The severity of carotid atherosclerosis and the levels of serum matrix metalloproteinase-9(MMP-9)in patients with obstructive sleep apnea syndrome(OSAS)increase with the severity of apnea,and that MMP-9 plays an important role in the progression of carotid atherosclerosis.This article reviews the relationship between carotid atherosclerosis and serum MMP-9 so as to analyze the possible mechanism of developing carotid atherosclerosis in patients with OSAS.

Intracranial aneurysms are mainly caused by the local arterial wal defects and the increased intraluminal pressure. Usualy, the unruptured smal aneurysms are asymptomatic, and the ruptured aneurysms can cause subarachnoid hemorrhage. So far, the etiology and pathogenesis of intracranial aneurysms are not fuly understood. A lot of evidence has showed that intracranial aneurysms are a complex disease of environmental factors and multi-gene interaction. This article reviews the correlation between polymorphisms of elastin and colagen type Ⅰ α2 genes and intracranial aneurysm.

The annual incidence of aneurysmal subarachnoid hemorrhage (aSAH) is 9.0/100000.Although it only accounts for 5％ of all strokes,its prognosis is poor.Among the aSAH survivors,46％ of them do not completely recover within 1 year,50％ have progessive memory impairment,14％ have language disorders,and 39％ have emotional disorders.Because the social and family responsibilities shouldered by the relatively young patients,the demand for quality of life,as well as the lack of about the prognostic data of aSAH in China,all these are particularly important for the study of the prognosis of cognitive function,quality of life,and the ability of returning to work in patients with aSAH.

Objective To investigate the intracranial vascular stenosis and risk factors in different types of ischemic stroke. Methods 525 patients with ischemic stroke were assessed by a transcranial Doppler. Lipids including total cholesterol (CHO),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were examined. Results Intracranial vascular stenosis in diabetic and non-diabetic groups of patients,hypertension and non-hypertension groups of patients showed significantly difference (P

Objective To determine the content of polysaccharide of prepared pinellia tuber. Methods The content was determined by sulfuric acid-anthrone colorimetric method with wavelength at (624?1)nm. Results The content of polysaccharide was 2.533 mg/g in prepared pinellia tuber. The average recovery was 99.54% and RSD was 1.69%. Conclusion The methods was simple, steady and reproducible.

Aortic arch atheroma is one of the causes of embolic stroke. With the deepening of research on aortic arch atheroma, its relationship with stroke is more and more clear, particularly the aortic arch plaque thickness ≥4 mm, is associated with cryptogenic stroke, stroke recurrence, and other vascular events. Although aortic arch atheroma and clinical features of stroke have been further understood, there are still many doubts.

Matrix metalloproteinases (MMPs) degrade extracellular matrix,participate in the atherosclerosis (As) formation and plaque rupture.They are associated with the stability of plaque.Tissue inhibitor of metalloproteinase (TIMP) is a specific natural MMP inhibitor.The disequilibrium between MMPs and TIMP is closely associated with the formation and development of AS.Therefore,it is a new approach for the prevention and treatment of cardiocerebrovascular diseases by regulating the equilibration between MMPs and TIMP, delaying the development of AS and preventing plaque rupture.

Objective To retrospectively analyze the complications and management of complications during percutaneous implementation of biliary stents in 17 patients. Methods Percutaneous biliary drainage and implementation of biliary stents for malignant biliary obstruction under fluoroscopic guidance was performed in 64 patients. 17 cases developed complications. Bradycardia and hypotension was seen in 5 cases, slipping of the stent into the duodenum in 1, bile duct perforation in 2, the fine guidewire broken in the hepatic parenchyma in 2, malposition of the stent in 3, hepato renal failure leading to hemorrhage in 2, exchanging guidewire broken in the duodenum in 1, and balloon broken leading to stent dislocation in 1, respectively. Results Bradycardia and hypotension in the 5 cases was treated medically and the procedure was interrupted. Slipping of the stent into the duodenum was passed off spontaneously. Broken of the fine guidewire in the liver did not present any complaints until the death of the patients. Perforation of bile duct was treated conservatively with a clinical successful outcome. Malposition of the stent was treated by reimplementation of shorter stents. The broken exchanging guidewire in the duodenum during implementation was removed with the gastroscope. The hepato renal failure leading to hemorrhage had poor prognosis. The broken balloon caused stent dislocation was treated by reimplementation of stent. Conclusion Percutaneous implementation of stent is effective and safe for elderly patients with proximal stenosis of the biliary tract. However, one must be very careful to avoid the complications.

Objective To screen the effective silencing targets of P21 gene at the cellular level in rhesus monkey . Methods To detect the expression of P21 gene in COS-7 cells ( derived from the kidney of African green monkey , Cerco-pithecus aethiops).Four small hairpin RNA (shRNA) sequences targeting rhesus monkey P21 gene were designed and in-serted into lentivirus-based gene silencing constructs FUGW-TDT.The vectors were transfected into COS-7 cells respective-ly.The suppression of P21 mRNA was detected by real-time PCR, and the expression of P21 protein was detected by West-ern blot assay .Results Four gene-silencing sequences were screened that lied in 541-561 bp, 542-562 bp, 215-239 bp, and 624-648 bp of the rhesus monkey P21 mRNA.Their silencing rate was (91.82 ±3.21)%, (82.47 ±2.48)%, (81.31 ±2.69 )% and ( 87.35 ±4.59 )%, and the protein expression was ( 11.97 ±0.70 )%, ( 20.22 ±0.65 )%, ( 23.21 ± 0.63)%and (14.42 ±0.86)%, respectively.Conclusions Four effective silencing target sequences are screened at cel-lular level , which can be used in gene silencing research of rhesus monkeys .

Objective To explore the effects of Six-Step standardized communication procedure in improving the communication ability of nurses.Methods C-I-CARE communication procedure was converted into Chinese.The Chinese version of Six-Step standardized communication procedure was Yi Kan,Er Yin,San Gaozhi,Si Wen,Wu Da,Liu Zaijian.The procedure was propagandized by making posters,setting up computer desktop,training nurses by lectures,video and role play.The effects were evaluated by pre and post self-control test among 100 nurses.Results The average score of communication behavior of 100 nurses after applying standardized communication procedure increased from 2.55±0.67 to 4.44±0.59 (t=-23.174,P＜0.001).In 2015,the nursing department received 622 silk banners and commendatory letters for appreciating nursing work,increased by 18.9％ compared to 2014.The discharged patient satisfaction increased from 94.2％ to 96.93％.The satisfaction of doctors to nurses' collaboration was 99.86％.There was no nursing complaint or dispute caused by bad communication.Conclusion The application of procedure and standardized communication method can improve the communication ability of nurses,optimize the relationship between nurses and patients and increase patient satisfaction.