

Objective:To explore the correlation among serum levels of resistin ,oxidized low density lipoprotein (ox‐LDL) ,high sensitive C reactive protein (hsCRP) and severity of acute ischemic cerebrovascular diseases .Methods :A total of 92 patients with acute ischemic cerebrovascular diseases ,who were treated in our hospital from Nov 2013 to Nov 2014 ,were selected ,including 36 cases with transient ischemic attack (TIA ,TIA group) ,29 cases with re‐versible ischemic brain damage (RIBD ,RIBD group) and 27 cases with focal cerebral infarction (FCI ,FCI group) . Another 70 healthy volunteers were regarded as normal control group .Serum levels of resistin ,ox‐LDL and hsCRP were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation a‐mong serum levels of resistin , ox‐LDL , hsCRP and severity of acute ischemic cerebrovascular diseases . Results:Compared with normal control group ,there were significant rise in serum levels of resistin [ (0.26 ± 0.42)μg/L vs . (0.63 ± 0.38)μg/L vs .(0.91 ± 0.45)μg/L ,(0.89 ± 0.42)μg/L] ,ox‐LDL [ (334.3 ± 142.5) mg/L vs .(451.7 ± 15.8) mg/L vs .(518.3 ± 205.7) mg/L ,(520.7 ± 198.9) mg/L] and hsCRP [ (5.8 ± 4.9) mg/L vs .(8.7 ± 7.6) mg/L vs .(13.5± 9.1) mg/L ,(13.6 ± 7.4) mg/L] in TIA group ,RIBD group and FCI group (P< 0.01 all);those of RIBD group and FCI group were higher than that of TIA group (P<0.01 all) ,and there were no signifi‐cant difference in above indexes between RIBD group and FCI group (P>0.05 all) .Pearson correlation analysis in‐dicated that serum levels of resistin , ox‐LDL and hsCRP were significant positively correlated with severity of acute ischemic cerebovascular disease (r=0.473~0.902 , P<0.01 all) .Conclusion:Serum levels of resistin ,ox‐LDL and hsCRP can reflect severity of acute ischemic cerebrovascular diseases ,which is worth extending .

BACKGROUNDIt has been proven that clusterin is a newly apoptosis-related factor and upregulates in many tumors. It plays important roles in carcinogenesis and tumor progression. The antiapoptosis of clusterin seems to be relative to other antiapoptosis factors. The aim of this study is to investigate the expression and significance of clusterin in non-small cell lung cancer (NSCLC) tissue.

METHODSThe expression of clusterin, p53 and Bax in NSCLC were detected by immunohistochemical SP method and Western blot assay.

RESULTSPositive expression rate of clusterin was 79.25% (42/53) in NSCLC tissues which was much higher than that in normal lung tissue (2/16, 12.50%) (Chi-square=23.68, P < 0.05). The expression of clusterin was closely related to pathological differentiation (rs=0.464, P < 0.01), clinical stage (rs =0.320, P < 0.01) and lymph node metastasis (rs=0.255, P < 0.05), but not correlated to the sex (Chi-square=0.007, P > 0.05), age (Chi-square=0.707, P > 0.05) and histological type (Chi-square=0.702, P > 0.05). The expression of clusterin in NSCLC was positively correlated to the expression of p53 (rs=0.589, P < 0.01), but was negatively related to the expression of Bax (rs =-0.346, P < 0.01). The relative expression level of clusterin protein in NSCLC was significantly higher than that in normal lung tissue (0.541±0.010 vs 0.201±0.020) (P < 0.05).

CONCLUSIONSClusterin may play an important role in the biological characteristics of NSCLC by the antiapoptosis pathway.

Objective:To analyze the related factors of neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies.Methods:A total of 300 patients with colorectal cancer treated with oxaliplatin in Zhejiang Cancer Hospital from January 2018 to December 2020 were randomly selected for baseline collection using the convenience sampling method. The occurrence of oxaliplatin-induced peripheral neurotoxicity (OIPN) was statistically analyzed. The factors that affect the occurrence of OIPN were analyzed using univariate analysis.Results:There was a significant difference in OIPN score between patients of different genders, between patients who had different education levels, between patients who had different occupations, and between patients who lived in different long-term residence places ( t = 7.29, 3.39, 2.53, 18.11, all P < 0.05). There was no significant difference in OIPN score between patients adhering to different religion's beliefs, between patients married and not, between patients who lived with and without members, between patients who paid medical costs and not, and between patients who had a previous history of smoking and not ( t = 3.25, 0.37, 0.69, 2.39, 0.15, all P > 0.05). There was a significant difference in OIPN score between patients with different tumor-node-metastasis stages, between patients who received medication via different administration routes, and between patients who received different times of oxaliplatin administration ( t = 8.40, 3.34, 3.49, all P < 0.05). Conclusion:Medical staff should pay attention to the occurrence of OIPN in patients with colorectal cancer treated with oxaliplatin, focus on the patient's factors related to the disease, and take correct and effective coping strategies promptly to reduce the adverse reactions, improve the quality of life, and ensure the therapeutic effect.

Objective To investigate the correlation between claudin-5 level and the risk of hemor-rhagic transformation(HT)in elderly stroke patients after thrombolysis.Methods A total of 192 elderly stroke patients hospitalized in our department from February 2021 to October 2022 were recruited,and divided into HT group(32 cases,including 14 of parenchymal hematoma type and 18 of hemorrhagic cerebral infarction type)and non-HT group(160 cases)according to the results of head CT or MRI 48 h after thrombolysis.The clinical data and serum claudin-5 level were com-pared between the two groups.Multivariate logistic regression analysis was used to identify the in-fluencing factors of HT risk after thrombolysis in elderly stroke patients.Restricted cubic splines were drawn to analyze the correlation between claudin-5 level and HT risk after thrombolysis.Re-sults The HT group had higher proportion of atrial fibrillation,longer onset to thrombolysis time,higher baseline NIHSS score,and fasting blood glucose and claudin-5 levels than the non-HT group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that time from onset to thrombolysis(OR=2.589,95％CI:1.202-5.573,P=0.015),baseline NIHSS score(OR=1.415,95％CI:1.213-1.651,P=0.000),and fasting blood glucose(OR=1.552,95％CI:1.014-2.375,P=0.043)and claudin-5 levels(OR=1.174,95％CI:1.076-1.281,P=0.000)were risk factors for HT after thrombolysis in elderly stroke patients.Restricted cubic spline anal-ysis demonstrated that claudin-5 level had a nonlinear relationship with the risk of HT in the pa-tients after thrombolysis(x2=12.380,P=0.006).Conclusion Serum claudin-5 level is associated with HT after thrombolysis in elderly stroke patients,and shows a dose-response relationship with HT.

Objective To investigate the effect of Euphorbia helioscopia on biological behaviors of non-small cell lung cancer(NSCLC)cells.Methods NSCLC cell lines PC-9 and A549 treated with different concentrations of Euphorbia helioscopia preparations were examined for changes in proliferation,apoptosis,invasion and migration using CCK-8 assay,colony formation assay,flow cytometry,wound healing assay and Transwell assay.Western blotting was performed to detect the changes in protein expressions of Bax,Bcl-2,E-cadherin,vimentin,MMP2,and MMP9 in the treated cells.PC-9 cells were injected subcutaneously into BALB/C nude mice to establish a nude mouse subcutaneous tumor model.According to the growth of subcutaneous tumors,mice were randomly divided into control group:gavaged daily with saline;Euphorbia helioscopia-treated group:gavaged daily with Euphorbia helioscopia 65 mg/mL,and Euphorbia helioscopia granules were dissolved in saline;cisplatin-treated group:injected intraperitoneally with cisplatin 4 mg/kg every 5 days,6 mice per group.The subcutaneous tumor volume and mass changes of mice were measured,and the toxic effects of Euphorbia helioscopia on heart,liver,spleen,lung and kidney as well as the therapeutic effects of Euphorbia helioscopia were observed in the mice bearing tumor.Results Euphorbia helioscopia granules concentration-dependently inhibited the proliferation and survival of PC-9 and A549 cells,significantly promoted cell apoptosis,suppressed invasion and migration abilities of the cells,up-regulated the expression levels of E-cadherin and Bax,and down-regulated the expressions of Bcl-2,vimentin,MMP2,and MMP9.In the tumor-bearing mice,treatment with Euphorbia helioscopia significantly inhibited tumor growth without producing obvious toxicity in the vital organs.Conclusion Euphorbia helioscopia can inhibit proliferation,invasion,and migration and induces apoptosis of NSCLC cells in vitro.

Objective To investigate the effect of Euphorbia helioscopia on biological behaviors of non-small cell lung cancer(NSCLC)cells.Methods NSCLC cell lines PC-9 and A549 treated with different concentrations of Euphorbia helioscopia preparations were examined for changes in proliferation,apoptosis,invasion and migration using CCK-8 assay,colony formation assay,flow cytometry,wound healing assay and Transwell assay.Western blotting was performed to detect the changes in protein expressions of Bax,Bcl-2,E-cadherin,vimentin,MMP2,and MMP9 in the treated cells.PC-9 cells were injected subcutaneously into BALB/C nude mice to establish a nude mouse subcutaneous tumor model.According to the growth of subcutaneous tumors,mice were randomly divided into control group:gavaged daily with saline;Euphorbia helioscopia-treated group:gavaged daily with Euphorbia helioscopia 65 mg/mL,and Euphorbia helioscopia granules were dissolved in saline;cisplatin-treated group:injected intraperitoneally with cisplatin 4 mg/kg every 5 days,6 mice per group.The subcutaneous tumor volume and mass changes of mice were measured,and the toxic effects of Euphorbia helioscopia on heart,liver,spleen,lung and kidney as well as the therapeutic effects of Euphorbia helioscopia were observed in the mice bearing tumor.Results Euphorbia helioscopia granules concentration-dependently inhibited the proliferation and survival of PC-9 and A549 cells,significantly promoted cell apoptosis,suppressed invasion and migration abilities of the cells,up-regulated the expression levels of E-cadherin and Bax,and down-regulated the expressions of Bcl-2,vimentin,MMP2,and MMP9.In the tumor-bearing mice,treatment with Euphorbia helioscopia significantly inhibited tumor growth without producing obvious toxicity in the vital organs.Conclusion Euphorbia helioscopia can inhibit proliferation,invasion,and migration and induces apoptosis of NSCLC cells in vitro.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.