ObjectiveTo investigate the effect of TPN and Ulinastatin(UTI) on acute phase proteins (APP) metabolism in postoperative patients with advanced gastrointestinal carcinoma.MethodsSixty postoperative patients were randomly divided into four groups: control group( n =15) receiving routine iv infusion; UTI group( n = 15) receiving iv infusion and UTI; TPN group( n =15) and UTI+TPN group( n =15). The serum acute phase proteins and nitrogen balance were observed. ResultsThe decrease of serum APP was greater in control group and TPN group than in UTI group and UTI+TPN group( P

By using the fuzzy min-max neural network, the quantitative structure-activity relationship (QSAR) of mutagenicity is studied. With the established QSAR model, the mutagenicity is predicted and the results showed that QASR is superior to linear-regression model. Further discussion on the models and the results is presented in this paper.
Algorithms ; Cluster Analysis ; Fuzzy Logic ; Models, Chemical ; Neural Networks (Computer) ; Quantitative Structure-Activity Relationship

From the status quo of medical and health services in rural areas,there exist the following problems:the insufficient number of clinicians,low quality of clinicians,the imbalance of the professional ranks and titles,and aging.Based on investigation and analysis of the rural community health technicians of Huzhou City,Zhejiang Province,the author put forward the new countermeasures of orientation training clinicians in rural communities according to the rural communities residents new demand for medical and health services.

Objective To evaluate the effect of problem-based learning (PBL)versus tradi-tional methods in medical statistics. Methods Computer retrieval was conducted to search for con-trolled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Results A total of 21 articles were retrieved,but only 7 were included. The results of Meta analysis showed that there was no significant difference between PBL and traditional methods in both the passing rate of student's score (RR=1.09,95%CI=0.98-1.23,P=0.12>0.05)and the exact score (WMD=0.30, 95%CI=-0.06 -0.67,P=0.10>0.05). Conclusion PBL showed no better learning results in medical statistics compared with traditional methods.

Leukoaraiosis (LA) has important clinical significance;however, the neurobiological mechanism was still unclear. In this pa-per, we reviewed literatures about the clinical symptoms, pathology and imaging of LA in order to improve the understanding of the patho-logic mechanism, recognize the reversible pathological change in the earliest stage, which can help to prevent dementia.

The effectS of survivin antisense RNA on proliferation of leukemia cell line HL-60 and taxol.induced chemotherapy was explorcd.A cDNA fragment of survivin obtained by RT-PCR was inserted into a plamid vector named pcDNA3 in the reverse direction.The vector encoding antisense RNA of survivin was confirmed by restriction enzyme digestion and DNA sequencing.The recombi-nant plasmid was delivered into HL-60 cells by electroporation.Growth curves were plotted based on cell counting.Trypan blue dye exclusion assay and MTT assay were carried out after the cells were incubated with taxol.DNA gel electrophoresis and nuclear staining were performed for cell apoptosis assay.The correct construction of the recombinant plasmid has been identificd bv restriction enzy.me digestion and DNA sequencing.A stable down.regulation has been achieved in HL-60 SVVas cells after G418 selection.Compared tO HL-60 cells.the proliferation of HL-60 SVVaS cells was signifi.cantly inhibited(P＜0.05).Cytotoxicity assays indicated that IC50 of HL-60 SVVas for taxol was rela-tively lower than controls(P＜0.01).Apoptosis assays revealed that taxol-induced apoptosis was de-tected in HL-60 sVVas cells incubated with 50 ng/ml taxol for 12 h,while in HL-60 cells incubated with 100 ng/ml taxol for 72 h.It was suggested that Survivin antisense RNA could inhibit the prolif-eration of HL-60 cells and enhance taxol-induced apoptosis in HL-60 cells.which may lay an ex-perimental foundation for further research on gene therapy in leukemia.

Objective To explore the clinical characteristics of cognitive impairment in different age groups with the same severity of white matter lesions.Methods This study involved 110 consecutively recruited patients with white matter lesions(WMLs)from the Department of Neurology at Beijing Tiantan Hospital from August 2014 to March 2017.Patients were aged from 50 to 85 with a mean age of 63.1±9.7,and they were divided into an elderly group with a mean age of 71.6±5.2 (range:65-85 years)and a middle aged group with a mean age of 54.8 ± 3.4 (range:50-60 years).The severity of white matter lesions was evaluated with the Fazekas scale.MoCA was used to evaluate the cognitive function of patients.Results For Fazekas 1,the MoCA score was 25.5 ± 2.2 in the elderly group and 28.1 ± 1.4 in the middle aged group(t =6.946,P =0.000);the score for visuospatial and execution abilities was 3.8 ± 0.9 in the elderly group and 4.5 ± 0.6 in the middle aged group(t =3.7 2 6,P =0.0 2 3);the score for delayed memory was 2.7 ± 1.5 in the elderly group and 4.0 ± 1.0 in the middle aged group(t =4.365,P =0.018).For Fazekas 2,the MoCA score was 22.5±2.5 in the elderly group and 24.1 ± 1.5 in the middle aged group(t =3.361,P =0.034);the score for visuospatial and execution abilities was 2.8 ± 1.2 in the elderly group and 3.8 ± 0.8 in the middle aged group(t=6.473,P=0.007);the score for concentration was 4.6± 1.3 in the elderly group and 5.6±0.5 in the middle aged group(t=0.491,P=0.721).For Fazekas 3:the MoCA score was 15.2 ± 3.4 in the elderly group and 19.4 ± 2.8 in the middle aged group(t =4.709,P =0.001);the score for visuospatial and execution abilities was 1.8 ± 1.1 in the elderly group and 2.8± 1.4 in the middle aged group(t =1.563,P =0.043);the score for concentration was 3.3± 1.1 in the elderly group and 4.4± 1.4 in the middle aged group(t=2.231,P=0.026);the score for orientation was 4.2 ± 1.3 in the elderly group and 5.7 ± 0.5 in the middle aged group (t=3.255,P =0.000).Conclusions WMLs can increase the risk of vascular cognitive impairment and cause decline in multiple cognitive functions in both middle aged and elderly people.Cognitive dysfunction in age-related WMLs is mainly characterized by impairment in visuospatial and execution abilities.

Objective To study the effect of white matter lesions location on cognitive function by comparing the correlation between the anatomical location of white matter lesions and cognitive function in leukoaraisosis(LA)patients. Methods A total of 75 LA patients with different degrees of white matter le-sion were randomly recruited.The modified Scheltens scale,Manolio scale and Fazekas scale were utilized to assess the severity of white matter lesions(WMLs)by two physicians.Montreal cognitive assessment (MoCA)was used to evaluate the cognitive function.The correlation between WMLs location and cognitive function was analyzed by spearman rank correlation analysis.The t-test was used to test the differences of periventricular white matter lesions with cognitive impairment(PWMLs-CI)and periventricular white matter lesions with cognitive normal(PWMLs-CN)in each goup. Results For Fazekas scale,PWMLs were signifi-cantly correlated with the decrease scores of MoCA score(r=-0.388,P=0.007),visuospatial and executive (r=-0.466,P=0.000),delayed recall(r=-0.461,P=0.001),abstraction(r=-0.355,P=0.011)and ori-entation(r=-0.337,P=0.016)(P<0.05).For Scheltens scale,PWMLs was negatively correlated with MoCA score(r=-0.390,P=0.003),visuospatial and executive(r=-0.464,P=0.000),delayed recall(r=0.484, P=0.000),attention(r=-0.375,P=0.008)and orientation(r=-0.342,P=0.013)(P<0.05),but not in deep white matter lesions(DWMLs)(P>0.05).Compared with PWMLs-CN,executive function(42.13 ± 0.89),attention(16.36±1.24)and visuospatial(2.25±0.31)in PWMLs-CI had statistical significance(P<0.05). Conclusion White matter lesions location affect cognitive function,PWMLs are more closely related to cognitive impairement,characterized by executive function,attention and visuospatial aspects.

Objective To explore abnormal microstmctural changes of white matter in patients with white matter lesions using diffusion tensor imaging(DTI),and to determine the association of such abnormalities of DTI parameters with cognitive function.Methods The objects who have already confirmed with WML were collected from March 2012 to February 2018 through magnetic resonance imaging (MRI) scan from the neurology department of Beijing Tiantan Hospital.Use The hamilton depression scale(HAMD) and the hamilton anxiety scale (HAMA) to eliminate anxiety and depression,and divided into WML-CN group,WML-VCIND group and WML-VAD group with Mini-mental state examination (MMSE),Montreal Cognitive Assessment (MOCA)and clinical dementia rating(CDR).In addition,select the healthy elderly people without WML by MRI scan as the normal control group.All of the subjects were detected with the superconduct magnetic resonance imaging system (German SIEMENS 3.0T) for the DTI scanning.Original images were processed with VBA.Then explore the changes of FA and MD of DTI in whole brain and regions of interest in NC group,WML-CN group,WML-VCIND group and WWML-VAD group,and its correlation with the severity of cognitive impairment in patients with WML.Results The damage degree of the fiber microstructure of brain white matter was significantly correlated with the total grade point of MoCA (P＜0.01).In figure FA,the variance analysis of F test results showed that the significant brain areas were the splenium of the corpus callosum,the genu of corpus callosum,bilateral posterior internal capsule,retrolenticular part of internal capsule,anterior thalamic radiation,partial inferior longitudinal fasciculus and inferior fronto-occipital fasciculus,cingulate,external capsule,upper and posterior part of the radiation crowns,partial superior longitudinal fasciculus,etc.(P＜0.05 after FWE correction based on TFCE method).In Figure MD,the variance analysis of F test results showed that the statistically significant brain areas mainly included the left external capsule and hook,partial genu and splenium of corpus callosum,Bilateral,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,anterior thalamic radiation,retrolenticular part of internal capsule,cingulate,etc (P＜ 0.05 after FWE conection based on TFCE).Conclusion No matter whether cognitive impairment exists in patient with WML or not,all DTI parameters are different from those of normal people.The integrity of white matter fiber has been damaged with different degrees.The more severe the cognitive impairment in the external manifestations of patients with WML,the greater the damage to the intrinsic white matter microstructure.

Objective:To explore abnormal microstructural changes of white matter in patients with white matter lesions(WML) using diffusion tensor imaging(DTI), and to determine the association of such abnormalities of DTI parameters with executive function.Methods:Totally 34 patients with WML were recruited from the department of Neurology, Beijing Tiantan Hospital, Capital Medical University from March 2012 to May 2019.All patients with WML were scored with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA), and assessed with Montreal cognitive assessment (MoCA) and clinical dementia rating(CDR). They were divided into WML-cognitive normal group, WML-vascular cognitive impairment-non dementia group and WML-Dementia group.The Stroop color and word test (SCWT), trail making test-A (TMTA), digit symbol test and verbal fluency test were carried out to evaluate executive function.In addition, the healthy elderly without WML lesions were selected as the control group after they were examined by MRI, and all brains of the subjects went through DTI with Siemens 3.0 T MR.The data were collected and analyzed by voxel based analysis (VBA). The anisotropy and mean diffusion coefficient of DTI in the region of interest (ROI) and other regions in the brain were studied in the four groups, and their correlation with scores of executive function in WML patients was analyzed.Results:(1)In these executive function test, there were significant differences between the patients with cognitive impairment (WML-VAD group, WML-VCIND group) and normal cognition group(WML-CN group, NC group), such as SCWT(B)(65.54±6.24 vs 43.67±0.95, 76.75±2.13 vs 43.67±0. 95, 65.54±6.24 vs 43.66±1.81, 76.75±2.13 vs 43.66±1.81), SCWT(C)(88.58±6.76 vs 61.63±1.31, 96.37±1.47 vs 61 63±1.31, 88.58±6.76 vs 66.31±8.19, 96.37±1.47 vs 66.31±8.19), TMTA(40.47±2.76 vs 30.92±0.47, 44.24±1.43 vs 30.92±0.47, 44.24±1.43 vs 31.99±2.07, 40.47±2.76 vs 31.99±2.07), TMTB(88.66±6.55 vs 80.34±0.61, 96.70±1.72 vs 80.34±0.61, 88.66±6.55 vs 83.10±5.91, 96.70±1.72 vs 83. 10±5.91), Digit Symbol Test(39.25±5.63 vs 47.00±2.55, 31.27±3.93 vs 47.00±2.5, 39.25±5.63 vs 48.86±4.34, 31.27±3.93 vs 48.86±4.34) and Verbal Fluency Test(8.94±1.00 vs 11.71±0.47, 6.64±0.81 vs 11.71±0.47, 8.94±1.00 vs 10.86±0.69, 6.64±0.81 vs 10.86±0.69) scores ( P<0.05); In the patients with cognitive impairment, there were significant differences between WML-VAD group and WML-VCIND group, such as SCWT(B), SCWT(C), TMTA, TMTB, digit symbol test and verbal fluency test scores ( P<0.05); There were significant differences between WML-CN patients and NC group in the scores of SCWT (C), verbal fluency test( P<0.05). (2)FA values in the genu of corpus callosum and the inferior longitudinal fasciculus were negatively correlated with the time of SCWT (B), SCWT (C) and the TMTA( r=-0.436--0.471), but positively correlated with the scores of digit symbol test and verbal fluency test( r=0.428-0.573). MD values in the genu of corpus callosum, the superior/inferior longitudinal fasciculus and the inferior fronto-occipital fasciculus were positively correlated with the time of SCWT (B), SCWT (C) and TMTA( r=0.432~0.609), but negatively correlated with the scores of digit symbol test and verbal fluency test( r=-0.424--0.630, all P<0.003125 after emendation). Conclusion:The executive function of patients with WML-Dementia decreases significantly.The more serious the damage of white matter microstructure, the more serious the damage of executive of function.