0.05),the odds ratio(OR)being 0.873,[95% confidential interval(CI):0.428～1.782].(3)The relationship between ischemic stroke and the risk factors was illuminated by the Logistic Regression analysis.The results showed that there was no significant difference of the positive rate of IgA antibody between the case group and control group.Conclusion There may be not relationship between CP IgA antibody and ischemic stroke.There is no relationship between IgA CP antibody and the other risk factors of ischemic stroke.

Objectives: The survivors of first-ever stroke are at a high risk of recurrent stroke. The time interval between first-ever stroke and first recurrence of stroke, however, have not been well studied. The aim of the present study was to evaluate the time interval between first-ever and first recurrence of stroke and the risk factors of stroke that were related to the length of time interval. Methods: Patients admitted in our hospitals during 2014 with first recurrence of stroke were included in the study. A total of 377 patients were enrolled and a standardized questionnaire was used to collect data in this retrospective study. Results: The mean time interval among all the subjects was 58.42 months (median, 36.01 months; range 0.16months to 455.98months). The mean time interval was shorter in hemorrhagic stroke group (56.78 months) than in ischemic stroke group (58.75 months), but the difference was not significant (p=0.819). The median of time interval was similar in the two groups. The associated risk factors to the length of time interval were age over 60 years, subtype of first-ever stroke, the length of history of hypertension. Age was the only associated risk factor to the time interval among patients with first recurrence of hemorrhagic stroke. Conclusion: Factors associated with the time interval are different among different types of recurrent stroke. This provides the basis for preventive treatment for recurrent stroke after their first-ever stroke
Stroke

Objective To study the teaching effect of prevention in clinical epidemiology teaching.Methods 187 clinical medical students of Grade 2010 from China Medical University were selected as the research objectives.2 teaching hours of prevention content was increased in the clinical epidemiology teaching,and the anonymous questionnaire survey was used to assess the teaching effectiveness.A total of 187 questionnaires were issued and 187 valid questionnaires were collected.All the data were analyzed by SPSS 16.0.Results 82.9％ (155 people) of the students believed that the addition of preventive content was necessary,40.1％ (75 people) of the students believed that there was a significant increase in the content of the prevention.For the understanding of the content,only 11.2％ (21 people) of the students said they had a complete understanding of the class,but after teaching 51.3％ (96 people) of the students expressed a clear understanding of the content.82.4％ (154 people) of the students thought that the teaching contents of prevention was tightly combined with the clinical,and 74.9％ (140 people) of the students thought that 2 hours setting was appropriate.Students' demands for prevent content also included:1) how to strengthen prevention in daily life;2) tumor disease prevention,including current international popular tumor vaccine;3) of emergent public health event instance;4) occupational disease prevention measures,etc.Conclusion Increasing the contents of prevention in the clinical epidemiology teaching has made students of clinical medicine change their clinical concept and realize the key role of prevention in clinical treatment.At the same time,this study understands students' needs for the content of prevention,and provides a basis for the setting and op-timization of clinical epidemiology course in the future.

Objectives To investigate the ameliorative effect of cannabinoid 2 receptor(CB2R)agonist JWH-015 on the cog-nitive impairment of Alzheimer' s disease(AD)model mice and to assess the correlation with microglial phenotype transformation. Methods Twenty adult male C57BL/6J mice were randomly divided into four groups:C57BL/6J solvent group,JWH-015 control group,AD model group,and AD model treated with JWH-015 group. Amyloidβ1-42 oligomers of 4μg and the same volume of saline were intraventricularly administered to construct the AD mouse model and the solvent groups. CB2R agonist JWH-015 or the corre-sponding vehicle at a dose of 0.5 mg/(kg·d)was administered by intraperitoneal injection for 3 weeks. Non-spatial learning and memo-ry was measured using novel object recognition task. Furthermore,the mRNA expression levels of M1 microglia marker inducible ni-tric oxide synthase(iNOS)and M2 microglia marker chitinase-3 like protein(Ym1/2)in brain samples of cortex and hippocampus were evaluated using real-time quantitative PCR(qPCR). In the meantime,fifteen CB2R knockout(CB2RKO)mice and five CB2R wild-type(CB2RWT)littermates were assigned to identify the specificity of CB2R in the research. Based on the genotype and different treatment,the animals were divided into four groups:CB2RKO solvent group,CB2RKO AD model group,CB2RKO AD model treat-ed with JWH-015 group and CB2RWT solvent group. Results Compared with solvent group,there was a significant decrease in nov-el object recognition index in C57BL/6J AD model group(P<0.01). The mRNA expression levels of M1 phenotype microglia marker iNOS in cortex and hippocampus were significantly up-regulated(both P<0.05)and the mRNA expression levels of M2 phenotype mi-croglia marker Ym1/2 were significantly down-regulated(both P<0.01). Interestingly,administration of JWH-015 could reverse the impairment of novel object recognition index(P<0.05);compared with C57BL/6J AD model group,administration of JWH-015 also decreased the iNOS mRNA expression levels(both P<0.05)and increased the Ym1/2 mRNA expression levels(both P<0.05)in cortex and hippocampus;compared with CB2RKO solvent group,the novel object recognition index of CB2RKO AD model group was decreased(P<0.05);the mRNA expression levels of iNOS in cortex and hippocampus were significantly up-regulated(both P<0.05),the mRNA expression level of Ym1/2 in cortex was significantly down-regulated in cortex(P<0.05);compared with CB2RKO AD model group,administration of JWH-015 had no effect on novel object recognition index and the mRNA expression level of M1/M2 in cortex and hippocampus,respectively. Conclusion JWH-015 improves the cognitive impairment of Aβ-induced AD mice by the specific activation of CB2R,the mechanism of which is related to the direct regulation of CB2R on the M1/M2 microglial phenotype transformation and microglia-mediated neuroinflammation in brain.

Objective: To learn the trend of death from injury in Fengcheng residents from 2009 to 2017 and predict from 2018 to 2021,in order to provide the basis for injury prevention and control. Methods: All cause of death monitoring data and demographic data of Fengcheng from 2009 to 2017 were collected,injury mortality,standardized mortality and annual change percentage（APC）were calculated,and GM（1,1）was established to predict the injury mortality from 2018 to 2021. Results: From 2009 to 2017,the injury death rate in Fengcheng was 52.68 per 100 000 and the standardized death rate was 46.50 per 100 000. The APC of the total standardized mortality was -5.10%,showing a decreasing trend year by year（P<0.05）. The injury mortality and standardized mortality in males were higher than that in female（both P <0.05）. The highest injury mortality lay in the group aged 65 years and above,which was 108.13 per 100 000. The top five causes of injury death were traffic accident,suiside,poisoning,fall and drowning,their mortality rate were 27.03 per 100 000,7.84 per 100 000,5.62 per 100 000,5.08 per 100 000 and 2.36 per 100 000,respectively. The mortality of traffic accident in males and suicide in females showed a decreasing trend（P<0.05）,while the mortality of fall showed an increasing trend（all P<0.05）. The model of GM（1,1）predicted that the injury mortality from 2018 to 2021 would be 48.00 per 100 000,44.15 per 100 000,40.61 per 100 000 and 37.35 per 100 000,which showed a decreasing trend year by year. Conclusion The injury death rates in Fengcheng dropp year by year from 2009 to 2017 and will probably keep dropping from 2018 to 2021. Men and people aged 65 years or over are at high risk of death from injury,traffic accident and fall are the main causes.

Objective : To study the association between bleeding sites and the quality and quantity of sleep in patients with cerebral hemorrhage. Methods: The hospitalized patients with cerebral hemorrhage in Liaoning Thrombus Hospital from September 2017 to June 2018 were included. Information about gender,age,history of smoking and alcohol,previous history and the sites of cerebral hemorrhage was collected;the levels of blood glucose and lipids were measured;the quantity and quality of sleep were evaluated by Pittsburgh sleep quality index（PSQI）. A logistic regression model was used to analyze the association between cerebral hemorrhage and sleeping status. Results : A total of 249 patients with cerebral hemorrhage were enrolled. The main bleeding sites of the patients were basal ganglia and thalamus,accounting for 59.84% and 22.89%. The proportions of the patients with sleep duration less than 7 hours,7 to 8 hours and more than 8 hours were 23.29%,41.37% and 35.34%. The proportion of the patients with good sleep was 76.31%. The proportions of the patients with or without noon break were 36.55% and 63.45%. The results of multivariate logistic regression analysis showed that taken basal ganglia hemorrhage as the reference group,thalamic hemorrhage was associated with poor sleep quality（OR=2.387,95%CI：1.144-4.985）;lobar hemorrhage was associated with frequent noon break（OR=13.027,95%CI：1.545-109.849）;brain stem hemorrhage was associated with short sleep duration（OR=9.434,95%CI：1.387-64.173）. Conclusion Short sleep duration may be a risk factor for brain stem hemorrhage,poor sleep quality may be a risk factor for thalamic hemorrhage,and frequent siestas may be a risk factor for lobar hemorrhage.

Objective : To learn the awareness of chronic diseases prevention and control and its influencing factors among high school students in regions inhabited by ethnic groups,so as to strengthen the prevention of chronic diseases among adolescents in these regions. Methods: Totally 1 050 high school students in Tuquan County,Hinggan League,Inner Mongolia were selected by cluster sampling method. The general information,family factors,attitude to learning,psychological factors,behavioral styles and awareness of chronic diseases prevention and control were investigated,and the influencing factors for the awareness were analyzed by multivariate logistic regression model. Results: There were 1 001 valid questionnaires recovered,with a response rate of 95.33%. There were 685 Han students,accounting for 68.43%,241 Mongol students,accounting for 24.08%,and 75 students with other ethnic minorities,accounting for 7.49%. The average awareness rate of chronic diseases prevention and control was 53.25%;the awareness rates of hypertension prevention measures,smoking and drinking hazards,food susceptible to aflatoxin pollution and high cholesterol food were high,all more than 70%;while the awareness rates of long-term high lipid hazards,high blood pressure diagnosis standard and diabetes symptoms was low,all less than 40%. There was no significant difference in the awareness rate of chronic diseases prevention and control among different nationalities（P>0.05）. The results of multivariate logistic regression analysis showed that the students who were female（OR=1.309,95%CI：1.008-1.700）,had high achievement（OR=1.509,95%CI：1.055-2.159）,and thought exams were important（OR=1.570,95%CI：1.204-2.046）were more likely to have high awareness,while the students who spent five to less than eight hours a day on screens（OR=0.514,95%CI：0.335-0.789）were less likely to have high awareness. Conclusions The awareness rate of chronic diseases prevention and control of high school students in Tuquan County is 53.25%,and there is no significant difference between Mongol and Han students. Gender,academic performance,attitude to examination and time spent on screens can affect the awareness rate.

Objective To study the distribution of the regions of ultrasound-guided erector spinae plane block (ESPB) at the level of T5 transverse process.Methods Thirty male patients,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracotomy,were enrolled in this study.ESPB was conducted with 0.5％ ropivacaine hydrochloride 0.4 ml/kg at the level of T5 transverse process under ultrasound guidance before induction of general anesthesia.Blocks in each thorax and back region (the left side of the body was divided into 18 different regions based on the anatomical "landmarks" on the body surface,No.1-18) were assessed by cold stimulation.Effective block in each region was recorded at 10,15,20,25,30,40 and 50 min after administration.The adverse reactions such as pneumothorax,puncture hematoma and local anesthetic intoxication were recorded.Results The blocking range was basically fixed at 30 min after a single ESPB injection at the level of T5 transverse process,and the regions covered from the sternal angle to the level of the rib arch.The regions of effective block were No.1-3 and 5-7 in ≥95％ patients,and the regions of effective block were No.1-15 and 17 in patients ≥90％ and ＜ 95％.No patients developed adverse reactions such as pneumothorax,puncture hematoma or local anesthetic intoxication.Conclusion The regions of effective ultrasound-guided ESPB at the level of T5 transverse process are mainly distributed in T2-T8 thoracodorsal skin areas.

OBJECTIVETo study the immunogenicity and safety of recombinant yeast-derived hepatitis B vaccine (YDV) in adults.

METHODSOne hundred and twenty-four healthy teachers aged 22 approximately 58 years with serum negative HBsAg, anti-HBs, anti-HBc and with normal temperature were randomly selected from Beipiao city, Liaoning province. All the subjects were immunized with 5 microg/0.5 ml of YDV made by Beijing Institute of Biologic Products, for three doses at an interval of one and six months, respectively.

RESULTSThe positivity of serum anti-HBs was 35.0%, 83.3%, 65.5% and 32.7% with a geometric mean titre (GMT) of 12.6 mIU/ml, 402.0 mIU/ml, 70.3 mIU/ml and 20.3 mIU/ml, respectively, three, seven, 12 and 24 months after immunization. The positivity and GMT of serum anti-HBs appeared the highest seven months after immunization, then began to decrease sharply. The positivity and GMT of serum anti-HBs in women was higher than that in men either three, or seven, or 12, or 24 months after immunization. The positivity of serum anti-HBs in those of 35 years or over was lower than that less than 35 years, seven months after immunization, but no age difference could be found 12 months after immunization. No local or systematic adverse reactions were found in all the subjects within three days after immunization.

CONCLUSIONThe recombinant yeast-derived hepatitis B vaccine (YDV) is immunogenic and safe for adults, but the persistency of serum anti-HBs in after immunization should be followed-up further.

Adult ; Age Factors ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization ; Middle Aged ; Sex Factors ; Vaccines, Synthetic ; immunology ; Yeasts ; genetics

Objective To evaluate the association between retinol-binding protein 4 (RBP4) and coronary artery disease (CAD) in Chinese.Methods A document retrieval was conducted by using retrieval systems,such as PubMed,Web of Science,Cochrane Library,Chinese National Knowledge Infrastructure (CNKI),CBM,VIP and WanFang Database,to collect the published papers of case-control studies on association between RBP4 and CAD in Chinese up to February,2015.Data collection and quality assessment were completed by two authors respectively.All the analyses were conducted with software RevMan 5.2.Results A total of 10 qualified studies were included in our meta-analysis.The pooled analysis showed that RBP4 might be associated with CAD in Chinese [WMD=7.17 (95％CI:3.56-10.78) μg/ml,P＜0.05].Clinical subtype specific subgroup analysis showed RBP4 might be also associated with both stable angina pectoris [WMD=4.81 (95％ CI:1.25-8.37) μg/ml,P＜0.05] and acute myocardial infarction [WMD=13.96(95％CI:6.12-21.80) μg/ml,P＜0.05].Age specific subgroup analysis showed the significant association between RBP4 and CAD was only found in patients aged ≤65 years [WMD=7.26(95％CI:2.73-11.79)μg/ml,P＜0.05].Sensitivity and publication bias analyses indicated that our results were stable and reliable.Conclusion The meta-analysis suggests that RBP4 might be associated with CAD in Chinese.