Vertebrobasilar dolichoectasia(VBD ) can increase the risk of stroke. Significant expansion, elongation and tortuosity of the vertebrobasilar arteries are the main morphology manifestations of VBD. However, there is no consensus on the quantitative imaging assessment of VBD. Many studies showed that some quantitative parameters, such as basilar artery length and bending length, basilar angulation, vertebral tortuosity index can be used for the quantitative imaging assessment of VBD.

Based on the experimental teaching reform of health information management courses in Capital Medical University, this paper has explored the paths of experimental teaching suitable for the health management profession and provided suggestions for the teaching reform. The research was carried out in three stages. In the first stage, the needs of experimental teaching of health information management course were investigated. In the second stage, the experimental teaching practice was carried out based on the hospital information system platform. In the third stage, the experimental teaching effect was evaluated. The results showed that medical undergraduates have a great demand for the experimental teaching of the course. The experimental teaching method can greatly improve the interest of students in learning. The experimental teaching effect is good, and it is helpful to improve the students' practical ability and logical analysis ability. Furthermore, it is necessary and feasible to introduce experimental teaching into the specialty of health management, and better teaching effects will be achieved by closely combining the teaching reform practice with hardware and software configuration, personnel quality training and management.

Objective? To explore the effects of aromatherapy on ameliorating nausea and emesis in orthopedic patients after surgery under general anesthesia. Methods? Totally 180 patients treated in the Department of Orthopedic Trauma, Suzhou Hospital of Traditional Chinese Medicine from November 2017 to July 2018 by convenient sampling, and the orthopedic patients receiving general anesthesia were divided into the treatment group (n=90) and the control group (n=90) according to the random serial generated by SPSS. Patients in the control group sniffed saline and received conventional nursing care, while patients in the treatment group received aromatherapy with essential oil and conventional nursing care. The incidence and severity of postoperative nausea and emesis was compared between the two groups. Results? The incidence rate of nausea and emesis in the treatment group within 24 hours post operation was 13.33%, lower than that in the control group, which was 51.11%, and there was statistically significant difference (χ2=29.406,P＜0.05). The number of patients showing nausea and emesis with different degrees in the treatment group within 24 hours post operation was Class 0 of 78 cases,8 cases of ClassⅠ, 4 of ClassⅡ and 0 of ClassⅢ,respectively. The number of patients showing nausea and emesis with different degrees in the control group within 24 hours post operation was Class 0 of 44 cases, 15 cases of Class Ⅰ, 27 of Class Ⅱ and 4 of Class Ⅲ,respectively. The severity of nausea and emesis in the treatment group was lower than that in the control group, and there was statistically significant difference (Z=-5.656,P＜ 0.05). Conclusions? Aromatherapy can effectively reduce the incidence rate and severity of nausea and emesis in orthopedic patients after surgery under general anesthesia.

Serious diseases and other negative events bring serious physical and mental damage to individuals, but there are still some individuals can construct positive meaning of life from adversity, which is closely related to the role of benefit finding. According to the theory of stress system, if negative events such as disease are taken as stressors, benefit finding can be regarded as a good manifestation of individual psychological stress response. At present, most of the studies on benefit finding are cross-sectional studies, ignoring the characteristics of its dynamic development and the predictive role of individual advantages and disadvantages on benefit finding. This paper reviews the predictive factors in the longitudinal study of benefit finding from protective factors and risk factors, in order to reduce the adverse effects of risk factors on the basis of exploring individual protective factors and provide a starting point for the research design of positive psychological cognitive intervention.

Objective To analyze the clinical presentation , the mutation of the pathogenic genes and imaging features in a Chinese Han early-onset Alzheimer's disease pedigree.Methods A pedigree of Alzheimer's disease was collected.The DNA sequence of presenilin 1 (PSEN1), presenilin 2, micro-tubule associated protein tau ,β-amyloid precursor protein gene was analyzed , the clinical presentation , results of accessory examination , neuropsychological evaluation of the proband were investigated and the point mutations of some members of the family , 50 sporadic Alzheimer's disease patients , 50 normal controls were verified.Results The proband of the family appeared as language impairment , memory loss, personality change, repeated language, visuospatial impairment, mental and behavior disorder.The gene detection showed p.L226R mutation in the condon 226 in the exon 7 of PSEN1 gene of the proband and five other family members (Ⅲ1 ,Ⅲ2 ,Ⅲ4 ,Ⅲ6 ,Ⅲ7 ).The mother of the proband had the suspicious symptoms , and the sister and the brother of the proband had the similiar symptoms with the proband , all of whom died.Fifty sporadic Alzheimer'disease patients and 50 unrelated normal subjects did not have the mutation .The computed tomographic angiography showed that the brain blood vessels were normal and 18 F-fludeoxyglucose positron emission tomography (18F-FDG-PET) showed brain atrophy and hypometabolism in frontotemporal regions, parietal regions, hippocampal areas, however, the MRI, MRA and 18F-FDG-PET of the two mutation carriers (Ⅲ6 ,Ⅲ7 ) were all normal.Conclusion We reported a novel mutation in an early-onset Alzheimer's disease family presented as language impairment in the early stage of the disease , the p.L226R mutation of PSEN1, which may be a pathogenic mutation to cause the family's dementia.

Objective To detect the down-regulation ofmiRNA-99b expression in cell invasion and its mechanism in human glioma cell line U251.Methods Glioma cell line U251 were routinely cultured in vitro.(1) U251 cells were divided into blank control group,negative control group and miRNA-99b inhibitor group;cells in the latter two groups were transfected with negative control sequences and miRNA-99b inhibitors,respectively;and cells in the blank control group did not give any treatment;mRNA expressions of miRNA-99b and mammalian target of rapamycin (mTOR) in U251 cells were measured by reverse transcription (RT)-PCR;the changes of mTOR,eIF4E-binding protein 1 (4E-BP1) andphosphorylated (p)-4E-BPl protein expressions in U251 cells were detected by Westem blotting;cell invasion was evaluated by Transwell assay.(2) U251 cells were divided into negative control group Ⅰ and mTOR siRNA group,and cells in the two groups were transfected with negative control sequences and mTOR siRNA,respectively;the miRNA-99b and mTOR mRNA expressions in U251 cells were measured by RT-PCR;the mTOR and p-4E-BP1 protein expressions in U251 cells were measured by Western blotting.(3) U251 cells were divided into miRNA-99b inhibitor+negative control group and miRNA-99b inhibitor+mTOR siRNA group,and cells in the two groups were transfected with miRNA-99b inhibitor+negative control sequences and miRNA-99b inhibitor+mTOR siRNA,respectively;the p-4E-BP1 protein expression in U251 cells was measured by Western blotting;cell invasion was evaluated by Transwell assay.Results (1) As compared with those in the blank control group and negative control group,the miRNA-99b rnRNA expression was significantly decreased,the mTOR mRNA and protein expressions and p-4E-BP1 protein expression were significantly increased,and the number of transmembrane cells was significantly larger in U251 cells of miRNA-99b inhibitor group (P＜0.05);there were no significant differences in 4E-BP1 protein expression among the three groups (P＞0.05).(2) As compared with those in the negative control group Ⅰ,the mTOR mRNA and protein expressions and p-4E-BP1 protein expression were significantly decreased in U251 cells of mTOR siRNA group (P＜0.05);there was no significant difference in miRNA-99b mRNA expression between the two groups (P＞0.05).(3) As compared with those in the miRNA-99b inhibitor+negative control group,the p-4E-BP1 protein expression and number of transmembrane cells were significantly decreased/smaller in U251 cells ofmiRNA-99b inhibitor+mTOR siRNA group (P＜0.05).Conclusions Down-regulation ofmiRNA-99b expression promotes glioma cell invasion,and its mechanism is related to the regulation of mTOR/4E-BP1 signaling pathway.

Objective To evaluate the clinical effects of Cyclic Cryotherapy system on early symptoms after total knee arthroplasty (TKA). Methods The randomized controlled trial(RCT) articles on Cyclic Cryotherapy system after TKA were retrieved from Cochrane Library, JBI, PubMed, Web of Science, EBSCO, CNKI, Wanfang database and China Biology Medicine disc (CBMdisca), with the time limitation from the establishment of the database to 31st May 2018. Two researchers screened the literature according to the criteria of inclusion and exclusion, extracted the data, and used RevMan 5.3.3 software for statistical analysis. Results A total of 12 studies (976 cases) were included. The results of Meta analysis showed that, comparing between the Cyclic Cryotherapy and ice pack, the differences on pain score 24 hours after operation [MD=-0.70, 95%CI (-0.97, -0.43), P＜ 0.000 01], volume of drainage 48 hours after operation [MD=-143.04, 95%CI (-166.51, -119.57), P＜0.000 01]and swelling 1 week after operation [MD=-0.22, 95%CI(-0.32, -0.13), P＜0.000 01]were all statistically significant. Conclusions The existing evidence shows that compared with the ice pack, the Cyclic Cryotherapy system has the advantages of early postoperative analgesia, hemostasis, later detumescence, promoting recovery, improving comfort and no adverse reactions of cryotherapy.